Dr. Mimi Guarneri Getting a Good Night’s Sleep

Sleep is a surprising complex process, regulated by our thoughts, hormones (such as melatonin), and environment (such as light exposure).  There are many reasons why someone may have difficulty sleeping that range from sleep habits, medical conditions, emotional states, age, shift-work, and neurotransmitter imbalances, to name just a few.

Sleep difficulties can occur at different phases of the sleep cycle.  Some people have difficulty falling asleep and simply don’t get enough hours of rest.  Others have difficulty remaining asleep or sleep very lightly.  If you don’t spend adequate time during the night in deep sleep, you don’t wake refreshed.  

Here are some common sleep-disrupters…and ways I recommend to change them!

1. Caffeine.  Avoid caffeine after 2pm, or consider eliminating it entirely.
2. Nicotine.  If you smoke, let us help you quit. Nicotine stimulates the brain in ways that make it difficult to fall asleep and stay asleep.  Non-smokers have fewer sleep problems than smokers.
3. Alcohol.  Although alcohol in the evening may seem like it helps you fall asleep, it actually disrupts your total night’s sleep.  Alcohol can cause waking, nightmares, and poor quality sleep.
4. Exercise.  This is a proven way to increase high quality deep sleep in the elderly.  Exercise during the day promotes good sleep; exercising close to bedtime can be too stimulating.
5. Electronic devices & screens:  The blue light from our computers, tablets and phones has been proven to disrupt melatonin release. Download f.lux to modify your screen to prevent this: https://justgetflux.com/
6. Environment.  The bedroom should be quiet, dark, and soothing.  Improve your sleep environment with heavy curtains, cool temperatures, dim lights, and quiet.  If the room is too noisy, consider a background white noise generator which plays monotonous soothing sounds such as ocean waves or classical music.
7. Regular sleep schedules.  Try to go to bed at the same time and get out of bed at the same time every day.  Don’t go to bed until you are sleepy; read a calming, non-stimulating book or do something boring until you feel sleepy.  If you do take naps, try to keep it to 1 hour in the early afternoon.  If possible, avoid shift work, as this is very disruptive to sleep patterns.
8. Bedtime Rituals.  Doing hectic computer work or watching an exciting movie right before bed makes the transition to sleep more difficult.  Adopt a regular pattern of slowing down to help you get ready for bed.  Sip chamomile tea and read a quiet book for a few minutes.  Take a tepid shower (not too hot or cold).  Do some deep breathing exercises or relaxation exercises.  THEN get into bed when you are feeling calm and drowsy.
9. Yoga and Yoga Nidra.  Do a few restorative poses; forward bends and legs-up-the-wall are especially calming. Yoga Nidra is a guided meditation that leads you through progressive muscle relaxation into the deepest state of meditation while maintaining conscious. You can find many recordings on U-tube. Check out the Omvana app for many guided meditations.

Supplements to help:

Take something (temporarily).  Sustained release melatonin replaces deficiencies in the body’s own sleep hormone. It is non-addictive but dosing is very individualized. Kava is a heavy-hitting botanical that relaxes the body and mind. Valerian increases GABA and as such, people can respond paradoxically.  Magnesium citrate, especially forms buffered with bicarbonate, improves sleep, muscle tension, and bowel movement. Progesterone is calming; if used, it should be taken before bed.