What’s keeping you up at night?

Originally written for LawTalk Magazine published 11 May 2020

If you have trouble with sleep, getting to sleep or getting enough sleep, chances are you’ve ventured into the world of sleep solutions and sleep tracking.  It’s a $432billion global market and like any other aspect of the wellness market, there’s dozens of devices, products and supplements out there purported to help you get a better night’s sleep.

If you want to track your sleep, you can take your pick from a range of smart watches and specific sleep trackers like the Oura Ring or a smart bed or mattress that gives you a score on how well you sleep.  In Europe and the US, you can take yourself off to a gym sleep class, where you can tuck into bed for a 45min nap or you could book an escape to an exotic location for a sleep retreat, like a yoga retreat, except sleeping.

Obsession with sleep, and the tracking of sleep, is on the rise – in 2017 a case report in the Journal of Clinical Sleep Medicine gave it a name.  Like orthorexia, the unhealthy preoccupation with healthy eating, they termed it orthosomnia to describe the phenomena of being so obsessed with getting the perfect sleep, overloading on sleep related information and setting unrealistic expectations of achieving the ideal set of sleep data that it causes anxiety and stress, making some cases of insomnia worse.

Its easy to see why you might start to get fixated with sleep tracking.  If you’re sleep deprived, fatigued and dealing with sleep problems, it seems like a logical first step to get a sleep tracking device or wearable technology to measure what’s going on. But just because you’re now collecting data on our sleep, it doesn’t mean there’s going to be an improvement over time without taking some deliberate actions.

There’s also anecdotal evidence of people who have not had sleep issues in the first place becoming obsessed with the metrics of their wearable technology and developing a perception that because the data isn’t perfect something must be wrong even though they wake up feeling refreshed.

This is not to say that sleep tracking is a bad thing to do and will always lead to obsessive behaviour, it can also be very helpful for identifying recurring patterns of sleep quality and inform better decision making and behavioural changes. For example, you may notice your sleep quality is worse after several glasses of wine and this could help you to make lifestyle adjustments that improve the sleep you get.

Keep in mind that wearable tracking technology do have limitations when it comes to accuracy, their results relying on things like movement and heart rate compared to more specialised sleep tracking equipment that measure brainwaves, eye movement, muscle tension and breathing to extrapolate data.


The Importance of Sleep

Sleep is as critical to us as food or water, and the ideal amount of sleep for each person varies but the US National Sleep Foundation Review in 2015 recommended that most adults generally need between 7 to 9 hours of sleep (although anywhere from 6 to 11 hours could be appropriate).

Aside from sleeping to alleviate tiredness, there’s a whole lot of other reasons why we need good sleep. Sleep affects almost every organ and system in the body – from heart, brain and lung function to metabolism, immune function and mood. It helps to maintain, repair and clean out neural or brain tissue, helping us to learn and create new memories, improving our concentration, productivity and performance.

Without adequate sleep our risk of developing issues like high blood press, cardiovascular disease, diabetes and depression increase.

From a weight loss perspective, sleep deficiency is linked with an increased risk in obesity and it plays out in several ways. A tired brain is more susceptible to bad decision making and low impulse control – it’s easier to give in to more cake, chocolate or wine when fatigued, just as it’s easier to skip that gym session.  Lack of sleep can disrupt hormone balance and influence your drive to eat – it increases ghrelin production (the hormone that makes you feel hungry) and decreases leptin (the hormone that tells you to stop eating because you’re full).  The stress hormone cortisol also rises with lack of sleep, causing more fat storage for energy conservation and within just 4 days of inadequate sleep, insulin sensitivity can drop by more than 30%, increasing diabetes risk and your ability to store fat.


Circadian Rhythm

One of the reasons sleep is disrupted for so many people is that our modern lives are so disconnected with our circadian rhythm. Our circadian rhythm is our body’s internal daily clock that controls almost all the functions in our body – from sleep/wake cycles to metabolic, immune and reproductive systems. All body functions are set to increase and decrease their function at different times through the days and months according to our circadian rhythms.

These rhythms are reset or adjusted each day from a number of cues from outside the body – light being one of the most important.  Sunlight signals to us to be alert and active and darkness encourages sleep with the production of the hormone melatonin.

Lower melatonin levels affect sleep cycles which in turn means we have poor repair and maintenance of the body and brain, lower levels of antioxidants which impacts on cell damage and lower mitochondria function affecting energy levels.

When you consider many of us may spend as much as 90% of our time indoors away from natural sunlight and then conversely spend our nights exposed to blue light from our devices, it becomes clear how our circadian rhythms can be disrupted, impacting  among other things, our sleep/wake cycles. And just because you’re exposed to artificial light during the day in the office, remember that the quality and spectrum of light you’re exposed to is not the same as sunlight – when you don’t have exposure to strong enough light during the day, melatonin production at night is affected.

Other circadian rhythm disrupters are obvious like shift work and long-distance travel or jet lag and late night eating can also have an effect as our bodies are not designed to be digesting food late at night or in the early hours.


Circadian Health Optimisation

We need less focus on generic sleep solutions that simply emphasise getting more sleep and look instead to improve sleep quality (and overall health) by optimising our circadian health, allowing our bodies to find our healthy sleep patterns again. This means paying more attention to the timing and type of light exposure.

If you feel your sleep quality is poor, consider these steps to improve circadian health and improve your sleep quality:

  • Minimise exposure to bright lights and electronic devices at least 2 hours before you go to bed. The blue light emitted from devices disrupts melatonin production so stay away from devices before bedtime, or if that’s not realistic, invest in high quality blue light blocking glasses.
  • Keep the lights in the house dim and use incandescent bulbs.  These have less blue light than halogens, LEDs and fluorescents and is less disruptive to melatonin production.
  • Ensure your bedroom is completely dark to promote optimal melatonin production.
  • Your bedroom is only for sleep. And sex. It is not for work or entertainment.
  • Develop a nighttime routine that allows you to relax and unwind. Try meditation or breathing exercises, reading (preferably from an old-fashioned book with pages or if you’re using an electronic device, wear your blue light blocking glasses) or a warm bath instead of catching up work or brain draining activities.
  • Expose your eyes to the morning sun to promote melatonin production at night.
  • If getting and staying asleep is still a problem, consider sleep restriction therapy which aims to improve your sleep efficiency by limiting the amount of time you allow yourself in bed trying to get to sleep.  As your sleep efficiency improves, the amount of time spent in bed is slowly stretched out.

To improve your sleep, look at how you can have your body more adjusted to the natural light and dark cycles of the day.