Monday, November 11, 2013

12 Steps to Defeat Depression: Sleep!

Regardless of the cause of your depression, it won’t automatically go away on its own. It can, however, be effectively controlled by treatment and often by lifestyle changes.
One symptom of depression is insomnia or sleep difficulties. Conversely, insomnia or sleeping problems can cause depression, so it can be a difficult issue to diagnose and tackle. Studies indicate that you’re at a higher risk of developing depression if you have difficulty falling asleep and staying asleep.
         Some of the symptoms include:
         ~ difficulty falling asleep
         ~ difficulty staying asleep
         ~ poor sleep that leaves you feeling tired upon waking
         ~ feeling sleepy during the day

In addition, if you are pregnant, recently given birth or have hormonal fluctuation, you may have difficulty sleeping and may be have a higher risk of suffering depression.

And if you are in a period of grief, you will most likely experience some type of depression that accompanies sleep disturbances.
Treatment for sleep problems can be a critical part of depression therapy. To help you and your doctor or therapist with your treatment, make sure you keep a detailed sleep diary or journal for at least two weeks. Knowing your sleep patterns and specific problems will help you get the best diagnosis and treatment.

What Kind of Damage Can Impaired Sleep Do?
Impaired sleep can:
~ Severely weaken your ability to fight disease
~ Increase rate of tumor growth and decrease your body’s cancer-fighting
~ Contribute to a pre-diabetic condition
~ Seriously affect your memory by impairing it (Just one night of sleep
   deprivation—only 4-6 hours of sleep—can impact your ability to think
   clearly the following day.)
~ Negatively affect your physical and mental task performance. Of course,
   if you’re suffering from depression, you’ve already noticed impairment 
    in these areas. Lack of sleep only worsens it.

Can You Catch Up on Your Sleep?
Unfortunately, no, you can’t. As one doctor said, “Lost sleep is lost forever.” And worse news is that when you lose sleep night after night, it has an accumulative effect on you.

What’s The Optimal Amount of Sleep?
Recent research indicates 7-9 hours of sleep a night for adults is optimal. Some people do all right on 6-8. Children and teens need much more. Unfortunately, our society and school system isn’t set up to provide them optimal sleep.

So What Can You Do to Improve Your Sleep—Naturally?

Exercise Regularly and Not Too Late in the Evening!!
Yes, I’m back to exercise and can’t say enough good things about it. Thirty minutes a day improves your sleep. Exercising in the morning gets your body charged and working efficiently. This helps you metabolize well and make sure your body’s humming along nicely. Then you’ll be all ready for a good, efficient night’s sleep.

Exercise too close to bedtime, and you may be wide-eyed well past your bed time. Some professionals say nothing past 7:00 PM, but you’ll need to personally judge what time is best to call it quits.

Sleep in Complete Darkness or as Nearly Dark a Room as Possible
Any kind of light filtering into your room disrupts your body’s ability to produce melatonin and serotonin, chemicals that make you fall asleep or feel relaxed. Even the alarm clock glow can disrupt your sleep. So cover your windows with drapes or blinds that have blackout backing. The tiniest amounts of light entering your optic nerve can signal your body that it’s time to get up and get going!

If you can’t get your room dark enough, put on those sexy eye covers you used to see starlets wearing in movies. But make sure the elastic isn’t too tight around your head. That can cause pressure and headaches!

Sleep in Optimal Room Temperature
When my son Parker had a bout of croup at the age of three, the first thing I did was take him out into the cool, humid coastal night air while Chris got the car ready to take him to the hospital. At the hospital, the nurse told me to never set your thermostat above 68 degrees at night, that anything above that negatively affects your respiratory system because the dry heat coming from your heating system dries out your respiratory tissues, making it difficult to breathe. (That’s one way to disrupt your sleep!)
Well, it turns out that studies show that the optimal temperature for sleeping is between 60-68 degrees. Anything hotter or cooler can cause you to have a restless sleep. Your body’s natural temperature drops about four hours after you fall asleep. Keeping it warmed up may interrupt relaxation and disrupt sleep. So drop that thermostat and sleep easier.

Get Those Electronic Devices Away Form Your Bed!
Move those lighted alarm clocks. The optimal distance is 3 feet.

Avoid Using Loud Alarms to Wake Up
They’re too stressful to the system. You don’t want your body jolted awake. Check out using a sun alarm that combines all the gadgets you want with a special light that gradually increases in intensity, just like the sunrise.

Stop Watching Television, Working on Your Computer or Texting in Bed!
These activities can make it hard for you to drift off to sleep. Watching television or working on your computer or texting on your phone before sleep makes it difficult to fall asleep because these activities stimulate the brain. Your brain needs to know that when you’re in your bed it’s time for sleep, not crunching away on your electronic devices. Television disrupts your pineal gland, which produces melatonin, that all-important sleep hormone!

Separate Bedroom, Anyone?
Because my husband is a snorer, sometimes I think that my grandparents’ idea of sleeping in separate bedrooms wasn’t such bad idea! And recent studies suggest that sleeping with a partner may significantly disrupt your sleep. (And don’t let the pet in your bed either!) It’s drastic, but if your sleep is severely hampered by your spouse, seriously consider this alternative. Or at least try it.

Have a Bedtime Ritual
Having a bedtime ritual signals your brain that bedtime is approaching and helps it to settle down for rest.

Get to Bed as Early as Possible
Different researchers suggest that your body does most of its recharging between 11:00 PM and 1:00 AM and that the liver does its cleansing between 1:00 M and 3:00 AM. The catch is that you need to be asleep for those things to occur. Consider going to bed soon after sunset, just like in the olden days, and just like most animals do. I firmly believe it’s what God intended for our bodies to function optimally.

Don’t Keep Altering Your Bedtime
Don’t have a work-week-wakeup time and a weekend-wakeup time. Get your body into a sleep rhythm. Constantly flipping back and forth makes it difficult for your body to get in a healthy sleep—wake groove.

Just Like You Do With Your Kids, Establish a Bedtime Routine
Wash, brush your teeth, pray, meditate, do deep breathing exercises, stretch lightly take a warm bath or shower or indulge in a massage just prior to going to sleep. Find something that helps you unwind and release the day’s tensions. A warm bath or shower raises your body temperature. Then, when you exit the shower or tub, your temperature drops. This is a signal to the body that it’s bedtime and actually helps you fall sleep. (When we get to integrative medicine, I’ll give you more great activities that trigger relaxation!)

Take Your Last Drink of Water (or any fluid) Two Hours Before Bedtime
That will decrease your chances of having to get up to use the bathroom in the middle of the night. (My urologist actually told me no beverages after 7:00 PM, so you might try the earlier time if nighttime voiding is a problem for you.)

No Large, Full Meals After 7:00 PM or Within Three Hours of Bedtime
You need to reduce the load on your digestive system before retiring to bed, and three hours before bedtime is the optimal time, especially if you’re suffering from Gastro-esophageal Reflux Disease, or GERD.

Eat a High-Protein Snack Several Hours Before Bedtime
Protein, like a nice slice of turkey breast, will give you the L-tryptophan that triggers sleep through melatonin and serotonin production. Adding a small piece of fruit to it will help the L-tryptophan get into the brain.

A neuroscientist told us at a recent lecture that eating a banana or drinking a warm glass of milk just prior to bed works well too. (That was my nightly ritual for years as a kid.) Sometimes a small spoonful of peanut butter does the trick.

No Snacks Before Bed, Particularly Grains and Carbohydrates
They’ll likely raise your blood sugar and postpone sleep. Then, when your blood sugar crashes, you’ll most likely wake up and have difficulty returning to sleep. Consuming sugar just prior to bed usually causes problems for me, and then I have a horrible time returning to sleep.

Wear Socks to Bed
Your feet have the poorest circulation than any other body part, and when they get cold, that can cause sleep disruption. A study has shown that sock wearers have less night waking. (My husband disagrees with this one, because his feet are always hot, so you’ll have to try it and see how you respond! Personally, I’m a sleep-with-socks-on devotee.)

 Put That Work Away At Least An Hour Prior to Bedtime
This gives your brain a chance to unwind so you can relax and prepare for bed.

Listen to Relaxation CDs
Some people like the sound of crashing waves, Celtic flutes, forest winds or white noise to stimulate sleep. See what works for you. In college, I often went to sleep with a love song playing. Drove my roommate nuts.

Read Something Spiritual or Uplifting
Keep the mysteries, suspense or detective novels for wide-awake time. They stimulate the brain too much.

Writing in a journal may help you unload your stressful thoughts and better prepare you for sleep. It may also get your brain wired up by replaying the day’s negative events. Try it to see if it works. If it worsens your go-to-sleep ability, journal at another time. 

What If You Can’t Fall Asleep After Going to Bed?
If after ½ hour you’re still staring at the ceiling, get out of bed, go into a quiet room and read until you feel sleepy. DON’T watch TV!

Watch Out for Any Drugs You’re Taking!
Some prescription and over-the-counter drugs can disrupt sleep, so be careful about taking, or combining them. Always check with your doctor, or, better yet, your pharmacist, especially if you’re having sleep problems.

Put Down That Cup of Caffeine!
Once again, you really need to limit your caffeine intake. Some people, like me, don’t metabolize it well and are left feeling wired and shaky long after they finish the last drop.

And pay attention to the sources of your caffeine. It’s found in coffee, tea and chocolate (the darker the chocolate the higher the levels of it). If I’ve had more than one cup of coffee during the day, I’m wide-awake at 2:00 AM. And if I add processed sugar to it, it’s even worse.

So, only one cup of coffee a day, and no caffeinated coffee after 3:00 PM. And if you’re suffering sleep deprivation, try to skip it all together. And that means no more Red Bull or caffeine-infused power drinks!! I’m serious about this. For many reasons besides sleep disruption, they are horrible for your health!

Skip the Alcohol
Yes, alcohol does make you drowsy, but as soon as that effect wears off, you’re wide awake and unable to get back to sleep. Alcohol also keeps you from entering that critical Rapid Eye Movement sleep that recharges and repairs the brain.

Skip The Ambien
At a recent brain science symposium I attended, the instructor told us that the sleep aid Ambien should be avoided. Even though it doesn’t cause dependence, after two days it can cause sleep disturbances and nightmares. So try everything else you can before resorting to this, or any other sleep aid drug.

Avoid Foods That Cause You Problems
Remember that food journal I asked you to keep in an earlier blog post? Well, keep working on it to determine if you have any food sensitivities.
For example: When I eat inflammatory foods, my arthritis flares up and wakes me up in the middle of the night. The pain makes it difficult for me to return to sleep. If I disciplined myself to not cave in and eat them, I’d be much better off and have a better night. Know what ails you, and avoid it!

Lose Any Excess Weight You’re Carrying Around
Now we’re back to diet and nutrition again. But being overnight can affect breathing and increase your risk of sleep apnea.

Keep Naps to a Minimum
If you have to nap, make sure you start napping around 1:00-1:30 PM, nap only for 15 minutes to 1 ½ hours, and don’t start napping after 3:00 PM. The 15 minutes is really just a cat nap, but it can do wonders for the energy system.

Research does indicate that naps are beneficial to older adults, so they get a pass on longer naps, like the hour-and-a-half kind. My mom doesn’t miss hers, and she’ll be 92 in four weeks!

Increase Your Melatonin
You can buy over-the-counter melatonin supplements, but the best way to increase it is by getting out in the sunlight, or using full-spectrum light bulbs in the winter. Melatonin supplements have been shown to increase sleepiness and help you fall asleep rapidly. It also decreases restlessness and helps decrease that daytime drowsiness.
         Warning: The long-term effects of melatonin are unknown. Use it
          carefully, as you would any other sleep aid. Do not use it long 
          term,and use it only under your doctor’s. Do NOT use it along 
          with any other sleep aid.

Get Your Thyroid and Hormone Levels Checked
If these are disrupted, they can cause sleep disturbances and unusual fatigue or jitteriness.

Get Into Bright Light as Soon as Possible in the Morning
Get up, get ready, and get out of the house, even if it’s just for a walk. There’s nothing like fresh air and sunshine to get the system up and working. It will have positive effects for you throughout the day and well into the night. Even if you don’t feel like it, get out of your jammies and head for the door, even if you just manage to walk down the driveway and back.

Identifying the cause of your sleep problems and depression is critical to your health and recovery. It’s when you are sleeping that you are healing and rebuilding protein. Sleep, exercise and nutrition are the BIG THREE to optimal health.

Start slowly, keep that sleep journal, make changes slowly and keep track of the benefits, which may take several days to severalweeks.

I pray that all of you suffering from sleep problems will soon have more restful nights!


NEXT WEEK: We’ll begin Fighting Depression with Mind-Body Medicine.

Thanks for joining me.

Until next week!



 An important note: If you are suffering from depression and sleep problems, make sure you tell your doctor about your sleep issues. It may make a difference in the kind of medication you’re prescribed. If you have diagnosed obstructive sleep apnea, sedating types of antidepressants can worsen this condition.