Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

Photo by drocpsu via Flickr

Today is the first day of the work week affected by the shift back to Standard Time and an extra hour of sleep. Daylight Saving Time was most recently legislated in the 1970s, during the energy crisis, to give an extra hour of daylight in the evenings during spring and summer for retail, leisure, and sports. The move back to Standard Time in the autumn readjusts our clocks to include the normal amount of daylight in the morning. This morning light is the most important light for synchronizing our circadian rhythms, a natural sleep-wake cycle controlled by a cluster of neurons deep inside the brain.

In theory, we should be able to sleep an extra hour during this “fall back,” but our circadian rhythms have already been set during the preceding months to wake up early for that hour in the gym or some extra time during the start of the day to collect our thoughts. This morning time is already ingrained in most of my patients to have a few minutes for themselves to catch up on email, review work projects, or make plans that allow family life to function.  Instead, we end up waking an hour early, despite the lack of alarms, and have to re-adjust to the new schedule. 

I ask my patients if they feel rested when they wake up in the morning, and the answer is nearly always no, regardless of the time of year. 

The amount of sleep that a person needs varies, but on average, most adults need about seven to eight hours of sleep per night.  Studies show that one in five adults fails to get enough sleep.  Current research indicates that too little sleep has profound affects on many areas of physical, emotional, and cognitive health.

Sleep deprivation—whether missing a night’s sleep or getting less sleep on a nightly basis than one needs—impairs attention, working memory, long-term memory, and decision-making.  If sleep deprivation is a long-term issue, people are at a higher risk for hypertension, heart attack and stroke, obesity, and psychiatric illness.

Weight gain may be due to the reduction in production of leptin, a hormone that tells us to stop eating, and an increase in the hormone ghrelin, which  increases hunger.  These hormonal changes occur in people who are chronically sleep-deprived.

Blood levels of cortisol, the adrenal stress hormone, are increased in the afternoon and evening in those who are sleep-deprived.  Cortisol causes increased blood pressure, pulse, and blood sugar, increasing the overall risk for heart disease.

More acutely, groggy drivers are estimated to cause more than 100,000 motor vehicle accidents a year, with over 1,500 deaths and 70,000 injuries attributed to drivers who fall asleep at the wheel.

It is common to hear from patients that they have trouble recalling information and at times difficulty with problem solving that had been easier in the past, especially in the setting of problems with sleep. Learning and memory are often ascribed to three discrete functions: acquisition—the introduction of new ideas into the brain; consolidation—the processes through which a memory becomes stable; and recall—the ability to access information after it has been stored.  Research suggests that the consolidation of memories occurs during sleep, and disruptions of sleep impair our ability to form memories.

Regardless of the time of year, it is clear that we need to find ways to improve our sleep hygiene.  Try to use this change in time to improve your sleep habits with the following simple tips:

1. Avoid caffeine after early afternoon.
2. Limit alcohol, since it acts as a stimulant, decreasing the quality of sleep throughout the night.
3. Go to bed and wake up at the same time each day.
4. Make your bedroom a calm and peaceful place.
5. Maintain the temperature in the bedroom between 65 and 70 degrees to improve sleep.
6. Keep the curtains open to allow the morning light to help re-set your circadian rhythm.
7. Develop a bedtime routine that helps you to wind down.
8. Turn off electronic devices one hour before bedtime.
9. Avoid unpleasant conversations in the bedroom.
10. Take time for meditation before sleep.

More on Sleep

The Annual Sleep-Loss Day by Patricia Yarberry Allen, M.D.

“My hour of morning light has been moved to the evening for people who want to walk or bicycle in the evening light. I wish these people would just go to the gym or do a Jane Fonda workout video indoors and leave my morning hour of sleep alone.”

Ask Dr. Pat: When Sleep Disorders Are Serious by Patricia Yarberry Allen, M.D.

Obstructive sleep apnea, which your symptoms suggest, is associated with hypertension and other medical problems and is statistically associated with death at an earlier age.