“Sleep is the golden chain that binds health and our bodies together”. – Thomas Dekker
As a primary care physician, I often see patients whose main complaint is insomnia. These individuals have dealt with it for much of their lives and many have given up hope that they will ever achieve a “good night” of sleep. In my search to find a solution for these patients, I came across the work of clinical psychologist, diplomate of the American Board of Sleep Medicine, and Fellow of the American Academy of Sleep Medicine, Michael Breus, PhD. He has devoted his career to researching the intricacies of sleep, and I have done my best to distill some of his work in this blog post.
What is a “good night” of sleep? There are many misconceptions regarding sleep.
The most common one is probably that every human requires eight hours of sleep to feel their best. However, this is not true. Our sleep requirements are as unique as our fingerprints, and they are constantly evolving—changing with age, seasons, diet, etc. For example, women generally require more hours of sleep in the first half of their menstrual cycle than the second due to hormonal changes. Ironically, many patients’ sleep troubles are worsened by the anxiety that they are not able to achieve this idea of a perfect eight hours. The first step to improving your sleep may be freeing yourself of this rigid idea, giving yourself permission not to need 8 hours.
Another common misconception regarding sleep is the idea of “catching up” on sleep. Many people think they can get through the week with hardly any sleep, with plans to catch up on the weekends. However, the human brain does not work like this, allowing you to make “large sum deposits” to your sleep deficit. Instead, the consistency of your sleep schedule is actually what makes you feel energized, rested, and clear headed. Hopefully, this post will teach you how to use your own rhythmic sleep patterns to your advantage in order to feel your best, by working with your body, not against it.
What is a Chronotype?
We all have a master biological clock ticking away inside our brains, but not everyone’s clock keeps the same time or even the same pace. If you’ve ever heard someone say, “I am not a morning person,” there’s actually a reason for that. Based on general morning or evening preferences, different people fall into different classifications or “chronotypes.” Interestingly, these subtypes have been found to be associated with particular gene variants (PER3 gene) and can actually be seen on widely available DNA tests like 23andMe.
The 4 Chronotypes:
These are the early birds. As natural leaders, they are also generally very orderly people who enjoy making lists, crossing off tasks one by one. They tend to focus best between the hours of 8am and 12pm, and the ideal sleep schedule for a lion is
from 10pm to 6am.
This is the most common chronotype, comprising about 50% of Americans. They are found in the “middle ground” and are generally extroverted and successful in the working world since our society runs on the 9-5 “bear” schedule. They focus best between 10am and 2pm and should aim to sleep from 11pm to 7am.
These are the “night owls.” As a group of creatives, they are very introspective, and are often musicians, actors, and artists. They perform best between the hours of 5pm and 12am and would ideally sleep from 12am to 7:30 am.
Highly intelligent but sometimes scatterbrained, these people commonly have true insomnia, or inability to sleep, as well as trouble with general anxiety. Dolphins may find they are most productive between the hours of 3pm and 9pm and should aim to sleep from 11:30pm to 6:30am.
Five Steps to Get Good Sleep
1. Learn your chronotype and wake up at your chrono typical wakeup time.
To better understand your biological clock and find which chronotype best fits you, take this quiz here.
2. Avoid any caffeine after 2pm regardless of chronotype.
Even if you are the type of person who can fall asleep after having a cup of coffee, caffeine still decreases your quality of sleep very dramatically. It prevents stages 3 and 4 of sleep, the stages during which physical restoration occurs.
3. Don’t drink yourself to sleep.
More people use alcohol than any other sleep aid in the world. Alcohol completely obliterates restorative stages 3 and 4 of sleep. It is also a diuretic, amplifying dehydration when you already lose about one liter of water per night of sleep via mouth breathing anyway.
4. Exercise daily.
Even 20 minutes of daily exercise has been shown to improve quality of sleep. Cardiovascular exercises like biking, running, swimming generally have more effect than static exercises like weightlifting. An important note about exercise is its ability to raise core body temperature. A good night’s sleep requires a drop in core body temperature, so be sure to complete exercises about 4 hours prior to going to bed.
5. Maintain a healthy wake up routine.
Always have about 15 ounces of water at bedside. As soon as you wake up, drink all 15 ounces, take 5 deep breaths and walk outside or near a window for 15 minutes of sunlight. The naturally occurring blue light in the sun turns off melatonin release when it reaches certain receptors in your eyes. This routine should clear any residual brain fog, allowing you to start your day.
Food and Sleep
There are countless studies regarding food and sleep with varying results. The most important tip I can give you is to find what works best for you, perhaps by keeping a food journal of daily intake, rating each night’s sleep, and looking for patterns. If that seems daunting to you, here are a few basic insights that are generally agreed upon by researchers.
Eating more animal protein can change your microbiome, the colony of healthy bacteria living in your digestive system, which can negatively affect your circadian rhythm. The Mediterranean Diet (mostly fish, veggies, and whole grains) is generally best for sleep according to current data.
Having a small snack before bed can prevent the blood sugar dip and resulting cortisol rush that occurs while sleeping, causing some to wake up in the middle of the night. Ideally, this snack would be about 200 calories, and a good balance of carbs and protein or fat.
Temperature and Sleep
Although less commonly discussed, temperature is equally important as light in regard to melatonin release. In order for adequate melatonin activity, the core body temperature must drop. To ensure this happens, avoid exercise prior to bed as above and aim to keep your bedroom on the colder side, about 65 degrees.
The partners of snorers lose an average of 1 hour of sleep per night. Aside from having the snorer manage his/her snoring by treating nasal congestion, wearing an internal nasal dilator, losing weight, or seeing a sleep specialist, the partner can wear earplugs or build a pillow wall to physically block disruptive soundwaves.
Technology before bed
Obviously, avoiding screens at night is best. Putting your phone on airplane mode, plugged in across the room will prevent you from nighttime scrolling. Blue-light blocking glasses are becoming more popular and widely available.
Try using a “worry journal.” Fill the left-hand column with your concerns. In the right-hand column, write down ONE step toward a resolution for each. Your mind works in mysterious ways, and having resolutions to your concerns permits a more restorative sleep.
Take Home Points
1. Consistency is key!
2. Learn your chronotype to work with your body, not against it!
3. Call my office at 985-807-1937 to schedule an appointment with me to discuss your sleep concerns.
3. If interested in the work of Dr. Breus, check out his website below or purchase his book, “The Power of When” or check out his website.
The information and other content provided in this blog, or in any linked materials is not a substitute for professional medical expertise or treatment.