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Roger Ekirch talks about the human experience of night over the centuries. Streets until the 1600s had only the light spilling from homes to light them. To be out at night was dangerous, and many towns would close their doors at night and enforce a curfew. For safety, fires and candles would be put out before bed. Their use would be conserved to save money, so some poor people would go to bed soon after dark.
Melatonin is a hormone secreted by the pineal gland of the brain. Melatonin is nicknamed “the hormone of darkness,” and helps us feel sleepy at bedtime. Unfortunately melatonin is very sensitive to light, particularly blue light, which suppresses it’s release. And what are 90% of us exposed to during the evening? The blue light of electronics which suppresses melatonin!
generic retard tramadol online pharmacy reviews The positive effect of light during the dayA recent study compared the sleep of office workers who get natural sunlight to those who work on the interior of the building and don’t. Those who got more light during the work day had better sleep quality, slept longer, and had more physical activity. They also reported a higher quality of life – something we’d all like!
buy ambien europe Using light exposure to improve sleep
The basic principle is to get historical light levels during both day and night. In other words, bright full-spectrum light it the morning and during the day, then full darkness at night. How can you do that? Here are some ideas:
– in the morning get some bright outdoor light as soon as possible. Maybe go stand on the porch and look out while having your morning tea.
– continue to get bright light in bursts throughout the day
– in the evening, have lights low, and use the yellow-red spectrum if possible (rather than blue or full-spectrum lights). Avoid electronics for the hour before bed.
– if you are up in the middle of the night, again have low lighting. Particularly troublesome in many homes are the bright bathroom lights, instead put a small night-light in the bathroom to use if need be.
– watch out for your neighbors too by turning off outside lights that aren’t truly needed, and if you need outdoor lights, aim them downward so you are not committing ‘light trespass.’ (Interestingly, Bogard cites studies showing that increased lighting does not decrease crime, that criminals like to work in a well-lit area just like everyone else!)
Be purposeful about making all of these lifestyle changes at the same time. Then notice after a week or two how your sleep has changed!
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.
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!
When a patient first sits down for their return appointment, I frequently can anticipate whether their sleep improved or not. All this before they say a word. How do I know?
For years I’ve thought it was because of the way their face looks – skin tone, color, skin around the eyes, and general ‘sparkle’ in the facial expression. New research from the British Medical Journal (http://bit.ly/eWOZPc) has shown that the amount of sleep we’ve had is reflected in our face, and impacts how others see us. In this study participants were sleep deprived 31 hours then photographed. They were also photographed after a regular 8 hour night of sleep.
When untrained observers looked at the photos, the sleep deprived people were rated as less healthy, less attractive, and more tired. The authors conclude that “This suggests that humans are sensitive to sleep related facial cues, with potential implications for social and clinical judgments and behaviour.” Think relationship success and job performance reviews.
Just another great reason to get enough hours of sleep each night, and to address any sleep problems that interfere with this.
Children’s Sleep and School Success – How they are related
School start is on the horizon. For those with children this can be a busy time, doing those last minute summer activities, getting school supplies, and preparing children for a successful year. Let’s take the time to get children on a good sleep schedule that will help them in school.
Why is it important to think about children’s sleep? To start, many children simply don’t get enough hours of sleep. Here’s how much sleep kids need:
• children 3 to 5 years old need more than 11 hours
• children 6 to 12 years old need 10 to 11 hours
• teenagers need 9 to 9.5 hours
Looking at the school start times here in Seattle, and allowing just one hour from wake-up to being at school, grade school children should be sleeping by 9pm, middle schoolers by 9:30p, and high school students by 9:30-10pm. (If your child needs more than 1 hour from wake-up to school start time then move bedtime earlier accordingly). Are your children getting to sleep at that time? If not, your child is probably feeling the effects of insufficient sleep.
Impacts of Insufficient Sleep
Going to school can be demanding, children are asked to concentrate, learn physical skills, and develop socially with their peers. Here are some highlights:
• Only 20% of children grades 6-12 get the necessary amount of sleep (>9 hrs)! Can you believe it?! In younger children, only 47% get the sleep they need.
• Increased playground injuries in children who sleep <10 hours.
• Children with insufficient sleep are more likely to be angry, depressed, or overly emotional. Kids who sleep less take more risks, and this is especially true in teens.
• Cognitive effects include impaired memory, creative problem solving, and decreased verbal fluency, all skills that your child needs in school
What you can do to improve your child’s sleep:
• Establish bedtimes for your children, so everyone in the household knows the standard. You may want to have a time when everyone finishes their activities and starts to “wind down.”
• Start a trend in your social group of starting activities early enough that they usually end an hour before bedtime. This gives you time to travel home safely, and wind down a little before going to sleep.
• Remove electronic media from your child’s bedroom so they are not tempted to continue with homework, TV, or texting after bedtime
• Kids (and parents) can get excited about activities. Emphasize quality wake hours rather than quantity. Is it really fun to stay up late if you are so tired that you can’t think or are teary the next day?
• Allow your children to catch up on sleep on the weekends or vacations if necessary. The golden standard is to wake up on their own, feeling refreshed and energetic throughout the day. If your child sleeps a lot more on weekends, consider moving their school night bedtime earlier in 15 minute increments until it evens out.
How Can We Use this Information?
First off, think back to a time that you were really well rested. It may be on a vacation or holiday break, before the kids were born, while unemployed, or if you’re lucky, in the last week or two. Then answer these questions:
– How much sleep do you need to really feel your best?
– Are you getting that amount of sleep most nights?
– If not, how much more sleep time do you need?
Now, how are you spending the last couple hours before bed? Are you watching TV, or doing other hobbies that you could do at another time in order to get the sleep you need? If so, could you move this TV watching to another time, maybe using some recording device?
The biggest question though, the ‘Million Dollar’ question to ask yourself is: “Would I benefit more from getting more sleep and being healthier, or do I benefit more from watching TV in the evening?” Let me know your answer!
In June 2009, Drs. Basner and Dinges published an article titled “Dubious Bargain: Trading Sleep for Leno and Letterman.” Is this something you can relate to- staying up late to watch your favorite show even when you know you’re tired?
The relationship between exercise and sleep
The U.S. Census Bureau has a continuous telephone survey of 105 million households. It is called the American Time Use Survey (ATUS). This paper looked at how people spent the 2 hours before bed, and the 2 hours after getting up. They grouped people into 3 categories: Long workers (>8 hours daily), short workers (<8 hours) and non workers.
An estimated 20-40% of adults sleep less than the recommended 7+ hours each night. Remember that measured sleep is usually less than reported sleep, so these estimates may be low. Short sleep duration is associated with increased illness and obesity. The researchers’ goal was to determine if there are discretionary activities that can be eliminated to increase sleep time.
Among the three groups, bedtime was the same, and the long workers got up earlier than the others. People watch TV for 55 minutes of the 2 hours before bed. Travel and work took up 27% (about 30 minutes) of the 2 hours after waking for the day.
The authors conclude that watching TV may be an important social cue of approaching bedtime. They also conclude that “giving up some TV viewing in the evening should be possible to reduce chronic sleep debt and promote adequate sleep in those who need it.”
When infants are 6-8 weeks old they will start to have more sleep at night, and less during the day. Their circadian system is starting to become entrained by the environmental light / dark cues.
By 6 months of age, 70-80% of babies are capable of sleeping 5-6 hours at a stretch in the night. Remember though, just like adults, babies will wake 4 to 5 times a night, at the end of each sleep cycle. This is when they may have difficulty returning to sleep on their own and call out to you.
Here’s how an infant’s sleep needs change over the first years:
– Newborns sleep 16-20 hours total
– 3-6 mos olds sleep 12-15 hours total
– 6-9 mos olds sleep 11.5-15 hours total
– 9-12 mos olds sleep 11-14 hours total
– 12-36 mos olds sleep 12-13 hours total
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
The last two nights I’ve gotten 10 hours of sleep each night, and it’s been fabulous. All day I’ve had lots of energy, a sharp mind, and a sense of humor. All those things a person gets from being well-rested. A quote by Ovid comes to mind “Take rest; a field that has rested gives a bountiful crop.”
A friend asked is it normal to sleep 10 hours? Here’s my answer.
Given how 47% of Americans get less than the recommended amount of sleep each night, it is thought that many people have an accumulated sleep debt. (One expert is said to have estimated the average American has a 50 hour sleep debt). So sleeping longer once in a while will help.
However, some people are considered “long sleepers.” These are folks who sleep 10 to 12 hours for at least seven nights in a row. This typically begins in childhood, and over their life they consistently need more than the typical amount of sleep. Their sleep architecture and stages are normal, and there are no other signs of disorder. About1.5% of women and 2% of men are long sleepers. These folks tend to be slightly anxious or depressed. It is thought that these people are on the high end of the normal continuum of sleep needs.
If you are one of the people who have a chronic sleep debt, or are a long sleeper, either way, get ready for the new year by getting the sleep you need – it will make all the difference!
Dr. Catherine Darley is a naturopathic physician who specializes exclusively in the treatment of sleep disorders using natural medicine. Learn more at www.naturalsleepmedicine.net.