The Morning Call (Sunday)

Stay Healthy With More Rest Each Night

Sleep has never been more important. Here are our most concrete recommenda­tions for getting more shut-eye.

- By Adam Popescu

MANY PEOPLE SPEND their nights now tossing and turning, struggling to unglue themselves from the unending scroll of coronaviru­s news updates.

But, while there is no body or life hack to make you impervious to the touch of disease, we do know that sleep is key to helping our bodies stay healthy.

“Sleep is an essential part of protection from and response to any infection,” said Douglas B. Kirsch, a neurologis­t and former president of the American Academy of Sleep Medicine.

But still, he says he hears you: “Sleep is hard when anxiety levels are high, such as in the case of a pandemic.”

There are some answers as to what you can do now. You may not like them.

CREATE AND MAINTAIN A VERY CONSISTENT SLEEP PRACTICE AND SCHEDULE THAT WORKS FOR YOU

The more consistent your wake-up time, the more consistent your body functions.

The National Sleep Foundation recommends sticking to a sleep schedule, and here’s a simple way to do it: Set a regular bedtime. Pair it with a set time to wake. (Many people aren’t currently commuting, so this might be easier than usual.)

Set yourself up for success by doing the little things: use blackout curtains if you’re sleeping while it’s bright, ditto to earplugs or a sleep mask (a light pillow or T-shirt works in a pinch).

No matter what you do, make your bedroom very comfortabl­e and very dark.

Are you easily awakened? Use a fan or a repeated track on Spotify for white noise. If you’re tired, get sleep while you can.

“If you’re tired during the day, get your rest then,” said Janet Mullington, a professor in the department of neurology at Harvard Medical School.

Just don’t let naps wreck your schedule. Michael Breus, a clinical psychologi­st who focuses on the link between behavior and sleep, said the sweet spot with naps is about 10 to 20 minutes.

SET A HARD CURFEW FOR ALL ELECTRONIC­S

Stay on schedule with the help of a strict electronic curfew: Try 90 minutes without social media, email and even TV before lights out, Dr. Breus said.

Kristen L. Knutson, an associate professor at Northweste­rn University’s Center for Sleep and Circadian Medicine, said, “It may be tempting to stay up late binge-watching your favorite shows because you don’t have to go to work in the morning, but it is more important than ever to prioritize your sleep.”

If you can’t do 90 minutes, start with 15. Also, probably don’t watch “Contagion.”

STAY INFORMED, BUT DON’T LOOK AT THE NEWS RIGHT BEFORE BED

Limit your types of media consumptio­n too, particular­ly to avoid things in the evening that increase anxiety. This might be the hardest but most sane advice.

“Only look at coronaviru­s news once per day, preferably not near bedtime,” Dr. Kirsch said.

You can set your phone to automatica­lly turn off notificati­ons in the evenings, by scheduling do not disturb hours.

“Isolation can increase the desire to stay electronic­ally connected even more,” said Lisa Medalie, a behavioral sleep medicine specialist at the University of Chicago.

She adds that it’s vital to stay discipline­d, which helps us minimize distractio­ns and regain control.

You can use the time before bed to put away fears, too.

“Setting up plans of action for the day, both for kids and adults, can help alleviate some of that uncertaint­y,” Dr. Kirsch said. “We tend to keep our anxieties bottled up, and they burst out in the dark. Try to clear out the mental cabinet ahead of time.”

Bottom line: Protect your sleep by protecting your bedtime rituals. Block off this chunk of time. The more minutes you are able to buffer before bed, the better. Do you really think you’re going to sleep better after mainlining Twitter?

MOVE YOUR BODY AND RAISE YOUR HEART RATE EVERY DAY

This is a must, not only because it makes you tired and ready for bed. Exercising also helps with something else we’re all dealing with, whether we’re sick or well: anxious, nervous energy.

Dr. Kirsch said, “This can be as simple as a neighborho­od walk or doing an exercise video at home.” (If you do go for a walk, stay six feet away from other people.)

TREAT ANXIETY WITH GRATITUDE, BREATHING, MEDITATION AND MAYBE MEDICATION

Many people think stressful thoughts as they fall asleep. That feeds a cycle of anxiety. Make a list, mentally or on paper, of things to be grateful for instead.

Try 4-7-8 breathing. In a comfortabl­e position, with your eyes open or closed: inhale for four seconds, hold your breath for seven seconds, exhale slowly for eight seconds. Then repeat as necessary.

Consider meditation or progressiv­e relaxation before bed or while falling asleep. There are many free podcasts, including one from U.C.L.A.’s Mindful Awareness Research Center, which promotes regulated breathing.

Dr. Kirsch suggested taking a few moments throughout the day to separate for a few moments and take some deep breaths: “Even people who are not typically anxious may be struggling. Sleep is difficult when anxiety is high, thus trying to manage anxiety levels during the day can also benefit nighttime sleep.”

Also, if you are suffering from anxiety, speak to a clinic or a doctor or a mental health profession­al, or at least try to. Debilitati­ng anxiety is a medical condition.

DON’T EAT BEFORE BED, AND DON’T DRINK YOURSELF TO SLEEP

You may have a new routine now. Another cup of coffee — or an early happy hour over Zoom — helps burn the midnight oil. Yes, coffee is good for you in moderation — up to 400 milligrams of caffeine per day — but more than that can lead to shakiness, nervousnes­s and an irregular heartbeat. And while alcohol makes you sleepy, it doesn’t promote quality rest. Alcohol “leads to sleep fragmentat­ion,” said Dr. Kirsch.

Don’t eat right before bed. Symptoms of heartburn or GERD are unpleasant enough, but can be indistingu­ishable from anxiety, leading to even more anxiety.

Feel out of control around food or drink? Start a food diary, just so you know what you’re actually consuming.

TAKE A HOT SHOWER OR BATH 90 MINUTES BEFORE BED (AND WASH YOUR SHEETS!)

Getting warm and then cooling off helps produce melatonin. One method to maintainin­g an electronic curfew is to combine it with a hot shower, both of which get you primed for a restful night.

And while you’re taking care of your body, take care of your space. If possible, use HEPA filter air cleaners for your bedroom, wash your sheets twice a week, and give your home, particular­ly your bedroom, a nightly clean. You’re probably spending more time than ever there; this can promote peace of mind and might lower anxiety.

WHAT IF YOU’RE FEELING SICK?

If you’re battling infection, your body needs a lot of rest to heal quickly. To start, increase your total sleep time by two hours, Dr. Breus said.

Optimize rest conditions: Use a bed wedge or extra pillows to keep your chest raised to avoid additional congestion and postnasal drip. And that nightly shower or bath can keep your body cool and create a better sleeping environmen­t. Change clothes and sheets frequently to control bacterial or virus spread.

“Focus on adequate sleep, stay hydrated, and manage symptoms to recover,” Dr. Medalie said. “During this time of uncertaint­y, work on what you can control: your sleep habits.”

WHY DOES SLEEP MATTER ANYWAY?

The American Academy of Sleep Medicine recommends seven to eight hours of sleep a night.

A 2015 study found a direct link between shorter sleep times and an increased risk of getting a cold for healthy adults ages 18 to 55; specifical­ly those sleeping less than five hours or between five and six hours had a greater likelihood of catching a virus than those sleeping for seven hours a night.

The science is simple: a good night’s sleep supports the release and production of cytokine, a protein that helps the immune system quickly respond to antigens — foreign substances which cause the body’s immune response to kick in — according to Dr. Medalie.

SLEEP IS YOUR BEST DEFENSE

Even in the best of times, Americans average under seven hours of sleep a night. It’s a seemingly small deficiency, but it weighs heavily.

Missing as little as 16 minutes tonight could harm your cognitive functionin­g tomorrow, since shifting sleep rhythms can slow or speed up our body’s internal clocks, which basically has the same effect as not getting enough sleep. Fatigue, irritabili­ty and mental confusion are all deprivatio­n symptoms.

Skipping one night of shut-eye can harm memory and bias behavior. Not only will you physically and mentally feel worse, but chances of depression, anxiety and weight gain rise, since sleep loss disrupts energy intake and expenditur­e.

 ?? DAVID BRANDON GEETING FOR THE NEW YORK TIMES ??
DAVID BRANDON GEETING FOR THE NEW YORK TIMES
 ?? KARSTEN MORAN FOR THE NEW YORK TIMES ?? Getting warm and then cooling off helps produce melatonin, which helps you sleep. Taking a hot shower can help get you ready for bed.
KARSTEN MORAN FOR THE NEW YORK TIMES Getting warm and then cooling off helps produce melatonin, which helps you sleep. Taking a hot shower can help get you ready for bed.

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