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8 February 2019

4 Ways To Improve Your Sleep

by Ian McCarthy 0

Ah, sleep, the one activity we all know to be extremely important yet seemingly universally neglect in order to sustain our hectic schedules. Speaking from my own experience, I’ve struggled over a period of about five years with just about every sleep-related issue imaginable: undersleeping, oversleeping, insomnia (struggling to get to and remain asleep), early…

Ah, sleep, the one activity we all know to be extremely important yet seemingly universally neglect in order to sustain our hectic schedules. Speaking from my own experience, I’ve struggled over a period of about five years with just about every sleep-related issue imaginable: undersleeping, oversleeping, insomnia (struggling to get to and remain asleep), early morning wakefulness (waking up earlier than intended and being unable to get back to sleep), and likely other difficulties I’m simply not remembering. As such, and also due to sheer curiousity, I’ve made a point of investigating and experimenting with a variety of means of improving sleep duration, quality, and consistently – and I’d like to share with you those I’ve found most effective.

1. The Role of Melatonin, ie Put Your Phone Down!

As you might expect, the body has systems designed to regulate your sleep. Perhaps most important is the production and effects of melatonin, a sedating hormone produced by the pineal gland (a small endocrine gland located at the base of the brain) and involved in the regulation of one’s circadian rhythm. Speaking more practically, melatonin effectively begins the pre-sleep process (for lack of a more technical term) and is a major component of your circadian rhythm, and thus its significance is difficult to overstate (both in theory and in practice). In order to encourage nighttime sleep (keep in mind that not all species usually function during the day, and thus patterns of melatonin secretion vary), melatonin secretion naturally occurs when you are exposed to darkness. On the other hand, its secretion is suppressed when you are exposed to light, encouraging daytime activity.

If it’s unclear how a lack of melatonin production benefits you, consider the fact that the negation of a negative statement is actually a positive (hey, two wrongs can make a right – sort of). For example, if I were to say “I’m not not walking.” (as strange as that sounds!), that would be equivalent to me saying “I’m walking.” By the same token, because melatonin has sedating effects (although its effects are quite distinct to those of pharmaceutical sedatives such as benzodiazepines), blocking its production during the day prevents melatonin from causing sleepiness which would interfere with physical and mental activity.

This inhibition of melatonin secretion in response to light exposure has a very important implication in our electrified world: while artificial light is undoubtedly a profound technological achievement, it, unfortunately, gives you the power to block your body’s melatonin production, thus dysregulating your circadian rhythm and making it more difficult to get to sleep. Because the various components which make up your circadian rhythm impact one another, the delay in melatonin secretion caused by exposure to artificial light can also have the indirect effect of making it more difficult to wake up at the time you desire. Avoiding directly and indirectly causing these sleep disturbances requires you to go to their source: your lights, television, computer, and phone. The earlier you stop using these at night, or at least decrease their intensity or put them in Night Shift mode (or equivalent – see the flux app for your computer), the earlier your body will start producing melatonin and the easier it will be to get to sleep.

(If you’re hoping for more specific instructions, wait for the Stop Working (Before Sleep) section coming up.)

 

2. Eat Carbs Before Bed

Have you ever felt simultaneously sleepy and happy after a high-carb meal? This is a normal physiological response to eating, and while the explanation for it isn’t entirely uncontroversial (indeed, I know of at least four different explanations on offer), I’d like to lay out my preferred explanation and give some practical takeaways.

Note: this section is going to be unusually biochem-heavy, but will hopefully lead to a better understanding of why I recommend what I recommend.

When insulin is secreted after a meal, the ratio of BCAAs (leucine, isoleucine, and valine) to tryptophan in the blood is altered in favor of tryptophan. For those who struggle with ratios (no shame – I know this is a common issue), this simply means that insulin secretion causes the amount of tryptophan in the blood to increase relative to the concentration of BCAAs. Now, given tryptophan and the BCAAs compete for transport into to the brain by the large neutral amino acid transporter (part of the blood-brain barrier – recall that compounds don’t usually pass directly into the brain), this shift in the blood tryptophan/BCAA ratio ultimately results in more tryptophan entering the brain. Since tryptophan is an essential amino acid (it can’t be synthesized from compounds already present in the body) and a precursor to both serotonin and melatonin. This insulin-mediated increase in brain tryptophan concentrations results in increased serotonin and melatonin production.

Okay, so where does this leave us? Interestingly, the punchline is surprisingly simple: since serotonin is implicated in a feeling of contentment, and melatonin is implicated in causing sleepiness, we have ourselves a plausible explanation for why eating can make you feel happier but also more tired.

Now, if you’re a particularly critical thinker, you may have noticed that the above explanation doesn’t say anything about carbohydrates specifically – just insulin, which is secreted in response to consumption of practically any food. This doesn’t end up being a problem, though: because eating high-carbohydrate foods generally results in more insulin secretion than does eating high-protein and/or high-fat foods (1), consuming a high-carbohydrate (and thus highly insulin-producing) meal most reliably produces these desirable post-meal sensations.

 

In short: eating carbs before bed can both make you feel better and help you get to bed faster. Speaking entirely from personal experience, I would suggest at least 50g of carbs be consumed at this meal, overall macronutrient needs permitting, with an upper limit of 150g of carbs to avoid an uncomfortable increase in carbohydrate oxidation (ever gotten hot after eating a huge amount of carbs? That’s what I mean.).

3. Stop Working (Before Sleep)

This is a message to the workaholic! In today’s high-stress, ‘go go go’ culture, it can be easy to take work with you to bed – whether literally, in the form of books, papers, or your computer or phone, or figuratively, in the sense of something you find yourself stuck thinking about. While I don’t doubt this works well for some (Hey, Gary Vee!), I think that for most of us, if our work is sufficiently stressful, or even just interesting, it can interfere with us getting to sleep. Through trial and error, I’ve found that one of the best means of combating this is to set a hard cutoff time for work (whatever that work specifically consists of). This way, it’s no longer a matter of just one more email, one more chapter, or one more paper. To be sure, I’m not suggesting being neurotic and beating yourself if you find yourself sending an email three minutes after your stop time. Rather, this is about giving yourself the gift of a block of time before bed entirely dedicated to self-care. Now, the particular form this takes will vary between individuals, and I encourage experimentation to find what works best for you. Some suggestions include:

  • Take a hot shower or bath.
  • Listen to music.
  • Call a friend.
  • Meditate (if you’ve not already checked it out, I remember the meditation app Headspace)
  • Go for a leisurely walk.
  • Read a book.
  • Have a glass of wine.
  • Have sex.

The theme here is to do something fun, and, perhaps even more than that, something which allows you to relax before bed (in other words, I’d probably advise fun activities which can also rev you up, such as violent video games). This way, you’re actually ready to sleep when you get in bed, rather than simply turning the phone off, hopping in bed, and attempting to fall asleep while still highly alert.

I do think it’s important to keep in mind that it’s probably wise to place some restrictions on your pre-bed recreation, to avoid keeping yourself up with something theoretically intended to help you get to sleep. Perhaps the best example of this is watching TV shows using services like Netflix, which, on top of being extremely enjoyable, are designed to encourage binge watching. If this isn’t something you struggle with, more power to you, but keep in mind that fatigue impairs impulse control, so immediately prior to bed is probably the worst time to seek out something you tend to do compulsively.

4. Supplement with Melatonin

Throughout this article, I’ve repeatedly talked about the body’s natural production of melatonin, and the ways in which this can be both positively and negatively impacted by our behavior. Fortunately, melatonin supplements do exist, which allow us elevate melatonin levels independent of the body’s natural production (see HERE for melatonin supplements).

The scientific literature on melatonin appears equivocal as a whole, with the trend in the literature I’ve seen being in the direction of melatonin not reliably treating sleep disorders. However, it’s important to keep in mind that studies of this kind are investigating actual disease states, not simply sleep regulation in healthy people, and this might be a case of setting the bar too high for a naturally-occurring supplement. Indeed, the balance of evidence is in favor of melatonin having modest beneficial effects in healthy persons (2). Keeping the issue a little closer to home, melatonin supplementation does appear to be effective in regulating the circadian rhythm and diminishing the negative effects of light and sound exposure during sleep (3), and I think this speaks to a role of melatonin supplementation in encouraging sleep in the context of occasional insomnia, changes in your schedule, or, interestingly, having to sleep in a bright and/or loud environment.

Unfortunately, appropriate melatonin dosing is something I still see widely misunderstood. Perhaps believing that more is necessarily better, or that customers will hold such a view, most commercially available melatonin supplements yield 1-10mg per serving. This is in contrast to the scientific literature, which reveals that even 1mg of melatonin consumed in supplemental form elevates serum melatonin concentrations by more than 10x baseline. (4)

In other words, taking a supplement containing even 1mg of melatonin should be much, much more than enough. Remember: we’re only talking about effectiveness at this point, not safety or the potential for side effects.

Fortunately, I’ve yet to see any literature indicating melatonin is unsafe in generally-used amounts. However, melatonin does appear to inhibit dopamine secretion (5), and given low dopamine levels have been implicated in depressive symptoms (particularly anhedonia – the inability to feel pleasure – and fatigue), it seems to me mechanistically plausible that melatonin supplementation could cause or worsen depressive symptoms. Admittedly, I don’t know of any scientific evidence of melatonin supplementation actually generating this outcome (keep in mind that mechanistic research is profoundly different to, and ultimately weaker than, research which looks at ‘real world’ outcomes), and we’re likely dealing with something of a double-edged sword given depression can cause sleep disturbances which can be lessened with melatonin supplementation. Sidestepping an extensive discussion of depression, I’ve seen a large number of anecdotal reports of melatonin worsening depression in those who already have it or causing depressive symptoms (such as irritability or depressed mood) in those who otherwise don’t display it. As such, on top of high doses of supplemental melatonin generally being unnecessary to generate the desired result, they also likely have an increased potential for unpleasant side effects (as melatonin’s antidopaminergic effects likely scale with dose). Admittedly, high doses of melatonin have been used in some studies (6) with minimal reported side effects, but I personally lean toward being better safe than sorry in this area and thus advise using the lowest dose you find effective.

In short, beware the ‘more is always better’ trap, as intuitive as it might be, and start off your melatonin supplementation at 300mcg (that’s 0.3mg) if at all possible. If you’re unable to find a supplement of that dose, 1mg should do it.

 

REFERENCES:

1. An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. Am J Clin Nutr 1997

2. Effects of exogenous melatonin on sleep: a meta-analysis, Brzezinski et al 2005.

3. Effect of oral melatonin and wearing earplugs and eye masks on nocturnal sleep in healthy subjects in a simulated intensive care unit environment: which might be a more promising strategy for ICU sleep deprivation, Huang Et Al 20015.

4.Effect of oral melatonin and wearing earplugs and eye masks on nocturnal sleep in healthy subjects in a simulated intensive care unit environment: which might be a more promising strategy for ICU sleep deprivation, Huang Et Al 20015, figures 2 & 3.

5. Melatonin-dopamine interactions: from basic neurochemistry to a clinical setting, Zisapel N et al 2001

6. Melatonin for Insomnia in Children With Autism Spectrum Disorders,

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