“Oh Sleep, Why Dost Thou Leave Me?”
I’ve gathered some practical advice from some experts about sleep, but before jumping in, let’s make sure we understand why getting enough high-quality sleep is crucial to wellness.
You are probably aware that we sleep in cycles of both rapid eye movement (REM) and non-rapid eye movement. Besides getting rest, other beneficial processes happen during these cycles. We relax, our blood pressure and core temperature drops, we restore our energy, and we release growth and other hormones into the bloodstream. We consolidate memory, turning short-term memories of the day into long-term memories, and even create new ones. (Ever wonder why we can’t hang on to all that information we crammed into our brains during a sleepless night before an exam?) We create long-term memories of physical activities we’ve done. We make new connections, even make decisions, and clean out toxins. And in REM, we dream.
So, it’s extremely important for every aspect of our health and longevity. Think of it this way: we can fast for months and survive. Many of us live for decades on junk food, rarely exercise, paying no attention to stress. But if we don’t sleep well, the next day is tough. If we don’t sleep at all one night, we are severely compromised. If we don’t sleep for just two days, we are downright dangerous. So why don’t we more actively manage our sleep?
Here are the simple rules of sleep hygiene promoted by two sleep experts. First, Michael J. Breus, Ph.D., is a Clinical Psychologist and both a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine:
- Stick to a strict sleep schedule. Each of us has a circadian (circa = around, dia = day) rhythm, mainly established by the rising and setting of the sun, but also determined by our own patterns.
- No caffeine after 2 p.m. It takes 6 - 8 hours to dissipate, and it effects the quality of sleep, even if you are one of those who can fall asleep after evening caffeine.
- No alcohol 3 hours prior to bed. It helps us fall asleep (especially after a late coffee!), but it leads to restless, fragmented sleep.
- No exercise 4 hours prior to bed – it raises your core temperature.
- Get sun during the day, especially early, to help you maintain a good circadian rhythm.
Kirk Parsley, M.D., became a doctor during his U.S. Navy service. He has been a member of the American Academy of Sleep Medicine since 2006 and has served as Naval Special Warfare’s expert on Sleep Medicine.
- Darken your room. Really, absolutely. Tape over the smoke alarm light. Get comfortable with a sleeping mask if necessary.
- Remove electronics. He’s a Navy Seal, so when he says “remove” he means “remove.”
- Get a large, comfy bed.
- Maintain a cool to cold room. Remember, our core temp needs to drop. We evolved sleeping at night as our environment continuously cooled until sun up.
- Maintain a quiet room, devoid of noisy distractions. Use ear plugs if necessary.
- Get your body ready for sleep. (Rick’s note: I watch my son and daughter-in-law prepare their kids for bed, turning off any devices well in advance, gradually calming down, quieting their voices, cleaning up, changing into PJs, reading a final book, and then lights out. It takes a little time, but it works. My pulse is slowing and I’m getting sleepy just writing this… Why shouldn’t we adults practice calming routines that prepare us to sleep?)
I’ll add one more that appears on other lists: get some blue-light blocking glasses. Blue light from lamps, TV, laptops, iPads, and mobile phones tells that the sun’s still up, no reason to lower cortisol and increase melatonin now – you just thought it was dark. By itself, this won’t do the trick – better to just turn off all the devices – but combined with other ideas it may help.
Try those ideas first, please, but if you still have issues, here are two others:
- Talk to your primary care physician (PCP), and ask about a referral to a sleep specialist. Get data from a sleep study. I did this about 15 years ago, learned I had obstructive sleep apnea, and used a C-PAP (continuously positive air pressure) machine for years. It takes some getting used to, and you look like you’re a patient in the ICU, but it was wonderful to return to restorative sleep. As part of my own journey and losing significant weight, I no longer need it.
Your PCP may suggest a “sleeping pill” like Ambien, but that should be a last resort. Just Google the myriad side effects of Ambien. That should scare you into trying something else…
- Try natural supplements that promote falling asleep and/or higher quality sleep.
If you decide to supplement, magnesium may be the place to start. Many of us are deficient in magnesium anyway. Chinese medicine has recommended green tea, with its calming ingredient L-theanine. You might then try 5-HTP, a precursor to the natural hormone serotonin which helps calm us. You may need to supplement with 5-HTP for a few weeks to feel the effect. Next in line might be melatonin itself, but take a low dose – 0.5 mg or less. I’ve seen melatonin pills in pharmacies at 5 mg, 10 mg, and 20 mg, a really high dose of a hormone our body makes anyway. You could disrupt your natural production, cause drowsiness the next day, or even have an adverse reaction, like insomnia. Stop if you still need it after a few weeks and keep looking for the underlying cause to fix.
Doc Parsley spent considerable time formulating a natural sleep aid he sells as Sleep Remedy:
“Ingredients: simply very small amounts of the nutrients involved in the production of melatonin: L-tryptophan, 5HTP, Vitamin D3, Magnesium, and a very small dose of melatonin. Since an increase in brain GABA levels is also a normal player in the initiation of sleep, we have also included a small amount of a GABA derivative that can cross into the brain called “phGABA”. The quantities of each ingredient are intended to replenish normal levels of these nutrients, to allow for the normal production of melatonin, and to help initiate the initial cascade of events that lead to deep, natural sleep.”
I have not tried it, but if it is good enough for the U.S. Navy, it may be worth a try if other methods above don’t work. And remember, even Doc Parsley recommends that you follow his six rules first and only use his supplement if necessary.
Sleep soundly, my dears!
Bonuses: For more information about sleep, see the National Sleep Foundation. And for a real treat, listen to the incomparable Renée Fleming sing “O Sleep Why Dost Thou Leave Me?” from Handel’s Semele.