Our bodies repair at night - while we sleep our brain is solidifying memories, clearing debris and dreaming new ideas and possibilities. Quality sleep is associated with improved mood, academic performance and well-being. Chronic sleep disorders have been linked to an increased risk of cardiovascular disease, depression, and chronic pain.
Despite all the evidence around the benefits of sleep, our society has glamorized busyness and the act of constantly producing with little attention to the repercussions on our individual and collective health. Before the discovery of electricity and other conveniences of modern life, humans had a more defined circadian rhythm with work and other activities performed primarily during the daytime. The idea of sleeping for 7-8 continuous hours is also a relatively new concept. In our natural state, most humans have a biphasic sleep pattern. Before the industrial revolution and the widespread use of artificial light, it was common to sleep for a few hours at a time with an awake period in between. Many civilizations used this watch period to perform simple tasks or for ceremonies to share ancient knowledge and traditions. In fact, biphasic sleep is still alive in remote communities without access to artificial lighting.?
While it would be near impossible to return to a completely dark night of biphasic sleep (at least not until we retire), it is reassuring to know we have a natural tendency towards divided sleep. The dilemma is: How can we develop better sleep habits while living in a fast-paced, artificially-illuminated world?
- Every positive change begins with awareness. As individuals and as a society, we need to recognize the importance of good sleep for our overall health and well-being. Try going to bed 8-9 hours before you need to wake up. Adding a little buffer time is especially convenient if you tend to awaken in the middle of the night.?
- Consider booking your sleep time and keeping a journal with your observations. Depending on your schedule and lifestyle, you might want to begin winding down 1-2 hours before bedtime. You will start making associations between specific activities and behaviors and how they affect your sleep. By designing your own sleep ritual, you ultimately get a personalized plan that fits your unique needs and preferences.?
- An essential part of customizing your sleep routine is creating a soothing environment conducive to rest. The ideal bedroom is cool and dark. Most experts recommend a room temperature around 68 F - you can experiment with different temperatures, pajama styles and fabrics to find the most effective combination for you. Whenever possible, avoid artificial light and technological devices in your bedroom. Before the advent of alarm clocks and artificial light, the duration of sleep was influenced by natural light and sounds and our own homeostasis processes. While using a classic alarm clock is likely better than a do-it-all smartphone, an indication of healthy sleep is the body’s ability to arouse naturally once it has had enough sleep.?
- Our daily activities and behaviors influence our sleep. The quality, quantity and timing of the foods we eat have a major impact. It is ideal to avoid large meals for the last 3 hours before bedtime. Magnesium-rich foods such as dark leafy greens, nuts and seeds naturally support a relaxed mood. Remember to limit caffeine and alcohol, especially for several hours before bedtime. Caffeine is a known stimulant. With an elimination half-life ranging anywhere between 1.5 - 9.5 hours, it can take over 10 hours to completely eliminate caffeine from your system! Alcohol can elicit both stimulant and sedative effects in humans. Although it might help us fall asleep easier, we will likely experience unrefreshing sleep. Alcohol affects primarily the deepest stages of sleep contributing to interrupted sleep and fatigue. A better option for a night cap is decaffeinated green tea. It contains theanine, a natural amino acid that promotes relaxation.
- Physical movement supports better sleep and health. While completing my 200-hour yoga teacher training, I practiced every day. I also journaled and practiced mindfulness - after all, yoga is a mind-body practice. While many of us notice how much better we sleep after exercising, it is hard to juggle a consistent exercise routine among all the other chores and responsibilities. The good news is that you don’t necessarily have to leave your home - or your office - to exercise. You can take a short walk in between meetings or perhaps use your own body as resistance while strengthening your muscles. For those nights when you feel wired up but didn’t find time to work out, there are easy yoga poses that can help you relax in a matter of minutes. Try putting your legs up the wall followed by a child’s pose.
- ?Practicing breathwork is perhaps the most accessible way to induce the relaxation response. In the 4-7-8 breathing exercise, you inhale for 4 seconds, hold your breath for 7 seconds and exhale for 8 seconds. If you are new to the practice, consider performing 4 repetitions in the mornings and in the evenings. You can progress to 8 repetitions twice a day - and whenever you need to relax. I like to practice breathwork when preparing for a speaking presentation or when I wake up in the middle of the night. Deep breathing is especially relaxing because it stimulates the vagus nerve and the parasympathetic system. The vagus nerve is a very long nerve that connects our body with our central nervous system. Any practice that strengthens your vagal tone will promote a sense of relaxation. You can stimulate your vagal tone by humming, singing and even laughing! Other mind-body interventions that help induce the relaxation response include progressive muscle relaxation and guided imagery.
- ?As a physician, one of the most common concerns I hear from my patients is difficulty sleeping. In the recent past, the use of sleep aids was popularized and even promoted to be safe. We know better now. Sleep aids such as antihistamines and sedatives promote fragmented sleep - you essentially forget you didn’t sleep that well. Moreover, the use of certain sedatives such as zolpidem has been associated with unpredictable behaviors such as sleepwalking, sleep eating and even sleep driving! First-generation antihistamines like diphenhydramine and benzodiazepines are listed in the American Geriatrics Society BEERS Criteria for potentially inappropriate use of medications in older adults. Safer options include lavender, low dose melatonin and Cognitive Behavioral Health for insomnia (CBTi). Cognitive Behavioral Therapy is also proven to be beneficial in supporting the discontinuation of benzodiazepines. Mindfulness- Oriented Recovery Enhancement is an integrative behavioral modality that uses savoring and mindfulness to help individuals suffering from chronic pain and opioid use disorder.
- ?If you are experiencing chronic insomnia or needing to regularly take sleep aids, you should consider seeing a doctor. Other reasons to seek expert medical advice include difficulty breathing, frequent heartburn and depressive symptoms. An integrative health professional will partner with you and help customize a whole person approach to improve your sleep and overall health.
Good sleep is a foundational pillar for optimal health and well-being. Have you tried these or other integrative modalities for better sleep? Please share your experience and feedback!
