A five-part series dedicated to workers on the front line.
Dear friends,
During times of stress, it's important to provide your body what it needs so you can persevere.  

Although often taken for granted, the simple act of closing your eyes and falling asleep is one of your body's best defenses. Sleep essentially "reboots" your entire body by repairing damaged tissue. Sleep has a restorative effect on the body, particularly on the immune, endocrine, and nervous systems. It also keeps your brain functioning so you can think clearly and focus.1

People commonly think they can “get by” on less sleep than they really need without negative effects. But research shows that is simply not true. Sleeping less than 7-9 hours nightly increases your risk for many adverse health conditions. In addition, if you are sleep deprived, then you can have trouble fighting common infections.1

My heart goes out to all of the health-care staff and other frontline workers doing their best to care for patients and save lives during the COVID-19 pandemic. I’m sure getting adequate sleep during the crisis is not easy – let alone waking up and doing it all over again. 

If I could package the benefits of a good night's sleep in a pill and prescribe it to you, I would. Until then, I hope the sleep tips in this article help, even if just a little bit. 

In health,

Dr. Bauer


Quality Sleep is Vital to Staying Healthy 

The recommended amount of nightly sleep for an adult is 7-9 hours. Yet more than one-third of U.S. adults report getting fewer than seven hours of sleep nightly.2 

Studies show that individuals who don't get quality sleep are more likely to get sick after being exposed to a virus, such as the common cold. Lack of sleep can also affect how fast you recover when you do get sick.3,4

During sleep, your immune system releases specific protein messengers that help fight infection. Sleep deprivation can decrease production of these protective proteins. In addition, infection-fighting antibodies and cells are reduced during periods when you aren't getting enough sleep.3,4

To stay healthy and be your best self, try these tips to get a good night's rest. 

Create a Sleep-Friendly Atmosphere

The first step to sleep success is to create a supportive environment. 

  • Keep your bedroom dark, cool, and quiet. 
  • Use sleep masks, earplugs, room-darkening curtains, a fan, or a white noise machine. 
  • Reserve your bedroom for having sex and sleeping – not for checking emails and working.2,5,6
  • Dim your household lights several hours before bedtime – exposure to indoor light can have a suppressive effect on melatonin, a hormone that promotes sleep.7 

Go to Bed and Get Up at the Same Time Every Day

Your body has an internal clock (circadian rhythm) that regulates many functions, including the sleep-wake cycle, hormone release, and digestion. Consistency is key to supporting your internal clock and getting restorative sleep.8,9

  • Stick to the same sleep schedule, even on weekends. 
  • Consistency makes it easier for your body and brain to fall asleep and wake up feeling refreshed.5-8

Don't Use Alcohol as a Sleep Aid

After drinking alcohol, your brain produces the sleep-inducing chemical adenosine, which does allow you to fall asleep fast. But the problem is, adenosine subsides quickly, making it more likely you'll wake up frequently.10,11

  • Having just two drinks daily can affect your sleep quality.10 
  • If you drink alcohol, then drink in moderation. And stop a few hours before bedtime so the alcohol can clear your system.

Limit Screen Time before Bedtime

Using a mobile device before bedtime is known to decrease sleep quality and duration. The blue light emitted from a screen (computer, tablet, cell phone, tv) can suppress melatonin.12 

  • Establish a nightly routine of turning off all electronics one hour before bedtime. 
  • Wind down with a quiet and relaxing activity, like gentle stretching, writing in a journal, or reading.5,6,8

Reduce Information Overload

Watching negative news before you go to bed can put your mind in an anxious state that can lead to bouts of insomnia or other sleep problems.13

  • Set limits on how much news programming you watch during a day's time. 
  • Avoid screen time before bedtime – and make your bedroom a tech-free zone. 

Exercise Regularly, but Timing it Crucial

Regular exercise helps you fall asleep and get better quality sleep.14,15 But revving your heartbeat too close to bedtime can wind you up, instead of down.

  • Save vigorous exercise routines for the morning or afternoon. 
  • Research shows that moderate-intensity exercise in the morning promotes deep sleep.14,15

Manage Stress

When you fall asleep, your body switches over from the active sympathetic nervous system to the calmer parasympathetic nervous system. However, if you're overly worried, then the sympathetic nervous system doesn't shut down, which keeps you from sleeping properly.16

  • Resolve your worries or concerns before bedtime. 
  • Experiment with aromatherapy, deep breathing, journaling, or meditation. 

For more information on ways to manage stress, read the second installment in this series: A Mayo Clinic Doctor’s Advice – Part 2: Science-Backed Ways to Manage Stress and Anxiety During a Crisis

Supplements that Promote Sleep

In addition to practicing healthy sleep habits, research shows that several nutritional supplements can help improve sleep.

Melatonin

Melatonin is a hormone naturally produced by the brain in response to darkness. Melatonin helps regulate your body's internal clock and your sleep patterns.17 Melatonin is available as a supplement, typically as an oral capsule.

  • Some research shows that melatonin supplements can improve your total sleep time, overall sleep quality, and shorten how long it takes you to fall asleep.*17,18
  • People who work night shifts commonly struggle with sleep disorders. Some research shows that melatonin supplements help shift workers fall asleep.*19,20  

Phytocannabinoids from Hemp 

Phytocannabinoids are plant-based, naturally-occurring chemical compounds that influence the body's endocannabinoid system (ECS). The ECS is involved in multiple physiological processes, including mood, pain sensation, appetite, and memory.

  • Phytocannabinoids are natural components of many plants, including hemp, clove, black pepper, Echinacea, broccoli, ginseng, and carrots.21
  • Several phytocannabinoids in hemp promote relaxation and sleep.*22

Magnesium

Some research indicates supplementing with magnesium helps improve sleep.* 

  • A study found that magnesium supplementation improved sleep quality in the elderly.*23
  • A cross-sectional analysis of the National Health and Nutrition Examination Survey found that adults who reported sleeping fewer than seven hours a night also consumed less than the recommended daily requirement of magnesium, calcium, and vitamin D.24

Sleep deprivation can have a significant impact on your body and your mind. Although you might not be able to control the factors that interfere with your sleep, you can adopt habits that encourage better sleep.

Read the full five part series

Part 1: Supplements for Immune Support

Part 2: Science-backed Ways to Manage Stress and Anxiety During a Crisis 

Part 3: Sleep – Tips that Can Improve Your Quality of Sleep 

Coming Soon:

Part 5: Physical Activity – Exercises that Boost Your Immune System and Reduce Inflammation


An important note: No dietary supplement can diagnose, treat, cure or prevent any disease, including COVID-19. With the ongoing COVID-19 pandemic, it is especially important to understand that no dietary supplement, no diet, and no lifestyle modifications – other than the recommended social distancing and hygiene practices – can prevent you from being infected with the COVID-19 virus. No current research supports the use of any dietary supplement to protect you from being infected with the COVID-19 virus.


References

  1. Sleep deprivation and deficiency: National Heart, Lung and Blood Institute. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency [Accessed April 20, 2020]
  2. Sleep and sleep disorders. https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html [Accessed April 20, 2020]
  3. Brain basics: Understanding sleep. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm [Accessed May 27, 2015] 
  4. Cirelli C. Definition and consequences of sleep deprivation. http://www.uptodate.com/home [Accessed May 4, 2020]
  5. Barbara Woodward Lips Patient Education Center. My road to better health: Sleep. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2011.
  6. Maski K. Insufficient sleep: Evaluation and management. UptoDate. https://www.uptodate.com/contents/insufficient-sleep-evaluation-and-management [Accessed April 20, 2020]
  7. Burgess H, Molina T. Home lighting before usual bedtime impacts circadian timing: a field study. Photochem Photobiol 2014;90(3):723‐726. 
  8. Sleep Awareness Week, April 23-29, 2017. Centers for Disease Control and Prevention. Announcement: MMWR 2017;66(15):411. https://www.cdc.gov/mmwr/volumes/66/wr/mm6615a6.htm [Accessed April 20, 2020]
  9. Circadian rhythms. National Institute of General Medical Sciences. https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx [Accessed April 20, 2020]
  10. Arnedt J. Insomnia in patients with a substance use disorder. UptoDate. https://www.uptodate.com/contents/insomnia-in-patients-with-a-substance-use-disorder [Accessed April 20, 2020]
  11. Lyndon D, Ram N, Conroy D, et al. The within-person association between alcohol use and sleep duration and quality in situ: An experience sampling study. Addict Behav 2016;61:68-73. 
  12. Grandner M, Lang Gallagher R, Gooneratne N. The use of technology at night: Impact on sleep and health. J Clin Sleep Med 2013;9(12):1301-1302.
  13. Stress in America 2017: Technology and social media. American Psychological Association. http://www.stressinamerica.org/ [Accessed April 20, 2020]
  14. Fairbrother K, Cartner B, Alley J, et al. Effects of exercise timing on sleep architecture and nocturnal blood pressure in pre-hypertensives. Vasc Health Risk Manag 2014;10:691-698. 
  15. Varrasse M, Li J, Gooneratne N. Exercise and sleep in community-dwelling older adults. Curr Sleep Med Rep 2015;1:232-240. 
  16. Parasympathetic nervous system. National Center for Biotechnology Information, U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025459/ [Accessed April 20, 2020]
  17. Melatonin: In depth. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/melatonin [Accessed April 20, 2020]
  18. Auld F, Maschauer E, Morrison I, et al. Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders. Sleep Med Rev 2017;34:10-22. 
  19. Sadeghniiat-Haghighi K, Bahrami H, Aminian O, et al. Melatonin therapy in shift workers with difficulty falling asleep: A randomized, double-blind, placebo-controlled crossover field study. Work 2016;55(1):225-230.
  20. Sadeghniiat-Haghighi K, Aminian O, Pouryaghoub G, Yazdi Z. Efficacy and hypnotic effects of melatonin in shift-work nurses: double-blind, placebo-controlled crossover trial. J Circadian Rhythms 2008;6:10. doi:10.1186/1740-3391-6-10.
  21. Gertsch J, Roger G, Vincenzo D. Phytocannabinoids beyond the Cannabis plant – do they exist? Br J Pharmacol 2010;160(3):523-529.
  22. Russo E. Taming THC: potential Cannabis synergy and phytocannabinoid‐terpenoid entourage effects. Br J Pharmacol 2011;163(7):1344-1364. 
  23. Abbasi B, Kimiagar M, Sadeghniiat K, et al. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci 2012;17(12):1161-1169.
  24. Ikonte C, Mun J, Reider C, et al. Micronutrient inadequacy in short sleep: Analysis of the NHANES 2005-2016. Nutrients 2019 Oct 1;11(10).pii:E2335.doi: 10.3390/nu11102335.