Sleep Your Way to Stronger Resilience Dr. Naiman: Hi, I m Rubin Naiman. I m a clinical health psychologist, and the Sleep and Dream Specialist at the University of Arizona Center for Integrative Medicine. I want to talk to you today about 10 essential suggestions for healthy sleep, based on what I call an integrative approach. Healthy sleep is absolutely essential in supporting resilience and we re talking about both biological and biomedical resilience, as well as psychological resilience. There is a mountain of data that links poor sleep to chronic inflammation. Many of us now are aware that chronic inflammation is a ubiquitous process that underlies a whole range of major disease processes. For many years, we ve also known that there is a very important link between poor sleep or sleep loss with mood disorders. Some of this has to do with actual sleep, and some of this has to do with support that we gain during REM sleep and dreaming. The single, strongest predictor for future clinical depression is poor sleep or insomnia, off-and-on for a full year. In terms of resilience around body and mind, sleep is critical. We are not a very resilient culture. There is an epidemic of sleeplessness in the United States, North America, and developed countries today. A lot of this is linked to a condition we now call hyperarousal, which is about an excessive, relentless drive in life. Again, we know that this is ubiquitous. We have evidence that there is a significant growing amount of dream loss which I think of as, Dream Deficit Disorder. We re dealing with an epidemic of sleep loss that has profound, negative ramifications for both our physical and mental health. Underlying this problem is the fact that we really don t get the sleep we need, because we don t get sleep. We don t understand sleep. Before going into these ten suggestions, I just want to briefly offer you some comments about what sleep is and what it s not. In the past twenty or thirty years, research of sleep science has taught us a tremendous amount about what sleep looks like biomedically. We know what goes on in the body in the brain during sleep but in its focus on sleep, science has unfortunately forgotten the sleeper. They have short-shifted this critically important aspect, this personal aspect of sleep the personal experience of sleep. To really understand that, we need to look at more psychological, and even psychospiritual, writings about sleep. Sleep is a default unconsciousness. Even though it may sound silly, there is a part of us that is always already asleep. Sleep resides in the backdrop of consciousness. It s the background around the whole range of waking experiences and that has implications for how we get to sleep, as you ll see.
Sleep also requires a dissipation of energy. We are an energy-hungry and energy-crazy culture. In fact, many of us nowadays think of the divine strictly in terms of energy. In contrast to walking, when it comes to sleep, we have to dissipate energy in a very real sense. It s not just about letting go of thinking and focus and productivity it s literally about letting go of heat. We have to cool when we sleep. Sleep is a profound state of serenity. It is a gracious state of serenity that is offered to all of us on a nightly basis, if we re willing to receive it. Ten suggestions about healthy sleep, about how to let ourselves really receive sleep: The first suggestion is a negative one, meaning something we ought not to do. We really need to avoid sleeping pills. There is substantial research that suggests that sleeping pills are basically a wolf in sleep s clothing. They are largely ineffective, despite the subjective experience of being asleep. Most people really are not. There is very frightening data suggesting that ongoing sleeping use is associated with morbidity and mortality. In contrast to standard over-the-counter and prescription sleeping pills, there is a whole range of complementary and alternative approaches botanicals, nutraceuticals, and things like melatonin and valerian that deserve consideration over sleeping pills. Suggestion number two is that we get rhythmic. We need to remember that rhythms are the infrastructure of all of life. Something I think of is the power of when it s not just what we do, it s when we do it. Daily life has rhythmic processes that are a bit like the rhythms we see in the ocean. There s a daily rhythm, a circadian rhythm, of tides coming and going. There are smaller rhythms, like waves, that are called ultradian rhythms. These combine in a kind of symphony, so there s musical structure. When we wake-up, our exposure to morning light or when we sleep, our exposure to evening darkness are all critical factors in creating the ultimate structure for us to sleep well. Suggestion three: cool your lifestyle. We need to down chronic inflammation. I think of this as night fever. People who can t sleep well are literally overheated at night. Their average body temperature doesn t drop as it normally should at night. They stay too hot. This is associated with the consumption of excessive energies during the day. It might be the overconsumption of high glycemic foods which overheats us. Or, it might be the overconsumption of high glycemic energy, the overconsumption of light during the day. So, we need to cool our lifestyle. This is simply about good nutrition, adequate exercise, effective stress management, and, at a very practical level regarding sleep keeping our bedrooms cool, dark, and quiet. Number four is we need to tone down hyperarousal.
We re in a world where there is this relentless drive. There s been a lot of research focused on defining and understanding this. We know that people who don t sleep well actually have elevated metabolic rates, elevated heart rates, and elevated beta EEG high level waking and awareness. People who don t sleep well are not actually deficient in sleepiness. They don t sleep well because they are excessively awake. Toning down hyperarousal is something we can do from any number of directions. We all are familiar with relaxation techniques whether they are bodily relaxation techniques like yoga, various forms of meditation, HeartMath, and so on. We really need to consciously engage in activities that help us chill and slow down at night. Number five. Although this seems counterintuitive to some people, get out of bed when you are sleepless. Many of us have thought, Well, if I can t sleep, it s better for me to hang out in bed and rest. That is generally not true. If we remain in bed and there is the slightest struggle to sleep if we re tossing and turning and we re agitated, we re thinking, we re trying to manipulate our way back to sleep the activation becomes classically conditioned and associated with the bed, and can interfere with future sleep. The idea is to go to bed when you feel sleepy. When you re not feeling sleepy, step out of bed, go sit somewhere quiet and meditate until you feel sleepy again. Then, return to bed. Number six is about getting time out of mind. It s a common experience in our world for people to wake up and check the time. This is an effort to gain a sense of control and understanding of our sleep. When people wake up and check the time, they invariably do the math meaning, they think, Well, if I can get back to sleep in 10 or 20 minutes, I can still get another two or three hours. That pulls consciousness back into the waking world and can inhibit our getting back to sleep. Why would we check the time in a place we don t want to be? We wouldn t check the time in London or Paris, for example. Why would we wake up and check the time in the waking world? A second related issue is the alarm clock. The vast majority of us feel that we need to limit or corral sleep so we set an alarm clock. We wouldn t think about setting a timer when we sit down to a lovely meal, or setting a timer when we re going to make love with a partner. If we routinely wake up with an alarm clock, we are routinely not getting enough sleep, and we re snipping off the end of our dreams. If we get sufficient amounts of sleep, we will wake up at about the same time on a regular basis without an alarm clock. Number seven is a very critical recommendation. It s about learning to fall back in love with sleep.
Unfortunately, most of us see sleep through these functional medicalized eyes. We think about sleep in terms of something we have to get. There are many, many good functional reasons to sleep. But the best sleepers I know are people who will tell me they actually love sleep. They really enjoy sleep. They don t do it simply for the benefit, but for the good feeling associated. Number eight is about befriending nighttime wakefulness and daytime sleepiness. It s very common in our world for people to wake up at night and have a negative reaction to their wakefulness. Against the expectation that a good sleeper sleeps solidly through the night, they get very upset and often will hurl an expletive at their wakefulness. Fighting wakefulness in the middle of the night creates anxiety and makes it more difficult to fall asleep. The counterpart to this is people who end up getting into battles with sleepiness during the day. It s normal to have occasional sleepiness during the day. If it s excessive, it s something we need to look at. But, if we re in a meeting or if we re busy at work and we suddenly get sleepy, many of us will go to battle with sleepiness. What happens then, is this classically conditioned association between sleep showing up but showing up at the wrong place and the wrong time. It s as if a good friend is showing up but, someone we love to have around at night. So, we get into an argument with that friend. But that argument might impact how that friend shows up at night. I like to talk about a non-violent approach to sleep. This is about a practice of both befriending nighttime wakefulness and daytime sleepiness. I think it has positive impacts in terms of how we sleep, and the quality of our sleep at night. Number nine is about reinstating our relationship with dreaming and REM sleep. This is very, very critical. We are at a time where we re dreaming less and less. This is an unrecognized, serious epidemic of dream loss. I suspect that, as a culture, we re actually more dream-deprived than we are sleepdeprived. It may well be that many of the negative medical ramifications we attribute to sleep loss are actually linked to dream loss. Dreaming is critical for learning and memory. It regulates our mood. It supports creativity. It s essential for spirituality. I encourage people to open their hearts once again to dreaming. Keep a dream journal near the bed. If you re not experiencing a sense of dreaming, you might experience with some melatonin at night, which can help promote REM sleep. The last recommendation is absolutely to get professional help if you need it. In truth, occasional sleeplessness is not considered a medical condition. Everybody on occasion will have a bad night for a variety of reasons usually, it s stress. If this persists, and it turns out that through many or most nights of the week you re having trouble falling asleep or staying asleep and you re losing sleep on a regular basis it s a really good idea to talk to a practitioner. Sleep loss is cumulative.
My recommendation would be to find somebody who provides CBTI, which is Cognitive Behavior Therapy for Insomnia. These folks are referred to as behavioral sleep medicine specialists. They are typically psychotherapists or psychologists who have special training and certification in behavioral approaches which are the most effective and certainly more preferable approaches to using medications. Thank you.