“No one knows what sleep is for,” said Dr. George Labrot, a board-certified sleep specialist. “But we do know there are severe consequences if you don’t get it.”
Research over the past decade has shown the health consequences of poor or interrupted sleep can include obesity, diabetes, cardiovascular disease, psychiatric illness and injuries due to accidents. Labrot, a board-certified specialist with the UCLA Sleep Lab, spoke to Pacific Palisades Optimists in December.
Labrot said that experiments showed that people who had adequate sleep, showed a better response with vaccinations and immune response.
“We know sleep must be important,” he said, “because all animals with brains, sleep.”
He explained that some mammals have four brain states. Wakefulness, hibernation and two states of sleep.
During hibernation, the brain is more at rest than during REM (rapid eye movement) sleep, but animals come out of hibernation to get REM.
Humans have three brain states: awake, non-REM sleep and REM.
Humans cycle through non-REM – Stage 1, Stage 2 and Stage 3 (deep sleep). During deep sleep, the body repairs and regrows tissues and builds bone and muscle. “During non-REM brain waves become quiet and synchronized,” Labrot said.
After cycling through non-Rem, people go into REM.
“No one knows what REM sleep is for,” Labrot said. “Fetuses have REM sleep and even newborns have 10 hours of REM.”
Many feel that REM sleep is connected with dreaming, but Labrot said, “We don’t believe dreaming starts until someone is about five years old, so REM isn’t for dreaming.”
REM generally occurs in the second half of the night. “We do know if one is deprived of REM sleep, the next time you sleep you get more REM,” Labrot said and explained during REM, “we are paralyzed except for our eyeballs and diaphragms.”
During REM, people also become “cold-blooded” body temperature drops and is not controlled. “That’s why we have to bundle babies.”
The doctor said there is a condition called REM sleep behavior disorder in which people fail to become paralyzed during REM sleep.
“It is dangerous in itself, because people act out their dreams–behaving with their eyes closed in a dream environment–and can suffer self-injury or cause injury to a bed partner,” said Labrot, noting that a person knows if they have been in REM sleep if they wake up with a clitoral or penile erection.
“Within 15 years of people diagnosed with REM Sleep Behavior Disorder will have one of three degenerative brain conditions: Parkinson’s Disease, Lewy Body Dementia or multiple system atrophy,” he said.
Doctors have discovered there are people without REM and have been unable to determine that there is any unknown consequence.
“Surprisingly, if we refuse to allow a depressed person to have REM, the depression will disappear after the first night of REM deprivation,” Labrot said, “and will re-appear following the first night in which they are again allowed to have REM.”
The doctor was asked about sleep walking and said, “Sleep walking is not dangerous, because the visual cortex wakes up.”
Labrot also addressed insomnia. “Regardless of the cause of acute insomnia, if it lasts long enough sleep will become the issue.
“Sleep aids such as Ambien might work for acute insomnia, but they are not good for chronic insomnia,” Labrot said.
Once people start worrying about not being able to fall asleep, “the sleep centers deep in the brain cannot put us to sleep if the cerebral cortex remains active, as it will if we are facing our greatest challenge of the day–falling asleep,” Labrot said, and noted that for chronic insomnia, cognitive behavioral therapy for insomnia works better than drugs.
The commonest cause of excessive daytime sleepiness in the U.S. is behaviorally induced insufficient sleep.
He explained that at the beginning of the 1900s, people averaged about 9 hours of sleep per night and that adults in pre-agricultural societies average about 7 ½ hours a night.
“Now, the average worker sleeps less than six hours a night,” he said. “Most adults average seven and half hours a night, but most require more than that.”
He said a study showed that adults whose sleep was restricted to less than 6-1/2 hours/night for three nights measured a deterioration in short term memory, timed-complex decision making and fine motor control.
“I tell people a bed should be for sleep or sex,” Labrot said, noting that good sleep hygiene includes: a quiet room that is not too hot nor too cold, no blue light (from phones, iPads) and no caffeine.
“People forget that chocolate has caffeine,” Labrot said. “Caffeine has a six-hour half-life.”
(Editor’s note: in a 2018 CTN story “ADHD May Be Linked to Lack of Sleep,” Labrot examined how the lack of sleep-in children could result in an ADHD diagnosis.)