Sleep is more important than a good diet or getting enough exercise! Extreme statement? Perhaps. But consider this:
Research indicates that many Americans get about an hour less sleep per night now than we did 50-70 years ago. Count that up and it is equivalent to missing over 1 full night’s sleep PER WEEK.
1 in 3 adults report one or more of the symptoms of insomnia: difficulty initiating sleep, difficulty maintaining sleep, waking up too early, and in some cases, nonrestorative or poor quality of sleep. 10% of adults report chronic insomnia that leads to significant impairment of daytime activity. It is estimated that 40% of all insomnia patients have a coexisting psychiatric condition. Among these psychiatric disorders, depression and anxiety are the most common, and vice versa, insomnia is a diagnostic symptom for depressive and anxiety disorders.
Sleep affects almost every type of tissue and system in the body – from the brain, heart, and lungs to metabolism, immune function, mood, and disease resistance. Research shows that a chronic lack of sleep, or getting poor quality sleep, increases the risk of disorders including high blood pressure, cardiovascular disease, diabetes, depression, anxiety, and obesity.
Even one or two hours of sleep loss can impact your food choices and lead to sugar and carbohydrate cravings. Poor sleep can be a factor contributing to increased chronic pain, increased susceptibility to infections, poor response to stressful situations, difficulty focusing, memory lapses, and brain fog. Sleepless nights can lead to acid reflux, nausea, constipation, diarrhea, and gut dysbiosis.
There are 2 primary types of sleep issues people have. One is called sleep onset insomnia which is where you have a difficult time falling asleep. This is usually caused by acute stressors like conflicts, deadlines, relationship issues, worrying about finances, or basically anything that keeps your mind busy when you are trying to relax and fall asleep.
The second is called sleep maintenance insomnia which is where you tend to fall asleep easily, but wake frequently throughout the night or wake and then have a hard time falling back asleep. In my practice, the most common causes of sleep maintenance insomnia tend to be more chronic conditions like caffeine overuse/dependence, blood sugar imbalance, toxic overload, and chronic stress with elevated cortisol.
Circadian Rhythm: setting the internal clock
Your body has its own built-in master clock. Every organ system in your body runs in cycles off of this internal timer called your Circadian Rhythm. At its most basic level, your body expects to be awake at certain times and expects to be resting at certain times. Your body produces hormones and alters a host of biological functions in accordance with where you are at in your Circadian Rhythm.
If sleep is an issue for you the first thing I recommend is a thorough assessment of how you are managing your circadian rhythm.
What triggers or “sets” your Master Clock to transition from sleep to awake and back?
The primary driver is light – specifically a full spectrum of bright light – aka – the SUN! How this works is that there are small receptors on the retina in your eye that sense sun light and this sends a signal to your brain that it is time to be awake. The initiates a huge cascade of events including increasing the ‘awake’ hormone cortisol, decreasing the ‘sleepy’ hormone melatonin, and increasing Serotonin – the neurotransmitter in your brain that helps regulate mood, appetite, and focus.
There are 3 main setbacks we face in modern culture to setting our Circadian Clock Rhythms. Let’s call them early light, middle light and late light.
It is critical that you get a bright, full spectrum of light exposure as early in the day as possible. The sooner the sun the better! In today’s society we may wake at dawn, get behind our UV protected car windows, go into our office jobs, and come home at dusk and never get good bright light exposure to kick off that clock. Grab that tea or coffee on the porch for 20 minutes. No sun, no problem – you can purchase a Light Box that emits 10,000LUX of full spectrum light and put it in front of you while you read a book or do your makeup first thing in the morning.
Another important component is what I’ll call middle light. Research shows that light exposure throughout the middle of day has a cumulative effect to keep that master clock going. So if you get up for work before the sun, taking a 30 minute lunch and eating it outside will really help.
The final modern society light issue is late light. This is HUGE. Modern LED’s and phone/tv/tablet screens emit a high level of the blue light spectrum. This spectrum is particularly good at preventing your brain from producing the sleepy hormone Melatonin. Binging Netflix, reading on your iPad or scrolling Instagram on your phone in bed is a sure way to keep your brain wired late into the night.
Remember even just 45-90 minutes less sleep for a couple nights can have a negative impact on your health. A few hour change in sleep timing is even harder on the body. We call it “Social Jetlag.” Staying out till 1am on the weekends massively shifts your Circadian Rhythm and takes days to get back to normal during the week – even if you got 8 hours of sleep on the weekends.
A few other things that we know are impacted by your Master Clock are energy and metabolism. Timing of meals can be very critical for a lot of people. Eating meals later in the day and especially within an hour or two of bedtime can have a negative effect on sleep and circadian rhythms.
Some people also will have more energy and more benefit from exercise earlier in the day as opposed to later. Exercising at night will increase stress hormones and adrenaline and make falling and staying asleep much more difficult.
Here are some takeaways and practical tips:
- Get sunlight exposure as soon after waking as possible
- Get sunlight exposure at intervals throughout the day
- Avoid screens and bright LED’s 3 hours before bed – you can use blue light blocking glasses like TrueDark or UVEX to block out the Melatonin suppressing effects of blue light if you must use screens at night. Set your phone/tablet to night mode and use the f.lux program on your computer to shift the light spectrum.
- Consistency is key – go to bed at the same time every night to keep the Circadian Rhythm consistent
- Schedule your bedtime – you will have more flexibility on when you go to bed than when you wake. Most of us have to be up for work or school early so be diligent about setting your bedtime boundaries to get adequate sleep duration – 7-9 hours for most people
- Keep mealtimes consistent, most people do better with bigger meals earlier in the day and a lighter dinner.
- Stop eating 3-4 hours before bed
- No alcohol 4 hours before bed – alcohol prevents deep restorative REM sleep and often causes people to pop wide awake middle of the night and disrupts Circadian Rhythms
- Exercise earlier in the day or at least 3-4 hours before bed