Each night, when I go to sleep, I die. And the next morning, when I wake up, I am reborn.
– Mahatma Gandhi
I’ve been writing about healthcare information technology since 2003, and in that time I’ve had the honor of learning and writing about (and meeting thrice fleetingly) an industry icon who to me is today’s version of the Renaissance Man. John Halamka, MD, has more titles than a dozen people put together. He’s chief information officer at Beth Israel Deaconess Medical Center in Boston, chairman of the New England Healthcare Exchange Network, co-chair of the HIT (Healthcare Information Technology) Standards Committee, professor at Harvard Medical School, practicing emergency physician, author, blogger (Life as a Healthcare CIO), board member of a nonprofit established by the Veterans Affairs Department, mushroom and poisonous plant expert to the Regional Center for Poison Control and Prevention, and farmer, who recently finished building a bridge and pier on his farm.
I have to catch my breath now. I have seen Dr. Halamka in action at conferences. He’s texting and reading e-mails while waiting his turn to speak at panel presentations, and completely smashing what one physician told me years ago that men’s brains are not built to be able to multi-task like women’s brains apparently are. When he breezed into our news room at our annual conference some years back, and everyone was in awe of everything that he does in so little time, he announced that he gets by on average on four hours of sleep. Ah-hah! I told myself. That’s his secret. He must possess that rare genetic mutation that was discovered in 2009. Sleep researchers found two DNA samples from two sleep study participants that had abnormal copies of the DEC2 gene, which affects circadian rhythms. These two women sleep study participants got by on six hours of sleep, going to be between 10PM and 10:30PM and getting up refreshed around 4AM to 4:30AM, ready to start their day.
For the longest time, I have been getting by on less than the suggested eight hours of sleep. Sleep deprivation was my middle name among my friends. It was the only way I could do everything I needed to do – get my work done for my day job, raise kids, housekeeping, get to my novel, do the volunteering for my kids’ schools, and more recently blog. I routinely went to bed around two and got up at six. During the busy season at work, I would routinely pull all-nighters and sometimes 48-hour work days and not show any signs of wear and tear the following day. And since that rare genetic mutation was discovered, I thought I, too, was in possession of that abnormal gene.
And then I got older and in the last two years I started feeling fatigued all the time. I would wake up exhausted. I thought to myself that it must be I was carrying my stress into my sleep. If only my four to six hours of sleep were restful and uninterrupted, I would be fine. I thought older people needed less sleep, so what was my problem? I thought I must be “going through the changes” and once that was over I would be fine. But I didn’t have years to endure to get back to my normal pattern. In addition to not getting restful sleep, it must be the food I’m eating, I deduced. My body must be changing and reacting to foods I have been eating for years. A couple of Christmases ago, I thumbed through a book that my brother-in-law had gotten for David’s parents called Wheat Belly. That’s it! I told myself. Gluten must be the source of my fatigue! I need to start doing food elimination to discover the culprit, if it’s not indeed gluten.
A few months ago, I was telling my friend and mom’s group member, Mimi, about my fatigue and tracing it to food, and she didn’t bat an eyelash as she told me in her usual frank tone of voice, “How about getting enough sleep?” I tried to brush her off. I’m used to getting by on less sleep than most people. But I’m realizing it’s not true. And if a study published in December 2013 by Duke University researchers is any indication, I need to change my dangerous ways. The study revealed that women need more sleep than men and that the amount of sleep is more closely tied to health issues for women than it is for men. I know that sleep deprivation, especially long-term, damages the brain to the point that it resembles a football player’s brain that has suffered several concussions. Heart disease, blood clots, stroke, depression – stop! I didn’t want to hear any more of what I was doing to my body! I couldn’t ignore it any longer.
In the last few weeks, especially, I have been feeling exhausted upon waking up every morning – not just every other morning, as has been the case for several months. I’d been told that women should go to bed around 10PM because the two hours between 10PM and midnight were critical for women to get sleep. But, I sputtered upon hearing that fact, those two hours are when I’m full-bore doing multiple things – blogging, writing, folding laundry, catching up. But in recent weeks I have noticed how it is taking me twice as long to do anything. Those Duke University researchers discussed how women, who are natural multi-taskers, need their brains, particularly the cortex, which is the seat of memory, language, thought, and so on, to go into recovery mode so they could function properly the next day. What good was I if I had to take twice as long to work on my novel or blog? Pushing through was simply not going to work anymore.
So I began my sleep experiment earlier this week. Get to bed by 10PM and see what happens. I have to admit that I have not felt exhausted every morning. I didn’t manage to be in bed by 10PM two nights this week. I got to bed at 10:30PM one night and 11PM another night. The onset of fatigue on some of those days didn’t hit until midday. I was greatly encouraged by these early results. Some nights my body was ready to drop off to sleep that early. Other nights I tossed around, understanding that my body was not used to going to bed so early.
But I’m more alert and more productive during the day. I’m heartened by that immediate change. I tell myself that I’ll be able to get more done when rested than I would if I stick to my old ways. I have always prided myself on being healthful. Eat healthfully. Check. Exercise regularly. Check. I have never been good about sleep; sometimes, wrongly, wearing sleep deprivation like a badge of honor. I’ve thrown the badge away. While I wish I could be my version of Dr. Halamka, I realize I need to take care of my health first. The rest will come later.