Tips for improving sleep and sleep hygiene
If you don’t sleep well, you’re not going to achieve optimal health – no matter how good you eat or how often you exercise!
Whatever your health goals, we all know that good nutrition and adequate activity are essential for optimal health. But the newest research is showing that sleep should be higher on our list of priorities. Why? Lack of sleep leads to a number of problems, including:
-Decreased immune function, leading to more infections and higher risk of cancer
-Increased stress on the heart and brain, which contributes to higher risk of heart attack, stroke, dementia/Alzheimers, depression/anxiety. Related to this, studies have shown that the plaque that leads to Alzeimers is mostly removed during deep sleep (stages 3 and 4), which many of us do not reach because of our lifestyles or due to undiagnosed/untreated sleep apnea.
-Increases leptin resistance and insulin resistance (both of these conditions lead to increased hunger and over-eating)
So, how can we get more - and better quality - sleep?
The following is a list of factors that affect sleep, why they affect sleep, and what we can do about it. Before you start reading, it is important to know that for any of these to work, you have to DECIDE to get more sleep. It's up to you to make this choice! Start with choosing just one of these suggestions, and try it out for at least 2 weeks.
The single most important thing you can do to improve sleep is to balance your exposure to light - blue light in particular, by increasing exposure during the day (30-60 minutes of sun light exposure), and eliminating exposure 2 hours before going to bed. Why? Blue light, emitted from sunlight and from our electronics (TV, phones, digital alarm clocks, etc) tells our brain that is it daylight. In addition, blue light suppresses melatonin (which most know as the "sleep hormone"). To help ease the transition at night, try wearing blue light blocking glasses, or purchasing screens that can cover and block blue light from your electronics. There are many options on Amazon.com - find what works for you! And for more information on blue light, click here.
In addition, if you tend to wake up in the middle of the night, place a red film or color over a flashlight, or over a nightlight, to avoid unnecessary blue light exposure in the middle of the night. And, of course, make your room as dark as possible at night - even the small amount of light from your digital alarm clock can affect you!
Food requires energy to break down, energy that doesn't need to be turned "on" if you're trying to get to sleep. Thus, don’t go to bed on a full stomach.
However, the reverse is true - don't go to bed on an empty stomach (causes rebound hypoglycemia, or low blood sugar, that will wake you up in the middle of the night).
And if you tend to wake up in the middle of the night, even if you're thinking it's because you just need to use the restroom, try adding some resistant starch to your dinner (keeps blood sugar levels steady for longer period of time). See our May blog post on resistant starch.
Stimulants are just what their name says - they stimulate the brain and body. But we don't need to be stimulated if we're trying to get a good nights sleep. Thus, avoid stimulants like caffeine, alcohol, nicotine, and sugar (and aim to avoid these at least 6-8 hours before going to bed)
Caffeine, nicotine, and sugar are relatively self explanatory as to why to avoid these. As for alcohol, which can make you sleepy at first, it actually induces a light form of sleep (not the deep restorative sleep), and increases the chance of low blood sugars 4-6 hours after drinking
Address TIMING, INTENSITY, and DURATION - and maintain these consistently (i.e. don't sleep in/stay up late on the weekends):
-Do you get to bed at a reasonable time (research shows the best time to go to bed is between 9:30 and 10:30)?
-Do you achieve all 5 stages of sleep? Obstructive sleep apnea, prescription sleep medications, and alcohol are the most common reasons someone skips delta wave (stage 3 and 4) sleep. See the image of the sleep cycle at the beginning of this article to learn what occurs during each stage of sleep.
-And are you sleeping the recommended 7-8 hours of sleep per night?
As mentioned previously, keep electronics out of the bedroom (phone, tablets, TV, computer), due to blue light exposure.
Another recommendation is to turn off wifi at night, since some studies suggest that electromagnetic frequencies may affect sleep, and wifi is a big contributor to this.
Keep your bedroom dark (including covering a digital alarm clock) and cool (ideal temperature between 60-75 degrees)
Create a sleep-friendly environment: comfortable, quiet (earplugs for if your partner snores, or try using a white noise machine), and only do 2 things in bed (no need to define these!).
One of the most common things I hear in our practice is how much easier it is to sleep after a patient starts exercising. Exercise is important for many reasons, but also the timing and intensity of exercise will play a role:
-Try to do more aerobic exercises in the morning, and weight lifting in the afternoon
-Avoid strenuous exercise 2-3 hours before bed
-Pay attention to your legs at night – prop feet up above level of your heart for 15-20 minutes before going to bed (will help decrease chance of needing to use the restroom at night, since our legs hold fluid thanks to gravity and we need to "pull" this fluid towards the bladder for elimination)
-Stretch lightly before bed, particularly focusing on your legs and shoulders
Certain prescription medications and herbal supplements can affect sleep, such as glucosamine/chondroitin, blood pressure medications, and asthma medications. Talk with your health care provider about this.
Prescription sleeping pills: I have to mention these since we are talking about sleep, but I am not a big fan of these because I believe most are misleading. Yes, they help you sleep (actually, they help you become unconscious), but it is rarely a deep restorative sleep.
Natural sleep aids:
This is what most people jump to when they want to improve sleep. Although these are important, I highly encourage addressing factors (mentioned in this post) that could be interfering with sleep. Here are some of my favorite supplements:
1. Magnesium. Magnesium has many important functions, but when it comes to sleep, it relaxes muscles and blood vessels, which helps calm the body. I recommend this to nearly all our patients, unless someone has significant kidney or liver disease. This is particularly good for muscle cramps. There are a variety of forms, but here are my 3 favorites:
-magnesium malate or magnesium glycinate, 400-800mg nightly (this form is less likely to cause loosening of the stools, i.e. diarrhea)
-magnesium oil or lotion - run on tummy or feet prior to bed)
-Epsom salt (a topical form of magnesium) bath or foot soak 10 minutes before bed
2. Chamomile or sleep aid teas. In particular, I like to add a dash of sea salt and a dash of honey, when may help balance cortisol and insulin levels. Notice I said "dash" - you really shouldn't be able to taste either of these! For those of you that like a measurement, this ends up being less than 1/8 teaspoon of each.
4. Aromatherapy. Lavender and chamomile are two common essential oils useful for sleep. Our sense of smell is underutilized - using calming scents work by bypassing the digestion, and go straight to the brain to stimulate relaxation. Try placing a few drops in your palms, rubbing your hands together, then cupping your hands near your nose as you take in 3 deep breaths.
If your sleep is affected because your mind won’t turn off, write out your to-do list before bed, and consider journaling.
I know there are many suggestions here, so start with one! Also, share your experiences and let us know which have helped you!
If anyone needs a great and thorough resource all about sleep, including the scientific studies that support it, check out Sarah Ballantyne's e-book (288 pages, see list of contents and more information here).
And for another great article on the importance of sleep, check out Dr. Mercola's article.
Thanks for reading!