Healthy Sleep, Healthy You

Getting quality sleep is an essential piece in creating optimal health. It is an essential function that allows your body and mind to repair. According to the CDC, about 70 million Americans suffer from chronic sleep problems. (1) Sleep disorders are associated with significantly higher rates of health care utilization. Conservatively placing an additional $94.9 billion in costs each year to the United States health care system. (2) Sleep is more complex than just putting your head on a pillow and closing your eyes. It has profound effects on our health and so many of our issues at night come from our actions during the day.

Each night, you cycle through different stages of sleep. There are two basic types: rapid eye movement (REM) and non-REM sleep.

The “deep sleep” stages are critical for brain healing, memory storage, hormone regulation, growth, and detoxifying. Each cycle of going through all non-REM and REM sleep stages last about 90 to 120 minutes.

Our circadian rhythm is a natural, internal process that regulates our sleep-wake cycles. There is an entire system at work within our bodies that is closely connected with our environment to help produce the hormones and neurotransmitters needed to either help with sleeping or waking. Two big hormones which regulate sleep and waking are melatonin and cortisol.

The most important factor that helps regulate our circadian rhythm is light. Given this, one can see how this can become problematic in our modern world. Since light boosts cortisol and inhibits melatonin, getting exposed to light first thing in the morning and throughout the early day is the most important thing you can do to help regulate your circadian rhythm. Your circadian rhythm is also affected by things in your environment and what you do all day. Things like stress, what time you wake up, when you eat your meals, what you eat, portions sizes of your meals, when you exercise, when you work, etc. can all affect your circadian rhythm.

Sleep is fueled by a molecule in our body called adenosine. It is used to transfer energy within cells by forming adenosine triphosphate (ATP). In the brain, it is an inhibitory neurotransmitter, meaning it acts as a central nervous system depressant and inhibits many processes associated with wakefulness. Adenosine builds up during the day and peaks at night. Caffeine looks very similar to adenosine in structure and has the ability to inhibit adenosine receptors. This means that caffeine can inhibit your sleep drive. Caffeine has an approximate seven hour half-life. Given that you need adenosine to build up over the day to fall asleep, you should avoid caffeine later in the afternoon and evening.

Sleep is also influenced by our peripheral clocks. The peripheral clock resides in various tissue throughout the body and communicates with our central clock. For some people, exercising too close to bedtime can cause trouble falling asleep right. Endorphin release can energize the brain, leading some people to feel more alert. Moderate to high intensity exercise provokes increases in circulating cortisol levels, which is the get up and go hormone. The timing of your meals can also affect the circadian rhythm. Consuming food alerts the body that it is time to work, not rest. Consistency is very important to the body, that includes mealtimes. The body is better equipped to process food better earlier in the day. For example, since melatonin reduces insulin release, the body is not able to process glucose properly when you eat late at night or very early in the morning, when melatonin is high. Getting our peripheral clocks in sync with our central clock is essential to getting restorative sleep.

Trying to get your circadian rhythm back on track is one major way to help improve sleep. Here are some tips to reset your circadian rhythm:

- Get exposure to light first thing in the morning before turning on your TV or going on your phone or computer. Go for a 15-minute walk, sit outside to have your coffee or tea, walk you dog etc.

- Try to get your exercise in before lunch. Exercising outdoors first thing in the morning can help regulate your circadian rhythm and also boost your metabolism if still in a fasted state.

- Try to eat lunch outside if the weather permits.

- Eat your last meal at least 3 hours before bed, if you cannot, then keep it your lightest meal. Your heaviest meal should be in the morning or midday.

- Try to stop drinking coffee ideally before noon, 2 PM the latest. Avoid chocolate, tea, or anything else which contains caffeine after 2 PM.

- Consider using incandescent light bulbs which emit an orange hue, similar to the color spectrum of the sun in the evening. Fluorescent bulbs emit blue light which stimulates wakefulness.

- Commit to turning off electronic devices at 8 PM. If you are unable to do this then consider using Night Mode, installing a red-light app on your electronic devices or use blue blocking glasses.

- Try a relaxation routine before bed such as breathing exercises, meditation, take an Epsom or magnesium salt bath.

- Keep your bedroom for sleep and sex only.

- Try to keep your bedroom as dark as possible. Consider using blackout shades or curtains, choose an analog alarm clock instead of digital, cover any light emitted from a light switch plate or cord indicator light with black electrical tape, if you need to bring your phone into your room, keep it on airplane/sleep mode.

- Try waking and sleeping at roughing the same time every day.

I hope this helps you focus on your current lifestyle and sleep issues to get an idea on areas that you can focus on to improve your sleep quality.

Stay well!

Reference:

1. Centers for Disease Control and Prevention. (2017, June 5). Sleep and sleep disorders. https://www.cdc.gov/sleep/about_us.html

2. Huyett P, Bhattacharyya N. Incremental health care utilization and expenditures for sleep disorders in the United States. J Clin Sleep Med. 2021;17(10):1981-1986.

3. England, B. (unknown). Stages of sleep [Digital Illustration]. Healthline. https://www.healthline.com/health/healthy-sleep/stages-of-sleep