THE SECRET TO DEEP SLEEP

OVERVIEW

Sleep is one of the most important health rituals that humans need to function, both physically as well as mentally and emotionally. Impaired quality or quantity of rest and sleep can seriously impact your daytime functions, including energy, weight balance, productivity, and mood. Chronic poor sleep can impact cardiometabolic function and is linked to hypertension, high cholesterol levels, blood sugar dysregulation and type 2 diabetes mellitus, as well as weight gain [1].

Sleep troubles are common and vary from difficulty falling asleep, through intermittent wakening, trouble falling back asleep, to waking early and/or unrefreshed. Just as your night-time sleep impacts your daily activities, vice versa, your daily routines also impact your sleep [2]. Sleep is a complex construct under hormonal and neuronal regulation and is affected by our internal clock – circadian n rhythm- as well as our direct external and internal environment. Common internal imbalances can disturb sleep quality and quantity and might include dysregulated stress hormone – cortisol- levels, a shift in sleep hormone -melatonin- regulation, and a disrupted neurotransmitter- brain chemical- balance (GABA, glutamate & aspartate) [3].

Risk factors to develop poor sleep might be shift work, as your circadian rhythm (internal clock) often shifts, thus disrupting a normal melatonin (sleepy hormone) balance; advanced age; certain medications; emotional arousal; sedentary lifestyle; as well as long-distance travel and jet-lags [4].

GOOD SLEEP HABITS

· Bedtime: 10-10:30 pm

· Latency < 30 minutes

· Duration: 7-9 hours

LIFESTYLE SUGGESTIONS

Exercise:

• Get out into nature first thing in the morning (30 minutes), a total of 1h

• Avoid heavy exercise at night, as that raises your core body temperature, and it will be harder to cool the body and fall asleep

• Try incorporating regular exercise during the daytime

Retrieved from Alaska Northern Lights, 2021 [5].

Sleep Routine:

• Avoid emotionally draining topics and stressors at night

• Try to get “difficult topics, tasks and conversations” out of the way first thing in the morning and at the beginning of the week

• Turn off artificial (blue light) 2 hours before bed and reduce light exposure in room when sleeping

• Use blue-light filtering glasses

• Take a hot shower (40C) 1 hour prior to bed

• Use a hot water bottle on feet or socks at night

• Open windows or put on a fan to cool room 30 minutes prior to bedtime

Waking throughout the night:

· When waking at night, expose yourself to minimal light (e.g., when going to bathroom)

· When waking during the night, use body scanning meditation technique to return to sleep

· If you cannot fall asleep after waking during the night, go into another room and do calming activities (with minimal light exposure), such as listening to calming music or a podcast

Sleep Times and Waking:

· If very tired from sleep deprivation, try to get as much sleep as possible, set your alarm to the latest time possible and get up straight away and then get some early day sun exposure

· Try to avoid the alarm snooze setting, as each alarm is a stressor to the body

· Try and avoid naps, unless they’re part of your daily routine

DIETARY STRATEGIES

· Eating breakfast before 9am can help to regulate blood sugar levels throughout the day and therefore modulate circadian rhythm.

· Incorporate protein rich foods, combined with essential fatty acids into dinner to provide precursors for night-time/sleep inducing hormones and brain chemicals to initiate and sustain sleep.

· Night meals should be light and easily digestible, as digestive capacity reduces throughout the day.

· Avoid alcohol for at least 2h prior to bedtime.

· Avoid caffeine after 2 pm.

· Limit sugar intake and artificial sweeteners to a minimum, as they can inhibit brain chemical production and impair balance.

FOOD AS MEDICINE

Kiwi Fruit: their antioxidant properties might address nutritional deficiencies and serotonin levels (brain chemicals), thus possibly improving sleep onset, as well as sleep quality and quantity [6].

Tart/Sour Cherry: Natural source of melatonin (sleep hormone), which supports circadian rhythm regulation, as well as high antioxidant profile, thus increasing sleep time and efficacy [7].

Milk: contains melatonin (see above). Careful, the body’s ability to digest lactose (milk sugar) diminishes with age and can cause digestive symptoms, not recommended then.

Fatty Fish: Contains vitamin D and omega 3 fatty acids, which are not only directly involved in hormone production and neuronal health, but also modulate the circadian rhythm. Requirements are higher in winter, as vitamin D from the sun is limited [8].

Nuts: The nutrients magnesium, zinc and melatonin are particularly present in walnuts, pistachios, and cashews. Those minerals are involved in many processes that are linked with sleep, thus have been shown to be beneficial for sleep regulation [9].

Other foods rich in Melatonin:

· Goji berries

· Eggs

· Leafy greens

· Red meat

· Turkey

· Yogurt

· Corn

· Rice

· Wholegrains- barley, oats

· Pineapple

· Strawberry [10]

SAMPLE DIET

Breakfast:

- Sliced turkey breast with smashed avocado on sourdough bread (2 slices) and 2 poached eggs

- Dandelion or green tea can be an alternative to coffee. Decaf coffee is another alternative.

Lunch:

- Mixed salad bowl with a base of mixed wild and brown rice. Topped with seasonal vegetables (fresh or baked), 1 salmon fillet (baked) and roasted nuts. If tolerated, a yogurt-tahini-herb dressing goes well, otherwise a simple vinaigrette.

Dinner:

- Sweet potato, cauliflower, lentil curry

Snack options:

- Fresh tart cherry juice 2/day

- Yogurt with nut butter and goji berries

REFERENCES

[1] S. D. Kyle, K. Morgan, and C. A. Espie, ‘Insomnia and health-related quality of life’, Sleep Med. Rev., vol. 14, no. 1, pp. 69–82, Feb. 2010, doi: 10.1016/j.smrv.2009.07.004.

[2] M. L. Perlis and P. Gehrman, ‘Types of Insomnia’, in Encyclopedia of Sleep, Elsevier, 2013, pp. 199–202. doi: 10.1016/B978-0-12-378610-4.00175-3.

[3] ‘Insomnia Overview: Epidemiology, Pathophysiology, Diagnosis and Monitoring, and Nonpharmacologic Therapy’, AJMC. https://www.ajmc.com/view/insomnia-overview-epidemiology-pathophysiology-diagnosis-and-monitoring-and-nonpharmacologic-therapy (accessed Sep. 12, 2021).

[4] R. Singareddy et al., ‘Risk Factors for Incident Chronic Insomnia: A General Population Prospective Study’, Sleep Med., vol. 13, no. 4, pp. 346–353, Apr. 2012, doi: 10.1016/j.sleep.2011.10.033.

[5] ‘Light Therapy and Sleep Disorders’, AlaskaNorthernLights.com. https://www.alaskanorthernlights.com/sleep-disorders/ (accessed Sep. 12, 2021).

[6] M.-P. St-Onge, A. Mikic, and C. E. Pietrolungo, ‘Effects of Diet on Sleep Quality’, Adv. Nutr. Bethesda Md, vol. 7, no. 5, pp. 938–949, Sep. 2016, doi: 10.3945/an.116.012336.

[7] J. N. Losso et al., ‘Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms’, Am. J. Ther., vol. 25, no. 2, pp. e194–e201, Apr. 2018, doi: 10.1097/MJT.0000000000000584.

[8] A. L. Hansen et al., ‘Fish consumption, sleep, daily functioning, and heart rate variability’, J. Clin. Sleep Med. JCSM Off. Publ. Am. Acad. Sleep Med., vol. 10, no. 5, pp. 567–575, May 2014, doi: 10.5664/jcsm.3714.

[9] M. Rondanelli, A. Opizzi, F. Monteferrario, N. Antoniello, R. Manni, and C. Klersy, ‘The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: a double-blind, placebo-controlled clinical trial’, J. Am. Geriatr. Soc., vol. 59, no. 1, pp. 82–90, Jan. 2011, doi: 10.1111/j.1532-5415.2010.03232.x.

[10] X. Meng et al., ‘Dietary Sources and Bioactivities of Melatonin’, Nutrients, vol. 9, no. 4, p. 367, Apr. 2017, doi: 10.3390/nu9040367.