The sleep/wake cycle impacts health in many ways. The hormone melatonin has become more familiar as it now more available over the counter as a supplement that may help with sleep. It may help with getting to sleep – but timing – when it is taken, and how much – not an excess, are important factors, and it may not help with staying asleep. Sleep and wake are very complex processes within the brain and body, with many chemical signals causing activation or inhibition of different areas of the brain which then signal activation or inhibition of body functions. Reviewing all of them is beyond the scope of this post – including just the summary points is my goal.
- Insomnia seems to be a hyperarousal of the system, both the brain and body remain more metabolically active than within normal sleep causing difficulties falling asleep and then leaving the person lest rested after sleeping because it was never reaching deeper relaxation of the brain’s activity levels. The hyperarousal tends to continue during the day so the person with insomnia may be irritable and not able to concentrate as well but may not feel tired or sleepy as might be expected after missing that many hours of sleep. The risk with ongoing insomnia though is the person is in need of deeper sleep and accidents may be more likely to occur in physical activity or in oversight of details in mental activity, especially when there are multiple demands on attention.
- The wake/sleep cycle is essential for health for many reasons but the overall point is that different functions of metabolism occur when awake than during sleep, and both are important to overall health. Repair and detoxification, roughly, are the focus of the sleep hours and energy use and activity and learning/creating new connections between brain and nerve cells are the focus of wake hours.
- Sleep and wake have different specialized genes and proteins for metabolism – what gets made or what gets cleaned up and reused or excreted/detoxified. Wakefulness activates genes that are used in active metabolism, using sugar for energy, and sleep activates genes that are important for using fats for building cell membranes or myelin sheaths around nerve cell connections.
- Chronic sleeplessness can cause insulin resistance and lead to increased risk for diabetes or metabolic syndrome, whether the sleeplessness was due to inadequate hours of sleep because of a busy schedule, or due to poor sleep quality because of insomnia or other health problems or overuse of caffeine or stimulating lights late at night. More about insulin resistance, Type 2 diabetes and metabolic syndrome is available in a TEDmed video talk about obesity and insulin resistance. A doctor suggests that the approach medical research has taken in looking at obesity as a cause of insulin resistance may be wrong – insulin resistance may lead to obesity. Peter Attia-What If We’re Wrong About Diabetes?, TEDmed.
- Hypertension, high blood pressure, is also a risk of chronic sleep problems.
- Add up the problems of reduced myelin sheath production, blood sugar and blood pressure problems, and it is easy to see that long term risks of poor sleep quality may include dementia whether typical forgetfulness type due to loss of connections between brain cells or the loss of brain cells in Alzheimer’s dementia.
Solutions vary depending on the type of sleep problem however general tips for an ideal sleep setting include:
- A cool room temperature – the body temperature is at its lowest during sleep.
- Complete darkness – for the pineal gland to make melatonin the use of a light blocking eye mask on long airplane rides may help provide deeper sleep. In the home setting or when traveling cover alarm clock lights or other digital lights during the night and close curtains. Complete light blocking curtains are ideal.
- Stop using digital screen devices about a half hour to an hour before intended time to try to sleep. Additional tips about electric light: Digital screens are a very bright type of light and blue lens glasses are available for eye protection for anyone who spends many hours per day using laptops or smartphones. The light settings on the device may also offer a dimmer evening setting which may help reduce eyestrain.*
- Avoid coffee or other caffeine containing stimulants for about four to six hours prior to intended time to try to sleep.
- Have a regular time to go to sleep and wake up each day. The average person does need about 7 to 8 hours of sleep each night and teenagers and toddlers ideally may need 10 hours of sleep for best cognitive performance and physical health. Lack of sleep for adults seems to negatively affect reasoning and verbal performance more than short term memory. (3)
- Avoid high fat, hard to digest meals or snacks in the hours prior to intending to try to sleep.
- A cool compress on the forehead or over the eyes or on top of the head may help relax sooner if insomnia and racing thoughts are a problem or feeling hot and jittery. Reusable gel packs designed for sprained ankles or other sore muscles can be kept in the freezer and then wrapped in a few layers of thin fabric to protect the skin from being overly chilled. The gel pack will eventually lose its coolness but use on the forehead may help slow down the metabolic activity of the brain, which then helps slow down signals to the body to be jittery – 20 to 30 minutes with a cool gel pack may help reach a more relaxed state before the pack is warm. Having several in the freezer could allow you to rotate the warm one with a chilled one if reawakening in the middle of the night is a problem. **
- If reawakening in the middle of the night is a problem but you are still sleepy, try not to use any bright lights while visiting the bathroom or kitchen, etc. If wide awake, then it is recommended to just get up and do something for a while until feeling sleepy again rather than tossing and turning in bed and getting more anxious or jittery.
- If reawakening in the middle of the night is consistently happening around 4:00 am then low serotonin levels may be a problem. (University Health News) Taking the precursor to serotonin, 5HTP or the herbal St John’s Wort, may help provide your body with serotonin.
- Cognitive Behavioral Therapy for sleep issues has been found to be as or more effective than sleep promoting medications while they are in use, and more effective at long term benefits even after the therapy or medication is no longer in use. Anxiety may be an issue but habits can also affect insomnia, naps and early bed times may disrupt sleep and staying awake during the day, and ideally getting some bright sunshine or full spectrum light during wake hours can help with the body’s 24 hour metabolic patterns. (CBT-I, National Sleep Foundation)
*Modern laptops or smartphones emit bluelight which may inhibit sleep. (1) Wearing blue light blocking glasses in the evening for any screen time may help reduce the effect. It has been found helpful to prevent sleep difficulties to wear them during the three hours prior to trying to go to sleep. The blue light blocking glasses are not needed for use throughout the day however. Eyestrain from a long day working with a light screen may cause dry itchy eyes and eyedrops for moisture and taking occasional breaks may help prevent that problem. Read more: (2).
**The tip about keeping gel packs in the freezer for use as a cold compress for the forehead that I mentioned for insomnia in a previous post (about the glymphatic system within the brain and its potential role in prevention of Alzheimer’s disease), is something that I have found helpful in the past for migraines. I tried it recently for insomnia after learning in the course about sleep and neurobiology that a “biothermal device” had been found helpful in sleep lab studies for patients with insomnia. (Sleep, Neurobiology, Medicine and Society, coursera.org)
The drawing suggested they had an electric blanket type compress size cooling device that laid over the forehead and slightly over the ear area, so a little bigger than a gel pack designed for sprained ankles. However a gel pack for sprained ankles is already at stores and electric cooling biothermal devices are not yet available to my knowledge. The point – my trial use with a freezer gel pack for insomnia was very helpful at slowing my thoughts and helping my body reach a relaxed state fairly quickly. I didn’t immediately go to sleep but it did seem to help. I’ve tried it several times now and one night got another out of the freezer when I was awake but sleepy in the middle of the night.
Environmental cues and genetic differences can effect sleep patterns. (Sleep, Neurobiology, Medicine and Society, coursera.org) (How Nature and Nurture Shape the Sleeping Brain, nature.com)
There is more on this topic however this is an overview of the importance of sleep.
/Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./
- Dustin Eves, Do Computer Screens Emit UV Light? techwalla.com, https://www.techwalla.com/articles/do-computer-screens-emit-uv-light
- Do Blue Light Blocking Glasses Really Work? 2018, nymag.com, http://nymag.com/strategist/article/blue-light-blocking-glasses-work.html
- Conor J Wild, Emily S Nichols, Michael E Battista, Bobby Stojanoski, Adrian M Owen; Dissociable effects of self-reported daily sleep duration on high-level cognitive abilities, Sleep, , zsy182, https://doi.org/10.1093/sleep/zsy182