The Sleep Doctor

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How to Get a Good Night's SleepSleep can have a huge impact on everything from your skin to your sex life. But could you be unwittingly sabotaging your health every night before you go to bed? Dr. Breus shares some of his tips to help you get a good night's sleep.

Do One Thing at a Time: Nicotine is a stimulant and it does affect your sleep. If you are trying to quit smoking and solve your sleep problem, you are in for a rough ride. Pick one or the other, but not both. Of course I want you to work on both, just not at the same time.

A Glass for a Glass:  If you drink alcohol, remember that while it may make you fall asleep quickly, it prevents you from reaching deep sleep. Drink one glass of water for every glass of alcohol. Not only will it slow down your drinking, but it will prevent you from getting dehydrated, which is why you get a hangover!
Wean the Bean: Drink higher-caffeinated beverages in the morning and move to less-caffeinated ones in the mid-afternoon. Try to move to fruit juices and water by 2 to 3 p.m. While many of my patients tell me, "I can drink an espresso and go to bed," they may be correct, but the sleep they are getting is more jittery than they are!

Watch Out for the Double Whammy: If you are going out with friends and have a few drinks (see the second bullet point) try to get to bed on time! Most people do both; they stay out late and they drink too much. No wonder they feel horrible in the a.m.

Cardio not Cappuccino: Exercise, specifically 20 to 30 minutes of aerobic, is one of the single-best ways to improve the quality of your sleep. Research shows that those who have a regular exercise program get deeper sleep.

Timing is Everything: Some people get relaxed from exercise, while others get energized -- which one are you? If running relaxes you, then do it about four hours before bed.

Let There be Light, Just Not at Bedtime: Light is the single biggest factor telling your body that it is morning. In the evening, use a book light for reading, change bulb wattage to 45 at the bedside table, and use a night-light in the bathroom to get you there and back to sleep.

Bothersome Bed Partners: Kids, pets and snoring bedmates can disrupt sleep. If you have any or all, make a new set of rules: Silence is golden. Consider earplugs with a noise-level rated at 32 or below so you can still hear the fire alarm, or a sound machine.

Pillow Talk: Your pillow should be replaced every year. If it has just "broken in," what is to keep it from continuing to break? Choose a pillow based on what side you sleep on, whether you have back pain and if you have allergies! Check out

TV or No TV? That is the Question: Many of my patients sheepishly tell me that they sleep with the TV on. Well, so does my wife! If it helps, then I am fine with it, but put it on a TV timer so it does not keep anyone up the rest of the night.

No Tummy Rumbling: Avoid large meals for at least two hours before bedtime. But don't go to bed hungry. Cereal and milk, apple pie á la mode, even cheesecake can be good (not an entire cheesecake) before bed. A study showed that high-glycemic index foods eaten four hours before bed can help you get to sleep. Milk contains the amino acid L-tryptophan, which has been shown, in research, to help people go to sleep. 

Write your stresses in a worry journal: On one side of the page, write what you’re worried about or can’t stop thinking about. On the other side of the page, write one solution to the problem. “That solution can be, ‘I’m going to think about this tomorrow,’” Dr. Breus says. “You don’t have to solve your problem right then and there.” Once finished, close the paper and put it away for the night.

Changing your pillow regularly: "You should be changing your pillow almost once a year,” Dr. Breus says. Make sure your pillow offers support as well as ventilation.

Wear pajamas that breathe and wick away moisture: If you suffer from hot flashes, you may find yourself sweating during the night. Find pajamas that are made with a natural moisture-wicking fabric that will help keep your body temperature cool.

Use aromatherapy: "There are double-blind placebo-controlled studies to show that there’s actually an effective component for aromatherapy,” Dr. Breus says.
©2009 The Sleep Doctor, Michael Breus, PhD

Bad Habit: Lack of Sleep
Do you ever have trouble waking up or just feel tired throughout the day? Whether you have a sleeping disorder or just don’t take the time to get enough Zs, learn how to quit those sleepless nights. “[Sleep] is actually important for just about everything,” Dr. Breus says. “Everything from immune system to cognition, how you think, how quickly you react. Anybody who drives a car should actually make sure they’re getting a good night’s sleep.”

If you do not get enough sleep, your body will not produce the hormone melatonin, which sets your biological clock and rids your body of waste products you don’t need. The melatonin is only released when you sleep in darkness and needs to be replenished every night.

How to kick the habit:
If you just can’t get the right amount of sleep, Dr. Breus suggests using light therapy, which can reset your circadian rhythm and help you get some shut-eye. Other sleep tips include setting your alarm clock for the time you are supposed to go to bed. “It forces you to walk into the bedroom, so now you’re in the bedroom,” Dr. Breus says. “It reminds you you’re supposed to be getting ready for bed.”

Taking melatonin supplements can help, as well, but make sure you are taking the proper dosage, which is between a half and a third of a milligram. Taking too much can cause health problems.

Does a Good Night's Sleep Equal Happiness?
Are you setting yourself up for misery if you don’t get your Zs? A new study says that restful sleep makes people happier. On the other hand, poor sleep triples the likelihood of life dissatisfaction.

“You may not be getting good sleep, because something's going on in your life that you’re stressed out about or depressed,” OB/GYN Dr. Lisa Masterson adds. “But we know that good sleep is very healthy.”

“I assume we’re all good sleepers. We can all relate to having one bad night of sleep, and it puts you in a bad mood. You don’t feel good. You don’t feel like you’re as effective. If you had that every day, you would start feeling pretty rotten and pretty unhappy," plastic surgeon Dr. Drew Ordon points out.

“Sadly, for perimenopausal and menopausal women, it’s not just one night a week. It can be every night for years,” Robin McGraw chimes in. “When you have insomnia for that long, you can’t think clearly. You can’t have a productive day when you haven’t slept well at night.”

E.R. physician Dr. Travis Stork suggests that women suffering from insomnia have a regular bedtime each night, turn the lights down, and turn the TV off.

Lack of Sleep
Fewer than 70 percent of Americans get eight hours of sleep every night. “If you’re getting between seven and eight hours, you’re doing a good job,” Dr. Travis says. “Not only is it sleep and the amount of time in bed, but the quality of sleep.”

The human body produces a hormone called leptin, particularly when you’re sleeping. This hormone helps decrease hunger, so if you’re not getting enough shut eye, less leptin is produced by your brain, thereby making you hungrier.

Studies have shown that women who don’t get enough Zs often have more cravings and weigh more than other women. Also, melatonin levels increase while you’re sleeping, and that helps to fight cancer.

One way to get more sleep is to take naps, but for no more than 30 minutes. Pediatrician Dr. Jim Sears tries an innovative new option for napping: the sleep pod, a white capsule that resembles a clam with a tail, where you lie down with your head and upper body covered by a shell. When he gets into the pod, he puts on his headphones and iPod, takes off his shoes and reclines in the chair. The front of the capsule comes down to cover the top part of his body. Dr. Sears explains that the relaxing atmosphere and dark environment in the capsule make for a good power-nap area.

More Tips for a Better Night’s Sleep
• Get ready for bed 15 minutes earlier to make sure the environment is just right
• Create a dark space where you slumber
• Hide the light emitted by your alarm clock
• Eat foods high in tryptophan, an amino acid that helps the body make serotonin, which produces a healthy sleep. Foods include: bananas, cereal and leafy green vegetables
• Keep your bedtime and wake time consistent
• Exercise
• Estrogen has been shown to increase REM sleep, so if you’re a woman who is going through menopause and has gained weight, consider hormone replacement therapy to obtain a better night’s sleep

Bedroom Basics
The average person spends more than one-third of his or her life in bed, and the average mattress can be a breeding ground for bacteria, allergens and unwelcome critters.

Most people shed approximately 1.5 million skin cells per hour and emit one quart of perspiration every day, even while sleeping. Skin cells accumulate in pillows and mattresses, and attract dust mites. The critters then multiply.

A mattress doubles in weight every 10 years because of the accumulation of human hair, bodily secretions, animal hair and dander, fungal mold and spores, bacteria, chemicals, dust, lint, fibers, dust mites, insect parts, and a variety of particulates, including dust mite feces. After five years, 10 percent of the weight of a pillow is dust mites.

How to Keep It Clean:
• Replace pillows every year
• Replace mattress every seven years
• Flip your mattress every six months to keep the surface even

When shopping for a new mattress, Pete Bils, senior director of sleep innovation and clinical research for Select Comfort recommends lying on your potential bed for 15 minutes in the store so it has time to settle down and you can test what it will feel like overnight.

Beauty Sleep

Is there really such a thing as beauty sleep? Liz Vaccariello reveals the answer in Prevention's Health Hearsay!

Bedtime Basics
Five-year-old Joelle refuses to go to bed, and her nightly ritual of stalling tactics is taking a toll on the whole family. Losing just one hour of sleep can cause permanent changes in the brain and be detrimental to its development, and Dr. Sears explains that a child's brain develops all the way up until the age of 21. Sleep deprivation can cause moodiness, crankiness, depression, and binge eating.

Young children such as Joelle need 11 to 13 hours of sleep a night, which she is clearly not getting. Dr. Sears pays a house call to teach Joelle’s parents, Jennifer and Ken, the best way to implement bedtime rules.

Dr.Sears' bedtime do's and don'ts: 
• Do make bedtime and waking time consistent
• Do make bedtime routine a happy time
• Do watch sugar intake
• Don't give your child caffeine
• Don't put a TV in your child's room
• Don't give in to the drama

Need sleep?

Getting the right amount of sleep can stave off restless leg syndrome. See if you and your family are getting enough shut eye.

• Age 2: 12 hours per night

• Age 5: 11 hours

• Age 10: 10 hours

• Teens: 9 hours

• Adults: 7-8 hours

Restless Legs
Restless leg syndrome (RLS) is a frustrating problem that can cause sleepless nights. It is a sensory disorder that causes an almost irresistible urge to move the legs. This urge to move is usually due to unpleasant feelings in the legs that occur when at rest. Some describe the feelings as creeping, crawling, tingling and burning sensations.

RLS research focuses mostly on adults, but symptoms often begin during childhood or adolescence. Eleven-year-old Kenny from Los Angeles is among the estimated 1.5 million children in the United States that suffers from RLS.

“It’s almost impossible to sleep because you keep moving around,” Dr. Sears says. “Why does this happen? Sometimes it’s actually due to poor sleep. In many kids it may be from caffeine, too, and those may feed off each other. Sometimes it’s lower iron.

“Kenny’s 11 years old, and at that age you should be getting about 10 hours of sleep a night, so maybe Kenny needs a little more sleep,” Dr. Sears adds. “Iron supplements, especially if the doctor finds anemia. Sometimes prescription medications are used kind of as a last resort.”

What Side to Sleep onBrianna, from Pacific Palisades, California, is 20 weeks pregnant and has been told that she should only sleep on her left side. But doing so has left her sore and worried if she wakes up in any other position. She asks Dr. Lisa what side is best to sleep on.

“You can [lie] on your right side, too,” Dr. Lisa says. “After the second trimester, though, you just don’t want to go flat on your back because the uterus can be heavy enough to compress the major vessel that’s supporting [the] baby. So what you want to do is if you’re even just wedged, you’re fine, but really, in studies, maximal is the left side, but you’re OK if you’re on your right side.

“You’re just going to get more and more uncomfortable when you sleep, so you may need to take catnaps, too,” Dr. Lisa adds. “But that’s absolutely normal during pregnancy.”

Sleep Time

 Samantha Harris, host of Dancing with the Stars, asks Dr. Sears how she can get her 2-year-old daughter to sleep through the night. Dr. Sears shares tips to keep your toddlers fast asleep:

• Keep the same sleeping schedule
• No naps late in the day
• Encourage your child to take a security object, such as a teddy bear or a blanket, to bed with him or her
• Limit the amount of caffeine your child consumes

Jet Lag
"The body takes approximately one day per time zone crossed to recover from jet lag," Dr. Breus says. "It's different depending on the direction of travel: east is least, west is best. If you're traveling west, it'll only take about a half a day [to recover], whereas if you're traveling east, it'll take almost a full day."

If you're constantly jetting between time zones, Dr. Breus suggests light therapy to address the disruption in the body's Circadian rhythms. NASA astronauts found they could shift their body clocks up to six hours in one day with timed light exposure. Products such as the Litebook stimulate the pineal gland in the brain, the locus of the biological clock. The pineal gland instructs the body when to wake up and when to go to sleep, and is responsible for the production of melatonin, a substance instrumental for sleep.

"Melatonin is the vampire hormone, it's only produced at night," Dr. Breus explains.

Sleep and Skin
Want clear and healthy skin? Get lots and lots of sleep. Adequate sleep allows the body to rebuild and replenish cells like collagen, which, among its many other functions, infuses skin with volume and resilience.

"I consider myself a skin expert, and every time I talk about good skin, I say that getting a good night's sleep, along with making sure you drink plenty of water, exercise, get fresh air, [use] moisturizer and sun protection are all part of good skin," Dr. Ordon says. "You can't get around it, you need to sleep."
Obstructive Sleep Apnea

At-Home Sleep Test

Worried you may have sleep apnea? Dr. Sears tries the NovaSom At-Home Diagnostic Sleep System to find out if he has the condition.

Learn more about NovaSom.

Stop Snoring with Didgeridoo!

 See how an Aboriginal musical instrument may help obstructive sleep apnea.

Obstructive sleep apnea is the collapse of the airways during deep sleep.

"Sleep apnea is a very, very dangerous disease when it is untreated," otolaryngologist Dr. Brian Weeks says. "Patients can be left with severe medical problems, like diabetes, high blood pressure, stroke and even heart attack."

Lenea, 42, suffers from sleep apnea, and undergoes a plasma blade surgery to reposition her airway and allow her to breathe freely.

"I call it a face lift of the throat," Dr. Weeks says. "We're basically lifting the throat. The plasma blade allows us to do that without damaging the throat and without burning the tissues."

Sleep Deprivation

One of the main functions of sleep is to allow the brain and other organs to recover and repair on a cellular level. Recent studies indicate that a poor night’s sleep is worse on a woman’s health than on a man’s. The greater the sleep deprivation in women, the higher the risk of heart disease, hypertension and type 2 diabetes.

One of the reasons women need more sleep than men, Dr. Breus explains, is that women's brains are more evolved and complex than men's, and therefore require more sleep.

“Since women, maybe, multi-task more than men throughout the day, they may, on average, need 20 more minutes of sleep per night,” Dr. Travis says.

The average sleep cycle is approximately 90 minutes long, and the average individual has five of those cycles per night. People cycle through five stages of sleep, approximately 50 percent of which is light sleep, 20 and 25 percent is deep sleep and the remainder is spent in REM (rapid eye movement) sleep, which is associated with dreaming.

To calculate your ideal bedtime, count backward seven-and-a-half hours, or five 90- minute cycles, from your wakeup time. For example, if your alarm is set for 6:30 a.m., bedtime should be 11 p.m. the night before. If you find you normally sleep up until your alarm goes off, Dr. Breus advises making your bedtime a little earlier.

Stressors such as family, career and relationships can all take a toll on a woman’s ability to fall asleep and maintain a high quality of slumber.