Well-Being: Sleep

During this pandemic, I’ve noticed a lot of articles about sleep issues.  I understand.  I am right there with you.  It is a difficult time to feel settled enough to fall asleep and sleep peacefully through the night without any wake-ups.  I set out to find ways to increase sleep quantity and quality.  Here is what I found in the hopes that it increases overall well-being and ability to work successfully.  Let’s look into melatonin, keeping cool, bedtime routines (reading a hard copy book or magazine), intermittent fasting, and sleep hygiene (cut the cord – move your iPhone out of reach).

First, melatonin.  What is it?  How does it work?  According to WebMD, “Melatonin is a hormone made by the pineal gland. That’s a pea-sized gland found just above the middle of your brain. It helps your body know when it’s time to sleep and wake up.  Normally, your body makes more melatonin at night. Levels usually start to go up in the evening once the sun sets. They drop in the morning when the sun goes up. The amount of light you get each day — plus your own body clock — set how much your body makes.”[i]  So promoting melatonin’s production seems like a good idea.  This can be done by avoiding bright lights (screens) within an hour before bed, not taking a shower or bath right before bed (actually stimulates the body to be more awake), and making sure that lights are dimmed in the bedroom or other parts of your home that you are in leading up to bedtime.  Melatonin supplements seem like a quick fix to any sleep issues, but the jury is still out on their effectiveness.  It’s probably best to try making changes to your bedtime routine (more on that below) before considering the supplement of melatonin.  Definitely consult a physician before taking any supplements because even melatonin, a seemingly harmless supplement, can interact with other medications and can cause other unwanted side effects.

Next, keeping cool.  Easier said than done these days.  Figuratively, it is a difficult time to keep our cool with such high numbers of deaths across the country and world from COVID-19, and new related respiratory diseases like MIS-C presenting and killing children being reported.[ii]  While there are methods and systems to help us all with anxiety before bed, including breathing exercises and sleep yoga, this keeping cool is meant to be literal.  There are added benefits to your sleep when you turn down the temperature in your home while you sleep.  The cooler temperatures (recommended between 60 and 67 degrees Fahrenheit) while we are going to sleep and during sleep help signal the brain to produce more of the sleep hormone melatonin.[iii]  Two ways to try this: 1) turn down your thermostat before getting into bed or if you can turn it down when you start your bedtime routine; or 2) if you have the Nest, program your thermostat to decrease temperature gradually over the course of your bedtime and sleep time.  Try to dive as deep as you can during your deep sleep hours.  For example, from 1am-4am try to decrease the temperature to 60 degrees.  Our circadian rhythm works best in cooler temperatures so anything we can do to facilitate that will give us more rest and quality sleep.  Additional keep cool measures include:

  • Take super warm comforters off in the summer and replace with a lighter blanket,
  • Change up your sleep wear seasonally,
  • Consider changing mattress pad, pillows, or actual mattress for increased coolness.[iv]

Now for the bedtime routine.  This is challenging to create and maintain for many reasons.  The best source I know of for creating habits is the excellent book, Atomic Habits, written by James Clear.[v]  It is inspiring and methodical in a way that makes creating habits and sustaining their routine attainable.  The best reason for creating a bedtime routine is just to have a system or number of steps signaling your brain to begin slowing down and in a way shutting down for the night.  These steps can be out of order, skipped or added to, but overall there is a need for some kind of bedtime routine.  This can include actual physical needs like washing your face, brushing your teeth, flossing, putting actual pajamas on (I’ve read that there is an additional bonus of wearing matching or specific pajamas – not just exercise or loungewear –  that tells your brain you are getting ready to sleep!).  This can also include some of the additional steps like stretching, doing a mindfulness meditation, listening to “pink noise,”[vi] keeping to a schedule – a start time for your routine and a lights out time as well as daily alarm even on the weekends, drinking chamomile tea or other sleep inducing tea after dinner but not right before sleep, and prayer. 

My biggest bedtime routine that works consistently for me is reading a hard copy fiction book or a magazine.  I would definitely say the fiction book works the best because it just takes my mind away into the storyline.  The one drawback of a magazine is that it may stimulate a thought or idea to be added to the “to-do” list, which is not good.  Overall, I think the idea of reading before bed is beneficial to slowing the mind down, distracting our thoughts away from worries, and decreasing our exposure to screens. 

Next, and most challenging of all, is attempting intermittent fasting.  The health benefits are numerous for this method of fasting for twelve hours at least per night.  My best suggestion is to challenge yourself to cut off all food after dinner.  This will help you keep to a strict regime of avoiding foods and drinks that break the fast especially less than two hours before sleep.  The National Sleep Foundation recommends, “If you can, avoid eating large meals for two to three hours before bedtime.”[vii]  This is in line with the theories behind intermittent fasting.  There can be benefits to your sleep, your insulin resistance, and your overall weight by consistently staying in a fast mode for twelve or more hours overnight and into the morning.  Coffee and tea (without any additions) in the morning do not break the fast so if you want to try adding more hours you can extend the morning fasting period by sipping on coffee (a natural appetite suppressant ) or tea.  Overall the intermittent fasting helps your body and mind relax and sleep restfully without having to expend energy processing and digesting foods and drinks eaten right before going to sleep. 

Finally, sleep hygiene is defined by the National Sleep Foundation as, “a variety of different practices and habits that are necessary to have good nighttime sleep quality and full daytime alertness.”[viii]  In addition, everyone has a different number of hours of sleep they need.  Having the right amount of sleep you need to feel rested is the biggest key to sleep hygiene.  The main recommendations in terms of practices of sleep hygiene include the following:

  • “Limiting daytime naps to 30 minutes. Napping does not make up for inadequate nighttime sleep. However, a short nap of 20-30 minutes can help to improve mood, alertness and performance.
  • Avoiding stimulants such as caffeine and nicotine close to bedtime. And when it comes to alcohol, moderation is key. While alcohol is well-known to help you fall asleep faster, too much close to bedtime can disrupt sleep in the second half of the night as the body begins to process the alcohol.  
  • Exercising to promote good quality sleep. As little as 10 minutes of aerobic exercise, such as walking or cycling, can drastically improve nighttime sleep quality.  For the best night’s sleep, most people should avoid strenuous workouts close to bedtime. However, the effect of intense nighttime exercise on sleep differs from person to person, so find out what works best for you.”[ix] 

 And the biggest and probably hardest practice to follow to have good sleep hygiene:  cut the cord!  Put your phone on a charger strategically out of reach from your bed and place it there as early as possible in the evening.  This may look like a simple movement of the charger from the nightstand to a dresser nearby or the closet.  Some may be able to charge and lock all devices on a central charging station in the kitchen, while others may need to have their phone closer for emergencies.  No size fits all here, but the main idea is to cut the cord – figuratively speaking! – so that you are not physically able to reach your phone from your bed.  The small hurdle of having to put your feet on the floor and step to reach your iPhone is a natural deterrent.  This small physical change will increase the likelihood that you will not reach out and open your phone whenever a thought wakes you up or comes to mind as you try to fall asleep.

Good night!  Sleep well for your well-being.

© 2020 Megan Davia Mikhail

[i] What is Melatonin? Reviewed by Melinda Ratini, DO, MS on March 18, 2020. Available at:  https://www.webmd.com/sleep-disorders/what-is-melatonin

[ii] CDC Health Advisory, dated May 14, 2020, Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19).  Available at:  https://emergency.cdc.gov/han/2020/han00432.asp

[iii] Real Simple magazine, “The Sleep Commandments,” by Jenny Comita, dated May 2020.

[iv] Id.

[v] See www.jamesclear.com for more information on Atomic Habits the book and related topics in James Clear’s website articles. 

[vi] “Pink noise is a “color” of noise. So is white noise. (Bear with us if you don’t get it. This is how experts talk about sound.) But how do they differ? Both colors contain all of the frequencies that humans can hear (ranging from 20 hertz to 20,000 hertz).  More scientific explanation? The human ear, though, usually hears pink noise as being “even” or “flat” and perceives white noise as “static.”  In one study, pink noise increased deep sleep and dramatically improved memory in older adults.” The Cleveland Clinic, “Why ‘Pink Noise’ Might Just Help You Get a Better Night’s Sleep” dated July 20, 2018.  Available at:  https://health.clevelandclinic.org/why-pink-noise-might-just-help-you-get-a-better-nights-sleep/

[vii] The National Sleep Foundation, “Health Sleep Tips,” available at:  https://www.sleepfoundation.org/articles/healthy-sleep-tips

[viii] The National Sleep Foundation, “Sleep Hygiene,” available at:  https://www.sleepfoundation.org/articles/sleep-hygiene

[ix] Id.

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