The Strategies I Use for Getting Great Sleep

Sleep has always been difficult for me. For years it was difficult to fall asleep and stay asleep. Often I would wake up at 2 in the morning, unable to fall back asleep again. Earlier in my life, I was fine with sleeping only 4 or 5 hours at night. I was ambitious. I had a lot to do. I thought that sleeping was a waste of my time. I did that in college, medical school, during my residency, and when I began working as a physician. When I had Zach and Zebby, I thought it was an advantage that I slept so little. Now I know better.

Sleep is an essential part of life¹. Important functions occur in our brains as we sleep, including the consolidation of memory⁴ and the removal of beta-amyloid and other toxins⁵ in the brain. Unfortunately, too many of us do not get enough sleep.

There are many varieties of sleep problems. Some people have trouble falling asleep, while others have trouble staying asleep. Restless legs–involuntary twitchiness, movement, or jerking of the legs at night–is also a common complaint, as is sleep apnea. Poor sleep increases the risk of weight gain,⁷ metabolic syndrome,⁸ diabetes,⁹ and mental health issues.¹⁰

Sleep disruptions are incredibly common among people with multiple sclerosis and other neuroimmune conditions² as well as those with Parkinson’s disease, Alzheimer’s disease, or other neurodegenerative problems.³ Sleep problems are an early sign of trouble brewing in the nervous system and often develop before a diagnosis of multiple sclerosis, Parkinson’s, or other neuroimmune or neurodegenerative disease.

Scientists don’t know if sleep problems are part of the cause of many nervous system disorders, or if they are simply part of the prodrome that often precedes nervous system disorders,⁶ but all those years of poor sleep likely accelerated my decline. I routinely ask my patients about their sleep and educate them about why sleep is critical to our health. Then we work to improve both sleep quality and quantity.

So, how is your sleep? Do you wake up refreshed most mornings? Do you fall asleep easily and stay asleep through the night? If you wake up during the night, can you easily fall back asleep again? If sleep is a problem for you, I have a few suggestions for you to consider.

1. Spend 20 minutes outside in daylight. This will help you get ultraviolet light to the retina in your eyes, signaling the biological clock in your brain and helping your brain make more melatonin at the right time.
2. Turn off the television, computer, and smartphones an hour before you want to sleep. At a minimum, activate the applications that remove the blue light in the evening. Blue light disrupts the brain’s ability to make melatonin and get your body to sleep at the right time.
3. Develop a calming, evening ritual that helps you set the stage for falling asleep. I do a gratitude meditation as I fall asleep. I visualize someone who has been helpful in my life, replay how that person helped me, and thank them for their help. It is a lovely way for me to gently slow down, give thanks, and drift into sleep.
4. Keep a notepad by the bed. If you have something that you want to remember, write it on the notepad. It will be easier to let go of the thought and drift off to sleep.
5. Take a melatonin supplement 2 hours before you want to fall asleep. Over the age of 60, the brain makes less melatonin, which contributes to problems falling asleep and staying asleep that occur as we age. I take melatonin and have found it useful.
6. Take magnesium threonate. Most people with sleep problems also have a relative deficiency of magnesium, which contributes to poor sleep. Magnesium is vital to healthy cognition, which includes long-and short-term memory, learning, stress management, and sleep.11 Magnesium threonate is the only form of magnesium that crosses the blood-brain barrier and gets into the central nervous system.¹¹ Magnesium improves sleep quality and quantity. I have found taking magnesium threonate in the evening to be very helpful for improving my sleep and reducing problems with restless legs. It has made a significant difference in my ability to fall asleep and stay asleep.

Now that I understand the critical role of sleep for the health of my brain, I prioritize getting 7 to 8 hours of sleep each night. I pay attention to what disrupts my sleep and what supports getting a great night’s sleep. These changes have made a huge difference in my overall health and well-being.

In summary, getting good sleep is essential for our health and healthy aging. Pay attention to your sleep. Note when you sleep well and when you sleep poorly. What factors contribute to having better sleep and what factors likely contribute to having poor sleep? Once you know what affects your sleep, you can slowly make changes and hopefully consistently sleep 7 to 8 hours each night, waking up in the morning fully refreshed.

References

1. Grandner MA. Sleep, Health, and Society. *Sleep Med Clin.* 2017;12(1):1-22.

2. Besedovsky L, Lange T, Haack M. The Sleep-Immune Crosstalk in Health and Disease.*Physiol Rev.* 2019;99(3):1325-1380.

3. Kokosova V, Filip P, Kec D, Balaz M. Bidirectional Association Between Sleep and Brain Atrophy in Aging. *Front Aging Neurosci.* 2021;13:726662.

4. Girardeau G, Lopes-Dos-Santos V. Brain neural patterns and the memory function of sleep.*Science.* 2021;374(6567):560-564.

5. Wang C, Holtzman DM. Bidirectional relationship between sleep and Alzheimer’s disease: role of amyloid, tau, and other factors. *Neuropsychopharmacology.* 2020;45(1):104-120.

6. Bohnen NI, Hu MTM. Sleep Disturbance as Potential Risk and Progression Factor for Parkinson’s Disease. *J Parkinsons Dis.*2019;9(3):603-614.

7. Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. *Obesity (Silver Spring).* 2008;16(3):643-653.

8. Smiley A, King D, Bidulescu A. The Association between Sleep Duration and Metabolic Syndrome: The NHANES 2013/2014. *Nutrients.*<2019;11(11).

9. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. *Diabetes Care.*2010;33(2):414-420.

10. Sampasa-Kanyinga H, Colman I, Goldfield GS, et al. Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: a systematic review.*Int J Behav Nutr Phys Act.* 2020;17(1):72.

11. Vink R. Magnesium in the CNS: recent advances and developments. *Magnes Res.* 2016;29(3):95-101.