Sleeping pills are among the most advertised, prescribed and profitable medications available. Last week, a market research group revealed that $54.9 billion were spent on sleep aids worldwide in 2013, and predicted the figure would rise to $55.8 billion this year . (1)
The figures continue to rise despite the fact that the use of sleeping pills has been found to increase the risk of death, and “could be as risky as smoking cigarettes,” according to one study author, Dr. Daniel F. Kripke. (2)
It’s time (past time, actually) to look for some alternatives. Since I prefer things I can do myself for free, I’d like to highlight two sleep-inducing, evidence-based approaches you can take at home: shiatsu massage and yoga.
This week researchers at the University of Alberta published a paper on a pilot study they conducted in which they taught 9 patients with serious, chronic, sleep-interrupting pain to give themselves hand shiatsu massages before bed. The results were promising: patients were able to fall asleep faster, and stayed asleep longer. Nancy Cheyne, who often lay awake most of the night due to back pain, reported: “Usually within a few minutes of doing the pressure treatments, I’m gone – asleep. Sometimes I can’t even finish. I just go out.” (3)
I was unable to find out which points were used in the shiatsu study, but there are some good youtubes by shiatsu practitioners demonstrating common approaches to reducing anxiety and promoting sleep. My favorite was this one from the folks at Bay Area Natural Health. (4)
Researchers were unsure as to what enabled the patients to sleep better. It could have been the shiatsu points themselves, or it might have been the simple fact that patients had to pay attention to something besides their pain when they were readying for sleep. Anxiety, and the thoughts that attend it, commonly keeps sleep at bay.
Napoleon reportedly taught himself to still his mind before bed by imagining that each thought was a drawer in an enormous cabinet and shutting one after another until he fell asleep. A elderly man once told me he counts back from 100 in order to fall asleep. Same idea.
Yoga has also been shown to improve sleep. Researchers at Harvard Medical School taught 20 insomniacs a series of basic yoga poses and asked them to practice daily for 8 weeks. They fell asleep sooner, and slept longer. Two 75-minutes yoga sessions a week were shown to improve sleep (and reduce symptoms) in cancer survivors. (5)
So next time you can’t fall asleep, or wake in the night, try doing the child’s pose (at right), or pressing that point at the crease of your wrist (above), or simply shutting the drawers on all your thoughts.
(1) BBC Research, Sleep Aids: Technologies and Global Markets, June 2014, http://www.reportlinker.com/p02212012/Sleep-Aids-Technologies-and-Global-Markets.html.
(2) WebMD, Sleeping Pills Called as Risky as Cigarettes, February 27, 2012, http://www.webmd.com/sleep-disorders/news/20120227/sleeping-pills-called-as-risky-as-cigarettes.
(3) Science Daily, Hand Shiatsu Treatment Explored as Sleep Aid, June 17, 2014, http://www.sciencedaily.com/releases/2014/06/140617121952.htm.
(5) Michael J. Breus, Yoga Can Help with Insomnia, October 4, 2012, http://www.psychologytoday.com/blog/sleep-newzzz/201210/yoga-can-help-insomnia.
Now that school is out, the days are long (for those of us living in the northern hemisphere), and summer’s heat is kicking in, it’s a perfect time to sleep outdoors. Whether you are camping in the back yard or in a national park, sleeping on the porch or the roof, or taking a nap on the beach or swinging in a hammock under a tree, outdoor sleep exposes us to the natural cycles of light and dark that tune our body clocks.
That’s because our eyes serve two purposes: to see what’s around us, and to identify the degree of light, which prompts hormonal changes that regulate many bodily functions, including hunger and sleep. (1) When we live indoors with artificial light, we delay the release of melatonin, the hormone that makes us sleepy, and often stay up late. When we wake in the morning, melatonin levels tend to remain high, leaving us feeling groggy for some time.
(If you struggle with what the scientists call “sleep inertia” – the desire to stay asleep no matter how late it is – get outside as early as you can (or turn on the brightest lights in the kitchen), so your eyes can tell your brain to reduce melatonin and wake up. Turning down the lights after dark and avoiding LED screens will also help avoid sleep inertia)
Back to sleeping outdoors. Researchers at the University of Colorado sent 8 volunteers out camping for a week without any artificial light to see what would happen to their sleep cycles. By the end of the week, they were all falling asleep and waking up around the same time, despite having vastly different sleep patterns before camping. The researchers tested their hormone levels and discovered that their bodies released melatonin at sunset and stopped releasing it at sunrise, making it much easier to get up in the morning. (2)
There was a time when people were encouraged to rest outdoors to improve their health. In the early years of the 20th century, when tuberculosis was rampant, people began building sleeping porches onto their houses, and hospitals rolled patients onto screened porches for fresh air. (3)
To this day, parents and day care centers throughout Scandinavia put children outside to nap – even in the winter – in the understanding that fresh air increases their resistance to coughs and colds. They also claim that the tots sleep longer outside. (4)
Mahatma Gandhi was a great fan of sleeping outside. He considered it to be one of the essential “keys to health,” as long as you can keep yourself warm and dry. He wrote that the “ever-changing beautiful panorama of the heavens” is soothing, making for a “peaceful, refreshing sleep.” (5)
In recent years, people around the world have been organizing “sleep outs” to raise money for refugees and homeless people who have no choice but to sleep outside. My favorite is the Souixland Sleep Out. As one member explained: “That’s when we’re getting together to freeze our collective tuckuses off,” adding: “Did you know that there were around 2,500 homeless people in Sioux City last year – about 200-250 on the streets on any given day?” (6)
(1) Ignacio Provencio, “Hidden Organ in Our Eyes Found to Control Circadian Rhythms and Emotions,” Scientific American, May 2011, http://www.scientificamerican.com/article/the-hidden-organ-in-our-eyes/.
(2) Michelle Castillo, “Camping May Help Reset Your Internal Clock, CBS News, August 2, 2013, http://www.cbsnews.com/news/camping-may-help-reset-your-internal-clock/.
(3) Charlie Hailey, “From Sleeping Porch to Sleeping Machine: Inverting Traditions of Fresh Air in North America,” Traditional Settlements and Dwellings Review, Volume XX, Number 11, 2009, http://iaste.berkeley.edu/pdfs/20.2d-Spr09hailey-sml.pdf.
(4) Helena Lee, “The Babies Who Nap in Sub-Zero Temperatures,” BBC News, February 21, 2013, http://www.bbc.com/news/magazine-21537988.
(5) Mahatma Gandhi, Key to Health (Ahmedabad, India: Navajivan Publishing House, 1948)
(6) “Siouxland Sleep Out: Getting Out There for the Homeless, www.siouxlandsleepout.com/.
It used to be that New York City alone claimed the title of “The City That Never Sleeps.” Then Berlin, Hong Kong and London joined in, followed by Buenos Aires, Sao Paulo, Tel Aviv, Mumbai, Cairo, Madrid, Barcelona and Belgrade. Now, most every urban center in the world can lay claim to the title, with active night lives and round-the-clock noise and light that can make sleep difficult at best.
Some cities are taking sleep back into their own hands. In New York, WNYC Radio has initiated a city-wide sleep project, encouraging residents to track and report their sleep online, and identify what keeps them awake. The idea, explained WNYC’s Brian Lehrer, is to learn “how New York sleeps and how we might sleep better.” (1) With over 3,000 people reporting to date, they’ve already learned that residents of the Big Apple tend to hit the hay an hour later than the rest of the country, but end up getting the same amount of sleep. (2)
Mayor Bill de Blasio, an admitted night owl, said in November 2013: “I think we should re-orient our society to stay up late. But I don’t think that’s happening right now.” (2)
Seven time zones east of New York, there’s a small spa town in Germany, Bad Kissingen, that has taken up the challenge to become sleep-friendly. The mayor and town council agreed to gather data about when residents prefer to sleep with hopes of adjusting school, hospital and clinic schedules and lighting accordingly.
Dr. Thomas Kantermann, the project supervisor, explained: “My great aim for this town is to make Bad Kissingen the first town in Germany… where your internal time is acknowledged.” (3)
Imagine that! Some say he’s dreaming, but I think they’re just envious.
(1) Clock Your Sleep: Young Kids and Parents, http://www.wnyc.org/story/clock-your-sleep-young-kids-and-parents/
(2) Six Facts That Will Change the Way You Think About Sleep in New York, http://www.wnyc.org/story/six-facts-on-sleep/
(3) The Town That’s Building Life Around Sleep, http://www.theatlantic.com/health/archive/2014/02/the-town-thats-building-life-around-sleep/283553/
The kind folks at Beyond Words (an imprint of Simon & Schuster) are publishing a book I’ve been working on for years, and it comes out tomorrow, March 11.
For those of you who have been following this blog for some time, I want to assure you that it’s not just a compilation of my posts.
The Secret Life of Sleep is the whole picture, digested, integrated and articulated as beautifully as I could manage.
Available here: www.katduff.net
These are the chapter titles:
Chapter 1: When the Sandman Comes: Falling Asleep
Chapter 2: Opening the Inn for Phantoms: Surrendering to Sleep
Chapter 3: Cribs, Cradles and Slings: Sleeping Babies Across Cultures
Chapter 4: Sleep Stages: Western Science and Eastern Philosophy
Chapter 5: Between Sleeps: The Midnight Watch
Chapter 6: When Sleep Never Comes: Insomnia’s Toll
Chapter 7: Downers, Benzos, and Z-Drugs: The Commercialization of Sleep
Chapter 8: The Social Divide: Separating Sleep from Consciousness
Chapter 9: When Sleeping Birds Fly: Half Awake and Half Asleep
Chapter 10: The Invisible Labors of Sleep: Memory and Invention
Chapter 11: Knitting Up the Raveled Sleeve of Care: Emotional Restoration
Chapter 12: Sleep Has No Master: Subversive Dreaming
Chapter 13: Ordinary Dreams: When One Hand Washes the Other
Chapter 14: Big Dreams: Encounters with the Other Side
Chapter 15: Waking Up is Hard to Do: Internal and Social Time
Chapter 16: Enamored with Wakefulness: Phasing Out Sleep
Chapter 17: Waking Up Again: Doubt, Certainty, and the Future of Sleep
The author’s multidisciplinary approach and relatable writing is a breath of fresh air, and her enthusiasm for her subject echoes how many of us feel—we love to sleep…Full of unique insights and surprising facts, this book brings to the fore an entire world that exists behind closed eyes. - Kirkus Review
After reading The Secret Life of Sleep, you may find yourself inhabiting a new, and enhanced, view of the world and of yourself. - Arifa Goodman, Jungian Analyst
What distinguishes Duff’s work from the average popular science title is her beautifully nuanced, lyrical prose and astute recognition that sleeping and dreaming have a much deeper meaning in our lives beyond the research laboratory. - Booklist
“Kat Duff’s exploration into this universal activity – or shortage of it – is both timely and highly original.” – The New Internationalist
I’ll be doing interviews about the book on radio stations all around the country on Thursday, March 13. (Click here: www.katduff.net and go to the events page for the schedule) Thanks for your continued interest and encouragement over the years.
Now that the book is out, I’ll be back to blogging.
If the results of the world’s largest sleep survey are accurate, it only gets better after 60. 156,000 adults answered questions about their sleep, health, and daytime alertness, and the results (published in the March issue of the journal Sleep) surprised everyone, including the researchers: Sleep problems and daytime tiredness declined across the lifespan, and those who slept best were over 80. (1)
While it is possible that 80-somethings reported the best sleep because they have fewer responsibilities and more flexible schedules, or are less inclined to complain in general, the findings refute the popular notion that sleep deteriorates with age. It now appears that the prevalence of insomnia often reported among older adults is due to other factors: pain, illness and the medications used to treat them.
This is not to deny that our sleep changes, often dramatically, as we traverse our middle years, especially among women. Our bodies produce less growth hormone, which in turn shortens the time we spend in the deepest, most restorative stage of sleep. Melatonin also decreases, making it harder to fall and stay asleep, while advancing our sleep/wake cycles. We get sleepy earlier in the evening, wake more often at night, and wake up earlier in the morning. (2)
Declining levels of estrogen, testosterone and serotonin trigger can hot flashes, increase the likelihood of developing sleep apnea, and leave us more vulnerable to life’s stresses. All told, our sleep becomes lighter, earlier, and more fragmented (by awakenings), requiring us to take better care to get what we need to function well the next day. (3)
By age 60, these biological changes have occurred, and most of us have made our adaptations. Maybe we’ve cut back on caffeine, started meditating or practicing yoga, developed ways to contain our anxieties, arranged our schedules to allow afternoon naps, or started taking melatonin supplements, herbal tinctures, or sleeping pills.
Whatever the case, we’re on the home stretch. In the study cited above, women reported greatest difficulty sleeping during childbearing and midlife years; but after 60, said they felt better rested than ever before.
The most important thing we can do for our sleep as we age is stay healthy (so we don’t need medications that can interfere with sleep) and address pain. Pain and sleep have an inverse relationship: the more pain we have, the less sleep we get, and the less sleep we get, the more pain we feel. It’s a vicious cycle. In one study, researchers found that a night of fragmented sleep caused subjects to become more sensitive to pain, have less ability to deal with it and develop new pains. (4) That’s why it’s important to address the pain, to get that massage, take that hot bath, or learn those relaxation techniques. You’ll get the reward of improved sleep.
1) Grandner MA, Martin JL, Patel NP, Jackson NJ, Gehrman PR, Pien G, Perlis ML, Xie D, Sha D, Weaver T, Gooneratne NS. “Age and Sleep Disturbances Among American Men and Women: Data from the U.S. Behavioral Risk Factor Surveillance System” Sleep 35(3), 395-406. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22379246.
2) Robinson, Lawrence and Segal, Robert. “How to Sleep Well as You Age” HelpGuide.org, last updated October 2013. Retrieved from http://www.helpguide.org/life/sleep_aging.htm.
3) Aubrey, Allison. “How Aging Changes Sleep Patterns.” NPR August 3, 2009. Retrieved from http://www.npr.org/templates/story/story.php?storyId=111415462.
4) Roehrs TA, Harris E, Randall S, Roth T. “Pain Sensitivity and Recovery from Mild Chronic Sleep Loss,” Sleep 35(12), 1667-72. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23204609.