Coming up on this episode of The Doctor’s Farmacy.
Dr. Mark Hyman:
If your cortisol is high in the afternoon or high in the evening, you may feel tired and wired. You want to sleep, but you can’t. Or you might fall asleep because you’re really tired, and then you wake up in the middle of the night.
Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman. That’s Farmacy with an F, a place for conversations that matter. And today, I’m bringing you a health bite to improve your health because taking small steps every day can lead to significant change over time. And today, we’re going to talk about sleep, and not just sleep problems in general, but why we may wake up between 1:00 and 4:00 in the morning and how you can fix that. Because a lot of times people have restless sleep, they wake up in middle of the night, they can’t go back to sleep, and it really affects the quality of their health, their life, and everything else.
So sleep is critical to our health, to longevity, to our mental health, to basically every physiological function we have, and it really is important to fix it. So let’s talk about what you can do to stay asleep and to sleep more deeply.
So we know that poor sleep makes us less productive and makes us tired, hard to focus. Basically, having sleep deprivation is basically equivalent of being drunk in terms of your performance. I read a study once where there were snipers who were excellent shots, and if they had eight hour sleep, they were like 100% accurate. If they had seven hours sleep, they were like 95% accurate. If they had six hour sleep, they were like 70% accurate. And if they were less than six hour sleep, they were basically like 50%. It’s like almost a hit-and-miss.
So not good. Even when you’re an expert in something, you can’t function when you’re tired. So next to sort of nutrition and exercise, and maybe even before I somewhat argue, sleep may be the fundamental foundation of health and disease prevention and even weight control. So why is it so important how the sleep dysfunction lead to changes?
Well, there’s a very important hormone called cortisol, which is your stress hormone. It helps, when it’s in balance to go up in the morning to get you energetic and focused and do the things you need to do for the day and at night it’s supposed to go down, and you’re supposed to calm down and relax. And a lot of people have an inversion where their cortisol is all in the morning, they can’t get out of bed and at night they’re tired and wired. Sound familiar? I bet you’ve, some may have experienced that. I certainly have at different moments in my life. When you lay get down into bed, you’re exhausted, but you can’t fall asleep because you’re just wired. That has to do with your adrenal glands. And they, they’re designed to keep things in balance, to regulate your weight, to moderate your stress response, your controlled blood sugar, regulate inflammation, and regulate sleep and wake cycles.
So when we’re constantly in a state of stress, we’re actually often struggling with sleep because of the way in which it affects our sleep. So when you’re thinking about it, when your cortisol’s high, you’re running from a tiger, you’re in danger, you don’t want to be sleepy, you want to be alert. And that’s the problem. So if your cortisol levels are balanced and they’re high in the morning and then low at night and your blood sugar stays even, we’ll talk about why that’s important, because fluctuations in blood sugar often will cause midnight or middle of the night wakening. But when your cortisol’s and your body stress response imbalanced and your pineal gland produces something called melatonin that pulses really strong in the afternoon and the evening, which gets you ready for sleep and lets your cortisols drop off and then you can feel calm and go to sleep at night and feel sleepy.
And if you’re healthy and balanced in your circadian rhythms and your cortisol melatonin cycles, you’ll be fine. But if your cortisol is high in the afternoon or high in the evening, you might feel tired and wired. You’ll want to sleep but you can’t. Or you might fall asleep because you’re really tired. And then you wake up in the middle of the night between one and four. And that happens when you sort of go, go, go, go, go, do your email, you’re working, working, working and busy, and then you go to bed and you’re like, and then you fall asleep or you’re exhausted, but you end up waking up because your body is still in a stress state and there’s still high levels of cortisol. So how does stress affect your sleep wake cycles? Well, it works in a lot of different ways.
Psychological stress can be a big factor, right?Worries about family work, money. Physical stresses, lack of exercise is a stress, believe it or not, too much screen time, junk food, toxic lifestyles, hormonal imbalances, environmental toxins, all these drive increased inflammation, increased brain inflammation, and also increased cortisol because by the way, do you know this, that when you eat sugar or starch, your body responds by jerking up the adrenaline and cortisol levels. So literally eating sugar is a stressful experience to your body. Even if you’re getting pleasure and you don’t think it’s stressful and you’re meditating while you’re eating sugar, you’re still going to have high cortisol and high adrenaline. So one are the things that are the two most common things that are screwing up your sleep wake cycles is probably blood sugar imbalances and spikes and crashes in blood sugar and chronic stress. So what should you do to optimize nutrition so you can regulate your stress hormones through food and lifestyle, and how do you deal with actually regulating sleep throughout the whole night and get high quality sleep?
So the first thing is our bodies, whether we like it or not, are biological organisms, and they run in circadian rhythms and they need to be balanced. So you have to live in rhythm. And I experienced the dangers of not being in rhythm when I worked in the emergency room. I would sometimes work seven in the morning till five at night shift. Then I’d work at two in the afternoon till the two in the morning shift. Then I’d work at 11 o’clock at night to a seven in the morning shift. Then I’d work at eight in the morning to an eight in the morning shift, 24 hour shift. I was all over the place and my whole system became dysregulated. And ultimately it led to chronic fatigue syndrome and a bunch of other stuff. My system just kind of collapsed because I was pushing through all these circadian rhythms, which have to be in balance for you to be healthy.
And whether we like it or not, we tend to do a lot better from our health perspective if we go to bed at the same time, if we wake at the same time, if we eat at the same time, our bodies are designed like that. So you want to make sure that you actually don’t eat before bed because that’s the worst thing you can do. But you need to make sure you’re having meals in a regular time space. So don’t eat three hours before bed. Don’t eat a heavy meal before bed because I guarantee you that’ll screw up your sleep. Also, carbohydrates, I think if you want to actually eat some starchy things like sweet potatoes or some more starchy foods and you can handle it metabolically, make sure you do it at night because the serotonin levels go up and it helps with sleep when you have your carbohydrates but still don’t eat white flour, sugar, processed, all that processed food.
Also, not eating enough is stressful. If your body’s not getting enough food, it gets also considered a stress. Now you can do time restricted eating and you can sort of narrow the window in which you eat for longevity purposes and so on. But you also want to make sure you’re getting enough food and not actually starving because that will increase cortisol and you’ll wake in the middle of the night. Now if you want to lose weight, you can use what I think is probably the most effective treatment ever found, which is the 10-day detox diet to help people lose a hundred and twenty, a hundred and thirty, two hundred pounds. It’s like a gastric bypass without the pain of surgery, vomiting, and malnutrition. Another thing you can do is get stuff out of your head. Write your worries down at night. So get a little piece of paper or journal, or maybe in your phone, write down all your worries, what you have to do, your day should be organized for the next day. Free up your mind so you can actually let go of things and go into a deep restful sleep.
Next you can try a number of supplements and things that I’ve found very helpful. Magnesium is super important, it’s the relaxation mineral. It helps regulate the stress response, helps you regulate cortisol, helps relax your muscles. I recommend two to 400 even more of magnesium glycinate before bed. Glycine also helps with sleep, so you can use glycine and you can use that to help relax the nervous system and your muscles. Next, try some melatonin. Mellow out with little melatonin. You can use half to up to two to three milligrams of melatonin at night. And that can often help you reset your circadian rhythms, particularly with travel.
Also, ashwaganda is an Ayurvedic herb that can be really powerful for resetting cortisol. I use a product called Cortisol Manager, which helps at night to reduce the stress response and improve sleep quality. Also, make sure, as I said, to get in rhythm where you can sleep at the same time. Try to go to sleep before 10. That’s the best sleep you can have is before midnight, believe it or not. So get in bed by 10, try to be asleep shortly thereafter, 11 at the latest, and try to wake up at the same time every day. Also, make your bedroom completely sleep supportive. For example, make sure you have eye shades or blackout shades on your windows or eye shades on your eyes. Earplugs, if it’s noisy, make sure you really take care of creating a carefully controlled environment.
Next is caffeine. Some tolerate it okay and metabolize it, others don’t. So I encourage you to sort of maybe stop after breakfast coffee, don’t have coffee throughout the day. That’s particularly important. If you’re still struggling, I would probably just stop coffee and caffeine altogether. Alcohol definitely screws up sleep. So if you want to sleep well and you’re not sleeping well, quit alcohol. Just get off it. It can interrupt sleep. It creates poor sleep quality. Also sunlight, is it a great basic great medicine. What do I mean? Sunlight, I’m going to go to sleep. No, but 20 minutes of sunlight in the morning without sunglasses on, outdoors, not behind a window has a big effect on your circadian rhythms. So we are a photo bio modulating organisms. The light affects us, it regulates our biology, and it’s important to make sure you have a good 20 minutes of light exposure in the morning. So those are some simple tips that you can do to help sleep issues.
Often, by the way, at night, if you’re having a crash and hot flashes at night and night sweats, that can often be low sugar. And so that’s really important to balance your insulin and blood sugar, and I’ve written a lot about that, like the 10-day detox diet is a great way to do that. Now, if you’re still having trouble sleeping, there are may be other reasons. It could be inflammation from food sensitivities, it could be thyroid issues, could be menopausal stuff, could be toxins, heavy metals, depression, many things, fibromyalgia, chronic fatigue. Make sure you work with a functional medicine doctor, but check it out.
And hope that was helpful for you. That was it for today’s Health Bite on Sleep. If you love this podcast, share with your friends and family, leave a comment, have you figured out how to hack your sleep? We’d love to know. And we’ll see you next time on The Doctor’s Farmacy.
Hi everyone. I hope you enjoyed this week’s episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search there. Find a practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner and can help you make changes, especially when it comes to your health.