The Art and Science of Sleep

Sleep is one of those things that you take for granted until you're not sleeping well.  And, if you're an adult over the age of 30, it may be a few years (or more) since you've "slept like a baby".  In my practice, I see a lot of peri-menopausal and menopausal women, most of whom have experienced some degree of sleep disturbance in the past few years.  And, while some of the information below pertains to these women, much of it can apply to any adult who needs a bit of help getting some zzzz's.The Anatomy of SleepSleep is divided into NREM (Non-Rapid Eye Movement) and REM (Rapid Eye Movement) sleep.  We first enter into stages 1 and 2 of sleep, and then fall into stages 3 and 4 sleep, which are the deepest and most restorative sleep.  REM sleep follows stage 4 and is when most dreaming takes place.

Each complete sleep cycle lasts about 90 to 110 minutes. Most adults will go through about four to six cycles in a full night of sleep.

It's important to know where sleep disturbances take place in the night as it can help pinpoint root causes and direct treatment

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There are a number of factors that can interfere with a good night's sleep - some are more transient than others.The following is on my "quick fix" list when people come to us with sleep concerns.

• Alcohol: While having a drink or two in the evening may help you fall asleep, it interferes with your ability to stay asleep.  More specifically, it impairs your ability to get into the really restful stages 3/4 sleep, and also increases wakefulness through the night.
• Ambient light: Lack of a dark room (think pitch black) can interfere with your ability to fall and stay asleep.  Streetlights, motion sensor lights and even light from an alarm clock can be problematic.  Opt for blackout blinds and turn your alarm clock around.
• Screen Time: Did you know that screens found on smart phones, tablets and even e-readers emit a wavelength of light that interferes with melatonin production?  You can read more about this "blue light" phenomenon here, but in the meantime limit screen time for at least 3 hours before bed.

And, when the above don't solve the problem, we focus on the following:

• Hormonal Balance: Shifts in estrogen and progesterone can alter our ability to get a good night's sleep.  Hot flashes and night sweats are particularly bothersome and make it difficult to transition from one sleep cycle to the next.
• Elevated Cortisol: Do you wake every night between 2-3 am?  Have difficulty falling asleep?  Wake hungry?  Elevated cortisol may be at the root of your insomnia. Getting to the root cause is essential!
• Melatonin: While cortisol may also be implicated here, melatonin levels may also need to be addressed. As noted above, screen time can suppress melatonin production which greatly impacts sleep.
• Diet: Aside form caffeine and alcohol (two common culprits), food choices (especially timing of meals) can affect sleep quality.

Sleep is critical to our well-being and long-term health.  Numerous studies have implicated sleep deprivation in the development of several chronic illnesses. And, while prescription sleep medications may help you get to sleep, they have a negative impact on the quality of your sleep so you may not wake rested.Sweet dreams!