The role of sleep is complex and a continuing focus of research. We do know that it's central to survival and health, both short- and long-term:

• Restorative – wound healing, immune system functioning
• Growth and rejuvenation – in the immune, nervous, muscular and skeletal systems
• Brain development and brain normalcy later in life
• Memory and mental processing

A night's sleep should move through a series of cycles, each linked to one or more of these functions. Poor quality or insufficient sleep interferes with each cycle, impairing all functions:

It's estimated that one-third of the population is sleep-deprived. Reasons range from chronic insomnia, stress and other sleep dysfunctions (sleep apnea, restless leg syndrome) to career/job patterns, to attitudinal issues – “I don't need more than 5 hours a night”.

Chronic Sleep Deprivation has the seriously damaging effects shown here.

However, research now links acute deprivation (e.g. 48 hours with no sleep) to other debilitating and high-risk conditions. A recent study found that healthy college students going without sleep in excess of 48 hours developed distinct symptoms of diabetes. Clearly, then, it's mistaken thinking to believe that transient reductions in sleep result in only temporary impairment such as lack of concentration.

How Much Sleep Do You Need?

It's not as simple as a single number. The conditions of sleep are critical. Sleep at the 'wrong' time of day is inefficient and inadequate because the body's two circadian markers (concentration of the melatonin hormone and minimum body temperature) do not occur or fail to occur in synch. Experts argue that at least 6 hours of sleep are necessary before the body reaches minimum temperature. By definition, then, one's looking at 7 to 8+ hours daily. Think of how difficult it is to achieve this, given our typical lifestyles!

We hear a lot about the basic Ways to Improve Sleep. More important is why these are relevant and how you can manage them.

• Depressants such as alcohol initially cause somnolence, but rebound later and disrupt sleep.
• Stimulants (caffeine, energy drinks, amphetamines – including those prescribed to treat conditions such as ADHD) slow the action of somnolence-inducing hormones (thereby impairing ability to fall asleep) and, when the effects wear off, cause a precipitous decline in alertness.
• Sleep hygiene – try to reinforce the circadian rhythm by sleeping at the same time daily, avoiding heavy meals immediately before, 'winding down' mentally, emotionally and ensuring a quiet, dark environment.
• Napping – the post-lunch 'dip' occurs because the biological clock causes the greatest drive for sleep about every 12 hours. Power napping (or siesta!) at this time typically does not impair sleep at night as long as it's brief and occurs long before the usual timing of night sleep.
• Melatonin – supplementation can augment the body's natural production but it takes several hours for adequate absorption to occur.
• Sleep medication – prescription medications work in the short-term to break disruptive patterns but quickly become habit-forming with other potential side-effects.

The deeply disturbing patterns of chronic disease in our Western society would be better addressed with the well-worn triad of nutrition, exercise and sleep.

Experts in the field of breast cancer screening advocate a tri-modal approach. Dr. Karina Bukhanov, Assistant Professor at the University of Toronto, recommends women at high risk undergo all three types of imaging:

1. Digital Mammogram (superior to the older analogue technique)
2. Ultrasound
3. MRI (magnetic resonance image) of the breast

Take a look at the impact of the unique advantages of each 'modality' in assessing different types of breast lesions.

Digital mammograms provide a dramatically clearer and more detailed picture.
An ultrasound reveals a benign cyst in what appeared in a mammogram to be a worrisome lesion.

And, as so many have discovered to their dismay, use of mammography alone can result in missing a tumor altogether. MRI is highly sensitive – especially important for women with dense breasts.

In the mammogram on the left the tumor can be missed, particularly in the case of denser breast tissue. It is clear in the MRI

We now know that conventional screening techniques - breast self-examination and standard annual mammography - are insufficient to detect all forms of breast cancer and are seriously inadequate for women at high risk.

Breast Cancer, whether treated successfully or not, robs years from a woman's life. We strongly advocate proactive steps:

• Begin screening at an age appropriate to your personal risk – in some cases as early as 30
• Request a digital mammogram
• Should you be concerned about the quality of the mammogram, request an ultrasound
• MRI should be seriously considered for all women at higher risk

Increasingly numerous studies demonstrate a link between Vitamin D and a long list of bodily processes, including immune modulation, blood pressure regulation, insulin regulation and brain activity. Researchers have also found that cells of essential organs (skin, breast, colon, bone marrow, kidney, lungs, prostate) are biologically responsive to D.

Because D has such a strong impact, a deficiency has been implicated as a causative factor in a variety of diseases, including osteoporosis, cancer, periodontal disease, peripheral artery disease, chronic pain, depression and cognitive impairment, coronary disease, lupus, and even multiple sclerosis.

Why would health-aware, fit individuals who are careful with their diets, have this high-risk deficiency? Our relied-upon sources of Vitamin D are simply inadequate: Sun

Diet

• We require at least 15 minutes of uninhibited exposure (no sunscreen) to sunlight with a UV index of 4 or higher for significant parts of the body (face, arms, back) about 3 times a week, year-round … a challenge even in the peak months of the northern summer and certainly impossible year-round.
• A significant number of the population (estimated at 20%) have a defective Vitamin D receptor gene – they cannot synthesize D well from sun.

Diet

• Typical North American diets seriously lack foods rich in D – fish oils, fatty fish, beef liver.
• Where D-rich foods are part of the diet, the food chain has depleted the nutrient levels.
• D-fortified foods such as milk contain totally insufficient levels. Furthermore D is best absorbed with some fats – the trend to low-fat and skim milk further impair the impact. Add to that the high combined incidence of lactose intolerance and food anti-body resistance to dairy products. Conclusion – fortification hardly makes an impact.
• Bottom line – supplementation is all but essential and, so, what's important for you to know?
One size does not fit all – know your Vitamin D level and work from there. A number of more advanced personal health clinics are now measuring D in the bloodstream (blood calcidiol – '25-hydroxy-vitamin D'). There's ongoing debate about 'healthy' levels – until recently, clinicians have referenced 1000 IU daily, but newer studies suggest 2 to 4 times that amount for adults.
• Emerging thinking about dosage also indicates a much more aggressive approach – 1000 to 2000 IU (international units) daily. New studies suggest that toxicity (hypercalcemia) requires 10 X this level and that up to 10,000 IU per day is likely safe.
• Absorption is key – Vitamin D is fat-soluble and is best taken with food containing some form of fats.

1. Sleeping 7-8 hours daily
2. Eating 3 meals at reasonable times each day
3. Maintaining a healthy diet - lean protein, complex fiber, fruit and vegetables
4. Exercising regularly – cardio 3x/week, resistance 2x/week
5. Taking 'mental health breaks' on a routine basis with family and loved ones

Dysfunctional responses to stress become ingrained behavior over time. When we're younger we believe we can get away with it. Fact is, we cannot! Let's discuss the physiological impact of stress.

The body secretes the 'stress response' hormone, Cortisol, in response to physical or emotional duress. Cortisol's function is to 'prepare' the body to meet these physical or emotional challenges by increasing the heart rate, blood pressure and level of alertness. In simplistic terms, this enables 'fight or flight defense' in event of 'attack'. But, here's the problem: this very survival mode, unless quickly 'unwound', takes a serious long-term toll on health. Chronically high Cortisol (read 'stress') impairs natural healthy metabolism:

Short Term – making us 'dumb' and 'fat'!

Cortisol-triggered survival instincts – quick decisions based on minimal analysis – impair sharp strategic thinking ability. Caffeine (in coffee, tea and cola-like beverages) is a major stimulant of cortisol secretion. Too much caffeine might make us more alert but not 'smarter'! Insulin – secreted in response to cortisol – causes sugars (from ingested carbohydrates) to move out of the blood stream and become stored in the form of fat – increasing overall body fat and weight. As blood sugar levels decline 'brain fog' ensues.

Long Term effects – triggering heart disease, cancer and chronic illnesses

The body can only endure increased cortisol secretion for a limited time. Beyond that the adrenal gland responsible for secreting the stress response hormone becomes fatigued, resulting in decreased immunity to infection, reduced ability to repair the body and increased inflammation and tissue damage.

If you think you're tough enough to sleep only 5-6 hours, skip breakfast, miss your work-outs or skip a vacation with your family – you've been warned! Change your lifestyle before it takes a permanent toll on your health!