WHEN IT COMES TO overall health and wellness, the tandem twosome most frequently discussed are diet and exercise. And with good reason – they are crucial contributors. What you consistently put into your body and how you move that body to build and maintain cardiovascular and musculoskeletal fitness are vital to your health across a lifetime. But did you know that some sleep researchers believe disordered sleep – a catch-all phrase that encompasses a wide variety of sleep conditions – may be more responsible for morbidity and mortality in American men and women than cardiovascular disease and pulmonary conditions combined?
Sleep is a critical time for overall body healing, regulation and restoration. Disordered sleep can affect blood pressure, heart rate, mental status, hormonal and immunological function, and a host of other critical aspects of our normal physiology. So many of the common diagnoses in the cardiovascular, pulmonary and even neurological categories may be triggered and influenced by disordered sleep. Here's the thing: In what has rapidly become of our modern 24/7 world, with more technology and demands for our time tugging at us than ever before, our collective ability to sleep well has suffered, big time. From difficulty falling or staying asleep to snoring, or many other conditions, sleep disorders aren't new. But they are on the rise. By some estimates, problems related to sleep affect more than 50 million Americans, and the number of people who report being sleep-deprived has significantly increased over the past few decades.
Sports neurologists, sleep experts, athletic trainers and strength and conditioning experts will tell you that the best and most consistently high performers on any team and in any sport tend to be the best sleepers. In fact, some would argue that the single most important intervention with the greatest effect on improving performance is optimizing sleep and minimizing fatigue. Mainly as it refers to sleep's influence on performance (physical or mental), research has shown that not getting enough sleep each night (under six hours) is associated with becoming physically fatigued sooner, a reduction in aerobic output, reduced peak and sustained muscle strength, metabolic impairment and as you can imagine, an increase in the risk of sustaining an injury. Conversely, studies have shown that optimizing sleep (sometimes by "forcing" a minimum number of sleep hours per night) can significantly improve a wide range of physical and cognitive performance targets.
Sleep is a neurological phenomenon. And many neurological functions are associated with sleep. From a sports neurologist's perspective, one of the things we're concerned with is the ways that impaired sleep affects something called the glymphatic system. You can think of the glymphatic system as the brain's "plumbing" network. It's a pathway for waste clearance in the central nervous system and is responsible for the disposing of toxins from the brain. It also contributes to neurological restoration, efficiency and performance. In fact, a 2013 National Institutes of Health-funded study that was published in the journal Science suggested that sleep is a linchpin in clearing the brain (by way of the glymphatic system) of those damaging molecules that are associated with neurodegenerative conditions like Alzheimer's disease.
So how can you know if your sleep patterns are healthy, and what can you do if they're not? We believe there are several factors that contribute to any individual's sleep efficiency. There are physiologic factors involved, such as presence of sleep apnea, restless legs syndrome and circadian rhythm disorders. There are work-related factors, such as early morning and overnight shifts, work-related travel and jet-lag – an area of focus with professional athletes, individual professional teams and leagues, given the clear evidence of effects on performance and injury. Finally, and just as important, are environmental/lifestyle factors, which individuals can adjust to improve their sleep efficiency. We refer to this last category as sleep hygiene. There are a few things that can let you know right away if something's off. Are you able to fall asleep within 15 to 20 minutes of lying down? Do you regularly sleep for a total of seven to nine hours during any given 24-hour time period? Is your sleep continuous (not characterized by periods of waking)? Do you wake up feeling well-rested? When you are awake, do you feel alert and productive throughout most of the day? If you answered yes to these questions, you're likely on the right track. If you answered no, it's essential to get to the bottom of why your sleep health isn't all it should be and to begin fixing it.
The good news is this: There is plenty you can do to improve your sleep hygiene if your sleep habits aren't up to snuff, and fixing the issues may even help you reach health, wellness, fitness or sports performance goals that you didn't know were affected by your ZZZs. Some of the most impactful interventions to promote better sleep health may also be the toughest at first. An important one is to get rid of bedroom distractions: smartphones, tablets, televisions and other bright light sources that can disrupt your brain's sleep signals. Making a commitment to eliminate them from your sleep space can be a massive help to the overall quality of your sleep.
But it isn't just what you do in the moments leading up to bedtime that matter. Another great way to promote better sleep is to get enough exposure to sunlight during the day, especially during the early morning hours. Again, this has to do with your brain's sleep-wake "clock" and is a frequently overlooked factor in getting better sleep since our society is spending less and less time outside these days. Likewise, finding ways to help your brain unwind before bed and throughout the day is crucial. Mindfulness meditation, light yoga or taking a warm bath can all help.
Sometimes, sleep problems need more help than what you can do on your own. If you feel like you've tried the above and still aren't getting the quality shut-eye you need, talk to your doctor about it. There may be a medically-related sleep disorder that needs to be addressed. Remember, these issues can affect your overall health – including your risk of developing cardiac, pulmonary, neurological and other diseases. Today there are a variety of sleep study options that medical experts can employ to figure out precisely what's going on and to get you back to your optimal performance levels – in sports, your career, in school and in your overall quality of life.