Sleep deprivation represented by a cartoon of an alarm clock (the old horrible ones with a hammer hitting small bells) — Alarm Clock Ringing by Nemo

Sleep deprivation has been (is) a norm in my life since I started school, mostly because school meant having to get out of bed to go somewhere long before I was ready to get out of bed.

For a long time I saw it as something normal. I would sleep 4-5 hours in the weekdays and then catch up in the weekends. However this routine did not always work out that smoothly. I almost got flunked in high-school for missing way too many morning classes. It also turns out, science has more or less proven that sleep deprivation isn’t at all healthy for you…

Sleep deprivation is harmful to health

Science has found that sleep deprivation is affecting several factors negatively [1], such as obesity [3], diabetes [4], cardiovascular disease [5], and mortality in general [2].

One study [7] of six young healthy men found that sleep deprivation caused a significantly higher diastolic blood pressure after total sleep deprivation (66.5 ± 1.7 mm Hg) compared to baseline control sleep (57.4 ± 3.3 mm Hg). I.e. a mean increase of 10 mm Hg (your doctor will tell you, in long term, that’s a significant increase).

Another study [8] found an even more disturbing effect of sleep deprivation; hundreds of genes starts to function differently when we are sleep deprived!

How much sleep is enough sleep?

Since both the blood pressure [7] and gene expression [8] effects could be proven after a short time (1 day for blood pressure and 14 days for gene effects) I figured my sleep regiment was not going to be healthy in the long or short run.

The next question to be filled in was; how much sleep do I need? Of course, you can just spend a vacation to get rested and then measure how long you sleep before you wake up on your own (this is what I did).

If you have a smart phone you can install an app that can help you keep track of your sleep times, among other things like sleep cycles (REM sleep vs deep sleep), total sleep debt, etc.

I would recommend Sleep as Android for Android. I would say this little app helped me going from “crawling out of bed totally stoned as if I was an undead on drugs” to waking up fairly alert and rested.

I say fairly not because the app has some flaw, but you still have to get your required amount of hours of sleep! For me, that amount is seven hours.

This number of hours falls within the norm of a study [6] of 669 persons in the ages 38-50 years, 58% women. This study found an over all average mean time in bed of 7.5 ± 1.2 hours, and a mean sleep duration of 6.1 ± 1.2 hours.

Change will be problematic

As of right now, I am in the middle of trying to even out my sleep hours for weekdays and weekends to all end somewhere around seven hours.

It turns out this change is messing with my internal clock, which seems to have some kind of “barrier” for when to feel “weekend drowsy” after more than average hours of sleep. The “barrier” seems to be somewhere around 6 hours of sleep.

So, during the transition period I’ll wake up drowsy and even oversleep.

Guess what? Most change like this has a tendency to be impractical, tiresome (no pun intended) and even painful – otherwise we would have performed the change a long time ago.

The good thing is that, just as the habit of sleeping less in the weekdays and longer in the weekends has a rewarding short term outcome, the pain of changing this pattern is also only short term.

Once my body adjusts to sleeping 7 hours a day, regardless of weekend or weekday, doing the opposite, current pattern will most likely feel painful, and even though changes in blood pressure and gene expression is fairly quick (short term?) changes such as obesity, cardiovascular disease and diabetes is long term effects, with even longer term (if ever) solutions.

Thoughts will try to trick me

My mind (thoughts) may still trick me into changing back to the old pattern of sleep, if for nothing else, for the initial pain of the change.

The main trick here is to simply accept that there will be a period of perhaps even less sleep satisfaction and alertness, until my body has caught up with the new regiment.

I can remind myself about the problems of the current sleep regiment – I have scientific sources clearly stating sleep deprivation is unhealthy.

I can also blog about it :D, and make it a “promise to the world”. After all, breaking a promise to yourself only means you need your own permission to break the promise for it to be okay…

My thoughts will also try to trick me into going back to the old, familiar way of sleeping. Here are some examples of thoughts:

“There will be no time to do anything more than work, eat and sleep in the weekdays if I don’t stretch them out a little”
“How do I know that the current sleep regiment isn’t exactly what my body needs?”
“I’ll perform bad at work if I’m so sleepy!”
“You can’t teach an old dog to sit”
etc etc etc

A part from reminding myself about the long and short term effects of both the old and new regiment I find the most effective way of handling these thoughts are twofold: Acceptance and cognitive decentration.

Acceptance to the rescue

I will accept my thoughts, and just let them say their peace. I will thank them for bringing this or that point up, and then I will return my focus to the objective.

If I try to stop a thought for instance by rejecting, opposing, analysing or evaluating (as good/bad/helpful/useless), the thought will be with me longer than if I simply accept it.

You can think of this as trying to move a beach ball under water as opposed to letting it float on the surface. Keeping the ball under is really hard work and sooner or later it will “explode” onto the surface, however moving it on the surface is really easy…

Unfortunately one strategy for avoiding a thought is to try to accept it. If acceptance becomes a strategy to avoid, it’s not acceptance any more. In order to truly accept I’ll just have to let my “thought space” be ruled by the thoughts while my inner eye or inner observer stays calm (more on that below), and even while the thoughts are trying to rearrange my mental furniture (or throwing it out the window) I can still go on working towards my objective.

A thought is not a decision, or even an opinion. An opinion has to be expressed by words or action for it to be an opinion! In fact, a thought has no more power than I give it! If I do not act on a thought it has no power at all!

Most disturbing or threatening thoughts are just something that pops up in my head, most likely sent there by a misguided self preservation – which is why rejecting or opposing the thought would be like rejecting or opposing self preservation… with is kind of “Darwin Awardish“.

Cognitive decentration to the rescue

Regardless of if a thought is in fact useful or not, I strive to have a first reaction that it is not, at least as opposed to running off and acting on the first thought that pops up in my head.

In order to determine if a thought is of use or not I need a moments pause, or some breathing space. In order to get this space I use cognitive decentration.

Cognitive decentration is a quite simple mind trick that uses the fact that your thoughts are not the same as your consciousness. You can watch a thought and analyse it with, what is some times called, the “inner eye”. I like to think about it as if I was in front of a theatre stage on which all my thoughts and emotions enter, say their piece and exit.

The best way to achieve this distance to thoughts is by describing them with a very simple formula.

Compare these two statements by thinking them silently to yourself:

I’m a failure.
I’m having a thought that I’m a failure.

How does the two variations feel? For me, the second one is far less threatening than the first.

The trick is to just simply state what just happened once more. When a thought about something threatening comes up, rephrase it by a simple observation of:

I’m having a thought that…
Here comes a thought that…
A thought comes up, stating that…

This has the effect of treating the thoughts as entities separated from yourself. Just because they exist in your head does not mean you have to explain or defend or defeat or reject them… you don’t even have to take responsibility for them… your thoughts are not actions.

Avoid evaluating the thoughts as good, bad, useful, worthless, evil, kind, nice, uncomfortable, etc. I.e. stay clear of both negative and positive labels.

So, when my thoughts above comes up, I will handle them like this:

“There will be no time to do anything more than work, eat and sleep in the weekdays if I don’t stretch them out a little”
I’m having a thought that there will be no time to do anything more than work, eat and sleep in the weekdays if I don’t stretch them out a little. Thanks for this… now when do I have to brush my teeth to get to bed in time?
“How do I know that the current sleep regiment isn’t exactly what my body needs?”
Here comes a thought asking how do I know that the current sleep regiment isn’t exactly what my body needs? Thank you for the pointer… OK, I should set up a calendar reminder for when I have to go brush my teeth…
“I’ll perform bad at work if I’m so sleepy!”
I’m having a thought that I’ll perform bad at work if I’m so sleepy! Thanks! So, should I set the reminder perhaps 15 minutes before I really have to brush my teeth?
“You can’t teach an old dog to sit”
I’m having a thought that you can’t teach an old dog to sit. Thanks! Maybe I should have one reminder an hour before, in order to get into “sleep mode”?

From the above “exchange” it may seem like I’ll ignore my thoughts, however, there is no danger in waiting for any further thoughts that have some worry they need to express. If a lot of thoughts come in a bunch, I’ll just restate them as they come.

The thought about work should prompt me to make sure the alarm clock goes off at the right time, if I don’t already has that in my plan. However, the thing about being sleepy at work, that I can simply acknowledge as something I thought and move on from.

In the above exchange, I am not trying to outsmart or defeat my own thoughts, because guess what?

You can never be the winner in the battle with yourself! (Because you are on both sides so even if one side wins, the other loses… you get it!)

Not getting stuck with the thoughts helps me to quickly turn my focus back to the main objective: sleeping more evenly both on weekdays and weekends.

Sources

Luyster FS, Strollo PJ, Jr, Zee PC, Walsh JK; Boards of Directors of the American Academy of Sleep Medicine and the Sleep Research Society (2012) Sleep: A health imperative. Sleep 35(6):727–734.
Cappuccio FP, D’Elia L, Strazzullo P, Miller MA (2010) Sleep duration and all-cause mortality: A systematic review and meta-analysis of prospective studies. Sleep 33(5):585–592.
Nielsen LS, Danielsen KV, Sørensen TI (2011) Short sleep duration as a possible cause of obesity: Critical analysis of the epidemiological evidence. Obes Rev 12(2): 78–92.
Knutson KL (2010) Sleep duration and cardiometabolic risk: A review of the epidemiologic evidence. Best Pract Res Clin Endocrinol Metab 24(5):731–743.
Cappuccio FP, Cooper D, D’Elia L, Strazzullo P, Miller MA (2011) Sleep duration predicts cardiovascular outcomes: A systematic review and meta-analysis of prospective studies. Eur Heart J 32(12):1484–1492.
Lauderdale DS, Knutson KL, Yan LL, Rathouz PJ, Hulley SB, Sidney S, Liu K., (2006); Objectively measured sleep characteristics among early-middle-aged adults: the CARDIA study; American Journal of Epidemiology 2006 Jul 1;164(1):5-16. Epub 2006 Jun 1.
Yuriko Ogawa, Takashi Kanbayashi, Yasushi Saito, Yuji Takahashi, Tsuyoshi Kitajima, Kenichi Takahashi, Yasuo Hishikawa, Tetsuo Shimizu; Total Sleep Deprivation Elevates Blood Pressure Through Arterial Baroreflex Resetting: a Study with Microneurographic Technique, SLEEP, Vol. 26, No. 8, 2003
Carla S. Möller-Levet, Simon N. Archer, Giselda Bucca, Emma E. Laing, Ana Slak, Renata Kabiljo, June C. Y. Lo, Nayantara Santhi, Malcolm von Schantz, Colin P. Smith, and Derk-Jan Dijk (2013); Effects of insufficient sleep on circadian rhythmicity and expression amplitude of the human blood transcriptome; Proceedings of the National Academy of Sciences (PNAS)

Sleep Deprivation, effects and my personal treatment