Sleep health lecture

There is no one-size-fits-all standard for healthy sleep. As long as there is no persistent fatigue, decreased concentration, or irritability after waking up, even if you only sleep 6 hours a day, or are used to going to bed at 2 a.m. and starting at 10 a.m., it is considered healthy sleep. Don’t be kidnapped by the sayings on the Internet that “it takes 7-9 hours to reach the target” and “if you don’t sleep at 11 o’clock, you will miss liver detoxification”.

Aunt Zhang, whom I met at a community free clinic last week, is a typical example. She lies down at 9pm every day and wakes up at 5am every day, sleeping for 8 hours. However, she still has headaches every day. She read a lot of health posts saying that she "slept enough but not enough". She bought sleep-aid essential oils and steam eye masks for half a year, but she couldn't sleep more and more. I wrote a sleep diary for her, asking her not to stick to bed time, lie down when she was sleepy, and get up when she woke up. Even if she only slept for 5 hours, she should not lie in bed to catch up on sleep. Half a month later, she came to me again and said that her headache was much better.

In fact, there are two different tendencies in the sleep medicine community. One group advocates "duration first" and believes that adults' sleep duration of 7-9 hours has been verified by large sample data. Long-term deviation from this interval is indeed related to the increased risk of cardiovascular disease and metabolic disorders.； The other group pays more attention to "rhythm consistency" and believes that as long as your sleep cycle is fixed and you sleep at the same time and wake up at the same time every day, even if the total duration is only 6 hours, or the day and night are completely reversed, the impact on the body will be much smaller than sleeping for 10 hours today and 4 hours of fragmented sleep tomorrow. I have been doing sleep intervention for 6 years. I have seen online car-hailing drivers who work three full-time night shifts, sleep 6 hours a day, and have normal physical examinations. I have also seen white-collar workers who go to bed at 10 a.m. and start at 7 a.m. but wake up three or four times throughout the night and are still groggy during the day. I can’t say which group is more right. I can only say that individual differences are much greater than you think.

Oh, by the way, there is also the question that everyone asks the most: "Should I lie down if I can't sleep?" This is even more controversial. Traditional cognitive behavioral therapy pays attention to "bed time consistency". Even if you are awake, you have to stay in bed until a fixed time and then get up again, slowly turning back the biological clock. ； But now many young clinicians prefer the "20-minute rule" - lie down for 20 minutes before getting up before you feel sleepy, sit in a dark place for a while, read mindless books, and then go back when you feel sleepy. Otherwise, the more you lie down, the more anxious you will be, and your mind will be filled with "Why can't I fall asleep? I will definitely collapse tomorrow", which will make it easier to fall into a vicious cycle. Two months ago, I met a kid who was a senior in high school. His parents took away his cell phone and forced him to lie down at 11 o'clock. He stayed up until 2 o'clock with his eyes open, and his grades dropped by more than 20 places. Later, I allowed him to finish his homework and play his favorite astronomy posts for 10 minutes. He didn't have to go to bed and went to sleep when he was sleepy. Two weeks later, he said that he could fall asleep after lying down for 10 minutes, and his mock test scores improved.

Don’t panic when you see a short video about “Lack of sleep can shorten your life span by ten years.” Sleep is a bit like charging a mobile phone. If you can charge from 10% to 100% without interruption, even if it only takes 5 hours to charge, it will still be fully charged. Everyone also asked whether melatonin can be taken. The current consensus in the industry is that it is okay to take it for a short period of time (within 3 months) to overcome jet lag and adjust temporary work and rest disorders, but it is not recommended for long-term use, especially for young people. In the past six months, I have met three girls who have taken imported melatonin for more than half a year. On the contrary, their own melatonin secretion was suppressed, and they could not sleep all night after stopping the medicine. Of course, there are also studies that say there are no obvious side effects if taken in small doses for a long time. This has not been conclusive yet. If you really want to take it, it is best to ask your doctor first, and don’t blindly buy Internet celebrity products.

As an aside, I also had sleep anxiety when I was working on a project two years ago. I checked the "Dangers of Lack of Sleep" every day when I couldn't sleep for 6 hours a day.

In fact, at the end of the day, sleep is your own body's business. Don't impose yourself on the standards on the Internet. If you can still run 5 kilometers on 5 hours of sleep a day and feel energetic while fishing at work, then there is no need to force yourself to lie down for 8 hours. On the contrary, it will cause sleep anxiety that outweighs the gain and loss. If you are really tired after waking up for more than two weeks in a row, and you can't feel relieved even after sleeping for 10 hours, then don't look up the information on your own. Go to the sleep department to do a polysomnography, which is more reliable than any health advice.

What I’m talking about today is not an iron-clad rule that must be followed. They are all real situations that I have encountered in the past few years while attending clinics and running in the community. Don’t blindly compare them when you go back. If you have any specific questions, you can talk to me alone after the lecture ends. That’s it for today’s lecture. Thank you all.