Dr. Ashley Riskin BSc, MD, CCFPFunctional Medicine, Sleep

Tips To Get Better Sleep
A lack of quality sleep is linked to nearly all major diseases of aging—heart disease, obesity, dementia, diabetes, and cancer. As doctors, we place a heavy focus on attaining deep, restorative sleep. In fact, it’s non-negotiable.

Humans are creatures of cycles and it is important to en- sure our bodies know when it is daytime. I advocate for getting outside and being exposed to bright light in the morning each day. This signals to the photoreceptors in our skin and eyes that it is time to wake up. Conversely, we need to remove bright lights in the evening and we support decreasing blue light (i.e., phones, screens, light bulbs) several hours before bedtime. This helps your body recognize when it’s time to boost melatonin—the sleep hormone. Consider using red light bulbs in the evening; enabling the ‘night mode’ on your devices; and wearing blue blocker glasses.

Your bedroom
Make your bedroom a place for sleep and romance, but not for work or TV. Humans are complex by design, but still creatures of habit. If your body gets used to screen time or work in bed, then it will associate that pillow with an awake brain. Resist that urge and commit to making the bedroom a sleep sanctuary.

• Your body needs a dark room. Get it as dark as possible with shades. Or use eye shades.
• Consider a HEPA filter to keep air clean, especially if you have allergies.
• Remove electronics and cell phones from your immediate vicinity.

Make sleep a ritual
We often take for granted that the body and mind need to transition from day to night. We can’t expect to sit on a computer stressing over emails, then simply walk away and hop into bed without any adverse impact on our sleep. Consider treating yourself to a sleep ceremony of sorts, so you can wind down and untangle prior to hitting the pillow.

• Disconnect from work and stop checking social media a few hours before bed.
• Plan to incorporate time for you before bed—a good book or 10 to 15 minutes to practice some stretching, mindfulness, or journaling.

In the morning, allow yourself 30 to 60 minutes of time to start the day on your terms. Don’t go straight to the phone or email. It turns out that the stress response caused by these devices is training our bodies to expect to wake up to stress. Your body could learn to ‘lighten’ the last bit of sleep to prepare for this learned expectation.

Caffeine, supplements and drugs
Sleep aids can be helpful but should not be used as a strategy to overcome poor sleep habits.

• Caffeine: the half-life of caffeine for most of us is about 5 hours. This means that after 15 hours, there is still 25% of the caffeine you consumed in your system; that morning coffee might still be impactful at bedtime.
• Magnesium: involved with hundreds of metabolic path- ways and our diets tend to be low on magnesium. Magnesium at bedtime can have a calming effected on the nervous system and it is generally very safe.
• Melatonin: a potent antioxidant and sleep hormone. This can be helpful to reset the circadian rhythm and promote sleep.
• Progesterone: when taken orally and in the right set- ting, this hormone can enhance the quality of sleep.
• Trazodone: when a medication is warranted, we con- sider this one as it preserves sleep ‘architecture,’ which means the body still gets the benefits of restorative sleep, unlike some of the other sleep medications on the market.

Finally, talk to your doctor if your sleep symptoms persist. It is important to rule out any sleep disorders including sleep apnea.

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