The Sleep Solution: Why Your Sleep is Broken and How to Fix It

318 Pages·2017·7.3 MB·English

by  W. Chris Winter

NEW AMERICAN LIBRARY
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Library of Congress Cataloging-in-Publication Data
Names: Winter, W. Chris, author.
Title: The sleep solution: why your sleep is broken and how to fix it/W. Chris Winter, MD.
Description: First edition. | New York: New American Library, 2017.
Identifiers: LCCN 2016034735 (print) | LCCN 2016035158 (ebook) | ISBN 9780399583605 | ISBN
9780399583629 (ebook)
Subjects: LCSH: Sleep—Popular works. | Sleep disorders—Popular works.
Classification: LCC RA786 .W56 2017 (print) | LCC RA786 (ebook) | DDC 616.8/498—dc23
LC record available at https://lccn.loc.gov/2016034735
First Edition: April 2017
Jacket design and illustration by Sandra Chiu
Every effort has been made to ensure that the information contained in this book is complete and accurate.
However, neither the publisher nor the author is engaged in rendering professional advice or services to the
individual reader. The ideas, procedures, and suggestions contained in this book are not intended as a
substitute for consulting with your physician. All matters regarding your health require medical supervision.
Neither the author nor the publisher shall be liable or responsible for any loss or damage allegedly arising
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Version_1
To my patients,
both to the ones I’ve tried to help and the ones I’ve yet to meet,
I humbly wrote this book for you.
To my wife, Ames,
you are my love and inspiration,
I solely wrote this book because of you.
Contents
Title Page
Copyright
Dedication
Prologue
An Introduction to Sleep Medicine
1: WHAT IS SLEEP GOOD FOR? ABSOLUTELY
EVERYTHING!
2: PRIMARY DRIVES
3: SLEEPY VERSUS FATIGUED
4: SLEEP STAGES
5: VIGILANCE AND AROUSAL
6: SLEEP STATE MISPERCEPTION
7: CIRCADIAN RHYTHMS
INTERMISSION
8: SLEEP HYGIENE
9: INSOMNIA
10: HARD INSOMNIA
11: SLEEPING AIDS
12: SLEEP SCHEDULES
13: NAPPING
14: SNORING AND APNEA
15: OTHER SLEEP CONDITIONS SO STRANGE, THEY
MUST BE SERIOUS
16: TIME FOR A SLEEP STUDY
Author’s Note
Acknowledgments
Bibliography
Index
Prologue
I
HAVE ALWAYS LOVED SLEEP, AND it’s always been important to me. I remember
as a child appreciating how fantastic it was to sleep in on the weekend. I have
very clear memories of waking up for school as snow fell and eagerly scanning
the radio to listen for school closing information. Finding out schools were
closed meant getting right back into bed for extra sleep! Because both of my
parents were public school teachers, it was always a family event.
When I was seven years old, my doctor prescribed me medicine for a bad
cold. It had to be given around the clock, so at some point during the night, my
mother woke me up to swallow some strongly flavored antibiotic liquid. The
nocturnal awakening and subsequent sleep always seemed to make the night feel
longer. I loved it.
I decided to become a doctor in third grade because I liked drawing organs
and memorizing the Latin names for muscles. Family members and friends
always gave me such high praise when I told them my plans, so I’m sure that
solidified my goal even further. As time passed, I would go through dermatology
phases, pediatric phases, and even orthopedic phases, but life decisions and luck
eventually landed me in the field of sleep.
I started learning about sleep and studying it long before I became a doctor,
even before medical school. I was fascinated by the study of sleep, running sleep
studies and getting my hands dirty when it came to research. And get dirty they
did. My hands were plenty dirty studying sleep apnea in Yucatán micro pigs
when I was an undergraduate. Pigs happen to be a fantastic model for sleep, and
they can snore just as loudly as any human sleep apnea patient. For those who
are not familiar with the Yucatán micro pig, there is little “micro” about them,
except for their patience as a teenager tries to shave their little tail and tape a
probe to it. When it came to sleep, smelling like a farm was a small price to pay.
My curiosity has continued to be unusually strong. As a physician, I like to
know as much as I can about what my patients are going through. To that end,
over the years, I’ve volunteered to have my blood drawn, and I’ve undergone a
three-hour neuropsychological test battery. I’ve had a nasogastric tube stuck in
my nose, my muscles electrocuted, lidocaine injected into my love handle,
making it go numb. I even had a powerful electromagnet applied to my head,
causing my arm to spasm uncontrollably.
My medical experimentation reached its peak when during a boring medical
call-night I asked if I could jump into an MRI scanner to take some pictures of
my brain so I could see what the experience was like and what was going on up
there. All of my patients said it was loud, claustrophobia inducing, and generally
miserable. I was fairly unimpressed. What did impress me was the size of my
cerebellum—strangely small. I posted my MRI in the neurology residents’
reading room the next morning. It was a tradition to post unusual images or
diagnostic dilemmas so other residents could write their guesses and theories
next to the images. For those who didn’t notice my name on the films, virtually
everyone wrote “cerebellar hypertrophy,” or an unusually small cerebellum.
Unexpectedly, my cerebellum (the part of the brain responsible for muscle
coordination; indicated by an arrow in the photo) was a little puny, as you can
see from the actual image. Of those who did notice my name, the overwhelming
guess was “testicular atrophy.” Smart-asses.
My brain, circa 2001.
The bottom line is this: Despite some occasional unwelcome information, I
like experiencing what my patients experience. It engenders trust and a common
ground from which to work. I want to help my patients with their issues and
understand what they are going through as much as I can.
As a sleep specialist, I help patients with their sleep problems every day. I’m
also lucky enough to work with many professional athletes and help solve their
sleep problems too. This might mean helping a team plan out the best time to
travel during a long road trip. It might mean helping an athlete and his family
adjust to a new baby in the house. Often athletes experience difficulty sleeping
before big games or after poor performances. Regardless of the situation, I hope
to help players improve their performance by improving their sleep.
The great thing about sleep is that it crosses so many groups of individuals.
Over the years, I have had the fortune of working with elite members of the
United States military and technology corporations as well as students across the
country, helping them achieve better performance through improved sleep.
These experiences have made me a better physician to my patients.
It is a rewarding occupation. From my desire to help my patients and clients,
this book was born. I wanted something tangible I could give people who were
struggling with their sleep to put them back in the driver’s seat and impart what I
have learned in my more than twenty years in the field.
This book is meant to be read like a sweeping novel. It is not a reference
book. I do not want you to skip ahead to the part of the book that you think is
most important for you. It’s all important! Think of it as a complete process for
understanding and overhauling both your sleep and the way you think about
sleep. If you do it my way, you are going to finish this book with a newfound
sense of what it means to have healthy sleep.