SLEEP & HEALTH March 8, 2018 Michael A. Grandner PhD MTR CBSM FAASM FAHA Director, Sleep and Health Research Program Director, Behavioral Sleep Medicine Clinic Assistant Professor of Psychiatry, Psychology, and Medicine University of Arizona College of Medicine www.sleephealthresearch.com • grandner@email.arizona.edu • @michaelgrandner
The Bigger Picture ➢ Sleep is a biological requirement for human life • Needs met based on both quantity and quality ➢ Yet our society perpetuates the idea that sleep is unproductive time ➢ The truth is that since at least the 1960s, we have known that sleep is an important predictor of morbidity and mortality 2
Guidelines for Adequate Sleep American Academy of Sleep Medicine and Sleep Research Society: 7 or more hours National Sleep Foundation: 7-9 hours American Thoracic Society: 7-9 hours American Heart Association: 7 or more hours 3
Prevalence by Age Habitual short sleep duration is highly prevalent in the US population 100.00% 5% 5% 6% 6% 6% 7% 7% 8% 10% 11% 12% 13% 16% 90.00% 80.00% 70.00% 54% 55% 54% 55% 54% 55% 56% 59% 55% 60.00% 60% 62% 61% 59% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% 18-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+ Very Short Short Normal Long 4
Sleep, Weight & Heart • People who habitually sleep 6 hours or less • Are more likely to be overweight or obese • Gain more weight, faster • Have more trouble losing weight • This (and other impacts of sleep loss) leads to • 55% increased likelihood of becoming obese • 21% increased likelihood of developing high blood pressure • 33% increased likelihood of developing diabetes • Insufficient sleep is also associated with • Impaired organ function across systems • Impaired immune system • Greater pain and pain sensitivity 5
Sleep regulates brain function • Sleep plays key roles for emotion regulation • Insomnia and sleep loss are key risk factors for depression and anxiety disorders, and predict recurrence of episodes • Insomnia and nighttime wakefulness are major risk factors for suicide • Sleep plays critical roles in clearing waste and toxins from the brain, implications for Alzheimer’s and other dementias • Sleep loss impacts decision-making • Risk-taking behavior • Judgment and planning • Processing multiple sources of information • Not fixed by stimulants • We are often unaware of the consequences 6
Drowsy Driving 6.5 Complete Sample Unadjusted 5.5 Adjusted Odds Ratio of Drowsy Driving 4.5 3.5 2.5 1.5 0.5 -0.5 ≤5 ≥10 6 7 8 9 Hours Hours Hours Hours Hours Hours BRFSS 2009 7 Maia, Grandner, Findley, and Gurubhagavatula et al., 2013
Recognition of Sleep • Sleep is increasingly recognized as the “third pillar of health” • There has been an explosion of public interest in the health and performance benefits of healthy sleep • Sleep is easier to change than diet or exercise so people notice benefits • And has strong placebo effects • Healthy sleep can fit with the narrative of both health and productivity • Most PCPs recognize the importance of healthy sleep but don’t know what to recommend to patients BRFSS 2009 8 Maia, Grandner, Findley, and Gurubhagavatula et al., 2013
Sleep and Metabolism • Calories close to sleep will be more likely to be converted to weight gain • Changes in sleep affect how your body processes food, including causing changes in: • What you choose to eat • When you choose to eat • Your blood sugar • Gaining or losing weight 9
KEY OPPORTUNITY AREAS • Rethinking the standard approaches • Harness the rebuilding process • Addressing potential deficiencies that can cause sleep problems • Role of an optimal diet (and supplements) in sleep health • Embracing chronotherapeutics • Approaching the morning • And others! 10
Thank You! 11
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