The All-Mighty Sleep

The All-Mighty Sleep

By Monita Böhmer - Humanlift

My relationship with sleep has been a complex and educational journey to say the least. If I have to choose the most important health game changer for me, it would be figuring out what constitutes good sleep and how to get to improved sleep architecture.

In 2012, I was assigned to Moscow, Russia for an international assignment. Prior to this job opportunity, my relationship with sleep was purely functional. I took it for granted. You sleep when you are tired and you wake up when you are done sleeping. Never did I think that my sleep would be taken away from me and what the impact would be. I would even say that I was one of those people that viewed sleep as a weakness that should only be participated in when absolutely necessary.

In addition to moving to a country that differs from my culture and my world on so many levels, there is a 4-hour time difference. Now you might think that 4 hours is not such a big deal. In addition to the time difference, Russia’s weather is quite harsh and the winter months were a huge shock to my system. Our hours of work were from 10 am to 7 pm, to compensate for the weather (and horrible Moscow traffic…yikes!). So overall, I had to deal with the challenges of weather, a different time-zone, city life, a vastly different culture and a new job.

Physically I felt fine initially (except for continued digestive issues, but that’s a story for another day), I continued training in the gym (mostly cardio), ate reasonably healthy (the traditional food pyramid and the occasional Russian delicacy, hahaha), managed to meditate every day and did my best to adjust to my surroundings. Progressively though, I was struggling to sleep. Initially I did not make much of it, but as time went by, I started to realize that there was an issue. And again, it happened over time. I would maybe struggle to fall asleep a couple of nights, or wake up during the night and then struggle to fall asleep again. So it just got worse and worse. Some nights I would only sleep a couple of hours, some nights almost nothing. In the end, it was so bad, I didn’t know what to do.

For those of you that have suffered from insomnia before, you would know that it is one of the worst experiences. It impacts absolutely everything. Not only was I seriously tired all the time, my digestive issues escalated (I had diarrhea most of the time and looked 4 months pregnant!), the brain fog was so bad, I was convinced my IQ dropped with 10 points, I suffered from memory loss, I was irritable (this is quite the understatement. I was in a horrible mood most of the time), I felt that I was going to fall asleep at any moment on most days (and did nod off for a couple of seconds many times), I had the flu pretty regularly (and developed pneumonia) and so the list continued. It was one of the worst times of my life. Over weekends I would sleep more, but I think it was purely the body collapsing of fatigue just to start a new cycle of insomnia the next week. How I managed to perform well at my job, I just have no idea…

I was allowed to go home a couple of times during the assignment and the first visit home I went to see my GP. He ran a number of blood tests, but could not make a diagnosis. He said everything looked fine (yes, I know what you are thinking). He prescribed sleeping pills and sent me on my merry way. Refusing to take sleeping pills but as an absolute last resort (and I was pretty much there), I started my journey in hacking my sleep. I was confused by the whole thing. I felt terrible, but there was nothing physically wrong with me according to my doctor. So the digging began and I very soon realized that sleep is the holy grail of achieving and maintaining health and wellness.

I did not get better immediately, and neither can I pinpoint the exact thing that changed the whole thing around for me. Initially I did look at my diet and nutrition and tried to figure out if maybe I had any issues with food. Of course I also suspected that my digestive issues were linked to all of this, but this was years before I really addressed my IBS. I started looking at stress management, time of going to bed and waking up, caffeine consumption etc. Slowly though (with a couple of times where I had to take sleeping pills, and some herbal sleeping aids as well), I started to look at my health holistically, and in the process, my sleep improved.

Today, my sleep hygiene is a non-negotiable. I protect my sleep with my life. I never want to go back to those days again. With loads of trial and error, reading many books, listening to many podcasts, these are in my view the game changers in upgrading or restoring your sleep. I am not a doctor, nor am I a sleep specialist and I do recommend you chat to your medical support system and do your own research. Also make sure you do not suffer from a sleep disorder like sleep apnea, which should be diagnosed by a medical professional and could be managed quite effectively with the correct medical interventions. You will however find the list below to be prevalent in most of the literature:

1. You need to give sleep the respect it deserves. The saying, ‘I will sleep when I am dead’ – might just cause your death to come earlier quite literally. Sleep is the most important consideration in a balanced healthy life. It is not fashionable or cool to brag about your ability not to sleep or to send a message that sleep is not important. Both heads of state Margaret Thatcher and Ronald Reagan were ambassadors for this anti-sleep movement. They communicated in public that sleep is for the weak. Guess what, both of them died of Alzheimer’s Disease. Listen to the podcasts where Dr Peter Attia (The Drive) interviews Dr Matthew Walker on the science of sleep https://peterattiamd.com/podcast/ . At the time of this blog, three out of a series of three podcasts would have been released. Sleep is possibly one of the most important considerations in the prevention of cancer, cardio vascular disease and dementia. The brain cleans up cellular garbage when you sleep and your body repairs itself when you sleep. If there is not enough opportunity for the body to repair itself, there is a decline in immune function, an increase in cortisol (stress hormone), imbalance in appetite and an increase in inflammation, to name a few challenges. Literally an unhealthy storm which could lead to serious health issues. These clean-up processes only happen when you sleep. Mere resting or taking it easy does not cut it. Your brain needs to be restricted from outside input. Only a few people with a very rare gene mutation can function with less sleep. You and I are probably not one of those people. If you feel healthy now, but do not prioritize sleep, these health issues might catch up with you sooner rather than later. The average adult needs between 7 and 9 hours of sleep. If you are an athlete or participate in high levels of physical activity, you might even need more sleep!

2. Manage yours stress levels. I almost just want to leave this one here and not say anything more. Do whatever you need to do. Meditate, participate in mindfulness practices, go visit spiritual healers… but get to it. In holistic health or functional medicine, the body cannot heal if the psychological or emotional health is left unattended. I think I have probably done most of my work in this area. And quite literally…you have to step into the arena. Face the things that cause you stress, anxiety or emotional pain and deal with them. If you have time, watch the documentary recently released on Netflix called Heal. Or go to healdocumentary.com to see what is meant by the mind body connection. It is truly eye-opening.

3. Eating healthy and the correct timing of meals are critical. I mentioned earlier that poor sleep causes an imbalance in appetite. If you really want to study sleep, you need to study what is referred to as our circadian rhythm. The circadian rhythm is a biological process responsible for your entire 24h day of wakefulness and sleep. Sometimes referred to as the ‘body’s clock’. Listen to the podcast Dr. Ruscio Radio 195. The Science Behind Intermittent Fasting and Circadian Rhythm where Dr. Ruscio interviews Dr Satchin Panda (https://drruscio.com/intermittant-fast-and-circadian-rhythm/.) Like many other important biological milestones, proper sleep is required for you to go through all the phases in a healthy and properly timed way. Circadian rhythm is regulated by light mostly. There are a few hormones though that are balanced by a healthy circadian rhythm. One of these hormones is called ghrelin, the hunger hormone. If you suffer from cravings throughout the day, your ghrelin and leptin (satiety hormone) are probably not well balanced. For those religious fasters reading this, if you suffer from cravings and you struggle to sleep, eat breakfast until your cravings are resolved and sort out your sleep first (an effective hack I promise you). You can then go back to fasting or a fasting regimen. Under normal circumstances, ghrelin is released in the mornings and leptin after sunset. Leptin shifts the body into fatty acid utilization, suppresses appetite and controls evening cravings. Eating late at night and blue-light inhibits leptin release. Another interesting hormone released at night is called adiponectin. Adiponectin release is also supported by supplementing with magnesium at night and is very important for fatty-acid metabolism. If you suffer from insulin spikes at night (possibly caused by high-calorie meals at night and low activity), adiponectin release is also inhibited. Anyway, working on my nutrition really made a huge impact on my sleep. Eating the wrong foods and eating big meals too late in the evenings caused gut distress and I could literally hear my tummy struggling at night when I was supposed to sleep. Not to mention having to jump up and go to the toilet during the night. These days’ nutritional information is easy to find and by working on your nutrition, you not only improve sleep but can also eliminate many other health issues. Research when to eat most of your calories and when to eat most of your carbs. If you struggle with sleep latency (falling asleep), avoid spiking insulin before bed. If you cannot avoid a large meal at night, go for a walk and take a cold shower. That helps with metabolizing the meal. Dr Satchin Panda does a lot of work around time-restricted eating and introducing a fasting routine or introducing an eating-window to your day which could have a huge impact on your digestion and sleep. Start with a Paleo diet and then move to an Elimination diet if you do not feel better and slowly introduce a fasting routine. Many people suffer from a leaky gut which also impacts sleep. 80% of the gut is repaired during sleep and if you eat big meals before bed, the gut has to work instead of repairing itself. As Dr Satchin says, you cannot fix the train tracks if the train is running, and if the liver and gut is working at night to digest meals, sleep becomes secondary. This is an evil cycle that has to be restored before sleep can become optimal.

4. Figure out your cronotype. This is something you can do for free, and it can quite literally change your sleep performance in days. I thought it was fashionable to stay up late and I worked late most evenings. On weekends I would go out with friends, read or watch TV until the wee hours of the morning. When I did sleep, my phone will be next to my bed and I would check messages and emails during the night. Although figuring out my cronotype came later for me, I think it would have made a huge difference in my sleep hygiene during my Moscow stay. My cronotype is what is called a Genetically (and it is not something you can change), I am an early riser and have to go to bed reasonably early. I have most of my energy early mornings and have to have my meals earlier in the day as well. Your cronotype determines when you should sleep, when you should exercise, eat and even when to have your morning coffee! Forcing yourself to go against your genetics can have a huge impact not only on your sleep performance, but your overall health and wellness performance. You can check yours at www.thepowerofwhenquiz.com and figure out if you are a Lion, a Wolf, a Dolphin or a Bear. You can also read Dr Michael Breus’ book, The Power of When to understand your chronotype and how to manage your life around it. It is truly eye-opening, I promise!

5. Figure out your caffeine tolerance. There is a gene called the CYP1A12, which plays a role in your coffee sensitivity. You inherit two copies of this gene, one from Mom and one from Dad. If you have the fast variants, you break down coffee really fast. Others are not so lucky. 40% of us are fast metabolizers, 45% are somewhere in the middle and 15% are slow metabolizers. Read more on this at https://drwillcole.com/caffeine-one-thing-standing-optimal-health/. I don’t think you should test for the gene but start to look into how you feel. For me, If I drink coffee after 14:00, it impacts my sleep. I used to drink between 6-10 cups a day, some well into the evening. And I like good strong coffee. I now mostly drink 1-2 cups of caffeinated coffee a day and switch to decaf or tea. Especially after 14:00.

6. Sunlight in the morning and no electronics at least two hours before bed. Back to circadian rhythm. Your body releases cortisol in the morning and is supposed to release melatonin in the evening. Sunlight helps maximize the release of cortisol in the morning (that jolt of energy you need to get going for the day) and ensures its natural decline in the evenings. If you cannot spend some time in the sunlight in the mornings, consuming moderate amounts of coffee or green tea helps. As for melatonin, you know this one by now guys. Melatonin is a critical hormone released for the induction of sleep and helps the body to repair itself. Melatonin is also critical to enable leptin to enter the hypothalamus which is required again for the burning of fat stores. Electronics and most of the lights in our offices and homes contain blue light. Blue light inhibits the secretion of melatonin; I wear blue blockers every evening during the hours before bed and have installed f.lux; justgetflux.com on all my devices. It reduces blue light on your phone, laptop etc. I read at candlelight before bed, and wearing the blue blockers, I feel sleepy before I know it. Also make sure your phone doesn’t bother you during the night. Put it on sleep mode or airplane mode so you are not disturbed during the night. Also make sure your bedroom is really dark so that street lights or other lights don’t shine into your bedroom. If you have to, get yourself a sleep mask to wear. In Moscow, my apartment was on the 22nd floor of a very noisy building and neighborhood. I had very light curtains and to top it off, I was pounding away on my laptop and phone well into the night.

7. Keep it cool. You need to feel comfortable to fall asleep and to stay asleep. Again, linked to the circadian rhythm, the body goes through a process of thermoregulation. Towards the evening, the body naturally lowers its core temperature. It rises its core temperature to signal the body to move into a state of alertness in the morning. It is not that easy though. Weather, inappropriate bedding, room temperature etc. plays a role here. It is about your core temperature and your environment can be too hot or too cold to facilitate good sleep. I recently purchased a ChiliPad for myself. It is a device that circulates warm water in winter and cold water in summer under your body. Since sleeping on the ChiliPad, I have taken my sleep performance from really good to great! You can find yours at chilitechnology.com. It is quite pricey, so other than that you can just make sure you keep your room’s temperature between 15 and 20 degrees Celsius for optimized sleep.

8. In general, if you exercise, you should notice improved sleep. Exercise improves the deep sleep phase. Deep sleep is critical for boosting the immune system, supports cardiac health and controls stress and anxiety. There is also evidence that exercise is particularly good for the treatment of insomnia. On a more basic level, exercise causes expenditure of energy, which makes you more tired at night. Exercise with all its benefits is however a stressor to the body and causes a raise in core body temperature and cortisol. High intensity exercise like CrossFit definitely increases the release of cortisol. So if you are doing rigorous exercises just before bed, your cortisol levels will be too high for melatonin to be released properly. Try to exercise earlier in the day or at least two to three hours before bed. If you cannot switch things around, try to do relaxing exercises before bed like walking or yoga and take a cold shower if your core body temperature needs to be regulated after exercise.