Desperately Seeking Shut-eye
Once upon a time, getting a good night’s sleep wasn’t an issue for me. I went to bed when I was tired and woke up feeling refreshed. No tossing and turning before I drifted off to dreamland—no middle-of-the-night awakenings. Then I started having babies, who roused me at all hours and made eight-a-night a thing of the past. But even after they started sleeping soundly, I couldn’t seem to slip back into my old, good-sleep patterns. Why?
“Many factors go into whether or not we’re able to fall asleep and stay asleep, such as stress, hormones, and what’s going on in our lives at a given time,” says Jacob Teitelbaum, MD, medical director of the Fibromyalgia and Fatigue Centers. “And since all of these factors fluctuate as we go from one life stage to another, we can expect our sleep patterns to change as well.”
The statistics alone on Americans and insomnia could keep you up nights. As a nation, we spend more than $3.5 billion on prescription sleep medications each year, trying to bring relief to the 126 million of us (that’s six out of 10 Americans) who experience symptoms of insomnia at least a few nights a week. How does this inability to get a good night’s rest affect us? Ninety-three percent of Americans believe sleep loss can impair work performance, and 86 percent feel a lack of sleep can lead to health problems.
So what’s an insomniac to do? “Understanding why you might be experiencing trouble sleeping can help you make changes that will lead to better sleep,” says Teitelbaum. Here’s a guide to how your sleep can change through the years—and what to do to give yourself the best shot at a better night’s rest.
Teens and early 20s
For a young adult, the obvious sleep robbers—late nights, too much television and computer time, poor diet, and school or new-job stress—clearly play a role in sleep disorders, but teens and 20-somethings also have a physiological reason for not sleeping well. Their circadian rhythm—the natural body clock that signals when to go to sleep and wake up—is in flux.
In young adults, the body produces melatonin—a hormone created by the brain to help induce sleep—at 9 p.m. or 10 p.m. (in adults that happens earlier, around 7 p.m. or 8 p.m.). So a teen’s sleep cycle gets pushed back, which explains why she might not feel sleepy until around 11 p.m. or midnight. What’s more, everyone gets a “dip” in their circadian rhythm twice a day; for adults they typically come at 2 a.m. and 2 p.m., while adolescents hit their low points around 7 a.m. and 4 p.m., which explains both their torturous early-morning wake-up calls and late-afternoon naps.
Too much caffeine can also affect sleep in this age group. From after-school lattes to late-night energy drinks, a caffeine jolt lasts well beyond bedtime—affecting a young adult’s ability to fall and stay asleep and worse, setting the body clock back even further.
• Stay warm. Take a hot bath or shower before getting into bed. Cold temperatures can delay the release of melatonin—the last thing a teen, whose melatonin release is already delayed, needs.
• Steer clear of sleep-sabotaging caffeine in the afternoon and evening.
• And parents, fill your kids in on another downside of smoking: Nicotine is a vasoconstrictor that affects circulation and prevents deep levels of sleep, which is when the body restores, heals, and regenerates.
• Consider blue light therapy. Scientists at the Lighting Research Center at the Rensselaer Polytechnic Institute in Troy, New York, found that light travels to the back of the eye and reaches the master clock in the brain, which means exposure to light and dark stimuli help re-set the body’s clock to match the solar day. Teens’ circadian rhythms are set to make them fall asleep late at night and thus wake up later in the morning. Keeping the lights dim when teens have to wake up for school or work—and then exposing them to blue light when they would’ve naturally awakened mid-morning— can reset their clocks enough so that they get sleepier earlier in the evenings. Why blue light? The researchers believe it’s tied to the thousands of years humans worked almost completely outdoors, making us blue sky-sensitive creatures.
20s, 30s, and early 40s
Sleep research shows that adults need seven to nine hours of shut-eye a night, with a little more than eight ideal. At this time in our lives, however, we’re often too busy creating careers and families to find that much time for sleep. Our outward focus not only cuts into that ideal snooze time, it also creates a lot of stress, says Evangeline Lausier, MD, assistant clinical professor of medicine at Duke Integrative Medicine in Durham, NC. “For so many, this is a high-anxiety time of life, because it’s nearly impossible to get as much solo time and relaxation as you need,” she says. “So even little stressors, like getting stuck in traffic or getting the kids ready for school, can cause a lot of anxiety.”
And while it may seem obvious that anxiety will keep you tossing and turning at night, research has shown that it actually produces a physiological change in the brain that can make drifting off next to impossible. Stress and anxiety trigger the release of cortisol, the fight-or-flight hormone that prompts you to feel alert and awake. Cortisol levels are typically high in the morning and low at night, but too much stress-induced cortisol production during the day causes a decrease in the evening production of serotonin—the hormone that helps you wind down. “If the cortisol stays high at night, when it should be low, then you get a double whammy of having too much cortisol and not enough serotonin at bedtime,” says Teitelbaum. This leaves you wide awake when you should be sleeping.
• Take power naps. Rather than disrupt your sleep-wake cycle by going to bed earlier than usual one night and late again the next, sneak as little as 10 minutes of snooze time before dinner. Research shows this can improve cognitive abilities, without the post-nap grogginess.
• Sleep with white noise. The steady hum of an air purifier or a fan will train your brain not to wake up to everything it hears.
• Exercise (and that includes having sex!). The feel-good endorphins released by physical exertion play a big role in helping us fall asleep faster and stay asleep through the night, says Teitelbaum. And you don’t necessarily have to work out in the morning. Some studies show exercising a couple hours before bed promotes sleep.
From late 40s on
As women enter their 40s and 50s, their menstrual cycle starts to change. During this transition, hormones seemingly run amok, and since they help control all bodily functions—including sleep—“the change” can disrupt shut-eye. Around age 50, for example, fluctuating hormones commonly cause hot flashes, which can wake a woman out of deep sleep and make it difficult for her to fall back. Men experience something similar, called andropause, which hits around this time. Most often marked by testosterone deficiency, andropause can cause depression, night sweats, and achiness—all of which can disrupt sleep.
Alcohol can also affect sleep. “So many of us think of alcohol as a sleep aid, because it helps us drift off quickly,” says Ulysses Magalang, MD, director of the sleep medicine program at Ohio State University Medical Center. “But while it’s true that alcohol will make you fall asleep faster, it actually causes a lot of brain arousal once it’s metabolized—which usually happens during the second half of the night.” The result? An inability to achieve deep, slow-wave sleep, the restorative type of sleep that helps us feel so well rested in the morning.
• Sleep on your right side. Recent studies support the yogic belief that the left nostril has more parasympathetic (calming) dominance, and the right side sympathetic dominance (fight-or-flight response). Yogic science teaches us to lie on our right side to encourage the parasympathetic effects of the body, prompting relaxation and decreasing blood pressure—which can help calm you during hormone-related symptoms such as hot flashes.
• Eat a well-balanced diet to reach or stay at your ideal weight. Being too heavy can throw hormones even further out of whack. And avoid spicy foods, especially in the evenings.
• Soak your feet in cold water before bed to help prevent hot flashes during the night. And go to bed in cozy layers you can peel off if you get too hot.
Jennifer Lang is a freelance writer in White Plains, New York.
The All-Natural Rx
Americans spend billions on prescription sleep aids each year, even though the drugs produce a number of unwanted side effects. Natural sleep remedies, on the other hand, are generally side effect-free. For the most part, they help you fall and stay in deep sleep without relying on sedatives. And because they’re muscle relaxants, they also help alleviate pain and may even improve libido. Some to consider:
L-theanine, an amino acid (protein) derived from green tea, improves deep sleep and helps people maintain a calm alertness during the day. It also plays a role in the formation of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that’s critical for sleep. Take 50 to 200 mg at bedtime; L-theanine can also be used for daytime anxiety.
Hops reduce hot flashes in menopausal women, studies show, and they also reduce anxiety and help muscles relax enough for you to fall asleep. Take 30 to 120 mg at bedtime. Often used in combination with valerian and lemon balm, hops have to be dried to have any medicinal effect—the hops in beer, however tasty, provide no sleep benefit.
Passionflower (Passiflora) is an herb commonly used as a calming agent. Take 90 to 360 mg at bedtime.
Valerian helps reduce the time it takes you to fall asleep and improves the quality of sleep you get—without next-day sedation. Take 200 to 800 mg at bedtime. (Valerian causes wakefulness in some people; if that’s the case for you, take it during the day to reduce overall anxiety.)
5HTP (hydroxytryptophan) is what your body uses to make sleep-inducing serotonin. One downside: It can take up to six weeks to start working. Take 200 to 400 mg at bedtime. If you also take serotonin-raising medications (for example, antidepressants), make sure your holistic practitioner supervises the use of the 5HTP to keep serotonin levels from going too high.
Melatonin retrains your circadian rhythm so you become sleepy when the lights dim and wake up more alert at morning light. Take 3 mg at bedtime for three nights and gradually increase to 6 mg if necessary. Melatonin is not recommended for teens, however.
How Yoga Helps Insomnia
“Most insomnia has to do with ‘restless mind syndrome,’” says Judith Hanson Lasater, PhD, a physical therapist and author of Relax and Renew: Restful Yoga for Stressful Times (Rodmell Press, 1995). Because the mind is always spinning, you need to do something physical to allow the central nervous system to come into balance. This quiets the mind and lets the parasympathetic nervous system dominate while you sleep—crucial for the body to restore. Three poses to help you drift off—and stay asleep:
Before bed: Savasana
This is the gold ring of relaxation poses, says Lasater, because there’s no stretching at all. Lie down on the floor with a blanket folded under your head and neck, another blanket rolled under your knees, a soft cloth over your eyes, and a blanket to cover your body. Stay in the pose for 15 to 20 minutes or longer if possible. Use a breathing practice with a long, slow inhale and a slightly elongated exhalation; the exhale helps stimulate parasympathetic nervous–system dominance, prompting your body to go into “rest and repair” mode.
Can’t fall asleep? Halasana
Also known as Plough Pose, this legs-over-head pose is especially helpful if you have trouble winding down. A modification: Lay on the floor and rest your thighs on a padded chair, so thighs and shins are parallel to the floor.
For midnight awakenings: Side-Lying Savasana
“Side-Lying Savasana is a position of emotional comfort,” says Lasater. “It’s great when you feel exhausted and overwhelmed, pulled in all directions.” Lie on your left side and put a pillow or bolster under your right knee, right arm, belly, and head so you feel completely supported.
Feng Shui for Fostering Sleep
The ancient art of feng shui seeks to maximize the flow of life force energy, or qi, through environments, homes, and other structures. Five guidelines to set your bedroom up for good sleep:
Place your bed diagonally across the room from the entrance, so you can lie in it and still have a full view of anyone entering.
Try not to position your bed so you look directly through other doorways (to the bathroom or closet, for instance). If that’s unavoidable, shut the door at night.
Don’t set up your bed directly beneath a window, otherwise you’ll lose vital energy during the night.
Keep clutter to a minimum; it can agitate the flow of energy in the room.
Add objects that help stimulate the movement of qi, such as mirrors, plants, and stones or statues, and remove overstimulating items, such as the stereo, computer, and TV.
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