How to Sleep Like a Baby, with the Top Science-Backed Insomnia and Sleep Strategies — Part 2 of 2
Improve Your Overall Health with Better Sleep Now!
The National Institutes of Health (NIH), estimates about 30 percent of people experience sleeping problems, with 10 percent of people having an impairment of their daytime function.
It’s estimated that about 25 percent of people have acute insomnia lasting a few days to a month annually.
Sleep Affects Our Overall Health
- How Improper Sleep Negatively Affects You
- Cardiovascular Health
- Cognition and Focus
- Insulin (Resistance vs Sensitivity)
- Muscle Growth
How Much Sleep Do We Need?
According to the Sleep Foundation, healthy adults need between 7 and 9 hours of sleep.
While a newborn needs 14 to 17 hours of sleep, the amount of sleep we need declines as we age, until 65 years or older, we need 7 to 8 hours of sleep.
Similarly, studies show excessive sleep over nine hours nightly can contribute to disease states.
The Sleep Foundation also tells us the seven to nine hours of sleep rule is a “rule of thumb” and getting one hour more or less within this range is acceptable depending on the individual.
The American Academy of Sleep Medicine (AASM), and Sleep Research Society (SRS), also suggest the average individual needs a minimum of 7 hours of sleep to optimize overall health.
What is a Short-Sleeper?
“The new research trend is raising questions that are harder than they first seem. How do you know when someone has gotten enough sleep? Enough for what?,” Michael Grandner, director of the Sleep and Health Research Program at the University of Arizona School of Medicine.
One percent of people are “short-sleepers”, which means they get 4 to 6 hours of sleep and report feeling refreshed upon waking.
Another 39% of people are short-sleepers who report feeling otherwise fine, except relying on caffeine and napping to get through their day.
As the one percent are considered true short-sleepers, scientists believe they possess a genetic mutation affecting their circadian rhythm, called DEC2, also promoting a notably higher tolerance for pain.
While the questions might be clearer than answers, we are finding growing reasons to believe our sleep patterns might be genetically predetermined.
We discover more researchers echoing short-sleepers should not pretend they are long-sleepers and vice versa.
Why Do We Wake Up in the Middle of the Night?
With waking in the middle of the night, we are conditioned to automatically believe this is the sign of poor sleep.
And we need to once again remind ourselves, “not so fast.”
Most people wake up one to two times in the middle of the night.
We wake at 3 am or thereabouts as this is the time we transition from deep sleep into lighter sleep.
If we are in bed at 11 pm, four hours later, we’ve completed our deep sleep and are shifting into prolonged light sleep periods, called rapid eye movement, or REM.
I Wake Up at Night to Urinate — Is this Normal?
Studies show waking to urinate is normal.
In fact, over two-thirds of men and women over the age of 70 urinate at least once, with up to 60 recent waking to urinate two times a night.
One in three adults over the age of 30 urinate twice nightly.
Technically, nocturia is the waking to urinate one or more times per night.
The reality is nocturia tends to be more invasive with two or more bathroom trips with significant interruption of sleep.
As we focus on how nocturia diminishes sleep quality, the relationship can likewise be inverse with poor sleep being a root cause of nocturia.
Despite it typically affecting those over the age of 60, nocturia can occur at any age, from an array of causes.
Nocturia could also indicate a serious underlying condition such as diabetes.
In men, often an enlarged prostate or benign prostatic hyperplasia (BPH), closing off the urethra serves as the cause of nocturia.
How Long is Normal to Fall Asleep and Fall Back to Sleep?
Normal sleep latency means it is normal for it to take 10 to 20 minutes to fall asleep once we get into bed.
Similarly, if it takes over 20 minutes to fall back asleep after waking in the middle of the night, this might be the sign of a sleep disorder.
The 9 Common Sleep Disorders
- Excessive Sleepiness
- Excessive Sleepiness (From Obstructive Sleep Apnea)
- Non-24 Hour Sleep-Wake Disorder
- REM Sleep Behavior Disorder
- Restless Legs Syndrome
- Shift-Work Disorder
- Sleep Apnea
What is Insomnia?
- Acute or Adjustment Insomnia: Most common lasting a few days to a month.
- Behavioral Insomnia: Childhood
- Chronic Insomnia: Long-term insomnia, typically from lifestyle and underlying health.
- Maintenance Insomnia: Difficulty staying asleep or waking too early.
- Onset Insomnia: Difficulty falling asleep or sleep latency.
Insomnia is the most common sleep disorder.
Stress and worry about family, finances, health, school, and work are typical underlying causes of chronic insomnia.
The Sleep Foundation shows 10% to 30% of adults have chronic insomnia.
In other studies, we find the estimates in the 50% to 60% range.
We also see insomnia affecting 30% to 48% of older people.
Sleep Cycle Stages
A Full Night’s Sleep
We cycle through these 5 sleep stages four to five times nightly.
Stages 1 and 2: Light Sleep
Starting our sleep cycle, light sleep is the transitional sleep stage into deeper sleep stages.
Our muscles relax during light sleep, as our breathing and pulse slow, in a state wherein we can wake easily.
- Muscles Release and can Twitch
- Pace of Respiration Decreases
- Pulse Decreases
- Temperature Decreases
Stages 3 & 4: Deep Sleep
Deep sleep is the restorative and rejuvenation sleeping stage.
We experience muscle growth and tissue repair, along with waste removal from the brain.
In this stage, you have difficulty waking up and are disoriented or groggy if awoken.
- Blood Pressure Decreases
- Blood Circulation Increases out to the Muscles
- Cellular Repair and Tissue Growth
- Hormonal Repair (Release of Growth Hormone (GH))
- Removal of Waste Products from the Brain
- Slow Brain Wave Activity
Stage 5: Rapid Eye Movement (REM) Sleep
The re-energization of our minds occurs during REM sleep.
REM promotes dreaming, learning, memory consolidation, and problem-solving.
The length of REM time generally declines with aging.
- Acceleration of Brain Activity
- Genitalia Blood Flow Increases
- Immobility of Body Prevents the Acting out of Dreams
- Regulation of Body Temperature Pauses
- Respiration Increases
- Pulse Increases
- Vivid Dreams (Lucid Dreaming)
We experience more Non-REM (NREM) sleep or dreamless sleep, in our earlier sleep cycles, whereas we undergo more REM sleep in our later sleep cycles.
When we enter the last sleep cycle, our body might bypass NREM deep sleep in transitioning into REM.
Neurotransmitters Involved in our Sleep-Wake Cycle
- Acetylcholine (Promotes REM sleep)
- Dopamine (Inactivates melatonin)
- GABA (Sleep as the major inhibitory neurotransmitter)
- Glutamate (Primary excitatory neurotransmitter)
- Norepinephrine (Fight-or-flight response: Sleep interrupter)
- Serotonin (Similar actions as norepinephrine)
- Adenosine (sleep-promoting neurotransmitter. Caffeine is an adenosine blocker.)
- Corticotropin-Releasing Hormone (CRH) (Peptide stress-response hormone)
- Cortisol (Steroid adrenal gland hormone made for stress and homeostasis.)
- Growth Hormone-Releasing Hormone (GHRH) (Promotes Slow-Wave Sleep)
- Melatonin (Sleep-Wake Cycle: Higher levels at night. Levels drop as we age)
- Orexin (Arousal and wakefulness)
Better Sleep Solutions
- Avoid alcohol and caffeine at night
- Block bluelight (Add blue-blockers to screens and/ or wear blue-light-blocking glasses)
- Cold shower (1–2 hours before bedtime)
- Consistent bedtime
- Cool room (Cooler rooms promote sleep)
- Darkroom (Block all light. Apply black electrical tape on all electronics)
- Earlier bedtime and dinner time (Small bedtime snacks may help some)
- Lower nighttime light exposure (2 hours before bedtime)
- Lower noise
- Relax (Wim Hof breathing, music, meditation, self-hypnosis)
- Black Electrical Tape (For electronics and light cracks)
- Blackout Paper (For windows; Tinfoil can be optimal for those sleeping during the day.)
- Blue-Light-Blocking Glasses
- Ice Pack to Cool-Down
- Fan for Bedroom
- F.lux (Blue-light-blocker for the desktop)
- Mobile Phone Blue Light Blocking App
- Oura Ring
- Sleep Mask (360 light blocking) and Soft Foam Ear Plugs
- Sleep Tracking App
- The Right Bed and Pillow
- Tiny Melatonin Friendly Flashlight (Such as Blocklite)
*Some report taping their mouth shut with electrical tape to promote nasal breathing.
Nasal breathing strips can open nasal passages to promote improved nasal breathing.
What’s the best way to take a nap?
Much like caffeine, many use naps as a daytime strategy.
Research shows us there is a more effective method of napping.
Short: Nap for 10 to 20 minutes.
Early Afternoon: Naps after 3 p.m. can disturb nighttime sleep.
Restful Environment. Napping cool, dark, quiet spaces can be helpful.
Sleep Disorder Treatments
- Cognitive-Behavioral Therapy
- FDA-Approved Sleeping Devices: (Sleep apnea devices)
- Medications: (Sedative-hypnotic drugs, sedative-antidepressants, antihistamines, sleeping pills, benzodiazepines, and others.)
- Sleeping-Aids (See the Previous Chapter)
- Sleep Hygiene Counseling
- Sleep-Restriction Therapy
- Stimulus-Control Therapy
- Sleep Supplements (See Part 1)
Promising New Insomnia Therapy: Triple Chronotherapy
Triple chronotherapy, or adjunctive triple chronotherapy, is emerging as an interesting and more importantly promising insomnia and sleep disorder treatment.
Already found more effective than exercise for depression, triple chronotherapy is undergoing testing with initially promising results on bipolar disorder, anhedonia, PTSD, along with even more severe sleep disorders, such as narcolepsy.
Triple chronotherapy combines total sleep deprivation (wake therapy), sleep phase advance, and bright light therapy.
We believe triple chronotherapy might restore the circadian rhythm, or sleep-wake cycle, along with dopamine and serotonin function.
Historically, white lamp therapy has been the primary first-line treatment for seasonal affective disorder, (SAD).
The effectiveness of white lamp therapy for SAD, a type of winter depression, is undeniable, however, it is ineffective for other types of depression and insomnia.
We are finding bright light therapy, while still equally effective for SAD as white light, might also be effective for insomnia and other sleep disorders along with an array of mood disorders.
Bright light therapy involves 20 minutes of sun exposure upon waking.
Blue light therapy machines have been found to be the next best option to natural sunlight, with studies using them for 30 to 90 minutes within the first two hours of waking.
One study actually suggests red light therapy could be effective in anxiety treatment, however, this is very much in its early stages.
Triple chronotherapy can be a bit tricky and is typically done under medical supervision.
The Truth About Insomnia Medications, and Other Drug Treatments of Insomnia
A recent warning from the Harvard Medical School tells us many insomnia medications used for treatments of insomnia, both over the counter and prescribed, contain drug actions which can be detrimental to our brain health.
The most common insomnia medications are antihistamines, and the evidence supporting their use as treatments of insomnia is not strong.
More researchers are sounding the alarm against insomnia medications, such as benadryl, Unisom, ZzzQuil, and others, with suggestions they decrease sleep quality, lead to drug tolerance, and increase the risk of developing dementia.
The drug mechanism of these insomnia medications are not treatments of insomnia and instead just promote drowsiness.
Those with cardiovascular disease, hypertension, and respiratory conditions should avoid these insomnia medications altogether.
Insomnia medications also may trigger central nervous system reactions leading to tachycardia, or high pulse rate.
According to Harvard Medical School, those with kidney or liver issues and older adults should avoid these insomnia medications due to increased risk of adverse effects.
If we must use insomnia medications, we should aim for no more than two weeks of use.
Common Medications which Can Disturb Sleep
- Anti-arrhythmic (Heart rhythm)
- Beta-blockers (Blood pressure)
- Clonidine (Blood pressure)
- Corticosteroids (Asthma and inflammation)
- Diuretics (Blood pressure)
- Cold, Cough, Flu Medications (Alcohol)
- Headache and Pain Medications (Caffeine)
- Sedative Antihistamines (Allergies and colds)
- SSRIs (Anxiety or depression)
- Stimulant medications (ADHD/ ADD)
- Theophylline (Asthma)
- Thyroid hormone (Hypothyroidism)
*This is not a complete list. Verify any medications you are taking have not been found to cause sleep disturbance.
Conclusions on Sleeping Problems and Strategies
With all health conditions and once again, in the case of fixing sleeping problems, we want to look for the underlying cause of the sleep disturbance.
It might be possible our sleep is genetically predetermined, with individual needs varying.
Some might even believe they are experiencing sleeping problems when they are in fact perhaps not.
We want to remind ourselves as health optimizers, when we analyze our sleeping, we want to compare ourselves to ourselves and not others, because we are all different.
Triple chronotherapy is interesting as an insomnia and sleep disorder treatment protocol and worthy of much deeper attention.
What’s your favorite sleep supplement?
Your Friend in Health