THE ANTICANCER LIVING GUIDE TO BETTER SLEEP
ANTICANCER ACTION STEPS
Evaluate your sleep health.
Identify your sleep patterns and challenges.
Understand if you need to consult a health-care professional.
Improve your day to improve your night.
Use your “senses” for optimal sleep health.
Sleep disturbances fall into six main categories:
Trouble falling asleep
Trouble staying asleep
Waking up too early
Not sleeping long enough
Irregular sleep schedule
Overall poor sleep quality
Take a moment to assess what your sleep health looks like. Do you face multiple sleep challenges, or do you have a specific area that needs attention? Do you have problems every night, or are your sleep disturbances intermittent?
If you want a clearer picture of your sleep issues, consider keeping a sleep diary to understand your sleep patterns or use an activity monitor that you wear on your wrist when you go to sleep. This information is then downloaded and provides an organized view of your sleep patterns.
Track the following with honesty:
Time you went to sleep
Time you woke up (did you wake up before it was necessary?)
Total hours of sleep
Amount of time it took to fall asleep
How many times you woke during the night
How long you were awake overall during the night
Rate your overall quality of sleep on a scale of 0 to 10
It may take time for your specific sleep picture to emerge, including how regular or irregular your sleep patterns are. Record your sleep patterns until you have a clear picture of your sleep health.
Consult the box here to view the sleep recommendations for your age. How does your nightly sleep line up with the recommended amount of sleep for your age group?
Your first goal is to get at least 6.5 hours of sleep and preferably between 7 and 8 hours a night. Once you are getting enough sleep, the question to ask is whether your sleep quality is good. In other words, are you sleeping well? Judging whether your sleep is good is a subjective measurement, but it is also simple to assess. Do you feel tired during the day? If so, it is likely that you are either not getting enough sleep or your sleep quality is poor. Common problems, along with too little sleep, include taking a long time to fall asleep, waking up too early, and repeatedly waking up during the night. Do you follow a regular sleep pattern? If you are getting enough sleep, but still feel tired during the day, it is likely that you are encountering one or more of these issues. While your sleep time is good, your sleep efficiency is not.
If you find you’re having trouble falling asleep or if you wake up in the middle of the night and can’t get back to sleep, try meditative breathing. Breathe in deeply through your nose and feel your stomach rise on the inhale. Pause for a few seconds and then breathe out slowly through your mouth. Repeat this technique for as long as it takes you to calm down and relax. Meditative breathing slows the heart rate and blood pressure simultaneously and helps you let go of any stress or anxiety that might be keeping you awake. Do your best to maintain a regular sleep pattern that does not deviate by more than an hour—you don’t want to induce jet lag on a regular basis.
Your sleep issue may require a doctor to evaluate your symptoms and make recommendations. Consider if you need professional help. One sleep expert described a more formal sleep disorder in the following way: If a sleeping problem occurs three times a week for three months, it qualifies as a clinically significant sleep issue. If this applies to you, consider seeing a professional to get advice about how to proceed. Cognitive behavioral therapy for insomnia is now recommended as a first-line treatment for sleep disorders. CBT-I has lasting effects because it teaches you how to optimize your sleep. Ask your doctor about that option before they write you a prescription for sleeping pills. Treat the problem, not just the symptoms. Other nonpharmacological approaches such as tai chi, yoga, or stress-management techniques are also effective.
Light Therapy: Without wearing sunglasses, go outside for half an hour every morning when you first wake up. This could involve an outdoor breakfast, or even better, a walk. If you don’t have the energy for that, just sit outside on your balcony or in your backyard (or sit close to a light box). By exposing yourself to bright light early in the morning, you can reduce your fatigue and improve your energy throughout the day.
Bedroom: If you are having trouble sleeping at night, your bedroom should be for sleeping and intimacy only. If you want to use your laptop, curl up on the couch, but be sure to limit your light exposure. If you want to watch television or listen to the news, do that in the living room. If you find yourself drifting off, get up and go to bed. Once you start to associate the bedroom exclusively with sleep, your body and mind will become more receptive to sleeping when you enter your room of rest.
Routine: Go to sleep at the same time every night. Hitting the sack at or near the same time will help you improve your sleep quality and circadian rhythms—you’ll feel like a perfectly tuned orchestra!
Napping: If you must nap, limit your naps to thirty minutes or less, and don’t nap after 5:00 p.m. Longer naps can disrupt your circadian rhythm and prevent you from falling asleep and staying asleep during the night.
Work Your Body: Aerobic activity for as little as ten minutes a day can dramatically improve your sleep quality. Yoga and tai chi have also been shown to improve sleep quality and duration. But avoid strenuous activities and workouts close to bedtime.
The first thing to look at when trying to improve either sleep duration or sleep quality is to make an honest assessment of your sleep environment and sleep habits. In thinking about sleep quality and how to improve our sleep, Alison and I like to consider our five senses—smell, sight, sound, taste, and touch. This is a straightforward way for us to remember all the things that influence sleep and home in on things we can do to improve our own sleep health and the chances of our three teenagers getting deep, restorative sleep every night.
Breathe deeply. It is important to engage throughout the day in your deep diaphragmatic breathing that you learned about in the last chapter and to do so especially before bed.
Meditation can be used across the Mix of Six. Before bed, meditation can be very effective at switching off the monkey mind, rewiring, and disengaging. It is also an effective tool to help you get back to sleep after waking during the night.
Use essential oils like lavender to help with sleep initiation. Consider an organic lavender essential oil spray on your pillows at night—it feels fresh and helps with sleep initiation. You can also get a diffuser to fill the room with the relaxing smell.
Decrease exposure to ambient light in the bedroom—LED lights, outside lights, etc.
Limit exposure to TV and all electronic devices thirty minutes before bed. They emit a blue light that makes it difficult for your pineal gland to start releasing the necessary melatonin to start your sleep cycle.
Your phone doesn’t belong in your bedroom. With your phone by your bed you are more tempted to look at it in the middle of the night, especially if you are having trouble sleeping or want to knock a task off your list that has just come to mind. Banishing your phone to another room is tricky in this day and age. With elderly parents or with teenagers out for the night we want to be available and reachable. Until someone develops an app that allows for a Do Not Disturb Except in the Case of Emergency setting, we are going to find this challenging. Consider placing your phone far enough away that you will hear it ring but not hear any bothersome texts at two in the morning. Also consider establishing a cut-off time with texting and emails. At nine or ten o’clock Alison and I stop looking at our phones and computers. Admittedly, it has been a challenge to get our children to abide by this rule, but we are always encouraging them to turn off, shut down, and disengage when it gets close to bedtime.
I swear by my eye mask. I wear the kind of mask that has recessed spots for the eyes so that the mask does not push on your eyeball and obstruct eye movement during REM sleep. Blackout curtains are good, but they are also surprisingly expensive. As a cheap alternative, a friend of ours bought thick foam and cut it to her window shape and size.
Travel with electrical tape to cover LED lights in hotel rooms. It is shocking how much light the TV red LED will emit. That light hitting your retina in the middle of the night if you open your eyes can disturb your sleep pattern.
Sound—neighbors talking, partner snoring, outside noises, etc. An easy solution is earplugs. The use of a light pillow over your head may also do the trick.
Sound machine—using a sound machine that makes white noise is a popular option. It masks the background noise by imposing a steady white noise sound.
Snoring is a challenge in a partnership—encourage sleeping on the side or stomach, as this often helps. Consider sleeping in a separate room or raising the snorer’s side of the bed with pillows.
Watch your alcohol consumption. While alcohol does have that sedative effect people enjoy and can help with sleep initiation, when alcohol is metabolized in the second part of the night, it becomes a stimulant and can cause you to wake up or sleep less deeply.1
Watch your daytime caffeine intake. Don’t drink coffee or caffeinated drinks after noon. Chocolate, while delicious, can have the same effect due to its caffeine content, especially the dark chocolate that we know is also healthy for us.
Eating close to bedtime means your body is busy digesting when it is supposed to be sleeping. If you mix in rich food, alcohol, and sugar, it will likely cause you to have difficulty getting to sleep. Heartburn is a common reason people can’t get to sleep or stay asleep. An easy solution: don’t eat rich food, citrus fruit, or carbonated beverages close to bedtime.
Temperature matters for sleep initiation and sleep maintenance.
Are your pj’s too warm or cool? Surprisingly, this makes a real difference in Houston—given the large swings in temperature, one needs to go from light cotton to warm flannel, sometimes from one night to the next. The amount and type of covers you have (and if your partner pulls off your covers in the middle of the night) can lead to the same effect.
Do you need to adjust the thermostat before bed? We sleep better in a cool room. One degree of temperature change can be the difference between a good night’s sleep and a poor one. A fan is an inexpensive solution.
Your body temperature naturally fluctuates during the night.2 When you sink into deep sleep, your body temperature drops. You do not want bedding, like an electric blanket, that interferes with this natural process. Down covers or the like are ideal as they cool down as your body cools and hold heat as your body heats up.
Are your bed and pillow comfortable or do they need to be replaced? Signs you need a better pillow or mattress—neck gets cricks, you sink to the middle of the bed, or you’ve had your mattress for over ten years.
Until you optimize your sleep health, you can’t know why you struggle in certain situations or in other areas of your life. Only when you adopt a steady sleep schedule and are getting a good night’s rest can you move on to address other more obvious lifestyle choices, like what you eat and how much you exercise.