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Home · Book Reports · 2018 · The Sleep Solution - Why Your Sleep Is Broken and How to Fix It

Published: December 4, 2018 (5 years 4 months ago.)
Tags:  Health · Sleep

The book in...
One sentence:
A little bit of everything sleep; from what it is, what it is good for, and how you can do it better. (insomniacs beware)

Five sentences:
First a basic of what sleep is, how much you need at the various stages of you life, how your internal clock (circadian rhythm), is regulated by environmental conditions as well as chemicals and inhibitors produced internally, like melatonin. Next a number of sleep disorders are discussed, the most notable probably being insomnia (simple and hard). The author tries to hammer home the idea that insomnia is really only a big deal if you make it a big deal; the fear you have surrounding bedtime and not being able to sleep can lead to, expectedly, an inability to sleep, at least temporarily. In the end, you sleep, everyone does, even if you don't feel like you sleep (paradoxial insomnia). The second half of the book covers sleep hygiene (dark, quiet, comfy) and the proper use of sleep aids, specifically drugs, which, although popularized in the media and often being the first line of defense a general practitioner will prescribe, are some of the worst paths one might take to remedy their poor sleep.

designates my notes. / designates important.


Chapter one introduces the ideas to be presented and gives a few salient examples to whet your appetite. First and foremost is what I would consider both the most important point in this or any book about health:

“…the three main pillars of good health that we can exert some control over are nutrition, exercise, and sleep…”

Two examples of some of the startling claims in support of sleep:

Amyloid beta (Aβ), is a protein that accumulates in the brain of Alzheimer’s patients. It is removed by what is known as the glymphatic system. This system is 60 percent more productive when we sleep than when we are awake!

The World Health Organization classifies shift work (sleep wrecking) as a class 2A carcinogen!

Chapter two lets you know that, even though you might not feel like it: you sleep. Period. You might not sleep well, or enough, or too much, but in the end you sleep. Or else you die. This is a little teaser for when you get to the insomniac chapter.

How much you sleep or how much you need to sleep is different for everyone.

From newborn to old-age, sleep requirements decline as we age. From 16-ish hours to 7-ish.

Newborns (to 3 months) = 14-17 hours
Infants (4-11 months) = 12-15 hours
Toddlers (1-2 years) = 11-14 hours
Preschoolers (3-5) = 10-13 hours
Children (6-13) = 9-11 hours
Teens (14-17) = 8-10 hours
Adults (18-64) = 7-9 hours
Adults (65+) = 7-8 hours

Chapter three compares fatigue to sleepiness; they are not the same thing. Next the book looks at the homeostatic and circadian systems regulate sleep. These are interesting and while their effects are probably common sense to most, the underlying physiology is likely not.

Chapter four continues to explain the scientific side of sleep. The phases of sleep, called cycles, generally run about 90 minutes give or take. Don’t forget that everyone is different though. Don’t try to follow some crazy sleep schedule you read about in books or online; listen to your body.

Years ago when I researched sleep for the first time there used to be four phases to sleep, but this has been reduced to 3 (plus REM).

Chapter five covers a host of drugs and chemical naturally occurring that relate to sleep. Some drugs that cause sleepiness and vigilance. Vigilance decreases throughout the day, sleepiness increases, it is constant march toward sleep as soon as you wake up.

Chapter six is where a lot of people probably start reading: insomnia. More accurately: paradoxical insomnia. This is when you are sleeping but not feeling like you are sleeping. You sleep will often feels shorter than it really is, but by God you are sleeping.

The author goes out of his way to ease people into this chapter. For those who think they ’never sleep’, it can be crushing to find out you actually DO sleep, but poorly. He points out that insomnia, most often self-diagnosed, can: 1. become a defining feature of you, and 2. will usually be ’treated’ hastily by overworked general practitioners with a quick fix: sleeping pills.

Chapter seven looks into circadian rhythms and how they are affected by routines and environmental conditions. There are cues throughout the day that set and reset the clock, fine tuning it to the individual’s behavior. On average the human circadian rhythm is set to a 24 hour and eleven minute clock.

Our bodies generally anticipate, or rather prefer to anticipate, rather than react to changes. For example if you follow a regular schedule -wake up at the same time, exercise, eat breakfast, etc- at the same time every day, your clock will set itself to this schedule. If then you try to change the schedule, your body will at first protest. You will wake up at the same time, even though you’ve set your alarm for an hour later. You will feel restless when you skip your exercise. You will feel hungry even though you plan on eating later. You body anticipates what is coming, it does not react. Of course you can, within a few weeks, retrain your body to your new schedule. This is one of the reasons shift work is so taxing; your body never settles into a set pattern.

Chapter eight lays out some principles for good sleep hygiene. First and foremost: remove all light! Light wakes you up by inhibiting melatonin production. If you can see your hand in front of your face, it is too light.

Next, if you are having trouble sleeping, one of the main culprits might be who you sleep with. This can include children and pets in addition to spouses. The author, suggests that (a) you should not sleep with children as it will train them to sleep only with mom and dad instead of on their own, and (b) if you are troubled or troubling your sleep partner you might experiment sleeping in separate rooms. This, he admits, might seem almost taboo, but I completely agree with the assessment. Sleeping in separate rooms can, in addition to alleviating sleep problems, also afford each person a kind of sanctuary; a place all their own. In regards to sex, this arrangement has been shown to increase intimacy by creating a sort of fantasy where you can steal away to the private room of your lover before returning to your bed (or sleeping with them occasionally) for a good night’s sleep.

Before sleeping one should not, and this seems quite the common sense, not smoke nicotine, drink alcohol, or eat within a few hours. There are some food, like tart cherries for example, that promote sleep, but for the most part food should be avoided.

Chapter nine is probably the most popular chapter. It deals with insomnia. Simple insomnia actually, as opposed to the hard insomnia of chapter ten. Simple insomnia is simply getting a little less sleep here and there and it is often no big deal. The difficulty comes with the associated anxiety and stress (often about not sleeping) that can lead to not sleeping. A potentially vicious cycle. Sometimes this can be treated with basic cognitive behavioral therapy and adjustments to your sleep routine. The old trick of sleeping with your head and the foot of your bed actually has some credence, but is not probably going to help all that much. On the other hand, changing up your sleep environment, getting new comfy pillows and blankets, maybe even a new mattress, painting the walls a cools gray or redecorating the room can all help trick your body out of the stress it has likely come to associate with your old sleeping environment.

This is no silver bullet and, as always, everyone is different. Some people who sleep perfectly in the current bedroom might experience simple insomnia when changes occur; as in sleeping in a hotel room.

Chapter ten looks at hard or primary insomnia and, similar to simple insomnia is usually exacerbated by your reaction to not sleeping more than actually not sleeping. Your fear of not sleeping and the effects you’ll feel the next day are quite possibly working to keep you awake. To reiterate, fear is keeping you from sleep.

If this continues, sometimes people go decades with hard insomnia, if may become part of your identity. If you talk about your bad sleep all the time, you may unconsciously want to sleep bad since it is part of how you have come to define yourself. The author puts forth a simple exercise: a list of questions you should ask a friend. At first they are simple, essentially pointless questions, to relax your friend. Then there is the one key question: “how is my sleep?” If you talk about your sleep a lot they will be able to answer, but normally people don’t talk about their sleep. If your friend knows about your sleep, you might be talking and identifying with it.

In chapter eleven the author suggests what I think is the most important aspect of the modern perception of pills: the media promotes them as a quick fix to everything. He uses several examples of television programs that promote this idea that, while I am not familiar with, seem the rule rather than the exception.

This isn’t to say that (sleeping) pills don’t have their uses. They are perfectly acceptable temporary stop-gaps. If you are traveling and want to avoid jet lag or the difficulty you might experience in a hotel or if you are dealing with stress that is affecting your sleep as in a divorce or death, they are perfectly acceptable. They are not intended for nightly use.

Sadly, another important point the author doesn’t belabor, is that general practitioners are under more pressure to increase throughput from insurance companies. They don’t have the time (if they want the income) to spend with every patient. This leads the ’easier’ ailments, like difficulty sleeping, to be plastered over with little consideration with a quick script.

While not overt, this chapter calls into question some societal practices that are likely causing more damage than they are stopping.

Chapter twelve offers, in my opinion, some of the more useful strategies for correcting sleep problems. Number one is sleep restriction. It might seem odd to restrict the sleep of someone having trouble sleeping, but it actually ends up making perfect sense.

First, set a wake up time, say 0600. Next, set a sleep time, say 0100. This will mean you are only going to get, at most, 5 hours of sleep. You probably won’t even get that; you are having trouble sleeping after all. After a few days you’ll likely be struggling to stay up until 0100; stick with it. Pretty soon your body will understand that it only has those 5 precious hours to sleep if it wants to sleep and you’ll likely start falling right asleep.

Now, you’ll still probably be tired. Only 5 hours of sleep is not going to cut it. Finally start backing off your bed time in 15 minute increments until you start waking up feeling good. Voilà, a perfectly adjusted sleep habit.

The key to maintaining your newfound schedule is to have a single wake up time. Less important is the go-to-bed time. You should not sleep in on weekends; wake up at the same time every day. Sorry shift-workers, you’re out of luck.

Chapter thirteen explores naps and their proper usage. Naps should generally range between 15-25 minutes, otherwise you run the risk of descending into deep sleep (N3) and will be a grouch when you wake up from that stage. As with all sleep, light, or rather dark, is key to a solid nap. When you first wake from your nap, light will help you regain your alertness quickly, the same way light in the morning, usually naturally provided by the sun, helps to get you out of bed.

If you are one prone to taking naps, it is best that you try to follow, as with all sleep, a schedule. You should try to take the nap at the same time everyday. You don’t actually need to take a nap ever day, but when you do take a nap a consistent time will be valuable.

It is, apparently, said that naps earlier in the day help with last night’s sleep while naps later in the day rob tonight’s sleep.

That said, you should only nap if you slept OK the night before. Don’t get in the habit of napping when you slept poorly, it will be harder to sleep the next night and might disrupt your schedule, often causing more harm than good. Don’t try to use naps to ‘catch up’ on you sleep debt. You can, within the next few days of missing out on some sleep, make it up by going to bed a little earlier.

Sleep apnea and its ill effects on you health are discussed in chapter fourteen. Sleep apnea, compared to rust, takes a toll over time. There are a host of problems that worsen as someone suffering sleep apnea continues to live with it. The least of which are not substantially interrupted sleep with the constant breathing interruptions.

It is not the same thing as snoring, but snoring usually occurs with sleep apnea.

Chapter fifteen covers a number of sleep disorders which need not be listed here.

Chapter sixteen examines sleep studies. It gives multiple images of various reading one might see during a sleep study and often asks the reader to interpret what is being show given the knowledge they’ve gained in the rest of the book.

Most of the sleep studies are done in a hospital or hotel, but more and more are being billed as in home sleep studies. The thing is, these home sleep studies don’t record the data required to tell you much of anything about your sleep. They focus on breathing and heart rate, but without being able to record mental activity, these are all but useless for diagnosing actual sleeping.

The author concludes that you should be wary of these in-home sleep studies. As with the insurance companies mucking around with doctor/patient relationships, the same thing seems to be occurring with sleep studies. The in-home studies are so much cheaper that they are pushed as a first test and then, when they are inconclusive, further testing is required but often not provided.

Table of Contents


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· 02: PRIMARY DRIVES: Why We Love Bacon, Coffee, and a Weekend Nap

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· 03: SLEEPY VERSUS FATIGUED: Too Tired for Your BodyPump Class or Falling Asleep on the Mat?

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· 04: SLEEP STAGES: How Deep Can You Go?

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· 05: VIGILANCE AND AROUSAL: (Sorry but Not That Arousal)

· 06: SLEEP STATE MISPERCEPTION: How Did This Drool Get on My Shirt?

· 07: CIRCADIAN RHYTHMS: The Clock That Needs No Winding

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· 08: SLEEP HYGIENE: Clean Bed Equals Sleepyhead

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· 09: INSOMNIA: I Haven’t Slept in Years, Yet I’m Strangely Still Alive

· 10: HARD INSOMNIA: Please Don’t Hate Me When You Read This

· 11: SLEEPING AIDS: The Promise of Perfect Sleep in a Little Plastic Bottle

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· 12: SLEEP SCHEDULES: I’d Love to Stay and Chat, but I’m Late for Bed

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· 13: NAPPING: Best Friend or Worst Enemy?

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· 14: SNORING AND APNEA: Not Just a Hideous Sound


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