Are you getting the right sleep?
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To boost immunity, forget ‘magic pills.’ Focus on sleep, exercise, diet, and cutting stress.
By Christie Aschwanden
If there has ever been a time to focus on keeping your immune system healthy, this long winter of the pandemic is it.
As the ongoing coronavirus crisis hits it darkest hour yet, we have the cold and flu season to contend with, too.
Amid these ongoing threats, the notion that we might somehow “boost” our immune system with one weird trick — an herb, a supplement, a particular food — holds obvious appeal.
If only it were that simple.
When it comes to bolstering the immune system, “a lot of people just want a quick fix or magic pill,” says Cristina Porch-Curren, an allergist and immunologist in private practice in Ventura County, Calif. Unfortunately, there’s no such thing, she says.
If that’s disappointing, there’s still some good news: the most scientifically sound approaches to keeping your immune system healthy are healthy habits that don’t require you to buy pills or eat strange foods.
One of the most effective ways to improve your immune system's health is by reducing stress.
Researchers have known for a long time that stress can hamper the immune system, Porch-Curren says.
For instance, a study published in the New England Journal of Medicine back in 1991 found that when researchers gave volunteers nasal drops containing common respiratory viruses, participants who reported higher levels of psychological stress were more likely to become infected and develop symptoms of the common cold compared with people who had lower stress levels.
The more stressed the volunteers were, the greater their chances of becoming sick.
More recently, a 2004 review summarizing 30 years of research and more than 300 studies on stress and immunity concluded that chronic stress can cause measurable suppression of the immune system. It said that even short-term stressors, such as academic exams, can impair the body’s immune response.
You probably cannot eliminate stress from your life in this time of uncertainty, but anything you can do to manage or reduce it will be helpful, Porch-Curren says.
The federal Substance Abuse and Mental Health Services Administration offers tips for managing distress during a pandemic that includes building social connections, managing negative thoughts, maintaining a sense of humor, getting outside, and finding ways to relax, such as listening to music or meditation.
Meditation is a well-known approach to managing stress, and it comes with another benefit — it may also help you sleep better.
A randomized, controlled trial published in JAMA Internal Medicine in 2015 found that meditation could produce “robust improvements in sleep among older adults,” says the study’s senior author, Michael Irwin, a psychiatrist at the UCLA Geffen School of Medicine where he directs the Mindful Awareness Research Center.
Sleep is crucial to maintaining a robust immune system.
“We know that sleep problems, especially difficulties maintaining sleep, make you more susceptible to viral infections,” Irwin says.
His research has shown that even modest amounts of sleep loss can increase the production of signaling molecules that promote inflammation and make someone more prone to illness.
“Even one night of disturbed sleep can have an impact,” he says.
One phenomenon Irwin has been tracking is how health-care workers often experience particularly serious outcomes from covid-19, the disease caused by the coronavirus.
(A report published by the National Nurses United in September estimated that more than 1,700 health-care workers in the United States have died of covid-19.)
Although some of this is probably a result of them being exposed to high doses of covid-19 in their work, Irwin also suspects that lack of sleep may play a role.
“We know that many of them are experiencing huge sleep debts because of scheduling and the long hours and night shifts they’re working,” he says.
To keep your immune system healthy, it’s important to maintain a regular sleep schedule, Irwin says.
“That means going to bed at the same time and waking up at the same time every day.”
Go easy on the alcohol, which can interfere with sleep, especially the deep sleep that Irwin calls especially critical for your body’s antiviral immune response.
Exercise can also improve your sleep — according to the American Academy of Sleep Medicine, even small amounts of physical activity can help you sleep better.
But it comes with a huge added bonus: It helps your immune system become better prepared to fight off viral attacks, too, researchers have found.
Regular physical activity at a moderate intensity — enough so that you’re breathing a little harder and your heart is pumping a little faster — improves the immune system’s surveillance against pathogens and reduces the chances of getting sick or dying from viral infection and respiratory illnesses, including the common cold, pneumonia, and influenza, says David Nieman, an exercise physiologist at Appalachian State University.
Thus, it may reduce your chances of getting sick at all.
Nieman has conducted numerous studies on exercise and the immune system.
Last year, he published a review of research over the past century regarding the relationship between exercise and the body’s immune defense system, which concluded that there’s “a clear inverse relationship between moderate exercise training and illness risk” and “habitual exercise improves immune regulation.”
Experiments have shown that exercise stimulates the recruitment of the immune system’s best fighter cells, Nieman says. “What exercise does is it signals the best fighters to come out and patrol the body at a higher rate than normal.”
It doesn’t take much to get these effects.
Something as simple as a 30 to 45-minute brisk walk is enough to activate this immune response, which studies show begins during exercise and lasts several hours afterward, Nieman says.
If you exercise day after day, “It’s like the military patrolling the countryside.
You’re going to keep the enemy-controlled a lot better as time goes on than if you haven’t done this patrolling.”
Nieman’s review concluded that exercise is associated with a 40 to 45 percent reduction in the number of sick days people experience from acute respiratory infections.
The research done so far has found this effect for the common cold, influenza, and pneumonia, but Nieman thinks that “it’s only a matter of time before we find that the coronavirus also responds in a similar fashion.”
If you’ve noticed that the list so far of scientifically confirmed approaches to maintaining immune system function essentially amounts to a set of common tips for improving one’s overall health, you can probably guess the final component that experts point to nutrition.
The Internet is littered with lists of “superfoods” that supposedly bolster the immune system, but Rene Leon, a clinical immunologist at Texas Regional Allergy and Asthma Center, says he doesn’t advise his patients to eat superfoods for their immune systems — in fact, “absolutely not.”
If there was a food or subset of foods that would help patients improve their immune response, immunologists would be the first to say so, he says. “But we don’t, because I don’t think there’s any hard science to prove that.”
Nutrition is definitely important to staying healthy, but “you can’t just say, ‘I’m going to eat blueberries,’ because they’re full of antioxidants,” Porch-Curren says.
Single foods aren’t the key to bolster immunity. Instead, it’s the totality of your diet that matters.
If you’re trying to maintain a healthy immune system, the best approach is to eat a well-balanced diet with an emphasis on whole foods rather than processed ones, she says.
Despite the heavy marketing, there’s no vitamin or nutritional supplement that can magically bolster your immune system, experts say.
Leon regularly works with patients who have suppressed immune systems because of diseases and genetic conditions.
He says that if an easy immune booster really existed, he would jump at the chance to point his patients to it.
“There are a lot of bogus claims out there,” Leon says.
Pay attention to the fine print, he says. “If there’s a disclaimer on there that says that [the product] doesn’t treat or cure any disease, then the proof is in the pudding.”
“I have patients who come in with a box of supplements and so many different bottles,” Porch-Curren says, but “none of them” have cured their immune deficiencies with any of these products.
When these things seem to work, it’s usually because of a placebo effect, and that might make it seem like there’s no harm in trying them.
But diet, weight loss, and sex supplements are tainted with unapproved drugs.
13 Weird-Yet-Proven Ways To Improve Your Sleep and Feel Revitalized
Ready to have a blissful night?
Fun fact: According to Dr. Michael Mosley, bestselling author of Fast Asleep: How To Get a Good Night’s Rest, the easiest and fastest way to know if you are getting enough sleep is to do the Spoon Test:
On any given day, skip your usual morning coffee or tea. Between 1 pm and 3 pm, head to your bedroom with a metal spoon and metal tray, close the curtains, place the metal tray beside the bed, check the time, and hang your arm over the same side of the bed where you put the tray, clutching the spoon. Lastly, close your eyes and try to sleep.
As soon as you drift off, the spoon will slip from your grasp and clatter against the tray, waking you up. When that happens, check your watch to see how much time has passed:
- Less than 5 minutes means you are severely sleep-deprived.
- Within 5 to 10 minutes, it is considered “troublesome”.
- More than 15 minutes means you’re probably fine.
Another more practical-yet-boring way to do this is to set an alarm for fifteen minutes and see if you fall asleep before it rings.
Regardless of the method you use, if you realize you’re in dire need of revitalizing sleep, you’re not alone.
Around 68% of Americans have reported they have sleep-related problems.
In March 2020, I woke up every day at 2 am.
My heartbeat so fast I couldn’t go back to sleep.
After a month, I felt as though I was permanently drunk. I couldn’t focus. Couldn’t think.
A quick Google search led me to study after study exposing the negative consequences of little-to-no sleep:
- Limits fat loss.
- Elevates heart disease risk.
- Hijacks learning.
- Increases risk of obesity and diabetes.
- Worsens bad moods and depression.
- Doubles car crash risk.
- Increases risk of Alzheimer’s.
- Triggers viral loneliness and social rejection.
- Lowers testosterone.
- Makes our skin age faster.
Desperate, I read Dr. Mosley’s book plus other research on how to get better sleep.
Beyond the typical tips we’ve all read a thousand times, I found others that have proven invaluable.
Hopefully, the following weird-yet-proven ways to improve your sleep will help you as well. But first… the basics.
The Tried and True Methods
Though you’ve probably read the following methods a thousand times, they’re worth summarizing. Time and again, they’ve proven helpful to countless people struggling with sleep.
That said, if you’ve already gone through the basics and they haven’t worked for you, skip to the next section.
For those who still want to recap the most common methods to improve your sleep, here they are:
1. Discard sleeping disorders or chronic health conditions
None of the other methods will work if you have a condition that needs medical attention.
Some people have sleeping disorders like Sleep Apnea, Restless Leg Syndrome (RLS), and many more, while others have chronic health conditions that make it harder to sleep.
For example, thanks to going to the doctor, I discovered I have a genetic heart problem that makes me feel palpitations throughout the day.
The doctor then suggested I avoid caffeine at all times to help my heart wind down.
2. Stick to a regular sleep window
Making sleep a habit by going to bed and waking up at the same time every day will make drifting off easier and will improve the quality of your sleep.
Our bodies are smart.
Creating a reliable pattern will help you squeeze the most out of every sleeping minute.
However, remember that the average adult needs between 7 to 9 hours of sleep per day, so ensure your sleeping and waking time give you what you need.
Moreover, if you want to know exactly how much, go to bed at the same time for at least a week and let your body decide when to wake up.
Afterward, register the average.
3. Take a morning walk
Studies show that sunlight exposure early in the morning can improve your sleep.
An easy way to do this is to take a morning walk since it can also help you get some exercise in the day, which also benefits your sleep’s quality.
If you don’t have time to go out, though, look out the window or try a lightbox, one of the weird-yet-proven methods I’ll explain below.
4. Avoid blue light before bedtime
Thus, watching TV late in the evening or using our phones right before dozing off can lead to insomnia or disrupted nights.
Instead, Dr. Mosley recommends disconnecting from our devices 90 minutes before our going to bed.
5. Darken your bedroom
Our bodies were designed to wind down in darkness.
That’s why Dr. Mosley recommends we dim our home’s lights 90 minutes before bedtime and that we ensure our rooms are as dark as possible when sleeping.
One way to do this is to use curtains.
Another — and cheaper — way is to buy sleeping masks.
Plus, they’re great for traveling. I take mine everywhere, and it’s helped me get restful sleep wherever I go.
6. Cool down your room’s temperature
According to the Sleep Foundation, “the best bedroom temperature for sleep is approximately 65 degrees Fahrenheit (18.3 degrees Celsius).
This may vary by a few degrees from person to person.
Still, most doctors recommend keeping the thermostat set between 60 to 67 degrees Fahrenheit (15.6 to 19.4 degrees Celsius) for the most comfortable sleep.”
7. Take a relaxing bath
Research cited in Dr. Mosley’s book states that “having a warm bath or shower an hour before bedtime can help you fall and stay asleep.”
Moreover, for it to have an effect, you have to be in the bath for around 10 minutes.
This ritual will increase the blood circulation to your skin, hands, and feet.
In time, this cools down your core temperature.
This is why it’s key to ensure it happens at least an hour before you go to sleep.
8. Avoid excessive exercise before bed
Doing a HIIT workout or running before bed will make it harder to fall asleep since it boosts your metabolism and accelerates your pulse.
Instead, leave intense exercises for the morning or early afternoon and do yoga or stretching before calling it a night.
This will help relax your muscles.
Moreover, if you have a heart condition like mine, you might consider not exercising every day.
For example, I only do intense cardio three times per week.
If I ever do more, I find it impossible to stay asleep for longer than 2 am.
Instead, I try to go out on relaxing walks.
9. Minimize noise
Like with darkness, our bodies need peace and quiet to rest, so close windows and doors and unplug devices that might cause annoying sounds.
If you have pets, try keeping them outside your bedroom since they tend to move and explore during the night.
If you sleep with a partner that snores or breathes heavily, opt for earplugs.
Though they’re annoying at first, if you find ones your size, you’ll get used to them.
And, like the sleeping masks, you can take them anywhere.
10. Avoid food, alcohol, and caffeine before sleep
Based on research cited in his book, Dr. Mosley recommends we:
- Finish dinner at least 3 hours before bedtime. Otherwise, digestion will make it harder to fall asleep. Note: Opt for light meals.
- Limit our liquid intake at least an hour before going to bed to avoid midnight bathroom visits.
- Avoid alcohol altogether (it makes us feel drowsy but keeps us from deep, restorative sleep) or stop drinking several hours before bedtime.
- Stop drinking caffeinated drinks 5 to 8 hours before going to bed (the half-life of caffeine).
The Less-Known Ways To Improve Your Sleep
Now that we’ve covered the basics, it’s time to get into “weird” territory.
Though unconventional, the following science-backed tips can help improve the quality of your sleep:
1. Invest in a lightbox
Initially created as a therapy to combat SAD (Seasonal Affective Disorder) — or winter blues — a light box is a device that emits a blast of light that mimics outdoor light.
This helps you sleep better because it boosts your mood, makes your body realize it’s daytime, and positively affects the production of melatonin.
Dr. Mosley recommends light boxes for people who wake up before sunrise or those who can’t leave their house and don’t have much sunlight coming in during the mornings.
However, don’t use a lightbox if you want to start waking up later in the day.
In that case, “shun the early light as much as possible” and “aim to get a good blast of light in the late afternoon, thereby delaying the release of melatonin.”
2. Try the 4–2–4 breathing technique
Stress is one of the leading causes of Chronic Insomnia.
That’s why Dr. Mosley suggests we practice the 4–2–4 breathing technique if we find ourselves unable to sleep.
By taking deep, measured breaths, you’ll slow your pulse and relax.
- Breathe in deeply through your nose while mentally counting to four. To know if you’re doing it correctly, put a hand on your belly. If it’s inflating, perfect.
- Hold your breath for a count of two.
- Breath out through your mouth to a count of four.
3. Listen to binaural beats
According to research cited on Psychology Today, when we listen to binaural beats such as this, we can create shifts in our brainwaves, “generating slower frequency brainwaves that promote deeper states of relaxation.”
These brainwaves are called Delta.
They are slow and characteristic of deep, restorative sleep.
Moreover, a small study has shown that exposure to slow-wave binaural beats causes positive changes in our DHEA, Cortisol, and Melatonin levels.
These three hormones have a direct impact on the quality of our sleep.
In short, listening to delta-inducing binaural beats improves the quality of our sleep, priming us to go deep. Just remember to use headphones as the idea is to listen to different frequencies at the same time.
Note: Listening to relaxing music like jazz or classical music can also improve your sleep.
4. Use supplements
Nowadays, people use sleeping pills to help them fall and stay asleep. However, Dr. Mosley warns us of two potential problems:
- You could get addicted.
- Most of these over-the-counter pills are like alcohol. They help you reach light sleep, but they stop you from going deep, making you feel tired the following day.
Instead, Dr. Mosley recommends we take supplements like:
- Melatonin. Taking 2mg of melatonin one or two hours before bedtime is safe and effective for adults. It can even be taken for up to 13 weeks.
- Magnesium. Small studies cited in Dr. Mosley’s book suggest that taking magnesium can help people fall asleep faster. That said, better to ensure your diet is rich in magnesium instead of purchasing a supplement. Some good sources are avocados, leafy green vegetables, legumes, and nuts.
- Tryptophan. In moderate doses, this supplement helps you relax. However, it interacts with other medicines such as antidepressants, so be careful.
- Valerian. Taking 300–900 mg of valerian before bedtime can improve your sleep quality.
5. Warm your feet
According to research, wearing socks or warming your feet with a hot water bottle helps you fall asleep faster.
The dilation of your extremities’ blood vessels aids in heat loss, which also sends a signal to your brain saying it’s time to sleep.
6. Try to stay awake
If you try to stay awake instead of worrying about falling asleep, you can feel less anxious, giving you enough time to relax.
In his words: “It sounds counterintuitive, but for those who find it difficult to sleep because they keep worrying about not falling asleep, do the opposite.”
7. Follow the 20-minute rule
In his book, Dr. Mosley recommends we apply the 20-minute rule for anything related to sleep. That means:
- If you’re trying to fall asleep and more than 20 minutes have passed, go to another room and do something relaxing until you feel drowsy.
- If you wake up in the middle of the night (like me) and more than 20 minutes have passed without regaining unconsciousness, like before, do something relaxing until you feel calmer.
- If you want to take a nap, keep it in the 20-minute range. Otherwise, you can disrupt your sleep cycle.
8. Blow some bubbles
Rachel Marie E. Salas, a physician and professor of neurology at Johns Hopkins University, recommended blowing bubbles to The New York Post. Apparently, this activity mimics a deep breathing exercise, and it can take your mind off any pre-bedtime anxiety, helping you relax and fall asleep.
9. Keep a “To-do” journal on your bedside table
A small study cited in Dr. Mosley’s book found that “those who spend five minutes writing about the day ahead went to sleep an average of nine minutes faster.”
Nine minutes doesn’t sound like a lot, but it is similar to the impact of taking a sleeping pill.
Note: This has been one of the most helpful tips to me.
10. Smell lavender
A University of Pennsylvania study found that the scent of lavender can help you improve your sleep quality, so why not buy a candle or put the real thing in your bedroom to see if it works.
11. Try the Mediterranean Diet
Research cited in Dr. Mosley’s book concluded that the Mediterranean Diet can help you sleep faster and better because:
- The foods — like olive oil, nuts, oily fish, legumes, and vegetables — contain anti-inflammatory compounds, which help us sleep better.
- This diet boosts the “good” bacteria in your microbiome, which then produce anti-inflammatory compounds and “feel good” chemicals that help reduce anxiety.
12. Purify your air
A recent 2017 study concluded that air pollution can disrupt sleep.
Bad air quality causes upper airway irritation, swelling, and congestion, and may also affect the central nervous system and brain areas that control breathing patterns and sleep.
Therefore, if you live in a city with high levels of air pollution, consider purchasing an air purifier.
13. Work on your optimism
A University of Illinois study found that optimistic people sleep better and longer.
According to professor Rosalba Hernandez, “optimists are more likely to engage in active problem-focused coping and to interpret stressful events in more positive ways, reducing worry and ruminative thoughts when they’re falling asleep and throughout their sleep cycle.”
To become more optimistic, Psychology Today offers the following three tips:
- Choose your version of optimism. In other words, try to look at the silver lining more than before, but don’t overdo it. Go for what feels natural.
- Question pessimistic thoughts. Ask yourself if your negative thoughts are true. You’ll be surprised how often you’ll answer no. Remember: Thoughts aren’t facts; they’re just thoughts.
- Hang out with other optimists. If we are the average of the five people we spend more time with, try to start meeting up with optimists. Some of their positive energy will rub off on you.
As you can see, there are more — and weirder — ways to improve your sleep than creating a sleeping routine, darkening your room, etc.
So why not give one of these a shot?
Why not take the time to experiment until you find the methods that work for you?
At worst, you’ll have a funny anecdote to share. At best, you’ll consistently experience rejuvenating nights.
Today, I hope you will have another inspired day,
that you will dream boldly and dangerously,
that you will make some progress that didn’t exist before you took action,
that you will love and be loved in return, and that you will find the strength to accept and grow from the troubles you can’t change.
And, most importantly (because I think there should be more kindness and wisdom in this crazy world),
that you will,
when you must,
be wise with your decisions,
and that you will always be extra kind to yourself and others.
When You Can’t Shake Your Fatigue, This Is for You
Being told it’s ‘normal’ doesn’t help
“I’m just so tired,” the man said.
“I can’t shake it.
This feels like the most exhausting year ever.”
In various forms, it’s the catch cry of nearly every person I work with at the moment.
Exhaustion, mental, physical, right-down-to-the bones-fatigue, is everywhere.
And, despite our best efforts to freshen up, it’s as stubborn as the pandemic that led us here.
Typically one of the signs of depression has been when people report they’re no longer enjoying the things they used to enjoy.
But that’s been hard to gauge when so many of our “fun” or leisure activities have been ruled out of bounds.
What can we do?
Knowing it’s normal doesn’t help.
Aren’t you tired of hearing that? Extreme fatigue in a global pandemic is Normal.
Sigh. It’s embedded in our language now, along with other things we never talked about two years ago, like lockdowns and R-values and testing stations.
But knowing you’re as weary as everyone else is one thing.
It doesn’t stop you from feeling 20 years older than you are, from desperately wanting a nap slap in the middle of a sunny day.
Or any day. It doesn’t suddenly fill you with energy.
Deep (unexplained) fatigue is the first presenting symptom in many mental health problems — especially burnout, depression, and anxiety.
It’s a red light that tells you you’ve hit psychological overload, that your adrenal gland is wound up off the dial as it tries to cope with stress.
After nearly two years navigating a pandemic, there are red lights flashing everywhere.
From bleary-eyed front line health workers to people with safe jobs and warm houses who feel guilty about their struggles.
Even those who are on the other side — who can travel and socialise again — are saying they don’t feel as upbeat at they thought they would.
As one fatigued client said: “I haven’t lost anyone.
I still have a job.
My marriage is pretty good.
I feel like I have no right to complain.
It’s way worse for a lot of others.”
He’s right but his struggle is still real.
Rumbling anxiety — stress, uncertainty, and constant change — is exhausting.
So are the daily Covid stats, the rolling updates on your phone, and expert forecasts of the worst possible scenarios.
So is trying to live with a handbrake on your life and a mask in every pocket and every bag you own.
So quit thinking about whether you should be tired and accept that you are.
Here are some other tips to help.
When You Can’t Shake Your Fatigue, This Is for You
“Fatigue makes fools of us all. It robs you of your skills and your judgment, and it blinds you to creative solutions. It’s the best-conditioned athlete, not the most talented, who generally wins when the going gets tough.” — Harvey Mackay
* Don’t look over the fence.
Struggle is not a competition; don’t rank your troubles against others.
Look, I’m not advocating for a lack of empathy for people who have it tougher than you.
But, in the broader sweep of life, that’s always the case; there will always be people with greater, or lesser, problems than you.
There will be people with better houses, cooler cars, and a bigger stash of bitcoin. It doesn’t pay to look over the fence.
If you’re struggling, you’re struggling.
Give yourself a break.
* Make your goals smashable.
Fact: Very few people write novels or learn new languages during global pandemics.
And if they did they probably weren’t trying to put food on the table and homeschool kids at the same time.
You don’t have to let go of your big, bold goals but shrink them so you can achieve — smash — them. Aim to cultivate a feeling of success by achieving one small thing every day.
Succeeding small often is better psychologically than constantly feeling like you’re failing.
* Drink lots more water.
I know, this sounds patronising, but good hydration is a guaranteed way of at least reducing fatigue. It’s the simplest strategy to take up — and it’s dumb not to use it.
If you’re drinking lots of water and still feel tired then you have a leave pass to complain.
If not, you don’t.
* Don’t sleep whenever you feel like it.
In other words, watch your nap quota.
Power naps can be a helpful way to recharge.
But, as much as possible, keep routine around your sleeping habits.
And if you must nap, keep it short.
Long daytime naps just make you feel groggy.
And older than your nana.
So keep a bleary eye on it.
* Do what fascinates you.
Those living with restrictions have more time than they once did.
Socialising without limits would be nice but, if you have a beat of public responsibility in your bones, it’s not gonna happen.
So allow your mind to roam and go down some rabbit holes you wouldn’t normally bother with.
Read some weird stuff or learn an odd skill or make some dumb, non-useful things.
I spent an hour yesterday drawing random faces without taking my pen off the page just because someone I don’t know suggested it.
My drawings were wickedly bad.
Then I coloured them in.
I might even paint them.
Complete waste of time?
But slightly rejuvenating.
And definitely better than staring at a wall.
The one helpful thing the pandemic has done is lower the bar on how we spend our time.
Do whatever you like with it.
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