Dr. Walter Conwell of Kaiser Permanente Bernard J. Tyson School of Medicine: “Follow consistent sleep times”

Follow consistent sleep times. Ideally, bedtime and wake up times should vary by no more than 1 hour every night, including weekdays, weekends, and holidays. This helps set our “internal clock” (circadian rhythm). Getting a good night’s sleep has so many physical, emotional, and mental benefits. Yet with all of the distractions that demand our […]

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Follow consistent sleep times. Ideally, bedtime and wake up times should vary by no more than 1 hour every night, including weekdays, weekends, and holidays. This helps set our “internal clock” (circadian rhythm).

Getting a good night’s sleep has so many physical, emotional, and mental benefits. Yet with all of the distractions that demand our attention, going to sleep on time and getting enough rest has become extremely elusive to many of us. Why is sleep so important and how can we make it a priority?

In this interview series called “Sleep: Why You Should Make Getting A Good Night’s Sleep A Major Priority In Your Life, And How You Can Make That Happen” we are talking to medical and wellness professionals, sleep specialists, and business leaders who sell sleep accessories to share insights from their knowledge and experience about how to make getting a good night’s sleep a priority in your life.

As part of this interview series, we had the pleasure to interview sleep expert Dr. Walter Conwell.

Walter D. Conwell, MD, MBA, is the Associate Dean for Equity, Inclusion, and Diversity and an Assistant Professor of Clinical Science at the Kaiser Permanente Bernard J. Tyson School of Medicine. He is a Pulmonary, Critical Care and Sleep Medicine Physician. Over the course of his career, he has undertaken a fellowship in Clinical Sleep Medicine at the University at Colorado; served as Sleep Core Co-Chair of the American Thoracic Society Education Committee; and served as Medical Director of Sleep Medicine and Outpatient Sleep Diagnostics at the Colorado Permanente Medical Group.

Thank you so much for doing this with us! Before we dig in, our readers would like to ‘get to know you’. Can you tell us a bit about your background and your backstory?

My name is Walter Conwell and I have an extensive background studying sleep. I’m a Pulmonary, Critical Care, and Sleep Medicine Physician. I’m also the Associate Dean for Equity, Inclusion, and Diversity, and an Assistant Professor, with the Kaiser Permanente Bernard J. Tyson School of Medicine, which opened its doors to the inaugural class in July 2020.

Can you share a story with us about what brought you to this particular career path?

I went to the University of Chicago for medical school and I realized very early on in my training that I had a love for physiology, particularly cardiopulmonary physiology — so within the first two weeks of med school, I knew I wanted to be a Pulmonologist. I also loved neurology, neuroanatomy, psychiatry and I became distraught because I didn’t necessarily know how I could bring together all the things that I loved. In my third year of medical school, I learned about the field of Sleep Medicine and how it’s a branch off of pulmonary. I found that this could bring together all the things that I loved, including cardio pulmonary physiology and neurology, and neuroanatomy and psychiatry, so it was the perfect field. I’m a persistent person, so once I determined which direction I wanted to go in, that’s where I put my energy and effort.

Can you share with our readers a bit about why you are an authority in the sleep and wellness fields? In your opinion, what is your unique contribution to the world of wellness?

As far as my sleep expertise, I’m board certified in Sleep Medicine and received my Pulmonary, Critical Care, and Sleep medicine training at the University of Colorado/National Jewish Health. My research in sleep has also been published in numerous peer-reviewed scientific journals. With my passion for the intersection of cardio pulmonary physiology and neurology, and neuroanatomy and psychiatry, I am able to bring a unique expertise and perspective to my patients and students.

Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?

My favorite literary character as a child was Sherlock Holmes. I love the idea of detective work. Similarly, that plays into my choice of specialty. My love for problem solving and detective work led me to Internal Medicine; my love for physics and physiology led me to Pulmonary and Critical Care; and my love for Neurology and Psychiatry drove me to Sleep Medicine.

Do you have a favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life or your work?

A huge part of what feeds into my “why” is the life lesson or notion that “if one of us fails, we all fail, but if we’re able to band together, we can lift others up.” This is most relevant in my current role as associate Dean for Equity, Inclusion, and Diversity. However, this is still one of the reasons why I still work in the world of Critical Care and why I find Sleep Medicine so enjoyable. Whether I’m helping patients in the Intensive Care Unit through critical illness or helping patients who suffer from sleep issues from insomnia to sleep apnea, it’s still all about helping people through their greatest times of need and lifting them up.

Ok, thank you for all that. Now let’s move to the main focus of our interview. Let’s start with the basics. How much sleep should an adult get? Is there a difference between people who are young, middle-aged, or elderly?

The range of sleep for humans is 6–10 hours. Generally, the younger we are, the more sleep we need. For example, infants often will sleep 12 hours or more, while younger children often need 10–12 hours. Teenagers probably need 8–10 hours; and young adults need around 8 hours. Then when we think of our grandparents, they may only need six hours of sleep. More importantly, there’s a lot of variability within the number of hours people sleep. In any age group, a person may require more or less sleep than others in their cohort.

Is the amount of hours the main criteria, or the time that you go to bed? For example, if there was a hypothetical choice between getting to bed at 10PM and getting up at 4AM, for a total of 6 hours, or going to bed at 2AM and getting up at 10AM for a total of 8 hours, is one a better choice for your health? Can you explain?

We have to put this in the context of the lives we live in and the society we are a part of. There’s generally a bias built into our society that favors early birds. The reason that plays a role is that if you’re a young adult or teen and you need 10 hours of sleep, but your internal clock is a little more delayed, it may be difficult to go to bed early and wake up early. In the society we live in, sleep may be truncated because of life’s typical demands of waking up early to go to school or work — so every day you may be running a deficit until the end of the week if your internal clock doesn’t allow you to sleep early enough to get the amount of sleep your body may need. Even if you’re trying to sleep in on the weekend, you still compound sleep debt into the next week. Sleep debt compounds over time and can turn into chronic insufficient sleep, which is one of the main causes of sleepiness in the U.S. The real answer to this question is that it depends on how much sleep a unique individual needs and their ability to go to bed at the time that they want and stay in bed for the time that they need.

As an expert, this might be obvious to you, but I think it would be instructive to articulate this for our readers. Let’s imagine a hypothetical 35 year old adult who was not getting enough sleep. After working diligently at it for 6 months he or she began to sleep well and got the requisite hours of sleep. How will this person’s life improve? Can you help articulate some of the benefits this person will see after starting to get enough sleep? Can you explain?

Chronic insufficient sleep can have consequences on your health and contribute to an increased rate of accidents, decreased attention, decreased performance, elevated blood pressure, affected mood, weight gain, etc. Conversely, if you’re able to get more and better quality of sleep, we anticipate all these things will improve.

Many things provide benefits but they aren’t necessarily a priority. Should we make getting a good night’s sleep a major priority in our life? Can you explain what you mean?

Yes, we should make sleep a priority. The benefits of good quality of sleep don’t live in a silo. Good quality of sleep can contribute to better overall health and quality of life. If there is another area of your life that you are looking to make changes to, such as weight loss, improved productivity and focus, stress reduction and more, it’s likely that good quality of sleep can positively impact or support your effort.

The truth is that most of us know that it’s important to get better sleep. But while we know it intellectually, it’s often difficult to put it into practice and make it a part of our daily habits. In your opinion what are the 3 main blockages that prevent us from taking the information that we all know, and integrating it into our lives? How should we remove those obstacles?

Most of what contributes to poor quality of sleep has to do with our habits. When we think about quality of sleep and related issues, such as insomnia, it’s really about developing good sleep hygiene. This means making sure your sleep environment is conducive to achieving quality sleep and that our bodies and minds are calm and quiet when we are trying to fall asleep. For example, if you are a person who is neither an early bird or night owl and you want to go to bed at 10 p.m., you would want to ensure that you are not overly energized or activated just before you want to go to bed — you have to provide enough time or buffer for your body and mind to be calm and quiet.

Do you think getting “good sleep” is more difficult today than it was in the past?

Yes, this is primarily related to the stress of our lives, the negative sleep habits that we often develop, and the impact of modern technology, such as electronic devices and fluorescent lights. With many of us having to balance several of these factors, it’s all the more important to work on getting good quality of sleep every day.

Ok. Here is the main question of our discussion. Can you please share “5 things you need to know to get the sleep you need and wake up refreshed and energized”? If you can, kindly share a story or example for each.

  1. Follow consistent sleep times. Ideally, bedtime and wake up times should vary by no more than 1 hour every night, including weekdays, weekends, and holidays. This helps set our “internal clock” (circadian rhythm).
  2. The bed should be only for sleeping or intimacy, not other activities (like watching TV, work, games). This will help train the brain to associate the bed with only sleeping and will help to improve sleep quality.
  3. Avoid light exposure (TV, computer screens, iPads, bright overhead lights, etc.) for at least 1 hour before bedtime and during sleep times. The bright light tricks the brain into thinking it’s daytime; and the activity on the screen tries to keep the brain awake. Light prevents the natural hormone Melatonin from being released, which is what helps us fall asleep and stay asleep at night.
  4. Keep the room and your body cool during sleep. We sleep more soundly when cool at night.
  5. Try not to nap during the day. If you do nap, try to limit naps to 15–20 minutes and end naps no later than 3:00 PM.

What would you advise someone who wakes up in the middle of the night and can’t fall back to sleep?

Get out of bed and do something boring or relaxing. Go back to bed on when you feel tired. You want to break the association of being in bed and not being able to sleep. What’s important to know is that everyone wakes up a few times a night, but that’s normal based on sleep cycles. It’s more worrying if you can’t go back to sleep after 20–30 minutes.

What are your thoughts about taking a nap during the day? Is that a good idea, or can it affect the ability to sleep well at night?

One of my top tips is to try not to nap during the day. If you do nap, try to limit naps to 15–20 minutes and end naps no later than 3:00 PM. A longer nap or later nap are likely to affect your quality of sleep at night.

How can our readers further follow your work online?

You can keep up to date on my professional work and list of publications and peer-reviewed research manuscripts within my biography here.

This was very meaningful, thank you so much. We wish you only continued success on your great work!

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