We have all suffered bouts of insomnia and difficulty falling asleep. For most people, the number one cause is stress. For some, it may be a side effect of treatment such as efavirenz, which is known to cause wild dreams in some people. For others, it may be a symptom of HIV itself, such as pain, numbness or the burning sensation of peripheral neuropathy, that keeps them awake at night.
Lack of sleep affects our mood, increases feelings of anxiety and depression, and can affect our memory and ability to concentrate.
When fatigued, the brain thinks more slowly and we make more mistakes. When managing a longterm illness such as HIV, good quality sleep becomes even more important.
Diwakar Balachandran,MD, director of the Sleep Center at the University of Texas, says, ‘A lot of studies show our T-cells go down if we are sleep-deprived . . . And inflammatory cytokines go up.’1 It is a combination that increases the risk of illness.
Sleep is vital for our wellbeing.
It is essential for optimal learning and memory function and critical for a healthy immune system.
Digestion, cell repair and the release of growth hormones are all increased during sleep.
With a few lifestyle adjustments and some simple techniques, you can improve your sleeping patterns so that you go to sleep easily and avoid those debilitating and frustrating 3am awakenings.
MELATONIN AND SLEEP
An important factor in getting a good night’s sleep is a natural supply of melatonin. Melatonin is the hormone produced by the pineal gland; its role is to govern our internal body clock: the sleep/wake cycle. It also causes drowsiness and lowers body temperature at night. Melatonin production increases at night in the dark, and diminishes in daylight.
Light and electricity disrupt the natural functioning of melatonin production. The blue light emitted by fluorescent lighting, white LED lights, and the light in computer screens, TV screens and smart phones inhibits melatonin production when we are exposed to it at night. Changing the light globes in your home to ones that emit a yellow or warm white glow can make a difference.
And dimming the lighting in your home progressively over the evening leading up to bedtime can help regulate your internal body clock. Caffeine also reduces melatonin production by up to half, for at least 10 hours after its consumption. If you enjoy coffee or chocolate, it’s best to have your caffeine in the morning.
Sleep research scientist, neurophysiologist and yoga teacher Philip Stevens has clinically proven that candle gazing, a commonly practised meditation technique, significantly increases melatonin production (see below)2.
Electro-magnetic radiation (EMR) is a form of energy with both electrical and magnetic fields that travels in waves. EMR is emitted from wireless and wired technologies, such as computers, mobile phones, wireless routers, TVs, microwave ovens, electric heating systems, and digital radio alarm clocks.
Philip Stevens recommends moving all sources of EMR at least two body lengths away from your bed. He suggests that at bedtime you turn off your wifi router, put your mobile phone into flight mode and, if you use an electric blanket, use it to warm the bed then turn it off at the wall before you go to sleep.
THE NERVOUS SYSTEM, STRESS AND THE BREATH
The autonomic nervous system affects the quality and quantity of sleep you get each night. It has two parts: the sympathetic, which controls the stress response, getting us ready for ‘fight-or-flight’ mode when a crisis arises; and the parasympathetic, which controls the relaxation response once the crisis is over. It is known as the ’rest and digest’ mode.
The pressures of day-to-day life, and how we respond to them, can over-stimulate the sympathetic nervous system.
Many of us are in fight-or-flight mode most of the time and so we tend to breathe in a shallow way, using only the chest. When we breathe like this, too much carbon dioxide empties from the blood, disturbing the body’s balance of gases. Shallow chest breathing maintains the physiological message to the body of fight or flight. When stress keeps us awake, it’s quite likely our sympathetic nervous system is still switched on. We can switch off the fight-or-flight mode by changing the way we breathe.
Abdominal breathing is a natural breathing technique that has positive physiological effects. When we breathe abdominally, the diaphragm muscle moves downward on inhalation, pushing the abdomen outward.
On exhalation, the diaphragm muscle recoils and the abdomen moves naturally inward.
Neuro-receptors on the wall of the main abdominal artery measure the pressure of the abdominal cavity and when they feel pressure like the one exerted in abdominal breathing, the neuro-receptors send messages to the brain to relax the body. This activates the rest-and-digest mode of the nervous system.
Opinions differ on what to do if you wake during the night.
Some specialists advocate getting up and doing some mindless task, such as ironing or washing up.
Philip Stevens advises not to get up, don’t turn the light on and don’t start reading. Instead, go back to slow-rate abdominal breathing.
Muktakiran is trained in the Satyananda yoga tradition. She is the manager of Manly yoga, where she also teaches yoga and meditation classes.