During the pandemic, just about everyone's sleep patterns have been disrupted. How can we get back on track?

Dr. Michael Howell is a neurologist dedicated to improving brain health and performance through better sleep. He's the vice chair for education and faculty affairs in the Department of Neurology at the U of M Medical School, and medical director of the M Health Fairview Sleep Performance Training for Athletes program.

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Jill Riley: How are you sleeping?

Michael Howell: I sleep pretty good. I do put quite a bit of effort into it as my as my teenage daughters will attest.

Sure. How are they doing with it? Oh, it's always hard to make a teenager go to sleep, I guess.

They sleep well. They could do with a lot less of their father giving them advice, though.

Sure, sure. Well, you know what, we talked pretty early in this global pandemic. And I think there was just kind of this moment where we didn't know how long the pandemic was going to last. There were so many unknowns. And I was just talking to a number of people who had been maybe having some trouble sleeping because of the anxiety over the pandemic. But here we are, a year later. What do you see as the most common sleep challenges now that we're a year into this pandemic?

Well, I think what's really challenging is the transition back to normalcy, if that is going to happen, I think people are starting to do that. They're starting to go back to school, they're starting to go back to work at relatively conventional times. And for many individuals, that is really causing them quite a bit of stress as they try to switch to waking up for the conventional hours they have. They may have trouble falling asleep at 10, 11 o'clock at night. And then once they've got to wake up at six o'clock in the morning, that can be quite troublesome.

I go through that every Sunday night, when it's time to wake up early for my morning show. The question is, I guess, you know, we talk about good sleep, you know, or bad sleep. But what does good sleep look like? I mean, how can good sleep have a positive impact on our lives?

Good healthy sleep is you fall asleep at night without too without too much trouble, without too much effort, you may wake up a couple times in the middle of the night, that's normal. But when you get out of bed in the morning, you're done sleeping, you're refreshed, you couldn't sleep any longer even if I paid you $10,000 and then you're able to function throughout the course of the day. Alert, awake, even in boring situations, boring meetings, classes, Zoom calls — God help us — you're able to stay awake and alert during those with the exception of maybe, you know, middle of the afternoon, when we would naturally take our little nap we can do all of that without any caffeine or stimulating beverage. That's what good healthy sleep would look like.

But in addition to that, good healthy sleep will help your brain function, help you perform better during the day, helps athletes perform better, you can see it clearly in terms of their reaction times and they make fewer errors. But that applies to all of us. But also improved mood, less anxiety, long term health, decreased cardiovascular risks, and dementia, cancer, all those things that we would like everybody to have less of.

Yeah, I have some work to do on the good sleep. Because you know what, Dr. Howell, I can tell there are signs, it starts to kind of come out in different ways when I'm not getting good sleep. What is actually happening to my body or my mind, if I'm neglecting sleep?

You're slower, you're more likely to make split second wrong decisions, whether or not that is just an instinctive decision to purchase something possibly. Whether that is while driving, you're more likely to make an error while driving. We're also quicker to temper. Our moods are worse off, we are more likely to see the worst in people. Unfortunately, all of us, myself included, are prone to this if we don't get good healthy sleep. And then the long term health consequences as well.

Yeah, I think listeners of The Current's Morning Show maybe have been able to tell at times when I haven't had proper sleep because there will be simple vocabulary words that I can't come up with on the spot. But you know, we talked a little bit about common sleep challenges during the pandemic and really, you know, kind of shifting back into what we call normalcy or getting back into the habit of our regular lives. But I wonder, are there other issues at play here? I mean, do you talk to people who are affected by anxiety or, you know, stress is causing them to lose sleep? Is that still part of it?

Oh, absolutely. The greatest challenge is, you know, we all go through stresses at different points of our life and most and most likely, you're not going to sleep well. If a family member is going through a horrible medical situation or breakup, a divorce, job loss, loss of a parent, we're not going to sleep well during those circumstances. However, the real key is, is that once that stress passes, and you get back to some sort of normal life, you should still be able to sleep well. And so the what we really worry about is not letting an acute sleep problem turn into a chronic one.

So the recommendations for the amount of sleep that we're getting, can you kind of bring me up to speed on that?

Yeah, I guess I would say for adults, you'd say seven hours. But I think that misses the more important point, which is, it's less important the amount you're getting than the timing of it. And what I mean by that is, your body has a natural 24 hour rhythm, and different individuals will naturally slip, fall asleep and wake up at different times of the day. You have night owls who would naturally fall asleep later and wake up later, early birds who do the opposite, and everything in between. All of us have a natural rhythm, it's as much a part of us as our height and our eye color. And first, understand what each person's individual sleep rhythm is. And then try to do your best to sleep at that time. If that's not possible, because you have to get up in the morning to host a radio show or go to school or go to work, then work on your circadian rhythm with strategies to move it. So you have maybe a little bit less tendency to be a night owl over time, so you can fall asleep earlier and wake up earlier.

Gosh, I feel like I've been fighting my body's rhythm since I graduated high school. It's been many years. So, okay, let's say that I'm not a great sleeper. There's somebody listening right now [for whom] it's a challenge, you know, just not getting that quality, great sleep. What are some steps that people can take to improve?

First step is just to understand yourself. So Jill, exactly as you just kind of developed, you know, a little bit of insight in regards to why this has been kind of my own natural rhythm. Understand that that's an intrinsic trait, there's nothing wrong about it, it's just kind of who you are.

And then if you for example, if you [have] a bit of natural tendency to be a night owl, but you because of work or school, you have to wake up earlier, start focusing on the morning. Bright light first thing in the morning, consistent wakeup times, or as best as you can make it, and get some sunlight. Or if it's not plausible, because you live in Minnesota in the winter, for example, get bright light from a 10,000 lux light box. These are the same sort of light boxes, people with seasonal affective disorder use, and then just you know, the other healthy lifestyle choices. Try to make good food choices, minimize alcohol and caffeine, particularly in the evening.

What is a good time to cut off the caffeine?

at least six hours before bedtime. So I guess I'd say three o'clock in that situation, but everyone's different. So if you still have trouble falling asleep, try to cut it back to noon, or cut it back to just one cup when you wake up in the morning.

Okay, I'll give that a try. I have a question. Because of the hours that I work — and there are plenty of early risers that listen to this show — is it okay to nap in the afternoon?

100%. Yeah, human beings are natural nappers. That's one of the things we help train athletes: any athlete who has to perform in the evening, if you're going to be an elite athlete, if you're going to be an Olympic athlete, or a professional athlete, you got to learn how to nap well, because you'll perform better if you do so. And that that applies to all of us, who just want to perform better in the evening.

How about for folks that lay down at night and find that they're just wide-eyed staring at the ceiling? I mean, what do you do? Do you just lay there and hope that it happens?

Thanks, Jill. That's a very important question. That's the most common sleep problem is just you lay down and the magic just doesn't happen. What's important to know, is stop trying. Don't try to fall asleep. You can think yourself asleep about as well as you can think yourself hungry. It either is going to happen or it's not going to happen. But you can make it worse by trying to force your brain to fall asleep. You'll start ruminating about all the various tasks you have to do tomorrow. Nobody ever laid awake in a dark room trying to sleep and thought about how great their life is. That just doesn't happen. Get up, go do something enjoyable. It can't be work. Don't pick on a task. Just do something that's enjoyable and relaxing to you. Preferably not on a screen and preferably in dim lighting. Be mindful when you start getting sleepy. Go back to bed.

Wellness Wednesday is hosted by Jill Riley, and produced by Anna Weggel and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License. This week's photo is by Ben Watkin (CC BY-NC 2.0). The image was altered: it was cropped, filtered to greyscale, and supplemented with a logo.