Establishing a solid sleep routine and good sleep hygiene is the most effective approach to helping the


body maintain a healthy circadian rhythm. Aim to go to sleep at the same time each night, even on weekends, to keep your circadian rhythm in check.


• Caffeine: During the day our cells generate energy, creat- ing the byproduct adenosine. Adenosine builds up in the brain and contributes to our feeling sleepy at night. Caffeine blocks the adenosine receptors, which is one of the ways it helps you wake up in the morning.


• Alcohol: We may think a glass of wine will help us sleep but when it metabolizes it actually causes sleep disturbances, especially in the REM phase, which shortens sleep.


by REM behavior disorder, which is when muscle movement occurs during REM sleep, resulting in hand twitching or thrashing about.


Insomnia and Its Causes


Insomnia is the most common sleep problem in adults 60 and older. Insomnia includes taking a long time to fall asleep, waking up in the night, waking up early and not being able to fall back asleep, feeling sleepy during the day, and not being able to fall asleep.


There are many factors that impact sleep and can cause insomnia including:


• Stress: Increased stress means increased cortisol, the steroid hormone that has an opposing rhythm to melatonin in our circadian rhythm. Elevated cortisol can disrupt our circadian rhythm and therefore sleep.


• Hypoglycemia: If you wake up in the middle of the night, it could be due to a spike in cortisol caused by low blood sugar. If this is you, eat a small snack that is high fat with a protein about an hour before going to sleep.


• Excessive warmth: Our body expects the temperature to drop at night, so keep your bedroom cool.


• Blue light exposure: Blue light—like the sky!—has wave- lengths of 450 nm. This blue wavelength decreases mela- tonin and disrupts your circadian rhythm. Be sure to block blue light from LED bulbs, TV screens, and your phone by shutting off electronics and shifting light to yellow-toned, low-watt lighting.


• Lack of oxygen by sleep apnea results in insomnia. People with sleep apnea tend to have REM earlier in their sleep pattern instead of toward the end.


• Movement disorders such as restless leg syndrome can wake you up.


• Working night shifts disrupts your circadian rhythm.


• Medications such as barbiturates and other antiepileptic drugs, beta antagonists, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, tricyclic antidepres- sants, and stimulants also delay or suppress REM sleep.


Establishing Great Sleep Hygiene


Establishing a solid sleep routine and good sleep hygiene is the most effective approach to helping the body maintain a healthy circadian rhythm. Aim to go to sleep at the same time each night, even on weekends, to keep your circadian rhythm in check. Es- tablish good sleep hygiene by incorporating lifestyle changes that encourage you to wind down before going to sleep.


Your sleep routine can include:


• Hydrotherapy: Taking a hot bath/shower 1–2 hours before going to sleep has been shown to improve deep sleep.


• Blue blocker glasses: If you can’t turn off the screen three hours before sleep, use glasses that block blue light to ensure melatonin secretion is not suppressed.


• Eat a low-carb, high-fat dinner several hours before your bedtime. Glucose oxidation from carbohydrates suppress slow wave sleep.


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