Sleep to Perform
By Mika Ono
Sleep? Why bother? Dozens of The Scripps Research Institute
(TSRI) employees gathered last week to hear Milt Erman, adjunct
associate professor at TSRI, president of Pacific Sleep Medicine
Services, and physician of Scripps Clinic Medical Group, answer
this question.
In the "Lunch and Learn" seminar on January 30, Erman argued
that, despite prevailing American culture, sleep is a necessary
part of our 24-hour cycle. Sleep is necessary for emotional
regulation, physiological functioning, and peak performance.
"Sleep affects waking functioning and waking functioning
affects sleep," noted Erman.
Our level of alertness cycles with the clock, with lows
between 3 and 5 AM and highs in the mid-morning and early
evening. Alertness also dips in the early to mid afternoon.
Erman noted that the number of fatigue-related automobile
crashes mirrors this curve over a 24-hour period. Notable
accidents in recent history—Three Mile Island, Chernobyl,
the Exxon Valdez, the Challenger—occurred during the
early hours of the morning, the period of the lowest alertness
in our circadian rhythm.
"It's a fantasy that our circadian clock doesn't matter,"
he said. "We are prisoners of our biological destiny. When
we try to change that, we run into problems."
Erman noted that sleep changes as we age. The young have
the most Delta sleep—the deepest sleep—and the elderly
spend the most time lying awake in bed. Sleep disorders become
more likely as we age, as we become more susceptible with
longer periods of lighter sleep.
Erman addressed recent speculation that a new medication
(modafinil/Provigil) could reduce people's need for sleep.
While the medication seems to stimulate the brain's wakefulness
center and reduce the negative impact of sleep deprivation,
Erman believes trying to minimize sleep is the wrong approach.
"If sleep were not important, it would have been selected
against years ago," Erman said. "Over time, nature would have
done away with it. But sleep has persisted."
In light of data that show that individuals who suffer from
insomnia are more prone to absenteeism, depression, anxiety,
and psychiatric disorders, Erman encourages measures to promote
good sleep. These include:
- Waking up at the same time each day;
- Discontinuing caffeine four to six hours before bedtime;
- Avoiding nicotine;
- Avoiding alcohol to facilitate sleep;
- Avoiding heavy meals close to bedtime;
- Exercising, but not within three to five hours of bedtime;
- Minimizing noise and light exposure during the sleep
period;
- Using the bedroom for sleep rather than normal daytime
activities;
- Reducing arousing stimuli (Erman recommends moving the
alarm clock away from the side of the bed);
- Promoting light exposure in the morning and early afternoon.
"If you take sleep seriously, even though society tells
you differently, you will improve your functioning and quality
of life," Erman concluded.
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Milt Erman is Adjunct Associate Professor
at TSRI, President of Pacific Sleep Medicine Services, and
physician of Scripps Clinic Medical Group.
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