5 August 2022

A Deep Dive Into Sleep- Increasing Synchronicity of the Circadian Rhythms

Sleep quality is critically important for your physical and mental health. 7-9 hours of “terrific” sleep is ideal for adults (8.5-11 hours for children to teenagers depending on age) for good health. Less than optimum sleep may impact negatively on:
• Mood- Depression
• Anxiety and Stress Levels
• Frustration and Irritability
• Concentration Levels
• Behaviour
• Overall Tiredness
• Physical Health and Well-Being

In addition to the typical sleep hygiene techniques recommended by most health care providers (and found below), understanding the biochemistry of the body and brain provides a deeper appreciation of some of these strategies as well as powerful solutions to improving clinically concerning sleep issues.

Biochemistry of Sleep

“Wakefulness” has been found to be detrimental to your ability to fall asleep at night. That is, wakefulness and sleep are tethered together and your sleep hygiene plan needs to accommodate the biochemistry and circadian clocks for effective outcomes.

Adenosine

• Adenosine is a chemical molecule in your body that builds up during the day and required for causing sleepiness. When you wake up your adenosine levels are very low and as the levels increase during the day they create a pressure for sleep or “sleep drive” or hunger. We need high levels of adenosine levels in our body to fall asleep. This requires adequate hours of being awake and some factors like caffeine and daytime sleep (vs a short nap) can get in the way of accumulating adequate levels.

Caffeine blocks Adenosine and impacts on the accumulation of this chemical in the body during the day. Many people find that they cannot have caffeine too late in the day or it impacts on your sleep. Some are not able to drink caffeine at all.

The Circadian Force

Circadian rhythms are 24-hour cycles that are part of the body’s internal clock. One of the most important of these rhythms is the sleep-wake cycle. When aligned well, a circadian rhythm can promote consistent and restorative sleep. Insomnia is often caused by out of sync circadian rhythms.

Most people do not realise that environmental cues are significant influencers of the master clock and that the time onset and quality of your sleep at night is strongly governed by sunlight at the start of the day.

1. When we wake in the early morning with our low Adenosine levels, cortisol and epinephrine is released from our body and brain to help us feel awake. This alerts our systems to start moving for the day. Once this system is activated it sets a timer for the pineal gland to release melatonin to your body in about 12-14 hours. The later the system is activated in the morning, the later the release of melatonin. Waking early closer to sunrise is best for optimal sleep by 9-10pm.
2. When our retinol ganglion cells in our eyes (brain neurons) access sunlight, these cells send a signal to the central circadian clock to time the release of both cortisol (to help promote wakefulness in the early morning) and melatonin (released later at night but time set in the morning by the clock) properly. Out of sync rhythms disturb sleep but also impact on general health, mental health and learning.
3. Accessing light in the morning requires the right type of light or the rhythms are not set properly. House lights and phones/laptops and devices are not adequate. The contrasts in yellows and blues in sunlight is optimal and activates the rhythms most effectively.
4. Your want low lying sunlight into your eyes as soon as possible after waking to activate your clock and access a good rhythm.
5. Research suggests that seeing sunlight through a window is 50 times less effective through a window or windscreen. Best outcomes occur when you are outside looking at sunlight.
6. Sunrise simulators or light therapy glasses can be used if access to direct sun is not possible (eg Luminette 3 light therapy glasses).
7. Looking at the sun during sunset can be additionally protective of the systems and clock.
8. It will take approximately 2-3 days of same wake-up cycle with direct sunlight for 20-30 min each morning for rhythms to align.
9. Intense morning exercise further enhances this process and increases sleepiness at night.

Other helpful tips/facts

• You do not want too bright light in your eyes between 11pm and 4am. Suppresses release of dopamine and can inhibit learning and other detrimental affects. Even if you are dimming screen you are still triggering these neurons
• Overhead fluorescent lights are the worst – dim lights set low in the room will reduce activation of neurons impacting on circadian clock
• Candlelight does not activate these cells so use candlelight where you can. Fireplaces also ok
• Wear blue light blockers if watching a late-night movie to manage bright light exposure

Other Sleep Hygiene Strategies To Improve Your Sleep
1. Regulate your sleep cycle: one of the best ways to improve your sleep is to go to bed and get up at the same time each day. This all relates to the rhythms discussed above.
2. Get up and try again: If you can’t get to sleep after 20-30min of trying, get out of bed and do something calming or boring for 10-15 min and then try again. If you get up, don’t do anything too stimulating.
3. Mindful Breathing and Body Scan: Mindfulness strategies such as mindful breathing and body scanning can assist with getting to sleep. If you don’t know what mindfulness is- ask your therapist to explain it to you and take you through a mindfulness exercise to demonstrate.
4. Yoga Nidra: means yogic sleep and is a form of meditation where the goal is to achieve a deep state of conscious awareness sleep. It significantly calms the sympathetic nervous system that alleviates anxiety and makes it easier to fall asleep. Guided yoga nidra meditations can be found on apps and online.
5. Avoid caffeine and sugar close to bedtime: having caffeine less than 4 hours before bed time will make it more difficult to fall asleep due to the blocking of Adenosine.
6. Use your bed just for sleeping: Set your bed up so that it is associated with sleep only. If you do other stimulating activities on your bed during the day and early evening, your body will not learn the connection between bed and sleep
7. Small nap no sleep: Avoid long naps and sleep during the day otherwise your body won’t be tired enough for a full night of sleep. If you need a nap keep it under an hour and don’t sleep later than 3pm.
8. Set up sleep rituals: develop your own rituals that remind your body it is time for sleep. Examples might include 10 minutes of breathing exercises or reading a non-stimulating book.
9. Have a bath: having a bath 1-2 hours before bed can help your body to feel sleepy as your body temperature drops
10. Don’t watch the clock: watching the clock can either wake you up with the lights or reinforce negative thoughts such as “it is so late, I will never get to sleep. This is terrible”.
11. Monitor your sleep: collating some facts about your sleep can help you to work out what factors might be contributing to your sleep difficulties. Keeping sleep diaries can then also be given to health professionals if you need medical help with sleeping.
12. No exercise less than 3-4 hours before sleep: while exercise is great, try not to do it less than 3 hours before bed time as it releases endorphins that will keep you refreshed and energetic.
13. Eat well and don’t go to bed hungry: healthy eating can assist sleep and ensuring that you don’t go to bed on an empty stomach will also help you to fall asleep and keep sleeping. Having a very full stomach can also affect sleep negatively.
14. Limit alcohol consumption before sleep as it impacts on sleep quality
15. Comfortable bed and bedroom: Having a comfortable bed will help you to sleep. Also having a bedroom where the temperature is comfortable will help you with sleep.

By Dr Michelle Pritchard
Clinical Psychologist