Monday, March 24, 2008

A good sleep is worth its weight in gold

A Dozen Ways to Get a Good Night's Sleep

Who doesn't need more sleep? Practically everyone I know complains about lack of sleep, whether due to a busy schedule, stress that keeps the brain buzzing or plain old insomnia. For those who think they've "tried it all," Sonia Ancoli-Israel, PhD, psychiatry professor at University of California, San Diego, and director of the Sleep Disorders Clinic in the Veterans Affairs Health Care Systems, has offbeat suggestions that really work. She explains why you might sleep better if you leave your sunglasses at home, what buying a low-wattage nightlight can do and why you should learn to love a hot bath at bedtime, among other things.

A Dozen Ways to Get a Good Night's Sleep
Sonia Ancoli-Israel, PhD
University of California, San Diego n any given year, 40 million Americans have chronic difficulties falling or staying asleep, while another 20 million report occasional sleep problems. It's no wonder that US doctors write as many as 43 million prescriptions for sleeping pills a year. Medication may help you sleep better immediately, but the best long-term solution is to encourage your body's natural sleep mechanism to operate more effectively.

There are a lot of myths and misperceptions about how to get a better night's rest -- and some sleeping secrets that most people have never heard of. Here are some rules to help you sleep better...

Wake up at the same time each day. Sleep is controlled by biological rhythms (also called circadian rhythms) that follow a very set schedule. To align your sleep pattern with these internal rhythms, it's important to wake up at the same time each morning.
Reason: Your biological rhythms aren't perfectly regular, but, for the best sleep, they do need at least one stable point in time around which they can fluctuate. While you can't always control when you fall asleep, you can control the time you wake up each day.
Another reason to maintain a consistent wake-up time is that, just as you need a certain amount of sleep to feel rested and alert, you also need a certain amount of time awake each day in order to feel sleepy at night.

Rising at the same time each day -- as opposed to "sleeping in" on the weekends, for example -- ensures that you will be awake long enough to fall asleep at your normal bedtime.
Spend time in sunlight. Even being outdoors on a cloudy day helps. In general, the more light exposure you get during the day, the better you'll sleep at night.
While you don't want to look directly at the sun, sunglasses will block the effect of the bright light. Check with your doctor about how much time he/she thinks is safe for you to spend in bright sunlight without sunglasses.
People over age 50 will especially benefit from about a half hour of light exposure at day's end -- in the late afternoon or early evening.

How it works: As we get older, our circadian rhythms shift forward in time, causing us to fall asleep earlier and wake up earlier. Exposure to late-afternoon or evening light shifts the rhythm in the opposite direction -- allowing you to wake up later in the morning.

Take a brief, moderately hot bath just before bed. Another part of our natural sleep rhythm involves core body temperature, which drops at night as we sleep, then rises again just before waking.
Core body temperature works in counterpoint to peripheral body temperature (the temperature of your hands and feet) -- when your peripheral temperature rises, your core temperature falls, and vice versa. Taking a hot bath just before going to bed raises your peripheral temperature, causing your core temperature to drop -- which helps you fall asleep. (This is also why wearing socks to bed helps some people fall asleep more easily.) Just make sure the bath water isn't too hot, because this could raise your core temperature.

Keep your bedroom at a comfortable temperature. This encourages the natural fluctuations in body temperature described above.

Keep your sleeping environment as dark as possible. Sleep is controlled in part by the hormone melatonin. The brain secretes melatonin only in darkness, which is why it's important to keep your bedroom dark while sleeping -- the darker, the better. Put up light-blocking curtains or blinds, or wear a sleep mask, if needed. If you have to get up in the middle of the night, use a low-intensity nightlight to guide your way, rather than switching on the overhead lights.
Reason: Turning on a bright light signals your brain to stop secreting melatonin.
Don't spend too much time in bed. When you stay too long in bed, your sleep actually becomes more fragmented and disturbed. If you need eight hours of sleep, spend no more than eight and a half hours in bed. Even if you didn't sleep well the night before, avoid going to bed early to "catch up" on sleep. Instead, go to bed and get up at your usual time.

If you wake up at night, keep your eyes closed. When people wake in the middle of the night, the first thing they usually do is look at the clock. But the mere act of lifting your head and opening your eyes is enough to take you out of transitional sleep (the lightest stage of sleep) into a full waking state, making it harder to fall asleep again. Instead, keep your bedroom clock out of sight -- and if you wake up in the middle of the night, don't open your eyes. This will make it much easier to drift back to sleep.

Avoid alcohol near bedtime. Alcohol acts as a sedative when it first enters your bloodstream -- but several hours later, when it leaves your bloodstream, it actually has the reverse effect of making you more wakeful. If you tend to wake up in the middle of the night and have trouble falling back asleep, you should avoid drinking any alcoholic beverages after dinner. If you have trouble falling asleep in the first place, then you may need to forgo drinks with dinner as well, since their "waking effect" will coincide with your bedtime.

Don't consume caffeine after lunch. That includes all caffeinated beverages -- not just coffee, but also tea and soda, as well as energy drinks. This is especially important if you have trouble falling asleep.
Exercise regularly. Although no one knows exactly why this is the case, data shows that the more fit you are, the better you'll sleep at night.

Don't lie in bed tossing and turning. Once you start tossing and turning, you get tense. If you find it impossible to drop off to sleep, get out of bed and stay up until you're sleepy enough to fall asleep. You may feel tired the next day -- but over time, this approach has been found to be very effective in establishing a restful sleep pattern.

Avoid naps. Physiologically, a mid-afternoon nap makes perfect sense, since your core body temperature takes a slight dip then. And for many people, such a nap won't interfere with nighttime sleep. However, if you have difficulty falling or staying asleep at night, a nap during the day will only aggravate the problem.