Do you resist going to bed….even when you feel exhausted?

Do you feel compelled to wrap up “one more thing” for work?  Respond to “one more” email?  Check out Instagram or Facebook “one more” time?  Send “one more” text?

So do 90% of American adults!

According to a 2018 poll conducted by the National Sleep Foundation, only 10% of American adults prioritize their sleep as a health goal—compared to other lifestyle habits, like fitness/nutrition, work, social life, hobbies or personal interests.1  And: only 27% get the recommended 7-9 hours of weekday sleep; over two-thirds (65%) get less!

Many of my clients tell me that they don’t go to sleep—even when they feel tired—because:

  1. They want to unwind and “de-stress” from the day.   **“Unwinding” typically refers to some kind of online engagement: social media, surfing the net, watching a favorite show (or several) and/or emailing or texting.
  2. They can “get more done” when everyone else has gone to bed.
  3.  They want “me time”.

Yes, I get it…but did you know…

  • Lack of sleep has been associated with increased risk of some cancers, including breast cancer and prostate cancer?2
  • Women who sleep fewer hours on a regular basis may develop more aggressive breast cancers compared with women who sleep longer hours?3
  • Sleeping too few hours and poor-quality sleep have been associated with increased risk of obesity, heart disease, Type 2 diabetes and total mortality?
  • Sleeping less than 6 hours a night may increase your risk of having dangerous polyps in the colon or rectum?4
  • Chronic sleep disruption is associated with increased risk of liver cancer?5
  • Insufficient sleep depresses your immune function, leaving you vulnerable to viruses, like colds and the flu?

In our 24-7 go-go culture, we undervalue sleep. Yet, getting enough quality sleep is critical for repairing your body, balancing your hormones and weight management, as well as for fat loss and building muscle.

Unfortunately, for many of us, simply going to bed early (or earlier) does not ensure that we will fall asleep easily, or sleep through the night.

So, how do we get enough quality sleep?

The Rhythm of Sleep

First, it is important to understand the “rhythm” of sleep.

Our bodies have a natural circadian rhythm, tied to light exposure, which affects cortisol, our fight-or-flight stress response hormone.  Cortisol levels are normally lowest at 3:00AM.  As the sun rises, cortisol levels also rise so that you awaken—with energy—in the morning.  Cortisol begins to rise from 6:00am and peaks around 8:00 AM.7  From this point, cortisol levels gradually drop throughout the day, especially after the sun sets, preparing your body for sleep.

Going against our natural body clock triggers a negative hormonal domino effect.  For example, if you struggle to wake up most mornings and cannot function without a generous hit of caffeine, you are likely starting your morning with low (instead of high) cortisol levels.  This sets the stage for weight gain because you will likely crave stimulants, like sugar and refined carbohydrates for artificial “energy” to get you through the day.

Lack of Sleep = Stress

Most of us think of “stress” in its most obvious forms: financial stress, a breakup or divorce, project deadlines, long commutes, a hostile work environment, or an acute health crisis.

A less obvious source of “stress”, however, is sleep deprivation.

When you get enough sleep, your brain is able to properly detoxify by removing cellular “trash”—metabolic waste proteins, like beta amyloid (its accumulation in the brain is associated with Alzheimer’s) that build up in the brain throughout the day. This brain-cleaning process may reduce the risk of Alzheimer’s.8

Sleep affects the body’s central stress response system: the hypothalamic-pituitary-adrenal axis, also known as the HPA axis. The three parts of the HPA axis include the hypothalamus (the forebrain; responsible for hunger, thirst and body temperature); pituitary gland (the master gland that controls all the endocrine glands in the body) and adrenal glands, two walnut-sized glands above the kidneys, that produce the stress hormone cortisol, as well as sex hormones, like estrogen and testosterone. Like a symphony, all three parts of the HPA axis work together to regulate your stress response, immune system, digestion, metabolism, mood and energy levels.

Sleep deprivation creates HPA axis dysfunction, the scientific name for adrenal fatigue. Some of the immediate effects can include: daytime sleepiness, excessive fatigue, greater hunger, mood issues (e.g., quickness to anger or irritability), weight gain and more accidents.9

Over time, chronic sleep deprivation can increase your risk of Type 2 diabetes (not enough sleep = higher blood sugar), inhibit proper wound healing and reduce cognitive function (poor reasoning skills and faulty memory).10
In one study, men and women who participated in one week of mild sleep restriction (for example, sleeping 6 hours instead of 8 hours) experienced increased inflammation in their bodies, evidenced by elevated inflammatory markers, such as high sensitivity C-reactive protein and interleukin.11  Some studies also suggest that women may be more susceptible to increased inflammation from sle­­ep deprivation. Associated with diabetes, heart disease and arthritis, chronic inflammation may also represent a link between diabetes and cancer.12 

The Hormonal Effect…

Lack of sleep affects hormonal balance in both men and women.  For example, if you have unwanted belly fat, in spite of regular exercise and healthy eating habits…look to your sleep!  Chances are that insulin, the hormone that ensures that your blood sugar is neither too high nor too low, is out of whack.

We want our bodies to be insulin-sensitive. Insulin acts like a key that unlocks the cells in your muscles and tissues so that glucose (from the food you eat) can be used for energy. Whatever glucose cannot be used by your muscles and tissues gets stored in fat cells.  Insulin resistance happens when your body’s cells become resistant to the effects of insulin (this often happens when you are consuming too many calories from sugar, refined carbohydrates, processed foods, unhealthy fats, or alcohol). The excess glucose ends up being stored in your fat cells, mostly visibly, around your mid-section.

Poor sleep changes how the body produces and uses insulin.  In a 2016 animal study, researchers found that one single night of complete sleep deprivation (zero sleep all night!) reduced insulin sensitivity more than 6 months on a high fat diet!

A common scenario for most Americans is partial sleep deprivation), which prevents the body from using insulin effectively and also raises blood sugar. After one week of sleeping 5 hours a night, a group of non-obese, healthy young men (ages 20-35) experienced a significant reduction in insulin sensitivity, as well as higher afternoon and evening levels of cortisol (the stress hormone), according to a 2010 study published in Diabetes.

In men….sleep loss can dramatically lower testosterone levels.  In a 2011 study, researchers found that when a group of healthy young men (average age was 24) spent one week sleeping less than 5 hours, their testosterone levels plummeted by 10% to 15%.  Keep in mind that, within the context of normal aging, men’s testosterone levels decline by 1% to 2% a year.13  Sleep loss accelerates that aging process!

Touted as the “fountain of youth”, the anti-aging hormone produced by the pituitary gland is human growth hormone (HGH), a.k.a., growth hormone (GH). Because it plays an important role in enhancing muscle growth, fat-burning, body composition, exercise performance and a healthy immune system, optimal levels of GH keep you lean and energized. Symptoms of low GH levels?  Increased abdominal obesity, decreased lean body mass, decreased muscle mass, high blood pressure, high triglycerides, lower bone density, among others.

Growth hormone is released in waves during sleep that are based on your body’s circadian rhythm. Sleep deprivation (or sleep loss) can drastically reduce the amount of GH your body produces. If you want to optimize your GH levels, aim to be in bed between 10pm and 11pm for 8 hours of uninterrupted quality sleep.  When you go to sleep matters: the largest waves of GH are released BEFORE midnight.

How to Fight Sleep Robbers 

Sleep robbers interfere with your body’s circadian rhythm) and / or sleep architecture. They include:

Sugar!  Do you graze on sugar, including refined carbs, all day (soda, juice, cereal, bread, pizza, crackers, cookies, etc.)? Or, do you “unwind” at night with a big bowl of ice cream while binge-watching Netflix or surfing online?  Sugar is a stimulant that interferes with sleep by delivering quick hits of energy that can cause multiple awakenings throughout the night. When you have higher blood sugar levels, your body spends the night trying to burn that excess sugar instead of burning fat! Studies have shown that lack of sleep raises blood sugar levels (thereby increasing risk of diabetes). It’s a vicious cycle: unstable blood sugar means less sleep.  Less sleep increases cravings for more sugar.

Rx:  Choose whole, unprocessed foods.  Ideally, this is some combination of protein and magnesium-rich sources of fiber (e.g., dark leafy greens) to help stabilize blood sugar and a modest amount (not too much!) of starch and fat. If you tend to wake up repeatedly during the night, try including just enough starchy complex carbohydrates at dinner, like a sweet potato (with the skin), butternut squash or black beans, to help promote sleep by increasing the level of serotonin in the brain.

Caffeine.  In all its forms—coffee, tea, soda, energy drinks and chocolate—caffeine promotes alertness and wakefulness. Depending on when and how much you consume, and whether you are a slow or fast metabolizer, caffeine can disrupt the quality and duration of your sleep.

Did you know: caffeine can suppress melatonin, the hormone that helps control your sleep-wake cycles, even more than bright light?

Melatonin production is influenced by your circadian rhythm (body’s internal clock) and the amount of light to which you’re exposed. Typically, melatonin rises mid- to -late evening, after sunset, and remains high throughout the night.  As the sun rises, melatonin drops—causing you to wake up.  Your coffee habit could be inhibiting melatonin production (when you need it most), making it a challenge to fall asleep.

It can take 5 to 8 hours for half of the caffeine you consumed to be metabolized by your body—even longer if you’re a slow metabolizer. For example, if you drink 200 mg of caffeine (apx. 1-2 cups of coffee) by 12noon on Tuesday; you will have 100 mg of caffeine in your system at 8pm. Eight hours later (4 AM), you have 50 mg of caffeine in your system. Eight hours later, by 12noon on Wednesday, you still have 25 mg of caffeine in your system!14  Even a small amount of caffeine can affect sleep quality if you are hyper sensitive to caffeine.

Rx:  Know your body on caffeine!  Many of my clients are highly stressed and have hormone imbalances, or they are in hormonal transition (perimenopause, menopause, andropause), and are sensitive to caffeine. If this describes you, reduce your intake or avoid caffeine altogether—until you stop feeling like you “need” caffeine to function.

If you are a fast metabolizer and able to tolerate caffeine well, have your last cup of coffee by 11AM.  Even if you have a healthy relationship with caffeine, try going 2 days on and 3 days off (caffeine typically clears out of your system after 3 days).15

Alcohol.  Although alcohol has a sedative effect that can make you drowsy and seemingly fall asleep faster, it disrupts your sleep architecture. This means you will spend less time in REM sleep (important for memory and emotional processing) the first half of the night. During the second half of the night, your body shifts from deep sleep, to lighter sleep with multiple awakenings (because of the alcohol), compromising the quality of your sleep.  You are more likely to wake up very early in the morning—and unable to fall back asleep. The consequences of alcohol-induced sleep loss include fatigue, irritability, inability to focus/concentrate, mood and performance. Consuming two to three drinks a day is enough to affect sleep and performance; heavy drinking and / or drinking close to bedtime worsens sleep loss symptoms.16

Rx:  Drink less. Drink organic.  You had to see this coming!  If improving sleep is a health goal, it is best to limit alcohol consumption to one drink 2 to 3 times a week and to have that drink between 5pm and 7pm (at least 4 hours before bed).17 The ideal scenario, especially if you are in perimenopause or menopause, is to abstain from alcohol altogether during the week and enjoy a glass of organic red wine with dinner over the weekend. Yes, organic, because conventionally grown wine grapes are heavily sprayed with pesticides.  Alcohol also raises estrogen levels; three or more servings of alcohol a week is linked to a modestly increased risk of breast and other cancers (13% to 15%).18

Exercising too much or at the wrong time.  Over exercise—too much exercise for an already stressed-out-body—raises cortisol levels. Timing of exercise matters too. By engaging in long-duration cardio sessions (like running or spinning) at night, you are ramping up cortisol levels at a time when cortisol normally drops off. This goes against your natural body clock, affecting sleep. High cortisol levels at the wrong time (night) prevent the production of melatonin, which helps your body get the sleep, rest and recovery it needs.19

Rx:  Exercise early in the morning, late afternoon, or early evening.  Early morning exercisers tend to sleep longer and deeper than those who exercise later in the day. That said, from a thermoregulation perspective (the process of lowering core temperature in preparation of sleep), exercising late afternoon or early evening can also be beneficial for sleep.20 The key is honor your internal body clock and not to engage in long-duration cardio or vigorous workouts (e.g., 1 hour of CrossFit) in the later evening.  Engaging in 30-minutes of resistance training (up until 7pm) was also found to help improve quality of sleep among college-aged subjects—with additional benefits for those with osteoporosis (bone loss), sarcopenia (muscle loss due to aging), anxiety and depression, researchers found in a study published in The Journal of Strength and Conditioning Research.

Light pollution.  Short wavelength blue light from electronic screens (computers, tablets and phones) at sundown, especially after 9pm, damages sleep by shortening sleep time and preventing quality sleep, Israeli researchers reported in a 2017 study published in Chronobiology International. Energy-efficient lighting, like curlicue compact lightbulbs and LED lights, also exposes us to blue light that interferes with sleep. Night exposure to blue light suppresses melatonin (you make less) and disrupts our circadian rhythm.21  A circadian rhythm that is continually “off schedule” (e.g., night shift workers who sleep in the morning and work evenings) can compromise heart health, metabolic function (diabetes, obesity), immunity, mood and cognitive function.22

A study conducted by Brigham and Women’s Hospital found that the use of light-emitting electronic devices (LED), including tablets, smart phones and e-readers, in the hours before bedtime can negatively impact overall health, alertness and circadian rhythm.  In a 2018 study published in Physiological Reports, all of the young adult participants who used LED in the hours before bedtime went to bed significantly later. Even a 30-minute later bedtime and/or shorter sleep duration in adolescents is associated with greater daytime sleepiness, caffeine use, depression and thoughts of suicide.

Rx:  Start dimming at sunset + Darken your bedroom at bedtime.

  • If you have to be on electronic devices after sunset, wear blue light-blocking amber glasses to enable your body to produce melatonin that will naturally make you feel sleepy.
  • Keep all electronic devices OUT of the bedroom, including the television.
  • Keep your bedroom dark, as in pitch-black, with these blackout curtains.
  • Swap out scanning your phone or tablet before bed for reading printed material, like a book!
  • Wear a sleep mask; I suggest this brand.
  • If you have a digital clock, turn it away from you or cover it.

EMF Overwhelm.  This one is hard to hear! From cell phones to WiFi, man-made EMFs (electromagnetic fields) are part of our modern everyday life. However, EMF exposure from these devices can significantly reduce melatonin, interfering with our sleep—and our overall health.  In fact, the International Agency for Research on Cancer classifies electromagnetic fields (EMFs) as “possibly carcinogenic” to humans, with the potential to transform normal cells into cancer cells.23

The National Institute of Environmental Health Sciences categorizes EMFs in two groups:
1.  Non-ionizing.  Low level radiation sources, such as microwave ovens, computers, house smart meters, wireless networks (WiFi), cell phones, Bluetooth devices, power lines and MRIs.
2.  Ionizing.  Mid- to high-frequency radiation that can lead to cellular and/or DNA damage, including UV, X-rays and Gamma.24

The human body is actually a complex electromagnetic system.  Our cells conduct electrical currents that our body uses; for example, the nervous system require electricity to send signals throughout the body and to the brain that enable us to move, think and feel.  Magnetic fields have also been detected from the human heart and brain.25
The problem, however, is that because the electromagnetic signals of the human body are very weak, chronic exposure to man-made EMFs (like WiFi, Bluetooth and cell phones) can disrupt the intricate but delicate electromagnetic systems of the body, in particular, for the heart, brain and mitochondria (the “powerhouses of the cell”).

People who are very sensitive to EMF exposure may develop electromagnetic hypersensitivity (EMHS), a condition not yet recognized by the conventional medical community. Those who are electrosensitive may experience a constellation of physical, emotional and neurological symptoms, including sleep disturbance (insomnia or problems staying asleep) and fatigue, as well as chronic inflammatory disorders.26

Rx.  Incorporate the following simple, cheap and practical tips for reducing your EMF exposure: 

  • Limit the time you spend gazing at your computer, tablet or phone to protect yourself from the cumulative damage of invisible electrical currents.
  • Do NOT sleep with your phone under your pillow!  (I can’t tell you how many people do this!)  If you use your phone as an alarm, switch to “Airplane” mode and place phone in another room.
  • Keep all of your wireless devices, including your phone, at least one foot away from your body.
  • Completely turn off all electronic devices (e.g., phone, tablet or computer); or, at a minimum, switch to “Airplane” mode and/or turn off the Wi-Fi function before bed.
  • Instead of a wireless and/or Bluetooth connection, opt for a hardwired ethernet cable connection to your computer, laptop and/or tablet.
  • If you have a WiFi router in your home, turn it off at night.
  • If you need to charge any wireless electronic devices during the night, make sure the device(s) are turned off or in “Airplane” mode—and keep as far away from the bedroom as possible.
  • Trade your digital clock, which runs on electricity, for a battery-operated alarm clock.
  • Just say “no” to a smart meter at your home; or if you have one, talk to the utility company about replacing it with an analog meter.

Monkey mind.  Last, but certainly not least, ceaseless mind chatter, driven by worry and anxiety can prevent us from getting the shut-eye we need.  One of the simplest ways to quiet the mind is to engage in mindfulness meditation.  In a JAMA study of middle-aged to older adults who had problems sleeping, researchers found that participants in the group who practiced mindfulness meditation experienced less insomnia, fatigue and depression by the end of just six sessions.

So many of us tend to live in the past or in the future, which can drive persistent negative thoughts.  Mindfulness meditation is about being present in the moment.  You can do it for 5 minutes or, ideally, 20 minutes. You can facilitate the relaxation process simply by focusing on your breath, a sound (“om”), a word (“peace”) or a phrase “I am relaxed”.  Release any self-judgement or self-criticism; the idea is to just “be”. If your mind wanders (and it will!), simply it back to the object of focus (sound, word or phrase), or to your breath.

Sleep can feel elusive—either because we are afraid to surrender to sleep, or because we feel afraid, stressed or anxious.  While we cannot choose our external circumstances, we can create a healthier body and brain to navigate life’s surprises—simply by choosing to sleep.

As Mahatma Gandhi famously said, “Each night, when I go to sleep, I die. And the next morning, when I wake up, I am reborn.”

Sources:

1   National Sleep Foundation. March, 2018
2   International Journal of Cancer.  July 17, 2018
3   Breast Cancer Research and Treatment. Aug. 2012, Vol. 34, Issue 3, pp. 1291-1295
4   Cancer.  Oct. 8, 2010
5   Cancer Cell.  Dec. 12, 2016, Vol. 30, Issue 6, pp.909-924
6  Science Daily. May 22, 2017
  ZRT Laboratory.
  Science.  Oct. 18, 2013, Vol. 342, Issue 6156, pp. 373-377
9  American Sleep Association.
10 Biological Psychiatry. 2008 Sept 15; 64(6): 538-40
11  Best Practice & Research Clinical Endocrinology & Metabolism. Oct 2010. Vol. 24, Issue 5, pp. 775-784
12Journal of Diabetes Research. 2012, Art ID 789174
13JAMA. Jun 1, 2011; 305(21): pp. 2173-2174
14, 15, 19, 20,Sleep Smarter. Shawn Stevenson. Rodale. March 2016