Sleep as a competitive edge


The majority of us need around 7-9 hours of restorative sleep with a smaller percent of us needing less to feel fully rested. That’s the foregone conclusion of the overwhelming research on sleep.

But here’s how I frame it.  We often don’t get enough zzz’s to function  anywhere close to the top of our game.  And that doesn’t matter, because what do we tell ourselves?  That to be competitive, to be more successful, all we need to do is sleep one hour less to gain one more hour of productivity in the day.

But whose the beneficiary?  Only a very small fraction of the population can get away with less sleep, and the stars probably don’t line up that your one of them.

Sleep deprivation.  A performance killer

If you want advice on sleep? Look to what the sleep experts have to say. And better yet? Someone who knows a thing or two about a competition. Harvard sleep expert and professional sports team go-to-advisor on sleep, Dr. Charles Czeisler, weighs in, “Like a drunk, a person who is sleep deprived has no idea how functionally sleep-deprived, he or she truly is,” he was quoted as saying. “Most of us have forgotten what it feels like to be awake.”

You probably heard this before. If you are burning the candle at both ends, eventually you won’t stay on top of your game.  According to Czeisler, if you average just 4 hours a night, day after day, your memory, cognition, problem-solving and performance speed will be just as cognitively impaired as someone who has stayed up 24 hours straight.

Take, for instance, the performance of Major League Baseball players on less than ideal sleep. According to a 1995 study, as reported in the Atlantic, if the visiting team is flown in on a red-eye, the home team scores more than 1.2 points. Back-to-backs have seen nose-dives in the performance of the NBA and other Major League teams.

More Zzzz’s? Who can benefit?

But it doesn’t take being a Major League player whose performance could benefit from more sleep.  People who are chronically sleep deprived, from working long hours- including those who need to make a decision, process a new memory, or use critical thinking skills- could benefit. Especially, since research has shown that consolidation of memories specifically occurs during sleep.

The upshot

If today you are sleep deprived and tomorrow you need to be on “top of your game,” what’s the takeaway? Sleep expert Czeisler’s advice to the Major League players can explain:

On the eve of game 7 of the 2011 Stanley Cup finals, Czeisler got an emergency call from the team physician of the Boston Bruins. Their game against the Vancouver Canucks was scheduled for 5 pm the next day with a team practice scheduled at 10:30 am. “Cancel the practice,” Czeisler advised. “The guys need to take a nap to perform at their best.”

Czeisler calculated that a 10.30 nap in the morning would equal a 1:30 nap in the afternoon in Boston. He also knew that memory, skill and performance speed would be affected if the team could not recoup the lost sleep. He went on to unexpectedly advise that the team then sleep at least 9 hours the very next night after the game. Czeizler stated: “It’s the sleep after the lesson, game or event that is most important.” He went on, “Interestingly, if you don’t sleep the night after training, then if you sleep the next night and the next, you never learn.”

The night of the Stanley Cup? The Bruins ended a 39 year Stanley Cup drought with their 4:3 win. Was it a striking turnaround, or simply good sleep?


Can a Professional Basketball Player Like Derrick Rose Recover Fully After a Meniscus Injury?

basketball[1] Q: Cynthia, I am beginning to think Derrick Rose, with the Chicago Bulls, just can’t catch a break (yes, pun intended). His most recent injury was his second tear to his right knee meniscus. How did he did he do this again, and will he be able to return to his pre-injury MVP form by next season?

A: Derrick seems to have this intolerably stacked deck. This is Derrick’s third knee injury in the last 3 years among an “assortment” of other lower extremity injuries. His most recent injury to the right meniscus in February was a big setback for him. He had just regained his confidence and rhythm after tearing the same knee meniscus, in late 2013. The good news is that this meniscus tear is a minor tear compared to the one last year. We need to remember that Derrick has been down this path before and knows exactly what he needs to do to put his rehab into gear.

Look, Its no secret that basketball is hard on the knees. All it takes is a hard foot plant and pivot, or a fast stop and start to easily cause the meniscus to tear. Typically the meniscus, especially the medial meniscus, is particularly stressed from a forced rotation in an improper direction during bending or extending the knee. Although no one seems to know exactly how Rose injured his knee, the mechanism of injury looks like this: As the knee initially begins to flex or bend, the tibia is supposed to rotate internally, or in an inside direction. If the tibia gets forced externally or in an outside direction, the meniscus gets torn from trying to move between flexion with the tibia and into rotation (in the wrong direction) with the femur.

With Derrick’s November 2013 meniscus injury, known as a “Bucket Handle” tear, he opted to re-attach vs remove the meniscus, which he well knew going in would be a longer rehab and possibly open the door for another meniscus injury.

According to my interview with Dr. Eric Chehab, orthopedic knee surgeon with Illinois Bone and Joint in the Chicagoland area, “repairing a meniscus provides a 70% success rate, with about a 1 in 3 chance of the meniscus failing again,”  he said.  “The reason a player would opt for this route is for a reduced risk of arthritis in the future,” he stated.  In a meniscus injury with a player that required surgery, would a sports surgeon recommend repairing or removing the meniscus?  Dr. Chehab opinioned, “Most sports surgeons would recommend salvaging and repairing the meniscus if possible as it’s in the player’s best long term interest.”

With this second more recent injury, Rose reinjured the same meniscus that was torn in 2013. He and his doctors opted to remove the torn fragment versus undergoing another repair. The part that was removed was the soft cartilage of the meniscus leaving just the hard cartilage to coat the bone. Dr. Chehab explained, “people often have a misconception that removing a meniscus leaves the knee bone on bone, but the hard cartilage actually remains.”  He also said,”removing the damaged fragment of a meniscus tear would improve the pain right away; however, it subjects the hard cartilage to more stress and damage over time.”

The recovery time for a removal is much shorter than a repair, with 6-8weeks for removing the fragment vs 6-8 months with a repair, which really looks hopeful for Rose doing well the rest of the season and definitely promising going forward into the next. When I asked Dr. Chehab how well a professional basketball player would be able to play at a pre-injury level after rehabbing this type of injury, he felt that a player should actually do quite well. “After all, it’s not until decades later that arthritis would be a problem,” he said. Meaning a player should not have it effect the rest of his career.

The last time I checked any recent news on Derrick Rose, apparently his rehab was really doing great. K.J Johnson, Chicago Bulls reporter for the Chicago Tribune, reported that Roses surgery got a test ride when his knee took full contact in practice already and so far, no ill effects have been reported.

The future for Rose? It’s looking pretty rosy.