Monday, September 20, 2010

Maintaining a Healthy Circadian Rhythm



Whether you're suffering from a circadian rhythm sleep disorder or your sleep problems are affecting your circadian rhythm, here are some effective sleep tips you can use to strengthen your sleep and circadian rhythm:

Sleep Tips

Regular Routine. Getting up and going to bed around the same time, even on weekends, is the most important thing you can do to establish good sleep habits. Waking and sleeping at set times reinforces a consistent sleep rhythm and reminds the brain when to release sleep and wake hormones, and more importantly, when not to.

Prepare for bed. It's important to understand that your body can't immediately switch from 'Drive' to 'Park.' You need time to slowly shift into sleep. Your bedtime preparation should include activities such as dimming the lights an hour or more before going to bed, taking a warm bath, listening to calming music, relaxation exercises, and lowering the bedroom temperature (60° - 68° is optimal). Just as you would clean a cluttered room, put things away (mentally and physically) that will distract you from going to sleep. Our bodies need time to produce enough sleep neurotransmitters to allow you to sleep, and lowering ambient temperature sends a feedback signal to the brain's sleep center, the Suprachiasmatic Nucleus or body clock, that it is night time, and that it needs to release more sleep hormones.

Don't use the bedroom for anything but sleep (and intimacy). Like Pavlov's dogs, we can unwittingly condition ourselves to not be able to sleep in the bedroom. If you find you can't fall asleep within an hour, get up and get out of the bedroom. Read a book or do some other calming activity for another 1 -1½ hours before trying to sleep again. If you can't fall asleep within the first hour, you most likely won't be able to for at least 1 -1½ hours (see ' sleep gates '), and staying in bed only causes stress over not sleeping.

Use the mood tracker. Often we can't sleep because of something we just ate that causes an allergic reaction or acid reflux. We usually don't know about the many behaviors, activities or substances can break our sleep cycle, but the mood tracker is perfect for ferreting them out.

Avoid harmful substances. This seems obvious, but many of the things we eat or drink can have sleep inhibitors in them. For example, caffeine even in small doses blocks sleep neurotransmitters. If you have a problem with sleep, cut out morning coffee and any caffeinated beverages. Alcohol has an initial sleep inducing, barbiturate effect, but also causes frequent and early awakening. Alcohol interacts with GABA receptors, blocking the brain's oxygen sensors, cutting oxygen and complicating sleep conditions, particularly for sleep apnea . Tobacco acts as a stimulant and blocks sleep neurotransmitters. Many medications, such as antihistamines, diuretics, antipsychotics and antidepressants also cause sleeplessness. If you're taking any necessary medication that interrupts your sleep, talk with your doctor about an alternative.

Review the guidelines for eliminating stress. Aside from physical problems, stress may be the number one cause of sleep disorders. Temporary stress can lead to chronic insomnia and circadian rhythm sleep disorders. The good news is that talk therapy and self-help tips are very effective for reducing stress. Take a look at the 'Sleep & Stress' section in this web page for more information.

Wake up right. Sleep researchers at the Mayo Clinic believe if you need an alarm clock to wake you up, you're not sleeping right. According to Mayo, almost all Americans need an alarm clock, and almost half cannot wake up on time with out one. Alarm clocks interrupt the sleep cycle and keep sleep from completing naturally, pushing sleep problems into succeeding days. Dawn simulation devices are much more effective at establishing a healthy sleep cycle and gently rousing you from sleep.

Don't nap! In general, short naps may not hurt sleep, but they can affect fragile circadian rhythms. Napping during the day can damage a good sleep rhythm and keep you from enjoying a full sleep at night. If you suffer from insomnia, the best thing to do is keep from napping during the day. If naps are absolutely necessary, make sure you only nap once a day and keep it under ½ hour.

Exercise. Exercise is one of the best defenses against insomnia. Exercise increases the amplitude of daily rhythms and tells the body to promote deeper sleep cycles to help replenish the muscle tissues from daily physical exertion. Aerobic and anaerobic exercise seem to work as well. Some sleep experts feel that exercise too close to bedtime can disrupt the sleep cycle. However tests have shown that exercise, even at night had a positive influence on sleep. The best time to exercise is 4 - 6 hours before bedtime, but studies also show that people are more likely to stick to a routine if they exercise first thing in the morning.
Increase your light and dark signals. Your brain's sleep control center, the Suprachaismatic Nucleus or body clock, uses signals to tell when it's morning or night. According to these signals, it produces certain amounts of sleep or active hormones. If you don't get very bright light like sunshine first thing in the morning, your body clock probably isn't working right. If you don't get dark signals in the evening and keep your room very dark at night, your body clock won't produce a full amount of sleep hormones at night. If you can't get bright sunshine in the morning, consider getting a specialized bright light box.

Take a Sleep Self Assessment Test. One quarter of all sleep problems are circadian rhythm disorders where the body clock isn't functioning properly and so isn't sending out the right sleep signals at night. Most other sleep disruptions also affect circadian rhythms, which in turn compound the sleep problem. A sleep assessment test can tell you whether you have a circadian rhythm sleep problem, and it develops a treatment schedule for optimal recovery.

Try to avoid sleeping pills, herbal remedies and melatonin. In transient insomnia cases, these aids can provide temporary relief. However, longer term use is still problematic in chronic insomnia. It is unlikely that melatonin can help in some insomnia cases, but it is best to work with a physician when taking melatonin for more than a week at a time. Over the counter sleeping aids such as antihistamines can provide some relief and are not addicting. Some prescription sleeping pills can be very addictive and should not be taken for more than two weeks without seeing your doctor. Long-term sleep studies show that sleeping pills do not improve duration of sleep, and more importantly, they do not improve daytime functioning.

See your sleep specialist. If you have tried everything else, now it is time to visit the doctor. You may have a sleeping disorder that is resulting from a physical problem such as diabetes, Restless Leg Syndrome or Sleep Apnea. In addition many emotional problems such as anxiety, depression, bipolar disorders, etc, will disrupt sleep. If a physical or mood problem has been ruled out, your doctor should recommend a competent sleep therapist who can help with cognitive behavioral therapy (CBT) or talk therapy. Specialists are very good at helping people talk through their problems that may be keeping them from getting a good night's sleep.

Maintaining a Healthy Circadian Rhythm

Circadian rhythms are intimately involved with sleep and energy, and the things we do on a daily basis either help or hurt our rhythms. Consistent sleep/wake schedules, strong morning light and dark evenings and nights reinforce healthy rhythms. On the other hand, innocent late night parties or studying can levy a toll we don't recognize until we can't sleep a few days later.

When circadian rhythm disorders develop, they can cause more problems than just insomnia. An out of sync rhythm is an indication that hormone production is also out of balance. When these hormones are in the system at the wrong time, they cause sleep/energy and mood problems. In addition to low daytime serotonin, melatonin has been linked with depression, and out of phase cortisol is an indicator of sleep problems. This is one reason why sleep labs monitor cortisol and other hormone levels. Because cortisol is also a stress induced hormone, the body can produce cortisol at the wrong time of day, further complicating sleep problems and throwing off circadian rhythms.
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