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Last year, we lost sleep: working at odd hours, worrying about the future, about falling ill, about financial security. The time we saved on the commute or evenings out didn’t always translate into better work-personal life balance. Instead, confinement and anxiety turned many of us into night owls.
Insomnia is never good news. While it is a nascent subject, sleep research tells us that without the right amount of zzzs (different for each of us) our reaction time slows down, our attention becomes short and scattered, and we risk the increase of serious health problems such as cardiovascular disease, diabetes, dementia and Alzheimer’s. It is not just social distancing that’s becoming the new norm, it is tiredness from lack of sleep, too.
Even as studies look into sleep as the latest casualty of the pandemic — a recent review of Covid-19 sleep research by Northumbria University, of over 50,000 people from 13 countries, indicated that around 40% have experienced sleep problems — research is exploring if melatonin, the hormone that regulates the sleep-wake cycle, could play a role in the fight against Covid-19 (preliminary research was published in PLOS Biology, the peer-reviewed scientific journal). The bottom line, sleep is key.
So this year, why not pay attention to the night rather than the day? Not only will it help you get up on the right side of the bed, but there are also added benefits such as better cognition and memory consolidation. Dr Abhinav Singh, Medical Director of the Indiana Sleep Center in the US, who has practised sleep medicine for 15 years, gives
The Hindu Weekend a two month, step-by-step guide to better sleep.
Week 1: Turn off the (night) light
The bulb heralded the death of sleep
Thomas Edison patented the light bulb in 1879, and while we can’t blame him for today’s light pollution, “light has been rapidly invading our nights”, says Dr Singh. Physiologically, our bodies are not designed to experience light at night, as it upsets the circadian rhythm, the body’s natural sleep-wake cycle. “When the sun sets, it is a signal for the hormone melatonin to cyclically rise. When you expose yourself to bright artificial light, it suppresses your melatonin,” he says.
Take away
* Don’t wear sunglasses in the morning. Getting sunlight between 9 am and 12 pm optimises the wake-sleep cycle.
* Use motion sensors at floor level, rather than having a night light.
* Stare at the dark sky to help your pupils dilate and melatonin to kick in, before you head to bed.
Week 2: Dull down screens
What junk food is to nutrition, screens are to sleep
Blue light impacts wakefulness and sleepiness, suppressing sleep rhythms. “If you must expose yourself to light, the yellow is a touch better than the tube light [white light has a higher spectrum of blue light],” says Dr Singh. And for screen time, use the built-in filters to block the blue spectrum.
Take away
* Set devices to night mode at 7 pm and be screen free from about 9.30 pm onwards until bedtime.
Week 3: Perform sleep ‘fourplay’
Look to babies who can sleep anywhere
We are born with the intrinsic knowledge of how to eat and sleep, but “as we grow older, we fight the feeling of sleep with substitutes: the access to caffeine, screens”. Dr Singh suggests we follow zeitgebers (natural cues that help our circadian rhythm) such as “the first rays of the sun [being a] signal to the brain that it is time to wake up”.
Take away
* Finish your last meal with the setting of the sun, or about three hours before sleep. Avoid heavy meals, caffeine, alcohol, or any stimulating activity that revs up your brain in the evening.
* It is possible to put your body into sleep mode. An hour before bedtime, take a warm shower to dilate the blood vessels. This makes you lose heat from the skin, so the core (head, neck, chest, abdomen) cools down, signalling the body to release more melatonin.
* For 15 minutes each, journal, read a book or listen to an audio book, meditate or do a slow breathing exercise.
You know you’re getting quality sleep…
- When you fall asleep and wake up naturally, without an alarm clock in the morning or a stimulant like alcohol at night. Feeling an afternoon lull is normal, but if you don’t feel refreshed with a 20 minute nap, you’re not rested well at night.
Week 4: Give anxiety a chair
Research says sleep deprived people perform worse on tasks involving alertness and cognition than those intoxicated with alcohol
A stressful episode during the day will make the body release cortisol, a stress hormone that wakes us up. “It chops your sleep up, so [the hours in bed] is never good quality,” says Dr Singh. Higher cortisol levels also lead to disruptive dreaming during REM (rapid eye movement) sleep.
Take away
* Aerobic exercise, meditation, listening to soft music, all reduce cortisol levels.
* Schedule worry, to offload the brain. Dedicate a time to it — 15 or 20 minutes — to jot down your troubles. You could designate a space or chair to it, so you take the time to acknowledge it and then move on.
Week 5: Take the exercise superdrug
It lowers everything from diabetes to anxiety
Exercise — “that will get your heart rate to above 120 beats per minute, about 30 minutes, five times a week” — is anti-diabetes, cholesterol lowering, anti-hypertensive, anxiety controlling, an anti-depressant, appetite regulator, and a sleep promoting agent. In terms of mental exercise, it is OK to do a crossword or Sudoku close to bedtime, “as long as you’re not fighting to win”. A gentle hobby like playing the piano, or unwinding with a gentle walk, is good too. Similarly, intimacy is a window to sleep.
Take away
* Wrap up exercise before 6 pm (before sunset), because it increases cortisol levels.
* Even if you’ve had a bad night’s rest, it is best to do some form of exercise with a reduced intensity, because you’re using it as a zeitgeber.
Week 6: Regulate environment temperature
The body warms up in the daytime and cools down at night to prompt sleep
A couple of hours before bedtime, the body’s temperature begins to drop, reaching its lowest point at about 4 am (the deepest phase of sleep), and then begins to rise. In its cool down phase, the body sends its warmth out to the extremities (arms and legs), so you may find that in winter, your feet are warm at night, but cold during the day.
Take away
* A colder room drinks the heat from the body, promoting sleep. Sleep promoting temperatures range from 15 to 20 degrees Celsius. “The idea is to just feel cold enough to want a sheet or light blanket,” says Dr Singh.
Week 7: Skip the wine, wind down with water
Coffee takes six hours to break down into half, so a potent cup at 8 am will still see half of it in your system at 2 pm, and a quarter at 8 pm.
Staying hydrated through the day is important, because symptoms of dehydration — headaches, dry mouth — may wake you up at night. Heaters, some medicines (like allergy and blood pressure), and breathing through the mouth can also cause a dry mouth. Snoring at night or having a bladder condition (like in menopausal women), could also rouse you. If this is happening regularly, do check with your doctor.
Gift yourself
- Are you trading sleep for more Netflix time? You might think you need the stress-buster after a long day, but it only feeds the cycle of tiredness. In a New York Times article, Dr Alex Dimitriu, founder of Menlo Park Psychiatry and Sleep Medicine clinic in the US, recommended getting yourself to sleep early by having “something fun or desirable to look forward to in the morning”, before work begins. It can be anything from coffee, listening to the news, or uninterrupted smartphone access.
Take away
* Taper off drinking water after 7 pm to have uninterrupted sleep. Later in the evening, green tea or herbal teas work better than coffee.
* Alcohol triggers snoring, and while it is a sedative that helps in the initial hours of sleep (acting in the same place as Valium does in the brain), in the second half, it interrupts slumber. If you’re drinking, three to four hours before bedtime is a good gap, and not more than a couple of small drinks.
Week 8: Breathe to kill cortisol
Yoga and pranayama activate the parasympathetic (rest system) in the body
A block of five hours of good sleep is better than eight hours of broken sleep. Social jet lag — coined by German researcher, Till Roennenberg, in 2006 — is the concept of not sleeping enough during the week and trying to catch up on it over the weekend. “Sleep loss is sleep loss. You cannot drive on a road with potholes five days a week, and on day six and seven, drive on an expressway,” says Dr Singh, because the damage is already done.
Take away
*
Pranayama exercises the lungs, so build it up like an athlete would do a particular muscle. Studies haven’t clearly established its benefits, but it does help with reducing anxiety.
* If you do have a bad night’s rest, the next day, aim to get to bed at the same time as usual.
* A short nap (less than 40 minutes) is OK in the afternoon if you need one.
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