Dear Dr. Roach: I read that seniors are strongly advised to get seven to eight hours of sleep a night. While I am in bed for that time, nature calls once or twice a night, and I have some difficulty getting back to sleep. So if I am resting while trying to get back to sleep — say, 20% of an eight-hour night — does that meet the sleep advisory?
R.G.
No, resting at night is not the same thing as sleeping. People who sleep seven to eight hours per night have a lower risk of developing disease and even death than people who sleep less. Interestingly, people who sleep much longer, over nine hours per night, are also at a higher risk of disease and death than people who sleep the optimal amount.
It isn’t clear that it’s the long amount of sleep causing the increased risk. It’s possible they have depression or other conditions that cause pain and disability that cause both the increased sleep and the increased risk.
Similarly, seven to eight hours per night isn’t right for everybody. There are some people who feel perfectly well-rested on less sleep and just can’t sleep any more. What’s right for a population might not be right for everybody in the population. Further, agonizing over how much time you sleep might actually worsen your sleep.
What is clear is that if you are forcing yourself to get up after little sleep and then feel tired all day, that’s not good for your overall health. Going to bed earlier or changing your schedule to be able to sleep later is a good idea. I heard a great quote from Asker Jeukendrup: “Never stay up late for something you wouldn’t get up early for.”
Dear Dr. Roach: What are the best things to eat and do when having Type 2 diabetes? I want to reverse the disease.
D.L.
Once you have a diagnosis of diabetes, it stays with you, even if your disease is controlled, with or without medication. This reflects the propensity for a person to get high blood sugars again unless they maintain the good behaviours that brought the blood sugars down.
For diabetes, being careful comes down to three things for most people: eating well, exercising regularly and losing weight.
Eating well means emphasizing what’s good: vegetables, legumes and nuts. Other good protein sources are fatty fish and lean poultry (no skin). Whole grains and whole fruits in moderate amounts are also good choices. Limit refined starches, like white rice, pasta and white bread. Avoid concentrated sweets, even if it’s made with some of the other good things (carrot cake, sadly, isn’t a good option).
Exercising regularly means very different things to different people. If you haven’t exercised much, start with a moderate 10-minute walk a day, and build up to 20-30 minutes of moderate exercise.
Losing weight is really hard with diabetes. Most people with Type 2 diabetes are overweight, and for those who are, many struggle with weight loss in part due to the high insulin levels that go along with insulin resistance, which is the hallmark of Type 2 diabetes. Many diabetes medications promote weight gain as well. However, there are several new classes of medicines, as well as one old one, that help promote weight loss, and your diabetes provider can discuss these with you.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
