Sleep deprivation can feel unbearable and leads to negative impacts on our physical and emotional health. Approximately two million people in Australia have trouble sleeping for various reasons that range from physical and mental tension, shift work, environmental disruptions, stress, challenging life events, and most commonly because of learned habits.
It is important to seek support if you or someone you love have trouble to fall or stay asleep, do not feel rested when you wake up, or feel tired during the day. With the help of an integrative GP, you can hopefully rule out sleep apnoea, restless legs, Periodic Limb Movements in Sleep (PLMS) and other underlying medical conditions.
Quality sleep is life changing and so important for our emotional and physical health. Many important functions take place while we sleep, some of these include:
- our immune system releases small proteins called cytokines that fight inflammation, infection, and trauma.
- our glymphatic system drains toxins from the day during slow-wave sleep, which occurs during the first hours of the night.
- levels of cortisol, also known as the stress hormone, lowers.
- hormones are released to help our body grow and repair.
- the sympathetic nervous system (which controls the fight, flight, freeze response) takes a break.
- our brain organises and processes information from the day.
Google sleep tips and you will find a sea of information on sleep hygiene which is often useful. However, the information tends to focus on tips to improve your sleep just before you want to doze off, thus overlooking the importance of daily habits that help to promote quality sleep. What you do during the day and all the way that you lead up to sleep directly contributes to how you will get to sleep.
Daily habits that can help sleep onset and maintenance include:
- Wake at the same time every day.
- Expose yourself to 15 minutes of sunlight when you wake up to activate your circadian rhythm. Circadian rhythms are like an internal timekeeping system that follow a 24-hour cycle to regulate cycles of sleep and wakefulness, hunger and digestion, hormonal activity, and other bodily processes. Bright morning sunlight is best to activate your internal biological clock because it is full-spectrum light that offers plenty of blue light. Sunlight through a window is less efficient as the window glass will block a lot of wavelengths. If you cannot get outdoors invest in a full-spectrum light.
- Eat meals earlier during the day and a lighter meal in the late afternoon. Digestion is strongest in the middle of the day. Meals consumed later in the evening will delay your melatonin onset. Melatonin is a circadian hormone that tells your body when it is time to decrease your arousal and go to sleep.
- Exercise as early as possible. Physical activity can increase cortisol and interfere with melatonin levels. If you exercise in the evening it will be harder to get the sympathetic nervous system to quiet down.
- Slow and deep breaths through the nose, not the mouth. Breathing through your nose is the most natural and efficient way to synchronise your breathing and heart rate. It will also lead to less issues associated with a sore throat, mouth, and sleep apnoea. For more information, please see Breath: The New Science of a Lost Art by James Nestor.
- Make a list of to-dos for the following day so you are less likely to feel the urge to do it in bed.
- Create opportunities to rest and restore where possible, for example:
- Meditation and yoga. Biofeedback via heart rate variability suggests that meditation and yoga can yield the same benefits as deep sleep such as improved executive functioning, attention, and working memory.
- Create blocks of technology free time.
- Prioritise time outdoors.
- Ground yourself barefoot on grass or sand.
- Connect to art and culture.
- Have a meaningful conversation with someone you care about.
- Enjoy a good belly laugh.
- Give or accept a bear hug.
- Find stillness and solitude to decompress and recharge.
- Take breaks from responsibility and learn to say no, what can you do less of?
Evening habits that can improve your sleep include:
- Avoid exercise 4 hours before bed.
- Avoid naps after 2pm.
- Avoid blue light after the sun sets. The absence of blue light tells your brain that it is time to turn down the arousal system and turn on melatonin. Filter screens to night shift which will look completely yellow, use candlelight, circadian light bulbs, or blue light blocking glasses that have yellow-coloured lenses.
- Avoid liquids at night.
- Avoid late night snacks.
- Relaxation and mindfulness.
- Epsom salt baths.
- Magnesium oil rubbed on the souls of the feet.
- Be mindful of your Ultradian Rhythm. The Ultradian rhythm is your natural sleepiness cycle which you can imagine as a wave. Your goal is to catch the wave of sleepiness when your eyes get heavy, or you start to yawn. If you miss one wave of sleepiness, you will need to wait 60-90 minutes for the next one.
Environmental, psychological, and physical factors that can improve your sleep include:
- Dark and quiet room.
- Comfortable temperature- ideally, 18°C give or take a couple of degrees.
- Clean air. A good quality air purifier can lighten allergen load, filter harmful chemicals, and remove mould spores from the air.
- Reduce thinking and worrying in bed. Set time during the day to do the thinking and worrying. Give your mind something else to do and it will in time get out of that habit.
- Find a dense book that requires some thought. The second you start to feel tired and drowsy- stop and go to sleep. Let the natural sleepiness wave take you.
- If you prefer a podcast or audio book, download it on your device first. This will allow you to turn off the Wi-Fi and data overnight.
- No technology devices in the bedroom where possible.
- If devices must be in the bedroom, make sure you turn the data, Wi-Fi and Bluetooth off from the settings menu and flight mode on.
- If you cannot sleep, get up and write until you are tired. Practice gratitude which can shift your attention from ruminative self-focused thoughts to positive things that are most important and meaningful to you. When you feel tired, try to sleep again.
- Sleep in a position that promotes nose breathing such as your side not back. It is important that you breathe through your nose all night long. You can use a small piece of tape as a gentle reminder to keep your mouth closed while you sleep. For more information, please see Breath: The New Science of a Lost Art by James Nestor.
So, when you think about falling and staying asleep, consider your rituals and rhythms throughout the day. The more opportunities that you create to quiet the mind and body throughout the day, the calmer your body will be in the evening. Lastly, don’t forget that it can take at least 6 weeks to see improvements, so perseverance is key.
For more information, please read The Power of the Downstate by Dr Sara Mednick
The information contained in this blog is not intended, nor implied to be a substitute for professional medical advice. It is provided for educational purposes only and is intended to encourage discussion with your health professionals. Readers assume all responsibility for how they choose to use this information.