Sleep Hygiene for the Working Human

Do you know the one thing that all healthcare practitioners agree on in regards to best health practices? SLEEP! We understand more about the effects of sleep on physiology and psychology than we do the effects of nutrition on the body and mind. Sleep may just be the most under-prescribed health optimization tool in our healthcare system. Why? Because it’s difficult to manage, difficult to monitor, difficult to monetize, and, like chronic pain, sleep debt is multifaceted.

We know that when we get a “good night’s sleep” we are referring to the quality and quantity of sleep. That when we sleep, and we are able to achieve a minimum of 4 REM cycles, we have given our bodies the minimum amount of rest time necessary to recover our brains and tissues for functioning at a similar rate than the day before. A REM cycle (Rapid Eye Movement) is the process by which our brains and bodies power down to deep sleep and then slowly rise from deep sleep, in a perfect stepwise cycle. The reference points of each level of sleep are detected by different wavelengths in the brain and can be tracked using electrodes during a sleep study.

In one study of young men’s testosterone, just one week of less than 5 hours of sleep resulted in a consistent loss of 10%-15%, serum testosterone in young men during the hours of 2 p.m. and 10 p.m. ONE WEEK! How many of you stayed up late for more than a week? EVERY. TWENTY-SOMETHING.EVER. Our society does not prioritize sleep. We have LED lights in our street lamps, city signs do not go dim after dark, social media and cinema keep us glued to our screens at night, extra homework and long work days keep us up late at night to finish and prepare for tomorrow…these assaults on our sleep are a constant in our society. If you have ever stayed up consistently until the early morning hours, you know that you feel like hell the following day; drained of energy, tired, craving carbs, headaches, etc. These memory-making years of our lives come at a high cost (1). Living it up means we accumulate sleep debt, affecting our hormones which result in changes in weight, energy, performance, brain function, and aging. Over time, chronic sleep loss can cause low testosterone in young men, thyroid disease in women, obesity during and after college, depression, anxiety, joint aching, chronic headaches, carbohydrate and sugar cravings, etc (1).

Let’s discuss the one cause of sleep debt that plagues society. Blue light exposure after sunset! A study of the use of screens post-sunset demonstrated a stark decrease in melatonin levels in those that were on the screen an hour before bedtime. This study also showed that the melatonin decrease lasted for 50 minutes after all lights were out! When our melatonin levels decrease due to the influence of blue light in our eyes versus the orange/red/pink hues of sunset, the cascade that helps us stay asleep and recover our tissue while we are sleeping decreases drastically! Melatonin is also a regulator of blood sugar, body temperature, and blood pressure. When melatonin production is decreased due to white and blue light exposure in the evening, the results can look like sore/achy joints, inhibited weight loss, simple carbohydrate cravings, increased blood pressure, decreased temperature acclimation (constant coldness). As most parents will note, never miss a child’s nap. This saying should be true for the 8 hours of recommended sleep per night for everyone. Here are some tips to help us prepare for sleep and enjoy a solid night’s sleep.

Habits to improve sleep quality?

  1. Turn off blue light devices 60-90 minutes before bed. If that’s not possible, wear orange tinted blue light glasses after sunset.

  2. Finish your last meal 4 hours before sleep, including alcohol.

  3. Decrease water intake beginning 4 hours before bedtime.

  4. Write down your thoughts/tasks/reminders on a notepad by your bedside.

  5. Practice belly breathing to calm the nervous system

  6. Expose your eyes, chest, and belly to the sunrise and sunset to reset your Sleep/Wake Cycle or Circadian Rhythm.

  7. Exercise daily- increase heart rate.

  8. Supplement with calcium/magnesium or valerian root

  9. If melatonin is taken, slowly wean yourself off .

  10. TRUST and ACCEPT that:

    1. You wrote down tomorrow’s list

    2. You did everything you could have done today

    3. Sleep will assist in productivity tomorrow

Following these 10 Rules of Sleep will assure that you get quality sleep and wake up feeling mentally and physically rested. The process of making new sleep habits takes time and patience with yourself. Remember that when we work on protocols to change our hormones, we have a 6 week cycling period before we see a real difference, so patience is an absolute MUST in this process.

Sleep on my friends!

JAMA. Author manuscript; available in PMC 2015 May 27.

Published in final edited form as: JAMA. 2011 Jun 1; 305(21): 2173–2174.

doi: 10.1001/jama.2011.710 PMCID: PMC4445839 NIHMSID: NIHMS690822

PMID: 21632481

Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy Men