Today's #Sleeptember FACT --- What is a short sleeper?

#SLEEPTEMBER

There are a rare few people in the world who need less sleep than the rest of us.

Now, before you get yourself excited by the possibility you could be one of them, please note this:

• If you are young and female, "both habitual short and long sleep duration was a risk factor for obesity" (Sleep Journal, 2013)
  
• If you are a short sleeper, "short-duration sleepers [consume] significantly more alcohol when compared to average- and long-duration sleepers" (PLOS, 2012)
  
• Studies suggest that so-called habitual short sleepers may not actually be short sleepers, technically--"rather, these individuals gradually accrue sleep debt over time" (The Neurobiology of Circadian Timing, p.380)

You may think that getting less sleep (under six hours nightly) is a kind of superhuman power that only you possess, but let's face the reality: the odds are slim you are actually a "short sleeper," which is defined, according to data from the American Academy of Sleep Medicine, as "[a] small percentage of people... who can function normally on only five hours of sleep or less."

The Wall Street Journal estimates that maybe as much as three percent of the population may be short sleepers. That's pretty darn rare. At the University of Utah, Dr. Christopher Jones, a professor of clinical neurology, says he has only actually ever identified "about 20 true short sleepers."

As writer Sam Atherton points out in his August 13 Sleep Matters article, "To date, only a handful of small studies have looked at short sleepers as these type of people are rare. They are unlikely to go to sleep clinics as they are not aware that they have a disorder."

But there are a few, and what makes them distinct from others is the fact that, even though they sleep five hours or less every night, they do not accrue sleep debt. They are naturally energetic, optimistic, thin, highly tolerant of pain and stress, and exuberant--a cognitive "elite" who can power through a lot of otherwise stressful living on a whole lot less sleep and still remain hopeful and upbeat.

The rest of us (all 97 to 99 percent of us), unfortunately, are running on fumes.

As desirable as being a short sleeper may be, it's a genetic predisposition and not something we can strive for as an act of self improvement.

According to a page on short sleep published at SleepDex, "It is not possible to turn yourself into a short sleeper, as much as you might want to do so.  It is something you are born with. Scientists have even identified a short sleeping gene in fruit flies."

Please don't mistake overwork and sleep restriction due to your lifestyle as evidence that you are a natural short sleeper, especially if you are moody, carrying extra weight, or experiencing daytime fatigue. Try to get your seven-plus hours a night instead. Your body will thank you for it later. Our culture needs no more excuses for not getting adequate sleep, no more "I'll sleep when I die" machismo. Sleep deprivation is a public health and safety problem with a million-dollar pricetag. Don't become another expensive statistic.

Source materials:

• American Academy of Sleep Medicine. Insomnia fact sheet.
  
• The Neurobiology of Circadian Timing. Kalsbeek A. (Elsevier 2012)
  
• PLOS blogs || Do short sleepers drink more?
  
• Sleep Journal || Both habitual short sleepers and long sleepers are at greater risk of obesity: a population-based 10-year follow-up in women
  
• Sleep Matters || Who are short sleepers and why don't they need sleep?
  
• Sleepdex || Short sleepers
  
• The Wall Street Journal || The Sleepless Elite: Why Some People Can Run on Little Sleep and Get So Much Done

INSOMNIA: What is CBTi? A quick guide to non-drug therapy for insomnia

Many people believe the only treatments available for chronic insomnia require drugs. The truth is, there is a non-drug therapy for insomnia which has been around for a while that can be very effective in treating insomnia. CBTi stands for Cognitive Behavioral Therapy for Insomnia, and it is often used by psychotherapists who have training in sleep medicine to treat insomnia disorders. Sometimes it is used in conjunction with sleep aids, but it can also be used with patients who are trying to wean themselves off of hypnotic drugs in an effort to try to sleep better naturally. 

Essentially, CBTi is a structured behavioral training approach which helps insomniacs to identify and replace thinking and actions which lead to or aggravate preexisting insomnia. This practical therapeutic training can help insomniacs discover, then overcome the root causes of their sleeplessness. 

Some techniques for CBTi can include (this list is not exhaustive): 

• Biofeedback. Observing your biological signs (heart rate, respiration, muscle tension, etc.) so you can see what needs to be adjusted, using a take-home device.
• Relaxation training. Mind and body helps, such as meditation, self-hypnosis, yogic breathing, muscle relaxation, etc. 
• Sleep hygiene. What we talk about all the time in SHC: better lifestyle habits lead to better sleep habits! 
• Sleep restriction. This is the strategic decrease of time in bed which helps to reset the sleep drive. Usually requires sticking to an odd schedule for a while.
• Sleep space improvement. It's not silly to rethink sensory comforts like bedding, lighting, even aromatherapy.
• Stimulus control therapy. This helps break down thought processes ("racing thoughts") that encourage resistance to sleep. 
• Relapse prevention. Behaviors can return; a good CBTi therapist can offer tools to prevent this from happening.

CBTi may not work immediately as it requires behavioral modification, unlike a sleep aid like Ambien, which you just take at night and (with any luck) fall asleep. For people who are impatient to find sleep again, these are therapies that require time and earnest effort. If you are resistant to the notion of using therapy to fix your insomnia problems, consider this: 

However, the problem with the vast majority of drugs used to facilitate sleep is that they have unsafe side effects, can negatively interact with other maintenance drugs and are often only meant for short-term use as they can be addicting or easily habituated to. For many insomniacs, drugs simply do not work because they are at best a temporary, Band-Aid solution, whereas the value in CBTi lies in the fact that this therapy can help address and conquer the underlying reasons for not sleeping.

CBTi also works for other kinds of sleep problems, such as adult acclimation to CPAP therapy, pediatric difficulties with falling or staying asleep and anyone suffering from recurrent nightmares.

Below is a quick list of excellent, in-depth resources on CBTi. If you have insomnia and have had no luck with prescription or over-the-counter sleep aids and your friends' home remedies aren't working either, please consider giving CBTi a try. Most insurance will cover it, and you can often meet with more than one practitioner in a free consult to determine if they are a good match for you. Ask them what kinds of therapies they support and get patient testimonials, whenever possible.

NATIONAL SLEEP FOUNDATION || Cognitive Behavior Therapy for Insomnia

SLEEPDEX || Cognitive Behavioral Therapy for Insomnia

STANFORD HEALTH CARE || Cognitive Behavioral Therapy for Insomnia (CBTi)

MAYO CLINIC || Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills

AMERICAN ACADEMY OF SLEEP MEDICINE || "Cognitive behavioral therapy is an effective treatment for chronic insomnia." Published June 9, 2009; accessed March 28, 2015.

“New Developments in Cognitive Behavioral Therapy as the First-Line Treatment of Insomnia.” Siebern, Allison T, and Rachel Manber. Psychology research and behavior management 4 (2011): 21–28. PMC. Web. 28 Mar. 2015. [PDF]

NPR: SHOTS || Working With A Therapist Can Help When Sleeping Pills Don't