Getting a good night's sleep

When Maria came to see me, fatigue was her primary concern. She felt exhausted all the time, she said, and had no real energy or passion for life. She was also experiencing fuzzy thinking, irritability, headaches, and achiness. Doctors tested her for thyroid disease, anemia, chronic fatigue syndrome, and early menopause — but concluded that she was probably “just” depressed. After starting an antidepressant, Maria came to Duke Integrative Medicine. “I just don’t think I’m depressed,” she said.

I had my doubts, too, so I started with an obvious culprit, asking her to describe her typical sleep pattern to me. “I usually have no trouble at all falling asleep,” she said. “But then, sometime between 2 and 4 a.m., I wake up, and then I have a hard time getting back to sleep.”

“Well, that’s certainly a factor in your fatigue, and the rest of your symptoms,” I said. She looked dubious. Her reluctance to recognize this connection would have surprised me if I hadn’t seen it so often in other patients. But Maria’s symptoms and sleep pattern are consistent with many women I see, as was her lack of awareness that her quantity and quality of sleep were even an issue.

Sleep is an essential bodily function, like eating and breathing. But more and more, we minimize its importance, and the health effects can be devastating. Besides affecting how we feel and function day to day, a chronic lack of sleep can set us up for diseases such as diabetes and heart disease. And the effects on our emotional and spiritual well-being add up, too.

Getting to the root of sleep issues, and making shut-eye a priority, is one of the best steps you can take for optimal health. Here’s how.

All animals, humans included, are programmed to have cycles of activity and rest. Even fetuses in the uterus, protected from outside stimulus and needing to do “nothing,” have sleep and wake cycles. Our very cells have active cycles and rest cycles.

Besides allowing our bodies and brains to refuel, sleep allows for our souls to recharge. When our conscious mind is in sleep mode, our unconscious mind goes to work (and play), processing intense experiences — positive and negative — during dreams. The symbols and feelings that linger from our dreams can provide crucial guidance for our waking lives. Whenever I have a patient who doesn’t remember her dreams, it’s a sign to me that she may be running on empty.

There are, of course, medical causes for subpar sleep, such as sleep apnea and hormone imbalances, and it’s a good idea to talk with your doctor to rule these out. But the vast majority of cases have more to do with stress and, increasingly, our 24/7 lifestyle. These days we are “plugged in” almost constantly and often never unplug before going to sleep.

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