According to the National Sleep Foundation, approximately 40 million Americans experience difficulties with falling or staying asleep every year. Insomnia is associated with difficulty remembering and performing tasks, irritability, depression and anxiety, and fatigue. Poor sleep is also associated with high blood pressure, memory loss, diabetes and weight gain, poor immune function, and increased risk of heart attack and stroke. Clearly, restful, rejuvenating sleep is important for maintaining health, but no one goes to bed at night with the intention of tossing and turning. How can you ensure that you are able to fall asleep and stay asleep on a regular basis?

Most parents know that a bedtime routine helps the body get ready to transition from wakefulness to sleep. Our brains are wired for routines. By going to bed and waking up around the same time each day, hormones are secreted that help us wake up (cortisol) and fall asleep (melatonin). When we don't follow a routine, the hormonal body clock rhythm is disrupted, and we won't sleep as well or wake up as easily.

What should be in this routine? Something relaxing of course. Mindfulness, meditation or prayer, light yoga or stretching, and reading are good examples. If watching television is a relaxation tool for you, avoid watching a violent or very dramatic show in the one to two hours before bedtime. The light coming from television or electronic devices will impede your body's ability to make melatonin, your sleepy hormone. (Indirect light, like a reading lamp, does not have the same effect as the blue electronic light shining directly into your eyes.) Taking a warm shower or bath with lavender is calming. Brushing your hair and teeth slowly, massaging your neck and shoulders, pressing a warm cloth to your face, or rubbing your feet and hands can help you unwind. When we breathe down into the belly, it helps to calm the nervous system: practice breathing in a way that raises and lowers your belly button (instead of your shoulders).

Acupressure points on the inside of the ankle below the ankle bone and in the center of the bottom of the heel strongly stimulate sleep. Use the heel of your right foot to slowly massage the inside of the left ankle and then switch sides: this is great for kiddos during a bedtime story too. You can also try tightening all the muscles in your body and then slowly releasing them one by one into relaxing, restful sleep.

Foods can have a powerful impact on whether or not we are able to sleep. High blood sugar levels are associated with stress. When we eat a sugary snack like ice cream right before bed, the sugar can act as a stimulant and prevent relaxing sleep.

Similarly, the high fat in common late-night snacks can activate the digestive system strongly, creating feelings of bloating and indigestion (not to mention loud gurgling sounds) that may keep you awake. The amino acid tyrosine, found in proteins, activates brain activity. For all of these reasons, it is best to avoid eating in general – and heavy meals in particular – for two or three hours before bed.

Caffeine is a stimulant found in coffee, tea, soda and some medications that will impact your ability to fall asleep. Even if it's labeled "decaf," decaf coffee typically contains 3-7 percent caffeine. Mint tea is a good choice if you need an alternative pick-me-up in the afternoon. In the evening, chamomile tea is calming and is regularly prescribed by European doctors for sleep.

Alcohol may help you fall asleep faster, but it disrupts the sleep cycle, making you more likely to wake up with little noises around the house. You can dilute alcohol's effects with drinking a glass of water for every glass of alcohol, but of course, trips to the bathroom are then in your future. Finally, alcohol can make night sweats and hot flashes worse. If you have difficulty sleeping, it is best to avoid alcohol for four to six hours before bedtime.

If you suffer from "monkey mind" as you are trying to sleep, journal about your thoughts or write down a list of tomorrow's "to do's" before the lights go off. If you wake in the night, keep a small pen light next to the bed so you can jot down your concerns without shining a lot of light into your eyes. Remember that it is normal to process our thoughts and emotions when we sleep, but if you have chronic difficulty falling asleep, you may have a vitamin or mineral deficiency or other health issues that need to be addressed by a medical professional. Snoring puts you at risk for serious medical consequences. It should be evaluated and addressed by your primary care provider or by a sleep specialist.

C. Leslie Smith, MS, MA, LAc, MD, is director of Culinary and Integrative Medicine for SIU Medicine. If you are interested in discussing your sleep concerns, ask for a sleep expert at SIU Medicine by calling 217-545-8000.

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