Sleep Health

Feature Story

A regular good night’s sleep goes a long way in improving one’s health and quality of life

By Blecenda Varona, DRPH, FACLM, DIPIBLM, RND, MPH

Call it modern life.

In today’s world, sleep is not anymore a priority. Average sleep time has declined to 20 percent during the last century. Everybody is busy. Life is fast-paced and exciting – and at the same time tiring and exhausting. Lack of sleep is an epidemic. People are searching for solutions that will restore their energy.

Why are you always tired?

You are tired because you may have an illness, such as a cold, or the flu, that is sapping your energy. Or you may be lonely or depressed.

Many otherwise healthy people, however, have sedentary jobs with deadline pressures and emotionally draining problems. These people are not likely to feel rested when they get out of bed in the morning.

In addition, few people get through a day anymore without pick-me up – usually coffee, tea, or cola. Caffeine is a central nervous system stimulant and may cause insomnia if taken in excess.

What about chronic fatigue?

Besides tiredness and lack of energy, there is also an increase in irritability. Tempers get short and “patience” goes out of the window. Everything requires more effort, until finally the simplest tasks seem overwhelming.

Fatigue also sabotages good relationship. Chronic fatigue can result to poor judgment. And if unrelieved, fatigue can culminate in exhaustion and depression.

Good sleep

Lifestyle medicine prescribes adequate sleep: for adults, 7-8 hours of sleep in total darkness. Babies need longer.

Good sleep allows your body to renew itself. Waste products are removed, repairs are in progress, enzymes are replenished, and energy is restored. It also aids in the healing of injuries, infection, and other assaults on your body, including stress and emotional traumas.

Good sleep strengthens your body’s immune system, helping protect you from diseases.

Good sleep can add years to your life. In a large population study of health habits, it was found that people who regularly slept seven to eight hours each night had lower death rates than those who averaged either less than seven hours or slept longer than nine hours.

Tips for good sleep health:

• Sleep in total darkness. If it is not possible, use an eye mask. An eye mask worn at night can help deepen darkness and protect against intrusive light. Choose a mask that is soft, comfortable, and flexible.
• Sleep in a cool room and comfortable bed.
• Go to bed and get up at the same time each day. Maintain a regular schedule as possible for going to bed, getting up, eating and exercising. The body flourishes on regular rhythms.
• Avoid caffeine such as coffee, cola, tea, and caffeinated energy drinks.
• Don’t use alcohol as a sedative. It makes the brain restless later in night.
• Exercise early in the morning or late in the afternoon, but no less than three hours before bedtime. Walking is still the best exercise: 30 minutes a day. Exercise relaxes, restores energy, helps banish depression, and combats nervous tension. Being physically active at daytime can lead to good sleep at night time.
• Exercise regularly. It may be the best medicine of all for ensuring a good night’s rest. It reduces stress and provides a pleasant physical fatigue that helps you sleep more soundly.
• Take frequent breaks during the workday. Walk around, get a drink of water, have some deep breaths.
• Breakfast in the morning can provide your body’s energy. Always remember to eat a good breakfast. Eat the evening meal at least four hours before bedtime. An empty, resting stomach is more conducive to quality rest.
• Try a lukewarm (not hot) bath. It is a helpful relaxation technique.
• Manage your stress properly. Emotional stress can also be reduced by handling disturbing problems earlier in the day.
• Don’t wait till bedtime to bring up problems.
• Count your blessing. Fill the mind with gratitude and thanksgiving. A clear conscience and a grateful mind are wonderful pillows to sleep on.

Melatonin and core body temperature

Healing and recovery can happen when you have good sleep. Melatonin is the hormone that regulates your sleep. Melatonin influences sleep by sending a signal to the brain that it is time for rest. The healing mechanism of our body through – DNA remodeling and DNA repair can happen when increasing melatonin and decreasing your core body temperature. Around sunrise, they do the opposite, decreasing melatonin and increasing core body temperature. The relationship between melatonin, core body temperature, and sleep propensity is shown below (Figure 1).

Figure 1: Diagrammatic representation of normally entrained endogenous rhythm of core body temperature (solid curve), plasma melatonin (dotted curve), and objective sleep propensity (dashed curve) in the context of the 24-hour clock time and normal sleep period (shaded area)

We need to understand the importance of light and darkness.

Melatonin is a hormone produced in the brain’s pineal gland, is often known as the “sleep hormone” or the “darkness hormone.”

The absence of light sends a critical signal to the body that it is time to sleep. The level of melatonin naturally rises along as your sleep propensity increases. This signal helps initiate the levels to naturally rise during the early evening as darkness falls and continue to climb throughout most of the night, before peaking at approximately 3 am. Levels of melatonin then fall during early morning and remain low during much of the day. Evening light, use of laptops, i-pads, TV, and cellphones hinders the rise of melatonin, which delays the onset of the body’s transition to sleep and sleep well.

Sleep physiology highlights

1. Sleep onset
a. Pineal melatonin secretion
b. Vasodilation of skin blood vessels and extremity warming

2. Early sleep
a. Rising melatonin levels
b. Predominantly slow wave (restorative sleep) on EEG
c. Increase peripheral skin temperature
d. Decreasing core body temperature
e. Signals physiologic restorative processes that occur throughout the body
f. Decrease blood pressure and sympathetic tone

3. Throughout sleep
a. DNA remodeling and repair
b. Leptin secretion (for control of appetite)
c. Increasing cortisol
d. Fatty acid metabolism

4. Late sleep
a. Declining melatonin levels
b. Longer REM periods – important for fear extinguishing
c. Decreasing peripheral skin temperature and increasing core body temperature
d. Increasing blood pressure, sympathetic tone, and baroreceptor sensitivity as body prepares to awaken

5. Awakening 
–characterized by a cortisol spike

Melatonin supplement

If you have exhausted all the natural ways to improve sleep, but still suffer poor-quality sleep – it’s time to ask for help. You might be in need of melatonin supplementation or other sleep aids. Your doctor is the best person to guide you on this.

“The absence of light sends a critical signal to the body that it is time to sleep, and the level of melatonin naturally rises along as your sleep propensity increases”

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