Insomnia, disturbed or restless sleep! What's hurting your sleep and what to do about it.

twinsfisch-GFKPATimbvM-unsplash.jpg


Sleep deprivation has been linked to:

  • Increased levels of obesity - lack of sleep increases levels of the hunger-inspiring hormone ghrelin, and decreases the levels of leptin, the satiety hormone leading to increased calorie intake and weight gain.

  • Diabetes - sleep deprivation can cause blood sugar dysregulation.

  • Cardiovascular disease - the increased dominance of sympathetic nervous system with lack of sleep increases blood pressure and heart rate, and damages / weakens vascular integrity, making one much more prone to atherosclerosis.

  • Cancer - sleep deprivation increases metastasis.

  • Immune disorders - sleep deprivation weakens the immune system.

  • Alzheimer’s - getting too little sleep over the span of one’s life increases risk of developing Alzheimer’s significantly.

  • Mental health disorders - sleep disturbances are associated with every psychiatric disorder – although causal direction is still unknown).

  • Decreased fertility rates - sleep deprivation decreases testosterone markedly in men and FSH in women.

  • The likelihood of experiencing just about any disorder – physical or mental – is increased with lack of sleep.

If you're not getting enough sleep and it’s affecting your mood, health and your life, here are some factors that could be worth exploring.

What’s hurting your sleep:

Diet

Are you eating a nutrient dense, whole foods diet with very few if any refined carbohydrates and processed food? The more balanced the diet, the better your sleep will be. Include lots of vegetables, some fruit, whole grains, good quality protein and healthy fats.

The last meal of the day should end at least 3 hours before going to bed. Eating a full meal too close to bedtime will make it difficult to fall asleep and can also lead to interrupted sleep. If you are eating any starchy carbs, eating them at dinner time and going a little lighter on fat and protein can have a beneficial impact on falling asleep, as the carbohydrates will increase production of sleep-promoting, feel good neurotransmitters such as serotonin, which can help initiate sleep.

While it’s not recommended eating a full meal before bed, sometimes a small snack can be beneficial. If night waking is an issue due to low blood sugar in the middle of the night, you can try eating a small snack before bed. A good snack could be nut butters which are higher in fat, full fat yogurt which is more of a balance between fat, protein and sugars, or raw honey which is all sugar (the thinking here is to fill up those liver glycogen stores).

Minimizing if not completely avoiding alcohol can also have a remarkable influence on sleep. Another obvious but important factor is to minimize water intake at the end of the day. Try wrapping up your water consumption at 6 pm (or 3 hours before bedtime) and only sip on a cup of soothing herbal tea before bed if it doesn’t cause any night wakings to urinate. If you are a coffee drinker, try not to have any caffeine after noon as it can take up to 8 hours for the body to fully metabolize it.

Fasting or any kind of calorie restricting may affect your sleep. Individuals who are fasting or being in a low calorie diet will sleep less since the brain is essentially tricked into thinking food has become scarce and is alert and hunting for more.

Stress and emotional state

Not much to say here as we all know how stress and emotional state affect our sleep. Trying to avoid or reduce stress can have a big impact on improving sleep.

Exercise

Exercise and sleep are mutually beneficial. Exercise promotes better, more restful sleep and good quality sleep enhances exercise performance. How you exercise and when you exercise can have an impact on your sleep negatively as well. Doing rigorous exercise within 3 hours of bedtime will make it challenging to fall asleep because it raises your body temperature, your heart rate and increases the secretion of stimulating hormones such as adrenaline. Restorative yoga or a nice evening walk, however, aren’t going to have the same physiological impact of a hard workout but be mindful if falling asleep is a problem. With that said, a good HIIT workout - high intensity interval training - of 10 to 20 minutes about 3-4 hours before bed can be very helpful in falling asleep.

Light exposure

Light exposure plays a critical role in sleep, both the proper exposure to natural sunlight and blocking off artificial lights later in the evening. To enhance and leverage your body’s natural circadian rhythm, its best to get some sunlight as early in the day as possible, ideally within the first couple of hours of waking (at least 20 minutes). Even on a cloudy day, you will receive the benefits of this natural daylight.

Later in the day, especially in the 60-90 minutes before bed, dim the lights and avoid fluorescent and incandescent light bulbs if at all possible. Also, turn off all screens - TVs, laptops, tablets, phones - in those last 60-90 minutes before bed. If it’s impossible to avoid screens or to dim the lights, then use light blocking glasses.

EMFs

EMFs have a profound impact on our health and our sleep. EMFs reduce melatonin production, reduce total sleep time overall and sleep efficiency.

Here are some ways to minimize EMF exposure in the bedroom:

  • turn off house WiFi - this helps even if there’s WiFi from your neighbors

  • keep cell phones out of the bedroom (and if you must have them in the bedroom, keep them on airplane mode)

  • keep other wireless and screened gadgets out of the bedroom

  • minimize electronics in the bedroom (including digital clocks)

  • keep fluorescent light bulbs out of the bedroom

  • make sure your mattress doesn’t have metal coils, springs and frames (the springs act as one big conductor)

  • there are also apps that you can use to dim and block specific light spectrums on your screens

Sleep environment

A good sleep environment is essential to a good night’s sleep. Bedroom should only be used for sleeping and intimacy (and reading before bed). This isn’t where you bring your laptop to catch up on emails, or where you do your workouts, etc. Your bedroom should be simple and clean with a good bed and a great mattress and pillows. You want to be supported, no metal, and have a mattress that allows airflow. The memory foam mattresses are supportive but they often almost suction to your body. So, get one that has memory foam core with other technologies on top of it to allow for airflow.

Your bedroom should be dark so consider blackout curtains and/or a sleep mask.

Sound is another factor. The quieter the environment, the better. Avoid noise machines as these can actually cause brain damage, especially in small children. Good old fashioned ear plugs can be very helpful when you have minimal control over your environment.

Body temperature

In addition to sleep pressure and melatonin production, one of the triggers that tells our body it’s time to sleep is a drop in our body temperature. In fact, our body temperature has its own circadian rhythm where it rises to peak temperatures in the late afternoon, and then starts its fall, reaching its lowest point about 2 hours after we’ve been asleep. You may have noticed that it’s much harder to sleep when it’s hot than when it’s cold.

Some strategies for optimizing body temperature for sleep:

  • keep the room cool - as cool as you can tolerate

  • if it’s hot outside and you don’t have air conditioning, apply a cold washcloth on your forehead at bedtime and try soaking your feet in cold water before you get into bed

  • get into a sauna or have a hot bath (it’s not actually the warming that gets you ready for bed, but the subsequent drop in temperature when you get out of the bath or sauna that inspires sleep)

  • also there are new bed-cooling technologies like the Chillipad that will cool the mattress

Blood sugar regulation

If you are struggling with sleep maintenance insomnia, where you fall asleep but then wake in the night and can’t get back to sleep, there are several likely physiological challenges that could be contributing to the situation.

The first, and most common issue, is poor blood sugar regulation. Specifically, a blood sugar crash in the middle of the night. When blood sugar levels dip too low, and if the liver ins’t able to mobilize glycogen stores quickly enough, your adrenal glands will come to the rescue, and secrete a rush of the hormones cortisol, adrenaline and noradrenaline to force glycogen into the blood. These hormones are very stimulating and this can wake you and then keep you up. One strategy for handling this is to eat a small snack before bed but that’s not solving the root cause. You want to support and address the hypoglycemia so that you don’t have these middle of the night crashes (well balanced diet!).

How to tell if it’s a blood sugar crash that’s causing the night waking? Doing a fasting blood glucose test on waking will let you know what that morning glucose looks like as well as looking at LD (Lactate Dehydrogenase) which will be depressed with reactive hypoglycemia. The other is to see if that pre-bed snack works. If it does, you’ve likely found your culprit and your strategy is to mitigate the hypoglycemia with dietary adjustments and appropriate supplementation.

HP Axis dysregulation and other hormone imbalances

A close companion to blood sugar dysregulation is Hypothalamus-Pituitary Axis dysregulation, which is a break somewhere in the chain of command between the hypothalamus, the pituitary and the adrenals. This can interrupt the body’s natural circadian rthythm and cause night wakings. The only way to know if this is a factor is to do adrenal testing. Other hormonal imbalances such as low progesterone can also impact sleep so testing in necessary to know what exactly is going on.

Vitamin D deficiency

There’s new research that has connected vitamin D deficiency to difficulty with sleeping, so testing your vitamin D levels and ensuring sufficiency is a relatively easy and doable strategy.

Immune activation

The immune system does the bulk of its work at night and this can have a stimulating effect. Consider that one of cortisol’s many roles is as an anti-inflammatory agent. If there is inflammation, which is a process of the immune system, then cortisol will engage to anti-inflame, which can be stimulating. Looking at a blood test can give us a sense of whether immune activation is a piece of the puzzle (looking at white blood cell levels and differential). Also, any gut infection and food sensitivities will cause this kind of immune activity and is one of the most common reasons the immune system is engaged so it’s important starting with a gut.

Gut health

Speaking of gut health, there has been fascinating research showing that the microbes in our gut have their own circadian rhythms and when they are out of balance, it can affect our circadian rhythm as well. Also, parasites in particular have been shown to trigger ammonia release in the brain at night which is one of the triggers for teeth grinding and also can increase wakefulness. So, again, testing the gut and addressing the findings is crucial.



Source: Restorative Wellness Solutions