For those that struggle with insomnia (or even with milder forms of “I just can’t sleep”), the list of solutions is slim and even dangerous. The most popular treatments are sleeping pills, but the negative impacts of sleeping pills don’t seem to have been widely publicized.
Currently, sleeping pills do not have the ability to naturally imitate sleep. Instead, they more closely resemble a sedative rather than mimicking natural sleep patterns. Put more simply: when people use sleeping pills, they aren’t getting any of the necessary restorative benefits of sleep. And to go one step further: sleeping pills are tied with earlier death across the board.
So where does that leave a bleary-eyed sleeper in the middle of the night, lying awake, tossing and turning?
This is where cognitive behavioral therapy for insomnia (or CBT-I) comes into the picture.* Right now, it’s being used in medical communities around the country as the front-line treatment plan for insomnia. The best part? No pills necessary.
How does CBT-I work? Well, it’s a collection of behavioral principles for better sleep health, and it’s also built on your body’s remarkable ability to form associations. You want to make your bed a place that you (and your body) associates calm, rest, and sleep rather than middle-of-the-night mind racing. Here’s the short list:
1. Go to bed and wake up at a consistent time.
Your circadian rhythm loves consistency. The more you can get your body into a wake/sleep consistent habit (within an hour, even on weekends), the easier it will be to feel tired when it’s bedtime and alert when it’s morning.
2. Go to bed only when sleepy.
Many insomniacs have trouble falling asleep, which becomes a downward spiral of sleepiness. Although the principle of delaying bedtime until sleepy seems counterintuitive at first, the reason behind this one is simple and goes back to association. If your body isn’t tired when you go to bed, you’re missing out on that clear signal that tired equals bedtime. This principle also uses sleep pressure to its advantage, so the longer you stay awake the stronger your urge for tiredness. We need that sleep pressure to build a bit so you’re body is actually tired when you go to bed and sometimes that might take sleeping a little less than recommended to start.
3. Get out of bed if you can’t sleep.
If you are lying in bed and your mind starts racing, it’s best to get out of bed. Again: you don’t want to associate your bed with stress. Go to a different room (dim lights, no screens) and do something relaxing like read a book, meditate, or listen to music until you find yourself getting sleepy (at which point, return to bed).
4. “Mentally decelerate” before bed.
Give yourself 30-60 minutes to wind down at the end of the day. Take up a bedtime routine and do everything in the same order each day. The best mental deceleration doesn’t involve TV, reading the news, or scrolling through social media (as these are all very brain-stimulating activities). Do try listening to calming music, journaling, reading books, or even just catching up on the day with your partner.
5. Remove visible clock faces from bedroom.
This one might seem a little odd, but the idea behind it is that you want to avoid the feeling of waking up in the middle of the night and looking at the clock, which just adds stress to the fact that you can’t sleep.
Next time you find yourself in a period of stress and have a few nights of angsty wakeups, try a few of these principles as an all-natural return to better sleep.
*We are not attempting to diagnose or treat insomnia. If you feel you or a family member is struggling with insomnia, visit your health care provider.
It’s probably the most widely used sleep supplement available, and at about five bucks for a month’s supply, it’s our pick for cheapest. But tales of overuse and unusual side effects make melatonin a not-so-straightforward choice. Here, we’ll clear up a few things—plus share some lesser-known facts about this ubiquitous sleep remedy.
It doesn’t just come in pill form.
Melatonin can be taken in tablets, capsules, liquid, and even in patches that transfer the hormone via your skin.
And you can get melatonin from your food.
Few foods actually contain melatonin, but tart cherries (especially Montmorency cherries) are a surprisingly good source of the stuff, and a few studies have confirmed its presence in grains like wheat, barley, and oats. (Some people even bake it into cakes and sell them as relaxation aids!)
While they might not actually contain melatonin, there’s also evidence that bananas and (to a much lesser extent) oranges and pineapples can lead to increased serum melatonin levels. And given that bananas are also packed with potassium and magnesium, two natural muscle relaxants, this makes ‘em a great bedtime snack!
But the most important way to control your melatonin is light.
Everything from your brain activity to your exercise performance is influenced by your circadian rhythm, an internal clock that responds predominantly to light and darkness, and your melatonin production is no different.
Want your body to keep this sleep-inducing hormone low during the day and high as you approach bedtime? Use a dimmer switch and table lamps as your day winds down, invest in some blackout curtains to keep your room, well, blacked out, and try to prevent your phone, digital clock, and other electronics from illuminating the darkness.
It’s not just used for better sleep.
Melatonin is actually an antioxidant, (and a pretty powerful one at that), so it protects against free radicals that can cause cancer, stroke, and heart disease. A July 2015 study in theJournal of Pineal Research, for example, concluded that melatonin may be an effective way to prevent various forms of heart dysfunction. It’s also been shown to be a really effective supplement for people undergoing chemotherapy. In some cases, it’s led to substantial improvements in tumor remission, alleviation of chemo side effects, and even overall survival rates.
It can have some funky side effects.
It’s a sleeping pill, but drowsiness isn’t the only side effect. Among some people it can lower body temperature, alter blood pressure, decrease libido, or induce stomach cramps.
And then there are the widespread reports that it gives you vivid, crazy dreams. Which is just another reason why…
You really shouldn’t take it without talking to a doctor.
It’s freely available over-the-counter, but melatonin may cause harm in combination with certain medications. Antidepressants and sedatives in particular appear to interact negatively with the drug, but even the common birth control pill affects the body’s production of melatonin and might give your system a surplus when used in combination. Diabetes meds, blood-thinners, and medications that suppress the immune system (common for folks on the receiving end of organ transplants) can also make cavalier melatonin dosing a very bad idea.
Unless you’re perfectly healthy and don’t use any medications, talk to your doctor before popping pills. And if you do decide to experiment with melatonin, start slow: begin with a dosage of 0.5 milligrams and gradually increase it until you find what works for you.
Insulin is the kind of word that everyone has heard and few people understand, but it’s critically important for everybody on Earth. Insulin affects how well your body absorbs nutrients, how it processes carbohydrates, and plays a major role in your body fat—both how much you have and how easily you can lose it. Since your body fat has a real effect on your inflammation and risk of chronic disease, how you manage your insulin is significant not only with regard to your diabetes risk, but the quality and length of your life.
And yes, sleep has an enormous impact on your insulin.
First, let’s get clear on the basics of insulin. Whenever we eat carbs (and a little bit when we eat protein), the pancreas releases insulin, which is a hormone that helps us move the sugars out of our bloodstream and into our muscles and organs where they can later be used for energy. Essentially, carbs give you energy, and insulin is what helps move the energy from your food into your own energy stores.
But what really matters when it comes down to diabetes and overall health is a factor called insulin sensitivity, which measures how well your body responds to the hormone.
See, your insulin spikes when you consume carbs, and it really spikes when you eat a source of carbohydrates without much fat, fiber, or protein to slow the digestion—candy, Oreos, and orange juice are great examples of foods that send your insulin soaring. If you eat sugary junk very frequently, you’ll spike your insulin so often that your body becomes less sensitive to it, sort of in the same way that drinking coffee every morning makes you more resistant to its effects.
If you have poor insulin sensitivity (also known as insulin resistance), you do a less efficient job of digesting carbohydrates, and carbs are a lot more likely to make you gain fat. And as you become more and more insulin resistant, the pancreas needs to produce more and more insulin to do its job, until it eventually gets worn out and stops being able to produce the hormone properly. That’s when type 2 diabetes is diagnosed.
So whether you have a family history of diabetes, or you just want to see your six-pack, your insulin resistance is something you want to keep an eye on. You might have picked up on the fact that maintaining a diet that’s low in sugar and high in fiber, protein, and healthy fats is a good start. But there are a lot of ways to improve your insulin sensitivity that have nothing to do with diet: Regular exercise, for example, is a well-known remedy. And one of the simplest and most effective ways to boost your sensitivity, slash your diabetes risk, and improve your body fat, is to simply close your eyes and go to sleep.
A 2012 study received widespread media attention when it found that sleep deprivation actually impairs the ability of fat cells to respond to insulin. Seven young men and women were studied for eight days, and were only permitted 4.5 hours of sleep per night during the second half of the experiment. At its conclusion, the participants’ insulin sensitivity was, on average, 16 percent lower than it had been at its beginning, and the sensitivity of their fat cells had decreased by thirty percent, leaving them at the same levels usually seen in people who are obese or have diabetes. The fat cells needed three times the regular amount of insulin in order to activate an enzyme called Akt, which is essential for regulating blood sugar—this was the first study to find the specific cellular mechanism that connects a lack of sleep with a higher diabetes risk.
The senior author of the study told CNN, “This is the equivalent of metabolically aging someone 10 to 20 years just from four nights of partial sleep restriction… fat cells need sleep, and when they don’t get enough sleep, they become metabolically groggy.”
To make matters worse, a lot of the diabetes markers exacerbate each other as well: eating a lot of sugar can increase urination, which can interfere with sleep, which can also make you more prone to mindless snacking and higher levels of body fat, all of which is a perfect storm for insulin resistance and a ticket to type 2 diabetes.
Fortunately, reversing the trend is also synergistic: eat plenty of protein, fiber, and good fats, exercise regularly, sleep deeply, and you’ll create the best possible environment for insulin sensitivity, longevity, and a healthy, powerful body.
It’s an unfortunate but nearly universal fact that as we age, we become a little less…um…what’s the word we’re looking for… quick. Or, as our slowed synapses might have it, the brain don’t work so good no more. This is nothing to get down on yourself for—deficits in cognitive performance are a universal consequence of the aging process. It can start from as early as 45 years old, and its myriad forms—cognitive decline, dementia, Alzheimer’s disease—stem from the same basic condition: age. Like your skin and your bones, your brain gradually becomes weaker over time, and things like learning new skills, retaining memories, and using language become more and more difficult. For most, it usually happens so slowly that it’s hard to notice that anything is happening at all.
So is there anything you can do to halt, or at least slow down, this process? For those of us already in the age group most likely to suffer from dementia and mental decline—65 years and older—a variety of methods may help slow the onset, including managing blood sugar levels, staying physically active, consuming a lot of antioxidants (berries are a brain favorite), and keeping the brain challenged with activities like crossword puzzles, ongoing study, and meditation.
But an ounce of prevention is worth a pound of cure. What can be done to reduce the risk of cognitive decline? How can we stop it before it’s begun? The tactics above are certainly useful, but there’s an undervalued factor that’s as simple and effortless as closing your eyes.
Oh yeah, we’re talking about sleep.
You probably already know that when you’re tired, your mind moves a little more slowly than usual, and science has proven this from every angle. Sleep deprivation severely diminishes your ability to learn and retain information, all while decimating your coordination and reaction time to boot.
What’s really troubling is that these problems compound over the long term. One day of low sleep will disrupt a litany of hormonal reactions that your body needs for optimal function. Fortunately, catching up on those lost Zs with some better sleep will more or less right the wrong—the body is nothing if not good at bouncing back.
But what happens if the body isn’t given the time it needs to recover? What if one day of bad sleep is followed by another, and another? A 2014 study in the American Academy of Sleep Medicine sought to answer that question by looking at 2,822 men with a mean age of 76 years. After using a wrist actigraph to study their sleeping habits over an average period of three and a half years, they found that fragmented sleep resulted in a 40 to 50 percent increase in the odds of clinically significant cognitive decline. This is such a severe increase that the study authors equated it with adding on five years of age. They also noted that cognitive impairment is actually increasing in the elderly, making it all the more important to nail down its causes.
Sleep (or lack thereof) is a pretty darn big one, and other studies have found plenty of reasons why. Sleep apnea, for instance, disturbs sleep quality and can result in less oxygen reaching the brain, and a 20-year study of Californian women found that women with problematic sleep were almost twice as likely to experience dementia or cognitive impairment. Other research has found that fragmented sleep, whatever its cause, results in an overall reduction in slow wave sleep, which is crucial for normalizing cortisol and inflammation, which can both lead to mental decline.
In the end, sleep isn’t just important; it’s a pillar of a healthy lifestyle, equally as crucial as diet, exercise, and mental health. Indeed, it has a profound effect on all three. While six pack abs may be impossible to maintain in a nursing home, cognitive function is—especially if you start sleeping better tonight.