Sleep - Is getting to bed by 11 better for your health?

Sleep:  "Going without makes you tired.  Having too much makes you lethargic.  Getting the right amount makes you feel good.  Going back to sleep makes you feel blurry.  Getting up straight away makes you feel good -- and noble.  Nothing better."  (The Rules of Life, by Richard Templar)

I have been going to bed between midnight and 1 am for many years.  Since I'm my own boss, and generally don't start work until 10 am, I still get 7-8 hours of sleep most nights.  Recently, though, I've had a few things come up that have made me rethink my sleep schedule.  First,  I've been reading books about the immune system, hormonal balances, and weight loss.  I keep finding references to the "ideal" bedtime, which is before 11:00 pm, preferably by 10:00 pm.  Second, I've started exercising in the mornings, and feel like I'm losing a lot of day by not getting up earlier.  Thirdly, I'm finding as I get older it takes me more time to get going in the morning, so I feel like it would be nice to have a little more time awake before facing the world each day.

Susan Blum, MD, MPH in the Immune System Recovery Plan, recommends going to bed by 10 or 11 to give your body the best rest.  Natasha Turner, ND, in The Hormone Diet, also recommends that you are in bed by 11, and 10 would be even better.  Dr. Christiane Northrup states that going to bed by 10 is good for your adrenals:  "Get plenty of sleep: Sleep is the most effective approach to high adrenaline levels. Many women require eight to ten hours of sleep to function optimally. Try to go to bed by ten P.M. Getting to sleep on the earlier side of midnight is much more restorative to your adrenals than sleep that begins later in the night, even if you sleep late the next morning to get in your full amount of sleep."

This particular paragraph was found on a multitude of web pages:  "Most people need at least 7-and-a-half sleep hours per night. If you find that you have problem sleeping, you should make sleep a priority in your life. Schedule the time for sleep and keep this schedule fixed no matter what. You must to go to sleep before 11 PM because our systems--particularly the adrenals--do a majority of recharging and recovering between 11 PM and 1 AM. The gallbladder dumps toxins at the same time. If you are awake between 11 PM and 1 AM, the toxins go back into your liver, which then dumps them back into your system and disrupts your health."

I am not quite sure of the physiology involved in being awake versus asleep and the functions of the gallbladder and liver, since they are both autonomic, and I'm not sure why being awake would make the toxins go someplace different.  Plus, I think that the liver's function is to filter out toxins, not "dump them back into your system."  So color me skeptical on that claim.

Throughout the Internet, there are recommendations to go to bed before 11:00 pm, because your adrenal glands recover between 11 pm and 1 am, and they won't do that if you're awake. My research points to the Chinese Acupuncture Meridian Clock as the possible source of this theory. 

“I encourage all of my patients to go to bed at 11 p.m. so that they are sleeping soundly by 1 a.m.,” says Susan Wadden, an acupuncturist in Shoreline, Wash.

Each organ system in acupuncture has an assigned two-hour time frame. One o’clock in the morning is when when the liver time cycle begins. Between 1 and 3 a.m. is the optimal time for the liver to cleanse itself. This cleansing, which plays a big role in whether we feel rested when we wake up, happens most efficiently when a person is in a deep state of sleep.

- See more at: http://www.thehealersjournal.com/2013/05/04/acupuncturist-health-tips-to-remember/#sthash.4X64SkHb.dpuf

 Since adrenal fatigue can cause a multitude of physical ailments, some of which I've been flirting with over the past couple of years, I did a PubMed search to see if I could find any research to back up the claims that going to bed earlier is healthier for your adrenals.  Or is healthier in general.  I didn't read all the papers, just the abstracts.  But this is what I found:

I found a study suggesting that diabetics that stay up late, sleep late, skip breakfast and fare poorly.  The researchers felt that skipping breakfast was probably the major contributor, not the staying up late.  (The Relationship Between Breakfast Skipping, Chronotype, and Glycemic Control in Type 2 Diabetes,Prog Mol Biol Transl Sci. 2013;119:155-90. doi: 10.1016/B978-0-12-396971-2.00007-5. )

A Japanese study found that people who went to bed later were more likely to have depression.  Again, though, the bedtime wasn't thought to be the problem as much as the shortage of sleep that resulted from the later bedtime.  (Bedtime and Sleep Duration in Relation to Depressive Symptoms among Japanese Workers., Behav Sleep Med. 2013 Oct 24.)

No other studies were found in my quick search to indicate that there is a direct relationship between health and bedtimes.  I did find, however, several studies that indicate that chronotype (whether we are early to bed or late to bed types) is genetic, and that the tendency to go to bed early or late is difficult if not impossible to change.  I also found that there is a journal that is dedicated to the study of chronobiology, called Chronobiology International.

A recently published study suggested that there were measurable differences in the brain tissue of people with different chronotypes, and suggested that work schedules should fit in with chronotypes as much as possible in order to avoid the problems associated with late chronotypes, such as sleep disturbances, depression, and overuse of stimulants. ("Early to bed, early to rise": Diffusion tensor imaging identifies chronotype-specificity, Chronobiol Int. 2014 Jan 7. )

Another study found differences in personalities between "larks" and "owls," with morning people being more future oriented and night owls being more present oriented.  They suggested that self-control was a mediating factor (I need to read this study, because the abstract seems to suggest that morning people have more self-control, which is interesting to me....maybe that's why so many of the morning people feel superior to us night owls).  (Explaining why larks are future-oriented and owls are present-oriented: Self-control mediates the chronotype-time perspective relationships.Chronobiol Int. 2013 Oct 16.)

Another study suggested that a morning chronotype is fairly constant throughout life, but people with an evening chronotype sometimes shifted to morning over time.  It also found a 1.3 times higher mortality rate for evening people versus morning people.  It found that "eveningness" has become more prevalent among the population recently.  (Long-term consistency of diurnal-type preferences among men.  Chronobiol Int. 2013 Oct 4.)

Web references suggested that you most likely cannot change your chronotype by force of will, although your body may change naturally over time.  One article I particularly liked on Mark's Daily Apple, gave a good overview of chronotypes and how to adapt.  Again, the suggestion was that it is better to arrange your life around your chronotype than to try to change your chronotype to fit the world's schedule.  Even Dr. Oz's blog suggested that the ideal bedtime is based on when you have to get up and how much sleep your body requires, not that any perfect time for everyone exists.

Now the quandary for me:  should I try to adapt my bedtime to the 11 pm crowd, potentially saving my adrenal glands and improving my health?  Or should I just go with my body's current 12-1 bedtime and adapt my life around that?  

My theory for right now is that, since 11 pm is only an hour or two earlier than I currently go to bed, I probably could make that change.  I fall on the in-between scale on the Chronotype Test, not completely an early or a late person.  So, my next experiment on me is seeing if I can get my bedtime to the point where I can wake up refreshed without an alarm at 7 am.  

In my next blog, I'm going to review all the suggestions for getting to bed and getting to sleep, and then choose a few to try.