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PART 2: A GOOD NIGHT’S SLEEP—GATEWAY TO A HEALTHIER YOU! Cognitive Function and Emotional Well-being

Poor sleep can impair cognitive functions in many ways. While some may seem as simple as grumpiness or irritability, others are more severe, including disruption of “concentration, alertness, and reflexes, making sleep-deprived individuals more prone to falls and accident-related injury.”[i] Recent studies have shed additional light on the nature of sleep as it pertains to psychological health: While previous generations perceived sleeping disorders to be a result of psychiatric disorders, the reverse is now being understood to be true. In other words, while medical and psychological professionals used to think psychological misalignments fostered poor sleep, they now believe  that chronic sleep disturbances encourage psychological imbalances.[ii] In fact, at this time, there is not a single known psychiatric disorder that doesn’t have an accompanying sleep disorder.

The Oxford Academic Journal released the results of a study wherein fifty-six otherwise healthy high-school-aged teens were subject to a short series of nights in which sleep was incrementally reduced until the duration reached only five hours per night. The subjects were otherwise academically proficient students performing at top-rated high schools. The nights with a five-hour sleep limitation were then maintained for a series of seven nights. Those deprived of full-length sleep immediately began to show decreased ability to perform academically, along with “deterioration in sustained attention, working memory and executive function, increase in subjective sleepiness, and decrease in positive mood.”[iii] The results of the study revealed that even just a week of sleep deprivation “impairs a wide range of cognitive functions, subjective alertness, and mood” for top-level performing students who, even after two nights of recovery sleep, still manifested such symptoms.[iv] In a separate, similar study, subjects likewise manifested these symptoms along with delayed reaction times (another contributor to dangerous driving, as mentioned earlier)—and worse, after fourteen days of this practice, they didn’t report feeling especially sleepy.[v] What’s alarming about this is the fact that, despite the body’s willingness to attempt to adapt to the lack of sleep, the underlying health consequences remain.

Sleep likewise facilitates the storage of memories accrued over the course of the day, which are temporarily stored in the hippocampus during waking hours. The hippocampus is the part of the brain that saves all incoming information until slow-wave sleep occurs, during which the information is consolidated and moved into the brain’s cortex. This data is then stored as long-term memories, or “learned information.” While adequate sleep is vital for people of all ages, the fruits of sleep deprivation can be particularly observed in young adults. Those who stay up late “cramming” for a test will likely receive less benefit than those who study in advance and then get a good night’s rest the night before the exam. Not only will the information be more reliably stored within the brain, but the decreased level of anxiety (because of adequate rest and the knowledge having been securely stored and accessible) will allow the brain to perform better as well.

On the other hand, many experts believe the hippocampus has a limited time for hanging on to new information—a sort of expiration date If information isn’t preserved by being purged and sent to the cortex within a set amount of time (experts currently estimate about sixteen hours), the information can become distorted or disappear altogether.[vi] Thus, chronic disruption of sleep interrupts the formation of new memories and the ability to learn. Because this transfer is completed during the slow-wave sleep phase, it is vital to get quality, deep sleep every night. The lack of this kind of sleep is a large contributor to cognitive impairment among the elderly; experts note a link between slow-wave sleep and “age-related medial prefrontal cortex (mPFC) gray-matter atrophy.”[vii] In plain English, brains deprived of slow-wave sleep for long periods can begin to malfunction where memory storage is concerned, leading to the brain’s inability to store and maintain memories.[viii] This sheds an entirely new light on ailments such as Alzheimer’s disease, which is accompanied by cognitive decline. In fact, a prequel to this illness is often chronic sleep disturbance, since it encourages the production of a degenerative protein called amyloid-beta, which collects in the prefrontal cortex, forming plaque and promoting the development of Alzheimer’s.[ix] “The severity of accumulation significantly predicts the degree and extent of cognitive decline associated with Alzheimer’s.”[x] In turn, amyloid-beta contributes to sleep deprivation, perpetuating the cycle.[xi] During normal slow-wave sleep, the brain is purged of up to 40 percent of this substance, thanks to the glymphatic system.[xii]

As the body encounters slow-wave sleep, the glymphatic system—a perivascular system that supports the blood vessels supplying the brain—rids the brain of toxins and waste, sending a rush of fluids that clear away “proteins and metabolites from the central nervous system” by expanding, essentially squeezing out toxins and then diminishing once again, creating space for the brain’s blood flow to again move freely, rejuvenating it.[xiii] This system is responsible for distributing beneficial substances to the brain, such as “essentials nutrients such as glucose, lipids…amino acids…growth factors and neuromodulators.”[xiv]

At this point, you may assume that these cognitive problems resulting from insufficient sleep are limited to the elderly, but allow us to assure you that this is not so. It can affect people as young as those in their late twenties.[xv] For some of these younger adults, snoring, sleep apnea, or other illness may contribute to this deprivation, but for a vast majority, the real culprit is lifestyle. Studies have shown that a sleep destitute period lasting up to thirty-six hours can instigate an increase in the level of amyloid-beta up to 30 percent.[xvi]

In addition to affecting the storing and facilitating of our memories, our sleep schedules also vastly influence our mood. We then carry these influences into our lifestyles, affecting our overall happiness and quality of life, which disturbs sleep, feeding a vicious cycle. Recent studies have revealed what is becoming known as a “phenotype of social withdrawal and loneliness,” meaning that sleep disturbance contributes to neural and behavioral components that can be picked up on by peers and that cause us to remain withdrawn from social interaction.[xvii] The result is isolation, which, in turn, contributes to loneliness and sleep disturbance, feeding the sequence. Those who suffer this cycle additionally see increased odds of “cardiovascular disease, alcoholism and suicidality, physical diseases related to stress and compromised immune function, and in later life, greater risk of degenerative dementia,”[xviii] while altering behavior and emotions…also disturbing essential metabolic processes and influencing the expression of immune-related genes.”[xix]

Having belabored the point already that, in order to enjoy good health, we must have social interaction, community, and quality of life, we will not linger here; this point speaks for itself.

The Importance of Melatonin

For many, sleep disruption is related to reduced melatonin production as we age.[xx] But melatonin is not just a sleep drug. It is responsible for many other functions, such as “regulating the neuroendocrine system…metabolism, sex drive, [and] appetite.”[xxi] Likewise, it prevents rapid reproduction of cancer cells and fortifies the immune system via its antioxidant properties.[xxii] It is said that by the time we reach the age of sixty, our melatonin production is nearly dormant in the evening hours. By age eighty, melatonin is nearly undetectable in the system. This correlation is significant, because as we note how many health problems occur as a result of poor sleep, we can see a spike in these same issues amongst the elderly. In fact, studies have shown that chronic sleep deprivation can actually increase the odds of premature death among seniors by 100 percent (X2).[xxiii] If we were able to ensure better, deeper sleep for these individuals, they would likely enjoy greater health into later years of their lives.

Inflammation

Cytokines is a generalized term that refers to “small secreted proteins released by cells [that] have a specific effect on the interactions and communications between cells.”[xxiv] When the length of sleep is shortened, our bodies secrete pro-inflammatory cytokines (which can include but are not limited to C-reactive protein or CRP, IL-6, and IL-17) within the body that are able to act on either the very cells that disbursed them, or on nearby or even distant ones.[xxv] A solid connection has been established between certain pro-inflammatory cytokines and chronic pain via “nociceptive sensory neurons,”[xxvi] otherwise known as pain receptors. In other words, when we are sleep deprived, our bodies secrete chemicals that move directly to our pain sensors—and this manifestation can be sporadic throughout the body—and instigate painful inflammation. If we wake up in pain, it is likely that we did not sleep well, and the body responded by secreting pro-inflammatory triggers in anticipation of pain or stress, ironically self-inflicting the anticipated discomfort upon itself. Studies have shown that CRP and IL-17 can remain in the body for more than two days past the time that normal sleep resumes.[xxvii]

However, there is more to be concerned than just mere discomfort. Dr. Zack Bush asserts that chronic inflammation is actually at the origin of all chronic illness.[xxviii] According to Bush, all disease, when scrutinized in its most microscopic form, is a byproduct of chronic inflammation.[xxix] With this in mind, it becomes apparent that the secretion of pro-inflammatory cytokines can be a large contributor to chronic illnesses, and these are fortified by sleep deprivation. Thus, one of the body’s best defense systems can be found in getting plenty of rest.

How to Sleep Better

If you realize, after reading this entry, that you haven’t been getting enough sleep, there are steps you can take to rectify the issue. Recall our discussion in a previous chapter of lifestyle and choices. When you decide to change your ways for the sake of your health, you’ve already taken the first step. However, as mentioned, as we age, melatonin production diminishes, leaving many who would be willing to sleep unable to do so.

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However, a determined person will find that there are many strategies to help alleviate this issue. You can begin to create space within your mind and schedule for the purpose of relieving anxiety at bedtime, and for allowing proper “wind-down” time before bed. It has been made clear by this point that our fast-paced lifestyle is counterproductive to inducing a healthy sleep schedule. So, it’s important to work on slowing your pace in the hours approaching bedtime. Your home life must be peaceful and allow for respite. If you can’t obtain peace in your setting of rest, surely you will be unable to achieve sleep just the same way. Remember that this is more than mental; hormonal secretions take place before bed, and they work best when they are able to follow circadian cues.

When we are experiencing stress (such as being worried about a hypothetical future, or reliving a past traumatic event), the brain reads the accompanying chemical responses just the same as if a life-threatening emergency were taking place. It is vital that we relinquish the worries of the day before we attempt to retire. This is why Philippians 4:6–7 tells us to “be anxious for nothing, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God; and the peace of God, which surpasses all understanding, will guard your hearts and minds through Christ Jesus” (NKJV).

We should limit participating in rigorous activities and taking in caffeine to earlier parts of the day. Ideally, we should engage in our heaviest physical activities in the hours before dinner. And, since caffeine can remain in the body for up to five to seven hours, if we must indulge in caffeine-loaded drink, the last one of the day we should have should be before lunch. As noted in our discussion of the circadian clock, if we don’t time these activities in accordance with the body’s rhythm, it will prevent melatonin and other necessary sleep-inducing functions to happen on target. On the same note, as explained previously, we should avoid snacking after dinner, as it will flip the body’s “fat-burning switch” back and forth, in and out of time, throwing off quality and quantity of sleep.

Beyond deciding to relinquish worries before bed, there are other practical things you can do to help wind down at night. For example, limit exposure to blue light. As we’ve stated, we’re exposed to light durations never known to previous generations, and which, quite frankly, aren’t even natural. When the sun goes down, blue-light exposure in your home should diminish as well. Keep lamps low and read a book, knit, do a puzzle, or hold a conversation with a loved one. Resist the urge to allow electronic communication (such as texting or social media) to keep you engaged late into the evening. We recommend no screens of any kind (i.e., scrolling through social media on your phone) for at least a half-hour before bedtime.

A routine at bedtime helps significantly. It can be difficult to come home from a busy day and go straight to bed. This is because the mind’s intellectual (not circadian) clock hasn’t completely received communication that bedtime is indeed imminent. A routine provides a subliminal messaging system that trains your mind to recognize the approach of sleep time.

It doesn’t need to be elaborate or expensive, but make sure your bed and bedroom are comfortable. If neatness is important to you, keep your bedroom clean. Make sure the room temperature is at an appropriate setting. Try to find a mattress comfortable enough that body pains don’t disturb the quality of your sleep; and ensure that pillows and blankets are comfortable. See that the room is dark enough that you’re able to drift off without trouble—and if noises bother you, try white noise such as a fan to drown it out.

Some find it helpful to make sure the bedroom is used only for sleeping. For example, I (Joe) have a friend who works from home, and for a short time, she attempted to work at a desk in her bedroom. However, when it was time to go to bed, the lingering stacks of undone work hovered too near, keeping her mind from being able to relinquish the day’s unfinished responsibilities. When she moved the desk out of her bedroom, she began to sleep better. So, make sure that your bedroom is used only for activities that don’t impede your ability to rest.

For years during the course of my medical issues, I (Joe) struggled with insomnia. If you try the suggestions we have made and still have problems getting to sleep, I’d like to share some solutions that have brought me relief. First, herbal teas consisting of chamomile, valerian root, lavender, lemon balm, or magnolia bark all work to increase or modify neurotransmitters that are involved in initiating sleep. Drinking a cup of one of these types of teas can be an inexpensive way to decrease nighttime awakenings and improve your overall sleep quality. Many brands offer a variety of blends of the aforementioned herbs, but I’ve found the most success with those that are organic, marketed specifically for sleep, and feature chamomile as the primary ingredient.

So, I’ve experienced significant success with herbal teas. However, nothing has helped me achieve consistent REM sleep the way that CBD (cannabidiol) oil has.

Unlike many of the over-the-counter and prescription sleep aids that often carry lengthy warning labels and side effects, CBD acts on receptors throughout the body known as the endocannabinoid system. CBD is non habit-forming, non—addictive, and an efficient way to fight insomnia and assure a deep, full cycle of sleep. It is also great as an anti-inflammatory agent, eases physical pain and anxiety, relaxes muscles, eliminates nightmares, and provides relief from psychological trauma-related conditions such as PTSD. We could literally write an entire book on the benefits of its healing properties, but for the purposes of this volume, here is an overview.

CBD is derived from the cannabis plant (Cannabis sativa), which sometimes causes people to shy away from its use. However, this is born out of a misconception that all cannabis products contain THC (tetrahydrocannabinol), the psychoactive element in cannabis that makes one feel “high” when using marijuana. However, cannabidiol is one of more than one hundred chemical compounds this plant produces.[xxx]

Many people assume that using CBD oil is the same as using marijuana, or that this product will make them lose control of their mental faculties or otherwise experience symptoms of drug use. However, that is not the case. The cannabis plant is actually very complex, and that renders many unique and valuable chemical elements. THC is a psychoactive compound, but CBD is not.[xxxi] While many areas are experiencing rapidly changing laws regarding the recreational use of marijuana, few medical professionals deny its value for patients who cannot escape physical pain. Thus, there are provisions for its medical use. However, for some, this leaves the moral conundrum regarding whether God approves of its use as a pain modifier and sleep aid. Thus, many forego this treatment. This is understandable, as those who perceive God as one who wants us to “be sober and vigilant” (1 Peter 5:8) at all times have a moral conflict with the concept of taking something that could potentially make them high.

However, as noted previously, CBD is not a psychoactive like its counterpart, THC. With this being said, many have found relief similar to that offered by other elements of the cannabis plant, but without the properties that may cause concern regarding the moral issues. We’ll discuss the use of CBD oil for chronic pain management in an upcoming chapter.

Finally, if sleep issues persist, you can consult a natural healthcare practitioner and see if they encourage the use of a melatonin supplement or other herbal solution. A professional will be able to note whether other culprits are contributing to sleeplessness, or even if another supplement will provide a better result.

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[i] “Restoring Deep, Slow Wave Sleep,” Nutrition Review, Retrieved March 4, 2020.

[ii] Andrew, Krystal. “Psychiatric Disorders and Sleep.” US National Library of Medicine. November 30, 2012. Retrieved March 5, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493205/.

[iii] Lo, June; Ong, Ju Lynn; Leong, Ruth, et. al. “Cognitive Performance, Sleepiness, and Mood in Partially Sleep Deprived Adolescents: The Need for Sleep Study.” Sleep Magazine, Vol. 39, Issue 3, p. 687-698. March, 2016. Retrieved March 5, 2020. https://academic.oup.com/sleep/article/39/3/687/2454041.

[iv] Ibid.

[v] Eugene & Masiak, , “Neuroprotective Aspects of Sleep,” Retrieved March 4, 2020.

[vi] Walker, Matthew. “Cognitive Consequences of Sleep and Sleep Loss.” Science Direct Magazine, Vol. 9, Sup. 1, Pg. S29-S34. Retrieved March 5, 2020. https://www.sciencedirect.com/science/article/abs/pii/S1389945708700145.

[vii] Mander, B. A., Rao, V., Lu, B., Saletin, J. M., Lindquist, J. R., Ancoli-israel, S., … Walker, M. P. (2013). Prefrontal atrophy, disrupted NREM slow waves and impaired hippocampal-dependent memory in aging. Nature Neuroscience, 16(3), 357–64. doi:http://dx.doi.org.ezproxy.regent.edu:2048/10.1038/nn.3324.

[viii] Ibid.

[ix] Walker, Matthew. “Sleep for Enhancing Learning, Creativity, Immunity, and Glymphatic System.” Found My Fitness. February 28, 2019. Retrieved March 5, 2020. https://www.foundmyfitness.com/episodes/matthew-walker.

[x] Ibid.

[xi] Ibid.

[xii] Ibid.

[xiii] Ibid.

[xiv] Ibid.

[xv] Ibid.

[xvi] Ibid.

[xvii] Ben Simon, E., & Walker, M. P. (2018). “Sleep Loss Causes Social Withdrawal and Loneliness.” Nature communications, 9(1), 3146. https://doi.org/10.1038/s41467-018-05377-0.

[xviii] Ibid.

[xix] Adrian, Jonathan. “Why You’ve Been Sleeping All Wrong.” Medium Health. September 14, 2019. Retrieved March 6, 2020. https://medium.com/@jonathanoei/why-youve-been-sleeping-all-wrong-87b2295314c0.

[xx] “Restoring Deep, Slow Wave Sleep.” Nutrition Review. Retrieved March 4, 2020.

[xxi] Ibid.

[xxii] Ibid.

[xxiii] “Restoring Deep, Slow Wave.” Nutrition Review. Retrieved March 4, 2020.

[xxiv] Zhang, Jun-Ming & An, Jianxiong. “Cytokines, Inflammation and Pain.” Us National Library of Medicine. November 30, 2009. Retrieved March 6, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785020/.

[xxv] Ibid.

[xxvi] Ibid.

[xxvii] Ash, Michael. “Sleep and Its Detoxing Effect on the Brain and Body.” Clinical Education Online. April 6, 2017. Retrieved March 6, 2020. https://www.clinicaleducation.org/news/sleep-and-its-detoxing-effect-on-the-brain-and-body/.

[xxviii] Roll. “GMOs, Glyphosate & Gut Health.” Accessed January 8, 2020.

[xxix] Ibid.

[xxx] Kubala, Jillian. “7 Benefits and Uses of CBD Oil (Plus Side Effects).” Healthline Online. February 26, 2018. Retrieved March 11, 2020. https://www.healthline.com/nutrition/cbd-oil-benefits.

[xxxi] Ibid.

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