We’ve all been told once or twice in our life by a family member or friend to “ get some sleep” and I am sure at some point or another a health care practitioner has asked about how well you are sleeping? Sometimes the practitioner may poke and prod a bit more about your energy levels, the quality of sleep and even times or; perhaps your practitioner asked the question and suggested you get better or more sleep but did not really provide tips and suggestions towards said better sleep. In our experience, if we don’t understand the why of a recommendation, the follow-up course of action tends to be short-lived, if at all.
So let’s dive in for some clarification, shall we?
What is sleep?
Firstly, let’s define sleep. Sleep is an altered state of consciousness. It’s a time where we have limited interactions with our surroundings. Depending on the stage of sleep, we are relatively quiet and still. Therefore, interruptions to our sleep have a direct impact on our body’s ability to optimally function as it’s performing this act which is essential to every process in the body- from our mental and physical functioning and our ability to fight disease and develop immunity, to our metabolism and chronic disease risk. Poor quality sleep can increase the risk of developing health problems like metabolic dysfunction, high blood pressure, obesity, cardiovascular disease, diabetes, anxiety, and depression.
Though the body remains relatively uninterrupted, the brain is actually quite active as we sleep. Sleep is imperative for nerve cell communication and without adequate sleep, we can’t form or maintain the pathways in the brain that facilitate learning and creating new memories.
There are internal biological mechanisms involved with sleep- one is called the circadian rhythm. The circadian rhythm responds to the light-darkness cycle and is thus referred to as our biological clock. Though it synchronizes with environmental cues (mainly light and temperature) it does continue in the absence of cues as well, making it partially genetically predetermined.
Not surprisingly, there are multiple structures involved in the process of sleep. The thalamus, brain stem, pineal gland, amygdala, basal forebrain and hypothalamus each have integral roles in your sleep quality, duration, and efficiency. Within the hypothalamus is the suprachiasmatic nucleus (SCN), a structure in the brain formed by thousands of neurons. This cluster of neurons coordinates the circadian rhythm and directly impacts things like wakefulness, body temperature, metabolism, and hormone regulation.
There are two basic types of sleep; Rapid Eye Movement (REM) and non-Rapid Eye Movement (non-REM). Non-REM is further broken down into three different stages. Each stage has a specific brain wave and neuronal activity, each with a different impact on the brain. REM and non-REM cycle through several times a night, with longer, deeper REM periods occurring toward the morning. REM sleep is the most active stage of sleep and is identified as the “dream state” and has a particular role in memory, emotional processing, and healthy brain development. The four stages repeat cyclically, the duration of each lasting about 90-120 minutes.
Sleep also plays a housekeeping role in removing toxins that build up while you’re awake. When you sleep, a sort of “plumbing system” called the glymphatic system allows cerebrospinal fluid to flow rapidly through the brain. Sleep also alters the cell structure of the brain as glial (brain cells) cells shrink or swell to increase the brain fluid to flow. Essentially, the glymphatic system eliminates waste from the central nervous system during sleep as well as distributes non-waste compounds such as glucose lipids, amino acids and neurotransmitters in the brain. The glymphatic system is largely disengaged during wakefulness, making sleep imperative for its function.
As you can see, sleep plays a very critical role in physical, emotional, mental, and metabolic well-being. Sleep should be a priority, not just for health optimization but overall biological functioning.
That means, focusing on appropriate sleep time, quantity and quality of your sleep would behoove you. If you’ve been experiencing health issues, there’s a good chance investing in your sleep will help the healing process.
What your sleep has a direct impact on:
Cognition and concentration
Blood sugar and caloric regulation
Heart disease risk
Mental health (depression and anxiety)
Ways to best support your sleep
Think back to the circadian rhythm that regulates your internal body clock. It’s particularly sensitive to light and temperature. Viewing sunlight within the first 30-60 minutes of waking as well as the late afternoon (before sunset) can be crucial for supporting your circadian rhythm, and thus your sleep cues. This can be difficult in the winter months, as well as for those who wake up before the sun. In this case, consider 30 minutes of exposure on the side of the face to a blue or 10,000 lux bright light first thing in the morning (amazon happy light is a great option here).
Research shows that keeping consistent waking and bed times has an impact on your sleep quality and fatigue levels. Establish reasonable times and stick to them, even on the weekends.
Be Cognizant of Caffeine
Caffeine has an average half life of 5 hours. That means it takes 5 hours for the caffeine in your system to be reduced to half the original amount. So, if you had 10 mg of caffeine, after 5 hours you’d still have roughly 5mg in your body. Maybe reconsider that mid-afternoon cup of joe (it could be the reason you aren’t sleeping well, and thus the reason you need it in the first place). Other considerations could be avoiding stimulants as a whole, and considering drinks like Mudwtr or Four Sigmatic instead. The nervous system may benefit greatly from a reduction in caffeine, even if for just a short period of time.
Avoid Bright Lights at Night
Melatonin is a hormone produced by the pineal gland. It’s important for regulating your circadian rhythm and restful sleep. Viewing bright lights impact your circadian rhythm, and blue light (the ones in your phone, laptop, tablet, etc.) reduce melatonin production. It’s ideal to refrain from any bright light usage for 2-3 hours before your scheduled bedtime. If necessary, blue light blockers may be a useful tool for you to combat the negative consequences of the blue light. The TV shows you’ve been falling asleep to could be the culprit for your less-than-ideal sleep. These are a great option!
Your sleep environment is imperative for your sleep quality. A dark, quiet room, ideally below 70 degrees is the most ideal for facilitating a good night’s sleep. A warm bath, tea, magnesium rich foods, kiwis and tart-cherries have also been studied to have a positive impact on sleep quality. Other considerations for optimizing your sleep environment:
Avoiding anxiety provoking activities close to bedtime
Turn down the light in the bedroom 15 minutes before going to sleep
Use a dimmer to reduce the light
Consider dark window shades or a silk eye mask when you sleep
Decrease irritating noise with ear plugs, a white noise machine, or a HEPA air filter
Creating a night time routine that supports the parasympathetic nervous system and allows both brain and body to calm down (things like journaling, music, candles, reading, etc.)
Track Sleep Quality
Oftentimes, people don’t know if they’ve had a good night of sleep or not. For example, you think you slept fine, but your partner tells you you roll around and snore in your sleep. That’s not ideal sleep. Tracking your sleep may offer a deeper understanding of sleep quality, as well as the things that are impacting your sleep without your awareness (dogs and cats are big here). There are multiple devices that aid in this tracking, the Oura Ring being one of the most efficient.
It’s clear that our sleep plays a much larger role in our health than just rest alone. Being intentional about sleep is a clear way to impact your hormonal, metabolic, and immune health amongst other aspects of well-being.
Health care providers don’t recommend getting more sleep for arbitrary reasons. We truly want you to optimize all aspects of your health, and catching some extra zzz’s might be the missing link!
Katie Morra MS, RD, LDN, IFMCP is an Institute for Functional Medicine Certified Practitioner and Registered Dietitian Nutritionist specializing in gut and hormone optimization. Katie runs a fully virtual functional medicine practice, Gut Honest Truth, based out of Maryland. Katie focuses on the root causes of inflammation, autoimmune disease, irritable bowel syndrome, food sensitivities, hypothyroidism, hormone imbalance, adrenal dysfunction as well as other chronic disease states.