Caffeine and alcohol
If the statistics are right, every second person reading this is sleep deprived to one extent or another. One remedy we tend to turn to is caffeine. Caffeine disrupts the ability of a chemical called adenosine to latch on to receptors in your brain. Adenosine’s job is to create what is termed sleep pressure, a force determining how sleepy you feel. The caffeine stops this chemical effect by latching on to the receptors instead. The problem is the adenosine in your brain continues to accumulate just waiting for its chance to invade the receptors. Once your body has removed the caffeine, using enzymes in your liver, the adenosine rushes in and you get that almighty mid-afternoon coffee slump. So, to offset this, as you feel it taking place, you drink more coffee, or tea (normal or green), or caffeinated drinks, or eat chocolate – all of which usually include caffeine. This can have a knock-on effect later when you are trying to get to sleep. The half-life of caffeine (the amount of time it takes your body to deal with 50 per cent of the drug) is five to seven hours. So that cup of coffee you have at 6pm is only halfway out of your ‘system’ by midnight. And be warned, ‘decaff’ is not ‘no caff’. There is still about 15 to 20 per cent of the amount of caffeine in there compared to a standard cup.
Alcohol is not helpful in promoting good quality sleep either and falling asleep after a few drinks is not giving us the quality of sleep we need. While many of us can report falling asleep easily after a few alcoholic drinks the reality is alcohol is a sedative. So, you are sedated rather than asleep, and this disrupts the NREM and REM pattern we’ve already explored. Alcohol makes sleep fragmented so it ‘is therefore not continuous and, as a result, not restorative’ (Walker, 2018, p 271).
The impact of good sleep
Sleep helps to maintain both physiological and psychological function. Here again we see the link between the three elements of the self-care triangle. In order to exercise effectively we need to be maintaining adequate sleep. In order to maintain focus on sound nutritional intake we need to have the psychological energy to do so. In terms of the overarching concept of ‘being organised’ we need to be able to apply all of our psychological functioning to the mental effort of the day.
The result of a lack of both the right quantity and the right quality of sleep is poor attention, poor planning, diminished cognitive functioning and poor judgement. The impact on our productivity as a consequence of poor sleep cannot be overstated. Research has shown that just one night when you sleep for a maximum of four hours can make you so sleep deprived you are more likely to make errors and be less attentive (Nakamura et al, 2019). Now imagine the number of mistakes you’d make if you were having less than our eight hours of sleep night after night.
Many work-based cultures almost celebrate the sacrifice of sleep, applauding people who work late and turn in early. But a week of reduced sleep can create an impairment in functioning the equivalent of a 0.1 per cent blood alcohol level, similar to being drunk. You wouldn’t put yourself behind the steering wheel of a car under those circumstances, yet are left to make important decisions, about other people’s lives, while experiencing the same level of impairment as intoxication.
A bad night’s sleep can also affect your IQ level by a few points. On the other hand, a good night’s sleep has been shown in research at the University of California Berkeley to make people twice as effective at spotting complex patterns in information; the research has also shown that people are able to solve 30 per cent more anagrams after a period of rest that included REM sleep (Webb, 2017). Sleep improves our cognitive function and skills like analysis and critical thinking.
Barber et al (2014) found better sleep practices could reduce the negative feelings people experience when placed under stress. People may respond less negatively towards the circumstances of the day when well rested and respond better to the rigours of the job. Also, better sleep may actually increase how much people feel in control of the stressful situations they encounter. This is possibly as a consequence of how much energy they feel they have to confront the situation, be that either psychological or physical energy, or both.
Schulz and Burton (2018, p 1640) state that a study of nearly 600,000 adults in a range of industries showed ‘Employees who achieved optimal sleep levels of 7 to 8 hours per night had the lowest average number of health risk factors, the smallest productivity losses, and lower odds of having several health conditions compared to poor sleepers.’ Surely then there is a role for us on an individual level to take care of ourselves but also for employers to invest in education for their staff about sleep. Businesses and organisations need to take a careful look to see if the working environment they have established is impacting negatively on the sleep of their staff and consider changes to ensure it is supportive of good sleep practices. While I believe self-responsibility is so important to self-care, organisations need to accept the impact of professional roles and also support staff in appropriate ways.
If we can achieve good sleep what can we expect? Dr Rangan Chatterjee, in his ‘4 Pillar Plan’ (2018), gives us the following list of benefits of a good night’s sleep:
increased energy;
improved concentration;
greater capacity to learn;
better ability to make healthy food choices;
improved immune system function;
enhanced autophagy (the way the body clears out damaged cells);
better memory;
increased life expectancy;
reduced risk of being overweight;
reduced stress levels;
reduced risk of developing chronic disease eg type 2 diabetes and Alzheimer’s.
(Chatterjee, 2018, pp 206–7)
Sound advice
The National Health Service (NHS, 2016) offers some simple, straightforward advice to improve your sleep environment and practices that may help. It would be useful to look at each of the ideas in turn.
Keep to a regular bedtime routine
Remember it’s not just babies that need a routine, it’s any human being. Much as we kick against it as adults, we are creatures of habit and routine. Your body is programmed into a chemical routine that does its best to achieve sleep, rest and waking. And what do we do? We ignore it! We stop up late and wonder why we are tired the next day. We get up late and wonder why we then can’t get to sleep the next night. We self-medicate with alcohol and caffeine to get that little bit more out of the day and out of our social life. Someone once said to me, ‘Drinking coffee steals hours from later in the day and drinking alcohol steals hours from tomorrow!’ All we achieve is the disruption of our programmed chemical clock and when we don’t attend to it for long enough the situation becomes chronic. You should establish a pattern of sleep that fits your biological clock and you should maintain it seven days a week, 365 days a year.
Sleep at regular times
This will train your brain and internal body clock, aligning you to a natural sleep pattern. As we’ve seen, we need around eight hours of sleep a night and we should be sleeping from about 10pm to 10.30pm until 6am to 6.30am. These timings are in tune with our natural rhythm. So that’s your starting point.
Don’t go to bed hyped
While exercise is an important aspect of self-care (see Chapter 4) you should avoid it for two or three hours before bedtime. A good way to wind down is to have a warm bath – again, isn’t that part of the routine we give babies? There’s a drop in your core