Going to sleep at night would seem as natural as rolling off a log, right? Well on any given night 30-70% of us don’t find it easy to do what’s so natural. Here are some of the most common mistakes we make:
1. Changing our bedtime from night to night
When we don’t have a consistent bedtime, the body never gets into a pattern of knowing when it’s time to go to sleep. We have to train the brain and the body that it’s time to get ready for bed, and then time to go to sleep. As much as possible, get to bed at the same time every night.
2. Eating too large or too rich a meal too close to bedtime
If you’re a working person, with the demands of today’s work world, it’s tempting to work late, come home late and shove down a fairly sizeable meal. The food barely has time to digest, and often doesn’t, interfering with the body’s need for a relaxed and clear digestive track. This in turn interferes with going to sleep. Consider how to fix that problem earlier in the day.
3. Going to bed hungry
In seeming contrast to 2. above is many people’s need for a bedtime snack. Because low blood sugar can often be the cause of waking up during the night, a bedtime snack IS a good idea, provided it’s the right kind. Since the goal is to even out the blood sugar, rather than kick it into high gear, the snack should contain a little bit of protein (that’s important) and some easily digestible carbohydrates. A bowl of ice cream does not really fill the bill, sorry to say.
4. Watching tv, surfing the web or text messaging right up to the moment of trying to go to sleep
Why not, you say? These things relax me! Well, actually, each of these is stimulating in itself, though it may focus your energy into one place. But the real reason is that each of these contains blue light, which interferes with the gradual production of melatonin, the chemical that gets us down into sleep. If you’re having trouble sleeping, try turning off these devices about an hour before bedtime and reading or relaxing in another way leading up to bedtime.
5. Going to bed in a less than comfortable sleep environment
Whether it’s a lumpy mattress, a stuffy room or a noisy bed partner that interferes with getting to sleep, each of these has an important role in our readiness to get a great night’s sleep. Most of these things are fairly easy to correct, unless you sleep with a snorer, but consider your sleep environment as you would the site of a great vacation. Choose it with care and thought, invest some money in it and reap the benefits.
6. Letting worries take over your attempts to go to sleep
All of us have things on our mind that could be the cause of a less than great night’s sleep. Try to keep a pencil and paper by your bed to write some of these things down and get them off your mind and onto the paper for the morning so you can relax into sleep. If worries persist over time, seek some help for them so you can sleep.
7. And perhaps most serious, is to let sleep problems persist, whatever their cause, without investigating what can be done about them. Most sleep problems can be helped. The longer you wait to find out what you can do about them, the more likely you are to develop secondary worries about going to sleep that are on top of the actual sleep problem.
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Writing about sleep medicines has not been a big part of my focus on how to improve sleep issues. But these recent findings from the American Association of Neurology offer possible hope to those plagued with a sleep disorder that is neurological in origin, and deserve mention. All research should be viewed with caution as an initial attempt to fit a small piece of data into a larger body of findings. Only when it has been replicated by other research, or studied on a longer term basis, can its place in the body of science be understood.
Restless Leg Syndrome (RLS) is not only a sleep disorder, but also a daytime problem which worsens at night, and, more importantly, interferes with the architechture of sleep by robbing the sufferer of the deeper stages of sleep. This means that the person with RLS rarely gets a good night’s sleep and experiences all of the daytime maladies of lacking good restorative sleep.
The main symptoms of RLS are creepy, crawly, tingling , burning or numbing sensations in the legs which underlie an urge to move the legs or to get up and walk to relieve the symptoms. Walking or other activity does relieve the problem temporarily, but sensations return when the person is at rest. When symptoms get worse at night, they interfere with the deeper stages of sleep, often awakening the person or their bed partner with kicking movements. Diagnosis of this disorder is best made by a neurologist or through an overnight sleep study, where leg movements are actually recorded graphically, like an EEG or EKG.
Dr. Diego Garcia-Borreguerro, Director of the Sleep Research Institute in Madrid, Spain reported in April, 2009 on a study his clinic conducted, jointly funded by Pfizer Pharmaceuticals. In his study, the medicine Pregabalin (aka Lyrica) was prescribed on a short term basis (12 weeks) to patients with RLS. Findings were significant for 66 % of the study participants, for whom Pregabalin relieved all of their RLS symptoms while those with remaining symptoms reported 66% improvement.
This particular medicine had already received FDA approval for and is currently being used to treat epilepsy, fibromyalgia, nerve pain and generalized anxiety. Other medicines approved for treatment of RLS have shown great promise for short-term relief of symptoms, but often include the rebound effect of having symptoms return in even stronger form over the long term. They all have in common that they treat through dopamine pathways, which Pregabalin does not, and, for the most part, do not improve the deeper stages of sleep.
Perhaps the most optimistic aspect of this study is the finding of the restoration of Stages 3 and 4 sleep over the course of this short term study. If this finding holds true for longer term use in other studies, it will be a remarkable aid to poor sleep worth examining.
Dr. Marcia Lindsey is a professional sleep coach/psychologist who trains individuals and groups by phone to change the mental and physical roadblocks to restful sleep. Read about her at www.thesleepdiva.com
Have trouble relaxing as it’s time to go to sleep? It may not just be the worries on your mind or the remains of the day knocking at your mind’s door. Studies show that many of us are deficient in the mineral magnesium, which is a big factor in going to sleep in a relaxed mode. Magnesium can be one of the body’s natural calming agents for nervousness, both at night and throughout the day. Magnesium is also a natural sedative.
Some of the major symptoms of chronic magnesium deficiency are agitated sleep with multiple awakenings, night terrors and restless leg syndrome. On the other side of the equation, a high magnesium, low aluminum diet has been associated with good quality sleep and not awakening during the night. Magnesium supplementation has been associated with reduced time to fall asleep and uninterrupted sleep, so consider magnesium as one of the essential ingredients of good sleep.
An ideal daily dose of magnesium is 1000 mg. taken across the day in divided doses to maintain muscle relaxation and the body’s sense of serenity, and 250 mg has been reported to be sleep-inducing.
Foods that are rich in magnesium include almonds, blackstrap molasses, brewer’s yeast, cashews, kelp and wheat bran. Because these are foods that we seldom consume in large daily quantities, most of us need a boost from a quality nutritional supplement.
In addition, another easy, relatively inexpensive way to get your magnesium is through a simple recipe from multiple preventive health experts: a baking soda/Epsom salts bath. Just add 2 cups of Epsom salts and a cup of baking soda + ten drops of your favorite relaxing essential oil (lavender is great for this, but there’s also tea tree or geranium) to the hottest water you can tolerate, and soak for 20 minutes. This relaxing bath not only lowers your stress level and enhances your sleep with magnesium, but it lowers your blood pressure and blood sugar levels. It’s an all around boon to great sleep.
Are you informed about the basics of getting yourself to sleep by what you eat? It’s hard to believe but what you eat all day has an important influence on how you sleep. This is especially true for the hours in the late afternoon and early evening. Here are the main everyday factors that have an effect on a peaceful night’s sleep
Eat a light to moderate dinner meal at least three hours before your bedtime so your food can digest completely. Because your digestive system slows at night, heavier meals closer to bedtime are difficult to digest and can remain in the stomach, interfering with going to sleep.
Better still, eat your largest meal of the day at lunchtime, leaving nighttime for warm, light, easily-digestible meals.
A light snack containing mostly carbohydrates and a little protein (such as an apple and cheese or yogurt) shortly before bedtime is an ideal way to avoid going to bed hungry or out of balance with blood sugar.
Certain foods are sleep promoting or have a calming, sedative effect. Among these are green, leafy vegetables, especially lettuce, whole grains (wheat, brown rice, oats), mushrooms, fruit and the spices dill and basil.
Certain foods increase serotonin, the neurotransmitter that promotes sleep (more about this later). These include breads and other complex carbohydrates, legumes, peanuts, fish and poultry.
Remember tryptophan. We’ve all heard how turkey makes us sleepy after the Thanksgiving meal, but there are other foods containing tryptophan that do the same. Among these are yogurt, milk, bananas, figs, dates, milk, tuna, nut butters, grapefruit and whole grain crackers.
And last, but not least, your grandmother was right! Warm milk with a little honey is an ideal pre-bedtime, sleep-inducing snack.
Think about being good to your body by considering what you eat at night as one way to get a restful night’s slumber.
If you’ve opened a magazine or newspaper in the last five years, you’ve probably heard or read about sleep apnea. Most of us think of it as the snoring problem which drives our bed partner to toss and turn, and even wake us up during the night so they can get some rest. Until our partner becomes more insistent about our snoring, we don’t even realize that we do snore, and that our snoring could rock a freight train off it’s tracks. Most people who snore are not aware of it until someone else points it out, and are often in denial about the potential seriousness of this sleep disorder that affects 5 – 8% of the population. So what if it bothers them, it doesn’t bother me, one of my clients told me.
Well, actually it does bother you. True sleep apnea, which is not necessarily all of those who snore, has significant health risks attached, and possible life-threatening consequences over time. Snoring is the body’s sign of not getting enough oxygen and gasping for breath in an attempt to take in more oxygen. At a lesser level, before snoring ensues, there may be several minor awakenings that rouse the body from deeper sleep into a state of lightened sleep which is not as restorative to the inner organs, blood pressure, blood sugar or the heart.
This often results in waking up tired in the morning even when you’ve had a normal number of sleep hours. This chronic state of fatigue can become so pronounced that you find yourself falling asleep in the daytime, even in situations where it could be dangerous, like when driving. Over time, when the body’s not taking in sufficient oxygen, the heart and brain are also deprived of oxygen and the low oxygen saturation level in the blood can result in heart attacks or even seizures.
Have you been told by your bed partner that you stop breathing briefly during your sleep? That’s another key sign that you may have a medical problem that needs investigating. Those with sleep apnea can rouse from sleep hundreds of times in an hour, and can completely stop breathing for more than a minute, both inducing oxygen-deprivation and fractured, disrupted sleep.
The message here is to take snoring seriously, both if you’re the one who snores or the one who is awakened by the snoring. Does snoring mean you have sleep apnea? NO. What it does mean is that some action needs to be taken to consult a doctor about your symptoms and how they can best be treated. There are many options for treating snoring that is not sleep apnea, and only a medical professional can suggest what’s best for you.
The orchestration of sleep is a delicate biological and hormonal process. The conductor of this orchestra is the pineal gland, deep inside the brain and behind the eyes, often referred to as the “third eye”. This is the master gland which produces melatonin from the amino acid tryptophan. Melatonin is a multipurpose hormone which
- Enhances our immuno-protective system by increasing immune functioning
- Lowers heart rate and blood pressure
- Lowers stress by shutting off the body’s stress response;
- Regulates female menstrual hormones;
- And, last but not least, regulates the sleep-wake cycle
Part of melatonin’s important role in sleep is to sense the light and dark cycles which underlie our circadian rhythms. Simply put, as light comes into the eye, the body senses it’s time to wake up. Conversely, as it becomes dark outside, the body’s natural rhythms slow down and we become sleepy. The onset of becoming sleepy and going down into sleep is controlled by an increase in melatonin production when the pineal gland senses melatonin is low. Melatonin levels begin to rise in the evening, stay elevated during the night and decline in the morning.
Unfortunately, melatonin decreases with age, and the potency of the melatonin we retain is not as powerful in older people as in younger people. This creates a double whammy for good sleep in middle age and definitely in the elderly. Surprisingly, the peak of melatonin production is at age five, and by age sixty we have lost 80% of the melatonin that we had at that peak age.
This declining melatonin production may lead to the use of melatonin, or it’s precursor 5-HTP, as a supplement. Side effects of melatonin in the general population occur no more often than placebo. If well tolerated, melatonin is a relatively safe supplement for both short-term and long-term use, according to WebMD and other reference sites. For some, it creates symptoms that are hard to tolerate. Among these can be fatigue, headache, irritability and dizziness.
Although not regulated by the FDA (like other supplements), a cautionary note is sounded for pregnant women, individuals with diabetes or seizure disorders, and those with serious mental health issues such as depression or psychotic episodes. Those on blood thinners should also be wary of melatonin.
Melatonin is a single piece of what are many factors that influence sleep, but one with such crucial importance in regulating the sleep-wake cycle that it bears exploring.
Do you awaken feeling like you haven’t had a good night’s sleep, and yet you have no trouble sleeping? Do you find yourself fatigued throughout the day with little energy to do the ordinary day to day things? Your bed partner’s snoring could be the source of this problem, as you may already be well aware. Being awakened several times a night by noises or bumps in the night in your own bed robs you of the deeper stages of sleep that are most restorative to your health and to your energy level.
You may already know of the cause of your poor sleep and daytime energy level, but what can be done about it? Snorers are notorious for disregarding the ill effects of their nighttime behavior on others because they’re so unaware of the snoring themselves. At first, when told they snore, many laugh and find it amusing. Often they disbelieve the person who tells them or put it off to exaggeration. In other forms of denial, the snorer may believe that they are snoring but minimize the consequences to others. Some who go even further, make excuses about why they can’t do anything about it even when presented with recordings of their nighttime sounds made in desperation by the one most affected by the snoring.
The causes and treatment for snoring are many and varied. Here are some steps you can take to get action on getting your partner to solve the problem through medical means.
- First, talk to your partner and appeal to their sense of compassion to help you out with your daytime problem caused by their nighttime problem. (Many of you have already tried this step and gotten poor results).
- Explain some of the simpler lifestyle changes that can be done to minimize the possibility of snoring, even before going to consult an MD: Avoidance of alcohol, smoking and food within three hours of bedtime; minimizing allergens in the bedroom – pets and dust mites; exercise and weight control; sleeping on your side rather than on your back or stomach.
- Next, talk to them about the potentially serious health effects of snoring for the snorer themselves. It is wise to take a thorough article on sleep apnea which outlines the long-term effects of oxygen deprivation to the brain and heart, resulting in greatly increased potential for heart attacks and strokes. When the body stops breathing, it is without oxygen for that time, having serious long-term side effects.
- Emphasize that you care about them and do not want to be without them for a problem that can be treated. (If you’ve ever tried to get someone who smokes to give it up for you, you know of the uphill battle you’re up against in achieving that goal).
- If you’ve given the above measures enough time for a reasonable person to respond, consider moving out of the bedroom with the snorer, both to get yourself a good night’s sleep and to let them know how seriously you are taking this problem and how much it is affecting you.
- Tell the snorer that you much prefer to be with them, if you do, but you also value your own health and your daytime energy, and will return to sharing their bed if they’ll consent to look into medical solutions for the problem. This may seem a bit drastic, but so is the problem of feeling tired and fatigued every day as you go about your day.
Sleep researchers are increasingly finding how the mechanisms that control the sleep/wake cycle are related to other important functions in the body. Although not completely conclusive, University of Chicago researchers have found a connection between chronic sleep loss and basic metabolic functions like processing and storing carbohydrates and also hormone regulation and secretion. These findings were reported in The Lancet, a highly respected, peer-reviewed medical research journal.
“Striking changes in glucose tolerance and endocrine function – changes that resembled the effects of advanced age or the early stages of diabetes” – were found in a group of young healthy males after less than one week of sleep loss. “We suspect that chronic sleep loss may not only hasten the onset but could increase the severity of age-related ailments such as diabetes, hypertension, obesity and memory loss, reported Dr. Eve Van Cauter, Research Professor of Medicine, who directed the study. When tested during the peak of their sleep deprivation, subjects in the study took 40 percent longer to regulate their blood-sugar levels, resembling insulin resistance, the early stage of Type -2 diabetes.
In addition to blood sugar, sleep deprivation slowed the production of thyroid-stimulating hormone and increased cortisol levels, the latter resembling age-related health problems of insulin resistance and memory impairment. This research was funded by the National Institutes of Health, the Air Force Office of Scientific Research and the MacArthur Foundation.
What does this mean for each of us who is unable to sleep? It means that the consequences of chronic poor sleep may underlie more serious health-related problems. It establishes the connection between sleep and weight as well as a potential connection between sleep and later memory impairment. More importantly, it emphasizes for each of us the need to pay attention to sleep as a crucial variable in our health. Most of these changes in the body occur slowly and out of sight of our awareness. They may not show up on blood tests or a physical examination until they have progressed to nearly a disease state. It cautions us to take sleep seriously and learn and do what we can to establish a peaceful, restorative sleep pattern and points to the possible benefits of better sleep quality for adults. And it encourages us to get help from sleep experts who can show us the pathway to normal, sufficient sleep.
Napping can be a wonderful thing. But as with many things, you can get too much of a good thing. Here are some tips from recent research about taking a nap:
- A short nap at midday, perhaps after lunch, can not only be very refreshing but can also improve our alertness and performance in the second half of the day. In such a brief nap, we are mainly in Stage 1 or Stage 2 sleep, which does not interfere with nighttime sleep patterns. For maximum effectiveness, the nap should be no more than 20-30 minutes. Beyond that, we run the possibility of going into deeper stages of sleep, which may interfere with peaceful sleep at night.
- Naps later in the daytime, for example after work or in the late afternoon around dinnertime, regardless of length, greatly increase the chances of disrupting normal sleep patterns, especially if these naps become routine or lengthy.
- Naps can not only improve alertness and effectiveness, but can be a physiological break from a stressful day. Like mindfulness or meditation, a nap can de-stress the body and put it into a relaxed state that helps disconnect stress from the bodymind.
- Short naps can be especially effective for certain circumstances – those planning a long drive, or having undertaken a long drive, find themselves sleepy during the drive. Those with regular shift work who sleep during the day often cannot get enough daytime sleep and benefit from a short nap before work.
Is there a downside to napping?
Napping is not for everyone. Some people develop grogginess and trouble waking up even after a short nap of 15 minutes or so. Others just find it impossible to sleep in any other place than their own bed or don’t have a cool, quiet environment that is conducive to sleep. Some find their nighttime sleep more difficult even from a short nap. The only way to find out if this is you is to try it out. Happy napping!
Dr. Marcia Lindsey is a sleep coach/psychologist who trains individuals and groups to change the mental and physical roadblocks getting in the way of good sleep. You can read more about her program at www.thesleepdiva.com.
Most of our grandmothers taught us that eight hours was a good night’s sleep. And in my grandmother’s time, where the average night of sleep was nine hours, getting eight hours was not nearly as difficult as it is today. People in her generation more often did physical labor, and although they rose at the crack of dawn, they frequently went to bed at 7 or 8 pm, a time when many people today are just getting home from work. It was commonly held in her time that hours of sleep before midnight were more valuable than hours of sleep after midnight. Thus the saying EARLY TO BED, EARLY TO RISE MAKES A MAN HEALTHY, WEALTHY AND WISE, which came from Ben Franklin in the eighteenth century.
Voluntarily cutting back on sleep today is a common response to the pressures of too many responsibilities and too little time. It is no wonder that the average night’s sleep has decreased from nine hours in our grandmother’s day to seven and a half hours today, and is undoubtedly still declining.
Perhaps sleep is just a luxury we can do without, we often think. Not so. The National Institutes of Health, our largest and most sophisticated government research body on all aspects of health, is clear that the whole eight hours is still needed, and that doing without the whole eight hours on more than an occasional basis, can lead to some significant health problems.
There are circumstances in which we come to accept sleep deprivation as completely normal. Ask any parent of an infant about sleep deprivation. It often becomes standard operating procedure as infants develop the maturity of their nervous systems to be able to sleep through the night that their parents rarely sleep through the night. This “acceptable” parental sleep deprivation may persist until the child is two years old or even longer. And that’s about the time, on average, when families choose to have another child, prolonging their sleep deficit for an additional two or more years. Most of these parents, male or female, are also expected to perform at work the next day after a night of sleeping poorly or sometimes not at all.
The longer a pattern develops and becomes entrenched, the more time it takes to overcome it. Sleep is no exception. Although the body becomes acclimated to a certain number of hours, do not allow yourself to think that less than eight hours of sleep a night is somehow acceptable and has no consequences for your health. Fight for that eight or even more hours of sleep in your schedule as if your life depended on it. It probably does.
Dr. Marcia Lindsey is a sleep coach/psychologist who trains individuals and groups to change the mental and physical roadblocks getting in the way of good sleep. You can read more about her program at www.thesleepdiva.com.
