“What’s So Great About Sleep Anyway?”
I was seeing a young patient in clinic* whose mother was concerned about her quality of sleep. She was struggling to fall asleep in the evenings and getting up for school in the morning was a battle. I went through my standard history and physical, and came to an initial assessment and considered a potential plan. I started into my recommendations about healthy sleep habits and about how she could shift her circadian clock to better match what was needed for school. I noticed the glazed look of boredom cross over her face and realized I needed to check in with my patient.
“What are your thoughts about what I’ve said so far?” I asked smiling
“Well, that all sounds good, but I just don’t don’t understand the point of sleep. I mean there are so many other things I’d rather be doing…” she trails off, with a quick yawn. “Most people my age don’t sleep that much anyway. We just don’t need it. I mean, what’s so great about sleep anyway?” She shrugged.
I looked at my young skeptic and appreciated her honesty. She hadn’t seen the point of her mother’s concern and therefore didn’t see the merits of my recommendations.
“Have you ever woken up from sleep feeling refreshed or well rested?” I asked.
She shook her head emphatically.
“Do you think that you can wake up from sleep and feel refreshed and energized?”
She continued to shake her head.
Ah. I was beginning to understand.
Because this young patient hadn’t noted any benefits of sleep in her own life, she was unable to see the point of it. She, like many, hadn’t experienced the benefit and didn’t simply want to take my word for it.
So, we chatted a bit more and we came to the conclusion that we should try and improve her sleep quality first. This particular patient had mild obstructive sleep apnea, attributed mostly to chronic nasal congestion from allergies. We treated her allergies and after a few visits, she started waking up feeling better and a little less irritable in the mornings. Now she was ready to talk a bit more about WHY working to improve her sleep time was in her best interest.
Sleep used to be considered a time when you were simply “not awake.” We now know that sleep is a time when the body rebuilds, grows and recovers. During sleep, memories and learning are consolidated, debris in the brain is cleared away, and children actually grow from the secretion of growth hormone. When we don’t get enough quality sleep hours, we can show increased irritability, low mood, decreased concentration and learning as well as increased susceptibility to the perils of stress and disease. Sleep is our very own “miracle” designed to help us mitigate the effect of stressors and recover from life’s challenges.
All that said, there are many who have simply not experienced the benefits for themselves and this can be caused by a primary sleep disorder like sleep apnea, or another condition that diminishes sleep quality. We can easily become used to feeling this way and assume there is not much to do to make things better. Like my young patient, you may be wondering if good sleep lives up to the hype.
For those that get only a few hours of sleep each night, I challenge you to find a time when you can sleep a bit more. Take note of how you feel after a few more hours of sleep. It may be hard to compare/remember, so I often recommend keeping a simple journal/diary to keep track of changes.
For those who wake up fatigued/sleepy despite “enough” sleep hours, consider if there is another circumstance (like sleep apnea) that is affecting your sleep quality - a clinician can help you sort that out.
As for my young patient, she was more willing to consider some of my recommendations now that she has felt for herself, the benefits of a better night’s rest. I’m hoping that she continues to progress to a point where she feels she can even influence her friends as well!
Sleep Well! Be well!
Caroline Okorie, MD, MPH
*The details of this patient case have been changed to protect patient privacy.