If you’ve heard the “sleep hygiene” advice once, you’ve heard it a million times. Turn off the tube and computer at least an hour before bed, take a warm shower, have a glass of warm milk … the list of supposed tried-and-true tactics goes on and on.
There is some truth to these often-repeated rules—after all, too much screen time can throw off circadian rhythms (your body’s 24-hour internal clock that controls sleeping, waking and more), and winding down before you hit the sheets can help soothe you into a state that’s conducive to sleep.
But for many people, the standard advice isn’t sufficient. Luckily, integrative and holistic practitioners have some novel—and helpful—things to say about why, exactly, so many of us can’t get the sleep we need.
Taking it all in, so you can take in a full night’s rest
“We need to look at sleep from the perspective of body, mind and spirit,” says Rubin Naiman, Ph.D., a psychologist specializing in sleep and dream medicine and a clinical assistant professor at the University of Arizona’s Center for Integrative Medicine in Tucson. “Conventional approaches are primarily body, with just a little bit of mind,” Naiman adds. “When we look at the whole picture, we come up with novel ways to help people sleep better.”
Following are 15 culprits—many of them surprising—that could be to blame for your sleep problems, along with changes that can help resolve them. If, after addressing the issues that apply to you, you’re still having trouble, consider visiting a sleep lab. Sweet Dreams!
- You assume asanas will soothe you. Doing yoga right before you hit the sack may not be conducive to sleep. “Obviously, a late-night session that’s all about moving around can keep you awake,” says Judith Hanson Lasater, Ph.D., a physical therapist and yoga teacher in San Francisco. But even slower-paced moves can rev up your system: “Stretching itself is a physiological stimulus,” Laster points out.So instead of active yoga, do 15 minutes of conscious relaxation to prep your body for sleep. Here’s how: Lie on the floor and put your lower legs up on a couch so your knees form a 90-degree angle. Put a small pillow or towel under your head and neck, and cover your eyes to block out light. “This reduces stimulation to the nerve center in the brain that keeps you awake,” says Lasater. Take slow, deep breaths and clear your mind.
- You’re a late night eater. When you lie down too soon after eating, the acid in your stomach can back up into the esophagus; a too-lax lower esophageal sphincter, the valve between your esophagus and stomach, is to blame. The result is sleep-disrupting acid reflux, aka heartburn. But there’s another reason a late supper is a sleep robber: “Your body will be too busy digesting to focus on the restorative aspects of sleeping: detoxifying, regenerating cells and reviving,” says Beth Reardon, R.D., an integrative nutritionist at Duke Integrative Medicine in Durham, N.C. She suggests closing your kitchen at least three hours before bedtime.
Here’s an Eastern take on the issue: In traditional Chinese medicine (TCM), the notion of the organ clock maintains that qi, or life energy, circulates throughout the body’s organ systems in a 24-hour period, and you don’t want to interfere with the natural rhythm of these processes. “For example, when you eat too late at night, qi won’t be circulating properly,” says David Scrmgeour, L.Ac., an acupuncturist and TCM expert in Boulder, Colo. “As a result, you won’t be sleeping well and rejuvenating your adrenals and digestive organs.”
- You need an oil change. The omega-3 fatty acids found in fatty fish, walnuts, canola oil and flaxeed that help protect against heart disease, are also key to sleeping soundly. “Twenty percent of the gray matter in the brain is composed of omgea-3s, and they’re also the building blocks of cell membranes,” says Reardon.
Neurotransmitters are chemicals that help relay signals from one area of the brain to another, and certain ones— including serotonin, dopamine, norepinephrine and acetylcholine—control whether we’re sleeping or awake. “If you compromise your cell membranes by eating too many trans fats (found in foods like french fries, doughnuts, cookies and crackers) and not enough omega-3s, those cells are not going to be able to make that connection,” Reardon explains.
- You like your nightcaps. Sure, that glass of cabernet has antioxidants. And it helps you fall asleep, right? Booze initially acts as a sedative, but a few hours later you’re going to pop out of that sleep cycle. “You’ll wake up in the middle of the night when the alcoholic beverage is completely metabolized,” says Frisca Yan-Go, M.D., medical director of the UCLA Sleep Disorders Center in Los Angeles. So stick to one drink at dinner—ideally, at least three hours before bedtime.
- Your cortisol levels are off-kilter. Your adrenal glands produce hormones, including norepinephrine (adrenaline), the stress hormone cortisol and dehydroepiandrosterone (DHEA, a hormone that’s inversely proportional to cortisol). When circadian rhythms are on track and the stress response is normal, cortisol levels are high in the morning and gradually decrease throughout the day.“But when a woman is stressed over a period of years, the cortisol response will be the reverse of what it should be—high in the evening, low in the morning,” says Christiane Northrup, M.D., an integrative physician in Yarmouth, Maine, and author of Women’s Bodies, Women’s Wisdom (Bantam). When cortisol levels are elevated at night, sleep suffers because your mind and body are revved up. “You won’t find this ‘adrenal stress’ showing up on conventional tests,” Northrup adds. “You need an adrenocortical profile, which measures cortisol levels in your saliva at various times during the day.”
To get your cortisol levels back on track, Northrup recommends focusing on loving thoughts (people you love or a fond memory, for example) for a few minutes several times a day to create what researchers call cardiac coherence. “This is a state of balance between the parasympathetic and sympathetic nervous systems,” she explains. “Research shows that those who learn how to achieve cardio coherence are actually able to increase the level of DHEA from the adrenal glands and decrease cortisol and epinephrine. Hormone balance ensues.”
- You’re on drugs. “Medications either stimulate or inhibit the brain,” says Yan-Go. For example, some over-the-counter painkillers (including Excedrin, Midol and Anacin) contain caffeine, so check ingredients lists. Common prescription drugs, including beta-blockers, can also inhibit sleep.
Many depressed people can’t sleep, but their antidepressants could be the culprit!
The most shocking sleep stealer? Antidepressants. Insomnia is a symptom of depression, so you would expect the pills to help you nod off. “But selective serotonin reuptake inhibitors (SSRIs such as Paxil, Lexapro or Prozac) release a relentless stream of serotonin that results in disturbed sleep for many people,” says Naiman. Talk to your doctor if you suspect a medication is messing with your z’s. There many be alternatives, or perhaps you can adjust your schedule so that you take a medication that stimulates you in the morning and vice versa.
- You work out too hard. Exercise can help you sleep better—as long as it’s at the right intensity. In a recent study from Northwestern University in Evanston, Ill., sedentary adults with insomnia slept better and longer when they did 30 to 40 minutes of moderate exercise four times a week for 16 weeks. However, says Yan-Go, “Excessive exercise can negatively affect sleep. It’s not just a problem if you exercise too late at night—you can overtrain, regardless of when you work out.”
Scrimgeour, who treats many endurance athletes, explains: “When you push yourself too hard, your body secretes excess cortisol, which in the short term can affect your ability to fall asleep,” he says. “Furthermore, over time, this will deplete your adrenals, which will affect your ability to sleep well through the night. Over-exercisers have a hard time calming down.”
So dial those sweat sessions down a notch, and balance out your routine with soothing, restorative movement, like qigong, tai chi or yoga (just not at bedtime). Research from the University of California, Los Angeles, shows that three 40-minute tai chi sessions per week can help you sleep longer and better.
- You worry too much. “There is no question that worrying and ruminating over issues that are painful or cause discomfort can lead to a rise in stress hormones and result in insomnia,” says Northrup. And anxiety intensifies at night: If you worry at a subtle level throughout the day, you may not notice it. Suddenly, when you turn out the lights, that whisper of anxiety becomes very loud.
What can you do to quiet it down? Just like you clean your teeth and face before bed, you need to clear your mind. Studies show that focused journaling at night, which involves writing down your worst fears in a short list, actually helps people sleep better.
Stinky AND can’t sleep?
- You sweat too late. It’s better to exercise in the evening than not to exercise at all, However, “Some people find that evening exercise makes them too excited and awake; it’s better for them to do it in the morning,” says San Francisco-based integrative family physician Daphne Miller, M.D. Reap extra benefits by heading outside in the early a.m. To pound the pavement or go for a bike ride: Exposure to natural light in the morning and throughout the day reinforces a normal sleep-wake cycle.
- Your supper is too stimulating. You know not to down a cup of joe right before bed—the half-life of caffeine is six or seven hours, which means it takes that long to metabolize just half of the substance. But here’s a surprise: Spicy foods are also a no-no at night. “They give your metabolism a jolt, similar to caffeine,” says Scrimgeour. “Cooling foods, like melon, do the opposite. Eating them at dinnertime could help you sleep.”
A meat-and-potatoes dinner could also keep you up. “Animal protein, particularly beef, is more difficult to digest than plant-based protein,” says Reardon. “After a big steak, your body is too busy digesting food to focus its energy and attention to sleep cycles.”
- You’re so hot. It may sound ideal, but a very warm room is no sleep sanctuary. “You need a cool environment,” says Yan-Go. Your body temperature naturally drops as you drift into sleep, and an environment that’s too warm can make you toss and turn. According to the National Sleep Foundation, temperatures above 75 degrees (or below 54 degrees) will disrupt sleep. Naiman suggests trying about 68 degrees if you can’t sleep.
- You have a thyroid imbalance. An overactive thyroid revs up your entire body, so you feel anxious and restless. This leaves you exhausted, yet you can’t sleep. But an underactive thyroid can also disrupt sleep. “Someone with a sluggish thyroid is not reaching the heights of wakefulness during the day,” explains Naiman. “We sleep better and more deeply when we’re able to ascend to peaks of energy during the day. “Plus, thyroid medications are stimulating, and if the dosage is off even slightly, it can keep you awake.
- You suffer from chronic inflammation. Persistent low-grade inflammation throughout the body—caused by processed foods, air pollution, stress and other sneaky factors—has been linked to heart disease, obesity, diabetes and rheumatoid arthritis. Turns out, it also keeps you up at night. “Most people don’t know that chronic inflammation is associated with a slight but measurable increase in body temperature,” says Naiman. We need to cool down to sleep, but inflammation prevents your body temperature from dropping.
Lifestyle changes can help. Cut out processed foods that spike your blood sugar, like refined carbohydrates (cookies, chips and crackers), and eat plenty of lean proteins, omega-3 fatty acids, whole grains, and fruits and vegetables to keep blood sugar on an even keel and counteract inflammation.
The ‘can’t sleep’ reversal diet
- You have food sensitivities. “Food sensitivity is one of the last things people think about when it comes to sleep, but it shouldn’t be,” says Reardon. The most common trigger foods are soy, nuts, wheat, chocolate, corn and dairy. But food sensitivities don’t stay in the gut.“They begin there, but then the body reacts systemically, particularly if there is any impaired digestion resulting from disruption or damage to the cells that line the digestive tract,” Reardon says. “This is often the case for people with a longstanding history of NSAID (Nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen) use. The immune system is revved up, and the central nervous system is wide awake—and so are you.
If you suspect a food sensitivity, keep a food journal, noting when you experience symptoms, but bear in mind that food sensitivities cause a delayed reaction: It’s not just what you ate for dinner tonight that’s keeping you up; it could be an ingredient you ate a few days ago. So look at a three-to four-day window when you’re reviewing the journal.
Once you pinpoint possible triggers, eliminate them one by one and see if your sleep improves. “And give it time—about three months. The gut needs adequate time to heal,” says Reardon.
- You’re always on. In our 24/7 world, feeling frazzled is a badge of honor. If you’re not go-go-going, you’re not doing anything that matters. “Our society is wake-centric, leaving us discouraged from genuinely experiencing, enjoying or understanding sleep and dreams,” says Naiman, who maintains that most of us walk around in a state of hyperarousal—our physiology is so revved up that we can’t even slow down at night.
But learning the importance of snoozing can help us make the most of our waking hours. “When we’re alert, we can allow subtle aspects of sleep—relaxation, inner peace and serenity—to seep through,” says Naiman. So instead of lying in bed thinking about everything on your to-do list tomorrow, think of sleep as an overnight getaway where something really interesting is happening—something that will also help you be more fully present when you get up.
Source: Natural Health Magazine, December/January 2012