30-day Sleep Challenge: How a sleep diary holds the key to better health

Our 30-day Sleep Challenge begins with understanding that sleep is essential to our health.

Special to the Star Tribune
Special to the Star Tribune

— Anna Boone, Star Tribune

As the Golden Gophers' matchup with Penn State approached this past fall, Dr. Michael Howell was tasked with making sure the football team was rested and ready for the game's 11 a.m. start.

Howell, a sleep medicine doctor and associate neurology professor at the University of Minnesota, advised the coaches to make sure the players soaked up artificial sunlight from a light-therapy lamp every morning during the week leading up to the game. That would help them align their body clocks and improve their sleep, Howell said.

How much of a role did that sleep hack play in the team's historic win? It's impossible to know, but research clearly shows that the quality and quantity of sleep we get is directly linked to our health, productivity and well-being, whether you're a college football player or a 9-to-5 office worker.

Sleep has become one of the nation's biggest — and most overlooked — health issues. Lack of sleep has been linked to an increased risk of developing conditions like obesity, diabetes, high blood pressure, heart disease or stroke. Yet more than a third of Americans aren't getting enough sleep, according to the Centers for Disease Control and Prevention.

"Sleep is the third pillar of health. Diet, exercise, sleep, these are the three things that will keep us alive," said Sarah Moe, a registered polysomnographic technologist and the CEO of Sleep Health Specialists in Minneapolis.

That's why the Star Tribune is hosting the 30-day Sleep Challenge. For the next four weeks, our goal is to make sleep a high priority, discover our natural sleep cycles and try small adjustments that local experts like Howell and Moe say can make a big difference in how well rested we are.

30-day Sleep challenge

Over the course of four weeks, make sleep a high priority, discover your natural sleep cycles and try small adjustments that local experts say can make a big difference in how well rested we are. Each week we’ll introduce a specific challenge, set snooze goals and provide information about the science of sleep.

Join the challenge

Each week, online and in the Sunday print edition, we'll introduce a specific challenge, set snooze goals and provide information about the science of sleep. We'll also host a private Facebook group with daily check-ins, discussion and more. (Join us by clicking the link above.)

If you don't use Facebook, don't worry — you can still participate by reading our stories in print or online at startribune.com/sleep.

Our first challenge begins today. All week, we're asking you to keep a sleep diary.

In the diary, you'll keep track of what time you go to sleep, what time you wake up, and how you feel throughout the day: Are you groggy in the morning, or do you wake up ready to jump out of bed? When do you first feel hungry? At what point(s) in the day do you feel tired?

Your responses will help you discover your current sleep patterns and give you clues about the changes that might improve your sleep.

As an educator and specialist, Moe works with Twin Cities-area companies to improve their employees' sleep — and boost bottom-line issues like performance and productivity as well as morale, recruitment and retention. When she teaches a one-hour "lunch and learn" class, she begins with the question: "How many people have heard that you're supposed to get eight hours of sleep?"

After most raise their hands, she follows up by asking: "How many of you try to get eight hours in six hours?"

"People laugh. But it's true," she said. "We call that aggressive sleeping."

Making time for sleep is an important first step toward actually getting more sleep, Moe said. So is changing the perception that it's normal to feel tired.

"We're supposed to have our alarms go off and say, 'OK, time to start the day,' but that is very rare," she said. Some experts suggest that if we get an adequate amount of sleep, we wouldn't need an alarm to wake us.

Our increasing reliance on cellphones and other devices has become a major disrupter, joining troublemakers like caffeine and alcohol, said Moe.

Research also shows that our natural sleeping patterns are wired into our DNA and develop as we age, as much a part of us as our height or eye color.

People who are naturally more inclined to stay up and wake up later shouldn't necessarily force themselves to hew to an early bird schedule that makes them sleep-deprived, doctors now say. They advocate for timing work or school around natural sleep patterns if at all possible, instead of the other way around.

We spend a third of our lives sleeping.

That isn't time we should take for granted, said Dr. Conrad Iber, a pulmonologist and sleep expert with M Health Fairview. During the past 15 years, the field of sleep science has grown exponentially, greatly expanding the knowledge about sleep's power.

Here's what we know: Each day, what we see and experience "remodels" our brains, as neurons and synapses make new connections, Iber said. But it is during sleep that we reinforce and integrate the connections that are important and prune away those that are not. When we don't get enough sleep or when our sleep is disrupted, this process is impaired, he said.

The toxins in our brain, including beta-amyloid, which is linked to Alzheimer's, are removed when we get appropriate stretches of uninterrupted sleep. If that doesn't happen, these neurotoxins can build up.

Additionally, sleep is closely connected to our mood. When we slumber, the amygdala, which governs emotions, connects to other parts of the brain to maintain "equanimity," Iber said. If this doesn't happen because we don't get enough or we get poor-quality sleep, mood disturbance and irritability rise measurably.

While making time for sleep is vital, not all sleep is equal.

A tossing-and-turning bed partner can interrupt our sleep and keep us from going through each part of our sleep cycle, while too much alcohol can suppress needed REM sleep. And, according to Moe, using a screen before bed can trigger "spontaneous awakening" later on.

There are many steps we can take to make our sleep better. But we don't need to make them all at once, said Amy Mattila, a wellness coach who has helped Mayo Clinic cancer patients get better rest.

She often asks clients to make a list of the things that they know might be making it difficult for them to sleep. Then, she asks them to start by choosing just one thing to change.

While one person might choose making their bedroom completely dark with blackout shades, another might decide to avoid television at night, she said. Still another might try a new bedtime self-care routine to wind down, like using lavender-scented oil.

Throughout the 30 Day Sleep Challenge, we will take a similar approach: We'll offer suggestions from local experts and invite you to choose one simple snooze goal that appeals most to you.

Something else you should know about sleep: It can unlock creativity or help us master skills, said Howell. He often asks clients to try harnessing sleep's power by using a short meditative visualization for about 3 to 5 minutes before taking a nap or falling asleep at night.

Gophers football players can visualize success on the field, but others can visualize everything from a successful presentation to a finished crossword puzzle.

"Just sleep on it — your brain will put it together," he said.

It sounds a little out there, but then again Paul McCartney has said that the entire tune for "Yesterday" came to him in a dream. Chemist Dmitri Mendeleev claimed the same thing about the periodic table of elements.

Who knows what the next four weeks could bring?

Snooze goal week 1: A sleep diary

Dr. Michael Howell calls sleep a gift.

“You have to receive it when it comes,” he said. “But that also means, if it’s not coming? You can’t force it.”

Keep that in mind as we begin the first Snooze Goal of our 30-day Challenge.

Our aim isn’t to obsess about our sleep or go to bed early even though we’re not tired (this often backfires). It’s to pay attention to when and how we sleep and how we feel during the day.

We’re going to keep a sleep diary for the next seven days. It’s something doctors often recommend for patients with sleep issues because it can give us insights into our bodies’ natural sleep preferences.

There’s no one way to keep a sleep diary.

The nonprofit National Sleep Foundation offers a free seven-day sleep diary form on their website that’s comprehensive and easy to use. You also could use a blank book or journal or a notes or journaling app.

Fitness trackers often include a sleep monitoring feature, but not all doctors find this in-depth tracking to be helpful. And for this challenge, we’re simply taking down our observations.

There’s no need to keep the diary on your nightstand or to know the exact time you drift off. Instead, take a few minutes in the morning and at the end of the day to make your entries.

Note what time you went to bed the night before and when you got out of bed in the morning. Then, ask yourself some questions about your sleep:

• What was it like to fall asleep? Was it easy, or difficult?

• What is happening in the hour or two before bed? Do you feel sleepy? Are you falling asleep while streaming a show, for example?

• Did you wake up in the night? How many times?

• Did anything disturb your sleep (noise, children, pets, stress, etc.)?

• What happens in the morning? Do you wake up on your own, with an alarm clock, or do you need a family member to wake you up?

• When you wake up do you feel alert? Groggy? Nauseated? Do you get a headache when you turn the light on?

• Within an hour, are you hungry?

• How much coffee (or other caffeinated beverages) do you drink and when? Alcohol?

• Did you exercise during the day? If so, when?

• How did you feel today? When were you most sleepy? Did you take a nap?

Good luck! Here’s hoping that we will be better able to accept the gift of sleep as our challenge continues.