A sleep specialist gives advice on how to sleep better and avoid SAD

November 17—If you have trouble getting out of bed in the morning, feeling depressed, and low on energy, you’re not alone.

Dr. Preetha Rosen is a sleep specialist at Gritman Medical Center in Moscow. She said that in winter, a lack of exposure to daylight can significantly affect the body’s circadian system, which she describes as its “master clock”.

“The clock is so powerful that it influences our sleep-wake rhythm, it also influences our energy level, our metabolism, our hormonal regulation,” she said.

When that rhythm is misaligned, Rosen said, it can have a profound negative effect on multiple parts of the body, including increased inflammation, obesity, blood sugar, diabetes, and even cancer risk.

People who have severe symptoms that affect their daily functioning are often diagnosed with seasonal affective disorder, or SAD. Symptoms include depression, fatigue, difficulty concentrating and trouble sleeping. The disorder is more common in women and in northern latitudes.

For other people, seasonal changes might not result in a diagnosable disorder. But they can still lead to many of the same symptoms on a lower level.

“Light isn’t just about sleep and wakefulness. Light is also important for vitamin D. Light has a big effect on mood,” Rosen said.

People should also make sure to eat foods rich in vitamin D, including oily fish and other fortified foods, and some may want to consider a supplement during the winter months, especially if they are often in indoors during the sunny part of the day. A blood test can determine vitamin D levels, which patients can discuss with their GP.

Typically, Rosen said, diagnosed SAD is managed by a primary care provider or psychiatrist. But for people with SAD and the winter blues, light therapy and prioritizing daylight exposure are important. Rosen recommends taking breaks for winter walks and light therapy, like dawn simulator lamps that slowly brighten a room in the morning.

Sleep and psychiatry are closely linked, Rosen said — one of the most common reasons she sees patients year-round is insomnia. In these cases, many patients say they find it difficult to calm their minds and are often dependent on medication.

“The question I ask my patients is, ‘OK, you’re on a drug: how long do you plan to take it?’ You can’t take these drugs for the rest of your life,” Rosen said.

Rosen uses tools like cognitive behavioral therapy and sleep diaries with patients to help them form better habits and a better relationship with sleep.

She also recommends patients work to keep a consistent bedtime and wake-up time — that means even if it’s the weekend, you probably shouldn’t sleep more than about 30 minutes.

The right schedule differs from person to person, so some people might be better off going to bed earlier than others. But the inconsistency disrupts the circadian rhythm, which can create problems including inflammation, poor cognitive function and a weakened immune system.

“Sleep lays hands on too many physiological processes for us to ignore,” Rosen said.

This advice comes with a catch. If you toss and turn, Rosen says, don’t stay in bed.

“The longer you stay in bed, the more you train your brain that it’s okay to be in bed tossing and turning because the bed should only be for sleeping, right? ” Rosen said. “So it’s almost like… some of my patients almost expect not to fall asleep. That in itself feeds into their anxiety about sleep.”

Sun can be reached at [email protected] or on Twitter at @Rachel_M_Sun. This report is made possible by the Lewis-Clark Valley Healthcare Foundation in partnership with Northwest Public Broadcasting, the Lewiston Tribune and the Moscow-Pullman Daily News.

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