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Cancer, Heart Attacks, and a Shorter Life Sleep Deprivation and the Body I was once fond of saying, “Sleep is the third pillar of good health, alongside diet and exercise.” I have changed my tune. Sleep is more than a pillar; it is the foundation on which the other two health bastions sit. Take away the bedrock of sleep, or weaken it just a little, and careful eating or physical exercise become less than effective, as we shall see. Yet the insidious impact of sleep loss on health runs much deeper. Every major system, tissue, and organ of your body suffers when sleep becomes short. No aspect of your health can retreat at the sign of sleep loss and escape unharmed. Like water from a burst pipe in your home, the effects of sleep deprivation will seep into every nook and cranny of biology, down into your cells, even altering your most fundamental self—your DNA. Widening the lens of focus, there are more than twenty large-scale epidemiological studies that have tracked millions of peop...

Appendix Twelve Tips for Healthy SleepI 1. Stick to a sleep schedule. Go to bed and wake up at the same time each day. As creatures of habit, people have a hard time adjusting to changes in sleep patterns. Sleeping later on weekends won’t fully make up for a lack of sleep during the week and will make it harder to wake up early on Monday morning. Set an alarm for bedtime. Often we set an alarm for when it’s time to wake up but fail to do so for when it’s time to go to sleep. If there is only one piece of advice you remember and take from these twelve tips, this should be it. 2. Exercise is great, but not too late in the day. Try to exercise at least thirty minutes on most days but not later than two to three hours before your bedtime. 3. Avoid caffeine and nicotine. Coffee, colas, certain teas, and chocolate contain the stimulant caffeine, and its effects can take as long as eight hours to wear off fully. Therefore, a cup of coffee in the late afternoon can make it hard for you to...

In the past month, almost 10 million people in America will have swallowed some kind of a sleeping aid. Most relevant, and a key focus of this chapter, is the (ab)use of prescription sleeping pills. Sleeping pills do not provide natural sleep, can damage health, and increase the risk of life-threatening diseases. We will explore the alternatives that exist for improving sleep and combating insipid insomnia. SHOULD YOU TAKE TWO OF THESE BEFORE BED? No past or current sleeping medications on the legal (or illegal) market induce natural sleep. Don’t get me wrong—no one would claim that you are awake after taking prescription sleeping pills. But to suggest that you are experiencing natural sleep would be an equally false assertion. The older sleep medications—termed “sedative hypnotics,” such as diazepam—were blunt instruments. They sedated you rather than assisting you into sleep. Understandably, many people mistake the former for the latter. Most of the newer sleeping pills on the mar...

CAN NAPS HELP? In the 1980s and ’90s, David Dinges, together with his astute collaborator (and recent administrator of the National Highway Traffic Safety Administration) Dr. Mark Rosekind, conducted another series of groundbreaking studies, this time examining the upsides and downsides of napping in the face of unavoidable sleep deprivation. They coined the term “power naps”—or, should I say, ceded to it. Much of their work was with the aviation industry, examining pilots on long-haul travel. The most dangerous time of flight is landing, which arrives at the end of a journey, when the greatest amount of sleep deprivation has often accrued. Recall how tired and sleepy you are at the end of an overnight, transatlantic flight, having been on the go for more than twenty-four hours. Would you feel at peak performance, ready to land a Boeing 747 with 467 passengers on board, should you have the skill to do so? It is during this end phase of flight, known in the aviation industry as “top o...

SLEEP PRESSURE AND CAFFEINE Your twenty-four-hour circadian rhythm is the first of the two factors determining wake and sleep. The second is sleep pressure. At this very moment, a chemical called adenosine is building up in your brain. It will continue to increase in concentration with every waking minute that elapses. The longer you are awake, the more adenosine will accumulate. Think of adenosine as a chemical barometer that continuously registers the amount of elapsed time since you woke up this morning. One consequence of increasing adenosine in the brain is an increasing desire to sleep. This is known as sleep pressure, and it is the second force that will determine when you feel sleepy, and thus should go to bed. Using a clever dual-action effect, high concentrations of adenosine simultaneously turn down the “volume” of wake-promoting regions in the brain and turn up the dial on sleep-inducing regions. As a result of that chemical sleep pressure, when adenosine concentrations p...