Turning the Tide – Lifestyle Medicine and its contribution to health(12)


The role of sleep in maintaining brain health (3)

 

Last week we described some of the physiology and anatomy of sleep.  Today we will discuss some of the common factors causing disruption to sleep but also factors that can enhance restful sleep.

 

Causes of sleep disruption

 

Environment

  • Bright light in the bedroom before you go to sleep, and absence of darkness during the night
  • Noisy environment
  • Uncomfortable bed
  • Temperature too hot or too cold
  • Restless or noisy bedmate
  • Mosquitoes or pets sleeping on the bed
  • Jet lag when travelling to different time zones
  • Work issues – night duty
  • small children needing attention during the night

Physical disease

  • Obesity with associated sleep apnoea (person stops breathing for up to 1 minute because of thick neck, or lax pharynx – often associated with heavy snoring)
  • Uncontrolled diabetes
  • Chronic pain
  • Medications (includes certain antidepressants, medicines for Parkinson’s, weight-loss tablets, anticonvulsants used in epilepsy, decongestants, steroids, etc.)
  • Dementia or psychosis
  • Kidney or bladder diseases causing frequency of urination during the night
  • Upper respiratory illnesses like ‘flu and colds or hay hayfever causing congestion

Habits

  • Alcohol (may put you to sleep but more likely to wake up during the night, or disrupt restful sleep. Withdrawal effects in an alcoholic may severely disrupt sleep).
  • Eating a heavy meal late at night
  • Lack of exercise or excessive exercise during the day
  • Use of “recreational drugs”
  • Smoking

Emotional

  • Worry/anxiety/fear
  • Anger issues
  • Depression and bipolar disorder
  • Bad dreams

 

This is by no means an exhaustive list but covers the most common conditions I have come across in my patients over the years.

 

Most of us function best when we have had a good sleep the night before.  We feel alert and enthusiastic about the day ahead of us.  There is much we can do to enhance our sleep which already starts in the morning.

 

  • Exposure to bright daylight first thing in the morning. This suppresses melatonin production and helps you to be wide awake and alert.
  • A wholesome fibre-rich breakfast with whole grains and various types of fruit
  • Avoid depending on artificial stimulants to get you going
  • Some vigorous exercise in the fresh air is ideal – it gets your circulation going, exposes you to bright sunlight, and enriches your life with the sound of birds, and the sight of beautiful things
  • Starting your day with spiritual connection – gets your mind in the right space and gives you a sense of purpose
  • Avoid highly processed junk foods – if you need a snack try fresh fruit or salad sticks
  • Plan your meals – take along a healthy lunch box, which can provide nutritious and satisfying meals.
  • It is a good idea to do bulk cooking over the weekend, then freeze meal portions so that when you get home in the evenings you don’t have to stress about making meals for the family.
  • Light physical activity in the late afternoon – playing with the kids in the garden, or with the dog, will improve your sleep
  • Make sure you are adequately hydrated during the day as this ensures you sleep better at night
  • Avoid alcohol and caffeinated drinks at least 2 hours before going to bed
  • Turn off TV and computer/cell phone screens at lease 1-2 hours before going to bed as the blue light inhibits melatonin production
  • Have a hot shower or bath before going to bed to enhance vasodilation of skin blood vessels to allow for cooling of your core body temperature.
  • Invest in a comfortable bed, and comfortable night time temperature in your bedroom
  • Have a pen and paper or white board next to your bed so you can jot down things to do in the morning – by writing it down, you allow your brain to stop stressing about the issue
  • Calming music may encourage sleep.
  • Candle light or a camp fire improves your sleepiness
  • Reading in bed in low light is much better than watching TV to bring on sleep

 

Is it safe to take sleeping tablets?  It probably is not an issue if you take them once in a while for unusual circumstances, like major crises, or post-operatively.  But prolonged use can have long term consequences in increased risk of heart disease, and Alzheimer’s and other dementias. It is much better to change your behaviours that inhibit sleep, or adopt activities that promote sleep than popping pills.

 

Next week we will look at the role of mindfulness in our wellbeing.

 

Dave Glass

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