It has been well-accepted that stress, physical and mental, is detrimental to our health and can contribute to illness. Mothers know it. Doctors talk and write about it. It is a prominent, irrefutable causal relationship for most of us. As convinced of the idea as you may be by your observations and what you have heard and read, I am asking you to look more closely and use a different point of view.
My experiences as a primary care physician for more than 30 years suggest there is more to the relationship between stress and illness. I observed that stress does not directly cause life-threatening illness, but rather, it is the lack of deep, body-repairing sleep that often accompanies stress that leads to illness.
This is because illness-causing reflexes are triggered when a person reacts to their stressors by doing and thinking more, while not allowing the body to maintain its essential balance with needed sleep.
Please take a moment to reflect on this: You usually do not become ill when you are actively engaged in meeting and overcoming the demands of your stressful responsibilities. Indeed, you often deny feeling stressed while you are most actively engaged mentally and physically. While in the midst of negotiating intended outcomes, you see yourself as overwhelmed, afraid, and having the usual complaints expected of someone under stress. You would likely describe yourself as being intent and determined to meet your challenges. You resist taking things off the list, hell-bent on pushing yourself to do more.
Often, I observed in my patients that it was only after they relinquished their intention to engage in overcoming their challenges – while forgoing balancing deep sleep – that they became ill.
If you observe your past illnesses, you will most likely see that they occurred within hours of relinquishing your intention and mindful attitude to meet the challenge.
This is the basis of my LOSS principle – the Washington Lack of Sufficient Sleep principle – which describes the relationship between stress, sleep, and illness.
The LOSS principle: The likelihood and severity of illness increase proportionally to the amount of activity, time, and energy, both mental and physical, that you expend to meet your challenges when reacting to stressful circumstances. Also, the likelihood of illness is inversely proportional to the amount and quality of your sleep. Ultimately, the illness will occur after you disengage from the mental and physical challenges of the stress.
In other words, your intention and determination to overcome or survive stressful situations can override your homeostatic balance between activity and sleep, which is the balance that allows you to maintain health.
Two groups are at higher risk of illness from stress.
Some groups are known to be at very high risk of illness throughout their lifetimes. They include:
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Victims of adverse childhood experiences (ACEs)
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People with type A behavior traits.
These groups are more vulnerable primarily because they cope with stressful circumstances in their lives by frequently resorting to emotional nighttime vigilance and mental problem-solving activities when they should be sleeping to heal. Unfortunately, many people in these groups are programmed this way and have lost their ability to relinquish control. They cannot easily allow themselves to completely let go and submit to experiencing the benefits of deep, mind-body-emotion-repairing sleep.
Fortunately, what can be programmed can be re-programmed.
Cognitive behavioral therapy (CBT), meditation, mindfulness, practices of gratitude, and prayer can all be valuable tools to allow the benefits of deep sleeping and repairing wellness at every level. The goal is to regain a healthy balance of sleep and wakefulness.
Lack of sufficient sleep, LOSS, affects how you experience the world.
Let me remind you of this in a way you see it play out quite often:
We are all familiar with the idea that hunger can make someone angry or cause them to exhibit angry behavior, a condition known as “hangry.” The funny thing about hangry is that the person doesn’t recognize the connection. They lack insight because they feel angry more than they feel hungry. It must be pointed out to them, like in that ad: “You’re not yourself when you’re hungry. Here. eat this.”
Being tired and not knowing it, has an analogy to hangry – I call it “tranky.”
Yes, being tired can also make one angry, but tiredness causes the mind to perceive things as worse than they are, and the tiredness is imperceptible. In urban speak, making a big thing out of nothing is called ‘trippin‘. So, ‘cranky’ combines trippin and cranky behavior—someone who is tired and doesn’t know it.
Feeling tranky is both an acute and chronic condition.
In other words, those chronically suffering from insufficient balanced sleep, what I call sleep debt, experience the world as more stressful than it is.
The tranky perception triggers more of a sense of being stressed or tired, feeling less motivated, less confident, with fewer capable thoughts, and more activities and behaviors that undermine health. In particular, chronically tired people ironically feel best in the middle and late evening when they would be ultimately better off sleeping. It becomes a vicious cycle.
So, to break your LOSS cycle, sleep is important to change your perception of deep sleep. By embracing it as a natural stress reliever and trusting in your body’s ability to heal, you can reprogram yourself not to resist sleep when you need it most. Additionally, practicing gratitude for this natural process can go a long way in keeping your sleep debt low, better paid in full, and mitigating the trauma and toxic stress in your life.
