The practices to restore or enhance sleep

Introduction

In the Natural sleep processes article we concluded that our human systems are designed for good sleep! We already have all the "electrical wiring, plumbing and mechanisms" you need to experience the quantity and quality of sleep you need to thrive. In most cases (except when a particular sleep disorder is at play) “all” that is needed to access good sleep is (re)activating this inherent capacity.

A good sleep practice enables us to do exactly that and allows the three natural processes to get on with the job of getting us a good sleep, without our modern way of living getting in the way.

Below you will find twelve routines or habits that together form a robust sleep practice. This doesn’t mean you have to adopt all twelve nor that you have to adopt all or almost all on day 1 of your “restore good sleep” plan.

Once you have digested the below, reflect on which one to three routines or habits are likely to have the biggest impact and start with those. Once you have settled into these initial ones and you still like to improve your sleep further, stack some more on top of the initial foundation you have put in place.

1. Get outside for at least 30 minutes in the morning

This might seem counter-intuitive! Hang on, aren't we talking here about setting up for a good sleep at night? Well actually if you wait until you go to bed to set yourself up for a good sleep, you are going to be sheer out of luck.

Morning (sun)light is the key time-keeper of your circadian rhythm. The rising of the sun and light striking your eyes triggers the transition to a new cycle. Researcher Dan Pardi refers to this as 'light anchoring" which resets your circadian rhythm and effectively starts a countdown. Think of it as turning an hour glass that says to your body, right this is the start of a new day and once the hourglass has finished it is time to start increasing the production of melatonin again.

Interestingly researcher have also found that an afternoon walk among trees adds an average of one hour of sleep compared to those either not walking at all or taking a walk in an urban area.

Light intensity experienced by the human eye is expressed in LUX. On a sunny day light intensity is around 100,000LUX which goes down to about 10,000LUX on a cloudy day. On average however the light intensity in an office is only 500LUX and given that in our modern society we spend up to 90% of our time indoors it is not hard to spot the challenge!

Unless we get outdoors (ideally early in the morning but at least before lunch time) we simply do not get enough exposure to sufficiently intense light to keep our bio-rhythms in tune.

Even though they are mostly designed to block out the UV rays and reduce glare, most sunglasses block out blue light to varying degrees depending on for example the lens tints (sunglasses with yellow, orange, dark amber, copper or brown lens tints block out the most blue light). A wide brim hat or cap has a similar effect. Whilst of course important to balance this with the negative effect of over exposure to the sun (especially in New Zealand), for an optimal circadian rhythm reset, it is best to at least have some time outside without these blue light blockers.

If it is difficult to get outside enough during the winter months, consider investing in a light therapy lamp and / or wake-up light.

2. Power down (ideally at sunset) in the evening

Building on the section above, the light from computer screens, televisions, and phones interrupt the natural production of melatonin, which means the hormones needed to enter the sleep phase are not available!

Developing a “power down” routine where you shut off all electronics, ideally at sunset but at least two hours before sleep, is vital and a routine your circadian rhythm and natural body process will thank you for.

Room lighting can also play an important role. Specifically, LED lights have a powerful energy-saving benefit but actually emit more blue light than other lights and as such have a hidden cost of sleep impairment. A Harvard study demonstrated for example that blue light suppresses melatonin production for twice as long as green light and shifted circadian rhythms by three hours as opposed to one and a half hours. Red light has the least impact on melatonin.

If avoiding these light sources in the evening is challenging, consider wearing special glasses that filter out blue light. A 2020 systematic review and meta-analysis found that there is some good evidence that “blue-blocking” glasses could be effective in improving sleep, particularly in individuals susceptible to sleep disturbances and/or with psychiatric disorders. Some studies indicate that these glasses may, restore melatonin production by as much as 58%.

3. Give yourself permission to sleep

If you are anything like a large proportion of the population (particularly in the Western world) the statement "There are not enough hours in the day" may resonate with you. You have a never ending list of things to do and may find yourself constantly juggling and a task lists that has more new entries each day than items you are able to cross-off.

Sleep can become a necessary evil and reducing it (often progressively) can seem a logical strategy to get more things done. As you have seen in the Why is sleep so important article, the reality is that insufficient sleep will ultimately reduce your productivity and performance (not to mention the other impacts on your health), thus further compounding the sense that "There are not enough hours in the day".

Key is to find a way to give yourself permission to sleep by for example changing your beliefs about sleep (based on what you have learned from all the sleep blogs), be honest with yourself about how a lack of sleep is impacting you and elevating the importance of sleep.

Often, simply expanding your knowledge about sleep (through this course) enables us to elevate the value we place on it. We realise that it is not just a necessary evil but actually a fundamental contributor to what is most important to us (be it our health, our performance, our career, our relationships etc).

4. Adopt a consistent schedule with "resets" during the day

Adopting a set sleep and wake-up time supports the functioning of all three sleep processes discussed in the Natural sleep processes article. Like any system, your body and brain love certainty and predictability which helps them to run like clockwork without having to continuously adapt to new schedules and re-calibrate. More specifically, our physiological functions are regulated by hormones in a fixed time schedule.

As much as possible this needs to include weekends. Those weekend sleep-ins are tempting and of course can be important to catch up on sleep following a particular full-on week. However a regular schedule across your entire week and making sure you get sufficient sleep during the week remains the better strategy in the long run.

A consistent sleep and wake up schedule helps your brain and related sleep systems build a structure for optimal sleep.

Ideally, allow yourself 30 more minutes in bed than what you need and work towards waking up naturally without the need of an alarm clock.

To avoid stress building and building up throughout the day it is important to take regular breaks and "reset" the stress response, allowing your parasympathetic nervous system to (practice) putting the brakes on. This will make it easier to unwind / down regulate during the evening and pave the path for a good and restorative sleep. These "micro-moments of recovery" also contribute to your overall stress versus recovery balance which is also good for your health.

5. Replenish the nutritional building blocks for melatonin

In addition complex carbohydrates are also important as they help the brain absorb tryptophan. Sweet potato may well be one of the best carbohydrate as it also contains Vit B6, calcium and magnesium as well as fibres that make you feel well-supplied as you sleep. Interestingly, a Taiwanese study found that people eating two kiwi fruit before bed for four weeks fell asleep faster, slept more deeply and for longer.

There are some foods, containing a stimulant called tyramine, that are best avoided. This includes, aubergines, pineapple, tomatoes, fermented / cured foods, chocolate and wine.

Melatonin supplements have been popularised as a safe and natural alternative to sleep medication. The reality is a more complex and caution is advised. Whilst it is indeed a natural supplement, a high dose can actually lead to disruption in the biorhythm, have side effects (hangover effect with daytime grogginess) and can be dangerous for people who are unable to break-down excessive amounts of melatonin (this affects about 10% of the population).

Melatonin has the same potential for psychological dependence as sleep medication has (your brain very quickly gets used to "needing" a pill to fall asleep) and it has little drowsiness or sleep inducing effect. Melatonin is a chronobiotic, not a hypnotic which means it can help regulate your circadian rhythm but does of its own not have sleep inducing power. It can help nudge the brain to create (more) melatonin though which is useful when re-adjusting after jet lag, to treat circadian rhythm disorders or to get back into a regular schedule when your sleep-wake cycle has been disturbed (e.g shift work). To avoid dependency, it is best to take it only occasionally and for a maximum period of 12 weeks.

Start with a lower dose (2mg slow release) first and if that doesn’t work experiment with a higher dose (most researcher advise up to 5mg is safe). Time recommendations vary a bit but it appears best to take it prior to the time melatonin is naturally produced (which is around 9pm for most people). So take it at least one to two hours before bed to avoids disruption to your biorhythm and / or prevent it from making your sleep problems worse.

6. Avoid or minimise food, alcohol and other substances after sunset

For optimal sleep preparation it is best to avoid heavy meals within 4 hours of your bed-time, as undigested food interrupts sleep. Light snacks later in the evening, especially if they prevent you from going to bed feeling hungry, are ok. As a rule of thumb, practised naturally by our ancestors, eat between sunrise and sunset.

Certain foods have a stronger inhibiting effect on sleep, including fats (take a longer time to digest), sugars and simple carbohydrates (stimulating effect), spicy food (extra load on our digestion), flavour enhancers (can cause digestive problems), cabbage (fermentation effect and extra load on our digestion) and foods containing tyramine, such as some cheeses, meats and wines (stimulating effect).

There are of course foods that promote sleep as well. These are foods that contain tryptophan (the precursors to serotonin which in turn is the precursor to melatonin) and the various nutrients needed in the conversion of tryptophan to serotonin and then to melatonin. Light evening snack foods rich in tryptophan include bananas, dates, milk, tuna, peanuts, almonds and yoghurt. Complex carbohydrates (e.g. full grain bread) result in an increase in serotonin and as such a light carbohydrate snack can also aid falling asleep.

Alcohol, especially when consumed later in the evening and not with a meal, significantly affects our sleep. It disrupts our sleep cycle (refer illustration below) and increases the chances of waking up and having trouble getting back to sleep.

Based on Firstbeat Lifestyle Assessments (refer image below) this is an effect observed in virtually everyone. On average it takes about an hour for our liver to metabolise a unit of alcohol and alcohol remains in our blood stream for much longer than that (6 hours). During this time our level of activation remains high(er) as our sympathetic branch stays dominant.

Therefore, even though alcohol can make you fall asleep quickly, every unit of alcohol equates to a loss of around one hour of restorative sleep as as can be clearly seen in the Firstbeat results below - four units of alcohol has resulted in poor quality sleep (red) from about 12:15am till 3:45am.

Therefore the advice is to not consume alcohol at least 3 hours before bedtime. This does not mean you can never have a drink of alcohol but if your sleep is suboptimal, it is best to minimise your intake and drink no alcohol at all or only have a glass with dinner. Once good sleep is restored, an occasional drink in the evening should be ok (from a sleep perspective at least).

It is also best to avoid other substances containing ingredients that activate / excite our brain or body (e.g. caffeine, nicotine). Of course from a holistic health perspective (beyond just a focus on sleep) many of these substances are best avoided altogether.

Chamomile tea, valerian root, Kava and other herbal supplements are believed to help you sleep and they may indeed help calm your nervous system albeit there is no real evidence to support their sleep benefits. Best to enjoy these for their own sake and not rely (or become psychologically dependent) on them for good sleep.

7. Allow for a low(er) body and room temperature

The onset of melatonin secretion during the evening causes an increase in heat loss and therefore a natural drop in temperature. Our body temperature continues to drop during our sleep and reaches a low point around 3 to 4am. This reduction in core temperature is essential for the body getting into deep sleep mode (during which our body and brain recovers).

Bed room temperature therefore plays a key role in getting quality sleep. Scientists report a bedroom temperature between 16 and 18 degrees celsius to be optimal.

Counter-intuitively this systematic and meta-analysis indicates that taking a hot shower or bath is associated with better sleep. A hot shower or bath increases blood flow to the skin. This allows your body to more effectively lose heat and achieve the goal of reducing your core body temperature. Our circadian rhythm reduces our core body temperature later on in the day as we head towards bedtime. Having the hot shower augments this process and helps us to initiate sleep and maintain deep sleep.

Timing and duration is everything though! This only works if you take the shower or batch 1 to 2 hours before bed. If you leave it until close to bed time, you end up heating your body back up which interrupts the natural cooling down process and signals the body it is time to wake-up instead of going to bed.

If regulating room temperature is not an option and the summer heat is causing poor sleep, consider investing in the Ooler system from Chilisleep. I use this myself and it has had a dramatic impact on my sleep during the summer months. (Disclaimer: I don’t receive a financial or other benefit from recommending this system).

At the same time, make sure to avoid cold feet as they contribute to a restless night. Cold feet make you uncomfortable, a feeling that inhibits sleep, and when our feet are cold, blood vessels constrict and cause less blood to circulate.

8. Use the bedroom for sleep and sex only

Set up your bedroom so that it promotes good sleep and avoid multi-purposing. The ideal sleeping environment is uncluttered, dark, quiet and (as mentioned above) cool. Remove TVs, computers and other electronics and anything else that can cause distractions.

If you cannot make the room dark and / or quiet consider a sleep mask and / or ear plugs.

Go to the bedroom only to sleep and don't use the bedroom (or, if you don't have access to another room, at least not the bed) for activities during the day.

If you find yourself waking up in the middle of the night and cannot fall back asleep easily, get up and leave the bed(room). Read a book or have a herbal tea and only return when sleepiness returns. This practice will avoid a psychological association between being in bed and being awake.

9. Increase physical activity / exercise

The benefit of (increased) physical activity / exercise go beyond sleep of course but active and fit people sleep significantly better than those who are less active / unfit. A Stanford University study revealed that regular physical activity can increase the amount of sleep by an hour and half the time it takes to fall asleep.

The exact mechanisms continue to be debated but exercise moderates weight (gain) and being overweight significantly impairs sleep. Exercise also appears to contribute to more sound and restful sleep, specifically increasing the time spend in deep sleep.

Exercise of course requires you to expend more energy and therefore helps you feel more tired and ready to rest at the end of the day and, regular exercise as part of a consistent routine can help increase sleep duration (in addition to boosting sleep quality).

A more indirect benefit is that exercise can reduce stress and relieve anxiety, both of which are common reasons for having trouble falling asleep and sleeping restlessly throughout the night. There is a also an important positive feedback loop that kicks-in; good physical activity promotes better sleep and better sleep in turn helps to be more physically active.

Exercise inside is not as beneficial as the same exercise performed outside, most likely due to the circadian rhythm effects of exercising outdoors. As much as possible therefore exercise outside.

The exercise benefits only occur when you adopt a regular and consistent routine. Acute / irregular exercise doesn't provide the same benefits and can create more of a stress load. Keep in mind also the important exercise caveat covered in the next strategy.

10. But, schedule high intensity workouts and mental tasks / work during the day

High intensity workouts and complex mental tasks require a lot of energy and have an activating effect on both our brain (mental tasks actually warm up our pre-frontal cortex - the executive center of our brain) and body. It leaves your nervous system feeling wired which makes it difficult to calm down at night. Even intense discussions stimulate us and keep our mind racing and our stress levels elevated.

All of these prevent the body and brain from calming down and where possible it is best to schedule (or park) these for the day-time and leave the time after sunrise for the natural and gradual unwinding process.

12. Avoid watching the clock

Once in bed it is best to put away the clock or position it in such a way it is not visible to you. Keeping an eye on the clock as you (are trying to) fall asleep or checking it when you wake up during the night does nothing other than make you worry and activate your mind, making sleep even more elusive.

Even when you are analysing your sleep (or lack thereof) and keeping a sleep diary, it is best to estimate times rather than having access to a clock.

You can download a one-page summary of these “12 Practices for optimal sleep” here.

What if good sleep remains elusive?

What if you have adopted a new sleep practice consistently for two to four weeks but are not seeing any improvement? The first thing to double-check is whether there really haven’t been any positive shifts. Even small wins are an indication of progress and often we need to persist for a while longer, before improvements are more obvious.

Perhaps you have noticed you are less sleepy during the day, or find that you fall asleep a bit easier, or no longer wake-up multiple times a night?

If good sleep continues to remain beyond reach, there may be more going on underneath the surface and / or you may need some professional help to kick-start good sleep again.