Improving Sleep with Ayurveda
A good night's sleep: nature's soft nurse, Jay L. Glaser, MD
When I was a child growing up in Colorado, in order to gain listeners, a local disc jockey held a contest to see who could guess how long he could broadcast music without falling asleep. I must have been fascinated with how a man could put himself through so much torture, since his stunt seemed like one of the worst possible violations of the laws of nature. He lasted about 8 days.
When Shakespeare wrote, "Gentle sleep is nature's soft nurse," he invoked the idea that there are few panaceas like a good rest, and restful sleep is the norm for all animals except humans. Even animals that are prey manage to sleep. Sleep problems happen to one third of us. One of the worst forms, chronic sleep maintenance insomnia, in which the sufferers regularly spend long periods awake after initially falling asleep, is the commonest and hardest to treat, affecting 5% of the population. In my practice, I have observed that sleep disorders have their roots in poor lifetime sleep habits.
Charaka Samhita, the oldest of the Sanskrit medical treatises of Ayurveda, the health science of the Vedic civilization, states, "A man sleeps when, with an exhausted mind, his sensory faculties and organs of action detach from their objects." Charaka implies that as long as the mind is engaged, sleep will not come. Sleep is healing, not only because it permits the body to physically rest, but also because it allows the mind to reorganize and digest our experiences and circumstances for understanding our situation and planning future action. Hence, the phrase, "I'll sleep on that."
The Vedic text states further, "Sleep brought on by the nature of the night itself is true sleep, called reparative sleep by the wise. Sleep caused by tamas [i.e. the quality of inertia in the mind, brought on by dulling foods, drink, medications and activities] is the root of misconduct and should be treated as a disease." The ancient author implies that sleep caused by imbalances, including heaviness in the body (kapha), disease and even fatigue is not true sleep. This Vedic physician understood that the circadian rhythms, the cycles of light and dark, are the synchronizers for our best sleep, and that we do our most important sleeping when we are actually rested. Just like an athlete or musician will prefer to perform when well rested, our minds and bodies are best healed by sleep when we are not exhausted.
Unfortunately, we take the same goal-oriented approach to sleep that we do to other aspects of our competitive lives. We think, "I've got to get a good night's sleep so I can do well in my presentation tomorrow." When we find ourselves lying awake, thinking about the presentation, we get anxious, further preventing the senses from withdrawing from their objects. Even worse, we start to get angry at things that seem to be preventing us from falling asleep. It becomes a vicious cycle.
People with insomnia may have developed the bad habit of using their bed to watch television, read, or plan their schedule for the next day and lying in bed gradually becomes associated with wakefulness rather than sleep.
In contrast, the Vedic understanding is that sleep is not something we plan or desire to do. It is the by-product of creating specific circumstances and letting nature do the rest. We go to bed to rest and not to sleep. We just lie down innocently, without any expectations, and whatever our nervous system needs, that is what we will get. This prevents us from disappointment at the results of our "efforts" to sleep and saves our psychology.
In this context it is interesting that in April 2001, Edinger and his group from Duke University found that people who were given cognitive behavioral therapy for treatment of sleep maintenance insomnia, the kind common in middle-aged and older people. Treatment group subjects were given a program to change the specific thoughts, behaviors, and beliefs that stand between them and a good night's rest. They were taught to (1) establish a standard wake-up time; (2) get out of bed during extended awakenings; (3) avoid sleep-incompatible behaviors in the bed/bedroom; and (4) eliminate daytime napping. This program essentially tested the Vedic approach to sleep. The treatment group had a reduction of 54% in the time spent awake in the middle of the night, compared with groups getting progressive muscular relaxation or sham, placebo counseling. This is one of the most important studies to address sleep disorders because it showed that dramatic improvements in sleep could be achieved by tackling sleep habits themselves, unlike the superficial effect of sleeping pills which are addicting and do not address the underlying issues.
Most people can change several factors to improve the quality of their rest at night and to prevent age-related sleep disorders. First, change your attitude toward sleep. Stop using the word "sleep" and substitute the word "rest." You will thus say to your spouse, "I'm going to rest now." Take the attitude that you are simply going to put yourself in a comfortable, quiet, dark place for six to eight hours, and let go. Whatever happens, fine. Take the outlook that you are just turning yourself over to God, and whatever He or She plans for you for that night is what you need. Dreams, thoughts, and those moments of silence between waking, dreaming and sleeping are all as important as unconscious, dead-to-the-world sleep. Stop judging how you slept. Adopt the attitude that as long as you spent six hours in a dark room being quiet, that you are ready for your day.
The ideal time for rest according to the Vedic tradition is from around 9 or 10 p.m. to 4 a.m. In these six to seven hours, more can be accomplished than from midnight to 9 a.m., and endocrinologists studying the circadian hormonal fluctuations of cortisol and melatonin would agree. Four a.m. is the onset of the brahmamuhurta, the Vedic period of the day when nature is beginning to stir, and the period most conducive to meditation. Take the attitude that you can get up anytime from 3:30 a.m. onwards, but at least get up before the sun.
You don't need eight hours of sleep. Many people do fine on as little as four to five hours. Some men of great achievement (and admirable longevity) including George Bernard Shaw, Churchill, and Darwin slept very little indeed. Thomas Edison was famous for staying up for days working in his lab, taking short naps on a cot.
Establish a regular time to arise. Get up at the same time every day, whether or not you think you slept well. Studies have shown that almost everyone functions well the next day, even if they have the perception they have not slept a wink. Make that time of the day quite early -- by at least six a.m. Then go to bed early enough to get the amount of "rest" you would like. If you want 8 hours, that means 10 p.m.
You don't need to adopt this new bedtime immediately. Many people with chronic sleep disorders end up retiring at 2 a.m. because they are afraid to go to bed and just lie there. They have learned that this experience just creates anxiety and is counter-productive. They wait until they know sleep is coming. Two hours later, at 4 a.m. (brahmamuhurta for the blue jays and the bees), their eyes pop open and they are wide-awake, superficially refreshed after 2 hours of sleep. After lying awake for couple more hours, they need to sleep in to 10 a.m. If this describes you, start moving your arising and retiring time earlier by ten to fifteen minutes per day. In a couple of weeks, you will have painlessly reset your biological clock to a healthier pattern.
Arise at the same time, but avoid using alarm clocks. Find someone to arouse you gently, or if you have to, set an alarm to play soft classical music. After a few weeks more, you will be waking up without assistance at your proper time.
If you spend 3 hours up in the night, do not sleep in. Get up and get going. Above all, do not indulge in daytime sleep to make up for missed time. Stay up, but not using caffeine. The next night you will fall asleep more easily and awake less often. It may take some time to culture this habit, but persistence will pay off.
If you find yourself lying awake, avoid giving in to anxiety or anger or to the thought that you are bored. Allow your mind to innocently experience your body. Let the mind go where it will go. Sometimes it will be aware of your breathing, sometimes of your heart, etc. Enjoy the feeling of your body resting. If you find yourself thinking thoughts that stimulate mental activity, come back to the body.
Establish another room in the house for resting during the night when you find that the body is not in a mood to sleep. Take the attitude that time spent in this room is just as valuable as time spent in bed. This room should have a comfortable chair for meditating and listening to music, ideally a recliner that will allow you to change positions. It can also have a yoga mat.
If you have been awake in the middle of the night for a prolonged period and feel restless, get up for a brief period. Avoid turning on the light, which may stimulate arousal. Put up a few night lamps so you can safely move about the house. Try sitting in a chair in a different room to meditate. University of Alberta researcher Daniel Milkman showed that the Transcendental Meditation technique significantly reduced sleep onset from over an hour in people with insomnia to fifteen minutes. TM also reduced time spent awake at night. You can sit in the chair and bring the awareness in the body, as above. If you prefer, practice the same technique sitting up in bed, and when sleepiness seems to be coming, slide down in bed and continue.
Cultivate bedtime routines that are conducive to this attitude. Use the evening hours for light, enjoyable activities, and not for exercise, work, or TV. (Get plenty of exercise during the day, however.) Listen to soothing music. Take a cup of hot milk (with a teaspoon of poppy seeds), perhaps a hot bath or shower. Read a few verses of spiritual texts. Unless you have a temporary problem like a death in the family or an acute illness or injury, resist taking sleeping pills. If you have been sleep deprived for a few nights your body will always end up getting what it needs. Use natural fibers such as cotton for your bed linens and bedclothes.
Avoid associating the bedroom with anything but sleep, including TV, reading or working. The bedroom should be for sleep or sex and nothing else. If you have a TV in your bedroom, move it out.
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