It should be raining.
It is March in the San Francisco Bay area, and we have had hardly any rain for the past three months.
It’s a funny thing, but even though I have been taking advantage of the good weather to go out bicycle riding and hiking, there’s a part of me that doesn’t feel quite right about this strange weather.
This morning, I talked with a young woman who is extremely bright and ambitious about the very difficult time she has been having getting enough sleep.
Her sleep cycle has been so disrupted, and she is so exhausted, that she was a little bit worried about whether it was safe for her to drive in for the appointment, and we had our session by Skype, instead of in person.
I did a careful sleep assessment, and it quickly became apparent that the problem she was having is that she has been building up a huge sleep debt during the week. She is staying up until one or two in the morning in order to get stuff done and then waking up around six or seven in order to get to work. She hopes to catch up on the weekend by sleeping in, but the quality of her sleep on the weekends is quite poor. This is an extremely common problem these days.
I talked to her about the problem, which is basically that what she is doing is completely at odds with how her body regulates sleep.
Just like nature’s seasons, our body also has cycles, in particular, there are a number of so-called circadian (about 24 hours long) cycles that determine sleep and wakefulness. Imagine that you have a desktop covered with alarm clocks, each running separately from each other, and that in order to sleep well and wake up refreshed, all of those clocks have to run in sync. Now add the complication that all of those alarm clocks (the separate circadian rhythms that drive multiple hormone systems that determine sleep and wakefulness) are also bad at keeping time, in fact, they run 30 to 60 minutes slow or fast each day.
On the drawing to the right you can see many of the events that happen at different times of day. Most of these events are driven by different circadian clocks or by more than one clock, for instance, the blood pressure rise at the beginning of the day is driven by a cortisol clock and a sympathetic nervous system clock (among several) that all have to line up to get you awake at the beginning of the day.
What drives all of these rhythms to stay in sync is a combination of exposure to bright light at the same time every morning, and a lack of exposure to light at night.
Further, these rhythms take a while to shift. It’s not really possible to switch back and forth between a weekday and a weekend sleep cycle and expect your body to keep up.
Our bodies developed when there was no electricity, and our days were very much the same length from day to day, and even week to week.
My plan was pretty simple to describe: Wake up at roughly the same time (within about an hour) every day, and get 30 to 45 minutes of bright light (either outdoors or from a therapy light) every morning very soon after waking up. This (perhaps combined with a nighttime does of melatonin an hour before sleep) should get almost anyone into a pattern of regular and deep sleep and clear-headed wakefulness during the day.
She was not excited about the plan, she enjoys the sense of “freedom” that comes from her routine.
But like many of us, she has trouble seeing that this “freedom” deprives her of the vitality that she craves.
Sure, it is possible these days to sleep during the day and work at night, or do any of a number of relatively odd (from the standpoint of our brains and bodies) things with our sleep, but is it worth it?