Health Wise
A health & wellness column by Victor Acquista, MD, Director Pathways Integral Health & Wellness, LLC; Author Pathways to Health: An Integral Guidebook http://www.facebook.com/PathwaysIntegralHealthAndWellness
Getting a Good Nights Sleep
Many people have difficulty falling asleep, sleeping through the night, or getting a restful sleep. Many folks rely on prescription or non-prescription medications or herbs to help overcome their sleep difficulties. In general, I am not a fan of medications or herbs to be used in this manner; although, I do see a place for them. The basics of good sleep hygiene should be recommended as a starting point for anyone having trouble with insomnia.
In this column, I shall focus on habits and environmental factors that should be evaluated when you or a loved one are having sleep difficulties. I shall not cover medical conditions which can interrupt sleep. Conditions such as sleep apnea, restless leg syndrome, or nocturia (getting up at night to urinate) should be evaluated by a medical professional as part of a strategy to improve sleep. A review of medications and non-prescription supplements should also be considered as many might have stimulants or can be activating in ways that affect sleep.
Habits
The body has a natural cycle which we refer to as a circadian rhythm. Having different schedules and erratic sleep wake cycles is disruptive to the body’s natural rhythm. A good place to start if you are having difficulty sleeping is to try and get on a regular schedule. To the extent possible, this cycle should correspond to the day-night cycle. Our bodies are naturally set to be awake during daylight and asleep at night.
Regular exercise is a good habit for many health reasons. When we are physically tired, it’s easier to sleep. However, it is not a good idea to exercise and then try and sleep. Exercise revs us up and it takes time to settle back down. In general, it is not a good idea to eat before bedtime. Among other reasons, going to bed with a full stomach tends to promote reflux of acid contents (GERD) which can interfere with sleep as well as damage the esophagus. Many people are sensitive to caffeine and caffeine like substances which are contained in foods such as chocolate and may be present in other consumables such as sports/energy drinks and diet aids. If you are having trouble sleeping it’s a good idea to avoid these. Similarly, alcohol and tobacco are generally things you should avoid if a good nights sleep is something elusive for you.
Environment
Although some of these might seem obvious, it’s a good idea to take stock of your sleeping environment focusing on sights, sounds, and comfort. Many people are sensitive to light. Even dim light can trigger an awake response in the brain and prevent sleep. In particular, blue light can be more stimulating. Try to eliminate or cover light emitting diodes (LEDs) on your electric devices visible from your bed. If outside streetlights, flood lights or other sources of illumination are present, try to use shades or blinds to reduce the indoor lighting. You can also try night shades or patches to cover your eyes provided these do not feel too uncomfortable. Since it can be dangerous to get out of bed in a totally dark environment, have a bedside night light or flashlight available should you need to get up.
Sounds and noises can interfere with sleep. Try to reduce any noises such as ticking clocks, buzzing sounds, etc. Foam earplugs are effective and generally comfortable and can block annoying sounds. Some sounds may aide sleep such as white noise. There are inexpensive white noise generators and other devices (such as the sound of ocean waves) which may provide a better nighttime acoustic environment as-well-as block out other interfering noises.
Take stock of your mattress, blanket, and pillow. If any of these are uncomfortable they can interfere with your sleep. Many people sleep better with some weight over them as in a snug blanket. We can speculate that this feels more secure. However, some people can only tolerate a light covering. Temperature is another factor to consider and is highly individualized. If you are too hot or too cold you will not be in a comfortable sleep environment. Also consider your sleep attire and assess whether or not it is comfortable. Ventilation is another consideration. If a fan or vent is blowing on you, this can make sleep difficult. A stuffy room might also create sleep difficulties. Consider all of these environmental factors if you are experiencing trouble sleeping.
Other considerations
Many people lie in bed craving sleep while they review the troubling circumstances of their life or things that happened earlier that day. Many people lay awake thinking about what they need to do tomorrow as in the tasks, the work deadlines, responsibilities, etc. When the mind is engaged in worries, anxieties, angers, frustrations or even engaged reviewing happy and exciting things that have happened or are anticipated it makes it hard to calm down and get some rest. If mental chatter is keeping you awake, try some focusing mental techniques to help calm and quiet the mind. This can be as simple as deep breathing, especially abdominal breathing as this has a calming effect. Try focusing first on your feet and appreciate the sensations in your feet, then gradually work your way up your body thinking all the while about relaxing tight muscles. Even counting sheep is an age old trick to help reduce mental chatter and allow you to get to sleep.
Better habits to improve your sleep hygiene and more attention to environmental factors to reduce stimulation and increase comfort may go a long way in helping you achieve a restful sleep. Some simple focusing techniques to help calm your mind might also be helpful. If you continue to suffer from insomnia, check with your medical provider for more guidance.
Pleasant dreams!
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