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Writer's pictureDr. Tom Rogers

Can’t Sleep?

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

It’s that time of the year. Welcome back to standard daylight time! For a lot of us it’s a signal that we are heading into winter. 

Many of us hate when the days get shorter, and for good reason. It gets darker sooner. It’s cold. And for those who have a tendency for depression, it can be a sad time. Winter is notorious for seasonal affective disorder.  

This reminds me how important SLEEP is, as well as sleep rhythms. 

I’ve had sleep problems dating back to college. And as you know, the older you get the more difficult it is to sleep. Almost every Baby Boomer I know has some sort of sleeping problem. 

If you’re not sleeping well, every disease in the world follows. 

  1. Metabolic syndrome 

  2. Cancer

  3. Mental problems 

  4. Dementia 

You name it and you’re more likely to get it.  Sleep is that important! 

Therefore, in today’s Note I am going to talk about HEALTHY SLEEPING PATTERNS. We will also go over some ideas on how to adjust to standard time.

Sleep Environments

Sleep is determined by the environment you are IN (room temperature, lighting, etc.), and the environment you are ON (mattress and your pillow). 

These things matter. 

It seems like I’ve tried every mattress out there and trust me, price is not the best indicator of how well you are going to sleep! Sleep position is also very important. Sleeping on your back is the best position for optimal sleep. Only a small percentage of the world can actually do this, mostly because of breathing problems. Breathing correctly is very important during sleep. You want to be a nose breather, not a mouth breather. 

Note: very few of us get the 7-9 hours of sleep we need to wake up feeling refreshed and ready to go. 

Two Forces That Help Us Sleep 

There are two forces that help us sleep: Adenosine and the Circadian Force. 

Adenosine is a chemical and neuromodulator. It’s produced in every cell of your body. Adenosine creates sleep hunger. The longer you’re awake the more of this you have produced. 

If you have been up for a long period of time you have a lot of adenosine to help you go to sleep. Caffeine actually inhibits adenosine. If you’re drinking a lot of caffeine it blocks adenosine out, and you’re not going to sleep as well. 

Note: people have different tolerances for caffeine. Some are more affected by caffeine than others.

Circadian Force is your circadian rhythm. This is the clock that’s in your brain that regulates your day and night cycle. It’s governed by sunlight. 

In the morning cortisol wakes you up. Everybody thinks of cortisol as a stress hormone, but it’s also a waking hormone. It should be high in the morning because that’s what wakes you up. Cortisol is being released which alerts you to wake up! 

At night it’s melatonin that is released. Melatonin is that hormone located in the pineal gland that helps promote sleep. This is why so many people take a Melatonin supplement at night. 

Note: You need a balance of these two hormones: Cortisol and Melatonin. They are difficult to regulate, especially if you’re stressed. 

Getting back to your circadian rhythm, I want to emphasize a few natural things that you can do to establish this rhythm. 

Turns out the SUN is the most important thing for sleep. Get up when the sun comes up. There is nothing like sunlight from the sun to wake you up in the morning. 

Note: within the first hour of waking up you need to get outside for 2-10 minutes. 

When you stare at the sun through a window glass, you are blocking out most of the good things that wake you up in the morning, the light that you need. This helps you establish the circadian rhythm.

If there is some way you can get outside for sunrise (or quickly thereafter) you’re going to realize a lot of benefits. 

Note: you also need to watch the sunset outside. 

Our bodies were designed for this. It signals your body to start winding down and time to start thinking about sleeping. 

Try to be outside for both of these things. 

What About Naps? 

Naps are something that will refresh you. I’ve always been a fan of naps, even though I don’t nap well personally.

In fact, naps can be really powerful. Naps need to be less than 20 minutes. If you wake up groggy from a nap, most likely that means you’re not sleeping well at night. If you can’t nap, meditation is a great alternative. It helps relax your body and induces calm. 

Meditating is a form of using your body to control your mind. 

It’s very hard for your mind to control the mind. But your body CAN control your mind. Things like breathing can control your mind. Exercise can also control your mind, as can intermittent fasting and sweating. 

There are a lot of ways to activate your parasympathetic nervous system. There is a whole cycle between wakefulness and sleep, and it’s important to control each one. 

Medications and Supplements For Sleep 

When we talk about sleep we also need to talk about drugs and supplements. 

Everybody thinks first of Melatonin when it comes to supplements for sleep. I like Melatonin. 

But one problem with Melatonin is that it may help you fall asleep but not stay asleep. 

If you like taking Melatonin make sure you take a quick release and an intermediate release. I like the LifeExtension Extended Release. If you wake up groggy you’re taking too much. 

Note: Melatonin is not regulated, which is why I like the LifeExtension Melatonin. It is.

With some of the Melatonin supplements, not regulated simply means you really don’t know how much you’re getting. You could either be getting 15% of the stated dose, or 200%. You can see how this would be a problem.  

Magnesium is also great for sleep. I tend to like Magnesium Threonate for sleep, as well as Magnesium Glycinate. The magnesium combinations are great too. Take them 30 minutes to an hour before bed. There are also a lot of other reasons to take Magnesium. 

L-Theanine is great for sleep. It produces a sense of calm. Take 30 minutes before bed. 

Apigenin is another one. It comes in 50mg. Apigenin comes from chamomile, which is well known for sleep. It can inhibit estrogen. So be careful with this, if you’re a woman especially. It’s probably good for men who are on testosterone replacement (although men need some estrogen too). 

Ambien is a medication often used for sleep. I don’t like Ambien. People go crazy on it. The longer you take these sleep medications the more they don’t work. 

Lunesta is another sleep medication you’ve probably heard of. This is a much cleaner drug than Ambien, in my opinion. You just don’t want to be taking these Z drugs every night. I’m not against taking them for those periods of your life when it is difficult to get enough sleep (i.e. business travel, extremely worried, etc)

Note: There are some newer drugs out there for sleep that we would be glad to discuss with you in the office. There’s also some wakefulness drugs out there for people with narcolepsy or people with shift worker syndrome and chronic fatigue (i.e Provigil). 

Sleep Studies 

If you are overweight or snore, you really need to get a sleep study. Sleep apnea is dangerous. It’s something you need to take seriously. 

Sleep apnea can cause: 

  1. Hypertension

  2. Cardiac arrest 

  3. Sudden death

  4. Chronic fatigue and sleeplessness

This is most common in people who are obese and/or snore. Skinny people have sleep apnea as well.

Final Thoughts 

I’m not very big on prescription drugs for sleeping. I like to try the natural things first, such as: 

Get sunshine. Even on a cloudy day you’re going to get more sun than you would from any alternative. 

 Avoid these things at night: 

  1. Overhead light

  2. Watching television or reading on a tablet or computer 

  3. Social media 

Avoid fluorescent lighting. This is an easy way to get depressed. Immediately replace these with LED lights at least. 

Sleep is one of the four main tenets of my practice: Nutrition, Exercise, SLEEP, and Balanced Hormones. 

Live longer with better sleep!

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About the Author

Dr. Tom Rogers is an experienced family doctor with 38 years of practice, and is board-certified in family, sports, and integrative medicine.

 

Since 1986, he has been dedicated to delivering personalized, patient-centered care, and for over 18 years, he has managed his own private practice.

Dr. Rogers founded Performance Medicine to prioritize patient care over insurance constraints, ensuring each patient receives individualized attention. He is well-known for his expertise in hormone balance and his commitment to guiding patients on their unique health journeys, making Performance Medicine a leader in integrative health care.

Outside of his practice, Dr. Rogers enjoys playing guitar, biking, pickleball, and reading, which help him maintain a holistic approach to health and wellness.

 

Performance Medicine serves the East Tennessee region, with clinics in Kingsport, Johnson City, Bristol, North Knoxville, and West Knoxville.

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