Sleep Deprivation

In our roles as preparedness experts for disasters and epidemics, we’re often asked to come on various media outlets to give our opinion, mostly on medical issues. Occasionally, we get the interview request that seems to be a medical topic but has obvious political overtones. Just yesterday, a radio station asked me to comment, as a doctor, on whether Donald Trump’s 4-hour a night sleep habit impacts his ability to make rational and sound decisions.

As for my opinion on this particular question, I’ll refer you to americansurvivalradio.com, but suffice it to say that he’s actually in pretty good company with regards to sleep habits.  Five hours was reported as a good night’s sleep for Bill Clinton while president. Winston Churchill liked naps but slept little at night. Martha Stewart is just one of many business leaders that get less than the recommended 7-8 hours per night. There are, in fact, quite a few highly successful folks who seem to do just fine with little shut-eye.

Sleep deprivation is a pretty serious issue: Some researchers believe that it can carry a mortality risk approaching that of cigarettes or heart disease. Indeed, sleep deprivation has been used as a torture method in interrogations. The CDC estimates that up to 50-70 million Americans suffer from some kind of sleep disorder. In the aftermath of a major disaster, you can imagine that issues with sleep deprivation will only increase.

How does sleep deprivation decrease your chances of succeeding in times of trouble? Not getting enough sleep can significantly impair your brain’s function. The parts of the brain involved in alertness and attention (the thalamus) and the area that controls many higher-level thought processes (the prefrontal cortex) are especially vulnerable.  If the brain doesn’t get enough rest, you may become incapable of putting events into the proper perspective and taking appropriate action, a pretty big issue whether you’re president of the United States or the survivor of a major disaster.

Scientific studies bear this out. Indeed, The British Medical Journal equates the effects of 17-21 hours without sleep as the equivalent, in terms of affecting behavior, of having a blood alcohol level close to the legal limit of intoxication. A number of articles that evaluated the performance of medical residents show that those getting less than 4 hours of sleep made more medical errors that residents who slept 7-8 hours a night.

What about the elderly? Don’t older people naturally sleep less hours and less deeply? Studies show that that the elderly do get less sleep, but it’s not necessarily because they need less. Sleep could be affected for all sorts of reasons: sleep apnea, arthritis pain, heart issues, etc. Those in their later years also might develop something called “advanced sleep-phase syndrome”. These folks’ bodies want to go to sleep earlier and wake up earlier but their minds (and HBO, I expect) keep them from getting to sleep at a reasonable hour. Result: Sleep Deprivation.

In addition to what’s happening in your brain, the failure to get 7-8 hours of sleep every night causes a whole set of symptoms, none of which are particularly good for a survivalist. Here are just some:

• Irritability
• Depression
• Tremors
• Bloodshot, puffy eyes
• Headaches
• Confusion
• Memory loss
• Muscle aches
• Hallucinations and other psychotic symptoms
• Ill effects on control of diabetes and high blood pressure
• Blackouts lasting up to 30 seconds (also called “microsleeps”)

There are a number of people that seem to function just fine with less than the average number of sleep hours. No one is quite sure why this is so, but it appears to involve about 5% of the population and may be related to genetics. For the rest, it rapidly becomes clear that they need more sleep.

There are things that you can do to get a few more hours of shut-eye each night. The best start is to consider a concept we’ll call “sleep hygiene”.  Sleep hygiene involves adjusting your behavior to maximize the amount of restful sleep you get.  Consider:

• Sticking to a standard bedtime and wakeup time
• Making your nighttime environment as comfortable as possible
• Avoiding Nicotine, Caffeine, and Alcohol before going to bed.
• Staying awake from heavy foods for at least 2 hours before going to sleep
• Exercising regularly, but not right before going to bed
• Eliminating as much light as possible in the room at bedtime
• Keeping your mind clear of stressful issues at bedtime

After a disaster, many of the above strategies are difficult to implement. Of course, there are drugs like Ambien and Halcion that you can use, but a better alternative to start with might be some form of natural sleep aid.  Some of the common alternative remedies for sleeplessness include the following teas:

• Chamomile
• Kava Root
• Lavender
• Valerian Root
• Catnip

Good nutrition is important for general health, but some foods are also thought to be helpful in promoting a good night’s sleep.  They contain sleep-inducing or muscle-relaxing substances like melatonin, magnesium, or tryptophan. Some examples:

• Oatmeal – melatonin
• Milk – tryptophan
• Almonds – tryptophan and magnesium
• Bananas – melatonin and magnesium
• Whole wheat Bread – helps release tryptophan

Yoga, massage, meditation, sound machines, and even acupuncture might also be effective ways of dealing with sleep deprivation.

Staying healthy in normal times or in the aftermath of disaster involves, not only maintaining good physical hygiene, but maintaining good sleep hygiene as well. To be at 100% efficiency, get some rest!

Joe Alton, MD