Better Sleep, Happier Life
"We only have one life, it is precious, and sleep is an essential component in it. Readers, I urge you to take advantage of the life and experiences of this knowledgeable expert in this field, and embrace this essential guide. Not only will it improve your sleep, but also you can utilize the information it contains and take stock of your own personal journey, evaluate what is important to you as an individual, and then using the tools given in this book, go forward with the rest of your life in a balanced and healthy way. Highly recommended! —Susan Keefe, The Columbia Review
Did you know that sleep is a key component for a happy life? Research shows us it is. But with all of today’s technology and stresses, many people are getting less sleep or experiencing poorer quality sleep. This can negatively impact mood, concentration, productivity, physical health and, yes, even happiness.
As a practicing physician for more than twenty years, Dr. Venkata Buddharaju (known as Dr. Buddha to his patients) has extensive experience treating patients with sleep problems. And the number of patients he is seeing with sleep disorders is on the rise.
In Better Sleep, Happier Life, Dr. Buddharaju teaches seven simple, practical, and natural methods to help you get better sleep in order to refresh your mind and body. Filled with wisdom from his years of experience as well as simple lifestyle changes, Better Sleep, Happier Life can help you find rest and refreshment in the midst of your busy life…and reap the benefits.
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“Dr. Buddharaju dissects the most complex sleep science into simple practical strategies that can be put to use by anyone!” —Murali Ankem, MD, MBA, Associate Dean School of Medicine at University of Louisville
“Dr. Buddha provides a much needed integration of science, patient experience, and common sense to guide both professionals and lay people in this underappreciated influence on our productivity, health and happiness.” —Sean R. Muldoon, MD, MPH, MS, FCCP, FACPM, Chief Medical Officer at Kindred Healthcare Hospitals
“Concise, easy to read... All you ever cared to know about sleep is incorporated in this fascinating book by Dr. Buddharaju, a well accomplished sleep specialist. A must-read for all.” —Kizito Ojiako MD, FWACS, FRCS (Eng), FCCP, Vituity Medical Director, Critical Care Medicine, Amita Health Saints Mary and Elizabeth Medical Center, Chicago, IL, Assistant Professor of Medicine, Rosalind Franklin University of Medicine and Science, Chicago, IL
“Dr. Buddha gives readers exactly what they care about and need to hear--an easy-to-understand and practical outlook not only on how sleep impacts our physical health, but also how it strengthens our passions, mindset, and creativity.” —Shubha Vedula (Shuba) American Idol Semifinalist and Recording Artist
Dr. Venkata Buddharaju (or Dr. Buddha, as his patients call him) is a fellowship-trained physician at the Albany Medical Center in Albany, New York. He is Board Certified in Internal Medicine, Pulmonary, Critical Care and Sleep Medicine from the American Board of Internal Medicine.
He now teaches and consults at hospital intensive care units and pulmonary units as well as sleep medical practices. He is a Clinical Assistant Professor of Medicine at the University of Illinois at Chicago (UIC) and teaches medical students from UIC, Chicago Medical School and Internal Medicine resident trainees at Weiss Memorial Hospital in Chicago.
He directs the Sleep Disorders Center and Clinic at Thorek Memorial Hospital in Chicago and serves as a Section Chief of Pulmonary & Critical Care at AMITA Health Saints Mary and Elizabeth Medical Center Chicago where he teaches Internal Medicine and Family Practice Residents while working in ICU as an Intensivist. Additionally, he is president of the medical staff at Kindred Chicago Lakeshore and Central hospitals. Dr. Buddharaju has numerous medical-device patents and is working to develop more patient friendly medical devices. Throughout his career, he has conducted clinical research, published his work in various medical journals, and worked to develop and implement high quality patient-care policies. He believes strongly that balancing natural healing practices with traditional medicine is important for the future of effective health care.
Over the decades, humans have gradually reduced the time they spend in quality sleep and are awake longer in a twenty-four-hour time cycle. According to a study by the Centers for Disease Control and Prevention (CDC) and other studies, about 35 percent of US adults are not getting the recommended seven to nine hours of sleep on a regular basis. Even teenagers, who need extra hours of sleep (eight to ten hours), are spending less time sleeping. According to a 2006 National Sleep Foundation poll, 87 percent of US high school students get far less than the recommended eight to ten hours of sleep.
Some of the consequences of poor sleep are anxiety, depression, suicidal thoughts, obesity, diabetes, hypertension, stroke, heart attack, excessive daytime sleepiness, poor concentration, and an increased risk for motor vehicle and other accidents. In addition to these worrisome health consequences and sleep deprivation’s impact on the body and mind, America’s lack of sleep is costing billions of healthcare dollars.
Humans live an average of sixty to eighty years, depending on where they live on the planet. People live much longer in some parts of the world than they do in others. The people of Okinawa, Japan, report one of the world’s highest life expectancies. In general, across the world, human life expectancy has steadily increased with advances in infection control, technology, and medicine. However, one thing that has not changed is the medical community’s recommendations for sleep time and duration.
We spend approximately 40 percent—a third of our lifetime—asleep, which we don’t remember, except for occasional dreams. At sunset, our brain releases a chemical substance called melatonin, which makes us sleepy and helps us get into sleep mode. Wake-promoting hormones decline at this time of day, and sleep-promoting substances increase
with the onset of sleep. Caffeine, alcohol, or other substances we consume can interfere with this balance and cause sleep difficulties such as insomnia and poor sleep quality.
Our brain clock, called the circadian rhythm, wakes us up at sunrise, bringing us to a conscious level so that we can function optimally throughout the day. The longer we are awake, the higher the concentration of adenosine, a sleep-promoting neurotransmitter that we need at the end of the day.
This sleep-wake cycle has evolved over thousands of years in various species, including humans. This cycle continues unabated unless interrupted intentionally by activity, diet, stress, or other health conditions.
A good night’s sleep prior to a major performance—such as a musical concert, athletic match, important academic test, or corporate presentation—is key for optimal performance. A well-rested brain and body feel more positive and perform much better. On the other hand, students who stay up too late and sleep only a few hours prior to a major exam, do poorly on the test due to their lack of ability to focus. That’s because the information that was learned during their awake state is stored in memory centers of the brain during sleep, particularly in deep Rapid Eye Movement (REM) sleep, which is when most dreams occur. They have not given their brain enough sleep time to process the information that they learned during the day. As a result, they do not retain the information they have learned.
The vicious cycle of sleepless nights and daytime worry due to less than optimal performance makes things worse. The two feed one another. But, by making small changes to your lifestyle and eliminating distractions, you can open up the door for more focused attention. This will lead to increased productivity at work and more success at both work and home. These changes should bring needed sleep and a chance to live a happier life. Lifestyle modification involves removing distractions. I hope you will find the information in this book valuable and helpful in bringing about the necessary yet simple changes to get better sleep and lead a happier life.
Chapter 1: Sleep Basics
Nature amazes me. As I sit writing this book, I wonder how the Earth is at a perfect distance from the sun, so that life here has just enough light and heat. I marvel at how the Earth has rotated around the sun for more than four billion years, creating our seasons, while continuing to spin on its axis, which causes day and night.
Nature plays a vital role in shaping sleep patterns for all creatures on Earth. Birds, butterflies, fish, mammals, and even plants respond to light-dark cycles. Humans can’t ignore nature’s long-established sleep patterns, either. Before digital technology, humans awoke with sunrise, spent most of their time in nature, and rested after sunset. They maintained natural circadian rhythms.
While other species have continued to follow natural patterns, human curiosity has caused us to seek improvements to our lives. We have invented comforts like artificial light, televisions, computers, and cell phones. But exposure to natural light at the right time of day is crucial to maintaining a proper circadian rhythm. Unfortunately, we are now constantly exposed to artificial light and technology inputs throughout the day and night, making it difficult for many of us to fall asleep.
What is Sleep?
Sleep is a need-based, reversible, unconscious state induced by changes in the brain. For sleep, people typically assume a supine or sitting posture, become immobile, close their eyes, and experience decreased response to external stimulation. Brain waves, eye movements, and muscle tone can be very different during the various sleep stages.
Sleep is as natural as drinking when thirsty. We can voluntarily postpone sleep in order to fulfill our daily obligations. We can yawn, move around, walk, talk, and even drink caffeinated beverages to fight our need for sleep. However, we can only do so much postponing before nature steps in to take over.
When we sleep well all night, we feel good the next morning and are happy and ready to handle life’s daily tasks. On the other hand, we can feel miserable, irritable, and not so happy after a night with fewer sleep hours or poor sleep quality. Ideally, people need a longer, uninterrupted, deep night’s sleep to achieve their best during their wake periods.
Without adequate sleep, life becomes miserable and we risk high blood pressure, stroke, and heart attack. We may also experience poor decision making and memory, feelings of stress, and be more prone to accidents. Studies have shown that the flu and pneumonia vaccines are more effective when someone sleeps well the night before the vaccination is given.
Sleep and the Brain
Interesting things happen in brain circulation during sleep, especially during deep sleep stages. Accumulated proteins, called amyloids, and other waste products and toxins are slowly washed away via a system of interconnected structures called the glymphatic system.
Sleep restores the mind and body so that we have the energy we need, can focus during the day, and are capable of cognition. While awake, the brain accumulates several waste products. Scientific studies have shown that sleep clears them. If not cleared, they may lead to neuronal damage and increase the risk of dementia.
A recent Boston University study that was published in Science Journal showed that water-like fluid surrounding the brain, called cerebrospinal fluid, pulses like waves during sleep and may help to flush out toxic, memory-impairing proteins from the brain. This study and others have shed light on how sleep disruption and lack of sleep can contribute to memory-impairing conditions like Alzheimer’s and age-related memory loss.
Bits and pieces of what we learn during our waking hours are stored in the brain in memory banks during sleep. This is called memory consolidation. It is one of the main reasons that learning happens primarily during deep sleep.
Sleep is divided into two main states: non-rapid eye movement sleep (NREM) and REM sleep. NREM is further divided into three stages. Normally, we enter into stage one of sleep 10 to 20 minutes after closing our eyes. It lasts a few minutes and then flows into stage two, which is another lighter sleep stage that lasts a little longer than stage one. Finally, the deeper sleep, also called slow wave sleep, of stage three arrives. This is when most of the body and mind restoration happens. NREM and REM cycles alternate every ninety to one hundred minutes with approximately four to six cycles during a seven-to-nine-hour adult sleep period.
NREM sleep comprises 75 to 80 percent of sleep time. It dominates the first third of the sleep period, with gradual progression from Stage 1 to 3 in slow wave sleep.
REM sleep, which accounts for 20 to 25 percent of sleep, occurs sixty to ninety minutes after sleep onset, and dominates the last third of the sleep period.
Most of the scientific community that studies sleep recommends 7-9 hours of sleep duration for young adults and adults (18-64 years of age) to maintain good health. Older adults (65 and above still need 7-8 hours of sleep, where as teenagers (14-17 years) need 8-10 hours of sleep, school age children (6-13 years) need 9-11 hours, Preschool age children (3-5 years) need 10-13 hours of sleep.
According to research, people who sleep six hours or less have significantly more lapses in psychomotor vigilance testing. Yet, according to the National Sleep Foundation (NSF),only 10 percent of American adults prioritize sleep over other aspects of life.
I once had a patient who was a cab driver. He worried about losing his driver’s license due to his declining health. He worked long hours, his blood pressure and blood sugar were elevated, and he had gained weight eating a high carb diet and not exercising or sleeping regularly. He drove a cab to pay for his son’s college tuition. Work up and evaluation found no sleep disorder. He simply wasn’t sleeping the required number of hours. After counseling on sleep, he was able to make changes to his priorities, able to sleep better and returned to a happy and healthy life.