Tips For Better Sleep

“Sleep dispenses a multitude of health-ensuring benefit, yours to pick up in repeat prescription every 24 hrs should you choose” – Matthew Walker

This is my new favourite topic – a patient of mine put me onto a book called:  Why We Sleep by Matthew Walker:  what a cracker of a book it is!

By Caren Wigmore, ND

I have no affiliation, no benefit in mentioning but if you do nothing else this year READ / AUDIO DOWNLOAD THIS BOOK.  This past professor of psychiatry at Harvard Medial School and currently professor of neuroscience and psychology at the University of California, Berkeley has spent decades researching sleep and this book is a gem:  easy to read and gets down to the business end of why its so important.  

But let me start off with some hard-hitting facts that won’t take much to convince you as to why sleep is SO CRUCIAL TO OUR HEALTH: 

• The World Health Organisation (WHO) recommends 8hrs sleep per night
• Routinely sleeping less than 6 or 7 hrs a night impacts your immune system and doubles your risk of cancer
• Poor sleep is a key lifestyle factor in determining the likelihood of developing Alzheimer’s disease later in life
• Disrupted sleep leads to high blood glucose – to the point of a pre-diabetic classification in some
• Depression, anxiety and suicidality are all contributed to by poor sleep  (it may not be the cause but is will most certainly compound any existing issues) 
• The shorter you sleep, the shorter your life span (the science is in)
• WHO has declared a sleep loss epidemic in industrialised nations:  those that have suffered the most significant decreases of sleeping hours have the directly correlating increases in physical disease and mental disorders.
• Do you know that more car accidents happen due to drowsiness / lack of sleep than caused by alcohol and drugs combined?!

Lets focus on the benefits that sleep provides for a moment:

• Sleep enriches: our ability to learn, memorise make logical decision and choices
• It recalibrates our emotional brain circuits which allows us to socially engage with more composure and perspective
• Dreaming is key:  (talk to me if you don’t have dream recall) it’s a process where “consoling neurochemicals” bath the brain and allow a virtual reality space to process painful memories, melding past and present knowledge merged with creativity. – now there’s some neurobiology insight for you!
• Our immune stem kicks into high gear with sleep:  malignancy and infection are scanned for
• Our metabolic state is re-calibrated:  balancing insulin and glucose, our appetite and therefor body weight are impacted helping us maintain healthy weight
• Our microbiome flourishes with deep restful sleep having a significant impact on our digestive and nutritional health and wellbeing.  
• Our cardiovascular system is directly impacted as well as blood pressure (have you ever considered poor sleep could be behind your rising blood pressure?)

The science is in: sleep is the single most effective thing you can do to rest your brain and maintain body health EVERY DAY

Some things you should know about sleep:

Our sleep is set by a circadian rhythm:  this is strongly influenced by sunrise and sunset – we have a 24hr biological clock run by our suprachiasmatic nucleus.

We are not all identical – some of us are night owls and others are morning larks. This can be genetic and the caution here is society’s work schedules that support morning larks but often leave night owls to burn the candle at both ends – greater health risks can be seen here.  What can you do?  Get your 8hrs regardless of night owl or morning lark status. 

Melatonin:

I’m often asked about melatonin – its not the be-all-and-end-all but melatonin is key.  Melatonin is a hormone that your brain produces in response to it getting dark. It is a biological signal that its time to sleep.  Matthew Walker describes it as “corralling the sleep generating regions of the brain to start the line of bedtime – it provides the official instruction to commence the event of sleep, but does not participate in the sleep race itself:”  We test melatonin and cortisol as the two have a direct influence on each other.  If your melatonin is low, then your sleep will benefit from improving it – either nutrients that support the melatonin pathway or directly taking a script of melatonin.  The question is:  WHY is your melatonin low – that that’s my job to find out. It is possible that your melatonin levels are fine in which case taking melatonin or supplements to support it will yield little.  Let us take the guess work out for you:  book an appointment today so that we know what your cause of insomnia may be.

Adenosine

Adenosine is another key player in the state of sleep.  This chemical acts as a barometer that recognises the time lapsed since your last slept – its steadily builds over the course of the day:  as it builds, so does your desire to sleep. Peaking at 12-16hrs.   Nutritionally this is another tool we assess for and utilise if we find it is low.  ** Caffeine however will mute adenosine – SO NO CAFFEINE POST 12pm if you don’t want your adenosine impacted. 

Caffeine: 

Most people do not realise how long it takes for caffeine to work its way out of your system.  Caffeine has a half life (how long it takes to remove half of the concentration of caffeine from your system) of 5-7hrs.  So if you had a coffee at 11am you still have 50% of that caffeine in your system at 6pm.  Remember other foods contain caffeine too:  chocolate, black tea, green tea, matcha energy drinks, some pain medications and weight loss pills.  Finally de-caff does not mean NO CAFFEINE:  it can contain up to 30% of the original caffeine dose. If insomnia is an issue for you:  cap your caffeine hits and keep them to the early part of the morning. 

How do you know if you are getting enough sleep?

If you are tired around 10/11am in the morning its likely you are not getting enough sleep.

Do you need a coffee to get you going in the morning?  Let me be frank, coffee is a wonderful thing, it does help us think faster, clearer and sharper but it can also mask chronic sleep deprivation and further deplete you.

Which part is sleep is the most important?

I tell my patients that the hours before midnight are golden:  these are often the most restorative and regenerative:  post midnight the grunt-work of cellular repair, rebuilding and immune surveillance takes place.  So in truth it’s all important:  light NREM sleep, deep NREM sleep and REM sleep offer the brain different healing at different times of the night –  you need them all. 

How do I convince my school aged child or myself as a uni student to get more sleep?

Sleep refreshes memory and ability to recall information, its involved in how we store and recall information.  A fascinating study took two groups who had a rigorous session of learning 100 new face-named pairs.  One group was given a 90min siesta after the learning session and the other was allowed to browse the internet, play board games or scroll social media. Later that day a second round of names and faces was introduced:  can you guess which team did better? Those who had a nana-nap had a 20 percent learning advantage and improved their ability to memorise facts.  When we sleep we product sleep spindles in light stage 2 NREM sleep.  These sleep spindles directly correlated to learning aptitude.  If you want to make the most of your study time:  sleep is as important as the study time.  6hrs of sleep or less and you impact sleep spindles therefore your ability to learn. 

Why Sleeping pills may be problematic

The elephant in the room – this will be no surprise to many.  If you have ever needed to use a sleeping pill you will know its does not feel the same.  You wake up groggy, out of it and it takes a little longer to get going.  Your energy is just not there like it is after a good long natural night of sleep.  That is because the electrical type of sleep that sleeping pills (nonbenzodiazepines and benzodiazepines, sedative-hypnotics:   temazepam (Temaze, Normison), zopiclone (Imovane) and zolpidem (Stilnox) target the same area in the brain that alcohol does:  they stop your brain cells from firing.  This type of sleep is however lacking in the largest deepest brainwaves – which is why your sleep is not restorative and you feel groggy, forgetful and have slowed reaction times during the day.  The other thing to be aware of is rebound insomnia:  when you stop these medications you will often suffer worse insomnia – often causing people to become dependant or requiring increased dosages to get the same effect.  Interesting research has shown that there is actually no difference in how soundly individuals slept on placebo or sleeping pills – they only improve the time it takes to fall asleep. 

Most importantly sleeping tablets may cause more longer term damage:

So we have discussed that existing prescription sleeping pills are minimally helpful but there is a question around their potential to cause harm.   We understand that natural sleep cements new memories and lays down traces within the brain but did you know that drug-induced sleep caused a 50% weakening (unwiring) of brain cell connections?  This is a significant finding: sleeping tablet sleep causes memory to actually be “erased rather than engraved. Finally a study of hypnotics published in 2012 found a staggering increase in cancer and earlier death in those using these drugs vs those not.

http://darksideofsleepingpills.com/

Why?  Lets go back to what natural sleep does:  it is one of the most powerful boosters of our immune system:  if our immune system is not working correctly then cancer incidence will increase, heart disease – remember the effect it has on blood pressure?  Melatonin plays a protective role in multiple cancers:  breast and colon hitting the top of the list. 

Sleep Hygiene Checklist:

1. First things first:  Give yourself a non-negotiable eight-hour sleep opportunity EVERY night
2. Reduce caffeine and alcohol
3. Remove screens from the bedroom – this should be a restful space cueing the body for relaxation.  (ideally 1hr before you intend to fall asleep)
4. Establish a regular bedtime routine to support your circadian rhythm
5. Go to bed when sleepy – avoid falling asleep in the couch.
6. Avoid daytime napping if you can’t sleep at night (this negatively impacts Adenosine levels)
7. Avoid anything that is likely to increase stress / cortisol before bed – leave significant discussions to the first part of the day / watch scary movies early in the evening 
8. Increase physical activity during the day (early is best)
9. What you eat impacts sleep:  a high glycaemic index diet decreases NREM sleep and more awaking at night  (have good quality protein and lots of vegetables in the evening) 

If you are struggling with sleep, I think you can see there are 101 reasons why you need to make it your TOP PRIORITY:  book a consult with me today so that we can assess the cause and contributing factors of your insomnia and help support deep restful sleep for your health and wellbeing not only today but disease prevention in the years to come!