by Guy Takamatsu
Lack of sleep is an issue which has affected all ages of modern society including seniors. Dr. Mehrdad Ayati, MD, Adjunct Clinical Assistant Professor, at Stanford University gave a presentation on getting a good night’s sleep. While the focus of Dr. Ayati is on aging, the information used in this presentation could be applied to people in other age groups.
Do you know why getting exercise helps one in getting a good night’s sleep? What is the relevance of melatonin to sleep? Why do people sleepwalk? Dr. Ayati provided the answers when he gave a detailed explanation on the mechanics of sleep.
The human body goes through two major stages of sleep non-REM and REM sleep. REM stands for Rapid Eye Movement. If one goes to bed at 10 PM the non-REM stage lasts to about 1 AM. During this time the body goes from light sleep to deep sleep. This is the non-dream stage of sleep. After the non-REM stage, comes the REM stage in which the body relaxes, but the brain becomes active, while the muscles are inactive. In other words the brain is “on” while the body should be “off” and immobile. For some people the muscles do not shut down. This results in the brain signaling the muscles resulting in the sleeper acting out his or her dream. One manifestation of this phenomenon is “sleep walking.”
Two chemicals in the body which contribute to the sleep cycle: Adenosine and Melatonin. Adenosine is generated in the body as a result of physical activity, such as exercise. In other words this chemical is the resulting product of muscle use. According to Dr. Ayati the best time of the day to exercise is from about 3 to 5 PM. Coffee can temporarily block the effects of Adenosine, but eventually Adenosine will “win.” The body will have to sleep. During this period of sleep the body goes through the process of getting rid of Adenosine. Perhaps one might say the body acts like a vacuum cleaner.
The second chemical which is part of the sleep process is Melatonin. This chemical is generated in the body when sun light travels through the eye to the pineal gland in the brain. In other words the body can generate its own Melatonin. Melatonin is a “messenger” which gives the signal to the body to sleep. Bladder and bowel functions of the body are told “slow down” so one does not need to go to the restroom. While Melatonin does serve a useful function, Dr. Ayati does not recommend taking a high dosage of the substance. In fact he recommended taking half the normal dosage. For some reason less seems to be better.
One intriguing non-drug therapy mentioned by Dr. Ayati was Bright Light Therapy (BLT). Yes, light can play a role in health. He mentioned the use of Bright Light boxes. Dr. Ayati also mentioned the use of sunlight in health. He mentioned that some senior centers in places like Japan are having some activities outdoors. After this lecture this writer talked to two people at another event. One of them mentioned something about an app involving blue light as a sleep aid. While light may seem like an innocuous part of our life, that element can apparently have an effect on our sleep life. Blue light has similar effect to sunlight and fools the body into thinking it is daylight. During a later event this writer had a conversation with two Steinbeck Center representatives about the issue of sleep. One of them mentioned an app which could be used on computer or phone which lessens the amount of blue light on the screen.
Dr. Ayati recommended one not watch television at night. Apparently television and computer have a way of keeping the brain stimulated and awake. Maybe the shows or screen content are designed to keep the viewers’ attention fixed on the screen. This writer remembers staying up until 2 AM watching a movie about a grizzly bear which could not be killed by high powered rifles. Finally someone kills the bear with a bazooka or rocket launcher. What a stupid movie! What a waste of time! How many times have people stayed up until early morning waiting to see the end of a story only to be disappointed?
As one ages, sleep patterns can change. Older people may go to sleep earlier and wake up earlier. Not everyone has to sleep from 10 PM to 6 AM. One need not feel guilty if one sleeps from 7 PM to 4 AM. As far as Dr. Ayati is concerned you’ve got your sleep time. There is no need to extend it to 8 AM. Not all people sleep continuously for 8 hours. Instead they may sleep in short blocks of time. Some have tried to “correct” that pattern with pharmaceuticals. Dr. Ayati’s recommendation is to leave those people alone. Everyone has different sleep patterns. For some taking a short nap could help. After hearing Dr. Ayati, this writer probably felt less guilty about taking a short half hour nap before attending the Showcase of Special Collections event, which happened later that evening. Of course not everyone believes in naps. But naps do seem to work for some people or even some cultures. Dr. Ayati spoke positively about the practice in Spain of shutting down business in the afternoon. During that time people take a long break or siesta. During the afternoon the day could be quite hot, so why not shut down? Later, when the temperature is cooler, people resume business. Of course not all cultures believe in shutting down during the heat of the day. There is a saying that only mad dogs and Englishmen go out in the midday sun. According to this link (http://www.phrases.org.uk/bulletin_board/56/messages/121.html) the phrase originated with Noel Coward, who poked fun at English would not adapt to their tropical colonial surroundings. The wonders of modern technology, such as electric lighting and air conditioning, have made it possible for one to work beyond sunset and during the heat of the day. But it has not always been this way. For many centuries farmers worked from early sunrise to sunset. It was not an easy life, but that is how many of our ancestors lived until recent times. The practice of working during daylight hours, sleeping nighttime is to Dr. Ayati the natural way of doing things. He does not say we should abandon the modern conveniences. He does not watch television, but don’t watch television if you want to get to sleep.
Much progress has been made in the field of sleep research. When Dr. Ayati was in medical school, only four pages of his textbook were dedicated to the topic of sleep. Now substantially more material is available. But in spite of the material accumulated, the topic of sleep still remains a mystery. This is just a brief overview of Dr. Ayati’s presentation. Those who wish to know more about the topic of sleep should check out his videos on YouTube.