Antoni Esteve and Luis de Lecea: The keys to why sleeping well lengthens and improves our lives

The time we sleep is a source of vitality. While we sleep, everything necessary in our body is prepared to function well during the day. The enormous lack of awareness about this leads our society to underestimate rest and steal hours from it, increasing the risk of work or road accidents, and causing low or reduced performance in our daily activities. "Sleep is a physiological state we go through every day, in which fundamentally the brain takes command, an extremely intelligent organ. It knows, perfectly, how to work for our benefit. While we sleep, it performs an exhaustive review of the entire organism, it has the great commitment to take care of us with a very well-planned exercise. We betray the brain if we don't sleep, because we don't allow it to fine-tune everything necessary for our optimal functional capacity, to be better and more competent people, thus unprotected our health." This is how graphically and forcefully Antoni Esteve, president and founder of AdSalutem Institute for Healthy Sleep, president of the Guttmann Institute and full member of the Royal Academies of Medicine and Pharmacy, presents the importance of sleep in this new session of Barcelona Global Duets. Esteve is president and founder of AdSalutem Institute for Healthy Sleep, president of the Guttmann Institute and full member of the Royal Academies of Medicine and Pharmacy. And, according to Luis de Lecea, professor in the Department of Psychiatry and Behavioral Sciences at Stanford University, "there are quite a few hypotheses about the restorative function of sleep and about what really happens at the cellular level, in our neurons, while we sleep." It is known that "sleeping is an opportunity to replenish resources that we need for daily life, which if we do not sleep enough are not replenished adequately," says De Lecea. Both experts attribute to sleeping well the function of theresetthat our body needs for optimal functioning, a benefit that society, in general, ignores. "Perhaps we, on the science side, are the culprits. The knowledge we have about sleep is extraordinary, much greater than what we had 20 years ago, butwe are finding it difficult to convey to society that very close link between sleep and health.We feel responsible for that consciousness," admits Antoni Esteve. Citing the discoverer of REM sleep phases, a pioneer in sleep medicine research, and founder of the world's first sleep laboratory, the Sleep Research Center at Stanford University, William Charles Dement, Luis de Lecea points out that, as Dement said,"sleep is not important, it is essential, one of the pillars of health". But there is still a long way to go before it is recognized as such. Rest, sleep, is universal, all animals sleep, and it must be for a reason," she expresses.As Antoni Esteve points out,"Sleeping 8 hours guarantees being able to lead an orderly life for the remaining 16 hours." Maintaining good habits, not committing excesses, not even exercising more than necessary, maintaining nutritional habits, good balances, an active social life, as well as knowing what our needs are, helps. And the important thing ---Esteve also specifies--- "is knowing how to apply our own recipes to our lives, knowing how our body can improve its functioning. All of this will help us have a peaceful sleep." That ---he points out--- "it is the virtuous circle, the feedback between sleeping well and functioning adequately during the day and, on the other hand, we speak of a vicious circle, if something of it does not work well."https://youtu.be/zNcw7hHB9Is?t=76The nap, does it help?

Sleeping between 10 and 15 minutes after eating is, according to Antoni Esteve, "an intelligent way to allow our brain to do a reset and prepare us for nocturnal rest." And he gave as an example the most cutting-edge, technological companies, which have provided adequate spaces for their workers to rest those 10 or 15 minutes after lunch. However, Luis de Lecea pointed out that the nap does not work for everyone.

What both sleep specialists do agree on is that one of the great obstacles to achieving enough hours of rest, quality sleep, is stress. In the words of Luis de Lecea, "stress is the greatest enemy of good sleep. Therefore, the way to manage stress is fundamental. From a biological point of view, an animal stressed by the threat of a predator activates in flight mode, as a defense mechanism. And our brain functions the same way when faced with problems that stress us."

Cognitive behavioral therapy for sleep, personalized, focusing on each person's problems and threats to sleep integrity, tries to correct it with various cognitive methods, making the patient aware of their problems.

Sleeping to prevent diseases The consequences of not sleeping well are many, "a long list," points out Luis de Lecea, who, just as an example, mentions that at a neuronal level, metabolic errors accumulate in DNA, while sleeping well helps to repair them. During sleep, furthermore, a very important immunological balance is restored, and, instead, chronic inflammation can occur due to lack of sleep. In short, that third of our lives in which we sleep affects all our physiological activity. Regarding the hours that are necessary to consider that we sleep well each night, Antoni Esteve indicates that sleeping between 7 and 9 hours is what is considered healthy sleep, but also specifying that there are always extremes. If 5 or 6 hours are enough, even if it is very strange, but if the person manages it well and that time allows them to maintain all their activities with sufficient capacity to carry them out throughout the day, it will be fine. However, Esteve took the opportunity to give the example of the well-known cardiologist Valentí Fuster, who had always been very proud because with the four hours he slept he said he had more than enough to recover, and the rest of the time he did not sleep he could use to work. But that was until Fuster participated in a study on cardiovascular risk due to lack of sleep. "The conclusions were so decisive that he became the best ambassador for the need to sleep," says Esteve.

Antoni Esteve: "sleeping 8 hours guarantees being able to lead an orderly life for the remaining 16 hours"

All these arguments were part of the second session of the Barcelona Global Duets cycle, organized by Barcelona Global and which this year has the collaboration of The New Barcelona Post. They are a series of dialogues that aim to confront the views of two global Barcelonians, one residing in Barcelona and the other living and working abroad. On this occasion, Antoni Esteve, president and founder of AdSalutem Institute for Healthy Sleep, president of the Institut Guttmann and full member of the Royal Academies of Medicine and Pharmacy, and Luis de Lecea, professor of the Department of Psychiatry and Behavioral Sciences at Stanford University, starred in the debate Sleep and healthy aging held this Monday, March 13, and moderated by fellow Barcelona Global partner, Bibiana Ballbè, founder of the creative agency TheCreativeAgency. The session could be followed live by streaming and now you also have it available in this same article or on the Barcelona Global YouTube channel.

And, taking advantage of the dual California-Barcelona perspective, the question was also raised whether there are differences regarding the best or worst habits to accompany good sleep in the United States and in Spain. And, although no comparative studies are known, "what is true is that publicly, in the United States it is more common to talk about the importance of sleep, even at a cultural level it is something that here we still have a long way to go. The research that Luis does, is not done here. In the United States, large sleep research studies receive significant funding, something that here is only an aspiration," declared Antoni Esteve.

How to reverse misinformation about sleep and health

Both Esteve and De Lecea consider that a good promotion of restorative sleep, as a pillar of our health, should begin during people's educational process, "not in universities, but in schools, that it be allowed to incorporate it into primary education," they specified. "In stages such as childhood and adolescence, moreover, which are essential periods for the formation of neural circuits, sleeping well is fundamental for having a healthy brain in adulthood," they indicated.

A healthy brain in adulthood, and also better aging, are the direct benefits of quality sleep, according to specialists. "It's pure science" ---they assured--- "living more years and in better conditions depends, to a large extent, on taking care of our sleep. If we manage to restore sleep, cognitive and cardiovascular quality and many other factors improve. On the other hand, when we suffer from stress and get older, the body adapts worse to the threats of a threatening event (predator), the brain is less willing to these types of situations because it has fewer resources, responds worse and damage accumulates in it," Luis de Lecea pointed out.

Luis de Lecea: "living more years and in better conditions depends, to a large extent, on taking care of our sleep"

If we sleep worse, the prevalence of problems is higher, but that is something that can be reversed, as Antoni Esteve pointed out, sleep is a modifiable factor. The scientist lamented the time society has lost by not paying attention when there is a sleep problem to try to recover healthy sleep. He also misses, even among healthcare professionals, the lack of knowledge even when the problem persists. "We have no other choice but to prescribe medications as a solution. They are extremely effective medicines with hardly any adverse effects, but their continued use can lead to serious health problems." Yes, he admitted that lack of sleep is not addressed medically well enough.

From California, and as a researcher on the subject, Luis de Lecea commented the colossal general trend towards the consumption of hypnotics, as opposed to the alternative which would be cognitive behavioral therapy, with treatments of 6 or 8 weeks, but admitted that it is not done because it is very expensive. Continued stress, lack of exercise, the environment in which one sleeps –such as a messy room–, everything that affects is part of the therapy. De Lecea considers that"education can greatly improve statistics and reduce the consumption of hypnotics."Because, as De Lecea commented, "the problem with medication is that you sleep, but the natural repair process does not take place. And, in that way, you don't rest, even if you sleep. If you sleep 8 hours, but upon waking you feel low spirits and fatigue, something is not right."

It is not strange, however, that lack of information, since De Lecea also referred to the "very little attention paid to explaining sleep to medical students, both regarding the basic mechanisms of sleeping and the therapies that promote it."

However, research continues to point towards healthier aging, and sleep plays a leading role in this, not only to prevent diseases but also as a predictor. Sleep disorders are already beginning to appear in studies as predictors of neurodegenerative diseases, as they recorded in the session ofBarcelona Global Duets. The experts put an end to it by inviting to consult and applythe decalogue of sleep hygiene, which includes habits such as always maintaining the same bedtime, minimizing the consumption of substances that stimulate the nervous system, and ensuring optimal conditions in the bedroom—light, temperature, and silence.