Sleep is fascinating.   Why do we need it?   What is actually happening when we sleep?  Stay up a couple of nights on only a few hours of sleep and one can experience the physiological changes that take place.

The neuroendocrine system definitely needs proper amounts of sleep to function well.  If one doesn’t get enough sleep brain function slows and the adrenal glands gets stressed with improper glucocorticoids regulation.  If there was a way to measure worker productivity in the Boston area as a whole I am sure it would show a marked drop-off in October 2013..  Bottom line is that if you don’t get adequate sleep you’ll be dead sooner.

Parent Sleep Deprivation

We are learning a lot about sleep from our sweet daughter Mira.  She turned 1 this past New Year’s Day and has not woken up any less than 4 times per night since she was born.  Right now she is in a mode of waking at least once per hour.   It is downright maddening. The health challenges of parent/baby sleep deprivation have been well documented.

Last week my patient was lamenting how her son was so frustrated because his daughter, the same age as Mira, was waking up once per night and he thought “she should sleep through the night”. My patient’s son has no idea how lucky he is.

Amazingly with how tired Mira looks she somehow she wakes up happy, smiling and  is a goofball.  She has such a zest for life and wants to play and play more.  She is also quite the daredevil.  We’ve commented several times how she has no problem with risk taking.  I am not sure how she keeps going on so little sleep as she needs to be getting 14 hours of sleep per 24 hour day rather than the 7-9 or so she gets now.

My wife, Joy, is bearing 99.99% of the sleep deprivation direct hit burden.   Somehow Joy, like Mira, for the most part remains Joyful.   It think a lot of it is just how she is ‘wired’ and some of it is sheer will.  But could some of it be the result of brain changes from sleep deprivation?

Sleep Deprivation Physiologic Changes

When we are sleep deprived there is an increase in activity of the mesolimbic pathway increasing the neurotransmitter dopamine.  Dopamine imparts generally positive feelings, motivation, cravings, sex drive and decision-making.   So sleep deprivation can lead to more positive feelings and that is what the research shows.  Sleep deprivation also causes depressed people to score more positive on tests. (however sleep deprivation is not a therapy for any sort of pathology and long-term deprivation causes the opposite!).

It also turns out that when we are sleep deprived the brain’s key planning and decision-making region shuts down (prefrontal cortex) and the primal neural functions (amygdala) are activated.   This also leads us to feel more positive – at least temporarily. Have you ever had that experience? – you are up all night having fun and sort of giddy and less worried the next day?   I certainly remember that from my college years (but that could have been from other reasons).

It can also lead to impulsivity and risk taking as the prefrontal cortex is shut down.  Remember I said Mira is a daredevil?  Could the sleep deprivation be contributing to the ‘no fear’ behavior?   Can the prefrontal cortex be that developed in a 1-year-old? I do not know the answer.   But it does make me wonder if some of her ‘no fear’ is further amplified by a lack of sleep.

Those are seemingly somewhat positive outcomes of short-term sleep deprivation, but there are many downsides. A study was just released this week that showed sleep deprivation may lead to the expression of proteins associated with brain aging   I tell my patients to get to sleep before they get tired so the endocrine system does not enter into a ‘stress response’. For many patients going to bed before fatigue hits for  3 nights in a row will bring about a much more focused energy and healthier feeling.    I also try to explain to my weight loss patients that good sleep is imperative for weight loss as a lack of sleep makes fat cells less sensitive to insulin therefore the body needs to make more insulin which in turns keep the fat in fat cells. (because that is what insulin does – tells the fat cells to hold the fat).

Getting adequate sleep is imperative to our health.  With that in mind we are working with a sleep consultant at ISIS Maternity who is fabulous.  Her name is Erin Evans.  (I am sure the other ISIS consultant is just as excellent).  Erin has given us some tips so that we can now put Mira down awake and she will put herself to sleep.  Now we just have to get her not to wake up every hour.   But maybe it is all an illusion and we are not as sleep deprived as we think.

Ironically I am finishing this blog fighting to stay awake at 11:10pm. (and Mira has woken twice in the past 40 minutes and this is the book that comes to mind.)

Addendum:  I just came across this while searching for something else.  This Huffington Post article sums up the results of sleep deprivation very nicely. 

Yours In Health,

George Mandler  Licensed Acupuncturist, Licensed Nutritionist / Dietitian

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