SLEEP
Sleep? Hold on, Dr. Dan. I came here to learn about food and human nutrition. What does sleep have to do with that?"
Sleep is an essential part of human nutrition. I start with sleep because it is that important. Without adequate sleep, good nutrition is impossible. The human body needs sleep to recover and repair itself, develop a healthy gut microbiome, and produce hormones that enable cells to function properly. Good sleep is fundamental to good health! This point cannot be stressed enough. If you don’t prioritize sleep, you can disregard everything else I write about. You read that correctly. Don’t bother changing anything else if you don’t optimize your sleep. Want another benefit? Good sleep improves our GLP-1 response. It’s nature’s weight-loss drug!
Good sleep will help you lose weight. Good sleep helps control anxiety. Good sleep adds years to your life! All of this is true. However, society often views sleep as “optional” or as something only weak people need. Working long hours is admired and encouraged. In reality, sleep deprivation directly contributes to mental and physical illness and causes more highway deaths than drinking and drugs combined. Inadequate sleep causes a significant number of workplace errors, including medical errors by my sleep-deprived colleagues. Instead of asking your surgeon where they went to medical school, ask how many hours of sleep they got last night. If you do one thing for your health, make it sleep.
Poor sleep, defined as getting less than six hours per night, makes losing body fat impossible. Restricting calories while getting poor sleep will cause you to lose muscle mass and worsen your health. Poor sleep contributes to poor eating habits by creating the urge to eat more, also known as “the munchies.” It also disrupts hormone balance, making it difficult to gain muscle and strength. This may make it seem like your exercise program isn’t working, but it’s actually your body’s inability to respond due to a lack of nutrition. Poor sleep disrupts the healthy gut microbiome, creating cravings for unhealthy foods. Poor sleep can lead to a poor diet. Sleeping less than five hours is equivalent to being legally intoxicated. The goal is seven to eight hours per night, but no more than nine. Beyond nine hours, the benefits of sleep decrease.
Good sleep starts here
Sleep experts suggest the following:
1. Create and stick to a sleep schedule.
First, determine your sleep chronotype. Our circadian body clocks are hardwired into our DNA and cannot be changed. We function best when our sleep schedule aligns with our circadian rhythm. Which of the following feels most natural to you? Do you prefer to go to sleep early, in the middle of the evening, or late? About 30-40% of the population naturally falls asleep a few hours past 9 p.m., so there's nothing wrong with you. Your body clock likely works from 11 p.m. to about 9 a.m., which is typical for teenagers. Some adults are hardwired this way, and it's best to honor that. Most people have a body clock that works from 9 p.m. to 6 a.m., so honor that, too.
2. Control your light exposure.
Early morning sun promotes an early bedtime (9 p.m.), while afternoon sun promotes a later one. In his book Why We Sleep, Dr. Matthew Walker suggests that those who tend to stay up late wear blue-blocking sunglasses in the morning and allow full sun exposure in the afternoon. Regardless of your bedtime, dim the lights 2-3 hours before going to sleep. If possible, switch to a warmer color temperature. Dr. Andrew Huberman and Roka have partnered to create Wind Down glasses that block blue light. I’m going to try them before recommending them.
3. Abandon the electronics!
Blue light, which can be adjusted through apps and settings, is not the only factor. Brain stimulation has also been shown to interfere with sleep. You should stop using electronics one to two hours before bedtime. No TV. No computers. No cell phones. No tablets. Imagine it's 1965, and all three TV channels have signed off for the evening. This is not optional. These devices activate the parts of the brain needed for alertness, not sleep.
4. Mentally and physically prepare for sleep.
What should you do if you follow the third step above? Now is a great time for gentle range-of-motion exercises, which I’ll discuss later. Meditation and reading a book are also great ideas. Yes, those paper things with words on them.
5. No alcohol or sleeping pills.
Both alcohol and sleeping pills are sedatives. They make you feel sedated and less alert. They both interfere with important components of sleep, especially REM sleep. This results in feeling worse the next morning, perpetuating the need for the sleep aid in the first place. If you are taking a prescription sleep aid, such as zolpidem (Ambien®) or eszopiclone (Lunesta®), please consult your doctor before stopping. These medications require careful withdrawal management.
6. Control your food intake.
When you enter a deep sleep, your brain circulates blood and spinal fluid. First, blood is moved out, and spinal fluid is moved in. Then, it reverses the process. It's sort of like a washing machine cycle. This process occurs most effectively during deep sleep, typically within the first few hours of sleep. However, when we eat a large meal, our bodies are busy digesting, which makes deep sleep less likely. The surges in glucose, insulin, and cortisol are unhelpful. It is best not to eat for at least three hours before going to bed. Eating before bedtime can also contribute to gastroesophageal reflux disease (GERD), which can disrupt sleep.
7. Control your liquids.
It's a good idea to avoid drinking liquids with food. This allows the bladder to empty, which reduces the need to get up at night. This becomes more difficult as we age because the bladder becomes less tolerant. It is also challenging because a low-insulin diet causes the body to release fluid. Start your day with plenty of water, then reduce your intake as evening approaches. You can find more information about this in the Water section.
8. Have a comfortable sleeping bed
There are many different types of pillows, mattresses, and sheets. You need to experiment with each one. Do you prefer a soft, medium, or firm pillow? Low, medium, or high? Some pillows are adjustable. The same goes for mattresses. Would you prefer soft, medium, or firm? Memory foam or springs? Sheets come in cotton, bamboo, silk, and more. They can be silky smooth or textured, like percale. Have you ever slept at a hotel and loved the setup? Ask them what they use. Sometimes they sell their bed sets. Keep trying until you find the perfect combination.
9. The dark, cool room.
Black out the windows. Turn off the lights. Remove all clocks. Nothing distracting. White noise, such as that produced by an air filtration unit, can help drown out traffic and other outside noises. Consider using a sleep mask if you cannot block out the light.
10. Control your body temperature.
As you turn down the lights, slowly lower the thermostat as well. Your body temperature needs to decrease for you to fall asleep. Taking a hot shower or soaking in an Epsom salt bath right before bed can temporarily raise your body temperature, helping you transition to the cooler bed. Some people also find that alternating between hot and cold showers helps them transition to sleep. Take a normal shower before bed, then turn the water all the way cold for one minute before getting out.
11. Watch your caffeine.
We love coffee! There's no doubt that caffeine is the world's most popular drug. It's exceptionally good at temporarily blocking the sleep hormone adenosine. Caffeine keeps us alert while it's active. Caffeine also remains active in the body for a relatively long time. The two cups of coffee you had at 8 a.m. today will still contain about 25 milligrams of caffeine at 9 p.m.—about one-fifth of a cup of coffee, or the equivalent of a 5 p.m. espresso shot. Some people process caffeine quickly and can drink coffee in the afternoon. However, most of us should limit our consumption to one or two cups before 8 a.m. If we want to sleep well, it's best to drink coffee earlier in the day. Decaffeinated coffee contains much less caffeine: 15–30 mg versus 100–120 mg for regular coffee. Try drinking only decaf for a day to see if your sleep improves.
12. Optional supplements.
Magnesium glycinate or bisglycinate is a good nutritional supplement that can help you sleep. Taking 400 mg one hour before bedtime is reasonable. It can also help prevent nocturnal muscle cramps. Some people find magnesium L-threonate to be more relaxing than magnesium glycinate. One study found that it improves sleep quality. (Hausenblas et al., "Magnesium-L-threonate Improves Sleep Quality and Daytime Functioning in Adults with Self-Reported Sleep Problems: A Randomized Controlled Trial." Sleep Med X, August 2024). Magnesium supplementation is very safe, even at one gram per day, but it is best spread out throughout the day. For example, take 200 mg in the morning, 200 mg at midday, and 400 mg at bedtime.
13. Extra credit- sleep tracking.
As a tech nerd who loves data and gadgets, I had to try the Sleep Cycle app, which tracks sleep. I like it and use it every night. It also records snoring, which can be used to monitor sleep apnea. I added an Oura Ring® Gen3 to track my sleep in a different way. The app and the ring track sleep differently and provide additional insights. There are other devices as well. Regardless of how you choose to track your sleep, it's a good idea. The first thing I noticed was how poorly I was sleeping. This motivated me to take action and improve my sleep. Tracking your sleep is an effective way to improve it. We can’t fix a problem if we don't know it exists.
14. Prescription Medications.
Talk to your doctor if you think one or more of your medications is affecting your sleep. There may be different times or ways to take them, or you may be able to switch to different medications. Never change your medications without consulting the prescribing physician. Seriously, do not change your medications without your doctor's knowledge. Do not stop taking your medication, reduce the dose, or increase the dose without consulting your doctor. This must be done in cooperation with your doctor.