Sleep Will Make You Stronger


How well are you sleeping right now? Are you getting more sleep because you don’t have a commute to contend with or because your typical work hours have been reduced or cut altogether? Maybe you don’t have to get the kids up and out the door for early school start times. You aren’t rushing to activities and events on the weekends. Or are you having more trouble sleeping? Maybe you worry about the current pandemic, the state of the country and the world, our future, finances, the safety of your family and friends. Maybe you spend hours researching how to apply for a small business loan, unemployment, or mortgage payment deferment. Maybe you are staying up late, enthralled by the news on tv or your phone. This pandemic is affecting all of us. Our normal routines have been suddenly and swiftly upended, and we have to adapt on a daily basis to new developments and advice. However, we need to attend to our sleep routine and make it a priority. Turning this challenging time into an opportunity to set good sleep habits will help us stay healthy now and help us to thrive in the post-COVID-19 era. Why is sleep so important?

Sleep is a critical period of recovery. Several processes in our bodies and brains occur only while we are sleeping that cannot take place when we are awake:

  • Immune cells are created and repaired

  • Immune chemicals are created

  • Cells and tissues are repaired

  • Tissue growth occurs as growth and developmental hormones are created and released

  • Blood supply to muscles increases for repair and recovery

  • Maintenance of brain cells and brain connections occurs, and toxins are cleared from the brain. (If this process is not able to occur sufficiently, the risk of Alzheimer’s disease is elevated. There is a strong correlation between sleep habits and the development of Alzheimer’s.)

Without enough sleep, we enter a state of inflammation which causes damage to many different tissues and organs in our bodies. Our risk increases for obesity, high blood pressure, Type 2 diabetes, arthritis, asthma, neurological conditions, chronic pain and chronic fatigue syndrome, digestive problems, depression, anxiety, other mood and emotional regulation problems, altered motor learning and planning, and balance problems. Immune functioning is reduced as is our ability to heal, therefore increasing our risk of infections and illnesses.

What can we do? Here are some ways to start developing better sleep habits:

  • Set regular bedtime and wake-up times, and stick to them on the weekends. This helps your natural biological rhythm, called circadian rhythm.

  • Train your brain that bed is for sleeping:

  • Avoid eating, drinking, watching TV and using electronic devices in bed.

  • Perform relaxation techniques while in bed, if needed.

  • Leave the bed if you cannot fall asleep after 20-30 minutes and do some relaxing activity in low light. Then return to bed when sleepy.

  • Create a relaxing bedtime routine: warm bath, reading, meditating, gentle stretching. Avoid stressful topics or TV before bed.

  • Avoid caffeine at least 4 hours before bedtime.

  • Avoid drinking alcohol 3-4 hours before bedtime—although it can help you fall asleep initially, it increases the frequency of waking up during the night.

  • Avoid cigarettes or nicotine products 3-4 hours before bedtime, as they can cause difficulty falling asleep. (We urge you to avoid cigarettes and nicotine altogether!)

  • Do not take unprescribed or over-the-counter sleeping pills—this is not a safe practice. Talk to your doctor first.

  • Avoid daytime or evening napping, which may prevent you from feeling tired at night. If you feel you must nap to get through the day, limit nap time to 30 minutes.

  • Create a comfortable and relaxing sleep environment:

  • low light (as dark as possible)

  • low noise unless you need a white noise device

  • cool temperature

  • comfortable pillow, mattress and blankets

  • Your body should be in a position that is not painful and keeps the neck, back, hips, and shoulders in a neutral position. You may accomplish this with additional pillows for support.

  • If needed due to reflux, keep the trunk, shoulders, head, and neck elevated.

  • Avoid light-emitting electronics 30-60 minutes before bedtime, as they suppress melatonin, which is an important brain chemical for sleep.

  • If you keep your phone in your bedroom, turn it face down. If alerts wake you up or you have the urge to check your phone frequently while in bed, place it on the other side of the room.

  • Avoid eating a large or spicy meal 2-3 hours before bedtime, which can increase stomach acid secretion and heartburn.

  • Avoid excessive liquid intake 2-3 hours before bedtime, as it increases the frequency of waking up to use the bathroom throughout the night.

  • Add exercise to your daily routine, as regular exercise increases total sleep time, increases restorative sleep stages (deep sleep), and reduces the time it takes to fall asleep.

Let me emphasize: put your phone away, turn off the news, and take advantage of an opportunity to go to bed a little earlier and sleep a little later.

The importance of consistent, quality sleep—meaning 6-9 hours of uninterrupted sleep per night on a regular basis—cannot be overemphasized as a critical element of overall health and longevity. Sleep gives a huge boost to our immune system, which we need now more than ever. Let’s stay healthy together!

References:

Chen CY, Schultz AB, Li X, Burton WN. The association between changes in employee sleep and changes in workplace health and economic outcomes. Population Health Management. 2017; 00(00): 1-9.

Buysse DJ. Sleep health: can we define it? Does it matter? Sleep. 2014; 37(1): 9-17.

Slengsukon CF, Al-dughmi M, Stevens S. Sleep health promotion: practical information for physical therapists. Phys Ther. 2017; 97: 826-836.

Kyle SD, Henry AI. Sleep is a modifiable determinant of health: implications and opportunities for health psychology. British Journal of Health Psychology. 2017; 22: 661-670.

Howard ME. The sleep-loss epidemic: understanding & managing sleep disorders. 2018. www.INRseminars.com.

Shokri-Kojori E., et al. Beta-amyloid accumulation in the human brain after one night of sleep deprivation. Proceedings of the National academy of Sciences. 2018; 115(17):4483-4488.

Yulung B. et al. Does sleep disturbance affect thte amyloid clearance mechanisms in Alzheimer’s disease? Psychiatry and Clinical Neurosciences. 2017; 71: 673-677.

Mullington JM., et al. Sleep loss and inflammation. Best Pract Res Clin Endocrinol Metab. 2010; 24(5): 775–784.

Motivala SJ. Sleep and inflammation: psychoneuroimmunology in the context of cardiovascular disease. Annals of Behavioral Medicine. 2011; 42(2): 141–152.

Written by Dr. Kim Richards, PT, DPT

Board-Certified Clinical Specialist in Orthopaedic Physical Therapy

Certified Applied Prevention and Health Promotion Therapist

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