I am convinced that if the benefits of rest could be put into a pill, it would be among the hottest selling supplements on the market. Unfortunately, in order to reap the benefits of rest, we must slow down and take the time to rest. Sadly, many of us do not believe that we can really pause long enough to take advantage of this vital remedial and preventative agency. Therefore, many are not even interested in learning about the far-reaching benefits of rest. They reason, why become convinced of the advantages of something that I do not have time for anyway? Because of these biases, I’d like to challenge you to think about rest as if it were a newly discovered vitamin, let’s call it vitamin R. In this hypothetical situation, we can now forget about whether or not we have time to rest. After all, every one of rest’s advantages can be obtained from taking a pill. Let us now look at this amazing “vitamin” and see if you want to include it as part of your daily program.

However, before we go too far with our illustration, I should clarify the fact that rest comes in a number of different forms. In fact, there are really four different types of vitamin R. Just as there are a number of B vitamins, so there are four siblings in the vitamin R family. They are listed in Figure 18: Vitamin R (Rest) Comes in four Kinds.

Vitamin R1 is sleep, or daily rest. Vitamin R2 is the weekly rest: in addition to sleeping each night, we need a weekly day of rest. Vitamin R3 is recreation: we need to take time to get away from work, physical tensions, and mental stresses of life. Vitamin R4 is also essential: this vitamin is meditation—and should be done at least on a daily basis. Let’s look more closely at each of these four types of vitamin R.

Vitamin R1: The Daily Rest
R1, the sleep vitamin, is in short supply with many Americans. Research suggests that the average person does best on seven to eight hours of sleep per day. This figure was associated with the greatest longevity in the Alameda county health study that we examined in the first chapter (“Principles for Optimal Health”).111 Statistics suggest that about two-thirds of American adults sleep between six and nine hours per night.112 Sleep needs vary with our genetics. Dr. James Perl, a Ph.D. psychologist and sleep expert, points out that about 20 percent of the population genetically needs less than six hours per night. He also observes that 10 percent of our populace genetically needs more than nine hours per night.113

Regardless of your specific need, anyone can come up short on vitamin R1. If you do not feel wide awake and energetic throughout your waking hours, you are likely sleeping too little. And if that is your problem, you are not alone. In the U.S., fatigue is one of the 10 most common reasons for visiting a physician.114 In fact, each year 3.3 million Americans visit their doctors for insomnia alone.115 Yes, problems with inadequate sleep are exceedingly common in our nation. The evidence suggests that as many as 60 percent of Americans have some problems relating to their sleep habits.116, 117

It may seem somewhat depressing to talk about how poorly the average American’s sleep needs are satisfied. There is some good news in this department, however. Those who handle stress better appear to require less daily sleep. In other words, if you are emotionally healthy and positive, your body is likely to sleep more efficiently.118 Exercise can also help you to have more energy on a given amount of sleep. Put another way, regular exercise helps to decrease our sleep requirements. In fact, exercise has been demonstrated to decrease fatigue and boost mental and physical vigor.119

Although positive moods and physical exercise can help us in the sleep department, there are things that work against our ability to get refreshing sleep. Television viewing is one reason why we do poorly in the sleep department. The more television you watch, the less time you have to sleep. This is particularly a problem for American youth. Many are not getting enough sleep because of their liberal diet of TV. There are, of course, many other reasons for our national sleep debt. I will not go into our tendency to squeeze too many activities into a finite number of hours per day. I would, however, like to stress one of the most fatal deceptions of the sleep-deprived. Most of those who are shortchanging themselves on vitamin R1 feel like they can get by without optimal amounts of this vitamin. Unfortunately, the medical literature is very clear on the effects of sleep deprivation and irregular sleeping habits (such as shift work).120, 121, 122, 123 Such practices slow reaction time and increase the risk of both fatal and nonfatal accidents. Sleep deprivation can clearly have life-threatening consequences. Probably one of the most notable is falling asleep while driving. One interesting aspect of the current research on falling asleep at the wheel is that accidents and fatalities seem to be the most common in those who have not learned their limits. In one U.S. study, 55 percent of such accidents occurred in individuals 25 years old or less, suggesting that inexperience in respecting fatigue’s cues can be costly.124 The toll of disability and death from fatigued drivers is not confined to the U.S., of course. A recent German study indicates that falling asleep at the wheel is the leading cause of German roadway fatalities, amounting to nearly 25 percent of the total.125

However, the risk of other types of accidents also increases dramatically in those who are sleep-deprived. Accidents at the work place also occur more commonly when we are short on sleep, working unusual hours, or otherwise fatigued. Large-scale disasters like the Chernobyl fiasco, the Exxon Valdez crash, and the Three Mile Island incident all occurred in early pre-dawn hours, when vigilance was at a low point. Dr. Fred Hardinge, an expert looked to by the Federal Aviation Administration on issues relating to fatigue and performance, has pointed out that most of the “friendly fire” problems in the Persian Gulf War were due to fatigue. Some of these short-term sleep deprivation problems—with long-term consequences, nonetheless—may result from what are called “micro sleeps.” In these settings your eyes typically are wide open, yet your attention lapses and you do not realize what is happening.

Although short-term problems with sleep deprivation often grab the headlines, serious problems result from chronically not getting enough sleep. Remember that even six hours of sleep per night is insufficient for many people and sets the stage for problems. Frontal lobe brain damage can occur in sleep-deprived animals. PET scans demonstrate decreased blood flow to the frontal lobe of the brain in chronically sleep-deprived individuals.126 With such chronic sleep shortages, irritability and belligerence rise while attention span drops further. Rapid mood changes and trouble coping with stress can result. Withdrawal from group action and even depression are among the outcomes of chronic sleep deprivation. Delusions and hallucinations can also be consequences of this downward spiral.

Both short-term and long-term sleep deprivation can affect your resistance to disease. Losing even three hours of sleep on a given night can cut in half the effectiveness of your immune system.127 A number of immune alterations occur with sleep deprivation: antibody levels are decreased128 while interleukins-1 and -2 fail to experience the rise that occurs with deeper stages of sleep.129 Growth hormone (GH) requires sleep for optimal release. Absence of GH further impairs immunity as important immune defenders, the cytotoxic T cells (a type of white blood cell), are dependent on this hormone.130 Chronic fatigue also increases the risk of problems that may not be so obvious: heart disease, heart related deaths, and stomach and intestinal problems.131

Even if you are spending nine hours each day in bed, you may not be getting the quality of sleep that you need. Sixty years ago, sleep was regarded as a static process of rest, but sleep quality can radically differ even if it looks like two people spend the same amount of time in bed. How can you increase sleep quality? Figure 19: Ways to Improve Sleep Quality lays out some of the basics.132

Sleep quality is actually related to the entire NEWSTART program. Although daily rest is an important aspect of health, we tend not to rest as well if we are not following other aspects of a healthy lifestyle. Perhaps nowhere is this seen more clearly than in research relating sleep and aging. Most have not questioned the “fact” that sleep quality deteriorates as a person gets older.133 However, new research from Stanford University Medical School and other centers is calling this assumption into question. What the newer data suggests is that people who stay healthy and follow a good lifestyle are unlikely to develop changes in sleep quality as they age.134, 135

Vitamin R2: The Weekly Rest
In America, it is not uncommon for people to put in a seven-day workweek. Many do this repetitively and do not seem to suffer for it. However, the medial evidence suggests that there may be both long-term and short-term consequences to such a practice. Just as the body has a natural daily clock (circadian rhythm), it also has a weekly clock (circaseptan rhythm). Circa-septan rhythms are just that: body rhythms that run about seven days in length.

Medical research has demonstrated such rhythms in connection with a variety of physiological functions. Some that have been identified included heart rate, suicides, natural hormones in human breast milk, swelling after surgery, and rejection of transplanted organs. To understand the significance of these rhythms, consider the latter two items in the list. A person will tend to have an increase in swelling on the seventh and then the fourteenth day after surgery.136, 137 Similarly, a person with a kidney transplant is more likely to reject the organ seven days and then fourteen days after the surgery.138, 139 Research on circaseptan rhythms continues and new relationships are continually being discovered. There are seven day rhythms that have been observed in both human and animal cancers and their response to treatment.140, 141, 142 Fibrinogen, a blood clotting compound that has been demonstrated to increase the risk of heart attack, has now also been observed to have a seven day rhythm.143 Further work has shown that in addition to inflammatory responses operating on a circaseptan rhythm, so do the drugs that we often use to treat them.144

An understanding of circaseptan rhythms has lead me to more fully appreciate the fact that I need to pay attention to weekly rhythms to protect my own health and the health of my patients.

Dr. Baldwin asserted some years ago that the current research indicated that “this seven-day rhythm is a normal built-in feature of our physiology.”145 Recent researchers have been even more adamant than Baldwin. “From the medical point of view so-called circaseptan (about 7 days) reactive periods are of predominant interest. This periodicity can be observed in numerous adaptive and compensating processes. It does not depend on the external week cycle and was already known to the antiquity.”146 What both of these authors are saying is that the importance of the seven-day rhythms should not be underestimated. Furthermore, these rhythms are a part of who we are; they are not a function of the fact that we happen to keep a seven-day week in our culture. Thus, this seven day rhythm “does not depend on the external week cycle.”

From a historical perspective the weekly cycle is also of great interest. We keep a 24-hour day based on the earth revolving on its axis. We keep a monthly cycle based on the periodicity of the moon. The year is based on the earth’s circling the sun. But what is the week based on? Some have conjectured that mankind over the years came to the conclusion that no other weekly cycle harmonized well with our internal rhythms. It is interesting to note that although cultures have experimented with different weekly cycles, all those that Baldwin is aware of have reverted to the seven-day program. He points in particular to France during the time of the French revolution. They then experimented with a ten-day (metric) week, with disastrous results. The mental institutions filled rather quickly to capacity and then some. Baldwin attributes the abolition of that program in part to the logical thinking of the renowned mathematician, Laplace.

However, others have pointed to an even more compelling reason for the existence of the weekly cycle: it is the way that God created us. Indeed, in the first of the scriptural books of Moses, the seven-day weekly cycle is described as part of God’s design in creation. That cycle is described as consisting of six days of work followed by a Sabbath day of rest. Baldwin sees significance in the Sabbath concept in relation to circaseptan rhythms.147 He recognizes this as a “zeitgeber” (“time-giver” in German). Zeitgebers keep our weekly rhythms synchronized by pausing one day in seven for a time of rest. In order for these time-givers to work, however, it must come at the same time each week. In other words, it is not sufficient to get one day in seven off; it is optimal to get a specific day in seven off on a regular basis.

My own experience agrees with this body of medical research. I personally need one day in seven where I set things aside and experience a true rest. That does not mean I sleep the whole day. Instead, I use it as a day for recreation, for reflection, for meditation, and for focusing in on spiritual values. Whether you keep the seventh day of the week as I do (from sundown on Friday evening to sundown on Saturday evening in harmony with the biblical injunction) or a different 24 hour period, there is a benefit to observing one specific day in seven as a day of rest.

One other observation is in order. In scheduling our daily rest of sleep, we often have to prioritize sleep even though we have not finished all of our work for the day. Many have learned by experience that in most circumstances it is best to go to bed on time. In the same way, even if your work for the week is not completed, I would still encourage you to take that specific day in seven off and rest as if your work was completed. In fact, a physician friend of mine once said that such a priority is one of the beauties of God’s Sabbath commandment. Even though he is aware of the importance of the weekly rest, if God did not specify a specific day, he feels he would not be regular in keeping one specific day per week as a “zeitgeber.” I have found the same true in my experience.

Vitamin R3: True Recreation
If you look at how most Americans spend their time, you would think that television is our nation’s number one form of recreation. However, in the sense of the term as I use it, TV programing does not meet my criteria for true recreation. When discussed in the context of rest, I see recreation as living up to its name, specifically: “re-creation.” I believe that after engaging in true recreation, I should be more able to meet life’s challenges, not less able. True recreation is revitalizing and helps me better accomplish the work and responsibilities that I have. What kind of activities then fit the bill as “true recreation?” From my experience and study, outdoor recreation tops the list. Options include a host of activities such as gardening, hiking, doing pleasant yard work, cross country skiing, walking, and dozens of other options. These activities provide a mental break from the routine, as well as offer the advantages of many of the other NEWSTART elements such as exercise, sunshine, and fresh air.

Vitamin R4: Meditation and Prayer
Meditation and prayer provide a form of rest that has been practiced for centuries. Even secular Westerners are becoming more interested in learning about this potent form of release from stress, tension, and anxiety. In my own experience, I have found meditation and prayer to be a vital part of a balanced lifestyle program.

Prayer is the breath of the soul, figuratively speaking. As moral beings and spiritual beings, we need to spend sufficient time in contemplating our trust in divine power. There is a connection between the “R” and “T,” specifically vitamin R4 and “T,” trust in God. It can help us in so many ways, such as in controlling stress, strengthening the immune system, providing protection against heart disease, cancer, etc. The list goes on and on. Yes, trusting in our Maker, Defender, Redeemer, and Friend. But how can we trust Him if we do not really talk to Him through prayer?

In Chapter 12 on the frontal lobe, I point to the example of Dr. Larry Dossey as an illustration of how even honest skeptics are now concluding that prayer has unique benefits.148 Dr. Dossey has collected a host of scientific studies that demonstrate that when people pray to God on behalf of others, health benefits result. These results even include the spontaneous regression—or cure—of cancer. Dossey’s experience illustrates that from the perspective of thinking scientists, the benefits of prayer extend beyond those of mere meditation. It is remarkable that the attitude of prayer makes a difference in whether or not healing ensues. It is the trustful prayer of faith in committing one’s life to God that most likely results in healing—not the aggressive prayer that prays for white blood cells to destroy cancer, or attempts to raise self to levels of unrestrained optimism.149

One of the themes with vitamins R1 and R2 is that these substances must be “ingested” regularly to provide optimal benefits. Just as we need daily rest in each 24 hour period, and weekly rest once in every seven days, so do we need regular periods for recreation on the one hand, and prayer and meditation on the other. Actually, each of the other types of rest affects vitamin R4 as well. As we have seen, lack of sleep or irregular and/or excessively long work hours contribute to some obvious problems: poorer quality and quantity of sleep, increased fatigue, poorer work performance and increased accidents. 150 However, inadequate sleep also affects us spiritually. The frontal lobe appears to be particularly prone to sleep deprivation. Surprisingly, our values even tend to suffer when we are short on sleep.151

This last element of rest—meditation and prayer—also addresses the most potent robbers of rest and relaxation, namely stressors and our maladaptive ways of handling them. As pointed out in Chapter 14, “Stress Without Distress,” the use of meditation and prayer offers powerful help on these levels. There I emphasize that we have a critical need for meditation and prayer on a daily basis. I go on record as defining these elements as forms of “rest and rejuvenation that few appreciate” to their fullest extent. The interested reader is referred to that chapter on stress for a further discussion—and practical application—of this vital vitamin R4.