Sleep is often said to be the foundation of health. Sleep is one of the most basic biological activities, by 70 years of age, the average person will have spent a total of between 20 and 25 years asleep. If you don’t sleep well for one night you might feel pretty rubbish the next day, but if you don’t sleep well for weeks or months then not only does it affect they way you feel, but it can have a detrimental effect on your health too. There is plenty of evidence linking poor sleep to health issues as diverse as high blood pressure (hypertension), weight gain (obesity),Type2 diabetes, cardiovascular disease, mental health disorders, neurodegeneration and dementia. There is science suggesting that it can even play a role in loneliness.
When it comes to insomnia nearly a third of the UK population report they have problems sleeping at least once a week and this in turn can increase your risk of disease and even increase your changes of dying. If you already have a chronic condition such as chronic obstructive pulmonary disease, heart failure, chronic pain and psychiatric conditions like depression, anxiety, substance abuse, and post-traumatic stress disorder, then you are more likely to have insomnia. Women are almost twice as likely as men to experience insomnia and older people are more at risk too.
A Vicious Circle of Sleep & Health Problems
It seems like chronic conditions put us at risk of sleep problems and sleep problems put us at risk of chronic disease. It sounds to me like it is a vicious circle that is hard to break out of.
In relation to chronic fatigue patients with ME/CFS often feel less refreshed and restored after sleep than they did before they became ill. Common sleep complaints include difficulty falling or staying asleep, extreme sleepiness, intense and vivid dreaming, restless legs, and night time muscle spasms. Even when they are sleeping well these people often have unrefreshing sleep, feeling tired still after 9 or 10 hours of sleep. In a study of CFS patients 89% met the criteria for having at least one type of sleep problem and several had more than one type.
The Impact of Sleep On Your Body
Sleep influences a vast array of behavioural and physiological functions, including memory and cognition, hormone secretion (e.g., melatonin and cortisol), glucose metabolism, immune system function, core body temperature, and kidney function. Sleep helps to keep all these body systems working well where as sleep deprivation has lots of negative impacts. Plus, the effects of sleep deprivation are cumulative, meaning that a mild reduction in sleep or sleep quality each night can, over a period of time, result in health problems.
So what are the mechanisms that scientists think are going on that make sleep such an important aspect of our health? Research tells us that sleep influences the two main body systems, the hypothalamus-pituitary-adrenal axis along with the sympathetic nervous system and our adaptive and innate immune responses. So basically, sleep has a strong influence on our how our body’s stress response and immune system work.
Inflammation is very linked with both of these body systems. Inflammation can help direct the immune system to the site of injury or infection to help resolve the problem. In many cases, inflammation “turns off” after the problem has been dealt with but sometimes it can become chronically activated. As well as injury and infection, it appears that insufficient sleep can provoke a pro-inflammatory (inflammation increasing) response which has been measured by looking at levels of inflammatory cytokines such as IL-1, IL-6 and TNF (molecules released by the immune system).
But studies where cytokines were injected into healthy humans showed that higher levels of cytokines can directly affect sleep quality and quantity resulting in increased fatigue, changes in sleep patterns, a decreased ability to concentrate and feelings of inactivity compared with placebo. These injections were also associated with a delayed increase in CRP (C-reactive protein) another marker of inflammation again indicating an immune system response.
Sleep & Your 24-hour Body Clock
What about our circadian rhythm? This is our 24-hour body clock that helps regulate our sleep and wake cycles keeping them in line with our active phase and rest phase. When our body clock gets out of balance it can interfere with our sleep patterns and the quality of our sleep. The circadian rhythm is mainly controlled by light via special cells in our eyes that communicate with our brain. As humans our bodies are designed to become more awake in bright light, especially blue light and become sleepier in dim light, especially orange or red light. This might make sense to you when you think about sun set and sun rise when we are sleepy or tired and day time when we should be wide awake.
A lot of research has recently gone into looking at how artificial lights from street lighting, house lights, car lights and screen use if affecting our circadian rhythm and the evidence suggests that it is not helpful and is leading to us finding it harder to get to sleep at night and stay asleep.
How Much Do I Need?
What is an optimum amount of sleep? Well the evidence suggests that between 7 and 8 hours of sleep a night is optimal for the vast majority of adult humans. Longer and shorter amounts of sleep are associated with increased health risks but this is still poorly understood as to whether one causes the other or vice versa.
How Can I Improve My Sleep?
Here is a list of ten evidence based suggestions that you may find helpful. They are focused on trying to reduce activation of our sympathetic nervous response (fight or flight) and bring you into a more relaxed state, help keep your circadian rhythm in balance and help reduce inflammation too.
1. Eat your last food at least 2 or even 3 hours before bed so that your digestive system has finished its job and is at rest.
2. Avoid bright artificial light in the evening for 1 or even 2 hours before bed. This might mean dimming lights, avoiding screens or using low light filters, using blue-blocking glasses.
3. Getting exposure to early morning blue light, ideally outside or using a SAD lamp.
4. Making sure to get some exercise during the day, not after dinner, brisk walking or cycling or something similar.
5. Having a wind down routine after dinner which might involve meditation or yoga, reading a book, listening to music, having a relaxing bath.
6. Using some aromatherapy oils on your wrists or neck pulse points when you go to bed.
7. Sleeping in the dark, either with black out blinds or using an eye mask.
8. Keeping your room cool and adjusting your bedding so that you don’t over heat.
9. Try journaling before bed, writing down your concerns, reflections, anything that is on your mind.
10. Practice gratitude by thinking of three simple things that brought you pleasure today.
I have a similar bedtime routine most evenings. I eat more dinner around 6pm and often I will go for a short stroll afterwards. I put on my blue blocking glasses an hour before bed and I usually meditate for 10 minutes using the CALM App and then I get ready for bed and spend half an hour reading before I turn off the light. I usually then do my gratitude practice and think of three simple things I am grateful for from my day and then I do a few deep breaths. In the morning I always go for a walk before I start work to get the benefit of early morning light in my eyes to help keep my body clock in balance. Most of the time I sleep really well. I tend to need around 8 and a half hours sleep to feel refreshed and at my best the next morning.
Goodnight, I hope you sleep well too!
If you are struggling with fatigue then I have a comprehensive FREE ebook that you can download which explains how the body makes energy and what can go wrong with this process along with simple advice to help you get your energy back. You can download it here.
Disclaimer: Before changing your diet or lifestyle and taking any supplements always seek the advice of your doctor or another suitably qualified professional such as a nutritional therapist. The content of this blog is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor with regards to any questions you have about a medical condition.
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