Early to bed…

I believe that sleep is a much under-rated past-time. Two years ago, I wrote a blog post which punted getting more sleep as a worthwhile New Year resolution. And my recent post of 10 potential New Year resolutions also included one on getting adequate sleep. So, I was interested to see a recent study getting some attention which found that, in adolescents, setting of bedtimes by parents of midnight or later was associated with an increased risk of depression and ‘suicidal ideation’ compared to bedtimes of 10.00 pm or earlier [1]. Such ‘epidemiological’ studies cannot be used to conclude that going to bed late causes low mood and suicidal tendencies. However, it is certainly one line of evidence which suggests that getting an early night might have benefits for us.

One reason for this is that individuals going to bed earlier might simply be more likely to get adequate amounts of sleep. For most of us, especially during the working/school week, the start time for the day is relatively fixed. It’s fixed by things like getting to school, ferrying the kids to school, getting to meetings, missing the rush hour traffic etc. Because of this, most of us do not have many options to extend sleep by staying in bed. If we want to get more (and perhaps adequate levels of) sleep, going to bed earlier is the only sensible tactic for the majority of us, the majority of the time.

Some people have theorised that going to bed earlier also reaps dividends in that ‘an hour of sleep before midnight is worth two after’. Part of the reason this might be is relates to the fact that, for a given amount of sleep, going to bed earlier can mean longer spent in deeper, more restorative (non-REM) sleep. I can’t find any definitive work on this, but what I do know from my experience in practice is that individuals who shift their sleep forward a bit (so that even if they are not sleeping longer, they are sleeping earlier) almost always feel better in time for doing this. Higher levels of energy in the morning, and right throughout the day, is not an uncommon finding.

There is, in my view, another reason for going to bed earlier ” it means that we find it easier (perhaps even easy) to get up earlier too. And the benefit here? Well, individuals who get up early tend to find something useful to do with the time they have created, such as taking exercise, having or at least preparing (to eat later) breakfast, or clearing emails and other distractions to enable the day to be started with a ‘clean slate’.

Compare these useful activities with, perhaps, the activity time you may have ‘stolen’ from the late evening the day before. Because, to be frank, for many of us this will be taken up watching or drifting in and out of consciousness in front of rubbish TV, doing some mindless internet surfing or engaging in some other not very enriching activity.

If you would like to shift your sleep cycle to an earlier time, then one big tip I have for you is to start by getting up earlier than you ordinarily do now. So, if you get up at 7.30, start getting up at, say, 6.00. In a day or two you’ll likely push yourself into such extreme sleep deprivation that you’ll be forced to go to bed earlier than usual. Often, within a week or two, individuals will find themselves settling into this earlier routine and reaping the dividends that usually come with it.

In the long term, the odd late night will not hurt. However, to avoid slipping back into old habits it’s important to be quite disciplined regarding your earlier bed time. Here are a few habits that can help:

1. Set a time when you’re going to commit to turn off the TV by (e.g.
10.00 pm)

2. If that’s too draconian for your partner and/or family, set a time by which you remove yourself from any room in which the TV is on

3. Perhaps better still, don’t turn on the TV in the first place

4. Set a time by which you will close down your computer, or at the very least cease on-line activity

5. Set a time by which you will stop any checking of email on a smartphone or similar device

6. Spend a few minutes planning the next day, in terms of the most important things you want to get done, and how and when you’re going to do them so that you are more likely to ‘rest in peace’.

Another habit worth getting into is to be quite disciplined in work and social situations. I was reminded of the importance of this recently during a conversation with a friend and colleague. He is an ‘early to bed’ type, who was telling me that he has quite specific strategies for dealing with evening events that are usually work-related. For example, if it’s a dinner, he sets an early start time. No ‘let’s meet at 7.30 for 8.00′ for this man. Meet times will typically be 6.30 pm. He will eat, discuss what needs to be discussed, and then has the conviction at a relatively early hour (e.g. 8.30 or 9.00 pm) to say, in effect: Thanks very much, that’s been a very useful/enjoyable/enlightening evening ” I’m going now. I know he’s true to his word on this, because I’ve witnessed him doing it several times in real life.

The result of this is that my friend rarely gets into bed later than he really wants too. But as he pointed out to me also recently, it can mean that maybe other people don’t stay up later than they want to either. Because, it’s not uncommonly the case that the reason events go on late into the evening is because no-one wants to be the first person to leave. My friend doesn’t have any inhibition about this, and because of this can ‘liberate’ his friends and colleagues earlier than they otherwise would be.

So, when in such situations yourself, you might like to do yourself (and your friends and colleagues) a big favour by meeting early, and leaving at a sociable hour too.


References:

1. Gangwisch JE, et al. Parental bedtimes and adolescent depression. Sleep 2009;33(01):97-106

14 Responses to Early to bed…

  1. Jamie 4 January 2010 at 2:31 am #

    Great post Dr Briffa!

    Along with nutrition workshops, I also run sleep workshops, and jusdging by the interest in these (often more than the nutritional stuff), there are lots of people not getting enough sleep & are desperate to get more.

    I educate about sleep cycles, which you are alluded to here. Sleep cycles tend to run in approx 90 minute intervals for most people, and I suggest people aim to get a minimum of 4 cycles per night (6 hours) & up to 6 cycles per night (9 hours). I typically need 6 cycles to feel refreshed.

    As you say, start times for the day are often fixed by things beyond our control. So if one needs to be up at 6am in order to meet the requirements of these fixed routines, but also needs 6 sleep cycles, then it becomes easy to calculate what time that person should be in bed & entering stage 1 sleep.

    The first two sleep cycles are the most restorative physically as this is where the likes of growth hormone is released. People will often comment that if they go to bed early, they wake up early in the night, e.g. if they go to bed at 10pm, they are awake ~1am. In actual fact, they are typically waking up after 3 hours sleep or 2 sleep cycles & have had their growth hormone release over this time (some will also comment that they wake up at 1am feeling like they have had a full nights sleep). After this point, people may sleep a bit lighter & not spend so much time in the deep sleep stages (4 & 5) but spend more time in dream sleep (REM). If people do awaken under their own steam as it were, they typically awaken at the end of a cycle (every ~90 mins) before drifting back down again.

    What many find the most tiring is being awoken out of deep sleep/REM sleep by an external source, e.g. alarm clock. My advice here is to learn to listen to your body & aim to have the alarm set at a time that is very close to a natural wakening time as you can get. For example, if you awaken naturally at 5:45am, get up then rather than drift back to sleep only to be woken up by the alarm at 6:30am, half way through your next sleep cycle.

    There is evidence to (when thinking of primal man), that humans, like many other animals, are natural biphasic sleepers – that is, we weren’t meant to gather all of our sleep in one block. This would have made sense from a security point of view, always having someone in your tribe who was awake guarding against predators, keeping fires burning etc. In modern times, going to bed early, getting the first deep sleep cycles, sleeping lightly through part of the night, then entering the REM cycles might actually be the normal state of things that doesn’t require further (often pharmaceutical) interventions.

    I have always admired countries where an afternoon ‘siesta’ is normal as this might actually be in keeping with our genes also. If napping during the day though, the advice is typically take a short power nap for <~20 mins or aim for a full cycle of ~90 mins. Anything in between is no man’s land & will ultimately leave you feeling worse than if you hadn’t slept at all.

  2. Jamie 4 January 2010 at 2:42 am #

    I meant to add also, that the 60-90 mins pre-sleep are critical for putting you in the right frame for sleep. The strategies outlined by Dr Briffa for shutting computers down etc at a set time are critical for removing stressors that may upset the intiation of the first few sleep cycles. Adding to this is the importance of ensuring that common sleep disruptors such as caffeine are not consumed in the hours preceeding sleep initiation. Something like caffeine has a half life of 4-6 hours from memory. This means that if you drink it by the bucketload & even if you stop consuming coffee after 3-4pm, then there is potential to still have 100-200mg circulating through the system close to bed time (the equivalent of an espresso). If you are an habitual drinker, this might not be enough to stop you entering stages 1-3 for sleep, but it may prevent you getting into or spending long in the deeper restorative stages of 4-5.

  3. James 4 January 2010 at 9:19 am #

    Some interesting points, though not anything I have not heard before. I agree that a good night’s rest is important, but so far I have had little luck cultivating the discipline to go to bed early. I do try. I stop drinking caffeine before 8pm, I cease TV and computer use by 10pm (most nights I do not even watch any TV, including boxsets or DVDs) and I spend the last hour or so in bed reading. In fact, in the last hour I avoid any other activity that would get my brain fired-up. I do not read magazines, heavy books or newspapers, instead sticking to frothy brain-fodder like historical fiction. I have even adjusted my diet accordingly: I eat few fats and sugars and I keep the lean meals of the day to the evening, so no heavy proteins, starches or fats when I go to bed.

    Alas, no luck. I do these things and then still lie in bed awake for a good extra hour, leading me to 1pm and eventually sleep. Waking up at a set time used to work, briefly, only to discover that I would get tired by 9pm and by 9:30 I’m awake again. No luck!

    But some reflection has made me consider that I am of the unfortunate few: a total night owl. Years ago I spent a year working nights and it was sheer bliss. I also recall, as a kid, that my parents had a terrible time getting me to go to bed early: I used to sneak out and hide under the couch to watch television or stay in my room and play or page through illustrated books. As an adult more than one person who had shared my bed (or at least morning routines) remarked on my severe personality switch before and after 10am. Morning person? Yes, the type who will assault you with a mug.

    Today my prime career ambition is to create a path where I can create my own hours, because I honestly cannot abide to the “Early to bed” rule. All the changes I have made to my lifestyle work great: I have more energy and I rarely indulge in ‘rubbish’ entertainment and distractions. But I just cannot get up early! Ask my alarm clock: we have had some interesting interactions over the years. Just the other day I discovered that during a sleep-stupored attempt to turn the alarm off, I managed to change the actual alarm time ahead by eight hours! And I can’t remember any of it :)

  4. Dr John Briffa 4 January 2010 at 3:06 pm #

    Jamie

    Thanks for all this (comments 1 and 2) – all highly useful (and correct, in my opinion).

    I think you’re right about the half-life of caffeine (about 5 hours), but this does seem to vary considerably between individuals. Some efficient metabolisers of it may not have real problems with it even when drunk quite late in the day, while others who are sensitive to it (slow metabolisers of it) may even be bothered/disrupted by a little caffeine had in the morning.

    As you allude to, habitual consumption general improves tolerance.

  5. Craig Burton 4 January 2010 at 8:18 pm #

    Great article Dr Briffa. Sleep in my experience working with clients is a major pillar that needs to be addressed equally with nutrition and exercise. After performing saliva cortisol testing for some time now I have seen every client who is exhibiting some form of disease (inlcuding obesity) suffering from adrenal fatigue. I see in most cases too that those suffering Candida also suffer from adrenal fatigue – chicken or egg? Then there is the strong link between high Cortisol and abdominal fat. So many reason to get to bed early.

  6. Dr John Briffa 4 January 2010 at 8:31 pm #

    Craig

    Thanks for your observations and comments. I do a fair amount of adrenal hormone testing (salivary samples) in practice, and like you, see a lot of ‘adrenal fatigue’. I also agree with you regarding the link with what appears to candidiasis/gut dysbiosis. Usually, in my experience, adrenal health needs some restoration for these other issues to resolve properly.

  7. Jamie 4 January 2010 at 10:05 pm #

    To John at #3;

    I’m a caffeine addict from way back & used to boast about my ability to have a flat white within an hour or so of bedtime & still (seemingly) get a good nights sleep. Curiously however, since going ‘primal’ & gluten-free over the last 6 months or so, I am considerably more sensitive to the effects of caffeine. Having cut most dairy, I have my coffee as a long black now (what is it the Italian’s say about milk being only for babies?), & I cannot consume these past 2-3pm without my sleep being disrupted. In fact, whilst I love my morning cup of liquid enthusiasm, my taste for it in the afternoon has changed significantly (I struglle to drink coffee in the afternoon & have switched to green tea predominantly). I have a couple of English friends living here in NZ who have also gone primal. Being British & not knowing what a good cup of coffee is :) they are both tea drinkers & have noticed exactly the same pattern with their tea consumption – fine in the morning, but less able to tolerate it late in the day.

  8. Dr John Briffa 4 January 2010 at 10:54 pm #

    Jamie

    We appear to be living parallel existences: I also used to be addicted to caffeine. I hardly have it at all now. I tend to use it when I ‘need’ it – say if I’m about to lecture in the morning and have had my sleep seriously curtailed for some reason.

    As with you, I generally have zero desire for it in the afternoon. For us, some of this might have to do with the fact that by eating primally, we’re unlikely to be getting the hypoglycaemic fatigue and listlessness that can cause individuals to reach for the espresso/Americano/whatever.

    Sleep tight ;-)

  9. Nigeepoo 8 January 2010 at 3:44 pm #

    Since starting supplementation with Vitamin D3 5,000iu/day (taken in the morning with my 1 cup of instant coffee/day), I can stay up ’till the wee hours surfing the interwebs, go out like a light when my head eventually touches the pillow and wake up the next morning raring to go! :-D

  10. Jason 9 January 2010 at 2:52 am #

    Hi Nigeepoo. consider yourself lucky, not all of us have that ability. Just curious though, how old are you and how large is your waist circumference? No doubt that some people seem to sleep more soundly, fall asleep faster, and supposedly “need” less sleep (so they think). I have been a health and fitness coach for over 20 Years, and often find that my clients who claim to “need” less sleep tend to be overweight or are over 60. Many studies have indicated that people who fit this description do not “need” less sleep as was once thought, but are are unable to sleep as long. Almost ALL of my overweight clients sleep for only short periods and think that is “impressive” or demonstrates “ambition”, until we discuss the link between adequate sleep and weight/health maintenance. I personally have been diagnosed with DSPS (Delayed sleep phase syndrome), and have struggled with it since i was a child. It’s ironic I am a health coach and fitness expert with about 6% bodyfat and practice what I preach in every other area, while sleeping at socially acceptable times has always been a struggle. I can easily sleep 9-10 hours per night by the way, especially on days where I was very active, worked out intensely, or even read or write with intense concentration for extended focused period. I suspect that I have developed unusually high nervous system activation and efficiency after 20 years of consistent and intense training and pehaps the downside of this level of high motor unit recruitment during exercise is linked to taxing the nervous system and adrenal glands more substantially (I am very strong and fast for my size and workout very intense intensely by nature).
    thanks again…
    Thanks for all the posts ok this, it is one area I have not been able to overcome despite trying for many many years.

  11. Everett 9 January 2010 at 3:04 am #

    My own experience supports the benefits of getting to sleep by 10:30 or so; the pompholyx eczema on my hands disappears after just a few good nights sleep, along with the avoidance of caffeine and sweets after 4pm.

  12. Nigeepoo 9 January 2010 at 3:09 am #

    Jason said:

    “Hi Nigeepoo. consider yourself lucky, not all of us have that ability. Just curious though, how old are you and how large is your waist circumference?”

    Hi Jason. I’ll be 55 in March and my waist is 38 inches. I’m 6 feet tall. Before supp’ing with Vit D, I used to sleep a lot and wake up feeling tired & not in the mood for doing anything.

  13. Tom 11 September 2010 at 4:26 am #

    Awsome post! i think people oftern forget the importacne of sleep on overall health.

    TOM

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