Lifestyle, behaviour and sleep
1. Stress management / relaxation
One of the primary causes of poor sleep or insomnia is anxiety or stress. For this reason, balancing and reducing your stress levels is a fundamental step towards better sleep. This could be through meditation, breathing exercises or relaxing exercise such as yoga or stretching, at any time of the day or specifically as part of a ‘down-time’ ritual before bed. Check out in particular the ‘HeartMath’ Quick Coherence technique, an easy breathing/meditation technique that can be done in as little as three minutes. (http://www.heartmath.com/quick-coherence-technique/)
Other practices that can help, include walking, spending time in nature, ‘grounding’ the body by walking outside barefoot, or taking Epsom salt baths. See also the section on ‘Preparing for sleep’ below for further tips and more details on Epsom salt baths.
Not only does stress affect our sleep, but lack of sleep increases our stress hormones (Spiegel, Leproult et al. 1999), causing a vicious cycle. We need to break the cycle!
2. Light, dark and circadian rhythm
Another important factor in good sleep is getting appropriate exposure to light over the day. This means maximizing your light exposure early in the day and reducing your exposure in the evening.
Getting enough daylight
Light exposure early in the day increases serotonin production, to help us feel more alert and energetic in the daytime, and helps to switch off melatonin production – the hormone that makes us feel sleepy at night. This synchronizes the circadian rhythm, and so getting enough light during the day actually helps to increase melatonin production at night, an effect that is proven in clinical trials (Obayashi K et al, 2012).
To maximize your daylight exposure:
- Open the curtains or blinds as soon as you get up to let in natural light.
- Walk at least part of the way to work or take a walk outside in the early morning so that you are in full daylight for at least 15–20 minutes. Maximise your time outside during the daylight hours – for example taking a 15-minute walk during a work break or at lunchtime, and eating your lunch outside, if you can.
- If you work indoors, try to work as near to a window as possible. A study of 49 workers found that those who worked in windowless environments had poorer sleep and more sleep disturbances compared to those who had good daylight exposure at work (Boubekri M et al, 2014).
If you can’t get enough natural daylight, then bright light therapy (a light box) may help. Light boxes emit a blue light that mimics the effect of daylight, and they are used to help people with circadian rhythm sleep disorders and insomnia, as well as mood disorders such as seasonal affective disorder (Shirani & St. Louis, 2009). Look for a light box that emits 10,000 lux of light, equivalent to full daylight. They are available from Amazon.
Reducing light exposure in the evening and at night
Thanks to the advent of electric lights – as well as electronic devices such as televisions, computers, tablets and smartphones – we have more exposure to bright light in the evenings than we should. Electronic devices could be particularly disruptive as they produce more blue light, which is similar to daylight and has a greater effect on suppressing melatonin production.
To combat this effect:
- Use low-level lighting in your home in the evening.
- Avoid using your electronic devices in the last 1.5 to 2 hours before going to bed. If you use a tablet for reading, then use a dim light setting or a black background. Or if you need to use these devices in the late evening, then:
- Download free software from the website f.lux for your computer – this makes your computer emit a warmer light in the evening, with the aim of minimizing disruption to your melatonin production.
- You can also download blue light filter apps for some smartphones and tablets, for example ‘Blue Light Filter’ for Android.
- Buy a pair of blue-light blocking sunglasses, which can be useful for watching TV or for using a computer, smartphone and so on (again, available from Amazon).
- Make your bedroom as dark as you can: avoid alarm clocks that have a bright display or any other bright lights on electronic devices (or cover them), and if your room is bright in the mornings, invest in black-out curtains, or try a sleep mask.
- If you have to get up in the night, use a dim night-light or torch or low-level lighting instead of switching on a normal light.
3. Sleep patterns and duration
The US National Sleep Foundation recommends that the optimal amount of sleep for adults is 7–9 hours. In fact, it’s been found that getting less than 6 hours sleep or greater than 10 hours is associated with greater risk of obesity, heart disease, stroke and diabetes (Liu Y et al, 2013). So, most of us need to aim for at least 7 hours sleep a night: this means planning your bedtime and getting ready for bed well in advance of the time you need to actually be falling asleep. See the section below on ‘Preparing for sleep’ for more on this.
It’s also thought that consistency of sleep times and wake times helps with optimal sleep – this means going to bed and getting up at the same time each day. Consistency helps to regulate our circadian rhythm so that melatonin is secreted at the right time. This can be hard to keep to on your days off, but if you are sleeping optimally throughout the week, then you shouldn’t have a problem waking up at the same time every day!
Lastly, what time should you go to bed? There is a theory that our quality of sleep before midnight is better than after and so we should aim to be asleep by 11pm. Some researchers, however, say this is false and we should simply calculate when we need to be asleep to get our 7 or 8 hours and wake up on time (e.g. if we need 7 hours, and need to be up by 6.30am, then we need to be asleep by 11.30pm). (http://www.wsj.com/articles/whats-the-best-time-to-go-to-bed-1412031660) However, if you are experiencing chronic stress or fatigue, Dr James Wilson – a renowned expert on adrenal fatigue – advises making sure you are in bed and asleep before your ‘second wind’ of energy hits about 11pm (Wilson J, 2001). This advice could also apply to overtraining syndrome.
4. Preparing for sleep
As well as avoiding use of electronic devices before going to bed, the following practices can help prepare you for a good night of sleep.
The ‘brain dump’. This is especially important if you tend to be a worrier, or if ‘buzzing thoughts’ keep you awake at night. Worrying in bed can impact subjective assessments of sleep quality (how well people feel they sleep) as well as physical measurements such as heart rate (Weise et al, 2013). Before you go to bed, write down anything that is going through your head – whether it be tomorrow’s to-do list, things you have to remember to take to work in the morning, or just any concerns or thoughts that might be bothering you. This will help clear the mind and aid relaxation.
Wind down. Whether stressed/worried or not, taking at least half an hour to wind down before going to bed may be important. This may involve a relaxing activity such as reading, or having a bath or shower (see next point).
Soak your troubles away. Having a hot bath or shower before bed may help to relax you and improve your sleep. This has been investigated in clinical studies, with one study on nine female volunteers finding that those who had a warm bath or foot bath had shorter sleep onset latency (time taken to fall asleep), reduced body movements during the first 30 minutes of sleep, and participants reported better sleep compared to those who had no bath (Sung & Tochihara, 2000).
Putting Epsom salts (magnesium sulphate) or magnesium chloride flakes into your bath may be especially helpful. Magnesium is a key nutrient for calming the nervous system and for sleep. It’s also essential for blood sugar management, for energy production, for normal muscle function and for electrolyte balance in our cells. Magnesium absorbs well through the skin, and although individual responses to magnesium supplementation and baths vary massively (some people’s serum levels simply do not respond), we have had success with many athletes following magnesium supplementation. Pour 400g of Epsom salts or magnesium flakes into a hot bath and soak for 20-40 minutes. Repeat twice each week.
5. Creating the right sleep environment
We’ve seen how keeping your bedroom dark can help you to sleep better. The following are also recommended for improving your sleeping environment.
- Check your room temperature. Either too hot or too cold can affect your sleep. The optimal temperature is between 18–22°C, but it’s whatever feels most comfortable to you. (http://www.webmd.com/sleep-disorders/features/cant-sleep-adjust-the-temperature)
- Keep your bed just for sleep (and sex, and potentially reading, if you find it relaxing). Working in bed, watching TV, sending emails, and so on, takes away from the association of your bed with sleep.
- Address noise levels. Being in a noisy environment is one of the most common factors causing sleep disturbances, as any of us with a partner who snores can testify! Do what you can to block or limit noise – use ear plugs, or try putting on ‘white noise’ which can be a fan or air conditioning, for example.
6. Exercise and sleep
It is important to be active if you want to sleep properly. Physical activity during the day tires you out and makes it more likely your eyes will be closing by the time your head hits the pillow. The US National Sleep Foundation 2013 ‘Sleep in America Poll’ found that people doing any exercise at all were more likely to report having ‘fairly good’ or ‘very good’ sleep compared to those who were doing no exercise (83% vs 56%). Those who did vigorous exercise (e.g. running, cycling, swimming or competitive sports) reported having the best sleep.
Specifically, it’s thought that exercise may help sleep by increasing serotonin levels (Melancon et al, 2014), and may also help by affecting body temperature regulation (Atkinson & Davenne, 2007).
HOWEVER:
- For some people, exercising too vigorously, too late at night, can negatively affect sleep. This may be through raising heart rate and body temperature, as well as the stress hormone cortisol. It is best to plan your hardest workouts for earlier in the day, allowing at least 3-4 hours before you hit the sack.
- If your exercise-induced pain and lack of recovery is preventing sleep, then (I can’t believe I’m saying this!) stop intense sessions and try to choose easy, relaxing, non-competitive forms of exercise.
Gentler exercise or stress-relieving exercise can include:
- Walking with friends – talking will also help you get 'out of your own head'
- A light-jog or slow cycle is another great way to get fresh air
- Fishing is not very stressful… (unless you're the fish!)
- Yoga and Tai Chi are commonly cited as being good for stress and having a calming, grounding effect on the mind and body.
7. Waking up
How you wake up is also important to how rested and restored you feel after a good night’s sleep.
Using a standard alarm clock can wake you up in a phase of deep sleep. This makes you feel tired and groggy when you wake, and more likely to need a coffee or two to get you going in the morning. We all know that feeling! An alternative is to use an ‘intelligent’ alarm that wakes you up at an optimal point – your lightest sleep – over a window of time that you set, say 30 minutes. You can buy a wristband for this, but a cheaper alternative is to download a smartphone app such as Sleep Cycle or Sleep Bot on Android or iPhone.
Many people also find a dawn simulation light or alarm clock helpful. A recent study at University College London found that participants using a dawn simulation light starting 30 minutes prior to waking rated their sleep quality as better and showed improved cognitive and physical performance compared to the control group (Thompson A et al, 2014).
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