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Fight Sleep Insomnia: 5 Ways to Sleep Better at Night

Posted by Dr. Gary Brewton, MD on
 August 1, 2014
  · No Comments
Mark Twain in Bed. Photograph by Van der Weyde.

Mark Twain in Bed. Photograph by Van der Weyde.

We keep learning more and more about the benefits of a good night’s sleep.

Sleep is something you need to take seriously for your health. Long-term problems with insomnia are associated with weight gain, heart disease and type 2 diabetes.

How can you sleep better?

Here are five ways to improve what’s known as your ‘Sleep Hygiene’. Try these key guidelines for a few weeks and see if you don’t begin to sleep better at night.

Sleep Insomnia – Key to Better Sleep #1: Cool It in the Bedroom

It’s hard to imagine living in Houston without air-conditioning.

So how did people sleep during Houston summers in the time before air-conditioning? Probably not that well. It’s hard to sleep at night when it’s hot and humid.

One of the strategies for keeping cool was the screened ‘sleeping porch’, often built on the second floor to capture any faint mid-summer Gulf coast breezes. You can still see ‘sleeping porches’ on historic homes in Houston’s original neighborhoods, like the Museum District, Midtown, Montrose and the Heights. Today you’ll notice that many of the original screened openings are enclosed with glass windows or walls — all thanks to modern air-conditioning.

It turns out that keeping your bedroom cool not only helps you sleep better but, according to a recent study published this June by the American Diabetes Association, it can also help increase your metabolism — if you keep your bedroom very cool.

Study subjects who slept in a bedroom chilled down to 66 degrees burned more calories while increasing their amount of internal brown-fat. Brown-fat, unlike white-fat, is now considered ‘good’ for maintaining an active metabolism level as well as possibly reducing the incidence of diabetes.

If you are sleeping in a bedroom that’s too hot, try to keep it cool with a fan — or consider using a portable room air-conditioner. These new models only require a small opening in a window for the exhaust heat vent tube.

Sleep Insomnia – Key to Better Sleep #2: Turn off All Electronic Devices

It’s not just for airplanes… electronic devices interfere with sleep as well.

We love our electronic devices, probably too much. We even take them into the bedroom, and use them in bed. A study in the UK indicates that over 90% of 18-24 year olds used electronic devices during the two hours leading up to bedtime.

While that iPhone or iPad or Kindle may seem like a modern replacement for reading old-fashioned hardcover books in bed, sleep researchers have discovered electronic devices are a major cause of insomnia.

Yes, that’s right: using electronic device before bedtime actually prevents your body from falling asleep.

How can this be?

Let’s consider the normal sleep cycle, before modern electronics and artificial light sources. The sun goes down at dusk, casting a warm amber glow. Your body naturally responds by producing the sleep-inducing hormone melatonin. You drift into a long, undisturbed natural sleep. The sun rises; with its blue morning light that announces it’s time to awaken. The body responds to the slowly increasing amount of light and adjusts its hormones accordingly. You wake up.

So how do electronic devices interrupt the natural sleep cycle?

Electronic devices emit blue light, which is not the natural color of light at night.

While we’ve had wood fires burning at night for millennia, oil lamps for thousands of years and Edison’s electric filament light bulb since 1879 — all of these emit a primarily orange wavelength light, which is the body’s internal signal to begin the sleep cycle.

What’s new is the appearance of modern electronic devices — like tablets, smart phones, flat screen TVs and LED lighting. It turns out these devices emit a strong blue wavelength light component, which is associated with ‘waking up’.

So, what to do? The simplest answer: avoid using your electronic devices for two hours before bedtime. If you must use them, consider turning down the brightness to the lowest level and hold them at least 12 inches away.

Wearing amber-tinted glasses that block blue light is another solution. While this may sound odd, amber-tinted glasses may become just another thing we wear to help us fall sleep, not unlike using ear plugs to control background noises.

You think this is crazy stuff, right? Well another scientific study released last month indicates there is a connection between dim light at night and the growth of cancer tumors in rats. Dim light also appeared to reduce the efficacy of the anti-cancer drug tamoxifen. Scientists suspect dim light at night suppresses production of melatonin in the body.

Bottom line: You’ll sleep better at night by avoiding use of electronic devices two hours before bedtime, turning out all the lights in your bedroom, and getting some old-fashioned solid, light-blocking curtains to cover up your bedroom windows from outside lights.

Sleep Insomnia – Key to Better Sleep #3: There is a Time and Place for Everything

Go to bed at the same time each day.

It’s bedtime! Most of us have an idea when we should go to sleep. Pick a time that’s right for you and stick to it. Even on the weekends. Use an alarm clock.

Get up at the same time each day.

Waking up at the same time each day helps improve the quality of your sleep in the long run. But wait? What if I woke up in the middle of the night? Shouldn’t I sleep in and catch up on sleep? The answer is no. Sleeping extra hours will only make your next night’s sleep more problematic.

Weekends can cause major sleep issues.

Going to bed late on Friday and Saturday nights with the intention of ‘catching up’ on sleep Saturday or Sunday mornings doesn’t work. You can’t ‘bank’ sleep hours. Try keeping regular sleep hours — including weekends! — for a month and see if you don’t feel more rested.

Caffeine intake has great influence over your sleep patterns. Limiting consumption to mornings only can help with sleep insomnia. Courtesy Amanda Mills, CDC.

Caffeine intake has great influence over your sleep patterns. Limiting consumption to mornings only can help with sleep insomnia. Courtesy Amanda Mills, CDC.

Caffeine before Lunch, Not After

If you are having difficulty sleeping at night, change your eating and drinking habits. Limit your coffee, tea and other sources of caffeine to the mornings only. Have a bigger breakfast and lunch then a lighter dinner, preferably by 6 p.m. Don’t drink alcohol in the late afternoon, evening or nights. Avoid smoking entirely.

What about Naps?

If you are having trouble sleeping at night, skip naps entirely for now. It’s more important to establish proper rest at night. Eliminating regular daily naps may make you more tired in the short term (due to a temporary sleep deficit) but over the long run it will help you sleep better at night.

Once you are sleeping well at night, you can try naps. A short 10-30 minute nap in the mid-afternoon has been shown to reduce stress and fatigue, as well as improve your mood, alertness and creative thinking abilities.

Sleep Insomnia – Key to Better Sleep #4: Reduce Allergens in Your Bedding

It’s estimated that a third of us are allergic to house dust mites, which lurk in our beds and pillows. They are also a primary trigger for asthma attacks. You won’t be able to see them unless you are looking through a 10x microscope. But if you wake up with a runny nose or itchy, watering eyes, you might be having an allergic reaction to house dust mites in your bedroom.

Remember our First Rule about Keeping the Bedroom Cool?

Keeping your bedroom cool not only increases your metabolism, it has an important secondary benefit: it dehumidifies the bedroom. This in turn helps reduce (though not entirely eliminate) the population of house dust mites hiding in your bedding, mattress and pillows.

Carpets are Problematic; Tile and Wood Floors are Ideal

You’ll have to remove your carpets and rugs from the bedroom if you have a serious allergic reaction to house dust mites. The good news is they can’t live on hard surfaces, like tile and wood floors.

New Microfibre Materials

Of course, if you remove your rugs, then the house dust mites will migrate to your bed.
If you want to protect your bed from dust mites, you can cover (or encase, as they say in the bedding industry) your mattress and pillows with sealed covers. The old style covers were very uncomfortable and ‘sweaty’ because they didn’t ‘breathe’. But now there’s a new generation of woven microfiber fabrics available that allow air to breathe while restricting passage of allergens.

What about Pillows?

If you don’t like the idea of covers on your pillows, an alternate strategy is to buy lower-cost synthetic pillows — wash them once or twice, and then replace them. At Target stores, for example, you can look for a very tall rack stacked with standard size polyester-filled bed pillows, priced for as little as $5 or $6 each.

Tips for Washing and Disinfecting Pillows and Bedding

To keep the pillows balanced in the washer, wash two at a time. Use less detergent than for regular clothes. Unless you have a special washing machine which can superheat the water to 140F, high heat in the dryer is actually more effective at killing organisms than your washer. Use the dryer’s medium setting (aka Permanent Press) or higher (approx. 135F) for the maximum drying time and you can skip adding chlorine to the washer.

Important: Keep an eye on your dryer when drying synthetic bedding and pillows on high heat. You don’t want the dryer to catch fire when you are out.

You can also let nature sanitize your bedding. On bright sunny days, put your pillows and bedding on the clothes line and let the sun’s UV rays do the work for you. Finally, it sounds very odd but you can also put your bedding or pillows in a freezer for 24 hours; the cold temperatures will kill house dust mites.

Sleep Insomnia – Key to Better Sleep #5: Exercise and Relaxation

Brisk exercise, such as walking at least 20 minutes each day, will improve your health in many ways, including improving your sleep.

But for many people, exercising right before bedtime can itself be a cause of insomnia. If that could be the case for you, try scheduling your exercise program in the morning or mid-day. If you can only exercise after work, try to finish at least four hours before your regular bed time.

If you have a lot on your mind, try making a list of things you need to do the next day as part of your routine before going to bed. This can help ‘put your mind at rest’ and reduce anxiousness which might contribute to insomnia.

There are many other relaxation and meditative techniques to try. Here’s an example: Try relaxing — from your head to your toes — by squeezing each of your muscle groups in sequence.

Begin by smiling to squeeze your face muscle for two seconds, and then relax. Repeat this several times. Then move to your jaw, then the neck. Repeat this muscle-by-muscle contraction and relaxation technique. Start with one shoulder, and then continue down one arm, working your upper and lower arms, hands and fingers. After doing both arms, tighten and relax your chest, then your stomach/abdomen and buttocks. Then move down each leg, tightening and relaxing your thighs, then calves, feet and toes. Still not sleepy yet? Keep this up for 45 minutes and you will probably be relaxed enough to fall sleep.

That sounds a lot like yoga and tai chi, doesn’t it? It turns out that according to some health studies both yoga and tai chi have been shown to reduce insomnia. We plan to look at yoga in a feature article in September.

Sleep Insomnia Postscript: Uncovering Signs of Sleep Disorders

If you’ve been having mild insomnia, we hope these five guidelines to improve your ‘sleep hygiene’ will help you sleep better at night. But how do you know if you have a more serious problem that requires medical attention? If you experience these issues, call us at (713) 529-9224 and schedule a consultation:

  • You fall asleep unexpectedly in the middle of the day.
  • You fall asleep during the middle of a normal activity.
  • You can’t move right away after waking up.
  • You feel like you have weak muscles after laughing, or getting excited or angry.

Important: If any of these symptoms are urgent, dial 911 for emergency responders.

Sleep Insomnia Medical Evaluation: Three Primary Ways to Assess your Sleep Health.

When you visit Dr Brewton’s office to discuss sleep insomnia, you may be asked to participate in sleep evaluation tests; sleep evaluations usually fall into these three categories:

The first way to evaluate your sleep insomnia is for you to keep a Sleep Diary, in which you document details of your sleep each night over a one to two week period.

Next is an Actigraphy test, which involves wearing a monitor on your wrist that detects motion at night, which in turn provides a record your sleep patterns. This information is typically recorded over a period of several nights.

Finally, there is a formal sleep test, or Polysomnography, which measures your movement, breathing, brain activity and other bodily functions during sleep. In some cases, this can be done at home with a portable sleep monitor; more thorough tests require an overnight stay at a sleep lab.

Categories : 2014-08 August Newsletter, Doctor Checkup, Manage Stress, Newsletter, Sleep Insomnia
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Doctor Brewton is your Board-Certified, Common Sense Community Doctor serving the Houston Midtown, Houston Montrose, Houston Museum District, Houston Heights and Houston Texas Med Center neighborhoods for over thirty years. Call us at (713) 529-9224 to make an appointment.

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Dr Gary Brewton, MD, FACP
1213 Hermann Drive, Suite 845, Houston, Texas 77004-7027 | Telephone (713) 529-9224
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