Using the alarm clock each morning to wake up is common for many Americans. It’s a practice that is hard on sleep, and a practice I’d like to do away with for everyone. Here’s some of the problems.
– If you are waking to the alarm, you haven’t gotten enough sleep. Most adults need a solid 8-9 hours of sleep nightly, and there are many negative consequences of being sleep deprived (see the video mentioned in the last post). Allowing yourself to wake on your own helps ensure that you are getting enough sleep.
– If you wake to the alarm, you may be woken out of deep sleep, or “slow-wave” sleep. This can leave you feeling groggy and take some time to “get with it” mentally.
– A feature many people use is the snooze button, giving themselves another 8-10 minutes of rest before the alarm goes off. Really it is disrupting your sleep for 10-20-30-40 minutes before you have to get up, making that sleep much less restorative.
So here’s my recommendations:
– If you’re waking to an alarm, move your bedtime earlier by 15 minutes every 4-5 days until you are waking up on your own at the time you need to. Alternatively, you can shift your committments later so that you can sleep later in the morning.
– Set the clock for the time you truly need to get out of bed. Then place it across the room so you have to be out of bed to turn it off. This will help you avoid the snooze button, and really get quality sleep until it’s time to get up.
Think about this for yourself, and for your kids too. If you are waking your children up for school they’re not getting enough sleep either.
Regularly there are new sleep products on the market. Just last week I saw one that really impressed me, so much so that I’d like to share. Rest assured, I have no affiliation with this company, financial or otherwise.
It is a new bed which was designed ergonomically so the body can be in a neutral side-lying position during sleep. There is a cut-away so that the lower arm is supported underneath the body, while the head and shoulders are supported above. In this position the spine is not twisted, as it commonly is when side-lying. The support system allows the shoulders to be in a neutral position also, instead of rolled inwards as commonly happens.
The mattress is wedge-shaped so that the head is elevated. There’s been some work showing that when the body is supine, edema can re-distribute and cause narrowing of the airway. That airway narrowing increases the risk of apnea.
The bed is made of foam, and when I first heard that my alarm bells went off. However, I’ve learned that they only use pure foam that has not been treated with the harmful chemicals found in some foam. There were no fumes evident in the store, either when first walking in or after spending time looking at the bed.
So many people have pain conditions which interrupt their sleep, and the improvements to their sleep are limited until the pain can be eliminated. This bed gives me hope for some of those pain patients
In the next weeks someone will be trying it out for me, and I post an update here after the test. If you’d like more information, you can find it on the inventors’ site http://www.squiresleep.com/
Many people talk to me about their difficulties sleeping, either difficulty falling asleep initially, or returning to sleep in the middle of the night, or in some cases waking up before they want to start the day.
One question that can be very helpful in this situation is “what woke you?” or “what prevented you from falling asleep?” Surprisingly often, there is a clear environmental disturbance that is interrupting sleep.
Here are some of the external sleep interruptions I’ve heard of over the years:
– a snoring, or moving, bedpartner who may have a sleep disorder of their own
– bedpartner who gets into bed later, or who gets up earlier, thus waking up the person experiencing insomnia
– dog’s collar jingling
– cat asking for attention by scratching on the bedroom door
– outdoor lights that turn off and on with movement (hate those!)
– children in the bed, snuggled right up against the patient who then is uncomfortable
– an appliance or toy that beeps
– the cell phone, often a problem when it is used as an alarm clock
. . . and the list could easily go on.
When you are working to improve your sleep, you first want to eliminate as many of these interruptions as possible. I recently was working with a woman struggling to sleep well, waking 2-4 times each night. When asked “what wakes you in the night” she identified that sometimes her husband’s snoring woke her. We dialed down into that a little more, and she estimated that his loud snoring is responsible for half of her wakings, and realized looking back on it that when he’s away she does sleep better. Another person, a mother, said that she’s often squished between her children during sleep, and has no sleep problem if she has the bed to herself.
When you are working to improve your sleep, a helpful first step is to see if any external factor is interrupting or preventing you from sleep. Systematically resolve those interruptions, and then re-assess. You may find that those interruptions you were tolerating are not so trivial!
To make a perfect ‘Sleep Cave’:
1. Dark. Should be as dark as a cave, this allows your natural melatonin levels to soar at night and help you sleep.
2. Quiet. Ever sleep in a basement and have a better night’s sleep because it was so quiet? Turn off everything that makes a sound, thus asking for your attention. Do what you can to keep the dog from barking, or his collar from jingling. If there are irregular sounds, a soft white noise machine might be helpful.
3. No electronics. Did a caveman have little lights flashing, or sales texts chirping in the night? Research this last year shows that many people are woken multiple times each week by the phone. Make sure you are not one of these folks by putting your electronics to bed in another room.
4. Comfy. Sleeping surfaces vary widely around the world. What’s most important is that the bed is comfortable for you. Unfortunately bedpartners can prefer different firmness in the mattress. Modify it with extra padding so it’s softer for one, or put a firm board under the mattress so it’s firmer for the other person.
5. Cool. People sleep better when it is cooler than 65, or even cooler at 60 degrees. Adjust both the temperature of the room, and the covers so you aren’t waking up too hot. Many patients tell me they like the bed to be warm when they get into it in the evening, but then get too hot in the night. You can use a heating pad, electric blanket, or hot water bottle to warm the bed beforehand, but then turn it off once you are in bed.
6. Minimal ‘stuff’. Back to those cavemen, they didn’t have so much stuff in their sleeping quarters, did they? Remove all the things from your bedroom that are thought provoking or call for action. You want the bedroom to be a place that you are ‘off-duty’ from the responsibilities of the day.
Although none of these recommendations are high tech, they are based on solid research, and make a huge difference in how well you sleep. Making these changes will be worth it as you get optimal sleep and all its’ daytime benefits!
Recently I spoke with journalists at ‘Whole Living’ along with other sleep specialists. It’s a great article, filled with information and skills that adults need to sleep well. Here’s a few highlights:
– Go to bed at your ideal bedtime
– Create a great place to sleep
– Avoid alcohol, the snooze button and oversleeping
– Learn to calm yourself back to sleep
More information on the many ways sleep impacts your health (think weight gain, heart disease, and wrinkles) can be found in the full article in the October issue. http://www.wholeliving.com/
Think about what a cave is like . . . dark, cool, quiet, and did I say dark? For the best sleep, a cave-like bedroom is ideal.
People sleep best in a cool room, no warmer than 65 degrees. Keep bedcovers in light layers that can easily be adjusted so you avoid getting too hot.
Keep the room quiet. If there are intermittent sounds you just can’t avoid, then use a soft sound machine through the night.
Dark makes all the difference in sleep. Melatonin which is so important for falling asleep is suppressed by light. Unfortunately in most urban settings there is so much light polution that it’s difficult to make the bedroom dark. Use black out shades to block outside light, then turn off all nightlights and electronic LEDs in the bedroom.
Making these simple changes to the bedroom can make a real improvement in your sleep.
Sleep is interesting in that it is a physiological process, which is strongly influenced by habit. When we work to have positive sleep associations with our bedroom, we can sleep better.
Remember Pavlov’s dogs? Whenever Pavlov fed the dogs, he would ring a bell. Eventually just ringing the bell would cause the dogs to start salivating, because they associated the bell with food.
People can also develop these type of associations. For instance, hard not to think about food when you’re standing in the kitchen. What associations have you developed about your bedroom?
Sometimes, when people spend a lot of time awake in their bed or bedroom, they start to associate it with being awake. This can feed into difficulty falling asleep or staying asleep.
To create a positive association of your bedroom as someplace to sleep, avoid being awake either in bed or in the bedroom.
– Choose to unwind before bed in another room.
– Don’t have a TV or computer in the bedroom, as those are waking activities.
– If you are awake more than 30 minutes at the beginning of the night, or 10 minutes in the middle of the night, get up and do something boring until you are sleepy enough to return to bed.
To learn more about Naturopathic Sleep Medicine go to www.naturalsleepmedicine.net.
As a naturopathic physician, it’s been a pleasure to do house calls for patients. It works out well for the patients and well for me, too.
For patients, they have the ease of fitting the visit into their schedule, with no added driving and parking hassles. They are comfortable and can be more relaxed in their home environment.
For me as the physician, I get to know my patients better, and to really understand their lifestyle. Since I specialize in sleep, it’s also helpful to see the bedroom sleep environment. Although we routinely discuss light in the initial office visit, I’ve discovered two patients had a skylight over their bed that they had forgotten to mention.
Historically, house calls were the way medicine was practiced until late into the 19th century. In 1971 only 1% of doctors visits were house calls. In recent years house calls have become more popular, especially for the elderly. My hope is that this type of visit can become more common for people of all ages, and helps deepen the physician-patient healing relationship.
So . . . ’tis the season for making New Year’s Resolutions. Here’s my healthy sleep resolutions that will help make this the best year ever!
1. Get enough sleep each night, enough so I am ready to get up and start the day with enthusiasm!
2. Stop work, TV and computer about an hour before bedtime so that I can unwind before lights out, and fall asleep easily.
3. Schedule my work day in accordance with my circadian rhythm – mentally hard work in the morning and late afternoon, with filing and less demanding tasks during the mid-day circadian dip (for me this is about 1:30-2:30pm)
4. Keep my bedroom a great sleep environment – cool, dark, quiet, and without all that clutter which makes me think of my ‘To Do’ list rather than sleep.
What sleep resolutions will you make this year?
Dr. Catherine Darley is director of The Institute of Naturopathic Sleep Medicine in Seattle. More at www.naturalsleepmedicine.net
About 20% of Americans do shiftwork, starting work either in the late afternoon or in the middle of the night. Their health suffers, and their relationships can suffer too. If you are on a shiftwork schedule, here are some strategies to manage the shiftwork lifestyle well.
– First, establish a wake / sleep schedule that you can maintain most days of the week. Try to have some of your sleep hours the same, regardless of whether it is a work day or day off.
– Shiftworkers typically get less sleep than those who work during the day. Adjust your schedule to allow enough sleep time, close to 8 hours each night is probably needed.
– To help you sleep those hours, make your bedroom ideal for sleeping. It needs to be cool, dark, relatively quiet, no pets, and no lit clocks. If you are trying to sleep during the day this can take more effort, but it will be worth it. Get blackout shades, or use an eyecover. Keep a fan running softly or earplugs to keep it quiet. Train your pets that you are not available during your sleep time. Set the alarm to wake you up, and then ignore the time, allowing yourself to be ‘off duty.’
In our 24 hour society people will need to work at all hours. With a thoughtful strategy working shifts can be easier.
At The Institute of Naturopathic Sleep Medicine, Dr. Darley provides care for people of all ages who have sleep problems. More at http://www.naturalsleepmedicine.net/