“A well-spent day brings happy sleep.” ~ Leonardo da Vinci

Oh, if only da Vinci’s words could be our mantra for encouraging us to get enough rest! By now we are all very acquainted with the need to obtain a sufficient amount of quality sleep, ideally from seven to eight hours nightly (or at least more nights than not). But despite medical advice and numerous studies attesting to the value of sleeping well, we still don’t seem to have made it a priority. And now, findings from a recent study published in JAMA Neurology indicates that premature death is more likely to affect poor sleepers.

The study looked at the association between sleep and overall health and well-being that has long been of interest to the scientific and medical community as well as the general population. Researchers reported that “At the highest level, a simple U-shaped association between total sleep time and mortality has been described from as early as 1964. Those who sleep approximately seven hours are at the lowest point in the curve, with the lowest mortality risk. Mortality increases incrementally as one moves in either direction on the curve, with a marked rise for those sleeping less than 4 hours or more than 10 hours. This study expands our understanding of this association by evaluating the link between a specific sleep stage, rapid eye movement (REM), and mortality. The findings that a lower proportion of REM sleep was associated with a higher all-cause mortality should make us aware of the amount of REM sleep to be used a biomarker of optimal health.” 1, 2

What is REM sleep?

During sleep, the brain moves through five different stages. One of these stages is rapid eye movement (REM) sleep; during this phase, the eyes move rapidly in various directions. The other four phases are referred to as non-REM (NREM) sleep.

People enter REM sleep within the first 90 minutes of falling asleep and, as the sleep cycle repeats throughout the night, REM sleep occurs several times nightly. It accounts for approximately 20 to 25 percent of an adult’s sleep cycle, and over 50 percent of an infant’s.

While much of our dreaming activity takes place during REM sleep it’s also the time when new learnings from the day are committed to memory.

Consequences of a lack of REM sleep.

Aside from the obvious fatigue and extra effort it takes to get through our days when we haven’t rested properly, a lack of REM sleep has been linked to:

Reduced coping skills – research indicates that animals who are deprived of REM sleep show abnormalities in coping mechanisms and defensive responses in threatening situations. Brain fog and cognitive dysfunction can result as well.

Migraines – not getting enough REM sleep has been linked to migraines.

Being overweight – a University of Pittsburgh study found that short sleep times and reduced REM sleep was associated with excess weight in children and adolescents.  

In addition to the increased all-cause mortality rates, sleep loss can contribute to health conditions such as:
-    Diabetes, due to impaired glucose tolerance.  
-    Risk of cardiovascular mortality. Several potential mechanisms could explain the link between sleep loss and cardiovascular events, including blood pressure increases, sympathetic hyperactivity, or impaired glucose tolerance.
-    Impaired immune system and immunological memory.
-    Increased risk of Alzheimer’s disease. Studies suggest that sleep plays a significant role in clearing our brain of harmful beta amyloid.

How to get More REM sleep.
 
1.  Going to bed and waking up at the same time each day (or as close to that as possible). Your body functions more efficiently when it is on a regular schedule and this applies to sleep too!
2.  Avoid alcohol before bedtime.
3.  Stop looking at screens (so put down those phones) at least one hour before going to bed; all that blue light from our devices can disrupt sleep patterns.
4.  Find your ideal room temperature.
5.  Avoid large meals and exercise too close to bedtime.
6.  Take time to relax and unwind. Try meditation to release your mind of nagging thoughts.
7.  Cut out caffeine after 2 p.m.
8.  Exercise regularly, but preferably not late in the day. If you can’t find time earlier then choose an activity like yoga that also has relaxation benefits.  
9.  Reserve your bedroom for rest and romance. Make your room a sleep sanctuary, but don’t start tidying up or cleaning too close to bedtime.
10. If you must nap, keep them to no more than 30 minutes.
 
Looking for some suggestions as to apps or other measures to help you get to sleep? Be sure to check out our June blog where we talk about a number of the latest apps and other resources that could be a good addition to your sleep program.

In closing, we’ll turn it over to Bon Jovi (yes, he’s on our playlist!) whose song “I’ll sleep when I’m dead” acknowledges that a fast-paced life and missing sleep (or as he wrote it, his “zzz’s”) wasn’t really a healthy thing to do. Given our current stressful times we know that sleeping well may be just a dream now, but it’s definitely to your advantage and your wellbeing to get the best rest possible so you can truly live your very best days.

Sleep well and in health,
Dr. Suzanne Gazda

References and additional reading:

1 Jaffee MS, Ashbrook LH, Pavlova MK. Should Neurologists Be Concerned With REM Sleep Quantity? JAMA Neurol. Published online July 06, 2020. doi:10.1001/jamaneurol.2020.2122
https://jamanetwork.com/journals/jamaneurology/article-abstract/2767709

2 Leary EB, Watson KT, Ancoli-Israel S, et al. Association of Rapid Eye Movement Sleep With Mortality in Middle-aged and Older Adults. JAMA Neurol. Published online July 06, 2020. doi:10.1001/jamaneurol.2020.2108

HAMMOND E. C. (1964). SOME PRELIMINARY FINDINGS ON PHYSICAL COMPLAINTS FROM A PROSPECTIVE STUDY OF 1,064,004 MEN AND WOMEN. American journal of public health and the nation's health, 54(1), 11–23. https://doi.org/10.2105/ajph.54.1.11

Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem.
Chapter 3: Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders.
https://www.ncbi.nlm.nih.gov/books/NBK19961/

Besedovsky, L., Lange, T., & Born, J. (2012). Sleep and immune function. Pflugers Archiv : European journal of physiology, 463(1), 121–137. https://doi.org/10.1007/s00424-011-1044-0
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

Sleep deprivation increases Alzheimer’s protein.
https://www.nih.gov/news-events/nih-research-matters/sleep-deprivation-increases-alzheimers-protein