Dr. Toshi Is In! "What can I do to get better sleep?

Dear Dr. Toshi,

I have trouble sleeping at night. What can I do to get better sleep?

Insomnia is "persistent problems falling and staying asleep." Interestingly, the COVID-19 pandemic has changed sleep habits for some people, according to a report I read. Some people are struggling with insomnia due to increased anxiety or stress, for example. But others are actually getting better sleep because changes to their daily schedule due to the COVID-19 pandemic have resulted in sleep that's more in line with their body clocks. In other words, now they might have the chance to sleep longer and wake up naturally without an alarm.

In our bodies we have something called our circadian rhythm, our internal body clock. You can find out what kind of clock you have by asking yourself, "If I had no responsibilities, when would my internal clock 'want' me to sleep and 'want' me to wake up?" And also ask, "what time of day am I most alert?" You might be a "night person" who is alert at night and hard to wake up in the morning, or a "morning person" who tends to go to bed early and naturally wakes up early in the morning. We sleep best when we stay in tune with our circadian rhythm. So, if you can work out your schedule to match that as closely as possible, it would be ideal.

The Stanford Center for Sleep Sciences and Medicine at Stanford University is one of the top research institutions in the country, although there are as many as 2,000 to 3,000 sleep clinics in the country and many top institutions have such research centers. I recently read a book called The Stanford Method for Ultimate Sound Sleep about good sleep by Dr. Seiji Nishino, who is a professor at the Stanford Center for Sleep Sciences and Medicine and the head of the Stanford Sleep and Circadian Neurobiology Lab.

According to the research, the amount of sleep you get isn't near as important as the quality of your sleep. In fact, there's a lot of research showing that sleeping too much is unhealthy. So, what's our goal? It's to have sleep that results in the best condition of your brain, mind, and body. While you're asleep, you want to make your body and brain do their jobs the best as they can so that your wakeful condition is optimal.

So, here are some tips on how to do that.

According to sleep research studies, the key to good sleep is to get high-quality sleep for the first 90 minutes of your sleep. This helps your nervous system. Also, most of our growth hormone is secreted during this first 90 minutes of our sleep. Growth hormone is important in children's growth, but it's also very important to us as we get older. It's thought that it helps in the development of our cells and metabolism as well as having some anti-aging functions in our bodies. We need high-quality deep sleep in the early part of our sleep in order for growth hormone to be secreted. Having this "golden 90 minutes" in the beginning of our sleep also helps with brain function.

Conversely, it's been shown that if a person's first 90 minutes of sleep is interrupted, he or she will have a hard time staying awake or alert the next day.

In order to have this "golden 90 minutes" early in our sleep, Dr. Nishino recommends that you do two things when you go to bed: quiet your brain and control your temperature.

It's known that when you are having good sleep, your internal temperature is lower than it is during the day. That means you need to lose some of your internal body heat when you want good sleep. Ironically, you can do this by first heating your body up so it can then lose heat for you. For example, before bed you could wear socks to warm up your feet, and then take them off when you go to bed to allow your body to lose that heat. Or take a hot shower 90 minutes before bed, which temporarily heats up your body, allowing it to then lose heat before you go to bed, going down to a temperature that is lower than it was during the daytime. So, you should go to bed when your internal temperature is lower than what it was during the day. By wearing socks before going to bed or taking a shower 90 minutes before going to bed, your internal temperature will go up temporarily, but then your body reacts and lowers it, and your internal temperature ends up lower than what it was.

The second thing is to quiet your brain. The goal is to have no thoughts in your head at all. Of course, that's almost impossible to do, but you can try to get close to that by reading a boring book, for example. The key is to use something monotonous. It's basically the same thing that tends to make people sleepy when driving on a highway for a long time with no change of scenery. Don't stimulate your brain with something new, exciting, or anything that requires a lot of thinking. For that, having a constant sleep routine that you follow every day is helpful. That may include something like going to bed at the same time and following the same habits every night before going to bed. If you want to try counting sheep, don't count them because counting makes you think; instead just repeat, "Sheep, sheep, sheep, sheep. . .."

Try these and see how you feel!

Dr. Toshiko (Toshi) Luckow, MD is a Family Medicine physician at the West River Health Services hospital and clinics.