Whether a youngster at the opening of the door to a lifetime of learning or an elderly adult winding down from decades of accumulating information, three similarities regarding sleep are stark:
1. Each requires sleep to live.
2. Many are not getting the sleep required for good health, be it compromised quality and/or quantity.
3. Neither knows much about it.
Somewhere in this arc of the lifespan, sleep deserves a respected space in the learning lexicon, maybe adding a new grouping of ABCs along with engaging in the acquisition of knowledge, appreciation, and respect for one of THE essential requirements for life, certainly for a mentally and physically healthy one. Yet in our 24/7 global culture, sleep for individuals of all ages is being compromised. Often viewed as dispensable, sleep is relegated to a back seat in favor of texting and watching Netflix or staying up past the time when eyes droop and the body begs for bed.
Why should we care about the ABCs of ZZZs? Without understanding WHY sleep is so important, the motivation to learn HOW to get adequate quality and quantity sleep is challenged all the more, leaving the impetus to take ACTION to optimize sleep less than likely. Aside from the fact that the sleep is fascinating, as a wealth of sleep science reveals (1), knowledge can serve as a catalyst to influence behaviors that support prioritizing sleep, be it for yourself or providing a healthy sleep environment for your children and family, or a sleep-friendly culture at work.
The ABCs of ZZZs offer a wealth of information that should be part of the education process, with adults needing to catch up from this knowledge gap. Few have ever had a course on sleep. To be literal, the A, B, and C of sleep offer a good beginning and illuminate considerations heretofore not widely considered:
- A = Airway– A healthy airway allows for the inflow and outflow of air to feed our organs and cells during sleep and during our waking hours. When the airway is compromised or restricted during sleep our sleep quality suffers. For example, snoring or obstructive sleep apnea (2) are signals of a compromised airway. (3) This can begin in the earliest stages of childhood and merits attention. (4)
- B = Breathing– To live we must breathe. And to sleep well, we must be able to breathe well. (5) Nasal breathing is the correct way to breathe during our waking hours and sleep. We humidify, purify, and warm the air when breathing through our nose. Mouth breathing bypasses these functions and compromises the flow or oxygen throughout our body. For some, due to congestion, allergies, a deviated septum, habit, or other causes, mouth breathing takes over. Advanced nasal stint technology such as Mute (6) can aid in opening the nasal airway and reduce snoring, or mouth taping with gentle paper tape or SomniFix (7) can help the shift from mouth to nasal breathing. Schedule a consultation with an ENT or see myofunctional therapist (8) to assess the issue and work towards switching to nasal breathing.
- C = Consistency– Our body clock, our circadian rhythm, (9) likes consistency. Like the predictable rising and setting of the sun, so too does our internal clock function in tune with the 24-hour rotation of the Earth. By having a consistent wake and sleep time, our biology is aligned with its natural rhythm and can function at its best to thrive. When we veer away from this consistency, our body clock gets out of sync, jet lag being a prime example, and we feel out of sorts, often seeking caffeine to stay up, medications to fall and stay asleep, or find ourselves nodding off at the wheel because our body craves the sleep it didn’t get at the time it was needed.
These simple ABCs offer some of the basic tenets for a good night’s sleep, but they are just the beginning of acquiring sleep literacy and taking steps to bring sleep education and training (10) to children, teens, adults, teachers, and even the medical profession. At the same time, prioritizing sleep is essential, as well as taking action to optimize sleep for yourself and your family, and prompting employers to provide sleep-friendly cultures for their employees. (11)
Our culture is in need of a paradigm shift. If a child behaves well, they get to stay up late but are relegated to bed early for misbehaving. How’s a child to buy in to bedtime if they’re getting the wrong message, not to mention virtually nil sleep education. Couldn’t sleep take a piece of the dinosaur and skeleton curriculum? How about categorizing sleep under technology? I suggest that the most sophisticated sleep technology is right inside us: our circadian rhythm and the intricate mechanisms of our sleep/wake cycle. A Nobel prize was recently awarded to scientists for “their discoveries of molecular mechanisms controlling the circadian rhythm” and the “exquisite precision” with which our inner clock adapts.(12) Recent findings about the brain’s cleansing system, the glymphatic system, (13) illuminate more about why sleep is essential. Without sufficient sleep, we risk our brain becoming like a dirty kitchen. (14) The growing body of research on the short and long-term consequences of inadequate sleep beckons attention. We are fostering health, developmental, learning, and economic challenges for current and future generations by ignoring these risks, school start times being one indicator of the risks and costs of insufficient sleep for children and adolescents. (15)
We’ve become intent on recycling what we use in our homes to protect the environment around us, but maybe what we need to recycle is our sleep behaviors and honor our biological needs so our internal environment can flourish. Sure, this may be at the expense of allowing children to stay up late to accommodate parental schedules that lead to later dinners, homework time, and extended bedtime to foster family time; or Mom and Dad catching another episode on Netflix; or your teen’s incessant texting until the wee hours. Our biology is screaming, “Time out! Wake up and listen! I can’t keep this up. I need my sleep!” The old adage, “I’ll sleep when I’m dead” should be edited to read, “I’ll be dead sooner if I don’t sleep.” Our biology isn’t changing any time soon. We’re going to have to adapt our behaviors to accommodate our essential sleep needs.
Science and clinical research, not to mention a tired public, are confirming more and more that not getting enough sleep at any age is not sustainable for health and well-being. (16) This growing body of research is clear in its message: Sleep is as essential as food and oxygen for people of all ages. The consequences of insufficient sleep cannot be ignored. Inadequate sleep for children is associated with increased risk for developmental, behavioral, learning and health deficits. (17) Instilling good sleep habits in children and initiating early sleep-related interventions offer a lifetime of prevention for myriad risks. We don’t yet know the long-term impact on children and teens, whose addiction to screens is contributing to the 80% who are not getting enough sleep. (18) As for adults, chronic sleep deprivation and undiagnosed/untreated sleep disorders are linked to many co-morbidities, including increased risk for cardiovascular disease, hypertension, obesity, depression, and anxiety cannot be overlooked. (19) The growing body of research on the relationship of sleep insufficiency to cognitive decline and Alzheimer’s Disease are raising more red flags. (20) That said, our ability to get the most out of our waking hours is challenged at any age when our sleep is inadequate, be it due to poor sleep habits and/or an untreated sleep disorder.
It’s time to empower ourselves, our children, and our colleagues to become proficient in the ABCs of ZZZs and take necessary actions, be it behavior or bedroom modifications, to get our best sleep quality and quantity for a healthy, long life. The quality of life tomorrow starts the night before, from the cradle until our last breath.
1 Walker, Matthew, Why We Sleep: Unlocking the Power of Sleep and Dreams. New York:
2 See My Apnea.org at https://myapnea.org/
3 The Foundation for Airway Health. https://www.airwayhealth.org/
4 The Importance Your Child’s Airway. HealthyStart. https://www.thehealthystart.com/list/the-importance-of-your-childs-airway
5 Are You Breathing Properly? Are Your Children? Optimizing the air you take in
24/7. Thrive Global. 2017. https://www.thriveglobal.com/stories/14381-are-you-breathing-properly-are-your-children
6 See Mute. https://mutesnoring.com/
7 See SomniFix. https://somnifix.com/
8 See Academy of Orofacial Myofunctional Therapy. https://aomtinfo.org/
9 What is Circadian Rhythm? National Sleep Foundation. https://www.sleepfoundation.org/articles/what-circadian-rhythm
10 See Sleep Well/Live Well. https://resonea.learnupon.com/store
11 See Resonea. https://www.resonea.com/
12 Nobel Prize in Physiology or Medicine. 2017. https://www.nobelprize.org/prizes/medicine/2017/press-release/
13 Jessen NA, Munk AS, Lundgaard I, Nedergaard M. The Glymphatic System: A Beginner’s Guide. Neurochem Res. 2015;40(12):2583–2599. doi:10.1007/s11064-015-1581-6
14 One more reason to get a good night’s sleep, Jeffrey Iliff. TEDMED. 2014. https://www.tedmed.com/talks/show?id=293015
15 Hafner, Marco, Martin Stepanek, and Wendy M. Troxel, Later school start times in the U.S.: An economic analysis. Santa Monica, CA: RAND Corporation, 2017. https://www.rand.org/pubs/research_reports/RR2109.html.
16 Chattu VK, Sakhamuri SM, Kumar R, Spence DW, BaHammam AS, Pandi-Perumal SR. Insufficient Sleep Syndrome: Is it time to classify it as a major noncommunicable disease? Sleep Sci. 2018;11(2):56–64. doi:10.5935/1984-0063.20180013
17 Half of U.S. Children Get Enough Sleep: Why That’s a Serious Problem. Healthline. 2019. https://www.healthline.com/health-news/children-lack-of-sleep-health-problems
18 Daugherty, Lindsay, Rafiq Dossani, Erin-Elizabeth Johnson, and Cameron Wright, Moving Beyond Screen Time: Redefining Developmentally Appropriate Technology Use in Early Childhood Education. Santa Monica, CA: RAND Corporation, 2014. https://www.rand.org/pubs/research_reports/RR673z2.html.
19 Sleep and Sleep Disorders. CDC. https://www.cdc.gov/sleep/index.htmlCDC.
20 Spira AP, Chen-Edinboro LP, Wu MN, Yaffe K. Impact of sleep on the risk of cognitive decline and dementia. Curr Opin Psychiatry. 2014;27(6):478–483. doi:10.1097/YCO.0000000000000106