If you sleep well you probably don’t give sleep much thought . But if you have trouble going to sleep or staying asleep, it ’s likely a subject never far from the top of your mind.
Sleep is a complex issue, but with some lifestyle changes and neurofeedback, almost everyone can learn to sleep better, according to Iza Boesler, M.D. “People think insomnia happens to them, but in reality people often inadvertently do it to themselves,” said Dr. Boesler. Dr. Boesler is a sleep medicine physician and Medical Advisor for Sleep at Center for Brain in Jupiter. “With repeated sleep disturbances, people begin to associate being in bed with being awake, and it can become a vicious cycle.”
Sleeping Medications – a Poor Long-Term Solution
“Sleeping medications are not the answer,” said Dr. Boesler. “They were never intended for long-term use. I don’t prescribe them much because they cause undesirable long-term changes in the brain, which are more difficult to treat than the initial sleep problem. And theyall have side effects.”
Can neurofeedback help?
“Despite what pharmaceutical companies tell us, the key to good sleep health is the brain being able to regulate itself,” said Dr. Boesler. “That’s something neurofeedback does really well, and I recommend it to many of my patients. When it comes to sleeping, neurofeedback is priceless. It works far better, without side effects, than any prescription or non-prescription medication on the market. It allows the brain to calm down and engage in a natural sleep pattern.”
“Most of the clients who turn to Center for Brain for help with sleep tell us they have tried ‘everything,’” added Mike Cohen, Director of Center for Brain. “In fact that’s usually the first thing we hear.
“The second is that they’re desperate to find a way to have normal sleep. By the time we see them, many are experiencing memory problems, mood swings, the inability to focus and chronic exhaustion. Medication may have stopped working or made things worse.
“At Center for Brain we have computerized neurofeedback tools, customized for every client and applied with scientific precision, that help you train your brain and nervous system to function as they did in those days when you ‘slept like a baby,’ before something caused them to malfunction.”
Neurofeedback is biofeedback for the brain. It uses innovative computer technology to gently guide your brain into changing itself so all the parts work better together. When your brain works better you sleep better. It’s that simple!– Mike Cohen, Director
So, in addition to doing neurofeedback, what can you do to create the best foundation for overcoming your sleep problems?
Here are Dr. Boesler’s tips:
Don’t go to bed unless you are sleepy.- Make your bedroom quiet, dark and cool.
- Minimize worrisome thoughts.
- Writing them down can help.
- Reserve your bed for just two things: Sex and sleep.
- If you are not asleep after 20 minutes, get out of bed.
- Begin rituals that help you relax each night before sleep (such as a warm bath or reading).
- Avoid caffeine, alcohol or stimulants six hours before bedtime.
- Do no exercise within three hours of bedtime
- Avoid naps.
- Try to wake up at the same time every morning (even on weekends and holidays).
- Avoid sleeping pills.
- Ask your doctor if any medications you are taking could interfere with sleep.
- Don’t try to “make up” for lost sleep by staying in bed longer on another day. “This just makes the sleep cycle worse,” Dr. Boesler cautioned. “Keep to a pattern as much as you can.”
Three Systems Impacting Sleep
According to Dr. Boesler there are three systems that impact sleep: circadian rhythm, homeostatic drive and the hypothalamic-pituitary-adrenal axis (HPA). If any one of those is disrupted, sleep disturbances can occur.
Circadian Rhythm
The circadian rhythm is the body’s “clock” – it regulates body temperature, hormone secretions and metabolism. It also regulates activities such as sleep, thoughts and behaviors that occur regularly during a 24-hour period. “To keep the circadian rhythm intact one should avoid interrupting it,” said Dr. Boesler. “This means getting up and going to bed at the same time, avoiding bright light at bedtime and not doing stimulating activities around bedtime like paying bills or writing business e-mails.”
Homeostatic Drive
The “homeostatic drive” is powered byadenosine, a neurotransmitter. Adenosine startsbuilding up in the brain from the moment aperson awakens until there’s so much that itcreates an irresistible urge to sleep. During sleep,the adenosine is absorbed back into the neurons.Once completed, the person awakens. Factorssuch as stress and medications can override theeffects of this neurotransmitter and result in theinability to go to sleep or stay asleep.
Hypothalamic-pituitaryadrenal axis (HPA )
This “axis” controls how much of our hormonesare secreted and when during any given 24-hour cycle. An excess of one hormone inparticular, cortisol, can be problematic forsleep. Cortisol normally diminishes aroundbedtime, then surges in the early morning toassist in awakening. However, if one’s nighttimeenvironment is stressful, elevated cortisol levelswill keep you awake.
About Our Experts
Iza Boesler, M.D.
Dr. Boesler is Medical Advisor for Sleep at Center for Brain. A doctor of internal medicine, she specializes in sleep disorders, stress-related disorders, autonomic dysregulation, fibromyalgia and obstructive sleep apnea for both children and adults. She is director of the sleep laboratory at Riverview Medical Associates in Tinton Falls, New Jersey. She interprets sleep studies, runs a CPAP clinic and treats an array of sleep issues. She also founded a biofeedback laboratory for patients with stress-related disorders. In 2014 and 2015 Dr. Boesler was chosen as one of New Jersey’s top physicians by a peer survey published in New Jersey Monthly magazine.
Michael Cohen, Center for Brain
Michael Cohen is one of the leading experts in brain biofeedback. For more than 20 years, he’s taught courses and provided consulting to MD’s and mental health professionals around the world to help incorporate new biofeedback technologies that help individuals adapt and strengthen their nervous system through neuroplasticity. This helps sleep, mood, attention and neurological function.