Cheers!

This is high on health. Your weekly reminder that it's vital to enjoy life, spend time with loved ones, and not always try to control everything.

It's been a hectic week for me. I took a few days off and returned to a pile of responsibilities. Nevertheless, spring has finally arrived in Berlin! The sun is shining, and we're experiencing temperatures above 20°C (68°F)!

As the seasons shift in Berlin, the city undergoes a dramatic transformation. Winter can be tough with its short days, scarce sunlight, and lack of mountains for winter sports. But with the arrival of spring, the city bursts into life. Cafes, restaurants, and bars spill onto the sidewalks, people chill in the sun at every corner, and it's as if the entire city is shaking off its winter blues.

I'm excited about one of my close friends' birthdays this week. We've known each other since med school, and she knows how to throw a party. It will likely involve one drink too many late into the night.

This week's topic is alcohol and its impact on sleep.

There are numerous myths, opinions, and conflicting research results about alcohol and its various effects on our health and performance. I'll delve into this further in future editions.

I hope you enjoy the spring sunshine and spend time with loved ones!

Take care!

Alcohol’s impact on sleep

Have you heard of having a nightcap? It refers to drinking an often alcoholic beverage before going to bed. Although alcohol is believed to help you fall asleep faster due to its sedative effects, it's important to distinguish between simply losing consciousness and getting proper sleep.

The rapid onset of unconsciousness induced by alcohol is not the same as the restorative sleep your body requires. It's the difference between being knocked out by a physical blow and entering a natural, restful sleep state. As a result, consuming alcohol can hurt the quality and restorative aspects of your sleep.

What alcohol does to sleep

Matthew Walker is a distinguished sleep scientist and a professor of neuroscience and psychology at the University of California, Berkeley. He is renowned for his extensive research on the effects of sleep on human health and its relation to diseases such as diabetes, heart disease, and Alzheimer's.

Walker is also the author of the best-selling book "Why We Sleep," which explores the critical role of sleep in our lives, highlighting its profound impact on our development, health, and longevity.

According to him, alcohol affects sleep in three main ways:

1. Alcohol induces rapid unconsciousness but does not lead to restful sleep.

2. Sleep becomes fragmented with frequent awakenings that are often unnoticed.

3. REM sleep is significantly reduced, which affects sleep quality and restoration.

While alcohol may cause one to lose consciousness more quickly, it lacks the restorative aspects of natural sleep. Alcohol consumption leads to fragmented sleep patterns, with brief awakenings throughout the night that the individual often forgets. These disruptions prevent the brain from entering REM sleep, which is crucial for cognitive functions and memory. Alcohol does not have much of an effect on deep sleep and may even slightly increase it in some cases.

Alcohol disrupts sleep, and it might be linked to aldehydes, which are metabolic byproducts of alcohol. Matt Walker states that these byproducts, particularly aldehydes, inhibit the brain's ability to generate REM sleep. REM sleep, or rapid eye movement sleep, is a stage of sleep crucial for cognitive functions and memory. Additionally, research suggests that a reduction in glutamate due to alcohol consumption can suppress REM sleep, as observed in animal studies.

What I have observed

Alcohol can make you feel bad when you wake up, even if you only have moderate amounts. You don't need an advanced tracker to tell you this.

However, monitoring your biometrics, such as resting heart rate, heart rate variability, and respiratory rate, can help you understand the impact of alcohol on your body. Devices like the Apple watch, the Whoop band, the Oura ring, or a Garmin watch, specifically designed to measure these biometrics, can do so.

I have done so in the past, and this is what I have found:

• Resting Heart Rate: It can increase by 6-8 beats per minute after drinking.

• Heart Rate Variability: It can decrease by 20-50% after drinking, indicating reduced autonomic nervous system balance.

• Respiratory Rate: After drinking, it can rise by approximately 2 breaths per minute.

It's important to note that the timing and quantity of alcohol consumption are crucial. A single drink taken 4-5 hours before sleep has minimal effects. However, two drinks or more can cause noticeable sleep deterioration, especially when consumed closer to bedtime.

These indicators suggest an increased sympathetic nervous system activity during sleep, which is not ideal as this should be a time of rest and recovery. The sympathetic nervous system prepares the body for physical activity and regulates the "fight or flight" response. It increases heart rate, elevates blood pressure, and redirects blood flow to the muscles while reducing blood flow to non-essential functions like digestion. Typically, this system is activated in response to stress or threats.

These effects of alcohol are not desirable when you want to get a good night's sleep and wake up feeling rested.

Why the bathroom visits

Do you ever wonder why you have to visit the bathroom more frequently after having a drink? This can further disrupt your sleep, especially when you are in bed.

The reason for this is that alcohol can increase the frequency of nighttime bathroom visits due to two main factors.

1. Firstly, consuming any liquid before bed, including alcohol, leads to more glomerular filtration¹ , which fills the bladder more quickly and therefore increases the need to urinate.

2. Secondly, alcohol inhibits the production of vasopressin, an antidiuretic hormone. This inhibition results in a diuretic effect, which makes you need to urinate more frequently.

There is little you can do to avoid the negative effects of alcohol consumption. Other than, well, not drinking.

While medication can counter some of these effects, I would not advise doing it. However, refueling your body the following day by replenishing lost minerals and glucose is essential.

Oh, and as for the hangover miracle cure, I will leave that as a cliffhanger for the future.

Drink responsibly.

I would love to get your thoughts and comments!

¹ The kidneys perform an essential function called glomerular filtration, which involves filtering the blood to produce urine. This process occurs in the glomeruli, small blood vessels in the kidneys. As the blood flows through these vessels, waste products, salt, and water are filtered out, while blood cells and large molecules, such as proteins, are retained. The filtered fluid then moves through the renal tubules, which undergoes further processing to become urine. This crucial process helps maintain the body's fluid balance and eliminates waste products.

DISCLAIMER: None of this (such as text, graphics, images, and other materials) is medical or health advice. This newsletter is strictly for informational, educational, and entertaining purposes only. While I’m a medical doctor and a dentist by training, I’m not your doctor. The content is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on high on health! Please be careful and do your research.