Wednesday, September 5, 2012
How to Sleep Right, Tonight
by: Liesa Goins
If you are sleeping with stress—and waking up at all the wrong times—here's how to put yourself on snooze control
Finding yourself wide awake after a few hours of sleep, or waking often during the night is called "sleep maintenance insomnia," and it's much more common than people think. A 2005 National Sleep Foundation poll found that 75 percent of adults frequently have symptoms of a sleep problem, including waking during the night.
Just as the victims in slasher flicks make fatal errors (why are you running up the stairs?), we are often our own worst enemies when it comes to a solid night of sleep. "People think that because they're able to fall asleep they'll stay asleep, even if they've had too much caffeine," says Rubin Naiman, Ph.D., a sleep and dream specialist at Andrew Weil's Program in Integrative Medicine at the University of Arizona.
But for most of us, the culprit's not that ill-conceived espresso at 5 p.m. "The root of most sleep problems is stress," says Jeffrey Thompson, director of the Center for Neuroacoustic Research and creator of an audio sleeping aid called the Delta Sleep System.
We're overloaded, over-stimulated, and overwhelming our bodies' ability to relax. "Our nervous system is built for a sprint, but we're living in a stress marathon," he says. "If you go to bed worried you're probably going to wake up in the middle of the night," Dr. Naiman adds. And when that happens, as you probably know, the next day is pretty much shot.
A new generation of sleep scientists are overturning the conventional wisdom about parasomnia. (Counting sheep? Out.) They say: You can do it. With a few simple changes in your routine, a little visualization, a couple of surprisingly counter-intuitive moves and perhaps an attitude adjustment, a peaceful night of slumber can be yours. Here's their best advice:
Throw out your definition of a good night's sleep
Just as three square meals a day has given way to all-day grazing and smaller portions, "what's good for you" has changed here, too.
"Thinking it's necessary to stay asleep for 8 hours straight may be unrealistic," says David Neubauer, M. D., associate director of the Johns Hopkins Sleep Disorders Center and author of Understanding Sleeplessness: Perspectives on Insomnia. "Just as we experience a dip in alertness mid-afternoon, the inverse is a dip in sleepiness in the middle of the night. There's strong evidence that there's a kind of awakening that's totally normal."
History supports this take, Dr. Naiman says. "Before the industrial revolution, people had their first sleep for 3 to 4 hours, awoke for an hour or two, then slept for another 3 or 4 hours."
Even waking every 60 to 90 minutes can be part of a healthy sleep pattern. The deeper stages of sleep, or REM (rapid eye movement) sleep, occur about every 90 minutes and get longer as the night goes on, so your brain might become more alert between those cycles.
Since we're conditioned to think that waking during the night is a problem, when it happens, we panic. That reaction causes our brains to awaken even further, Dr. Neubauer explains.
If you find yourself awake in pre-dawn hours, Dr. Naiman advises first assessing your physical state. Do you have an ache, a cramp, or need to go to the bathroom? If so, take care of it.
If you don't have a physical complaint, then chances are you are experiencing a normal stage of the sleep cycle. Knowing this "helps replace worries that you'll be useless without 8 solid hours of sleep with more neutral thoughts," suggests Sat Bir Khalsa, Ph.D., instructor in medicine at Brigham and Women's Hospital at Harvard Medical School. "The useful thought is: ‘I can handle the disruption and still feel rested.'"
After an action-packed day (or one equally packed with worry), our brains need some time to catch up, to make order of things, and to slow their frenetic firing before we're ready to sleep. Pure bodily exhaustion can probably get you at least that first hour of dozing, but then worries will rise to the surface and cause you to stir. How can you get your mind to chill?
"We need to learn to apply the brakes before the car is in the garage," Dr. Naiman says. "Clearing your head is key to a good night of sleep." Simply taking 15 minutes to sit quietly, meditate, pray, or do rhythmic breathing can allow your mind to slow down enough to sleep through the night.
Establishing any ritual that you do before bed—anything but checking your e-mail!—will do more than relax you right then and there. The repetition also conditions your brain and body for sleep, Thompson explains.
While you're transitioning to Z-mode the same way night after night, you're also creating a Pavlovian response to your ritual. So simply sitting in the spot where you do your breathing or turning on the shower water signals your mind that it will be sleeping soon, Thompson says.
Another way to condition yourself sleepward is by playing off the body's internal clock. Dr. Naiman suggests simulating dusk about an hour before you plan to go to bed and dimming the lights significantly. This triggers natural circadian rhythms that help us prepare for sleep.
Make the breath-brain connection
Dr. Khalsa recently supervised a small Harvard study using specific breathing techniques to treat insomnia, and all subjects reported an improvement in the quality and quantity of sleep. "There is evidence that long, slow abdominal breathing will reduce anxiety and arousal," Dr. Khalsa explains.
Dr. Naiman recommends one breathing exercise (similar to those Dr. Khalsa used) called the 4-7-8 breath exercise. With your tongue resting on the roof of your mouth, just behind your upper teeth, exhale completely. Close your mouth and inhale through your nose for four counts. Hold your breath for seven counts. Then, exhale while mentally counting to eight. Repeat the cycle three more times. Both are important for restful sleep.
Take a pose to the doze
"There's a feedback loop between the muscles and the brain," Dr. Naiman explains. "When you stretch and release tension, the brain relaxes too." The deepest meditative state is known as "sleepless sleep."
To get to a sleepful state, Dr. Khalsa finds the yoga Bridge pose especially useful. Lie on your back with knees bent at a 90-degree angle and your heels parallel, close to your butt. Lift your hips and arch up onto your shoulders. Lace your palms together underneath your body and press your arms into the floor or mat. Hold the posture while taking 10 to 15 long, slow breaths.
When you wake up anyway
Despite all your best efforts, here you are, awake at an hour even a fisherman would call ungodly. What do you do now? First, here's a big don't: "If you open your eyes and see the clock, that's it for many stressed people," Dr. Walsleben says. "Seeing the time can trigger them to become fully awake." Keep your eyes closed, roll over, or move the clock so the display isn't visible.
If you're still far from dreamland try a mantra. Silently repeat any word that's soothing or pleasant to you, or simply think "inhale" as you inhale "exhale" as you release your breath.
Thinking the words over and over focuses and relaxes you, but requires less energy and attention than counting sheep, which can actually be too engaging to work the way it's supposed to.
"Get out, get out"
After 15 minutes of lying awake in bed, you need a change of venue. "When someone can't sleep, the bedroom can become a torture chamber," Dr. Khalsa says. "Staying there is counter-productive." And you risk associating the bed with your trouble sleeping, which will exacerbate the problem in nights to come.
Go to go to another room. You don't want to become too alert, so make sure you have a nightlight in your hallway and won't need to turn on brighter lights. Occupy yourself with something calming like knitting, listening to chill music on your iPod, or even performing your pre-sleep ritual again. Only when you feel drowsy, Dr. Khalsa says, should you go back to bed. In a very short while, you should be the picture of blissful sleep.
Getting your nap on
It's not just for toddlers. Napping makes great sense for adults, whether or not it puts you in touch with your inner child. When adults napped between 2 and 4 p.m., one recent study showed, they performed better on tests and had no problems falling asleep at night.
NASA found that military pilots and astronauts who took a 40-minute nap improved alertness by 100 percent and performance by 34 percent, and recent Harvard University research also revealed that college students who napped between tasks performed better than those who stayed awake.
How does napping work its brain magic? "It may protect brain circuits from overuse until those neurons can consolidate what's been learned about a procedure," says Robert Stickgold, Ph.D., coauthor of the Harvard study.
Unless you know the correct way to conduct a daytime doze, however, you could snooze and lose. "Napping can steal the drive for nighttime sleep, so you need to be cautious," says David Neubauer, M.D., associate director of the Johns Hopkins Sleep Disorders Center. "The key is to nap early and short."
By early he means daylight hours, at least five hours before you plan on going to sleep that night (between 2 and 4 p.m. is prime). Any later and your circadian rhythms will kick in, possibly making you feel disoriented upon waking and likely preventing you from conking out come your regular bedtime. As for short, keep your naps to less than an hour; 20 to 30 minutes is enough for most people to get the benefits.
To help stick to this nap-plan, stay out of the sack—likely not a problem at the office—since you associate your bed with long periods of rest. Find a quiet couch or carpeted floor where you can lie down. Even shutting your eyes in your office chair for 20 minutes will relax and refresh you. (That's if you can stifle your phone; if not, find an unused conference room.)
Home or work, you'll find that—just like in kindergarten—after a nice restorative nap, you'll play much better with others.