Sleep Better to Feel Better

The Importance of Sleep in Health and Cognition

“The death of each day’s life, sore labour’s bath,
Balm of hurt minds, great nature’s second course,
Chief nourisher in life’s feast.”
-Macbeth


In the passage above, Shakespeare’s Macbeth extols the virtues of sleep when he believes he has been cursed to never sleep again. He notes the restorative properties of sleep to both mind and body, and 600 years on, modern science supports this intuitive view of sleep as the “chief nourisher in life’s feast.”
While scientists haven’t quite landed on a single theory of why we sleep, the functions of sleep are clear and two-fold; to repair and restore the body, and to synthesize and store new learning and memories.
The vast physiologic repair that occurs during sleep spans immune function, appetite regulation, muscle repair, and the release of metabolic and reproductive hormones. In one experiment, rats who were totally sleep deprived for just over a month completely lost their immune function and died. The role of sleep in cognition has also been shown to have immense impact, particularly on cognitive performance, insight and creativity, mood and emotional stability, and even regulation of pain.
Most men require 7-8 hours of sleep each night, while most women should aim for 8-9 hours. This number generally shrinks in the second half of life. Without it, we are not only tired but sick, overweight, emotionally unstable, mentally cloudy, and we feel more pain.
Good sleep is a staple of health, with arguably greater influence than eating well and exercise. But it eludes many, with 1 in 3 Americans getting insufficient sleep and most of those clocking in at under 6 hours a night. With 70 million Americans reporting sleep deprivation in 2014, the CDC labeled it a public health epidemic.
Major contributors to sleep deprivation are time demands, like caring for children, working from home, or simply time-consuming habits like TV or social media at night. But disorders like anxiety or depression are also common perpetrators of insomnia in the average American. Here are a few, evidence-backed steps to take to help you get better sleep.

1. Whether it is an earlier bedtime or a later wake-up call, carving out 7-9 hours a night is the first step. I set a notification on my phone to remind me to start getting ready for bed.
2. Sleep hygiene is underrated and crucial to both falling and staying asleep. In the hour before bed, avoid all screens and electronics, including TV, computers, and cell phones. That means no scrolling social media and no bingeing the latest serial killer documentary right before bed! Constructive bedtime routine activities could include conversation, reading, journaling, stretching, meditation or prayer, etc. Ensure your bedroom is as dark as possible. In my experience, this is the most difficult change as it requires letting go of destructive habits and building better ones. Like all change, start small—say, just 15 minutes of electronic-free time before bed. It’s hard to create this space in your daily routine, but it is the single most evidence-based recommendation for treating insomnia.
3. Meditation, especially mindfulness-based meditation, has amassed impressive evidence for its utility in improving quality of life in a number of areas, including sleep. If falling asleep is difficult for you, try 5-10 minutes of mindful meditation before bed. I use the Calm app, but there are many other free or subscription-based resources that can guide you through forming this new skill.
4. No supplement or medication is a silver bullet, but both can be helpful in the quest for a good night’s rest. Start with melatonin—your body’s natural hormonal signal that it’s time to sleep. A good starting dose is 3-5mg taken 60-90 minutes before bed (it takes this long to start working in your system). Gradually build your dose if you don’t notice a difference at first (and make sure you are practicing good sleep hygiene). Another over-the-counter supplement worth trying is L-thianine, which has a longer half life than melatonin, and may help you stay asleep longer. Antihistamines can work in a pinch, but aren’t a long term solution. Consult your health care provider with questions about these or other supplements, and let them know about your insomnia as they may suggest non-habit forming prescription medication that can help when you’ve exhausted other options.
5. If the underlying perpetrator of your insomnia is anxiety or depression, as it is for many people, the steps above are still a great starting point. But there’s no substitute for getting effective treatment for your mental health. That includes counseling, social support, coping techniques, and sometimes, prescription medication. Psychology Today is a great place to find for a mental health professional that fits your needs and preferences.
6. If you find yourself still struggling with insomnia, poor quality sleep, or chronic fatigue, it’s time to visit your health care provider to rule out medical causes. Sleep apnea is a common culprit here, afflicting more than 30% of Americans.

I know from personal experience how destructive insomnia and sleep deprivation can be. Everything suggested here stems from a wide body of evidence and are practices I’ve adopted in my own life to great effect. Be encouraged that better sleep is possible! Good luck, and sweet dreams.