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Good Sleep Recipe

Good sleep comes from what you do during the day as well as what you do at night.

Day - Homeostatic Process

Sleep results from 2 physiologic processes -- process S (homeostatic process) and process C (circadian process). Process S is the process by which a growing sleep debt or pressure occurs the longer one is awake. The currency by which the brain measures time awake is in the accumulation of adenosine. Adenosine is a byproduct of cellular metabolism, so the more active and alert we are during the day, the more adenosine builds up in the brain. Exercise for example can increase brain adenosine levels and through stimulation of adenosine receptors promote sleep. During sleep, adenosine is recycled and levels are reduced in the brain; less adenosine receptor stimulation leads to more alertness. In essence, the longer you’re awake, the more adenosine you accumulate, the more sleep pressure you acquire, and the more likely you are able to fall asleep at bedtime. Likewise, the less adenosine receptor stimulation there is, the more alert you feel. Caffeine is an adenosine-receptor blocker and promotes alertness. However, with habitual caffeine use, the brain may upregulate adenosine receptors over time, leading to decreased effect of caffeine or need for escalating doses. Therefore, to sustain the wake promoting effect of caffeine, it may help to take breaks from caffeine to downregulate brain adenosine receptors.

Good Sleep Recipe

  • Avoid long naps during the day since napping will decrease the adenosine levels in your brain which may otherwise help promote sleep at nighttime
  • Avoid caffeine close to bedtime since caffeine is an adenosine-receptor blocker, and can inhibit the ability of adenosine to induce sleep
  • High-intensity exercise can increase brain levels of adenosine and help you sleep

Day - Circadian Process

The circadian process (process C) controls the 24-hour cycle of alertness and sleepiness. Melatonin is the main orchestrator of process C, and melatonin is strongly influenced by light and dark exposure, but can also be affected by other zeitgebers (like food or activity/exercise). Within a 24-hour cycle, your best chance of falling asleep and the best quality of sleep will occur when your sleep drive is high (ie, process S is high), and your circadian level of alertness is low (ie, process C is low). Several disorders like depression or sleep phase disorder may lead to misalignment of process C and process S, resulting in insomnia or nonrestorative sleep. In these cases, a sleep expert should be sought to help align sleep processes for improved sleep quality.

Good Sleep Recipe

  • Wake up as close to the same time every morning to regulate your process C.
  • Make sure to get bright light, either in the form of sunlight or a light source with at least 10,000 lux for at least 30 minutes in the morning.
  • In addition to a regular light/dark schedule, keep a regular mealtime and exercise schedule. Keeping these activities as routine as possible entrains your biological rhythms for maximal alertness during the day and maximal sleepiness during the night.

Day - Light and Dark Exposure

Light and dark exposure are the most potent regulators of melatonin secretion, which in turn regulates your circadian rhythms including your sleep/wake cycle. To ensure you are sleepy at night, minimize light exposure, including light from electronics, at least 4 hours before your intended bedtime. Even an ordinary room light can suppress melatonin secretion, and melatonin is needed to help induce sleep. Melatonin is hypnogenic, and regulates hormone secretions during the night like cortisol, growth hormone, leptin and ghrelin which regulate alertness, metabolism and feeding behaviors. Similarly, to experience the most alertness and to anchor your sleep/wake cycle, make sure to expose yourself to bright light either in the form of sunlight or a light source of at least 10,000 lux for 30 minutes or more at the same time in the mornings.

Good Sleep Recipe

  • Turn off your screens at least 4 hours before bedtime
  • Use black out shades or blue light spectrum blocking glasses to minimize light exposure starting about 4 hrs before bedtime

Day - Alcohol Use

Alcohol can impair sleep quality. While alcohol initially acts like a sedative and helps you fall asleep, as alcohol is metabolized during sleep, it’s metabolites can significantly disrupt sleep. Alcohol increases N3 sleep at the beginning of the night, but suppresses REM sleep, and causes significant sleep fragmentation and awakenings during the latter half of the night leading to overall nonrestorative sleep.

Good Sleep Recipe

  • Avoid alcohol close to bedtime

Night - Body Temperature

Your core body temperature naturally drops as your body’s melatonin secretion increases during night--this all to facilitate sleep. Studies show a cool sleeping environment not only helps induce sleep but also maintains sleep. In fact, it is well known that heat can dysregulate REM sleep and cause sleep fragmentation, while cool temperatures keep the body longer in N3 stage or deep sleep (the restorative sleep). To help fall and stay asleep, keep your room temperature cool between 63-68 degrees F. Taking a hot shower before bedtime may also help sleep since a shower dissipates body heat and cools the body temperature. Exercising initially causes an increase in body temperature but is then followed by a drop in core body temperature after an hour or so which may facilitate sleep.

Good Sleep Recipe

  • Exercise in the late afternoon or evening, but not too close to bedtime
  • Take a hot shower before bedtime
  • Keep your bedroom temperature at night cool between 63-68 degrees F

Night - Stimulus Control

We can train ourselves to fall asleep more easily by training ourselves to feel relaxed or less anxious in bed through a technique called stimulus control. You should avoid spending long periods of time awake in the bed especially if you’re feeling anxious, alert, or stressed, since this can develop an association of these feelings with the bed, interfering with sleep onset. The best thing to do, while counterintuitive, is to get out of bed when you’re unable to sleep, go to a nearby dark cool resting area and do some relaxation exercises or activities (like meditation, breathing exercises, biofeedback, light reading, for example) until you feel relaxed enough to fall asleep. Only then should you get back into bed. Stimulus control therapy (or sleep conditioning) takes time to work. In the beginning you may feel like you’re spending more time out of bed than in it, and with fewer hours of sleep, but eventually, your body learns or is “trained” to fall asleep more easily when you are ready to go to sleep. Some people who have chronic difficulty stopping their brain from ruminating while in bed or have difficulty detaching the feeling of stress from their bed, may benefit from cognitive behavior therapy for insomnia.

Good Sleep Recipe

  • Have a regular bedtime routine, whether that is to shower, read, meditate, etc, something to signal to your body that you are ready to sleep
  • Start the routine about 30-45 minutes before your bedtime, and reserve at least 15-30 minutes for relaxation
  • Don’t use the bed for watching TV, eating, lounging, work, or any other activity except sleep and intimacy.
  • If your mind is racing or you feel anxious, do not linger in bed. Go to a quiet dark place instead near your bed and do a light activity that distracts your thoughts like reading, crosswords, listening to the radio, for example.
  • If you feel preoccupied by a list of things to do, try quickly writing them down, and scheduling a time for yourself to think about them the next day. The goal is to have an exercise that allows you let go of these thoughts before bedtime.