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Posted: 9/26/2017 2:38:22 PM
Edited: 5/6/2019 8:33:42 AM (6)
Page edition: 2019-04-28
This is not a trivial matter. Its prominence continues to rise in Dr. Davis’ books,
earning 4 pages in Undoctored (304-308 of the print edition),
2018 blog post. See also my
review of Matthew Walker’s 2017 book “Why We Sleep”.
Even if you think your sleep is fine, it’s very likely not.
Here’s what I’ve been conjecturing for some time,
and these are not in any particular order:
- For people on standard diets, daytime sleepiness is commonly a result of
blood sugar excursions. These recede rapidly when following the Undoctored
or 2014+ Wheat Belly programs. If diet isn’t corrected, the remainder
of these tips are apt to be of limited value.
magnesium to program target. As this is usually balanced
across the day, biasing it toward evening may not be necessary.
Vitamin D in the AM, which mimics sun exposure, although
getting actual sun exposure early is ideal.
gut health — add daily prebiotic fiber to diet, avoid gut and
microbiome antagonists, and consider a course of a quality high-potency probiotic.
This often has a profound effect on both sleep and dream quality.
- Take advantage of the optional L.reuteri
yogurt, unless contraindicated
- If weight loss is the goal, discard caloric restriction from the tool box,
as it disrupts sleep. Sub-seasonal keto is probably OK. Intermittent fasting
might not be (until normal sleep is restored), if the fasting interval lasts more than
- If you are working evening or night shift, bid on a day job or apply elsewhere.
Shift work is frankly carcinogenic per IARC (Group 2A).
Adjusting your personal environment, circadian rhythm and metabolism to compensate for this, ranges
from extremely difficult to impossible. The shift premium is no prize.
- If snoring is present, get checked for sleep apnea, which is a
serious hazard (esp. if your day job is driving trains).
If you have weight to lose, there’s an excellent chance the apnea
will vanish with it. Despite what you see in TV adds, no, CPAP may be "normal",
but it is not healthy, and is very far from optimal.
- Get adequate hydration (and not all just before bed).
- Avoid alcohol 4 hours before sleep. 6 or more hours would be even less
damaging to REM sleep.
- Consider not eating, period, 4 hours before sleep.
- Don’t nap after 3:00 PM. Let the sleep pressure build.
- Design a regular sleep schedule, which is the same every day.
You cannot trivially shift your schedule around.
You cannot bank sleep ahead, nor back-fill to any material degree.
- If you must arise at a specific time, ideally get to bed
early enough that you can get 8 hours in before the
alarm clock. This gives you some chance or awakening naturally,
after the final REM phase, and before the alarm.
- Obey the sun. Get to bed as soon after sundown as possible. In any event,
all bright and blue light after sundown, and continue to avoid
them if you need to arise in the night.
- Yes, this means no (zero) electronic devices in the bedroom:
no TV, no tablets, no phones, no reading lamps.
Ask your routine night-time callers to stop trying to kill you.
- Do not take problems to bed. If you’re married to one, of course,
that could be a challenge to remediate.
- Get bright light in the AM. Look at the sky (although not directly
into the sun, of course).
- Don’t exercise at night. The problem here is that it raises core temperature,
which needs to decline for proper sleep. Otherwise, exercise during the day
can enhance sleep.
- On the other hand, a hot bath or shower before bed triggers a peripheral
response that can accelerate sleep onset.
- Set thermostat for cool bedroom overnight (well under 75°F/24°C
and 65°F/18°C might be ideal).
- Avoid caffeine after 2:00 PM, or even earlier if you are a slow coffee
metabolizer. Decaffeination does not fully fix this. Many processed food-like
substances have added caffeine.
- Consider having a sleep study done, or invest in a wearable
device that tracks aspects of sleep quality.
- Consider melatonin and tryptophan supplementation.
Undoctored, page 307 covers dosing.
- Look into physiologic and psychological techniques that can
enhance relaxation and sleep. CBT-I is already known to be more
effective than all current sleep medications.
- Completely avoid all current OTC and Rx sleep aids.
If they even “work”, what they provide is unconsciousness
that provides none of the key benefits of sleep.
Some of these agents are literally suicidal risks.
If you have daytime sleepiness, and it’s not clearly optional blood sugar excursions,
one or more of the above are suspect causes or corrective measures.
|Tags: circadian rhythm