Your Guide To A Better Night's Sleep

Good quality sleep is essential to our general wellbeing, particularly our immunity and mental health, so it’s absolutely vital that we sleep well! If you’re finding yourself going to bed later and later, waking up several times in the night, waking up with anxiety, or feeling groggy upon waking, read on to learn more about how and why you need to focus on improving your sleep.

“For the body, first—sleep, and enough of it, is the prime necessity.” 

(Edward Everett Hale)

Sleep deprivation has become a significant problem in recent years. For instance, a 2018 survey found that only 6% of adults in the UK manage to achieve the recommended 8 hours sleep a night!1 Strikingly, those with less than 7 hours sleep per night are up to 3x more likely to develop the common cold than those with 8 or more hours sleep.² Poor sleep quality can lead to a wide variety of health issues, ranging from anxiety, depression, poor cognition, fatigue, and low immunity, to an increased risk of stroke and coronary artery disease.³ Read on to learn more about how you can support your sleep quality and re-establish this vital foundation of optimal health. 

There are two main stages of sleep, each of which is linked to specific brain waves and neuronal activity. A ‘sleep cycle’ refers to the transition through these two stages: non-rapid-eye-movement (NREM) and rapid-eye-movement (REM) sleep. A full cycle takes around 90 minutes, and it happens several times during the night, with longer and deeper REM periods occurring towards morning.⁴ Human beings have an internal clock that lasts about 24 hours and resets itself daily, regulated by our exposure to environmental light and dark. This is known as our circadian rhythm.⁵ A healthy sleep-wake cycle has a significant effect on our hormone balance. For example, cortisol (our principle stress hormone) should peak at the beginning of the day to promote wakefulness and then drop in the evening to help us wind down in readiness for sleep. This rise and fall of cortisol should be entrained by appropriate exposure to morning light and evening darkness. The onset of dim light in the evening should also coincide with the conversion of serotonin to melatonin (our sleep hormone). In addition to supporting sleep quality, melatonin is a powerful antioxidant and anti-inflammatory agent,⁶ making it protective for the immune system, as well as every other body system, not least the cardiovascular system.⁷ Our sleep-wake cycle is all too easily disrupted by various aspects of the modern world, especially insufficient daylight exposure, shift work, regular travel across different time zones, and/or excessive blue light exposure in the evening (e.g. phones, TV).⁸ 

Another key driver behind sleep disorders can often be stress, and therefore reducing stress levels can be another good way to improve sleep. When the stress response is out of balance, hormones such as cortisol, can be dysregulated and circadian rhythm can be lost. This is notable in people with insomnia, who usually experience higher numbers of stressful life events, compared to those without insomnia.⁹

Sleep issues could also stem from an imbalance in gut bacteria which play a huge role in regulating our nervous system and are partially responsible for the regulation of our mood, stress response, and sleep.^10,11 This is because gut bacteria produce different neurotransmitters, including melatonin and the main calming neurotransmitter - GABA. Low levels of GABA have been associated not only with insomnia, but also anxiety and depression.¹² 

Genes can also play a role, in particular the CLOCK (Circadian Locomotor Output Cycles Kaput) gene, which regulates our circadian rhythm, can potentially determine whether we are ‘owls’ or ‘larks’. Genetic variations in the CLOCK gene have been associated with insomnia,¹³ difficulty losing weight,¹⁴ and major depressive episodes in patients with bipolar disorder.¹⁵

From our clinical experience to date, there seem to be several main drivers of the deterioration in sleep quality this year. Amongst the most significant are:

• Disrupted light exposure – our internal clock, or ‘circadian rhythm’, is entrained by our daily exposure to light and dark. We are meant to be exposed to abundant blue-light rich daylight during the daytime, followed by exposure to the red hues of the setting sun and dim light in the evening. This diurnal rhythm of light and dark helps to ensure that cortisol peaks in the morning to promote wakefulness and dips in the evening to help us wind down, alongside a nocturnal rise in melatonin to further prime us for deep sleep. As many of us have transitioned to working from home and seemingly non-stop Zoom or Teams meetings, the majority of us have experienced low levels of daylight exposure alongside very high levels of blue light exposure, not to mention those individuals working in different environmental  settings whhere  this abnormal light exposure is the norm (hospitals, warehouses, factories etc.) ! This amount of ‘light pollution’ facilitates higher levels of cortisol throughout the day, coupled with lower nocturnal levels of melatonin, which collectively make us feel stimulated well into the night and drives lighter sleep. 
• More stressed and anxious – a high sympathetic nervous system response is another undoubtable driver of poor sleep quality at the moment. This can lead to many of us having our mind racing at bedtime and feeling too anxious to sleep, tossing and turning in sleep, waking up at night with anxiety, and/or not being able to fall back asleep easily. Many of us are tempted to check our mobile phone when we wake up in the middle of the night, but that blue light exposure only disrupts melatonin and stimulates our mind further, making it even harder to fall asleep! Furthermore, after a night of poor sleep, we tend to crave caffeine and sugar during the daytime, which can then negatively affect our sleep quality further, driving a vicious cycle! Notably, those with insomnia usually experience a higher number of stressful life events, in contrast to those without insomnia.¹⁵
• Increased alcohol intake -Alcohol can interact with several neurotransmitters important in the regulation of sleep and increases wakefulness during the night when consumed in high amounts.¹⁶
• More sedentary lifestyle –Bearing in mind that increased daily physical activity has been positively associated with sleep quality,¹⁷ being sedentary has an important role to play for general worsening in sleep quality. Physical activity tires our body which can be a helpful cue for rest in the evening. For many of us, physical activity also means getting outside and into nature, whereby the increased daylight exposure supports nocturnal melatonin levels, which can further support sleep quality.

• Increase awareness of sleep quality by tracking your sleep (e.g. Sleep Cycle, Fitbit, Oura ring). This can be especially useful for highlighting the nutrition and lifestyle variables which both help and hinder sleep quality to help you implement meaningful, personalised changes. 

•  Increase daily intake of supportive nutrients and botanicals:
• • Magnesium has been used for centuries for its calming properties. Magnesium taurate is a good option as both magnesium and taurine enhance the calming action of the neurotransmitter, gamma aminobutyric acid (GABA).¹⁸
  • Vitamin B12 can potentially improve sleep, daytime wakefulness, and mood upon waking, by supporting melatonin synthesis.^19,20
  • Tryptophan is used to make serotonin, which is then converted to melatonin. Rich food sources include oats, bananas, turkey, oily fish, and eggs. These can be used in tray bakes, casseroles, and stews to make easy and delicious meals. Melatonin itself is found in certain fruits and vegetables, mainly tart Montmorency cherries, which are typically consumed as cherry juice concentrate.   Smoothies are an easy way of getting the nutrients you need for healthy sleep. A combination of banana, tart cherry juice concentrate, almonds, oats, and cashew nut milk can be a lovely way of switching to a healthier bedtime nightcap.   
  • Lemon balm can increase GABA levels.²¹ has been shown to reduce anxiety by 18%, stress-associated symptoms by 15%, and insomnia by 42% within 2 weeks.²²
  • L-Theanine can increase the production of alpha waves (associated with relaxation),²³ reduce cortisol,²⁴ and increase serotonin.²⁵
  • Taking probiotics may be another way to help you manage stress, therefore promoting healthy sleep. Certain strains of Lactobacilli and Bifidobacteria, including Lactobacillus rhamnosus, can produce GABA26 and also positively influence serotonin level.²⁷
  • Hops is found to have calming effect on nervous system and improve sleep quality.²⁸
  • Montmorency Cherry can increase sleep time and sleep efficiency.
• Prioritise sleep and create a sleep routine with a regular sleeping pattern (e.g. 10pm-7am each night). Perhaps we should learn from our pets, pause for a moment, and prioritise relaxation more? We are the only mammals that can keep ourselves awake when our body is telling us it’s time to go to bed? No other mammals allow their sleep to get compromised like we do, even though sleep requirements vary amongst different species. For instance, dogs spend over a third of the day asleep, and they dedicate another 21% to ‘relaxed drowsiness’.29 
• Journal before bed to clear and calm your mind.
• Make your bedroom your sleep sanctuary - if your desk is in there, try to move it to another room if you can
• Increase your daylight exposure e.g. lightbox for waking (such as Lumie), walk or run before work or on your lunch break, or evening walk to watch the sunset.
• Reduce your evening exposure to blue light. Avoid technology at least 1 hour before bed and engage in a non-tech, calming, mindful activity instead, e.g. board game, or aromatherapy bath.
• Sleep in a dark, quiet room – e.g. blackout blind, earplugs, eye mask.
• Increase daily movement outside for daylight exposure as well as physical activity, such as an early morning walk in the park. 
• Adjust the timing and frequency of your eating to ensure balanced blood glucose levels. Aim for 2 or 3 well-balanced main meals rich in good quality fats, protein, and plant fibre, minimise snacking, and make sure to consume all food within a maximum 12-hour eating window (e.g. 7am-7pm).
• Minimise daily intake of caffeine, alcohol, and sugar, all of which can disrupt sleep quality. Opt for healthy alternatives, such as herbal tea, a glass of chilled kombucha, and naturally sweetened snacks, respectively, instead.
• Find a relaxation technique that you love and would enjoy practising on a daily basis, such as yoga, meditation, gardening, singing, reading fiction, jogging, or having a bath. Apps such as Calm and Headspace provide guided meditations and can help with a night of restful sleep.

If you would like more personalised support, please seek the advice of a registered Nutritional Therapist or contact our Clinical Nutrition team on 0121 433 8702 or via email clinicalnutrition@biocare.co.uk. 

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