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Get More Sleep
In 2012, University of Chicago endocrinologist Eve Van Cauter subjected a group of healthy, lean men to sleep deprivation in a lab – the guys logged five hours a night – and monitored their testosterone levels. She expected some drop in the sex hormone – earlier work had established that men with sleep apnea are more likely to have "low T" – but was shocked to discover that after a week, these fit dudes had an average 15 percent drop in testosterone. Consider that science's standard T decline is a 1 percent drop per year for men in their late thirties and, Van Cauter says, "we're able to say that sleeping five hours a night, which many people regularly do, corresponds to 15 years of aging in one week." Hormonally speaking, of course. She adds that while a lot of middle-aged men talk to their doctors about testosterone gels to enhance libido and boost energy, "it's possible that an extra hour in bed might do the trick."Let's be clear. The testosterone number on your lab report isn't the be-all for libido. But to the best of our knowledge, testosterone is the primary biochemical driver of desire. Keep those levels as close to your youthful high-water mark as possible, and you defend your drive against the predations of time, especially if you're one of the 25 percent of men with low T readings, in the 200 to 400 range.
Van Cauter explains that one reason testosterone is so tethered to the amount of sleep you get is because that's when the body produces some 80 percent of its androgens (male hormones and human growth hormones). And most of that production occurs during the first and deepest phase, "slow-wave" sleep. Sadly, this rejuvenating interlude does shrink with age. A guy in his mid-twenties may get 80 to 100 minutes of slow-wave sleep, Van Cauter says. By age 40 that number can be cut in half or more.
The remedy for that is straightforward: exercise. The man who regularly sweats can stave off half of his slow-wave sleep decline, Van Cauter estimates, keeping T levels high. This past spring, Swiss researchers refined the exercise prescription. They found that regular, vigorous exercise increased hormone-enhancing slow-wave sleep by up to 15 percent more than moderate-intensity routines. According to study coauthor Serge Brand, evening workouts, within a couple hours of bed, delivered the biggest bang for the buck.
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How to Sleep Less and Function Better
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Of course, the notion of sleeping less as a key to success flies in the face of conventional wisdom, which says Americans as a whole are grossly underslept – snapping at our spouses, nodding off behind the wheel, getting fat and sick from the hormonal imbalances that can be caused by long-term sleep deprivation. According to the National Sleep Foundation, as many as 63 percent of the adults in this country fall under that description. Yet 45 percent of us say we're just sleeping less to accomplish more. As James Gleick, author of the best-selling Faster: The Acceleration of Just About Everything, has noted, "Cheating sleep is the closest thing we have to cheating death."
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But recently medicine has started to give us what we've been asking for. As understanding of the biology of sleep has improved, a handful of maverick researchers have begun to argue that a lot of us may be babying ourselves when it comes to sleep. This new analysis has spawned fledgling behavior modification techniques that are as radical and counterintuitive in their way as low-carb diets once were to the weight loss world, and it has heightened the controversy surrounding one very hot little drug.
As a matter of fact, it's the drug I'm on right now. It's 4 a.m., humans' most tired time of day, but 12 hours after downing a tablet of Provigil I'm still a house on fire, writing like the wind. Provigil isn't like the speed I took in college that kept me up for two days, jittery and wired, alphabetizing my CDs. This drug is reputed to have uncannily few short-term side effects; so far my only complaint is the mild headaches, which are suffered by 10 percent of users. I feel so calm and focused, in fact, I could go to sleep right now if I wanted to. But that's just it: I don't want to. Instead, I want to stay up and write and pay some bills and then maybe go for a jog.
ONE MIGHT EXPECT THAT SIX-AND-A-HALF TO SEVEN-AND-A-HALF HOURS WOULD HAVE BEEN ASSOCIATED WITH A HIGHER MORTALITY RATE, BUT DATA SHOWS IT HAD A 15 PERCENT LOWER RATE.
I am a little concerned about keeping this up for too much longer (I'm on my third night of three hours of sleep, with none of my usual naps or lattes). I'm also a bit nervous that no one – not Provigil's manufacturer, Cephalon, which won FDA approval for the drug in 1998 for the treatment of narcolepsy; not the U.S. military, which has extensively tested Provigil and allegedly handed it out to pilots in Afghanistan and Iraq – can say exactly how it works. But, hey, maybe that's just the hour talking.
Already, millions of nonnarcoleptics have taken Provigil over the past five years. Many of them are people with serious diseases, such as MS and Parkinson's, whose doctors prescribed it to help them to deal with the fatiguing effects their illnesses. Many others, presumably, are long-distance truckers and shift workers, investment bankers and somewhat somnambulant freelance writers who went to fda-rx.com, wrote in the "Describe your symptoms" box "I'm having a hard time getting all my work done because I'm tired," and had a package of pills delivered to their door second-day air. When one panel member asked if broadening the approved uses for Provigil might encourage more doctors to view it as a lifestyle drug, an FDA official said he didn't think so, but added that it was "not completely obvious" that such a development would be a bad thing. As he pointed out, if someone tired were driving next to him, "I think I'd prefer they be on it." Which reminds me, I have some errands to run.
If the new science of helping us to sleep less has some parallels to low-carb diets, then Dr. Daniel Kripke would be its Robert Atkins. In 2002 the veteran University of California–San Diego sleep researcher announced the results of a six-year study analyzing the sleep patterns and mortality rates of 1.1 million people. One might expect that sleeping six-and-a-half to seven-and-a-half hours (as opposed to the usually recommended eight or more) would have been associated with a higher mortality rate, but Kripke's data showed it was associated with a 15 percent lower rate, a finding that the National Sleep Foundation found unbelievable. "You have to understand, the NSF is largely financed by the sleeping pill industry," says Kripke. "I've got a million subjects that prove people shouldn't be afraid of restricting their sleep and seeing how they feel."
Scientists have trouble even agreeing on what sleep is or why we do it. What they do know is that sleep seems to perform important repair and clean-up functions, like the diagnostic program on a computer. The body's internal clock – which is not just a figure of speech but an actual clump of cells located in the lower front of the brain – tells the program when to run. And once it does we cycle through the stages of sleep every 90 minutes. Stage 1 takes us from wakefulness to the home page of nod. It's a transition phase, and it provides little or no recuperative value. Stage 2 is still a bit unclear, but it appears to be important for restoring mood and mental alertness. Stages 3 and 4 combine for our deep, or slow-wave, sleep. This is when the most significant restoration occurs: Growth hormone, so critical for development in children, is secreted and tissues are rebuilt. There's also a fifth stage, called rapid eye movement (REM), when memories associated with learning new tasks are likely stored and when we do most of our dreaming. (Interestingly, this is the stage suppressed by many antidepressants, which may actually help explain their effectiveness.)
THERE COULD BE ANOTHER WAY TO GET BY ON LESS SLEEP: SLEEP LESS. SERIOUSLY.
One theory is that Provigil works by overriding the go-to-sleep signals with commands to the hypothalamus, a key part of the brain involved in waking. Unlike amphetamines, Provigil leaves surrounding gray matter alone. Still, no one is sure how it gooses the hypothalamus, or what the long-term effects might be of regularly using it to cheat yourself of sleep's restorative benefits. "People used to think cocaine was safe," Kripke says. "In terms of a lifestyle drug, I'd say we don't know nearly enough about Provigil." All I know is that after four days of taking it at various strategic points in the day I had completely lost track of my normal sleep rhythms. Whenever I wondered if it was time to go to sleep, the little timer inside my head seemed to be flashing "00:00."
RELATED: Why Exercise at Night Probably Won't Hurt Your Sleep
If all this sounds too scary or untested for you, there could be another way to get by on less sleep: Sleep less. Seriously. "If you reduce your time in bed you shorten your Stage 1 sleep and lengthen your Stage 4," explains Arthur Spielman, director of the Sleep Disorders Center at the City College of New York. "You become a more efficient sleeper. That's just logic." Long sleepers like me tend to putz around in Stage 1, take our sweet time smelling the flowers at the start of Stage 2, and eventually settle in Stage 3 and 4 for the really good stuff. It's classic inefficient sleep. But by carefully restricting our sleep over the course of several weeks we can train ourselves to maximize the sleep we get and eventually do just as well – maybe even better – with less of it.
As with all training programs, the first step is to rule out any underlying medical conditions. In a visit with Spielman I learned that I probably have a mild case of sleep apnea, which, in addition to making me snore like a freight train, has also likely been making my sleep less restful. Although some apnea sufferers have to spend a night in a sleep lab, and may even require surgery, for the time being forcing myself to sleep on my stomach seems to have fixed the problem.
At the same time I consulted with Anneke Heitmann, a sleep researcher with Circadian Technologies, a Massachusetts-based management consulting firm that advises companies with 24-hour operations. A bigger fan of the sleep-less techniques than Spielman, Heitmann helped me determine exactly how much sleep I needed using the vacation method: For three or four straight days you let yourself sleep as much as you want (as you would on vacation) to make up whatever sleep debt you're running. On the next night you will sleep noticeably less. That's how much sleep you need on a typical night.
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In this manner I determined – much to my amazement – that I need only about seven hours of sleep. Then I started limiting myself to just the amount that maximized highly restorative Stage 3 and 4 sleep. The key was not to backslide and sleep in, even on weekends, which would just throw off my sleep rhythms again. In fact, if I was going to be out especially late on Friday or Saturday night, it would be better if I still got up around the same time and caught up with a nap.
I DETERMINED – MUCH TO MY AMAZEMENT – THAT I NEED ONLY ABOUT SEVEN HOURS OF SLEEP.
That first week on the new program and off the Provigil was difficult. I was even more exhausted than usual; when the alarm went off that first Saturday I hit the snooze and woke up at noon, more than a little disoriented and demoralized. But in a fit of uncharacteristic Wesley Clark–like discipline I stuck with it, and by week four I started seeing definite improvement. I was more alert, energetic, and – lo and behold – had an extra 90 minutes a day to, you know, do stuff.
Someday there may be drugs everyone takes to allow them to sleep just three hours a night. Even now scientists are studying the short sleepers among humans and animals, including migratory songbirds, which go days without shut-eye, and dolphins, which always have one half of their brains awake so they can surface for air. What researchers uncover could transform all of us into alpha wakers. In the meantime I have great hopes for my new sleep routine.
