How to Improve Sleep Quality
I had the pleasure of chatting with sleep expert Tracy Davenport on my Wellness Wednesday series about how to improve sleep quality - as it affects most of my clients and community.
She has a Ph.D. in human development and growth, covering performance across the lifespan and looking at different ways to live better. She also has a graduate degree in Psychology.
Dr. Davenport is also into sports, as are her husband and her two sons, one of whom is a pro athlete and the other a college athlete
She explains that her mother had Alzheimer's disease for at least eight years and this was really the driver behind her work.
Read on to find out what she has to say about the link between lack of sleep and illnesses such as Alzheimer's, as well as how we can improve our quality of sleep.
Five Things We Know About Sleep
1. Sleep is a very active time for us
We used to think sleep was a timeout for us and that during sleep nothing was really happening.
However, since microtechnology and Alzheimer's research, we now know that's simply not true. What we know to be true is that sleep is a very active time for us.
We can do images of the brain while someone is asleep and we see the brain is actually very, very active while we are asleep. It's actually, almost as active as when we're awake. It is something we didn't really understand before.
During sleep, in terms of brain activity, a housekeeping role happens at night where fluid rushes through our brain and cleans out protein plaque deposits.
When we're not getting the sleep we need, our brain is not able to do this. We see these protein plaque deposits in Alzheimer's patients.
There may be multiple reasons for Alzheimer's, but we do know there's a connection between sleep deprivation and Alzheimer's. It's what we call a bi-directional influence where lack of sleep can make you more prone to Alzheimer's and Alzheimer's can make us sleep less.
Dr. Davenport stresses that we have to be very real about this in our conversations with ourselves, our parents, and our kids. She points out that by the year 2050, we're expecting the rate of Alzheimer's to double or triple in the US.
As it stands right now, past the age of 55, 1 in eight of us will be developing Alzheimer's disease.
It's a very expensive disease. It's a life-stopping disease because you lose your independence. It's an incredibly difficult disease and we know sleep can make a difference.
2. Sleep helps with our intelligence
All day long, all of our senses are bombarding our brain with information. At night, we are going to forget much of what our senses picked up during the day. We want that to happen.
It's going to make way for things that are more important for us to remember tomorrow. So, at night, our brains do memory filing and consolidation, sifting through what is important and what isn't.
It's why sometimes when we have an emotional connection to something, we tend to remember it the next day because it gets coded at night.
Dr. Davenport goes on to explain that sleep also affects procedural learning. This has to do with learning the steps in performing a task. People who are getting sufficient sleep are going to be more likely to understand what is required of them. They are better able to learn and perform those steps.
We are all performing throughout the day, like when you get behind the wheel of a car and pick up your child from school. We have to be sharp throughout our day. That's one thing improved sleep can help us with.
3. Sleep improves our physical functioning
Sleep helps us heal. If you go out for a run or you go to a Zumba class or a hot yoga class, whatever you're into, most likely, you're going to have a little bit of inflammation. That's okay. Inflammation is a good thing.
Muscle biopsies show us that inflammation is one way our body brings more nutrients to our muscles, our tendons, and the places where they attach. That's okay.
Once something stays inflamed, as with chronic inflammation, injuries and chronic pain occur.
Every night when you, your child, or your parents go to sleep the body is reducing inflammation that happened during the day. It's a very important chemical process for us.
People with chronic diseases, such as fibromyalgia and inflammatory arthritis, have more inflammation than others. And, what's interesting is often they sleep worse than the rest of us.
Once again, with these diseases, we see the bi-directional influences where one really impacts the other. They impact sleep and sleep impacts them.
This is why it's very important while we're healthy, to take control of developing good sleep habits, so if we do develop a disease, we really can hit the ground running with tools to manage that disease the best we can.
Continuing on sleep and physical functioning, Dr. Davenport also points out that besides inflammation reduction, sleep also helps with growth.
She explains that there is a growth hormone released over each 24-hour period and about three-quarters of it is released at night.
We can even pin down what time of the night or how many hours after you went to sleep the growth hormone is released.
By studying twins, we can see that when one twin gets enough sleep and the other twin does not, on average, the sleep-deprived twin is shorter and has a higher BMI. Much of this has to do with the growth hormone being mostly released at night.
If we're up all night, things that should be happening in our brain and throughout our body systems are not happening. So, physically, improving sleep is very important.
4. Sleep affects our emotional health
Dr. Davenport reveals that, as a college professor, emotional health is one of the things she focused on with her student-athletes.
Depression and anxiety are on the rise and they were increasing before COVID. It is easy to put the can blame on COVID but, especially with our young people, we've seen a rise in depression before this.
Dr. Davenport suggests that much of it has to do with phones, social media, and lack of sleep.
She adds that when we do not get enough sleep we tend to catastrophize. We tend to be less emotionally stable.
So, when things happen, such as your child breaks a tooth or you don't get the paycheck you were hoping for, it's definitely bad but, emotionally, we don't go up and down as much when we have enough sleep.
We tend to stay a lot steadier, rather than catastrophize.
This is really important for parents because you do not want your children to remember you being all over the place with your emotions.
Bad things happen. They just do. But, our reaction to them is very, very important and sleep is one way we can really help ourselves in terms of emotional stabilization.
5. Sleep impacts weight gain
When sleep is disrupted, we see weight go up. We can see this across the board, for example, with
- Shift workers
- People who are not sleeping enough because of chronic pain
- Alzheimer's patients
Sleep is one of the two main reasons. (The other one is hormones, where instability occurs because hormones aren't balanced every night.)
In terms of sleep and its relationship with weight, Dr. Davenport explains that because sleep is related to emotional health it also impacts our food choices.
Late at night when we're really tired or frustrated because we've been working on bills or taxes or a college paper, etc., very few people are going to choose hummus and carrot sticks to eat.
Most people are going to pick high-fat, high-salt foods and are more likely to go for another round of fast food or ice cream.
Late at night, we do not make as healthy food choices as we do when we have had enough sleep. That really matters.
For people who have not had enough sleep, their brain is literally driving them to eat high-sugar, high-fat, high-salt foods.
We can't blame them and ask them to just be more disciplined because what you are craving when you do not have enough sleep is really brain-driven.
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Sleep and Hormones
Sleep Difficulties Are a Hallmark of Menopause
Menopause is defined as after we stop our period for 12 months. Peri-menopause is the time leading up to menopause when we are maybe having a period or missing a period. It's on and off and very irregular.
Dr. Davenport admits she didn't really know about sleep problems during her own menopause. She now has "a million things" to say to educate people about the topic.
She points out it's important for people to understand, on a very basic level, that it's real. Twenty-five to 50% of women, maybe more, suffer from sleep problems during menopause.
It often happens in marriages that husbands will say, "I just don't understand why my wife's going through this. She doesn't want us to sleep together anymore. She's really grumpy. She's not getting enough sleep."
This isn't a choice women have.
Also, women in menopause who experience hot flashes seem to have more sleep problems than other women. It may be because they're hot at night or maybe it just signifies a big chemical imbalance as what is waking them up. We don't know.
But we do know this group of women seems to suffer a little bit more.
It is all very intertwined where women with hot flashes also tend to have more depression during menopause. And, interestingly, depression leads to sleep deprivation.
Sleep Issues in Menopause Are Often Connected to Other Issues We Face
Apart from the problem of hot flashes, it could be you have gone to bed with a lot of anxiety or depression and they can also keep you up at night.
Dr. Davenport, who is now 58, remarks "People used to tell me when I was younger and my kids were younger, that your problems get bigger as you get older. And, at the time, I was thinking, what could be bigger than whatever I was going through at the time?"
But, it is true that at the same time you're hitting the menopause phase of your life:
- Your parents are aging.
- You are supporting friends who may have developed some very serious diseases.
- Your children are venturing out on their own, whether it's driving a car or getting their own apartment or becoming a parent themselves.
All of these things can be incredibly scary.
There is an integration of things happening during this time that are keeping you awake, apart from it just being that phase of your life.
So, along with the menopause phase and its sleep irregularity, you may also be dealing with anxiety, and depression, along with other very real issues - all of which can really wreak havoc on you.
During menopause and peri-menopause, it's rarely one thing.
Another concern with poor sleep in menopause is that issues you already have can become much more pronounced.
Dr. Davenport highlights acid reflux, sleep apnea, and weight gain as examples of issues that have bi-directional influences with sleep during menopause.
She explains that whereas they tend to show up during menopause and affect how we sleep, they can, in turn, be worsened by poor sleep.
Dr. Davenport advises, "If you tell your doctor, I'm having trouble sleeping and you're at menopause age and they ask if you are turning making your room dark at night, it's time to run in the other direction"
She stresses that any doctor "worth their salt" needs to understand that this is all very complex during each phase of our life.
Another concern is the effect the COVID-19 pandemic has had on women. Women have plenty of responsibilities and they took the biggest hit during COVID financially.
They have had to pivot their lives a bit, whether it's to childcare or adapting to changes in their professional lives.
There's so much pressure on women, especially during COVID, and sometimes we bring that to bed with us.
Seven Tips to Improve Sleep from Expert Tracy Davenport
1. Educate yourself and your family about sleep
Education is not only just about learning through reading. It's also important to have communication around it.
It may involve educating your partner and children about the phase of life you are in and how it affects your sleep.
Dr. Davenport gives the example of how she discussed the topic with her two teenaged sons when she first started struggling through poor sleep associated with peri-menopause and menopause.
She shares how she related this to them, asking them to be quieter at night so she could get better sleep.
She also tells how after having been married for almost 35 years and being in a "beautiful marriage," she no longer sleeps with her husband as his sleep schedule interferes with hers.
She continues that it's time to lose the stigma about couples having to sleep together. Many couples no longer sleep together during menopause.
It's not something to be ashamed of. In fact, the majority of homes right now are being built with two master bedrooms, because we're getting smarter about the importance of sleep.
She emphasizes that while she is not advocating not sleeping with your partner, self-care for you and your partner is important.
If you're not sleeping well, you really have to educate yourself and educate your partner about it. Let them know this is where you are at right now.
Explain your fear of developing dementia as you grow get older. Let them know one way to prevent it is to make sure you are getting a good night's sleep.
A partner who's in love with you would at that point ask what they can do and that is your opportunity to explain the kind of sleep you need.
We just have to be loving enough with one another to help each other, get our sleep.
Educating anybody about sleep also includes educating them about the effects of phones.
For example, Dr. Davenport advices not texting or calling in the middle of the night and not letting children sleep with their phones.
2. Record your sleep for a month
Using what you know about sleep in this way will give you some power. It'll also be a communication tool you can take to your gynecologist or your general practitioner and say, "Over the last 30 days, I only slept well 14 of them."
And you have that record in front of you that he or she can look at and say, "Wow, you really do have a problem."
However, remember, you do not have to stress over recording your sleep. There are easy ways to do it. Many people use the Loop app or an apple watch to track their sleep for them.
You can use whatever works for you. You could even just write down what time you go to bed and what time you wake up. That works, too.
You can visit Dr. Davenport's website, Tracyshealthyliving.com, as well. Her affordable sleep book is available there and it has a sleep tracker in it.
Tracking your sleep from month to month can definitely be powerful. It can show that your concern about your sleep is not all in your head - you are not just feeling tired. You can look back at your sleep tracker and say, "I really am tired. This is what's happening."
3. Eat nutrient-dense, wholesome food
Try to avoid spicy foods and greasy foods. Greasy, high-sugar, and high-salt foods can be difficult to digest. You don't want to go to sleep not being able to digest your food.
It could lead to lead to more acid reflux - even if you do not know you have it. You can have silent reflux which can wake you up at night.
Time and time again research has shown how very healthy plant-based diets are for us.
While the research also shows that meat is acceptable for most people depending on your health, before you go to bed, you want something that's easily digestible.
That includes foods such as whole grain, fruits, and vegetables, depending on how fibrous they are. You may want to avoid very fibrous vegetables because they can take a longer time to digest.
Something easy, like whole-grain cereal with half a banana, could work. But, as Dr. Davenport points out, each person is different and you should always make sure that what you have chosen is working for you.
Even if it's generally acknowledged as something that's good for everybody, we are all different - you should make sure that it's working for your body
4. Get regular exercise
Dr. Davenport begins by sharing, "There are two things in the scientific community that we don't argue about. One is smoking, and the other is exercise. We argue about everything else, but we don't argue about those two - that says something, right?"
There are a couple of things exercise does for us that everyone might not be immediately aware of.
- Exercise boosts mood.
It does this in a variety of ways, not only through hormones and balancing but also from just being in the sunshine and being in the fresh air.
If we are exercising with friends or in a class, that also helps. Plus, regular exercise lowers cortisol, also called the stress hormone, over time.
Of course, weight loss is another benefit of exercise and when we get our body in a good place, we feel happier. We can sleep better.
- Exercise helps with the management of disease and disability.
Dr. Davenport shares that for her Ph.D., she specialized in disease and disability, applying it to performance because she realized that there is almost no disease and disability that is not improved by exercise.
In the past, someone with an illness, such as Parkinson's or rheumatoid arthritis, would be cautioned not to exercise for fear of back injuries.
But, almost every disease and disability now, including Alzheimer's, is known to be improved through exercise.
There aren't many persons who can't talk to their doctor, even if they've not exercised before, and get the go-ahead to begin an exercise program to improve their sleep if they're having problems with sleep.
Dr. Davenport shares an experience she had speaking with a registered dietician about better eating for eyesight. They were looking at tips to help with diabetic-related macular degeneration.
After giving six tips in the food realm, the dietician gave exercise as number seven. Dr. Davenport thought this was really interesting and asked why she felt the need to include exercise.
The dietician's reply was that when talking about anything related to food we also have to talk about exercise. The two go hand-in-hand in terms of blood sugar and blood pressure.
5. Stay in contact with your doctor
Dr. Davenport urges us to reach out and find a doctor to whom we can relate - male woman, young, or old. She points out that if you do not have a doctor you can relate to, then it's "Jack time" to find one and establish a relationship with them.
She describes sleep problems as possibly being "the canary in a coal mine" and urges the importance of finding a doctor you can talk to if you are struggling with your sleep.
Ensure it is someone who's well-educated about sleep. They must also understand that people who are having big sleep issues are also most likely having some other issues that need to be investigated.
These issues could include your
- Mental health
- GI health
- Heart health
- Respiratory health
6. Take the time at night to wind down
Many people are not aware of how important it is to take time at night to wind down. Winding down in preparation for sleep is something we do naturally for babies - dimming the lights, rocking them, cutting down on noise, etc. However, we tend not to do it for ourselves.
What happens over time is things get in the way of that routine. For example: teenagers may have soccer or football practice, high school calculus homework that ends late in the night. Adults get home late from work, need to make dinner, get kids to bed, work a bit more, etc.
We intuitively know how to wind down at night, but we allow the outside world to inhibit doing it.
However, good sleepers know it's not a choice. They know it is what they have to do because they've always had to do it - and it works.
Dr. Davenport makes the strong point that sleep is one practice that has lasted throughout evolution in the animal kingdom. Sleep has lasted even though sleeping leaves animals vulnerable. That is how important it is.
7. Talk to a friend or five
Find a friend and really tell them what's going on in your life. That friend could be your husband, a good girlfriend, or a sister - whomever you choose.
There's no denying COVID has been a difficult time for everyone. Mental health is of particular concern to us right now. Dr. Davenport encourages us to find someone and tell them how we are feeling.
Tell them how hard this time is for you. Tell them about the things that are really annoying you about what people are saying. Find a friend who can listen to and hear you because it is incredibly important to be able to do that.
In order to have a good night, you need to have a good day. And part of having a good day is being able to be brutally honest with a friend who will be nonjudgmental.
Someone who, even if they don't agree with you, can see where you are coming from and show appreciation for it. That's going to help you sleep better tonight.
We often feel like the connection to our friends is something extra, kind of like a treat for us that we have to earn or deserve. But, that's simply not true.
We're meant to have somebody who is close to us, whom we can really confide in. So, if you're struggling, talk to your doctor, talk to a friend - someone who can help you get on the other side of it.
Dr. Davenport shares that she sees our relationship with sleep as being just like any other relationship. It takes respect, communication, and clarity.
With any relationship, you're going to have a bad day, but in a good relationship, we can say, "You know what, tomorrow is going to be a better day for us."
And, that's what we need to do with sleep. If we have one bad night, it's okay. It is not a sign we are going to get Alzheimer's.
Look at developing a good relationship with sleep as a process. It is going to take some time to get it right but once you get it right, you are going to find a variety of tools that are going to help you keep that relationship healthy.