My hands are locked up tight in fists. My mind is racing filled with lists.
Of things to do and things I’ve done another sleepless night’s begun.
-Barenaked Ladies, Who needs sleep
Fatigue makes cowards of us all.
On the wall in my office are all the certificates and degrees I have earned.
I decided to put them up because they have followed me from house to house
in the same box for years. My wife loaded them up and said, “Take
them to your office. They don’t need to live here.” So being
an orthopedic surgeon, I grabbed some finishing nails, and the first thing
that looked like a hammer (my stapler) and started hanging up all that
represents my post high school education and a ton of student debt. Right
in the middle of the wall is a small, nondescript certificate that recognizes
the completion of my first year in residency as an Intern in General Surgery.
This is one of my proudest accomplishments because it was the hardest
working year of my life. Before the implementation of the 80-hour work
week for residents, the intern year operated on a natural selection model
– the successful interns were the ones who worked for 24-36 hours
straight then got to go home (at 10 p.m.), fall asleep and wake up at
4 a.m. to do it again, and again, for an entire year. I always knew if
I awoke in my own bed that I was on call that day. There are 168 hours
in a week, and during that year, I worked about 120 hours of them, meaning
I was getting about four to five hours of sleep a night. Surprisingly,
I was quite functional with such little sleep. My body adjusted to the
schedule, and I spent five years sleeping less than I did after any of
my four children were born.
Success without sleep
Many successful people subsist on the same sleep schedule. Our new president,
Donald Trump, claims he averages four hours of sleep a day. The CEO of
Apple, Tim Cook, gets up every morning at 4:30 and is the first to arrive
at the office. The most extreme examples of the lack of sleep are by Nikola
Tesla (father of electricity) who said he only slept for two hours a night
and by Leonardo daVinci, who would nap for twenty minutes every four hours.
So the questions are, “Who really needs sleep?” and “Why
is sleep so important?” These are successful guys. Could you be
equally as accomplished under the same circumstances?
The people listed above represent only one percent of the population and
are called, “short sleepers.” They regularly feel alert and
refreshed after sleeping less than six hours per night. Then there are
the rest of us who need on average over seven hours of good sleep per
night. For the elite athlete, sleep is paramount to achieve optimal performance.
“If you told an athlete you had a treatment that would reduce the
chemicals associated with stress, that would naturally increase human
growth hormones, that enhances recovery rates, that improves performance,
they would all do it. Sleep does all of those things,” says Casey
Smith, Head Athletic Trainer for the Dallas Mavericks.
So according to the NBA, sleep is vital for performance.
What does science say? One study tracked the Stanford University basketball
team for several months. Players added an average of almost two hours
of sleep a night. The results? Players increased their speed by five percent.
Their free throws were nine percent more accurate. They had faster reflexes
and felt happier. Other studies have shown similar benefits for football
players and other athletes.* Serena Williams says that, given the opportunity,
she likes to go to bed at 7 p.m. and get at least nine hours of sleep.
Sleep is shown to improve the body’s production of cortisol, an
anti-stress hormone. Less sleep has also been linked to poor recovery
after injury or exertion.
When thinking about how to get an athlete ready to perform, I often use
the analogy of the athlete as a sports car. Proper conditioning is the
turbo-charged six-cylinder purring under the hood. The focus on a good
diet leading up to an event and during recovery after an event is the
high-octane gas fueling the engine. Daily hydration and maintaining proper
fluid balance is the oil lubricating all the parts, preventing breakdown
in a high intensity environment. Mental preparation can be thought of
as all the luxury items, like the leather seats and A/C that allow the
driver to feel relaxed. And finally, sleep can be considered the high
performance tires that allow everything else to work in unison, from the
first burst of acceleration to the last hairpin turn. Without sleep, an
athlete will perform like a car without tires.
Improve reaction times
There are multiple areas of an athlete’s performance that can be
directly affected by lack of sleep. Elite athletes must react to a play
that is unfolding in front of them. Sleep deprivation can severely impair
reaction times by up to 300 percent. That is as much as being legally
drunk. Clearly not getting sleep is different than throwing back a few
beers, but an elite athlete would never expect to be at the top of their
game after a couple of beers nor can they expect to perform well on less
than a full night’s sleep.
Reduce injury and improve overall health
Proper sleep habits can also reduce injury rates and improve overall health.
A University of California study concluded that injury rates increased
in athletes that got less than six hours of sleep prior to competition.
This ties in with my previous point about how fatigue affects reaction
time. In my own experience while standing on the sidelines, I have seen
athletes get injured late in the game because they are tired and slow
to react to a hit. Sufficient sleep also allows the body to regenerate
cells and recover from the abuse of workouts, scrimmages and games. Without
adequate sleep, the cumulative effects of training and competition may
lead to a persistent state of injury, prevent an athlete from fully recovering
and thereby spending more time on the sidelines with me.
Fewer mental errors
Finally, good sleep habits can lead to fewer mental errors. We all know
that sleep loss impairs judgment. Lack of sleep can also impair focus,
memory, motivation and learning. I learned this the hard way during my
college career by pulling a few all-nighters before a test and then bombing
the exam. Without sleep, the brain struggles to absorb new knowledge that
can affect good decision-making ability on the field, resulting in the
poor first touch, bad pass or wayward throw.
Forming good sleep habits
Now with all I’ve said about why an athlete should get good sleep,
are there any recommendations on how to get good sleep, you ask? Below
are a few recommendations for how an athlete can incorporate good sleep
habits into their routine to maximize sleep:
- The bedroom should be cool, dark and quiet. Eye masks and earplugs can
be useful, especially with travel.
- Create a good sleep routine by going to bed at the same time and waking
at the same time each day.
- Avoid watching television or surfing the web in bed.
- Avoid caffeine approximately four to five hours prior to sleep.
- Napping can be useful; however they should be less than an hour and in
the early afternoon.
- Mental preparation is important, but do not dwell on the next day’s
competition because anxiety can be detrimental to sleep patterns.
In today’s world of social media, it is easy to fritter away an hour
or two before going to bed. It’s amazing how many times I have made
an honest decision to go to bed at a decent time, but I “quickly”
check my phone. What I think is only a few short minutes going through
my Instagram, scanning Twitter, erasing trash e-mails, checking the weather
for tomorrow and perusing the stories on ESPN turns into an hour, and
suddenly it’s way past my bedtime. So don’t be me. In order
to be the best you can be the next day, whether you are an athlete or
an average Joe, make sleep a priority.
*Sleep Magazine July, 2011