Health Education / Events

Folsom PT held free lecture given by Michael J. Moore on Sleep Deprivation; Below is the information presented.

MichaelRoizenMichael Roizen, MD

Chief Wellness Officer, Cleveland Clinic, Ohio

Stress is one of the 4 components of wellness besides physical training, smoking avoidance, eating well

Stress – “the silent killer”, one of the chief components of negative stress is sleep depravation and fractured sleep, April 3, 2014, Conference on Integrative Health for Pain Relief

MJM’s evolution to sleep deprivation over decades:

  • Increasing demands of life due to increasing number of children
  • Opening a business
  • Volunteerism with children’s activities
  • Increasing wakefullness through gourmet coffee exposure
  • Growing concerns and care giving aging, declining parents
  • Concerns for adult children (no control) MJM lecture

Is it a problem?

  • “The purpose of sleep and measuring its quality are both evolving areas of study without solid conclusions at this time”, Terese Hamond, MD, Clinical Director of Sleep Disorders, USC.
  • “The one clear fact we know is that there is a significant percentage of humans who do not get enough sleep”, Terese Hamond, MD
  • “Optimal sleep for most adults is 7 hours”, CDC, Atlanta, 2010
  • 40% of all Americans do not hit the optimal 7 hour mark*
  • Teenagers need more sleep, up to 8-9 hours, and 70% are sleep deprived*
  • 2011, 60 million prescriptions for sleep medications*
  • Americans on average sleep 2 hours less than they did in 1975*
  • 65% of all Americans have cell phones next to their beds*
  • 28% of truck drivers suffer from sleep apnea leading to fatigue on the highway*
  • 40 recommendations by the National Transportation Safety Board to add legislative safeguards against accidents caused by sleep deprivation have all been ignored*

*Public Good Projects, National Institutes of Health and NatGeo, November 2014

 Specific Consequences of Unhealthy Sleep

  •  Stroke: risk increases 4x (sleep 5-6hr/nt)
  • Obesity: 5-6 hours or less increases the production of hormone Ghrelin – the hunger hormone
  • Diabetes II: decreased sleep (<5-6hours) causes the body to resist insulin
  • Memory: permanent cognitive loss and early brain deterioration
  • Osteoporosis: bone mineral density and bone marrow decreases are evident within 3 months in rat model studies
  • Cardiac Disease: 48% increase in early cardiac death
  • Colon Cancer: increased risk

*David Johnson, MD, Chief Gastroenterology, Eastern Virginia Medical School

 Frontal Lobe Function with Sleep Loss or Framented Sleep

  •  Studied impaired performance of tasks associated with frontal lobe and sleep that were measured by:
  • Verbal fluency
  • Creativity
  • Planning skills
  • Measurement techniques compromised by lack of technology at time of study
  • Sleep and Mood
  • Either irritability, short temper, vulnerability to increased stress
  • Chronic loss of sleep had 20x more likely possibility of depression or anxiety disorder

Korea study of 47,000 men and women completing a questionnaire and assessment of coronary artery calcium and plaque buildup

  • Short sleepers < 5 hrs
  • Long sleepers > 9-10 hrs
  • Poor quality
  • Slept 6.5 hrs and categorized the quality as good
  • Short sleepers had 50% more coronary artery calcium buildup than optimum group
  • Long sleepers had 70% more coronary artery calcium buildup than optimum group
  • Poor quality had 40% more coronary artery calcium buildup than optimum group
  • Chan-Won Kim, MD, Kangbuk Samsung Hospital of Sungkyunkwan University School of Medicine, Seoul, South Korea, 2015

Dr. Kim was inspired by 2013 literature review

  • People who got 6 hrs or less sleep had hypertension, abnormally high cholesterol, Type II diabetes, obesity, and clinical depression.

MJM lecture2American Thoracic Society personal health and safety policy statement on Sleep

Getting enough sleep ESSENTIAL for maintaining personal health and quality of life (personal responsibility)


Not getting enough is dangerous to health and public safety (public responsibility)

American Thoracic Society personal health and safety policy statement on Sleep (continued) Specifically

  • To sleep less than 6 hours or sleeping more than 9-10 hours may be linked to negative health outcomes
  • Adult sleep times are less than teens sleep times
  • School districts who have established later start times for high school have noted measured statistical changes in decreasing absenteeism, decreasing aggressive behavior, and increasing academic performance
  • With respect to public safety – advocates all people applying for drivers licenses should receive education on the recognition of the symptoms and consequences of drowsy driving.
  • Optimal amount: 7-9 hours
  • Age based recommendations should be developed with community support with employers and school districts
  • Increased education for health care providers for education on sleep hygiene
  • Public education on the emphasis for sleep hygiene

Dr. Kay’s advice regarding electronics

  • No electronic light emitting devices after 6PM, e.g., iPads, cell phones, for his children, Dean, Dornsife College of Letters, Arts and Sciences, USC.
  • Dr. Johnson’s advice regarding societies macho attitude about less than normal sleep
  • 2014, Brigham and Women’s Hospital, Boston, MA, regarding REM cycles studying volunteers with blood samples and sleep analysis of those with and without electronic devices within 4 hours of bedtime.  Print media at bedtime went into deep REM unlike people on the electronic device (blue light stimulation) – lower levels of melatonin.
  • Listen to body – rest when it says rest knowing that one may need to allot for some makeup sleep if the signs are present in the day.
  • Be aware you will be most awake mid-morning and 2-3 hours before a normally established bedtime
  • Be aware that the afternoon following lunchtime there is a lull in our bodies
  • At night, several deep cycles of sleep that last ~90 minutes duration and when you wake relax and go back to sleep as the waking is normal.
  • Wake up consistently at the same time. Backup by 7-9 hours, make sure you are in bed 15 minutes earlier so as to fall asleep on time.

 Helpful Tools-Rosenburg & Breus

  • Do not drink alcohol after dinner and think it will help your sleep hygiene.  Alcohol has an initial drowsiness effect but when your body breaks down the alcohol it may have the opposite effect.
  • Electronic device emit light that may effect the production of melatonin.  Charge your cell phone in a different room to lessen temptation.  No electronics at least 60 – 90 minutes before bedtime
  • Foods high in refined carbohydrates, e.g, chips/dip, late at night generate an insulin response causing a drop in blood sugar which then triggers a release of stress hormones leading to inadequate sleep.
  • Sleeping In – most people think they can catch up on the weekend but thought process interferes with an individuals circadian rhythm – be consistent with both wakeup and bed times.
  • Bedroom temperature – the room should be between 65 – 75 deg. F
  • Waking soreness or stiffness is possibly due to mattress breakdown.  Consider a new mattress every 8 years.

*Breus, M., PhD. & Rosenburg, R., DO, Center of Disease Control, “Insufficient Sleep is a Public Health Epidemic”, 2015




A Way to Get Fit and Also Have Fun


Gretchen Reynolds


Credit Getty Images

Gretchen Reynolds on the science of fitness.

Can exercise that is intense also be fun?

Researchers in Denmark recently began delving into that issue and in the process developed a new approach to intense interval training that could appeal even to those of us who, until now, have been disinclined to push ourselves during exercise.

High-intensity exercise, usually in the form of short bursts of very arduous intervals interspersed with rest, has much to recommend it. Many studies have shown that even a few minutes of these intervals can substantially improve health and cardiovascular fitness.

But high-intensity interval workouts have a drawback that is seldom acknowledged. Many people don’t like them and soon abandon the program.

In a telling study published last year, researchers in New Zealand asked overweight, out-of-shape adults to complete three months of high-intensity interval training, using one of two common types of training programs. One consisted of either four minutes of fast jogging, a rest, and four more minutes of strenuous jogging. The other consisted of 30 seconds of all-out effort, followed by rest, and was repeated three times.

Some of the exercisers’ sessions were supervised, and some were supposed to be done on their own.

Both programs would have been expected to round the volunteer into much better shape.

They didn’t. Few of the participants became significantly more fit, especially in the 30-second hard interval group. The probable reason, the researchers speculate, was that most of the participants had quit doing most or all of their assigned exercise early on in the study.

This finding and others like it troubled Jens Bangsbo, a professor of physiology at the University of Copenhagen in Denmark, who studies high-intensity interval training. In studies at his lab, repeated hard intervals had almost invariably made people fitter, faster and healthier.

But those studies typically had involved highly motivated athletes riding high-tech stationary bicycles and had been supervised by the scientists, who personally had cajoled the participants to complete each interval.

Those were hardly real-world circumstances, Dr. Bangsbo realized.

So he and his colleagues began to wonder if there might be more practical and palatable approaches to high-intensity interval training.

“We wanted to create a workout that could be employed by everyone, from the nonexperienced person to the elite athlete,” Dr. Bangsbo said.

After some trial and error, they came up with a candidate routine and named it 10-20-30 training.

It has become my favorite interval program.

The essentials of 10-20-30 training are simple. Run, ride or perhaps row on a rowing machine gently for 30 seconds, accelerate to a moderate pace for 20 seconds, then sprint as hard as you can for 10 seconds. (It should be called 30-20-10 training, obviously, but that is not as catchy.) Repeat.

The enticements of this particular program are many. It is easy to remember and low-tech, requiring no gym membership, heart rate monitor, or flow chart, as some complicated interval programs seem to demand. You don’t even need a stopwatch to monitor the 30-, 20-, and 10-second time changes. You can, like me, count to yourself, which seems to make the intervals pass quickly.

Perhaps best of all, the grueling, all-out portion of the workout lasts for only 10 seconds, which is far more manageable for most of us than 30 seconds or 4 minutes.

But of course the program must be effective if scientists are to recommend it. So for a study published in December in The Scandinavian Journal of Medicine & Science in Sports, Dr. Bangsbo and his colleagues set out to test the routine with a large group of average exercisers.

Approaching running clubs throughout Denmark, the scientists found 132 mostly middle-aged, recreational runners who agreed to substitute 10-20-30 training for two of their usual weekly workouts.

As a result, their weekly mileage fell by about half.

The scientists also recruited 28 runners to serve as controls and continue their normal training.

All of the runners underwent physiological testing at the start of the study, including a simulated 5K race.

Then the scientists turned the runners loose to continue with or abandon their training as they chose.

After eight weeks, almost all of the runners in the 10-20-30 group were still following the program. And when they repeated their 5K runs, they had shaved an average of 38 seconds from their times. Most also had lower blood pressure and other markers of improved health.

There were no changes among the runners in the control group.

Of course, any regular interval training should improve someone’s athletic endurance and health if it replaces slower training, which is why serious athletes incorporate interval sessions into their regimens.

But in Dr. Bangsbo’s study, the 10-20-30 program not only allowed the runners to train less while growing faster, it seemed to make the workouts pleasurable.

“The running clubs in our study reported much improved social interactions between members” during the workouts, Dr. Bangsbo said, because when the fastest runners turned around after each set of five 10-20-30 sprints, as most did, they found themselves following the slower runners, who had the satisfaction of being in the lead, at least for the moment.

You can undertake the program solo, too, or, as I have, with dogs. They are likely to be enthusiasts. This is how they always have run.

If you wish to try 10-20-30 training, Dr. Bangsbo recommends starting by replacing one or two of your normal weekly workouts with a 10-20-30 session.

Warm up with an easy jog (or pedaling or rowing), then ease into the intervals. The 30-second portion should feel relaxed; the next 20 seconds moderately hard; and the final 10 seconds a full gallop. “The aim is to cover as much distance as possible in those 10 seconds,” Dr. Bangsbo said.

Do five of the 10-20-30 intervals in a row without pause, then rest for two minutes by standing or very slowly walking about. Repeat the five consecutive intervals one more time, cool down, and you are done. The whole session, minus warm-up and cool-down, will have lasted 12 minutes.

If you are already in fine shape, Dr. Bangsbo said, add another set of the five uninterrupted intervals.

Rest the next day, he said, or very lightly exercise; don’t do two of the intense interval sessions in a row. Although a smaller percentage of runners in the 10-20-30 group sustained injuries than did runners in the control group in his study, “we recommend very slow progress.”



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