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MORNING HOURS of sleep can provide some people the best and deepest sleep of the night—music to the ears of those who relish morning snoozing—maybe because for them, natural (waking with no alarm clock) sleep includes more and longer “sleep cycles.” People generally need four to six sleep cycles, which last from about 90 minutes to two hours, during which sleep quality moves from very light to very deep, followed by REM sleep during which dreams are likely.
Adding minutes with the snooze button provides “crappy sleep,” according to Michael Breus, PhD, sleep expert for Web MD and in private practice in Los Angeles. Breus suggests setting an alarm for the last possible moment so there’s no temptation to go back to sleep; and when it goes off, sit up and breathe deeply to “orient yourself to the real world.”
Up to one-third of people living in industrialize countries suffer from “poor sleep.” Those for whom medical and behavioral solutions have proven unsatisfactory are generally advised, first, to pay attention to the length of their natural sleep time over a period of days. Then, in order to get more deep sleep, go to bed later and sleep later in the morning. The recommendations also apply to those struggling with restless legs, which can be triggered by sleep deprivation.
Restless Leg Syndrome (RLS) affects approximately 10% of the population and is one of the most prevalent neurological disorders in Europe and North America, with women being afflicted almost twice as often as men. Though the cause is unknown, nearly half of sufferers have a family member with the condition, suggesting a genetic explanation. Some are helped by medication; others by the FDA-approved Relaxis vibrating pad.
For all troubled sleepers, weighted blankets have recently become popular. Swedish researchers at the University of Gothenberg found blankets weighing more than 10% of a person’s body weight “provided beneficial, calming effects.” Of 31 healthy participants who completed the protocol, most chose the 8 kg (about 17½ pounds) chain-weighted blanket, and all experienced better sleep as measured both objectively and subjectively.
Chain-weighted blankets cost upwards of $1,200. Alternatives for lower cost (at Brookstone and on Amazon ranging from $100 to $200) and weight, starting at around 12 pounds, have beneficial effects, at least anecdotally. The Brookstone model, often available on sale, has been criticized for having a strong odor right out of the box but this dissipates once aired out.
Other sleep-improving suggestions include warm baths before bed; heating pads or ice packs—because a change in temperature can be soothing; and releasing tension with slow deep breaths, dim lights and soothing music.
Then there’s what to reduce or avoid: alcohol and cigarettes, and caffeine—with effects lasting up to 12 hours. Too close to bedtime, avoid electronic devices like computers and TVs; and exercise—although getting more during the day can improve sleep. During long periods of sitting—at work, on airplanes, even during long movies and lectures—try to walk around.
Also, pay attention to medication: iron supplements can help by increasing dopamine levels, while some anti-depressants as well as antihistamines have been linked to RLS and other sleep issues, although many OTC sleep aids contain antihistamines.
Melatonin can not only help with sleep but might be useful in long-term brain health. Among the array of prescription sleep drugs, some are targeted to help with falling asleep and others, for staying asleep. In the first category, the most popular is zolpidem or Ambien, though taking it can lead to both tolerance, meaning the drug no longer works, and dependence—so that without the pills, it becomes difficult to sleep at all. The new oral spray, Zolpimist, might help with short-term treatment.
Ambien and Lunesta are long lasting and, when there isn’t time to sleep for seven or eight hours, can cause grogginess the next day—as can the benzodiazepines, and these also risk dependence. Sonata, a newer medication, stays active in the body for the shortest period—meaning you can try falling asleep on your own, and then, if unsuccessful, take Sonata in the early morning hours.
Finally, less appealing behavioral measures to improve sleep suggested by MedicalNewsToday include “Stimulus control therapy—only go to bed when sleepy. Avoid watching TV, reading, eating or worrying in bed.” Also the more challenging: “Sleep restriction—decrease the time spent in bed and partially deprive the body of sleep, this increases tiredness ready for the next night.”
In personal experience, both anxiety and sleep have improved for one family member using a weighted blanket, and for another after a course of Mindfulness-Based Stress Reduction.
—Mary Carpenter
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What is recommended to STAY asleep?