A consequence of being a sleep doctor is that I constantly get bombarded with questions about sleep by complete strangers at parties, gatherings, and especially on airplanes. It seems that almost everyone I meet has or knows someone that can’t sleep. They’ve tried all the typical methods and hacks recommend by friends or found online, with minimal to no success. At this point, I use NOSTRILS as a reminder of the 8 important steps to help those of you that are struggling to fall or stay asleep.
Before I describe the 8 things to consider, my basic premise is that all modern human have smaller jaws and airways, predisposing everyone to various degrees of breathing problems at night. If you had wisdom teeth removed, or needed braces, then you’re at risk. Crooked teeth comes from smaller jaws, which leads to more narrow airways from the tip of your nose to your voice box. Breathing problems result during sleep, leading to various physical ailments that are so common in our society today. This is what I talk about in my book, Sleep Interrupted: A physician reveals the #1 reason why so many of us are sick and tired.
Being able to breathe optimally through your nose is the single most important thing to start with. If you can’t breathe through your nose, this will force you to mouth breathe, which causes more obstructed breathing, as explained in my last post. If you are breathing well through your nose but suddenly suffer from an allergy attack, you begin to toss and turn, because your nose is more stuffy. This is due to the vacuum effect that’s created in your throat like what happens when you suck on a straw with the other end pinched closed. (Read my free report on How to Unstuff Your Stuffy Nose.)
Getting more oxygen is commonly touted as being more healthy. This is a myth.
- The air you breathe has plenty of oxygen that’s available to your body. When you stop breathing multiple times at night, it creates a stress response that shuts down blood flow to your gut, your reproductive organs, and higher-level areas of your brain. As this problem worsens, it can carry over into the daytime, leading to poor oxygenation of tissues that are required for optimal health.
- Another important process that lowers oxygen to your body occurs when you don’t breathe through your nose. The nose makes a gas called nitric oxide, which dilates blood vessels. Once this gas reaches your lungs, it relaxes smooth muscles in your blood vessels allowing more oxygen absorption. Bypassing the nose while breathing can result in 10 to 20% lower oxygen intake.
- Lastly, if you have obstructive sleep apnea, long pauses in breathing can definitely deprive your brain and body of oxygen.
Due to smaller jaw development and narrowed airways in modern humans, most modern people prefer to avoid sleeping on their backs. However, if something happens to force you to sleep on your back (such as an injury or surgery), your sleep quality can go downhill rapidly.
Certain professionals advise people to sleep on their backs. For example, chiropractors advice supine sleep for better spinal alignment. Dermatologists recommend against side or tummy sleep due to increased risk of facial wrinkles. Ideally, back sleep is preferred, but if you can’t breathe properly, then your sleep quality drops, and you end up aging faster with more facial wrinkles. Traditionally, doctors recommended pinning a sock filled with a tennis ball behind your back, but these days, there are more effective sleep positioners which can be found online (Slumberbump and others)
Proper timing of when you eat dinner is the single most important thing to consider if you want to get a great night’s sleep. Since most modern humans stop breathing occasionally (even without sleep apnea) any additional stomach juices can be forced up into your throat, causing more inflammation and swelling with more obstructions and and less efficient sleep. Poor sleep in general promotes weight gain, and this can aggravate sleep-breathing problems.
In my book, Sleep Interrupted: A physician reveals the #1 reason why so many of us are sick and tired, I explain that frequent obstructions with brain wave arousals leads to fragmented sleep, which in turn, intensifies your body’s physiologic stress response. Whether physical, emotional, or psychological, your body reacts to stress the same way. The biologic consequences of stress is well described in Dr. Robert Sapolsky’s book, Why Zebras Don’t get Ulcers. This is why whatever you can do to reduce stress is vital to getting a good night’s sleep. Regular exercise, routine breaks, deep breathing exercises, yoga, or meditation are common options you can choose from.
However, if you physically can’t breathe due to a severe deviated nasal septum or huge golf ball sized tonsils, then no amount of breathing exercises or relaxation techniques will help to calm you down.
You are what you eats and food is medicine. It’s common sense that eating a healthy diet while minimizing damaging toxins and chemicals is important for good health and well-being. I discussed these issues extensively in my past podcasts (How I Stay Thin and Healthy and Toxins).
Lower your exposure to artificial lights, especially computer/phone screens, or fluorescent lights after dinner. Light, especially blue light, lowers melatonin, which starts to rise about 2 hours before your natural sleep time. Spend more time outdoors and expose your eyes to indirect sunlight during the day. Expose more of your skin to sunlight to get the benefits of natural vitamin D (hormone) production.
There are many documented benefits of healthy levels of Vitamin D, including protection against cancer. One study looked at this question and concluded that a moderate increase in sun exposure may lead to improved overall cancer survival, over the risk of developing skin cancer.
This section includes all the basic fundamentals of good and healthy sleep habits and thoughts. You can find more important about his in my interview with Dr. Gregg Jacobs, author of Say Good Night to Insomnia: The Six-Week, Drug-Free Program Developed At Harvard Medical School. In short, here are the 7 basic steps:
- No eating close to bedtime
- Don’t sleep on your back
- No electronic screens before bedtime
- Use the bed only for sleep and sex
- Don’t eat in bed
- If you can’t fall asleep within 30 minutes, get up and do something quiet or relaxing for 10-15 minutes.
- If you normally take 2 hours to fall asleep in bed, stay up until 30 minutes before your typical sleep time.
Make Good Sleep a Priority Habit
Many of you are still struggling with getting a good night’s sleep. You may have tried various sleep remedies, pills, hacks or even sleep apnea treatment options. Unfortunately, there’s no one single technique or pill that’s going to solve your sleep problems. Optimal sleep is a cumulation of habits, thoughts and actions that layer on top of one another. Additionally, many doctors miss the fact that there may be a breathing problem on top of your bad thoughts or habits. If you’re overweight, then that needs to be addressed as well. The challenge in losing weight is that poor sleep promotes weight gain.
Always start with the basics described above. If the above steps don’t help, then see a sleep professional. If you have any breathing problem, see your primary care doctor or an ENT surgeon as well. Some people with sleep problems do well with just eating an early dinner and improving nasal breathing. Others need to layer on the other steps mentioned. If none of these remedies help, it’s time to see a sleep physician. Remember, getting a great night’s sleep doesn’t happen by taking a pill or using a device. It’s a focused and determined lifestyle of slowly layering on different techniques to not only improve your sleep quality, but to maintain it as well.