Go to Sleep!

Written by Laura Hilgers | Illustration by Olivia Wise

Easier said than done during our modern times, but just as important as ever when it comes to overall health.

For the past three or four years, I’ve been plagued by a variety of ailments. At least once a month, and sometimes more frequently, I caught a cold or flu and missed work days because I was sick. I went from doctor to doctor, had CT scans on my sinuses, took antibiotics, worked with a nutritionist and meditated regularly, thinking maybe constant illness was a reaction to stress.

Late last year, my 25-year-old son started saying to me, “Mom, I hear you gasping when you wake up in the middle of the night.” He encouraged me to get a sleep test. I’m a woman and relatively thin, so I seemed an unlikely candidate for sleep apnea, even though I’ve struggled with sleep most of my adult life. My son insisted. One home sleep study and two overnight sleep studies later, I discovered he was right: I had sleep apnea, a condition in which people stop breathing, sometimes for long periods, during sleep. In January, I started using a continuous positive airway pressure, or CPAP, machine (a sexy addition to my flannel pajamas) and have gotten sick only once since. I sleep through the night most nights, wake up feeling refreshed, and no longer experience daytime headaches — which I didn’t realize I had until they were gone.

My experience points to how tricky and pervasive sleep disorders can be. According to the Stanford Sleep Medicine Center, 70 million people in the U.S. suffer from chronic, severe sleep disorders. These include not only sleep apnea, but also insomnia, restless leg syndrome, narcolepsy and circadian rhythm disorders. The consequences are serious: Unhealthy sleep and sleep deprivation have been linked to heart disease, depression, obesity, lowered immune function and even lowered life expectancy.

“As a society, we are chronically sleep-deprived,” says Dr. Christopher Tyler, medical director of Kaiser Permanente’s San Francisco Outpatient Sleep Clinic. He says that people have not slept enough — seven to nine hours per night is recommended for adults — since Thomas Edison introduced the incandescent light bulb in 1879 and that even before the pandemic, National Sleep Foundation surveys found that 60 percent of American adults had sleep problems a few nights a week or more.

“In these current times, sleep is the most powerful form of selfcare that we have. Nothing will make you feel better than a good night’s sleep.” — Dr. Rafael Pelayo

Then came COVID-19. Amid uncertainty, fears of illness and economic security, people were beset by “COVID-somnia.” A 2021 American Academy of Sleep Medicine survey found that 56 percent of adults in the U.S. experienced an increase in sleep disturbances because of the pandemic.

Tyler attributes COVID-somnia to a variety of factors. People who were — and are — lucky enough to work at home weren’t exposed to enough sunlight because suddenly they weren’t leaving the house for their commute, which threw off their circadian rhythms (the internal system that tells us when to wake and sleep). Some people were napping, which had the same effect. Alcohol use also spiked, despite being what Tyler calls “a terrible soporific,” notorious for disturbing sleep. Add the sleep-delaying blue light and sometimes disturbing content of Netflix binging as well as the weight that many people gained (increasing their risk of sleep apnea) — and it’s understandable why the pandemic hampered getting a good night’s rest.

But even more, our minds have been unsettled. “We sleep best in states of serenity,” says Dr. Rafael Pelayo, a professor of sleep medicine at Stanford and author of How to Sleep: The New Science-Based Solutions for Sleeping Through the Night. “And we’ve had a bunch of people who have insecurities about their situation during the pandemic.”

Essential workers and working moms got hit especially hard. Yet some people were snoozing more dreamily than ever. “There were people who told me they were sleeping better during the pandemic because they didn’t have to commute anymore,” Pelayo adds, “which highlights how stressful that can be in the Bay Area — where a global pandemic is less stressful than your commute to work.”

Luckily, Bay Area residents who struggle with sleep have access to one of the world’s largest and most renowned sleep clinics: the Stanford Sleep Medicine Center. Started in 1970 by Drs. William Dement, Christian Guilleminault and Vincent Zarcone, the center was originally a narcolepsy clinic. But in 1972, the three doctors expanded it to cover other disorders, creating what’s believed to be the world’s first sleep clinic. “It was considered the birthplace of the diagnostic and therapeutic management of sleep apnea,” says Dr. Clete Kushida, medical director of Stanford Sleep Medicine. Fifty years later, the center logs about 16,000 patient visits per year and treats 90 different sleep disorders.

Dement, who died in his sleep in 2020 after a battle with heart disease, was known as the “father of sleep medicine.” Along with a handful of other scientists, he created an entirely new medical specialty devoted to sleep. He founded the first professional organization for sleep researchers, the American Sleep Disorders Association, now called the American Academy of Sleep Medicine. And he worked tirelessly (pun intended) to alert U.S. policy makers to the dangers of sleep deprivation. His work resulted in legislators establishing the National Center on Sleep Disorders Research. A legendary teacher at Stanford, he taught the wildly popular undergrad class Sleep and Dreams, which 20,000 students took prior to his passing.

At any given time now, the Stanford Sleep Medicine Center is involved in 25 or so individual clinical trials. “Given the proximity of Silicon Valley,” Kushida says, “a lot of the devices that are developed there are evaluated by us.” Pelayo adds that Stanford scientists are also conducting quite a bit of research into the role of sleep in chronic neurological conditions such as Parkinson’s and Alzheimer’s. “The possibility that these diseases are actually caused by poor sleep is out there now,” he says. That would include a 2021 Stanford study that found that patients who slept less than six hours a night had a higher rate of brain plaques associated with Alzheimer’s.

But that’s not the only reason we need to prioritize getting enough good, quality sleep — or that I strap a fairly unattractive CPAP mask on my face each night. Sleep nurtures and restores us, which we need more than ever. “In these current times, sleep is the most powerful form of self-care that we have,” says Pelayo. “Nothing will make you feel better than a good night’s sleep.”

5 Simple Tips for Sound Sleep

1 Lock in a regular wakeup time. Most people wake up based on when they fell asleep the night before. “But that’s not how sleep really works,” says Dr. Rafael Pelayo. The brain, he explains, is always trying to “predict on and off.” You can help this system run smoothly by waking at the same time each day.

2 Have a wakeful day, with plenty of exposure to sunlight. Dr. Christopher Tyler says that it’s essential to have an active day — without naps — and to expose yourself to as much daylight as possible to keep your circadian rhythms on track.

3 Find time to be alone with your thoughts before you go to bed. People’s minds often race at night, says Pelayo, because the first time they’re alone with their thoughts is when they’re in bed — which can make it hard to fall or stay asleep. So, find a little time to review your thoughts (or maybe even write in a journal) earlier in the day.

4 Create a “slowdown period” before bed. To give your body a chance to wind down, dim the lights, avoid exercise and shut off screens as you near bedtime. “You might also want to try a self-calming technique,” Pelayo advises, “such as quietly breathing or going through your body and gently tightening and relaxing your muscles.”

5 If you snore — or your partner says you do — see a doctor. “All snoring is abnormal,” says Pelayo. “When a person says, ‘My wife says I snore and may have sleep apnea,’ I tell them, ‘Go home and give that person a kiss. They may have just saved your life.’”

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