Sleep your way to better health
It is tempting to take sleep for granted. Sleep seems automatic. But a night of staying up late working or streaming TV can leave you tired and out of sorts.
Now consider getting poor sleep night after night. Medical research is discovering that the effects on our bodies, minds and health of a poor sleep routine are much more serious than low energy and concentration. Frequently inconsistent sleep has been linked to memory problems, weight gain, cardiovascular problems, weakening of the immune system and even higher rates of some cancers.
Sleep is not only about dreaming. Many important processes happen while we are asleep. Short-term memories stored in the hippocampus are moved to other areas of the brain that allow for accessing that information over the long term. Sleep modulates the levels of your hormones that affect weight, raising the level of the hormone leptin, which gives us a feeling of fullness, and lowering the level of the hormone ghrelin, which stimulates appetite. While we sleep the levels of stress hormones like cortisol reset, impacting blood pressure and blood sugar. Sleep also promotes a strong immune system. Studies have shown that reduced sleep increases the risk of catching viruses that cause the common cold.
Still more ways sleep impacts our overall health have not yet been fully explained. In recent years, studies following the health of nightshift workers began reporting higher rates of breast cancer. What does working the night shift have to do with cancer biology? This wasn’t expected and was not fully understood, but the findings were intriguing and seemed to persist in subsequent studies. What has become clear is that sleep is a very important biological process that affects our health in many unexpected ways.
Good sleep is more than just putting in the hours. If I am getting some sleep isn’t that enough? Not exactly. As anyone who has slept on an uncomfortable couch can attest, sleep quality matters.
The highest quality sleep comes from long-standing patterns of behavior and daily routines that reinforce this biological process. Some of our routines promote high-quality sleep and others detract from it. These behaviors become more and more important as we get older because the biological forces that drive sleep tend to weaken.
First, focus on wakefulness
It may seem counterintuitive, but great sleep starts with supporting the wakefulness part of your natural sleep-wake cycle. Like a pendulum that swings from one side to the other, our bodies need high-quality wakeful hours to get high-quality sleeping hours. This means getting exposure to daylight and participating in light-to-moderate exercise. One way to get both is by going for a walk. Completing a task that requires focus and concentration like a crossword puzzle is another way to stimulate wakefulness.
What you do before sleep matters
There are a few things that can really throw a wrench in your body’s sleep biology. Caffeine seems obvious, but it is often an unrecognized factor when I talk with patients. Caffeine is metabolized slowly by the body, so limit how much you drink and confine that consumption to the early morning hours.
Screen time is another factor that many patients don’t recognize. The bright lights of a computer or television confuse our sleep-wake cycle and lead to more trouble falling asleep or trouble with waking up or fitful sleep. I recommend that my patients turn off televisions, computers, phones or tablets at least one to two hours before bed. Alcohol also erodes sleep quality. Although it has a sedating effect, that effect is short-lived, and alcohol tends to cause low-quality, intermittent sleep.
A conducive place for sleep
The conditions that foster sleep are quiet and darkness. Turn off lights, close doors and curtains. If you can’t eliminate light and noise, consider using an eye mask and earplugs. Help your body to anticipate sleep by setting a bedtime and sticking with it. If you tend to oversleep, set a regular wake-up time so that you are consistently sleepy when bedtime rolls back around. Lastly, make sleeping the primary occupation of your bedroom and do other things like watching television or paying bills somewhere else. This helps your subconscious to associate going into the bedroom with sleep and results in a shorter time to fall asleep and less time up during the night trying to fall back to sleep.
Isn’t there a pill for that?
Try not to rely on pills. Work through the aspects of good sleep habits before you consider medication. Sedating medications distort sleep quality and some are habit-forming. If you and your medical provider decide to use one, it is best to keep the duration of treatment short. Once sleep cycles are back on track, you can rely just on good habit, or "sleep hygiene."
Melatonin is an exception. It is a natural substance produced by your brain to regulate circadian rhythm, and you can take a melatonin supplement. It can help to reinforce that rhythm and lead to less time spent trying to fall asleep and improvements in sleep quality. Therapy for sleep – training ourselves to calm our thoughts and put away the cares of the day – can be just as effective as medication.
Still having trouble?
Because sleep is both a habit and a biological process it can take time to retrain your body into good sleep patterns. If you aren’t making progress, consider asking for help. If you have a spouse or a partner, enlist their help observing how you sleep. Even five minutes of observation the next time they wake in the night or come to bed later than you do can reveal clues that might point to restless leg syndrome or obstructive sleep apnea. Then talk with your healthcare provider about what they noticed and how to evaluate or treat it.
More than ever before, health professionals are recognizing that good sleep matters. Sleep is about more than just recharging your batteries. It is a complex biological process that supports many other biological systems. Bad sleep leads to more than fatigue the next day; it can drag down your health over the long term. Getting great sleep requires the right behaviors and habits. Like an athlete at a competition or a musician at a recital, performing at our best requires some planning and preparation. It also takes repetition, so consistency is key. Fortunately, we have lots of opportunities to practice!
Peter Barkett, MD, practices internal medicine at Kaiser Permanente Silverdale. He lives in Bremerton.
This article originally appeared on Kitsap Sun: Sleep your way to better health
