Ask the Doctors

Dear Reader: In our last column, we explored some of the links between sleep deficit and Alzheimer's disease. This was in response to a question from a reader who was worried that his poor sleep patterns, which are becoming more pronounced with age, might put him at risk.

As we said, poor sleep doesn't portend an Alzheimer's diagnosis. But it does have health effects that can range from serious to grave. In the short term, lack of sleep affects learning, mood, memory and coordination. In the long term, chronic sleep deprivation is implicated in diseases like diabetes, obesity, cancer and heart disease.

Experts in the field agree that a healthful night's sleep lasts about eight hours. It is made up of the dream state of REM (rapid eye movement) sleep and several levels of a deeper state known as non-REM sleep. Not only do we need all these phases of sleep for optimal mental and physical health, but we also need them in adequate quantities. There are no shortcuts. And due to the nature of sleep and its effect on the brain and body, it's not actually possible to make up for missed sleep.

The good news is you can take steps to ensure a better night's sleep, but the challenge is following the rules consistently. As we have seen in our own practice, where some sleep-challenged patients can't find the time or impetus to follow through, this can be easier said than done.

Watch the caffeine. From the moment you open your eyes in the morning, a chemical called adenosine is prepping your body for its next sleep cycle. It builds up throughout the day and attaches to receptors in the brain, which then send signals that eventually cause you to feel drowsy. Caffeine blocks those adenosine receptors, so a crucial part of the sleep cycle gets blocked.

While a morning cup of coffee probably won't throw things too far out of whack, caffeine in the afternoon or into the evening can be detrimental to sleep. Alcohol also disrupts sleep. If you're serious about sleeping better, switch to non-caffeinated beverages after breakfast, and skip the nightcap.

Make your life sleep-friendly. Start by putting the screens away at least an hour (some experts say three hours) before bed. Phones, tablets, computers and video games emit so-called "blue" light that disrupts sleep. To our brain and eyes, this light says it's morning. We need the natural light of evening, dusk and then night to signal our internal clocks that it's time to shut down.

Keep your bedroom dark and quiet. Blackout curtains, a sleep mask and earplugs can help overcome disturbances from outside or inside the house. Also, research shows we sleep best in a cool room, from 60 to 68 degrees Fahrenheit.

Set a sleep schedule. Go to bed at the same time each night and get up at the same time each morning. Keep the momentum going on weekends as well.

We know that enacting these changes can be challenging, but keep in mind that good-quality sleep is vital to our physical and emotional well-being. It's worth the effort and the follow-through.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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