Lifestyle Changes do Not Happen Overnight Series: Sleep and Getting a Good Night’s Sleep!

I put these newsletters/blogs together in advance and send or post them on the first of the month.  As I post this, I am recuperating from hand surgery that released 3 trigger fingers in my left hand, my right hand will be done in a few weeks. Unfortunately, something that happens for many with RA, but these surgeries are a permanent fix to a several year problem, so I am relieved to have the surgeries done!

Insomnia is said to be the most commonly reported sleep problem. While it is universally frustrating and even debilitating, the bio-individual “flavor” of your insomnia may vary.  Insomnia can express as having difficulty falling asleep (onset), difficulty maintaining sleep (maintenance), and/or by experiencing sleep of short duration (despite ample time in bed for a full night of sleep) (Colten & Altevogt, 2006).

We schedule activities all day from the time we get up, do you schedule when you go to bed?!  Falling asleep and waking within an hour, every day of the week will ensure a good night’s sleep.  Be sure to schedule your bedtime so that you get ENOUGH sleep.  I do best with 8 to 8-1/2 hours myself and turn off all computers, phones, tablets, etc. at 9:00 PM 7 nights a week.

Things that affect sleep:

Caffeine has a half-life of 5-7 hours!

 Sugar/carbs, cause blood sugar cashes, that then cause the adrenals to pump out adrenaline and cortisol to have the pancreas make emergency supplies of insulin.  This often occurs at 2-4 AM.

 Bright light during the daytime and low light at night are required to maintain circadian rhythms.

 Exercise, particularly in the late morning or early afternoon, seems to send healthy messages to our circadian rhythm.

The time we take in food during the day is extremely important to our circadian rhythms, particularly to the circadian rhythms of our liver (Cribbet, et al., 2016) – and is ideally consumed during the daytime hours, as our ancestors would have eaten. Though the exact “optimal” timing of eating isn’t well understood (and likely varies, bio-individually), there seems to be some evidence that consuming food during the earlier daylight hours has healthier metabolic effects than shifting eating times into the later daytime and evening hours (Nas, et al., 2017). Do you routinely skip breakfast? Do you routinely eat late at night?

And then there is stress…The stress-induced activation of the HPA axis and sympathetic nervous system is associated with higher levels of both cortisol and epinephrine. Studies show– and you have more than likely felt– that increases in these stress hormones are associated with all types of sleeplessness (sleep onset difficulties, night waking, and premature wakefulness) (Chrousos, Vgontzas, & Kri,kou, 2016).

In addition to the obvious impacts of stress, there other metabolic causes of nighttime waking. As you sleep, you are likely not eating (though there are sleep disorders with “sleep eating” as a symptom). During this prolonged period of fasting, your blood sugar regulation systems are very much involved in keeping you alive. When your blood glucose begins to dip too low, gluconeogenesis or betaoxidation of fats keeps your body producing the energy it needs. If one– or both– of these systems are struggling, the drop in blood glucose is perceived as a major emergency. Production of cortisol and epinephrine increases to maintain blood sugar levels, but may also cause you to wake up, as epinephrine– in particular– has dramatic effects on your nervous system and cardiovascular system.

Here are several ideas you could do to set up a space that is conducive to sleep:

 ‣ Make sure your room is dark– and particularly that it’s free from cool, bright light sources to protect your circadian rhythms. Dark tape over LED lights or removing those objects from the room and black out curtains can be very helpful.

‣ Create a calm environment. Decorate your room in a way that feels peaceful or relaxing to you.

‣ Temperature that is not too hot, and not too cold. Body temperature drop

at night is an important aspect of circadian rhythms. Most studies show people sleep best at a room temperature of approximately 65 degrees Fahrenheit or 18 degrees Celsius.

‣ White noise. Many companies offer white noise generators that are very good at drowning out high pitch frequencies – sounds that are particularly arousing to the brain and can interrupt sleep. Here are some lifestyle strategies that can be used around bedtime to help ensure and enhance sleep:

‣ Unwind a few hours before bed. Make sure you’ve allowed at least a few hours in the evening, before bed, to disengaging from work and stimulating activities. Social and relaxing is good, but mellow is key.

‣ Maintain a consistent bedtime. It is just as essential to have a consistent bed and awake time as it is to get enough sleep, particularly in the maintenance of circadian rhythms. This goes for weekends and weekdays alike.

‣ Part with ALL electronics at least 1-2 hour before bed. If you must use them, it’s advisable to avoid blue light as it suppresses melatonin production.  The warmer end of the light spectrum isn’t as disruptive to the sleep cascade. Purchasing special glasses that block blue light make for a quick and easy solution. Many electronic devices and software now allow users to control the amount of blue light emitted from them.

‣ Charge your phone OUTSIDE of the bedroom.  Many find the phone itself charging in the room will cause sleep disturbances.

‣ Take a bath, shower, or wash your face. This promotes blood flow, lowers body temperature, and calms the nervous system– all things that encourage sleep.  Adding magnesium salts to a bath can also relax not only the muscles, but the brain allowing you to feel sleepy and fall asleep, maintaining sleep through the night.

Here are some lifestyle strategies that can be done throughout the day to enhance sleep:

 ‣ Wake up gently. Do away with noisy alarm clocks, as this is very startling to your system and can elicit a stress response right from the first moments you wake. Consider using a light alarm clock– one that gradually gets brighter, mimicking the sunrise – rather than one that uses sound. If you must use sound, choose a calm soundscape.

‣ Manage stress. (See breathing techniques at the end of this)

‣ Connect with nature. Go outside so that your body can calibrate with the earth’s natural cycles. When you’re indoors, live in tune with the rhythms of the day. Dim indoor lights in the evening to mimic in the natural light outside. Seasonal variations should be considered as well. It is natural to sleep more during darker/winter months of the year. Allow this natural progression and mimic the lighting and temperature somewhat, to simulate your natural setting. More than just eating seasonally, embrace living seasonally.

‣ Include daily movement and exercise into your routine, ideally in the earlier part of the day. This can help create more successful sleep by encouraging circadian rhythms and metabolism. Exercising late in the day may delay sleep or decrease the quality of sleep for some, as it can reset the circadian clock.

‣ Nap. Napping can do wonders for your brain and overall function– even if it’s just a short nap. Remember how important it is for learning and the direct transfer of memories from short to long term storage!

‣ Prioritize sleep in your schedule. This may mean eliminating other activities. Evaluate what is important and learn to ask for help if overload is impairing your ability to carve out appropriate time for sleep.

Breathing Technique before sleep (or any time you feel stressed!):

There are many simple breathing techniques that help to calm the nervous system by inducing the parasympathetic or ‘rest and digest’ response. The 4-7-8 technique is one such breath:

1. Exhale completely through your mouth, making a whoosh sound.
2. Close your mouth and inhale quietly through your nose to a mental count of four.
3. Hold your breath for a count of seven.
4. Exhale completely through your mouth, making a whoosh sound to a count of eight.
5. This is one breath.

Most of this information is taken from the Nutritional Therapy Association. Sleep Stress and Movement Student Guide.