Create the Life You Want
The goal for the vast majority of us is to live for a long time, and to enjoy life to the greatest degree possible during that time. For ease, we’ll talk about these things as lifespan (Are you alive?) and healthspan (Are you actually living while alive?).
Unfortunately, there is a disparity between these terms, which is why we want to differentiate them. It is safe to say that we all know someone who has gotten to a point that they are still alive (not yet deceased), but they aren’t necessarily living. They’re limited in the physical aspects of what they can do, the cognitive rigor they can engage in, or are somewhat limited in the relationships they have (or have lost). They can’t fully participate in life. Their health span stopped long before their lifespan.
Our objective over the coming weeks and months will be to share some of the most impactful ways in which we can positively affect either lifespan or healthspan, and usually these will affect both simultaneously.
Practical Solutions to Live Better, and Longer
After a couple decades in practice, there are a few key changes that people can make that can have tremendous impact on their physical and cognitive health, capacity to heal, and enjoyment of life. We’re going to tackle some of the big ones, in basic terms and usable strategies, so that we can hopefully help a bunch of people to make positive changes that will affect their lives and that of the people around them. The first few topics we will discuss are vital and fundamental components to a long, active and healthy life: sleep, nutrition, and challenging your body to move.
In the Sleep, Eat, Move trilogy, we’ll dig in to why these things are important, what happens if you ignore these concepts, and how you can practically make changes in these areas that will improve your quality of life.
Why Sleep?
We are talking about sleep first because it is so often overlooked as a health-related concept or strategy in healing. All studied species on the planet engage in sleep (or a sleep-like state), and 70+ years of sleep research has clearly delineated the dramatic effects quality and quantity of sleep has on the body. It is an unfortunate mystery why it is so often forgotten, ignored, or disregarded when we evaluate the overall health status of a person.
Sleep is a funny thing, in that all species engage in this activity which makes them less responsive to our environments, and therefore less protected from predators (while essentially unconscious). Additionally, sleep takes up so much valuable time from important tasks of seeking food, shelter and reproduction. Why on Earth would we just shut down the body for 1/3 of our lives? It would seem counterintuitive that evolution wouldn’t have phased it out by now (if there weren’t such phenomenal benefits!).
You’re Not Just Knocked Out
Part of this disconnect and misunderstanding of the importance of sleep is that we’ve long considered it a passive process. “Shut down, relax, recover, knock-off, turn off” are all common ways of thinking about the time we spend asleep. We talk about it like a passive event where bodily activity ceases. After all, that’s what happens when we put our computers to “sleep”, right?
It turns out, sleep as a passive activity is grossly inaccurate. It is, after all, what does happen during sleep that gives it its fundamental value. It is an active, biological process. Dr. Matthew Walker, PhD, succinctly describes sleep as “the single most effective thing we can do to reset brain and body health each day.” That bold statement is why we chose to put this topic first in our series.
Consequence of Sleep Deficits
Simply stated: if you don’t get the sleep you need, bad things happen to your body and brain.
According to repeated research findings, consistently getting inadequate sleep quantity or quality is associated with:
increased cancer risk (getting 4-5 hours of sleep per night reduces cancer fighting natural killer T-cell function by 70%
decreased immune function (lower white blood cell production and slower immune response)
mood changes, emotional volatility, and irritability
increased inflammation, more sensitive to pain, and slower healing and recovery (lower protein synthesis and growth hormone release)
metabolic dysfunction and diabetes – altered glucose metabolism
more car accidents (getting only 5 hours of sleep per night for a week reduces cognitive function the same extent that alcohol intoxication does)
decreased ability to focus
increased sports injuries
increased odds of obesity
memory loss and increased risk of dementia
hormone disruption
Lack of sleep not only disrupts the quality of your life, but can actually shorten your life.
So, What Exactly Happens During Sleep That is so Important?
As mentioned, sleep is not a passive process. There are hundreds of active processes going on in the body to clean, repair, rebuild and grow your body and brain while you sleep. Many of these processes only happen when you sleep, and some of them only during specific stages of sleep. When you don’t sleep enough, or well enough, these cleaning, healing, growth and repair processes lag, and the functions of your body and brain suffer.
Many times, these reductions in performance and health aren’t noticeable. We get away with a little bit more for a little bit longer when we are young as well. As time goes by, these losses add up, and even though we may be used to it, significant deficits arise.
Stages of Sleep
While we are asleep, the brain demonstrates different levels of activity corresponding to its function at that time, and the different stages of sleep are associated with those changes. Each stage is important, and has different bodily processes that are evident or prominent during those times.
Brain scans of patients while awake and during Deep NREM and REM sleep are shown here, from Dr. Matthew Walker’s book, Why We Sleep. The second figure shows a model of how brain activity corresponds to the normal cyclical changes in stages of sleep recorded over a typical night by a typical human.
Non-Rapid Eye Movement (NREM) sleep has a few different substages.
N1 – transition to sleep. Body may twitch as muscles relax and body gears down.
N2 – light sleep, slow heart rate and breathing; Slow brain waves with bursts of faster waves called spindles that aid in memory.
N3 and N4 are deep, slow brain wave sleep. This part is imperative for memory consolidation and long-term storage, physical restoration of the body, the glymphatic system cleans the brain, and optimization of brain circuits (pruning unnecessary connections).
Rapid Eye Movement (REM) sleep isn’t as “deep” as NREM, but is vital to learning and memory, emotional regulation, creativity and problem solving capacities.
Making a Habit of Poor Sleep
Consistently poor sleep routines can cut specific stages or depths of sleep, giving rise to long-term or chronic deficits. Additionally, some functions happen at specific times of the night, and if we miss out on that repeatedly, other maladies can arise.
Early in the night, sleep help our bodies with:
Physical restoration and repair, immune function, and replenishing resources (muscle glycogen, etc).
Cleaning out unnecessary neural connections and removing waste products from the brain (like beta-amyloid that is associated with some types of dementia).
Memory consolidation, and transferring from short-term to long-term storage.
Cardiovascular health is aided by the deep rest that lowers blood pressure and heart rate.
Later in the night/early morning, in the last few hours before we wake, REM dominant sleep aids in:
Emotional processing, separating painful memories from emotions associated with them.
Intelligence and creativity are aided as the brain forms new connections between new and old information, and creating complex and creative associations.
Motor skills are bolstered and cemented in the last couple hours of sleep.
Mood regulation and emotional stability rely heavily on quantity of REM stage sleep we get.
As you can guess, if we are consistently missing out on a specific stage of sleep, then specific symptoms can arise. Solutions to many of the problems we seek treatment and medications for may simply need a more consistent and adequate sleep pattern as a foundational start.
Age Dependent Needs
Through the course of human life, the body and the brain have different needs. The brain continues to grow and develop into our early twenties, and can begin to show signs of decline in as early as our thirties, depending on different lifestyle factors.
The general sleep requirements for humans as we age are:
Newborns (0-3 months): 14-17 hours
Infants (4-12 months): 12-16 hours
Toddlers (1-2 years): 11-14 hours
Preschoolers (3-5 years): 10-13 hours
School-age Children (6-12 years): 9-1
2 hours
Teenagers (13-18 years): 8-10 hours
Adults (18-64 years): 7-9 hours
Seniors (over 65 years): 7-8 hours
While you or someone you know may “get by” on less than what’s shown, that does not mean that they are functioning optimally, or near the level they would be with consistent adequate sleep.
Different Strokes for Different Folks
While it is true that some people can thrive on a shifted sleep schedule (going to bed later and getting up later than others), the requirements for overall quantity and quality of sleep stand for nearly everyone. Even though there are rare cases of genetic variances that requires a bit less sleep, the percentage of those people in our population is “essentially zero”, according to sleep researchers.
The shifted sleep schedule seems to do well for teens and early adulthood, and some members of other age groups. These people are typically called “night owls” Others perform very well when they get up early and go to bed early, and have been referred to as “morning larks”. If you feel that you fit well into one of these categories, it would be a great idea for your sleep quality if you are able to construct your life (work, social activities, school schedule, etc.) to match your individual sleep needs.
Tips for Better Sleep
Many of us are somewhat constrained in the way that we can adapt our lives to match ideal sleep. In those situations, you have to stack the deck in your favour to best capitalize on the hours of sleep opportunity that you get.
Here are some tips to improve your chances of quality sleep:
Make it non-negotiable. While it seems like this is a silly thing to say, you have to cognitively decide that sleep is a higher priority than keeping up with your favourite shows, watching the end of the game live, scrolling, streaming, snacking, shopping… Pick a number of hours you will set aside specifically for sleep, and build around that.
Set a Consistent Schedule to provide the sleep duration you picked in the previous point. If you picked 7 hours as your objective, and you have to get up at a specific time, you have to be ready to shut everything off and close your eyes seven hours before that time. Your pre-bedtime routine is accomplishing all the things you have to do to make the morning go smoothly when you wake up. Work backwards in that list of tasks and determine the time you need to start “getting ready for bed”: let the dog out, lock the doors, set the coffee maker, brush your teeth, then get yourself in a state that’s ready for sleep.
Set your bedroom up to be cool and dark room. Scientists say that the best sleep is achieved when the room is between 16° and 19° Celcius, and without light in the blue end of the spectrum.
Bedtime relaxation routine – for some people this could be ten minutes of reading, and for others it could be light stretching and breathwork, or possibly posture exercises and some corrective neck curve traction ;). As you do this, keep these in mind:
No screens (phone, tv, ipad, computer, etc) or bright LED lights. They stimulate the parts of the brain that you want to chill out before bed, making sleep harder or less efficient. So, limit tv, phones, screens and blue light exposure in the last couple hours before bed.
Avoid alcohol before bed. The term “nightcap” and routine cultural practices have gone against this idea, and it seems like alcohol makes you sleep. But, the sleep you get after alcohol consumption is of significantly lower quality than natural, sober sleep. There’s a massive difference between getting a deep sleep and passing out!
Avoid caffeine after 2pm (even earlier for some people). Caffeine (obviously) interferes with the brain’s ability to shut down and achieve good sleep.
Keep a journal by your bed to empty your head of worries, tasks for tomorrow, reminders, random thoughts, shopping lists or anything else that is on your mind. Once it’s written out, you can forget about it until tomorrow, which may help you shut down for the night.
Get adjusted! Regular chiropractic care can act to ease stress on the nervous system, tap the brakes on your stress response, engage the “rest and digest” parasympathetic nervous system, improve pain levels, and aid help you get comfortable enough to get quality sleep.
Other tips to remember
Limit naps after 1:00pm, as they can interfere with your ability to fall asleep and stay asleep.
Avoid heavy meals late in the evening. Your blood sugar is more stable for sleep, and you can get more comfortable when you aren’t overstuffed.
Exercising regularly improves sleep quality for several reasons (fatigue, weight loss, cardiovascular efficiency…), and fosters a symbiotic cycle of two practices that both drastically improve health.
Manage your weight to reduce risk of sleep apnea and other comorbidities. (Lack of sleep is also associated with weight gain and obesity)
Get more direct sunlight in the early part of your day (yes, we know that’s a rare commodity sometimes!) Get what you can, and only wear sunglasses when you need to.
Supplements to consider (ask your trusted health care providers for their opinions regarding specific guidelines for you): Magnesium L-Threonate crosses the blood-brain barrier 70% better than any other form of magnesium and has great potential to positively benefit sleep, L-Theanine has been shown to help with anxiety and calming the nervous system, GABA is also often related to positive changes in sleep quality. Ask us at your next appointment for more specific details or recommendations.
Medications are generally not recommended by sleep researchers, unless specifically prescribed and after trying these other approaches first, as they don’t contribute to quality sleep, and do not result in more rested waking hours. There is also significant concern for dependency and numerous other potential side effects.
How Should I Sleep? A Note on Sleep Position
You will have better chances of sleeping well if you are in good position for your body. In the end, you have to sleep in the position that gives you the best sleep. While everyone is different, there are some considerations to which sleep positions best support your body.
Side sleeping is generally considered to be the best, producing less snoring and better breathing. Side sleeping is good during pregnancy, and has been shown to produce reduced symptoms of GERD, or reflux. Side sleeping may put pressure on some achy joints, and could foster facial wrinkles.
Back sleeping is great for spinal alignment, especially with a thin pillow under knees to alleviate stress on the lower back. Back sleeping is problematic, however, in that it often leads to more snoring and difficulty breathing in some people, and may worsen reflux and sleep apnea.
Stomach sleepers tend to snore less, but that sleep position puts greater strain on their necks and lower backs.
Change Your Sleep to Change Your Life
Sleep is not a passive, optional activity, but an active biological process imperative for you to thrive at your greatest potential. Improving your sleep quality can only help your health and longevity in a positive way. By making sleep non-negotiable, forming strategies to create an adequate sleep opportunity to meet your goals, and setting the stage with some better lifestyle choices, you are having a tremendous impact on your quality (and length) of life.
Remember that any positive changes are good. You are not aiming for perfection, but for consistency. Build a lifestyle you can stick (most of the time) with that helps you for the rest of your life.
