Stay Healthy Over the Holidays Despite Insomnia

When my family gathers for a few days over the holidays, usually someone brings along a sore throat or a cough. Try though that unlucky person may to keep the germs from spreading, they almost inevitably do.

I catch colds fairly easily, and I’ve often wondered if insomnia has a part in that. A new study suggests that chronic insomnia does—at a minimum—increase our susceptibility to influenza. Here’s more about the study and precautions poor sleepers can take to stay healthy over the holidays.

Insomnia compromises immunityWhen my family gathers for a few days over the holidays, usually someone brings along a sore throat or a cough. Try though that unlucky person may to keep the germs from spreading, they almost inevitably do.

I catch colds fairly easily, and I’ve often wondered if insomnia has a part in that. A new study suggests that chronic insomnia does—at a minimum—increase our susceptibility to influenza. Here’s more about the study and precautions poor sleepers can take to stay healthy over the holidays.

Sleep and the Immune System

A robust immune system confers protection from colds and flu. In order to stay robust, the immune system needs ongoing attention, and it’s during sleep when the body’s metabolic resources are freed up to do this maintenance work. During sleep antibodies are created to fight invading viruses. Short sleepers develop fewer antibodies, past research has shown, and this puts them at higher risk for developing infections.

Insomnia Compromises Immunity

Chronic insomnia—trouble sleeping and daytime impairment—may also compromise the immune system, according to new research published in Behavioral Sleep Medicine. Participants in this study were 133 healthy college students, half meeting diagnostic criteria for insomnia and the other half experiencing no insomnia.

Via blood draws, the students’ influenza antibody levels were assessed twice: once before, and once 4 weeks after, they received flu shots (containing influenza vaccine). The expectation was that 4 weeks after receiving the flu shots, participants in the Insomnia group would have lower levels of influenza antibodies than participants in the No Insomnia group.

What the researchers found was telling. Both groups showed increases in antibody levels from pre- to postvaccine. But not only did the Insomnia group have lower antibody levels than the No Insomnia group 4 weeks after receiving the flu shots. The Insomnia group also had lower antibody levels to begin with.

Researchers can only speculate about why. But the result lends support to something I’ve thought (and sleep researchers have suspected) for a long while: chronic insomnia dysregulates the immune system, making insomniacs less able to fight off colds and flu.

Recipe for a Healthy Holiday Season

So if you’ve got persistent insomnia it’s wise to take extra precautions around the holidays. Here are suggestions for how to avoid colds and flu:

If you’re traveling: People with insomnia are said to sleep better away from home. Not me—I’m susceptible to sleep onset insomnia wherever I go. If you’re going away for the holidays, pack along all the accoutrements you need for a comfortable night’s sleep at home: ear plugs, eye mask, pillows, white noise machine, etc. I take a foam rubber futon for use in case the sleeping accommodations aren’t quite right.

Travel by plane: Airplanes are virus magnets. Pack along a couple face masks for use if nearby passengers are coughing or sneezing. Use antibacterial wipes on seatbelt buckles, tray tables, overhead air vents, and bathroom fixtures before touching them.

Avoid airborne viruses: Viruses are mostly spread through the air via coughing and sneezing and then inhaled. Steer clear of Uncle Dalbert if he has the bad manners to come down to Happy Hour hacking away. A hug for a sister who’s obviously contagious can wait for another day.

Hard surfaces that harbor viruses: Touching doorknobs, light switches, faucets and then absentmindedly touching your face is another way infection spreads. To lower your risk of infection, wash your hands with soap and water frequently (take along hand cream so your hands don’t dry out). Better yet, avoid use of your hands altogether. To open doors and turn on lights and faucets, use your arms instead. (It’s amazing what dexterous forearms and elbows I’ve developed since I set my mind to it.)

Pass on communal towels: Avoid sharing them—or give the sick one a towel of their own.

Passing dishes at the table: Leave the sick one out of the loop.

When you’re out and about: Carry a small bottle of hand sanitizer in your pocket or purse and use it often, especially after handling money, signing for credit card purchases, and pumping gas.

A final suggestion: I have a brother who swears that daily nasal irrigation (with dilute salt water or a commercial sinus rinse) keeps him from coming down with colds. I don’t have enough discipline to incorporate this habit into my daily ablutions. But I use a sinus rinse when I’m bothered by allergies or feel a sinus infection coming on, and it helps.

Got any tips for staying healthy during flu season? Please share them in a comment below!

Are Insomniacs Unreliable at Assessing Sleep?

You’ve heard it said before: insomniacs typically overestimate how long it takes to fall asleep and underestimate the amount of sleep we get. Time and again, sleep experts ask us to estimate our sleep time. Then they conduct overnight sleep studies with polysomnography (PSG) and find, on average, that we fall asleep faster and sleep longer than we think.

Are insomniacs just unreliable when it comes to estimating time? What else might account for this discrepancy? Should we be reassured that we’re probably sleeping more than we think?

Insomnia sufferers underestimate how long they sleepYou’ve heard it said before: insomniacs typically overestimate how long it takes to fall asleep and underestimate the amount of sleep we get. Time and again, sleep experts ask us to estimate our sleep time. Then they conduct overnight sleep studies with polysomnography (PSG) and find, on average, that we fall asleep faster and sleep longer than we think.

Are insomniacs just unreliable when it comes to estimating time? What else might account for this discrepancy? Should we be reassured that we’re probably sleeping more than we think?

Time Estimates in the Daytime

Normal sleepers are fairly accurate when it comes to assessing their sleep. Their estimates of sleep onset latency (the time it takes to fall asleep) and total sleep time are in sync with the results of PSG.

Overall normal sleepers are also quite accurate at estimating time during the day. They can reliably estimate various time intervals (5 seconds, 35 seconds, 19 minutes) and keep a steady beat in a finger tapping task.

So can insomnia sufferers. Research suggests that overall, we, too, are quite accurate at estimating time intervals and keeping a steady beat during the daytime. It’s not the perception of time per se that gets distorted in insomnia. Insomniacs’ unreliability in estimating the passage of time occurs only at the night.

“It Takes Me Over an Hour to Fall Asleep”

Most studies show that people with chronic insomnia tend to overestimate sleep onset latency. For example, after having a sleep study, you’re told you drifted off 25 minutes after closing your eyes but you could swear it took you at least twice as long to nod off. How to account for this discrepancy?

One thing to keep in mind is that Stage 1 sleep—the lightest sleep stage, when the faster, unsynchronized brain waves associated with wakefulness are slowing down into more synchronized alpha and theta rhythms—is easy to perceive as wakefulness. In fact, if you’re woken up during Stage 1 sleep, you may feel you were never sleeping at all.

Research has also shown that unlike good sleepers, insomniacs tend to have elevated levels of high-frequency brain activity in the period leading up to sleep. These faster brain waves are associated with pre-sleep cognitive arousal—with thinking, rumination, and worry. They’re also associated with low-level awareness of what’s going on in the environment—a flushing toilet, a flash of lightening, the smell of skunk wafting through the window.

Unsurprisingly, insomniacs have been shown to take twice as long as normal sleepers to descend into deep sleep. So we’re hovering longer in the lighter sleep stages. All these things could help explain why we perceive we’re taking longer to fall asleep than PSG says we are.

“I Don’t Get Much Sleep”

Not all insomniacs are created equal. When it comes to estimating total sleep time, some insomnia sufferers are relatively good at it. (And results of some studies suggest that some insomniacs actually overestimate their total sleep time.) These are the so-called objective insomniacs, whose estimates of sleep time match up pretty well with their assessments by PSG. The diagnosis for this type of insomnia is often psychophysiological insomnia.

People whose sleep studies indicate they’re consistently sleeping less than 5 hours a night are called “short sleepers.” Short sleep is associated with physiological hyperarousal and an elevated risk for related medical disorders, as well as persistent trouble sleeping. Of all the variants of insomnia, short sleep is thought to be the most severe.

All I Get Is 1 or 2 Hours”

Other insomniacs’ perceptions of sleep duration are wildly at odds with assessment by PSG. A person who complains of getting just 1 or 2 hours’ sleep a night and goes in for a sleep study is often found to be sleeping 6, 7, or even 8 hours a night. The diagnosis in this situation is paradoxical insomnia, a disorder affecting about 26 percent of people with chronic insomnia.

Because their sleep duration is normal and their sleep architecture (as assessed by PSG) largely intact, the thinking is that these insomniacs are getting most of the benefits that sound, sufficient sleep affords. This may be reassuring. But the jury’s still out on the underlying mechanisms at play. Multiple irregularities may contribute to the feeling of being awake when most of the brain is asleep.

The Upshot

Should we be relieved to know that most of us are getting at least a little more sleep than we think? It’s not a bad idea. Once I stopped caring about how much I was sleeping, my sleep improved. Whether or not this would be borne out in a sleep study, it feels like I fall asleep faster and sleep longer than I did before.

If you can swallow the idea that in this one place your perceptions might be a tad unreliable (believe me, I know how hard this can be!), you won’t regret it.

Short Sleep and Your Health

The October issue of the journal Sleep showcases research that may be sobering for people who struggle with chronic insomnia. Short sleepers—defined variously as people who report getting 5 or fewer, 6 or fewer, or less than 7 hours of sleep a night—are more vulnerable to a host of nasties, including obesity, heart disease, stroke, diabetes, suicidal ideation, and dementia.

But sleep length is only one factor in the equation that predicts long-term health.

colorful-vegThe October issue of Sleep showcases research that may be sobering for people who struggle with chronic insomnia. Several studies now suggest that getting 7 to 8 hours’ sleep a night is protective of long-term health. Short sleepers—defined variously as people who report getting 5 or fewer, 6 or fewer, or less than 7 hours of sleep a night—are more vulnerable to a host of nasties, including obesity, heart disease, stroke, diabetes, suicidal ideation, and dementia.

In this same vein, researchers who conducted a study recently written up in ScienceDaily say that reports of short sleep and poor sleep quality—the stuff of insomnia—are associated with a greater build-up of β-Amyloid in the brain, a marker of Alzheimer’s disease.

What’s a Short Sleeper to Do?

Taking measures to improve sleep is always a good idea. Particularly regarding sleep quality, there’s a lot to learn and much to do. But sleep length may be less amenable to change. Thirty more minutes’ sleep a night may be possible to achieve under the right conditions. Beyond that, nature may not allow us to go.

But sleep length is only one factor in the equation that predicts long-term health. Short sleepers can minimize health risks by eating healthy meals and getting plenty of exercise. Following are recommendations from the US Department of Health and Human Services:

Dietary Guidelines

  • Increase your intake of fruit, vegetables (especially the colorful ones), beans, and peas.
  • Eat more whole-grain foods and fewer refined grains.
  • Increase your intake of fat-free or low-fat milk products and fortified soy beverages.
  • Go strong on seafood, and supplement with lean meat, poultry, eggs, soy products, and unsalted nuts and seeds.
  • Cook with oil rather than butter and other solid fats.

Exercise Guidelines

  • Do at least 2 ½ hours of moderate-intensity aerobic exercise, or 1 hour and 15 minutes of vigorous-intensity exercise, each week, or a combination of the two.
  • Get better results by doing 5 hours of moderate-intensity exercise or 2 ½ hours of vigorous-intensity exercise every week, or a combination of the two.
  • Do muscle-strengthening exercises at least twice a week.

Sleep is important to long-term health, but diet and exercise are, too, and may be easier to control.

How many hours do you sleep each night? Does it feel like enough?