The Foundations of Excellent Sleep

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Sleep impacts nearly every area of our health, from blood pressure and inflammation to brain function and mental health. Good sleep is critical for good health. We all know this, and yet a third of Americans report having trouble getting a good night's sleep, whether struggling to fall asleep, stay asleep, or get enough hours of shuteye.

The following sleep guidance was designed by Robert Kachko, ND, LAc, Director of Integrative Health at Atria and the founder of the New York and Connecticut Centers for Integrative Health. It details how to ensure sound and stable rest to optimize your day-to-day performance and recovery and your long-term health.

The four golden rules of sleep

Our bodies have a finely tuned preference for when we should be asleep and awake, governed by our circadian rhythm. When your biological clock is out of sync, falling asleep can be challenging. To align with these natural processes and improve sleep quality, consider these four rules:

  1. Reduce time in bed
  2. Wake up at the same time no matter what
  3. Only go to bed when you're sleepy
  4. Stay in bed only if you're asleep

1. Reduce time in bed

  • Spending excessive time in bed can actually undermine your ability to sleep well. Research shows it's best to only use your bed for nighttime sleep and sex, and to avoid other activities like napping, watching TV, or having stressful conversations. This helps your body clearly associate the bed with sleep, making it easier to fall and stay asleep when you actually intend to.

2. Wake up at the same time no matter what

  • We are creatures of habit, and a consistent sleep schedule is key to quality rest. Irregular sleep patterns can disrupt your biological clock, making it harder to sleep.
  • While it might seem beneficial to catch up on sleep when you can, this can actually confuse your body's internal clock and disrupt your sleep drive. The most crucial factor for setting your biological clock is your wake-up time.

3. Only go to bed when you’re sleepy

  • People who deal with insomnia (and especially those with chronic pain) often describe feeling tired but not sleepy. It's important to recognize this difference. Tiredness is a physical sensation of exhaustion, while sleepiness involves feeling ready for bed, with heavy eyes.
  • Keeping a sleep diary can help you track when you feel tired versus when you're sleepy. Aligning your bedtime with your biological clock is crucial. For many, going to bed before midnight and waking up before 8 a.m. works well.

4. Stay in bed only if you’re asleep

  • If you've followed the previous rules and still can't fall asleep within 15 minutes or so, try this counterintuitive approach: Get out of bed. Engage in a peaceful, quiet activity, like reading a book or meditation. After 15-30 minutes, return to bed and try again for another 15 minutes. Repeat this process as needed until you successfully fall asleep.

Understanding sleep drive and your internal clock

Imagine a bucket that starts full after a restful night's sleep. As you go through your day, the water drains, representing your growing sleep drive. Ideally, the bucket empties just as you're ready for bed, indicating you're primed for sleep.

Two issues can arise: If the bucket empties too soon, you may feel sleepy earlier than planned. If it still has water at bedtime, falling asleep might be difficult.

The rate at which the bucket drains varies throughout the day, reflecting your biological clock. It drains slowly in the morning and afternoon, keeping you alert, and more quickly in the evening, signaling bedtime.

This metaphor illustrates the interplay between sleep drive and your biological clock, both crucial for regulating your sleep-wake cycle.

Other factors that affect rest

Caffeine and alcohol: Limit caffeine after 1 p.m. if you have trouble sleeping. Depending on your genetics and other factors you may want to cut caffeine entirely — some people metabolize it quickly, whereas others may experience the effects for up to 12 hours. Though it’s considered a depressant, alcohol can also profoundly disrupt sleep, so limit your intake and avoid it within three hours of bedtime.

Exercise and stressful conversations: Stimulating activities, like exercise as well as stressful conversations, should be avoided in the two hours before bedtime. Both can raise your heart rate and adrenaline level, leading to alertness.

Wind-down routine: Engage in relaxing activities like a warm bath or light reading to wind down before bed. This helps release daily stress and prepares you for restful sleep

Relaxation techniques: Counting sheep may not actually work, but techniques such as thought-stopping and box breathing—which calms the autonomic nervous system—can support a transition into a restful night of sleep.

Room temperature: Research shows that a slightly cooler room can be helpful in achieving restful sleep; 67-68 degrees Fahrenheit is often a helpful starting point.

Devices: Avoid screens that emit blue and white light, such as TVs and smartphones, before bed, as they can interfere with melatonin production and circadian rhythm.

Fluids: Many people have to urinate overnight, but if this is a frequent occurrence for you, try reducing your fluid intake for a few hours before you plan to go to sleep.

Dark environment: Try to keep your sleep environment as dark as possible, as any light can interfere with your circadian rhythm. Blackout blinds and sleep masks can make a huge difference.

Snacks: Though eating before bed is not generally recommended, those who wake often may benefit from a small snack high in protein to help stabilize blood sugar.

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