Sound Body

Resolutions to sleep on

Getting a full eight hours doesn’t just make a difference the next day — it can affect your health

By Stephen Smith
December 27, 2010

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You could resolve to exercise more (although that home treadmill makes such a lovely clothes rack).

You could resolve to eat less (right after polishing off that piping-hot sticky bun).

Or, with the bright promise of a new year aborning, you could . . . curl up in bed and sleep your way to a healthier you — although that might require abandoning those Calvinist impulses that sleep is the refuge of the slothful.

“Making a resolution to sleep more is almost antithetical to what New Year’s resolutions are about,’’ said Dr. Charles Czeisler, chief of the Division of Sleep Medicine at Brigham and Women’s Hospital. “Many people don’t realize that by sleeping more, they can achieve so many of those things, and it’s actually pleasant.’’

But that doesn’t mean it’s going to be easy. Many Americans’ lives read like the “Legend of Hollow Sleep.’’

An annual survey, conducted by a polling agency for the National Sleep Foundation and evaluated by university-affiliated specialists, found that most people feel well-rested only a few times a week and that many of us trudge along with fewer than seven hours of sleep, less than what’s considered optimal for most adults.

Sometimes, fitful sleep is evidence of a serious medical condition such as sleep apnea, a disruptive disorder tied to erratic or shallow breathing while slumbering.

In other cases, though, the sleep-deprived simply fall prey to the siren call of a never-off-the-grid society. There’s the flat-screen TV howling from the wall, and the BlackBerry chirping on the nightstand, and the late-afternoon cup o’ joe to rev you up for a 12-hour workday. Who has time to sleep, really?

“We have all these inducements to stay awake and do stuff, to watch television, read, computer stuff, Twittering, Facebooking,’’ said Dr. Sanford Auerbach, director of the Sleep Disorders Center at Boston Medical Center. “One hundred years ago, after dinner, people would sit around and tell stories or play music. They didn’t have this great array of things to keep them going.’’

Running a sleep deficit, it turns out, can have very real consequences for the balance sheet of life.

Research shows that sleeping too little — say, six hours a night or even less — can cause hormones such as leptin and ghrelin to go haywire. They’re prime actors in appetite regulation, and when we fail to get enough rest, cravings for calorie-laden food can be inflamed, sparking weight gain.

Sleep deprivation also affects insulin, the hormone pivotal to efficiently processing sugar. And that’s why scientists believe there’s a link between sleep loss and diabetes, a condition caused when insulin is out of whack.

Researchers have also found that sleep deprivation exacerbates the risk of heart disease. A 2008 study tracked nearly 500 Chicagoans and discovered that volunteers who got an extra hour of sleep were 33 percent less likely than the sleep-stunted to have dangerous plaque gumming up blood vessels.

Forfeiting sleep even leads to weary disease-fighting soldiers in the immune system. In a study published last year, scientists found that when they gave volunteers nose drops seeded with cold virus, participants who slept less than seven hours were nearly three times more likely to get sick than those who rested at least eight hours. Similarly, researchers have found that when the well-rested get flu and hepatitis A shots, they mount a more robust immune response than the sleep-deprived.

“With smoking, it took decades of research for people to believe it’s bad for you. Everybody accepts at face value that sufficient sleep is important because we know how it feels,’’ said Dr. Matt Bianchi, a neurologist at Massachusetts General Hospital and faculty member of the Harvard Division of Sleep Medicine. “But we’re actually accumulating more and more studies proving the long-term risks of insufficient sleep and, by extension, the long-term benefits of making sleep a priority.’’

Sometimes, the effects are as plain as the nose on your face — or the circles under your eyes. A small pilot study published this month in the British Medical Journal found that when people were shown pictures of the same person — one taken after a good night’s rest, the other snapped after a dearth of sleep — the weary were judged less healthy and less attractive. The differences were small but statistically valid.

“My daughter once looked at the ‘Sleeping Beauty,’ and she asked, ‘Is the Sleeping Beauty so beautiful because she slept so much?’ ’’ said John Axelsson, a sleep researcher at the Karolinska Institute in Stockholm and leader of the study on the cosmetic effects of sleep deprivation. “As a scientist, I have to tell children the truth. There was no scientific evidence for beauty sleep.’’ Until now.

Donato DeNovellis saw the effects of sleeplessness in his own life for decades. The 65-year-old retired chief financial officer from Andover sometimes muddled along for as long as three days without meaningful rest.

“As I jokingly told people,’’ said DeNovellis, diagnosed with insomnia and sleep apnea, “I became the neighborhood night watchman, patrolling the halls of my house, looking out the windows and seeing who would come and go.’’

Initial treatments did little to ameliorate the problem. Bianchi, the Mass. General sleep specialist, had a hunch and further testing showed DeNovellis had a particular kind of sleep apnea that called for a particular kind of breathing apparatus, which he now uses regularly. He’s sleeping well now, and certain conditions he suffered, including high blood pressure, have improved.

“I’ve actually introduced new phrases into my portfolio of phrases,’’ DeNovellis said. “The one I never used before that I use now is, ‘Gee, I’m really sorry. I overslept.’ ’’

Along with the breathing machine, DeNovellis has other strategies for getting a good night’s rest, including no caffeine past late morning and no TV past Jay Leno’s monologue. There are plenty of other tactics, and here’s a sampling, provided by sleep specialists.

Stephen Smith can be reached at

Schedule your sleep

Come up with a routine that incorporates ample sleep. Don’t make going to bed something that’s subject to the whims or vicissitudes of daily life. “Some people stay up as long as they can until they can’t stay awake any more rather than trying to anticipate and go to sleep a little earlier,’’ Boston Medical Center’s Auerbach said.

Make the bedroom a sanctuary for sleep

Don’t keep a cellphone or BlackBerry on the nightstand, and allow no TV or computer in the bedroom. “It’s a bad, bad, bad idea,’’ the Brigham’s Czeisler said. “People have been sleeping for tens of thousands of years without a television.’’ Studies have shown, he said, that people with a TV in the bedroom tend to sleep less soundly. The light and noise prove disruptive, with the light sending cues to the brain to be wakeful. The same is true for other devices, such as computers. “Stop doing these activities that excite you,’’ Axelsson, the Swedish researcher, said, “like watching ‘CSI’ with all of this blood.’’

No caffeine late in the day

This seems obvious and, yet, it’s a recommendation many of us ignore. We slug back coffee and tea to get us through the late afternoon and evening, and then, when bedtime arrives, we lie with weary eyes peeled. And remember, caffeine lurks in lots of other products, including chocolate and soft drinks.

No double cheeseburgers late at night

If you’re getting ready to tuck into bed, it’s probably not a great idea to tuck into a calorie-rich, fat-heavy meal. “A light snack is fine but not an actual meal,’’ said Mass. General’s Bianchi. That means, for example, choosing a couple of slices of toast and maybe a glass of juice an hour or two before bedtime. Getting your body into the habit of expecting a hulking meal late in the day could interrupt natural sleep and waking cycles. It could also have an adverse effect on the hormones and sugar involved in processing food and regulating appetite and, potentially, lay the groundwork for obesity and diabetes. “But it’s not an all-or-nothing thing,’’ said BMC’s Auerbach, noting that the sedating power of a late-night snack could induce elusive sleepiness.

Don’t check work e-mail at bedtime

Who hasn’t done it? You log into your work e-mail for a quick peek before turning in for the night. “And that’s when you get the e-mail sent three hours earlier from your boss saying, ‘Can you do these 45 things before work tomorrow?’ ’’ Czeisler said. “That’s not what you want to get right before bedtime.’’

Avoid things that rev you up at night, including cardio exercise and tense discussions

As bedtime approaches, don’t slam on the brakes and come to a screeching halt. Instead, consider taking a warm bath or pulling on warm socks. The process of getting warm and then cooling eases the body into a state of sleepiness. And try to avoid late-night outings to joints with bright lights and other stimuli. “In England, they have all of these pubs that close at 11 o’clock.’’ Axelsson said. “When I was young, I thought it was stupid. Now, I think it’s a great idea. If you don’t know at 11 o’clock it’s time to go to bed, it’s good that someone tells you.’’

Focus on your waking time each morning, more than your going-to-bed time

Mass. General’s Bianchi makes the argument that it’s more important to be consistent with the time you arise than when you crawl under the covers. “If you try to go to bed and you’re not tired, you’ll lay in bed hoping you fall asleep or trying, and then that creates anxiety that you’re not being successful, and then that keeps you up later,’’ he said. By sticking to a waking-up time, that can adjust your sleep schedule so that you naturally begin going to bed at a more routine time — without the pressure.

Use a bedtime alarm clock

Czeisler recommends using an alarm clock to alert you when it’s time to go to bed. “Instead of just having an alarm clock to wake you up, have the thing go off at 9:30 in the evening,’’ he said. “You can hit the snooze button a few times.’’ In fact, it’s a good sign if you don’t need an alarm clock for awakening. That means your body is adjusting to appropriate sleep rhythms and that you’re getting enough sleep.