All About Sleep
Sleep is important for both mental and physical health. With it our productivity increases, our recovery time is shorter, our immune system is boosted and our mood improves. Everyone can benefit from better sleeping habits, although not everyone is aware of the various ways that sleep hygiene can be improved. That's the topic of today's post, so read on.
THE STAGES OF SLEEP
First, let's run through the stages of sleep. There are five total*. Stages 1-4 are non-REM sleep; stage 5 is REM.
*The sleep profession in the US eliminated the use of stage 4 in 2008; stages 3 and 4 are considered stage 3 or N3.
Stage 1 is light sleep when you drift in and out and can be awakened easily. Your eyes move slowly and muscle activity slows down. It is during this stage that you may have sudden muscle contractions (twitches) or experience the sensation of falling.
Stage 2 is when your eyes stop moving and brain waves slow down for the most part, with occasional bursts of rapidity. Your body temperature drops slightly and your heart rate slows down.
Stage 3 is when delta waves (very slow brain waves) are interspersed with smaller, faster waves. This is considered deep sleep and is the point where people may experience parasomnias (abnormalities or undesirable behaviors while sleeping) such as sleepwalking, night terrors, talking in one's sleep and bedwetting.
Stage 4 continues deep sleep, but the brain produces almost exclusively delta waves. People awakened from this stage feel disoriented for a few minutes.
Stage 5 is the stage where you experience REM (rapid eye movement). Brain waves mimic activity during the waking state; the eyes remain closed but move quickly from side to side, possibly related to the dreams and brain activity during this stage.
Progressing through all five stages is considered one sleep cycle. The first sleep cycle takes approximately 90 minutes; after that, they average between 100-120 minutes per cycle. Typically, you will go through 4-5 sleep cycles each night.
Deep sleep (stages 3 and 4) provide the most restorative sleep. This is why if you take a short nap during the day you can still sleep at night, but taking a longer nap which allows you to fall into deep sleep will result in you having trouble going to bed in the evening.
WHAT HAPPENS WHEN YOU SLEEP?
During deep sleep, human growth hormone is released and repairs and builds up your body and muscles from the stresses of the day. Your immune system strengthens itself. Your blood supply to the muscles regenerates and you experience an increase in new cell production. It is suspected that during REM, the brain refreshes itself for new learning the following day.
When you sleep well you reduce your risk of heart disease and cancer. You reduce inflammation and lower stress and blood pressure. Sleeping improves memory and makes you more alert. It may reduce risk of depression and possibly help you lose weight as the hormones ghrelin and leptin, which regulate appetite, are disrupted by lack of sleep and insulin production increases with lack of sleep, leading to increased fat storage.
WHAT IS SLEEP HYGIENE?
The term sleep hygiene refers to the rituals, behaviors, and norms that you follow near bedtime. Improving it is an easy way to help correct trouble sleeping and should be the first thing you adjust when this trouble arises. Sleep hygiene education is in fact an essential part of the cognitive-behavioral therapy used to treat insomnia.
Poor sleep hygiene includes behaviors such as regularly pulling all-nighters or sleeping in on the weekend to "make up" for lost sleep during the week. The opposite of any of the below tips will lead to less restful sleep.
Good sleep hygiene involves following a regular sleep schedule and avoiding stimulants in the early evening through lights out. See the below information for details of other positive bedtime habits.
HOW MUCH SLEEP DO I NEED?
The very first thing you need to know is how much sleep you need. Our sleep needs change throughout our lives due to factors such as age and stress. As a general rule, adults require 7 - 7.5 hours of sleep. The National Sleep Foundation conducted a study regarding sleep duration and came up with this handy chart of average requirements:
Note that if you regularly sleep more or less than the recommended or 'may be appropriate' times, you may have a sleeping disorder and should consult a physician.
WHEN SHOULD I SLEEP?
This question may seem like a given, but it actually isn't. In addition to varying work schedules, everyone has a different circadian rhythm. A circadian rhythm is a roughly 24-hour cycle in the physiological processes of all living creatures which determines their sleeping and eating patterns. There are clear patterns of brain wave activity, hormone production, cell regeneration and other biological activities linked to this cycle. Ever wonder why you're absolutely not a morning person but that chipper coworker of yours seems most alert before dawn? That's a difference in circadian rhythm.
A recent study by the University of Basel has shown that the mitochondrial network (the network of 'powerhouse' organelles within your cells) produces energy according to the circadian rhythm. If you are resting and working in sync with your rhythm, your energy production is boosted. If your actual sleep-wake cycles are out of tune with your internal clock, you will struggle to find the energy you need to perform your daily tasks.
How do you suss out your circadian rhythm? It's pretty intuitive actually. Our alignment to our internal clock is called a chronotype which in layman's terms would translate to being a "morning person" or "night owl." This chronotype is primarily a factor of genetics. Although it can change some over time according to age, overall it's something we're born with. There is actually a fancy wearable called the Oura ring which tracks your pulse, movement, body temperature etc and recommends an optimal sleep time. On the other hand, if you don't have money to burn you can keep notes on your wakefulness, energy levels and sleep patterns in a sleep journal to see what works best for you -- experimenting with different patterns (adding a short nap or taking a nap out, adjusting bedtime or wake-up alarm, etc) is another way to do the same time and best of all, it's free.
STRATEGIES TO IMPROVE YOUR SLEEP
There are all sorts of ways to improve the quality and regularity of your sleep. Here's a list of ideas:
If you have tried a combination of the above and still have trouble sleeping, you may have a sleep disorder or another health issue which complicates your rest. Keep a sleep diary and consult your doctor.
CONSEQUENCES OF POOR SLEEP HYGIENE
An occasional sleepless night will make you tired and irritable the next day, but it won't harm your health. However, after several nights without proper sleep you may experience foggy thinking, making it difficult to concentrate and make decisions. You may fall asleep during the day (this is called microsleep), and will experience increasing levels of depression, moodiness, quick temper and/or being excessively emotional. You risk injury and accidents at home, work and on the road and this risk level rises the longer you continue with poor sleep habits. Long-term sleeplessness will affect your overall health, weakening your immune system. Your sex drive lowers, and your balance and coordination suffer.
A lack of sleep may also trigger mania in people who have manic depression. Sleep deprivation prompts your body to release higher levels of insulin after you eat. Insulin controls your blood sugar level and higher insulin levels promote fat storage and increase your risk for diabetes as well as obesity.
Sleep affects processes which keep your heart and blood vessels health, including your blood sugar, blood pressure and inflammation levels. It also plays a vital role in the body's ability to heal and repair the blood vessels and heart. Studies show that people who don't sleep enough are more likely to have cardiovascular disease including heart attack, stroke, and high blood pressure.
As mentioned previously, human growth hormone is released during deep sleep. These hormones build muscle mass and repair cells and tissues. For testosterone production you need at least three hours of uninterrupted sleep. If you are not sleeping enough, you are also compromising the benefits of your fitness regimen as it is during rest that your body builds itself.
Should You Train When Sick?
We're heading into cold and flu season now, so other than encouraging folks to keep their vaccinations up to date I thought to broach the subject of training when you are sick. This is a question that comes up with a good deal of frequency especially heading into the fall. There are a LOT of opinions on this subject and most research focuses on cold and flu. I'll do my best to summarize the research-backed verdicts here.
Before going any further, let me say this: never disregard the advice of your doctor. A trained medical professional who has examined you and prescribed your treatment will know the most about what ails you and how to best recover.
If you DO train when sick, do not do so at the gym or in a group setting as you will likely infect others. Viruses and bacteria travel through your breath, so you don't even need to cough in order to infect those around you. Do your training at home and/or on your own, where you will not share your illness.
Finally, eating a nutritious diet and engaging in regular physical exercise has a protective effect and boosts immunity.
HOW SICK ARE YOU?
The first thing you need to suss out is how sick you actually are. Understand that there are different levels of sickness just as there are different levels of hunger, tiredness and any other physical ailment or discomfort. Whether or not pushing through is the wisest choice depends on a number of factors.
An easy way to gauge whether or not you can participate in physical exercise is to use an above the neck/below the neck principle:
Above the neck means exactly what it sounds like: you have a stuffy (or runny) nose or sore throat. Mild cold or sinus/allergy symptoms fall into this category unless severe.
Below the neck means anything from fever and extreme tiredness to muscle aches, dizziness, shortness of breath, chest congestion, light-headedness, diarrhea, vomiting, swollen lymph glands etc.
Above all else, listen to your body before you decide to train.
HOW SHOULD YOU TRAIN?
Light physical activity such as walking, gardening, Tai Chi, gentle yoga, low-intensity outdoor bike riding etc (also employed during active recovery) should not cause a worsening of symptoms.
Moderate exercise such as lower-intensity (non-panting) outdoor cardio actually boosts the immune system provided that symptoms are not severe. Moderate exercise does not affect the duration or severity of the common cold.
Prolonged vigorous exercise has an immunosuppressive effect and should be avoided when sick. There have been instances of chronic fatigue syndrome developing and lingering for months or even years when athletes have continued training when ill without adjusting intensity.
If your illness is classified as above the neck and symptoms are mild, you may train as normal and still see the session as wholly productive.
If your illness is above the neck but has also moved into the throat, most of the time you can still train BUT you will have to dial your workout intensity and duration back especially if your nutrition is lacking, you are under a lot of stress or your immune system is compromised. Ways to adjust would be to do 1-2 sets of lifting instead of your normal 5, or walking or light jogging (or walk/jog intervals) for 20 minutes instead of the 40 minutes you were going to run.
If your illness is below the neck, rest, recover and sleep. If your nutrition hasn't been the best, get some healthy food into your system and let your body heal itself.
The below handy infographic was made by the folks at Precision Nutrition:
If you are using a decongestant, your heart rate will increase more rapidly than it would based on the intensity of the workout alone. This may cause shortness of breath and/or difficulty breathing. Dial back your training if taking a decongestant, or avoid all together.
If you have asthma and exercise while you have a cold your asthma symptoms may worsen.
Diabetics may have an issue as well because being sick causes an increase in blood sugar at rest as well as a decrease in blood sugar during activity. Diabetics need to monitor their blood sugar more closely when sick.
Other factors which affect how the body responds to exercise when sick include:
Age: our immune response can break down as we get older. The good news is that staying active and eating a nutritious diet can offset much of this effect.
Gender: Menstrual phase and oral contraceptive use may affect how the immune system responds. Estrogen usually enhances immunity while androgens suppress it.
Sleep: Poor quality sleep and/or prolonged sleep deprivation decreases immune function.
Training Age: The more often you exercise, the better your body will handle exercise when sick. As stated above, higher levels of fitness have a protective effect and may limit stress response to exercise.
GETTING BACK TO THE GRIND AFTER ILLNESS
Any significant lapse in training will cause a little fall back in your performance. After being sick, give yourself 2-4 weeks to build back up to the level you were training at prior to your illness. Be sure to give yourself extra rest, as even after symptoms abate your body is cleaning up the remnants of the virus or bacteria which knocked you out in the first place. Jumping back in too soon may cause the illness to relapse, and/or you may injure yourself because you've taken on too much too soon. As stated previously, listen to your body as you get back to your grind and be kind to yourself.
A Hydration How-To
Everyone knows that water is essential to wellness because it is what the body is primarily composed of. The proper balance of water and electrolytes determines how our bodies function, including the responses of our nerves and muscles. Water removes metabolic waste, controls body temperature, heart rate and blood pressure and maintains a balanced metabolism. Without it, our bodies begin to shut down. But how much do we need, how can we work that requirement into our daily lives, and how can we check our hydration levels? Let's dig in.
HYDRATION AND PERFORMANCE
Everyone knows that both urinating and sweating results in loss of water, but there are other ways in which our fluid levels are reduced throughout the day: in bowel movements, by breathing (we exhale water vapor; the exact quantity depends on the humidity level of our environment), in the processing of medications, via a moisture-deficient diet (dry foods require more water to process and store nutrients) and via heart rate and breathing related to stress. We are constantly losing water, which is why we need to replenish.
In both anaerobic and endurance exercise, athlete hydration levels are critical to performance. It is crucial for anyone engaging in intense and/or prolonged physical activity to go into said activity properly hydrated, and to develop a plan of fluid replacement based on their individual fluid loss ratios.
The body's work capacity drops in direct relation to the degree of dehydration an athlete suffers. Aerobic activity sees a sharp decline in performance whereas sports or exercise requiring muscle strength and endurance see a variable decline.
The primary causes of performance decline include reduction in blood volume, decreased skin blood flow, decreased sweat rate (therefore decreased heat dissipation and increased core temperature), and increased rate of muscle glycogen use. The fluid in your body is the highway, and with less of that medium available your body has to work harder to circulate the necessary fuel to the active muscles and remove the cell waste.
HOW MUCH WATER DO I NEED?
Ever hear the old "8 8oz glasses of water daily" prescription? This is a good rule of thumb, but it is nevertheless a generalization and doesn't hold true for every person due to differences in activity level, environment, body size, diet, medications and medical requirements, etc.
The easiest way to tell if you are properly hydrated is the urine color test. A properly hydrated individual goes to the bathroom every 2-4 hours.
Athletes, fitness enthusiasts and those who work outdoors require more water than someone with an office job and sedentary lifestyle. The exact amount required differs by individual for this population, too.
The biggest problem especially for those new to fitness is knowing when to hydrate. Oftentimes they gauge whether or not they need water by their thirst. The problem is that your body's thirst mechanism is turned down during exercise, so if you get thirsty while working out you are actually currently dehydrated and need to drink some water immediately and sip on it as you continue your activity, whether or not you are thirsty.
A good way to gauge how much fluid you lost during your workout is to weigh yourself directly before and immediately afterward. As you recover you will continue to lose fluid through sweating and urination. You will need to replace 125-150% of the fluid deficit in the subsequent 2-6 hours after exercise. 1 pound is 16oz, so if you lost 2lbs during exercise you will need to drink 40-48oz of water, which is 125-150% of the fluid you lost while working out.
If you are not exercising but still find that you don't get thirsty very often, your thirst mechanism is not functioning properly. This article has a great suggestion for how to kick it back into gear:
Get one of those small, Dixie paper cups, or a shot glass. Fill that cup up with water and drink three to five shots in quick succession, one right after the other. Wait 30 minutes then do that again. Do that in the morning and in the evening, and by the second day, you’ll probably start noticing your mouth getting dry more frequently throughout the day. Do that routine for a week, and your thirst mechanism should be in full functioning order.
Plain water is the best source of hydration, but there are other ways to meet your requirements including eating foods high in water content or consuming other beverages. Be aware that any alternate hydration source potentially contains sugar and calories. For some populations such as endurance runners this is advantageous, but for an average person doing an hour-long workout to lose weight, the best possible source of hydration is the one to stick to. Plain water contains zero calories, zero sugar, and is most readily absorbed by your body. Also note that you will absorb less water from alternate hydration sources; a cup of fruit juice or a smoothie is not equivalent to the same size cup of plain water.
Alternate hydration sources include:
Caffeinated beverages have a mild diuretic effect which causes you to urinate out some of your water, so the widespread rule of thumb is that for every caffeinated beverage you consume you need to drink an equal portion of plain water. Alcohol is a diuretic as well as typically being high-calorie and full of empty carbs. It is best to drink responsibly and limit your consumption. The 1 to 1 ratio of diuretic to plain water also applies to these beverages.
WHEN SHOULD I HYDRATE?
The easiest answer to this question is ABD: Always Be Drinking. If you drink a large volume of water at one time, your body will be unable to absorb it all. Sipping on your beverage is the best way to ensure proper absorption as well as preventing major bouts of thirst.
To ensure that your sleep is not interrupted, it is recommended that you finish any beverage you're working on at least two hours before bed. That way you have enough time to process it before settling in for the evening -- disturbing your rest by having to go to the bathroom every few hours overnight is counter-productive.
WATER AND WEIGHT LOSS
Maintaining proper hydration can assist in weight loss. Water is an appetite suppressant. Drinking before you eat helps make you feel fuller, thereby reducing how much food you eat. According to WebMD, drinking before eating results in an average reduction in intake of 75 calories per meal.
Focusing on your fluids, if you can swap out calorie-filled drinks for plain or infused water, that change alone can potentially result in weight loss depending on how many calories you drink. You can easily use a tea infuser to add cucumber slices or fruits to your water to give it natural flavor without the artificial sweeteners or food dyes. You could also grab a water infuser bottle or pitcher for the same purpose, or just add a slice of lemon.
Drinking it cold helps to slightly boost your metabolism as your body has to work harder to to warm the water up. This boost is very slight, but getting in the habit of consuming cold water also aids the body's absorption rate. Optimal temperature for maximum absorption has not been ironed out but studies indicate 45-55 degrees F to cause the water to empty from the stomach more quickly into the small intestine, where absorption happens much more rapidly.
CAN I DRINK TOO MUCH?
YES. Overhydration, or hyponatremia, occurs when the concentration of sodium in your blood is abnormally low. When you drink too much water, you throw off your electrolyte balance. Since electrolytes regulate the amount of water in and around your cells, without the proper balance your cells begin to swell.
Some of the symptoms of hyponatremia include headache, confusion, nausea/vomiting, loss of energy/drowsiness/fatigue, muscle weakness, spasms or cramps, restlessness or irritability, and eventually seizures and coma.
An easy way to prevent exercise-related hyponatremia is to consume sports drinks (which include electrolytes in them) during demanding and/or prolonged physical activities where you sweat and expire an excess of water, and checking your hydration level via the above urine chart. If your urine is in the safe range and you are not thirsty, you are getting adequate water.
Everyone's been there: you've just started up a new physical activity or killed a particularly tough workout, and a day or two later your body's caught on to what you did and gets tight and achy. This is called delayed onset of muscle soreness (DOMS) and it's the bane of program adherence. So what can you do? Let's start by learning a little about our enemy.
What is DOMS?
Another theory is that DOMS is caused by metabolic stress; still another states that it may even be a mild form of rhabdomyolysis which is caused by muscle proteins spilling into the blood. Some sources suggest it may even be genetic or neurological. The long and short of it is that experts cannot agree on WHAT causes it exactly, though physical or metabolic stress does seem to exacerbate it.
Note that DOMS is different from acute muscle soreness, which occurs during or immediately after a workout. Acute muscle soreness is often described as a burning pain, and is caused by a buildup of lactic acid in the muscles. This type of soreness resolves itself fairly quickly and can be prevented in the same ways as DOMS.
How Can I Prevent It?
Consistency is Key
While it is true that in the long term you need to change up your workout in order to reduce chances of hitting a training plateau, consistency in movement is how your body improves at those movements. You have to let your body adapt to the new activity in order to reduce how sore you get when performing those exercises.
Engage in Proper Warm-up and Cool-Down Routines EVERY TIME
EVERY TIME you train, you need to allow yourself a proper warm-up and cool-down sequence. With a proper warm-up you ready your muscles for the stresses you are about to place on them. In doing so, you may avoid generating quite so much of the micro-trauma previously mentioned. A cool-down is less effective to this purpose, but aids in keeping the muscles limber and gradually dropping your body temperature so that your muscles do not seize up. This study suggests that warm-up and cool-down together have an additive effect on prevention of DOMS.
Hydration helps stave off fatigue, aids in digestion, and is crucial to muscle protein synthesis. If you are dehydrated following a workout, this process which rebuilds the muscles will be slowed and therefore recovery will be delayed.
Caffeine Can Help
Research has been shown that caffeine taken before your workout can cut post-workout pain down by almost 50 percent. Just be sure to hydrate properly between that and your training!
Eating To Prevent Soreness
I'll be covering pre- and post-workout nutrition in depth at a later date, but as related to muscle soreness, here's what you need to know pre-workout:
Eating foods rich in branched-chain amino acids (BCAAs) or taking a BCAA supplement before a workout has been shown to reduce incidence of muscle damage and increase muscle protein synthesis. Taking 5g or more at least an hour before exercise is the amount which studies show to be most effective.
While your pre-workout meal will depend on how much time you have between eating and training, a good rule of thumb is to ingest a mix of carbs and protein before and after your work out. The carbs boost your glycogen levels, which are your body's main source of energy. If you run out of glycogen, you may experience hypoglycemia (low blood sugar). As a response to hypoglycemia, the body will produce catabolic hormones such as cortisol which break down muscle tissue in order to convert it to glucose to fuel the work. The protein you ingest increases muscle protein synthesis, improves muscle recovery and helps with muscle growth.
Okay, So I'm Sore. Now What?
Even though movement hurts, you can seriously reduce your recovery time by engaging in active recovery. This can be something as simple as a walk or slow jog for 20 minutes, doing some gardening or even cleaning the house.
Rest is important for recovery, but the boost in circulation and production of endorphins even during light exercise will help reduce the sensations of soreness. The movement also helps to keep your muscles from getting stiff. Muscle stiffness can make the soreness that much more intense, so engaging in active recovery is a good method by which you may more quickly recover.
Focus on Form
Proper form reduces incident of injury, and if you are experiencing muscle soreness you are more likely to "cheat" on your form. This can lead to worsening the soreness as well as injury.
Avoid Eccentric Movements
Eccentric training is a slowed-down version of any exercise where the muscles are being lengthened under a load: the downward motion of the arm during a biceps curl for example. While eccentrics can seriously boost your training gains, if the muscles involved are very sore it may be wiser to back off this type of training for a few days (at least for the sore parts) -- that is, you should avoid taking more than 2-3 seconds on the downward motion of the arm during the aforementioned biceps curl.
Roll It Out
Foam rolling has been shown to improve recovery from DOMS. This can be done as a preventative measure or after you are already sore -- tension and soreness can be cumulative.
Ibuprofen and Arnica Gel
Here's something most people don't know: arnica gel or cream is show to be just as effective as ibuprofen in easing pain according to this study -- and it doesn't have the negative damaging effects of NSAIDs. All the same, ibuprofen is a time-honored staple in reducing muscle soreness. It has been studied time and again and shown to work as well.
Deep-tissue massage does not eradicate DOMS, however what it does do is increase the blood flow to the sore muscles, which speeds up the removal of the chemicals producing soreness. It is shown to be most effective within 48 hours of exercise. You can perform self-myofascial release (SMR) and some trigger point therapy using a foam roller and lacrosse ball if you aren't able to see a massage therapist.
Compression clothing has been shown to assist with recovery, however there are not standard protocols for things such as the length of time the garments are to be worn. Compression therapy such as the use of Normatec boots after a race increases circulation and helps massage sore areas, thereby assisting in recovery as outlined in those sections above.
Eating for Rapid Recovery
Replenishing your body after you've hit your workout is crucial. Within an hour -- preferably that first 30 minutes -- after your training you need to ingest a combination of carbs and protein in a 3:1 ratio for the reasons listed above in the prevention section.
Eating foods rich in branched-chain amino acids (BCAAs) or taking a BCAA supplement has been shown to reduce incidence and intensity of DOMS.
Omega-3 fatty acids are natural anti-inflammatories that can help dial back soreness. Take them in supplement form or eat foods rich in Omega-3s to boost your recovery.
Tart cherry juice was shown to assist in reducing muscle damage, inflammation and oxidative stress according to this 2010 study. Add some to your post-workout smoothie or drink it straight for max benefits. Even if it's not the best muscle recovery aid, it has numerous other benefits due to the high antioxidant count.
Other anti-inflammatory foods such as watermelon (see studies from 2013 and 2017), pineapple, ginger, and curcumin as found in turmeric are additional natural selections for faster recovery.
It's safe to say that there are studies swinging every which way about what causes DOMS and how to recover quickly. The below are two topics which are (at the time of my writing this article) pretty often bandied about -- moreso than the above content.
Stretch To Alleviate Stiffness
Stretching does not directly affect DOMS, but it does assist with alleviating muscle stiffness which can worsen the pain of muscle soreness. Stretching efficacy as a recovery modality has been debated in more recent years, but dynamic stretching (stretching which involves movement) is a form of active recovery and therefore I personally recommend it.
Ice It? Heat It?
The old advice is to ice up after training, but more recent studies have shown that icing does not have a clear effect on DOMS and primarily treats pain temporarily. It also inhibits the inflammatory response and reverses it to a certain degree, which may even be causing more harm than good as the inflammation is part of the body's natural repair process. Heat increases circulation, and moist heat in particular such as a steam sauna has been shown to assist reduction of DOMS.
Take a Hot (Epsom Salt) Bath
Epsom salt (magnesium sulfate) baths are an old remedy -- but studies have shown that magnesium supplementation in any form has marginal restorative benefits. It's most likely the moist heat from the bath that relieves the soreness more than the Epsom salts themselves.
Jala Prendes, NASM Certified Personal Trainer and Fitness Nutrition Specialist