S2E31. Sweet Dreams Are Made Of This

When I was growing up, my mother valued her children’s sleep above all other bodily functions. When I was 12, I used that to my advantage when I wanted to play hooky from Hebrew school by staying up late the night before and then pretending not to wake up the next morning when she called me.

In college, a had a fierce bout of depression and found myself sleeping 12-16 hours every day. My therapist told me it was a defense mechanism whereby I tried to escape from reality. It sounded plausible at the time.

I used to wake up most nights at 3am. My best guess was that it was a little bit of residual trauma from when I was 6 or 7 and I was startled awake by the phone ringing. It was the hospital calling to tell us that my grandmother had died. My mother jumped out of her bed, wailing and crying hysterically. I glanced at the clock in my room and saw that it was 3am. Just recently, I learned that about 35% of us habitually wake up at 3am…and a related trauma is not a prerequisite at all.

In my early 30s, when I was the executive director of a performing arts center, I used to doze off in my office every afternoon. I fought it for a long time in the belief that I shouldn’t  be sleeping on the job, but then I decided, screw it! As soon as I’d start to get drowsy, I would buzz my secretary and ask her to hold my calls, lean back in my chair and nod off.

My afternoon napping habit never left me. When my first wife and I ran a B&B in northeastern Pennsylvania, I would retreat to the rope hammock hung between a pair of birch trees or lie down on the porch swing on most days in the late spring, summer and early fall. Those were the best naps of my life!

Fifteen years later, as the staff psychologist on an inpatient behavioral health unit, I took my nap a little earlier to coincide with my lunch break. Without my asking, our director sent out a notice that staff should not disturb Dr. Braffman during lunch unless there was an emergency and a patient was in crisis. Now that’s how you value nap time!

In graduate school, I learned about the 4 phases of sleep. Later studies revealed that you cycle through these phases 4-6 times every night, and that you can dream at any time, not just during REM sleep. 

New research published last month reported that there is a noradrenaline cycle that wakes you up as many as 100 times during the night. The awakenings are measured in milliseconds, so you are unaware of the vast majority of them.

Although we appear quiescent while we sleep, there’s actually a lot of important business going on under the hood. It’s the time when we consolidate memories and new learning and replenish our available stores of vital neurotransmitters. If you don’t sleep well or long enough, you’re going to have cognitive problems the next day, e.g., brain fog and you’ll be prone to making a lot of mistakes.

Another critical function of sleep is to clean up the chemical detritus left over from your brain’s daily activities. There is a whole separate network in your head that performs this task, running in parallel with the neural networks with which we are all so familiar. It’s called the brain’s glymphatic system.

It’s hypothesized that your brain’s ability to clean up the daily messes that it makes plays a critical role in preventing dementia. One way this might work would be by removing beta amyloid that is created as part of an immune response like a fever. 

What I haven’t been able to find anywhere in the literature, though, is a description of the magnitude of this cleaning power. Can your brain completely clean house every day? Is there enough residual power to clean up festering messes that overwhelmed the system on earlier occasions? In other words, is it destiny that our brains eventually be overrun with chemical garbage? Or can we chip away at accumulations of waste products until all our neural pathways are functioning again? Or is breaking even on a daily basis the most we can hope for?

We don’t know the answer to those questions yet, but we do know that somewhere between 7-9 hours of restful sleep on a regular basis helps tremendously. And naps are good for you, too (thank you, lord!), so long as you don’t overdo it to the point where they start to affect your nighttime slumber.

The impact of consistently high-quality sleep on your brain’s health can not be overstated. If you aren’t sleeping well (i.e., less than 6 hours each night), you might want to consider implementing some behavioral changes now that will reduce your risk of dementia by 30-50% later on.

To sleep better, lay off the alcohol in the evening and no more caffeine after 12 noon. Set a fixed schedule for going to bed and waking up. Stow your electronic devices about an hour before bedtime. Make a list of all the things you want to do the next day so you don’t lie awake thinking about them. You might want to do a meditation/relaxation/deep breathing exercise just before bedtime. Make sure your bedroom is dark and the temperature is somewhere in the 60s.

If you do all of these things and still have trouble sleeping, it will be well worth your while to get evaluated. There are a range of products out there—both natural and pharmaceutical—that can offer you support, if you need it.

Pleasant dreams!

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