In my experience, you can have the best diet in the world, have the best exercise program and be free from emotional stress, but if you aren't sleeping well, for whatever reason, it is virtually impossible to be healthy.
In this interview, Dr. Rubin Naiman -- a clinical psychologist, author, teacher, and the leader in integrative medicine approaches to sleep and dreams -- , explains the importance of this crucial aspect of health.
Dr. Naiman earned his Ph.D. in Clinical Psychology at Alliant University in San Diego.
During the 1990's, he served as the sleep and dream specialist at Canyon Ranch Health Resort in Tucson for 10 years, where he created the first formal sleep laboratory outside of a hospital setting. Dr. Andrew Weil was also on the staff at that time.
Later, he served as director of sleep programs for Miraval Resort. For more information on Dr. Naiman, please see his web site, www.drnaiman.com .
Sleep is an essential part of optimal health. In fact, if you're not sleeping well, it's virtually impossible to be healthy…
In this interview, clinical psychologist and sleep specialist Dr. Rubin Naiman shares his extensive knowledge of this often overlooked aspect. His work has focused exclusively on sleep and dreams for the past 20 years.
What is "Sleep"?
This is an important question, because as Dr. Naiman says, "too often, we try to resolve sleep issues without knowing what it is."
He draws a parallel to the general topic of health. Many people think that "getting healthy" equates to "fighting disease," but health is much more than just the absence of illness…
"Likewise, sleep is not simply the absence of waking," Dr. Naiman says. "This is a very common misunderstanding around the world today. We define sleep negatively. We define it in terms of what it's not.
… So we believe that sleep is "not waking," but to define it in those simple terms, which suggests that any kind of unconsciousness is a kind of sleep, is simply not true. There are certain qualities associated with sleep that most of us have become desensitized to.
So what is sleep?
When you look at changes in EEG, in electrical brain activity, as we go from waking into deeper stages of sleep, those changes parallel the same changes we see when people go into truly deep restful states. More specifically, I'm talking about meditators. Accomplished meditators have been shown to be able to access brainwave activity that looks very much like deep sleep.
In a sense, we need to think of sleep as not the absence of waking but another kind of experience in its own right. There is actually some data that suggests that you can learn to cultivate awareness during deep stages of sleep."
The Spiritual Dimensions of Sleep
While research has shown that sleep is important for a number of different reasons, from improved performance and alertness to improved immune system function, and increased creativity, these benefits still do not tell the whole story.
"We need to remember that sleep, in addition to providing support to waking life, is of value in it of itself," Naiman says.
"Sleep delivers something important. It takes us to another place in consciousness.
I deeply believe that sleep has spiritual benefit. It's a valuable experience in it of itself.
When we recognize that, we really shift our attitudes towards sleep as something we can actually enjoy -- not something we simply need to do to be healthier."
A lot of people are interested in spirituality, but how many of you have ever considered tapping into, or taking advantage of this spiritual dimension of sleep? I agree that looking at sleep from this renewed perspective could have a very positive impact on your relationship to sleep.
Viewing it as a sort of spiritual process, as opposed to a temporary shut-down from waking life, could help relax your anxiety about "having" to sleep.
Understanding Why and How Insomnia Occurs
The most commonly reported sleep disorder is insomnia; having trouble falling asleep or staying asleep, or the inability to get quality sleep throughout the night.
According to Dr. Naiman, one of the most common symptoms of insomnia is a condition called "cognitive popcorn:"
"Cognitive popcorn is something that occurs when you put your head down, trying to go to sleep or trying to get back to sleep in the middle of the night, and suddenly your mind starts to produce all of these thoughts.
They're unwanted thoughts, uncontrollable thoughts. It's as if the mind has a mind of its own. That's a very common complaint that keeps people awake."
In order to understand why you can't sleep, you need to understand that sleep is the outcome of an interaction between two classes of variables: sleepiness and "noise.
- Sleepiness – Under normal conditions, your sleepiness should gradually increase throughout the day, peaking just before you go to bed at night. This is ideal, as you want your sleepiness to be high at the beginning of the night.
- "Noise" – refers to any kind of stimulation that inhibits or disrupts sleep. If noise is conceptually greater than your level of sleepiness, you will not fall asleep.
"Noise" occurs in three zones: the mind level, body level, and the environmental level.
Dr. Naiman gives this example: "If you're energized during the day, you're feeling passionate, you want to move, be productive and so on, that's great. But if that experience occurs in the middle of the night, that becomes a kind of noise."
The most common type of mind noise, however, is the "cognitive popcorn;" unstoppable thoughts running through your mind at night.
Examples of body noise include pain, discomfort, indigestion, side effects from prescription drugs, or residual caffeine from drinking coffee too late in the day.
Environmental noise is usually obvious, such as noises in your room or house, a snoring partner, music, lights, or a bedroom that's too warm.
In order to get a good night's sleep, you want your sleepiness level to be high, and the noise level to be low.
According to Dr. Naiman, more often than not, the reason why people can't fall asleep is NOT because of lack of sleepiness, but rather because of excessive noise.
Therefore, the FIRST thing you need to ask yourself when you can't sleep is:
- "Where/What is the noise (mind/body/environmental)?"
Typically, people will find a number of different factors that contribute to the noise burden keeping them awake!
So it's important to carefully evaluate your environment and inner/outer state to determine ALL the contributing factors. If you address one problem, but not the others, you still may not be able to fall asleep, or stay asleep throughout the night.
For more in-depth details about the various forms of insomnia, please listen to the interview in its entirety, or read through the transcript.
Two Common Problems that Can Keep You Tossing and Turning
Two very important contributing factors that can make sleep elusive are:
Why You Need to Sleep in Complete Darkness
Having too much light in your bedroom at night can interfere with your body's production of melatonin. Melatonin is both a hormone and an important antioxidant against cancer.
Disrupted melatonin production, caused by lack of bright light during the day, and too much light in the evening and at night, can also have a significantly detrimental impact on your health, aside from "just" disrupting your sleep. There's actually strong evidence showing there is a dose-dependent relationship between exposure to light at night and a significantly increased risk for breast cancer.
Dr. Naiman takes a small amount of melatonin each night even though he does not have any sleep problems. He takes it because -- like most people living in developed countries -- he believes he's overexposed to light at night, which contributes to melatonin deficiency.
"Years ago, the average length of a day was 12 hours; 12 hours of light, 12 hours of darkness," Naiman says. "Today the average length of a day is 16 hours. We are exposed -- this is true for children as well -- to so much more light than we used to. … But it's poor quality light. It's like the empty calories that we get in a lot of food today.
And, during the day, most of us are underexposed to light."
Using full spectrum lights in your home and office can help ameliorate the lack of high quality sunlight during the day, and paying attention to the amount of light you flood your home with in the evening is important as well.
You can now also find light bulbs that do not give off blue light, called "low blue lights," which emit an amber light. The blue wavelength in the light spectrum is the light that specifically suppresses melatonin, so these types of light bulbs are ideal for your bedroom and bathroom.
TVs and computers also emit a lot of blue light, which will zap your melatonin if you work past dark.
Keep in mind that even a small amount of light, like turning on the bathroom light to go to the restroom, can be enough to temporarily suppress the melatonin production. This is why it's so important to avoid using night lights, or turning lights on if you have to get up in the middle of the night.
This is also why I strongly recommend installing blackout shades to ensure total darkness in your bedroom.
Keep it Cool!
In addition to making sure your bedroom is kept pitch black, maintaining the ideal room temperature can have a dramatic impact on your ability to fall asleep and stay asleep.
Keep the temperature in your bedroom no higher than 68 degrees F. Many people keep their homes and particularly their upstairs bedrooms too warm.
Studies show that the optimal room temperature for sleep is quite cool, as low as 60 degrees.
Keeping your room cooler than 60 degrees F. or hotter than 70 degrees F. can lead to restless sleep.
This is because when you sleep, your body's internal temperature drops to its lowest level, generally about four to six hours after you fall asleep. Scientists believe a cooler bedroom may therefore be most conducive to sleep, since it mimics your body's natural temperature drop.
Why Sleeping Pills aren't the Answer
About two years ago, the National Institutes of Health (NIH) produced an excellent meta-analysis on the effectiveness of sleeping pills.
What did they find?
Sleeping pills DON'T WORK!
"If you look at polysomnography (objective measures of sleep)… more often than not, sleep is worse on a sleeping pill," Naiman says.
In this meta-analytic study, they found that on average, sleeping pills would help people fall asleep approximately 10 minutes sooner. If it's taking you an hour or two to get to sleep, 10 minutes is statistically significant, but frankly, personally, biomedically, it's not significant at all.
On average, sleeping pills increase total sleep time maybe 15 to 20 minutes. Again, if you're looking at an eight-hour night – it's really insignificant.
But here is the catch. This was a really phenomenal find. They found that what most sleeping pills do is they create amnesia for awakenings and poor, fragmented sleep. Sleeping pills disrupt your memory formation.
So you wake up thinking you had a good night sleep, but when you look at objective measures of your sleep, it's really very poor. So we're tricking ourselves. Sleeping pills result in poor quality sleep--what I call counterfeit sleep."
Sleeping pills also come with a slew of detrimental and potentially dangerous side effects.
Additionally, most people do not realize that over-the-counter (OTC) sleeping pills -- those containing Benadryl -- can have a half life of about 18 hours. So, if you take them every night, you're basically sedated much of the time. Not surprisingly, they're associated with cognitive deficits in the morning.
Many sleeping pills are also a potent anti-cholinergics, which suppress REM sleep and dreaming. These drugs are also known to increase dementia risk in seniors.
In 2008, Americans filled more than 56 million prescriptions for sleeping pills and spent more than $600 million on over-the-counter sleep aids. But anticholinergic sleep medications in particular may be causing far more harm than good, especially long term, without providing any benefit at all.
Trust me, there are far better, safer and more effective ways to get a good night's sleep.
For a long list of safe and sane tips to improve your sleep, please see this article.
This interview contains a treasure trove of important information, so please, if you or someone you love suffers from poor sleep, take the time to listen to the entire interview, or read through the transcript. It contains much, much more than what I've summarized above. (Please note that we did have some technical problems with the audio so the transcript might be better)
Also keep an eye out for the second installment of this interview, in which Dr. Naiman will discuss the ideal amount of sleep time.
There's convincing evidence showing that if you do not sleep enough, you're really jeopardizing your health.
Everybody loses sleep here and there, and your body can adjust for temporary shortcomings. But if you develop a chronic pattern of sleeping less than five or six hours a night, then you're increasing your risk of a number of health conditions, including:
- Heart disease
- Autoimmune diseases
- Neurodegenerative diseases
For even more helpful guidance on how to improve your sleep, please review my 33 Secrets to a Good Night's Sleep. If you're even slightly sleep deprived I encourage you to implement some of these tips tonight, as high-quality sleep is one of the most important factors in your health and quality of life.