Ways to De-Stress Before Bed to Ensure a Good Night’s Sleep

You experience varying degrees of stress all the time. And getting enough sleep is a great way to cope with that stress. When you wake up feeling recharged and alert, you are better able to handle the demands of work, home, and life. 

But what if your daily stress is keeping you from getting the restorative shut-eye you need? Too much tension and anxiety can affect your body and disrupt your sleep in several ways. That’s because the stress you experience during the day doesn’t end the minute your head hits the pillow. Your body produces stress hormones, which can linger in your body and stimulate it well into the night.

Here are a few scenarios you might experience:

• Your mind is racing, making it hard to fall asleep.

• You remain in a light sleep, rather than reaching deep sleep.

• You wake up often, finding it hard to stay asleep.

How to Wind Down Before Bedtime

The good news is that you can overcome sleeplessness by learning a few easy relaxation skills you can do before bed. You can even do some of these techniques should you wake up in the middle of the night and need help falling back asleep. Not only do these skills help you ward off daily stress responses and improve the quality of your sleep, they may also reduce your need for sleep medications. Ensure a good night’s sleep with these relaxation skills.

• Take a deep breath: One of the easiest ways to manage stress and anxiety is to simply breathe deeply. This technique goes by a few names: diaphragmatic breathing, abdominal breathing, or belly breathing. It may seem like a new skill you have to learn, but it’s really your body’s natural way of breathing. By taking slow, deep breaths, you inhale more oxygen and exhale more carbon dioxide (CO2). The benefit: a slower heart rate and lower blood pressure. Just 10 minutes of deep breathing is all you need to help your body relax before you hit the hay.

• Brew a cup of evening tea: Hot or iced, sipping a cup of tea in the evening makes for a calming and refreshing bedtime ritual. As it becomes a habit, the familiar act of sipping your evening tea can signal to your brain that it’s time to wind down for the night. There are many soothing and delicious teas out there, like Yogi Bedtime Tea and Teavana Lavender Dreams White Tea. Just be sure to drink it at least an hour before you turn in, so you don’t find yourself getting up to use the bathroom multiple times in the night.

• Perform Shavasana: There’s a good reason many yoga sequences end with a 5-minute Shavasana—this basic move can help you calm your mind and lower your heart rate after a good workout. But you don’t have to attend a yoga class to reap the benefits of the pose. You can practice this “deeply quiet posture” before bedtime to release the day’s stress and tension. All you have to do is lie back on a comfortable surface, close your eyes, focus on finding any tension in your mind and body, and then let it go. Experience total relaxation with these step-by-step Shavasana instructions.

• Go for a stroll: It’s hard to find the energy to exercise when you’re exhausted, but maintaining your fitness can help you sleep better and restore your energy. If you’re feeling too depleted for a full workout, go for a 10-minute stroll after dinner with your spouse, kids, and/or dog. Keep your pace slower than normal; the idea isn’t to get your heart rate up but to release pent-up emotions from the day. This is also a great time to practice a little mindfulness, taking in the scenery, sounds, smells around you.

• Create positive mental imagery: As the saying goes, what goes up must come down—and that’s as true of gravity as it is your stress level. Negative thoughts can boost your stress response, while positive thoughts can help you keep it at bay. Lowering your stress levels as you get ready for bed can reduce the time it takes to fall asleep—and that’s where positive mental imagery comes in. Give it a try: Picture yourself someplace that feels peaceful and serene to you. Perhaps it’s a footpath winding through a lush forest, a quiet beach on a tropical shoreline, or a horizon lined with awe-inspiring red rock formations. This kind of visualization can encourage your mind to relax. And who knows, you may find yourself being whisked away to those very places in your dreams.

• Drift off with binaural beats: Listening to soothing music is a nice way to go to sleep, but any tunes with lyrics can be distracting and keep your mind busy. Want to try something new and different? The relaxing rhythm and repetition of binaural beats may be just what you need to turn off your mind at night. While the beats themselves may not lull you to sleep, listening to them could help you to feel less stressed and anxious, leading to a more restful slumber. Tune into this free playlist and find out if binaural beats work for you.

Snooze the Night Away

How do you like to unwind before bed? Can you think of other relaxation skills you’d like to try? Let us know how you’ll make relaxation and better-quality sleep part of your healthy lifestyle.

Sleep as if your health depends on it!

We all need more sleep, right? YAWN! We have said it or heard it hundreds of times. Get more sleep for better health. Yet despite the prevalence of the advice, there is a clear disconnect between hearing it and implementing it. For one, there is a positive stigma or bragging rights associated with “I only need 5 hours of sleep per night.” Secondly, our lives have become so busy, over scheduled, and over stressed, that it is easy to prioritize everything else before sleep. And lastly, even when we want to get more sleep, many of us are unable to do so for a variety of reasons that we will address.

As with many areas of health, the first step is educating ourselves about the importance of sleep. Only once we understand the real importance of sleep can we prioritize sleep adequately, thus committing to the sleep hygiene practices that help us achieve better health. Without education, the rest never follows.

The scientific literature is saturated with evidence that sleep is important for health. It would be overwhelming to try to summarize all the literature here, but here are some of the highlights. Poor sleep has been linked to:

  • Depression
  • Anxiety
  • Hypertension
  • Diabetes
  • Weight gain
  • Poor job performance
  • Poor athletic performance
  • Car Accidents
  • Coronary artery disease
  • Strokes

And more…

One of the most common associations is the connection between poor sleep and poor performance in life. What does that mean? It means not achieving your goals. Whether it is athletic performance, work performance, or improving your overall health, inadequate sleep dramatically reduces the chances of success.

Let’s look at one of the most frustrating failures of lack of sleep- inability to lose weight. Numerous studies have shown that poor sleep habits lead to increased hunger, increased snacking and poor nutritional choices. Not only is there a proven relationship, but there is also a biological reason for this. Ghrelin is a hormone in our body called the “hunger hormone.” It signals to your body that you are hungry and need to eat. Leptin has the opposite effect. It says to your body that you are full and don’t need to eat. When we do not get adequate sleep, our ghrelin levels spike and our leptin levels are inhibited. Thus we have a biological reason for feeling hungry and snacking more. Plus, since our mental clarity is reduced and our emotional control is inhibited by poor sleep, we tend to make impulse decisions in reaction to the feeling of hunger. Impulse decisions rarely end in preparing a well-balanced meal of veggies with high-quality fats and proteins. Instead, they may result in standing in front of the freezer eating the Ben and Jerry’s right from the carton with no end in sight. I’d be lying if I said I have never been there before. But I can also say that I will never be there again.

The next concept I want to address is our perception of how much sleep we need. Many people with inadequate sleep may feel like they are doing just fine. But a fascinating study published in the journal Sleep in 2003 showed that people who got no more than 6 hours of sleep for 10 days had a similar decline in cognitive function and physical reaction time as those who were completely deprived of sleep for 2 whole days. The amazing part, however, was that they had no idea how bad their performance was. They felt they were thinking clearly and performing well on all the required tests, and they did not feel tired. That makes it even more dangerous! To perform so poorly and not even realize it is a recipe for disaster. At least those who were deprived of sleep for two whole days knew they were exhausted, and they could change their lives accordingly. The same cannot be said for the group who got less than 6 hours of sleep per night. So it is clear that we frequently need more sleep than we realize.

Yet another incredible study was recently published looking at the sleep patterns of traditional hunter-gatherer tribes. Sleep problems were so rare in their cultures that the three tribes studied did not even have words for insomnia in their language.

The study showed that they averaged 7.5-8 hours in bed per night. In addition, they had an absolutely consistent sleep-wake schedule thus maintaining a stable diurnal rhythm. Couple that with their lack of distractions from computers and phones, and it is no wonder their society had no concept of sleep problems.

What about those who say “Sleep is a waste of time. It is unproductive time I could spend accomplishing things.” This couldn’t be further from the truth. “Restorative Sleep” is a combination of Stage 3 sleep and REM sleep. It is appropriately named because your body literally restores itself while you sleep. Learning, memory, and concentration are improved while you are in REM sleep, and your body is able to heal and restore physical energy when you are in Stage 3 sleep (deep sleep or delta wave sleep). Without adequate time spent in each stage of sleep, the body is not able to perform its essential “reboot” functions. Lack of sleep robs your body of these restorative functions. In addition, alcohol and sleep medications can disrupt the balance of sleep stages, thus resulting in less restorative sleep. Part of the importance of maintaining a steady sleep schedule is that it allows your body to cycle through the stages of sleep consistently, ensuring that you get adequate time in the deep and restorative stages.

Lastly, part of the problem is that even those who want to sleep more find they cannot. Insomnia is a growing problem in our society with prescriptions for sleeping medications increasing over 50% since 2008. As with many things in medicine, prescription drugs are simply Band-Aids. They treat the symptom without addressing the underlying cause. Sleeping medications come with their own risks of developing dependence, rebound insomnia, potential short-term memory loss, and distorting the stages of sleep so that the sleep you do get does not have the full restorative power of naturally achieved sleep.

Once you have made sleep a priority for your health, there are a number of specifics to consider. Here are some tips to incorporate into your life for better sleep:

  • Reduce exposure to screens and artificial light– they disrupt the circadian rhythm and fool your brain into not being tired. Avoid screens 60 min prior to sleep or if that is not possible, consider using blue blocker glasses which help filter out the blue light from your devices. You should also maintain a very dark room for sleeping. Use black out shades, cover your clocks (or if you need them keep them more than 3 feet away from your head), if you need light use low wattage yellow, orange or red lights, not standard white lights
  • Maintain a consistent schedule– this can be difficult for many, but going to bed and waking up at the same time every day has been scientifically shown to improve sleep performance and allow for consistent deep, restorative sleep
  • Meditation-A study comparing individuals engaging in a mindfulness meditation practice vs. those who were given general sleep hygiene education showed significant improvements in sleep quality as well as less depression and fatigue in the mindfulness group. This does not mean you need to meditate for an hour a day. Just 10 minutes of mindfulness meditation has proven results.
  • Avoid caffeine in the afternoon. Caffeine is a stimulant that can keep you from falling asleep. Even those who say caffeine has no effect on them have demonstrated reduced sleep performance than those who do not drink caffeine
  • Limit alcohol or any liquid for that matter. The more you drink, the more likely you are to wake up to urinate, thus giving your brain a chance to wake up and start spinning and reducing the chance of going back to sleep. Although alcohol may make you feel tired and help you “get to sleep,” it can dramatically alter the stages of sleep and prevent you from getting fully restorative sleep
  • Get outside and get light exposure during the day- This helps your circadian rhythm stay in sync with proper sleep-wake patterns. Studies in Hunter Gatherer societies have highlighted the importance of daytime light exposure. This may also help with your vitamin D levels, which are also linked, to better sleep performance.
  • Exercise during the day, but not within an hour before going to bed.
  • Keep your room cool, between 60-68 degrees
  • Bed is for sleeping and sex only, no TV books or phone use
  • Journaling to clear your mind before bed. This helps you get your thoughts out on paper so your mind is not ruminating on them and keeping you from falling asleep.
  • Low carb diet increases slow wave sleep, but fat can increase GERD, very individualized
  • Magnesium supplements (usually in the form of magnesium glycinate or malate) has been shown to help with falling and staying asleep
  • Melatonin is beneficial for short-term use when natural timing is disrupted, such as with travel or when your sleep cycle has been disrupted for other reasons. It is not meant to be used long term
  • Get checked for sleep apnea – This is a very common cause of poor sleep and now there are easily accessible home screening tests that can be ordered by your physician. Keep in mind that sleep apnea is more common in overweight people, as well as those who drink alcohol or take sedatives

The list is long, but hopefully, you will notice that most of these are actions that are easy to implement. Once we understand the importance of restorative sleep, and we prioritize sleep as a pillar of our health, then the above list becomes an easy “to do list” that will help you on your path to better sleep, better health, and a better life. 

How To Be A Morning Person

There are many benefits to rising early. It boosts your energy and lifts your mood. It amplifies your productivity and sparks your creativity. And it improves your chances of getting to work on time!

Are you looking for ways to become a morning person? Getting more sleep is a great first step. In fact, the National Sleep Foundation recommends that adults get seven to nine hours of shuteye each night. But it’s not just the number of hours you sleep that affects your ability to wake up and seize the day. It’s also the quality of those ZZZs.

Even if you’re a true night owl, you can transform yourself into a morning person by making a few tweaks to your daily routines. So what are you waiting for? Adopt these healthy sleep habits and you’ll soon find yourself waking up refreshed and ready to go

  1. Set bedtime reminders: Sticking to a healthy sleep schedule starts with hitting the sheets around the same time every night. On your smartphone, set an alarm with a soothing sound that reminds you when it’s time to start winding down. (If you have an iPhone, check out the Bedtime tab on your alarm clock for a sleep analysis bonus.)
     
  2. Start slowly: Training your body to get sleepy when it should doesn’t mean you need to convince yourself to hop into bed at 9 p.m. when you’re used to doing so much later. Making too big of a leap will keep you lying awake and restless, plus more likely to rebound into old habits. Instead, try turning in just 15 minutes earlier than usual. When your body adjusts to this new bedtime, turn in another 15 minutes earlier.
     
  3. Stay consistent: Waking up at the same time every day will also help you stick to your new schedule, which you may find easier to commit to on weekdays. If you’re tempted to reward yourself with extra shut-eye on the weekends, resist the urge to lounge in bed. Sleeping in a couple of hours later than normal may feel luxurious now, but it can throw off your body’s internal clock—and land you with “a case of the Mondays.”
     
  4. Reframe your thinking: Do you tend to procrastinate when it’s time to go to bed? How you think about bedtime sends signals to your body, which may trigger or inhibit a sleepytime response. By the time you feel tired, you might find yourself saying, “It’s late, I should go to bed.” A little trick to make bedtime less flexible is to shift the way you think about it. Next time you’re up an hour later than intended, try saying to yourself, “It’s an hour past my bedtime.”
     
  5. Destress your morning routine: How you start your day can set the tone for a positive day—or not. Hectic mornings may seem like the norm, but they don’t have to be. Shorten your morning to-do list by shifting tasks to the night before, like picking out what to wear, preparing a make-ahead breakfast, packing a healthy lunch, setting the coffee timer, and organizing your work bag.
     
  6. Skip the snooze button: Tired of being tired, even after a full night’s sleep? If you tend to hit the snooze button, you may be making yourself more tired than you think. Setting your alarm to go off just eight to 10 minutes into a new REM cycle can lead to sleep inertia or that feeling of heavy morning grogginess that’s hard to shake. Moving your alarm clock away from your bedside will encourage you to get up and start moving right away.
     
  7. Cut back on caffeine: Any coffee lover knows that going cold turkey on the joe can be quite the feat. Gradually scale back on your caffeine intake. Not only will it help you snooze more soundly, you’ll be less likely to spend those extra dollars on a cup of coffee the next morning.
     
  8. Jumpstart your day: You don’t have to leap out of bed and hit the gym for a vigorous workout to reap the benefits of morning exercise (unless, of course, you want to).There are plenty of early-bird workouts you can do from the comfort of home, and all you need is 10 – 30 minutes of moderate physical activity to get your heart pumping and feel more energized for the day ahead.

All it takes to start your journey to becoming a morning person is to make one small change. You’ve got this! Which healthy sleep habit will you try tonight?

 

 

 

 

3 Simple Breathing Techniques You Can Practice Anywhere

It doesn’t always take a vacation to a private island or a lavish spa day to get some relaxation time in. There are simple, quick techniques you can learn and incorporate into your everyday schedule to help ease that nagging tension and anxiety you might feel, and they take only take 5 minutes or less! Any time you might feel overwhelmed by an upcoming deadline at work or stressed out just coping with everyday tasks, you can try out any of these three breathing techniques. Find a quiet space wherever you are (even at work!) and try one of these out to help you feel more relaxed and ready to tackle the rest of your day. 

Belly Breathing 

Also known as diaphragmatic breathing, this technique requires you to focus on expanding your stomach, rather than your chest, as you take in each deep breath. 

1. Preferably lying on your back, place one hand over your stomach and another over your chest. 

2. Breathe in slowly through your nose and through your stomach so that you feel your stomach rise against your hand as your abdomen fills with air. 

3. Exhale completely and as you exhale through your nose, feel your stomach deflate to its neutral position. 

4. Repeat this process for 5-10 minutes, focusing on the sensation of your stomach rising and falling with each breath. 

The 4-7-8 Method

This exercise helps you breathe more deeply while putting your mind into a meditative state as you focus on counting the seconds during each breath in and out. 

1. Sit in a comfortable position and start by slowly inhaling through your nose on a count of 4 seconds.

2. After the fourth second, hold your breath for a count of 7 seconds*

3. After 7 seconds, exhale your breath for a count of 8 seconds. Repeat this exercise 3-4 times. 

*If 7 seconds feels too long, lower the count to a number of seconds that feels more comfortable for you. 

Progressive Relaxation

Your entire body will take a role in this breathing exercise as you coordinate each breath with the tensing and relaxing of your toes and feet all the way up to your shoulders and head. 

1. Lying or sitting, start by tensing the muscles in your feet as you breathe in through your nose. Hold the breath for a moment as you experience what the tension feels like in your feet and toes. 

2. As you relax your feet, release your breath and exhale through your nose. Take another moment to appreciate the feeling of your feet no longer tensing and contracting. 

3. Continue the process throughout your whole body, including your legs, abdomen, arms, hands, shoulders, jaw and eyes. 

4. Finish the exercise by tensing the entire body as you take a final deep breath in, and as you release your breath make sure to focus on the sensation of each muscle returning to a relaxed state. 

Taking the time to breathe deeply not only helps remind your brain to calm down but it can help remind you to be mindful and present in the moment.  Just by taking 5 to 10 minutes out of your day to try any of these breathing techniques you’ll notice a difference in how you cope with your stress, negative thoughts and the tension you’re holding in your body. Give it a try and let us know which one works best for you! 

Why I Ate My Wife’s Chocolate Chips. All of Them.

I didn’t sleep at all Saturday night.

 

 In college, that may have been an exciting statement full of fun and intrigue.

 

In medical school and residency, it was a badge of honor and usually involved clinical challenges and valuable experiences.

 

This past Saturday, it involved consoling my son as he kept throwing up. Changing his sheets, wiping his head with a damp towel, and most importantly, just letting him know I was there and that he would be OK. It is a rite of passage all parents go through, more than once.

 

On Sunday, he was much better and slowly getting back to his usual self. Me? I was hungry and craving carbs.

 

I also almost never crave carbs. I practice intermittent fasting, I eat a “veggie first diet” with healthy fats, appropriate portions of animal sources, some fruit and almost no refined carbs. Through years of this practice, I have been able to drastically diminish my sweet tooth and control my hunger and cravings

 

A Different Story

 

Sunday was a different story. I had the carb cravings and munchies all day. Instead of eggs, veggies, and avocado, I had fruit and granola for breakfast. But didn’t stop there. I still had this crazy craving so I added toast and a banana.

 

Later in the day the cravings really hit. Chocolate.

 

I was craving chocolate like you wouldn’t believe. Fortunately, my wife had some chocolate chips in the freezer. Let’s just say I need to make a run to replenish the supply before she sees what I have done. Without thinking, I polished off what was left in the bag.

 

How could this be? This was all so unlike me. What could have happened?

 

Sleep.

 

Or more importantly, lack of sleep.

 

Sleep and Our Hormones

 

Sleep is intimately involved with our hunger and our cravings. As a result, sleep is intimately involved with our weight gain, weight loss and our health. It effects not only our ability to make decisions, but also alters our hormones, our cravings and our feelings.

 

That’s powerful stuff!

 

It turns out that inadequate sleep affects our hormones ghrelin and leptin. They sound like comic book villains, but they are hormones that control our feelings of being hungry or feeling full. Ghrelin, the “hunger hormone,” signals to your body that you’re hungry and need to eat. Leptin has the opposite effect, and signals that you’re full and don’t need to eat. Research consistently shows that poor sleep spikes ghrelin and suppresses leptin levels.

 

The result? Poor sleep leaves you feeling hungrier than usual regardless of what you eat or how much you eat. You eat more and expend less energy. Bad combination.

 

Leptin and ghrelin load the gun, our lack of mental clarity pulls the trigger (it’s a terribly violent analogy, but it makes the point none the less).

 

When we are sleep deprived we don’t think with the same level of clarity and with the same emotional control. We tend to react impulsively when we feel hungry. Impulse decisions rarely end in a well-balanced meal of veggies with healthy fats and proteins. More often, the result is standing in front of the freezer, door open, eating your wife’s stash of chocolate chips.

 

Guilty as charged.

 

Ripple Effect

 

Guess what else I did (or more importantly, didn’t do) in my sleep-deprived state on Sunday.

 

I didn’t go to the gym as I had planned.

 

I didn’t get out for a hike or nature walk.

 

I drove to the grocery store instead of riding my bike.

 

I sat and watched a movie with my son rationalizing that he wanted me there so it was OK to plant myself on the couch for an hour and a half.

 

Sound familiar? When we are tired and run down from poor sleep, the rest of our healthy lifestyle decisions suffer. It is the classic ripple effect.

 

And poor sleep can cause it all.

 

The solution?

 

Sleep better.

 

“No kidding. We already knew that. Thanks for nothing doc!”

 

Ok. We all know we need more sleep. And there is a laundry list of sleep hygiene techniques that I review in more detail in my book and elsewhere.

 

But life happens. We can’t always prepare for the night of consoling our children. Or the night before a big presentation when we are too excited/nervous/scared (take your pick) to get to sleep. What do we do then?

 

Be mindful and be aware.

 

Mindful Power

 

In this case, knowledge truly is power. Simply being aware that our hormones will be off kilter and our decision making will be impaired gives us the power to control our day.

 

You may need an extra reminder, or you may have to try harder than usual, but staying in the present and being mindful of your decisions is the skill you need to counteract the effects of poor sleep.

 

Instead of acting rashly, take a breath. Step back, breathe and realize you did not sleep well. Remind yourself that poor sleep alters your hormones and your perceived needs. And realize that you can still control these feelings and cravings. When you are mindful, you are in control.

 

It turns out, studies show mindfulness also helps you sleep better. When compared to a group of individuals given sleep hygiene education, individuals who practiced regular mindful meditation slept more and felt more refreshed. So not only does being mindful help you get through your day with minimal damage, it also helps you get back on track.

 

Once again, that’s a pretty powerful effect. If that were a pill you better believe there would be a multi-million-dollar marketing campaign behind it.

 

But it isn’t a pill. It’s free for anyone to do. It’s a skill anyone can try and everyone can improve. Being mindful is like exercising a muscle. The more you practice it, the stronger it becomes. The stronger it becomes, the easier it is to use.

 

You won’t be perfect and it may not always be easy. But I promise you this. Practice being mindful, practice your breathing, and you will be better.

 

Action Item:

Start recording your sleep. Activity monitors like FitBit Alta HR, FitBit Charge, Garmin Vivosport, Mio Slice, the Apple watch and many others all record sleep duration. Or simply record it yourself with a pen and paper (old school). When you get less sleep than usual, make a concerted effort to control your surroundings more. Make a concerted effort to practice your mindfulness techniques more. Treat yourself with more compassion and more love.  And make sure you get to bed a little earlier that night to help break the cycle. You can do this. You just need to be aware.

 

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

 

 

 

Bret Scher, MD FACC

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