Protocols for Your Optimal Sleep Program

Disclaimer: Not Medical Advice. Opinions are my own.

In partnership with Eight Sleep

In today's newsletter, we will do a deep dive into how to optimize your sleep hygiene program.

My mindset is that everyone has their own personalized instruction manual. We will dissect the central pillars surrounding sleep, but it's your responsibility to fine-tune and make it your own.

After 25 years of being on call as a Cardiovascular Surgeon, I have traded well-rested nights to be there for my patients. That comes with the responsibility of the role.

I struggle with sleep.

You may be in the same boat as me or a naturally talented sleeper. We all have room for improvement to prioritize sleep.

Sleep is too important to sacrifice.

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Sleep is a Necessity, Not a Luxury

Let's review some of the astounding benefits of a good night's rest:

1. Memory Consolidation and Learning

During deep sleep, the brain processes and consolidates information from the day, transferring memories from short-term to long-term storage.

2. Emotional Regulation

• Sleep, especially REM, is vital for regulating mood and managing emotional responses. Poor sleep leads to heightened emotional reactivity and a reduced ability to manage stress.

3. Immune System Support

• Sleep strengthens the immune system, making the body more resilient to infections and illnesses. During sleep, immune cells and proteins fight infections and modulate inflammation and stress.

4. Physical Health and Recovery

• Sleep is fundamental to tissue repair, muscle growth, and overall physical recovery. Growth hormone, which aids in the regeneration of cells and tissues, is released during deep sleep.

5. Hormone Regulation

• Sleep regulates critical hormones, including those involved in hunger, stress, and metabolism. For instance, sleep deprivation leads to increased levels of ghrelin (the hunger hormone) and decreased levels of leptin (the satiety hormone), promoting overeating and weight gain.

6. Cardiovascular Health

• Sleep is essential for heart health. During sleep, blood pressure and heart rate drop, which gives the heart a chance to rest. Chronic sleep deprivation is associated with higher blood pressure, increased heart rate, and inflammation, all of which can contribute to cardiovascular diseases.

7. Detoxification of the Brain

• During sleep, the brain undergoes a unique process called glymphatic clearance, flushing out metabolic waste and toxins that accumulate throughout the day. This is particularly important for brain health and the prevention of neurodegenerative diseases.

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If a supplement or pharmaceutical company could deliver these results without side effects, we would run with cash in hand to purchase whatever they were selling.

These are the benefits we are sacrificing when we trade anything for sleep.

The beauty is that you can access phenomenal benefits cost-free when you achieve 7-9 hours of quality sleep.

Now, the central pillars of attaining a good night's sleep.

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Circadian Rhythm: Our Internal Clock

The circadian rhythm is a natural, internal process that regulates the sleep-wake cycle and repeats approximately every 24 hours.

This internal clock helps our body/brain dictate when we are awake vs. when to sleep. The region responsible for the body's "master clock" is the hypothalamus (suprachiasmatic nucleus - SCN).

Maintaining a consistent circadian rhythm is crucial for optimal sleep. The noticeable fatigue from jet lag, shift work, or irregular sleep patterns is primarily due to falling out of your routine rhythm.

2 Daily Takeaways:

• Prioritize a consistent sleep routine. You can utilize the iPhone's Sleep|Wake Up Alarm to help hold you accountable. Fortunately, Eight Sleep's App has a sleep routine feature to help me track how I'm doing.

• Minimize light stimulation an hour before bedtime to allow the body to produce melatonin. Darkness naturally triggers melatonin, while light suppresses melatonin, making it harder to fall asleep.

Sleep Pressure

Sleep pressure, also known as homeostatic sleep drive, is the body’s increasing need for sleep. It’s a biological mechanism that gradually builds up throughout the day, ideally reaching its peak at night and prompting the body to sleep.

As we stay awake, adenosine builds up in the brain. Adenosine is a byproduct of cellular activity and energy use. The more adenosine accumulates, the stronger our urge to sleep.

When we finally sleep, adenosine levels drop, “resetting” sleep pressure.

Best Practices to Increase Adenosine:

1. Stay Physically Active: Physical activities, moderate to intense exercise, require energy, leading to increased adenosine production. Exercise can help build sleep pressure throughout the day, making it easier to fall asleep at night.

However, it’s best to avoid intense exercise close to bedtime, as it can be stimulating.

2. Engage in Mentally Stimulating Activities: Cognitive tasks, like studying, problem-solving, or working on complex tasks, also use brain energy and contribute to adenosine buildup.

3. Limit Naps: Long naps or those taken later in the day can reduce adenosine levels.

If you need to nap, try to keep it to 20–30 minutes and take it earlier in the afternoon to avoid interfering with the natural buildup of adenosine.

4. Avoid Caffeine: Caffeine blocks adenosine receptors, temporarily reducing the effects of adenosine and masking sleepiness.

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Sleep Environment

Even after checking off all we have discussed today, if your sleep environment is disruptive, you are setting yourself up for failure.

The good news is you have a lot of control over your sleep environment.

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Light Control

We know that darkness promotes melatonin, and living in a city can make complete darkness challenging. We invested in blackout curtains to minimize any light pollution from street lights, car lights, etc. We highly recommend them! Sleep masks are an easy alternative if you get used to them.

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Sound Control

In addition to the excess light at night, you might also struggle with excess noise. We utilize an air purifier, which doubles as an excellent noise machine.

If you haven't tried a white/pink noise machine, do so and see if it improves your sleep. It's recommended that the noise machine be no more than 50 dBs. ​
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Temperature Control

The final factor of the sleep environment is temperature regulation. Your body naturally cools down as you prepare for sleep and reaches its lowest point during deep sleep.

60–67°F (15.5–19.4°C) is ideal for most people to aid this process. We used to crank the AC down or open a window in winter, but now we leave it up to our Eight Sleep to handle our temperature regulation.
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Experiment with your sleep environment via trial and error until you build a space consistently producing favorable results.

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(BONUS) Sleep Supplementation, Sleep, Alcohol, Trackers, & Sauna ​
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I'm going to touch on a handful of frequently requested topics briefly.

Sleep Supplementation: Magnesium (Glycinate & Citrate), L-theanine, and Apigenin have all been effective for me. I use Momentous Sleep Pack and love it (Note: Momentous is a newsletter sponsor). I avoid taking melatonin altogether.

Disclaimer: Don't start, change, or alter supplements or medication without consulting your qualified health professional.

Sleep Trackers: You are not your sleep score. Sleep scores may be helpful when observing long-term trends. However, don't let a number dictate your perceived feeling for the day.

Alcohol: Any amount of alcohol will impact your sleep. You may fall asleep faster, but your sleep quality will be negatively affected, and you will most likely wake up more frequently throughout the night. Eliminating alcohol has drastically improved my sleep.

Sauna: I'm a huge fan of sauna therapy. Not only do I feel great afterward, but I can see a direct impact on my sleep. I would add a sauna to the list to increase daytime sleep pressure. We recently got a Sisu Suana and couldn't be happier.

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Documenting My Sleep Journey

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All the best,

Jeremy London, MD