What I’m Reading: The Promise Of Sleep
I finished Dr. William C. Dement’s excellent book, The Promise Of Sleep earlier this week.
What Is It About?
Well, it’s about sleep. Whereas Lights Out: Sleep, Sugar, and Survival looked at sleep through the lens of evolution and how it affects our cravings for food, The Promise Of Sleep looks more at the basics of sleep, sleep phases, and general health. And there is nothing about conspiracy theories in Dr. Dement’s book.
Who Should Read This Book?
- Anyone with an interest in how sleep affects health
- Anyone with sleep issues
Where It’s Good
Dr. Dement is one of the pioneers of sleep research so he knows his stuff. It’s obvious that he is both passionate and very knowledgeable from years spent in the sleep lab, working in a very niche field to formulate most of the knowledge that we have on the subject of sleep. He touches on the history of sleep research, specifically how the field has grown and how it has dispelled much of the folklore surrounding sleep and dreams of the past. Further, Dement delves into sleep studies and how they’ve expanded the depth of knowledge in the world of sleep. He also dispels a few rumors; did you know that you won’t go insane without sleep?
Dr. Dement spends a good bit of time discussing the various stages of sleep and how we know what happens when those stages are disrupted. For instance, the lack of REM sleep in narcoleptics keeps them from ever being fully rested. He operates from the prospect of a sleep “bank account” (Sleep Debt) and describes how to make sure you keep your sleep debt low enough to function properly throughout the day. Mental function, physical function…it all ties to sleep and making sure we get enough of it. And it’s not natural to be sleepy during the day.
Basically, as Dement explains it, there are two competing “clocks” in the body, one pulling us into sleep and one keeping us alert. The alerting clock has a dip in mid afternoon and again in the late evening with a peak in the early evening. Only at night should our sleep debt be high enough to overcome even the low alerting of the mid-afternoon dip.
Finally, Dr. Dement goes into various protocols for improving sleep and sleep disorders. In his hometown of Walla Walla, WA, Dr. Dement has setup a clinic that has improved the lives of many people that previously suffered from sleep apnea and other sleep disorders. Oh, one more thing that is never okay: snoring. If you snore, you’re not getting proper healthy sleep.
One word of advice that he gives is, “If you’re engaged in a dangerous activity (like driving) and you feel drowsy, stop now!” As he says, once your eyelids are feeling heavy, you are just a lapse in concentration away from falling asleep and having an accident. Even a 30-minute nap will perk you up enough to get you through and won’t set your trip back by much.
What I’d Like To See
With my interest in general health, I’d like to have a better understanding of how sleep affects the various hormones. It’s not all that important for the layman to understand, but for my own edification, I think it would be cool to see the various hormonal cascades and effects from lack of sleep.
Overall Rating
It was a bit dry in places, but the book is packed with solid information. It’s 450 pages (which is why it’s packed with so much information) and can take awhile to get through, though I have been tied up with lots of other stuff in the past 6 weeks and took my time reading it. I recommend reading this book if you have a major interest in sleep and how it affects health.
Since the book has a copyright of 1999, I’m trying to get in touch with Dr. Dement to discuss how our understanding of sleep has changed in the past decade. Hopefully I can manage to get an interview with him.
About Scott
Scott Kustes loves to cook and loves to eat. He started Real Food University to help you get maximum enjoyment out of the meals that you eat. To find out more about how he has rebelled against the fast food culture and counting calories or carbs, join the Real Food Revolution.
15 Reader Comments
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As a person with problems sleeping, the topic is extremely interesting to me – although I will admit I couldn’t finish Lights Out – maybe I was too tired!
Anyway, an update interview would be great – good luck!
Stop it now Scott. My queue of books to read is getting unmanageably long, and you have contributed more than most!
Great book. Sleeping is one thing I need to improve on. I am still cutting on my sleep when I am in crunch mode which is worse because I know I actually need more sleep during those times. I definetely want to read this book to see what the damage is
.
Thanks Scott.
Great book, I read it awhile ago…
My only complaints are that he doesn’t seem to tell the whole story about sleep and mood. It is proven in clinical studies that a lot of depressives respond to sleep deprivation with elimination of depresssive symptoms (google “sleep deprivation therapy depression”) … about 60% of depressives find this true.
It is also known that people officially diagnosed as bipolar can become hypomanic or manic if they are forced to lose sleep.
All Dement talks about int he book is that sleep loss and insufficient sleep make one tired and depressed… which is certainly true for normal people without mood disorders,…but it is definitely NOT true for people with bipolar disorder or depression of a bipolar type (I suspect the 60% that respond to sleep deprivation probably have a form of bipolar disorder).
For my whole life I have always been depressed. When I was younger (childhood and teens), I was severely and chronically depressed.
For my whole life I have tended to push my nights later and later because I had always noticed that as I stayed awake I became more excited, disinhibited, and my depression got better.
When I went on a very low carbohydrate diet, overnight my depression got much much better just like a lightswitch turning on (literally, as high blood sugar suppresses the alerting mechanisms in the brain via hypocretin). It did not go away totally, but it improved 300%,
In my early 20s, I began to realize that when I stayed up really late I felt very good. I did research and learned about “theraputic sleep deprivation”.
Shortly after this period, I had my first episode of hypomania… it occurred after sleep deprivation off a night. I went from fatigue and lethargy (expected after sleep deprivation) to suddenly laughing maniacally, having an overwhelming need to move around, wanting to run down the block, etc… this was followed by psychotic symptoms/insane paranoia. It went away relatively quickly fortunately enough (a couple of hours).
Ever since then I have had hypomanic symptoms when I do not sleep enough.
One of the reasons I was interested in this book is because I was really hoping this would have some kind of information about *why* this happens to me… what goes on in the brain when we don’t sleep so that it relieves abnormal depression and trigger hypomania?
It is patently false that sleep loss causes depression, or that it makes depression worse… this might be true of euthymic people, but then again, euthymic people aren’t the ones who need help with moods, right? It’s kind of like talking about how to maintain a normal weight by examining the metabolism of people who are not vulnerable to obesity. Duh.
BTW if anyone is curious why sleep deprivation alleviates depression and triggers hypomania, I did my own research and discovered that it has something to do with reducing glucose metabolism in the brain. I suspect this reduced metabolism of glucose reduces free adenosine, and like taking stimulant drugs the end result is that your brain is flooded with dopamine and norepinephrine and lights up like a christmas tree (if you’re bipolar)… if you’re a regular depressed person then what happens is the slight bit of extra dopamine and norepinephrine from the reduced concentration of adenosine helps improve mood.
I was not surprised to discover that glucose metabolism in brain cells is at the seat of a lot of types of depression. I can almost time like a watch my moods to my blood sugar.
If I eat a bit too much carbs/food, I become very mixed (energy + depression). It is like having energy, but you feel like crap and you’re quite crazy.
If I eat like a regular american (a horrendous amount of carbohydrate) then I relatively quickly become very very very depressed. I mean, severe, suicidal, can’t function can’t do *anything* depressed. Staring into the end of time depressed, winded in the chest that I have to live depressed.
On the flip side of that coin, if my brain is primed for hypomania, eating a lot of fats with no carbs can set me over the edge into laughing insane maniacal running down the street nuttery.
So, anyway… I feel my best if I am on the border of ketosis at any given time.
Blood sugar is the ruin of me, it smothers my brain and turns me into an invalid.
So I guess Im not getting enough sleep then since I just awoke from a mid afternoon nap.
Does it say anything about disrupted sleep caused by evening exercise?
Paul – in the section about sleep hygiene it would deal with this situation. Exercise increases stimulant neurotransmitters like dopamine, because exercise is stress. Dopamine and norepinephrine prevent sleep.
He gives a lot of good tips on how to manage stress so as to counter insomnia and poor sleep. Exercise before bed is a definite no no for a lot of people..
You said that the book dispelled a lot of rumors about sleeping. I had a friend, who played college football, that would take a supplement aimed at increasing the amount of REM sleep he would get a night. Would increasing the amount of REM sleep do anything in the way of helping an athlete’s body to recover from physical exertion?
Thanks for the post!
All the Best,
Andrew R
Go Healthy Go Fit
Methuselah, just going my part. People long ago expanded my reading list to somewhere between 20 and 40 years worth of books. Figure I should spread the love.
Woooo, great information on depression.
Dr. Dan, he does advise napping as a way to cut into sleep debt.
Paul, as Woooo said, it does touch on exercise and the basic advice is “pay attention to how it affects you.” He says that if watching TV or reading stimulates you, don’t do it before bed. If it makes you sleepy, then it’s okay for a bit before bed. Same with exercise.
Andrew, Dr. Dement points out that REM sleep is necessary, but so are the other levels of sleep. I’m not sure if additional REM would help, but if I ever hear back from him, I’ll ask that question. He does note that when people are deprived of sleep, then get to sleep, they sleep more efficiently, dropping into REM more quickly and spending more total time in REM. What supplement was it?
Cheers
Scott
I’ve read this book a few times, and your post has motivated me to give it another read. Here’s a link to a YouTube video of the author, Dr. Dement giving a lecture on sleep.
I’d be interested in knowing his take on caffeine. There’s a school of thought that caffeine (even if you’re the type that fall asleep right after consuming it) interferes with the deepest and most restorative stage of sleep. So even though you might get enough quality-wise, it ends up being poor quality and fails to restore you.
Jeff,
As I recall, Dr. Dement recommends cutting back on caffeine and using it only when you need to be perked up. As he points out, there is a 4-6 hour half-life of caffeine, so cutting it off early in the day is important.
Thanks for the video…watching now.
Cheers
Scott
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