There are practical steps that you can take to improve your sleep. These include creating a relaxing sleep environment, lowering the temperature in the bedroom, making sure it is dark, and having a comfortable mattress, etc. Yet, many people don’t realize that a good sleep is more about what we do away from the bed than what we do in bed.
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In the era of social media, technology, and 24-hour news that are always available in the palm of our hands, our minds are going a million miles per hour. Many of us are juggling so many things and have even more worries. We worry about work, about the kids, emails, social media reactions, finances and many other things. Some of us get to bed with exhausted bodies but minds that are still going at full speed.
So, what do you need to do to help the brain shut down? Here are the five steps to help you unwind your brain and get a better sleep.
Step 1: Don’t carry today’s problems into bed
Your mind is not going to stop thinking about today’s problems and worries unless you help it clean up. You must tie up all the loose ends from the day. The best way to do that is by allowing your mind to settle down two hours before bedtime. Simply, write down ALL your thoughts and worries on a paper or in a notebook. It does not matter how or what. Think of it as a thought download or a brain dump.
Do this process outside the bedroom and leave the notebook or paper there. This will train your brain to leave the worrying thoughts outside the bedroom. It allows space for positive thoughts. Positive thoughts are calming and will help you to go to sleep.
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Step 2: Plan your tomorrow
After you downloaded your thoughts, look at your plan for the next day. Look at your calendar and prepare for that early meeting, pick workout clothes, prepare and pack for lunch. Your attention to details will help your mind avoid the worry about tomorrow. This will set you up for success and give you control. The control that will help you settle your mind.
Step 3: Keep your phone outside of the bedroom
In fact, keep all electronics out of the bedroom. The bedroom is for two things, sleep and intimacy. I actually recommend that you stop looking at your phone, social media, emails or any other projects for two hours before going to bed. Trust me, I know it is hard and I am guilty of this too.
I also get that some of you may be in a profession like me where you take calls at night and may need a phone nearby. But in the era of smartphones, it is easy for the mind to wander at night. These types of phones bring your worries and the whole world with you to the bedroom. Do you want the world to be in your bedroom when you’re trying to sleep?
So, if your profession requires it, get a landline or cheap flip phone to be by your bed for emergencies. No texting, no social media, and no news in the bedroom. Research found that one third of people wake up at night and check their smartphones.
Step 4: Create a bedtime restorative ritual
A restorative ritual signals your brain that you’re going into a relaxed state. These rituals include things like taking a bath or a hot shower, drinking hot green tea, lighting up candles, dimming the lights, praying or meditating. You can also read a fiction book to take your mind out of your own story into the story of the book.
Step 5: Think happy thoughts
Pick a location of your dreams. If you love to be on the beach in Hawaii or on top of mount Everest immerse yourself in the experience. Feel it, smell it, see it and dream it. Visualize it as if you are living in it. This powerful way will calm your mind and set it up for dreaming. The goal is to feel calm, safe, quiet and “tucked in.”
Bonus: what if you wake up in the middle of the night
Waking up in the middle of the night is not unusual. Researchers found that 31% of people wake up in the middle of the night at least 3 times a week. So, if you wake and you can’t go back to sleep, use the 15 minute rule. If you wake up in the middle of the night and after 15 minutes you don’t drift back into sleep, you should get out of bed. Do not lay there and start thinking about going to sleep. Do not look at the time, do not check your phone, and do not make a cup of coffee.
Get up and go to another room. Sit in a comfortable chair, read that novel, light up a candle. If your mind is racing again. Go back to that piece of paper or notebook and write down your thoughts and worries again. Do not do these things in bed because that will train your mind to associate your bed with wakefulness instead of sleep. When you feel drowsy again, go back to your bed and go to sleep.
The Bottom Line
Here is the trick though, you have to do these steps every night. You may feel like you want to stay up watching a movie on your favorite app or stay on your phone or catch up on a project instead of your bedtime ritual. But your health and your mind deserve a good sleep. So, this simple promise to yourself will help you establish the good habit of sleep and set you up for better health and success.
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Modifiable Lifestyle Factors for Primary Prevention of CKD: A Systematic Review and Meta-Analysis
Short or Long Sleep Duration and CKD: A Mendelian Randomization Study
People with short sleep duration of less than 6 hours were found to affect kidney function. Since the average person spends a third of her life sleeping this has a great implication on the development and progression of CKD. We wrote a blog about sleep and CKD also.
Particulate Air Pollution and Progression to Kidney Failure With Replacement Therapy: An Advanced CKD Registry–Based Cohort Study in Taiwan
This study showed that air pollution is associated with faster progression of CKD toward failure.
Glycemic Status, Insulin Resistance, and the Risk of Nephrolithiasis: A Cohort Study
This study showed a strong link between insulin resistance and the development of kidney stones specially men even if blood sugar is normal. This is another aspect that we need to pay attention to in our integrative approach to kidney stones.
The post February Research and News appeared first on Integrative Kidney.]]>- Regularly getting less than 7-8 hours of sleep per night
- Waking up in the morning not feeling fully well rested most mornings
- Regularly have trouble falling asleep
- Wake up frequently once or more during the night and can’t fall back asleep
- Wake up earlier than intended regularly
- Snore or told you have sleep apnea
- Suffer from daytime sleepiness
If these resonate with you, your sleep quality may be negatively impacting your kidney health. Research has uncovered a strong connection between sleep for general well-being as well as an important key for kidney health.
The Scale of the Problem
Sleep disorders are very common in patient with chronic kidney disease (CKD). Because sleep symptoms can be subjective, it’s difficult to nail down the exact prevalence. Studies report that the prevalence of sleep disorders in kidney patients ranges between 31-57% depending on published studies. Although it appears that there is no association between the severity of sleep disorders and the stage of kidney disease, those who have kidney failure and are on dialysis are more likely to have problem with sleep than other CKD patients.
When you look at specific sleep disorders such as obstructive sleep apnea (OSA) or restless leg syndrome (RLS) you will find that these are very common in patients with CKD. In fact, studies that measured the frequency of sleep apnea in CKD patients reported results as high as 94%.
Why Adequate Sleep is Important
Insomnia is the most common recognized sleep disorder. It is defined as the subjective complaint of difficulty in initiating or maintaining sleep for at least three times per week for a duration of four weeks or more to a degree that daytime functioning is impaired.
Sleep problems can lead to a decreased performance at work or school. They may slow reaction time increasing the risk for motor vehicle accidents. They have also been linked to depression, anxiety and substance abuse. Sleep disorders have been associated with increased risk for diabetes, high blood pressure and heart disease.
When thinking about sleep health, it is important to think about these following qualities:
- Sleep duration (the total amount of sleep in 24 hours)
- Sleep continuity or efficiency (the ease of falling asleep, staying asleep, and returning to sleep if woken during the night)
- Timing (What time are you sleeping)
- Alertness/sleepiness (the ability to maintain attentive wakefulness throughout the day)
- Satisfaction/quality (the subjective feeling of “good” or “poor” sleep)
A sleep questionnaire can be very helpful in identifying those who have sleep issues and need for intervention. Try our sleep questionnaire here if you’d like to understand your sleep quality better.
Disrupters of Sleep
Many factors can lead to sleep disruption. These factors include toxin exposure, genetic risk, nutritional deficiencies, medications, and of course stress and anxiety.
Toxins
The hours we are sleeping are very important for nerve cells restoration and clean-up. In fact, studies have demonstrated that sleep promotes clearance of neurotoxic waste products that accumulate during waking hours.
The sleep-wake cycle is also important in liver detoxification of toxins and medications. But most importantly, toxins such as arsenic, pesticides, phthalates, polyfluoroalkyl compounds (PFAs) have been specifically linked to sleep troubles in one of the largest studies conducted in the US. Higher levels of urinary arsenic were found to be associated with leg jerks. Pesticides were associated with increased leg cramps during sleep. PFAs not only can directly cause kidney damage, they also disrupt sleep due to increased leg jerks during the night.
Nutrient Deficiencies
There are several nutrients hat are implicated in disrupting sleep:
- Vitamin D , a hormone that interacts with many cellular receptors including those in the gut, bone, breast, prostate, brain, skeletal muscle and the immune system has been found to play an important role in the time to fall asleep.
- Maintaining good blood sugar balance by reducing excessive carbohydrates, and eating foods rich in fiber, healthy fats, and protein is also important for getting good quality sleep.
- Deficiencies of tryptophan, an amino acid precursor of serotonin and melatonin, or B6 which is needed to regulate sleep hormones may also impact sleep.
- Many micronutrient deficiencies have been associated with sleep disturbances, with the strongest link is found between magnesium and zinc deficiency.
Medications and alcohol
Many prescription drugs have been found to interfere with sleep. Medications such as antidepressants, asthma and blood pressure medications are the most common offenders. In addition, many over-the-counter medications such as pain medications, allergy, and cold medication and weight-loss products can contain caffeine or other stimulants that can disrupt sleep.
Even sleep medications, which are commonly used to treat insomnia may cause sleep disturbances. This is because they do not allow those who take them to fall into the normal, deep sleep pattern that results in restorative sleep. Alcohol may make you sleepy, however studies show that regular consumption of alcohol is also disruptive to healthy sleep.
Biological factors
As you may expect, stress has been documented to lead to poor sleep quality. This association is maybe mediated by the hormones that drive up activity of the hypothalamus-pituitary-adrenal (HPA) Axis, driving the fight-or-flight-response. Multiple hormones have been found to affects the sleep cycle, particularly cortisol for example. Cortisol is a driver of inflammation and can contribute to insulin resistance which leads to blood sugar imbalances, which we’ve already learned affect sleep quality.
Lastly, it appears that our genes play an important factor in setting our internal clock. Genes our sleep-wake patterns that can influence our physiology, our cyrcadan rhythm, we utilize nutrients, and handle toxins and medication – all the factors that impact sleep. The field of chronotherapeutics which studies these associations is still in its infancy but we will learn more about it in the near future.
Impact of Poor Sleep on Kidney Health
Poor sleep can impact the kidneys in two ways: directly and indirectly.
Indirectly, the factors we described above may lead to insufficient sleep, poor quality of sleep and apnea can lead to elevated blood pressure (hypertension) or make it more difficult to control. There is also a strong body of evidence linking blood sugar (glucose) metabolism with sleep quality and quantity. Fragmented sleep has been associated with increased insulin resistance and metabolic disease. Finally, fragmented sleep has been shown to impact the hormonal control of satiety and hunger leading to excessive eating and obesity. It is well established that diabetes, hypertension and obesity are associated with linked to the development and progression of CKD.
Directly, sleep can be a key regulator of kidney function. During sleep, sympathetic activity (fight-or-flight) decreases, and parasympathetic activity increases leading to a drop in blood pressure providing a positive benefit on the circulation in the kidneys. Patients with sleep disorders, especially those with sleep apnea may lose this drop in blood pressure because their parasympathetic system doesn’t kick on.
Shift work and irregular sleep timing and poor quality has also been found to affect the regulation of the renin-angiotensin-aldosterone system (RAAS). RAAS plays an important role in the development and progression of kidney disease. Last but not least, obstructive sleep apnea is associated with increased inflammation and oxidative stress which leads to kidney damage.
Impact of Kidney Disease on Sleep
CKD itself can be a risk factor for sleep disorders. Melatonin, which is a hormone secreted by the pineal gland, is responsible for the sleep-wake cycle usually increase during the night to induce sleep. In kidney patients, this natural rhythm seems to be blunted. CKD can lead to a short, fragmented sleep and difficulty falling asleep. In addition, CKD has been associated with OSA, restless leg syndrome (RLS), and increased leg cramps.
The Bottom Line
Sleep disorders are common in kidney disease and they have been associated with the development and progression of CKD. They also can lead to inflammation, diabetes, hypertension and obesity. Multiple factors plan a role in the development of sleep disorders. It is important to work with an Integrative or Functional medicine provider to evaluate your sleep and kidney health.
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