Complete Wellness

A Place for Healing MindBodySpirit

 

Sleep

Sleep is an integral part of good health. Every person has a different need for sleep; some requiring 9 or more hours, and others only need 3-4 hours of sleep to feel fully rested. And the need can change throughout life, even day to day. The measure of adequate sleep is how you feel in the morning. If you feel rested and can go through your day without undue fatigue, you’ve had enough sleep, no matter how few hours. On the other hand, if you’ve slept 8 or 9 hours yet you wake up feeling lousy and tired, you haven’t had good quality sleep.

Sleep is a very mysterious process. Modern science doesn’t really understand how we fall asleep or how we wake up. We certainly don’t understand the whole dreaming thing and how we mostly disengage our brain from our muscles.

But we do know that sleep is vitally important to overall health. It seems that our bodies have a lot of work that gets done while we sleep. Our muscles undergo repair. (That’s why poor sleep leads to aches and pains.) Our stomachs do an acid wash. (That’s why people with ulcers and GERD are often wakened by stomach pain between 2 and 4 AM.) Our brains reboot and our hormone levels reset. (That’s why we don’t learn or perform well if we don’t sleep well and why women going through menopause are often bothered by night sweats and headaches during that 2-4 AM window.) It seems that if we disturb these repair processes, they don’t get done.

Trouble sleeping can be of different types. Some people have trouble falling asleep. Others can fall asleep just fine but then wake up later to be unable to fall back asleep. Some people have both problems. Sleep difficulties can be a lifelong problem for some. For others it can be just around a particular stress or hormonally cyclic.

Everybody is different in their sleep habits, likes and dislikes. There are many doctors and scientists who study sleep and make recommendations about what they call sleep hygiene. The recommendations consistently include a regular bedtime. This bedtime should be preceded by a quiet routine of preparation; eg. bathing, reading, no TV or stimulation, certainly no exercise before bed. They often recommend that the bed be only used for sleep. It should not be where you do work or engage in hobbies, like knitting. These measures are to try to get your body to associate the bed only with sleep. You know yourself better than anyone else. If knitting calms you and readies your mind and body for sleep, then listen to that.

Make sure you are comfortable. Some like a cold room, others prefer warmth. Have a pillow that supports your neck in comfortable extension, not all squished to one side or the other. Have a mattress that feels good and supportive, soft and comfortable.

Usual sleep hygiene recommendations would also say never to nap. If you find that the promise of a nap the next day allows you to worry less about your insomnia, then use that. For some napping is a wonderful way to make up for missed rest. For others, if they nap, they know they will lie in bed and just toss and turn in bed that night. Do what works for you.

In general, exercise is good for every part of healthy living. Good exercise helps every part of your being. It is good for sleep too. Making sure that you are getting daily exercise, yes, daily, for at least 20 minutes helps mood, cardiovascular health, digestion, and, of course, sleep. As mentioned, some experts feel that exertion in the pre-sleep hours is ill-advised. If you know that you feel good and tired at the end of exercise, as one might after yoga, qi gong or tai chi particularly, then follow your own wisdom.

If you have a hard time falling asleep, relaxation techniques can be very useful. These kinds of techniques could include meditation, hypnosis, progressive relaxation and breathing exercises. And then there are drugs. There are a ton of medications that can help induce sleep. Benadryl, by itself, or in products such as Tylenol PM, is sold by the millions because this is such a common problem. Melatonin at doses up to 3mg helps some. Chamomile, valarian and other herbs have been used for millennia and can be all that is needed to get you to sleep.
Alcohol helps some relax and sleep more easily, and makes others wake in the middle of the night. (Too much is never good. 1 ½ ounces of hard liquor, equals 4 ounces of wine equals 12 oz. of beer. Up to two of these size servings seems to be OK for men long term, and a bit less for women.)

There are, of course many prescription drugs that help induce sleep, like Ambien, Lunesta, and Sonata. These are all very short-acting and should be taken on your way to bed. Don’t take them and then go make a cup of tea. They work in minutes and are out of your system within a few hours. The beauty of these is that some people sleep better the rest of the night if they just get a good start.

If your trouble is staying asleep, try to figure out what’s waking you and fix that, if you can. If it’s pain, you need to try to fix it or treat it adequately. If it’s hormones, you can try to address the imbalances. If it’s stomach trouble, acid-reducing therapies might help. But if you can’t fix the problem, or sometimes even identify the underlying problem, then you just have to deal with it. Relaxation techniques can be very important in that they help you get rest even if you are not asleep.
See; Relaxation Response.

Sometimes medications can help, but they have to be longer acting than the medicines used to get you to sleep. The potential issue with medications that are longer lasting is that they might still be having an effect in the morning. If you feel “hung over” in the morning after taking a sleeping pill of any kind, one of the easiest responses is to take the medicine a little earlier so you body can clear it out before the morning. Some medications will stop having that hangover effect if you just stick with it for a couple of days.

Your homeopath or naturopath might have remedies for you to try. An acupuncturist might offer help. Sometimes something that helped at one point, stops working and you have to start your search for an effective sleep aid all over again. Try things again that might not have worked so well before. They may be fine this time around.

Sleep apnea is becoming a more widely recognized reason for people to feel not rested in the morning. Sleep apnea means you actually stop breathing at some points during the night. If your sleep partner notices that you snore unevenly, or have episodes during which you seem to be startled and take a big gasping breath, you may have obstructive sleep apnea. The obstructive part of this condition is that the back of the throat and soft palate relax to the point of blocking the airway. Your diaphragm moves, trying to suck air in to the lungs, but the soft tissues are blocking the flow, until you need air so badly that you gasp for air. It sounds like this;, grrrrrrr……grrrrrrrr…...grrrrrrrr ………………………….. GWAAAAck. This process disturbs all the work your body is trying to do in deep sleep. It leaves you feeling like you didn’t really get good rest at all even though you may not have wakened to full consciousness.

There is a less common form of apnea called central apnea, in which your brain just doesn’t give the signal to breath. It is much less dramatic in its presentation. There are just long pauses between breaths, without all the sputtering and noise. The affect is still the same. You wake up TIRED.

In order to diagnose these problems accurately, sleep studies are conducted. In these studies, a monitor is placed under your nose to detect air movement, on your finger to detect oxygen levels and on your chest to detect movement of the chest and heart rate. If your chest moves, but no air moves, that indicates an obstruction. The monitors record all these measurements through the night. Usually this study Is carried out in a sleep lab, but some slightly less intricate tests are actually carried out in your home, so you can be in your own environment. The results can help guide the therapy.

You can try some easy over the counter remedies before you get into much testing and treatment. Sometimes the application of BreathRight strips to keep the nasal passages open can make a world of difference. You will know in one or two nights if it is helping. An inexpensive bite guard that you can buy in any pharmacy will sometimes keep a little better muscle tone in the back of the throat and keep the airway open. Again, a night or two will tell you if it is effective. The careful use of a nasal decongestant spray, like Afrin, can sometimes help, but you have to make sure you do not get into a habit of using these medicines every day or you can end up with a dependency which makes it super difficult to stop using them.

If none of those things has worked and you have gotten a sleep study done that indicates obstruction, you may be helped by a CPAP machine. Continuous positive airway pressure, CPAP, is applied by way of a mask over the mouth and nose or just the nose. It keeps blowing air in to hold the airways open and keep you breathing regularly. The masks can be uncomfortable and you may need to try a few types to find one you tolerate. When you do find one that fits, it needs to be replaced every year or so to keep the seal intact. These machines can be a lifesaver for those who need them, and their bed partners too.

If you have had sleep problems for some time, you may not feel the full benefit of restored sleep for some time. I usually will recommend getting good sleep for every night for a whole month, by whatever means necessary, to get your body to work properly, believing that it will have the opportunity to do all its sleep work every night, and then back off and see what happens.

It may take some time to figure out what works and doesn’t work for you, but it is totally worth it. It takes a bit of objectivity to put all the pieces together. There was a brilliant nuclear physicist who used to do his own personal “sleep studies” in which he would go up to his room in the afternoon and pay attention to what his mind did as he fell asleep. His attempts to be the scientist as well as the subject in this study ends up being an interesting type of meditation. That’s how geeks relax, I guess. Whatever works for you……

 

 

 

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