Why we should approach sleep as a project

How was your night and how are you feeling today? I hope you woke up refreshed and fully charged for the day! Sleep is deeply interconnected with our health and poor sleep will sooner or later lead to an array of health issues.

If poor sleep occurs more often than not, sleep medics will call it a sleep disorder. It can be anything from a too short or too long duration of sleep, sleep that gets interrupted too often or sleep that is not restful. You can get 7 or 8 hours of sleep, but still wake up unrefreshed and with low energy levels. The reason for any case of poor sleep is that the duration of REM sleep and/or deep sleep have deviated from healthy levels.

REM sleep and deep sleep
In our sleep we go through different phases; light sleep, REM sleep and deep sleep.

In REM (rapid eye movement) sleep phase we dream and our emotional impressions from the day are processed and consolidated.

In deep sleep on the other hand, is where regeneration and rejuvenation takes place. In this motion- and dream-less phase of sleep the human growth hormone (HGH) gets released, blood pressure is lowered while blood flow to muscles increases, triggering a repair of body tissues and replenishment of energy levels.

Brain detoxification happens in deep sleep
Only in 2012 did researchers find out, how the brain gets rid of its waste and toxins. It happens through a contraction of brain cells in size of up to 60% that predominantly happens when we are in deep sleep. The contraction creates more space between the cells, allowing cerebral spinal fluid (CSF) to wash more freely through the brain tissue. After the waste removal, brain cells expand back to their normal size and the CSF can't move through the brain anymore.
This is why when we don't get enough deep sleep, toxins and waste can build up in the brain, leading to a compromised mental state with decreased memory, cognitive abilities and brain fog.

Deep sleep and age
While the percentage of REM sleep in adulthood remains almost constant at around 20% of the total sleep duration, our deep sleep decreases as we age. While young adults spend around 18% of their sleep time in deep sleep, this number goes down to 10% around the age of 60 and by the age of 80 and above deep sleep is often down to a few minutes a night, also reducing the ability to effectively detoxify the brain.

Making sure we get enough deep sleep is one of the best health and anti-aging strategies there is.

So let's have a look at how we can naturally increase deep sleep.

Why the beginning of sleep is key
A key insight is that deep sleep happens mostly earlier in the night and decreases later on during sleep.

One of the best strategies to increase deep sleep is to go to bed in an already tired and relaxed state. The goal should be to have the lowest heart rate, also called resting heart rate, during the first third of your sleep. The earlier you reach the resting heart rate, the more deep sleep you will get.

It makes perfect sense. If you go to bed stressed or still with a busy mind, you had a stimulating or even heated discussion or watched a thriller, there will be too many stress hormones and neurotransmitters in your body, effectively preventing you from entering deep sleep in the first part of your sleep. You will not be able to catch up the deep sleep you lost in the beginning of your sleep in later stages of the night.

Good sleep strategies
Good strategies are to stop working at the computer at least an hour before going to bed, consciously winding down in that last waking hour of the day. Listen to soothing music, meditate, do some gentle yoga or qigong exercise or take a warm bath or shower whatever helps you calm down.

Taking supplemental magnesium about an hour before bed can provide additional help. Magnesium plays a key role in over 300 physiological processes including sleep. Research has shown that even a marginal lack of it can prevent the brain from settling down at night. The magnesium and mineral contents in our top soil and food have sharply decreased over the past 100 years. Poor dietary intake of magnesium has become an increasingly important factor and about 60% of the US population does not meet the US RDA for dietary intake of magnesium.

A good form of magnesium to be taken at night is magnesium malate. You can use the consistency of your morning stool as a feedback to find the optimal dosage. If you don't have a bowel movement in the morning or your stool is rather hard, up your intake of magnesium. If your stool in the morning is too loose, reduce your evening dosage.

A warm bath with Epsom salt (best in the form of magnesium chloride flakes) in the evening is also a very good and relaxing way to soak in magnesium through the skin, increase your levels of electrolytes and preparing you for the night.

Get your melatonin up and avoid blue light
Melatonin is our main sleep hormone. Its production is coupled with the circadian rhythm.
Evolution has come up with a perfect design. When the sun sets and it's getting dark, the body starts secreting melatonin, and when the sun rises the next day, production is suppressed. Specifically it is the high degree of blue light in the light spectrum of the morning sun that blocks melatonin.

Nowadays we interfere with this natural rhythm through heavy use of artificial light. What makes things worse for our sleep is the now widespread use of LEDs. The light spectrum of LED contains a high degree of blue, which can block melatonin production up to 80%. LED light bulbs, computer monitors, tablets, smart phone and smart watch displays, TVs all have this effect.

So what can we do to prevent LEDs from decreasing melatonin levels and thus sabotaging our sleep? You should avoid LEDs in the evening as much as possible or at least in the hour before sleep. If this is not possible or practical, you can get special blue light blocking glasses. You can find these on Amazon or at other retailers. Also use blue light filter apps (like f.lux) on your computer, tablets and smartphones to filter out as much of the blue light components as possible in the evenings.

Late dinner and alcohol are interfering with deep sleep
The timing and type of your last meal of the day is very important for your sleep. Do not eat too close to bed time if you want to get a good restorative sleep. Do not have heavy meals and refrain from foods that will let your blood sugar spike.

While a (small) glass of organic red wine may be healthy, alcohol will prevent you from getting a good, refreshing sleep. Sure, it can help you fall asleep, but (too much) alcohol will at the same time prevent you from getting your healthy dose of deep sleep.

Sleep as a project
The above actions are important, but when it comes to sleep, it's much like getting an orchestra to playing a symphony. There is a lot that can be done to optimise and get more and more instruments to play well tuned and in sync with each other.

I'm very passionate about sleep. Improving sleep was the turn-around in my own journey to regain health. When we are talking about chronic sleep disorders, we are talking about vicious cycles. Poor sleep will not only set you up for health problems but also for increasingly poor sleep.

When I was working on my turn-around, deep sleep had come down in average to 0-10 minutes a night. Now, my average deep sleep is back to well above 1 hour a night and with the increase more and more symptoms have been resolved.

For me it was important to get some sort of feedback on my sleep in order to see what worked well and what did not. I use the OURA sensor ring to analyse my sleep data including sleep phases (www.ouraring.com , you can use coupon code carmine50 to get USD 50 off if you like).

I would encourage you to do some research on your own to get you going on your sleep-project. Two books I can highly recommend to read on the subject are:

1. Shawn Stevenson, Sleep Smarter: 21 Essential Strategies to Sleep Your Way to a Better Body, Better Health and Bigger Success, 2014
2. Dr. Michael Breus, the Power of When, 2016

What you can do
To give you an idea, for what might be a good addendum to your personal sleep orchestra, here are some measures that can help to improve sleep:

1. Optimise your sleep environment
o Make your bedroom as dark and quiet as possible.
o Try to keep room temperatures in the bedroom on the lower side
o If you have cold feet, put on socks
o Use a quality mattress and pillow (without hazardous fire retardants)
o Metal free bed frame (to avoid you potentially sleeping on a big antenna)
o Switch off your cell phones and WiFi routers during the night

2. Things you can do during the day
o Train your circadian rhythm by synchronising with the sun (whenever possible spend a few minutes outdoors around sunrise or after you wake up and again around sunset. This will re-sync your hormonal rhythms with the natural cycles of day and night).
o Get as much fresh air and outdoor time as possible during the day.
o Do not use stimulating substances in the afternoon and evenings (think of Coffee, green and black tea, vitamin B12, folate, etc).
o Reduce your stress levels and/or increase your stress resilience (If you are someone who easily gets overwhelmed or suffers from too much stress, consider reading Heidi Hanna's book "The Sharp Solution: A Brain-Based Approach for Optimal Performance", in which she offers a variety of short, effective methods to help shift your stress response into relaxation in just a few minutes.)

3. Preparations in the evening
o Have your last meal latest three hours before you go to bed
o Limit your intake of alcohol
o Have a calm down period of 30-60 minutes before going to bed
o Avoid blue light from LEDs after sunset or wear blue light blocking glasses
o Magnesium 1 hour before bedtime can help to prepare for sleep
o Planning and optimising your sleep timing based on your sleep personality (are you an early riser or a night owl?)
o Be consistent with your bedtime and avoid social jet-lags as much as you can (i.e. go to bed at around the same time each day, including weekends)

4. Right before bedtime
o Get some fresh air into your bedroom
o Try taping your mouth (Do you snore or do you sometimes wake up with a dry mouth? If so, try taping your mouth with a hyposensitive tape at bed time. It prevents you from having your mouth open during the night and in many cases will keep you from snoring. You can google 'mouth taping' to find out more.)
o Use breathing techniques that switch on the parasympathetic state and activate the vagus nerve.
o Additional "hacks" that I’ve experimented with and helped me to get more deep sleep include a; sleep induction mat with tiny sharp acupressure spikes; brain entrainment devices (light and sound devices to induce delta and theta brainwaves); pulsed electromagnetic field devices; red light therapy devices (red light aids melatonin production).

5. During the night
o Are you waking up several times during the night with the urge to use the bathroom? Drinking more water/fluids in the morning and less in the afternoon and evening might help.
o Do you wake up at around 3am? Your body might run hypoglycemic, i.e. your blood sugar might get too low when the liver starts working at around 3am in the morning. The low blood sugar then triggers the release of stress hormones that wake you up. To counter this, eat some carbs together with fat before you go to bed. The fat will help with a slower release of the carbohydrates (i.e. sugars) into the blood.

I hope this blog was interesting for you. I'd be very happy if I was able to motivate you to think of sleep as a top priority health project. The dividends it can pay you in terms of better health, energy, cognitive abilities and in general better ageing are huge.

To your health,