Sleep as THE Foundation of Health: Part 1

I used to not think about sleep much at all. The adage of needing 7–9 hours was about all the attention I gave it. In school we learn very little about sleep, so it wasn’t an area I ever explored. I assumed those hours were important, but if something else needed done, sleep took the back burner. That belief worked… until it didn’t.

My wake-up call happened in chiropractic school. Every morning my alarm would go off at 4:45 AM so I could study for a couple hours before our 7:30 class. At the time it worked out pretty well. Those early hours were when I was sharp, focused, and able to retain more information than any other time of day. I’d get two solid hours of studying in before most people were awake. Once class started, I would sit through lectures from 7:30 until three or four in the afternoon, squeeze in an hour of studying afterward, knock out a CrossFit workout, and then come home feeling good about the day and able to put school aside for a relaxing evening with my wife. On paper it looked disciplined and efficient. In reality it was barely sustainable.

I told myself that if I got into bed around 9:45, that was seven hours of sleep and I was good to go. That should be enough, right? What I didn’t realize was that seven hours in bed is not seven hours of sleep. It sits right at the bare minimum before things begin to unravel. And unravel they did. I started getting tired. Then burnt out. Then I couldn’t stay awake during class, and eventually I picked up a small workout injury that turned into chronic low back pain lasting more than a year. At the time it felt random. Looking back now, it was predictable.

This was the moment I stepped back and re-evaluated . I started tracking my sleep with the Oura ring and quickly learned the hard truth: although I set my alarm for seven hours, I was regularly getting six or less of actual, quality sleep. No wonder I was falling apart. Those metrics gave me a window into what was really happening. My routine wasn’t sustainable; it was slowly draining my battery.

For about three months I was taking naps nearly every day after class out of necessity, stopped intense workouts, started sleeping more, leaned into nutrition and supplements to support my burnt-out adrenals, and rebuilt myself from the inside out. Eventually, I felt back to normal again. Despite fewer hours of studying, I was able to keep my grades up and continue learning the material. By sleeping better and focusing on my health, I was able to be more effective in less time.

Somewhere along that stretch I read Why We Sleep by Matthew Walker. This book truly blew my mind. It completely changed how I view sleep and opened the door to learning more about sleep as the foundation of health. Written by a PhD sleep researcher, it reframed my understanding of what sleep does for our bodies. I learned what actually happens during sleep, how deeply it supports our health, the staggering statistics around what poor sleep does to us (some listed below), and even what the world could look like if sleep were prioritized. With this knowledge in hand, I could look back on the previous year and clearly see how and why I started to fall apart. I could also look ahead with a better strategy for helping my patients avoid the same issues.

One line from the book still sticks with me:
“I was once fond of saying sleep is the third pillar of good health alongside diet and exercise. I have changed my tune. Sleep is more than a pillar, it is the foundation on which the other two health pillars sit. Take away the bedrock of sleep or weaken it just a little, and careful eating or physical exercise become less effective.”

This concept is not just a catchy phrase. It is backed by extensive research. The statistics around sleep are staggering, profound, and honestly hard to ignore once you’ve seen them laid out. Below are only a handful of the studies Walker shares that show just how essential a good night’s rest really is. Make sure to read the one on daylight savings time. I found it to be the most drastic example of how even a tiny shift in sleep can create a massive impact on our health.

Cardiovascular Risk
“Adults forty-five years or older who sleep fewer than six hours a night are 200 percent more likely to have a heart attack or stroke during their lifetime, as compared with those sleeping seven to eight hours a night.”

Cancer Risk

“Routinely sleeping less than six or seven hours a night demolishes your immune system, more than doubling your risk of cancer.”

Exercise & Physical Performance
“If you’re getting six hours of sleep or less, your time to physical exhaustion drops by up to 30 percent.”

Testosterone Levels
“Men who sleep five to six hours a night will have a level of testosterone which is that of someone ten years their senior.”

Blood Sugar & Pre-Diabetes
“Participants were limited to sleeping four hours a night for just six nights. By the end of that week, these formerly healthy participants were 40 percent less effective at absorbing a standard dose of glucose compared to when they were fully rested. What that means is if the researchers showed these blood sugar readings to an unwitting family doctor, the provider would immediately classify that individual as being pre-diabetic.”

Appetite Hormones
“Inadequate sleep decreases concentrations of the satiety-signaling hormone leptin and increases levels of the hunger-insatiating hormone ghrelin. It’s as though, when sleep-deprived, you are punished twice for one offense.”

Coronary Artery Disease
“Progressively shorter sleep was associated with a 45 percent increased risk of developing and/or dying from coronary artery disease within 7 to 25 years.”

Cardiac Arrest Risk
“Over a fourteen-year period, those sleeping six hours or less were four- to five-hundred percent more likely to suffer one or more cardiac arrests than those sleeping more than six hours, even when researchers controlled for other cardiac risk factors such as smoking, physical activity, and body mass.”

Daylight Savings & Heart Attacks
“In the Northern Hemisphere, the switch to daylight savings time in March results in most people losing an hour of sleep. Should you tabulate millions of daily hospital records, as researchers have done, you discover that this seemingly trivial sleep reduction comes with a frightening spike in heart attacks the following day—by an increase of 24 percent. In the fall, when countries step back and gain an hour of sleep, rates of heart attacks plummet by 21 percent.”

Athletic Performance — Andre Iguodala Study
“When Andre Iguodala increased his sleep to more than eight hours a night, his performance metrics improved dramatically: 12 percent increase in minutes played, 29 percent increase in points per minute, 2 percent increase in 3-point percentage, 9 percent increase in free-throw percentage, 37 percent decrease in turnovers, and a 45 percent decrease in fouls committed.”

All of this may sound extreme… because it is. Sleep isn’t just important. It is the foundation of good health. Recovery, mental clarity, mood stability, hormonal balance, immunity, and athletic performance all depend on how well you sleep.

I learned this the hard way. When I pushed through exhaustion in chiropractic school and tried to outwork my lack of rest, things began to fall apart. My energy, ability to focus, and even my physical health started to decline. It took some time and effort, but in a few months of changing my daily habits and focusing on sleep, I had recovered.

Consider this. One of the most powerful health interventions available is completely free, accessible every single night, and yet it’s often the first thing we sacrifice. If something so simple can make such a profound difference, it’s worth paying attention to.

In Part Two, I’ll walk you through the practical side: how to sleep well, the routines that make a difference, the habits worth keeping, and the ones quietly working against you.

In health,

Dr. Ryan Gengler