CHAPTER TWO

ENHANCING SLEEP

As mentioned in the last chapter, there is a wellspring of techniques and strategies that can be beneficial in transforming our relationship to rest. These can be helpful in amplifying our well-being in a more holistic and integrative way. Some of these are derived from an approach known as sleep hygiene, while others are integrative lifestyle practices that can help inspire relaxation. As you will see, there are numerous possibilities to explore, allowing you the freedom to find ones that appeal to your individual interests and address the underlying factors that keep you from a good night’s sleep.

Sleep Hygiene

As the sleep loss epidemic has escalated, there’s been a growing interest in a branch of health promotion specifically designed to champion habits that support better sleep. And while it may not have the sexiest of names — it’s called sleep hygiene — its efficacy has resulted in it gaining significant recognition for the numerous benefits it accords. The term sleep hygiene was coined by one of the fathers of sleep medicine, Nathaniel Kleitman, in his 1939 book Sleep and Wakefulness; it was further codified as a health-promotion system in the 1970s by psychologist Peter Hauri. Today, it’s an integral part of an approach to sleep medicine called Cognitive Behavioral Therapy for Insomnia (CBT-I for short). Owing to its demonstrated success, CBT-I has been recognized by both the U.S. National Institutes of Health and the American Academy of Sleep Medicine as an approach that can help those with insomnia disorder. If severe insomnia plagues you, you may want to look for a licensed health-care practitioner skilled in this practice. If you have challenges here and there in getting a good night’s sleep, though, trying out some foundational sleep-hygiene principles on your own may do the trick. They may help transform sleep from your adversary into your ally. Here are some core principles of the sleep-hygiene approach.

REVERE SLEEP

See sleep for the exceptional worth and value that it has. Remember how important it is to your physical and emotional health (including your connection to your dreams). Elevate it from being a second-rate citizen of your life, forgoing any inclinations to be a card-carrying member of the “I’ll sleep when I’m dead” club. If you prize it, you will more readily be able to prioritize it.

BEDS ARE FOR SLEEPING, DREAMING, AND SEX

A core sleep-hygiene principle is to only think of your bed as a place for sleeping, dreaming, and sex. We should see our bed as a haven, a place dedicated to these intimate and cherished experiences. If, instead, we view our beds as locations where we can do anything — catch up on social media, chat with our friends, watch television, and engage in other waking-life activities — we’ll weaken the association that it holds with our sleep; this can impede upon our natural ability to drift off into cherished slumber once we’re tucked in. Given that these other activities may be rousing and irritating, it may have us associate our bed as a site of struggle, and therefore a place that we don’t feel at peace.

DON’T TOSS AND TURN IN BED

If we’re beset with a bout of insomnia, sleep-hygiene professionals suggest that we get out of bed and go to another location to engage in a relaxing activity that may lull us back to sleep. The rationale for this is as follows: if you’re tossing and turning, you’ll see your bed as a place of strife, rather than of tranquility. Also, if you do find yourself waking up in the middle of the night, try not to stress about it. Getting agitated may only make it worse, kick-starting a cascade of stress hormones that will further keep you from feeling peaceful.

MAINTAIN A REGULAR SLEEP SCHEDULE

Try to have your bedtime be as consistent as possible, since this will allow your body to get into a regular groove when it comes to knowing when to sleep and when to awaken. To determine this time, calculate how much sleep you need (see here for general guidelines) and at what hour you need to awaken; make sure to also build in extra time to wind down and fall asleep, as well as linger in bed in the morning so that you can connect to your dreams.

AVOID NAPS

If you regularly nap but then find you can’t sleep well, restrain from your midday slumber for a week and see if this is helpful. While napping can be a luxurious experience, it can also impede upon our ability to fall asleep, since it reduces our “sleep pressure” (a biological response that encourages us to do so), keeping us awake past the time we want to doze off.

CREATE A SLEEP-INSPIRING ENVIRONMENT

Make your bedroom a place in which you feel relaxed. Encourage sleep by having the room be around 65°F (18°C), which is suggested to be a slumber-supportive temperature. Have it be as dark as possible at night, while also exposing yourself to lots of bright natural light when you awaken. You can find more suggestions for transforming your bedroom into a sanctuary in chapter 4.

AVOID EATING TOO CLOSE TO BEDTIME

Try to have your last meal hours before you go to sleep, so that your body won’t be busy digesting when you’re trying to power down. Also consider limiting or avoiding slower-to-digest foods — like meats and high-fat fare — at dinner. Additionally, try to steer clear of spicy foods close to bedtime; not only can they possibly cause heartburn, but they also may elevate your body temperature, which goes against the tide of the cooling necessary to promote sleepiness.

Normal Sleep Now Wasn’t Normal Back Then

While we currently define good sleep as getting 7 or so uninterrupted hours, this wasn’t always the case. Before the nineteenth century, segmented sleep was the norm, as documented by researcher A. Roger Ekirch in his book At Day’s Close: Night in Times Past. People would sleep for several hours, called “first sleep,” and then be awake for 1 to 2 hours. Then they would go back to sleep for several hours, called “second sleep.” The span between the two sleep periods was referred to as “the watch,” and was generally a time for reflection, dream-pondering, and sex (and sometimes even gathering with neighbors). So, if you find yourself getting up in the middle of the night for a bit, it may not be as abnormal as you might think. Just adjust your sleep time to accord for it, and enjoy this reflective watch period.

BE DISCERNING WITH BEVERAGES

Since caffeine has an average half-life of 5 hours (the amount of time it takes for 50 percent to be cleared from your body), avoid consuming it after midday. Remember that it’s not only coffee and tea that have caffeine, but chocolate as well. While alcohol may help lull us to sleep, it leads to disruptions in our slumber pattern over the entire night. Finally, stay well hydrated during the day by drinking an adequate supply of water, but limit your intake about an hour before bedtime so you can reduce the chance of disturbing your sleep for a middle-of-the-night sojourn to the bathroom.

EXERCISE, BUT AT CERTAIN TIMES

Regular exercise promotes good sleep when done earlier in the day. Traditional sleep-hygiene recommendations suggest avoiding exercising hours before slumber, given that working out, notably in a high-intensity fashion, stimulates endorphins, as well as the sympathetic nervous system. Recent research differs, though, noting that non-high-impact exercise may not detract from drifting off. Connect to your personal experience to know what’s best for you. If you find yourself challenged to sleep and you exercise in the late afternoon or evening, change up your fitness schedule and see if it makes a difference.

RELAX AND UNWIND

Begin to wind down a couple of hours before bedtime. Do some light stretches, take a bath, read a book that’s inspiring and not agitating, and/or write in your journal. Dimming the lights or using candles a few hours before bedtime not only creates a calming environment but is also a melatonin-enhancing strategy (melatonin is a hormone that helps us slide into sleep).

LIMIT ELECTRONICS

While this one may be challenging in today’s world, try to avoid being online an hour or so before bedtime. This can help limit your access to information that can be triggering or unnerving. Plus, avoiding your devices can curb your exposure to melatonin-depleting light. That said, if you’d rather not opt for a printed book over a digital one, or swap perusing photos on Instagram for those in magazines, make sure your phone, tablet, or computer has a blue-light-blocking screen filter. Or use a pair of blue-light-blocking glasses at night.

Self-Care Practices

There are many self-care practices that can help us to relax, reducing the tension we feel and allowing our nervous system to claim a restored sense of balance. Many of these practices not only have long histories of use, but they have also recently garnered support from the medical community, owing to research that demonstrates their benefits. (There are also a host of natural remedies — including herbs, essential oils, and flower essences — that can help you relax and invite in sleep, details about which you can find in chapter 3.)

MEDITATION AND MINDFULNESS

Numerous studies have found that meditation and mindfulness practices are associated with better sleep and may help people who struggle with insomnia. Why? While the reasons haven’t been fully determined, it’s thought to be related to the greater level of emotional resilience and diminished stress response that they offer. In fact, mindfulness practices have been shown to lower levels of cortisol, which is important because higher levels of this stress hormone have been linked with greater rates of insomnia. Once solely associated with spiritual traditions, there are now popular meditation and mindfulness practices that have a more secular bent.

In mindfulness, we work toward letting go and accepting. We find a way of perceiving that is unattached and equanimous; both our inner judge and the racing mind that often accompanies it become quiet, and we find ourselves filled with more calm and quietude. And with this shift in mental orientation, there is a concomitant adjustment in physiological factors, which seem to include both stress and inflammation reduction. Research has shown that those who are more apt to engage in repetitive thought processing, the experience in which our thinking gets stuck going back over the same notion again and again, have compromised sleep quality. Mindfulness practices help to create concentration and inspire intentional focus, reducing repetitive merry-go-round thinking.

Even if you feel that your busy schedule doesn’t allow you the time for a regular meditation practice, you can still benefit by taking relaxing “mindful time-outs.” For example, Take 5! — by just taking 5 minutes each day to close your eyes and mindfully concentrate on your breath, you’ll have a direct route to experiencing more tranquility and relaxation. You can even do this mini-meditation practice without closing your eyes; for example, when you’re in line at the supermarket, waiting for an elevator, sitting in traffic, or even doing the dishes, pay attention to your breath and see how this begins to ease your mind. You can also inspire inner calm by practicing mindful eating, in which you concentrate without distractions when you enjoy your meals, savoring each bite.

In addition to stillness-oriented meditation, there are mindfulness practices that incorporate movement, which have been found to offer sleep-supportive benefits. These include activities such as hatha yoga, tai chi, and qi gong, all of which have been found to improve sleep quality and/or reduce the severity of insomnia. While yoga may be familiar to many people, for its optimal slumber-supporting benefits, it’s important to connect with your breath when you’re practicing it. Tai chi is a style of martial arts known for its calm and integrated movements. Qi gong is a practice that coordinates breathing and meditative focus with a series of body postures.

How to Meditate

Here’s a simple way to meditate:

1 Maintain a comfortable position. Some people like to sit cross-legged on the floor on a bolster or pillow. Others prefer to sit in a chair. Use any props you need to help your body feel supported. Try to keep your spine as straight as possible. If sitting doesn’t work for you, by all means lie down on the floor, placing a rolled-up towel under your knees if that feels more comfortable.

2 Close your eyes. Breathe naturally and notice your breath. If your mind wanders, just return your attention to your breath. Importantly, don’t judge yourself if your mind starts to chatter and you forget to mind your breath. It’s OK; just return to feeling and observing it.

3 Some people find it helpful to think the word inhale when they breathe in and exhale when they breathe out. Others like to say a mantra or word each time they inhale and exhale. Do what feels best for you.

4 Start off doing this practice for 10 minutes, building up to 20 minutes or more.

BREATHING PRACTICES

Slow and focused breathing techniques have been found to be calming to the central nervous system by enhancing parasympathetic activity, which helps us recover from stress. This calming has transformative value during the day, including helping us to prepare for deeper sleep. This suggestion comes not only from traditional health systems that feature breathwork, but also from modern scientific research. For example, one study found that 20 minutes of slow breathing helped improve sleep: people fell asleep faster, woke up less frequently, and were able to get back to sleep more rapidly if they happened to wake up in the night. And speaking of somnambulist benefits, another study found that diaphragmatic breathing helps to reduce the production of cortisol and promote levels of melatonin. On these pages are two easy-to-do breathwork practices to try. You can do them any time during the day, including right before bed.

The "365" Method

This is an approach that some health-care practitioners recommend for reducing stress and anxiety. Its benefits may extend to better sleep. The 365 signifies:

▪ Do the practice 3 times a day.

▪ Take 6 full breaths each minute: five-second inhales through your nose and five-second exhales through your mouth.

▪ Do this for 5 minutes. (Ideally, do this practice every day.)

The "4-7-8" Method

This technique is thought to be very relaxing, with many people saying that it is helpful in lulling them to sleep. (Since children’s respiration rates are different than those of adults, this sequencing may not work best for them. For a child-friendly breathing practice, see here.) The 4-7-8 signifies:

▪ Inhale through your mouth for 4 counts.

▪ Hold your breath for 7 counts.

▪ Exhale through your mouth for 8 counts.

RELAXATION PRACTICES

In addition to mindfulness and breathing practices, there are a handful of other easy-to-do relaxation practices that may aid you in getting good sleep.

Yoga Nidra

Yoga nidra is a form of guided relaxation practice. Rooted in the yogic tradition, it is a technique that allows you to reach a very deep state of relaxation. It galvanizes a heightened awareness of your inner state, helping you to access a consciousness of quietude that can serve as a bridge to sleep. It does so through numerous mechanisms, including bringing your attention gently and habitually to various parts of the body in a way that allows you to withdraw your attention from them altogether. Research has suggested it has calming properties, able to reduce stress and anxiety. Also known as yogic sleep, it is thought to be helpful for those who struggle with slumber. Resources that can help you practice yoga nidra include online guided meditations or classes that may be offered at your local yoga studio or wellness center.

Hot Baths

Taking a bath about 90 minutes before bedtime may inspire sleep. Not only is the practice itself relaxing, but the warm temperature serves as a soporific signal. While you’ll heat up in the bath, when you get out, your body will work to reduce your core temperature; given that reduced body heat is a prerequisite for the sleep cascade to unfold, this will help you to wind down into slumber. If you don’t have a bathtub, or you’re inclined to reduce your water consumption, opt for a 20-minute footbath instead; studies have shown it to have similar benefits. Make your bath more relaxing by turning off or dimming the lights and using candles. Play gentle music or use a pink noise machine to block out ambient sounds. Add 2 cups (475 ml) of Epsom salts and your favorite essential oils (use ½ cup [120 ml]) of salts if taking a footbath). You can also add some calming fragrance to your environment by using essential oils in an aromatherapy diffuser.

Progressive Muscle Relaxation

This technique, developed in the early twentieth century by physician Edmund Jacobson, is a practice in which you tense and then subsequently relax muscles throughout your body. It has been shown to be of value in treating insomnia. The benefits may come through both the tension release it affords, and how it engages you to focus your mind on something other than the thoughts that are streaming through. Do this relaxation practice in the evening to wind down. The whole process should take about 15 minutes. If you find it challenging to do on your own, look for recordings that will lead you through the process. Or get guidance from a skilled health-care practitioner trained in this method. To do the practice:

1 Lie down in a comfortable position.

2 Starting with your hands, clench them for about 5 seconds, and then relax them for 10 seconds before moving on to doing so in the next part of the body upon which you’re focusing.

3 While different practitioners may suggest a different sequence, one common order is as follows: hands, lower arms, upper arms, shoulders, forehead, eyes and cheeks, mouth and jaw, neck, chest, back, stomach, hips and buttocks, thighs, lower legs, and feet.

Autogenic Training

Autogenic training is a self-guided relaxation technique that involves passive concentration. It was developed in the early twentieth century by psychiatrist Johannes Heinrich Schultz. Several research studies suggest that it not only plays an important role in stress management, but that it can also improve sleep patterns. It has been shown to help people fall asleep quicker and return to sleep more effortlessly should they have mid-sleep awakenings. Do this practice in the evening, as you’re winding down near bedtime. Practitioners teach autogenic training in a sequential manner, having people concentrate on one of the phases for a short stretch of time before adding another. To do this practice, first find a comfortable position, whether sitting or lying down, and then begin to breathe in a rhythmic, even fashion. From there:

1 Focusing on your arms, say to yourself several times that your arms are very heavy, as you notice this sensation. Follow this with saying that you are completely calm.

2 Focusing again on your arms, say to yourself several times that your arms are warm, as you notice this sensation. Follow this with saying that you are completely calm.

3 Continue by focusing on your legs, applying the same approach as you did for your arms in steps 1 and 2.

4 Then focus on your heart, noting to yourself several times that your heartbeat is calm and regular as you notice this sensation. Follow this with saying that you are completely calm.

5 Now focus on your breath, noting to yourself several times that it is calm and regular, as you notice this sensation. Follow this with saying that you are completely calm.

6 Then focus on your abdomen, noting to yourself several times that it is warm, as you notice this sensation. Follow this with saying that you are completely calm.

7 Finally, focus on your forehead, noting to yourself several times that it is cool, as you notice this sensation. Follow this with saying that you are completely calm.