Adequate sleep has long been known to be vital to good health but not getting enough sleep can be detrimental on many levels. Sleeplessness at night results in lack of alertness during the day, impairing your judgment and increasing the risk for accidents. Chronic sleeplessness can affect the appearance of your skin, reduce libido and overall vitality, decrease cognitive function, contribute to weight gain, and increase the risk of diabetes and cardiovascular diseases.
Your quality of sleep can be affected by many things including perimenopause (hot flashes, night sweats, sharp drop in melatonin over age 40); obesity (over half of obese people also have sleep apnea); shift work (interrupts sleep/wake cycle) and the use of tablets and phones at bedtime (blue light keeps us awake).
Ideally, the sleep hormone melatonin (produced by the pineal gland) should be in balance with the stress hormone cortisol (produced by the adrenal glands in response to stress), creating a healthy sleep/wake cycle. Disturbances in this balance can affect the quality of your sleep too.
There are some common hormone-related causes of sleep loss that often involve:
- High Cortisol
Results in insomnia, anxiety, sugar cravings, feeling tired but wired and increased belly fat.
- Low Melatonin
Low melatonin contributes to poor sleep onset or prolonged sleep onset. Poor sleep causes fatigue and depression.
- Neurotransmitter Imbalance
Changes in sex steroid hormone levels during menopause can impact neurotransmitter levels, leading to recurring sleep issues.
Healthy solutions to end sleepless nights
The American Academy of Sleep Medicine recommends that adults get at least seven hours of sleep every night. It’s also important to stick to a sleep schedule. “We all have a built-in biological clock called our circadian rhythm and tend to function best if we are ‘in sync’ with our rhythm,” says Fariha Abbasi-Feinberg, MD, FAASM, Medical Director of Sleep Medicine at Millennium Physician Group in Fort Myers, Florida.
“Keeping a regular sleep/wake schedule helps to entrain our circadian rhythm and keeps our bodies healthy and functioning well,” Dr. Abbasi-Feinberg adds. She usually recommends keeping wake-up times within one hour of your normal wake-up time. “If you vary it too much on the weekends, for instance, you can have trouble falling asleep on Sunday night and start the week with sleep deprivation. It can take a few days to retrain your rhythm, so it is healthiest to stick to a schedule.” Dr. Abbasi-Feinberg is board certified in sleep medicine and has been practicing for over 20 years.
Trouble falling asleep quickly and/or lying awake for hours?
Do you ever notice that the harder you try to fall asleep, the more difficult it becomes? If you are struggling to fall asleep, here are a few solutions:
- Get out of bed and do something else for a while.
- Read or listen to a relaxing podcast.
- Consider listening to a favorite show or audiobook over and over each night.
- Choose one that preferably has words and dialogue. This can help you pay attention to the external dialogue versus your own internal dialogue.
- When you listen to a show multiple times, your brain knows what is coming next. This allows the brain to relax, and it becomes easier to fall asleep faster.
- It might sound crazy but sometimes a movie like, “Star Wars,” might be easier to focus on and tune out rather than a meditative show.
- Write down your thoughts in a journal, which can often help you work out troubling issues.
- Remember to stay away from electronic devices near bedtime as that may delay sleep onset even more.
- Skip the nighttime news.
Eating and drinking before bedtime
“It’s always surprising to me, how many people are not aware of the effects of caffeine on sleep,” Dr. Abbasi-Feinberg says. “It can stay in your system for many hours and can interfere with sleep onset and sleep quality.” If you’re having trouble with sleep, she says to stay away from caffeine after 1 - 2 pm, which includes coffee, tea, sodas, energy drinks, chocolate, and some ice creams. Having a very heavy meal and too much sugar can also disrupt sleep, and no alcohol one to two hours before bed.
Studies have shown that the ideal eating time for the best sleep is a few hours before bedtime. There are people who feel very hungry right at bedtime and can’t sleep but do okay with a small light snack. Keep in mind, however, that the human body is designed to have a digestive rest at night so you will probably sleep better if you don’t eat after dinner.
Worry, stress, and naps
Without a doubt, worrying and stress can interfere with sleep. Dr. Abbasi-Feinberg recommends setting up a “worry time” a few hours before bed to write down all your thoughts with possible solutions. She’s also a huge fan of making lists before bed. “So often you are thinking about everything you need to do tomorrow, and you don’t want to forget,” she says. “If you write it down, you know you will not forget, and it relaxes the mind.”
In addition, if you have a ritualistic evening routine, it can slow you down at bedtime and allow sleep to occur. Some people also find meditation and prayer very helpful and there are certain apps and podcasts that can help with relaxation as well.
In terms of napping, there is much individual variability. “For some people, short naps earlier in the day, give them more energy and the ability to enjoy life in the evening hours,” Dr. Abbasi-Feinberg says. But if you have trouble sleeping at night, she usually recommends you avoid naps. “You need to allow the natural drive for sleep to build up during the day and a nap can delay nighttime sleep. If you absolutely have to nap, keep it short (20 to 30 minutes).”
What else can be done to set the stage for a good night’s sleep?
- Keep your bedroom cool, dark, and quiet (kind of like a cave).
- No laptops or TV; white noise or earplugs can help.
- Have a comfy bed and the nicest coverings (make it a delight to get into bed).
- Participate in regular physical activity and/or exercise early in the day (about four to six hours before bed; too close to bedtime can interfere with sleep). Match your exercise activity to your stress levels.
- An evening walk can be beneficial for sleep too.
If you have tried these ideas and are not getting answers, consider testing your neurotransmitter and hormone levels.