Image by Jill Wellington from Pixabay

July 29, 2024

Sleep Part III

Finally, the other elephant in the room related to sleep is STRESS. Stress alters the function of the hormone cortisol and can significantly alter night sleep function. There are three major chemicals that affect sleep: cortisol, adenosine and melatonin. 

In normal conditions, adenosine rises during the day making you sleepy, cortisol hits its low point at night and melatonin rises as the sun goes down. This combination puts pressure on you to feel sleepy and want to go to bed. Unfortunately, modern life has made many of us feel stressed and sympathetically fired up which affects cortisol function. Instead of being at its nadir at night, the stress response causes cortisol to rise at inappropriate times disrupting sleep onset and maintenance. Couple this stress with facebook addiction and screen induced melatonin suppression and you have a recipe for insomnia and disrupted sleep. (Hanson et. al. 2010)

My partner, Wayne Koontz, and I talk all the time about which is the more detrimental risk factor for poor health: stress or poor nutrition. The answer is likely dependent on your genetics. Stress is clearly the more problematic player in the sleep realm according to my understanding of the literature. 

Chronic sleep disruption will lead to neuroimmunoendocrine abnormalities that over time lead to increased metabolic disease, increased tendency to infection, increased risk of autoimmunity and cancer. There is a huge body of literature looking at the immunology of sleep and it is not good in the chronic sleep deprived state.

Simple family ideas for a better sleep:

1) No screens around the dinner table. Especially when you are out at a restaurant. Children do not need a device to have good behavior at a public establishment. They need love, conversation and your time. This is a major problem in America. (Not to mention emerging data that screen time in the very young (<2 yo) is highly associated with ADHD)

2) Keep all devices in a main docking station in full view and never in a child's room. Definitely, no TV's or screens in the bedroom. This can help reduce the anticipatory anxiety of waking up and checking a device at night or early am. In my experience, boys are using the devices to play games and watch videos while girls are more into the social media nightmare of comparison and projection. 

3) Enable the blue light suppressor option on all devices from 6PM to 8AM. This will help prevent the melatonin hormone suppression at night. 

4) Encourage a routine at bedtime with a consistent "lights out" time that is adjusted by age. Keep bedrooms as dark as possible to induce melatonin production and promote sleep onset. Dim night lights are ok. Use blackout shades in the longer summer days.

5) Meditate and pray often to induce the parasympathetic aspect of your autonomic nervous system and move you away from flight or fight mode. Stress definitely messes with sleep onset and latency. 

6) Learn the relaxing breath to reduce sympathetic tone. Link

7) Practice yoga or stretching relaxation in the early evening to wind down and destress if stressed. 

8) Avoid caffeine and late alcohol consumption as they mess with sleep onset and reduce deep restorative sleep volume. (adults)

9) If you are suffering insomnia from serious stress, go and see a quality counselor to begin the resolution and acceptance phase. Remember that the past is the past, it will not change. Only your interpretation and acceptance of any event can reduce its power over self.

10) Exercise and move often daily as sleep is tremendously enhanced by exercise. 

Sleep well,

Dr. M

Scientific American

Tonini Neuron

Czeisler JAMA Pediatrics

UCBerkley News

Lliff Science Translational Medicine

Ooms JAMA Neurology

Walker Sleep Medicine

Teens and Sleep Newsletter

Benedict Alzheimers and Dementia

Gottlieb BMC Medicine

Paiva Sleep Medicine

Chaput BMC Public Health

Irwin Pychosomatic Medicine

Irwin Neuropsychopharmacology

Wheaton Journal of School Health

Hanson Health Psychology Article

Peter Attia - Matthew Walker Podcast