Hard Things: Good hard sleep

Ep 189  Hard things: Good hard sleep

Sleep is a hard thing. Good sleep is even harder.The complexity of our network of systems makes it even harder to isolate the keys to getting a great night’s sleep when literally anything and everything can disturb our sleep. While occasional sleep disturbances can be normal for sure, long term sleep disruption is not. Our work IN this week is changing the way we look at the complex puzzle of sleep from a nice to have to a non negotiable priority in our health. 

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Transcript

Ep 189  Hard things: Good hard sleep

Sleep is a hard thing. Good sleep is even harder.The complexity of our network of systems makes it even harder to isolate the keys to getting a great night’s sleep when literally anything and everything can disturb our sleep. While occasional sleep disturbances can be normal for sure, long term sleep disruption is not. Our work IN this week is changing the way we look at the complex puzzle of sleep from a nice to have to a non negotiable priority in our health. 

Sleep is where radical responsibility for our health choices and the puzzle that is mind body connection intersect. Fatigue is a symptom of literally every possible thing that could be wrong with you. But when you live in fatigue it can be hard to isolate the causes and the fixes. Not only can subtle and not so subtle diseases interfere with how we sleep but food, drink, pharmaceuticals, relationships, mental health, hormone status and exercise can too. 

Now we have talked about sleep hygiene many many times on this podcast and I don’t want to beat a dead horse. If you are doing all the things, getting morning and daytime sunlight, eating early, no blue light, trying magnesium (This won’t keep you asleep) , changed nutrition and lowered caffeine intake, go to bed and get up at the same time every night, black out curtains and room temperature and you STILL aren’t sleeping well. As in waking multiple times, not able to get to sleep, or waking up exhausted then it’s time to ask more questions. And while sometimes pharmaceuticals might be on the menu and are fine if you are ok with them. There are some other upstream causes and solutions to explore as well.

Think about it like a puzzle. In my family every Christmas there’s always some kind of complex puzzle for the family to put together. Even if you’re not a fan of puzzles you have probably done one or 2 in your life. How do you start completing a puzzle?

The edges. You do the border first. Those are the easiest pieces to find, right? Then you have a framework to start to fill things in.

When we’re talking about the sleep puzzle all those sleep hygiene pieces are the edges of the puzzle. They give you a solid framework and hint at what the next pieces might be and where they might fit. We have to start there.  Well you don’t have to but that’s the cheapest easiest least invasive place to start. You don’t need a prescription for any of it.

Then if you are still having chronic insomnia defined as  sleep disruption 3 or more nights a week for 3 months or more then you have something to share with your health provider…these are all the things you have tried and how they have or haven’t worked for you. 

That’s when perhaps bloodwork and hormone testing might be valuable. Sex hormones, particularly progesterone, blood sugar and cortisol as well as micronutrient balance all play a role in how well or not well we are able to sleep.

There’s another way to look at the edges of that puzzle though that I think that puts this process in the category of hard things in our health. And that is looking at those edges as a boundary that we protect in order to elevate sleep and prioritize it as non negotiable self care.

Let’s think about that for a minute. How important is it to you to sleep well? 

I would guess that the answer to that is inversely proportional to how well you already sleep. In other words the harder it is to sleep the more important it gets, until you reach a point when you just give up. 

Why do we sleep? We need sleep, we know that, but why?

During sleep the brain and the body are still working to repair and recover from your day. In children and teens it’s a vital time for brain development.  How you sleep affects how well you think, react, work, learn, and get along with others. Sleep affects your heart and circulatory system, metabolism , respiratory system, and immune system. And lack of sleep has been linked to 

• Coronary heart disease
• High blood pressure
• Obesity
• Stroke
• 
  
• Higher levels of the hormones that control hunger, including leptin and ghrelin, inside your body
• Decreased ability to respond to insulin
• Increased consumption of food, especially fatty, sweet, and salty foods
• Decreased physical activity
• Metabolic syndrome
• Not getting enough sleep or enough high-quality sleep can lead to problems focusing on tasks and thinking clearly

We’ve discussed before the importance of the different stages of sleep for the brain, deep sleep for cleaning and repair and REM for memory.

So how we sleep affects every other aspect of our health. And yet fatigue is a symptom that we don’t place a very high priority on. I know I didn’t for years. In fact I’m not even sure I know what a day without fatigue is. Can it be fatigue if it’s your normal? That’s just wrong.

So let’s get back to our puzzle. Let’s say we’ve got all our edges in place and we’ve decided improving sleep could be a cornerstone to improve all other health issues. Great. Where do we go to find all the missing pieces in the middle.

If we can’t get to sleep…

Check the nervous system. In order to get to sleep we have to be able to let go and shift into the parasympathetic  side of our nervous system. If we get stuck in hypervigilance, worry, rumination, or activation for whatever the reason, the nervous system will stay sympathetic. The fight, flight side. 

While there are medications that will knock you out they don’t typically help you get into the deep sleep cycles necessary for true rest and repair that the brain needs. And they can have nasty side effects.

On the supplement side, magnesium and L-theanine can help relax the body enough to drift off but the mind can and does override that response if the NS is triggered. If magnesium and guided meditation like I-Rest doesn’t work we can take other steps.

Measuring blood glucose, insulin and cortisol levels as well as sex hormone changes can be important pieces of information. SOmetimes this is the underlying physiologic cause if it is then your health care provider has a lot more options to help than they once did.

If we can’t stay asleep…

Restlessness isn’t just annoying, it can be a symptom of serious issues. Sleep apnea, snoring or breathing interruptions can be very bad for us. Not to mention that it can throw your overnight levels of hormones out of whack. If you’ve been told you snore or stop breathing during the night, getting into a sleep study can be a game changer for your health.

Also depending on your hormone status having a conversation about HT might be on the table. Sleep disturbance and insomnia is high on the list of complaints from perimenopause and postmenopausal women because of the relative drop in progesterone. And you can tailor your personal HT cocktail to fit exactly what you need to feel better. Look for an integrative or functional medical practitioner preferably who is certified by the National menopause society. And don’t take no for an answer there is a lot of misinterpretation and misunderstanding of data within the medical community at large when it comes to HT. If you’re looking for a book to get you started check out The New Menopause by Mary Claire Haver.

If you get up multiple times to use the bathroom and you stop drinking an hour before bedtime, you may want to see a urologist. Some medications can also be diuretic and if this is the disruption we need to way the risk and benefit. 

If we wake far too early…

This one’s a challenge. The first question is when did you go to sleep? Just like when we stay up too late and miss our deep sleep window, getting up too early cuts off our REM sleep window. Some of the same things that I’ve already mentioned could be at play. Hormones, sleep apnea and also medication side effects. 

When it’s time for us to wake up our cortisol levels naturally start to rise. Sometimes that happens way too early. Some have found CBT or Cognitive Behavioral Therapy may help change that habitual response. 

Looking into hormone balance and blood sugar responses can also help here because changes in blood sugar levels through the night affect that cortisol rise.

If we can’t wake up, or wake tired…

This is often an indicator of sleep apnea but not always. If it seems like you sleep but you still wake up counting the minutes you can get back in bed (been there done that) and you don’t have Sleep apnea AND you’re doing all the things that make up the edges, the frame of the puzzle we might look at overall mental health. Depression can show up as deep fatigue and very low energy. It is a parasympathetic nervous system response that falls into the freeze category.  This isn’t normal even if you’ve dealt with it for a long time. You don’t have to suffer. Seek out a mental health professional or ask someone you trust to advocate for you. 

It might seem like an over simplified answer but our health and behavior habits are intricately tied and sometimes cognitive behavioral therapy can be very effective for improving sleep habits.

It’s never about only one thing when it comes to feeling better and getting healthy. As much as we wish for a simple answer, it’s rare that we can change this one thing and get the results we want. 

Sleep is the canary in the coal mine when it comes to a nervous system disruption and also can be a symptom and cause of other deeper health issues including cardiovascular disease, insulin resistance, type 2 diabetes, obesity, autoimmune dysfunction, hormone imbalance and many more. And yet it’s often an ignored symptom. How many times has your doctor asked you how well you’re sleeping? Good restorative sleep is required for the body and the brain to heal and to stay healthy. And yet it’s the last piece of the puzzle that we look at. As if on the list of good health, good sleep is just a “nice to have” not a “must have”.

What if we focused first on the edges of the puzzle and included sleep as a non negotiable part of our own health framework?

As a reminder here are a few of those pieces again that you can look at today. 

Sunlight + limit tech/blue light exposure close to bedtime

Temperature - in the bedroom or warm shower before bed to lower body temp

Sugar + Caffeine + Alcohol  All of these chemically stimulate the body in some way Take a hard look at how you can limit your exposure to all them throughout the day but especially within 4 hours of bedtime.

Supplement support - Magnesium, L-theanine, Ashwaganda, chamomile teas and other supplements can have a soothing and calming effect to help sleep

Routine - guided meditation, soothing music or self massage can help shift into sleep mode.

Next week we’re looking at our next hard thing in our series: Connection 

Thanks for listening today! 

 If you're looking for ways to handle the effects of stress, physically, mentally and emotionally through the body head over to savagegracecoaching.com/theworkin you’ll find all the show notes for this and other episodes plus lots of free resources. And if you’re in a place where you are ready for more and you live in the Dayton Ohio area I’m taking private clients for trauma informed yoga and trauma release exercise in person and online. So you can book a discovery call and we can have a real life conversation. And of course I’d be ever so grateful if you would take a moment to like and subscribe to this podcast wherever you’re listening. 

Thanks again everyone and as always stop working out and start working IN.   

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