From newmarkettoday.ca
By Debora Kelly
Dr. Beverly David shares her guide to the rest that's essential to our health and mental health, including a cool room, routine, no screens or pills
Take away our sleep and watch us unravel.
“Sleep is important to our whole psychology — what it is being a human,” sleep expert and clinical psychologist Dr. Beverly David said at the recent Women’s Health Summit in Aurora presented by Tracy Smith, founder of Oh Yes We Can! events. “It affects our thinking, our emotions, our behaviour and, of course, our body.”
“You can see things like word fluency, word finding, patience, parallel thinking, planning, risk — all of these start to just deteriorate very, very quickly without sleep,” she added.
Whether it’s a mom of a newborn getting only a precious few hours of sleep, or a hot-flashing woman in perimenopause having minimal hours of uninterrupted shut-eye, sleep — or, more specifically, the lack of it — is an impactful topic for women’s health.
There is nothing quite as important to our health as good sleep, says David, the owner of Uxbridge-based Your Psychology Centre, who specializes in insomnia.
The need for sleep is linked to our brain’s prefrontal cortex, which enables planning, decision-making, memory consolidation, cognitive behaviour and emotional regulation — “every bit of us that is a human,” she said.
Sleep also “washes” the brain of the amyloid proteins that accumulate as plaque in the brain, which is a primary hallmark of Alzheimer’s disease and is linked to an increased risk of strokes and dementia. Insulin and glucose control are also affected by sleep, as are our skin and muscles.
“So, it's the pillar, it's the pillar that everything else sits on,” David said.
The duration and quality of our sleep naturally changes as we age and go through stages, such as when hormones change in puberty, during menstrual cycles and in perimenopause.
By age 25 or 30, we typically settle into our normal sleep patterns.
Chronotypes are real — those natural and genetically influenced inclinations to sleep and wake at specific times often described as early birds, or larks, or night owls, she added.
“It's so important, and we know that there is no magic — no magic pill — that can replace sleep,” David said.
Literally, pills don't work, said David, emphasizing that the recommended treatment for insomnia is cognitive behavioural therapy.
“Most people with insomnia are doing a lot of 'the things.' In fact, they're doing too much of 'the things.' They got the weighted blanket, they've got the noise machine, they've got the eye mask. They're over-egging the pudding,” she added.
Here are her tips for reclaiming your sleep.
Keep your bedroom cool
“You want to be cold — so think like you want to be hibernating,” David advised. “So often our bedrooms are far too warm, and we need to cool off to fall asleep.”
You want a temperature of 18.5C to “cue” your circadian rhythm and keep it on a 24-hour track.
“It's the ambient temperature that you want to be cool, but you're cosy and comfortable under your sheets,” she added.
Don’t get into bed too early before you’re ready for sleep, she suggested.
“You might want to think about reading that book somewhere else … or sitting somewhere else in your bedroom, so that when you get into bed, it feels crisp and fresh, and you have that benefit of just cosying.“
If you’re having hot flashes at night, she recommends wearing sweat-wicking clothing to be more comfortable.
Stick to a routine
“And how do we keep that clever (circadian) clock on track? We do things at the same time. Routine is the guardian of sleep,” David said.
Your circadian rhythm puts the brakes on melatonin production when it sees the light of day, and releases it later in the evening to help initiate that readiness for bed and sleep.
“You want to be slowing down as you ready for bedtime. You can't expect yourself to stop at that intersection if you haven't slowed down a little bit before you approach it.”
Create a calm environment
Often her clients with insomnia associate their bedroom with stress, as it is the place where they think through the day, worry about tomorrow and fill their brain with “unfinished things,” all of which is counterintuitive to sleep she said.
Your bedroom shouldn’t be a place for work, or arguments.
“Try not to have the arguments in the bedroom, try not to send your children to their bedrooms (as punishment.) Bedrooms are supposed to be that place where you find it cosy and calm.”
Cognitive behavioural therapy techniques can help restore calmness, she said, even for coping with hot flashes.
“So that when we might wake and we might be in a hot flash, we're able to think, I know what this is. Nothing’s wrong with me, my temperature is up …. I'm not going to be angry about this because that effort and anger and frustration is actually the bit that then goes on to contribute to the lack of sleep.
“(Otherwise) we're going to teach ourselves that bed is where we are hot, bed is where we are frustrated, and that is where we don't sleep. And if you pair the two together too often, you're going to get really good at not sleeping.”
No screens in the bedroom
While many people enjoy winding down in front of a screen, whether a TV, smartphone, e-reader or other technology, it can hamper the hours of sleep we need, David said.
While studies have shown that blue light from screens suppresses the body’s ability to make melatonin, interrupting our circadian rhythm, the bigger impact is that it “accidentally displaces our sleepiness” — we lose track of time, she said.
“Once we've started looking at technology, whether it's Instagram or Downton Abbey or Bridgerton or whatever we're into, it often just lets the time go by. And we have to try and preserve the opportunity to get our seven to nine hours.
“Now everybody needs a different amount of sleep … but if you've scrolled till midnight and you know you're getting up at 6, you can't get even seven hours… So that's why we want to be careful with technology.”
And since the bedroom is meant to be a place of rest, you shouldn’t be using it as a place for “thinking and working and stimulation.”
“This is classical conditioning: Do what you want to do in the place you want to do it. You need to practise being restful, calm, and inviting that sleepiness … If you're looking at an email, you might see something that you've missed, it's going to trigger a cortisol response, you’re going to worry, it's going to be on your mind and you're going to displace that opportunity for sleep.”
Avoid bringing your smartphone into the bedroom — buy an alarm clock if you need one — or at least tuck it in a drawer where you can hear a call in case of an emergency, she said.
“It really is so important because our children are getting the brunt of this, especially with their screens and with their gaming and with their lack of movement and lack of natural light. And what we're seeing … is more and more anxiety, depression, social difficulties, emotional dysregulation, and a lot of that is actually the lack of sleep. It’s a direct relationship with the amount of time they're on the screens.”
Don't use substances
Caffeine, nicotine, cannabis, alcohol are sleep disrupters.
Often the behaviours that interrupt our sleep are happening in the hope they’ll bring sleep, she added.
For instance, having a glass of wine to relieve stress before bedtime. Certainly, the wine may make you feel calm. But rather than regulating your emotions, you’re engaging in coping behaviour, David explained.
“If you like your sleep, don't drink,” is her blunt advice. Yes, alcohol will make you fall asleep quicker, but the rest of your night will be fragmented because your body wants another drink, she said.
That impacts rapid eye movement, one of the four stages of sleep, occurring about every 90 minutes. REM is crucial for cognitive functions like memory consolidation, emotional regulation, and brain development.
“Each part of sleep plays a different role. Some of these are for memory consolidation, or practising procedural memory, like a piano scale. Some of it is for emotional regulation, some of it is to 'wash' the brain. Now, rapid eye movement, we know plays a huge role in emotional regulation, reading people, humour, sarcasm, social complexities, and alcohol, as well as cannabis, as well as nicotine, all push the rapid eye movement into a different place.
“And, so, often we'll wake up feeling a little bit edgy, a little bit more paranoid... less socially confident. And of course, what do we do then? We think I better use that thing again. I'm going to have another drink tonight or I'm going use my cannabis."
Studies since cannabis use was legalized are showing it also not only affects rapid eye movement, it creates insomnia rebound, David said.
“If anybody has been on sleep medications — which you shouldn't be, if you have insomnia — when we try to come off them, you'll experience insomnia rebounds, which is horrible. It's the worst sleep ever because it's like a tolerance that is now biting back at you. Cannabis does the same.”
If you’re taking magnesium supplements, they won't induce sleep, however, it does relax us, which is conducive to sleep.
Make sleep a priority
Making time for sleep is essential, particularly for women, who often put the needs of others before themselves, David said.
“It can sometimes be hard to say, 'You know what? I'm going to get to bed early tonight. I'm not going to watch that show with you.' So have the conversation with your family that you do need to preserve (your sleep) because that's your mental health, and that's your patience. And they probably want you to be a nice person. And a well-slept person is a nicer person.”
While time for sleep is important, be sure to also make time for the “fun things,” she added with a smile.
“So keep going to the fitness classes, see your friends, be social. You want to enrich your day so that your bedtime is even better. Don't avoid the fun stuff.”
