Sleep : The Forgotten Cure!

November 24, 2016

 

 

What is wrong with our modern life?

We are always in a hurry.  We are always trying to accomplish too much. 

 

According to Gallup's annual Work and Education Survey for 2013 and 2014: adults employed full-time in the U.S., report working an average of 47 hours per week, almost a full workday longer than what a standard five-day, 9-to-5 schedule entails.  In fact, half of all full-time workers indicate they typically work more than 40 hours per week, and nearly 4 in 10 say they work at least 50 hours.  And nearly 1 in 5 (18%) of us work a grueling 60 hours or more.  This translates into 12-hour days from Monday to Friday -- or into shorter weekdays with lots of time spent working on weekends.

 

In addition, the average travel time to work in the United States is 25.4 minutes, according to the U.S. Census Bureau.  And according to a study done by the Harvard Health Watch, an average American spends 101 minutes per day driving.

 

How do we accomplish this?

By skipping meals or eating in a hurry, in a car while driving.

By skimping on sleep.

By forgetting our families and friends.

By limiting exercise time, or exercising in lieu of resting to "compensate for our bad eating habits and to trim our ever-increasing waistline".

 

People may cut back on sleep, thinking it won't be a problem, because other responsibilities seem much more important.  A common myth is that people can learn to get by on little sleep (such as less than 6 hours a night) with no negative effects.  But research shows that a number of vital tasks carried out during sleep help people to stay healthy and function at their best.

 

A recently published quarter-century study of businessmen found those who worked more than 50 hours a week and slept less than 47 hours weekly, when they were middle-aged were in worse physical health as older men, than their peers who had healthier work-sleep habits when they were in their prime.

 

Shortness of sleep increases stress and strain, which are important aspects in our quality of life.

Professionals with interrupted/disturbed sleep or sleep deprivation experienced physical, cognitive and emotional changes, in addition to a drop in immune function. (1)

 

While you sleep, your brain is hard at work forming the pathways necessary for learning and creating memories and new insights.  Without enough sleep, you can't focus and pay attention or respond quickly.  A lack of sleep may even cause mood problems.  Growing evidence shows that a chronic lack of sleep can also increase your risk of obesity, diabetes, cardiovascular disease, and infections.

 

I'd like to review the latest literature on the benefits of sleep:

  • Habitual sleeping less than 7 hours per night cuts your lifespan by 25%. (2)

  • Sleeping too little (less than 7 hours) along with sleep disorders such as breathing irregularities and insomnia, may be linked to cardiovascular risk factors. (3)

  • A link has been identified between chronic pain and lack of sleep.  People with chronic back pain, fibromyalgia, and arthritis, who believe that they won’t be able to sleep, are more likely to suffer from insomnia, thus causing worse pain.  Fortunately, this false belief can be effectively managed by cognitive–behavioral therapy (CBT).  With better sleep, pain problems were significantly reduced. (4)

  • Sleep–deprived people consumed an average of 385 kcal extra per day, which is equivalent to the calories of about 4.5 slices of bread.  Long-term sleep deprivation results in an increased calorie intake and contributes to a significant weight gain. (5)

  • Shorter sleep duration is associated with increased susceptibility to the common cold. (6)

  • A lack of sleep can result in worsening depression, anxiety, and ADHD-like symptoms.

  • Sleep duration and sleep quality during late childhood is a predictor of substance use/abuse later on in adolescence.  Every hour less of sleep at age 11 was associated with a 20 percent acceleration to the first use of alcohol and/or cannabis. (7)

  • Sleep deprivation contributes to hot flashes and depression in menopausal women. (8)

  • Curtailing sleep alters the abundance of bacterial gut species that have previously been linked to compromised human metabolic health.

  • Sleep loss is also associated with an increase in insulin resistance, thus contributing to diabetes, high triglycerides and the metabolic syndrome. (9)

A good night sleep is vital to our well-being.  What can we do to accomplish this?

Here are some suggestions that might help you to sleep better:

  • Avoid alcohol (wine, beer, and hard liquor) within 3 hours of bedtime.

  • Avoid beverages and foods containing caffeine after 2 pm.  If sensitive to caffeine, avoid these after 12 noon.  (These items include Pepsi, Coke, Mountain Dew, tea, coffee, lattes, chocolate, as well as ice-cream and desserts that contain coffee/espresso). Read the labels of everything you eat and drink!

  • Avoid Sudafed or other decongestant cold medicines at night.  Some medications may have stimulating effects.  Consult your doctor or pharmacist to determine whether any of them might be contributing to sleep problems.  Do not discontinue them without permission from your doctor.

  • Finish any aerobic exercise before 6 pm (or at least 3 hours before bedtime).

  • Avoid anxiety-provoking activities close to bedtime.

  • Avoid watching the news or working on a computer before going to bed.  Avoid reading stimulating/exciting materials in bed.

  • Avoid paying bills before bed.  Avoid checking your financial reports or the stock market before bedtime.

  • Avoid arguments before bedtime.  Try to achieve some action plan or resolution of a discussion or argument before trying to go to sleep.

  • Avoid repeated negative judgments about the fact that you are unable to sleep.  Use positive self-talk phrases regarding your ability to relax and fall asleep: “I can fall asleep,” “I can relax.”

  • Try writing in your journal any disturbing thoughts that are running through your mind.

  • Schedule a time within the next few days to deal with whatever is troubling you.  If you are having trouble managing your concerns for more than a few weeks, consult your healthcare provider for treatment suggestions or a counseling/therapy referral.

  • There are many relaxing yoga or stress-reducing mindful breathing CDs, DVDs, apps available to help you find a relaxing bedtime ritual that works for you.

  • Plan your sleep by putting it into your schedule; plan for 8½ to 9 hours in bed.

  • As much as possible, go to sleep and wake up at the same time each day.  This will help train your biological clock.

  • Begin preparing for bedtime 30 minutes before getting in bed.

  • Avoid getting in bed after 11 pm as late-hour sleep is not as helpful as earlier sleep.

  • Avoid late afternoon or evening naps.  Avoid naps longer than 45 minutes unless, you are sick or quite sleep deprived.

  • Avoid large meals or spicy foods before bed.  Finish all eating 3 hours prior to going to sleep.

  • Avoid drinking more than 4-8 ounces of fluid before going to bed.

  • Take a hot salt/soda aromatherapy bath—raising your body temperature before sleep helps induce sleep.  A hot bath also relaxes muscles and reduces tension.  Add 1-2 cups of Epsom salts (magnesium sulfate absorbed through the skin is very relaxing), ½ to 1 cup baking soda (sodium bicarbonate which is alkalizing to a stressed out acidic body) and 10 drops of lavender oil (helps lower cortisol levels).

  • Don’t stay in bed more than 20-30 minutes trying to fall asleep.  Leave your bedroom and go to a relaxing room other than the bedroom and read or do a relaxation technique (e.g. meditation).

  • Consider reading a good neutral book under low light to help with falling asleep.

  • If using a tablet or phone for reading, make sure they are in the night-time setting and brightness is as low as possible. 

  • If using a light, don’t use a table lamp.  Instead use a HUD light or other small light that only illuminates the reading material.

  • Consider using amber glasses for at least 30 minutes before bedtime to reduce light exposure.  Use dark window shades or consider an eye mask or a black cover for your eyes, when trying to sleep or if you awaken too early due to light streaming thru your windows.

  • If you awaken early because of recurrent thoughts, try writing them in a journal.  If this does not help, consider counseling.  Depression might be a factor.

  • Decrease irritating noises in your space by closing windows, using ear plugs, or using a white noise generator or a HEPA air filter.

  • Turn off or remove any appliances or clocks that make noise.

  • Make sure your sleeping area is the correct temperature range (not too hot or too cold).

  • Avoid sleeping near electromagnetic fields.  Try to have your head at least 8 feet away from electromagnetic fields, if possible.  Possible sources of electromagnetic fields include: electrical outlets, clock radios, stereos, cell phones, computers and monitors.  Consider moving these devices or moving your bed or your position in the bed away from such devices.  Consider using a Tri-Field or other meter to test for these fields.

  • Avoid sleeping with an electric blanket turned-on.  Instead, turn on the blanket when preparing for bedtime, then turn it off when getting into bed.

  • Consider replacing your pillows with hypoallergenic pillows.  Use an ultrafine allergy pillow and mattress covers.

  • Consider using a “side sleeper” pillow for under your neck when sleeping on your side.

  • Consider using a body pillow to hug and put between your knees to align your back and shoulders at night.

  • Roll backwards at a slight angle onto a body pillow, if you have hip bursitis or shoulder pain.

  • Sleep on the highest quality bed linens that you can afford.

  • Establish an evening herbal tea habit, such as lemon balm and passionflower, to support relaxation and sleep onset.

  • Consider ½ hour exposure to a blue or 10,000 lux bright light (first thing in the morning), if you are going to bed too late and want to shift to an earlier bedtime.

 

Consider taking supplements to aid your sleep:

  • Melatonin 

  • 5-HTP  

  • Taurine  

  • Magnesium

  • Glycine

 

To decrease nighttime cortisol or stress consider:

  • ashwagandha

  • phosphorylated serine 

  • lactium casein decapeptide

  • L-theanine or other calming herbs

 

For more helpful tips on a healthy lifestyle, please schedule an appointment with Dr. Koganski at 215-750-7000, or www.newtowninternalmedicine.com

 

References:

1)  von Bansdorff MB, et al.Working hours and sleep duration in midlife as determinants of health-related quality of life among older businessmen. Age and Ageing.October 25, 2016.

2)  Aurora RN, et al. Habitual Sleep Duration and All-Cause Mortality in a General Community Sample. SLEEP 2016;39(11):1903–1909.

3)  Sleep disorders may influence heart disease risk factors. American Heart Association Scientific Statement. September 19, 2016.

4)  Sleep is key to curing chronic pain. University of Warwick Health and Medicine News, 09/23/2016.

5)  Sleep deprivation may cause people to eat more calories. King's College London News, 11/04/2016.

6)  Prather AA, et al.  Behaviorally assessed sleep and susceptibility to the common cold. SLEEP 2015;38(9):1353–1359.

7)  Pitt research links sleep habits to adolescent drug and alcohol useUPMC, 09/20/2016.

8)  DOI: http://dx.doi.org/10.1210/jc.2016-2348.

9)  Sleep loss tied to changes of the gut microbiota in humans. Uppsala University News. October 31, 2016.

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