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By Dr Denton D. Weiss, M.D.

1/21/2014 (1 year ago)

Catholic Online (www.catholic.org)

And on the 7th day he rested. (Genesis 2:2) We need our rest. It is a part of His plan and the path to healthy, happy and beautiful living.

I receive a lot of questions about winter blues and difficulty sleeping this time of year. Many of those who write, or whom I meet in my medical practice, simply express what is so very common this time of year - It is winter and I am tired, why? Some express exasperation over not even being able to sleep. Even more express their concerns over that winter weight gain which seems to accompany the entire pattern! They are often all connected. As the winter seems to just drag on, let us consider once again the connections between that extra weight, winter blues and the need for good sleep.

Highlights

By Dr Denton D. Weiss, M.D.

Catholic Online (www.catholic.org)

1/21/2014 (1 year ago)

Published in Health

Keywords: Dr Denton D. Weiss, M.D., Beautiful Living, Bella Vitae Foundation, REM sleep, cortisol, Light therapy, S.A.D., seasonal affective disorder, health and wellness


PORTSMOUTH, VA (Catholic Online) - I receive a lot of questions about winter blues and difficulty sleeping this time of year. Many of those who write, or whom I meet in my medical practice, simply express what is so very common this time of year - It is winter and I am tired, why? Some express exasperation over not even being able to sleep.

Even more express their concerns over that winter weight gain which seems to accompany the entire pattern! They are often all connected. As the winter seems to just drag on, let us consider once again the connections between that extra weight, winter blues and the need for good sleep.
 
There are many causes for those worn out feelings, that funk or just plain feeling blue. We just came off the most celebrated part of the year: Thanksgiving, Christmas, and New Years. Stress, anxiety, overeating, too much alcohol, cold medication, and that hot chocolate, hot tea, or hot toddy before bed, can all cause a serious disruption in our sleep patterns.

Such choices also affect the overall chemistry of this gift we call our body. When our body is mistreated, our whole person feels the effects, including our emotions and yes, our spirit. We are a unity, body, soul and spirit.  Those choices can also lead to sleep deprivation.

The body's response is the release of a stress hormone called Cortisol and BINGO - you have a bigger waist line building up. Sadly, that does not help the self image and the cycle worsens. The winter pattern can feed the winter blues while you feed yourself - thinking it might make you feel better. It rarely does and it feeds even deeper problems.

All of this can interrupt the sleep cycle and, we all know the effect that can have emotionally. Our emotions, our spiritual well being and our physical well being are all connected because we are all connected. We are human persons, body, soul and Spirit. Sleep is essential to what I call beautiful living.

Let me make this perfectly clear - we need REM sleep. No, no not the old rock band called REM; I mean Rapid Eye Movement (REM) sleep. There are two types of sleep. Non Rapid Eye Movement Sleep (NREM) is the first stage of sleep and it represents a build up to the deep REM sleep which we all need. During NREM sleep, people will have possible leg movement, sleep walking, and even night terrors.

In REM we dream, our bodies relax, and true, healing rest is achieved. Without this, our bodies can't recharge and once again that old nasty stress hormone called cortisol is released. You know that inner tube waist I am working on? Thank you Cortisol!

So why do we sleep? The circadian clock or rhythms is often mentioned when sleep is concerned. Simply put the circadian clock is our own internal timing device that our body uses. This clock can be modified by the foods we eat and the life we choose.

Typically, during the day our body builds up a natural enzyme, a fancy name for a sleeping pill. This enzyme, adenosine, builds to a peak level typically at night. The higher the level the more sleepy we get. Our body uses this and its natural clock, remember the circadian clock, to say to the brain release melatonin and decrease the bodies core temperature. Our response is Sleep.

The bottom line is we need to keep our circadian clock normal so our bodies get enough REM sleep. To achieve this, a normal routine of going to bed and getting up is ideal. Our adult bodies require 6 to 7 hours a night to be at our peak performance the next day. Only a few of us have a genetic variation that allows us to sleep less than 6 hour and stay healthy. (P.S. sorry moms if you have one of these little genetic wizards in your brood.)

REM sleep usually occurs somewhere in the last 2 to 3 hours. Adolescents require even more sleep 8.5 to 9.25 hours. (see, research of Carskadon et. Al., 1980). Children and infants can require 12 to 14 hours of sleep during early brain development years.

REMEMBER, the amount of restful sleep is meaningless if you don't have a routine pattern so that your inner clock can work. 7 hours of sleep one night starting at 10 pm and then the next night at 3 am is not going to give you restful sleep. The inner clock is established by those old hormones after a week of routine. We're simply not wrist watches that can just be reset. Now having said that, there are a few things we can do to make our bodies recover our inner clock more efficiently.

After a trip overseas - or with this Great Nation's coast to coast travel - the body's circadian clock can be off by 4 - 6 to even 12 hours. This is what we call jet lag. Jet lag occurs in part because our natural clock is off. Our bodies are trying to reset our inner clock.

Some physicians recommend taking oral melatonin, 2-3 hour prior to your normal sleep time in an attempt to quickly reestablish the normal circadian clock. Ideally take a slow release form and go with the lowest dosage 3 mg or less. Recent studies indicate that doses less than 1 mg are sufficient. Don't use melatonin beyond 2 weeks.

Professor Francesco Cappuccio from the University of the Warwick Medical School has presented work which is very interesting. In 2007 Professor Francesco Cappuccio reflected on his research findings stating, "Short sleep has been shown to be a risk factor for weight gain, hypertension and Type 2 diabetes sometimes leading to mortality."

This makes sense when we look at diet and sleep deprivation. Our bodies crave carbohydrates when we are sleep deprived. We are basically looking for fast energy to keep the engine running. Poor fuel is better than no fuel. This leads to obesity, diabetes... and loss of our vitality.

Two separate animal studies have shown clearly that lack of sleep in a 24 hour period leads to decreased immune function and poor wound healing. This makes complete sense when you consider that the 1st stage of wound healing requires white cells (the immune fighting cells) to move into the wounded area.

Sunlight also seems to play a role in the body's ability to slip into a normal sleep pattern. Extreme variations in weather during the winter months or even in some episodes in the summer can lead to variations in the body's normal rhythms. Some individuals are extremely sensitive to these variations. It may well be that the extreme variations in weather have similar effects as jet lag on some individuals.

Light therapy plays an important role. I know people who suffer from Seasonal Affective Disorder. The acronym SAD fits their experience. Though some may say this is foolishness, the symptoms of depression or winter blues for some people sensitive to less light in the winter months can be devastating!

For these folks, light therapy has been found to be a saving grace. A simple thought: If you have the hibernation blues keep a room in your house lit extremely brightly (Sunlight imitating bulbs are ideal) during the day and early evening. For some, light bars are a great help.

Actually, cooling the body will enhance the feeling of fatigue and slow the body down. Remember a cooling of the body is a trigger to sleep. A room with bright lights and warmth sounds nice right now and will actually help stem the tide of dark day sleepiness.

Finally, winter seems to always be a time of increased food intake and alcohol consumption. Be careful, alcohol will reduce your REM sleep. No hot toddies. Have a single class of wine at dinner and call it good. Really, watch out for those fast carbohydrates (cookies, candy bars, one little chocolate ...eaten 5 times) when you're tired. They will perk you up for an hour and then a big crash will follow. So will a big tummy.

Here it is, simplified. Seven hours of sleep for adults is healthy. Less than 6 -7 hours is unhealthy PERIOD! In order to get this extra 5lbs .Ok maybe 20 lbs off of me I have got to start with sleep.... simple, consistent, rejuvenating, refreshing, healing sleep.

Some call it Beauty sleep I just call it Beautiful living - one night at a time. We need beautiful sleeping for beautiful living.

And on the 7th day he rested. (Genesis 2:2) We need our rest. It is a part of His plan and the path to healthy, happy and beautiful living.

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Dr Denton D. Weiss, M.D. is board certified in both Plastic and Reconstructive Surgery and Otolaryngology-Head and Neck Surgery. Dr. Weiss' approach to his medical practice flows from his convictions about the meaning of life which are deeply rooted in his Catholic Faith. He and his wife, Michelle attempt to live an integrated approach to life which recognizes the unity of the body, mind and soul, and find great joy in helping  others to do the same. They call this approach "Bella Vitae" or "Beautiful Living". They founded a nonprofit charitable foundation to promote beautiful living called Bella Vitae. He, and Michelle, are contributing writers to Catholic Online.

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