Understanding Sleep Body, Mind & Social

DR. MICHAEL GRANDNER IS A RESEARCH PSYCHOLOGIST AT THE UNIVERSITY OF

PENNSYLVANIA. THE PRIMARY FOCUS OF HIS RESEARCH IS TYPICAL SLEEP PATTERNS AND HABITS AND HOW THEY RELATE TO HEALTH OUTCOMES. THIS ARTICLE IS BASED ON A DISCUSSION WITH DR. GRANDNER AND A MEMBER OF THE AMERICAN SLEEP & BREATHING ACADEMY.

U N D E R S T A N D I N G S L E E P : BODY, MIND & SOCIAL

BY JENNIFER TAYLOR

BIOPSYCHOSOCIAL MODEL OF SLEEP MEDICINE

The biopsychosocial model of medicine promotes the notion that wellness is tied not only to biological factors but also psychological and social elements. Dr. Grandner believes the discipline of sleep medicine is best explained using a biopsychosocial model. That is, sleep can be best understood by investigating a person’s body and mind and the social aspects of his life.

Body

body structure, heart rate, body temperature, circadian rhythms

Psychological

stress, mental activity, mood, attitudes, beliefs

Social

family, friends, work, routines

GETTING OPTIMAL SLEEP

Typically people feel most rested and function best when they sleep 78 hours each night. Dr. Grandner advised, “It should take you a few minutes to fall asleep when you go to bed. If you fall asleep immediately when your head hits the pillow, you either aren’t getting enough sleep or you ’re going to bed too late. ”

Research shows that people sleep best when it’s dark, slightly cool, and when they are comfortable. Even a little bit of light at night can disrupt biological rhythms, so you should keep your room slightly cool and as dark as feasibly possible.

Our bodies run on biological clocks known as circadian rhythms. Every morning this internal clock is reset by bright daylight. Our clocks can get messed up when we don’t get enough light during the day (such as during a long, northern winter) or when we get too much light at night (such as when we watch TV or use digital devices in the evening). If your biological clock isn’t in sync with your daily schedule, you may feel groggy or even depressed, but you can reset your clock by exposing yourself to bright light in the morning. You can even adjust your biological clock by up to an hour a day, training yourself to be alert earlier in the morning and go to bed earlier in the evening, by using light therapy.

Many people sufer from insomnia. That is, they either have a hard time falling asleep or they wake up in the night and have a hard time falling back asleep. Dr. Grandner said while many things can cause insomnia—illness, job stress, a family crisis—the initial cause of insomnia has little to do with long-term insomnia. That is, the original cause of insomnia usually goes away, but the insomnia persists. Why is that? When people first experience insomnia, they spend extra time in bed, hoping to get some extra sleep. But instead of sleeping, they spend a lot of time in bed, awake, doing

other things. They program their minds to stay awake in bed. Then, no matter how tired they are, they just can’t sleep well. To resolve long-term insomnia, people need to reprogram their minds by using the bed only for sleeping. That means if you wake up in the night, you get out of bed and do something for a little while and then go back to bed to sleep. It seems counterintuitive, but it works. You should sleep in your bed, and your bed should be for sleep and sex only. A lot of people use their beds for other activities, like work, reading, watching TV, playing video games, and talking. In general, the more“People who are sleep-deprived don’t think as clearly, they are not as able to make sound decisions, and they are more emotionally fragile.

C O N T I N U E D H

UNDERSTANDING SLEEP: BODY, MIND & SOCIAL

time you spend in bed doing things that are not sleep, the harder it will be to sleep when you ’re trying to.

Of course, if there’s a readily identifiable reason why you ’re up at night, you must address that issue directly. Biological, psychological, and social aspects of your life afect your sleep. For example, if you ’re angry, you ’re going to have a difcult time falling asleep. Don’t go to bed angry; work through what you can before you go to bed. Give yourself permission to let things go for the night; chances are you aren’t at your mental sharpest right before bed. In the morning, often things will look better or make more sense or you ’ll be able to see a solution you couldn’t see the night before.

EMOTIONS & MEMORY

Sleep serves some very important functions in terms of emotional regulation, so sleeping on your problems is genuinely helpful much of the time.

People who are sleepdeprived don’t think as clearly, they are not as able to make sound decisions, and they are more emotionally fragile. They are more prone to mood swings and do not derive as much pleasure from the things they would enjoy if they weren’t tired.

Brain research has shown that the areas of the brain that control memory and emotion are right next to each other. Memory is profoundly afected by emotions because emotions signal to our minds what is important. You may not remember what you ate

for breakfast last Tuesday, yet you remember what you ate for breakfast the day your mother passed away years ago; that’s because your mother’s death was a powerful emotional experience, so the memory is preserved in vivid detail. The intensity of the emotion surrounding diferent events afects how well you remember them more than whether the events were positive or negative. Even more profound, it has been determined that if you are able to change your feelings about an event, you will also change your memories of that event. In efect, you can “ spin” your own history.

PROCESSING INFORMATION AT NIGHT

How do emotions and memory relate to sleep? What really happens when we “ sleep on it”?

During the day, you take in information during every moment. You do things, you hear things, you learn things, you feel things. By the end of the day, you can be overwhelmed with data. That’s one of the reasons why it’s not best to make important decisions at night before bed. While you sleep, your brain processes the information it has taken in during the day. It determines what is important and what things mean. Some of this data processing manifests itself as dreams, which you may or may not remember upon awakening in the morning. Often, you ’ll find that something that stymied you at night before you went to bed makes sense to you

“Memory is profoundly affected by emotions because emotions signal to our minds what is important.

Dr. Grandner is a licensed clinical psychologist and Instructor in the Department of Psychiatry. He has published over 40 articles on issues relating to sleep and health appearing in journals including SLEEP, Appetite, Sleep Medicine, and JAMA. He currently serves on the Mental Health Task force of the NCAA. Dr. Grandner maintains leadership positions with the American Academy of Sleep Medicine, Sleep Research Society, and Society of Behavioral Sleep Medicine, and he is the outgoing President of the Pennsylvania Sleep Society. in the morning. Your mind has processed that information and knows what to do with it.

HOW DOES IT ALL FIT TOGETHER?

Sleep is essential—and complex—because it afects and is afected by every part of our lives. When you work with a person on improving his sleep, you are dealing with every part of his life: how he feels physically and emotionally, what he can do, his worries and fears, even what is important to him. That is why there is no “ one size fits all” solution for sleep problems and why it’s important to consider biopsychosocial elements that take in the broad view and treat the whole person.

Sleep medicine is a field that bridges the gap between traditional medicine and wellness. Sleep, like diet, is truly a pillar of health. Emerging solutions for sleep disorders, which often take into consideration multiple aspects of a person’s life, have a great impact on overall health and well-being. S&W