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Sleepless in Greenville, DE

It's happened to all of us, a sleepless night. Maybe we have a newborn teething in the next room (I can commiserate!), or we are working late on a presentation, maybe we are sick or we tweaked an old injury at the gym and can't get comfortable. There are countless obstacles that keep us from sleeping that its a miracle we even close our eyes! That being said, even without a good reason, I would bet most of us don't get great sleep. And when we don't, we feel it the next day don't we? It can start feeling slow to get going, maybe ordering another shot of espresso in our coffee, the clock at work seems to move slower. Beyond these immediate consequences, there may be more impactful effects on our mood, memory, and energy. Well, what can we do about it? How we can improve our relationship with sleep? And when it may be a good idea to talk to an expert about our trouble sleeping?

So, what does good sleep look like and why do I need it? Good sleep starts as it gets dark and ends when it gets light. Like many components of a healthy life, we pay homage to our genetics. Evolutionarily speaking, our DNA has spent that majority of its existence, going back generations, without things like electricity or even shelter. Good sleep indicates to our physiology that we are "safe". Conversely, if we are not sleeping our body thinks that we are in "danger" (but we will talk about that later). The initial stage of sleep, or light sleep, is when we close our eyes and can take minutes and causes our heart rate to slow down, our thoughts to slow down, and our muscles relax. Early sleep (roughly the next three hours) functions to recuperate us physically. This is why we can still physically function with 3-4 hours of sleep, but we wouldn't want to! During the next 3-4 hours, or late sleep, we recuperate neurologically and psychologically through REM sleep. REM sleep is characterized by two big facts: our body is not moving, and this is where we have dreams. The longer we sleep, the more REM cycles we have and the longer the REM cycles become in length. Good sleep should feel refreshing, energizing, and familiar.

Now that we know what are goal should look like, why aren't we getting there? A lot of it comes down to what we call sleep hygiene. Good sleep hygiene is a set of behaviors that transition us into a relaxed stated in order to start the process of falling asleep. Here are some tips for good sleep hygiene, maybe you can find a couple that you are already doing.

  1. Limit sensory stimulation - our bedroom is quiet, dark, avoiding screens like TV's/cellphones/tablets

  2. Limit chemical stimulation - avoid caffeine, nicotine (both stimulants), avoid alcohol as it decreases late sleep, food can impact our ability to sleep or not depending on the person

  3. Use the bed only for sleep - avoid eating in bed, working in bed, spending the day in bed

  4. Have a regular time we go to sleep - human beings love habits

  5. Exercise regularly - an early mentor of mine always said "Coal miners never have insomnia"

If you are anything like me, this list may just be a checklist of all the things we are doing wrong when it comes to sleep. And that's great news! It means you can make some very easy changes to our routine that can have a big impact on sleep.

What if we are doing all the right things and we are still struggling with sleep. When should we reach out to talk to an expert? In general, my advise is to think about how your quality of life is effected. Everyone has a different definition of what good sleep feels like. Specifically, there are some signs that you should see a sleep specialist.

  1. Do you snore?

  2. Does your partner observe that you stop breathing periodically at night?

  3. Do you wake up with a sour taste in your mouth?

If you said yes to these questions, you should reach out to your primary care doctor to discuss your poor sleep.

How can you tell is a psychological issue is impacting your sleep? Usually, when we struggle with anxiety it becomes harder to fall asleep. While depression normally impacts our sleep by causing frequent awakenings throughout the night. If you have having these sleep impacts and symptoms, your primary care doctor or a psychiatrist may be very helpful getting to the cause of our poor sleep and providing options for treatment.

Thank you so much for taking a moment to learn a little bit about sleep.

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