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    Sleep is super important, but it’s not always easy to achieve. Sleeping becomes harder as we age due to changes in our synapses which can cause disturbances in our circadian rhythm (an ebb and flow of hormones that determines when we feel awake or sleepy.) Poor sleep will lead to poor cognitive functioning, poor memory, altered behavior, and an overall decline in health and well-being (Sun et al 2012).

  • The good news: There are several things we can do to improve sleep duration and quality which in turn will improve our overall health and well-being!

  • Exercise

  • Let’s start with our favorite word in physical therapy: Exercise! Turns out, regular exercise creates significant changes in sleep quality, adding up to 45 minutes to your total sleep time (Driver and Taylor 2000). The improved sleep is not because you are completely exhausted from exercising - that kind of exercise actually decreases your quality of sleep. The improved sleep results come from 45 minutes of mild to moderate exercise in the late afternoon (not late evening) every day. So, going for a long walk after work every day will improve your sleep, but going for a long run just before bed will actually make your sleep worse.

    Additionally, overall fitness improves quality of sleep. So maintaining healthy life choices (such as regular exercise and a healthy diet) while avoiding poor life choices (such as smoking) will improve your ability to sleep.

  • Sunlight

  • The sun plays a big part in your sleep cycle. Not only will the timing of your exposure to light affect your circadian rhythm, but the amount of daily light you receive matters as well. According to Driver and Taylor, people who receive 45 minutes of sunlight per day experienced better sleep at night (2000). That means you can combine your 45 minutes of exercise with 45 minutes of sunlight and get the benefits of both at the same time. Perfect!

  • Diet

  • We’ve all heard the saying, “You are what you eat.” Your food choices affect a lot more than just your weight and cholesterol levels...they affect your sleep quality too. Caffeine, alcohol, lactose, and spicy foods can keep you awake as a result of the uncomfortable side effects of ingesting these foods (Harvard Health Letter 2013):

    • Caffeine stimulates your adrenergic system keeping you alert and active, which are not the qualities you’re looking for when you want to relax and sleep.
    • Alcohol may make you sleepy initially, but it will decrease your quality of sleep by creating an inconsistent sleep pattern during the night. Lactose and spicy foods may only affect your sleep if you are sensitive to those foods.
    • Individuals with lactose intolerance may experience bloating and discomfort that will make it difficult to sleep. Individuals with GERD may experience pain and discomfort that will increase when laying down to catch some Z’s.

    Any food can affect your ability to sleep, not just the ones above. Therefore, overall awareness of how various foods affect you is important. Become a mindful eater and practice observing how certain foods make you feel. If you tend to feel bloated and generally “icky” after eating ice cream or a creamy pasta, don’t eat them before bedtime. What your brain enjoys may not be what you gastrointestinal tract enjoys, so bridge the gap and become aware of your body’s reaction to your food.

  • Relaxation

  • If you’ve ever taken a yoga class with a guided relaxation at the end, you know how soothed and tranquil you feel by the end of it. The technique that yoga instructors often use is called progressive muscle relaxation. It’s a proven technique for reducing stress, anxiety, fatigue, and pain, as well as improving sleep quality (Sun et al 2013).

    However, you don’t need to hire a yoga instructor to help you fall asleep. There are plenty of progressive muscle relaxation videos online that you can use. Just type “progressive muscle relaxation” or “guided sleep meditation” into the search bar on YouTube to find endless options you can listen to to help you fall asleep. Begin playing the video on a portable device, such as a smart phone, and then set the device aside while you listen and drift off to sleep. The device will also go into “sleep mode” when the video has finished.

    My personal favorite is this video that combines soothing music and an attractive sounding British man:

  • There are also several apps that use mindful meditation techniques to help you relax. My two favorite mindfulness meditation apps are Insight Timer (it’s free!) and Buddhify.

  • Blue Light

  • Not all light is created equal. Turns out, different wavelengths of light effects production of melatonin, a hormone that impacts your sleep and wake cycles. The shorter light wavelengths, especially blue and blue-green light, have been found to suppress melatonin production (Wright 2001). So how do we limit our blue light exposure in the evening to help us fall asleep?

    Our favorite electronic devices are the biggest culprit of our evening blue light exposure. In 2011, Cajochen et al found that the light emitted by LED computer screens suppressed study participants’ normal evening increase in melatonin levels, impacting their circadian rhythms and increasing their alertness levels. Our phones, tablets, and e-readers also emit blue light. So start turning those screens off at least two hours before bedtime. There are also some useful programs and apps that can modify the blue light emitted by your devices in the evening. Here are some examples:

    • Twilight App (Android) - Applies a red filter based on local sunset/sunrise times. I use this app on my phone and I like it.
    • F.lux (Mac, Windows, Linux) - Adapts your display’s blue light emission to the time of day. I use this for my desktop computer.
    • RedShift (Linux) - Gradually adjusts your display’s blue light levels throughout the day.
    • “Night Shift Mode” (Apple devices) - I don’t have Apple products, but there’s a handy guide from Apple Insider about how to turn on this feature.
    • “Blue Shade” (Kindle Fire) - Amazon added this feature in 2015 and their website has instructions to turn it on.

    The artificial lighting we use in our homes can also impact our circadian rhythms.  Not only does the lighting we use contain a moderate amount of blue light but evening exposure to artificial light may also slow down the body’s transition from “wake” to “sleep” modes (Santhi et al 2011). If you have trouble falling asleep, keep this in mind when you’re replacing light bulbs. Consider light bulbs with less blue light (ex. “Warm white”) or even giving an amber LED light a try. You could also consider getting amber glasses to wear around the home in the evening as they have been found to block blue light and improve sleep (Burkhart and Phelps 2009).

  • Of course, more serious sleep disorders can’t be addressed through these methods alone. Some conditions, such as sleep apnea, may require a sleep study to get to the root of the problem. Be sure to talk to your doctor if you suspect you may be suffering from a sleep disorder.

    For more reading and information about sleep disorders be sure to check out the National Sleep Foundation at sleepfoundation.org.

    Sleep tight and don’t let the bedbugs bite!

    ~Theresa

     

    References:

    Burkhart K, Phelps JR. Amber lenses to block blue light and improve sleep: A randomized trial. Chronobiology International. 2009;26(8): 1602-1612

    Cajochen C et al. Evening exposure to a light-emitting diodes (LED)-backlit computer screen affects circadian physiology and cognitive performance. J Appl Physiol. 2011;110:1432-38.

    Driver HS, Taylor SR. Exercise and sleep. Sleep Medicine Reviews. August 2000;4(4):387-402. doi:10.1053/smrv.2000.0110

    Improve sleep by eating right. Why caffeine, spicy foods, and alcohol make poor bedfellows. Harvard Health Letter / From Harvard Medical School[serial online]. September 2013;38(11):5.

    Santhi N et al. The spectral composition of evening light and individual differences in the suppression of melatonin and delay of sleep in humans. J. Pineal Res. 2012;53:57-59.

    Sun J, Kang J, Wang P, Zeng H. Self-relaxation training can improve sleep quality and cognitive functions in the older: a one-year randomised controlled trial. Journal Of Clinical Nursing [serial online]. May 2013;22(9-10):1270-1280.

    Wright HR, Lack LC. Effect of light wavelength on suppression and phase delay of the melatonin rhythm. Chronobiology International. 2001;18(5):801-808.