Integrative Gynecologist Dr. Bronwyn Fitz discusses common issue with sleep, and offers effective tips for a more peaceful night’s sleep.
This is a question I hear from my patients over and over. We all want to feel rested and refreshed when we wake up, but why is it so difficult for some (dare I say, most) people? I think many of the problems stem from our very tanked up, roaring to go lifestyles that today’s society demands of us. To have a good night’s sleep, our “fight or flight,” or sympathetic nervous system that dominates during the day needs to quiet down so that our parasympathetic, or “rest and digest” side of the nervous system can dominate. The trouble is that it is hard for many people to make that shift. When we don’t sleep well everything takes a hit: mood, mental focus, metabolism, energy, immune function, you name it. So, here are a few tips for better rest based on the two biggest complaints I hear.
I can’t fall asleep
- Set the stage – your room should be completely dark, no lights from electronics. Keep it cool also, <70 degrees is optimal. Reserve your room for sleeping and sex only. Do not watch TV, use screens, or even read in bed.
- Make a routine – your body needs cues that it is time to wind down to go to bed. Turn off screens one hour before bed. Have a relaxing cup of herbal tea. Take a bath or shower. Do a relaxing activity such as meditate or write in a gratitude journal. Shifting your mindset to something positive before you go to sleep is very helpful.
- Exercise late in the day can disrupt sleep. Try to have at least 3-4 hours between exercise and bed time.
- Avoid caffeine and alcohol before bed. Many people should not have caffeine beyond their morning cup of coffee or tea.
- Review what medicines and supplements you are taking with your doctor. Many prescription medicines can interfere with sleep, especially ADHD medicines, anti-depressants, anti-histamines, beta blockers, pain pills, and more.
- Avoid very intense TV shows or games late into the night. They stimulate your sympathetic nervous system so much that it is harder to wind down.
- Use blue light filter apps on your phone, computer if you have to do evening work. You can get blue light filtered light bulbs and even glasses if that helps. Get enough direct sunshine during the day – at least 30-60 minutes if possible.
I fall asleep, but keep waking up in the night
- First, it is important to know that night time waking is completely normal. Most people wake up once or twice each night. But it shouldn’t take more than a few minutes (if that) to fall back to sleep.
- Try not to look at the clock when you wake up. If you feel like more than 20-30 minutes have passed, get out of bed and go to another room to do a very calm activity such as read. Do not turn on any device that has a screen. Once you begin to feel tired, go back to bed.
- If you are getting up more than once or twice to use the bathroom, consider limiting evening liquid intake.
- If you or your partner snores, please get a sleep evaluation. Snoring is not normal and could be a sign of sleep apnea or other obstructive airway issue. These can and should be addressed to improve sleep quality and prevent chronic illness. Even children can have obstructions in their airway that can lead to attention and behavior problems, headaches, and more.
- If you find that your brain is busy running “to do” lists and re-livin moments from yesterday or imaging moments for tomorrow, you need to learn how to quite the mind. This is where mindfulness practices such as meditation can be so helpful.
- If you feel that anxiety is a strong component to your sleep issues, please seek help from a healthcare provider.
Should I take a sleep aid?
- Always seek medical attention before deciding to take a sleep aid. A healthcare provider can help determine if you need a referral for a sleep specialist, especially if you have signs of sleep apnea. Not all people with sleep apnea snore, so if your sleep problems last more than a few weeks, please have it checked out.
- Avoid medicines that are habit forming or produce poor quality sleep like antihistamines and Ambien. Additionally, some sleep aids like Ambien can produce dangerous side effects like sleep walking or even sleep driving.
- Melatonin supplements in small doses 0.5-1mg taken 1-2 hours before bed can often help with falling asleep. It is not habit forming and generally safe. Melatonin can cause drowsiness, so never take it if you have important activities to do.
- Numerous herbs are used for both relaxation and sleep: chamomile, valerian, lemon balm, hops. Some can cause drowsiness. Always check with a healthcare provider who is knowledgeable about herbs to determine if one is safe for you.
Getting a good night’s rest is so important for our quality of life. When you haven’t gotten a good night’s rest, you feel it the next day in your mood, energy, mental focus, metabolism, appetite – everything is off. Prioritize sleep and think about ways that you can improve your sleep tonight!