Adequate sleep is one of the foundation blocks for building good health. What you might not realize, though, is getting quality sleep is a way to fight inflammation, too. “In the parts of the brain that control sleep, there are areas that influence immune response, body temperature and inflammation,” explains Christopher Winter, MD. Based in Charlottesville, Virginia, Winter is a sleep specialist/neurologist and author of The Sleep Solution.
During deep sleep, growth hormone (GH) is secreted by the brain, he says, and “GH is huge in the body’s ability to maintain health and minimize inflammation. Mess up sleep and diminish GH and muscle does not repair itself fully, bones become weak and your body gets sick and takes longer to recover from illness and injury.” We know we should turn off screens and go to bed at the same time every night. But to take your sleep game from amateur-level to peak performance, try these pro moves.
Amateur Move: Seeing your regular doctor to treat insomnia.
Pro Move: Getting a referral to a sleep specialist, stat.
Most primary care physicians have virtually no training with sleep. “Most likely, you are just going to get a sleeping pill and no real insight or help with the problem,” says Winter. Sleep specialists come from various backgrounds — internal medicine, psychiatry, psychology, neurology, gerontology, and other fields — but also have additional training and background in sleep conditions. They might administer tests such as polysomnography, which monitors a person while they are sleeping. Because getting an appointment with a specialist can take awhile — they’re in high demand — don’t dillydally.
Amateur Move: Going to bed whenever you get tired.
Pro Move: Hitting the hay around 10 p.m.
A 2021 study from the University of Exeter found people who went to bed at midnight or later had a 25 percent higher risk of cardiovascular disease compared with those who went to bed between 10 p.m. and 11 p.m. People who fell asleep before 10 p.m. had a 24 percent raised risk. This sweet spot of 10 p.m. to 11 p.m. is related to the workings of the circadian timer in the pineal gland, explains Surrey, England-based Nerina Ramlakhan, PhD, a neurophysiologist and author of several books on sleep, including Finding Inner Safety: The Key to Healing, Thriving and Preventing Burnout.
According to Ramlakhan, this inner timer responds to light and darkness and adjusts levels of melatonin (the sleep hormone), and other neuropeptides, affecting our sleep/wake cycle. A healthy sleep routine, she says, optimizes our parasympathetic nervous system (PNS) — also called the “rest and digest” nervous system — and it controls sleep, digestion, sexual function, and immunity.
Amateur Move: Ignoring snoring.
Pro Move: Checking in with a doc.
“Someone who snores should seek medical evaluation if the snoring disturbs the sleep of others or occurs regularly, especially if it is associated with pauses in breathing or gasping for air,” says Eric Kezirian, MD, professor of clinical otolaryngology-head and neck surgery at Keck Medicine of USC in Los Angeles. Snoring can be a sign of obstructive sleep apnea, in which a blockage of breathing disrupts sleep (there are three main types of sleep apnea). All have serious negative effects on health.
Snoring and obstructive sleep apnea may also increase inflammation in the throat, he says. “The direct swelling appears to be related to the vibration of the tissues like the soft palate and sides of the throat, whereas the indirect inflammation is likely due to the increased levels of chemicals like adrenaline and epinephrine that circulate in the bloodstream as a result of significant obstructive sleep apnea.” Talk with your doc if you snore and don’t feel refreshed after a night of sleep, Kezirian says, or if you snore and have high blood pressure or heart disease.
Amateur Move: Downing a nightly melatonin gummy.
Pro Move: Saving melatonin for certain situations.
Melatonin — a hormone produced by the brain and available as a dietary supplement — is generally safe, says Winter. However, it’s not helpful to take it nightly. He says melatonin should be used to address a specific circadian issue such as jet lag or shift work, rather than using it as an evening ritual.
“For those who have difficulty falling asleep, it’s recommended to take melatonin about two hours before bedtime. People who fall asleep easily but have trouble staying asleep may find taking melatonin at bedtime can be more helpful,” says Kezirian. “Often, we suggest using 9 to 10 milligrams for a couple of weeks, just to see if it will provide benefits. If it helps, then you can try using a lower dose. If it doesn’t work at the higher dose, then it will likely not help [at all].” (And if it leaves you with a sleep hangover, try a lower dose.)
Amateur Move: Not taking time to unwind.
Pro Move: Practicing yoga asanas that promote relaxation.
Use yoga positions that signal to the brain that you can relax, suggests Patrick Franco, yoga director of YogaRenew Online Teacher Training and a yoga instructor in Hoboken, New Jersey. His three favorites for this are calming, seated poses: seated forward bend (paschimottanasana), bound angle pose (baddha konasana) and seated wide-legged forward bend (upavistha konasana). “Any kind of exercise, including yoga, done during the day aids in better sleep,” says Franco, because exercise helps relieve stress and anxiety. “But these slower forward folds and restorative postures done right before bed are a great way
to wind down and release any built-up stress.”
He also suggests Yin Yoga or Restorative Yoga practices for addressing sleep issues. “The pacing and energetics of Restorative Yoga are similar to Yin Yoga, but the physical practices are different. In Yin Yoga we seek to find deep stretches and release tension in the connective tissue. In Restorative Yoga the poses are set up using props to help remove any physical sensation from the body and instead help you feel comfortable and supported.”
Amateur Move: Staring at the ceiling at 3 a.m., brain spinning.
Pro Move: Trying deep breathing.
“It activates the parasympathetic nervous system and brings the mind to a focused, calm state,” says Franco. “Take a deep inhale to the count of four and a deep exhale to a count of four.”
Amateur Move: Skipping breakfast.
Pro Move: Eating first thing.
For those prone to anxiety, it’s key to eat soon upon waking, says Ramlakhan. Breakfast
helps stabilize blood sugar which then reduces stress on the body. “It’s the equivalent of telling the caveman brain that our environment is well-stocked with food; we don’t need to run on adrenaline. That turns on the PNS, which enables us to produce the melatonin needed for good sleep later in the day.”
Amateur Move: Sleeping in on the weekend.
Pro Move: Using extra z’s carefully.
It’s fine to sleep in if you lost those hours through a situation not of your own making, says Winter, such as a late flight. But if you’re sleeping in because you’re making poor decisions, like binge-watching TV, then you’re enabling bad habits. “Sleeping in can worsen sleep problems,” he says.
Amateur Move: Worrying about sleep data.
Pro Move: Trusting yourself.
It’s perfectly normal to wake up during the night, says Ramlakhan. “We should be more concerned with how we feel when we wake up — the quality of our energy, our ability to be creative and mentally sharp, our ability to make good lifestyle choices.” Instead of obsessing over your sleep stats, work on learning how to relax, breathe and let go of worry.
Are sleeping pills ever a good idea?
Only rarely. According to Eric Kezirian, MD, prescription sleeping pills are most helpful when they’re used to treat short-term sleep problems, those that have been going on for three months or less. Examples would be insomnia due to a new medication, pain or a stressor, such as grief. Prescription sleeping pills are generally ineffective for treating long-term sleep issues like chronic insomnia.
Nor does he recommend over-the-counter (OTC) sleep aids. “Many OTC sleep aids contain diphenhydramine or other antihistamines.” They aren’t harmful for occasional use, he says, but while they make you drowsy, they worsen the quality of sleep. And diphenhydramine should not be used long term, as some studies have found it may increase the risk of dementia. Both OTC and prescription sleeping pills can be habit-forming.
Sleep specialist Christopher Winter, MD, is even more blunt. “I despise sleeping pills,” he says. “They cause far more problems than they solve, and the data behind their ability to improve sleep is virtually nonexistent.” Ask your doctor about other options that may work.
A version of this article appeared in our partner magazine, The Complete Guide to Anti-Inflammation.