by Keri Ashkenazy
Holistic Health Coach | Mindfulness Meditation Teacher | M.A. in Social-Organizational Psychology
The bees do it, bears do it, even educated fleas do it. Let's do it...let's fall asleep!
Okay, so the above actually refers to song lyrics from Ella Fitzgerald’s famous ballad, persuading us to all “fall in love” (not fall asleep). However, I think one of the best things we can do for our overall health and well-being (perhaps second to falling in love) is to prioritize enough high quality sleep.
I hear you say, “But, Keri, I don’t need sleep to function. I get by just fine on my five hours a night.” And I would reply, “That’s nonsense, poppycock, mullarkey, balderdash...,” and that would be my way of kindly calling you out on your misperception.
Unless you happen to be among the 3% (or less) of the population who have the short sleep gene (known as DEC2), then you need somewhere between seven and nine hours of sleep a night. Any less and you are putting yourself at risk for a weakened immune system and serious medical conditions, including obesity, heart disease, and diabetes; as well as serious cognitive impairment. Sleep is so vital to our health, the Center for Disease Prevention and Control (CDC) named insufficient sleep as a public health epidemic.
Show Me the Numbers
● Approximately one in four people today experience some sort of sleep disturbance.
● 35% of adults don’t get enough sleep (seven hours a night) according to the CDC.
● 40% of people age 40 to 59 reported that they are getting less than the recommended amounts of sleep.
● 37% of people between 20 and 39 years-old reported short sleep duration.
● 20% of teenagers get less than five hours of sleep, while the average amount is six and a half hours.
These are stunning numbers, considering how crucial sleep is for our bodies to function properly.
So, why is sleep so important? I’m very glad you asked!
When we sleep at night, our bodies can take the extra energy it uses during the day to help our muscles and brains function, and redirect it toward building up and maintaining a healthy immune system.
A lack of sleep not only causes the immune system to go awry and makes you more susceptible to viral and bacterial infections, but it also leads to the breakdown of what doctors call “immune self-tolerance” (your body’s ability to tolerate its own immune system), which triggers autoimmune diseases.
What’s worse is that multiple studies confirm a reciprocal link between sleep and the immune system, meaning sleep loss impacts the immune response (as mentioned above), and the immune system, in turn, alters sleep patterns by changing how the brain processes signals, as well as how the brain regulates sleep. And in the case of ongoing, persistent and chronic inflammation, the body requires much more energy, meaning you have to sleep longer to have enough energy.
What’s also interesting is that, according to Dr. Matthew Walker, sleep is not like “the bank.” You can’t accumulate a debt and then hope to pay it off at some later point in time. For example, if you under-sleep one night, your immune system is going to be compromised the next day. And for that day, while you are compromised, you have a higher risk of infection. Then, if you try to get some recovery sleep the following night, it doesn’t wipe away the damage that was done. You’ve suffered the vulnerability and there’s nothing you can do about it, except to prevent further damage in the future by getting enough sleep.
The New Curse Word: Autoimmunity
I said it, “autoimmunity,” so now I hope I have your attention.
According to the National Institutes of Health (NIH), autoimmune diseases are estimated to afflict over 20 million individuals in the United States. Currently, there are over 100 recognized autoimmune diseases, and the prevalence of many autoimmune diseases continues to rise.
Hashimoto’s thyroiditis, lupus, multiple sclerosis, psoriasis...oh my! I’d bet my bottom dollar you or someone else you know is suffering from an autoimmune condition.
The major factors that contribute to the development of autoimmunity are genetic susceptibility and environmental triggers, which means you have the gene that makes you susceptible and then something in the environment triggers that condition to manifest. These environmental triggers can include infections and toxins, which functional medicine doctors can help you address. However, there are no number of pills, supplements, magical elixirs, herbs or any other sort of treatments doctors can provide that will help you manage your autoimmune disease if your lifestyle factors are not simultaneously addressed. Bottom line: In order to manage our condition, we must reduce our stress, move our bodies, eat nourishing foods (specific to our unique bodies) and get adequate amounts of rejuvenating sleep.
Getting Back to Sleep... This is How We Do It.
By now, I hope you recognize the importance of sleep (if not, you can check out more scary statistics regarding sleep here), so now I want to share the latest and greatest tips in sleep hygiene from leading health and wellness experts.
Prepare your Sleep Space:
- Make your room as dark as possible. Invest in blackout blinds or curtains or simply use large, black, heavy-duty trash bags to cover your windows. Use tape to cover any other light sources in your room, including the small dots on your TV and your digital alarm clock. (You won’t think I’m crazy anymore after you see how much these moves will improve your sleep.)
- Eliminate all sources of artificial blue light. That includes the light that comes from your TV, computers, smartphones and energy-efficient light bulbs. Too much blue light disrupts your brain’s production of melatonin, a hormone that tells your body when it’s time to sleep, by up to 50%. Aim to shut down all electronic devices at least two hours before going to bed and instead read non-stimulating material or, even better, talk to your partner. You can also swap out your compact fluorescent bulbs (the curly ones) for red or amber bulbs. If you still want to read from your iPad, then you might want to consider investing in blue-light blocking glasses (here is an option).
- Adjust the temperature. The ideal room temperature for restorative sleep is between 65 and 72 degrees (18 to 22 degrees Celsius). You may want to invest in an affordable thermometer (such as this one) to keep track of room temperature. In addition, you can try to warm up your body temperature before bed with heavy pajamas or a hot Epsom salt bath and then remove your extra clothing to cool down before lying down to sleep. If you find that your bed keeps you hot and interferes with your sleep, you might also decide to invest in a cooling mattress pad (like this one).
- Reduce noise. Try to prevent any external sounds from waking you up by using earplugs or playing white noise from either a sound machine (like this one) or an affordable phone app (such as this one).
Maintain a Consistent Sleep Schedule:
- Aim to go to bed at the same time every night and wake up at the same time every morning, even on the weekends. Regularity is king. It’s what our bodies were designed to receive; and it will help anchor your sleep and improve both the quantity and quality of your sleep.
- Go to bed before you catch a second wind. Aim to be in bed with the lights off by 11 p.m. Past that point you might catch a “second wind,” a surge of cortisol (your stress hormone) that can keep you awake until 2 a.m. Please note, however, everyone is different. Some people are naturally early risers and tend to turn in early, while others do better staying up late and sleeping in the next day. Listen to your body and if you start feeling sleepy at 9:30 p.m., go to sleep. Again, regularity is king!
- Don’t remain in bed awake. If you’ve been trying to fall asleep or you’ve woken up and can’t fall back to sleep after about 20 or 25 minutes, then get out of bed and go to a different room to read a book or a magazine (nothing too stimulating) in dim lighting. The reason for this is that if you stay in bed, you are training your brain to think your bed is the place of being awake, not asleep.
- Consider monitoring your sleep. Some sleep apps (like this one and this one) can provide a range of data about your sleep (i.e, when you fell asleep and woke up); as well as identify your general sleep patterns and offer advice on how to improve it. If you have more money to spend, sleep devices (i.e, wearable rings and sleep headbands) can give you the most comprehensive and detailed analysis of your sleep. (You can check out this review by biohacker Dave Asprey for more information.
Prepare your Body:
- No caffeine at least 8 hours before bed. It’s more difficult to fall asleep and stay asleep if you have caffeine in your system. Even if you are able to fall asleep and stay asleep after that evening espresso, the depth of your sleep will be impaired, usually by about 20%.
- Limit evening alcohol consumption. You might think you fall asleep faster with that regular nightcap, but you’re just sedating the brain and disrupting your circadian rhythm. This means you’ll be waking up more times throughout the night, which will ultimately leave you feeling unrefreshed in the morning. Alcohol is also very good at blocking your rapid eye movement (REM) sleep, which is your deep dream-state sleep.
- No sugar for four hours before bedtime. This will help prevent a surge in cortisol, which would keep you awake.
- Reduce stress and anxiety. Here are some ways to do that:
○ Exercise. As long as you’re moving your body and getting your heart rate up, you will feel the benefits. However, when you’re exercising regularly, please note you will need more sleep because your muscle tissues require deep sleep to recover. In addition, be careful not to work out too close to bedtime because exercise might stimulate your body to release cortisol, preventing you from being able to fall asleep.
○ Develop a gratitude practice. Numerous studies show that a daily gratitude practice can make you happier, less anxious and more emotionally open. One way to cultivate more gratitude is to think about three specific things you’re grateful for each morning and write them down in a journal or tell a friend or family member. Alternatively, you can do this same practice before going to bed at night, which might help your brain wind down before sleep.
○ Meditation. Meditation helps take your mind out of unproductive worry, fear, guilt, and anxiety from the past and future, so you can bring your mind back to the present moment, ultimately helping you to reduce stress and anxiety. Please check out my previous post to learn more about meditation, the benefits of a regular practice and ways to begin.
- Nourish your body with healthy fats. Foods with high omega-3 fatty acids (e.g., sardines, wild salmon, walnuts and chia seeds) have been shown to improve sleep quality and help people fall asleep faster. In addition, foods high in saturated fats (like pastured butter or grass-fed beef) feed your myelin, the fatty sheath that insulates your brain’s wiring, which can help protect your brain and lead to improved sleep. As always, I suggest you work with your functional medicine doctor and/or health coach to determine if these foods are good for you and in what amounts.
- Consider taking natural supplements. Some examples include:
○ Melatonin. A powerful antioxidant and natural sleep aid, you can talk to your functional medicine doctor about taking an over-the-counter melatonin supplement 30 minutes before bed as needed to treat insomnia.
○ Magnesium. Science shows magnesium-rich foods such as leafy greens, avocado, wild-caught salmon, almonds and cashews can help improve your sleep. If you find you’re not getting enough from your diet, you could also supplement with 600 to 800 milligrams of magnesium a day. Another way to get more magnesium is by taking an Epsom salt bath before bed.
○ Raw honey. By taking 1-2 tablespoons before bed you can replenish your body’s liver glycogen, which your brain uses for energy at night. When your glycogen levels run low, your body thinks it’s running out of fuel and the resulting stress response could wake you up.
If you’ve tried everything and still aren’t able to fall fast asleep, Dr. Maurice Beer suggests the following exercises to his patients:
- Shut and roll your eyes. This might sound bizarre, but rolling your eyes when they’re shut is a surefire way to fall asleep fast. Rolling your eyes causes your brain to release melatonin, which, as we learned above, helps you fall asleep faster. Bonus: As you roll your eyes, think about your day (i.e., what you did, who you saw, where you went), which might also help your mind start to drift and make it even easier to doze off.
- Breathe through your nose (not your mouth). Most people subconsciously breathe through their mouth; however, according to Psychology Today, this actually has a “stress effect” on your brain, making it more difficult to fall asleep. By instead breathing through your nose, your sending relaxation signals to your brain, therefore helping you to fall asleep faster.
- Use reverse psychology. What happens when you say to yourself, “I’m not going to think about carrots.” I bet you started thinking about carrots...am I right? The next time you’re struggling to fall asleep, shut your eyes and tell yourself, “I’m going to stay up, I’m not going to sleep.” I think you’ll be surprised by how well this works.
I hope you’re starting to understand that sleep is the foundation for a long, healthy, happy and prosperous life. Please try out some of my recommendations above and, as always, our team at Integrative Medical NY is here to support you.
 LeBlanc M, et al. Incidence and risk factors of insomnia in a population-based sample, 2009
 Lange T, et al. Effects of sleep and circadian rhythm on the human immune system, 2010
Straub RH, et al. Energy regulation and neuroendocrine–immune control in chronic inflammatory diseases, 2010
 Palma BD, et al. Effects of sleep deprivation on the development of autoimmune disease in an experimental model of systemic lupus erythematous, 2006
 Dantzer RO, et al. From inflammation to sickness and depression: when the immune system subjugates the brain, 2008
 Bryant PA, et al. Sick and tired: does sleep have a vital role in the immune system? 2004