If health is on your priority list, then sleep is on your priority list. Quality sleep should come before diet. Before nutritional supplements. Before exercise.  

Sleep is not a passive state. From a hormonal perspective, sleep is an active, heightened anabolic state. Quality sleep is essential for cortisol, insulin, leptin, testosterone and other hormones that control metabolic rate. Sleep reduces inflammation and promotes detoxification.

What is sleep for?

We will die more quickly from lack of sleep than we will from lack of food. And yet, strangely, we do not yet understand exactly what sleep is.  

We do know that sleep is an active metabolic state that has restorative effects on the brain and body tissue. And we know that chronic lack of sleep causes immune dysfunction, insulin resistance, leptin resistance, obesity, carbohydrate craving, depression, poor cognitive function, cancer and much more.

The physiological changes that occur with sleep.

• Improved insulin sensitivity. Insulin resistance can be induced in sleep-deprived young adults. "[When] restricted to four hours [of sleep] a night, within a couple of weeks, you could make an 18-year-old look like a 60-year-old in terms of their ability to metabolize glucose," says Harvard sleep researcher Charles Czeisler. This is important information for sufferers of pre-diabetes and PCOS.
• Secretion of the appetite-suppressing hormone leptin. Sleep is when your appetite 'resets' itself. Lack of sleep will result in abnormal appetite and over-eating.
• Enhanced release of the anabolic hormones testosterone, DHEA and growth hormone. Sleep is important to build muscle mass and to prevent ageing. It's not called "beauty sleep" for nothing.
• Reduction of the stress hormone cortisol and which allows critical regeneration of tissue and cells.
• Synchronises the release of female hormones.
• Dramatically improved immune function. With lack of sleep, your white blood cell count will plunge, leaving you vulnerable to infections.
• Improved memory and concentration.
• Improved mood.
• Cellular detoxification. Sleep permits the removal of inflammatory waste products such as interleukin and adenosine. It recycles glutathione (an important antioxidant) into its active form.

How do you know if you're not getting enough?

The first - and most common—symptom of sleep deprivation is the feeling of constant hunger. The craving for sugar. This occurs because lack of sleep disturbs the metabolic hormone leptin.

How much sleep do we need?

Without exception, adults need 7 or 8 hours sleep. Children and teenagers need substantially more.

Sleep is a physiological requirement, like oxygen, so there is not really much wiggle room. It is not a sliding scale where some people need more than others. Your requirement cannot be decreased by the right supplement or the right meditation practice.

Your evening should be spent in low light, gradually relaxing and moving towards sleep that comes over you like a wave. If, instead, you are trying to grab a few more hours of work time on your computer, you may not be gaining as much as you think. According to Harvard professor of psychiatry Robert Stickgold: "[People getting by on four hours per night] are not gaining anything, but are losing a huge amount: you'll see it in their health, their social interactions, their ability to learn and think clearly. And I cannot believe they are not losing at least 20 percent in their efficiency."

Think of it this way, if you sleep less now, you will die earlier. Any waking working hours that you gain now, will be taken away from you eventually.

Also, if you sleep less, you will enjoy life less. You may not even realise how badly you're doing. You don't have to suffer irritability and difficulty concentrating. Again from Professor Stickgold: "When you live on four hours a night, you forget what it's like to really be awake."

Health conditions that interfere with sleep

• Sleep apnea is frequent waking due to restricted breathing. Is associated with obesity and insulin resistance, and most sufferers are not even aware that they wake through the night. The primary symptoms are snoring and severe morning fatigue.
• Thyroid problems
• Pain
• Big shifts in female hormones such as PMS or menopause
• Restless legs (consider treatment with magnesium, iron or vitamin E)
• Depression

Bladder waking you up?

Normally, bladder activity slows through the night, but many people report problems, especially with age.

• If you're a man over 40, you may suffer from an enlarged prostate. Prostate symptoms are diminished urine stream, incomplete voiding, and frequent urging. Enlarged prostate responds well to natural treatments such as zinc and saw palmetto.
• If you're a menopausal woman, oestrogen deficiency can thin the bladder wall, and result in bladder irritation and frequency. Natural treatments such as an oestriol pessary can help.
• Other problems that women may experience are fibroid or ovarian cysts putting pressure on the bladder.

• Other medical problems such as cystitis or diabetes can cause urinary frequency.

Is it really your bladder waking you, or do you notice your bladder more because you're awake? It may be stress hormone and the agitation of your nervous system at night that is causing bladder symptoms. If you reduce your stress response and stabilise your nervous system, then your bladder may settle down.

A check list for sleep

• Reduce caffeine consumption
• Sleep in a dark room
• Reduce electromagnetic fields in the bedroom or on the walls adjoining the bed. (Sleep a couple of meters away from WiFi, cordless phone base, appliances, power points or electrical/breaker boxes.)
• Schedule a "work-free" pre-sleep time. You may need a couple of hours to wind down. Stay in low light such as reading lamp or TV
• If noise is a problem, wear earplugs
• If partner disturbance is a problem, negotiate a separate bed at least some of the time

Natural treatments that can aid sleep

• Deep breathing, meditation, and yoga
• Melatonin supplement
• Magnesium supplement
• Glutamine, which converts to the sleep-promoting neurotransmitter GABA
• 5-HTP and vitamin B6, which promote melatonin
• Sedative herbs Zizyphus, Kava, Valerian, Hops, or Passion Flower
• Anti-inflammatory treatments such as fish oil and turmeric. (Chronic inflammation elevates the stress hormone cortisol)
• Natural progesterone cream 
• Alkalising minerals such as potassium citrate at bedtime. The nervous system needs to be alkaline to sleep. Something as simple as this can make a big difference for some people.

It doesn't have to be 8 consecutive hours

Our modern expectation of a healthy sleep is 8 hours without awakening, but that is not the sleep pattern that our ancestors had. Records show that the normal sleep pattern for Medieval Europeans was a segmented sleep or divided sleep. After the first 4 hour period of heavy sleep, people would wake into a semi-conscious peaceful state for a couple of hours. It was a highly valued time to pray, reflect, write, talk or make love. It would then be followed by a second, lighter sleep until morning. It was often balanced by a daytime sleep or siesta.

Understanding segmented sleep sheds some light on why night-time waking is such a common form of insomnia. Maybe it's not insomnia at all. It's merely an expression of our body's natural rhythm. Maybe it's fine to wake as long as you can then enjoy a second sleep and a siesta to make up the hours.

References:

Deep into Sleep. Harvard Magazine. July 2005