Winnipeg Free Press - PRINT EDITION
To sleep, perchance to dream...
The alarm goes off on another blustery morning, awakening you from a dream. You might think, "it can't seriously be morning already." And I know you're not the only one.
Every day, I meet with patients struggling with sleep deprivation, whether it's difficulty falling asleep, staying asleep or even sleeping at all. Sound familiar? If so, you might experience morning sluggishness until you have that first caffeine hit. This boosts you before your usual afternoon low. When you get home, you may be drained and ready to rest. Except come bedtime, instead of counting sheep, your mind is racing with thoughts of tomorrow's to-do list, paradoxically feeling "tired but wired" all at the same time.
Sleep is a necessity, not a luxury. Shakespeare picked up on this, even in his time before electric lights and non-stop technology. Since the 1900s, our sleep duration has decreased by nearly 30 per cent from 9.5 hours nightly. Studies show seven to eight hours is optimal, and any less can increase weight gain and increase risk of diabetes, dementia, heart attacks, blood pressure and depression. It can also reduce cognitive function, hampering our memory, mood and ability to learn new tasks.
The best time to sleep is by 10 p.m. Why? Our body is telling us to head to bed, by way of the natural sleep-wake cycle or circadian rhythm. It's dependent upon cortisol, our body's main stress hormone, which naturally decreases at night. Sleep deprivation spikes cortisol and alters our sleep pattern. I've seen this a lot in shift workers, including hospital workers, commercial airline pilots, and (ahem) newspaper staff.
As cortisol drops, melatonin rises. It supports nightly healing and repair along with growth hormones, helping us look and feel younger. Melatonin decreases as we age, and can be depleted by medications, leading to less sleep and less dreaming. I prefer to measure levels through saliva to personalize supplementation.
Side effects of too much melatonin? Nightmares. There is a fine line, however, as dreams themselves are important and indicate good-quality REM sleep. If you're dreaming in colour, that's even better! This means not only do you have those vivid dreams, but that your memory is in good shape too.
Here are some dos and don'ts for catching some quality zzzs:
-- keep your room dark (so you can't see your hand in front of you)
-- have a hot shower or bath before bed, and keep your bedroom one to two degrees cooler than normal (this temperature shift induces sleep; think of it as a mini-hibernation)
-- turn on bright lights in the morning
-- take magnesium and B vitamins (which help melatonin work)
-- cut back on caffeine (it spikes cortisol and depletes nutrients needed for sleep)
-- correct conditions that contribute to insomnia (menopausal hormone imbalance, adrenal fatigue, depression or sleep apnea)
-- brew a cup of chamomile, lemon balm or passion-flower tea
-- use computers and tablets two hours before bed (they stimulate cortisol)
-- turn on the light if you awaken (this instantly drops melatonin)
-- stare at the alarm clock (focus on calming music, nature sounds or a favourite vacation destination)
-- use alcohol to induce sleep (it reduces dreaming and causes rebound awakenings)
-- smoke two hours before bed (nicotine is a stimulant)
-- supplement with melatonin without the advice of your medical practitioner (instead, include food sources: bananas, oats, walnuts)
-- take sleeping pills for longer than two weeks if possible (they disrupt the normal sleep architecture and reduce dreaming)
A recent Facebook post from a night-shift-working nurse friend spelled out what was on many a wish list this year: "All I want for Christmas is my circadian rhythm back."
Although Santa may not have brought you a midsummer night's dream, you now have some tips to take you through the Winnipeg winter. In restoring your sleep, I hope your dreams will lead you to a new world in living colour. And apparently, Shakespeare does too.
Tara Maltman-Just is a licensed pharmacist at Vitality Integrative Medicine in Winnipeg. She focuses on "treating the person, not just the disease" to help people live better, more balanced lives. www.vitalityintegrativemedicine.com
Republished from the Winnipeg Free Press print edition January 5, 2014 A5
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