Your diet is on point and you don’t miss a workout even if it means running late to work or showing up with a mascara wand in one hand and a blow dryer in the other. But you’re still struggling to lose that extra bit of belly fat, you have a gnawing sense that you’re actually not as energetic as you could be, and you’re more anxious than you’d like to be. The answer could be lying in your bedroom.
Sleep has emerged as the third pillar of good health, being strongly linked to metabolic and mental health in particular. Given today is World Sleep Day, we asked sleep scientist, founding member of the Sleep Health Foundation, and Honorary Research Fellow at the Children’s Hospital Westmead, Dr. Carmel Harrington, to answer some of our burning questions about sleep including how much we actually need, how our children’s development could be affected by their sleeping patterns, and whether sleep can really help us lose weight. Read on and if you’ve slept in one morning this week, you’re about to feel a whole lot better about it!
RESCU: Sleep is being acknowledged as the third pillar of good health — after diet and exercise — why do you think it took so long for the importance of sleep to come to the forefront?
Dr. Carmel Harrington: When it comes to sleep I think that today we are in much the same position that we were in the 1960’s in regard to nutrition and exercise. Before then we had to work hard for our meals. We could only buy what was in season, we had to shop numerous times per week and cooking was from first principles as there were minimal prepared sauces and meals and there was little if any “fast” food. All that changed with the development of big supermarkets and the fast-food industry. Suddenly, food was easy and plentiful and we could eat whenever and wherever. As a result we lost our discipline around food and it was only when we saw the consequences of not paying enough attention to the quality and quantity of food we were consuming that we began to realise that good nutrition was fundamental to our health and well-being. A similar thing happened when the use of the car became almost universal. All of a sudden we lost our constant incidental exercise, and the flow-on effect to our health was recognised.
In a similar way we have lost our discipline around sleep. Over the last 20 years we have been increasingly exposed to imperatives to be wakeful. This has been particularly accentuated with the ubiquitous rise of the internet and social media, which constantly encourage us to stay awake. As a result people today are getting, on average, about 20% less sleep than in the 1960’s and we are beginning to see the health consequences of this with the rise of chronic disease such as depression, obesity and Type 2 Diabetes. We desperately need to recognise sleep as our third pillar of health and bring back the discipline that good sleep requires.
RESCU: How much sleep do we really need?
Dr. Carmel Harrington: As adults we need between 7-9 hours sleep every night. However how much exact sleep each of us requires is an individual measure with some needing 7 hours and some needing 9 hours. The key measure for each of us is what amount of sleep allows us to wake up refreshed and feel vital throughout the day.
RESCU: Can you tell us a little about how sleep is linked to metabolic health?
Dr. Carmel Harrington: A healthy body weight is essential for good metabolic health and if we do not get the sleep we need we are much more likely to be overweight or obese and suffer poor metabolic health. This is because when we are sleep deprived: 1. We have an imbalance of appetite hormones making us hungrier: In controlled studies, people sleeping 6 hours per night consumed 350-500 calories a day more than those people who were allowed to sleep 7-9 hours. 2. Our metabolic rate reduces between 10%-15%, decreasing the burn rate of calories – meaning we gain weight more easily. 3. Our body will preferentially burn lean muscle tissue rather than our fat – not great news for someone trying to lose fat. 4. We have poor decision making ability, decreased motivation and an increase in risky behaviour – a combination which frequently results in abandoning dieting. 5. We are tired and lethargic and much less likely to exercise – an important consideration for weight loss.
RESCU: What role does sleep play in mental health?
Dr. Carmel Harrington: Sleep is absolutely fundamental to good mental health. Most of us recognise that after just one night of not sleeping well we are more impatient, more easily annoyed and much less likely to be in a happy mood. If night after night we don’t get the sleep we need research shows very clearly that we are more likely to develop depression and in old age more likely to develop dementia.
RESCU: Do you have any tips for new mothers who really don’t have much control over their sleeping patterns?
Dr. Carmel Harrington: The common advice given to new mums – sleep when the baby sleeps – can be counterintuitive when it comes to maintaining night-time sleep. Instead, if possible, practise the habit of a 20 minute nap during the day while the baby sleeps. This will refresh you and enable you to continue with the day but not interfere with your nightly sleep. Also the new mum and her partner need to be aware of how much sleep they are getting and need to keep a track of their sleep hours. If either of them get less than 6 hours for 2 nights in a row, then on the third night that person needs to get at least 8 hours’ uninterrupted sleep. If the baby is being breastfed this may require a bit of planning (expressing milk ahead of time) but it will ensure that both parents are adequately, although not ideally, slept.
RESCU: You have done some work with the Children’s Hospital at Westmead. Can you tell us a little about that and the role sleep plays in a child’s development?
Dr. Carmel Harrington: Because children are growing their brain and body sleep is absolutely vital for their physical and mental health. Many children today do not get the sleep they require. On average, 3-5 year-olds require 11 hours of sleep, 6-13 year-olds 10 hours and 14-17 year-olds require 9 hours. When children do not get the sleep they need research clearly shows that they are:
– twice as likely to be obese,
– twice as likely to have problems at home, at school and with their peers
– 2-3 times more likely to suffer depression
– 2-3 times more likely to have health problems
RESCU: What’s more important if you’ve had a late night: waking up early to fit exercise into the day or sleeping in to catch up?
Dr. Carmel Harrington: Definitely do not skip on sleep in order to exercise. To be healthy we do not need to go to the gym and work out strenuously for an hour. A twenty minute walk sometime during the day is sufficient exercise for the maintenance of good health. Always remember there are not just 2, but 3 pillars of health and without sufficient sleep we will struggle to maintain the other 2 pillars.
RESCU: You’re involved with the A.H. Beard 6 Week Sleep Challenge — can you tell us a little about what is involved in this? Does it take 6 weeks to form good sleep habits?
Dr. Carmel Harrington: Poor sleepers can be overwhelmed by their sleeping issues and not know how to start improving their sleep. This is why the sleep challenge is so important. By breaking down the reasons for poor sleep into bite-sized components people can improve their sleep one week at a time. The AH Beard sleep challenge deals with the more common reasons why people don’t sleep well and presents each of these as a challenge participants need to manage each week. By having only one thing to change each week we are more likely to be successful . By contrast if we try to make all the changes at once we run the risk of finding it all too hard and ultimately being unable to make any changes at all. One-step at a time gives us the best opportunity at building on our success so that at the end of the 6-week period our unhealthy sleep practices are replaced by good sleep practices and better sleep is achieved.
RESCU: And, finally, your top tips for developing great sleep habits?
Dr. Carmel Harrington: How we sleep at night is often dependent upon how we spent our day. To get the best sleep possible we do need to prepare our mind and body for sleep. To prepare the body we need to:
– Get up at the same time every day.
– Exercise for at least 20 minutes per day (a walk at lunchtime is good)
– Don’t have caffeine after midday
– No alcohol
– Do not sleep during the day (a nap of 20 minutes is ok)
– Small meal at night and especially no big meal within 3 hours of bedtime.
– Do not exercise within 3 hours of bedtime (this will alert the body)
To prepare the mind we need to:
– Deal with the issues of the day: in the early evening spend no more than 20 minutes writing events of the day that are of concern along with potential solutions. Close the book and put it away.
– Set an alarm one hour before bedtime. At that time:
– turn off all technology
– dim the lighting in the room
– warm-hot shower
– relaxation exercise
– Ensure that the bed and bedroom environment is conducive to sleep
– absolutely no technology in the bedroom