Sleep

Sleep – is a primary need.

If you don’t sleep, you die.

Three main pillars of good health are: nutrition, exercise and sleep. This post discusses the importance of sleep, why you are experiencing difficulties falling/staying asleep and how to fix it.

Good night’s sleep helps you to:

  • Fit back into your favorite jeans. It helps you to maintain healthy body weight. There is a strong correlation between poor sleep and obesity. By poor sleep I mean less than 6 hours a night. In short, not adequate amount of sleep messes up our hormonal systems. Ghrelin and leptin are being affected which causes us to overeat;
  • Keep your heart and circulatory system healthy;
  • Be happy, positive and energized. Poor sleep = depression, anxiety, bad mood and negative emotions. Doesn’t sound too appealing to me;
  • Stay cancer-free. Especially strong correlation has been shown between poor sleep and breast cancer;
  • Have a strong immune system;
  • Detoxify and cleanse your body. During the day we accumulate all kinds of toxins in our bodies and brains. A good quality sleep activates a system for removing waste: the glymphatic system. This system is 60% more productive when we sleep than when we are awake. (some studies shown that it work better by simply sleeping on your side);
When you don’t sleep properly, you don’t work properly.

According to the most recent (October 10, 2018) survey done by Statistics Bureau of Canada, there is a correlation between poor sleep, stress and mental health:

How much do I need to sleep?

Enough. You should be sleeping just enough, not more or less. Every person is different, so is the need of sleep.

Sleep needs change over lifetime and as we get older, the need of sleep is declining.

Are you actually sleepy or fatigued?

Sleepiness and fatigue are different things and its important to be able to differ one from another, as the treatment is not the same.

In describing fatigue, I will use the phone battery analogy. When the battery is low, your phone lets you know that its time to recharge it by turning the icon red or putting the exclamation point next to it. Unfortunately our bodies are not equipped with such feature, so we have to use other senses to determine what’s going on. When you’re fatigued – your body’s energy is low, it might feel like your strength was drained away. You can try to go to bed, but you won’t fall asleep. This is the red light your body gives you.Fatigue can be caused by million of things. Iron deficiency, Anemia, Low T, Depression are only few possible reasons.

Falling asleep during the presentation at work, while driving, when trying to read your favorite book? You are sleepy and you need to get some rest. Sometimes you can compensate for the reduced sleep quality by quantity. A nap of an extra hour of sleep in the morning could be very helpful here. However you can’t always fix the sleepiness by just sleeping more. You need to get to the root cause of the issue, and most likely it lays in the sleep quality. 

“Sleep Deprivation Impairs Ability to Interpret Facial Expressions”, Blue, A. (2017, March 22)

Sleep Stages

You sleep consists of three stages: light sleep, deep sleep and dream sleep.

  1. Light Sleep. It is the foundational stage and works like a bridge between being awake and dead asleep. You spend about half of your sleep in this stage.

2. Deep Sleep. This stage occurs at the first half of the night. This is the most restorative sleep and it makes you feel rested in the morning. Not to mention, the precious growth hormone is produced in this stage. Growth hormone injections are widely used by bodybuilders chasing muscle growth. You can get your dose of it without needles and pills – get a gooood night rest.

“Both sleep and exercise induce the release of human growth hormone. Experts estimate that as much as 75% of human growth hormone is released during sleep. The major period of HGH release occurs during the first period of Stage 3 sleep stage (Deep sleep) during the night, about an hour after you first fall asleep. Deep sleep is the most restorative all stages of sleep. During this stage of sleep, HGH is released and works to restore and rebuild your body and muscles from the stresses of the day”, (Tuck Sleep, 18 Feb. 2018).

3. Dream Sleep (REM). This is where you dream. It comes in 20-40 minutes cycles 4-5 times a night. The longest and deepest cycle usually comes in the second part of the night or right before your alarm goes off. Still the purpose of this stage is poorly understood, however some studies has shown the links between memory processing, attention, concentration, mood, etc.

“These are the first data to show that an extended bedtime in mildly sleepy healthy adults, which resulted in increased sleep time and reduced sleepiness, reduces pain sensitivity”,Roehrs, T (Dec 1, 2012)

Circadian Rhythms

I bet you heard this term before and have a general idea of what this is, so I am not gonna go into depth into it. I’ll just say that its a basic built-in mechanism in your body that dictates pretty much everything you do, including when you get sleepy or awake without a watch or signals from the outside environment. It’s easy to brake your circadian rhythm and as a result your sleep.

Major things that brake your circadian rhythm:

  1. Jet lag. When you travel across different time zones, day and night cues outside the window confuse your circadian rhythm which causes a lot of unpleasant symptoms.

Some of the symptoms are:

  • Sleepiness and difficulty sleeping;
  • Digestive problems;
  • Mental fog & reduced motivation;
  • Impaired concentration.

It’s not easy to recover from jet lag and it takes time, for ones more, for others less. There are some jet lag calculators that based on your location, sleep schedule and the destination you travel to, can give you and estimate of how long it should take for you to recover your circadian rhythm.

I used Jet Lag Rooster. It is free and it provides you with the sleep plan to follow upon arriving to your destination or a few days before departure to smoothen the transition. For example, traveling from Toronto, Canada to Kiev, Ukraine I will be crossing 6 time zones. According to calculator I will need around 5 days to readjust. To minimize negative effects of jet lag I will take proactive approach and begin readjusting my sleep schedule 2 days before departing.

Let’s look at the guidelines provided by the calculator:

Jet Lag Rooster

  • Light ideal means try to get as much light as possible. Spend time outside in sunlight (even if it’s cloudy) or near a bright window. If it’s dark out, seek bright artificial light, preferably from a portable light box. Intermittent light works, but try to stay in light for as long as convenient.
  • Dark ideal means avoid as much light as possible. Your bedroom must be DARK, really dark. Turn off all the electronics and close curtains, or wear a sleep mask..
  • Sleep ideal means that sleep is ideal during this period. On days with no suggested sleep times, sleep as needed.

Beginning 2 days before departure I will be shifting my bed time 30 minutes earlier than the night before and waking up 30 minutes earlier respectively. It is important to get yourself exposed to the bright light for at least 3 hours right after awakening. When arrived, I’ll be going to bed at my normal times, from 9 pm to 5 am, but I’ll be playing with light and darkness, tweaking my body’s exposure to it. The first morning in Ukraine I wake up at 5 am and  restricting my body’s light exposure to 2 hours, until 7 am. My second night of sleep begins again at 9 pm, but instead of limiting my light exposure for 2 hours, the next morning, I’ll reduce it to 1 hour, which will be followed by 3 hours of bright light. My bed time doesn’t change on the third night either. The only thing that changes is that I am not limiting my light exposure after awakening and allowing myself to have at least 3 hours of bright light from the moment I woke up.

Thats it! Only by the third night after departure I sleep like a baby, waking up energized and refreshed.

Few tips for the time of travel:

  • Drink a lot of water (no tea, no coffee, no alcohol!);
  • Eat healthy, nutritionally rich food (a lot of fruits and vegetables). Plane food is far from ideal, so will be best to bring your own food in a sealed container;
  • Make sure to take ear plugs and an eye mask with you;
  • Take a contrast shower upon arrival to refresh your nervous system;
  • If feeling really sleepy, it is ok to take a short, 20-30 minutes, nap at the new place;

2. Shift work. 

Firefighters, police officers, doctors, nurses, paramedics, factory workers, and office cleaning staff have in common one thing – broken circadian rhythm. You probably didn’t know, but shift work in United States considered a sleep disorder! and even has its own diagnosis code: 307.45. According to National Sleep Foundation, the symptoms of shift work disorder include:

  • Excessive sleepiness when you need to be awake, alert, and productive;
  • Insomnia, or the inability to sleep when you need to. This can mean trouble falling asleep, or waking up before you’ve slept sufficiently;
  • Sleep that feels unrefreshing or insufficient;
  • Difficulty concentrating;
  • Lack of energy;
  • Irritability or depression;
  • Difficulty with personal relationships.

It is simple to say that you need to stay away from shift work. However I understand that people not always choose to work nights and working shifts is the only way to make the living. If you one of those people, here are some tips to reduce the harm that shift work does to your body:

  • Try not to work a number of night shifts in a row. If possible, limit night shifts and schedule days off in between;
  • Avoid frequently rotating shifts. If you can’t, it’s easier to adjust to a schedule that rotates from day shift to evening to night rather than the reverse order;
  • Keep your workplace brightly lighted to promote alertness;
  • Limit caffeine;
  • Avoid bright light on the way home from work. Try wearing dark sunglasses and a hat to shield yourself from sunlight;
  • Ask those around you to limit phone calls, visitors and noise level during your sleep;
  • Buy yourself blackout blinds or heavy curtains to block sunlight when you sleep during the day.

Sleep Hygiene

The bed is for sex and sleep

Now you know what sleep stages are, what ruins your sleep, and you understand why sleep is so important to your well-being. Next I will teach you how to get the mosts out of your sleep without drugs, shamans, or crazy expensive piece of technology. I will explain how to implement the knowledge about sleep you already have and give you guidelines with actions to take in order to sleep like a baby.

Sleep hygiene is the act of implementing and controlling different practices and habits in order to have good nighttime sleep quality. You can’t control every aspect of your sleep, but there are certain things that you can, and certainly have to.

  1. Make your bedroom DARK, really dark. Eliminate any light sources, that include  cell phones, laptops, tablets, TV, even that crack under your door and digital clock etc. I suggest that you don’t keep any electronic devices in your bedroom and leave them in the kitchen. Also limit your light exposure close to bed time by keeping your environment dim. We all need to sleep in the dark;

2. Invest in your bedding and buy the nicest things you can afford. Go wild and creative with your bedroom setup, keeping the goal in mind: to make your bed as comfortable as possible. You should love your bed;

3. Wear less. Ideally I suggest to sleep naked. Let your body breath;

4. Expose yourself to green spaces and nature. According to the most recent research:

“We found that spending time in, or living close to, natural green spaces is associated with diverse and significant health benefits. It reduces the risk of type II diabetes, cardiovascular disease, premature death, and preterm birth, and increases sleep duration”, (University of East Anglia. 2018, July 6).

5. The bed is for sex and sleep. Only! Not for watching Netflix, not for working on your laptop, not for talking on the phone or scrolling the Instagram feed. Sleep and sex. Period;

6. No pets in the bedroom. I love my dog, but when it comes to sleeping, he knows he’s not allowed in the bedroom;

7. Avoid stimulants.  Cut down on tea and coffee in the second part of the day. Eliminate nicotine and alcohol. If you can’t get rid of it completely, reduce consumption to minimum before bed time. My experience shows that as little as one glass of red wine before bed ramps up my resting heart rate by 5-8 beats, making me feel like crap in the morning. If you wear Fitbit or similar HR tracker, do the wine experiment yourself and measure your RHR before and after wine consumption. I promise you will be surprised;

8. Stop eating two-three hours before bed time. In addition, foods rich in protein tend to keep you up at night, while high GI (glycemic index) foods could shorten time to fall asleep. Some foods contain high amount of melatonin and have potential of promoting good night’s rest. Some of those foods are:

  • Walnuts;
  • Tart cherries;
  • Game meat;
  • Chickpeas;
  • Kale;
  • Chamomile and passionflower teas;

9. Exercise. It’s good to exercise any time during the day, but particularly morning exercise in the bright light promotes the positive effect on sleep. Be consistent with your morning exercises and you will be sleeping like never before. Also try some relaxing exercises like meditation, breathing, gentle yoga;

10. Reduce your core temperature. The ideal temperature for falling asleep is in the mid-60 degrees Fahrenheit – between 60 and 67 degrees. Find the temperature that works best for you.

“The body’s core temperature needs to drop by about two to three degrees to initiate sleep. If our core temperature is too high, the brain cannot easily make the switch from being awake to being asleep, or create the best quality sleep”, (REDDY, S. 2016, February 24).

Final tip. If you can’t fall asleep for 20-30 minutes, get up and do some slow, quiet activity until you feel sleepy. The more you try to force your sleep, the more stressed you get which certainly won’t help you. Even resting without sleeping is good for you., it’s not the waste of time.

If 10 stepsI outlined above seem like too much work, let me remind you of what sleep deprivation does to your body:

  • It makes you fat;
  • It leads to heart failure;
  • It may cause breast cancer.

Should I continue? I think thats enough to start putting a bit more effort into improving your sleep and implementing tips I shared with you.

What’s the single most important advice for achieving quality, refreshing sleep?

Pick a wake up time and stick with it

Train yourself, every morning, regardless of day of the week, waking up at the same time. If you chose your wake up time to be 6:00 am, no matter what happens in your life, you still wake up at 6:00 am sharp. There is no good or bad wake up time. Every person is different, some are larks, others are nights owls. We all also need different amounts of sleep. Don’t take the magazine article that says everyone should be sleeping not less than 8 or 9 hours, as a dogma. Those numbers are averages and you should be sleeping not more or less than your body requires.

Napping

To begin with, I am not a huge fan of napping from the approach that people use it to make up for lost night’s sleep. I think that adding naps reduce your drive to sleep at night. So the excessive amount of naps leads to inability to fall asleep later at night. However napping can be okay if done wisely.

“A nap is not meant to make up for lost sleep when the sleeper had the opportunity to sleep, but didn’t”, (Winter, W. C. 2018).

But let’s say it’s a lunch time and you feel really sleepy and you think you desperately need to catch a little snooze to make it through the day. Do it! But do it’s best if you do it earlier in the day, rather than closer to the bed time.

“An early nap adds to the previous night of sleep, but a late nap subtracts from the upcoming night of sleep”, (Winter, W. C. 2018).

Naturally we all feel a little sleepiness after lunchtime. Researchers believe that this is not only a great time to nap, but also an evolutionary mechanism. Duration of your nap is really important. Ideally you want to keep it short, not longer than 20-30 minutes. Keeping it this short will give you a boost of energy without making you feel dull, fuzzy or even having a headache. In addition, the nap should always follow a schedule. It means that if you decide to include it in your days, it has to be taken at the same every time you take it. A quiet, dark place, where you won’t be disturbed is ideal. Get comfortable, hug your favorite pillow, maybe even put a blanket over, set the timer for 25 minutes and fall into the world of dreams.

Snoring & Apnea

You definitely have a friend or relative that snores like a train at night. One third of people over 30 snore.

Sleep apnea syndrome is when an airways are closing off and you’re not getting enough oxygen. Our brains are highly dependent on oxygen and using as much as 20% of your body’s oxygen. How much oxygen your brain is getting has a strong correlation with how much sleep you’re getting. Sleep apnea disturbs your breathing, giving your brain a choice to make: stay asleep and let the suffocating continue or wake up and catch some breath. Guess which option your brain will choose?

If you ignoring your snoring, you essentially sacrificing your sleep quality and as a result shortening you life. Sleep apnea is killing you slowly by causing:

  • High blood pressure;
  • Weight gain;
  • Hight blood sugar/diabetes;
  • Mood disorders, depression;
  • Increased risk for heart attack and heart failure;
  • Stroke;

If you noticed you wake up every morning with a headache, you pee much more at night than during the day, consult with your doctor as you might be experiencing the sleep apnea.

Restless Legs Syndrome

According to National Advisory Neurological Disorders and Stroke Council (NANDSC):

“Restless legs syndrome (RLS), also called Willis-Ekbom Disease, causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them”, (NINDS, May, 2017).

The legs are not the problem here – the brain is. There is a lot to do with your hormones, specifically with dopamine. Dopamine is not only important when it comes to pleasure, but it also plays a huge role in keeping you awake. It has the opposite effect to melatonin and promotes the muscle activity, keeping you alert. This is a serious condition and has to be treated by professional, so go to the doctors as soon as you start suspecting the symptoms.

Narcolepsy

According to Winter (2018):

Narcolepsy is a condition of excessive daytime sleepiness in which the individual loses the ability to properly stabilize his wakefulness.

In other words, people with this condition can quickly fall asleep or experience some aspect of sleep while being fully awake and conscious. Here are some symptoms of narcolepsy:

  • Excessive daytime sleepiness and sudden sleep attacks;
  • Hallucinations as you are falling asleep or waking up;
  • “Cataplexy” – suddenly becoming weak when experiencing strong emotions;
  • “Sleep paralysis” – awakening and being conscious, but maintaining the paralysis;
  • Disrupted nighttime sleep.

There are some medications that reduce sleepiness and cataplexy attacks. Xyrem is commonly used and most effective drug for curing this condition.

Conclusion

Sleep is a skill and it takes years to master it. Every person deals with sleep problems from time to time and its important to have tools and tricks to be able to take care of yourself before the problem gets worse.  This post touched on some basics of sleep that every health conscious person should be educated on. It provided you with some insight into your own sleep and gave you some ideas of how to increase the quality of your night’s rest. There are thousands of books and articles on web, that go more into depth of the science of sleep. But before you dig deeper, nail your basics.

 

References:

Blue, A. (2017, March 22). Sleep Deprivation Impairs Ability to Interpret Facial Expressions. Retrieved from https://uanews.arizona.edu/story/sleep-deprivation-impairs-ability-interpret-facial-expressions

Roehrs, T. A., Harris, E., Randall, S., & Roth, T. (2012). Pain sensitivity and recovery from mild chronic sleep loss. Sleep, 35(12), 1667-72. doi:10.5665/sleep.2240

“How Sleep Affects Your Human Growth Hormone (HGH) Levels.” Tuck Sleep, 18 Feb. 2018, http://www.tuck.com/sleep-hgh/ 

Symptoms of Shift Work Disorder. (n.d.). Retrieved November 3, 2018, from https://www.sleepfoundation.org/shift-work/content/shift-work-disorder-–-symptoms

University of East Anglia. (2018, July 6). It’s official — spending time outside is good for you. ScienceDaily. Retrieved November 3, 2018 from http://www.sciencedaily.com/releases/2018/07/180706102842.htm
REDDY, S. (2016, February 24). For a better night’s sleep, you’ve got to really work on that core (temperature). Retrieved November 3, 2018, from https://www.theaustralian.com.au/life/health-wellbeing/for-a-better-nights-sleep-youve-got-to-really-work-on-that-core-temperature/news-story/34fa8c4fa2a795d0cc447cabc24d9606

Winter, W. C. (2018). The sleep solution: Why your sleep is broken and how to fix it. New York: Berkley.

National Advisory Neurological Disorders and Stroke Council (NANDSC) (2017, May). Restless Legs Syndrome Fact Sheet. Retrieved November 3, 2018, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet