Wellthy adjective - characterized by focusing on good habits to make it easier to make healthy choices to have a balanced, healthy life that includes enjoying simple pleasures without guilt.

Advice about how to be healthy is everywhere. It is overwhelming to decide what to focus on and even where to start. What should you eat? Should you be taking any supplements? How often should you exercise? What’s the best type of exercise? Is it okay to pee in the shower?

Let me make the decision easy for you.

Start with sleep.

The science is compelling: sleep is the foundation for the proper functioning of your body and brain.

Here are just four examples.

1. Inadequate sleep leads to poor food choices. When you don’t get enough sleep, the body produces more ghrelin, a hormone that makes you feel hungrier. Poor sleep quality also reduces the chemical leptin, which sends signals to the brain that you are full. Short sleep will increase hunger and appetite, compromise impulse control within the brain, increase food consumption (especially high-calorie foods), decrease food satisfaction after eating, and prevent effective weight loss when dieting.

2. Inadequate sleep adversely affects the immune system. In one study, researchers separated healthy young adults into two groups: one group was restricted to four hours of sleep per night for six nights, and the other group was allowed to have seven and a half to eight and a half hours of sleep. At the end of six days, all participants received a flu shot. A few days later, researchers took blood samples to determine each participant's antibody response to the vaccine. The participants who were sleep-deprived showed less than a 50% immune response compared to those who had full nights of sleep. Sleep deprivation is also linked to several cancers, particularly colon, breast, ovarian, and prostate cancers.

3. Inadequate sleep has a significantly negative impact on the brain. Sleep deprivation affects your ability to learn information and store memories. Studies have shown that a person who gets two weeks of six hours of sleep per night has a similar performance to someone who has gone twenty-four hours without sleep. Studies have shown that drivers who slept six to seven hours were 30% more likely to be in a car crash than those who got more than seven hours; those who slept for five to six hours a night were 90% more likely to have an accident. According to Charles A. Czeisler, the Baldino Professor of Sleep Medicine at Harvard Medical School, pulling an all-nighter or having a week of sleeping just four or five hours per night actually “induces an impairment equivalent to a blood alcohol level of 0.1%.” Lack of sleep is also a risk factor for dementia and Alzheimer’s disease.

4. Inadequate sleep negatively affects the cardiovascular system and recovery after a workout. Poor sleep disrupts blood pressure and heart rate. Proper sleep is essential to recover from intense exercise and prepare your body for the next workout session.

Improving your sleep is one of the best things you can do to be wellthy.

For two years, I traveled from my home state of Arizona to a client in Baltimore. Half the year, it’s a three-hour time difference. According to studies, for every hour of time difference, it takes about one day to adjust. I used to fly to Baltimore on Sunday. Three days later on Wednesday, I was supposed to be adjusted. On Thursday, I returned to Arizona. So much for the adjustment.

When I traveled back-to-back, the weeks were more manageable because I wasn’t in Arizona long enough to adjust back. The weeks where I traveled every other week were tough because I was adjusting to a different timezone every week. I finally decided to stay on East Coast time when I was home. I was in bed by 8:00 PM and woke up to sign on at 4:00 AM. When I rolled off that assignment at the end of 2018, my sleep was a complete mess.

So what’s my sleep like nowadays?

• According to my Oura ring sleep tracker that I’ve worn for almost two years, I have been consistently getting just over 7.5 hours of sleep. My sleep efficiency, which is the amount of sleep time divided by time in bed, is an average of 89% (anything above 85% is considered good). My average sleep latency (the time it takes to fall asleep) is eight minutes.

• I go to bed and wake up at the same time seven days a week.

• I do not use an alarm to wake up.

• Other than magnesium, I’m not currently taking any other supplements for the purpose of enhancing sleep; however, I did experiment with supplements as I was trying to get my sleep under control.

• My sleep is consistently good, but that doesn’t mean I don’t have an occasional bad night. Ironically, one of the nights when I was writing this article, I woke up wide awake at 2:30 AM and couldn’t get back to sleep. I couldn’t pinpoint any particular cause. It happens, but my goal is to make sure this is an exception and does not become a pattern.

How do you optimize your sleep?

My suggestions are for typical situations and people who do not have sleep disorders or medical conditions that affect their sleep. If you think you have a sleeping disorder such as insomnia, sleep apnea, or something serious, you should seek help from a medical professional.

There are no quick fixes. It took me about four months of experimenting before I finally achieved consistent sleep at home and on the road. You don’t have to overhaul everything at once. Start with small changes that you can build into your routine.

Schedule

Without question, the change that most impacted my sleep quality was establishing a consistent sleep schedule. I go to bed and wake up at the same time, seven days a week. “Sleepin’ nine to five, what a way to keep on livin’” I know that’s not for everyone. It’s a bummer when I want to be out late because I know I will wake up at the same time regardless. Your schedule is also a personal decision related to your chronotype.

A chronotype is a person’s biological clock and natural preference for morning/evening and sleep style. In his book The Power of When, Michael Breus classifies people into one of four chronotypes: lions, dolphins, wolves, and bears. Take the quiz at https://thepowerofwhenquiz.com to find out your chronotype.

Light

Sunlight resets our circadian rhythm. Human beings evolved to wake up with the sunrise and call it a day at sunset. Our modern lifestyle with artificial lighting has disrupted that pattern. I try to get exposure to sunlight in the morning. It works even if it’s cloudy. There is a dual benefit in that exposure to sunlight causes the body to begin synthesizing Vitamin D, a critical component of your immune system. Minimize artificial light from light bulbs and electronic devices close to bedtime. I swapped the bulb in my nightstand lamp with a red light to use in the evening. If I cannot avoid looking at screens (or just don’t want to give them up), I’ll wear blue-light blocking glasses. If you are interested in products like these, you can find more information at Truedark.com. I’m not an affiliate just a fan.

Bedroom

I had a lot of work to do to create a proper sleep environment in the bedroom. I replaced my mattress and went through several pillows before I found the right one. I eliminated all lighting sources to have a completely dark environment. I removed the TV from my bedroom. I keep my iPhone on the nightstand, but I put it in airplane mode when I sleep to avoid disruption and minimize exposure to EMF signals. I have an air purifier to ensure that the air I’m breathing all night is pristine. The bedroom should not have anything that induces stress. It should be a calm and inviting place. The experts say there are only two things you should be doing in bed: sleeping and as Jim Lange from the Dating Game used to say, “making whoopee.”

Temperature

Temperature preference is highly individualized, so you’ll need to find out what works for you. I live in the desert, and ironically I cannot stand to be hot while sleeping. According to sleep scientists, the ideal sleeping temperature is between 60 and 67 degrees Fahrenheit. If I cranked the AC down to the 60s during the summer, I would have the equivalent of another mortgage payment with the electric bill. This summer, I purchased a device called an Ooler. The Ooler is a mattress pad filled with water that connects to a pump that circulates the water and maintains it at your desired temperature between 55 and 115 degrees Fahrenheit. GAME CHANGER. I didn’t realize how much temperature affects sleep until I started using this device. Now I refuse to go without it. I have programmed the Ooler to be colder earlier in the evening and then gradually warm up during the second half of the night to encourage REM sleep. There is a cheaper version called the Chilipad with fewer bells and whistles. You can find more information about these products on their website. I’m not an affiliate, just a fan.

Evening Routine

Everyone has experienced the ritual when a plane starts its descent in preparation for landing. Tray tables up and in a locked position. Seatback fully upright. Seat belt “securely fastened.” Well, how else do you fasten a seat belt? Flight attendants come through the cabin one last time to ensure your compliance and pick up the last of your trash. It’s a ritual.

I treat the 90 minutes or so before bedtime as a wind-down ritual. No violent TV. No vigorous exercise within 2 hours before bedtime. Yah, right. Who am I kidding? I am not interested in vigorous exercise at any time of the day. I have been experimenting with calming yoga stretches and breathing exercises that help me relax before bed.

Has this ever happened to you? You’re on the couch watching Netflix and catch yourself dozing off. You’d love to just go to sleep right there on the couch, but you know you have to get up, change into PJ’s if you aren’t already wearing them, brush teeth, and do anything else you need to do. You finally get into bed, and now you’re wide awake. What is that?! You were just ready to pass out, and now you can’t fall asleep. What may have happened is you hit something called “second wind.” The time around 11:00 PM (give or take with the seasons) is a critical cut-off for many people. If you choose to stay awake past this cut-off, you might get a cortisol-driven second wind that can keep you awake for hours.

All else fails, you can listen to this short podcast episode and remember, “You gotta go to bed!”

Eat/Drink

When you consume food or drink, the body undergoes all kinds of processes to digest the food, distribute the nutrients, and eliminate waste. This process takes time and is in direct conflict with all the functions that need to occur for sleep. My rule is to stop consuming all calories a minimum of three hours before bedtime. Whenever I break this rule, I pay for it in the form of a lousy night of sleep.

Caffeine metabolism varies for individuals based on genetics and overall caffeine consumption. Some people can have one cup of coffee in the morning and still be buzzed at night. Others can down a triple-shot expresso and go to sleep immediately after. I’m somewhere in the middle, so my rule is no caffeine after 2:00 PM or at least eight hours before bedtime, whichever comes first.

I’m sorry to be the bearer of bad news. Alcohol is a significant sleep disrupter. Alcohol is a depressant. It sedates you out of wakefulness, but it does not induce natural sleep. Alcohol fragments sleep by causing brief awakenings throughout the night (whether you remember waking up). Alcohol is also one of the most potent suppressors of rapid eye movement (REM) sleep, the stage of sleep when we dream. I eliminated alcohol while trying to get my sleep back on track and nowadays I imbibe sparingly.

There are many supplements touted to improve sleep, and I have tried a lot of them. You have to be careful when taking any supplements. I would suggest starting with the other techniques before experimenting with supplements. For now, I will leave the topic of supplements for a future article.

Sleep Tracking

If you are interested in having objective data about your sleep quality, there are many options available. In terms of wearable sleep trackers, the device I have been wearing for almost two years is the Oura ring. There are other less expensive options, including a smartphone sleep app called Sleep Cycle. This app allows you to place your phone on the mattress under your bottom sheet and set the alarm. No sleep tracker is as good as a sleep study, so consider the data merely as a guide and rely on how you feel to measure your progress.

Sometimes it is unavoidable. What should you do after a bad night of sleep?

1. Avoid sleeping later that morning. Wake up at your normal time instead of trying to “catch up” by sleeping later. The reason is that when you sleep later in the morning, you won’t be tired until later that evening. For example, if you sleep two hours later in the morning, that will delay your onset of sleep for two hours that evening. This will lead to shifting your bedtime schedule later and waking up later.

2. Avoid napping during the day after a bad night of sleep. It will be very tempting to take a nap sometime during the day. Don't do it. Again, it's short-term vs long-term pay-off. You may feel great after the nap, but there is a major chance that you will find it hard to get to sleep at your normal time that evening.

3. Use caffeine strategically. You will probably need it that morning because you’ll feel pretty rough. The recommendation is to stop drinking caffeine 14 hours before bedtime. For most people caffeine has a half-life of six hours and a quarter-life of twelve hours. For example, if you have a cup of coffee at noon, at 6 PM half the caffeine is still in your system, and at midnight one-quarter of the caffeine is still in your system. Of course, this varies by individual. Some people can drink a quad latte at dinner and sleep like a baby.

4. Go easy on physical activity. After a poor night of sleep, your body has not had the proper recovery to make exercise effective. In fact, any strenuous activity could actually be detrimental if you are not fully recovered. Take it easy and save the heavy workout for when you are fully rested and recovered.

In summary, after a bad night of sleep, you should take the hit. Realize that you won't have an optimum day and that's okay. The important thing is to recover as quickly as possible and return to your regular sleep schedule as soon as possible.

I know this is a lot of information. Start small with a few changes. Don’t get obsessive about it like I did when I started. I was obsessing so much about getting good sleep that it was making my sleep worse! A lot of poor sleep comes from bad habits. Fix those, and your body will take care of the rest.

Additional resources

This was only the tip of the sleep iceberg. It is such an important topic that I will be doing deep dives on all these aspects of sleep in the future. In the meantime, here are some additional resources.

Matthew Walker, Ph.D. is a sleep scientist. I first heard about him on Joe Rogan's podcast. I credit his interviews and his book Why We Sleep (affiliate link) with kicking me into high gear to improve my sleep. I hope you will at least carve out 19 minutes and watch or listen to Dr. Walker’s TED talk Sleep is your superpower. 

Finally, I have a Facebook page called Improve Your Sleep where I share resources and articles with the latest research about sleep.

Prioritize your sleep as best you can. It is a fundamental component to be wellthy.

Oh, and I almost forgot. I believe the standard rule (and I may be wrong) is that if you can direct the stream of urine completely into the shower drain then have at it. Obviously, if you share a shower with anyone else, you would need consent from all.

The day doesn’t start when you wake up in the morning. The day starts when you go to bed the night before. —Satchin Panda, PhD

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