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If your 2020 was a year of tossing and turning and bleary-eyed mornings, you’re not alone. It’s not for lack of effort. The basics of a good night’s sleep—quitting caffeine early, avoiding alcohol later, turning your thermostat down at night—just aren’t cutting it anymore, and it’s just you and the ceiling when 2 a.m. rolls around. “People then start to make understandable mistakes,” says Andrew Stiehm, MD, a pulmonologist and sleep specialist at Allina Health’s United Lung and Sleep Clinic. Coffee, napping, hitting the pillow early—all things that, yes, feel good after a bad night’s sleep, but also make it more likely that the string will continue. “Instead, just know that today is going to be a bad day,” Dr. Stiehm says. “We all have them—but avoid that nap.”
“Your bedroom should really be a sanctuary,” says Ben Trapskin, founder of Sleep Sherpa, a mattress showroom and review site. “You want to assess your entire sleep environment and how that affects your senses.”
The feel of your bedding, mattress, and pillow are obvious factors, but the smell of the room and the routines you establish around sliding into the sheets contribute too. “If you just do a quick five-to-ten-minute massage before you go to bed every night, you’re associating that massage with sleep,” Trapskin says. After a few nights, you’ll find yourself nodding off faster.
Your body associates your routine with sleep. Drop a scent into a diffuser, and that smell will start to trigger Zs. Though the studies are small, Dr. Stiehm says, lavender has been shown to improve relaxation.
Though it’s relatively safe to use long term, melatonin isn’t your bedtime BFF. “I’m very fond of getting to the bottom of things first,” Dr. Stiehm says. “Whenever a patient tells me they take a long time to fall asleep, I ask them why. The why is the real issue, and we shouldn’t just take medicine—we should deal with the why.”
It can be an occasional quick fix, though. “Say I just watched a scary movie, or I watched an action movie, and I’m really jazzed up and I need to go to bed,” Trapskin says. “I’ll take it, and that just helps get [my] body prepared for sleep.”
The snooze function: friend or foe? There is no science behind the nine-minute snooze standard. None. It was the easiest mechanism to create in analog clocks (remember those?), and it somehow pervaded. The official recommendation: Say no to snooze. “Snooze interrupts your sleep,” Dr. Stiehm says. “If you set your alarm for 7 a.m. but plan on snoozing until 7:18, it’s just better to set your alarm clock to 7:18 and get up. … Why should the last 18 minutes of your sleep have two forced awakenings?” But the recommendation isn’t always reality. “That being said, I snooze twice most mornings.”
Vitamin D supplements have been linked, Dr. Stiehm says, with improved sleep quality. In a study, half of participants received vitamin D and half received a placebo. “Those that received vitamin D reported improved sleep quality,” Dr. Stiehm says. But vitamin D can also worsen sleep quality in postmenopausal women.
The Firm Debate:
“There is a common mattress myth that firmer is better. … It is really about the correct combination of firmness, comfort, and support based on your body type and size that matters most.” —Brad Rau, Sleep Number
“Kids up to early 20s should be on a very firm mattress while their body is developing to help with proper alignment and bone development.” —Karna Hatzigeorgiou, Naturepedic Organic Mattress Gallery
“A lot of companies are infusing CBD into textiles; the latest is the CBD pillow. As you lie down, your body slowly absorbs a small dose of CBD, which helps you fall asleep.” —Ben Trapskin, Sleep Sherpa
Advancing tech allows you to control your bed from your smartphone (you read that right). “You can tell it to heat up your bed before you go to sleep,” Trapskin says. It will even start your coffee maker as it senses you waking up (!!).
Lower Back Sufferers:
“Most people will tell you that a firm mattress will do it for lower back pain because you want to have your spine properly aligned as you lie down. And that’s usually a good start,” says Ben Trapskin of Sleep Sherpa. But newer mattresses have evolved. “They’ll put firmer coils toward your lower back to keep that firm so it doesn’t sag and take you out of alignment. But then they’ll place softer coils (higher-gauge coils) toward your upper back and shoulders so that you can sink in.”
For the Nonstoppers: Parents, Athletes, People on the Move
“Get something for maximum recovery,” Trapskin says. A cooling layer will help you fall asleep faster. The Eight Sleep Pod is uniquely cooling: “It basically runs conditioned water through the top layer of the mattress,” Trapskin says. “A lot of times people have trouble because they sleep too hot or, conversely, if you’re cold at night, especially in Minnesota.”
“Now that we have such long nights, it’s sometimes hard to wake up in the morning. You can buy lights that will simulate a sunrise for you so you wake up more naturally.” —Ben Trapskin, Sleep Sherpa (Psst, they’re called Philips Hue bulbs.)
From snoring and pauses in breathing during sleep to the large umbrella of poor sleep quality, the signs of sleep apnea are varied. Waking up frequently, daytime fatigue, and morning headaches? Also signs of sleep apnea, says Kim Ledermann, DDS, TMJ specialist at Minnesota Craniofacial Center.
As high as 15 to 30 percent of men and 10 to 15 percent of women have sleep apnea, says Dr. Andrew Stiehm of Allina Health. “It affects men more than women, but after menopause, the risk of sleep apnea in women gets closer to that of men.”
And those suspecting sleep apnea but putting off the dreaded sleep study no longer have an excuse. “The broad use of home sleep apnea testing is transformative,” Dr. Stiehm says. “Most patients can be diagnosed with sleep apnea in the comfort of their own homes.”
Though CPAP machines are not the season’s hottest accessory, the masks are getting a little more comfortable, Dr. Stiehm says.
“CPAP remains the gold standard,” Dr. Ledermann says. But other options can be pursued for mild cases. And in the case that a CPAP doesn’t work for you, a hypoglossal nerve stimulator is a promising new implant, Dr. Stiehm says. The implant “stimulates the tongue to move out of the way when you sleep.”
Beyond medical treatments, Dr. Ledermann encourages patients “to pursue adjunctive measures, including optimizing nasal breathing, looking at whole-body health and nutrition, and using good sleep hygiene measures.”
This article originally appeared in the February 2021 issue of Mpls.St.Paul Magazine.
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