The Single Most Important Health Habit

Have you ever had one of those days that never seemed to go that well from the minute you heard the alarm clock go off? Maybe you forgot your CAC card at the house, missed breakfast, lost your temper when someone cut you off on your way to work, reflexively sent an email response that you really wished you hadn’t, you ate poorly all day, couldn’t concentrate on a thing at work, and then couldn’t find the energy to go the gym?

Welcome to the experience of sleep deprivation.

Daniel T. Johnston, MD, MPH LTC, US Army, MC Medical Director, Comprehensive Soldier Fitness

Unfortunately not getting enough sleep is all too common in the military and across the US–it’s often looked at as a “badge of courage” or the “price you pay” to get ahead. Some sacrifice sleep for social activities at night; often mixing sleep loss with alcohol consumption with further worsens the issue. Bottom line, not getting enough sleep is pervasive, not ranks discriminatory, and has big negative effects on you personally (relationships), medically (your health) and professionally (career advancement, mistakes made on the job).

Research has shown that the effects of sleep loss have the same affect on performance that alcohol intoxication does. So, coming to work sleep deprived, is like coming to work drunk if you look at just performance alone. There is also plenty of internal damage going on in addition to the outward effects we see with sleep loss. In fact, sleep loss has a ripple effect into virtually every dimension of health and wellness to include the physical, emotional, social, family and spiritual (the five domains here at Comprehensive Soldier Fitness). It affects you biologically and personally; increasing your rates of disease and costing you personal relationships and possibly your professional reputation.

Sleep deprivation can be a by-product of mission demands, of course. However, all too often we are trading sleep for that one more article to surf on the web, one more television show or video game, one more email, or one more drink out with your buddies.  Sleep loss also affects our direct job performance and has a huge impact on safety. In the military, we occasionally use sleep loss as a weapon on the battlefield; wearing our enemy down through non-stop engagement; the problem is that can backfire on us too. So senior leaders are cautious and extremely careful of employing this tactic and when it is used, only for specific, organized and orchestrated periods of time allowing for a full rest and recovery before massive errors occur that can cost lives.

I believe sleep is the single most vital wellness function we do every single 24 hour period and yet it requires no treadmills, no weights to be lifted, no personal trainers, and not even a special set of clothes. It has dramatic implications on our entire body and sets you up for success everywhere else. It’s commonly overlooked at the doctor’s office because we as physicians don’t understand exactly how it works and it’s difficult to test for (in fact, there is not standardized medical test to see if you are getting enough sleep). But that is no reason to ignore the health treasures afforded to those who get a great night’s sleep on a regular basis.

On average, in our entire life, we spend 20-25 years of our lives sleeping and 5-7 of those are spent dreaming in the critical period known as “REM” or “Rapid Eye Movement”. Unfortunately, many of us look at this time as wasted! Not true—it can be some of the most glorious “unconscious” time to improve our health!

During REM periods which occur at regular intervals throughout a night of good rest (not impaired by alcohol, caffeine, or other drugs) our brainwave patterns register signals that are very similar to those produced when we are awake and concentrating and we secrete growth hormone as well. We are actually intensely concentrating and focusing for several hours throughout a good night’s rest and repairing our bodies! Your brain, the center of all health, is exercising while you lie quietly in dream-land! What do you think happens if we destroy the quality of that REM sleep? Poor performance, inattention, obesity, hormonal imbalances, poor appetite, lack of normal growth, high blood pressure, poor interpersonal skills, no energy for the gym, possibly diabetes, and the list goes on and on.

As mentioned, during sleep we secrete hormones that repair tissue and renew microscopic damages to cells and organs before they develop into bigger problems.  Getting good amounts of sleep means you will live longer and experience less disease. You will retain information better, perform better, and get more out of your work outs. You will be more patient with others, less demanding and prone to anger, and vastly improve your social and physical dimensions of Comprehensive Soldier Fitness which is a crucial piece of your overall health. It will likely also benefit your family relationships. Don’t overlook the simple beauty of a good night’s rest because most people do.

Additional information (Summary of Sleep Loss Effects)

Immune system: If you sleep on average less than 7 hours, you are three times more likely to get sick. Do you know that your immune system is also constantly surveying and killing cells that can develop into cancer?

Weight Control: If you don’t get enough sleep, chances are you will be battling obesity. A 2008 review article in the journal Obesity looked at 36 different studies and the relationship between sleep duration and body weight. There seems to be an especially strong association with children…guess what is virtually an epidemic in this country? That’s right–childhood obesity. Make sure your child is getting enough, for their weight and performance in the classroom, children need significantly more sleep than adults! Sleep loss disrupts normal hunger and appetite through hormonal mechanisms and the resulting daytime fatigue often discourages you from exercising. Of course obesity carries with it all its own health problems.

Mental Illness: People that don’t get enough sleep are four times more likely to develop major depression according to a recent study looking at 1,000 adults over a three year time period. In young children and teenagers this seems to be especially true–where sleep deprivation on a regular basis precedes depression 69% of the time and anxiety 27% of the time. And worst yet, these can be the groups that just don’t see the need for sleep and due to social pressures, feel the need to stay up, online and texting with their friends.

Diabetes: Thought to be the result of the hormonal changes, people with regular sleep loss have a three-fold higher incidence of type II diabetes. And you know what this means–heart disease and other health complications. Who would have ever thought that sleep had anything to do with your metabolism of sugar? Well, it does!

High Blood Pressure: If you sleep less than six hours per night, you have a three and one half times greater risk of developing high blood pressure, another major factor in heart disease. This was described in a 2009 Journal Sleep that looked at over 1700 men and women.

Heart disease: Even short term sleep deprivation increases your risk of heart disease by elevating your cholesterol, triglycerides, and blood pressure. And if you have sleep apnea–this greatly increases your risk of irregular heart beats, stroke, and heart failure.

Risk of Death: Well, and if all that just isn’t enough for you to start sleeping more, people that short themselves on sleep have a 1.3 fold risk of death overall, and this is much greater if you have sleep apnea.

Performance Decrements: So often I hear people wanting to stay up to study more or prepare for a big speech or think about their moves on the athletic field. Forget about it and go to bed. Those extra hours rehearsing will only hurt your performance and you are much better off trading the sleep for less preparation so that what you have prepared for will be executed with precision, accuracy, and grace; no matter what you are doing.

I hope that you start taking sleep very serious for your health, wellness, performance and if you have children, for their sake. You will be a better parent when responding to their needs and you will instill habits in them that also reap their own rewards both academically and physically. Sleep affects everything about a person since it affects your brain so make it a regular part of you (and your family’s) wellness routine.

Blog post submitted by 

Daniel T. Johnston, MD, MPH

LTC, US Army, MC

Medical Director, Comprehensive Soldier Fitness