It will soon be six months that we've been living in a pandemic. Uncertainty continues and with the unknown brings added stress. And that's just one reason that sleep can be affected. Medical and treatment factors, pain, menopausal symptoms, age, mental health, and more all contribute to challenges with sleep. Sleep disturbances and fatigue are beyond commonplace. The quality and quantity of our sleep can significantly affect our health - physical, mental, and emotional.
Sleep is crucial for your physical functioning. It allows your body to restore and repair itself, and is essential for proper immune function. Lack of sleep hinders coordination, reflexes, and our ability to learn new skills. Sleep deficit has been associated with long-term health challenges including obesity, diabetes, and high blood pressure. Additionally, there is evidence that sleep disturbance increases the risk of certain cancers as a product of shift work, including breast, prostate, colorectal, lung, skin cancer, and possibly others. Several studies suggest that sleep deprivation affects our ability to process carbohydrates, manage stress, fight infection, and regulate hormones.
Sleep is intricately connected with our mental and emotional health as well. Sleep disturbances are particularly common in those experiencing anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD). Disrupted sleep affects our neurotransmitters and stress hormones, which wreaks havoc in the brain, impairing our thought processes and emotional regulation.
Tips for Better Sleep
It's recommended for adults to get about eight hours of sleep though our needs do vary somewhat. Do your best to prioritize sleep and not sacrifice to squeeze more into the day. If you feel drowsy during the day, you likely need more and/or higher quality sleep. For many, simple behavior changes can significantly improve sleep quality. Utilizing one or more of these strategies for six weeks or longer may help you drift into your dreams.
Develop a bedtime ritual that eases the transition to sleep. Set aside time to unwind. Read, meditate, listen to music, or consider relaxation stretches. A hot bath or shower before bed may be helpful as well. Epsom salt baths have the added bonus of magnesium, a calming mineral that helps facilitate proper sleep. Diffuse lavender in your bedroom for relaxing aromatherapy.
Keep your biological clock in rhythm with a set sleep-wake schedule. Try to go to bed and wake up at the same time daily, even on the weekends. Use the light in the morning to help set your body clock to a state of wakefulness. When you do wake up, get up and expose yourself to light. Lying in bed reading your phone in the morning delays your wakefulness and may alter your cortisol. Chronic stress contributes to elevated cortisol where you may find yourself anxious, wired and tired, and sleep-deprived. Similarly, poor sleep can lead to elevated cortisol production.
Sleep environment - be sure your room is completely dark; darkness stimulates your production of melatonin. Melatonin is a hormone that regulates our sleep timing by helping prepare our bodies to fall asleep. Use dark or blackout curtains to block out external light sources or consider an eye mask. A slightly cool room, about 65 degrees F, is ideal for sleeping. Avoid screens and their blue light exposure in the evenings. If exposed, consider the use of blue light blocking glasses in the evenings.
Be mindful of your food & beverage intake - Avoid eating or drinking at night, particularly large amounts of food and/or fluids. Going to sleep on a full stomach will inevitably disturb your sleep. Studies have paired poor sleep with a high carbohydrate intake - avoid energy drinks and sugar-sweetened beverages. And the quart of water prior to bedtime is great for hydration, but will likely have you up in the middle of the night needing to use the bathroom, and hence, disrupting your sleep. Caffeine and alcohol can worsen our sleep quality. While alcohol initially has a sedative effect, it tends to disturb sleep after for several hours. While there are those who drink espresso 30 minutes prior to bedtime and fall asleep without difficultly, for most, it is best to avoid caffeine for at least 4-6 hours prior to bedtime. Caffeine is metabolized by a liver enzyme coded by the gene CYP1A2. Note, however, that even if you're a fast metabolizer of caffeine, you still may be sensitive to coffee depending on how you metabolize catecholamines, specifically, epinephrine and norepinephrine as identified by the enzyme, COMT. COMT and CYP1A2 can both be read via common genomic reports.
Limit nap time or avoid naps altogether if your sleep is disrupted at night.
Utilize stress management techniques - consider breath work and/or meditation. Acknowledge to yourself that you will address your worries another time. Consider noting your concerns and 'to-do' lists before bed to help clear your mind.
Exercise - when we exercise, we tend to fall asleep more easily and sleep more deeply compared with those who don't exercise. Exercising vigorously, however, within two hours of bedtime may impede your sleep.
Supplements to Facilitate Proper Sleep
While store aisles are filled with various dietary supplements aimed to improve sleep, you likely do not need to take all of them. I'll highlight a few ingredients oftentimes used for sleep though there are many more to consider. Determining why you're not sleeping will be helpful in choosing an appropriate product. For example, phosphatidylserine (PS) is effective in lowering cortisol; using PS may be effective for someone who has elevated cortisol in the evening, but not so beneficial for someone with low or normal cortisol in the evening. Melatonin is oftentimes effective in helping one fall asleep, but less so on keeping you asleep through the night. Magnesium, on the other hand, may be useful for all of us. Stress depletes magnesium, so many of us find ourselves in need of more. Magnesium glycinate is highly bioavailable and an excellent option. Magnesium threonate works very well for anxiety and also a wise choice for sleep. And for those of you struggling with constipation, magnesium citrate may be a great option with a laxative-like effect.
Summary
Establish good sleep hygiene. Manage blood sugar levels by consuming plant foods rich in dietary fiber, pairing protein and fat with your meals, and avoiding refined and processed carbohydrates. Incorporate daily physical activity. Implement stress management strategies to promote healthy sleep. If sleep is a challenge, consider assessing your HPA axis via testing. Cortisol and melatonin work together within the HPA axis to regulate sleep and wakefulness. Hopefully, utilizing one or more of these suggestions will lead you to restful sleep.