Sleep - The Hidden Part of Your Care

People have come to value time so much that sleep is often regarded as an annoying interference, a wasteful state that you enter into when you do not have enough willpower to work harder and longer.”  - Susan L Worley

It often feels to me like good-quality sleep is one of the most elusive life hacks. It’s so easy to ruin it. High stress makes it harder. Eating an abnormally big meal makes it harder. Kids make it harder. Pain definitely makes it harder. Changes in hormones make it harder.

While this post is mostly about what you can do to improve your sleep, I want to be very honest about one thing: changing sleep habits can be really tough. When you start out trying to improve your sleep, you will have nights that you’re blown away by how much it helps! And you will also have nights where you toss and turn and wonder what you’re doing wrong. If you’re in the latter group, have patience. With persistence, sleep can always get better.

Benefits of Sleep

Some of the more well-known benefits of good-quality sleep include:

·       Decreased risk of cardiovascular disease & arrhythmias

·       Decreased risk of mood disorders

·       Decreased risk of neurodegeneration & dementia

·       Decreased hypertension

·       Decreased risk of obesity and type 2 diabetes

Already pretty wonderful reasons to prioritize sleep quality! But here are some more unusual benefits we’re seeing as well:

Multiple studies show well-rested individuals have reduced sensations of loneliness, and report better social interactions. People who sleep well demonstrate better cognition, longer attention spans, better vigilance, and more emotional regulation.

Another one is prioritizing sleep quality may actually reduce your need to pee at night. (aka nocturia) This one is mind-blowing. When you have to pee frequently at night, your sleep is disturbed and lower quality. But lower quality sleep can increase the need to pee at night partly due to how it affects vasopressin – an important hormone that our body uses to suppress the production of pee at night. So it becomes a never-ending cycle. While Pelvic Floor PT can address many of the causes of needing to pee frequently at night, prioritizing and protecting your sleep is also vital!

AND – individuals with sleep apnea have an even stronger risk of nocturia than those without sleep apnea. It is worth talking to your primary care physician if you suspect sleep apnea.

Stick with me on this post, I know it’s getting long, but there’s so much good to share:

Sleep is when our body does its primary work of healing. It lets our immune system mount better responses. This is important in two ways – 1) It helps you fight off those cold bugs your kids brought home from daycare. And 2) it improves your body’s response to vaccines. Vaccines can literally be more effective just by getting better sleep. It’s also when our body synthesizes protein – which means wound healing is most effective during this time.

Nighttime is when our body balances hormones: estrogen, testosterone, cortisol, appetite hormones, vasopressin. So another way of saying this – more energy, better response to exercise, fewer symptoms of menopause, better blood pressure regulation, better sexual function, less stress, easier weight management… need I go on?

The human body is amazing at how well it can adapt to new things – but it can take time. If you want to try to improve your sleep, I recommend picking 1-3 tips at a time, and trying them daily for 2 weeks before adding anything new. Because it might take a week or 2 to see the effects of a change.

My favorite tips for improving sleep come from Dr. Andrew Huberman, of the Huberman Lab podcast.  For his full post about these tips, visit this link: Toolkit for Sleep - Huberman Lab

For a quick summary of his tips read on:

1.      Sunlight: When you first wake up, get outside or open a window and get unobstructed sunlight on your face! Obviously don’t look at the sun, enjoy viewing your backyard, the birds, anything. This helps you wake up and re-set your circadian rhythm. In the evening, in that beautiful golden hour, get outside again, because that hue helps kick off important nervous system pathways for sleep readiness.

2.      Consistency: As much as possible, try to go to bed at a consistent time, and get up at a consistent time. Our bodies love and respond well to habit, and will start helping you feel sleepy at your bedtime if it’s close to the same every day.

3.      When you’re sleepy – GO TO SLEEP! This is one of those things that should be obvious, but we all ignore it. We all want to finish that TV episode, read one more page, finish one more task. Let’s break this habit. If you’re sleepy, your body is ready for rest. Listen to it.

4.      Avoid caffeine 8-10 hours before your bedtime: If you’re one of my clients, you know I ignore this one a little too often, but it is true. Just start cutting back little by little

5.      Avoid overhead lights at night: Light up the pathway at night (if you need to get up) with literally low lighting – below your waist. Dr. Huberman explains really well why, but generally your eyes won’t perceive the light as daylight and will be less likely to trigger wakeful patterns.

6.      If you take naps, make them short: 20 minutes is usually optimal

7.      If you can’t sleep, try to meditate instead: It won’t affect your sleep as much as a screen will, and has benefits that are similar to sleep, so it can help reduce the negative effects of lack of sleep.

Other tips I love:

·       Light dinners, earlier in the evening so your body has time to digest

·       Avoid alcohol – it suppresses REM sleep and reduces the benefits of sleep

·       Eat foods high in melatonin – such as fatty fish, kiwi, cherries, berries. And eat foods high in fiber such as oatmeal, leafy green veggies, beans, poultry. Most Americans are deficient in fiber. Eating enough is proven to improve sleep quality, reduce inflammation, improve blood pressure management (our bowels are KEY to our health!).

I’m so glad you stuck with me on this one, because the science is coming to a big consensus – quality sleep is key. Remember – the best chance of habit change is keeping it simple. This is a long list of suggestions, and trying to do them all at once may not help. BUT picking 1-3, you will start to see something get better. Maybe you fall asleep a little faster. Maybe you don’t rush as quickly for that first cup of coffee. Maybe you don’t feel a crash after lunch. The changes start small, but they are powerful.

Worley, Susan L "The Extraordinary Importance of Sleep. The Detrimental Effects of Inadequate Sleep on Health and Public Safety Drive an Explosion of Sleep Research". P.T. 2018 Dec; 43(12): 758-763

Rutledge, Thomas PhD "10 Surprising Facts About the Benefits of Sleep". Psychology Today. 8/1/2021.

Kemmer H; Mathes AM; Dilk O; Groschel A; Grass C; Stockle M. "Obstructive Sleep Apnea Syndrome is Associated with Overactive Bladder & Urgency Incontinence in Men". SLEEP 2009; 32(2):271-275