The Lucky Years: How to Thrive in the Brave New World of Health (31 page)

Clearly, the body ages. It’s a normal physiological process. Hormone levels change, cells don’t turn over as fast, and we don’t bounce back as easily the older we get. It’s normal and natural to age. I have faith that one day we’ll be able to change the effects and tempo of aging through some of the therapies I’ve already described, such as turning on sleeping stem cells and leveraging the body’s internal machinery naturally. But to try to reverse aging through synthetic antiaging drugs is cheating the system. There are ramifications. After all, there’s a reason the body doesn’t produce the same amount of growth hormone when you’re seventy as when you were seven. That growth hormone is spurring development in the youngster; in the older adult, it’s also stimulating growth but at a huge physiological cost. And if that older adult happens to have any cancerous cells growing, guess what that supplemental growth hormone is doing: Acting like Miracle-Gro.

Any kind of hormone therapy used to combat the effects of aging should be suspect. We all want to look and feel younger, but there are better ways to achieve that goal without compromising your system’s natural process. The real antiaging secret is using proven metrics to optimize your health, like eating dinner before seven in the evening to get a good night’s sleep or taking a 20-minute walk at two in the afternoon to beat the midday lull and resist the craving for a sugar fix. With technologies to help us stay attuned to ourselves, we can effect positive changes to our body’s system without artificially tinkering with it. And as you’re about to find out, whatever we can do to tame inflammation will go a long way to keeping us looking and feeling as young as can be.

Our bodies are our gardens, to the which our wills are gardeners.

—William Shakespeare,
Othello
, act I, scene III

T
he next time you’re at a high-stakes baseball game or watching one on TV, think about all that went into preparing for the game, from equipment to strategy, coaching and consulting. I bet that among the things that cross your mind, seeking advice from sleep experts is not on the list.

In April of 2015, Matt McCarthy, a doctor himself, reported on an unusual story for
Sports Illustrated
: Major League Baseball’s experiments with sleep.
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Put another way, his article covered the league’s attempt to manage “circadian disadvantages”—sleep deprivation due to traveling across time zones and the impact on a player’s performance.

At the heart of McCarthy’s reporting was the story of Red Sox’s first baseman Mike Napoli, who underwent surgery in 2013 to reconfigure his chin, jaw, and sinuses to help him breathe easier at night. Napoli had suffered from a very common sleep disorder called sleep apnea since his early twenties. The disorder causes the airway to collapse during sleep
when the muscles in the back of the throat fail to keep the airway open. So your breathing essentially gets cut off multiple times, your sleep becomes fragmented, and your blood is not as oxygenated as it should be. Loud snoring and dreamless sleep are often telltale signs of sleep apnea. Napoli couldn’t recall a dream in more than a decade before his surgery fixed his problem. Sufferers of sleep apnea who don’t receive treatment never feel fully rested, and this can result in chronic sleep deprivation that raises risks for a slew of health conditions, from hypertension and heart disease to mood and memory problems.

An illustration of how sleep apnea happens and how the air breathed in can be blocked by the position of the throat. Sleep apnea is caused by the muscles of the upper respiratory system relaxing. The throat then becomes narrow or even completely blocked, which doesn’t allow enough air to pass, leading to loud snoring noises when the individual breathes in and out. As a result, the body does not get enough oxygen.

In 2015, an alarming new study published in
Neurology
found that sleep apnea doesn’t just casually hasten memory and thinking declines as if you’re having a benign “senior moment.”
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It may in fact lead to earlier diagnoses of mild cognitive impairment (MCI) and Alzheimer’s
disease; MCI is often a precursor to dementia. The New York University researchers of this particular study found that patients with sleep apnea were, on average, diagnosed with mild cognitive impairment nearly ten years earlier than those who didn’t suffer from breathing problems during their sleep. The time span for developing Alzheimer’s also seemed to speed up: those with sleep apnea were diagnosed, on average, five years sooner than were sound sleepers. Among the theories given to explain this connection are the adverse effects of oxygen loss on the brain, as well as the fact that sleep entails a slew of physiological events that help the brain to “freshen up,” do some housecleaning, and clear out proteins that can otherwise gunk up nerve cells.

For professional athletes in their prime, major sleep deprivation can be destructive to performance. Although it hasn’t been shown to impact muscle strength, it can impair reflexes, judgment, healing, attention, and motivation, all of which are key ingredients to success on a court, field, or racecourse. By some measures, chronic sleep deprivation can slow reaction times nearly tenfold, so imagine that kind of impact on a Major League Baseball player who has just fractions of a second to decide whether to swing at a fast curveball. Dr. Scott Kutscher, a neurologist and sleep expert at Vanderbilt University Medical Center, has looked at players’ behavior while up to bat, measuring a player’s tendency to swing at pitches outside of the strike zone (what’s also called plate discipline). Kutscher argues that for many players, their discipline in this regard becomes progressively worse over the course of a season. And he’s convinced that this has to do with fatigue, which impairs judgment.

Dr. Christopher Winter, board certified in both neurology and sleep medicine, is medical director of Charlottesville Neurology and Sleep Medicine in Virginia. His landmark 2009 study put time zones and baseball players to the test when he looked at how traveling across time zones for games impacted players and the outcomes of their performances.
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After evaluating ten seasons (that’s over the course of ten years), he found that if a team crossed a time zone to play a game, it was at a slight disadvantage compared to a visiting team that did not
deal with a time change. And a team that crossed three time zones had a less than 50 percent chance of victory. The reason for this weakness is a disruption in circadian rhythm—the body’s internal clock that revolves around its sleep/wake cycles and is paced by environmental cues such as light and temperature, as well as the hormone melatonin. Dr. Winter’s work has inspired a number of Major League teams to find the secret sauce to fight fatigue and leverage the circadian
advantage
—being in the right place at the right time to perform optimally. Interestingly, his research has also revealed that players who wrestle with sleep deprivation don’t typically stay in Major League Baseball as long as those who get their beauty (er, athletic) sleep. When the Giants consulted with Winter during the World Series in 2014, the team opted to spend the night in Missouri after a game rather than fly home that night. The following week they won the Series.

The idea that a well-rested ballplayer is more likely to be a winning ballplayer is the example we need to keep in mind for all of us, no matter what we do for a living or what kind of performances we’re giving in our personal and professional lives. According to the National Institutes of Health, chronic problems with sleep that can significantly diminish health, alertness, and safety affect up to 70 million Americans. The number of chronic diseases linked to chronic sleep deprivation and untreated sleep disorders is astounding. In addition to the ones I’ve already mentioned, others include uncontrollable weight management, stroke, diabetes, and cancer. If colds haunt you throughout the year, perhaps it’s because you’re not getting enough shut-eye; in 2015 a group of researchers confirmed that people who are “short-sleepers,” meaning they sleep six hours a night or less, are more than four times more likely to catch a cold, compared to those who get more than seven hours in a night. In fact, Centers for Disease Control and Prevention considers insufficient sleep a public-health epidemic. From a scientific perspective, sleep is emerging as so potent a factor in better health that we need to view it as a nonnegotiable priority and install policies to support it. It may be among the lowest-tech strategies we have at our disposal to enhance the quality of our life and health in the Lucky Years.
And there won’t ever be a gizmo, gadget, or drug we can take to negate our need for sleep or replicate its benefits on the body.

Most people know when to seek medical help for pain or unexplained symptoms that disrupt their daily life. But sleep problems are often ignored or overlooked. Which is why the overwhelming majority of people with sleep disorders do not seek treatment and are not diagnosed.

In 2015, the National Sleep Foundation (NSF), along with a group of experts, issued its new recommendations for sleep. The report suggests wider sleep ranges for most age groups. The NSF arrived at these updated figures after they formed a panel from various fields including pediatrics, neurology, gerontology, and gynecology to reach a consensus. The panel revised the recommended sleep ranges for all six children and teenage groups. A summary of the new recommendations includes:
⁴

Newborns (0 to 3 months):
Sleep range narrowed to 14 to 17 hours each day (previously it was 12 to 18).

Infants (4 to 11 months):
Sleep range widened two hours to 12 to 15 hours (previously it was 14 to 15).

Toddlers (1 to 2 years):
Sleep range widened by one hour to 11 to 14 hours (previously it was 12 to 14).

Preschoolers (3 to 5):
Sleep range widened by one hour to 10 to 13 hours (previously it was 11 to 13).

School-age children (6 to 13):
Sleep range widened by one hour to 9 to 11 hours (previously it was 10 to 11).

Teenagers (14 to 17):
Sleep range widened by one hour to 8 to 10 hours (previously it was 8.5 to 9.5).

Younger adults (18 to 25):
Sleep range is 7 to 9 hours (new age category).

Adults (26 to 64):
Sleep range did not change and remains 7 to 9 hours.

Older adults (65+):
Sleep range is 7 to 8 hours (new age category).

I’ll
admit that I may preach the value of restful sleep but find myself equally challenged by the task of achieving high-quality sleep on a routine basis. I’m constantly at the mercy of an unforgiving work schedule and commitments to events that often require me to make long trips across multiple time zones or get up super early after an evening dinner I had to attend. But I do my best, and I know that I don’t suffer from any serious sleep disorder. That’s the first thing you can do if you find yourself routinely sleep deprived: focus on your nightly slumber and find out if you have a problem that should be addressed by a physician. Does it take more than twenty or thirty minutes to fall asleep? Do you wake up in the middle of the night and have a hard time falling back asleep? Has anyone told you that you snore?

We live in a world that makes sleep look outdated, undesirable, and optional. With our overscheduled lives, 24-7 access to media, screens, online retail, and artificial light, and our urge to check our phones and emails constantly, it’s no wonder we suffer from a lack of sleep.

But I can’t tell you how many times I’ve cured someone’s low energy and chronic exhaustion by suggesting they get their sleep habits under control and maintain a regular schedule. One of the most commanding roles sleep has is its ability to dictate our hormonal balance—from hormones that control appetite to hormones that help us manage stress, replenish cells, heal and fight infections, utilize energy efficiently, control weight, renew skin and bones, lower risk factors for heart disease and stroke, sharpen our planning and memory skills, improve concentration, and return organ and tissue function to more youthful states.

So while you may think that your body is powered down for the night when the lights go out, that couldn’t be further from the truth when it comes to what your brain is doing. It’s catching its breath. It’s the command center where a legion of neurons spring into action as soon as you surrender to sleep. This is when metaphorical data processors in your brain go through all the information that your brain took in that day and organize it so you can take in more and learn more the following day. This is also when your brain runs through its trusty checklist to ensure your hormones, enzymes, and proteins are balanced and in sync.
Meanwhile, the brain’s janitors are at work to sweep out any toxic debris that can gum up its systems if left to build up.

Sigrid Veasey is a leading sleep researcher and a professor of medicine at Perelman School of Medicine at the University of Pennsylvania. She’s been working with mice to understand just what happens when the brain doesn’t get its break to conduct certain business. Using her mouse models, she’s found that when the brain is kept alert by neurons firing constantly, these brain cells shed free radicals as a byproduct of making energy.
⁵
Free radicals are rogue molecules that have lost an electron and thus they are highly reactive in the body, damaging healthy cells and tissues. They can potentially be toxic to the brain if they are not swept up. And it turns out that during sleep, these same neurons also produce antioxidants that take care of these free radicals. But periods of sleep loss, even if they are brief, can be damaging: the cells fail to make enough antioxidants to counter the buildup of free radicals. As a result, some of the neurons die and they cannot be recovered. After several weeks of depriving her mice of adequate sleep, the mice “are more likely to be sleepy when they are supposed to be active and have more difficulty consolidating [the benefits of] sleep during their sleep period.”
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