Serious about sleep
By Lenore Shepard. This article originally appeared in the Daily Hampshire Gazette on 4/18/23. View here.
Do you often wake up in the morning feeling foggy and underslept? If so, you are not alone. Over 80 million Americans do not get the regular, recommended 7-9 hours of uninterrupted sleep each night.
One of the biggest factors affecting our ability to feel replenished upon waking is our stress response. Apart from physical sleep disorders, stress is one of the biggest factors that affects and inhibits our ability to get nourishing, routine sleep. So what happens during sleep and how can we enhance our sleep hygiene and by extension our health?
At night, we progress through four sleep stages: Non-REM 1, 2, 3, and REM sleep, with the latter 2 stages being when we get the deepest, most reparative sleep. Each cycle confers different benefits for cognition, memory, creativity and our emotional centers.
Much like the lymphatic system, which is one of the ways we detoxify metabolic waste, during sleep, the glymphatic system kicks into high gear. This elegant and sophisticated system is akin to a street cleaner; it washes away neurotoxic and metabolic waste as well as amyloid plaques but can only occur during a consistent and restful night’s sleep.
The research tells us that once we incur a sleep debt, we cannot repay it — therefore, being vigilant about what is getting in the way between you and healthy sleep is the first step toward staying ahead of a sleep deficit.
Insomniacs have a stronger awake system and a weaker sleep system than healthy sleepers, for which there are manifold reasons, one of the big ones being stress. Women have twice the rate of insomnia as men due to hormones and increased susceptibility to mood disorders, among other factors. Having had my own struggles with insomnia, I know well the trauma of sleep loss.
tress and sleep are inextricably intertwined. Do we sleep less due to a high stress response or does stress exert a powerful influence on our circadian rhythm, and alter our sleep cycles?
People with insomnia are found to have higher concentrations of cortisol at night, leading to more nighttime awakenings. If you have experienced chronic insomnia for more than three months, speaking to a sleep professional can be a beneficial first step.
There are some practical, non-pharmacological steps you can follow to reset your clock and boost your sleep hygiene and health. The National Sleep Foundation has 12 helpful steps you can take, and below I expand on some and offer additional tips.
The No. 1 thing we know is to maintain a regular sleep routine, both going to bed and rising at the same time every day, weekends included.
Our bodies and brain crave routine and regularity. Plan your day backwards. Think about what time you want to be in bed and begin a nighttime routine that will allow you to be in bed at the appointed hour. Pay attention to when your body cues its nighttime drowsiness so that you do not miss this sleep opportunity.
Keeping a journal, or in sleep parlance, a worry journal before bed can be a helpful way to contain your worries and repetitive thoughts and get them out of your head. Finish the journal with the things you are grateful for and the things you are looking forward to.
Doing breathing exercises, guided meditation, listening to a sleep story, incorporating creative visualization, and progressive muscle relaxation can help the body wind down and literally take your mind off of itself. Additionally, avoiding anything stress-inducing like the nightly news or a suspenseful book and dimming the lights an hour before bedtime can help signal to the brain that relaxation is in order.
As we are entering into warmer weather, keeping your room cool, usually recommended around 65 degrees, is a proactive strategy as the body dips 2-3 degrees at night to facilitate melatonin production.
Cognitive Behavioral Therapy for insomnia (CBT-I), is now the recommended first-line treatment for chronic insomnia, boasting more than a 75% success rate. The less you linger in bed when you cannot sleep, the more your mind can make the association to bed with sleep. Think of consistent, nourishing sleep as the super-charger for your body, immune system, mental health and lifespan; quite simply, it is the best non-prescriptive medicine that nature offers.
These topics, along with other practical steps you can take to help get consistent, healthful sleep will be the focus of a presentation at Forbes Library on Thursday, April 20 and again on Saturday, April 22.
Lenore Shepard is a board-certified health coach and licensed clinical social worker who maintains a private practice in Northampton.
