Taking Command of Your Sleep and Rest

Each night, when sleeping appropriately, we go through multiple cycles of sleep that include Non-rapid eye movement (NREM) and Rapid Eye Movement Sleep that last approximately 90 minutes each.  NREM makes up 75% of our sleep, REM makes up 25% of our sleep.

NREM sleep has 4 stages, with stages 3 and 4 being the deepest and most restorative sleep.  REM sleep is when dreaming occurs and they eyes dart back and forth, hence the name!  Interruptions in these cycles alters the function that they serve, leading to symptoms, illness, disease, and death.

We all know that sleep is important for wellness and there are many of us who experience tiredness and exhaustion throughout the day.  Our sleep habits are affected by what we do during the day, what we think about, our emotional state, and what we do in the evening before bed.

Some of us do not get enough sleep because we want to fit more into one day.  We strive to get everything done, to be efficient and productive.  When we fail to get it all done, we work harder and stay up later in hopes of getting more done.  When we still don’t get enough done, we get up earlier and earlier in the mornings, getting less and less sleep.  Some of us are wired, but tired.  We simply cannot stop our minds and activity to allow ourselves to sleep.

The paradox is, by striving and pushing harder and by resting and sleeping less, we actually become LESS productive and efficient.  We take longer to do tasks when tired and fatigued than when we are well rested.  We make poor decisions and may be more likely to cross ethical lines.

Other effects of poor sleep and rest include:

• Impaired immune function

• Increased Inflammation (increased lab markers for CRP, IL-6 and other inflammatory cytokines)

• Altered Hormone Production, particularly Cortisol, the stress hormone

• Altered Neurotransmitter Receptor Sensitivity (these are the chemicals that communicate between nerve cells and affect all areas of the body)

• Lower headache/migraine threshold (have more headaches!)

• Altered mood, more frequent depressive states

• Weight Gain due to altered leptin and ghrelin levels (hormones that influence appetite – we feel hungry, not satiated by our food)

• Reduced Emotional intelligence, Empathy toward others, Positive thinking, Sense of independence, Self-Control

• Reduced quality of our interpersonal relationships

• Short Term Memory problems. Impaired mental processing.

The Great British Sleep Survey surveyed 20,814 individuals in the UK from March 2010 to June 2012.  Some of their findings:

• “The ‘racing mind’ is the main cause of sleeplessness…Worries about tomorrow and the day’s events are the most common thoughts that bother us at night.”

• They found that as we age our sleep becomes poorer and that different things begin to disturb our sleep pattern.

• Women have a 10% lower average Sleep Score and are more likely to be long-term poor sleepers.

• Poor sleepers are:

• 7 times more likely to feel helpless.

• 5 times more likely to feel alone.

• 3 times more likely to struggle to concentrate.

• 2 times as likely to suffer from fatigue.

• 2 times as likely to have relationship problems.

• 2 times as likely to suffer from low mood.

• 2 times as likely to struggle to be productive.

Some of the world’s disasters have been linked to lack of sleep, including the Exxon Valdez wreck, the explosion of the Challenger, and nuclear accidents.  Lack of sleep is also associated with a variety of diseases and disorders including obesity, type 2 diabetes, and heart disease.  Lack of sleep affects many of our hormone levels, in particular cortisol which can contribute to weight gain, abnormal blood glucose levels, and changes in appetite.

A recent study summarized in Time Magazine indicates that getting 5 hours of sleep or less for just ONE night may affect our ability to encode new information to memory.  This may lead to us becoming more receptive to suggestions by others that we may normally reject as false with a full night’s sleep.

If you love reading and learning, view these websites:
How Sleep Works
CDC
National Sleep Foundation

This assessment is designed for you to learn more about how you sleep, what thoughts and attitudes you have about sleep and rest, and how it came to be this way.  If you prefer to do this activity on paper, download the Sleep and Rest Lifebook.

What is true for you right now?

1. Do you awaken in the morning refreshed and alert?     Yes           No

2. Do you get sleepy during the day?   Yes     No

3. Do you sleep 7-8 hours each night?     Yes           No

4. Do you have a regular bedtime routine?     Yes       No

5. Does it take you longer than 20 minutes to fall asleep at night?     Yes    No

6. Do you awaken in the middle of the night?      Yes            No

7. Do you have a regular wake time?     Yes             No

8. Do you use your bed for activities other than sleep and sex?  Yes          No

9. Is your bedroom dark enough to shut out all light?     Yes             No

10. Is your bedroom comfortable and conducive to sleep?     Yes         No

11. Does your pillow allow for comfortable sleep without neck pain or headaches?  Yes       No

12. Do you consume caffeinated beverages after 2pm?  Yes           No

13. Do you consume alcoholic beverages in the evening?  Yes        No

14. Do you take a 10-20 minute nap during the day if you are sleepy?  Yes               No

15. Do you snore frequently or do people tell you you have pauses in your breathing at night?  Yes   No

Inquiry to delve deeper

How did you get here?  What in your past experiences led you to be this way?  Does everything have to be done before you can sleep/rest?  Who determines what needs to be done before sleep/rest happens?

What in family, work, culture or society perpetuates these behaviors?  Is exhaustion a status symbol for you? Are you proud of your exhaustion?  Does it make you a “good” or “better” person that you are doing so much that you are tired or exhausted?  What do people tell you when you say you are tired/exhausted?

What are your thoughts about taking naps?  What kind of person does it make you if you take naps?

How is your current relationship to sleep and rest working for you now?  What thoughts do you have about being tired or exhausted?  How does being tired and exhausted impact your satisfaction with life, your relationships, your ability to do what you want?  How does being tired impact other areas of health and well-being?  What other costs do you see?

What would it be like to be well-rested and full of energy and vitality?  What thoughts do you have about what it would take to get there? What would it be like to tell others that you are well rested and full of energy?

What thoughts do you have about committing to making changes that would have you feel more rested?  Is this something you are willing to commit to right now? Are you willing to make changes in your life to allow you to be more rested?  Do you notice any resistance to this?

Most people function best on an 8 hours of sleep. Some require more, some less.  The average american is chronically sleep deprived, which leads to a variety of symptoms and illnesses.

The number of hours is not as important as the way you feel and operate during the day.  Quality of sleep is important as well, and is better addressed in other tabs.

All of the tabs below will support you in increasing your sleep quantity.

One of the easiest steps is to add 15 extra minutes to your sleep schedule each week until you regularly have 7-8.

Use tips from another area, which may help this area as well.

If you answered yes to question 15 about snoring, please notify your healthcare provider for further assessment to rule out sleep apnea.  With untreated sleep apnea, no matter how many hours of sleep you get, it will not be restful.

Did you answer NO to “Do you have a regular bedtime routine?”

Doing the same activities each night at the same time, in the same order, trains your body to know when it is bedtime, making it easier to fall asleep and improves the quality of sleep!

Here are some things to consider:

• Avoid physical activity, especially vigorous exercise, within 2 hours of sleep.  It warms up and stimulates the body.  Physical activity during the day has been found to improve sleep cycles and reduce insomnia.

• Turn off all electronic devices (especially those that emit blue light) 1 hour before bedtime.

• Take a bath 1 hour before bed.  The cooling of your body after the bath encourages your body’s release of melatonin, a hormone that induces sleep.  Consider adding Epsom Salt (or Magnesium Oil or Flakes) – the magnesium is a relaxing mineral for the body and is absorbed through the skin.

• Dimming the lights in the room 30-60 minutes before bedtime also encourages your body’s release of melatonin!

• Do the breathing audio included in this activity!

• Use aromatherapy by rubbing a  drop of lavender oil on your hand or on a cotton ball.  Take 2-3 deep breaths, inhaling the relaxing scent!

• Set the alarm in your bedroom for your bedtime [that way you have to go to your bedroom to turn it off and you might as well start your bedtime routine then!]

• Schedule sleep as you would schedule an appointment.  Keep the appointment with yourself!

• Oh so many racing thoughts!  Keep a notepad and pen by your bed to make a list of to-dos before lying down.  Empty your mind onto the paper!  Let it all go!

Did you answer Yes to “Does it take you longer than 20 minutes to fall asleep at night?”  

• Add a bedtime routine, see above

• Avoid caffeine after 2pm

• Use this guided audio to create relaxation in your body and to calm your mind.

• Listen to binaural beats [available on Youtube, as an app in Playstore/Apple store].  This website offers additional information on how this works and the science behind it!  If you have a history of seizures, contact your provider before trying this technique.

• Avoid eating large, heavy meals within a couple of hours of bedtime.

• Magnesium is a mineral that supports relaxation in the body.  Add magnesium rich foods for dinner (green leafy vegetables, pumpkin seeds, avocado, black beans) or desert (dark chocolate, banana, figs).  It may also be supplemented by mouth at 400mg before bed.  It can also be added to your bathwater (Epsom Salt, Magnesium Oil, Magnesium Flakes) and it is absorbed through the skin.  It is a very safe mineral – most common side effect is diarrhea if too much is taken.

• Supplement Melatonin. Melatonin is a hormone that triggers the body to fall asleep.  It is released when the eyes sense darkness.  Melatonin is available as a supplement.  It is safe with few side effects.  Consult your healthcare provider.

• If you find yourself having ongoing mental chatter, consider adding journaling to your bedtime routine.  Take 5-15 minutes to write down all of the incomplete or frustrating areas of the day.  Release the thoughts into the journal for follow-up later.

• Are you so stressed that it is difficult for you to leave your day behind and fall asleep?  Do our Taking Command of Your Stress Module!

Did you answer yes to “Do you awaken in the middle of the night?”  

• Avoid caffeine after 2pm

• Avoid alcohol in the evening.

• Avoid eating large, heavy meals within a couple of hours of bedtime.

• The stress hormone, cortisol, causes sleep disruption.  Reduce your overall stress level, and thus your cortisol, by doing our module Taking Command of Your Stress!

• Some individuals may experience a drop in blood sugar, which causes Cortisol to be released and interrupts sleep.  A small bedtime snacks containing protein is helpful in maintaining steady blood sugar.  Avoid sugary foods (simple sugars cause drastic rise and fall in blood sugar) just prior to bedtime.

• Get up to do a calming, relaxing activity in a room that has dim lighting [Avoid turning on bright lights or digital devices as they reduce melatonin, causing you to wake up MORE!]

• If you answered yes to question 15 about snoring, we recommend you see your healthcare provider for further evaluation.  You may be awakening due to snoring.

• Are there causes in your environment for you to be woken up? A partner who snores, a pet or child who awakens you, any other?  Consider environmental changes to reduce this cause. Earplugs. Close the pets out (We know you love them and this may cause temporary discomfort, but it is impacting your wellness!).  Sleep in a separate room (even if it is some nights to allow for restorative sleep).

• Consider Binaural Beats Audio to support you in falling back asleep. ***See Fall Asleep Quickly Tab for additional information!

• Oh so many thoughts!  Are you awakening at night, think about the stress of the day or things you didn’t get accomplished or completely forgot about?  Keep a notepad and pen by your bed to write down a “to-do list” or other thoughts when waking up.  Do our Taking Command of Your Stress Module!

Did you answer Yes to “Do you have a regular wake time?”
Maintaining a consistent wake and sleep time allows for better sleep.

• Wake up at approximately the same time each day, even on weekends, holidays, and vacations!

• Schedule sleep as you would schedule an appointment.  Keep the appointment with yourself!

Did you answer yes to “Do you use your bed for activities other than sleep and sex?”

The brain begins to associate your bed for activity instead of sleep when it is used for other purposes.

• Avoid reading or doing work in the bed

• Avoid watching TV in bed

Is your bedroom dark enough to shut out all light?  Darkness stimulates the release of melatonin.

• Use Dark Curtains/Shades

• Remove Night lights and other bright lights (especially blue lights) whenever possible.

•  Avoid using TV or electronics 1 hour before bedtime. Move alarm clock outside room.

• Has two benefits -removes light from room, forces you to get up and not snooze.

Did you answer NO to “Is your bedroom/bed comfortable and conducive to sleep?”

• Keep your bedroom cool at night.

• Consider cooling gel topper or pillow to keep body cool.

• Consider new mattress topper or mattress.

Did you answer no to “Does your pillow allow for comfortable sleep without neck pain or headaches?”

Mal-alignment of the neck and spine during sleep cause discomfort which interrupts sleep cycles.

• Consider a new pillow that is based on your primary sleeping position.

Did you answer Yes to “Do you consume caffeinated beverages after 2pm?”

Caffeine affects people differently. Caffeine is metabolized in the liver and people metabolize caffeine at different rates, depending on their genetic sturcture.  Learn more Here.  Caffeine consumed up to 6 hours prior to bedtime has been shown to reduce the quality, duration, and efficiency of sleep.  It makes it harder to fall asleep.  Many experience a lighter sleep stage, leading to shortened deep sleep time and more frequent awakenings.  Some people think they are sleeping well, but may not be resting as completely as they would without caffeine later in the day!

Did you answer Yes to “Do you consume alcoholic beverages in the evening?”

Yes, alcohol has a depressant effect on the body, making you sleepy initially.  However, alcohol disrupts the later phases of sleep, especially by interrupting REM sleep which is the most restorative phase of sleep.

Did you answer NO to “Do you take a 15-30 minute nap during the day if you are sleepy?”

Some companies are now putting rest areas for sleep or meditation into their structures to promote employee wellness!  According to David Randall, author of Dreamland:  Adventures in the Strange Science of Sleep“, a short nap “primes our brains to function at a higher level, letting us come up with better ideas, find solutions to puzzles more quickly, identify patterns faster and recall information more accurately.”  If you plan to take longer than 30 minute naps, aim for 90 minutes as this is a whole sleep cycle and you will be less likely to wake groggy and sedated.

In order to feel refreshed, relaxed, and rested, sleep is very important.  However, there are other factors that give us the experience of being refreshed, relaxed and rested.  You may be surprised to find that experiencing play and flow are valuable in creating rest.

Play and Flow

Stuart Brown, MD, a predominate play researcher and Founder of the National Institute for Play, asserts that we are designed to play throughout our lifetimes.  He rates the biological importance of play to that of sleep and oxygen.  Dr. Brown’s definition of play may surprise you.  Play is a state of being that is purposeless, fun, and pleasurable, that has no obvious survival value.  Play is an activity in which the participant:

• engages voluntarily.

• loses track of time.

• experiences a diminished sense of self-consciousness.

Play for each individual is different!  Dr. Brown indicates it could be rock-climbing for one person, baking bread for another.

In similar research done by Mihaly Csikszentmihalyi introduces the concept of flow and its significant contribution to our happiness.  He challenges us to spend more and more of our daily lives in flow.   He indicates people experiencing flow:

• Are completely involved, focused

• Experience a state of ecstasy, a sensation of being outside everyday reality

• Experience great inner clarity

• Know they possess the skills to do the task and that the task is doable

• Experience a sense of serenity and feeling of growing beyond the boundaries of the ego

• Enter a state of timelessness

• Experience a sense of internal reward simply from the experience of the situation [intrinsic motivation]

Play as an adult incorporates many of the same characteristics as flow. We would like you to consider that play and flow can be introduced throughout your day, even within your work.  Play and flow are very individualized experiences.  For one it may be painting or creating art, for another it may be inventing new creations, and for yet another it may be getting lost in a great fiction novel!  Play and flow both leave adults feeling relaxed, energized, happier, in touch with themselves, and more complete; thus contributing to their sense of well-being.  It seems that more we play, the more joyous we feel!

Use the following questions to begin learning what is play and/or flow for you! You may wish to use this list of activities to guide you in your exploration of what is play/flow for you.

• What did you do as a kid that brought you utter joy, that you never wanted to stop doing, didn’t worry about your appearance, and possibly were fussed at for losing track of time?

• What do you love to do so much that you lose track of time? That you don’t want it to end?

• What do you love to do so much that you don’t worry about looking goofy, weird?

• What activities do you do just for the joy and pleasure of doing them?

• How can add more play and flow into your daily life?

• What activities create a sense of relaxation and rest?  What activities create a sense of vitality and energy?

Take some time to explore what gets in the way of you doing these activities. You may wish to use these questions to inquire into what gets in the way of you resting and playing.

Inquiry to delve deeper

How did you get here?  What in your past experiences led you to be this way?  Does everything have to be done before you can sleep/rest?  Who determines what needs to be done before sleep/rest happens?

What in family, work, culture or society perpetuates these behaviors?  Is exhaustion a status symbol for you? Are you proud of your exhaustion?  Does it make you a “good” or “better” person that you are doing so much that you are tired or exhausted?  What do people tell you when you say you are tired/exhausted?

What are your thoughts about taking naps?  What kind of person does it make you if you take naps?

How is your current relationship to sleep and rest working for you now?  What thoughts do you have about being tired or exhausted?  How does being tired and exhausted impact your satisfaction with life, your relationships, your ability to do what you want?  How does being tired impact other areas of health and well-being?  What other costs do you see?

What would it be like to be well-rested and full of energy and vitality?  What thoughts do you have about what it would take to get there? What would it be like to tell others that you are well rested and full of energy?

What thoughts do you have about committing to making changes that would have you feel more rested?  Is this something you are willing to commit to right now? Are you willing to make changes in your life to allow you to be more rested?  Do you notice any resistance to this?

Now you have learned strategies that will help you mange your stress!  How do you Live the Alternatives and Take Command of Your Sleep & Rest regularly?

Situations and circumstances in our daily lives make it difficult to maintain our commitment to the alternatives we are creating.  These circumstances drain our mental energy and the will power we rely on when changing or creating new routines.  By exploring what hurdles and obstacles will get in your way, you can develop strategies to overcome these barriers.  Proactively planning for these barriers will improve your success in creating the routines you desire.

To help you identify what the hurdles and obstacles are, consider the following questions:

• Where are areas that will make it difficult for you to complete your routine as you envision it?

• What has caused you to fail instituting the change in the past?

• What stressful situations do you anticipate in the near future?

• Will you have exhausted your will power before doing this routine? How can you not rely on will power?

• What could you put in place that would help you succeed? [See the strategies listed below]

• By when will you have these in place?

Consider planning ways to add the following strategies:

• Maintaining your commitment to your new future by completing the form entitled Living My Commitment to Wellness  and posting where it will be visible regularly.

• Substitute your habitual perspective with a mantra that represents the future you are creating for yourself and including the mantra on the Living My Commitment to Wellness.

• Review the Living My Commitment to Wellness form each morning and periodically throughout the day!

• Create a reminder system for yourself! Schedule it on your calendar.  Use an alarm on your phone.

• Create a reward for yourself! How will you celebrate your success???Intrinsic rewards are more successful than extrinsic rewards over time.  Intrinsic rewards are those that come from within, like feeling accomplished or successful or pleasure from completing an activity. Extrinsic rely on external circumstances, like rewarding yourself with food, money, prizes etc.

• Visualize yourself energetic and full of vitality!  What will you experience when you Take Command of Your Sleep and Rest!   What will your feelings/thoughts about yourself be when you have accomplished the routine?  How will your body feel?

• Avoid the “I must do this alone” mentality by enrolling a support partner in this journey!