“When we shrink our whole reality down to pending projects, when our life becomes our endless to-do list, it’s difficult to put them aside each night and let ourselves fall asleep and connect with something deeper.” ~ Arianna Huffington, The Sleep Revolution: Transforming Your Life, One Night at a Time
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If a magic answer to a better night’s sleep existed, I think we would have all bought in by now and I would be one happy person. This topic never seems to lose momentum throughout life. It is a focus of attention in infancy/childhood (especially when you are a parent longing for your child to sleep through the night), in adolescence (a recent push exists to start high school later in an attempt to encourage more sleep for teenagers), in adulthood (when life is busy and work may be stressful) and in late adulthood (when sleep is complicated by many factors such as activity level and health status).
Trouble sleeping is a common reason why people visit their primary care physician, but unfortunately, not much medically can be reasonably and safely done on a long-term basis. Choosing Wisely has developed some guidelines in an attempt to aid in the discussion around this common complaint. It is apparent that much of the management for sleeping problems is not an easy fix and must come from the individual themselves.
If you have ever worked shift work or been on-call, you quickly realize the impact this type of work can have on your ability to sleep long-term. Personally, my sleep problems became most apparent in medical school during the call associated with clerkship and then snowballed with having children during residency (without exaggeration, neither one of our children slept through the night until school age). Throw in anxiety, stress and a family history of sleep difficulties, I am now in my early 40’s working just as hard as everyone else to get an adequate amount of sleep each night.
Arianna Huffington’s Sleep Revolution
Arianna is a well-known public figure as the co-founder and editor-in-chief of the Huffington Post, and as a best-selling author, but she is also a true sleep advocate. In her media appearances, TED talks and books, including Thrive and The Sleep Revolution, she often tells the story of the dramatic wake-up call she had about burnout and exhaustion, when she collapsed on her desk at work and broke her cheekbone. Since then, she has made it her mission to redefine our image of success and what it takes to be successful.
One of her main messages revolves around the importance of sleep. In fact, she believes it to be so important that she has nap rooms at her Manhattan headquarters. Not surprisingly, other high profile companies have followed her lead and recently joined the movement.
As Arianna outlined in a recent podcast episode of 10% Happier with Dan Harris, we are facing a sleep crisis with our fast-paced, ever connected world. She goes on to state that our need to be “plugged in” is hurting our health, productivity, relationships and happiness.
So how can we improve our sleep?
This goes back to my original comment that no simple solution exists. Sleep medications are beyond the scope of this discussion, and again, are limited in their effectiveness unless used on a short-term basis.
In the end, it all comes down to sleep hygiene and developing a sleep ritual.
1) Your sleep environment:
- Keep the room dark (room darkening blinds, an eye mask)
- Keep the room cool (ceiling fans certainly help my family)
- Keep the room device free (obviously not possible if you are on-call, but Arianna suggests a “dumb phone” without data that only key people can call)
2) Your sleep ritual:
- Start during the day by engaging in regular physical activity and limit caffeine intake long before bedtime (3 p.m. is my cut-off)
- Enjoy a warm bath (I find this a necessity and Arianna agrees; a shower will do in a pinch)
- Say a prayer or expression of gratitude (Arianna suggests the latter and I think it is an excellent habit that I myself have adopted)
- Try to go to bed at the same time every night and awake at the same time every morning (ideally try to plan for 7 to 9 hours of sleep)
- Engage in sex – a good addition to the ritual (balances hormones such as oxytocin and cortisol to enhance sleep)
3) Your “obnoxious roommate”: As part of the podcast with Arianna and Dan, they discuss the “obnoxious roommate” also know as rumination – the one we all have that ends up being the greatest saboteur of our sleep. Unfortunately, this is of course the most difficult to manage as our thoughts seem all too clear and pressing in the middle of the night.
Some other tips:
- Keep a pad of paper and a pen beside the bed – try to write down anything that might bother you in the night. Sometimes it helps to identify these thoughts before trying to go to sleep.
- Arianna suggests meditating if you wake up – this helps if you practice meditation during the day as well.
- Thought stopping – I find this can be helpful to stop the thoughts from entering as much as possible. Nothing can be solved during your sleeping hours. Cognitive Behavioural Therapy (CBT) may help develop these skills.
Hope this helps you or your patients sleep your way to the top and be a success in all aspects of your life! Do you have any other tips to share that have worked for you?