Sleep is one of those tricky things that can influence so many aspect of our life and health. And at the same time can be influenced by so many other things. It's a tricky situation. Certain health issues and stresses can cause poor sleep and then poor sleep can cause and exacerbate certain health conditions.
Sometimes it feels like a giant hamster wheel that is impossible to get off. If you feel like that you might need to see a functional medicine doctor to help you get to the root causes.
In the mean time, here are some simple things that can help improve your sleep.
Insomnia affects women more than men by about 50%. One of the reasons is the mensural cycle. Often women sleep better during different times of the month. Sleep problems occur more during the second 1/2 of the cycle. This is believed to be due to the rise of progesterone and the associated increase in the core body temperature. We may not be able to control the rise in progesterone, but Read More…
The 2017 Nobel Prize in Physiology or Medicine was awarded to researchers for their discoveries of molecular mechanisms that control circadian rhythm, our biological “clock.” This sleep-wake cycle helps us move between sleepiness and alertness at regular intervals, and regulates important functions such as:
- Brain function
- Hormone levels
Although we’ve long known the circadian rhythm exists, the Nobel awardees isolated the gene that controls it and identified the proteins that govern its cyclical function.
The importance of healthy circadian rhythm
Humans are similar to other animals in that our internal clocks are set to the rising and setting of the sun. A healthy sleep-wake cycle is critical for many aspects of our health. Circadian rhythm imbalances increase risk for heart disease, obesity, mood disturbances such as depression and anxiety, diabetes, cancer, dementia, and Alzheimer’s, and other neurodegenerative diseases.
Despite the circadian rhythm’s intuitive design, our modern lives tend to sabotage its critical balance. Some disruptive factors can’t be avoided while others can, but for most of those things we have the tools and knowledge to minimize the negative effects. We just need to do it.
Daylight savings wrecks the biological clock each year
Daylight savings time changes throw a kink in our daily rhythm. The time change is minimal, but studies show rates of driving fatalities, workplace injuries, suicides, and heart attacks rise after the spring-forward change. And night owls take the longest to recover. It will also have a big effect on those that work night shifts.
Prepare for daylight savings time by shifting your bedtime and waking time a bit every day the week before.
Traveling across time zones
Everyone laments how jet lag can wipe you out. Jet lag occurs when the time of day doesn’t line up with your body’s clock. Crossing two time zones should take you about a day of readjustment; however, crossing six time zones can easily take three days or more to recover. So if you are going in vacation somewhere far, just about the time you are recovering from jet lag of getting there its time to go home just to repeat the process all over.
My recommendation is that the farther you are traveling and more time zones you are crossing the longer you should stay, giving your body more time to recover. Plus you get the added benefit of a longer vacation under the guise of it being better for your health.
You can also try taking some melatonin to help trigger your sleep cycle and stay asleep longer. There are also other sleep aids that can be helpful such as valerian root, chamomile, and hops. I have included some links that you can check out.
Beware; chronic time zone jumping can lead to a suppressed immune system,
chronic fatigue, and memory issues.
Here are some other tips to help you when traveling to lessen the effect of jet lag.
Plan ahead by moving your body’s time clock toward the destination time zone during the week before.
Hydrate before and during the trip.
Choose a flight that gets to your destination in early evening and stay up only until 10 p.m. local time. If you arrive early and are exhausted, take a two-hour nap but no longer.
Once at your destination, expose yourself to the sun’s rays to help your body sync up with the new time zone. This one is actually really simple and one of the most effective things to do.
Poor sleep habits
Twenty percent of the population is estimated to sleep too little (less than 6 hours a night); this can lead to changes in genes that regulate stress, our immune system, sleep-wake cycles, inflammation, and aging. Chronic sleep deprivation is linked to heart disease, diabetes, obesity, stress, inflammation, dementia, and depression. 7-8 hours is really the best amount and some people may even need more.
Let’s talk electronics!
The CDC says insufficient sleep is a public health epidemic and research has established that the constant exposure to blue light from electronic devices is a major culprit.
Blue light and screen time
Changes in the levels of the hormone melatonin in your body are what make you fall asleep. During a normal day, morning light stimulates the body to decrease your melatonin level, promoting wakefulness, then as the day darkens, melatonin increases to encourage sleep.
However, adults and children disrupt this cycle by using smart phones and tablets late into the night. This can cause chronic insomnia because the blue light these devices emits is perceived by our brains as daytime light, which suppresses melatonin and keeps us awake.
Some tips to reducing the melatonin disrupting effect of blue light
Minimize blue screen time. Read a book instead. Turn off all screens (phone included) two hours before bed. If you can’t do that, get a pair of orange safety glasses. Side note: Turn you phone to airplane mode before you go to bed. That wi-fi is damaging.
Also, change the settings on your phone to what is called “night-shift” or “day-shift.” The phone will automatically shift the light type based on the time of day.
Improper daytime and nighttime light exposure
Proper patterns of light exposure during the day are a major factor affecting how well we sleep.
Start each day with as much bright light as possible. Eat breakfast with as many lights on as possible to stimulate serotonin production, which helps melatonin production later in the day. Serotonin converts to melatonin. You can also add a sun light.
Get light during the day at home and work. Open the shades; turn on all the lights (try full-spectrum); sit by a windowand look out often; take a walk outside during your breaks.
Minimize light in the evening by dimming or turning off unnecessary lights. Put orange bulbs in lamps you use at night, especially next to your bed and for reading. This helps to jump start melatonin production in preparation for sleep.
Lack of sunlight
Patterns of light during the day aren’t the only way light affects our circadian rhythm; exposure to actual sunlight is key for healthy function of the body and brain.
Research shows the average person spends less than an hour a day outside. Shift workers spend even less time outdoors. Lack of exposure to sunlight inhibits production of melatonin, affecting sleep and potentially affecting our ability to produce Vitamin D, key for bone health, mood regulation, and immune function.
Get direct sunlight every day. If you can’t get outside, use a quality light box early in the day.
Go sunglasses-free even for just 10–15 minutes, to provide beneficial sunlight exposure to your eyes and brain.
Respecting our body’s natural rhythm
Your body’s innate sleep cycle is largely controlled by the amount and pattern of light and dark you are exposed to each day. By managing the lifestyle factors that disrupt your circadian rhythm, you will support your body’s ability to function well and stay healthy. For help with sleep issues, please contact my office.
I have included a bunch of links at the bottom of this post for some products that can help improve your quality AND quantity of sleep.
And for those that like to save some more money check out my link HERE to a page on my website where you can buy supplements direct and in many cases 10-15% cheaper than on amazon.
I primarily use Physician only brands such as Xymogen and Designs for health, which if you are a patient, you can order directly from them or in my office. Another great option is Healthwave, also known as Fullscript. This is were I recommend patients get the rest of their supplements if they aren’t able to make it into my office. We buy in bulk and don’t charge extra sales tax so you get it cheaper, but these websites are great alternatives.
I’m Dr. Craig Mortensen
Be healthy, be happy.
Melatonin -.5-1mg should be plenty
Kava - also a natural anti-anxiety supplement
Gaba - See my post on testing for leaky gut with gaba
Products to help circadian rhythm (or not impair it)
Light therapy box
Blue blocking glasses/orange glasses
Full spectrum lights
It’s now common knowledge that nighttime exposure to computer, tablet, and TV screens sabotages sleep —the light they emit simulates sunlight, thus suppressing sleep hormones. There are even special glasses that you can purchase pretty cheaply on Amazon that block the most disruptive light wavelengths.
However, plenty of daytime sunlight is vital for good sleep, and most of us don’t get near enough.
Research shows the average person spends less than an hour a day outside. Compare this to our ancestors that would literally spend all day outside.
For shift workers it’s even worse. So for all you firefighters, nurses, police officers and whoever else on those night shifts, thank you, but prob best to leave those shifts to the young ones.
That lack of exposure to sunlight inhibits production of melatonin, a hormone that triggers the sleep cycle and puts us to sleep. Also remember that Serotonin is converted into Melatonin.
So if you have a serotonin deficiency (think depression) it can make it even more difficult to get a good nights sleep. Now your tired, depressed and can’t sleep. And the cycle continues in a wonderfully perpetual cycle of never-ending torture. But, thankfully there is help!
A Finnish rat study observed one group living under fluorescent lighting (hmmm - sounds like just about every person in America right. Living in our little work boxes inside our bigger building boxes. We drive from our living box to our gym box to our shopping box to our work box, back to our house box. All to rinse and repeat the next day) Anyway, the other group was exposed only to sunlight through windows every day. While both groups received the same duration of both light and darkness during the study, the rats exposed to sunlight produced significantly more melatonin.
It’s not that the artificial light was detrimental. It simply wasn’t strong enough — the sunlight was more than seven times brighter than the fluorescent light. Nature knows best!
This is what boosted melatonin production. Researchers assert that variation of light throughout the day, from dawn to dusk, also supports healthy melatonin production. Basically, it is better to have a little variation in the strength of the light like the sun rising, mid day, and late afternoon sun as opposed to the constant light from your little boxes.
During a sunny day, lux levels (which measure the intensity of light) reach 50,000. Compare this to indoor lighting, which ranges in the low to mid hundreds at the most. For most of human history we have lived with natural light and it plays a significant role in the function of the body and brain.
Why melatonin and light rhythms are so important
Anyone who has suffered through insomnia and sleep deprivation understands the importance of sufficient and quality sleep. Generally we should get at least 6 hours but preferably 8 for most people. And getting naps is a great way to help make up for a sleep deficiency, as long as they aren’t too late in the day. A short 20 - 30 minute power nap is a great way to regenerate your lagging brain function.
However, melatonin and our sleep-wake cycle (also called circadian rhythm) are intertwined with every system in the body, affecting much more than how rested or tired we feel. Tons of studies point to the importance of a healthy sleep-wake cycle for overall immune, hormonal, and mental health.
Remember, our body is like a complex spiderweb. Everything is connect to one another. I talk about this in some of my other blogs.
For instance, one study found that women suffering from PMS show chronically low melatonin levels. Just two hours a day of exposure to sunlight increased their melatonin levels and relieved their symptoms.
A German study showed subjects with mood imbalances exhibited healthier serotonin levels after just one week of light therapy. And there are some pretty cheap options for some light therapy products. Check out the link for the most common light therapy lamp I recommend in my office.
Another study showed subjects experienced a 160 percent increase in melatonin at night after just a half hour of exposure to bright light from a light box.
How to get enough outdoor light in an indoor world
It’s not easy getting enough sunlight when you’re indoors all day working or going to school. But it’s vital for healthy sleep, brain function, and metabolic function to get enough light exposure. As long as its the right type of light.
Some solutions are obvious —
1. Spend as much time outside as you can (my personal favorite, but not always feasible). Eat lunch outside and go for a walk on your breaks. Maybe you can even work outside on your laptop if your job is portable. This is what I do when I’m working on patient files on my non patient days.
2. If possible, work near windows that get plenty of natural light. One study showed employees working near a window received twice as much light as their coworkers who didn’t and hence enjoyed more sleep.
3. If sufficient exposure to natural light isn’t possible, indoor light therapy has been shown to help relieve sleep and mood imbalances. Again, check out my link to my favorite lamp. You want to get one that is 10,000 Lux
Look for a light box that delivers plenty of lux and is big enough for sufficient exposure. The Center for Environmental Therapeutics provides criteria for purchasing a reliable light box, which they recommend using for at least a half hour in the morning. I often recommend doing 2 - 30 minute sessions per day. Or, just leave it on all day.
So let your light shine on!
I’m Dr. Craig Mortensen
Be Healthy, be happy!