If you’re not sleeping, you’ll get sick. It’s that simple. Continue reading to discover tips for helping you get a great night’s sleep.According to the Harvard Medical School’s published Mental Health Letter, 50-80 percent of psychiatric patients suffer from sleep disturbances, compared to 10-18 percent of the normal population. Traditionally, sleep disturbances are regarded as symptoms of psychiatric illnesses, however, more and more researchers are suggesting the opposite is true as well: That addressing sleep issues may ameliorate symptoms or decrease the onset and frequency of mental illness.
Sleep and mental illness may very well have a chicken-or-egg type of relationship. With sleep disturbances, the risk of developing depression increases two-fold and anxiety, four-fold. Research shows that depressed and anxious people have both compromised deep and REM sleep, which on an EEG, looks like they “lost” their dreams. REM sleep, in still yet undiscovered ways, is strongly correlated with emotional health and mental well-being, so losing REM sleep may predispose someone to mental illness.
Some research indicates that lack of sleep can trigger a manic episode in bipolars. Many kids diagnosed with ADHD have terrible sleep hygiene, which may exacerbate the illness or even cause it. Insomniacs are hyper-aroused by design and have an increased metabolic rate over a 24 hour period, which can easily predispose them to anxiety, especially if they consume stimulants such as caffeine throughout the day.
The importance of a good night’s sleep is well known. Sleep boosts our immunity, decreases stress hormones, promotes memory, cognition and a feeling of wellbeing. Lack of sleep does the opposite. Forced disruptions of circadian cycles in animals is known to result in decreased life spans. Shift work is associated with an increase risk in mental illness and gastrointestinal issues. There is also a prominent cyclic signature to mental disorders, which some speculate relates to circadian dysrhythmias. Obviously, much research is still needed in this area, but the take-home message is this:
A good night’s sleep only helped, and never hurt, anyone.
The first step in promoting good sleep hygiene is to determine one’s “sleep” pattern. You can use theEpworth Sleepiness Scale, a measurement for scoring daytime sleepiness, easily found online. Experts suggest that if you score more than a 10 on this test, you should consider improving your sleep hygiene and discussing your score with your doctor, in case he or she thinks a sleep study is warranted to rule out things like obstructive sleep apnea or nocturnal asthma. Instead of the Epworth Sleepiness Scale, you can just as easily maintain a sleep diary, noting how you sleep each night, your level of sleepiness throughout the day, and things that make it better or worse.
To enhance good sleep hygiene practice, one needs to first be mindful of the fundamental rhythmic nature of life by setting up regular bed and waking times, regular meals and setting aside a time for exercise. The timing and quality of all of these things will help create an optimal, regular sleep schedule. When you’re first trying to adjust your sleep pattern, it’s always good to create a schedule for each day. Write one out on paper or create a spreadsheet on your computer, at the beginning of each week, including waking times and bed times for each day, scheduled meals and scheduled workouts. Many experts recommend maintaining a schedule, at least in the beginning, because people who follow schedules are more likely to make necessary lifestyle changes.
Good sleep hygiene also means nixing any caffeine use after mid-afternoon. Caffeine has a very long half-life, so caffeine drinkers should limit their intake to the morning hours only. Nicotine and alcohol also create sleep disturbances and are best avoided when trying to fall asleep.
Exercise raises our core temperature, or our metabolic rates in general, which can make it very difficult to fall asleep. It’s best to avoid working out 3-4 hours before going to sleep. That said, exercise earlier in the day can help manifest healthy sleep habits come nighttime, so timing really is everything here.
Certain nighttime snacks can help promote sleep better than others. The best snacks are ones that contain a lot of tryptophan, since tryptophan is a precursor to serotonin, which has a calming effect in the brain, and serotonin can be enzymatically transformed into melatonin, a hormone that plays a major role in regulating our sleep/wake cycle. It’s also best to avoid high-protein foods, since they increase the levels of tyrosine, an amino acid, which has a stimulant effect in the brain. Foods high in tryptophan are oats, yogurt, cottage cheese, milk, dates, turkey, sunflower seeds, pumpkin seeds, chickpeas and peanuts. Dairy products, in particular, are a great bedtime snack, because they contain high levels of both tryptophan and calcium, and calcium works as a cofactor in manufacturing melatonin from tryptophan.
Some people recommend using Melatonin, an over-the-counter, natural supplement, to promote sleep. Melatonin is also referred to as the “Dracula hormone,” because it only comes out at night. It’s produced by our pineal glands, tiny endocrine glands in the center of our brains, and its production is triggered by darkness and inhibited by light. When darkness falls, our pineal glands begin to secrete melatonin, and in yet unknown mechanisms of action, melatonin makes us feel less alert and sleep becomes more inviting. Melatonin levels stay elevated for about 12 hours, then drop drastically in the morning. In fact, melatonin levels in our bloodstreams are almost undetectable during the day.
In conjunction with melatonin production, it’s important to note the effect light has on our sleep/wake cycle. When light hits our retinas, it triggers a neuronal pathway that activates an area in our hypothalamus, known as the supra-chiasmatic nucleus. The supra-chiasmatic nucleus sends signals to other parts of our brain and body that raises our core body temperature, releases stress hormones, like cortisol, and inhibits production of melatonin. In very simple terms, the supra-chiasmatic nucleus is our night and day clock: It makes us alert and ready for our day, then tired and ready for sleep at night. Light controls it, which makes sense since our earliest ancestors revolved their day around the sun, which is why it’s very important to have all lights off when you’re trying to sleep.
A bedroom should be completely dark and quiet. This means no computer or phone glows, no street lights shining in, and experts even recommend darkening alarm clocks, since even a tiny amount of light can inhibit melatonin production. (Don’t sleep with your phones or laptops either, and do simple things, like turning your ringer off. If noise is an issue, invest in a cheap pair of ear plugs.)
There’s scant research on the benefits of supplementing with melatonin as a sleep aid, and more of its recorded benefits is based on anecdotal evidence, however a recent double-blind, placebo-controlled study, published in the Journal of American Geriatrics Society in January, 2011, evaluated the supplementation of melatonin, zinc and magnesium in 43 patients diagnosed with primary insomnia in a long-term care facility in Italy. Researchers noted a statistically significant improvement in quality of sleep, hangover on awakening from sleep, morning alertness and the restorative value of sleep in those who supplemented with melatonin, magnesium and zinc. The exact way magnesium and zinc enhances sleep are unknown, although they do serve as cofactors for many cellular reactions and they also activate second-messenger systems throughout the body. ( Interestingly enough, magnesium and zinc supplements are also recommended for depression. A 2009 study in Denmark on 5708 people showed an inverse association between Magnesium intake and depression scores.)
Those whose sleep suffers due to allergies or asthma, may want to consider investing in a HEPA filter tohelp purify the room air. If that doesn’t help, they may want to consider making an appointment with their primary care doctors, because their allergy or asthma symptoms may not be well-controlled with meds.
Valerian, a natural supplement, may also work as a sleep aid. Valerian is approved by the German health authorities as both an anxiolytic and sleep aid. A small, double-blind, placebo-controlled, randomized, cross over trial in 2002 showed that Valerian, dosed at 600 mg, resulted in decreased anxiety. One can surmise from this that a state of decreased anxiety would be more conducive for sleep than an anxious one. It should be noted that amounts over 600 mg seemed to create increased agitation, so 600 seems to be the optimal dose. A study published in the Australian Family Physician in 2010 searched the AMED and MEDLINE data bases for published research on valerian as a helpful sleep aid between the years of 1950 and 2009. 12 studies concluded that Valerian helps improve the quality of sleep, but lead authors noted that research designs varied tremendously in these studies and more, randomized, larger, well-controlled studies need to be conducted on Valerian to properly evaluate its efficacy. Valerian may also work for people trying to discontinue Xanax and other hypnotic drugs. It should be noted that the World Health Organization contradicts the use of valerian in pregnancy.
There are numerous mind/body and positive psychology therapies recommended for improving sleep hygiene. Some of these include prayer, deep breathing exercises, relaxing music, cognitive behavior therapy, guided imagery, yoga and meditation. Mindful meditation is an easy relaxation technique one can practice before going to bed, and it serves to increase relaxation and nonjudgmental, purposeful awareness of one’s own body and surroundings. There’s a wealth of information online in regards to finding meditation teachers and mindful practices, but one quick example is:
Close your eyes and sit Indian-style on a comfortable surface fifteen minutes before your target bedtime. Take deep breaths in through your nose and out through your mouth and start noticing each inhalation and exhalation. When you breathe in, start saying “In,” and when you breathe out, start saying “Out.” Notice the movement of your abdomen, moving up and down with each breath. Start to notice your feelings- bad or good, anxious or calm. Keep breathing. Then when you breathe in, while still noticing what you’re feeling, say, out loud, “I notice my feelings and emotions.” When you breathe out, say, “I smile to all of my emotions.” Then force yourself to smile. Continue deep breathing exercises and start to notice your different body sensations: your temperature, heart rate, pains, etc, starting from your head down to your toes. When you breathe in this time, say, “I notice all of my body sensations.” Then, when you breathe out, say, “I smile to all of my sensations.” Then allow yourself to smile. Repeat as many times as you want.
Hope this helps! If you remember anything, remember this: SLEEP SAVES! 🙂
p.s. A little humor therapy below. 😉