Beyond Counting Sheep: Tips for Sleep
Getting good quality sleep of sufficient duration is absolutely vital to health, but its importance is often understated. It can be one of the first things we sacrifice when life gets busy; setting the alarm an extra hour early to fit in those all-important tasks before going to work may seem like dedication, but it could be having a much longer term detrimental impact on your wellbeing. I see plenty of patients for whom sleep is a major issue - not because my patients are atypical, but because they proportionally represent the general population. Sleep is a big issue for people across the UK and beyond, and lack of it is a major contributor to perceived poor quality of life, stress and depression, amongst other things. Given that these are in themselves indicators of poor health, and all lead towards much poorer health in general, addressing any issues with sleep is an important aspect of the holistic approach in functional and lifestyle medicine.
Contrary to popular belief, there is no set requirement for how much sleep we require. Some people function entirely well on 6 hours; others need 8. It varies from person to person. However, the UK population reports sleeping less now than they did 10 years ago - in fact, we are now reportedly sleeping 25% less than we did 60 years ago. This may possibly be related to an increased prevalence of conditions such as those listed above, but it is indubitably linked to a change in our culture and lifestyle. I'll go into more depth about the effect of smartphones and screen time on our sleep in a bit; spoiler alert: the effect is not positive.
We need sleep to give our body a chance to repair, replenish and recuperate, as well as to lay down memories, and recharge our immune system. Better sleep is associated with a reduced risk of being overweight, developing chronic conditions such as type 2 diabetes, and a reduced risk of developing Alzheimer's. Over time, if we under-sleep chronically, we accrue a sleep debt - and that's not something we can repay through a few extra hours on a couple of nights. Aside from increasing the risk of developing the health conditions, a sleep debt also decreases cognitive function, performance at work and the risk of being in a road traffic accident. If you struggle with sleep, or are cutting corners with it, it really is something that you would benefit from addressing.
For those suffering with poor sleep (reportedly a third of the UK adult population), there can be some handy ways to help, including eliminating some of the habits which may be contributing to poor sleep:
1. Go Dark. Ideally you need to be in a completely dark environment to be able to sleep. This triggers the body to release melatonin, which helps us to sleep, and it's a really important factor in establishing and maintaining our circadian rhythm. And I do mean complete darkness - using blackout curtains, switching off your electronics (no red LED standby lights), and getting rid of that glowing alarm clock can all be helpful in achieving this.
2. Cut the screen time. The growing tendency for us all to sit in front of screens - be that television, computers or phones, means that we are absorbing a whole lot of blue light from them. Blue light wakes us up. Ideally, you need to be staying off screens in the couple of hours leading up to bedtime, but if you're a bit of a screen addict who likes to catch up on the news or uses TV to wind down, there are options to help. Some phones have a setting to dim the display brightness at a time you can set - otherwise there are apps available to do this for you. Alternatively, if you're feeling dedicated, amber glasses can reduce how much light you take in. Don't underestimate the impact of screen time on your sleep quality - this is the number one change that makes a difference for patients I recommend it to.
3. Enjoy the light. Just as we need darkness to set our circadian rhythm, so too do we need light. Spending some time in the daylight in the morning helps to set our body clock. I mean natural daylight - not sitting in a brightly lit office! Even on a cloudy day we get a huge amount more light from natural daylight than we do from indoor lighting. Get out and walk the dog, park your car further from work so you spend longer outdoors before getting into work, or even sit by the window when you eat your breakfast. If the thought of having to do anything extra before work makes you want to cry, settle for the next-best thing; get out in daylight as soon as you can during the day - whether that's a mid-morning break or at lunch time. 20 minutes or so should do the trick.
4. Actively wind down. Our body needs time to get ready for sleep. Simply jumping into bed and switching the light off doesn't give your body that time to adjust towards sleep, and a busy head is cited as the reason for poor sleep by many. This can be partially due to a lack of bedtime routine - i.e. not gently winding down to sleep over the course of the evening. Find something relaxing to do in the hour or so leading to bed time. Try not to watch anything too stimulating or upsetting on television - the news can be particularly stressful at the moment! Read a book in dimmed lighting, have a lovely relaxing bath, sit and chat with your partner or loved one.
5. Stick to a routine. Maintaining a fairly regular sleep pattern is really useful - going to bed around the same time, and waking up around the same time ensures that there is no disruption to the rhythms we have set. Shift work makes that difficult, unfortunately, but for the rest of us, sleeping at relatively fixed hours can help. If you end up having a late night, grab a cat nap in the day, and then go to bed at your usual time, rather than ploughing through the day and then going to bed early.
6. Limit your caffeine intake. If you're a caffeine fiend, this may well be contributing to the issue. There is nothing wrong with a morning coffee if that's what makes you feel human at the beginning of the day - but try to leave it there if you can. If you drink caffeinated drinks beyond lunch time, there will still be caffeine floating around your system by the time you go to bed at night - you know it wakes you up, so you know it's no good having it in your system when you're trying to sleep!
7. Exercise. Apart from the feel-good effect of exercise, and all of the physiological benefits it brings, it can also aid in getting good quality sleep. Try not to exercise within a couple of hours of bedtime though, as it has a stimulating effect.
8. Try mindfulness. If stress is an issue, apart from winding down in the evening time, incorporating some mindfulness into your day can provide your mind with some vital 'breathing space'. Practising mental stillness not only aids sleep, but improves focus, capacity and soothes and calms too. In an increasingly busy and stimulating world, mindfulness can be your oasis. There's lots of apps about to help you get into the swing of it - I often recommend Insight Timer, Calm, and Headspace.
Finally, there are supplements and changes to your nutrition that may help you with sleep - supplementing or changing your diet to add magnesium is the main one I recommend. However, approach this with caution - it can interact with medications if you take any, and is associated with causing stomach upsets in some forms. Speak to a practitioner to work out whether it's safe for you to use, and which form to take in order to lessen the likelihood of unpleasant side effects.
These are all simple lifestyle orientated changes that you can make yourself. If, having tried all of these, you're still struggling, do consider going to your GP. It may be that your poor sleep is down to a medical condition such as sleep apnoea, or another sleep disorder. It's worth talking this over if you're struggling; sleep is a key component in creating and maintaining health. Sleep well, live well!
Do you think you might be in need of a lifestyle MOT and some detailed professional advice, tailored to you, to address all of the contributors underpinning your health and quality of life? If so, I can help. Book in for a no obligation scoping call to discuss what I can do for you in my Lifestyle Medicine clinic.