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Pleasant Dreams

A guest blog by: Dr. Michael Schutz

Pleasant dreams. That is what my mom used to say to me when going to sleep.  As a child, we had little to disturb our sleep other than the occasional nightmare. The rest refreshed and rejuvenated us.

As we get older, getting an undisturbed night of sleep can be more difficult, but is still very important for refreshing and rejuvenating our bodies.  About 1 in 5 adults can have sleep deprivation. Causes include voluntary sleep deprivation, behavioral or occupational obligations and medical problems such as restless leg syndrome, psychophysiological insomnia, Parkinson’s disease or sleep apnea.  

Quantity of sleep is important but depth of sleep also matters. Depth of sleep is divided into different stages. Stage 1 and 2 are lighter sleep and Stage 3 and 4 are deeper sleep stages.  Stage 4 or Rapid Eye Movement (REM) sleep is when the most regenerative activity occurs. It is also when we dream.  As we get older, we get less REM sleep. Deeper stages of sleep help us fix memories in our minds and retain learning.  A deficit of sleep impairs our ability to learn. Men have a longer life span if they get a proper amount of sleep. Women are twice as likely as men to sleep poorly.

Some of the effects of sleep deprivation include irritability, anxiety, difficulty concentrating and problem solving and reduced alertness and attention.  Lack of sleep was a factor in the Exxon Valdez oil spill, Chernobyl and Three Mile Island nuclear accidents. Sleepiness contributes to 100,000 traffic accidents and 1500 traffic deaths each year according to the National Highway Traffic Safety Administration. 

Sleepiness increases the risk of heart disease, hypertension, diabetes, weight gain and stroke. Sleep affects the production of peptide hormones that regulate appetite. Ghrelin stimulates hunger and Leptin tells the brain we have eaten enough food. Less sleep raises Ghrelin levels and reduces Leptin causing us to eat more. It can reduce one’s libido and sex drive.  We release less growth hormone with less sleep. This reduces one of the hormones that are responsible for maintaining muscle mass, thick skin and stronger bones.  This can contribute to the black circles under the eyes, puffy eyes and wrinkles.

Sleep apnea is a respiratory disease that causes pauses in breathing during sleep that can last from a few seconds to minutes.  Sleep apneas causes you to leave deep sleep and go to lighter sleep which is less restful and refreshing. This is usually caused by an obstruction of the airway.  Obesity can be a contributing factor but it can occur in anyone. It is an important health issue as it can be related to sudden death, heart disease and hypertension. The diagnosis has to be made by a physician but the first clues are from a sleeping partner or family member that notices the pauses and snoring. There are specific treatments that can be very helpful. Alcohol avoidance, sleep positioning, weight loss and keeping the nasal passages open at night can help but the problem may need professional assistance.

Nutrition plays an important role in providing the body nutrients it need to relax the nerves and muscles. The most important nutrients include magnesium, potassium and calcium. Dietary sources of magnesium include leafy greens, soy and black beans, avocado, peanut butter, yogurt and nuts. Foods rich in potassium include yogurt, sweet and white potatoes, tomatoes, fish, leafy greens including beet greens and spinach, soy and white beans, avocado and fruits including melons, banana, apricots and citrus. Calcium rich foods include yogurt, dairy, cheese, salmon, and leafy greens including kale, Chinese cabbage and turnip greens.

Calcium also increases the production of melatonin, the hormone that helps us fall asleep. A natural source of melatonin is cherries. Check for any interactions with the medications you are currently taking as some supplement pills can interfere with your prescriptions or other supplements. A balanced diet with a good source of vitamins, especially B and D, is also important for good sleep.  Caffeine, alcohol and nicotine all impair sleep. Alcohol can help bring on sleep but can impair deep sleep later in the night and should be limited.

Exercise is also very helpful for inducing sleep. Aerobic exercise is better than anaerobic exercise but any activity is better than none. Moderate aerobic activity reduces the time it takes to fall asleep and leads to deeper sleep, the REM sleep. It also increases the length of sleep compared to people who do not exercise.  The exercise reduces one’s stress level and clears the mind for sleep.

Time of day for exercise is also important. One needs cool down time to help bring on sleep. Late afternoon or early evening is likely the best time to bring on sleep. The exercise causes one’s body temperature to rise and fall and the drop in temperature allows one to fall asleep easier.  Late evening or strenuous exercise does not allow the cool down time that is most effective to bring on sleep and stimulates the release of cortisol which can increase alertness.

Mental exercise can also make it easier to fall asleep and get to a deeper level of sleep. One needs a period of time to relax before trying to fall asleep. Reading, listening to music or simple mental games can bring this relaxation.

You want to create a sleep environment that is dark, quiet and cool. The dark will increase melatonin production. Quiet surroundings also make a more restful sleep. If you have to, use earplugs. Try to keep your sleep environment between 60 and 75 degrees. A comfortable bed and pillows also help. Make your bedroom a refuge from the stresses of the day. Leave the laptop and cell phone outside and reserve your bedroom for sleep and intimate time.  You should develop a sleep routine to relax, rest and get a good night’s sleep.

A good nIght’s sleep is very important to our well being. As we get older, it is not as easy to get as when mom would come in and tuck us in. Using some of these techniques can help us avoid the problems associated with poor sleep. That glass of warm milk will help too.


About the author:

JUG PICTURES 074Dr Schutz was born in Newport News, VA and grew up in Flemington, NJ. He attended Rutgers University and New Jersey Medical School where he graduated in 1985. He was selected as a “Top Doc” in NJ Monthly Magazine and is the former President of the Medical Staff at Shore Memorial Hospital. He is married and has 3 children. He is active in religious and youth activities.

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