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Your Good Night’s Sleep Checklist

Written by Wellness Club on April 13, 2018 – 1:08 pm -

Why Sleep is “Essential” (what happens during sleep)

 

 How much sleep do you need?

 What things interfere with good sleep? (how to have a good night’s sleep)

 

 Like breathing, sleep is an “essential” human requirement. “Essential” means that your body must have it and you would die without it.

How long can a person go without sleep before death ensues? The jury is still out on this. But death isn’t the biggest problem of sleep deprivation because the body will eventually take “microsleeps.”  Microsleep refers to brief moments of sleep that occur when you’re normally awake.

You can’t control microsleep, and you might not even be aware of it. For example, have you ever driven somewhere and then not remembered part of the trip? If so, you may have experienced microsleep.

Even if you’re not driving, microsleep can affect how you function. If you’re listening to a lecture for example, you might miss some of the information or feel like you don’t understand the point. In reality though you may have slept through part of the lecture and not been aware of it.

Exactly how long a person can go without sleep isn’t fully known, but we do know that extreme sleep deprivation causes hallucinations, automobile accidents, job injuries and memory impairment.

 Why does your body need sleep?

 

Researchers have found that the brain clears out waste material accumulated throughout the day as we sleep at night. During sleep, neurons temporarily shrink and allow for more cerebrospinal fluid to wash over our brains, carrying away toxins and waste. In other words, sleep is when our brains clean out daytime garbage.

A research team from University of Rochester Medical Center (URMC), write about their findings in the journal Science.

“This study shows that the brain has different functional states when asleep and when awake,” said U of R researcher Maiken Nedergaard. “In fact, the restorative nature of sleep appears to be the result of the active clearance of the by-products of neural activity that accumulate during wakefulness.”

Some of the debris cleared from the brain during sleep includes beta amyloid, a harmful protein that accumulates in the brain and may be the cause of Alzheimer’s.

A “clean sleep” results in a more complete clearing of waste proteins from the brain, but “dirty sleep” has the opposite effect.

So, in addition to many other necessities of sleep — physical restoration and healing of muscles, endocrine (hormonal) balancing, R.E.M. or “dream sleep” for mental health — the brain needs sleep in order to take out the trash.

Are You Getting Enough “Good” Sleep?

 

“Dirty sleep” happens when we fail to get enough sleep, or fail to get sufficient deep sleep. Fortunately, most of the causes of poor sleep are within an individual’s control.

[Caution: Dr. Myatt "micro rant" ahead.]
So, you’re not getting enough sleep or enough good sleep? Here’s a tip. The problem is NOT caused by a sleeping pill deficiency. Most of these drugs have dangerous side effects and do NOT target the cause of poor sleep. Don’t just “drug” the problem, work my check list and correct sleep problems at the cause level. This is effective, cheap, and most importantly, safe.
[END OF RANT]

Good Sleep Checklist

 

Work the list. This is what a good physician would do for you / with you before prescribing dangerous sleep medications.

1.) Bedtime/wake time. The body manufactures melatonin before and during sleep unless light interferes with its production. Melatonin functions as an antioxidant in the brain and central nervous system and its production begins as the setting of the sun stimulates the pineal gland. This normally occurs in most people around 9:00 PM, with sleep usually occurring around an hour later by 10:00 PM. Solution? Set a regular bedtime, and stick with it.

2.) Beware of light after sundown. The pineal gland, a tiny gland deep in our brains that is connected to the eyes, is responsible for producing the sleep and antioxidant hormone melatonin. It begins to churn our this important substance in response to the ”dimming of the lights” as the sun sets. If the light doesn’t dim, the pineal gland doesn’t know to produce melatonin. And, once the light does dim and it begins its work any amount of white light promptly shuts it off – by making it think it is dawn.

Since humans evolved over millions of years sleeping in the safety of the flickering subdued orange light of a cozy fire, we tolerate low levels of this color of light after dark. But exposure to white light or, more specifically, light that contains specific frequencies of blue light – like daylight or televisions, or computer monitors, or full-spectrum light bulbs–  during the hours before bedtime will seriously disrupt melatonin production, making natural sleep very difficult.

Solution? When the sun goes down you need to start lowering the light levels in your environment as well – not an easy task in our modern world, but possible if you remember that it is the harsher blue-white lights that disrupt melatonin production. Try candle light or soft (warm) incandescent lights, limit your TV watching  for the hour or so before bed, and limit exposure to bright phone, tablet, and computer screens before bed.

If you must get up at night try to avoid turning on bright lights – consider using low-wattage incandescent nightlights.

3.) Eliminate other nighttime light hazards. Related to white light in the evening is the twinkling of myriad electrical and electronic devices that seem to litter our sleep spaces. Little red lights, green lights, blue lights, all glowing and twinkling and blinking… Not only are the lights distracting, many of these devices also emit occasional noises – beeps, chirps, hums, whirs…

The solution? Do yourself a favor and banish all the electronics from your sleep space. Unless you are a surgeon on call, or have some equally important reason  to receive calls after bedtime, turn the phone off. Shut the tablet and computer down for the night.

Many people also believe that there may be a sleep-disturbing effect from all the EMF (electromagnetic fields) created by these devices in proximity to your sleep area, another good reason to nix the electronics.

4.) What you eat and drink in the evening matters. That nice sweet dessert may help you feel satisfied and sleepy when it raises your blood sugar, but when your blood sugar crashes a few hours later and your body responds with a shot of adrenalin you are going to find yourself wide awake with the jitters. Look for that “wide awake” feeling between 2-4 a.m. – sound familiar?

Try a little snack bite of protein instead, if you really must have a before bed snack.

5.) What you see before you sleep matters too.  Upsetting or stressful imagery  immediately before sleep can be unsettling and make it difficult to get to sleep, and can give your brain plenty of unpleasant material to craft its dreams from. The 10:00 news with horrific images of war-torn countries, or crime shows with nasty people doing ugly things to each other, or zombie horror shows dripping with gore…  are these really the sights that you want to try to fall asleep to?

A better bet might be something uplifting or soothing. Pleasant short stories, or poetry, or spiritual reading or meditation. And remember, like I said in point 2, that TV screen, with its bright light, is preventing the normal production of melatonin. Ever hear of an old fashioned thing called a “book”? Try some good reading an hour before bedtime. But remember, “book” refers to old-school ink-on-paper pages – not your Kindle reader with its bright sleep-inhibiting screen!

6.) Oversleeping. Those who insist on sleeping in late in the morning are setting themselves up to seriously disturb their circadian rhythms. Further, late waking combined with daytime napping can leave you feeling wakeful in the evening, and wanting to stay up beyond a healthy bedtime. It can easily become a vicious circle.

So, you are retired with not much to do and feel like there is no reason to get up in the morning? Make a reason! Get up and get moving – the physical activity throughout the day will also contribute better sleep at night.

7.) Drugs and medications: Many prescription drugs can cause insomnia and poor sleep. Here are some of the more common offenders:

Alpha-blockers
Beta-blockers
Corticosteroids
SSRI antidepressants
ACE inhibitors
ARBs (Angiotensin II-receptor blockers)
Cholinesterase inhibitors
Antihistamines and H1 antagonists
Glucosamine/chondroitin (if taken late in the day)
Statins (cholesterol drugs)

Non-prescription drugs can do the same. And recreational drugs can too: even alcohol can cause problems – in smaller amounts alcohol has a stimulating effect and more than a few drinks, while sedating for sure, can cause rebound insomnia when the effect wears off. A pre-dinner drink? Sounds good. A glass of wine with dinner? Also good. A few drinks “to put you to sleep”? Not so good…

8.) Sleep medications: You really aren’t taking a sleeping pill are you? If you are then you obviously haven’t read our previous HealthBeat News articles describing the dangers of sleeping pills . Do yourself a favor and drop the sleeping pills. Many of them are downright deadly. Even the so-called “lightweight” over-the-counter sleep aids containing anti-histamines are associated with some serious side effects and they really don’t produce improved sleep.

9.) Muscle cramps at night can disturb sleep.  Something as simple as some extra magnesium can prevent cramps and can be relaxing overall. Magnesium oil, actually a thick brine of magnesium salts, can provide nearly instant relief for many muscle cramps when rubbed over the affected area.

Other causes of sleep disturbance:

 

10.) Caffeine or nicotine too close to bedtime. Both of these common “drugs” increase alertness. Discontinue them several hours before bedtime.

11.) Lack of exercise. Humans are made to move. It your idea of daily exercise is walking from the couch to the refrigerator, it time to re-think. Aim for twenty to thirty minutes of exercise daily. Your sleep, weight and overall health will be better for it. BUT, do not do strenuous exercise within an hour of bedtime because exercise is stimulating/energizing in the short-term.

12.) Get to a normal weight. It’s not entirely clear why, but overweight and obese people have a higher likelihood of sleep disorder. It might be because sleep difficulties like sleep apnea are more common in the obese.
[Dr. Myatt's note: it might also be because the same eating behaviors that make a person fat --- typically high carb diets --- are the same factors that cause blood sugar to drop precipitously between the hours of 2-4 a.m. See point 4 above. ]

Here’s the “Fix my Sleep” Checklist

 

1.) Bedtime: pick a time and stick to it. 9-10 p.m. is best because of melatonin production. Get up at the same time every day. Start lowering the light and eliminating blue light an hour before bedtime.

2.) Exercise during the day.

3.) Stop eating 3 hours before bedtime. If you do have a snack, make it a high protein snack like a cup of hot chocolate whey protein,  not something high carb.

4.)  Take melatonin within an hour of bedtime. If you are melatonin deficient, this will help you sleep. But even if low melatonin is NOT the cause of your insomnia, it is the only antioxidant the crosses the blood-brain barrier and helps keep the brain healthy. I recommend it, sleep problems or not.

5.) Take Magnesium Glycinate within an hour of bedtime (along with melatonin). In a double-blind randomized clinical trial of 46 elderly subjects, the group that received 500 mg of magnesium daily for 8 weeks showed significantly improved quality of sleep.

What NOT To Do for Insomnia

 

Don’t keep looking at the clock. It doesn’t help. AND, studies show that people who keep “clock checking” actually over-estimate the amount of time they are awake. This anxiety over sleep loss only adds to the problem.

Don’t get up and go to Denny’s. (Seriously, I heard this from someone. I couldn’t make stuff like this up). So… bright lights, loud sounds and food are going to help you sleep? Give your head a shake and call me if anything sounds loose in there. The right idea when you are awake at night is to do something relaxing, not something that makes you more awake. Get up and by old-school incandescent light read a relaxing novel. This will take your mind off worries or concerns. Or listen to relaxing music. Or practice meditation, guided relaxation or self-hypnosis. Any of these might put you back to sleep. Even if they do not put you to sleep, the relaxed state still functions to some degree like sleep.

Don’t make it bigger than it is. Sometimes, the best cure for a bad night’s sleep is to go about your day (exercise, good eating, etc.) and try it again tomorrow night. Just like “hunger makes a great sauce,” so missing some sleep for a night or two can contribute to a good night’s sleep in the subsequent nights.

There you have it – the tips and information you need to get a good night sleep that will allow your brain to “put out the trash!”

 

 

References and further reading:

 

Kenji Obayashi  Keigo Saeki  Norio Kurumatani. Bedroom Light Exposure at Night and the Incidence of Depressive Symptoms: A Longitudinal Study of the HEIJO-KYO Cohort. American Journal of Epidemiology, Volume 187, Issue 3, 1 March 2018, Pages 427–434, https://doi.org/10.1093/aje/kwx290

Levenson JC, Kay DB, Buysse DJ. The Pathophysiology of Insomnia. Chest. 2015;147(4):1179-1192. doi:10.1378/chest.14-1617.

Insomnia: Relaxation techniques and sleeping habits. U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072504/

Abbasi B1, Kimiagar M, Sadeghniiat K, Shirazi MM, Hedayati M, Rashidkhani B.. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012 Dec;17(12):1161-9.

Fiorentino L, Martin JL. Awake at 4 a.m.: Treatment of Insomnia With Early Morning Awakenings Among Older Adults. Journal of Clinical Psychology. 2010;66(11):1161-1174. doi:10.1002/jclp.20734.

N Buscemi, B Vandermeer, R Pandya, N Hooton, L Tjosvold, and L Hartling. Melatonin for treatment of sleep disorders. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Trouble sleeping? Experts say skip antihistamines. Baylor College of Medicine https://www.bcm.edu/news/sleep-disorders/experts-warn-against-antihistmaines-sleep-aid

Sleep Drives Metabolite Clearance from the Adult Brain Lulu Xie et. al.,Science  18 Oct 2013:, Vol. 342, Issue 6156, pp. 373-377, DOI: 10.1126/science.1241224 http://science.sciencemag.org/content/342/6156/373.long

10 Types of Meds That Can Cause Insomnia, AARP http://www.aarp.org/health/drugs-supplements/info-04-2013/medications-that-can-cause-insomnia.html

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