Go To Bed by Sarah Ballantyne

14 Easy Steps to Healthier Sleep
BY DR. SARAH BALL ANT YNE, PHD
go to bed by Dr. Sarah Ballantyne 1

14 Easy Steps to Healthier Sleep
by Dr. Sarah Ballantyne, PhD
© Copyright 2015 The Paleo Mom LLC.
No part of this publication may be reproduced, distributed, or sold in whole or in part, by any means, with or
without financial gain, without the prior written consent of the author.
The information contained in this book is for entertainment purposes only.
Always consult your healthcare provider before making any diet or lifestyle changes. The recommendations in this
book are not intended to diagnose, treat, cure, or prevent any disease. By reading this book, you agree that The
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buyer.

Table of Contents
6 Introduction
Why “Go to Bed”?
10 Part 1 139 Part 5

The Science of Sleep Troubleshooting Sleep Problems
33 Part 2 161 Part 6

Sleep and Health Now, Let’s Go to Bed!
80 Part 3 Part 7
Making Sleep a Priority
207 The 14-Day Go to Bed Challenge
Part 4 Part 8
97 Beyond the Bedroom
280 Frequently Asked Question
Click on each icon
Printables
to visit each part!
Index
References

About the Author
Sarah Ball ant yne, Ph.D. is the cre-
ator of the award-winning online resource
The Paleo Mom; co-host of the syndicated
top-rated The Paleo View Podcast; and New
York Times bestselling author of The Paleo
Approach, The Paleo Approach Cookbook,
and The Healing Kitchen. Sarah earned her
doctorate degree in medical biophysics at
the age of 26 and spent the next four years
doing research on critical care medicine,
innate immunity, gene therapy and cell biology, earning a variety of awards for
research excellence along the way. Sarah’s transition from academic researcher
to stay-at-home mom to award-winning and internationally recognized health
advocate and educator was driven by her own health journey, which included
losing 120 pounds and using both diet and lifestyle to mitigate and reverse a
dozen diagnosed health conditions. As a scientist both by training and by na-
ture, Sarah is deeply interested in understanding how the foods we eat interact
with our gut barriers, immune systems, and hormones to influence health. Sar-
ah’s innate curiosity goes further than just understanding diet and she is also
deeply interested in the impact of lifestyle factors like sleep, stress and activity.
Her passion for scientific literacy and her talent for distilling scientific concepts
into straightforward and accessible explanations form the foundation of her
work and her dedication to improving public health. Learn more by checking
out Sarah’s website, podcast and books. You can also find Sarah on Facebook,
Twitter, Instagram and Pinterest.
Additional Contributions
Katie Pickworth, B.A. is a current medical student studying for a Doc-
torate of Naturopathic Medicine and Masters of Integrative Medical Research
at the National University of Natural Medicine in Portland, Oregon. She began
doing research in human physiology starting in high school at the University
of Chicago. Continuing her studies as well as research training, she graduated
summa cum laude from Albion College in 2013 with Bachelors of Arts degrees

in Biology and Psychological Science, receiving assorted awards and accolades
such as the Psychology Department Award for Outstanding Research, the Albi-
on College Honors Thesis Excellence Award, and the honor of being invited to
join seven honorary societies, including the prestigious Phi Beta Kappa. Because
of her passion for research, she authored two undergraduate theses; for Biolo-
gy, she studied anti-inflammatory cytokines, and for Psychology, she examined
treatment methods for anorexia nervosa. She was a recipient of the Nation-
al Institutes of Health Undergraduate Scholarship and spent over two years
working at the Eunice Kennedy Shriver National Institute of Child Health and
Human Development, studying the effectiveness of psychological interventions
on long term psychopathology, eating behavior, and metabolic factors (e.g.,
weight & insulin resistance) in teenage girls with a leading worldwide expert in
pediatric obesity. She has been an author on almost 40 scientific abstracts and
more than 10 peer-reviewed journal articles, making her a uniquely well-pub-
lished young scientist.
Charissa Talbot, AOS, CPT is the COO for The Paleo Mom. She holds
an AOS in Holistic Healthcare and is a graduate of The National Personal Train-
ing Institute. She has over 6 years of experience as a movement, nutrition, and
mindset coach and has been working behind the scenes in the Paleo community
for over four years. Charissa has overcome her own struggles with depres-
sion, anxiety and panic attacks, insomnia, food fears, and chronic heartburn
with real, whole foods and a healthy lifestyle. She is the creator of the popular
hashtag #nocookpaleo and enjoys showing her friends and followers that eat-
ing healthy, whole foods can be just as easy and fast as picking up a pre-pack-
aged meal from the corner store or drive-through.
Graphic Design
Nicole Pittman is a freelance graphic designer specializing in brand-
ing and information development for health professionals in the online Paleo
Sphere. With a background in nutrition, design , marketing and ancestral life-
style, Nicole combines her passions and love of life into her work. Nicole has
worked with some of the top leaders in the paleo world and prides herself in
her client base and scope of work. You can find more of her work at her website
here.
INTRODUCTION
Why “Go to Bed?”
In the past half century, American culture has shifted to focus on increasing
productivity at the expense of health. We eat more convenience and fast food,
spend less time outside, and are more sedentary than ever. Changes in sleep
patterns are no exception to this problem. In the last 50 years, the average
amount of time that Americans sleep each night has decreased by 1.5–2 hours
from over 8 hours of sleep every night to under 7. That’s a staggering amount
of sleep– equivalent to a full month of continuous sleep every year!–that we
need but are not getting. Perhaps unsurprisingly, this leaves a significant sleep
deficit that is never resolved. From what we know about how lack of sleep af-
fects our brains, hormones, and
immune system, this may be
Trends in sleep in America since 1950
the single greatest contributor
8.5
to chronic illness in general.
8
That’s right: Sleep. Not diet.

7.5
Not activity. Not stress. Sleep.
7
Epidemiological studies show
6.5
a very strong correlation be-
tween short or disturbed sleep 6
1950 1970 1980 1990 2000 2010 2020
and obesity, diabetes, and
YEAR
cardiovascular disease. In fact,
lack of adequate sleep has been
associated with increased morbidity and mortality from all causes. This means
that if you consistently don’t get enough sleep, you have a much higher risk
of getting sick and/or dying. It also indicates that shortchanging yourself on
sleep could not just undermine your health, but shorten your lifespan. Studies
have also evaluated the role that sleep plays in healing from specific diseases,

like breast cancer, and show that the less you sleep at the time of diagnosis and
through treatment, the less likely you are to survive. Even more compelling,
mechanistic studies explaining exactly how sleep, or lack thereof, affects our
body at the cellular and molecular level are showing us exactly why sleep is so
important for health.
Not only that, but how much we sleep impacts our hunger levels, what foods
we crave, how impulsive our behavior is (in general, in the grocery store, and
at the dinner table), how we respond to stress, our emotional state and re-
sponses, how motivated we are to be active, and how likely we are to suffer
addiction (including tobacco use, alcohol,
drugs and food addiction).
Getting enough sleep is important for

health directly but also indirectly, since it
reduces the likelihood of us engaging in
other destructive behaviors.
In fact, as our scientific understanding
of exactly how sleep impacts health and
is sleep deprivation
behavior increases, the stronger the case influencing your
is for sleep being the lynchpin of health: addictive behaviors?
Sleep holds everything together.
And yet, with this vast body of scientific literature proving just how critical
adequate sleep is to health, getting more sleep is a hard sell. What most people
seem to want is a pill or tasty beverage to compensate for not getting enough
sleep. Case in point: the burgeoning gourmet coffee, coffeehouse, coffeemaker,
energy drink, and energy supplement industries. However, there is currently
no substitute for sleep. Caffeine and energy drinks/supplements mask fatigue,
giving us the illusion that we’re doing fine without enough sleep, while simul-
taneously eroding the quality of our sleep when we do finally get ourselves
to bed. This causes a vicious cycle, where we are reliant on these dubious sub-
stances to keep us functioning at a sub-par level while living our lives in a
chronically sleep-deprived state.

Sleep is that determinant of health that we so willingly give up for any other
priority, including both work and play. Ironically, it seems easier to completely
overhaul the foods on our plates than it is to make small changes in our pri-
orities with regards to lifestyle. Diet is important, certainly, but it’s far from
the only important input to health. The scientific literature hammers home the
importance of adequate sleep, stress management, and activity for long term
health and longevity. When we get enough sleep, it’s easier to manage stress,
easier to be active, and easier to make good decisions with regards to our food.
This is all demonstrated in the science. If you are making changes to your diet
and/or exercise regime with the goal of improved and lifelong health, putting
sleep at the top of your priority list may be the single best thing you can do to
guarantee success.
This book will motivate you to get enough sleep.
U.S. Gallup poll: hours of Sleep/Night 1942-2013

“ Usually how many hours do you sleep per night? “
Hours of Sleep/Night 1942 1990 2001 2004 2013
% % % % %
5 HOURS (OR LESS) 3 14 16 14 14
6 HOURS 8 28 27 26 26
7 HOURS 25 30 28 28 25
8 HOURS 45 22 24 25 29
9 HOURS (OR MORE) 14 5 4 6 5
NET: 6 HOURS OR LESS 11 42 43 40 40

NET: 7 HOURS OR LESS 84 57 59 59 59
AVERAGE HOURS PER NIGHT 7.9 6.7 6.7 6.8 6.8

A huge proportion of this book is about sharing the biological mechanics be-
hind sleep and how sleep impacts health. I hope that, with a science-nerd-level
understanding of the full implications of your sleep choices, you will feel highly
motivated to put sleep back up near the top of your To Do list. Yet, I recognize
that it can be challenging to adjust priorities to make this happen, so I’ll also be
sharing tons of strategies to help you succeed at your sleep goals.
Of course, even when you do shift your routine to allow for more time in bed at
night, that’s no guarantee that your body will cooperate. This book will also de-
tail how other choices we make during the day impact sleep quality, including
the science explaining why the body responds the way it does to certain choic-
es. Even better, this book contains every scientifically-validated tips and trick
for improving your sleep.
This book will give you the tools you need to improve your sleep.
This book is jam-packed with the science of sleep as well as strategies to help
you get the sleep you need. It also contains the 14-Day Go To Bed Challenge. I’ve
distilled the vast field of sleep science into 14 simple steps that you can take to
improve your sleep. Now that this book is in your hands, you are just 14 days
away from better sleep and better health!

Part One
The Science of Sleep

Chapter QUICKSTART
Part One: The Science of Sleep
pg. 13 1. What is Sleep?
Click on
each
number to !
•• Scientists use behavioral and electrophysiological definitions to explain
visit each
page the phenomenon of sleep.
•• Non-rapid eye movement (NREM) sleep is characterized by less frequent

but stronger brainwaves and delineated into four separate stages. A lot
of the physiological recovery we associate with sleep happens during this
type of sleep.
•• Rapid eye movement (REM) sleep is characterized by frequent, unsynchro-

nized brain waves. Most dreams occur during this phase.
pg. 20 2. The Purpose of Sleep

•• There appears to be three main reasons for sleep: restoration, synaptic
plasticity, and energy conservation.
pg. 23 3. Sleep-Wake Cycles

•• The circadian clock is controlled by specialized cells in the brain that
connect to the retina of the eye and tell the brain what time of day it is,
regulating many hormonal and other responses.
•• Circadian rhythm depends upon proper functioning of the hormones

cortisol (the stress regulator) and melatonin (a sleep-inducing peptide).
•• Sleep homeostasis is the process by which our bodies regulate the feeling
that we need to go to sleep.
•• Our brains use complex mechanisms to regulate the drive for sleep, but
the accumulation of the protein adenosine is one critical contributor.
Adenosine builds up as we use energy throughout the day, then it is
cleared while we sleep by specialized nerve cells.
Click on each number to visit each part!

Part:
1 2 3 4 5 6 7 8 go to bed by Dr. Sarah Ballantyne 11
pg. 27 4. How Much Sleep Do We Need?

•• The National Sleep Foundation has compiled expert opinions and sleep
research to determine that the average adult needs 7-9 hours of sleep per
night.
•• For people with an autoimmune disease or other chronic illness, 9 hours

or more is a common and often necessary part of the healing process.
•• Keeping honest estimations of the amount of sleep we get, including the

time that it takes us to fall asleep, could be a hugely important part of
monitoring our sleep habits.
•• Research on modern hunter-gatherers has demonstrated that they also

sleep between 7 and 8.5 hours per night, tending to cycle their sleep with
the sun (including shorter sleep in the summer and longer sleep in the
winter).
pg. 31 5. Sleep Debt

•• Sleep debt occurs every time you do not get enough sleep – even just
sleeping 30 minutes less than your body needs on weeknights.
Part:
Part One
What is Sleep?
Pop quiz: what is your definition of sleep? If you had to describe sleep, how
would you do it?
Kind of a tricky prospect, isn’t it? Believe it or not, scientists are still fine-tuning
the scientific definition of sleep—in part because it’s a common experience for
all animals, and in part because we’re still making frequent discoveries about
the details and the “whys” of sleep. There are two different ways that scientists
look at sleep: behaviorally and electrophysiologically.
The behavioral criteria for sleep are all of the following:

•• Decreased behavioral activity (i.e., you’re still and not engaging in
conversation)
•• Site preference (i.e., your sleeping place, like your bed)
•• Specific posture (i.e., lying down)
•• Rapid reversibility ( i.e., you can be woken up, unlike when you’re in
a coma)
•• Increased arousal threshold ( i.e., you are not aware of your envi-
ronment while sleeping)
•• Homeostatic control ( i.e., your body rebounds and makes you sleep
more after being deprived)
Of course, these criteria are completely common sense when you think of it:
while they may not seem particularly quantifiable, behavioral definitions are
sufficient for many kinds of scientific studies.
The electrophysiological definition of sleep identifies a specific pattern of

whole-brain activity (measured by electroencephalogram, or EEG), eye move-
ment (including patterns of both non-rapid eye movement, or NREM, and rapid
eye movement, or REM), and changes in muscle tone. This method of defining
Part:
sleep allows for better quantification of sleep as well as defining and under-
standing the sleep stages.
In general, there are two different types of sleep: non-rapid eye movement
(NREM) and rapid eye movement (REM). These two types of sleep can be iden-
tified by movement of our eyes underneath our eyelids while we sleep and by
examining brain activity, as measured by electroencephalogram (EEG). An EEG
is a non-invasive method of detecting small electrical currents in the brain (the
brain version of an electrocardiogram, or ECG, which measured small electrical
currents in the heart and is used as a diagnostic test for some types of heart
disease). Neurons (brain cells) communicate with each other using electrical
signals, called impulses, which show up as wavy lines on an EEG recording (we
call this a measure of “brainwaves”). Neurons are active all the time, even when
you’re asleep, but the pattern of their activity changes depending on what sleep
stage we are in, i.e., the shape, frequency and amplitude of the brainwaves
change.
NREM sleep is character-

ized by brainwaves that are
less frequent but stronger
Sleep BrainWaves
in amplitude and are more
synchronized. REM sleep,
RELAXED WAKEFULNESS
on the other hand, is char- Alpha Waves
acterized by brain waves

that are more frequent and STAGE 1 Theta Waves
less synchronized. During

NREM sleep, the body po- Sleep Spindles
K-Complex
STAGE 2
sition will move about
once every 20-30 minutes,
whereas your body is func-
STAGE 3 & 4
tionally paralyzed during Delta Waves
REM sleep. As you might

have guessed, REM sleep is
also characterized by ob-
servable rapid eye move- REM OR DREAMING SLEEP
ment (your eyes are darting

back and forth beneath
Part:
your eyelids), whereas there is no such eye movement in NREM sleep. NREM
sleep is sometimes called “quiet sleep,” because the brain activity measured
by EEGs shows a much less active pattern than REM sleep, which in contrast is
called “active sleep”.
NREM sleep is separated into four sleep stages. Healthy sleep has you pass
through each phase sequentially in a “sleep cycle”: stage 1, then stage 2, then
stage 3 (and 4, which is sometimes combined with stage 3) and finally culmi-
nating in REM sleep. The next cycle starts at the beginning with stage 1. Each
night when you fall asleep, your body goes through this cycle about four or
five times. A complete sleep cycle takes an average of 90 to 120 minutes, with
each complete cycle taking longer and longer through the night. The first sleep
cycles each night also have relatively short REM sleep times and longer periods
of deep sleep (stage 3 and 4); but, later in the night, REM sleep periods lengthen
and deep sleep time decreases (which is why we dream more in the morning).
Each sleep stage seems to allow for slightly different beneficial processes in
the brain. Although the details remain a mystery, the sleep cycle stems from an
interaction between the circadian clock and a separate sleep-wake homeostatic
process.
Stage 1 sleep is a light NREM sleep that begins the moment you drift off.
You can think of stage 1 like your
Stage 1 transition from being awake to be-
ing asleep. From a brainwave per-
spective, this stage is the transi-
tion from waking-type brainwaves
when the body is resting, called
“alpha waves,” to sleeping-type brain waves, called “theta waves.” During this
stage, which lasts only about 5 minutes, your heart rate will decline, your body
temperature will drop, and your eyes will slowly move in a pattern from side to
side. This phase of sleep is usually dreamless and is easily disturbed. Have you
ever woken with a start shortly after going to bed, thinking you heard someone
calling your name or that you were falling? These are relatively common phe-
nomena during the early phases of sleep. An interesting fact about stage 1 sleep
is that how we perceive it varies per individual; so, you might think you were
Part:
just drowsy for this part of your sleep cycle, whereas your partner might con-
sider this to be actual sleep for them.
After that, the body begins to transition into established sleep.
In stage 2 sleep, which lasts between 10 and 25 minutes in our first sleep cycle
(remember: each cycle lasts longer and longer), eye movement stops and
brain waves become slower with only an occasional burst of rapid brain waves,
called “sleep spindle,”.
During sleep spindles, it is theo-
Stage 2 rized the brain is sorting through
the information it picked up that
day and synthesizing it with exist-
ing knowledge. As you might have
expected, memory consolidation
occurs while we are in stage 2
sleep. Along with sleep spindles, the brain activity of stage 2 sleep is charac-
terized by sharp, short bursts of brain activity; these brainwaves are called a
“K-complex,” and scientists believe that their purpose is to keep the brain pre-
pared in the event that we need to be awakened.
Deep sleep begins when a person enters stage 3 sleep, characterized by ex-
tremely slow brain waves called delta waves.
During this stage, more of the brain’s active centers shut down for the night,
and the remaining active brain cells
Stage 3 & 4 become more synchronized in their
brainwave pattern. As the neurons
fire in more synchronized pat-
terns, their combined frequencies
increase to create the delta waves.
The goal of stage 3 sleep is to get to
this point.
In stage 4 (which, again, some scientists characterize as just an extension of

stage 3), the brain produces the slow delta waves almost exclusively.
This is why the stages 3 and 4 are referred to as slow-wave sleep, deep sleep, or
Part:
delta sleep. In this stage of sleep, there is no eye

movement or muscle activity, blood pressure is
reduced by 20-30%, and the brain becomes much
less responsive to external stimuli. It is very dif-
ficult to wake someone from deep sleep—and if
you do happen to wake up during this stage, you
will likely feel very groggy and unrested. This
is when some children experience bedwetting,
sleepwalking or night terrors.
Deep sleep seems to be one of the most critical

times for body repair.
At the beginning of stage 3/4, the pituitary gland releases growth hormone,
which stimulates the growth and repair of important tissues. Your brain cools
during this phase, as less blood is directed to it (in part because of the lowered
blood pressure), which may help to improve its function and allow for repair.
Interestingly, it seems that there are also increased levels of interleukins (there
are many different types, all of which are released by white blood cells, some
of which reduce inflammation and some which stimulate inflammation), indi-
cating increased immune system activity during this phase of sleep as well; so,
immune function is related to deep sleep too! Since slow-wave sleep is so im-
portant, our bodies designate a lot of time to it: at its peak importance, which is
generally young adulthood, deep sleep makes up about 20% of our total sleep-
ing time, but then it declines in later adulthood (especially after the age of 65).
When someone is sleep-deprived, they pass more quickly through the earlier
stages of sleep and spend more time in this stage as well.
After deep sleep, REM sleep begins. Brain waves during REM sleep increase
to levels experienced when a person is awake, appearing more erratic in their
pattern and with higher frequency.
Unlike the restorative quality of
REM Sleep “quiet sleep,” this dreaming, “ac-
tive” sleep is just that: it is almost
as active as if you were awake! In
general, breathing becomes more
rapid, irregular and shallow, eyes
Part:
jerk rapidly, and limb muscles are temporarily paralyzed (except in those who
sleepwalk, acting out their dreams). Similarly, heart rate increases, blood pres-
sure rises, sex organs become aroused, and the body loses some of the ability
to regulate its temperature. Additionally, the sympathetic nervous system,
which is responsible for the “fight or flight” response, is twice as active as when
you’re awake! However, despite all of this activity, your body remains rela-
tively still, since all muscles except for those controlling eye movement and
breathing are paralyzed during this phase of sleep.
This is the time when most dreams occur. Scientists are still trying to under-
stand how dreams contribute to our health and what they may mean, but it ap-
pears that dreaming sleep is really important for managing learning and mem-
ory. Studies have shown that repeated interruption of REM sleep, rather than
NREM sleep, decreases cogni-
tive performance compared to
a night with the standard 3-5
REM cycles.
Waking may occur after REM,

when you cycle back to stage
1 sleep. If the waking period is
long enough, the person may
remember the dreams from
the most recent REM cycle, but
short awakenings might not
be remembered. As the night
progresses, REM cycles become
longer and can last up to an
hour depending on how long
and restfully you sleep. In total,
REM sleep accounts for about
one to two hours of your sleep
each night, with the rest of the time spent in light sleep to deep (NREM) sleep.
How much time we spend in each sleep stage changes as we age. Infants spend
almost half of their time in REM sleep. In contrast, adults spend nearly half of
our sleep time in stage 2, only about 20% in REM, and the other 30% is divid-
ed between the other three stages. Older adults progressively spend less time
Part:
in REM sleep. Differ-

ences in how much REM SLEEP CYCLE
time is spent in each
stage of sleep is called
REM REM REM REM
“sleep architecture”,
and scientists are still
debating the best way
to represent the tran- REM
Low voltage,
mixed frequency
sition between stages + rapid eye
movement &
muscle atonia
throughout the night.
0 1 2 3 4 5 6 7 8
How does the brain TIME OF SLEEP
control the sleep stag-

es?
Recent research provided new insight on how a small number of specialized
neurons in the brain regulate these phases of sleep — some of these cells cells
promote wakefulness while others promote sleep. These neurons work togeth-
er in a complex way; those that promote wakefulness inhibit those that pro-
mote sleep, and vice versa. This interaction normally leads to either a relatively
stable period of wakefulness or a relatively stable period of sleep.
When I talk about sleep quality, I’m talking about how the body cycles through
these sleep stages, including whether or not we’re spending the appropriate
amount of time in each sleep stage at the appropriate time of night, in order to
optimize all of the necessary biological processes that occur while we’re asleep.
The most important take-home here is that there is a normal structure to sleep
and this structure is sensitive to many factors, like hormones, what we eat
during the day, our stress levels, and our sleep environment. Improving sleep
quality means progressing towards achieving a healthy sleep architecture, in-
cluding lighter stages of sleep, deep sleep, and REM sleep.
Part:
The Purpose of Sleep

Sleeping is like eating and drinking:
we absolutely need to do it to live. But
have you ever stopped to think about
why? Believe it or not, the exact pur-
pose of sleep evaded researchers until
the past decade (and there are still
tons of unanswered questions). We’re
now beginning to be able to dissect
those essential biological process-
es that happen while we’re sleeping
to more completely understand the
f2unction and importance of sleep.
There appears to be three main reasons for sleep.
1. Restoration
Sleep provides the opportunity for total-body rejuvenation. In fact, many body
processes are enhanced or only take place during sleep: muscle growth, tissue
repair, protein synthesis, and growth hormone release are just a few examples.
Likewise, new research demonstrates that the major purpose of sleep is to al-
low for detoxification processes in the brain.
The brain uses about 20% to 25% of the total calories we

burn every day.
Yes, the brain needs a lot of energy to carry out all the
wondrous functions it performs. And when our cells use
25% energy, they produce waste. This metabolic waste is made
up of a variety of biological compounds, many toxic, that
are the byproducts of cellular metabolism. So, considering
how active the brain is, this equates to a large accumula-
TOTAL CALORIES tion of metabolic byproducts concentrated in one relative-
PER DAY ly small organ. In most of the body’s organs, this waste en-
ters the bloodstream, and it’s part of the liver and kidney’s
jobs to filter it out and make sure it’s eliminated from the
Part:
body via urine and stool. However, the brain is protected from the bloodstream
via the blood-brain barrier (BBB) and requires many specialized systems to get
molecules from the brain into the bloodstream.
The BBB is a highly-selective barrier, meaning that it only allows certain sub-
stances into and out of the brain. In general, the BBB is totally critical to the
health and safety of our brains, but it makes detoxification a more complicated
process.
To remove metabolic waste products from our brains, our brains have a spe-
cialized system called the glymphatic system. The glymphatic system con-
sists of a gentle flow of normal brain fluids (cerebrospinal and interstitial fluid)
through the brain which propels waste products of neuron metabolism to the
space around veins in the brain (paravenous space). Close to the veins are small
lymphatic vessels, into which the waste products are directed in order to re-
turn to the circulation for clearance by the
kidney and liver; however, the glymphatic
system is vastly more functional while
we’re asleep.
During sleep, the brain cells (neurons)

shrink by 60%, increasing the space
between them so the toxins that build up
during the day can be flushed away
more effectively.
Additionally, the brain has specialized
neurons called “microglia” that are like
the housekeepers of the brain. While we
sleep, they go through and aid in sweeping up the toxins and damaged neurons
that built up during the day. From there, the toxins are either converted back to
their active form or are flushed into the circulation and brought to the liver for
filtration.
The buildup of certain proteins is a normal part of the process of a working,

happy brain. For example, while we are awake, our brains produce the by-
product adenosine, a naturally-occurring protein whose accumulation seems
to indicate to our brains that it’s time to sleep. Without sufficient sleep, the
metabolic byproducts like adenosine buildup in your brain. This can then neg-
Part:
atively impact cellular health, neurotransmitter systems, hormone systems,

communication between brain cells, and stimulate inflammation in the brain.
And anything that impacts the health of the brain impacts every other system
in the human body.
2. Synaptic Plasticity
Synaptic plasticity refers to our brain’s ability to change. This concept sounds
simple but is fairly new: for a long time, scientists believed that we were hard-
wired from a young age and that the brain didn’t change much until old age.
However, our brains are flexible (like “plastic”) and make new connections all
the time. The brain is kind of like a muscle in that the connections that are used
all the time are reinforced and the connections that are hardly used tend to de-
grade or disappear. These changes are related to memory and other brain func-
tions, and our plasticity depends on getting adequate sleep. So, a newly discov-
ered purpose of sleep is the formation of memories. Though learning happens
while awake, sleeping improves our ability to encode and consolidate memory,
and it looks like sleep is necessary for long-term memory.
3. Inactivity and Energy Conservation

Understanding sleep from an evolutionary perspective, there are two more
functional advantages to sleep. Sleep is a process that mammals adapted over
time so that they were inactive during the most dangerous time, the night,
when reduced ability to detect predators
using vision would have been a major disad-
vantage. Being inactive at night and in a safe
resting/hiding space would make it easier for
the species to survive in the wild. Addition-
ally, the metabolism slows (about 10% less
in humans), so it helps to conserve energy
and reduce the need to hunt and gather food
during the day to a more manageable level.
Part:
Sleep-Wake Cycles
I’m sure that you can already beginning to see that sleep in super important,
and we’re going to discuss that in even more detail in Part Two. But, in order to
understand all of the the many ways that sleep
impacts our health (and how we might be able
to make small changes that could have huge im-
pacts on our sleep!), it’s important to note how
our bodies regulate sleep-wake cycles.
Circadian Rhythm
The term “circadian rhythm” refers to the fact
that a huge array of biological processes within
the human body cycle according to a 24-hour
clock. Circadian rhythm allows your body to
assign tasks to various organs and parts of your brain based on the time of
day (and whether or not you are asleep). For example, prioritizing tissue repair
while you are sleeping, and prioritizing the search for food, metabolism, and
movement while you are awake. Circadian rhythm also influences a natural
pattern of daily variations in body temperature, blood pressure, time-sensitive
hormones, and digestion. Circadian rhythms are how your body knows what
time it is (like when it’s time to get up in the morning)–and properly regulated
circadian rhythms are critical for health.
Your brain has a master clock, called the circadian clock, which is controlled by
specialized cells in a region of the brain called the suprachiasmatic nucleus of
the hypothalamus (abbreviated SCN). The SCN is connected to the retina of the
eye by specific nerve fibers, which is how our brain knows what time of day it
is - based on the light our eyes are being exposed to! This eye-brain connection
is one of the critical reasons why getting the right kind of light exposure at the
right time of day is so important for keeping our bodies in a regular hormonal
rhythm; this is also why some people with traumatic brain injury experience
disrupted sleep patterns.
We know that the SCN is absolutely critical for the sleep-wake cycle, because
damaging the SCN eliminates regular, patterned sleep behavior based on time
Part:
NOON
12:00
HIGH ALTERTNESS
10:00 BEST COORDINATION
HIGHEST TESTOSTERON SECRECTION 14:30
09:00 FASTEST REACTION TIME
BOWEL MOVEMENT LIKELY 08:30 15:30
MELATONIN SECRECTION STOPS
GREATEST CARDIOVASCULAR EFFICIENCY
07:30 AND MUSCLE STRENGTH
SHARPEST RISE IN 17:00
BLOOD PRESSURE 06:45
06:00 18:00
18:30 HIGHEST BLOOD PRESSURE
19:00 HIGHESTBODY TEMPERATURE
LOWEST BODY TEMPERATURE 04:30
21:00 MELATONIN SECRETION STARTS
02:00
DEEPEST SLEEP 22:30
00:00 BOWEL MOVEMENTS SUPRESSED
MIDNIGHT
of day. This part of your brain is the conductor: it controls the ebb and flow of
certain hormones that act as messengers throughout the body, communicating
the time. As the levels of cortisol and melatonin cycle throughout the day (cor-
tisol peaking shortly after waking and melatonin peaking during the first half
of the night), they tell all the cells in your body what “time” it is. The cells each
then set their own internal clocks to the brain’s clock (like setting your watch
to Greenwich Mean Time).
In order to have healthy circadian rhythms, your circadian clock needs to be

set to the right time.
OUTPUT RHYTHMS;
Light Physiology
Behavior
Suprachiasmatic
Nucleus (SCN)
Part:
The circadian clock is set by a variety of external factors, called “zeitgebers”

(that’s a German word for “time givers”). The most important zeitgeber is light,
as I mentioned before, because the relationship between the retina and the hy-
pothalamus provides general feedback for your circadian rhythm. This notion
is supported by the fact that visually impaired people almost always (~90% of
the time) have circadian rhythm and sleep problems. Your lifestyle (e.g., activity
throughout the day) also sends a signal to your brain to help to interpret when
in your circadian rhythm
you are - this explains why
some people aren’t able Circadian Rhy thm
to tolerate exercise right Daily Cortisol & Melatonin Cycles
before bed; it confuses their
SCN! Finally, hormones are
a critical zeitgeber that can
make a huge difference cortisol
when it comes to sleep

quantity and quality.
The vast majority of your

hormones cycle during the
day (not just melatonin melatonin
and cortisol), meaning that

6am 9am 12pm 3pm 6pm 9pm 12am 3am 6am 9am
the amounts in your blood
vary throughout the day.
Hormones are the chemical messengers of the body and aid organs in commu-
nicating with the brain and each other; so, this cycling impacts every system
in and many functions of your body, from your immune system, to how well
you digest your food, to how much insulin is released in response to sugar in-
take. You can see why prioritizing circadian rhythm is so important: it not only
helps regulate the levels of and sensitivity to different hormones, but, even
more critically, it regulates the natural ups and downs that your hormones go
through during the day and night. And this is necessary for health. When your
circadian rhythms are properly regulated, you sleep well, you have energy
in the mornings, your energy is constant throughout the day until it starts to
gradually diminish in the evening… and it reduces your risk of developing or
worsening chronic disease.
Part:
Sleep Homeostasis
Our circadian rhythm is an incredible, fine-tuned tool that our bodies use to
tell time and function at our healthiest. A less-considered aspect of sleep-wake
regulation is called sleep homeostasis, which creates your drive for sleep. “Ho-
meostasis” is a general term used in biology to describe processes your body
takes to stay in a stable and/or constant condition, and “drive” in the field of
biology is considered to be an innate urge or need. So, we can consider sleep ho-
meostasis to be the process by which our
bodies regulate the feeling that we need
to go to sleep. In comparison to circadian
rhythm, we know much less about the
details of sleep homeostasis, but it ap-
pears to be controlled by the sleep-regu-
lating substances that accumulate in the
cerebrospinal fluid during waking hours.
The best-understood sleep-regulating
substance is adenosine.
As I mentioned before, adenosine is a protein that accumulates in the basal

forebrain during wakefulness and is a natural byproduct of using energy stores
in the brain. Being the central protein for adenosine triphosphate (ATP, the basic
energy molecule of the body that fuels biochemical reactions), free adenosine
accumulation is a sign that the brain is using energy stores in the form of gly-
cogen. During sleep, the adenosine is cleared away and replaced by more glyco-
gen—as you might recall, this was one of the examples of why we need sleep in
the first place. Commonly-used stimulants like caffeine actually work as ade-
nosine antagonists, preventing the effect
of drowsiness (and this is also one of the
reasons why we don’t want to overuse
caffeine!). However, the details of this
process and what other factors may be
involved in regulating sleep homeostasis
are still being uncovered by scientists.
In other terms, the “sleep homeostat” is
Part:
basically your sleep debt.

It is a term that refers to
Homeostatic drive Circadian drive for arousal both your body’s gauge of
(Process S) (Process C) Sleep
the amount of sleep you’ve
experienced recently as
well as its drive to return to
balance, i.e., paying off your
sleep gate sleep gate
awakening awakening
sleep debt. You can think of
it as the sliding scale of how
7am 11pm 7am 11pm 7am
Sleep-wake regulation: interaction between the homeostatic sleep drive (Process S) and the circadian tired you feel based on how
drive for arousal (Process C).
much sleep you’ve had the
last few nights. When your circadian clock tells your body it’s time to prepare
for sleep and your sleep homeostat agrees that sleep is currently needed by
your body (and you actually listen and go to bed!), that’s when you have a good
night’s sleep!
In combination, your natural circadian rhythm and sleep homeostat generate

a drive for sleep each day that may be influenced by other factors. If you are
looking to improve your sleep, these two biological mechanisms may be the
key!
How Much Sleep

Do We Need?
The National Sleep Foundation
recently convened with experts
from sleep research, anatomy
and physiology, as well as phy-
sicians from a variety of special-
ties, including pediatrics, neurol-
ogy, gerontology, and gynecology
to reach a consensus on our gen-
eral sleep needs from the broad-
est range of scientific disciplines.
Part:
The panel revised the recommended sleep ranges and came up with these
guidelines:
NEWBORNS (0-3 MONTHS) 14-17 hours

INFANTS (4-11 MONTHS) 12-15 hours
TODDLERS (1-2 YEARS) 11-14 hours
PRESCHOOLERS (3-5 YEARS) 10-13 hours
SCHOOL AGE CHILDREN (6-13 YEARS) 9-11 hours
TEENAGERS (14-17 YEARS) 8-10 hours
YOUNGER ADULTS (18-25 YEARS) 7-9 hours
ADULTS (26-64 YEARS) 7-9 hours
If you are trying to heal from an autoimmune disease or other chronic illness,
don’t be surprised if what your body needs is on the longer end of that range
(say 9 to 10 hours) or even exceeding that range (some people with autoimmune
disease report needing 12 hours of sleep every night to heal). I believe even
grown-ups need bedtimes. By making sure yours is early enough to hit a min-
imum of 7 hours of sleep every night, you’ll be greatly improving your health
and reducing risk of all chronic illnesses.
I think this recommendation is deserving of some contemplation. As

health-conscious members of the Paleo and/or the alternative health com-
munities, we are used to thinking in terms of going beyond the minimums
established by conventional medical and scientific communities. For example,
we strive to regulate our blood sugar so perfectly that we have an even lower
HbA1C than what is considered normal; we understand that optimal range is
different than lab range for a variety of tests; and, we understand the RDA is
likely a gross underestimate of how much essential nutrients we need to be op-
timally healthy (as opposed to just not completely malnourished). The conven-
Part:
tional medical and scientific communities are shouting from every megaphone
that we need a bare minimum of 7 hours of sleep every single night. Not only
are we not doing our normal one-upping thing and saying “oh yeah? Well, we’re
going to get a minimum of 8 hours per night, so there!”, but we’re not even lis-
tening at all!
The fact is that 35% of Americans don’t ever get 7 hours of sleep. 65% of
Americans never get 8 hours of sleep. And, however much sleep you think
you’re getting, you’re very likely getting less.
Most of us overestimate how much sleep we get. We look at the clock when we
turn out the light and think of that as the beginning of our sleep. But, it’s nor-
mal to take 30-60 minutes to fall asleep, and it’s normal to have at least a few
brief wakings in the night. When we simply look at the clock at the beginning
of the night versus the morning, we think of that as how much we slept.
Studies that have compared how individuals report their sleep with how much
they actually slept measured by wrist actigraphy (like a Fitbit) and have found
that on average, we report that we got 48 minutes more sleep than we actually
did. But, here’s where things get interesting: the less you sleep, the more likely
you are to overreport your sleep. So, people who got 5 hours of sleep per night
on average overreported by 1 hour and 20 minutes (so, they said they got 6.3
hours instead of 5) and people who got 7 hours of sleep only overreported by 20
minutes. What does this mean? That if you get 6 hours or less, chances are good
that your sleep situation is worse than you think.
Maybe you’re scoffing at me and thinking, “well, I eat a super healthy, nutrient
dense diet! I don’t need that much sleep!” So, let’s use the Paleo approach to this
topic and take it back to what the science says about our evolutionary biolo-
gy-established need for sleep. It’s fascinating when the research goes back to
an ancestral model by studying hunter-gatherers, because it gives us a sense of
our biology without the many alterations that have occurred with modern life
(e.g., our constant exposure to screens!). Then, we can compare what’s changed
and hopefully optimize our behaviors to meet our genetic needs–because even
though our world has changed infinitely just in the last century, our biological
adaptations develop over a much, much longer period of time (think from tens
of thousands to millions of years). Looking specifically at our sleep needs, two
Part:
recent studies of hunter-gatherers show that

our general recommendation of 7-8.5 hours per
Hunter Gatherers night is about right.
A study of Argentinean hunter-gatherers (the

Toba/Qom) published recently showed that
these people go to bed a couple of hours after
sunset and get up at dawn. The results showed
that while they spend 9-10 hours “in bed,” they
get a total of 7-8.5 hours sleep: an average of 7
near the summer solstice (i.e., the longest days
of the year with the most sunlight) and an aver-
age of 8.5 near the winter solstice (the shortest
days of the year, when there’s much less sun to
9-10 hours “in bed” enjoy and be productive in). Sleep quality was
but a total of 7-8.5 hours sleep comparable to what medical professionals in
Western countries deem normal sleep.
A second study examined three different hunter-gatherer societies (the Hadza

of Tanzania, the San of Namibia, and the Tsimane of Bolivia) for both their sleep
habits and sleep efficiency. These peoples also typically go to bed several hours
after sunset and rise a little before or at dawn, yielding between 6.9 and 8.5
hours of sleep (again averaging toward the lower end of that range in the sum-
mer and the higher end of that range in the winter). Additionally, researchers
found that sleep latency (the time it takes to fall into a deep sleep at the begin-
ning of the night) was pretty similar to our society’s standards: about a half an
hour to an hour. Again, their sleep quality is comparable to what we call normal
in Western societies.
What does this information tell us? Aiming for 7-8.5 hours of quality sleep
every night (or you can get really geeky and track with your FitBit in sensitive
mode and aim for a more specific 6-7 hours after “restless” time is subtracted)
puts us at levels comparable with hunter-gatherers and, presumably, our Pa-
leolithic ancestors. And to get that, we probably need about 9 hours in bed.
Part:
Sleep Debt
IN SLEEP
Defining how much sleep you need within OU DE
Y B
the normal ranges can be a challenge. Do E
T?
AR
you enjoy perfect health with 7 hours ev-
ery night, or do you need 9 hours on a reg-
ular basis? And what if you’re someone
who needs more sleep than the top end
of the range (which happens during both
chronic and acute illness)? How do you
know? While scientific researchers are
indeed working on a blood test to evaluate sleep debt, being able to ask your
doctor to run a test that will tell you if you’re getting enough sleep is probably
at least a few years from being a reality.
In the absence of a definitive test, you can ask yourself the following
questions:
•• Do I have to set an alarm in the morning? Would I sleep past my alarm
time if I didn’t have one set?
•• Do I drag myself out of bed? Or need caffeine in the morning to get me
going?
•• Do I always sleep in on the weekends?
•• Do I get less than the minimum 7 hours sleep per night even once or
twice per week?
If the answer is “yes” to any of these questions, you owe a sleep debt. And even
if you’re almost getting the right amount of sleep, (i.e., your sleep debt is very
low), your health will suffer. A recent study showed that getting just 30 min-
utes less sleep per night than your body needs on weekdays (while sleeping in
on weekends) can have long-term consequences for body weight and metabo-
lism!
Most research into the role that sleep has on health uses “short sleep” as an in-
vestigatory tool. Short sleep means sleep that is restricted to a shorter duration
than you would normally get (typically 3-5 hours is used in most studies). How-
ever, as researchers start to look at sleep debt, which can be a tad more subtle,
instead of more dramatic situations, it’s becoming clear just how sensitive the
human body is to inadequate sleep.
Part:
In one case, the study participants kept sleep logs, and the researchers calcu-
lated how much less sleep they got than the recommended 8 hours a night
cumulative over the work week (not including sleeping in to “catch up on sleep”
on the weekends). The study participants were people newly diagnosed with
type 2 diabetes. At the start of the study, when the participants were recruited,
those that typically didn’t get enough sleep were 72% more likely to be obese.
The researchers then followed the participants over a year to see what would
change. The amount of sleep debt that individuals had didn’t typically change
over the course of the study, but they found that sleep debt dramatically im-
pacted risk of obesity and insulin resistance, and the correlation between the
two increased throughout the study. At 12 months, for every 30 minutes of
weekday sleep debt, the risk of obesity was 17% higher and the risk of insulin
resistance 39% higher. That’s right, just 30 minutes of sleep debt had a huge
impact on blood sugar regulation!
Now, this study was done in a population that has much higher risk of develop-
ing these conditions than the average Paleo dieter. But, when you combine this
with the huge collection of mechanistic studies showing that inadequate sleep
increases insulin resistance, causes cortisol secretion, causes toxins to build up
in our brains, causes neurotransmitter imbalances, contributes to inflamma-
tion, and causes increased hunger and cravings... this isn’t research that should
be dismissed. Another recent study showed that some components of the im-
mune system that become overactive during short sleep do not return to nor-
mal after two days of sleeping in. Basically, the weekend isn’t enough to help
restore healthy immune function. This is super important for everyone but
especially those of us dealing with chronic illness or autoimmune disease.
So, we’ve talked a lot about what constitutes the science of sleep and discussed
our minimum sleep needs and recommendations. I’ve said over and over again
that sleep is critical for health, so I want to get into the nitty-gritty of the link
between sleep and many facets of health!
Part:
Part two
Sleep & Health

Sleep and health
Chapter QUICKSTART
Part Two Sleep & Health
pg. 39 1. Sleep and Disease Risk
•• Sleeping less than 6 hours a night has been associated with an increased
risk of all-cause mortality by 12% - almost as much as being obese. It is
also associated with increased risk for being obese, inactive, and not eat-
ing enough vegetables; type 2 diabetes and/or insulin resistance; auto-
immune disease; stroke; myocardial infarction (heart attack); colorectal
cancer onset; and breast cancer prognosis.
•• Sleeping more than 9 hours per night increased risk of disease by 25%, so
being a long sleeper isn’t always great for your health either!
pg. 44 2. Inflammation
•• Inflammation refers to a response from the immune system, which can
be specific (like fighting an infection) or non-specific (as is the case in that
systemic, bad-type of inflammation).
•• Three consecutive nights of inadequate sleep has been shown to produce

an inappropriate immune response, and the effects of losing sleep last
several days after the incident.
•• Sleep deprivation may also increase changes of developing an infection

and susceptibility to onset of a cold.
pg. 48 3. Autoimmune Disease

•• Autoimmune disease occurs when the immune system attacks cells that
are our own; there is no common etiology or understanding of their origin
– it appears that there are many underlying factors associated with the
onset of autoimmunity.
•• Less sleep is associated with worsened autoimmune disease systems and

may contribute to the onset of rheumatic autoimmune disorders like lu-
pus and rheumatoid arthritis.
Part:
Sleep and health
pg. 50 4. Weight Gain and Obesity

•• Medical research also shows that there’s a stronger connection between
obesity and lack of sleep than any diet factor.
•• Short-term changes in sleep patterns can worsen insulin resistance, dys-

regulate cortisol, and increase leptin – all of which can lead to a pattern of
seemingly uncontrollable weight gain.
•• Sleep deprivation changes the amount of dopamine receptors in the brain,

mimicking the neuropathology of someone with food addiction-type be-
haviors (think obesity or binge eating disorder).
pg. 60 5. The Hypothalamic-Pituitary-Adrenocortical

(HPA) Axis
•• The HPA axis regulates the physiological stress response and is a known
contributor to many health conditions.
•• The stress hormone, cortisol, is a critical component of the sleep-wake

cycle.
•• Chronic stress is related to many health issues, including immune system

problems, inflammation, and weight problems.
pg. 65 6. Cardiovascular Disease

•• Even without a diagnosed sleep disorder, there is a relationship between
sleep and cardiac function, endothelial cell function, and coagulation.
•• Sleep disorders are associated with increased risk for serious cardiovas-
cular problems, including hypertension, atherosclerosis, stroke, and heart
failure.
pg. 67 7. Sex Hormones

•• Given the complex and incredibly important role of the sex hormones, it is
not surprising that their rhythms may be altered by inadequate sleep.
•• There is some evidence of an association between estrogen, sleep, and the

onset of certain cancers.
•• Follicle stimulating hormone patterns may change in post-menopausal

women.
Part:
Sleep and health
•• Testosterone levels are altered by sleep deprivation in both men and

women.
•• Pregnenalone is a hormone precursor that can act on the GABA receptor,

is related to improved sleep, but its relationship to the hormones proges-
terone and cortisol make it an easy target for dysregulation.
pg. 70 8. Cognitive Function

•• Reduced sleep duration is related to a partial shutdown of the prefrontal
cortex, which makes attentiveness quite the challenge for most people.
•• Sleep deprivation makes people more impulsive, and getting enough sleep
optimizes decision-making.
•• Cravings, especially for calorie-dense foods, are increased after sleep

deprivation, and these have been demonstrated to alter behavior.
•• Working memory is disrupted in people who don’t get enough sleep. This
phenomenon has been best-studied in school-age children; those who got
enough sleep tended to do better on tests and have better behavior than
their sleep-deprived peers.
•• Conversely, doing exercises that improve working memory may improve

sleep quality.
•• Not getting enough sleep is related to memory consolidation and long-

term memory.
pg. 73 9. Mental Health

•• Something about sleep disturbance alters brain chemistry such that we
are more susceptible to mood disorders; research points to people with
obstructive sleep apnea being much more likely to develop depression
within one year of being diagnosed.
•• Researchers are examining whether there is a relationship between sleep

and other psychological conditions like borderline personality disorder
and psychotic episodes.
Part:
Sleep and health
Part TWO
Sleep & Health
Research is exploding with new reports linking inadequate sleep with disease.
There are many obvious effects to not sleeping enough, even after one night.
You might be familiar with some of the symptoms of inadequate sleep: being
forgetful, inability to concentrate or calculate, mood swings, irritability, feeling
drowsy, yawning, feeling less motivated, sugar cravings, and a fantastical will-
ingness to switch from drinking coffee to a straight caffeine IV!
Of course, you don’t feel good when you don’t get enough sleep. But the impact
that sleep deprivation has on our behavior is just the tip of the iceberg. Inad-
equate sleep is also linked to an impaired immune system, increased risk of
diabetes, increased risk of cardiovascular disease, increased risk of obesity, and
a growing list of other chronic illnesses. And while the world debates about the
The Effects of Sleep Deprivation
Part:
Sleep and health
perfect carbohydrate to fat ratio of our diet and whether or not saturated fats
are evil, how little sleep we get as a society in relation to how much we need is
the elephant in the room!
The body of scientific literature linking inadequate sleep, more technically

called “short sleep”, with disease is vast, so vast that there’s now huge me-
ta-analyses combining data from multiple studies to establish a statistically
powerful link. There’s also a very broad collection of mechanistic studies ex-
ploring the cellular and molecular details of exactly why we need sleep and all
the bad things that happen in our bodies when we don’t get enough of it. The
benefit for us is that quantifying the role that sleep plays in disease is pretty
easy: I can tell you exactly how much your risk for diabetes, obesity, cardiovas-
cular disease, cancer and autoimmune disease goes up if you don’t get enough
sleep.
More than a third of U.S. Adults don’t

get Enough Sleep
MORE THAN A THIRD OF U.S. ADULTS DON’T GET ENOUGH SLEEP
Percent of adult by self-reported sleep duration
0% 20% 40% 50% 80% 100% 120%
Less than 5 hours 11.8%

6 hours 23%
7 hours Adults should get 7 or more hours of sleep 29.5

8 hours 40 27.7%
9 hours 5 4.4%
More than 10 hours 0 3.6%
Source:CDC
Source:CDC
Part:
Sleep and health
This is also the body of scientific literature that the American Academy of
Sleep Medicine and the Sleep Research Society used to establish their guidelines
and the consensus statement, published in 2015:
“Adults should sleep 7 or more hours per night on a regular basis to

promote optimal health. Sleeping less than 7 hours per night on a reg-
ular basis is associated with adverse health outcomes, including weight
gain and obesity, diabetes, hypertension, heart disease and stroke, de-
pression, and increased risk of death. Sleeping less than 7 hours per
night is also associated with impaired immune function, increased pain,
impaired performance, increased errors, and greater risk of accidents.”
So, the recommendation that we get a minimum of 7 hours of sleep is no joke.
And it should be a hard and fast rule for anyone who prioritizes their health
(especially those of us who are health overachievers, as many in the Paleo com-
munity are!).
Confession: I may have spent just a tad too much time geeking over the cool
science that connects sleep and your health. So, some of the following sections
might be a bit dry at times. I think everyone should devour every inch of this
book with gusto, but I understand if you’re having trouble with your sleep and
don’t want to miss another night of rest; if that’s the case, I give you formal
permission to skim this section and head to Part 3, where we start to talk about
the more practical tips.
In the meantime, the following is perhaps one of the most comprehensive

summaries of the relationship between sleep and all aspects of your health and
wellbeing that you can find anywhere... So enjoy!
Sleep and Disease Risk

One of the scientific strategies for quantifying how a factor impacts health is
to look at something called all-cause mortality. Large cohorts of people are
followed for years (sometimes decades) and every death, including cause, is
recorded. Then scientists can compare how many people died in each category
of the factor being evaluated. In the instance of sleep, these studies tend to de-
fine short sleep as less than 6 hours per night, normal sleep as 6 to 9 hours per
Part:
Sleep and health
night, and long sleep as over 9 hours per night. Some

studies look at narrower ranges, for example <5
hours, 6 hours, 7 hours, 8 hours, 9 hours, >10 hours.
Comparing the number of deaths in each category
gives us an indication of how sleep affects health.
Yes, the number of deaths include deaths as a result
of acute illness, chronic disease, old age, and acciden-
tal death. However, when you look at this number
as a whole, it’s a very good way to measure overall
health and longevity regardless of the type of dis-
ease or natural cause. More sophisticated statistics
can account for other known health inputs such as
smoking, being overweight, and activity level to
hone in on the effect of sleep independent of other
risk factors.
A 2010 meta-analysis pooled data from 27 different cohorts and found that
sleeping less than 6 hours per night increased risk of all-cause mortality by
12%. To compare, being obese increases risk of all-cause mortality by 18%.
Smoking about doubles the risk of all-cause mortality. For every hour of phys-
ical activity that replaces sedentary time, risk of all-cause mortality drops by
16%. And, for every daily serving of vegetables (up to 5 servings), risk of all-
cause mortality drops by 5%. So, using all-cause mortality as an indicator, the
health impact of getting less than 6 hours of sleep per night is in the same ball-
park as being obese, being sedentary, and not eating enough vegetables.
But here’s where things get interesting.
Getting less than 6 hours of sleep per night also increases the chances of
being obese, being inactive, and not eating many vegetables.
So, not only is not getting enough sleep an independent risk factor for disease,
but the probability of having additional risk factors goes up! In the Paleo com-
munity, we are focused on the healthiest diet choices, activity, and maintaining
a healthy weight. We need to add consistently getting 7-8 hours of sleep to this
list of Paleo priorities. And guess what? Not only will that make us healthier,
but being well rested makes making healthy food choices easier, increases our
Part:
Sleep and health
motivation to move, and di-

rectly affects hunger and me- Trends in overweight, obesity, & extreme obesity:
Adults aged 20-74 years United States, 1960-2008
tabolism, major contributors to
40
body weight.
Overweight
30
Sleeping less than 6 hours per
night increases risk of obe-
25
sity by 55% in adults (90% in Obese
children!). But, when it comes 10
to obesity, researchers have Extremely Obese

0
teased out some other fascinat- 1960-1962 1971-1974 1976-1980 1988-1994 1996-2000 2007-2008
2003-2004
YEARS
ing links between how we sleep
and obesity risk. Variability in
bedtime during the week >2 hours increases risk of obesity by 14%. That means
that if you normally go to bed at 10pm on weeknights and stay up until mid-
night Saturday for a party, your risk of obesity is higher. This is such a normal
pattern for students and working adults alike! Sleep duration variability in-
creases risk of obesity by 63% for each hour of standard deviation. That means
that if some nights you get 6 hours and other nights you try to make up for it
and sleep 9 hours, that inconsistency is dramatically increasing risk of obesity!
It’s also important to sync our sleep time with the sun: following the night owl
patterns of late-to-bed, late-to-rise doubles risk of obesity compared to early-
to-bed, early-to-rise, even in people
Number & Percentage of U.S. Population who get enough sleep!
with Diagnosed Diabetes
8
20
18
Sleeping less than 6 hours per night
7
Number with Diabetes

16 increases risk of type 2 diabetes by
6
Percent with Diabetes 14
12
50%. But, if you pool diabetes and
impaired glucose tolerance togeth-
5
10
4
3
8
er, that risk soars to a whopping
240%!
6
2
4
1 2
0 The link between sleep and insulin

0
1958 62 66 70 74 78 82 86 90 94 98 02 2006
YEAR sensitivity is very strong. In fact,
there are studies where participants
are only allowed 4-5 hours of sleep per night and develop glucose intolerance
within a few days! What might be even more fascinating is that there’s emerg-
ing evidence that the impact of sleep on insulin sensitivity and glucose metabo-
Part:
Sleep and health
lism is even greater than diet. Research

Rise of Cardiovascular disease presented at last fall’s Obesity Society
RISE OF CARDIOVASCULAR DISEASE
7 Annual Meeting shows that a single
6 night of lost sleep was worse than six
5 months of a high-fat Western diet in
4 terms of insulin sensitivity and glucose
3 metabolism!
2
Research into risk factors for auto-
1
immune disease is still in its infancy.
0
1950 1975 1980 1985 1990 1995 2000 2007 There have yet to be any large popu-
YEARS
lation studies looking at average sleep
duration and autoimmune disease
incidence. However, having a non-apnea related sleep disorder (the most com-
mon of which is insomnia, which can be as mild as having a night or two a week
where either you can’t fall asleep or you wake up in the middle of the night
and can’t get back to sleep) increases risk of autoimmune disease on average
by 50%! Some autoimmune disease incidences are more sensitive to non-apnea
sleep disorders that others. For example, the risk of systemic lupus erythema-
tosus goes up 81%, rheumatoid arthritis risk goes up 45%, ankylosing spondy-
litis risk goes up 53%, and Sjögren’s syndrome risk goes up 51%. It’s even worse
if you suffer from obstructive sleep apnea, a condition that tends to go along
with obesity and diabetes,
which more than dou-
bles risk of autoimmune Number of people dagnosed with
disease. Shift workers,
cancer in the US 1975-2006
known for having erratic 1,500,000
sleep schedules and rou- 1,400,000
tinely getting inadequate 1,300,000
sleep, have a 50% high-

1,200,000
er risk of autoimmune
1,100,000
disease. It’s also known
1,000,000
that short sleep increases
900,000
symptoms of many auto-
immune diseases. 800,000
YEAR
Part:
Sleep and health
Routinely sleeping less than 6 hours per night compared to getting between 6
and 8 hours every night doubles risk of stroke, doubles risk of myocardial in-
farction, increases risk of congestive heart failure by 67%, and increases risk of
coronary heart disease by 48%. Those are huge numbers! And it’s worth adding
here that we are so quick to blame diet factors for the dramatic increase in car-
diovascular disease seen over the last 50 years. In the 70s and 80s, saturated fat
and cholesterol were to blame. Now, it’s high fructose corn syrup, PUFAs, and
processed food chemicals. I certainly believe that diet is a factor here, but when
you look at the body of literature explaining how inadequate sleep raises LDL
cholesterol, raises blood pressure, increases heart rate variability and causes
inflammation, I think there may be a bigger fish to fry (in non-hydrogenated oil,
of course!).
When it comes to cancer risk, finally, there’s some less than morbidly bleak
news. In the studies that have looked at prostate, breast and lung cancer, there
was no increased risk with short sleep even comparing people who get under 5
hours of sleep per night to those who get 7-8 hours. The exception is studies of
colorectal adenoma, in which the risk increases by 50% with less than 5 hours
of sleep. However, how much sleep you get
upon and after breast cancer diagnosis is a
predictor of survival, and getting less than
6 hours of sleep increases risk of death by
46%.
Is sleeping too much a problem?

The coin does have a flip side. There’s a
collection of studies showing increased
disease risk in long sleepers. A large me-
ta-analysis looking at all-cause mortality
showed 25% higher risk for those sleeping
more than 9 hours per night (compared to 7-8 hours) and a 54% higher risk for
those sleeping more than 10 hours. However, there’s a chicken versus egg dis-
cussion to engage in here. Are people sleeping more because they’re sick or are
they sick because they’re sleeping more? A recent study evaluated the effect
of sleep on survival rate in groups with different levels of physical activity and
found that long sleep, more than 9 hours, only increased all-cause mortality in
physically inactive people.
Part:
Sleep and health
And when the American Academy of Sleep Medicine and the Sleep Research
Society reviewed the scientific literature on this topic, they came up with the
following for their consensus statement:
“Sleeping more than 9 hours per night on a regular basis may be

appropriate for young adults, individuals recovering from sleep debt,
and individuals with illnesses. For others, it is uncertain whether sleeping
more than 9 hours per night is associated with health risk.”
As you can see, the consequences of inadequate sleep is far more dire than sim-
ply walking around feeling like a zombie the next day. Sleep isn’t just import-
ant, it’s critical for health! And, there’s no substitute. This isn’t like outdoors
time where we can take a vitamin D3 supplement and use a light therapy box
for circadian rhythm entrenchment and suffer no ill effects from a life spent
indoors. Coffee, energy drinks and supplements just mask the fatigue, give
the illusion that everything’s fine, and then erode sleep quality the next night.
They are crutches that don’t provide our bodies with any tangible support other
than to allow us to continue to ignore our body’s signals and abuse our bodies
through neglect.
Inflammation
Inflammation is a hot topic in the scientific
community today. This buzzword has been IS inflammation stealing
your sunshine?
linked with several medical conditions that
are of major concern for the modern West-
ern world (gastrointestinal diseases, auto-
immune diseases, heart diseases–and more!).
And if you read my blog, you’ve probably
learned about these links before. But did
you know that we’re now starting to believe
that inflammation is also the explanation
for depression and other mental health con-
cerns? Seriously! So, understanding inflammation is an absolute key to master-
ing your health.
Part:
Sleep and health
“Inflammation” is a general term used by the medical community to describe a

response from the immune system. The immune system is an incredibly com-
plex, fine-tuned machine that allows our body to respond to an overwhelming
diversity of microbes to fight off infections.
So, in typical, non-disease states, inflam-

the Immune system is your
Biological Defense weapon mation is actually a good thing! Let’s take
a small cut on your hand as an example.
Though you may bleed to begin with, your
body develops a natural clot in a timely
fashion (if you don’t have any clotting disor-
ders, of course). You will also probably notice
some swelling and pain; these inconvenient
side effects are actually your body mounting
an immune response to any potential patho-
gens (invaders like bacteria and viruses) by directing blood flow to the area of
the injury so that the soldiers of the immune system can respond and fight any
infections. This is all part of the normal inflammatory reaction. What gets us
into trouble is when your inflammation is non-specific, because your immune
system is turned “on,” ready to fight intruders all the time. That’s the bad kind.
This is what we call “systemic inflammation” and generally what we refer to
when we discuss someone having elevated inflammation. And, as I mentioned
above, having uncontrolled systemic inflammation is really bad for your health.
I’m sure you’re wondering, “what does this have to do with sleep?”
Believe it or or not, just plain old “not getting enough sleep” (a common prac-
tice for so many of us!) causes inflammation. Scientists have measured this in
a few ways. A variety of studies evaluating the effects of acute sleep depriva-
tion (typically by restricting sleep to 4 hours per night) for several consecutive
nights (on average, 3 to 5 days) have shown increases in markers of inflamma-
tion and the numbers of white blood cells in the blood. Specifically, even just
three consecutive nights of inadequate sleep can cause increased monocytes,
neutrophils and B-cells in the blood, increased proinflammatory cytokines (this
includes cytokines known to stimulate maturation of native T-cells into Th1,
Th2, and Th17 cells; all of these activated immune cells means that our bodies
would be ready to mount an attack against infections that don’t exist–that’s
bad!), increased C-reactive protein (our general marker of inflammation), in-
Part:
Sleep and health
creased total cholesterol, and increased low density lipoprotein cholesterol

(LDL; the “bad” kind of cholesterol that is linked with worsened heart dis-
ease-related outcomes). These are the kinds of results that we just can’t ignore.
We can see similar effects of this even from a common practice amongst young
people: “pulling an all-nighter.” Even just one night of lost sleep (measured as
going at least 40 hours without sleep) causes inflammation in young, healthy
people. Pulling a single all-nighter dramatically increases markers of inflam-
mation in the blood, including C-reactive protein and pro-inflammatory cyto-
kines. Studies that evaluated not just sleep deprivation but also recovery after
sleep restriction (with the idea of simulating a typical workweek, where some-
one might get less sleep for 4 or 5 nights straight and then try to make up for it
on the weekend) have also shown that the proinflammatory cytokine known to
stimulate Th17 cell development persists for at least two days after increasing
sleep to 8 hours per night, even though other markers of inflammation have
recovered. This means that even if you try and “catch up” on your sleep during
the weekend, the stimulation to the immune system keeps going–unfortunate-
ly, your sleep debt recovery just isn’t a 1:1 ratio: you have to sleep more to make
up for it. If you follow this stereotypical pattern of not getting enough sleep
during the week and sleeping in on the weekend, the consequences are pretty
clear: you still run the risk of cumulatively causing detrimental changes in the
immune system. Certainly, you can recover from lack of sleep, but it takes per-
sistence, consistency, and commitment (even, or perhaps especially, during the
week!).
Sleep deprivation is also associated with increased susceptibility to infection.

In fact, the less sleep you get, the more likely
you are to catch the common cold. Our immune
Is sleep system varies with our circadian rhythm, along
deprivation with antibody formation (the way our bodies
know to respond to super-specific invaders,
making like chickenpox), which takes place during
you sick? sleep. So, someone who is not getting enough
sleep is also not adequately forming antibod-
ies. As a result, simply getting adequate sleep
can protect you from infection. One study
even showed that the longer the sleep dura-
Part:
Sleep and health
tion, the lower the incidence of parasitic infections

in mammals. Increased inflammation from a lack of Chronic
adequate sleep goes hand-in-hand with an increased inflammation is
risk of heart disease and hypertension. Studies have not your friend
shown that as sleep quality declines, the chances
of coronary artery calcification increase. Because
inadequate sleep also results in increased stress,
decreased ability to cope with stress, and elevated
blood pressure, sleep becomes an important factor
in reducing your risk of developing heart disease or
dying from a heart condition (especially if you have
a family history of heart disease).
The relationship between sleep and inflammation

isn’t just applicable to short sleep duration or sleep deprivation; it’s also highly
linked to interrupted sleep (also called sleep fragmentation and applies to low
sleep quality, etc.).
Studies in mice have shown that just one day of fragmented sleep led to a sig-
nificant increase in stress hormones and several inflammatory markers’ (like
cytokines) genetic expression in critical areas of the body for health: fat tissue,
the heart, and the hypothalamus. These are all especially related to hormones,
which we know are critical for sleep AND for overall health! Indeed, the results
seems to be very clear when it comes to this topic; even when looking at gener-
al sleep quality, participants have been seen to have elevated c-reactive protein
(the most widely-used marker of systemic inflammation).
There are two consequences of the inflammatory response seen in worsened

sleep patterns: when our immune system is overactive, we are more likely
to develop inflammatory diseases or flares of autoimmune diseases; and on
the flipside of that, our immune system may not be able to respond to disease
properly (and yes, that’s as much of a problem as it sounds like!). Interestingly,
it looks like our specific reaction is age-dependent: younger adults (18-39 years
old) are more likely to have an inflammatory condition like irritable bowel
disease develop, whereas older adults (60+ years old), whose immune systems
tend to be less responsive in general, have weakened capacity to respond to
infection. Not to mention, elevated inflammatory markers are associated with
a host of health concerns, including cardiovascular disease and cancer. In fact,
Part:
Sleep and health
this elevated inflammation has been described in the literature as a major ex-
planation for the link between short sleep patterns and mortality!
Autoimmune Disease
Since we now know that there’s an absolutely key relationship between sleep
and the health of your immune system, it’s probably not surprising that au-
toimmune disease is related to sleep as well. In fact, inadequate sleep has also
been investigated as a possible cause of autoimmune disease, and having a
non-apneic sleep disorder has been specifically linked to the development of
any autoimmune disease. Seriously.
For those of you who don’t suffer from an autoimmune disease, let me give
you a brief run-down of the basics. Our immune system is an incredibly com-
plex machine (as I described a bit above) that is designed to recognize cells and
particles that are “self” versus those that are foreign. Every cell in your body
has a surface protein called “major histocompatibility complex (MHC Class I)”.
Your immune system cells circulate and check for this complex and are not
supposed to mount an allergic response against them. In autoimmune disease,
this system fails, and it’s kind of like our body becomes allergic to itself or to
something that it shouldn’t.
This is what happens in rheu-
The Immune system matoid arthritis, celiac dis-
ease, Hashimoto’s thyroiditis,
and many other autoimmune
diseases that are still being
explained in the scientific
literature. In the case of auto-
immune disease, we know a
lot of the “hows” but not a lot
of the “whys.” But what we do
know, in a broad sense, is that
inflammation is almost defi-
nitely an underlying cause.
And sleep is most definitely
related to inflammation.
Part:
Sleep and health
Sleep deprivation seems to be related to worsened symptoms of autoimmune

diseases in both human and mouse models. Sleep deprivation and sleep dis-
orders have been specifically linked to the onset and worsening of rheumatic
autoimmune disorders (diseases like lupus, rheumatoid arthritis, and fibromy-
lagia, but there are more than 100 classified rheumatic diseases). In an animal
model of psoriasis, sleep deprivation caused significant increases in proinflam-
matory cytokines, cortisol levels, and increases in specific proteins in the skin
associated with symptoms of psoriasis (like the flaking, dry, scaly skin). In an
animal model of multiple sclerosis, mice subjected to sleep deprivation devel-
oped the disease earlier than mice that slept normally. Once the mice devel-
oped multiple sclerosis, sleep deprivation caused increased disease activity and
pain sensitivity. Furthermore, sleep disturbances are commonly reported by
people with chronic inflammatory conditions (like rheumatoid arthritis, sys-
temic lupus erythematosus, inflammatory bowel disease, and asthma). A com-
plicating factor is that many autoimmune diseases involve chronic fatigue and
pain, which can disturb and otherwise influence sleep patterns. So, whether the
sleep disturbances cause the disease or the disease causes the sleep disturbanc-
es is not well understood, and we see this difficulty in both human and animal
models. However, such sleep disturbances are known to worsen the course of
the disease, aggravate disease symptoms, (including pain and fatigue), increase
disease activity, and lower quality of life.
Getting enough sleep isn’t just about preventing or improving inflammation;

it’s also about repairing the body and modulating the immune system.
Certainly, the process of tissue repair in the body is predominantly performed
during sleep. However, an important study showed that regulatory T-cell ac-
tivities (which are absolutely essential for responding to infection and for prop-
er immune system function!) follow a circadian rhythm, meaning that, just like
many functions within the human body, they increase and decrease throughout
the day. In healthy people, regulatory T-cells are highest in the blood at night
with lowest numbers in the morning (similar to melatonin production and the
opposite of cortisol). The activity of the regulatory T-cells also follows a circa-
dian rhythm, having the highest suppressive activity during sleep and lowest in
the morning. When volunteers were subjected to sleep deprivation, the sup-
pressive activity of their regulatory T-cells was decreased (even though the ac-
tual numbers of T-cells remained the same). This implies that sleep is required
Part:
Sleep and health
for the suppressive activity of regulatory T-cells, meaning that if you want to
modulate your immune system and reverse your autoimmune disease, sleep is
critical. This idea also helps to drive home just how much sleep can help people
without autoimmune disease prevent their immune system from going awry.
If you have an autoimmune disease and aren’t getting eight hours of good sleep
every night, I cannot emphasize enough the importance of putting sleep on the
top of your priority list. You need sleep. Now. Tonight. Every night. Seriously,
stop reading and go to bed. Strategies for prioritizing sleep and what to do if
you are trying to get more sleep but are having trouble are discussed later in
this book.
Weight Gain & Obesity

Research has shown time and again that there is a
direct relationship between sleep duration (how long
you sleep at night) and weight problems over time.
Short sleep duration is specifically implicated in the
development of obesity, though getting both too
little and too much sleep is related to weight gain.
There are many hypotheses seeking to explain these
findings, but there are two main topics that are best
Is sleep
described in the literature: hunger hormones and the
deprivation
dopamine-food addiction relationship. making
you fat?
Hormones
Medical research also shows that there’s a stronger connection between obesi-
ty and lack of sleep than any diet factor. One mechanism by which inadequate
sleep increases your risk of weight gain and obesity is its profound effects on
hunger hormones and metabolism. We know that hormones are tiny molecules
that play an incredibly huge role in our overall health and happiness. Hor-
mones are the way that different organ systems communicate with each other;
one hormone may be released by a central organ, like the liver, and circulate
the blood to act on receptors at the cell surface of the skin and then give more
feedback to the brain! So, small changes in amount of hormones in circulation
Part:
Sleep and health
can have a huge overall ef-

fect. Hormones are also hard
to monitor, as they fluctuate
by the hour, day, month, and
season! I think it’s really im-
portant to understand how we
can get more in tune with our
hormone health because of
the magnitude of their impor-
tance. Sleep is absolutely crit-
ical for keeping our hormones
in balance. Through changes in
hormone signaling (both our
sensitivity and the amounts
that we produce) throughout
the body, not getting enough sleep alters food preferences (towards more ener-
gy-dense, highly palatable foods), increases hunger, decreases fat metabolism,
and increases the stress response, which affects basal metabolic rate.
Inadequate sleep has profound effects on hunger hormones and metabolism

(and a fun fact: hunger hormones such as insulin, leptin, ghrelin, and cortisol
are also important modulators of the immune system, so this also links back to
our discussion of inflammation!). For example, when food intake is measured
following sleep deprivation (5 consecutive days of 4 hours sleep), people tend
to eat substantially (20%!) more than normal. However, it doesn’t take five
full days of inadequate sleep to see dramatic effects on insulin, cortisol, and
leptin. These hormones, plus ghrelin, are said to control hunger and satiety and
should, in theory, all work together to balance your energy intake and expendi-
ture (this is a fancy way of saying, “how much you eat and how active you are”).
Before we examine how inadequate sleep negatively affects these hormones,
let’s explain what their roles are in the body.
Part:
Sleep and health
Insulin
The hormone insulin, which is released by the pancre- insulin
as in response to increased blood sugar, facilitates the
transport of glucose into the cells of your body and
signals to the liver to convert glucose into glycogen
for storage. When glycogen stores are maxed out, in-
creased insulin levels stimulate conversion of glucose
into triglycerides (fat) for long- term storage in adi-
pocytes (fat cells). But beyond this important action
for the metabolism of fuels, insulin has an additional
role as an adiposity signal to the brain, i.e., it tells the brain whether or not you
should eat and informs the brain about the energy status of your body (basical-
ly, whether we have too much or too little fat on our bodies).
The major stimulant of insulin secretion is an increase of blood glucose levels,

as detected by the pancreas (blood glucose levels go up when you eat carbohy-
drates). Circulating insulin enters the brain (proportionally to the amount that
is circulating in the blood), where it binds to receptors in the hypothalamus re-
gion of the brain. Although the exact details are unknown, it is understood that
through this interaction with the central nervous system, insulin stimulates a
decrease in food intake. This makes some sense. You eat, your blood sugar level
rises, your body releases insulin to store all that glucose, and that increase in
insulin tells your brain that you’ve got enough energy, thank you very much.
Importantly, the degree of glucose-stimulated insulin secretion by the pancreas
is a direct function of body fat. The more body fat, the more insulin is secreted
both at a basal level and in response to feeding. There is actually a maximum
amount of insulin that can cross the blood-brain barrier to interact with the
brain to stimulate satiety. As the blood concentration of insulin increases be-
yond this level, no further signaling to the brain can occur.
Insulin resistance occurs when the same amount of insulin elicits less of a
response, so your pancreas has to release more and more of it to manage your
blood glucose.
Eventually, the cell receptors for insulin in the brain may stop being expressed
(meaning there are fewer of them on the cell surface), so our circulating insulin
doesn’t decrease appetite the way it’s supposed to.
Part:
Sleep and health
The relationship between sleep

and our hunger hormones is pretty
clearly delineated in the literature.
Believe it or not, even short-term
changes in sleep patterns can have a
huge impact on the balance of these
hormones. One study showed that
even a single night of partial sleep
(4 hours) causes insulin resistance
in healthy people. Another study
showed that a single night of partial
sleep (3 hours, in this case) caused re-
duced morning cortisol levels (when
cortisol should be its highest) and
elevated afternoon/ evening cortisol levels (when cortisol should be gradually
decreasing) as well as elevated morning leptin levels (more on why that’s im-
portant below). This means that one night of three or four hours of sleep causes
insulin resistance, dysregulated cortisol and increased leptin. Yikes!
Leptin
Fat storage cells, called adipocytes, produce the hormone leptin, which acts
as a negative feedback control for adiposity (fatness). “Negative feedback”
just means that increases in the amount of leptin lead to an inhibitory action
somewhere else. Leptin is secreted by adipocytes in di-
leptin
rect proportion to the amount of stored body fat, partic-
ularly with the amount of subcutaneous fat. Similar to
insulin, circulating leptin enters the brain through the
blood-brain-barrier, where it binds to receptors (there
are receptors for leptin in the hypothalamus but also
several other areas of the brain). Again, the exact details
are unknown, but it is understood that leptin’s interac-
tion with the brain stimulates a reduction in food intake
and increases energy expenditure. When you have a good
amount of fat stores, leptin is released and tells your brain
that you have enough energy so you don’t need to eat
Part:
Sleep and health
anymore and “hey, let’s get moving!” These changes are very subtle relative to
our cognitions. When you have high leptin levels, you aren’t just going to have
the sudden thought that you should head to the gym (though, wouldn’t that
be wonderful?). Instead, these hormones work very delicately on our drive to
exercise to either expend or conserve more energy slowly over time. As such,
leptin is responsible for changes over a long period of time that accumulate to
have a big impact on your body fat.
It was initially believed that leptin’s dominant role was to tell the brain to stop
eating. However, recent studies have shown that it mediates the adaptation to
fasting.
Fasting or consuming too few calories on a regular basis can lower sensitivity
to leptin, which leads to increased hunger, cravings and lack of energy.
This has a very important implication in weight maintenance after weight loss
since reduced leptin sensitivity is likely responsible for lowered metabolism
and increased hunger, a combination that tends to lead to weight gain (and
that’s why it’s so hard to keep weight off after going on a diet). There is also
a link between leptin and cortisol release, potentially explaining the cortisol
spike that many people experience in response to intermittent fasting. The
many roles of leptin in the human body are still being studied. It has also been
implicated in the regulation of the reproductive, thyroid, growth hormone, and
adrenal axes, independent of its role in energy balance.
And analogous to insulin resistance, the body can also become leptin resistant,
although this can happen from both obesity and overconsumption of ener-
gy and by fasting or consuming too few calories and losing weight! Uh, yeah.
Leptin is tricky. Also importantly for the bigger picture, insulin is a short-term
hormone (variations occur on an hourly basis), whereas leptin is a long-term
hormone (variations occur over weeks or months). As such, it’s a bit easier to
“fix” your insulin by helping your tissues become more sensitive, but both hor-
mones are related the amount of fat that you have on your body and both com-
municate directly with the brain about satiety. There are receptors in the brain
for both insulin and leptin in areas of the brain known to be important in the
control of food intake and energy balance. Studies which have injected insulin
or leptin show that this causes a reduction in food intake, whereas injection of
antibodies to block insulin and leptin causes an increase in food intake. Impor-
Part:
Sleep and health
tantly, recent studies have demonstrated that insulin and leptin have additive
effects when administered simultaneously.
Like I mentioned earlier, the literature most definitely supports the notion that
sleep impacts leptin. In mice, chronic short sleep duration is related to stress
of the hypothalamus that leads to leptin resistance. This result is of particular
importance to us, because “chronic short sleep duration” is essentially the stan-
dard American sleep schedule. And, it looks like this relationship starts at a re-
ally young age to predict long- term adiposity differences. A fascinating study
examined children over the course of their youth, measuring sleep and leptin
at a young age (3 years) and then again during late adolescence (16-19 years). A
one-unit decrease in sleep length and quality resulted in a significant decrease
in leptin over time, which was related to greater adiposity at the end of the
study. Interestingly, this result was more robust in girls than boys. This paper is
supported by other cross-sectional data (measured only at one time point) that
demonstrated the relationship between sleep duration, leptin, and weight in
children. Basically, the concept that kids need more sleep is way more than just
a myth!
The research is so strong that leptin has even been proposed as an indicator for
sleep disorders! Clearly, the amount and quality of sleep you get is highly relat-
ed to your leptin regulation. While this is important for all of us, I think espe-
cially about those people who have struggled with long-term weight loss and
other metabolic problems. Could the missing link be committing to permanent
changes in your sleep pattern?
Ghrelin
ghrelin
What about that other hunger hormone, ghrelin?
Have you ever heard the statement “it takes 20 min-
utes for your stomach to even know that it’s full”
before? That would be the layperson’s understand-
ing of ghrelin–and, like almost all examples of collo-
quialisms, this generalization isn’t quite right.
Unlike leptin and insulin, ghrelin is released by the

gastrointestinal tract to tell your body that you’re
Part:
Sleep and health
hungry. The mechanism of release is based on the physical status of your stom-
ach. When it’s empty, your stomach releases ghrelin, which talks to the brain
in the same way that the other satiety hormones do (in fact, ghrelin even uses
the same receptors as leptin). Once the stomach is full of food, it stops releas-
ing ghrelin, and we realize that we’re satiated. Optimizing ghrelin function (and
even using it therapeutically, like an intravenous drug) is actually linked to im-
proving both metabolism and inflammation! How cool is that? So, even though
you may not hear about this hormone as much in the media, its importance is
supercritical too.
Researchers are also looking at how ghrelin may be related to our sleep and
vice versa. However, there are more conflicting and unclear results here in
comparison to leptin and insulin, whose relationship with sleep has been pretty
exhaustively described. It seems that ghrelin promotes sleep, at least in men.
Importantly, ghrelin stimulates the production of growth hormone, which is
a wildly important hormone released during sleep that promotes many main-
tenance activities (like cell regeneration) in both adults and children. Since
growth hormone tends to be released during
non-REM sleep, ghrelin is linked with pro-
moting non-REM sleep and suppressing REM
19.4
sleep (we talked about this during Part 1). It has

been suggested that ghrelin is the connection
17.6 (57)
16.0
(158)
(59) between the hypothalamic- pituitary-adrenal
(167)
14.4
(76)
(147)
(HPA) axis, which is responsible for alertness
13.0
(54)
and stress responses, and the hypothalam-
6.0 6.5 7.0 7.5 8.0 8.5 9.0 ic-pituitary-somatotropic (HPS) system, which
AVERAGE NIGHTLY SLEEP (HRS)
is responsible for release of growth hormone.
30 Who knew that a hunger hormone could have
25 such an important role in sleep? And, chang-
20
(69)
es in sleep affect the amount of ghrelin that
15
(67) (172)
is released. One study found that ghrelin re-
lease during sleep was blunted after sleep
10
(115) (144)
(89)
5 (150)
deprivation (so we could expect that there’d be
0
(50)
4.5 5.0 5.5 5.0 6.5 7.0 7.5 8.0

less growth hormone released too!), but then
TOTAL SLEEP TIME (HRS) ghrelin release after sleep was actually in-
Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated
with reduced leptin, elevated gherlin, and increased body mass index.
PLos Med. 2004;1(3): e62
creased! This relationship helps us understand
Part:
Sleep and health
why we might have trouble controlling our eating behavior the day after not
sleeping enough–we are literally responding to a stronger hunger signal from
our bodies. And in fact, the research supports this concept: after even just one
night of restricted sleep, healthy people have elevated ghrelin throughout the
day and consume more calories.
The long-term consequences of sleep deprivation (even in “non-clinical” or

“normal” doses; say, 5-6 hours of sleep per night) on our hunger hormones is
very clear, and the relationships go hand-in-hand. Our hormones affect our
sleep, and our sleep affects our hormones, and our hormones affect our hor-
mones… Yeah, it’s complicated. The good news is that, because of our depth of
understanding, we can make some informed decisions to help us improve our
hormone health and our sleep.
Dopamine, Food, & Reward

The relationship between our hunger and satiety
hormones and sleep is clearly of significant con-
cern for all of us. But, there’s a whole lot more to
the link between sleep and obesity. The dopamine
link is perhaps even more impactful.
Dopamine is a neurotransmitter that plays important roles in motor control,

motivation, arousal, cognition, and reward, as well as a number of basic low-
er-level functions including lactation, sexual gratification, and nausea. The par-
ticular effect of dopamine signaling depends on the particular nerve pathway
that’s involved, but the most relevant effect of dopamine for our purposes is
responses to reward. In order to perform its functions, dopamine must bind to a
receptor, so its efficacy is only as good as both its levels and the levels of its re-
ceptors (you could say this about almost any chemical messenger relationship).
In addition, receptors can be more or less sensitive to dopamine, adding another
layer of complication to understanding how this system impacts our health.
Dopamine has been studied in many contexts because of its variety of func-
tions. A particularly important relationship is the one between dopamine and
food. When we eat highly palatable foods (those that are manufactured to be
high in fat, sugar, and salt), our bodies release neurotransmitters that make us
feel good (with dopamine being the main one).
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Sleep and health
Because of that signaling, we crave more of these foods; this can create a horri-
bly addictive process and compulsive eating. Certain foods quite literally have
the same effect on the brain as drugs. This simple relationship can get skewed
(and feel uncontrollable!) in a variety of other situations, including drug addic-
tion and anxiety disorders.
Certain characteristics can
make people more sus-
ceptible to these patterns
because of differences in
their dopamine pathways,
including obesity and eat-
ing disorders.
The concept of “food addic-

tion” is very controversial
in the world of obesity and
eating disorder researchers, so I’m going to avoid using that language too much
(though, I am pretty strongly in the camp of believing that it is a real phenom-
enon). What’s not controversial? The notion that different people have varia-
tions in their release of and responsiveness to dopamine as well as the amount
of receptors found on their brain cell surface, and these differences can impact
our mental and physical health over time.
We already know that differences in sleep patterns can impact our eating, but
did you know that it can actually change your brain chemistry as well?
The link between dopamine and sleep is also highly linked to obesity risk. Op-
portunistic eating behavior and body mass index (BMI) are both positively as-
sociated with something called dopamine D2-like receptor binding potential
(essentially, how readily D2 dopamine receptors bind to dopamine) in a partic-
ular part of the striatum (but they were negatively associated in the rest of the
striatum). This pattern suggests that obese people have alterations in dopamine
neurocircuitry that may increase their susceptibility to opportunistic over-
eating while making food intake less rewarding, less goal- directed, and more
habitual. This translates into the vicious cycle that a lot of people with binge
eating behaviors and weight problems (which are not necessarily seen in all
of the same people!) experience: a cycle of being completely able to resist eat-
ing certain foods and then not being able to stop eating them once they start.
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The reason for this is actually a dampened or

reduced reward response to foods. You would
think that food addiction-like behavior would
be a result of an exaggerated reward response
the to food, but actually, it’s the opposite! So, in
vicious
dopamine addition to a compulsion to eat, those of us with
cycle a history of obesity find eating to be less ful-
filling, and our brains register less enjoyment
from food. We eat because it’s a habit to eat….
and that also means that we’re compelled to
eat more in order to feel satisfied.
Well, it turns out that this altered dopamine receptor pattern in the brain may
also be caused by lack of sleep. A recent study measured the effects on dopa-
mine receptors in the striatum region of the brain in healthy volunteers de-
prived of sleep. The authors of this study were interested in discovering the
biological mechanism responsible for the decreased alertness we experience
after a night of lost sleep. So, they looked at both dopamine levels and the lev-
els of dopamine receptors. Sleep deprivation caused no change in the levels of
dopamine but a major decrease in dopamine receptors in the same part of the
striatum region of the brain (ventral striatum) where dopamine receptors are
decreased in those with obesity or binge eating disorder, the part that mediates
the reward response to food and motivation to eat.
What does this mean? From the perspective of simply understanding the ef-
fects of sleep on the brain, this means that sleep deprivation causes changes in
the brain that make it less able to use the dopamine that it produces; so, dopa-
mine can’t do all the things that dopamine does. And this likely explains the
reason for common sleep deprivation behaviors, like increases in risk-taking
behavior, impulsivity, and drug relapse (yes, addiction). The relevance to obesi-
ty is that these are the exact same changes in the brain seen in people who are
obese or who have binge-eating disorder. Maybe it’s not opportunistic overeat-
ing that gets us to food addiction, but chronically not getting sufficient sleep.
Or both.
Yes, those late night movies or study sessions are directly related to food addic-
tion and impulse-driven eating behavior. And the more chronically you suffer
from inadequate sleep, and the amount of sleep you’re short each night, direct-
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ly impacts your ability to achieve and maintain a healthy weight.
The Hypothalamic-Pituitary-
Adrenocortical (HPA) Axis
The HPA axis is known as the major neuroendocrine regulation system of the
stress response, so maintaining a healthy, well-regulated HPA axis is proba-
bly one of the great challenges of modern life. This axis is responsible for the
chronic stress that plagues millions of people everywhere. Chronic stress is
known to affect health in a variety of ways, including causing the development
of metabolic syndrome (the group of symptoms associated with heart disease,
stroke, and type 2 diabetes: high fasting blood sugar, waist circumference,
blood lipids, and blood pressure, combined with low HDL cholesterol [thought
to be protective]) and dysregulation of the hypothalamic-pituitary-adrenal
(HPA) axis along with sympathetic nervous system activation, sleep disturbanc-
es, systemic inflammation, impaired immunity functions, blood coagulation and
fibrinolysis, and poor health behaviors (chronic stress causes increased appe-
tite, cravings for energy-dense foods, and uninhibited eating behaviors). Un-
derstanding the link between the HPA axis, our perceived stress, and our sleep
quality is essential for optimizing health.
One of the reasons that we are not managing our stressful lives is that we are
just not equipped to physiological-
ly handle long-term stressors.
Historically, all stress was acute
(short-lived), and a stressful event
would include situations like being
chased by a lion or slipping off the
edge of a cliff. During these events,
the fight-or-flight response is
activated, and cortisol and adrena-
line work together to ensure sur-
vival. At the end of the event, you
are either dead (because you fell
from the cliff onto craggy rocks
Part:
Sleep and health
four hundred feet below) or alive and safe (because you grabbed onto a branch
as you slipped off the cliff and pulled yourself back up to safety). In either case,
there is no need for the body to continue producing adrenaline and excess
cortisol (more on this below). Levels return to normal (unless you’re dead, of
course), and you go on your merry way.
Chronic stress is that unrelenting stress that never goes away. It can be at a low
level, perhaps the stresses we all experience from having a job, raising kids,
and having to make ends meet. It can be moderate, perhaps from an impending
deadline or exam, your kids getting into trouble at school, or ripping your fa-
vorite shirt. It can also be high, such as in illness, divorce, or a death in the fam-
ily. What’s different about chronic stress is that it’s never over. There’s no big
relief at the end before you go on your merry way. It’s always there, leaving its
insidious effects building up over time. How quickly and severely the effects of
chronic stress are felt depends on the severity of the stress and your resilience
(more on that below too).
The HPA Axis
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The hypothalamic-pituitary-adrenocortical axis (the HPA axis) is responsible

for the flight-or-fight response, i.e., how the body responds to stress.
The HPA axis is made up of the complex communication between three organs:
•• The hypothal amus: The part of the brain located just above the
brainstem that is responsible for a variety of activities of the autonomic
nervous system, such as regulating body temperature, hunger, thirst,
fatigue, sleep, and circadian rhythms
•• The pituitary gl and: A pea-shaped gland located below the hy-
pothalamus that secretes a variety of important hormones, such as
thyroid-stimulating hormone, human growth hormone, and adrenocor-
ticotropic hormone
•• The adrenal gl ands: Small, conical organs on top of the kidneys
that secrete a variety of hormones, such as cortisol, epinephrine (also
known as adrenaline), norepinephrine, and androgens
As you might imagine, this system relies

upon a variety of hormones that need
to work together in the appropriate
concentrations and at the right time (it’s
all part of the greater symphony that
is the endocrine system). The hypothal-
amus (which receives signals from the
hippocampus, the region of the brain
that amalgamates information from all
the senses and can thus perceive danger
and make decisions) releases a hormone
called corticotropin releasing hormone
(CRH), which signals to the pituitary gland to release a hormone called adreno-
corticotropic hormone (ACTH), which signals to the adrenal glands to secrete
cortisol as well as catecholamines (like adrenalin).
Cortisol
Cortisol has a huge range of effects in the body, including controlling metabo-
lism, affecting insulin sensitivity, affecting the immune system, and even con-
trolling blood flow. If you’re running away from a lion, all these effects (includ-
Part:
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ing the combined effects of catecholamines and some direct effects of CRH)
combine to prioritize the most
essential functions for survival
daily cortisol pattern
(perception, decision making,
DAY NIGHT
energy for your muscles so you
can run away or fight for your
life, and preparation for wound
healing) and inhibit non-essen-
tial functions (like some aspects
of the immune system especially
not in the skin, digestion, kidney Cortisol
function, reproductive functions,

growth, collagen formation,
amino acid uptake by muscle, protein synthesis and bone formation).
Cortisol also provides a negative feedback to the pituitary and the hypothala-
mus. It’s the body’s way of saying “hey, we got the signal that we’re supposed to
be stressed now; thanks, we’re on it!” If the stressful event has ceased (the lion
gave up and left), this is what deactivates the HPA Axis. Of course, if a stressor
is still being perceived (that lion is still there), the HPA axis remains activated.
And this is why chronic stress (deadlines, traffic, sleep deprivation, teenagers,
divorce, being sick, being inflamed, alarm clocks, bills, and internet trolls) is
such a problem. All those essential functions suppressed by high cortisol never
get a chance to be prioritized.
Cortisol has profound effects on the immune system and is required for nor-
mal wound healing and for fighting infection. Studies have shown that acute
(short-duration and intense) stressors (like running away from a lion) induce a
redistribution of immune cells in the body, resulting in enhanced immune func-
tion in organs like the skin. White blood cells are released from bone marrow
and travel to the skin during acute stress, most likely in preparation for wound
healing. Other aspects of the immune system are activated in anticipation of
being needed. In this situation, cortisol enhances the immune system response.
However, what is beneficial in acute stress becomes quite the troublemaker

during chronic stress.
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There is a spectrum of responses by the immune system to a high-cortisol en-

vironment, probably reflecting different effects at different cortisol levels and
in the presence of other chemicals produced by the body and in the context of
different levels of sensitivity to cortisol. The waters are murky in terms of the
details, but what is universally accepted is that chronic stress causes immune
system dysfunction.
Cortisol alters the chemical messengers of inflammation (called cytokines)

secreted by cells in the immune system. This changes how the immune system
communicates with itself, turning on some aspects of the immune system (like
the parts of the immune system that attack foreign invaders or that produce
generalized inflammation), while turning off other aspects of the immune
system. There are a wealth of studies to show that high cortisol causes inflam-
mation.
The exact response of the immune system to chronic stress seems to depend on
other physiologic factors, such as hormones, cytokines, and neurotransmitters,
as well as the state of activation of the immune system (like if you’re already
fighting a cold virus, for example). Even genes may play a role in how the im-
mune system responds to chronic stress. The immune system is complex and
only just beginning to be understood, but the bottom line is that chronic stress
greatly diminishes its effectiveness.
Given cortisol’s wide range of importance, and of course its direct role in the
sleep- wake cycle, it’s unsurprising that sleep disturbances can alter cortisol
patterns, thereby affecting our health in multiple ways. Cortisol levels are
supposed to be the highest during the morning, immediately upon waking up;
the intent of this is to help us wake up! It should then fall throughout the day
rhythmically, with the last peak around 3pm. This decline allows for melatonin
to take over to promote sleep later in the evening. Our cortisol awakening re-
sponse, however, is one of the best measures of HPA axis function. Undersleep-
ing generates an exaggerated cortisol awakening response and lower overall
morning cortisol. Generally, the HPA axis goes on overdrive when we’ve under-
slept, so insomnia can have serious detriments to our cortisol regulation.
Over time, chronic stress and sleep deprivation can lead to the adrenal glands
shutting down (this is called adrenal fatigue), which can lead to worsened
sleep-wake cycles. Then, worsened sleep exaggerates the poor cortisol regula-
tion… and so on and so forth.
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Considering the value of cortisol, keeping the HPA axis healthy cannot be over-
stated!
Cardiovascular Disease
Some of the links between sleep and health are obvious based on the informa-
tion I’ve already presented in the introduction to the mechanics of sleep. I’m
sure it’s not surprising that impaired sleep or sleep debt is linked with autoim-
munity or with obesity, because the way our body operates during sleep helps
to support a healthy immune system and endocrine system. But, cardiovascular
health is not exempted from the effects of sleep deprivation and quality. Re-
search has shown that there is a direct link between cardiovascular disease and
sleep!
Cardiovascular disease is a huge concern in

the United States and beyond. Scarily, car-
diovascular problems are the largest killers
here–but, as a result, this fact leads to very
large, well-funded studies that allow us to
better understand the risks. According to
the American Heart Association, there are
four main categories of heart disease: valve
problems (issues with valves that control
the flow of blood to and from the heart),
arrhythmia (irregular heart beats), heart attack, and stroke. Risk factors for the
development of any of the above are varied: genetic, environmental, lifestyle,
and psychological factors have all been linked to these dangerous health prob-
lems. And, since lifestyle plays such a huge role, I think we need to do every-
thing we can to promote our best health. Sleep is probably one of those factors
that doesn’t get thought about a lot–staying up late to finish that assignment or
watch a movie after the kids go to bed feels like a method of coping with stress
or just plain getting by, but it could be detrimental to your health. Prioritizing
sleep can make a big difference. In fact, studies have shown that reallocating
sedentary time (like moments in front of the TV) to sleep or to high intensity
exercise has a significant impact on your cardiovascular disease risk!
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Sleep and health
Even without a diagnosed sleep disorder, there is a relationship between sleep

and cardiac function, endothelial cell function, and coagulation. The science
shows that there is a direct cause-and-effect, moderated by the amount of
sleep you get. Researchers hardly ever make these solid conclusions (we tend
to prefer non-committal phrases and papers, always doubting our work!), so
you can feel very comfortable with the quality of research that went into these
rules. Additionally, time spent sleeping has been linked with vascular events,
cardiac arrhythmias, and even sudden death. Remember: all of these associa-
tions are within folks who do not have sleep disorders. Sleep truly is critical for
everyone, even if you don’t think you have a problem with sleep. On the flip
side of that, getting enough sleep has actually been shown to reduce cardiovas-
cular disease risk! One study with a large sample size (almost 20,000 people),
showed that getting enough sleep, in combination with eating a healthy diet,
staying active, not drinking too much, and not smoking (things we all aim to
do... right?) reduced the risk of any cardiovascular event (like a heart attack, for
example) by 65% and a fatal cardiovascular event by 83%! These kind of results
are no joke, people.
Unsurprisingly, sleep disorders, especially chronic short-sleep duration, shift

work, and sleep-disordered breathing, are associated with a host of serious
chronic problems, including hypertension, atherosclerosis, stroke, and heart
failure. Insomnia has also been linked with cardiovascular disease, pointing to
Part:
Sleep and health
the importance of just plain ol’ getting enough Zzz’s. Researchers are still look-
ing into the mechanisms behind why such a strong link between sleep prob-
lems and cardiovascular disease exists, but the evidence certainly suggests that
this connection cannot be ignored!
Worried about what the right amount of sleep is? Well, as I mentioned before,
your sleep requirement can vary according to your sleep debt and other factors
like whether you have an autoimmune disease. However, the literature has
specifically pointed to getting 7 hours or more as a kind of “magic number” for
cardiovascular disease risk. One of the nice things about cardiovascular re-
search is that we can often get huge sample sizes, but it’s important to remem-
ber that the context of epidemiological research can be skewed toward statis-
tics instead of reality. So, 7 might be the magic sleep number for the population,
but preventing cardiovascular disease likely depends on you finding your magic
number.
Sex Hormones
It has also been shown that poor sleep (either not enough sleep or not enough
high- quality sleep) negatively affects sex hormones. Like the hormones linked
to obesity, the sex hormones work together delicately and require the appro-
priate balance and rhythm to properly control dozens of aspects of fertility
and menstruation, as well as things like thyroid function, bone formation, and
immune health (have I ever mentioned that the human body is, like, insanely
complicated?!). Compared with other topics that we discuss in this book, the re-
lationship between sleep and your sex hormones is less understood, and there
is much less extensive literature
on this topic. It’s difficult to dis-
cuss these complex relationships
without going into exhaustive
detail, but I think a brief over-
view of the sex hormones is really
important for understanding how
they fit into the bigger picture and
how altering them could affect
your overall health.
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Sleep and health
Estrogen is often thought of as the

THE HORMONAL SYSTEM stereotypical female hormone, but
it’s found in both men and women.
Its functions are incredibly vast and
depend somewhat upon a person’s
lifecycle stage. Early in life, estro-
gen helps with the development of
female reproductive parts and fe-
male secondary sex characteristics
(breast development, for example).
It also helps to promote proper lipid
(fat) storage, coagulation (blood
clotting), fluid balance, and gastro-
intestinal movement, among other
functions. As you probably know,
estrogen levels tend to fall with age and drop drastically in postmenopaus-
al women. And on the other hand, estrogen dominance (essentially, clinically
elevated levels) can be an extremely difficult challenge for a woman’s health.
Despite being a notoriously delicate hormone to balance, there’s no literature
examining a direct link between estrogen and sleep in women of childbearing
age. However, there is some mild evidence for a relationship between sleep and
estrogen receptor-mediated breast cancer incidence, which suggests to me that
sleep must mediate our cellular expression of estrogen receptors to some ex-
tent. In one study, supplementation with estradiol (one of the chemical names
for estrogen) improved sleep quality and insomnia in both premenopausal and
postmenopausal women with hot flashes (suggesting that they already had
some hormone dysregulation). Follicle stimulating hormone (FSH), another
hormone critical for menstruation and female reproductive health, has been
linked with sleep disturbances, specifically wakefulness after going to sleep,
as women transition to menopause. So, this small amount of information defi-
nitely alludes to sleep being important for keeping female hormones in balance
naturally.
On the flipside of this, we have testosterone, which is typically associated with

male reproductive health but is also released in small doses by the ovaries.
Testosterone is responsible for an equally complex series of functions, includ-
ing male reproductive organ development and beyond. In men, high levels of
Part:
Sleep and health
testosterone have been
associated with an increased
risk of heart attack, hyper- sex hormone production in
tension, and obesity, while men and women
low testosterone is associ-
ated with balding and poor Testosterone
100%
libido. In women, high tes-
tosterone is a classic symp- 80%
tom of Polycystic Ovarian

60%
Estrogen
Syndrome (PCOS), which
often results in infertility. 40%
Turning to sleep, it seems

Menopause
20%
that testosterone plays a
more direct role than estro- AGE
gen. Testosterone has been
linked to sleep onset and circadian rhythm (but not sleep duration or quality).
Sleep deprivation lowers testosterone, which can be a problem for men and
women, and research is showing that paying attention to the timing of sleep
actually plays more of a role in the recovery of testosterone levels than sleep
duration, which is important to keep in mind for restoring hormone balance.
There are other perhaps less well-known sex hormones that could be having
an equally important role in our sleep. Pregnenolone is a hormone precursor
that can act as a neurosteroid with (once again) many functions, but one of
these is to act on the GABA receptor. GABA is a neuropeptide known to re-
duce brain activity; it is even used as supplementation to help with sleep. So, by
acting on GABA receptors, pregnenolone can also improve sleep! And this has
been shown in the literature using EEG studies (they measure brain activity).
Finally, the hormone progesterone is another less-talked-about sex hormone
with huge importance. Progesterone is incredibly unique in that it can be a
precursor for sex hormones OR for stress hormones while it also has its own
neurosteroid functions. So, it’s pretty easy for this important hormone to get
out of whack, because it’s such an important player in so many physiological
functions. When the body is stressed (like from lack of sleep), it starts using up
progesterone to make cortisol. It needs more progesterone, so it starts using
more pregnenolone to make it. And before long, everything is out of balance.
And once sex hormones are out of balance, it can be a long and difficult road to
restore that balance again.
Part:
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Cognitive Function
So, we’ve gone through a pretty exhaustive description of what happens to
your physiology when you don’t sleep enough. But what about your mind?
I’m sure it’s no surprise that there’s a strong link between sleep and cognitive
function: in fact, there’s some evidence that it might be the first thing to go
when you don’t sleep enough! “Cognitive function” is the vague term used for
the acquisition of knowledge and its execution; it’s the thinking and remember-
ing as a result of our prefrontal cortex that sets us apart from other primates.
Interestingly, high cognitive load seems to work alongside sleep to influence
our behaviors: people with more cognitively-demanding jobs have altered sleep
homeostasis compared to those with less cognitive demand.
Researchers are showing that our sleep now affects our cognitive function in
later years, and inadequate sleep has been
linked with the onset of dementia. The
g n it i v e f u
field is booming, and the literature is dense, Co n
so I’ve chosen to focus on just three main &
c
ep
ti
aspects of cognition and how they relate to Sle
on
sleep.
Attention
I’m sure you know the feeling: you didn’t
get enough sleep the night before, and
you’re sitting in your morning meeting, and
you just. Can’t. Pay. Attention. No amount of coffee can make your boss’s voice
sound interesting today. And trust me, that phenomenon is not unique. In fact,
there is some serious science backing the notion that we can’t focus unless we
get enough sleep! There is more and more research being published about the
specifics of the sleep-inattention relationship. A paper just published in 2015
points to a really interesting phenomenon: it seems that inadequate sleep di-
minishes your ability to intentionally focus on voluntary things (like your boss,
or maybe your spouse) but instead enhances your focus on involuntary things
(so maybe you can’t stop thinking about the buzzing overhead light or seem
way too distracted by the car alarm that won’t turn off outside).
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Sleep and health
Differences in attention seem to

be related to both repeated wak-
ings (I’m looking at you, nursing
mothers) and to short sleep dura-
tion, and these differences, like
so much else I’ve discussed in this
book, happen after just one night
of disturbed sleep. Interestingly,
it seems that if we must use our
attention resources, it is serious-
ly detrimental to our ability to
control our behavior and mood.
Scientists are even going so far
as to try to quantify the specifics of this relationship. In a study that measured
sleep data using a FitBit-like device and a series of cognitive tasks, statistics
revealed that sleep explained a full 30% of the variance in attention (and in the
world of statistics, this is a ton). This may be explained by a partial shutdown
of the prefrontal cortex: the attentional network seems to exhibit less activity
with less sleep, so our brain is literally less active after we’ve had less sleep.
Additionally, the thalamus seems to go into overdrive, which may be further
contributing to our inability to focus: it’s kind of like the thalamus is saying, “we
need to sleep! We need to sleep! Let’s sleep!” and putting more of its energy into
getting you to bed (so I basically feel like a sleep-deprived thalamus as I write
this book. Do you want to go to bed yet?).
Decision Making
Here’s a section that won’t be be a shocker for anyone: sleep deprivation im-
pairs decision-making skills. No matter how hard a person wants to make the
right choice, sleep loss does something to the brain that simply prevents it
from effectively using feedback and information from the environment. Spe-
cifically, studies are showing that something about sleep deprivation makes it
difficult for the brain to decide between choices that are unexpected or respond
appropriately when situations are uncertain. This kind of work has really im-
Part:
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portant implications when it comes to emergency responders: hospital em-

ployees and the military service come to mind in particular, but this absolutely
applies to the many other shift workers and emergency responders who help
to make our country run efficiently while the rest of us sleep! We can think of
this as a short-term effect of sleep deprivation on decision-making, but there
is evidence that this applies in the long term as well. In patients with idiopathic
REM sleep disorder, decisio-making seems to be lacking in strategy and consis-
tency–a sign that some executive functioning mechanisms have been damaged
or altered (kind of scary, right?). Likewise, decision-making is impaired in pa-
tients with obstructive sleep apnea syndrome, and this impairment seems to
be modulated by the extent to which patients were hypoxic (without oxygen)
during their sleep. Conversely, studies in healthy people have shown that get-
ting enough sleep helps to optimize decision-making.
Another very cool study looked at the commonly-prescribed idea of “sleeping

on it.” Participants were given the Iowa Gambling Task, a very well-studied
cognitive task that allows us to quantify how well a person makes decisions,
for two trials. The sessions were either back-to-back or separated by sleep.
Participants randomized to the sleep condition were likely to make “better” de-
cisions based on their performance on the second trial; basically, their ability to
“sleep on it” allowed them to process and improve their decision-making skills
for this particular task, demonstrating that there may be something to that old
saying. It seems that these studies confirm that the parts of the brain that help
with decision-making depend on adequate sleep to function properly! So, while
staying up to finish some work might seem like a great idea (I know I’m guilty
of this too!), it can really affect your performance the next day and beyond.
Even worse, the combined effects of sleep deprivation on hunger and deci-
sion-making certainly creates the ‘perfect storm’ with regard to shopping and
food purchasing, leaving individuals hungrier and less capable of employing
self-control and higher-level decision-making processes to avoid making im-
pulsive, calorie-driven purchases (as I mentioned before, those highly palatable
foods become even more appealing, and we’re able to resist them even less.
What a disaster!). In fact, not only do people crave more calorie-dense foods af-
ter inadequate sleep, but studies show that people purchase approximately 20%
more food if they go grocery shopping while sleep deprived. So, clearly, sleep’s
Part:
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influence on decision-making extends way beyond the workplace and truly

plays a role in our whole life, whether we’d like to admit it or not!
Memory
Have you noticed that after a night (or two, or three) of poor-quality sleep, you
have trouble remembering things? Suddenly can’t recall your spouse’s phone
number, or you forget to pick up the kids from soccer practice. This symptom
of mild sleep deprivation is very real and very supported in the literature (and
at this point, you know what that means: a sub-section with sub-sections! Woot
woot!). As I mentioned in Part 1, one of the main purposes of sleep is to consol-
idate memories, so some forgetfulness is of course going to be a result of not
getting enough sleep! The examples I already brought up here are of long term
memory. But first, what about the short term (deemed “working” in the cogni-
tive psychology world) memories that you accumulate during the day?
Working Memory
Like many things in the cognitive psychology world, we’re still trying to fig-
ure out just how working memory, well, works. My best real-life example of
working memory is trying to remember a phone number or date or a phrase of
some kind. Like, “315768.” Chances are, unless you have totally awesome work-
ing memory, you might repeat “315768...315768… 315768” until you have a pad
of paper (or, maybe more realistically, you pulled out your phone). Because you
know that if you don’t repeat it over and over, you’ll forget the number. Your
ability to remember that number for a few minutes or however long is your
working memory. It completely varies between people, and researchers are
still trying to understand how it works and what makes it better in some peo-
ple versus others.
Working memory has been studied a lot in school children, because these cog-
nitive factors can make a huge difference in academic performance and seem
to vary a ton according to whether a child has a learning disability or other
challenge. Sleep time and quality seem to affect children’s cognitive resources
the next day and create more fluctuations in these resources (though I think
any parent could have told me that!), particularly when it comes to working
Part:
Sleep and health
memory. It looks like short sleep du-

ration can impact working memory
by changing the amount of receptors
expressed at the surface of the hippo-
campus–and yes, these cellular-level
changes can be seen in just a day.
And the relationship goes both ways.

It turns out that doing exercises to im-
prove working memory actually helps
your brain to more efficiently store
these memories away during sleep.
This change reflects what we under-
stand as the plasticity of the brain: its
ability to change, become more effi-
cient at certain tasks, etc. So, unsur-
prisingly, sleep is super important for working memory and thereby helps us
perform better in day-to-day tasks. But what about long term memories?
Long Term Memory

As I already noted, one of the new and exciting ways that we understand sleep
right now is that it serves to move what’s in our working memory into our
long term memory. The sleep state of the brain (both the differences in waves
produced and the physiological changes, as I discussed in Part 1) create an ide-
al environment for consolidating information. The process of consolidation
is absolutely incredible: it is essentially taking a complex neural pathway and
changing it so that it’s simpler and smaller. Or that is at least how we under-
stand it now. Interestingly, this sleeping time not only generates long- term
memories but also memory reorganization, making insightful decisions or new
connections more possible.
Did you know that there are two different types of long term memories?
Declarative memory is the kind that I’ve had to use constantly in my scientific
career: the long-term memorization of facts and numbers. It is also the type
Part:
Sleep and health
of memory that catalogs personal experiences. And, probably unsurprising-

ly, sleep is super important for storing declarative memories. The sleep stage
that is most critical for declarative memory is that slow-wave, deep sleep that
isn’t part of rapid eye movement sleep. It appears that the brain re-activates
the pathways that it had made during the day in order to consolidate them, so
the so-called “memory trace” gets reorganized in a way that makes it easier
for your brain to access it again. The current science is theorizing alterations
in slow-wave sleep can create long-term deficits in our ability to consolidate
declarative memories, with symptoms from certain disorders (including Alz-
heimer’s disease, fibromyalgia, and schizophrenia, exacerbating this problem
by increasing sleep disturbances (increased wakefulness, etc.). Researchers are
proposing that the thalamus, a gland that has critical roles in sleep and con-
sciousness, may be an important player here. The hippocampus, which I talked
about in Part 1, may also work to connect sleep and declarative memory.
Procedural memory is, essentially, our memory of how to do things. And like
the rest of memory, sleep is necessary for consolidating these memories too.
Procedural memories, like declarative memories, require “reactivation” in or-
der to access the neuronal synapses that are being used to store these memo-
ries have to be activated again. So, for the example of procedural memory, this
could be a kitchen skill that you acquired while adopting the real food lifestyle;
say, chopping sweet potatoes into thin fries. Every time you handle the knife
that way, it’s activating the same part of your brain that originally fired when
you learned the skill. And like declarative memories, we need to sleep in order
to consolidate these memories. Hey, maybe this is just one of the reasons that
elite athletes tend to need more sleep (even though they totally aren’t getting
it, and there’s even a scientific study showing this. Seriously.).
What about memory consolidation during REM sleep?

Isn’t that important too? Well… Yes. Scientists are still trying to figure out how
the slow-wave, nREM sleep and the fast-twitch, REM sleep work together to
process memories. New evidence is pointing toward REM sleep being specifi-
cally for the purpose of processing and consolidating emotional memories; it
looks like amygdala, which is our brain’s emotional center, might be the biggest
player during our REM sleep. And in a way, it makes sense: if this is the time
we dream, and dreams are often quite emotional, doesn’t it kind of follow that
Part:
Sleep and health
the amygdala would be doing something at this

REM SLEEP time? Interestingly, cortisol has been flagged as
responsible for communicating with the amyg-
dala to indicate when memories are particular-
ly important; so, this adds even more details to
the picture of how out-of-whack sleep patterns
can influence memories.
Responsible for processing and
Memory is complicated. Sleep is complicated.
consolidating memories
And they work together in a totally compli-
cated way. But, the message seems clear: sleep
is essential if you want to remember what you did (and, of course, read! wink
wink) today. If you aren’t getting enough sleep, you just plain won’t be consoli-
dating your memories. It’s a matter of off/on here, and it needs to happen in the
right amount, at the right time every single night. Now that should be easy to
remember!
Mental Health
I don’t think I would be doing this work justice if I didn’t at least mention the
importance of sleep for mental health. The reality is that, like so many of the
things we’ve already talked about, there is an overwhelming link between
getting adequate sleep and maintaining good mental health. Considering this
is hardly my area of expertise, I am not going to make many claims here, but
the reality is that sleep has a shockingly critical relationship with the onset
and maintenance of psychological
disorders that affect so many people
around the world.
And, as of now, the evidence points

toward reduced sleep duration and
quality being associated with in-
creased risk for any severe mental
health problem.
That poor sleep negatively impacts
your cognition probably doesn’t
Part:
Sleep and health
come as a surprise, as these things are commonly considered symptoms of

“being tired.” But did you know that sleep is also important for regulating your
mood? Whether you suffer from anxiety,
depression, Seasonal Affective Disorder
(SAD), or simply don’t cope well with stress, IS SLEE P
sleep plays a pivotal role in stabilizing your DEP RIVAT ION
mood. One mechanism by which sleep regu- MAKING YOU
SA D?
lates mood is the calming neurotransmitter
GABA, which, among other things, helps us
fall asleep. When our cortisol is high due
to stress or lack of sleep, GABA decreases,
resulting in anxiety, rumination (negative
thought patterns), and decreased ability to
cope with stress. Managing stress, improv-
ing sleep hygiene, and hormone-stabilizing
activities like exercise and meditation can
Seasonal Affective Disorder
help improve GABA levels. So can including
more sulfur- rich foods like broccoli, Brus-
sels sprouts, cabbage, and onions in your diet,
as sulfur is a component in the synthesis of GABA.
Affective Disorders
Affective disorders are the category of psychological conditions related to
mood. Some commonly known examples are major depressive disorder, anxi-
ety disorder, seasonal affective disorder, and bipolar disorder. As I mentioned
before, there is some research to support the idea that sleep is related to these
conditions. Something about sleep disturbance alters brain chemistry such that
we are more susceptible to mood disorders; research points to people with ob-
structive sleep apnea being much more likely to develop depression within one
year of being diagnosed. EEG data have also shown that patients with depres-
sion have reduced slow-wave activity during deep sleep; in fact, researchers are
even suggesting that EEG might be a diagnostic tool for depression in the fu-
ture. In adolescent youths, it’s been shown that the long-term sleep deprivation
(<6 hours of sleep a night, which is insanely common in middle and high school
Part:
Sleep and health
years) is a predictor for depression onset. We find

much of the same relationship in anxiety disorder,
and research indicates that improving sleep quality
(even without increasing the amount of sleep) im-
proves the mood-related symptoms. So, improving
sleep is even being suggested as a potential en-
hancement to our current standard of care for mood
disorders.
Psychotic Disorders
Psychotic disorders are the group of mental condi-
tions related to psychoses (hallucinations, paranoia,
and delusions). The best-known psychotic disorder
is schizophrenia. There is less research in this area, but some preliminary find-
ings suggest that impaired sleep may worsen the cognitive function of patients
as well as worsening their psychotic episodes. Particularly, insomnia seems to
be related to increased risk for hallucinations, and sleep dysfunction in general
is related to psychotic experiences overall.
Personality Disorders
You might be slightly shocked that researchers have closely examined the
relationship between sleep and personality disorders. And yet, there are pa-
pers doing just that. In general, having a personality disorder is associated with
worsened health outcomes.
Interestingly, personality in of itself is related to sleep quality: people with

more extraversion, agreeableness, and conscientiousness tend to sleep better,
whereas those with more neuroticism sleep worse.
Borderline personality disorder is probably the best-studied of the personality
disorders, and it is associated with problems in sleep continuity and REM cycles
(and more sleep disorders in general). It also looks like patients with borderline
personality disorder may have altered circadian rhythm due to a mutation in
their CLOCK gene family.
Part:
Sleep and health
Conclusions
So, we just covered a lot. I warned you! Hopefully, you were able to hone in on
some of the topics that most interested you or applied to your current health
concerns. The bottom line is that sleep impacts every single aspect of our
health, and the science overwhelmingly supports my recommendation that
every person should be prioritizing and improving their sleep. And now that
we’ve gotten through the science together, I think we can tackle that task so
that you can start sleeping better tonight.
Part:
Part THREE
Making Sleep a Priority

making sleep a priorit y
Chapter QUICK START

Part three: Making Sleep
A Priority
pg. 84 1. Entrenching Your Circadian Rhythm
•• Getting enough vitamin D is one essential way to communicate with the
part of the brain responsible for circadian rhythm. This can be accom-
plished by getting sunlight during the middle of the day, using a sun lamp,
or taking vitamin D3 supplements.
•• Wearing amber-tinted glasses to block out the blue light from our modern
technology helps to signal to the brain that it’s night time.
•• Making seasonal changes to your sleep duration and temperature is an

easy and naturally-oriented way to improve your sleep hygiene.
•• Relaxing before bed sends cognitive signals to the brain that it’s time to
sleep.
•• Socializing and social connection can be excitatory and confuse your circa-
dian rhythm clock, so keeping social events during the day may be anoth-
er way to solidify your sleep-wake rhythms.
pg. 90 2. When to Sleep

•• A natural early-to-bed, early-to-rise cycle may be related to better
health.
•• If a full night’s sleep is impossible or doesn’t happen one night, making

up for the time with a nap is actually an effective strategy for recovering
physiological and mental health issues.
pg. 92 3. Sleep Hygiene

•• White noise generators are a good way to mask outdoor sounds by pro-
viding your brain with radio static sounds that are easily tuned out.
Part:
•• Keeping indoor temperature at 65F or lower is one strategy for lowering

your body’s core temperature more easily, making it easier for you to ease
into deep sleep.
•• Sleeping on your left side is one way to promote lymphatic drainage of

the brain.
pg. 95 4. Routine
•• Research shows that having a regular bedtime and wake time with min-
imal day-to-day variation decreases health risk separately from getting
enough sleep.
Part:
Part three
Making Sleep A Priority
Okay, so sleep is important. You get it. I convinced you. Now there are two
things to do. First, restructure your life to make sleep a priority (that is less
daunting than it sounds, I promise). Second, make choices to help your body en-
joy the best sleep possible!
Getting plenty of sleep is critical for healing, for regulating hormones, for re-
solving (and preventing) inflammation, and for the normal functioning of the
immune system. Maintaining good sleep patterns (including getting enough
sleep every single night) is the key to preventing disease, and studies are even
showing that good sleep habits can improve someone’s course of treatment. As
important as sleep is, it is one of the easiest lifestyle factors to give short shrift
to as we attempt to accomplish everything else on our to-do lists. Some of us
have been depriving our bodies of adequate sleep for so long that we don’t even
know what “enough sleep” would feel like. It can also be intimidating to con-
template having less time in your day.
What do you give up to make more time for sleep?

The answer to this question is entirely up to you. You will need to assess your
own priorities and responsibilities to figure out what you can shift so that you
can go to bed earlier. You bought this book for a reason, right?
Entrenching Your Circadian

Rhythm
What can you do to set your circadian clock, protect your circadian rhythms,
and therefore regulate so many important hormones?
The light-dark cycle that I discussed in detail in Part 1 is the most important sig-
nal to your circadian clock, and the research suggests that alterations in your
Part:
exposure to light throughout the day can make a huge impact on your circadian
rhythm. This means that one of the best ways to set your circadian clock is be
exposed to bright light (ideally, sunlight) during the day but be in the dark at
night.
In fact, sunlight exposure during the day is probably the single most important
thing you can do to support the normal production of melatonin in the eve-
ning.
Vitamin D is a hormone that controls expression of more than 200 genes and
the proteins those genes regulate. It regulates absorption and transport of
calcium, phosphorous, and magnesium as well as modulates bone growth and
breakdown (we store minerals in our bones and need to break them down when
our body needs to access them). Vitamin D is also crucial for regulating sever-
al key components of your immune system, including formation of important
antioxidants. Very importantly, Vitamin D has recently been shown to decrease
inflammation and may be critical in controlling autoimmune and inflammatory
diseases. Vitamin D is also involved in the biosynthesis of neurotrophic factors,
regulating release of such important hormones as serotonin (required not only
for mental health but also for healthy digestion and, as we will discuss, mel-
atonin production). Vitamin D helps control cell growth, so it is essential for
healing. Vitamin D also activates areas of the brain responsible for biorhythms.
(And for those confused: yes, too much exposure to intense ultraviolet light can
cause DNA damage in your skin cells and increase your risk of skin cancer, but
as long as you aren’t getting sunburns, exposure to ultraviolet light is not only
safe - it’s essential for your health.)
Part:
So, you can see that this vitamin is com-

pletely critical for your health. But what
does it do for your sleep? It turns out that
vitamin D production from ultraviolet
light exposure is not the only important
aspect of sun exposure. Cells throughout
the body, including the skin and eyes, are
sensitive to blue light from the sun, which
is strongest in the morning. When special
cells in the retina of the eye are stimulated
by sunlight, they directly affect the pitu-
Vitamin D
itary gland and the hypothalamus regions
Natures Sleep Aid
of the brain. As I mentioned before, the
hypothalamus is responsible for circadian rhythm, the regulation of hormones,
and the nervous system.
Proper regulation of circadian rhythm is crucial for quality sleep, stress man-
agement, and the cyclic pattern of expression of so many hormones in the
body.
One important circadian rhythm hormone, produced by the brain’s pineal gland
and regulated by sunlight, is melatonin. In addition to being critical for quality
sleep, melatonin is a powerful antioxidant, is important for intestinal function,
and can help prevent depression. The hypothalamus and the pituitary gland
influence the adrenal glands, which control cortisol production. These import-
ant effects on brain activity, which increase alertness, improve cognition, and
boost mood and vitality, are all independent of Vitamin-D production. So, while
taking a Vitamin-D3 supplement is very helpful when the sun is scarce in the
winter months (or if you do shift work or face other challenges to getting out
into the sun), it can’t replace the huge range of health benefits of just plain old
getting outside.
How much time should you spend outside?

It depends on your personal body chemistry, how much skin is exposed, what
time of day it is, what time of year it is, clouds and air quality, and where you
live. Aim for as much as possible (taking care not to get a sunburn!), but at least
20 minutes most days is a good rule of thumb. And while you’re stuck inside?
Part:
Studies show that spending time by a bright window can be helpful.
So, what do you do if you’re a shift worker or live in a climate with limited
daytime or have other barriers to being outside when the sun is out?
A great biohack available for getting blue light exposure during the day is a
light therapy box. There doesn’t seem to be a difference between the white
light boxes and the blue light boxes in terms of supporting melatonin produc-
tion, so you can pick the least expensive option–but choose one that is bright,
at least 10,000 lux. Use it (placing it a foot or two away from your face in your
peripheral vision) for at least 15 minutes (30+ minutes is better) at roughly the
same time every morning or midday (and if you are a shift worker, use the light
box during whatever time of day is your morning or midday). Another option is
to make many small changes to brighten your environment during the day: us-
ing sunlight spectrum light bulbs in your house (but you’ll want to avoid using
these light bulbs in the evening), keeping curtains open during the day, making
sure your computer monitor and other screens are set to their brightest set-
ting, and driving with the windows down will all help, but still aren’t typically
as bright as a light therapy box or just being outside, even on a cloudy day.
Just as it’s important for your body to get the signal that it’s daytime during
the day (or your day, if you’re a shift worker and using a light therapy box), it’s
important to tell your body it’s night time once the sun goes down. Your body
starts releasing melatonin about two hours before you normally go to bed to
start preparing your body for sleep. This makes you feel sleepy and lowers your
body temperature. But melatonin production can be inhibited by exposure to
bright indoor lights. This means avoiding blue light
and sticking with red and yellow wavelengths of
light (that’s what your amber-tinted sunglasses are
for) as well as keeping the overall light level much
dimmer.
You can achieve this important “darkness signal” to

your circadian clock by keeping your indoor light-
ing as dim as possible in the evenings with dimmer
switches, or just turning on fewer lights, in con-
junction with investing in red or yellow light bulbs
for whatever lamps will be used in the evening. If
Part:
you plan to use a computer monitor

or to watch TV, there are two options.
The first is to install f.lux on your
computers, Android devices, or jail-
broken Apple devices and then set the
screen brightness to the lowest set-
ting. The second and probably the best
biohack for supporting evening mel-
atonin production (more technically
called dim-light melatonin produc-
tion) is to wear amber-tinted glasses
for the last 2-3 hours of your day. In
fact, several scientific studies show
that wearing amber-tinted glasses in
the evening improves sleep quality and supports melatonin production.
What are amber tinted glasses?

Quite simple: glasses with yellow lenses. These could be driving glasses, glau-
coma glasses, or safety glasses. Amber-tinted glasses are also a great option for
shift workers trying to get their circadian rhythm in check.
A more sophisticated option for getting both your bright blue light in the day
and your dim red light in the evening is programmable light bulbs where you
can set the color spectrum and the brightness for the time of day (and you can
program them to automatically change at whatever
time you want! How cool is that?). It’s an investment,
but then you can ditch the goofy safety glasses (al-
though you’ll want to pull them out again if you’re
going to watch TV).
Sleeping in a completely dark room is really important

for protecting circadian rhythms.
Cover up any LED lights on phones, toothbrushes,
baby monitors, or whatever other gadgets you have
plugged in in your bedroom (seriously. And masking
tape works great for alarm clocks and duct tape works
great for little LED lights). And ditch the night lights–
Part:
or switch to ones with red light bulbs. Blackout curtains can be one of the
greatest biohacks for getting a good night’s sleep (especially if you are a shift
worker or if you have artificial lights
such as street lamps outside your
bedroom windows).
It is natural, normal, and healthy to

sleep more in the winter and less in
the summer. You can embrace sea-
sonal variation by adjusting things
like bedtime (what time you dim the
lights and put on your amber-tint-
ed glasses) by the time of year. This
might look like naturally sleeping 7
to 8 hours during the warmer months and 9 to 10 hours during the winter time.
You can also adjust your indoor temperatures to more accurately reflect what’s
happening outside (also a great way to save on heating and cooling bills!).
Ignoring your circadian rhythm by forcing yourself to stay awake at night or to

get up before you are well-rested will negatively affect your circadian rhythm.
As I mentioned above, your melatonin starts increasing about two hours be-
fore bed to prepare your body for sleep. If you’re muscling through that with
a sugary snack, a scary movie, or whatever else you do to keep yourself awake
at night, you are affecting your circadian rhythms. If you are going to get your
seven to ten hours of sleep every night, you may need to shift your bedtime
earlier so you aren’t pushing through that fatigue to get a second wind (which
by the way, usually also means you’re increasing your cortisol right when it’s
supposed to be at its lowest).
To wind down before bed, you might read, solve a crossword, cuddle with a
loved one, do some yoga stretches, meditate, take a warm bath, or listen to re-
laxing music.
It’s important to have a routine that cues your body that you are getting
ready to sleep.
But don’t do any of these things in the bedroom. If you frequently read, watch
TV, surf the web, or eat in bed, your brain will begin to associate those activities
Part:
with the bedroom and when you lie

down to go to sleep, your body will
start revving up in anticipation of
another episode of Game of Thrones
or another chapter of The Hunger
Games. The only thing other than
sleep that should be going on in the
bedroom is sex. This may mean mov-
ing your TV out of the bedroom. Sor-
ry.
On a related note, it’s a good idea to

do your socializing during the day
and to keep things intimate at night.
Believe it or not, social connection can influence your circadian clock. Dr. Paul
Jaminet recommends limiting big social gatherings (and even things like watch-
ing TV shows that have lots of characters) to the daytime, and keeping things
intimate (just your family and closest loved ones) in the evening to help you
relax before bed. The reason for this is that the emotional and visual stimuli
associated with social gatherings or processing many faces at one time is con-
nected to the name brain center (the SCN) that regulates our circadian rhythm.
Prescription medications can also affect your ability to fall and stay asleep. If
you are taking any prescriptions and having difficulty sleeping, talk to your
pharmacist about the possible effects your medications may be having on your
sleep. And if you do learn that one or more of your prescriptions can affect
sleep, ask if there are alternatives that won’t.
When to Sleep
Getting enough sleep is important, but it might matter just as much when you
sleep. There is a growing body of evidence that living outside the normal light-
dark cycle has negative impacts on our long-term health. And this doesn’t just
mean shift workers and night owls. Prior to electric lighting (and we still see
this in hunter-gatherers, horticulturalists, and rural villagers in South America
Part:
and Africa), we went to bed shortly after the sun

went down and woke up around the same time as
the sun. A recent study of rural villagers in Brazil
with a natural sleep cycle showed that they prefer
to go to bed around 9:20pm and wake up around
6:30am. And this early-to-bed, early-to-rise rou-
tine is linked to much better health.
Researchers are starting to understand the many

mechanisms behind why disrupted circadian
rhythms undermine health. But what’s fascinat-
ing to me is that we’re starting to understand that
this harms us separately from not getting enough sleep. In fact, there’s grow-
ing evidence that the use of indoor lighting has links to breast cancer, obesity,
diabetes, and depression, and possibly other cancers. This is interesting, because
it implies that getting 8-9 hours of sleep a night isn’t enough by itself: those
hours should also align with what the sun is doing. Clearly, not everyone has
the luxury of shifting their schedules to “sleep when the sun sleeps,” but if you
think you’re not capable, scientific studies show otherwise. Studies putting a
variety of types of sleepers, from night owls to morning larks in a camping
situation (no electricity, lots of daylight during the day, darkness or firelight at
night) shows that people’s circadian rhythms align with the sun in as little as 2
weeks.
Naps
Certain conditions, especially au-
toimmune diseases, are marked by
sleep disturbances, either because
of pain, neurological symptoms, or
the need to pee in the middle of the
night (as in the case of interstitial
cystitis). Then there are external
factors, like a new baby, which might
mean that a good night’s sleep, no
matter how hard you try to make it
Part:
a priority, is simply not going to happen. If your slumber is interrupted or you

just can’t spend as much time in bed every night as you know you need, then
napping is a very good plan B (and a plan that is well-established in the scien-
tific literature - so well-supported, in fact, that companies are starting to add
nap rooms. How frickin’ genius is that?!). Studies show that napping after inad-
equate sleep the night before decreases sleepiness, improves performance, and
causes beneficial changes in cortisol and markers of inflammation. So, if you
can swing it, a nap is always worth it.
If all you have time for is a quick power nap, studies

have shown that naps less than twenty-five or thir-
ty minutes long can be very restorative, improve
cognition, and won’t affect your nighttime sleep at
all. The trick is to spend three to twenty minutes in
stage 2 sleep and to avoid entering the deeper sleep
stages. However, it’s important to keep in mind that
most of the benefits of being asleep are attributed
Be a nap queen to the time you spend in deep sleep (stages 3 and 4),
(or king!) plus the time in rapid eye movement sleep (consid-
ered separate from the other sleep stages). So, while
a power nap can’t replace the benefits of good-quality nighttime sleep, it can
help you get through your day.
If you have more time to devote to a nap, sleeping longer than thirty minutes
will get you into the deep-sleep stages (stages 3 and 4). The best-case scenario
with a longer nap is to be able to sleep for at least ninety minutes. Studies with
the elderly show that, while napping ninety minutes or longer does decrease
nighttime sleep, the twenty-four- hour sleep total is longer (and that’s the
whole point!). Plus, these same studies show that even napping in the evening
does not affect the quality or quantity of overnight sleep compared with nap-
ping earlier in the day, which is all to say that you should get your sleep when-
ever you can. And you certainly don’t have to wait until you’re elderly to stra-
tegically use naps to increase your sleep!
Part:
Biphasic Sleep
Biphasic sleep, or dividing your sleep time into two phases with a period of
being awake in the middle of the night, is actually not abnormal. The typical
pattern would be to sleep for four or five hours, be awake for one or two, and
then sleep again for three or four. If this sounds like your sleep pattern even
after you’ve tried to protect your circadian rhythms, you can embrace it and
schedule your life to accommodate it. But it’s also important for you to pri-
oritize even more time in bed (so that your total sleep before and after your
middle-of-the-night waking still adds up to at least eight hours), which might
mean aiming for ten hours or more in bed. If this is your natural sleep pattern,
it’s OK to read or get up and do something quiet in the middle of the night, but
remember to protect your circadian rhythms by wearing amber-tinted glasses
and keeping lights very low (better yet, remain in complete darkness and listen
to an audiobook or use the time to meditate). In this way, you can make use of
your middle-of-the-night waking time but still safeguard your body’s ability to
fall back to sleep.
Sleep Hygiene
Sleep hygiene is just the practice of utilizing techniques and forming habits
to get the best sleep possible (Sleeping in a completely dark room is both the
most important aspect of sleep hygiene and essential for entrenching circadian
rhythms). Once you’ve biohacked your bedroom to make it as dark as possible,
there are some other aspects of sleep
hygiene that are each a small change
that can add up to big improvements in
sleep quality. So, instead of having to
search the Internet for tips and tricks,
I’ve compiled them all here for you! Here
are the best and easiest changes you can
make to improve your sleep hygiene.
Noise
Part:
White noise generators can be tremendously helpful, especially if there are

high frequency/pitch noises in or outside of your home, since these are very
stimulating for the brain (therefore making it hard for your brain to go into
sleep mode and keeping you in that very light sleep). I’m sure it’s no surprise
that trains, traffic, barking dogs, and noisy neighbors are not conducive to a
good night’s sleep; a white noise generator can help drown out these sounds
by masking them with “radio static” that your brain can easily tune out. If you
have respiratory issues (especially ones that get worse at night), you may also
benefit from an air filter. A small HEPA filter is adequate for a single room (in
this case, your bedroom) and can have dramatic effects on your sleep if one of
the reasons your sleep quality is poor is that you are frequently congested or
coughing at night.
While you’re improving your sleeping environment, ditch the alarm clock.
Waking up to a jarring noise is very physiologically stressful (and can impact
that cortisol awakening response that I mentioned - especially if you’re hit-
ting the “snooze” button multiple times. Think about it: if your body releases a
burst of cortisol upon your first alarm, and you’re sleeping through your body’s
“wake up” signals, then you’ll be tired for the rest of the day! So those extra 10
minutes of sleep just aren’t worth it). The best option for protecting your circa-
dian rhythms and overall health is to sleep until your body naturally wants to
wake every morning, but a lot of people don’t have that luxury. To combat the
jarring effects of a traditional alarm clock, a light alarm is a great investment
that is considerably more soothing and helps to even more effectively entrench
your circadian rhythm, especially during those darker winter months!
Temperature
Believe it or not, the temperature that you’re sleeping in is also a cue to your
circadian clock. There are few aspects to this. Firstly, your core temperature is
in sync with your circadian rhythm - they actually communicate! You might re-
member from Part I that your body temperature decreases during sleep (that’s
your core temperature). When your bedroom temperature is lower, it actual-
ly makes it easier for your body to reach its sleep temperature, making sleep
latency (the time it takes to fall asleep) and sleep quality better. Ideally, your
indoor temperature at night should be 65F or lower. Being warmer during the
Part:
day than you are at night, typically above 75F, also supports circadian rhythms
by saying, “it’s time to be awake!” Like light exposure, there might be some
evidence that you’d opt for a colder environment in the winter and a warm-
er environment in the summer (both at night and during the day). Like a lot of
physiology, this process is a balance: cool temperature at night and warm tem-
perature during the day is ideal. If you find yourself overheating at night de-
spite having the AC set to 65F or lower, you may benefit from using breathable
cotton sheets, wearing minimal cotton sleepwear, and turning on a ceiling (or
floor) fan while relying on a thick comforter for warmth as needed.
Sleeping Position
The position you sleep in may also be affecting your quality of sleep. Do you
wake up with back, neck, or joint pain? The traditional advice is to sleep on
your side in the fetal position with a pillow beneath your head and another one
between your knees. However, lying on one
side all night can often leave that side sore
or numb the next morning or result in a lot
of tossing and turning, trying to get comfort-
able. For most people, sleeping on the back
eliminates this discomfort. With soft pillows
under your head and knees, your weight is
well distributed on your mattress and you
are not placing any undue pressure on any of
your joints.
However, I can’t make a universal suggestion

about sleeping position. Research published
recently suggested that a lateral (side-lying)
sleeping position is ideal for brain glymphatic
support. What does that mean? The glym-
phatic system is that waste-clearing func-
tion of sleep that I mentioned in Part 1. And
brand-new research supports the notion that sleeping on our side might actu-
Part:
ally help this system work! It’s even being implicated in Alzheimer’s research.
So, based on both the past and current research, I will let you experiment with
what feels best. Take note of when you feel the most rested. What was differ-
ent on those days? Sleep position could be making a huge difference to your
mental clarity and physical recovery! Experiment to figure out what feels best
for you.
Routine
Separate from the issue of getting enough quality sleep and sleeping in sync
with the sun is consistency of sleep hours.
Research shows that having a regular bedtime and wake time with minimal
day-to-day variation decreases health risk separately from getting enough
sleep.
There are two different measures here, variation in the time we go to bed and
variation in how long we sleep, referred to as sleep time variability and sleep
duration variability, respectively.
An example of sleep time variability is staying up later than usual on weekends

because we don’t need to get up early the next morning, a very typical pattern
for teenagers and adults, yet one that isn’t healthy. Another common scenario
is staying up late to meet a deadline or study for an exam. Separate from how
long we sleep, variability in bedtime during the week that is more than 2 hours
increases risk of obesity by 14%, mean-
ing that your chances of battling weight
issues is higher if you stay up two hours
past your usual bedtime just once in the
week.
An example of sleep duration variability

is sleeping in on weekends, a common
way that many people try to make up
for inadequate sleep during the week.
Sleep duration variability increases risk
of obesity by 63% for each hour of stan-
dard deviation in sleep duration. That
Part:
means that if some nights you gets 6 hours and other nights you try to make
up for it and sleep 9 hours, that inconsistency is dramatically increasing risk of
obesity! Studies that evaluate the relationship between inadequate sleep and
inflammation show that two days of increased sleep duration (like sleeping
in on weekends) isn’t sufficient for the immune system to return to normal.
Th17 cells, major culprits in autoimmune disease, stay elevated for at least two
days after sleep recovery. Another study in newly-diagnosed type 2 diabetics
showed that sleep debt during weekdays increased risk of obesity by 17% and
insulin resistance by 39% for every 30 minutes of sacrificed sleep time less than
what the participants needed, completely independent of whether or not they
slept more to “catch up” on sleep during the weekends.
What do these disheartening facts about sleep time and duration in variability
mean?
Routine in what time we go to bed and what time we wake up in the morning
is important in addition to getting enough sleep and getting good quality sleep.
And, we need to maintain that routine 24/7/365. Unfortunately, paying down
sleep debt is not something that can be accomplished during a weekend. Cer-
tainly, we can recover from lack of sleep, but it takes persistence, consistency,
and commitment, especially during the week! The long and the short of it is
that every one of us needs a bedtime, one that is early enough that we wake
up when we need to in the morning without an alarm clock (except maybe as
back-up); and, we need to stick to that bedtime with unwavering devotion.
Part:
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Part four
Beyond the Bedroom

beyond the bedroom
Chapter quickstart
Part four Beyond the Bedroom
pg. 101 1. Dietary Suggestions

•• A Paleo diet that emphasizes a nutrient-dense, anti-inflammatory variety
of foods free of grain, dairy, and legumes is a fantastic strategy for pro-
moting sleep.
•• Targeting insulin resistance and blood sugar regulation is one strategy for
promoting sleep with food. Focusing on having protein with every meal
and not eating too many or too few carbohydrates is a start.
•• Eating a balanced profile of omega fatty acids and not shying away from
saturated fat promotes proper hormone, immune, and cardiac function,
but making sure not to overdo it on fats can be one of the great challenges
of the Paleo diet.
•• The sleep-promoting hormone, melatonin, is produced from the protein

tryptophan, so eating the right sources of protein is one strategy for pro-
moting melatonin production.
•• Recent research has demonstrated a direct link between fiber intake and
sleep quality and duration – getting enough fiber in is yet another simple
tool for improving sleep!
•• Increasing the intake of other nutrients, like vitamin A and C, has been
directly linked with improving specific aspects of sleep.
pg. 127 2. Exercise

•• Exercise has a profound effect on every hormone system in the body, so
exercising in moderation promotes better sleep.
pg. 130 3. Stress

•• Chronic stress can be managed by reducing the number of stressors and/
or increasing resilience.
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•• Caffeine is a known addictive stimulant that may disrupt sleep patterns

and promote cortisol, so removing or reducing it can help sleep.
•• Smiling and laughing more promotes the release of endorphins, which

reduce the effects of stress.
•• Meditation is an incredibly effective tool for promoting resilience.
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Part FOUR
Beyond the Bedroom
We’ve been through a lot of the standard “here’s what you need to do to get a
good night’s sleep.” But what if you’ve done all of those things, put the time and
effort in to maximize your sleep hygiene and entrench your circadian rhythm,
made sure to go to bed at a good time every night, but you still can’t sleep or
still are not feeling rested? There’s nothing more frustrating than doing every-
thing right and either lying awake for ages before falling asleep or waking up in
the night and being unable to fall back asleep.
In fact, studies estimate that as many as 50% of Americans suffer from the
inability to fall asleep and/or stay asleep.
That is no joke statistic and, in my opinion, must explain some of the rises in
chronic health conditions in this country. Many of these sleep problems are
likely due to things we’ve already discussed: as a rule, we spend too much time
inside during the day, we light up our houses in the evening, and we’re con-
stantly stimulating ourselves with caffeine, late-night TV, and our evening
To Do lists. But, there are some other aspects of the typical American diet and
lifestyle that are equally disruptive for sleep: as a society, we experience more
chronic stress than ever before, we are less active than ever before, and our
diets are more sugar-laden than ever before.
Indeed, improving sleep requires not just attention to our light-dark cycles and
our sleep environment. It also requires an overhaul to our entire diet and life-
style to make good sleep as natural to our bodies as movement and laughter.
But, here’s the best part: every choice that helps to improve sleep (like a nutri-
ent-dense anti-inflammatory diet, an active lifestyle, and stress management)
are all things that independently improve health too! And, there’s a ton of
synergy too. Eating healthier foods makes you sleep better, which makes you
naturally choose healthier foods. Being active makes you sleep better which
makes you feel more energetic and motivated. Reducing stress helps you sleep
better, which helps regulate your body’s response to stress. All of this is win-
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win, and once we get into some of the practical tips, you’ll find that most of this
is a collection of very small changes, each one completely doable.
Dietary Suggestions
I’ve been focusing on sleep this entire book, but there’s no skirting around the
fact that I’ve written multiple books about the Paleo diet and am, of course, The
Paleo Mom. Clinical trials demonstrate that a Paleo diet improves cardiovas-
cular disease risk factors, reduces inflammation, improves glucose tolerance,
helps with weight loss, lowers colon cancer risk, and can even improve auto-
immune disease. The bottom line is that science supports a nutrient- dense,
anti-inflammatory diet for total body health, and that includes sleep. Getting
proper nutrition is absolutely key for sleeping your best.
In this section, we are going to discuss the basics of the Paleo diet plus specific
nutrients (from specific foods) that you can use to improve your sleep.
Paleo: The Ultimate Anti-Inflammatory Diet

The Paleo diet is the first example of a set of diet principles being compiled
using modern scientific health and nutrition research. While the initial insight
leading to the Paleo diet
was gleaned from studies
of Paleolithic man and
both modern and his-
torically-studied hunt-
er-gatherers, the core
support for this way of
eating comes from con-
temporary biology, phys-
iology, and biochemistry.
There are thousands of
scientific studies that each
evaluate how components
in foods interact with the
human body to promote
or undermine health.
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These are the studies used to form the basic tenets of the Paleo diet.
Some people like to think about Paleo as a diet that eliminates problematic
foods. But I love to think about the incredible variety of delicious foods that are
available to me, even on stricter variations of the Paleo diet such as the auto-
immune protocol! Others criticize Paleo by saying that it’s too hard to follow,
but sticking to a Paleo diet is actually pretty simple. There’s a huge variety of
health-promoting foods to choose from, including all meats, seafood, vegeta-
bles, and fruits; eggs; edible fungi (like mushrooms); and nuts and seeds! At its
core, the Paleo diet is a plant-based diet, with two thirds or more of your plate
covered with plant foods and only one third with animal foods (and yes, I might
differ here from other “Paleo experts” and their recommendations, but all I can
say is that I’ve reviewed thousands of scientific papers and have come to these
conclusions for specific reasons). Of course, meat consumption is enthusiasti-
cally endorsed as well, because it provides vital nutrients that are not obtain-
able from plant sources like vitamin B12. Going beyond just the types of food,
sourcing the highest quality food you can is encouraged in this lifestyle, mean-
ing choosing grass-fed or pasture-raised meat, wild-caught seafood, and local
organic fruits and vegetables whenever possible.
Eating a Paleo diet also encourages eating a vastly different array of foods
instead of fixating on just a few main foods (another difference from what you
might see on the Internet… you can eat so much more than bacon, steak, sweet
potatoes, and kale. I promise). Variety in any dietary protocol is very important,
because a wide assortment of different foods supplies a variety of different
nutrients. In fact, research has actually found that a diet that includes a wide
variety of foods was associated with achieving the recommended amount of
sleep! By focusing on as many
different whole foods as possible,
it’s easier to achieve sufficient
and synergistic quantities of all
the nutrients, including poten-
tially some that haven’t been
discovered yet (isn’t that cool to
think about?!). Easy strategies to
increase variety include “eating
the rainbow,” meaning that you
choose fruits and vegetables of
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different colors, and “eat-

ing snout-to-tail,” mean-
ing you eat every part
of the animal, including
offal.
Alright, so I know what

you’re thinking: “what
foods do I have to stop
eating for this Paleo
thing?”
The foods that are elim-
inated in a Paleo diet are
the ones that provide our
bodies with very little
nutrition (especially for the amount of energy in calories they contain) and that
are difficult to digest (which can cause gut health problems and contribute to
gut dysbiosis), and have the ability to stimulate inflammation or mess around
with important hormones. Generally, a Paleo diet excludes grains and pseudo-
grains (wheat, barley, millet, quinoa, rice, etc.), legumes (including peanuts,
lentils and soybeans; legumes with edible pods like green beans are fine), dairy
(especially pasteurized industrially-produced varieties), and refined and pro-
cessed foods (including refined seed oils like canola oil and safflower oil, refined
sugars, and chemical additives and preservatives).
There are many foods that can be additionally problematic (meaning that
they disrupt health in some way for some people; for example, nightshades
like potatoes, tomatoes, and eggplant can cause inflammation, especially for
those with chronic health conditions, and are typically referred to as “gray-ar-
ea” foods (I talk about this in perhaps excruciating detail in my New York
Times-bestselling book, The Paleo Approach, which describes the Autoimmune
Protocol in incredible detail). However, I believe that someone trying to im-
prove the quality of their sleep is best off keeping to strict Paleo until their
sleep disturbances are resolved. Many people starting a Paleo protocol notice
that they’re experiencing the best sleep of their lives; we really cannot under-
estimate the value of this part of the program!
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By focusing on the most nutrient-dense foods available and by eliminating

foods that can contribute to hormone dysregulation, inflammation, and gut
dysbiosis (where the bacteria in your gut are the wrong kinds, wrong diversity,
wrong numbers, and/or in the wrong part of the gastrointestinal tract), a Paleo
diet can improve a vast array of health conditions, including sleep disturbanc-
es! If you think about the many relationships between sleep and health that we
examined in Part 2, there are some very obvious ways that the Paleo diet can
improve our sleep quality. Mainly, these differences are likely a result of im-
provement in our gut functioning and reduction of systemic inflammation.
The Paleo diet provides the foundation for a healthy digestive system. It sup-
ports healthy growth of a diversity of probiotic bacteria in the gut through its
focus on prebiotic and probiotic foods and through its avoidance of foods that
contribute to gut dysbiosis. It supports the health of the tissues that form the
gut barrier by supplying essential nutrients required for gut barrier integrity
and by avoiding foods that are inherently difficult to digest, are known to irri-
tate or damage the tissues that form the gut barrier, or that are known to stim-
ulate the immune system. The Paleo diet reduces inflammation and supports
normal functioning of the immune system. Foods that are inherently inflam-
matory are avoided, removing this unnecessary stimulus for increased inflam-
mation. By providing the essential nutrients that the immune system requires
to regulate itself, an overactive immune system can be modulated. By providing
the essential nutrients that the immune system needs to function optimally, a
suppressed immune system can recover. Furthermore, the Paleo diet supports
liver detoxification systems by providing the essential nutrients that the liver
needs to performs its functions. This lifestyle supports hormone regulation by
focusing on foods that contain the nutrients required for hormone balance and
avoiding foods known to stimulate or suppress vital hormone systems. Because
providing the body with the essential nutrients that it needs to be healthy
forms the basis of the Paleo diet, every system in the human body is positively
affected by this approach to food.
Importantly, there are no hard and fast rules about when to eat, how much pro-
tein versus fat versus carbohydrates to eat, and there are even some foods (like
high quality dairy and white potatoes) that some people choose to include in
their diets whereas others do not. This means that there’s room to experiment
Part:
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so you can figure out not just what makes you healthiest but also what makes
you happiest and fits into your schedule and budget. For now, I believe you
should stick to the core Paleo protocol, but I’ve found that keeping future flexi-
bility in mind is better for people’s psyche. Because, in the end, the Paleo diet is
not a diet in the sense of some hard thing that you do that requires a great deal
of willpower and self-deprivation until you reach some goal. It’s a way of life.
And I love that this philosophy synchronizes so well with my hopes for your
sleep: like the Paleo diet, you will likely need to make the lifestyle changes nec-
essary to prioritize sleep and accommodate the routine necessary to maximize
the potential of your time in between the sheets! (Oh, you know what I mean).
Eating to Promote Hormone Regulation

Scientists are still trying to elucidate the
relationship between blood sugar, hormone
regulation, and sleep. But, we do know that
you can change your dietary patterns to
promote sleep–and it’s all based on real
science! As I’ve mentioned before, we are
mostly concerned with the hormones cor-
tisol (the excitatory, “let’s wake up!” and
“I’m stressed out!” hormone) and melatonin
(the “let’s go to bed!” hormone), which act
in contrast: when your cortisol is high, your
melatonin is suppressed, and vice versa. So,
helping your body master this difference is totally one of the keys to getting
the best sleep ever.
Subtle changes in the way you eat can have major impacts on your hormones.
These differences are generally driven by changes in your body’s insulin re-
sponse and blood sugar regulation. Many hormones are sensitive to swings in
blood sugar, including both melatonin and cortisol, so stabilizing your blood
sugar throughout the day (and especially before bed) could be absolutely critical
for your sleep quality. The key to altering your blood sugar response is playing
with your carbohydrate intake; studies have shown that the difference lies in
Part:
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the amount of sugar you consume per day, not in the amount of calories (and
this can make a big difference for some people mentally). This fact has been
confirmed over and over again in the scientific literature; a very recent paper
confirmed that patients staying overnight in a sleep clinic were more likely to
have arousals than patients who ate less sugar.
Likewise, as your circadian rhythm depends on many factors, it also relies on

you eating in a regular pattern that promotes healthy blood sugar.
Eating two to three large meals a day and avoiding snacking is a great place to
start when it comes to blood sugar regulation. Why? Contrary to some modern
myths, snacking throughout the day actually promotes constantly high blood
sugar (whereas some say that it keeps your blood sugar stable. This notion is
false.). So, when you head off to bed at the end of the day, your blood sugar
crashes—and this can lead to an upswing of cortisol in the middle of the night.
Giving your body the opportunity to do its natural ebb and flow of insulin by
eating regular meals promotes insulin sensitivity and prepares your blood sug-
ar for sleep at the end of the day.
Keeping your blood sugar stable doesn’t mean eating super low carb. In fact,
eating too low carb can disrupt circadian rhythms by increasing cortisol and
affecting insulin sensitivity. Instead, I’m suggesting that you avoid spikes in
blood sugar from high glycemic load foods. Glycemic load is essentially a food’s
impact on your blood sugar; aiming for a low glycemic load is generally a great
idea and is way easier to accomplish when your diet doesn’t have grains or
legumes. So, depending on your
current dietary habits, a de-
crease in carbohydrate intake
might be a good call—but I’m
hardly suggesting a ketogenic
diet here. If you’re following a
Paleo diet, chances are really
good that you’re doing this al-
ready.
If you reduce the amount of car-

bohydrates you eat, that means
increasing the amount of ei-
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ther protein or fat (or both) that you eat. And there are nothing but benefits to
choosing those macronutrients for improving insulin sensitivity and maximiz-
ing the benefits of sleep! Numerous studies have shown that increasing protein
intake can greatly improve insulin resistance; this mechanism may partially be
explained by the fact that a meal with at least some protein helps the liver to
digest carbohydrates, particularly fructose (a common carbohydrate in fruits in
particular).
Fat, on the other hand, has gotten more of a bad rep with the media, but did you
know that increasing your fat intake in moderation could actually help your
hormones? Fats are a necessary component of the body; we simply can’t live
without fat in our diet. In particular, I want to address the concern of saturated
fats, because they are actually the bomb when it comes to improving hormone
problems—but recent science has shown that overdoing it on saturated fat isn’t
going to help your sleep, either. Saturated fats found in eggs, meat, coconut
and palm oil are difficult to oxidize, which means they don’t go rancid easily
and don’t cause oxidative stress in your body. Saturated fats are the only fats
you should cook with on a regular basis. The saturated fat in meat and eggs is a
long-chain saturated fat: it is not the unhealthy fat that was once wrongfully
accused as the cause of cardiovascular disease, but how healthy it is for you is
still under debate. And the extra critical thing about saturated fats? Contrary
to some (totally nonsensical) contemporary claims, saturated fat is an absolute
nutritional requirement for every
single body; we require saturated
fats to build every single one of our
cell membranes. Now how’s that
for important? As an added bonus:
coconut and palm oil contain a me-
dium chain saturated fat, and this
fatty acid type is very special: it can
actually be used directly for energy
by your cells, without modification
and without a spike in insulin or
blood sugar.
However, we have some new in-

formation in the form of a recently
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published scientific paper that presents enough evidence for me to be hesitant

to suggest reaching for saturated fats when it comes to seeking better sleep.
The study measured what people ate the day before an overnight stay in a sleep
clinic and then aspects of their sleep: sleep latency and quality.
Researchers found that those who consumed more saturated fat experienced
less deep, slow wave sleep.
While this study falls under the “Paleo caveat” that we don’t know anything
about the participants’ diet quality or the specifics of their choices, we know
enough to be cautious when it comes to saturated fats. In fact, my current re-
search project has me very concerned about the Paleo obsession with high fat
diets—based on my findings, I would never recommend a diet with higher than
40-45% of calories coming from fat overall (just something for you to chew on
as you read).
Similarly, it is also important to reduce your

intake of omega-6 fatty acids to the best of
your ability (and budget). Omega-6 fatty acids
would most commonly be found in poultry,
eggs, and avocado in our Paleo template; out-
side of the Paleo world, you’d find a boatload of
omega-6s in cereals, whole grain breads, and
vegetable oils (all things you should consider
avoiding anyways!). Omega-6 fatty acids tend
to be pro-inflammatory, especially in people
who have systemic inflammation problems or
autoimmune disease. This means no modern
vegetable oils or products made from them, like
mayonnaise or store-bought salad dressings.
Also, be mindful of your nut consumption and try to eat grass-fed meat, free-
range poultry, and wild game whenever it’s not prohibitively expensive. At the
same time, try to increase your omega-3 intake by eating more wild-caught fish
(canned salmon and sardines are great, inexpensive options), omega-3 eggs, and
maybe also using a fish oil supplement. Omega-3 fatty acids are known to help
prevent and reduce inflammation, with positive outcomes including lower-
ing cardiovascular disease risk. However, new research has specifically linked
omega-3 intake with better sleep. Just another reason to get your fatty, fresh-
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water fish intake up! Omega-6 and ome-

ga-3 fatty acids directly compete for
space in your cellular membranes, so
knowing about how much you’re eating
of each could be huge for promoting an
anti-inflammatory lifestyle.
So, we know that we don’t need to

avoid fat and protein to help our hor-
mones stay balanced. That doesn’t mean
you should be avoiding starches all
the time. High starch meals about five
hours before bedtime have been shown
to improve sleep quality! But, it’s im-
portant to avoid sugar in the evening, so choosing starchy carbs like plantains,
sweet potatoes, yucca, and squash is a much better bet. On the other side of
that, it’s important to have a rule not to eat within two hours of your bed time:
when you do, you kick up some growth hormones and boost your metabolism
right when these things are supposed to be slowing down. Eating before bed
essentially tells your body, “hey, we still need energy to do things!” And since
your sleep-wake cycle is kind of like your car gas pedals, you can’t pump the
gas (eating food) and the brake (sleep hormones) at the same time and expect
a good result. The exception to this rule is for those with hypoglycemia (low
blood sugar), who may do better with a snack before bed to help keep their
blood sugar stable overnight. And if you must have a snack before bed, studies
have shown that a protein-rich snack before sleeping is the best bet.
Melatonin
One of the best ideas if you’re trying to target your nutrition is to focus on
increasing your nutrient-density to support the production of melatonin. Mela-
tonin is made from serotonin, which is made from tryptophan. Organ meat and
seafood have more tryptophan while also having less of the other amino acids
which compete with tryptophan to cross the blood-brain barrier. So, eating
more organ meat and seafood is a great way to boost production both of sero-
tonin and melatonin; the result is kind of like a targeted dose of these proteins,
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and, since they both have such massively

important effects on the body, there is
never going to be a reason not to increase
your fish and offal intake! Eating seafood
also contributes long-chain omega-3 fats
to your diet (DHA and EPA); these help
support circadian rhythms by improving
neural health in the brain and by improv-
ing resilience to stressors (if you’re get-
ting high dietary omega-3s, you secrete
less cortisol in response to stress). And
you know how awesome that is for your
HPA axis regulation!
Fiber: It’s Kind of a Big Deal!

Recent studies have shown that fiber is so important that it can determine the
extent to which someone gets slow-wave (deep) sleep. So, I want to give fiber
the love and respect it deserves.
Fiber is a type of carbohydrate, meaning that fiber is simply a long string of

sugar molecules (saccharides). Fiber comes from the cell walls of plants. In plant
cells, it acts as a skeleton and helps to maintain the plant’s shape and struc-
ture. There are many, many different types of fiber (different length strings
composed of different saccharides, some with branches and some without).
The only dietary source of fiber are plant-based foods. What separates fiber
from other carbohydrates (starches and sugars), is that the digestive enzymes
produced by our bodies that digest carbohydrates by breaking them down into
simple sugars (monosaccharides, which are then absorbed across the intestinal
barrier and into the body) are not able to break fiber apart into monosaccha-
rides. Instead, fiber passes through the digestive tract, mainly intact.
Some types of fiber (called fermentable fibers) can be digested by the bacteria
in our intestines (these bacteria mainly reside in the large intestine but there
are some in the small intestine too). In fact, fiber serves two main functions in
the digestive tract: it adds bulk to stool (this makes it easier to pass) and it feeds
the probiotic bacteria that live in there (there are many ways that this benefits
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us). When probiotic bacteria eat fiber,

they produce short-chain fatty ac-
ids—such as acetic acid, propionic acid,
and butyric acid. These are extreme-
ly beneficial energy sources for the
body, including the cells that line the
digestive tract and help to maintain a
healthy gut barrier. Short-chain fatty
acids are also essential for regulating
metabolism and they aid in the absorp-
tion of minerals, such as calcium, mag-
nesium, copper, zinc, and iron. Healthy gut bacteria have many other important
beneficial effects in the body, such as aiding digestion (they release important
vitamins and minerals from our food so we can absorb them) and regulating the
immune system.
Fiber has other effects, like regulating peristalsis of the intestines (the rhyth-
mic motion of muscles around the intestines that pushes food through the
digestive tract), stimulating the release of the suppression of the hunger hor-
mone ghrelin (so you feel more full), slowing down the absorption of simple
sugars into the bloodstream to regulate blood sugar levels and avoid the excess
production of insulin. Fiber also binds to various substances in the digestive
tract (like hormones, bile salts, cholesterol and toxins) and depending on the
type of fiber, can either facilitate elimination or reabsorption (for the purpose
of recycling, which is an important normal function for many substances like
bile salts and cholesterol), both of which can be extremely beneficial if not es-
sential for human health.
So, even though fiber doesn’t provide us with energy (like other carbohydrates,
fat and protein) and isn’t an essential micronutrient (like vitamins, minerals and
phytochemicals), it’s pretty darned important (in fact, one might argue that its
classification as non-essential is erroneous).
In fact, one of the biggest culprits in the rise of chronic disease seen in the
last 50 years is the decrease in fiber consumption relative to total carbo-
hydrates (you know, the part where the carbohydrates we eat are becoming
more and more refined, meaning the fiber is stripped out of them).
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Take this graph for instance, which I find fascinating. It shows that the current
“high carb” consumption in the Standard American Diet isn’t actually that dif-
ferent from a hundred years ago. But how refined those carbohydrates are has
changed dramatically. And, during the last 50 years, while the percentage of
carbohydrates we consume that come from refined sources has been steadily
increasing, so too has been obesity, type 2 diabetes, cardiovascular diseases, im-
mune diseases like asthma and autoimmune diseases like rheumatoid arthritis.
TOTAL CARBOHYDRATE CONSUMPTION VS. FIBER

1909-1999
500 6.00
5.80
450 5.60
5.40
400 5.20
5.00
350 4.80
4.60
200 4.40
4.20
250 4.00
09 14 19 24 29 34 39 44 49 54 59 64 68 74 79 84 89 94
YEAR
Certainly, there have been some other important changes in the typical Amer-
ican diet in this time as well. The amount of omega-6 polyunsaturated fats we
consume has skyrocketed. The total caloric intake has increased. Our vegeta-
bles are less nutrient dense (due to a variety of factors, one of which being that
there’s typically a longer period of time between when they are picked and
when you buy them and eat them). But, the authors of this paper were able to
tease out a very important role for fiber intake, by looking at food availability
data (the best measurement we have on what the population as a whole eats)
and incidence rates of diabetes over the last 100 years.
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They found:
1. Dietary fiber is inversely correlated with the prevalence of type 2

diabetes (meaning the lower your fiber intake the higher your risk
of developing T2D)
2. Corn syrup intake (marking refined carbohydrates) is positively
correlated with the prevalence of type 2 diabetes (meaning the more
corn syrup you consume, the higher your risk of developing T2D)
3. There is no correlation with dietary protein or dietary fat with diabe-
tes incidence once you accounted for total energy intake
The take-home message is that eating whole foods (and therefore avoiding
refined carbohydrates) reduces risk of type 2 diabetes. And that it’s much more
important that your carbohydrates are coming from whole foods rather than
how many grams of them you are eating. Just look at total carbohydrate con-
sumption in the early 1900s versus now… pretty similar, but ten times as many
people suffer from type 2 diabetes now compared to 100 years ago. The im-
plication is that you’re health is far more dependent on fiber intake compared
to total carbohydrate intake. This can be inferred from the high carbohydrate
intake in the first half of the twentieth century, when the percentage of fiber in
the diet was also much higher and disease rates were lower.
Diets rich in fiber also reduce the risk of many cancers (especially colorectal
cancer, but also liver, pancreas and others) and cardiovascular disease, as well
as overall lower inflamma-
tion. Prospective studies
have confirmed that the
higher your intake of fiber,
the lower your inflam-
mation (as measured by
C-reactive protein). In fact,
a new study showed that
the only dietary factor that
correlated with incidence
of ischemic cardiovascular
disease is low fiber intake
(and not saturated fat!); so,
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the more fiber you eat, the lower your risk. If you have kidney disease, a high-
fiber diet reduces your risk of mortality. If you have diabetes, a high-fiber diet
reduces your risk of mortality. High fiber intake can even reduce your chances
of dying from an infection.
You can see that the importance of fiber goes way beyond the need for fiber to
improve sleep. What are some of the vegetables richest in fiber? Leafy greens
(like spinach, kale, and/or collard greens) are at the top of the list – there are a
lot of reasons to think about aiming for several servings of leafy greens every
day. Other high fiber vegetables include Brussels sprouts, broccoli, and arti-
chokes. Some high fiber fruits include avocados, blackberries, raspberries, and
pears.
The Many Types of Fiber

So, does it matter what types of foods your fiber comes from (and thus what
types of fiber you’re eating)? There are an increasing number of studies sup-
porting the idea that the health benefits of high-fiber diets really come from
those diets high in vegetables (so vegetable fiber) and, to a lesser extent, fruit
and nuts (the health benefits are not experienced with diets high in cere-
al grains). These high-vegetable diets also reduce cardiovascular disease risk
factors and markers of colon cancer risk. How much of this can be directly
attributed to the types of fiber in vegetables (mainly insoluble) versus the high
vitamin, mineral and phytonutrient content of vegetables compared to other
carbohydrate sources remains unknown. Prob-
ably, the benefits come from both. Fiber is a
carbohydrate present in the cell walls of plants
that our bodies can’t digest. It provides us a vari-
ety of benefits through feeding probiotic bacte-
ria in our digestive tracts, by binding with tox-
ins, hormones, bile salts, cholesterol and other
substances in the gut, by stimulating the release
of some hormones (like ghrelin) and some neu-
Fiber is your poop’s
rotransmitters (like melatonin) and by adding best friend
bulk to the stool.
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Carbohydrates, including fiber, are chains of monosaccharides (simple sugars)

and of chemical derivatives of monosaccharides. Both the types of simple sug-
ar (and their derivatives) in the chain and the ways they link together to form
chains (both overall structure and the types of chemical bonds between sugar
molecules) determine what type of carbohydrate it is.
What separates fiber from other carbohydrates is that the way the sugars link
together are not compatible with our digestive enzymes—our bodies just aren’t
capable of breaking apart those types of molecular bonds.
Most of us are familiar with soluble and insoluble fiber— at least the terms if
not the details of the definition. Broadly, soluble fibers are types of fiber that
dissolve in water and insoluble fibers don’t. This greatly affects how they be-
have in the digestive tract.
Soluble fiber forms a gel-like material in the gut and tends to slow the move-
ment of material through the digestive system. Soluble fiber is typically readily
fermented by the bacteria in the colon (although not all soluble fibers are fer-
mentable), producing gases and physiologically active byproducts (like short-
chain fatty acids and vitamins).
Insoluble fiber tends to speed up the movement of material through the diges-
tive system. Fermentable insoluble fibers also produce gases and physiolog-
ically active byproducts (like short-chain fatty acids and vitamins). Non-fer-
mentable insoluble fiber increases stool bulk by absorbing water as it moves
through the digestive tract (which is be-
lieved to be very beneficial in regulating
bowel movements and managing consti-
pation). Within these two broad catego-
ries, there are actually many different
types of fiber, classified based on the types
of simple sugars and other components
they are made from, the types of bonds
between sugars, and the overall struc-
ture of the molecule. The major classes of
fiber will be discussed in more detail, but
this is how they divide among the soluble
versus insoluble categories. Depending on
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the food in question, some foods

have more insoluble fiber types INSOLUBLE SOLUBLE
and some have more soluble. Hemicellulose (most) Hemicellulose (some)
However, classifying a fiber as Chitosan (neutral pH) Chitosan (acidic pH)

either soluble or insoluble is only
Beta-Glucan (some) Beta-Glucan (most)
one way to describe a particular
fiber. They can also be classified Cellulose Fructan
based on whether or not they Lignin Pectin
are fermentable (if they are, they
are considered to be “prebiot- Chitin Gum
ics”, which just means that they Resistant Starch Mucilage
are food for the bacteria that
live in our digestive tracts). While soluble fibers have the reputation of being
the fermentable fibers, there are plenty of types of insoluble fiber which are
fermentable as well and even some types of soluble fiber which aren’t fer-
mentable (or are only weakly fermentable). Fibers can also be classified based
on whether or not they are viscous, meaning how thick they are when they mix
with water and other substances in your digestive tract (this classification is
used to classify soluble fibers because insoluble fiber doesn’t dissolve in water).
Many of the health benefits of soluble fiber are specific to high viscosity fi-
bers. Functional fiber is the term for an isolated fiber used as a supplement. The
fibers discussed in more detail below can also be categorized based on whether
or not they are fermentable.
You might be surprised to see that most types of fiber are actually fermentable
(some more readily than others, of course)… not just soluble fiber. I want to
point this out because it’s a myth that soluble fiber is “the fermentable kind of
fiber”.
As already mentioned, there are actually many types of fiber (which are then
either lumped into the soluble or insoluble categories or lumped into the fer-
mentable or nonfermentable categories). And, it turns out that if you want to
understand what types of fiber (or whole food sources of fiber) are most ben-
eficial for you, you actually need to go into far more detail than just whether a
fiber is soluble or insoluble.
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The Main Classes of Fiber

Cellulose is the main component of plant cell walls. Celluloses are identical
to starch in the sense that they are long straight chains of glucose molecules
(anywhere from several hundred
to over ten thousand glucose mol-
FERMENTABLE NONFERMENTABLE
ecules long); however, the links
between the glucose molecules Hemicellulose (most) Hemicellulose (some)
are different than starch (they are Chitosan Lignin
in what is called a beta configura-
tion) which make cellulose indi- Beta-Glucan Chitin
gestible to humans. Celluloses are Fructan Mucilage
insoluble dietary fibers. The bac-
Resistant Starch
teria in your intestinal tract can-
not ferment most cellulose par- Gum
ticularly well (although cellulose
Pectin
is partially fermentable). Cellulose
is found in all plants, but foods that contain particularly large amounts of cellu-
lose include bran, legumes, nuts, peas, root vegetables, celery, broccoli, peppers,
cabbage and other substantial leafy greens like collards, and apple skins.
Hemicellulose is a common component of the cell walls

of plants. In contrast to cellulose, hemicellulose is made of sev-
eral types of sugar in addition to glucose, especially xylose but
also mannose, galactose, rhamnose, and arabinose. Rather than
forming long straight chains like cellulose, hemicellulose may
have side chains and branches. Because of these variations, some
hemicelluloses are soluble in water and some are insoluble, plus
some forms are fermented by bacteria while others are not. Hemicellulose is
particularly high in bran, nuts, legumes and whole grains as well as many green
and leafy vegetables.
Pectin is soluble in water and highly fermentable (very little

passes through to the colon since it is so readily fermented by
bacteria in the small intestine). Pectins are rich in sugar, are rich
in galacturonic acid, and can be found in several types of config-
urations (further subdividing this class of fibers by structure).
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Pectins are found in all fruits and vegetables but are particularly rich in certain
fruits, including apples and citrus fruits, and are also found in legumes and nuts.
Lignin is a type of fiber with lots of branches made of chem-

icals called phenols (rather than sugar molecules). Phenols are
currently being studied for a variety of health- related effects
including antioxidant actions (for example, it is the phenolic com-
pounds in olive oil that appear to be responsible for its cardiovas-
cular health benefits). Lignin is unusual because it lacks an overall
defining structure. Instead, it consists of various types of sub-
structures that appear to repeat in a haphazard manner. Lignins are insoluble
and are not fermentable. Most commonly a component of wood, food sources
include root vegetables, vegetable filaments (like the stems of leafy greens and
the strings in celery), many green, leafy vegetables, wheat and the edible seeds
of fruit (such as berry seeds and kiwi seeds).
Chitin is similar to cellulose in the sense that it is made of long

chains of glucose (in the case of chitin, it’s actually long chains of
a particular derivative of glucose called N-acetylglucosamine)
and also has amino acids attached. Chitins are insoluble in water
and are fermentable, albeit weakly. Chitin is interesting because
this fiber is found not only in plants and fungi but also in the exo-
skeletons of insects and in the shells of crustaceans.
Chitosan is similar to chitin in the sense that is composed of a

long chain of N-acetylglucosamine molecules, but it also contains
randomly distributed D-glucosamine molecules (like cellulose,
linked in a beta configuration). Chitosans are naturally found in
the cell walls of fungi but are also produced as a functional fiber
by treating shrimp and other crustacean shells with sodium hy-
droxide. Chitosan is a very unique fiber. It is soluble in acidic en-
vironments so it starts its journey through the digestive tract as a soluble fiber
in the stomach, but when the acidity of the chime (stomach contents) is neutral-
ized in the small intestine (by pancreatic secretions), it becomes insoluble. It is
also fermentable (much more so than chitin).
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Gums are a diverse group of fibers that plants secrete when they are dam-
aged. They are very complex molecules that contain a variety of types of sugars
as well as acids, proteins, and minerals. Gums are soluble and highly viscous
fibers and are also fermentable. Isolated (functional fiber) versions are used in
food manufacturing as thickening and gelling agents (like guar gum and xan-
than gum). Some gums used in food manufacturing increase intestinal perme-
ability through an action on the tight junctions between epithelial cells (one
of those cases of the isolated concentrated compound being a problem but the
small amount naturally occurring in whole foods being fine).
Beta-glucans (more technically Beta(1,3)-glucans) are

closely related to gums and are also soluble (a minority are
insoluble), viscous and fermentable. They are found in some
grains (mainly oats and barley, but also rye and wheat), fungi
(yeast and mushrooms, particularly those mushrooms that
are used medicinally like shiitake and maitake), and some
types of seaweed (mainly algae). Beta-glucans are the fiber in
oats that are mainly responsible for the cholesterol lower-
ing properties of oats and, as functional fibers in supplement
form, are also known to activate the immune system. They may even act as an
adjuvant (that could be helpful if you’re battling cancer but definitely not good
if you have an immune or autoimmune disease).
Mucil ages are rich in the simple sugars xylose, arabinose,

and rhamnose and have very complex structures. They are
soluble and very viscous fibers, forming a thick gluey sub-
stance, and are produced by nearly all plants and some mi-
croorganisms. They are particularly concentrated in cacti and
other succulents (like aloe), many types of seaweed (like agar
agar algae), flax, chia and psyllium. They can also be found in
relatively large amounts in a variety of fruits and vegetables,
including plantains, bananas, taro root, cassava, and berries.
While soluble, mucilages are not particularly fermentable (only partially de-
graded by bacteria in our digestive tracts). Mucilaginous extracts are often used
medicinally, and many of these extracts are known as immune modulators or
stimulators.
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Fructans are fructose-rich soluble and highly fer-

mentable fibers with simple structures (long chains,
some with branches–like the fructose equivalent of
cellulose). Shorter chain fructans are called fructool-
igosaccharides, whereas longer chain fructans are
called inulins. Inulin fiber is one of the most heavily
studied functional fibers. They are naturally occurring
in a variety of plants including chicory, onions, and
Jerusalem artichoke (see FODMAPs).
Resistant starch is really starch (also some-

times called oligosaccharides) and doesn’t fit the orig-
inal technical definition of fiber, which was limited to
plant cell wall constituents. Resistant starch is consid-
ered to be a fiber because amylase, the enzyme that
breaks starch into individual glucose units, doesn’t
work on this type of starch. Resistant starch is insolu-
ble yet highly fermentable. Green bananas, green plan-
tains, potatoes and legumes are all sources of resistant
starch (particularly when eaten raw).
Would you believe that these are only the major classes of fiber?
Most of these types of fiber can be further divided into sub-classes of fiber.
They are almost all found to some degree in almost all plants, so when you eat
whole vegetables, fruits, nuts and seeds, you’re getting a mix of many of these.
You’re also getting different forms: the cellulose in an apple peel is different
than the cellulose in cabbage and this may have a slightly different effect in
your digestive tract (like so many things in biology/physiology/nutrition, the
details have yet to be worked out).
What’s most important to emphasize is that different fibers feed different

bacteria and produce different organic acids when fermented. As we talk about
some of the scientific studies evaluating the health benefits (and maybe less
beneficial properties) of different classes of fiber, the important thing to keep
in mind is that when you eat a variety of vegetables and fruit, you naturally
consume a variety of fiber types. This may be the single best thing you can do
to ensure a healthy diversity of gut bacteria and reap all the benefits of a resil-
ient and diverse microbiome.
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There are actually very few studies that have even measured the different
types of fiber found in different fruits and vegetables. While generalizations
can be made, such as leafy greens being high in insoluble fiber and starchy
tubers being high in soluble fiber, the truth is that the exact amount of solute
versus insoluble fiber in most plant-based foods remains a mystery.
When it comes to sleep, we don’t yet know if one type of fiber is more import-
ant than another. In fact, most studies evaluating the impact of dietary fiber
on human health do not differentiate between soluble and insoluble but show
that fiber in general is beneficial. From the few studies that do differentiate
between the two types, we know that a high intake of insoluble fiber reduc-
es the risk of colon cancer, pancreatic cancer, and diverticulitis and correlates
even more strongly with lower levels of C-reactive protein (a marker of in-
flammation) than soluble fiber (which also lowers inflammation). There is also
evidence that insoluble fiber can improve insulin sensitivity, can help regulate
blood-sugar levels after eating, supports reabsorption of bile acids, and is es-
sential for regulating hunger hormones, especially ghrelin.
However, a great many studies on animals evaluating the health benefits of

fiber specifically look at inulin (which is a highly fermentable, fructose-rich,
soluble fiber found in sweet potatoes, coconuts, asparagus, leeks, onions, ba-
nanas, and garlic) and show that it reduces intestinal permeability and regu-
lates the immune system. For this reason, soluble fiber gets a lot of attention.
In contrast, studies also show that insoluble fiber can improve ulcerative colitis
in animals, and there are studies suggesting some potential negative health
effects from very high intake of soluble fiber in the absence of insoluble fiber.
It may be that the health benefits of fiber are derived from whether the fiber
is fermentable (meaning that the bacteria in your gut can eat it) rather than
whether it’s soluble or insoluble. While soluble fiber typically is more readily
fermentable, most soluble and insoluble fibers are prebiotics. The medical liter-
ature currently offers no clear answer as to whether soluble or insoluble fiber
is more desirable; however, the wealth of studies showing health benefits to
both imply that each is required for optimal health.
One important factor to consider is that non-starchy vegetables tend to have

much higher fiber content per calorie than starchy vegetables which tend to
have a little higher fiber content per calorie than most fruit. Of course, all of
these choices are better than grains, which contain a ton of sugar, starch, and a
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high glycemic load for relatively little vitamin, mineral and fiber content. We
are accustomed to thinking that we have to eat “healthy whole grains” to get
our dietary fiber, but the truth is that grains do not have any more or better
fiber than fruits and vegetables.
Remember that cooking does break down fiber, which can make vegetables
easier to digest but also potentially reduce some of the benefits of high fiber
intake. As a general rule, some nutrients are enhanced by cooking whereas
others are degraded, so eating a mix of raw and cooked vegetables is a good
way to optimize the benefits of each! Another important factor to consider is
that non-starchy vegetables, while high in insoluble fiber, are also good sources
of soluble fiber. They also tend to have outstanding amounts of essential vita-
mins, minerals and phytochemicals. By focusing on non-starchy vegetables as
the foundation of your fiber intake, and then having moderate portions of fruit
and starchy vegetables as well, you are able to easily reach the recommended
intakes without overconsumption of calories or carbohydrates.
How Much Fiber Do We Need?

The Recommended Daily Allowance
from the USDA is 25g of fiber (and
most of us don’t get that!). However,
a variety of studies of hunter-gath-
erer diets show that most hunt-
er-gatherers consume between 40g
and 100g per day (with some popu-
lations eating as much as 250g per
day!). And that’s with only typically
20-35% of their calories coming
from plants!!
It is exceedingly difficult to hit the

100g mark with the types of vegetables and fruit available to most of us. But,
40-50g per day is pretty doable with a little awareness of which vegetables
pack the best fiber punch and a focus on making two thirds to three quarters of
every plate of food covered in vegetables! And, from the study on the impact of
fiber intake on sleep, we can gauge that 30g per day is a good minimum amount
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beyond the bedroom
to aim for in order to support healthy sleep!
And here’s an important caveat for anyone whose current fiber intake is on the
low side: 30g is a great daily target, but work up to it gradually! Because gut
bacteria are crucial to our ability to digest fiber, and because the desired probi-
otic strains of bacteria that do this job tend to be slow-growers, going from 0 to
100 miles per hour in 0.6 seconds is likely to end in some gastrointestinal dis-
comfort. Instead, think about gradually increasing from where you are now, by
maybe a gram or two per day to your 30g target. Incorporating more fermented
foods and other sources of probiotics will help with this transition as well. And,
as if you needed even more incentive to get enough sleep, sleeping is actually
critical for gut microbiome health too!
Tips & Tricks to Get More Fiber
•• Eat vegetables with every meal. Yes, even breakfast.

•• Gradually increase your serving sizes of vegetables. This helps your gut
microbiome adjust to higher fiber intake, which makes it easier to digest
a larger amount of veggies.
•• Try wilted salads and lightly braised or sautéed greens like spinach.
Since they are heated for a very short period of time, much of the fiber
remains intact, but they decrease in volume greatly!
•• Add more vegetables to soups, stews and casseroles. Canned pumpkin or
pureed cauliflower can be used as a thickener. Spinach is a very neutral
flavor and works with most meals. You can even puree greens to add to
a soup to make it “disappear”.
•• Choose smoothies over vegetable juices. Remember that these are easier
to digest as part of a meal.
•• Raw veggies like celery, carrots and radishes make a great portable
snack. Think of ways you can bring veggies “on the road” with you
during the day.
•• Add veggies to dessert! Vegetable smoothies freeze into ice pops very
well. The Paleo community is embracing vegetable powders as flour al-
ternatives for baking and treats!
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Fiber super stars

Check out this handy dandy list of my top 14 fiber super stars, that give you the
biggest bang for your buck in total fiber & micronutrients and low calorie density.
For a full (and awesome) list of high fiber foods, including soluble and insoluble val-
ues, check out page 320 for 12 pages of fiber goodness.
TOTAL FIBER
P RO D U C E SERVING g/100g
NAME SI Z E
Artichoke 1 MEDIUM 10.3
Apple, with skin 1 MEDIUM 3.7
Avocado, raw half fruit 6.7
Beets 1 CUP 3.4
Blackberries ,raw 1 CUP 7.6
Broccoli, cooked 1 CUP 2.6
Brussel Sprouts 1 CUP 6.4
Cabbage, green, cooked 1 cup 3.4
Jicima, raw 1 CUP 2.6
Onion 1 CUP 2.9
Parsnip, cooked 1 CUP 6.2
Raspberries , raw 1 CUP 8.4
Sweet potato 1 CUP 7.6
Spinach, cooked fresh 1 CUP 5.4
Part:
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Nutrients to Improve Sleep

Research shows that nutrition has an
incredible effect on our sleep. It looks
like short sleepers tend to eat more,
and long sleepers tend to eat less;
this is likely due to the mechanisms
I discussed in the Obesity section of
Part 2. But did you know that specific
nutrients are associated with out-of-
whack sleep patterns as well? In one
epidemiological study, long sleepers
were found to consume inadequate
amounts of theobromine, lauric acid,
and choline, while short sleepers
didn’t eat enough foods containing vitamin C, lutein, lycopene, or selenium. Ba-
sically, the specifics of what you eat are important - and committing to a Paleo
diet is a great first step to improving nutrient-density and sleep.
As I discussed, the Paleo diet is an incredibly powerful tool for us to improve

our sleep. But, I think I’d be doing you a disservice if I didn’t note the specific
nutrients that you can focus on as you transition to a strict Paleo protocol for
at least the duration of my Go to Bed Challenge. So, I did my research (like I
always do!), and I’ve identified some key nutrients and the foods you can eat to
boost your intake of each one! And I put it in this awesome table for you. Woot
woot!
The table on next page is a dense source of information, so take a few min-
utes to look it over in detail. I’ve included each nutrient’s common name, its
nutrient category (vitamin, mineral, macronutrient type, etc.), its scientifical-
ly-demonstrated effects on sleep, and what foods it is found in. Just a reminder
that “sleep latency” means the time it takes to fall asleep. Here, I’ve included
“insomnia” as an abbreviation for sleep maintenance insomnia, which is the
phenomenon of waking up in the middle of the night and being unable to go
back to sleep despite exhaustion (this is different from biphasic sleep, which we
discussed in Part 3). Promoting restorative sleep just refers to improving sleep
quality such that people wake up feeling more rested. Some of these nutrients
Part:
beyond the bedroom
are going to be slightly more difficult to track down than others (hello, lyco-
pene!), so I included specifics when I felt it was appropriate. I also included an
incredibly detailed series of nutrient tables in the back of The Paleo Approach
that could be a great supplemental reference for you as you explore new foods!
Really, all of these amazing nutrients should already be a part of your diet
(because you’re eating a nutrient-dense Paleo protocol, right?), but focusing on
nutrients that are more attuned to your particular ailment could be an incredi-
ble way to enrich your sleep experience.

Nut r i e n t C at e g o r y o f K n o w n E f f e ct s
F o u n d I n...
Name Nut r i e n t on Sleep
Alpha-Carotene Vitamin Improve sleep latency Yellow, orange, & dark green vegetables
(Vitamin A sub-type) (carrots, sweet potatoes, broccoli,
spinach)
Butyric Acid Short Chain Fatty Improve insomnia/ Butter/ghee, fermented foods
Acid sleep quality
Calcium Mineral Improve sleep Leafy greens, bone-in canned fish (e.g.,
latency, promote sardines)
restorative sleep
Lauric Acid Medium Chain Improve sleep latency Coconut

Triglyceride & insomnia
Lycopene Vitamin/ Improve insomnia/ Tropical fruits, tomatoes, sweet red

Antioxidant sleep quality peppers, asparagus, carrots
Palmitic Acid Saturated Fatty Improve sleep latency Red meat, butter/ghee, palm oil
Acid
Potassium Mineral Reduce daytime Winter squash, beets, leafy greens,

sleepiness sweet potato
Selenium Mineral Improve sleep latency Brazil nuts, liver & seafood
Vitamin C Vitamin Promote restorative Dark green vegetables, citrus fruits,

sleep berries
Vitamin D Vitamin Improve insomnia/ Liver, fatty fish, egg yolks

sleep quality
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Exercise
Studies show that inactivity causes poor sleep. In fact, just sitting at your desk
job all day or sitting to watch TV or playing videogames in the evening are
known to disrupt your sleep quality and even increase your risk of sleep disor-
ders! And the combination of being sedentary and not getting enough sleep is
believed to be the leading cause of the rise in childhood obesity.
How does being active improve sleep quality?

Whether that exercise is aerobic or anaerobic, cardio- intensive or strength
training, low-intensity or high-intensity, and short duration or long duration,
exercise affects each hormone system. It also matters what time of day you ex-
ercise, whether or not you exercise in a fasted state, and what other stressors
are present (mental stress, lack
of sleep, poor quality diet, etc.).
However, what is uniformly true OPTIMAL
is that mild and moderate activi- BENEFITS
ty are beneficial to hormone reg-
ulation. Some of the benefits of
exercise are obvious. Increasing
muscle mass causes an increase
in metabolism, making it easier to
maintain a healthy weight. Most
LOW EXCESSIVE
people like the way they look
better when they have bigger
and more defined muscles (I do!).
And it’s just plain handy to be stronger, faster, more flexible, and more agile.
But there are some additional benefits that you might not immediately think of
as you contemplate adding more or different types of activity to your life. The
field of exercise endocrinology (how exercise affects hormones) is enormous
and gives us many helpful clues how to live active lives that can benefit our
hormone health the most.
Exercise is known to regulate key hunger hormones such as leptin and ghrelin
and may even promote healthier digestion through hormone regulation. It is
not necessarily true that exercise makes you hungrier, although it may feel
that way. In fact, for many people (and depending on the type of exercise),
Part:
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exercise makes it easier to natural-

ly consume fewer calories in an en-
tire day (even if you eat a bigger meal
right after working out). Not only does
exercise regulate your appetite, but
many people find that they natural-
ly crave more nutrient-dense foods. I
myself crave fish and vegetables after
an intense workout and, while I feel
famished, I actually fill up much more
quickly than on days that I don’t exer-
cise as much or as intensely.
Exercise helps to improve insulin sensitivity through a direct action on the

glucose transport molecules in the individual cells of your muscles.
It also affects the full range of hormones related to accessing stored energy
and regulating how that energy is used. This “boost” in metabolism is one rea-
son why exercising can make you feel more energetic throughout the day.
Exercise is very effective at modulating cortisol levels.

This is a bit of a double-edged sword, because exercising too intensely for your
body can increase your cortisol level too much and lead to adrenal fatigue over
time. However, if you keep exercise to a more appropriate duration and intensi-
ty for your fitness level (and appropriate for how well you eat, sleep and man-
age stress in other areas of your life), exercise becomes very potent at reducing
and normalizing cortisol levels (which can also help reduce inflammation and
promote healing). This makes it easier to burn stored energy (especially fat), im-
proves your sleep, and makes you feel more relaxed and able to cope with life’s
surprises.
Beyond its effect on cortisol, exercise regulates several key hormones related
to circadian rhythms. This means that when you exercise during the day, you
fall asleep easier, sleep more soundly, and experience more restorative sleep
so you wake up feeling more refreshed (providing you allot adequate time for
sleeping). This is another double-edged sword, because exercising too intensely
too late in the day unless it’s routine (say, you always go to CrossFit in the eve-
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ning, and your body has adjusted) can make it more difficult to fall asleep. And
working out in a really bright environment in the evening can be a problem (the
combination of bright lights, maybe in your gym, and activity in the evening
suppresses melatonin). But, other than that, any kind of activity any time of day
(even better if it’s outside!) will help support circadian rhythms.
Exercising also increases blood flow to the brain, which can help reduce in-
flammation in the brain (which also has the net effect of boosting your mood),
which is an important strategy for those with gut-brain axis problems .
Along those lines, I can’t help but wonder if exercise may aid in optimizing the
glymphatic system, which is what clears the toxins from the brain overnight.
There are different benefits of exercise, depending on type, duration and in-
tensity, but with the exception of over-training (exercising too intensely or for
too long of a duration for your body and current fitness level), all exercise is
extremely beneficial. What exercise is best for you depends on your goals and
your current health status. What matters most is that you do something—even
just a gentle stroll. And even better, do something you enjoy. If you enjoy your
activity, you are far more likely to keep doing it.
Here are a few simple ways to incorporate more movement into your day:
•• Walking is a simple way to get more exercise without a lot of effort. If
you live in the city, you may be able to walk to the grocery store or oth-
er places where you need to run errands instead of driving. If you can’t,
finding the time to go for a walk around your neighborhood or drive to
the park for a walk around the grounds is a simple change that can have
huge rewards. Taking the stairs instead of the elevator or escalator is
another simple way to work more walking into your day.
•• If, like most people, you sit for a large portion of your day (at a desk at
work and then again on the couch when you get home), there are a few
hacks you might consider to change some of that time sitting into time
exercising. Standing and treadmill desks have become increasingly pop-
ular as more and more research shows how detrimental sitting can be
to our health. If you have a standing desk, you can buy a stool so that
you can easily slide on and off of the chair to alternatively stand and sit
throughout the day. You may find that changing up the position you work
in benefits your body and also your focus and productivity. If you can’t
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get a standing or treadmill desk, try taking a ten-minute break every

hour to get up from your desk and walk around a little. You might go
outside to get some sunlight and find somewhere to stretch, do squats, or
meditate.
•• Another great way to incorporate more movement into your day is to
play with your kids, pets, partner, and anyone else in your life more of-
ten. Not only will playing make-believe or soccer with your kids, kickball
with your friends, or fetch with your dog get you moving, it’s also a great
way to spend more time with your loved ones and manage your stress!
Stress
Of all the sleep problems I’ve seen, being
a chronically stressed person might be the
most common cause of sleep disturbances.
At the root of it all is that oh-so-important,
oh-so-delicate hormone cortisol. How do
you know if your cortisol is dysregulated?
Do you carry much of your extra weight
around your middle? Do you have to pee in
the middle of the night? Do you have trou-
ble sleeping? Does your energy tank in the
afternoon but then pick up again after sup-
per? Are you having trouble losing weight
even though you should be based on what
you are eating? Are your workouts getting progressively harder rather than
easier? If the answer to any of those questions is yes, then cortisol may be to
blame.
More importantly, when it comes to your sleep, there are some fairly simple
criteria we can use here. If you’re feeling “tired and wired” late in the evening
after late afternoon fatigued stage, you might have cortisol dysregulation. If
you are consistently jolting awake too early (around 3am), your body could be
starting your cortisol awakening response too early due to your psychologi-
cal stressors. Conversely, if you are insanely, unbelievably tired after getting
enough hours of sleep and just can’t wake up in the morning, your adrenal
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glands may have become so exhausted by all of this stress that they’ve stopped
functioning altogether. And yes, if you’re familiar, these may be signs of ad-
renal fatigue– and though this isn’t a book about chronic adrenal insufficiency
(the medical term), the good news is that many of these techniques, including
just sleeping more, are great for adrenal health and can promote recovery.
Chronic stress is best handled from two sides: reducing stressors and increas-
ing resilience.
Resilience is the ability to adapt successfully in the face of stress and adversity.
This doesn’t mean that stressful events don’t affect you but rather that you can
handle them without the wheels falling off your cart. Activities that increase
resilience include yoga, meditation, walking, laughing, and social bonding.
These activities, while getting sufficient sleep may be the best tool for reducing
the effects of psychological stressors.
Lifestyle Changes
Straight-up removing stressors
is also important. Whether that’s
saying “no,” asking for help, or
making changes to the structure
of your life, whatever you can do
to reduce stress will make a dif-
ference. How your body responds
to chronic stress is also affected
by diet (at least in part). Studies
have shown that a deficiency in
omega-3 fatty acids exaggerates
stress responses but that supple-
mentation with fish oil reduces
cortisol secretion in response to
stress. Habitual coffee drinkers
also have exaggerated cortisol
release in response to chronic
stress, so you might want to re-
duce coffee or give it up altogeth-
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er (we’ll discuss caffeine in more depth in just a few paragraphs!). Reducing your
carbohydrate intake but making sure to include starches with dinner is another
dietary strategy that is simple to incorporate (again, we’ll discuss this in more
depth later). On the harder side: make sure you are eating a strict Paleo diet
while you’re trying to improve your sleep quality; from there, you can make
some tweaks and start re-introducing those “grey area” foods to see if any of
them affect your sleep (or any other system of your body!).
The rest is more individual. You need to find the best way for you to manage
the people/places/events in your life that cause you stress. What small things
can you add or remove from your life to help? Can you take a minute to just
breathe? Can you take a bit longer to meditate? Can you carve out some time
for yourself? Can you ask somebody for help? Can you take some time for
something fun? Can you just take a moment to appreciate what is good and
wonderful in your life right now? Yes, life is stressful, but you do not need to
be stressed. Your health and the health of your family are more important. So,
change what is in your power to change, and divest yourself emotionally from
the things you can’t control.
Caffeine
You probably already know that caffeine is a stimulant; as we discussed in Part
1, caffeine acts by blocking the sleep signal generated by adenosine, a protein
waste product that accumulates over the course of the day. In addition to this,
caffeine acts to increase cortisol secretion by elevating production of adreno-
corticotropic hormone by the
pituitary gland. Thus, caffeine
inherently disrupts HPA axis
function and can make improving
the effects of chronic stress ex-
tremely difficult. Excessive corti-
sol production can lead to a vari-
ety of health issues, including an
overactive immune system, dis-
rupted sleep, impaired digestion,
and depression. When you con-
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sume caffeine, your cortisol level increases (dependent on what your cortisol
management is like to begin with and how much caffeine you consume) and can
stay elevated for up to 6 hours. With daily consumption, your body will adapt
somewhat and not produce quite as much cortisol, but complete tolerance to
caffeine does not ever occur. Very importantly, if you are a habitual consumer
of caffeine, your cortisol will increase more dramatically in response to stress
(like that guy cutting you off in traffic) than someone who doesn’t consume caf-
feine. If you have difficulty managing stress or falling asleep as it is, caffeine is
not helpful to you. In fact, recent studies have shown that caffeine intake actu-
ally disrupts your circadian rhythm by pushing it back; so, even if you’re tired, if
you want to go to bed earlier, consuming caffeine later than noon might make
that goal impossible.
Endorphins
One simple hack for increasing endorphins (and thereby reducing stress) is to
smile and laugh more. As is
typically the case with re-
search at the intersection of
neurobiology and psychol-
ogy, there is far more left
unknown than known, but
there are some intriguing
results. Smiling and laughing
activates the ventromedi-
al prefrontal cortex, which
produces endorphins. The
name endorphin is derived
from the words “endoge-
nous morphine” (endogenous
means natural to the body, and I take it that you’ve heard of morphine). Endor-
phins are opioid peptides (small proteins) that function as neurotransmitters.
They are produced in response to exercise, excitement, love, and orgasm and
are associated with a feeling of happiness and euphoria. They suppress pain
through mechanisms similar to analgesia, and, even more importantly, endor-
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phins increase the release of dopamine. As we discussed in Part 2, dopamine is

a neurotransmitter with many functions in the brain, including reward-based
learning, inhibiting negative emotions, boosting mood, improving sleep quality,
and increasing motivation, cognition, and memory.
Smiling and laughing also activates parts of the limbic system of the brain (the
amygdala and the hippocampus). The limbic system is a primitive part of the
brain that is involved in emotions and helps us with basic functions necessary
for survival. When the limbic system is activated, serotonin levels are acti-
vated, contributing to feelings of wellbeing and happiness. There are further
effects on the autonomic nervous system, which balances your blood pressure
levels, heartbeat, and respiration. Smiling and laughing also lower blood sugar
levels after a meal, stimulate your immune system, reduce muscle tension, and
very importantly reduce cortisol, growth hormone, and catecholamines.
As you would probably expect, laughing and smiling work through the same
pathways, but laughing is more powerful than smiling. What might surprise
you is that even a fake smile and a fake laugh can have a positive effect on your
mood, your stress level, your immune system, your vascular health, your di-
gestive health and even your blood sugar regulation (although clearly, the real
thing is even better!). I think this is the most exciting piece of information of all.
Even if you don’t feel like smiling, forcing your facial muscles to adopt a smile
causes the same (albeit at a lower level) body and brain chemistry changes as a
real smile or laugh. And this means that forcing a smile will actually make you
feel happier and reduce your stress levels!
So, take a minute to smile or laugh a few times a day every day. It’s even better
if you can take that minute to reflect on something joyful, because then it will
be a real smile and be even more effective at prolonging a feeling of happiness
and reducing stress.
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Meditation
It’s already been mentioned several
times: meditation can help you be
more resilient to stressors in your life
and improve your sleep quality.
But, exactly how do you meditate?

There are two meditation strategies
that can both be applied to improve
sleep: mindful meditation and guided
meditation.
Mindful meditation (sometimes

called “mindful breathing practice” or “mindfulness”) may just be one of the
most powerful stress-management tools you can have in your arsenal. Besides
the fact that you can reap a huge benefit from it with a relatively short time
commitment (studies show benefits even with only ten minutes of meditation),
it can be practiced anywhere at any time by just about anybody. Essentially,
mindful meditation entails sitting and focusing on your breath for a set amount
of time. Your attention is sustained by maintaining concentration on your
breath so that your mind does not wander.
Mindful meditation is fairly simple. Choose a comfortable position, wheth-

er sitting, reclining, or lying down. Keep your attention on your breath. You
might find it easier to maintain focus by doing a breathing technique that re-
quires mental control (strategies for this are described in detail in The Paleo
Approach). Or you can simply breathe as deeply and slowly as possible. Or you
can “watch” your breath while trying not to control it (harder than it sounds).
As thoughts come to you and vie for your attention, acknowledge them (“Yes, I
know I have to do the dishes when I’m done” or “Yes, yellow would be the per-
fect color for the kitchen walls”) and then consciously let those thoughts go
and bring your attention back to your breath. In many ways, mindful medita-
tion is the practice of stopping repetitive or obsessive thoughts. It may help you
become aware of which issues truly need your attention and which ones are
less important. It may also help you become more in tune with your body.
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You can practice mindful meditation in

silence, outside with the sounds of nature,
or with music in the background (typically
something soothing without lyrics). While
studies generally show that ten to fifteen
minutes a day are beneficial, if you have
only five minutes, you will probably find
that it helps tremendously with stress
management and your overall mood. You
can either block off a time of day for medi-
tation or do it as you feel the need through-
out the day (or both). And practicing
mindful meditation as you lie in the dark
preparing to sleep can improve sleep quality dramatically.
Guided meditation is equally as powerful for stress-management. It involves

listening to a voice guide you through a series of intentional relaxations. There
are podcasts, apps (my favorite is Calm), and books with guided meditation
scripts for you to use. When working from a script, you can record your own
voice on your smartphone or other device to play back while you’re in your bed
preparing for sleep, or ask your partner to soothingly read the scripts for you.
Meditation apps will additionally allow you to choose a backgrounds sound
(like waves or relaxing chimes). Different voices, background noises, and scripts
work differently for different people, so try a few to find what you like. The
following is a sample script, one that I find works particularly well for me.
Read it slowly, pausing after each point. Begin by lying on your back in a relaxed
and symmetrical position (you may move or shift your position as necessary,
but try to be still and calm even while moving).
Click to play audio
You’ll find the full script for this audio on the next page
Part:
beyond the bedroom
Begin by taking three deep, slow breaths. Fill your lungs with air on
each inhale.
Expel every bit of air in your lungs with each exhale.
Now, mentally scan your body for areas of tension or discomfort.
Make note of how your body feels. Know that you will soon feel en-
tirely relaxed, content, and ready for sleep. Continue to take slow,
deep breaths, but don’t force the air in at the top of the inhale and
don’t force the air out at the bottom of the exhale.
Focus on your toes. Scrunch them up tightly, hold the tension, and
then release. Let your toes feel entirely relaxed.
Now focus on your ankle. Scrunch your whole feet as tightly as possi-
ble, hold the tension, and then release. Let your toes, feet, and ankles
feel entirely relaxed.
Now focus on your calf muscles. Contract the muscle, hold the ten-
sion, and now release. Let your calf muscles feel entirely relaxed.
Now focus on your knees and notice any tension you may have there.
Release any tension you may feel there. Let your knees feel entirely
relaxed.
Now focus on your quadriceps and hamstring muscles. Contract the
muscles, hold the tension, and now release. Let your whole legs feel
entirely relaxed.
Remember, release any thoughts you may have while you focus on
relaxation and preparation for sleep. Acknowledge the thought and
then let it float up and away from you.
Now focus on your buttocks. Contract the muscles of your buttocks,
hold the tension, and now release. Let your behind feel entirely re-
laxed.
Now focus on your pelvic area and notice any tension you may have
there. Release any tension you may feel there. Let your pelvic area
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Now focus on your abdomen. Contract the muscles of your abdo-

men, hold the tension, and now release. Let your abdomen feel en-
tirely relaxed.
Now focus on your back and notice any tension you may have there.
Release any tension you may feel there. Let your back feel entirely
relaxed.
Now focus on your shoulders. Lift them up, scrunch them close to
your ears, and then release them completely. Let your shoulders feel
entirely relaxed.
Now focus on your neck and your jaw and notice any tension you may
have there. Take a deep breath in and as you breathe out, release any
tension you may feel there. Let your neck and jaw feel entirely re-
laxed.
Now focus on the space on your forehead between your eyes. Notice
any tension you may have there. Release the tension in your forehead
and your eyes. Release any other tension in your face. Let your face
Finally, focus on the top of your head. Hunch your shoulders up one
last time and as you release your shoulders, any remaining tension can
sink down and flow out of you. Let your entire body feel relaxed and
calm.
Again, mentally scan your body for areas of tension. Make note of
how your body feels. Take slow, deep breaths. If you feel any remain-
ing tension, take a slow inhale and on the exhale, release that tension.
Release any thoughts of things that happened to you today. Release
thoughts of what you may have to do tomorrow. Now is the time to
clear your mind for sleep. Tomorrow you will feel refreshed, ener-
gized, strong and prepared for whatever the day may bring. Acknowl-
edge the thoughts that come to you and then let them float up and
away from you. Continue to take slow breaths.
Now your mind is calm and peaceful. Your body is relaxed. You may
now easily drift into pleasant, restful sleep.
Part:
Part five
Troubleshooting Sleep
Problems
6 7 8 go to bed by Dr. Sarah Ballantyne 139

Chapter quickstart
Part FIVE: Troubleshooting Sleep
Problems
pg. 141 1. Supplements to Support Sleep

•• Magnesium
•• L-Theanine
•• Tryptophan
•• GABA
pg. 148 2. Pharmaceutical Sleep Aids
•• There are many options that require a good understanding of pharmacol-
ogy. Please consult with a physician before using a pharmaceutical sleep
aid.
•• Over-the-counter aids
•• Prescription aids
pg. 153 3. Sleep pathologies
•• Insomnias are sleep disorders that involve a disruption in sleep patterns
that occur regularly. Treatment for insomnia includes both psychological
and pharmacological interventions.
•• Parasomnias include unwanted behaviors or experiences (like extreme

emotions) that occur when falling asleep, sleeping, or waking up.
•• Hypersomnia is described as pathological oversleeping, which might be

the result of a disorder like narcolepsy.
•• Sleep-related breathing disorders involve difficult breathing during sleep.

Sleep apnea is included in this category and is associated with a host of
serious health problems like cardiovascular disease, type 2 diabetes, and
stroke.
Part:
Part Five
Troubleshooting Sleep Problem
So, you’ve done your best to implement the diet and lifestyle changes that I
discussed in Part 4. You’re loving your new Paleo diet (I mean, obviously, right?),
re-committed to a workout routine (even just some gentle walking), and are en-
joying daily meditation practices. My guess is that, at minimum, you’re feeling
better than you have in a long while–but maybe your sleep problems haven’t
resolved completely. And that may mean that it’s time to dig a little deeper to
troubleshoot some of those sleep problems. Of course, this could take the form
of new stress management techniques, limiting your caffeine intake, or explor-
ing new supplements to support healthy sleep patterns and quality. But, it may
also take the form of seeking medical diagnosis and intervention.
Everything in this chapter falls under the purview of “under medical super-
vision” or “talk to your doctor first”. This information is here so that you can
start an educated conversation with your doctor and fas trak to a solution!
Supplements to Support Sleep

So, you’re eating an awesomely anti-inflamma-
tory Paleo diet, rich in the nutrients you know
you need to support sleep. But, you still think
you could up the ante and add some specific
supplements to shorten your sleep latency or
help you achieve deeper sleep. Including the
right supplement for your sleep problem could
make a huge difference. Supplementation from
a high-quality practitioner brand can be very
effective, but it’s important that you talk to your holistic health care provid-
er before making any changes to your supplement routine. Here, I discuss the
scientific findings for some of the most common supplements used to improve
Part:
Troubleshooting sleep problems
sleep, including the side effects shown in clinical trials that may be overlooked
by some Internet resources.
Magnesium
If you find that you really need a sleep aid to help you
drift off (at least initially), there are several options.
Magnesium is an excellent place to start, because it
is easy to find and is supported by some solid science
(even randomized controlled trials, the gold standard
of clinical research). The proposed mechanism for
magnesium’s role in sleep is that it blocks glutamate action in the brain while
simultaneously promoting GABA action. Magnesium has also been shown to
improve inflammation, which is never a bad thing! A meta-analysis recently
revealed that supplementation with magnesium improved sleep duration and
efficiency while promoting melatonin production and release of the hormone
renin, which controls your mean arterial pressure (which should go down
during sleep and can cause problems if it does not). If you’re looking to start
with food, magnesium content is very high in dark green vegetables, nuts and
seeds, and some types of fish (again, eating the bones would be a must here).
So, where do you get your magnesium supplement? If you peruse a supplement
catalog or explore your local natural foods store, you might be overwhelmed
by the many options available to you. My favorite magnesium supplement is
magnesium glycinate, because it’s so highly absorbable, but it tends to be on the
pricier side. An added bonus of this form is that glycine, the protein included,
also helps to promote sleep! Natural Calm is another great option and a close
second in my book (plus, it’s cheaper). It’s important to keep in mind that the
cheaper the magnesium supplement, typically the less absorbable it is, which
may upset some people’s stomachs or cause diarrhea since any unabsorbed
magnesium acts like a stool softener (so start with a small dose!). It also helps to
eat more dark green vegetables during the day. Plantains are also very high in
magnesium. Magnesium is also known to promote muscle relaxation in gener-
al, so steeping in a warm bath with epsom salts before bed can be awesome for
helping you get into “sleep mode.”
Part:
Melatonin
Melatonin is another option, however studies evalu-
ating melatonin supplements as a sleep aid are fairly
inconclusive. Despite its great importance in regu-
lating the sleep- wake cycle, attempts to use as mel-
atonin as a sleep cure-all have been unsupported in
the literature. Melatonin supplementation appears to be great for readjusting
circadian clocks in shift workers and in the case of jet lag, but there are mixed
results regarding sleep-related health conditions such as insomnia. And this
totally makes sense, right? We understand that melatonin acts specifically on
circadian rhythm, so we can’t expect that taking a melatonin supplement will
improve all aspects of sleep!
Melatonin is a potent antioxidant, it modulates the immune system, and it reg-

ulates gut peristalsis. The results of studies evaluating melatonin supplemen-
tation in autoimmune disease have been very mixed: melatonin has improved
symptoms (in inflammatory bowel diseases, fibromyalgia, and chronic fatigue
syndrome), and it has also greatly exacerbated them (also in inflammatory
bowel diseases, as well as in celiac disease). A study evaluating melatonin in
rheumatoid arthritis showed no benefit (and even an increase in some markers
of inflammation, although it was not associated with a worsening of symp-
toms). However, an evaluation of melatonin in mice with metabolic syndrome
demonstrated that it improved systemic inflammation and insulin resistance,
so I would definitely say the results are mixed. Therefore, using melatonin as a
sleep aid should be carefully considered.
Taking a typical dose (one to three milligrams) of a melatonin supplement may

elevate your blood melatonin levels one to twenty times above normal, so it’s
really important to use that dosage in abnormal situations rather than as a hab-
it. However, if you choose to use it with the goal of using it for only up to three
months to help reset your circadian clock, a smaller dose (more like 0.25 milli-
grams) is believed to be much more effective. Of course, check with your doctor
first. Also, avoid slow-release melatonin capsules, as they don’t replicate the
spike in melatonin that your body normally produces in the evening. Support-
ing natural melatonin production to improve your sleep quality is the best
Part:
place to start— meaning that melatonin supplementation should be considered

only after you’ve implemented changes in diet and lifestyle, including spend-
ing time outside during the day, wearing amber-tinted glasses in the evenings,
sleeping in a dark room, and eating glycine- and tryptophan-rich foods.
L-Theanine
In a recent review of sleep aid options, natural and
pharmaceutical, L-theanine was touted as the best op-
tion. Among alternative treatments for sleep problems,
L-theanine is one of the best-studied and best-support-
ed. Theanine is a non-protein amino acid, meaning that
it isn’t encoded for in our DNA but can be used by the body as an amino acid. It’s
naturally found in tea, especially green teas, but now it’s been isolated for use
in higher doses. So far, there are no studies demonstrating adverse effects of
this awesome little protein.
L-theanine is being hyped by researchers, because it induces a calming, sleep-

promoting effect without causing drowsiness (which, as we’ll see, can be a
dangerous side effect of pharmaceutical interventions). Interestingly and im-
portantly, L-theanine has been shown to specifically counteract the effects
of caffeine, which could be very powerful for people who can’t yet quit their
morning coffee. That includes both the circadian rhythm disturbances AND
the vasoconstrictive and behavioral effects (can you say, “goodbye to coffee
withdrawal headaches and jitters and anxiety” or what?!). So, if you’re thinking
about adding a supplement but want something fairly benign that you won’t be
able to get from your food… Theanine may be your best (and only) bet.
Part:
Tryptophan
Tryptophan is an essential amino acid found naturally
in meat, fish, and eggs. And you’ve probably heard that
the tryptophan in turkey is notorious for inducing naps
after Thanksgiving feasts, but this is partially myth (the
naps might have more to do with blood sugar crashes after those desserts!). The
literature on this one is dense, simply because of the importance of this amino
acid in many metabolic functions, but there is some specific research on tryp-
tophan for sleep. It’s important to remember that tryptophan is used to make
serotonin, a neurotransmitter associated with mood, and that serotonin is then
used to make melatonin.
There is some evidence that tryptophan can seriously improve your sleep.
Studies have pointed to low-to-moderate doses of tryptophan being related to
better sleep latency and stage 4 (deep) sleep duration increases, which can lead
to feeling more rested and better cognitive performance (recall our lengthy
discussion of how sleep affects our cognition, including deep sleep’s critical role
in long-term memory). And, of course, that makes for a great advantage over
taking pharmaceutical sleep aids, which often impair cognitive performance
and general awareness/arousal, even during the day. Tryptophan has also been
used in trials examining its effects on sleep disorders. It appears that this ami-
no acid could be an effective treatment method for obstructive sleep apnea in
particular.
Despite these promising results, there have been multiple cases of tryptophan
overdose leading to adverse side effects that are pretty scary. The known po-
tential side effects of too much tryptophan include tremors, dizziness, and nau-
sea; one paper cited these reactions as being mainly associated with tryptophan
doses in the 70-200mg/kg range, which is a huge dose. But, I always want my
readers to know when a supplement could be potentially dangerous. And, since
tryptophan leads to increased serotonin, adverse reactions are much more
common when patients also take drugs that promote serotonin production or
binding; for example, selective serotonin reuptake inhibitors (SSRIs like Prozac,
Paxil, or Zoloft) prevent the breakdown of serotonin so that you have an ex-
aggerated “happy time” response (essentially–bear with me here). Tryptophan,
Part:
especially in high doses, could be a dangerous addition to this neurochemical

dynamic and generate what is called serotonin syndrome. This adverse reaction
includes delirium, myoclonus (spontaneous jerking muscles), hyperthermia, and
coma. So, I urge you to never, ever take tryptophan as a sleep aid without con-
sulting and developing a treatment plan with your physician or holistic health
practitioner.
One way to get around this? Get your tryptophan from whole food sources! The
great benefit of this, other than getting additional vitamins and minerals (that
may even help to process tryptophan), is that you pretty much could not physi-
ologically consume enough whole food to overdose on tryptophan (I’m not say-
ing this can’t be done… but I don’t hear about too many people overeating liver).
Foods highest in tryptophan include liver, meat, fish, eggs, seeds, and nuts, so
perhaps including at least one of these in your nightly meal could be helpful for
getting relaxed in the evening.
GABA
We’ve mentioned the importance of GABA before, so it
may be no surprise that GABA is a supplement option
that is known to be effective at prolonging sleep and
improving sleep quality in humans and mice. GABA is
found naturally in our brains and calms the overall ac-
tivity of neurons, preparing the body for sleep. Brand new research has also re-
cently linked GABA with REM sleep promotion, which is a big clue to just how
important this neuropeptide is. Like L-theanine, supplementation with GABA
has also been demonstrated as an effective way to combat the energetic and
behavioral effects of caffeine (but that isn’t an excuse to increase your caffeine
intake!). Likewise, GABA supplementation has been shown to improve sleep la-
tency and increase non-REM (deep) sleep. And, since GABA has also been asso-
ciated with circadian rhythm, this may be a supplement that could be used for
circadian entrenchment help. Yet, there just aren’t that many studies on GABA
yet, so making sure to consult with your doctor is critical.
Part:
Complementary & Alternative

Medicine Treatments
Beyond these supplements, there
are many herbal and homeopathic
options that exist at your holistic
health care practitioner’s office (and,
oftentimes, your local health food
store). There is a difference between
evidence-based practice and scien-
tifically-based practice that I will
acknowledge, but my scientific train-
ing wants to inform you that re-
search has been done on many herbs
for sleep, and not a single one has
been shown effective in a randomized controlled trial. That includes some of
the most well- known alternatives to pharmaceutical interventions, including
valerian root, kava kava, chamomile, and wuling. There is one study looking at
homeopathy for sleep disorders, but it was published by the journal Homeop-
athy, so that in and of itself limits that article’s credibility. Despite this, I can’t
say that people haven’t seen success with these sleep aids. So, some herbal
remedies that may help (and don’t contain gluten, which is a common ingredi-
ent in herbal sleep aids) are Bach’s Rescue Sleep, Bach’s Rescue Night, and Gaia
SleepThru (though please note that these are not appropriate for those with
autoimmune disease).
If you’re interested in using alternative medicine (outside of a

licensed naturopathic physician, who should be able to ad-
dress almost all of the concerns outlined in this book), anoth-
er option would be to try acupuncture. Believe it or not, acu-
puncture is one of the best-studied alternative treatments
for sleep problems, and there is good evidence suggesting
that it could be helpful! Considering the variety in treatment
methods (that range both from practitioner to practitioner
and from philosophy to philosophy), finding a practitioner
that you like and respect could make a huge difference in
Part:
your treatment. Likewise, some of the potency of acupuncture seems to be gen-

erated by placebo effect and the effect of designated relaxation time (since you
rest with the needles in you for 45 minutes or so).
The Bottom Line

It may take some time trying supplements before you can determine if they’re
effective or not. You should work with your practitioner to make sure that you
don’t start a host of new supplements at the same time–that can make it diffi-
cult for you to determine which are really working for you. I include all of this
information in this book to hopefully empower you. If nothing else works, then
the detrimental effects of consistently not getting enough sleep or enough
quality sleep may outweigh the cons of taking a prescription sleep aid. Talk to
your doctor about the possible side effects, which can include drowsiness, indi-
gestion, changes in brain chemistry and sleep behavior, and dependence.
Pharmaceutical Sleep Aids

I’ve said this many times, but I’m just going
to preface this section with an important
reminder: I’m not a physician. I hold a Ph.D.
and feel that I have a great grip on medi-
cal literature, but I can’t make any medical
recommendations. What I can do is lay out
your options for pharmaceutical sleep aids
(including the physiological mechanisms
and side effects) should you and your doc-
tor determine that a medical intervention
is needed for you to achieve your best
health. And just another reminder that NO
sleep aid is appropriate for use in people
with an autoimmune disease (even though I know those with autoimmune dis-
ease can be the most exhausted–I’ve been there).
Part:
Over-the-Counter Aids
So, you’ve tried everything that I’ve already described in this book and yet
still can’t get a good night’s sleep (either because you can’t fall asleep or stay
asleep). Considering the amazing resource of alternative tools available to you, I
can only imagine how frustrating (and, ultimately, tempting) it would be to pick
up a pack of Benadryl to get your body to sleep. If you’re at this place, my first
thought is that you need to consider the option of a sleep disorder and should
strongly consider getting a sleep study (most of which are covered, at least in
part, by insurance; please read Part 6 in great detail if you think this might be
you). But, if natural supplementation doesn’t work, what are your other over-
the-counter options?
First, a note on how to pick the “right” over-the-counter pharmaceutical: read

the Active Ingredients List! Just like reading the ingredients list on your pack-
aged foods, having the medical knowledge to be able to recognize different
active ingredients could be a (literal) life-saver. So take the time to flip the box
over and see what’s inside these medications. Likewise, look at the INactive
ingredients as well–many over-the-counter products have gluten and other
ingredients that could be downright dangerous for some of us.
Diphenhydramine
(Benadryl, Tylenol PM, Unisom SleepGels,
etc.)
Diphenhydramine is an antihistamine
(meaning that it reduces natural histamine
reactions in the body) that is known to in-
duce drowsiness. If you’re unsure if a med-
ication fits into this category, make sure to read the label! So, these medications
were obviously intended for the treatment of allergies and allergic reactions to
things like a bee sting, but what about the drowsiness component? It turns out
that, like many pharmaceuticals, the side effect of drowsiness was just so com-
mon that it started to be recommended as a sleep aid without us understanding
its mechanism of action. A paper that was published in Neuropharmacology in
late 2015 finally revealed how these drugs act on the brain to promote sleep:
Part:
they inhibit excitatory receptors for glutamate found in the brain. These are
the receptors that must be turned off in order for us to sleep that work in syn-
chrony with GABA receptors. So, these drugs function in the same way as a
magnesium supplement (but are likely more efficient). Isn’t that an awesome
parallel?
Like anything pharmaceutical, these sleep aids are not without side effects. Side
effect for using these drugs include dry mucous membranes, dizziness, nausea,
vomiting, loss of appetite, constipation, chest congestion, headache, muscle
weakness, nervousness, vision problems, and/or difficulty urinating. So, we can
see that the drowsiness effect is not the only mechanism that we don’t under-
stand here–and I think I can comfortably say that these sleep aids must not be
used on a regular basis.
Doxylamine Succinate
(Unisom Sleep Tabs)
Like diphenhydramine, doxylamine succi-
nate is an antihistamine that also happens
to cause drowsiness. Yet, in comparison, this
drug has not been studied in the context of
sleep; it is just known to induce sleepiness
and is therefore used as such. The side ef-
fects are similar: drowsiness, dizziness, headache, constipation, upset stomach,
blurred vision, decreased coordination, and/or dry mucous membranes.
The bottom line with these is that, if you’re going for an over-the-counter op-
tion, it might be best for you to head to your Whole Foods and pick up a natural
supplement (like one of those I’ve discussed above). Considering those are bet-
ter-studied than the pharmaceutical options, I feel much better recommending
natural sleep aids.
Part:
Prescription Sleep Aids

In comparison to our over-the-count-
er options, there are many more
prescription options–though maybe
that isn’t surprising (holding back
comment about the pharmaceutical
industry here). Some of these medi-
cations are likely a household name,
but maybe because of their notori-
ous side effects. I know I’ve heard of
many people sleep walking, eating,
or even driving when they’ve taken
these medications. So, these are really only to be used in cases of severe sleep
disorders that can’t otherwise be helped (again, opinion here–I know some phy-
sicians hand out these prescriptions like candy), and the reality is that you need
sleep or will suffer from extreme health conditions.
I considered including the physiological mechanisms of these drugs in this

book, but I also understand the intense volume of scientific material in this
work–so I’m going to distill the information into what I think is the most useful
for you to know upfront. I think one of the most important aspects of these to
note is that a majority of them are habit forming. What does that mean? Es-
sentially, using that medication over time creates a dependence, so that person
ends up needing it to get normal sleep at all (if anything, this results in an exag-
gerated sleep disorder when the person isn’t using the drug).
I think it’s also important to note that the majority of these drugs also have
side effects that include mental health changes. Specifically, many of these are
implicated with mood disorders and increased risk for suicidal ideation. If you
have a medical history of depression or depressive tendencies, it is so import-
ant that you clearly state your concerns to your doctor before he or she decides
on the appropriate medication for you. Many of these sleep aids list “changes in
thinking or logic,” which I know I wouldn’t want to have on my plate!
Part:
Prescription Sleep Aids

BRAND NAME USED FOR... HABIT COMMON SIDE EFFECTS
(GENERIC NAME) FORMING?
SILENOR Improved sleep No Dry mouth, thirst, burning, stinging

(doxepin)
maintenance
ESTAZOLAM Improved sleep Yes Dry mouth, upset stomach, feeling tired
latency & sleep
maintenance or weak, headache, dizziness, sleepiness
through the next day
LUNESTA Improved sleep Yes Bad taste in your mouth dry mouth,
latency & sleep
(Eszopiclone)
maintenance headache, dizziness, feeling sleepy
throughout the day, signs of the
common cold
ROZEREM Improved sleep No Sleepiness, dizziness, feeling weak
(Remelteon)
latency
RESTORIL Improved sleep Yes Headache, dizziness, feeling tired or

latency & sleep
(Temazepam)
maintenance weak, feeling sleepy through the next
day, upset stomach
TRIAZOLAM Improved sleep Yes Headache, dizziness, feeling tired or
latency
(Halcion) weak, feeling sleepy through the next
day
AMBIEN Improved sleep Yes Dizziness, headache, upset stomach,
latency
(Zolpidem) diarrhea, feeling tired or weak, feeling
sleepy through the next day
AMBIEN CR Improved sleep Yes Dizziness, headache, upset stomach,
latency & sleep
(Zolpidem extended
maintenance diarrhea, feeling tired or weak, feeling
release) sleepy through the next day
Part:
Sleep Pathologies
I believe that I have compiled the best, most compre-
Do You Feel hensive resource for how to improve your sleep that
is available anywhere. With that said, the advice and
like the
information in this book is, for the most part, for peo-
walking ple who do not have a sleep disorder. If you are making
dead? changes to support better sleep and your body is not
cooperating, it’s important to talk to your doctor about
possible sleep disorders, like insomnia, narcolepsy
(sounds counterintuitive, but it can wreck your night-
time sleep quality), and obstructive sleep apnea. In fact,
there are over 100 different disorders that affect sleep.
While sleep disturbances can be a symptom of autoim-

mune disease, hormone imbalance, unmanaged stress,
inactive lifestyle, high sugar diets, and poor circadian
rhythm entrenchment and sleep hygiene, there are
situations where the diet and lifestyle recommenda-
tions listed in this book are not going to be enough. It’s
important to know exactly why you can’t sleep well
and work with your doctor to find a solution. Having
an undiagnosed sleep disorder can be a life-threatening
situation.
Insomnias
Insomnia is probably the best-known type of sleep disorder, and it’s likely the
most common. Patients report insomnia in some 5 million doctor’s visits per
year, though self-reported insomnia is generally less severe than a diagnosable
sleep disorder. This formal condition involves the inability to fall asleep or stay
asleep, which includes waking up in the middle of the night or rising early (for
example, 3AM) and being unable to go back to sleep. In order for the insomnia
to be a diagnosable sleep disorder, the person needs to be unable to sleep de-
spite the opportunity and circumstances to sleep, and the resulting exhaustion
from not sleeping needs to be severe to the point of impairing function.
Part:
Complications of insomnia
Short-term insomnia occurs when the above symptoms are present for three
months or less; chronic insomnia is, as you would expect, when insomnia occurs
for longer than three months. In order for diagnosis, a physician needs to assess
self-reported sleep habits for the duration of the insomniac episodes. Despite
slight normalization of insomnia in our culture (some studies estimate that up
to 50% of adults will experience insomnia in their lifetime. 50%! So it’s no won-
der that it’s a “normal” disorder to have), there are serious health consequences
associated with this disorder. Patients with insomnia are more likely to report
anxiety and depression and have been found to have a lower quality of life in
general. These patients also tend to have worsened performance in their jobs
and home life, likely due to impaired cognition. Importantly, insomniacs have
increased risk for cardiovascular disease and type 2 diabetes. But, based on our
careful review of the relationship between sleep and health, none of this is too
surprising, right?
Treatment for insomnia generally includes two methods: psychological and/ or

pharmacological. The best-studied mental treatment for insomnia is cognitive
behavioral therapy, which is a favorite of psychologists for helping patients
develop appropriate responses to cognitions, because the relationship between
mood disorders and insomnia tends to be bidirectional–so treating someone’s
Part:
depression or anxiety can actually resolve their insomnia. The most common
treatment for insomnia, however, is the pharmaceutical options that I de-
scribed in Part 5, though a naturopathic physician or holistic healthcare practi-
tioner would certainly opt for the natural supplements first. [KP13]
A new complementary medicine-based option for treating insomnia that was

recently validated in the scientific literature is the use of a weighted blanket
for sleeping. Weighted blankets have been recommended by occupational ther-
apists to mitigate sleep issues in children with autism spectrum disorder (ASD)
and sensory processing disorder (SPD) for decades. While science supporting
this strategy is lacking, a recent scientific study showed that weighted blankets
improved sleep quality in insomniacs using both objective and subjective mea-
sures. Not only did patients prefer to sleep with the weighted blanket, but they
also woke less in the night, moved less while sleeping, and enjoyed a longer
total sleep time. The idea for weighted blankets originates with the observation
that many people feel more comfortable when “cocooned” in many blankets,
and the use of weighted vests and deep pressure therapy has been shown to
provide a calming and relaxing effect on children with ASD and ADHD. Look for
a blanket that weighs between 10% and 12% of your bodyweight.
Parasomnias
Parasomnias are a group of sleep disorders that involve unwanted events or
experiences that occur while you are falling asleep, sleeping, or waking up.
What’s meant by “unwanted events or experiences?” Things like movements,
behaviors, emotions, or dreams. The type of parasomnia is determined as be-
ing NREM- or REM-related. NREM parasomnias are considered to be issues of
arousal and include night terrors, sleepwalking, and sleep-related eating dis-
order. REM parasomnias involve some type of abnormal (generally, exagger-
ated or absent) feature of REM sleep; so this could mean a nightmare disorder
or sleep paralysis or the like. As you can imagine, both types of parasomnias
can be very distressing for people, so it’s pretty likely that someone experi-
encing parasomnias, even infrequently, will go to a doctor to seek help (as they
should!).
Part:
Hypersomnia
Hypersomnia may refer to either excessive sleeping, which may be a result of
narcolepsy, or excessive daytime sleepiness, which is a person being excessive-
ly sleepy during the day. Those with hypersomnia describe feeling so exhaust-
ed that they aren’t functional. As a result, people with hypersomnia may fall
asleep at times that are inconvenient or even dangerous, such as at work or
while driving. This problem is another common one, with 10-25% of the popula-
tion reporting hypersomnia. In general, the excessive daytime sleepiness is also
a result of an underlying sleep disorder like obstructive sleep apnea, so noting
hypersomnia to your doctor is important–no, we aren’t all that tired.
Sleep-Related Breathing Disorders

Sleep-Related Breathing Disorders involve difficulty breathing during sleep.
This could be an abnormal respiratory pattern, like an apnea (temporary pause
in breathing), or an abnormal gas exchange, like not releasing enough carbon
dioxide during expiration. There are several types of sleep-related breathing
disorders, all of which need to be diagnosed by a doctor through a sleep study
and questionnaires about your sleepiness. Because of the chronic insufficiency
of nutrients associated with sleep-related breathing disorders, the long-term
health consequences can be severe, including increased risk for cardiovascu-
lar disease, type 2 diabetes, stroke, and mood disorders. The good news is that
these disorders are generally treatable with a continuous positive airway pres-
sure (CPAP) machine, and, most of the time, this treatment method is covered
by insurance.
Sleep-Related Movement Disorders

Sleep Movement Disorders includes conditions that cause movement (specifi-
cally, simple, stereotypic movements) during or prior to sleep that may or may
not be in the consciousness of the person. These disorders can make it difficult
to fall asleep, stay asleep, or get restful sleep. The most common sleep-related
movement disorder is a result of restless leg syndrome; the leg(s) continue to
be restless during sleep, making restful sleep almost impossible. Like several
Part:
of the other disorders, it can be hard to determine what’s going on with your
health, because the most significant symptoms are general fatigue and exces-
sive daytime sleepiness. Treatments for this category of disorders are often
pharmaceutical, so consultation with a physician is an important step.
Circadian Rhythm Sleep-Wake Disorders

Circadian Rhythm Sleep-Wake Disorders are conditions in which sleep times
are out of alignment. A patient with one of these disorders does not follow the
normal sleep times at night due to an issue with circadian entrenchment. This
issue may exist as a result of one of several problems, including shift work and
jet lag (these are the most common of all of the disorders). The types of circadi-
an rhythm sleep-wake disorders is very intuitive: we see a delayed subtype (not
falling asleep in a normal window, depending on personal circumstances) and
an advance subtype (waking up too early for someone’s sleep time). In order
to be diagnosed (other than in the case of jet lag disorder, which is generally
temporary), patients must experience these symptoms for longer than three
months. Issues with circadian rhythm are often seen in children and adults
with a developmental disorder and in neurodegenerative diseases; this pattern
speaks to the critical role of fundamental brain regions to circadian rhythm
maintenance. However, in many cases, this disorder can be treated natural-
ly with supplements like melatonin that are intended to reset the circadian
rhythm.
Diagnosing a Sleep Disorder

We already covered some of the diagnostic tools used to figure out if someone
has a sleep disorder. In some cases, like insomnia or excessive daytime sleep-
iness, a questionnaire and/or detailed sleep recall interview can be enough
for a formal diagnosis. In more complex sleep disorders, like sleep apnea, it’s
impossible to determine if you really have the problem without taking an in-
credibly detailed look at your sleep. How is that accomplished? A sleep study.
Sleep studies are tests that record what happens to your body during sleep in
order to diagnose the cause of your sleep problems. Generally, your primary
care physician might refer you to a sleep specialist if you report common sleep
Part:
disturbances that are interfering with your daily life, like:

•• Snoring, gasping/choking in your sleep (as reported by your partner or if
you jolt awake as a result)
•• Excessive daytime sleepiness (which may be different from fatigue or
not)
•• Drowsy driving
•• Mood, memory, or attention problems
•• Morning headaches, dry mouth, or sore throat
•• General difficulty falling or staying asleep
You can see that some of these symptoms have been described as relatively
easy to resolve or manage using alternative options (like circadian rhythm-en-
trenching supplements), so I implore you to stick with a doctor that will con-
sider natural options before pharmaceutical interventions (and a potential-
ly-very-expensive sleep study). That being said, as I’ve mentioned before, the
health benefit of getting sleep greatly outweighs the consequences if someone
is chronically sleep-deprived. But some people really need these tests, so I
thought that I would cover the basics here in case a clear description of your
study and the results aren’t provided for you.
Polysomnogram
The most common type of
sleep study is a polysomno-
gram. The main goal of this
study is to determine if there
is sleep disordered breathing,
which could be obstructive
sleep apnea, upper airway re-
sistance syndrome, or primary
snoring (just snoring without
apneic episodes), but a poly-
somnogram can also be used
to detect less common sleep
disorders, like narcolepsy and
parasomnias.
Part:
So, what do you need to do during this test? Sleep! A polysomnogram involves
staying for one to two nights (or, in the case of shiftwork, daytime studies are
occasionally done) in a laboratory that is designed to look and feel like a com-
fortable bedroom. In this room, a technologist hooks you up to many electrodes
and wires that record several body functions during sleep, including brain
activity (by electroencephalogram, or EEG), eye movement, oxygen and carbon
dioxide blood levels, heart rate and rhythm, breathing rate and rhythm, the
flow of air through your mouth and nose, snoring, body muscle movements,
and chest and belly movement.
Now, I know what you’re thinking: “how the heck am I supposed to sleep like
that?!” Unfortunately, you probably won’t sleep amazingly well–but the pur-
pose of the sleep study is to get enough of a picture of your sleep that a doctor
can piece together what might be going on with you. So, you may not get the
most restful sleep of your life, but, chances are, your pattern of breathing and
your brain activity won’t vary that much between when you’re at home ver-
sus when you come in for the sleep study. Alternatively, some sleep centers
are now offering at-home sleep studies, where you hook yourself up to sim-
pler machinery. These studies are less accurate but way more convenient (and
cheaper!); in general, they give physicians enough information to make diag-
noses, but there is a chance that you would still need to go into the lab for an
overnight study. Once you have finished your sleep study, a physician will take
at least a couple days to review the data that has been collected on you.
Multiple Sleep Latency Test (MSLT)

Someone might be referred for a multiple sleep latency test if their primary
care physician is worried that they have a sleep disorder like narcolepsy. Oth-
er indications for this type of sleep study are excessive daytime sleepiness,
suspicions of fragmented nocturnal sleep, hypnagogic hallucinations, or sleep
paralysis. This test measures how long it takes you to fall asleep and deter-
mines whether you enter REM sleep (including whether you enter REM sleep
too quickly, which can cause REM parasomnias). An MSLT will be ordered as a
follow-up to a polysomnogram. During an MSLT, a patient will take a series of
short, daytime naps.
Part:
Maintenance of Wakefulness Test (MWT)

This test measures whether you can stay awake during a time when you are
normally awake. Someone would need a MWT if they are having so much trou-
ble staying awake that their ability to fulfill their personal responsibilities is
impaired. Like the MSLT, a MWT is often preceded by an overnight polysomno-
gram.
Actigraphy
If your doctor thinks that you may have shift work sleep disorder or another
problem with your circadian clock, you may have a test called actigraphy. This
test tells your doctor what time of day and night you are active by tracking
your movement throughout the 24-hour day. This test is as simple as wearing
a device on your wrist that looks like a watch (like a FitBit) and is generally at
least a week in duration. Actigraphy can give a clear picture of sleep latency,
quality/efficiency, and duration, \which is often enough information to deter-
mine how to support sleep.
After the Diagnosis

Don’t despair if you suspect or are diagnosed with a sleep disorder. Remember
that knowledge is essential for problem-solving, which is partially why I’ve
included the summaries in this book. For most sleep disorders, all of the recom-
mendations in this book are likely to still provide a benefit and can work in tan-
dem with your treatments to get you the absolute best sleep of your life. Talk
to your doctor about additional strategies, treatments and medications that are
available for you. If you suspect that you may have a sleep disorder that is a
barrier to getting enough good quality sleep, don’t put off talking to your doc-
tor about doing a sleep study–having the right resources for sleep can make a
world of difference in your overall health.
Part:
Part six
Now, Let’s Go to Bed!

Chapter quickstart
Part SIX Now, Let’s Go to Bed!
1. Put Sleep at the Top of the To-Do List

•• Setting a regular bedtime is an essential and easy way to self-regulate the
amount of sleep you get.
•• You don’t need to do it all! And prioritizing sleep is perhaps the best way
to promote health and enhance brain function (to make those busy days
more efficient).
•• Having a social support network improves your health, and not having
one actually increases your risk of disease. Let your loved ones know that
you’re prioritizing sleep and explain that you need their support!
•• Utilize assorted strategies for reducing stress and promoting resilience.

•• Think about sleep as a habit – and work on forming good sleep habits!

Now, Let’s go to bed!
Part SIX
Now, Let’s Go to Bed!
When it comes to getting enough quality sleep to support optimal health, there
are two barriers: first, our busy modern lives in which we tend to choose just
about any other activity over sleep; second, all the ways that our busy mod-
ern diets and lifestyles negatively impact the quality of our sleep. So, when it
comes to making sleep a priority, there are two sides of the coin to consider:
quantity and quality.
The single most important aspect of getting more sleep for most people is just
making the choice to go to bed at an early enough time in the evening that we
have the opportunity to get the sleep our bodies need before morning! Hence,
the title of this book. Simply making the decision that sleep will not be sacri-
ficed for work, social life, or doing the laundry is arguably the most important
thing you can do for your short- and long-term health. Throughout this book,
topics relating to simply putting sleep at the top of the To Do list have been
classified as changes to your routine, color coded purple. It’s true that each one
of us has to figure out that give-and-take solution to make this possible in our
own lives, but we can distill this major factor in getting enough sleep to a very
simple concept: just go to bed.
We’ve also covered a variety of ways

in which the foods we eat (the caf-
feine we drink!) and the way we live
our lives can interfere with our body’s
ability to sleep well. And, there are
few things more frustrating that
deciding to go to bed at a good time
only to lie there awake for hours, or
to awaken a few hours later and then
toss and turn the whole night! I’ve
already covered the huge range of in-
Part:
puts that influence sleep quality, broadly falling under the other three catego-
ries: Sleep Hygiene, Circadian Rhythm, and Healthy Hormones. When it comes
to making sleep a priority, it’s also important to make changes to our sleep
environments as well as our internal body chemistry (like protecting dim-light
melatonin production and regulating cortisol) to support sleep. Overall, that
means sleeping in a dark, cool, and quiet bedroom as well as being active during
the day, spending time outside, and eating a nutrient-dense anti-inflammatory
diet (go Paleo!).
As we move from science to implementation, keep in mind that, in the end,

you are the one in control. Your sleep reflects the sum of all of the choices you
make that both promote sleep quality and ensure sufficient sleep quantity.
Put Sleep at the Top of the

To-Do List
People in our culture generally put their social life, leisure activities, and job on
the front burner and sleep on the back burner. The bottom line is that refusing
to go to bed makes us sicker (kind of like we’re a country of children throwing
temper tantrums at bedtime, right?). If you have any diagnosed chronic illness,
neither work nor fun should come between you and slumber. Ever. But, as al-
ready abundantly emphasized in this book, a continued commitment to getting
sufficient sleep is essential for achieving and maintaining health for everyone.
Easier said than done. Many of us feel

completely powerless in our lives to get
any more sleep than we already do. It’s
probably the most common negative re-
sponse to this book, “I’d love to get more
sleep, but I just can’t”. So, here’s where
I inspire you, solve all your logistical
challenges to more sleep, and create
the space you need in your life to be the
King or Queen of everything!
Okay, maybe not. The truth is that fig-

uring out how to put sleep at the top of
Part:
the To-Do list is going to require as many different strategies to accomplish as

there are people reading this book! Making the changes you need to make to
prioritize sleep is a multifaceted and highly individual challenge. It involves a
vast spectrum of inputs (such as what you eat at dinner, whether or not you go
outside for a walk, what time you go to bed, the environment you sleep in, and
how well you manage stress), each with its own effects and own solutions. Your
health, your individual priorities, your responsibilities, and your preferences
will all influence how you restructure your life to get more sleep. So, instead
of providing you with definitive answers, think of this section as your starting
place. We’re doing a brainstorming session to give you ideas about what chang-
es you can make to simplify your life so that you can add the necessary time in
bed and time for activities (like meditation and a relaxing bedtime routine) that
are going to be essential for supporting sleep.
Establishing a Bedtime
At the core of your lifestyle chang-
es is the idea that you must change
your sleep routine in order to
accommodate more sleep. And
I know that you’re not sleeping
enough, because the data tells me
that the average American’s sleep
duration has decreased by about
2 hours per night. That’s almost a get a bed time...
25% decrease! More than an entire
sleep cycle! I know that our culture
go to bed...
emphasizes working more, watch-
ing more, doing more; but the bottom line is that we are making the choice to
sacrifice sleep for other aspects of our lives. And our health as a nation is suf-
fering as a result.
Even if you drastically improve your sleep quality by implementing the tech-
niques I mention above, you need to put the hours in. Think about sleep as an
additional obligation that should be at the top of your priority list (I know, in
Part:
a way, that doesn’t help your

stress–but if you’re getting
enough sleep, you’ll be more ef-
ficient, think better, and be phys-
iologically able to handle some
additional stress during the day).
How are you going to make sure
that you get enough sleep? That’s
right: a bedtime.
We’ve talked about this before,

but I really want to drive it home:
adults need bedtimes, too. As a
general rule, eight to nine hours
of sleep every single night should be considered a bare minimum. If you know
that your sleep quality is not great, aiming for more sleep than this is strongly
worth contemplating. How do you get nine hours every night? Work backward
from the time you have to get up in the morning. Next, add at least half an hour
to account for the time it takes you to get ready for bed and fall asleep. (If you
take a shower or have other more lengthy pre-bedtime rituals, add more than
half an hour.) Then figure out how long you need to unwind (do you like to read
a book before going to bed?) so you know when you need to start your pre-bed-
time rituals (and maybe start wearing your amber-tinted glasses). The pros-
pect of getting that much sleep might be daunting for some who use late night
hours to increase their productivity. But household chores can wait. The work
you brought home can wait. That blog post can wait. (Can you tell I’ve learned
from experience?)
It’s maybe easiest to think of bedtime as “what time you turn out your light to
roll over and start trying to fall asleep,” perhaps more aptly called “lights out
time.” Most of us take between 30 minutes and an hour to fall into a deep sleep
from this time, so that needs to be factored into the equation when it comes to
total sleep time goals–the stingiest way to do this is to add 30 minutes to your
total sleep time goal when calculating your bedtime.
Part:
You can also use this handy dandy table to find what time your “lights out” time
needs to be depending on your total sleep time goal and what time you need to
get up in the morning.
Total Sleep Time Goal

WAKE TIME 7.5 HOURS 8 HOURS 8.5 HOURS 9 HOURS 9.5 HOURS
SLEEP SLEEP SLEEP SLEEP SLEEP
5:00 9:30 9:00 8:30 8:00 7:30
5:15 9:45 9:15 8:45 8:15 7:45
5:30 10:00 9:30 9:00 8:30 8:00
5:45 10:15 9:45 9:15 8:45 8:15
6:00 10:30 10:00 9:30 9:00 8:30
6:15 10:45 10:15 9:45 9:15 8:45
6:30 11:00 10:30 10:00 9:30 9:00
6:45 11:15 10:45 10:15 9:45 9:15
7:00 11:30 11:00 10:30 10:00 9:30
7:15 11:45 11:15 10:45 10:15 9:45
7:30 12:00 11:30 11:00 10:30 10:00
7:45 12:15 11:45 11:15 10:45 10:15
8:00 12:30 12:00 11:30 11:00 10:30
Let’s go through an example. Let’s assume you need to get up at 6 a.m. so that
you don’t have to rush to get ready for work or get your kids to school on time.
Now, let’s assume that your goal is an ambitious nine hours of sleep. That puts
your “asleep time” at 9 p.m. Adding half an hour to fall asleep means that your
bedtime or “lights out” time is 8:30. If you like to read before falling asleep,
maybe you will aim to start reading at 8. You’ll want to schedule some time
to change into your pajama and brush your teeth, which means starting to
get ready for bed at 7:50. This probably means that your amber- tinted glass-
es should be perched on your nose by about 7. Yes, this is early. Yes, this might
even be before your kids are in bed. Yes, this means finding some time during
Part:
the day for everything you used to do between 8 and 11 at night. Yes, you’ll have
to get used to eating dinner earlier. And yes, it means that some things just
might not get done.
Creating Time for Sleep

If you read through the first few parts of this book feeling doomed, I want to
emphasize a few things. First, you don’t need to make all the changes suggest-
ed for better sleep all at once. Second, every single change that you do make is
going to get you one step closer to healthier sleep and a healthier you.
So, what do you do if you have a crazy full and busy life with too many things to
get done each day to create any time for an earlier bedtime or those activities
scientifically- proven to support better sleep?
Probably the best place to start is with this

phrase: It’s OK if you can’t do it all.
Yes, I know you read that and didn’t believe me.
I’m the same way. I truly want to do it all and con-
stantly struggle with setting boundaries for my-
self to protect my health. Whenever you are faced
with a choice, it’s helpful to say to yourself, “It’s
OK to say no.” One of the most common barriers
to getting enough sleep is the idea that we have to
do everything and be everything to everyone. We
don’t. We can trim back substantially, still be awesome, and put our own health
first. Yes, you’re allowed to make sure your sleep and your health come before
other commitments.
In a similar vein: It’s OK to ask for help.
One of the best ways you can protect your own health priorities is to ask for
help. This might mean asking your spouse to cook dinner a couple of times a
week or asking your kids to set the table. This might mean asking your neigh-
bor or a friend to watch your kids so you can take a nap or get errands done
more efficiently. This might mean asking a family member to pick up your CSA
box for you. It’s true that sometimes it is just easier to “do it myself.” It’s true
Part:
that someone else might not do as good a job as you would. It’s also true that
that’s OK. It’s OK if your husband doesn’t clean the floor as well as you would
have. It’s OK if your mom folds your socks differently than you do. Heck, it’s
even OK if the laundry doesn’t get folded.
Another strategy is multitasking. Okay, so science now shows that multitask-

ing is a myth and that the more activities we try to do simultaneously, the
worse we perform each! But, when it comes to supporting sleep, there are some
amazing and very painless ways we can incorporate things that will improve
our sleep into our lives. This is where sleep gadgets and biohacks come in, sum-
marized in the Sleep Aid Shopping Spree section. Too busy to get outside during
the day? Use a light therapy box in the kitchen in the morning while you’re
making breakfast and packing lunches. Too busy to get your 30 minutes of ac-
tivity every day? Time to invest in a treadmill desk,
DeskCycle or FitDesk Elliptical Trainer. Need to work
in the evenings? Use your amber-tinted glasses and
install f.lux onto your computer. Can’t find time to
meditate? Listen to soothing sounds like Anne Ange-
lone’s Peaceful Sleep tracks, available here, while you
brush your teeth and get into your pajamas, and listen
to the Deep Relief track whenever you have a quiet
moment in your day (not while driving!).
Another major thing to keep in mind is that getting

sufficient sleep will dramatically improve your effi-
ciency during the day. Many top entrepreneurs, like
Arianna Huffington of the Huffington Post, have
reported that once they put sleep at the top of their To-Do list, they actually
got much more done per amount of time committed to other tasks during the
day. This has certainly been my own experience as well. I’d venture so far as to
say that I can get nearly twice as much work done per hour when I’m getting
enough sleep every single night compared to even after one late night. Depend-
ing on the size of your sleep debt, this can take a bit of time to really see the
difference. However, once getting sufficient sleep is part of your routine, you’ll
likely find that superhero status with all your other commitments stops being a
competing priority.
Part:
Perhaps the best advice I can provide though is to just keep reading this section.
There are so many little tips where you can find efficiency in your life to make
the time for sleep. And, hopefully, by the time you’re reading about the 14-Day
Go To Bed Challenge in Part 7 of this book, you’ll be ready to tackle it and expe-
rience what better sleep can do for you!
The Importance of Support

A big part of being able to ask for help (and getting it) is having a good support
network. Social connection is key for mental health and stress management.
Research has proven the role that connection plays in health through two ex-
tremes:
1. Social isolation and loneliness corresponds with increased risk of morbidity

and mortality
2. A strong social support network corresponds with decreased risk of disease
and increased longevity.
Having a social support network improves your health and not having one
pretty dramatically increases risk of disease. How does this work? We are
hardwired to be social creatures. Positive social interactions stimulate changes
in hormones that affect nearly every system in the body. So, how large is the
impact on our health from feeling connected and having a sense of community?
This quote sums it up well:
“Social relationships, or the relative lack thereof, constitute a major risk

factor for health—rivaling the effect of well-established health risk factors
such as cigarette smoking, blood pressure, blood lipids, obesity and physi-
cal activity” — House, et al; Science 1988
Did you catch that? Connection is just as important for your health as not
smoking, being a healthy weight, and being active. That’s great news if you are
close with your family, have an awesome group of friends, and live in a tight-
knit community. Not so cool if you’re like a growing number of us who live far
from home, feel like we have friendly acquaintances in our lives more so than
true friends, and generally have a sense that life would be better in a different
city or region. Sound familiar? Did you also catch the part where this has been
well established in the scientific literature for more than 25 years???
Part:
Having a strong social network provides a huge range of benefits. It can make
all the difference to have someone you can count on to watch your kids, pick
something up at the grocery store for you, or talk to when you’ve had a bad
day. And I don’t just mean your spouse. Research actually shows that having a
closer inner circle of 8 to 10 people
that you can depend on and confide
in is optimal.
Feeling socially connected lowers

cortisol and makes us more resilient
to psychological stressors, meaning
that our body produces less cortisol
when we’re stuck in traffic and late
for a meeting. Having positive social
interactions in your life reduces the
effects of chronic stress, and that
leads to improved health over the
long term.
Physical touch may be even better. Research has shown that physical connec-
tion— whether hugging a family member, enjoying sexual relations with your
partner, cuddling with a pet, or receiving therapeutic touch or massage—reduc-
es cortisol. A variety of studies have shown that therapeutic touch, when added
to hospital care, improves patient outcomes in a variety of ways.
Touch, love, and positive social interactions increase the hormone oxytocin,
what is sometimes referred to as the “love hormone.” Oxytocin is produced
by specialized neurons in the thalamus and then stored and released by the
posterior pituitary gland. Upon release, oxytocin is associated with feelings of
contentment and calm, reductions in anxiety, and increases in human bonding
and trust. It also inhibits fear and nervousness. You may recognize oxytocin as
the hormone released during childbirth and breastfeeding. Like most hormones
discussed, it has many roles in the body.
Importantly, increased oxytocin levels lead to a decrease in activity in the hy-

pothalamic-pituitary-adrenal axis (the HPA axis controls the production of
cortisol!) and enhanced immune function. Essentially, increasing oxytocin pro-
tects against stress. In fact, positive social interaction has been shown to have
Part:
a direct impact on wound healing, attributable to increased levels of oxytocin.

Oxytocin also modulates inflammation by decreasing some pro-inflammatory
cytokines (chemical messengers of the immune system). Whether the effects of
oxytocin are completely owing to direct interactions with the immune system
or to the effects on cortisol and the HPA axis remains unknown. Either way, the
feeling of connection is important for general health and wellbeing.
A recent study established that the influence of social relationships on health

is comparable with well-established major risk factors for mortality such as
smoking and alcohol consumption. You get as big a boost to your health from
social connection as you do from quitting smoking! Even more astounding, this
study showed that social relationships are bigger contributors to your health
than risk factors such as physical inactivity and obesity, meaning that social
isolation is more detrimental than being a morbidly obese couch potato. Yes,
connection is that important.
It’s important to nurture relationships and feel connected to people in your life.
This time investment is worth every minute when you think of not only the in-
creased quality of life when that life is shared with wonderful people, but also
the direct health benefits you can experience!
Part of having a functional support network is ac-

tively choosing the people in it. If there are people in
your life who are not supportive or who undermine
your efforts to heal (either subversively or overtly)
or who simply cause more stress than they allevi-
ate, you can choose not to have these people in your
life. Yes, navigating family (and friend and work and
school) politics can be tricky, and each situation has
its unique challenges. But limiting the presence of
negative people in your life as much as possible (you
don’t necessarily have to totally cut them off) will
significantly decrease your stress.
This is also the part where I remind you the importance of communicating with
the members of your support network about your new goal to put sleep at the
top of the To-Do list and what steps you’re taking to accomplish that. Have a
conversation about how much sleep you need and what you need to do during
Part:
the day to support better quality sleep. Better yet, get the members of your
support network to join you in a 14- Day Go To Bed Challenge! Brainstorming
and problem-solving with the members of your support network is likely to be
far more fruitful than any collection of suggestions I can put together here.
Stuff that’s Harder to Control

The things that keep us from sleep are stressors. Whether you associate those
tasks/commitments/obligations/jobs/distractions with stress or not, they are
creating stress on your body simply by the fact that they are depriving you of
the sleep you need. But, most of the time, the obligations and commitments
we feel must come before sleep are part of a greater problem: chronic stress.
You’ve already read in great detail how stress negatively impacts our health
and destroys our sleep quality. And, we’ve already talked at length about add-
ing in activities that improve our resilience to stress (like meditation!) as well as
strategies for simplifying our lives to reduce stressors and create more time for
important health priorities like sleep.
Here’s a very important thing to emphasize: working on stress management

will help you sleep better and sleeping better will naturally make you more re-
silient to stress. It’s a fantastic link because working on one of these areas helps
the other which then helps the one you’re working on. In biology, this is called a
positive feedback loop. In life, this is called “heck yeah, that’s awesome!”.
Reducing stressors in our lives is often difficult because it entails the external
forces that we have the least control over. Taking a good, hard look at what
is causing stress in your life is a worthwhile exercise. The next step is to rec-
ognize what you have the power to
change and what you don’t, and so,
must accept.
Job stressors can be some of the hard-

est to address, but since most of us
spend so many of our waking hours at
work, it’s a good place to start. Most
people, even if they love their jobs, still
find working to be, well, work. And the
Part:
physical stress that sitting at a desk all day has on the body
can further impact your health negatively (we’ve already
?%$#!St talked about the benefits of movement). Look for ways
SS r
to reduce your physical and psychological stress at work.
$#! S T RE
es
s ? %$#!?
Maybe you can get a deadline extension or change your
schedule so you can grab some extra sleep in the morning.
?%
#!S t r ess
%$ Maybe you’ve been working long hours to “get ahead” but
no one really expects you to, so you can cut down your
work hours without ill consequences. Maybe your boss will
pay for your gym membership so you can squeeze a work-
out in at lunch or buy you a standing desk or treadmill desk to increase your
activity level during the workday. Any positive changes you can make at work
will make a difference. It doesn’t hurt to ponder the possibilities. And it doesn’t
hurt to ask!
However, not everyone has the luxury of a flexible schedule or lightening a

workload. Maybe it seems next to impossible to avoid getting sucked into a
dysfunctional dynamic. Maybe the person you share your cubicle with is an en-
ergy drain. And, yes, bills do need to be paid. And, yes, getting a better job with
a more flexible and understanding employer is not always realistic.
But there are things you can do to minimize psychological and physical stress
on the job:
1. Take a few moments for some deep breathing or to
stretch during the day. Even if it’s only thirty seconds of look-
ing away from your computer screen, standing up, doing a few shoulder
rolls and then reaching your arms overhead and taking three or four deep
breaths, it will help. Apps for your cell phone and computer can be used
to set reminders to take these mini-breaks. A good place to start is a thir-
ty-second break every ten minutes.
2. Maintain good posture. Whether you’re sitting, standing, or

walking at work, maintaining good posture is very important for reducing
the physical stress that any job has on our bodies. Your computer monitor
should be at eye level and your keyboard shouldn’t be higher than your el-
bows. If possible, incorporate movement into your desk job (see here). If you
have a job that requires standing for long periods of time, make sure you
Part:
are wearing good shoes that ideally support natural movement of your feet
(minimalist footwear, natural-movement shoes, or barefoot-style running
shoes—yes, this means no high heels). If you need to, set reminders on your
smartphone or write a reminder note where it will catch your eye to check
your posture. This gets easier and more natural over time.
3. Find excuses to get up and move. Sitting for prolonged peri-

ods can be intense physically and is actually associated with a variety of ill-
nesses, including cardiovascular disease and type 2 diabetes (no matter how
active you are when you get home from your desk job). Maybe those pa-
pers need to be taken to someone else’s office, on a different floor: use the
stairs! Maybe your water bottle needs to be refilled. Maybe the office needs
someone to pick up everyone’s lunch orders (even though you brought your
lunch). Maybe you park a little farther away so you have to walk a bit more
going to and leaving work.
4. Leave your work at work. As much as possible, don’t answer

work phone calls or emails when you get home, don’t agree to meetings
outside your normal work hours unless you get to go home early on anoth-
er day to compensate, and don’t work in the evenings to “catch up” or “get
ahead” unless it will greatly reduce your job-related stress in the long run.
As much as possible, emotionally disassociate yourself from the office pol-
itics and social dramas that are part of your workday. Once you get home,
let go of whatever happened.
5. Focus on stress-relieving activities before and af-

ter work. If you can’t change how stressful your job is, then it’s extra
important to fit in fun activities the rest of your day. And yes, remember
that going to bed on time for eight juicy hours of sleep is itself a stress-re-
lieving activity!
This last point is maybe the entire point of this section—incorporate things
(small or big) you can do to decrease the effect that stress has on your body:
changes you can make that will help you cope with the stressors you can’t do
anything about and what you can do to boost your resilience. Resilience is the
ability to adapt successfully in the face of stress and adversity. This doesn’t
mean that stressful events don’t affect you, but rather that you can handle
them without the cortisol wheels falling off your HPA axis cart.
Part:
Certain qualities are recognized to make a person more resilient:
Psychosocial Characteristics of Resilience
Realistic Optimism
Active coping & high coping self-efficacy
High cognitive function & autonomy
Planning, motication, positive risk-taking
Strong cognitive reappraisal & emotional regulation
Secure attachment, trust
Strong social skills & social network
Self-confidence, positive identity
Religious belief that gives life meaning
You may read this list and think, “Yep, I’ve got that covered,” or you might
think, “Well, jeepers, there’s my problem.” You don’t need to have every char-
acteristic in this list to successfully navigate life’s ups and downs. Being resil-
ient is about more than just personality traits. It’s also about coping strategies,
establishing healthful routines, and finding a positive attitude with which to
approach life. This last is up to you, but I can offer you some coping strategies
and suggest some stress-relieving activities to incorporate into your daily life.
Activities that improve resilience and which haven’t already been covered in
this book (like activity, connection, and getting enough sleep!) include:
1. Having Fun. Making time to have fun is probably the most powerful
thing you can do to reduce stress. So many of us get stuck in the daily grind
of work, commuting, chores, looking after the kids or our parents, cooking,
cleaning, and running errands that we forget to take time for ourselves
to do something we enjoy. Sometimes we’re so busy and distracted that
even when we are doing something we love, we forget to appreciate it and
Part:
actually have fun doing it. Just the acts of smiling and laughing can reduce
stress and improve mood. Smiling and laughing activate the ventromedi-
al prefrontal cortex, which produces endorphins. Endorphins are opioid
peptides that function as neurotransmitters. They are naturally produced
in response to exercise, excitement, love, and orgasm, and are associat-
ed with a feeling of happiness and euphoria. They suppress pain through
mechanisms similar to analgesia. And even more importantly, endorphins
increase the release of dopamine. Dopamine is a neurotransmitter with
many functions in the brain, including reward-based learning, inhibiting
negative emotions, boosting mood, improving sleep quality, and increasing
motivation, cognition, and memory.
2. Enjoy and Connect

with Nature. Studies show
that the sights, sounds, smells,
and textures of the outdoors all
have positive effects on the body
and the brain. This includes being
in wilderness-type nature, such
as going for a walk in the woods
or sitting on the beach and watch-
ing the waves, but also tamed
nature, like sitting in a tranquil
garden or looking at an amazing
view of the mountains from a balcony. Even walking in your backyard in
your bare feet, or standing still a minute to listen to the birds after drop-
ping your child off at school, can decrease stress and impart a feeling of
peace.
If you live in the city, finding a rooftop garden or park to visit or growing a
few herbs on your windowsill can provide a connection to nature.
3. Use Your Brain. Using your brain for fun intellectual activities,
whatever that might mean for you, can help increase blood flow to the
brain, which is critical for resolving inflammation in the brain. Intellectu-
ally stimulating activities come in all flavors: reading a book that’s chal-
lenging (because of the topic or the style of writing or maybe even the
language it’s written in), learning to play a musical instrument, solving a
Part:
puzzle (crossword, Sudoku, Rubik’s Cube, jigsaw), taking up a new craft (like
knitting lace), or learning a new language.
4. Turn Off Your Brain. Are you thinking “This again? I thought
this section was for those of us who don’t have time to meditate!”? I really
can’t emphasize enough how much daily meditation practice—and I mean
just 10-15 minutes per day—can improve every aspect of your health. And,
what’s even better, it can make all those things that seem beyond your
control much, much easier to manage.
And, what if you find that you need a ton of sleep?

Many people healing from autoimmune disease and serious chronic illness re-
port needing 12 or more hours of sleep every night to be able to see meaningful
and continued improvement in their symptoms. That’s an even bigger challenge
to prioritize than those of us who need 8 hours! 50% bigger! It’s important to
mention that as your body heals, you will probably notice that the quality of
your sleep will improve to the point that you might find that you eventually
need less sleep than you did initially (although you can pretty much count on
needing seven to nine hours a night for the rest of your life). And for most peo-
ple, the more you sleep, the faster you will heal. And if you don’t have a chronic
illness, you could prevent one by sleeping enough (seriously–remember all that
science we talked about in Part 2?).
Remember that small changes can make a big difference. An almost endless
variety of small adjustments that you can make collectively add up to a big im-
provement to your ability to put sleep first. In fact, that’s the whole point of the
14-Day Go To Bed Challenge outlined in Part 7 of this book: to distill this vast
collection of knowledge down to 14 easy steps that will make a huge improve-
ment to your sleep.
And you can think of each of these small changes as creating a new healthy
habit. When you approach it this way, if feels a little less like life is conspiring
against you and your attempts to get enough sleep, and more like the ball is in
your court and you are the one empowered to take control and make one small
healthy choice at a time.
Part:
Habit Formation
Whether you’re working on sleep (which I hope you are after reading to this
point of this book!) or any other change to improve your health (like starting
the Paleo diet or an exercise program), you can distill the work you’re doing
to the concept of creating new healthy habits, and maybe breaking a few un-
healthy habits along the way. Whenever we tackle a new challenge or some-
thing like a New Year’s resolution, we all hope that by putting a good effort
toward our goals for a few weeks, we’ll develop positive momentum to keep
going in the right direction.
Unfortunately, it’s a myth that it takes only 21 days to make or break a habit.
So much for 21-day challenges (or even 30-day challenges) that promise that by
the end of the challenge, maintaining your new healthy lifestyle will be easy!
It’s much, much more common for people to complete these challenges and
then slide right back to their old bad habits afterward… hence the concept of
re-upping for these challenges on a monthly basis!
For the vast majority of us, it takes dedication and commitment to repetitive-
ly perform a task for a much greater length of time before that task becomes
automatic. Scientific research shows that the average length of time it takes to
form a new habit is more like 66 days; however, the length of time required for
habit formation varies from 18 days to 254 days (about 8 months)! And, it very
likely varies from person to person, but also by type of habit and the individu-
al challenges each of us face to making a specific change. Yes, that means that
it can take up to 8 months of continued dedication and, dare I say, hard work
before that new change we’re working on feels completely natural and easy.
Being prepared for a longer haul when it comes to creating new healthy habits
is the first key to success.
Once you’ve decided on the healthy habit you want to create, the next step is
to decide on which simple action you are going to repetitively perform for each
new healthy habit being created. For example, for a goal to get more sleep, that
action may be setting a bedtime (hello Day 1 of the Go To Bed Challenge!), per-
haps even putting a reminder in your phone, and every day at your chosen time,
going to bed. Maybe part of your action is creating a relaxing evening routine to
prepare your body for sleep (hello Day 5!). (As a more general rule, habit forma-
Part:
tion aside, it’s also important to establish what action you will take even if your
goal is to break an unhealthy habit. For example, if your resolution is to quit
smoking, plan a simple task that you can do at the times you would normally
reach for a cigarette, such as going for a walk or doing a household chore.)
Once you’ve decided on the action to perform, the next step is figure out when
and where you’re going to perform that action every day. When it comes to
sleep, chances are good that’ll be your bedroom; but, that might not be where
you start your relaxing bedtime routine. Maybe you start your routine in the
living room with a book and a cup of chamomile tea. Or maybe you start your
routine in the bathroom with a relaxing mineral salts bath. And, just like having
a bedtime is important, having the time you need to start winding down for bed
is equally as important. Then, every evening at your designated time, perform
you activity: wind down for bed then go to bed!
1. 2.
3.
Part:
Scientific studies have identified these five simple steps for habit formation:
1. Decide on a goal that you would like to achieve for your health.
2. Choose a simple action that will get you towards your goal
which you can do on a daily basis.
3. Pl an when and where you will do your chosen action. Be consis-
tent: choose a time and place that you encounter every day of the week.
4. Every time you encounter that time and place, do the action.
5. It will get easier with time, and within 10 weeks [but up to 8
months] you should find you are doing it automatically without even having
to think about it.
So, how does habit formation pertain to sleep specifically? Many inputs into the
complex formula of getting enough good quality sleep are related to things like
diet, activity level, time spent outside, stress level, hormone regulation, sleep
hygiene, and the many signals to our circadian clocks—not routine. And while
creating a routine surrounding sleep clearly falls under the banner of creating
an action-centered habit, it’s harder to think of all these other aspects of prior-
itizing sleep in the context of habit formation. But, there’s still always an action
that can be made, a step you can take, and a habit you can form.
Part:
Check out the Sleep Checklist in the next section. You can think of every sin-
gle item in that checklist in the context of habit formation (or breaking bad
habits, like quitting the consumption of caffeine after noon). Certainly, some
of these habits are indirect. For example, taking up a mindfulness meditation
practice has profound positive impacts on cortisol regulation, which then im-
proves sleep. Yet, finding ten minutes per day to meditate is definitely making a
healthy habit!
When you think of improving sleep in the context of habit formation, suddenly
you’re the one in control. Yes, not every action will be easy (if it was, it would
be a habit already!), but this means that you can hone in on the most important
things that you personally need to work on to put sleep at the top of the To-Do
list and prioritize those habits first. It also means that eventually, everything
that you’re working on now will feel easy and natural, like just another part
of your day, and something that makes you healthier every day. That’s pretty
awesome.
Sleep habits have another major bonus over other health-related habits: as
you get more sleep, your body is more responsive and achieves the necessary
physiological adaptations to the changes you’re making more easily.
And, while there are no scientific studies done to tell us exactly how many
days adequate sleep is likely to shave off the total time it takes to make our
new habits, chances are really high that sleep habits will be some of the easier
health habits to form that you’ve ever tackled.
Sleep Checklist
The checklist on the next page can be thought of as a comprehensive summary
of all of the factors affecting sleep in this book. Certainly, not every item be-
low will be critical for every person’s ability to get sufficient quality sleep. For
example, the steps chosen for the 14- Day Go To Bed Challenge represent only
a selection of the items below–those that are most likely to provide the best
bang for your buck, so to speak. However, if you aren’t experiencing amazing
sleep by the end of the challenge, come back to this checklist to look for inspi-
ration for more changes that you can make to improve your sleep.
Part:
Sleep Checklist
Routine
Go to bed at a time that allows you to get 7-10 hours of sleep
before you have to wake up
Spend the last hour or so before bed winding down with a book,
crossword, warm bath, stretching, or cuddling
Choose to spend time in blue light (via sunlight or a light therapy
box) around the same time every day, as your schedule permits
Healthy Hormones
Meditate several times a day including one session right before
bed
Socialize during the day
Keep things intimate (family only) in the evenings
Talk to your pharmacist if you are taking any prescriptions that
may affect your sleep
Increase the amount of mild and moderate activity that you get
during the day
Switch to a standing or treadmill desk
Go for walks
Play with your kids, pets, and friends
Eat 2-3 large meals a day
Part:
Increase healthy dietary fats, especially omega-3 fatty acids

and medium chain triglycerides
Decrease your consumption of unhealthy dietary fats, like
omega-6 fatty acids and trans fats
Consume a moderate amount of carbs (not too high or too
low)
Focus on organ meats (tryptophan) and seafood (omega-3s)
Eat sulfur-rich foods like onions, garlic, cabbage, broccoli,
cauliflower, and Brussels sprouts to support GABA
production[KP18]
Avoid snacking, especially before dinner
Eat starchy carbs with dinner
Avoid sugar in the evenings (even from fruit)
Avoid eating in the 2 hours before bedtime (4 or 5 may be
even better)
Avoid alcohol
Limit caffeine intake
Stop drinking caffeine after noon
Try a magnesium supplement
Keep a strict Paleo diet
Carve out the time for a nap if you got inadequate sleep the
night before
Talk to your doctor about whether or not to try prescription
sleep aids or melatonin.
Part:
Circadian Rhythm
During the Day:
Get blue light exposure via sunlight for at least 20 minutes in the
morning or midday
In winter months or because of shift work, utilize a light therapy
box to acquire your 20 minutes of “sunlight” before the end of
sunlight hours
Use sunlight spectrum light bulbs in your house (for daytime
hours ONLY)
Keep curtains open
Set screens to be at their brightest setting
Drive with the windows down
Take a vitamin D3 supplement in the first half of the day
Set the temperature to 65F or less at night
During the Evening:
Use f.lux on electronic devices
Set devices’ brightness to the lowest setting
Wear amber-tinted glasses if using lights or electronics after
sunset
Keep indoor lighting to a minimum once the sun is down
Pass on sugary snacks
Skip the scary movie
Ditch your night light (or switch to red bulbs)
Stay out of your bedroom until you’re ready for bed activities (sex
and sleep ONLY)
Maintain these rules if you have biphasic sleep
Set the temperature to 75F or more during the day (at least in
the summer)
Part:
Sleep Hygiene
Use blackout curtains in the bedroom
Remove or cover up all lights in the bedroom at night (including
LEDs, alarm clocks, and night lights)
Switch to a light alarm clock or ditch your alarm clock altogether
Use a white noise generator if there is a lot of ambient noise
around your house
Use a HEPA air filter if you have difficulty breathing at night
If you get hot at night, use cotton sheets and/or minimal cotton
sleepwear
Try sleeping on your back with your knees and neck supported
with soft pillows
Try sleeping on your side with a pillow between your knees
Part:
Why a 14-Day Go to Bed

Challenge?
I want to help you put sleep first (well, maybe not first, but high up enough on
the priority list that it actually gets done!), which is why I created the 14-Day Go
To Bed Challenge, detailed in the next part of this book. But, I’ve also just told
you that it takes an average of 66 days to make or break a habit, so what’s up
with a 14-Day challenge?
The idea behind the 14-Day Go To Bed Challenge is iterative implementation

of the fourteen smaller changes that will add up to give you the best bang for
your buck in terms of supporting your sleep goals. Rather than giving you a list
of changes to make all at once and then telling you to stick to them day in and
day out for two months, I’ve distilled all of the information in this book down to
something that is both completely manageable and that will create some great
zzzzz’s.
I do want you to create lasting healthy habits that support sufficient and qual-
ity sleep. But, I don’t expect that to happen in two weeks. Instead, there are
three reasons for this program containing a 14-day challenge. First, committing
to something for fourteen days doesn’t seem that daunting for most people.
Second, 14 days is enough time for most people to see noticeable improvements
in their sleep (and their health thanks to getting enough sleep!). And third, it’s
my hope that giving you that taste of what getting enough sleep feels like (and
how easy it really is) will be all the motivation you need to continue on this
path and keep sleep on your priority list from now on!
I mentioned somewhat derogatively that common 21-day and 30-day nutri-

tional challenges promise to break bad diet habits by then end of the challenge,
but instead have people re-upping month after month (often after derailing
completely the day the challenge ends). With the 14-Day Go To Bed challenge,
I’m not expecting getting 8 quality hours of sleep every single night to be such
a natural part of your routine that you aren’t even thinking about it. Instead,
I want to ease you into what scientific research emphasizes are some of the
most important choices to make to support healthy sleep and then leave you
at a place where you’ll work to make those choices a habit. And, if maintaining
those changes is tough for you, I absolutely do expect you to re-up for month-
Part:
ly challenges. Unlike nutritional challenges that imply that you’re a failure if

you don’t have it all mastered in 21 or 30 days, I want you to know up front that
maintaining these steps to support sleep does require dedication and commit-
ment (and, you know, something like 66 days to become habit). And, re-upping
every month for another 14-Day Go To Bed Challenge doesn’t mean you’re
failing. It simply means that making lasting change requires a commitment.
And it’s my goal to create the resources you need within the 14-Day Go To Bed
Challenge— whether you tackle it on your own or join a Group Challenge host-
ed by the Go To Bed Facebook and Instagram communities—to ensure that each
time you do the challenge, you get substantially closer to lifelong habits that
support healthy sleep.
The Power of Journaling

for Positive Self Change
Journaling has been thought
of as a therapeutic practice for
a long time, specifically in the
world of psychotherapy. Jour-
naling has been studied in the
context of mental health and
in the context of overall stress
reduction (which we all know
is SO important for overall
physical AND mental health!).
Specifically, we know that jour-
naling about both your thoughts (cognitions) and emotive process is great for
stress reduction, which has actually been linked to reporting fewer symptoms
of illness.
In this book, I’m not just talking about improving mental health (though I do go
into some science behind the relationship between sleep and mental health);
my goal is to instigate habit formation (of arguably one of the most essential
healthy habits you can have!) and positive self-change.
Part:
As I just discussed, habit formation is actually something that takes a heck of a

lot longer than 14 days or even the more stereotypically quoted 21 days (the av-
erage is actually 66 days, but it varies between 3 weeks and 8 months!!!). But, we
also need to learn new behaviors and be exposed to new tools if we’re going to
forget old habits. Journaling is one of the tools that I hope to give you that will
become a habit, because it’s a powerful way to help yourself change!
The concept of “self-change” is just what you’d think: it’s the idea that some-
one changes habits for themselves.
Commonly used in the mental health world for problems like addiction, we also
see self-change in the realms of other forms of self-help. I’m using it here be-
cause I believe that the only person who can instigate the necessary changes to
your sleep life is you. I can write tens of thousands of words about the impor-
tance of sleep for your health and wellbeing (with which you’re well familiar
because you’ve already read them!), but YOU are the one who needs to actually
put action to them! And, you know, go (literally and physically) to bed!
Some people think of journaling as an accountability tool, but that’s not really
it. And if you do approach journaling that way, it can trigger those same rebel-
lious behaviors that strict nutritional challenges and crash diets can trigger (I’ve
heard stories of people lying to their journals the same way some people will
try to bend all the rules in nutritional challenges). Your journal isn’t there to
nag you or make you feel guilty. It’s there to encourage awareness, reflection,
and intention. Instead of being the nagging family member, it’s the supportive
friend, the confidante, and the therapist.
Researchers have shown that repeated attempts at self-change, deemed “false

hope syndrome”, tend to be rough on people’s psyches. For anyone who’s been
on a cycle of weight loss and gain, for example, you’ve probably experienced
this phenomenon before… and it totally sticks. It should go without saying that
feeling defeated before you even attempt some new positive change, isn’t help-
ful! That is just one more reason why I’m trying to give you all the tools you
need to succeed the first time.
The journaling and the surveys in this program could be combined to be called
“self-monitoring behaviors.” Self-monitoring behaviors have been studied in
relation to other behavioral changes, like weight loss. There are a lot of mech-
anisms by which self- monitoring behaviors help you make changes that ac-
Part:
tually stick. As I mentioned, journaling allows for self-reflection, which can

act as a form of mild self-therapy. You’ve already read that mental illness and
inadequate sleep are highly related, so, improvements in your sleep may lead to
improvements in your mood. Tracking your daily habits will make these small
changes more noticeable and provide you with powerful positive reinforce-
ment! Journaling also helps people make decisions—it gives us time in our days
to concentrate and organize our thoughts, which can be a challenge amidst the
chaos of family life or our otherwise busy lives. So, we know that self-monitor-
ing behaviors like journaling are an awesome idea for anyone trying to make
changes or meet goals.
But, here’s some crazy cool news for those of you who are totally excited to
see what health improvements more and better sleep can make for you: There
is brand-new research about the potency of self-monitoring behaviors and
interventions for improving sleep. Researchers examined the sleep behavior
of college students by measuring four sleep hygiene behaviors (restful sleep
environment, going to bed hungry/thirsty, avoiding stressful activities close to
bedtime, and avoiding caffeine in the evening). They also measured participants’
sleep quality and insomnia symptoms. From there, participants were instruct-
ed to either journal their sleep behaviors or make some specific changes. After
two weeks, researchers found that both groups improved their sleep environ-
ment before sleep, got better at avoiding going to bed thirsty or hungry, and
both improved their insomnia and sleep quality scores.
The intervention implementation group was better at avoiding stressful events

before sleep after two weeks, but the self-monitoring behavior group was
more likely to complete the entire study.
Basically, self-monitoring is about as important as learning about the neces-

sary changes when it comes to improving your sleep lifestyle. Seriously!
This larger trial is supported by other studies that have tried to investigate
how to improve sleep habits in at-risk populations like adolescents. The results
are very clear: daily journaling helps to improve sleep behaviors, likely for the
exact reasons I described above. So, the combination of surveys and journaling
included in the Go to Bed 14-Day Sleep Challenge should make a statistically
significant difference in your adherence to the program AND to your actual re-
sults. I am so excited to watch all of you succeed in this new adventure toward
the best sleep of your life!
Part:
Tracking Sleep Quantity

and Quality
By now, I know you’re ready to get going with your 14-Day Go to Bed Chal-
lenge. But, we have just a few more details to get through before we move on
to the challenge. One of the last tools I’m going to give you is information on
the importance of the use of sleep trackers to quantify your sleep duration and
quality. There are a couple of different approaches you can use (or you can opt
for both!). As you make changes to your bedtime routine, sleep hygiene, overall
diet and lifestyle to support sleep, it’s helpful to track your progress. Don’t you
want to be able to look back and see how much your sleep improved?!
Sleep Trackers
Sleep trackers, such as a FitBit or apps for your
smartphone, like Sleep Cycle, can be very help-
ful in gauging the success of your efforts to get
more good quality sleep. These devices are not
perfect, since they only track movement while
you sleep (and some movement is completely
normal), and cannot replace the insight gleaned
from a sleep study. However, they are a useful
tool for tracking sleep and night wakings and
allow you to get a general estimate for sleep
quality. If you don’t need a sleep study, these
are a great way to visualize your wakefulness during “sleeping” hours. If your
tracker appears to indicate poorer sleep quality or efficiency than you were
expecting, this gives you a great baseline for the start of your challenge. While
the subjective data (like how you’re feeling after sleep, how easy it can become
to fall asleep, etc.) is absolutely important, the objective data (like sleep dura-
tion) is just as important if you want to examine your sleep over the long term.
Part:
Sleep Journal
Keeping a sleep journal, in which you
write down all of the changes you’ve
made to your routine every day and
then grade how well you slept that
night when you wake up the next
morning, can help you not only keep
track of your progress but also trou-
bleshoot any problems you may run
into along the way. You can maintain
a sleep journal with or without the
aid of a sleep tracker, but a sleep
tracker will help you quantify the
quality of your sleep in ways that a
journal can’t. For example, perhaps you were in bed for 8 hours but your sleep
tracker tells you that you tossed and turned for 3 of those hours. You can then
record both your total sleep time and the time that was good quality sleep and
track both numbers as you make changes to increase sleep.
Without a sleep tracker, make notes about how you felt sleeping. Did you look
at the clock in the night? Get up to pee? Did you have particularly vivid dreams
or nightmares? How do you feel in the morning? All of these qualitative indica-
tors are still useful to track your progress.
Find a printable the full 14-Day Sleep Journal here and a sample journal entry
on the next page.
Part:
DATE: 5-20 DIET LIFEST YLE ENVIRONMENT SLEEP
Lights out: 6:15am Breakfast:

Fell asleep well
10:30 Chicken soup but woke up
Lights & electronics
30 minute walk several times
11:30am Lunch: off at 6pm
feeling hot
Wake Time: Leftover pot roast
Yoga and even though I
6:30
5pm Dinner: Temperature 70F was cold when
meditation
Cobb salad I went to bed.
Need to lower
Times Awake: 8pm Dessert: Apple AC or find a
1 - to pee with almond butter lighter com-
forter.
Total Sleep:
8.5 hrs
The morning was okay, but I ran out of steam in the afternoon.
how I felt
today:
Part:
DATE: DIET LIFEST YLE ENVIRONMENT SLEEP
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Part:
Sleep Score
Another tool for measuring the efficacy of your commitment to sleep is to
get your Sleep Score. The Sleep Score is to a Sleep Challenge as a scale is to a
weight loss diet. It’s that number that you get to watch climb (okay, that’s the
opposite of your goal with a scale in this analogy) and get that quantitative pos-
itive reinforcement for your efforts of seeing a measureable improvement in
sleep. If you’re working hard on diet changes to lose weight, seeing the number
on the scale go down is tremendous motivation to continue. The same is true of
watching your Sleep Score go up and up and up!
To get your Sleep Score, you’ll take a 2-minute anonymous survey of 25 ques-
tions. This survey will give you a number between 0 and 100 that will tell you
just how healthy your sleep is. This is something called semi-quantitative anal-
ysis, a statistical trick to turn qualitative data (like how energetic you feel) into
a number in order to make easier comparisons. The Sleep Score Survey is a way
to quantify how well you’re doing with your sleep and to see the improvements
after completing the challenge, as well as see how your health has improved
with renewed focus on sleep.
I recommend taking the Sleep Score Survey before you begin your challenge
as well as periodically during and after. You’ll likely see the biggest difference
the morning after you complete your 14-Day Go To Bed Challenge, but this is
also a great tool to gauge how well you’re maintaining your new sleep-focused
healthy habits during the weeks and months afterward. Perhaps you’d like to
set a reminder to take the Sleep Score Survey again on Day 30 after finishing
your challenge to decide if it’s time to take the challenge again!
There is a separate link for the Sleep Score survey depending on when you take
it in relation to your challenge. For ease of data analysis, please make sure to
fill out the appropriate survey.
Here are the links:

Before you start
After you complete your challenge (14- 15 days)
30 Days after the start of your challenge (about 2 weeks after you finish)
Any other time
Part:
Quantity vs. Quality

One of the most common questions that I get about sleep is what to do if when
something interferes with your ability to sleep. Yes, we’ve already discussed
how to improve sleep quality if your body just doesn’t seem to want to cooper-
ate with your intentions to sleep more (managing stress, entrenching circadian
rhythms, regulating hormones). We’ve covered strategies for new moms (yes,
that old adage “sleep while the baby sleeps”, while patronizing, is actually the
best strategy!) and for those with chronic illnesses that impact sleep quality
(naps, again!). The same strategy holds true for postmenopausal women, anyone
working on addressing a sleep pathology: if you are faced with barriers to sleep
quality, then you’ll need to make it up with sleep quantity.
Increasing the amount of sleep you get, to make up for sleep interruptions or
poor sleep quality, can come in two flavors: spend more time in bed at night,
and take naps.
If your particular sleep barrier is internal–for example a sleep pathology, adre-
nal fatigue, or hormone imbalances–then the strategies provided in this book
should still yield improvements in sleep (even if those improvements are incre-
mental). Working with a healthcare provider, such as a functional medicine or
integrative medicine specialist, may also hone in on additional interventions to
support sleep and get you enjoying quality zzz’s as soon as possible. In contrast,
if your particular barrier is external–for example, a new baby, a snoring spouse,
or very loud nightowl neighbors–then finding ways to mitigate the interrup-
tions (take turns with your spouse at night with the baby, co-sleep with the
baby to minimize how disrupting night feedings are, get earplugs and a white
noise machine to block out annoying noise) can be very helpful in addition to
increasing sleep quantity.
Also, take heart in the fact that the vast majority of the time, these barriers are
transient. What you have to do now to make sure you’re getting enough sleep
may seem like a hassle, but chances are good that in the not-too-distant future,
things will normalize, your body will embrace sleep, and going to bed won’t feel
like a chore.
Part:
Sleep Aid Shopping Spree

The information in this book is de-
signed to naturally provide you with
the best night’s sleep possible. But,
you’ve probably read in a few places
where cool gadgets can actually give
you the best of both worlds; for ex-
ample, wearing amber-tinted glasses
in the evenings allows you to protect
your dim-light melatonin production
while also enjoying evening activities
that involve computer or television
screens and indoor lighting. These
biohacks can help support sleep
while minimizing the intrusiveness that changes designed to improve our sleep
can be in our lives.
I have compiled a summary of all of the great scientifically-validated gadgets

and sleep-aids mentioned in this book for you. You almost certainly don’t need
all of these, which should be a relief since some of them can be quite an invest-
ment! But, a few of these provide a tremendous benefit for very little cost.
The only one of these biohacks that is used in the 14-Day Go To Bed Challenge is
the amber-tinted glasses because these are so well established in the scientific
literature to support circadian rhythm entrenchment, improve sleep quality,
and they require very little investment. In fact, amber-tinted glasses can be
purchased at any hardware store! However, there are some options for those
who don’t want or can’t wear amber-tinted glasses, so don’t despair.
As for the rest of these sleep aids, use this summary to determine if they would
be a worthwhile investment for you. There are also page number references so
you can go back and read the more detailed science behind each of these.
Part:
Amber-Tinted Glasses
C o s t: $6 to $50+
U s e f u l f o r : everybody who uses indoor lighting,

shift workers
Amber-tinted glasses block blue light from entering

your eyes, which, when worn for the last 2-3 hours
before going to bed, helps protect dim-light melatonin
production. This means they help you fall asleep more
efficiently and sleep more deeply. Remember to also
dim indoor lighting in the evening since there are blue Bu y i t h e r e !
light sensitive photoreceptors in skin too. More info in
Part Three.
Amber-tinted glasses can be purchased very inexpensively from Amazon or from

most hardware stores (yellow lensed safety glasses!). More stylish versions are avail-
able as well at a higher cost.
f.lux
C o s t: FREE
U s e f u l f o r : people who need to work in the
evenings
f.lux is free software that you can download onto your

computer (not compatible with Apple devices unless you
jailbreak them) that adjusts your screen brightness and
hue to reflect the time of day. If you need to work on
your computer in the evening, especially if you choose
not to wear amber-tinted glasses, f.lux minimizes the get it here!
amount of blue light emitted from your screen, shift-
ing the average wavelengths towards yellow and red.
If for any reason, you need to be able to see true colors for an application, f.lux has an
added feature where you can disable it for an hour at a time. More info in Part Three.
Part:
Light Alarm Clock

C o s t: $70 to $140
U s e f u l f o r : everyone who needs an alarm
Instead of waking up to a jarring beeping sound, mu-

sic or the news, light alarm clocks wake you up with
a gradually brightening light to simulate sunrise. This
gadget is all about waking you up gently, and avoiding
that little adrenalin rush and stress boost that conven-
tional alarm clocks offer. Some change color as they
brighten (red to yellow to white) and also provide na- Bu y i t h e r e !
ture sounds to add to your gentle waking experience.
Others actually combine a light therapy lamp with a
light alarm, making it two gadgets in one! More info in
Part Three.
Red Light Bulbs

C o s t: $2.50 to $8.50
U s e f u l f o r : people who don’t like wearing
glasses
If you don’t like wearing amber-tinted glasses, another

option is to put red lights into lamps and light fixtures
around your home for evening use (have regular light
bulbs in other lamps and light fixtures for during the
day). These run as cheap as $2.50 per bulb for incan-
descent to $8.50 per bulb for compact fluorescent. Bu y i t h e r e !
Make sure that if you’re using this strategy to avoid
blue light exposure in the evening that you also avoid
all computers, tablets, smartphones, TVs and any oth-
er screen! More info in Part Three.
Part:
Philips Hue Lightbulbs

C o s t: $200 (starter kit)
U s e f u l f o r : people who don’t like wearing
glasses
If the thought of extra lamps with red light bulbs in

them cluttering the house gets you twitching, then
you’ll love the versatility of Philips Hue. These light
bulbs can change both color and brightness and can
be controlled from your smartphone! You can even
program them to automatically turn off when you Bu y i t h e r e !
leave the house, and automatically change color and
brightness based on the time of day. The 2nd genera-
tion starter kits typically run at $200. Additional light bulbs run $60 a piece, however
these are LED lights and will last a very long time. More info in Part Three.
Light Therapy Box

C o s t: $60
U s e f u l f o r : shift workers, people who can’t get

outside
The idea behind using a light therapy box for 20 min-

utes to an hour daily is to provide a comparable circa-
dian clock syncing stimulus to your brain as sunlight.
This is a great gadget for anyone who can’t spend time
outside every day year round (note that these lights
provide no UV wavelengths so they will not tan the Bu y i t h e r e !
skin or stimulate vitamin D production). Created for
Seasonal Affective Disorder, you might prefer to use
this light in winter months if you live somewhere with
dreary, cold winter weather, or you may choose to use yours year round if you work
long hours indoors. Look for one that provides at least 10,000lux. Scientific studies
show no difference in benefit between white light and blue light boxes. More info in
Part Three.
Part:
Treadmill desk
C o s t: $1200+
U s e f u l f o r : people with desk jobs
A treadmill desk allows you to walk slowly all day

while you work (or you can turn if off and use it as
a standing desk if you need a break). Typical speeds
are between 1 and 2 miles per hour, so this isn’t
about getting your workout in, but rather, staying
in constant gentle motion to enjoy all the health
benefits (and sleep benefits!) of movement. All- Bu y i t h e r e !
in-one options run about $1400, but if you already
have a treadmill kicking around, you can buy just
the desk for about $500 in order to convert your
treadmill into a treadmill desk.
DeskCycle
C o s t: $160
If your office space doesn’t allow for the large foot-

print of a treadmill desk, if you need a movement
solution that is less conspicuous, or if you simply
need a more affordable option, the DeskCycle is
designed to fit under your desk where you can
pedal away unnoticed! The pedals are very close to
the floor, making this option work even with desks
as low as 27”. It has 8 different resistance settings
and is very quiet! More info here.
Bu y i t h e r e !
Part:
FitDesk Elliptical
Trainer
C o s t: $170
Another option for people who want movement

in their office space but for whom a treadmill desk
is not an option. The FitDesk Elliptical Trainer is
designed to fit under your desk, where your day
of movement can go unnoticed! The motion of an
elliptical trainer can be easier on the knees than Bu y i t h e r e !
that of a bicycle, plus the FitDesk Elliptical Trainer
is designed so that your knees won’t hit the bot-
tom of your desk even for desks as low as 25”. It also comes with 8 different
resistance settings and is very quiet! More info here.
Blackout Curtains
C o s t: $33+
U s e f u l f o r : everyone with lights outside their

bedroom windows and shift workers.
Whether you live in the city or suburbia, light pol-

lution can be a big problem! Beyond the fact that
backyard astronomers can’t see the stars, this
makes it hard to have a dark enough bedroom to
promote high quality sleep. Blackout curtains are
an excellent solution to minimize the amount of
light seeping into your bedroom at night (or to Bu y i t h e r e !
block out sunlight if you’re a shift worker). Best
Home Fashion makes relatively inexpensive yet
very effective blackout curtains in either 52”x63” or 52”x84” size and in a vari-
ety of colors. More info in Part Three.
Part:
White Noise Machine

C o s t: $28 to 65
U s e f u l f o r : noisy bedrooms
If you’re a light sleeper and find that even small

noises wake you up at night, or if there are loud
noises that you are unable to control that affect
your sleep, a white noise machine is a great solu-
tion. These produce soothing, repetitive nature
sounds that mask other noises (especially high
frequency noises, which are more likely to disrupt
sleep) to diminish their effect on your sleep qual- Bu y i t h e r e !
ity. From a basic version made for babies to a de-
luxe version with pillow speakers, there’s a wide
range to choose from! More info in Part Three.
Meditation CD,
Podcast or App
C o s t: Free to $50
U s e f u l f o r : everyone
New to the idea of meditation? There’s a huge

variety of CDs, podcasts, and apps that will guide
you through meditations in an approachable way!
We’re spoiled for choice here, so I’ll share my two
favorite resources. Steven Halpern, one of the fa-
thers of New Age music, writes meditation music
designed to stimulate alpha and theta (calming) Bu y i t h e r e !
brainwaves, and his album Sleep Soundly is lovely
background music to self-directed mindful med-
itation. Another amazing option is the Anne Angelone’s Peaceful Sleep and
Deep Relief tracks, available here. The binaural beats and subliminal messaging
will help relax your mind and support better sleep. Either dedicate some time
Part:
to just relax and listen or play it while you’re doing your other chosen relax-
ation activities (just don’t let these tracks lull you to sleep while in the bath!). If
you prefer guided meditation, the app Calm, available on iTunes and Android,
is a great choice. You can choose your background noise (or none), meditation
length (from 2 minutes to 20) and the theme for your meditation (sleep, anxiety
release, positivity, etc.) A nice selection of guided meditations come with the
app for free, but a subscription which is purchased in-app is required to unlock
the full array of meditations available.
Weighted Blanket
C o s t: $200 to $250
U s e f u l f o r : insomniacs, high stress, high anxi-

ety
Weighted blankets improve sleep quality and total

sleep time by providing a comforting and cocoon-
ing pressure to the body. Scientifically validated for
insomnia, there may be some benefit for individu-
als under high stress or who suffer from anxiety.
Look for a blanket that weighs between 10% and Bu y i t h e r e !
12% of your body weight. More info in Part Three.
This weighted blanket comes in varying weights,

up to a 25lb blanket suitable for up to a 200lb person. The company makes blan-
kets to order, so if you need something special, you can contact them directly.
Part:
Sleep Supplements
C o s t: $18 to $41
U s e f u l f o r : sleep problems related to nutrition-

al deficiencies
Certain supplements discussed in this book are well

supported in the scientific literature to effectively
improve sleep quality with very few contraindica-
tions. However, remember to always talk to your
healthcare provider before taking any supple-
ment. You may find benefit with Vital Proteins
Bu y i t h e r e !
Grass-Fed Beef Liver Capsules as a whole foods
source of tryptophan (not to mention lots of other
great nutrients!), Vital Proteins Collagen peptides for the calming and anti- in-
flammatory glycine content, and Magnesium Glycinate, L-theanine, and/or
GABA to help improve sleep quality. Make sure that supplement use is not a
crutch for poor implementation of routine, circadian rhythm entrenchment,
hormone regulation, and sleep hygiene. More info here.
FitBit
C o s t: $79 to $242
U s e f u l f o r : tracking sleep and daytime activity
A FitBit is a great gadget for tracking daytime ac-

tivity, sleep quantity, and sleep quality. It measures
sleep quality by looking at your movements during
sleep (FitBits that are also equipped with heartrate
monitors use this data as well). The two entry
level FitBit models are the One, worn on your
waistband, and the Flex, worn on your wrist, both Bu y i t h e r e !
of which are very functional but do not include a
heartrate monitor. The Charge adds to this func-
tionality with a heartrate monitor to auto-detect
Part:
both activity and sleep. The most deluxe model is the Surge, which not only
includes a heartrate monitor but also GPS tracking for more accurate activi-
ty measurements. Regardless of which model you choose, all have the added
bonus of social connection so you can cheer your friends’ milestones, com-
pete for the most number of steps in the day, and stay motivated. Another
bonus, FitBits are very comfortable to wear during sleep! More info here.
Sleep Tracking Apps

C o s t: FREE to $2
U s e f u l f o r : tracking sleep
If you own a smartphone, you don’t need to invest

in a FitBit. Apps like Sleep Better (basic version is
free, full version is $1.99) are available for Apple
and Android devices and can track your sleep us-
ing your phone’s accelerometer. Depending on the
battery life of your phone, and whether or not you
choose to have your phone beside you in bed or
worn in an armband, this may or may not be the Bu y i t h e r e !
most practical solution. However, it’s a very cost
effective option with similar accuracy to a FitBit!
Part:
Part SEVEN
The 14-Day Go To Bed
Challenge

The 14-day go to bed challenge
Part seven
The 14-Day Go to Bed Challenge
Welcome to the 14-Day Go To Bed Challenge! I am so excited you are ready to
create a new and lasting habit of better sleep! Of course, I’m fully aware of the
magnitude of information that I threw at you with this book. I also know some
of you may have just skipped all the science and want to jump right into your 14
days. Hey, I completely understand wanting to get going on a new venture…es-
pecially one that can dramatically improve your health! While not necessary, I
do highly encourage you take a day or two to read the full book then come back
here and start. A big part of habit forming is knowing the why; this book gives
you all the knowledge to get fired up about the importance of sleep! Just un-
derstanding the detailed science about why our bodies need sleep is a tremen-
dous motivator to problem solve when life throws a curveball! And then, once
you’ve got that foundation, the 14-Day Go To Bed Challenge will give you a vari-
ety of strategies to set you down the road toward the best sleep of your life!
What is the 14-Day Go To Bed Challenge?

his challenge hones in on just 14 small changes, each supported by the sci-
entific literature, that each add up to generate the biggest improvements in
sleep quantity and quality. Yep, that’s right: 14 steps in 14 days! The 14-Day Go
To Bed Challenge is designed
such that each step is an incre-
mental change. Each day of the
challenge, you will add one new
change and all 14 changes that
you will implement over the
challenge will add up to one big
improvement in sleep. For ex-
ample, the step you do on Day 1
is maintained for the rest of the
challenge (okay, I lie, the step
Part:
you do on Day 1, which is to set a bedtime, is actually modified on Days 11 and 14,
but I’ll get to that…). On Day 2, you ADD another small change, so on the second
day of the challenge, you’re doing both your Day 1 and Day 2 steps. This step-
by-step approach is designed to ease your body into better sleep, rather than
trying to tackle everything all at once and potentially have your body refuse to
cooperate! These 14 steps are also all chosen to give you the best bang for your
buck, and it all adds up to great sleep (and great health)!
Part:
14-Day roadmap
Before
Create a
1 Wear
2 Get
3
you
Bedtime Your Amber Meditating
begin
Gl asses
Make sure your bed- Turn out your lights Meditate (mindful or
room is dark, cool & 8 hours before your Wear amber tinted guided) for at least
quiet. Get yourself alarm goes off in the glasses for the last 10 minutes
some amber-tinted morning. 2 hours before daily.
glasses, which you’ll bedtime.
need on Day 2!
Get
4 Get a
5 6 Get 30g
7
Don’t Eat
Outside Routine before bed of Carbs
Get 30 minutes Create a relaxing Make a rule not Eat 30g of starchy
bright light bedtime routine to eat for 2 hours carbs with dinner
(sunlight) at least 30 before bedtime. every night
exposure minutes before from starchy
daily. bedtime. vegetables.
Step
8 Create
9 Cut out
10 Get to
11
Away From more Time Afternoon Bed Earlier
Screens to Rel ax sugar
Adjust your bedtime
Start a Make it a rule to
Make it a rule to
avoid screen time
relaxing bed- 1 avoid all added sugars
a little earlier. Lights
out 8.5 hours before
time routine at after 3pm.
for 1 hour before your alarm goes off
least 1 hour before
lights out time. in the morning.
lights out.
12 13 Get to 14
Cut off Get bed even
the Caffeine moving Earlier
Make a rule Commit to Adjust your bedtime
to consume 30+ minutes of even earlier. Lights
no caffeine activity per out 9 hours before
after noon. day. your alarm goes off
in the morning.
Part:
Before You Begin

The key to successfully completing any challenge is to take a bit of time to
prepare. Fortunately, the preparation for the 14-Day Go To Bed Challenge is
pretty easy. And that’s what this little section is all about: taking a day or two
(or however long you need) to make sure you’ve got all your sleeping ducks in
a row so that your 14 days are spent successfully implementing each step of
the sleep challenge (and enjoying the incrementally better sleep those steps
will support!), rather than getting flustered, hitting roadblocks, or feeling like
everything is just too hard! Let’s set ourselves up for success!
You’ve read through the science of sleep, you’ve seen the detailed Sleep Check-
list, and you’ve already seen a preview of what this Sleep Challenge is going to
look like. Now is a good time to take stock.
Did any particular section, tip, or fact resonate especially well with you? Do you
have a strong suspicion that one particular thing (an aspect of routine? Circadian
rhythm entrenchment? Stress? Hormones?) is the culprit responsible for your in-
adequate sleep? Is that area already sufficiently addressed in the Sleep Challenge?
If not, I recommend that you add a Day 0 to the Sleep Challenge and make a
change geared at addressing this particular thing that you suspect is a prob-
lem for your sleep. For example, maybe you know that your diet is deficient
in tryptophan. Make your Day 0 step to include more tryptophan-rich foods
in your diet. As another example, maybe you take a medication for a chronic
health problem that has sleep disturbances as one of the side effects. Make
your Day 0 step talking to your healthcare provider about alternatives. Maybe
you know that you’re very dependent on caffeine. Instead of waiting until Day
12 of the Sleep Challenge to address that, cut your caffeine intake way back on
Day 0. Or, if you’re the parent of a new baby, your Day 0 may entail prioritizing
a nap while the baby is sleeping once every day.
Now is also a good time to check your attitude in approaching this Sleep Chal-
lenge. I’m not saying you need to approach this challenge with a 100% roses
and sunshine mindset. It’s okay to be skeptical going into it. It’s okay to recog-
nize that a step or two is going to be particularly tough to figure out how to
fit into your life. And, it’s okay to doubt that getting more sleep can actually
make that big of a difference to your health. But, it is important to be com-
Part:
mitted to the challenge. It’s important to dedicate these next two weeks to
improving your sleep and put in the effort required to complete each step of
the challenge. Remember that each day of the challenge adds a step to all of
the days before. That means that on Day 10, you’re making room for 10 small
changes in your life to support better sleep. It’s time to put your game face on,
and hunker down and get it done. If you’re head isn’t in the game before you
even begin, chances are good you won’t see this through the 14 days. So, take a
moment to make sure you’re ready.
Choose When to Do Your Challenge

First and foremost, you’ll need to decide
when you’re going to start your challenge and
whether or not you’re going to join a Group
Challenge hosted by the Go To Bed Instagram
and Facebook communities or take on this
challenge on your own schedule.
The Facebook and Instagram Go To Bed com-

munities host a new Group Go To Bed Chal-
lenge every month (more on that in the next
section), but you can find help and connect
with fellow challengers here no matter when you want to start your chal-
lenge. These are also fun places to find inspiration, grab sharables, connect
with others, and find daily support. And, you don’t need to wait for the next
Group Challenge if you want to get started right away: You’ve got everything
you need within this book to successfully complete a 14-Day Go To Bed Chal-
lenge.
When choosing a start date, carefully consider whether or not you have any
events or obligations (examples could be anything from a wedding to a tight
deadline at work) that might keep you up past your bedtime or whether you
have travel planned for the two weeks after your start date. If so, it’s better to
wait until you know you’ll have a good solid run of time without interference
from evening obligations, crazy busy days, or jet lag. Similarly, once you have
your two weeks booked off, make sure not to schedule any events during that
time that will compete with your goals during the challenge. Many people find
Part:
it easiest to start the 14-Day Go To Bed Challenge at the beginning of a work/

school week (Sunday evening if you work Monday through Friday) because get-
ting more sleep during the workweek makes such a big difference to how we
feel and it delays that first early bedtime on a weekend.
Once you have your start date figured out, mark it in your calendar, set alarms
in your smartphone, write notes to yourself, and do whatever you need to do to
stick to it and actually start on that date. Once this date is decided, consider it
set in stone, completely non-negotiable, no extended warranties or refunds, do
not pass go, do not collect $200. The hardest part of any challenge is starting it.
Don’t let Day 1 defeat you by never even getting there.
How To Join a Group Go To Bed Challenge

If you know that the excitement and support of being part of a large group of
people all working toward the same goal will help you succeed, then the Go To
Bed Group Challenges are a wonderful resource for you!
Group challenges are hosted by the Instagram and Facebook Go To Bed commu-
nities. To join, simply follow one or both accounts, turn on notifications, begin
your 14-Day Go To Bed challenge on the specified date, and check-in to the com-
munities daily. There will be threads/posts during the Group challenges specif-
ically for you to share your experiences, ask questions, get extra inspiration for
the day, and connect with others. You’re also always welcome to post on the
Go To Bed Facebook Wall, or tag either account in your own social media posts
about the challenge. The more you engage on these pages (meaning, the more
you post, like, follow, reply, comment, and share), the more you’ll get out of the
being part of a group.
Group challenges begin the first Sunday of every month (unless that Sunday
falls on a long weekend and then the challenge starts the following week).
Part:
Here are the Start Dates for all of the 2016 and 2017 Group Challenges:
2016 2017
January 3rd January 8th
January 17th February 12th
(Bonus January Group!)
March 5th
February 7th April 2nd
March 6th May 7th
April 3rd June 4th
May 1st July 9th
June 5th August 6th
July 17th September 10th
August 14th October 1st
September 11th November 5th
October 2nd December 3rd
November 6th
December 4th
Being part of a Group Challenge is absolutely free. Once you’ve got this book
in your hands, there are no additional fees whatsoever. There’s also no limit
to how many Group Challenges you can join. If you’re a person who thrives in
the group challenge environment and who needs the persistence of monthly
challenges in order to stick to the program, then feel free to join every single
month!
Part:
Get Your Bedroom Ready and the Gear You Need

Before you begin the 14-Day Go To Bed Chal-
lenge, it’s important to take some time to ad-
dress sleep hygiene, which is color-coded as
green throughout the book. There are three
things I want you to focus on: make your bed-
room dark, make your bedroom cool, and make
your bedroom quiet. There are many ways to
do this. I suggested heading back to Part Three
as well as the Sleep Checklist to determine
what you will need based on your current sleep
environment. Some simple fixes for a typical
sleep environment include: covering up any LED lights on chargers (such as
smartphone, toothbrush, or baby monitor—duct tape works great!) or move
the charging location of these devices to another location in the house; place a
layer of masking tape over your alarm clock display (you’ll still be able to read
it at night!); install blackout curtains if there’s too much light coming in through
your windows at night (or temporarily cover your windows with cardboard or
aluminum foil); turn down the thermostat; and if your bedroom is the victim of
noise pollution, download a white noise app or purchase a white noise machine
(see Sleep Aid Shopping Spree).
The only other prerequisite for starting the 14-Day Go To Bed Challenge is
amber- tinted glasses, which you’ll need starting on Day 2 of the challenge. Yes,
the only gear required to complete the 14-Day Go To Bed Challenge is a pair
of $6 glasses with yellow or orange lenses (more information in the Sleep Aid
Shopping Spree). Pretty great, huh? If you aren’t excited about an additional
investment or have some other barrier to wearing amber-tinted glasses, there
is another option. As an alternative, you can turn off all indoor lights two hours
before bedtime and avoid all electronic devices that emit light (like TVs, com-
puters, tablets, e-readers, and smartphones). If you need a bit of light for eve-
ning activities, you can put red light bulbs into a few lamps that you can leave
on for the last two hours of the day or spend the last few hours of the day in
a candlelit room. The reason why amber-tinted glasses are so fantastic is that
they are a very low-cost biohack that allows us to enjoy normal contemporary
Part:
evening activities while ensuring that we protect our dim-light melatonin pro-
duction.
I know how exciting it can be to jump right into a challenge like this. However,
the best way to set yourself up for successfully completing this challenge is
to take the few extra days to read this book in full, order your glasses (or pop
over to the hardware store to grab some), make sure your bedroom is an en-
vironment conducive to great quality sleep, and set a plan in place for imple-
menting each step of the 14-Day challenge.
Shore Up Your Support Network

Studies show that the stronger your social network, the healthier you’re like-
ly to be and the longer you’re likely to live. This is both because of the direct
health benefits of connection and because of how important a support net-
work is in helping us do those things needed to look after our own health! The
importance of a good support network was already discussed at length in Part
6. This is simply the part where I remind you that talking to your family and
friends about your goals and what to expect during the 14-Day Go To Bed Chal-
lenge is a great way to make sure that everyone is on board and ready to help
out as needed!
As you read through the details of the 14-Day Go To Bed Challenge, think care-
fully about what you’ll need to be able to successfully implement each step
of the challenge, being especially mindful of the role that other people may
play. Perhaps you’d like to ask a friend to go for a 30-minute walk outside with
you every day (that handles both Day 4 and Day 13!). Or, maybe you’ll talk to
your spouse about your upcoming new bedtime routine and your need to avoid
stimulating TV shows for the hour before bed every night (that’ll help with
Day 5, Day 8 and Day 9!).
Get the Family On Board!

Your family is part of your support network, and what better way to shore up
support than to turn the 14-Day Go To Bed Challenge into a family project?!
With that in mind, I’ve added some tips for making each step of the challenge
kid-friendly!
Part:
Chances are good that when your kids notice your amber-tinted glasses or
catch you in the act of meditating, they’ll be curious! Beyond being an awesome
role model for them, this is a great opportunity to teach your kids about the
importance of healthy sleep and some easy ways to help their bodies get better
sleep! There are even kid-size yellow lensed safety glasses available for them
to wear in the evening!
Kids do a lot of the steps in the 14-Day Go To Bed Challenge naturally or as part
of school routine (like spending time outside during recess and being active
during PE). But, don’t be afraid to get them on board with other healthy habits
to support sleep. One good trick is to make sure than any nightlights in their
rooms have red light bulbs in them and that any alarm clocks have red displays
(rather than green or blue, which are common these days). You can implement
other sleep hygiene strategies for your kids like getting a white noise genera-
tor, keeping their rooms cool at night, and making sure any charging lights (like
on a baby monitor microphone) are covered up with something like duct tape.
My kids also have red light bulbs in their bedside lights, the only light that is
on in their room from once they start getting ready for bed, through bedtime
stories, until lights out time. We also have nightlights with red lightbulbs on in
the hallway and bathroom for any middle-of-the-night potty trips.
Remember to be creative when it comes to modifying the challenge steps for

kids.
Instead of meditating, they might

enjoy being read to, coloring, building
with Legos, or putting together a puz-
zle. Part of a relaxing bedtime routine
can include a bath, cuddles, lullabies,
listening to music, bedtime stories, and
any other activities that help them
wind down. Have a look at things your
child already enjoys and see where it
might fit in terms of stress reduction
(play!), circadian rhythm entrench-
ment (being outside!), and bedtime
routine (bath and stories!)
Part:
Pre-Challenge Sleep Score Survey

There’s no better positive reinforcement than seeing a measureable improve-
ment in response to your effort. If you’re working hard on diet changes to lose
weight, seeing the number on the scale go down is tremendously motivating
to continue. So, how do you measure sleep? It’s one thing to look at journal
entries and see your qualitative assessment of mood and energy level, but it’s
another thing entirely to be able to say “here is my new number!”. That’s why I
created the Sleep Score Survey.
This survey will give you a Sleep Score, a number between 0 and 100 that will
tell you just how healthy your sleep is. This is something called semi-quantita-
tive analysis, a statistical trick to turn qualitative data (like how energetic you
feel) into a number in order to make easier comparisons. The Sleep Score Sur-
vey is a way to quantify how well you’re doing with your sleep and to see the
improvements after completing the challenge, as well as see how your health
has improved with renewed focus on sleep.
Click here to fill out this anonymous pre-challenge survey. You’ll repeat this
survey at the end of the 14-Day Go To Bed Challenge and again on Day 30 day
(marked from the start of your challenge) as well as at any other time you like!
At 30 days, you’ll be able to see how well you’ve maintained your sleep priori-
ties and whether it’s time to re-up for another challenge! The anonymous data
that I collect with these surveys will also be used to refine this program, cre-
ate additional levels of the program, and create spiffy graphs proving just how
effective sleep is at mitigating a host of health problems! There is a separate
link for the survey depending on the cost when you take it in relation to your
challenge. For ease of data analysis, please make sure to fill out the appropri-
ate survey.
Here are the Sleep Score links again:

Before you start
Any other time
Part:
Get Your Journaling On

You’ve got two choices for tracking
your progress throughout this Chal-
lenge using a sleep journal!
The first journaling tool is the blank

sleep journal that can be printed off
here, designed to help you hone in
on how well you sleep in relation
to diet, lifestyle, and environment.
This is a great tool for anyone who is
trying to hone in on optimal choices
to support better sleep for themselves as individuals, as well as for a general
journal to maintain between challenges. Each evening, fill out any diet, lifestyle,
and environmental notes. Then in the morning, fill out any notes about quality
and quantity of sleep. Each blank journal page contains 3 days of journal entries.
The second is the 14-Day Go To Bed Challenge Journal, a journal specifically

designed as a companion to the Sleep Challenge with each entry created as a
simple questionnaire to help you track your progress in about a minute per day!
Fill out your journal pages the morning after that day’s challenge. For exam-
ple, you’ll actually fill out your Day 1 Challenge Journal page on the morning
of Day 2. This journal is designed to increase self- reflection and awareness of
how your body is responding to the Sleep Challenge as well as the effort you’re
putting in. As already discussed in Part 6, journaling is a very effective tool for
positive change, and these pages are designed to fit the bill without being yet
another drain on your time during the day!
There’s also a Challenge Reflection questionnaire for you to fill out once you’re
done the challenge. This is a great way to reflect on the progress you’ve made,
identify what you still need to work on, and get you thinking about more
healthy habits to support sleep!
Whether you prefer the more detailed sleep journal or the Challenge journal or
want to do both, make sure to print out relevant pages before you begin!
Part:
My Sleep Score
A great way to quantify your success in prioritizing sleep is to take the anon-
ymous survey on the previous page before you begin your 14-Day Go To Bed
Challenge, after you finish the challenge, and 30 days after the start of your
challenge.
Write your Sleep Score (a number between 0 and 100) here to track your
progress:
Before Challenge:
Day 15:
Day 30:
Challenge Modifications to Suit Individual Needs

I’ve already discussed adding a Day 0 to your challenge to address any particu-
lar area that you suspect needs work in order to improve your sleep. However,
there’s other ways that you may wish to modify the 14-Day Go To Bed Chal-
lenge.
If you just plain ol’ need more sleep than the challenge allots, it’s okay to mod-
ify the challenge to suit your needs. For example, if you already get 9 hours of
sleep every night but know that your body needs more (perhaps due to a chron-
ic health problem, a challenge to sleep quality, or due to a particularly active
lifestyle), you may wish to move the bedtimes created on Days 1, 11 and 14 of
the challenge to an hour or even two earlier than suggested. Another alterna-
tive is to add a Day 0 to your challenge that involves taking a nap each day.
If you routinely have trouble falling asleep or staying asleep, you may wish to
prioritize stress reduction as well as circadian rhythm entrenchment before
other aspects of the Sleep Challenge that you may already have in place, such
as limiting caffeine intake and afternoon and evening sugar consumption. Feel
free to swap steps around to put things like meditation, a relaxing bedtime rou-
tine, activity, wearing amber-tinted glasses in the evenings and outside time at
the beginning of your challenge.
Part:
If you know that you’ll lack patience for an iterative process and know from
previous challenge experiences that you do better with an all-in approach, you
may choose to implement all of the steps of the 14-Day Go To Bed Challenge all
at once and simply work on maintaining all of those steps for two weeks. If this
is the case, then you’re in luck because when you approach the challenge this
way, there are actually only 11 steps. With the iterative implementation, three
days of the challenge involve moving bedtime earlier and two days of the chal-
lenge involve creating a relaxing bedtime routine. You’ll jump straight to nine
hours a night in bed with an hour-long pre-bedtime routine in addition to the
other steps of the challenge that target stress management, circadian rhythm
entrenchment and hormone regulation.
On the other end of the spectrum, if you recognize that one step per day for
two weeks is going to be overwhelming, there’s no rule saying that you can’t
extend this challenge over four weeks or even four months! Choose how many
days you are going to work on each step of the challenge and mark your cal-
endar for when it’s time to implement the next step. As an example, perhaps
you’ve decided that you’ll work on each step of the challenge for a full week
before moving on to adding the next step. In that case, you’ll choose what day
of the week you’ll start your next “day” of the challenge (now week of the chal-
lenge). Extending a challenge like this can work really well for some people
because it focuses much more strongly on habit formation; but for others, ex-
tending a challenge can mean that it’s hard to keep up momentum. I only rec-
ommend this strategy if you know from experience that baby step approaches
are the best way for you to sustain positive change.
Finally, if you’re tackling the challenge for a second (or third!) time, you may
wish to raise the bar. Try using the “For the Pro” suggestions on each day of the
challenge. If those are mastered, check out the Sleep Check List and identify
what additional steps you’d like to add to your challenge to improve sleep even
more!
Remember that the goal is for everyone to get the quality sleep they need to
be healthy. And while the scientific literature is fantastic at providing direction
for the best choices to improve sleep, no challenge can ever be a one-size-fits-
all approach. I encourage you to use the extensive science in Parts 1 through 5
of this book to modify the sleep challenge as needed to cater to your individual
needs.
Part:
Before You Begin

Quick-Start Checklist
Read the full Go To Bed book
Make changes to my bedroom environment: dark, cool, &
quiet.
Purchased amber-tinted glasses
Get an awesome new pair of pajamas (not required, but a
great idea!)
Print out the Go To Bed Sleep Journal and place it by the
bed
Talk with family/housemates and gain support
Sign up for support emails
Follow our social media communities on Facebook &
Instagram
Check out the Go To Bed Roadmap
Fill out the pre-challenge anonymous survey here
Print out the 14-Day Go To Bed Challenge Journal
Part:
Online Support & Inspiration

There’s one last collection of
tools that I’ve created to help
you succeed at achieving your
sleep goals. This collection
includes the online Facebook
and Instagram Go To Bed com-
munities as well as a bonus
content e-mail series designed
to provide you with extra tips
and inspiration while you tack-
le your 14-Day Go To Bed Challenge. Connecting with others and having daily
reminders is another great way to ensure success when it comes to a challenge.
Facebook Community
This vibrant community is a great place to ask questions, connect with
others, find more fun facts about sleep, link to articles in the media
focused on sleep, and get inspired during your Sleep Challenge! This
community hosts a new Group Challenge every month, but you can
find help and fellow challengers here no matter when you want to
start your challenge.
Instagram Community
This engaged Instagram of dedicated Go To Bed’ers is a great place
to connect with others, get tips and tricks to help with your Sleep
Challenge, keep up-to-date on sleep research and media happen-
ings, as well as find inspiration and a sense of community. Insta-
gram is a fun place to grab sharables, connect with others, and find
daily support. Also make sure to check the Facebook page regularly for flash
giveaways!
Part:
E-mail Series
How awesome would it be to get an email each morning with a
game plan for the day ahead? When you sign up for this bonus
content email series, you’ll be asked what day you plan to start
your Go To Bed Challenge and you’ll start receiving daily emails
every morning the day before your Challenge starts and ending when you’re
through your challenge. These emails provide tips beyond those presented in
this book as well as useful reminders, encouragement and knowledge bombs.
Share with Your Friends

By sharing your experiences on social media, you’re achieving two things si-
multaneously: you’re paying it forward by inspiring someone you care about
to work on their sleep and you’re shoring up your support network by keeping
your social circle in the loop!
Hashtags create a fun way to connect over a variety of platforms. Check out
our official Go To Bed hashtags and use them as often as you want! The Face-
book and Instagram communities will be monitoring these hashtags and re-
posting favorites!
#gotobedchallenge Make sure to use this hashtag when sharing

any aspect of your 14-Day Go To Bed Challenge on all social media platforms,
whether you’re participating in a group challenge or are doing the challenge on
your own! Feel free to talk about what
you’re doing for each day of the challenge!
#amberselfie Let’s be trendsetters

by showing that wearing amber-tinted
glasses in the evenings to protect our
dim-light melatonin production is super
cool! Take a photo of yourself wearing
your amber-tinted glasses while doing
whatever it is you do in the evenings (food
preparation for the next day, reading a
book, working in your home office, buy-
Part:
ing groceries, or enjoying an [early] evening out with your friends) and use this
hashtag on all social media platforms!
#sleepismysuperpower As you find yourself feeling better and seeing

progress toward your health goals, use this hashtag whenever you’re sharing
any posts related to the health benefits of better sleep across all social media
platforms! Whether it’s celebrating energy in the afternoon, reduced symp-
toms of disease, a personal best at the gym, weight loss, better moods, better
focus and mental clarity or any other health milestone big or small, help others
understand the importance of sleep for our health by sharing your sleep story!
Part:
What to Expect During Your

Challenge
We all want to know what we’re in for when we put effort into any healthy
change. We want to know if there’s an adjustment period, if we’ll feel worse
before we feel better, what the time scale for results will be, or if we can ex-
pect sunshine and roses to accompany glorious and miraculous instantaneous
results.
It’s a little bit tricky to give you a firm idea of what to expect during your 14-
Day Go To Bed Challenge since people’s sleep can be insufficient in so many
different ways due to so many different factors. Just like different aspects of
the 14-Day Go To Bed Challenge are more challenging than others for different
people, exactly how each body initially responds to this new focus on sleep var-
ies from person to person. If you’re a postmenopausal woman, you’ll likely have
a very different experience from a 20-year old male athlete. Some people find
that their bodies start to crave more sleep once they’ve had a few good nights
in a row and they’ll suddenly feel even more tired than usual in the evenings.
Others find that they have instant energy, clarity of thought, and boosted
moods. Still others will find that their bodies just won’t cooperate despite their
efforts, a minority experience but a very frustrating one when it happens.
Early adopters of the Go To Bed strategies have reported a variety of observa-

tions in terms of how they felt during and immediately after the challenge. I
have summarized the most common experiences and some reasons why they
may be occurring.
Feeling amazing after 2-3 days: This is the kind of feedback I love to hear!
Many, many people have reported better moods, clarity of thought, increased
drive and focus, and high energy throughout the day. Some participants have
reported easy weight loss. Some have reported improvement in disease symp-
toms. This is what I like to think of as the light bulb experience: It’s as though
everything came together as easily as flipping a switch. This is the typical ex-
perience when the barriers to sleep were routine-based or due to minor de-
ficiencies in circadian rhythm entrenchment, and the sleep debt owed wasn’t
Part:
too great. By this, I mean that the biggest reason these people weren’t getting
enough sleep before the challenge was the simple fact that they were just plain
ol’ staying up too late. Really, that’s probably the most common reason for
inadequate sleep, simply not putting our bodies into our beds early enough at
night to get a solid 8-9 hours before our alarms go off. And, the best part about
this situation is that it’s an easy problem to fix! Sure, it takes some adjustment
of our routine and priorities, but if the major reason why you aren’t getting
enough sleep is because you’re choosing to do other activities in the evenings,
it’s fairly reasonable to expect fast results. The exception here is when a very
large sleep debt is owed or when there are more than minor disruptions in cir-
cadian rhythm entrenchment. In those cases, either participants will feel more
tired for a while before the energy hits, or they’ll find that they need to follow
the challenge strategies a bit longer for sleep quality to catch up to sleep quan-
tity.
Feeling more tired in the evening / feeling ready for bed earlier: If you owe a
major sleep debt, your body may respond in a counterintuitive way. You’re ex-
pecting amazing energy once you finally start going to bed earlier, but instead
you’re crashing in the evenings, feeling ready for bed even before your new
early bedtime, and maybe you’re even be tempted to embrace napping! This
evening crash may still go along with great energy the rest of the day, but it
feels like by dinner time, you’re spent.
Why does this happen? Ever get sick right after a period of high stress is over
like finishing exam week or meeting a hectic work deadline?
That’s related to a sudden change is cortisol secretion and its effect on the
immune system. And, it’s kinda the same thing happening here: your body now
knows that sleep is an option and it has known for a long time that it’s not get-
ting enough. There’s a hormonal shift that goes along with getting more sleep
and because such a huge sleep debt is owed, that shift involves your body tell-
ing you it needs more and more and more! The good news is that this is a crav-
ing that you’re completely allowed to give in to! The best way to get over this
phase is to pay down that sleep debt as efficiently as possible. If it lasts more
than a couple of weeks though, or if it’s accompanied by any other new symp-
toms, make sure to consult with a healthcare professional!
Part:
Impatient for energy: Even if you aren’t experiencing the rebound

effect of craving extra sleep, you still might find yourself in the absence of the
amazing energy you’ve been longing for. This can be the result of a couple of
things. The most likely culprit is sleep quality that’s not fantastic. Sleep quali-
ty is greatly affected by things like stress, too much caffeine, suboptimal diet,
inflammation, hormone imbalances, and chronic or acute illness. Often, sticking
to the program for longer will start to see things fall into place (especially if the
culprits are things like stress). If not, trying a therapeutic diet strategy like the
autoimmune protocol may help. It may also help to get evaluated by a health-
care professional (typically a functional medicine or integrative medicine spe-
cialist) for adrenal fatigue or cortisol dysregulation, sex hormone imbalances,
nutrient deficiencies, neurotransmitter imbalances, and sources of unresolved
inflammation (like persistent infection, gut Dysbiosis, or autoimmune disease).
Another possibility is that you have a large sleep debt to pay off but circadian
rhythm entrenchment and/or stress levels aren’t optimal. In that case, focusing
your efforts on the challenge steps that address those issues should see you
feeling more energetic in the relatively short term.
Harder time staying up l ate for events: Many of the steps

of the 14-Day Go To Bed Challenge are geared at entrenching your circadian
rhythms and training your body to sleep for a consistent amount of time in-
cluding falling asleep within a fairly narrow window of time. You’re teach-
ing your body to expect sleep regularly and predictably, so when you want to
go out for an evening, your body might not cooperate! Some people find that
they’re falling asleep at social events that used to be their norm! I know it’s
frustrating, but this is actually a really good thing: it means that your body has
responded beautifully to the changes you’ve made to support healthier sleep!
Try to avoid falling into bad habits in an attempt to not miss out (like energy
drinks or high sugar intake)! Remember all the work you did to get sleep dialed
in? Is a girl’s night out worth wrecking that? If you do have an evening obliga-
tion that will keep you up later than normal, try making time for a long nap in
the afternoon beforehand. A 2-3 hour long nap will delay your natural sleep
onset time and is a much healthier way to get energy for a late night than any
of the usual crutches!
Feeling rebellious: Independent of how great you feel, you might see
certain steps in the 14-Day Go To Bed Challenge and think to yourself “oh heck
Part:
no, I’m not ever doing that!!!” Feeling a little rebellious (and dare I say skeptical)
is a totally normal response to anything that’s hard work, that requires you to
give up something you love (like dessert or evening horror films), or that push-
es you out of your comfort zone (like meditating or wearing goofy amber-tint-
ed glasses). Remember that this isn’t about someone else telling you what to
do but instead about you using the information in this book to make informed
choices. Instead of feeling nagged, you can feel empowered to improve your
sleep and your health! If your struggle is more about keeping up with the steps
after the challenge because you feel like they’re intrusive or inconvenient,
then I encourage you to think about the health benefits of adequate sleep and
what that can mean for your entire life. This is also a good time to evaluate
your support network. Sometimes the feeling of rebelliousness stems more
from feeling alone in this journey than from how big of an adjustment you
need to make in your life to make room for better sleep habits. This is also
what the Facebook and Instagram communities are for! They’re a place where
you can vent to sympathetic ears and still get encouragement to keep on keep-
in’ on!
Dreaming more or dreaming less: Changes in how much you

dream or how well you remember them are quite normal and both dreaming
more and dreaming less can be good signs! As you’ve already read, we dream
predominantly while in REM sleep and remember our dreams when we have
brief awakenings afterward. We also spend much more time in REM sleep in
the last half of the night. Our bodies prioritize deep sleep when we’re sleep
deprived, so when we don’t get enough sleep, we spend a higher proportion
of the night in slow wave sleep compared to lighter sleep and REM sleep. So,
some people will find themselves dreaming more simply because they are
getting more sleep and spending more time in REM sleep thanks to extending
that second half of the night. The 14-Day Go To Bed Challenge also hones in
on many factors that influence sleep quality. If you started this challenge as a
very light sleeper, you might find that you’re dreaming less because your sleep
quality has improved and you are sleeping more deeply, spending more time
in slow wave sleep in the first half of the night and not experiencing as many
brief awakenings after REM sleep in the last half of the night. If you’re worried
about how much you are dreaming or what you’re dreaming of, it’s worth-
while consulting with a sleep specialist.
Part:
Changes in Sleep Score: Early adopters of the 14-Day Go To Bed Chal-

lenge anonymously self-reported their sleep scores before and after the chal-
lenge which lent itself to some pretty fun statistics! Even though starting plac-
es vary pretty dramatically from person to person (some people start the sleep
challenge with a Sleep Score of 40 while others are starting at 70!), every single
person who reported their results saw improvement in their Sleep Score over
14 days! What’s even better, when subjected to some statistical analysis, the
improvement in sleep score turned out to be statistically significant!
This graph shows the increases in individual Sleep Score over the 14 days of
the challenge. On average, Sleep Score increased by about 14 points! That’s 1
point per day of the challenge! And, a repeated measures t-Test revealed a very
strong statistical significance!
AVERAGE SLEEP SCORE BEFORE & AFTER

14-DAY GO TO BED CHALLENGE
100
90 *p<0.05
80
70
60
50
40
30
20
10
0
BEFORE AFTER 14-DAY AFTER 30 DAYS
CHALLENGE CHALLENGE (16 Days After challenge)
Even when you look at average Sleep Score, the improvement over the 14-Day
Go To Bed Challenge is obvious! One-Way Analysis of Variance shows another
statistically significant result! Unfortunately, at this time, there haven’t been
enough surveys turned in for the 30-Day time point to say much other than the
trend looks good. Some people see a slight dip in their Sleep Score at 30 days
compared to 14 (still higher than before the challenge though!) whereas others
see their Sleep Score continue to go up and up.
Part:
This is exciting data that I’ll be adding to over time. As a science nerd (I mean,
you’ve read through this book, so this isn’t a surprise, right?), I love being able
to see quantifiable results proving that this program works! It’s also helpful to
be able to have a realistic goal for what to expect: something like 14 points of
improvement in your Sleep Score, with the possibility of continued improve-
ment over time with your commitment to the Go To Bed Challenge strategies.
If you haven’t filled out your Sleep Score yet, please do so now! There is a sep-
arate link for the survey depending on when you take it in relation to your
challenge. For ease of data analysis, please make sure to fill out the appropriate
survey.

Before Challenge
Any other time
Part:
14-Day

1 2 3 4 5 6 7 8 9 10 11 12 13 14
Create a Bedtime
TO DO
W
HO
IT
Turn off your lights 8 hours before your alarm
goes off in the morning.
Bedtime? Whoa... adult bedtime? Yep! That’s right, your first step is to
establish a bedtime. Lights must be out 8 hours before your alarm is set
to go off in the morning. YES, 8 full hours!! This first step is actually the
most important step to get those close to you on board. Whether it’s
your college roommate or your 5-year-old, talk to others who share
your space and let them know you now have a bedtime. Kids are the
best helpers when it comes to this step. They will love to remind you
not to stay up past your bedtime. What if my schedule shifts around of-
ten? Does it have to be the same time each night? Life happens. I think
it’s best, especially during the challenge, to have a set time. But as long
as you account for your 8 hours in bed, your ‘lights out’ time can move
to fit your day-to-day life. Consistency is important though: make sure
the priority is at least 8 hours every single night!
Part:
why?! The single biggest barrier to getting the sleep we need is giving our
bodies the opportunity! By making sure that your lights are out a full
8 hours before your alarm goes off in the morning, you are setting the
stage for some great sleepy things to happen.
tical
ac A visual reminder is a great way to help those you share a living space
Ti
Pr
with to be respectful of your new bedtime. It can also be something

with which you can have a lot of fun.
o Tip
pr If this is something that is already easy for you, and you feel that you are
someone who needs more sleep than you typically get, move your
bedtime to a half hour earlier than your typical bedtime now.
Of course, kids need a regular and consistent bedtime too! It just needs to
K IDs TIP be earlier because kids need more sleep than grown-ups! A bedtime
between 7pm and 8pm will likely be right on target for kids to get the 9
to 14 hours they need (depending on age) and be up on time for school and
other activities in the morning.
Part:
1
An hour before my set bedtime, I felt: (check one)
2
Wide awake and energized
3
Wide awake but worn down
4 Somewhat sleepy
5 Tired but not worn out
6
Tired and worn down
I slept for total hours l ast night.
7
8 I went to bed hours before I had to wake up.
9
With 1 being easy and 5 being difficult, how easily
10 did I fall asleep l ast night? (check one)
11 o1 o2 o3 o4 o5
12
My mood at bedtime was: (check one)
13
o Just OK o Good o Happy o Excited o Calm o Peaceful
14
o Upset o Hurt o Angry o Irritated o Indifferent o Sad
I woke up time(s) throughout the night.
How much I dreamed l ast night, with 1 being not at

all and 5 being way too much: (check one)
o1 o2 o3 o4 o5
If I remember my dreams, they were: (check one)

o Happy o Weird o Scary o Boring o Nightmare o Unusual
o Sexual o Disturbing o Lucid o Overly Realistic o Normal for me
Part:
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Wear your Amber Glasses!
TO DO
W
HO
IT
Wear amber-tinted glasses for the last two hours
before bedtime.
“I wear my sunglasses at night” I know that was going through your

head just now. Go ahead and keep on singing it all the way to better
sleep...I do!! Amber- tinted glasses, while they may feel a bit silly at
first, really help your body get ready to go to bed. Put them on 2 hours
before bedtime and remember to also keep your lights dim.
Going to be out in public 2 hours before your new bedtime? No worries,

these glasses have been gaining popularity and you can find stylish
alternatives here.
Part:
The blue wavelengths of light we’re exposed to when we use indoor

why?! lighting after dark are arguably the biggest suppressor of our evening
melatonin production. By blocking blue light (yes, it can’t travel through
yellow plastic!), we’re helping our brains get the signal that we need to
start preparing for sleepy sleep time.
tical
ac Find yourself without your amber shades? Dim your lights as much as
Ti
Pr
you can and keep all electronics off. If possible, set up a few lamps with
p
red light bulbs for evening use. Need to use your computer? Install f.lux
to put an amber glow on your screen.
Already rocking your shades at night? You can up your game by also
o Tip
pr dimming indoor lighting. While the dominant photoreceptors that send
signals to your circadian clock are in your eyes, you also have photore-
ceptors in your skin! Keeping indoor lighting dim (and red, if possible) will
help entrench those circadian rhythms even more! Got that down too?
How about wearing your glasses for 3 hours?
s TIP
KID Kids can wear amber-tinted glasses too! Look for yellow safety glasses
that are kid-size! If that’s not going to fly, red light bulbs in bedside lamps
in their rooms for that last hour or two of the day is a great substitute.
Part:
1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5

Part:
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Get Meditating
TO DO
W
HO
IT
Meditate (mindful or guided) for at least ten
minutes daily.
For some, this may be the hardest step: sitting still, not being busy,
and just being in your body. Many of you will say “but I could be doing
something I really need to do right now!” Every one of us could come
up with ten-plus excuses for why we don’t have ten extra minutes per
day. However, these 10 minutes will have such positive health impacts
once you just surrender to it, improving resilience to stress and regu-
lating cortisol (and therefore improving sleep) being chief among them!
Meditation can be so many things (for example, there are many styles
of guided meditation) and you may want to try out a few different
styles before you pick one you enjoy. During the day (or even shortly
before bed), plan 10 minutes for meditation. Choose either a breathing
technique or do a guided meditation. There are many great apps like
Calm. See a full list of recommended mediation styles starting here.
Part:
Meditation is one of the most powerful scientifically-proven stress man-

why?! agement techniques. And, since chronic stress is such a common barrier
to good quality sleep, adding meditation to your routine is an important
strategy to improve sleep quality. This is especially important if you find
yourself waking up in the middle of the night.
tical
ac Does the idea of meditation seem overwhelming or even uncomfortable?
Ti
Pr
Grab a beginner yoga video off YouTube and follow along for the first
p
10 minutes. This is an easy way to get past any preconceived ideas about
meditation that may be blocking you from this step.
o Tip
pr Already do some meditation? Take the time to create your own medita-
tion altar. Creating a space just for ‘you time’ can take your meditation
practice to a new place and be a fun project too! Check out this example.
s TIP
KID Coloring, jigsaw puzzles, and even some forms of quiet creative play like
building with legos can be very meditative for kids and grown-ups alike!
Get a double whammy by turning this into a family activity!
Part:
1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5

Part:
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Get Outside!
TO DO
W
HO
IT
Get 30 minutes of bright light exposure daily
(this means go outside!).
It may seem hard to carve out yet more time in your day, but this step is
easily added once you start to get creative. Plan to take a walk every day
and suddenly your 30 minutes outside also becomes 30 minutes of activity
(see Day 13! You just got a head start!). Also, make sure not to wear sun-
glasses! This is all about getting that lovely bright light into your eyes to
help send signals to your brain that entrench your circadian clock!
Check out this awesome list of other ideas on how to integrate this
regularly into a busy day:
••Walk your dog ••Do your shopping at an outdoor mall or

farmers market
••Play with your children
••Take a phone call outside ••Live close to work? Ride a bike instead of
driving
••Eat a meal outdoors ••Take your break time outdoors
••Skip the gym, take an outdoor
Part:
bootcamp class
why?! Just like our brains need darkness to know that it’s nighttime, they need
bright (blue wavelength) light to know that it’s daytime. And this helps to
regulate our circadian clock, which even helps with melatonin production
in the evening, thus supporting sleep!
tical
ac Busy day of errand running? Park the farthest away from entrances all
Ti
Pr
day long! Just can’t get outside? Then the best solution is to use a light
p
therapy box for at least 30 minutes per day (preferably in the morning or
middle of the day).
o Tip
pr Already get outside 30 minutes each day? Why not up the ante to an
hour? Also, science shows that the circadian rhythm entrenchment is
stronger if you’re also active outdoors, so a good challenge is to take that
30 minutes for some tennis, outdoor yoga, or a hike!
s TIP
KID
Kids typically get about 30 minutes of outside play time without trying.
Don’t be afraid to encourage even more than this for them though! Be-
ing outside, playing in nature, and running around is good for them on so
many levels!
Part:
1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5

Part:
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Get a Routine!
TO DO
W
HO
IT
Create a relaxing bedtime routine and start at
least 30 minutes before the lights-out
Now, this step is going to take a little planning and thought. I want you
to map out the 30 minutes before your new bedtime, turning it into a
routine you can stick with night after night. My rule here is to keep it
simple. Of course, you’ll use some of this time to change into your jam-
mies, brush your teeth, remove any makeup, and perform any other
personal hygiene habits you like to take care of in the evening. But this
step is not about doing 20 things. Instead, it’s about doing one or two
calming things each night. Some examples: Drink an herbal tea (like
chamomile) while listening to calming meditation music, stretch or
“roll out” with a foam roller, meditate (may be combined with Day 3), or
enjoy a magnesium salts bath. For the purpose of this 14-day challenge,
I encourage you to stick with the same things, but as you move past
your 14 days, you can come up with a few different relaxing things you
enjoy and rotate them.

why?! It’s hard for our bodies and brains to go from busy to asleep! We need
time to slowly unwind, relax, and prepare for sleep. And when we take
that time, it tends to reduce the amount of time it takes us to fall asleep
while also allowing us to get into a deep sleep more easily!
tical
ac Find yourself still not having 30 minutes each night to take it easy? Is
Ti
Pr
that really true? Do you enjoy a TV show each night? Time to skip it and
roll that time into your pre-bedtime routine.
o Tip
pr
Already have a relaxing bedtime routine going strong? Take it to the
next level by starting 15-20 minutes earlier.
s TIP
KID Even babies need a predictable bedtime routine to prepare for sleep! For
your kids, a soothing bedtime routine might involve a bath, getting into
their PJs, bedtime stories, cuddles, and lullabies.
Part:
1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5

Part:
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Don’t Eat Just Before Bed
TO DO
W
HO
IT
Make a rule not to eat for 2 hours before
bedtime.
This step will also take some planning ahead to make sure you leave
enough time to eat a healthy dinner. Being prepared food-wise and
having a set dinner time during this challenge will make this step a
breeze. Another great piece you may add during this challenge is fami-
ly dinner time! Life can get away from us so easily and we can find our-
selves and/or our family buried in electronics at night. Bringing back a
set time for family dinner might get some resistance at first, but in the
long run it will be a great tradition. Live with housemates? Plan a set
roommate dinner each night during this challenge! And keep in mind
that there are many other ways that you can tweak your eating habits
for optimal sleep (this is coming up in tomorrow’s challenge step!).
Part:
why?!
When we eat, our metabolism increases, interfering with the work our
sleep hormones are trying to accomplish in preparation for sleep.
Live alone but looking for the social aspect of this step? How about
tical
ac finding 8 new restaurants you want to try and making plans with a
Ti
Pr
different friend you have been meaning to catch up with? Talk about a set
p
dinner time (I suggest early so you can be home in plenty of time for
your relaxing pre-bedtime routine and an on-time bedtime!) and you can
show off your new amber shades after dinner!
Got this step down? Science shows that having your last meal of the day
o Tip
pr 4 to 5 hours before bedtime may be even better for improving sleep
quality! If 2 hours is easy for you, try 3 hours! If 3 is easy, try 4! If you
already routinely eat dinner 5 hours before bedtime (and the reason for
this is not because your bedtime is ridiculously late!), then enjoy today
because you’ve got no extra work to do!
s TIP There’s no good evidence to support whether or not avoiding eating

KID
before bed helps to support sleep in kids. Your kids get a pass on this
one. Instead, experiment with dinner timing and bedtiming to see if you
can dial in on a good schedule for your kids’ sleep.
Part:
1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5

Part:
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Get 30g of Healthy Carbs!

TO DO
W
HO
IT
Eat a serving of starchy carbs with dinner every night,
aiming for 30g of carbohydrates from starchy
vegetables, and eat at least 30g of carbohydrate in the
form of fiber throughout the day.
Eat carbs you say? Day 7, you had me at hello! Time to focus on what’s on your plate at that
newly-set dinner time. This can be as simple as microwaving a sweet potato or you can try
your hand at my Cassava Oven Fries recipe. Other examples of approved starchy carbs in-
clude green plantain, acorn squash, parsnips and spaghetti squash. What about rice or white
potatoes? I recommend a strict paleo diet as the best nutrition companion to this challenge,
although it is not required. Sleep health can definitely be your first step towards creating a
healthy lifestyle. For more info on the Paleo diets and its “Yes” and “No” foods click here. The
first table has examples of starchy vegetable serving sizes for 30g carbohydrates.
When it comes to getting in your fiber, you don’t need to be intimidated! The easiest way to
get it all in is to break it up throughout the day (there’s no reason to have it all at dinner –
that’d be a pretty big meal!) The next table has some examples of fibrous vegetables and the
amount you’d need for 30g of fiber. You can see that getting all of these veggies in is no joke!
But you can do it with some planning.
30g STARCHY CARBS SERVING SIZE 30g FIBROUS VEGETABLES SERVING SIZE
Yucca (aka cassava) 2/3 cup Kale 10 cups

Green Plantain ½ cup Cauliflower 3 Medium heads
Sweet Potato ¾ cup Brussels sprouts 7 1/2 cups
Parsnip 1 cup Broccoli 6 cups
Acorn Squash 1 cup Beets 8 cups
Butternut Squash 2 cups Artichokes 3 medium ‘chokes
Part:
Our bodies seem primed for slow-burn starchy carbohydrates in the

evening. We produce more starch-digesting enzymes in the evening,
why?! and studies show that eating a decent quantity of starch at dinner
significantly improves sleep! Fiber is a totally essential form of
carbohydrates when it comes to maintaining health–it helps to prevent
gut dysbiosis and has even been linked with better sleep quality and
latency! From what we know, there’s hardly too much when it comes to
fiber, so go ahead and gobble those fibrous veggies up.
Don’t try to do everything at once! If you are newly on a path to health
a ctical don’t worry much about the diet piece during these 14 days. Making a
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big shift in how you eat and how you approach sleep health may be too
p
much. Set a goal to work on your food choices after you successfully
complete this challenge. Healthy sleep goes a long way in improving
your health, so don’t undervalue your efforts!
o Tip
pr Already eating your carbs at night and following a strict paleo diet? Try
going sugar-free for the rest of this challenge. Yes, even natural sugars
like honey and maple syrup! Keep fruit servings on the moderate side,
too.
There haven’t been any scientific studies to quantify an optimal dose of

sT
KID IP starchy carbs for kids with dinner to support sleep, but certainly kids
benefit from sources of complex carbohydrates. Use your own judgement
on this one to find an amount of starchy veggie that your kids will eat
happily and still eat the other nutritious foods on their plates.
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1 2 3 4 5 6 7 8 9 10 11 12 13 14
Step Away From Screens
TO DO
W
HO
IT
Make a rule to avoid screen time for one hour
before the lights-out time.
Do not pass go, do not collect $200 dollars, go directly to Day 9! If

you’re wondering what to do during that hour, see Day 9. Totally
tricked you into moving a day ahead! But in all seriousness, this is a
great time to evaluate what is working and what is not. Look at steps
1-7 carefully and adjust or make changes where you need to. I know
many of you will be tempted to say “well, my TV show or social media
time is how I relax at night.” Having all electronics off is a great way to
move toward real connection with others and even yourself. So much
of our day is filled with technology that taking an hour off is a-okay,
and trust me the internet will be there in the morning.
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Not only do screens emit tons of blue light (which interferes with our
why?!
dim- light melatonin production when used in the evenings), but they’re
emotionally and cognitively stimulating too! Put them away to protect
your circadian rhythms and also to help better wind down and prepare
yourself for sleep!
tical
ac Make a list of what in your life would improve with a rested mind and
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body. Hang this list up where you can see it every day. A strong list of
p
personal why’s will help propel you over the next week to completion!
o Tip Start a Journal. Journaling is a great way to improve your mental health.
pr
While it’s a hard habit for most to stick to, it is a rewarding one. I put to-
gether a short and question-prompted mindset journal within the print-
able Go To Bed Sleep Journal. I also really enjoy The Five Minute Journal.
s TIP This absolutely goes for kids too! In fact, many medical community rec-
KID ommendations have kids limiting total screen time to under an hour dai-
ly! Make the hour before bedtime play time, family time, or wind down
time instead!
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Create More Time to Relax
TO DO
W
HO
IT
Start a relaxing bedtime routine at least one
hour before lights out.
Now this step is where you really see things come together. You’re
going to take the 30 minutes you carved out on Day 5 and add 1-2 more
relaxing activities. Remember, you can roll up your 10 minutes of med-
itation from Day 3 into this time as well! The first 30 minutes you want
to do something still low key but slightly active and fun! Some great
activities you can add in are: reading, jigsaw puzzles, family storytime
or gametime, intimate relations/adult time, listening to a podcast,
journaling, stretching, light yoga, foam rolling. Some people find simple
tasks to be calming and almost meditative: washing dishes, meal prep
for the next day, dusting, sweeping. If any of these things sound stress-
ful for you then don’t include them in your personalized plan.
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why?! Let’s face it: 30 minutes isn’t really enough time to shake off the day and
slow down enough to really be ready for a good night’s sleep. But,
jumping into a full hour seemed a bit harsh, which is why this was divided
into two steps!
Try to pick out relaxing activities that are already on your to-do list, or
tical
ac
maybe ones that should be, i.e., it’s perfectly healthy and ok to have
Ti
romantic relations on a to-do list! And your partner almost certainly

Pr
won’t mind your early bedtime or new eating habits if they come with
some extra snuggle time (etcetera, wink wink, nudge nudge)! Also you
may find falling asleep even easier. It’s a win-win all around.
o Tip
pr
Got an awesome hour-long pre-bedtime routine already in place? Well,
you rock! Why not jump onto the Go To Bed Facebook or Instagram and
share your successes with others. We would love to hear how you made
it a habit and what your unique routine is!
s TIP Instead of a full hour of relaxing bedtime routine, your kids may do well
KID with part of this hour being quiet play time (no screens or chasing games)
and then moving on to their normal bedtime routine, such as bath, PJs,
bedtime stories, cuddles and lullabies!
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Cut Out Afternoon Sugar
TO DO
W
HO
IT
Make a rule to avoid all added sugars after 3 PM.
Ok, now you really don’t like me; I know. It’s ok; I can take it, but I know
YOU can do this! Sugar is so addictive and is a challenge in itself to
reign in. But for the next 4 days you can leave the sugar for the first
part of your day. Remember this includes natural sugars and nonnutri-
tive sweeteners and large quantities of fruit, although a serving of fruit
with dinner is fine. Oh, and just when you were starting to relax and
feel like this one isn’t the end of the world, remember that alcoholic
beverages contain quite a lot of sugar (alcohol itself is a sugar). Where
sleep is concerned, it’s definitely preferable to not imbibe, but for the
sake of this challenge, limiting yourself to one small drink in the eve-
ning (and not too close to bedtime) is acceptable. However, if sleep
quality remains elusive, I highly encourage you to set aside alcoholic
beverages (at least for now).
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This one isn’t just about hormone regulation to improve sleep (although it
does!). It’s also about breaking the habit of using sugar as a crutch to give
why?! us energy in the afternoon and keep us awake in the evening.Alcohol gets
roped into this one, and not just because of the sugar content: It’s also a
crutch that many people use with the idea that it helps improve sleep. Yep,
we sugar-up in the afternoon and then bring ourselves down with half
a bottle of red after the kids are in bed. The trick is that while you might
think you’re sleeping more soundly after a few drinks, you’re really not.
Sugar craving after 3pm? Here are some craving busters: Sip on hot tea
tical
ac or bone broth (What’s bone broth? Click here to find out more). Snack
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Pr
on foods with ‘sweet notes’ to them; Almonds, carrots, cherry tomatoes,

p
jicama. Take your 30 minutes outside–being active can take your mind out
of craving zone.
o Tip On day 7, I suggested for you to go sugar-free if you were already eating
pr
strict paleo. I have a sneaky feeling you may have not proclaimed your
pro status then. If not, now’s a great time to go sugar-free (ooh, and let’s
add alcohol-free too)... after all it’s only 4 more days!
s TIP
KID
Kids tend to go to bed even earlier than us, so they may do better with an
earlier sugar cut-off time! Instead, indulge their afternoon sweet tooth
with whole fruits.
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Get to Bed Earlier
TO DO
W
HO
IT
Adjust your bedtime a little earlier and turn the
lights out 8.5 hours before the alarm goes off.
Now hold the phone: this means I have to push up my new hourlong
pre-bedtime relaxing routine and my dinner time! Yep, that’s right, and
I know you can make this shift! Look at the changes you have made and
stuck to so far! Give yourself some credit and have faith that you can
push this one step further. Just think about the amazing collection of
added benefits you stand to gain from this extra 30 minutes of sleep!
Lights-out time now needs to be 8.5 hours before your alarm goes off
in the morning (the start of your evening routine is still an hour before
that, and dinner is still at least two hours before!). I repeat: You CAN
do this!! This step is much more of a mental shift though; and while it
might take moving around your priorities a little bit, keep in mind it’s
only 3 more days. And who knows? You may find yourself loving that
extra 30 minutes of sleep more than that TV show, time on social me-
dia or being busy with all the things that cloud our actual productivity
time.
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Remember those 7-9 hours per night guidelines? That’s sleep after the
why?! average 30 minutes to an hour that it takes to fall into a nice deep sleep.
Turning out your light eight hours before you alarm clock goes off is just
plain ol’ cutting it too close to the very lowest part of that range. And,
because we know how essential good sleep is for health, we’re aiming for
better than just getting the bare minimum!
Really struggling to find that extra 30 minutes? Here are some time
a ctical saving ideas: • Shower at night. This could even be part of your hour-long
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pre-bedtime relaxing routine, especially with the addition of some calm-

p
ing essential oils! • Lay out your clothes for the next day. If this is not a
stressful task for you, then it could also be part of your pre-bedtime rou-
tine.
If you already set your lights out time this extra 30 minutes earlier on
o
pr Tip Day 1 of this challenge, try using all the time saving tips above and see
how much extra sleep time (or relaxation time) you can get in. Remember
that if you still need an alarm clock to wake you up in the morning, you
still aren’t getting as much sleep as your body truly needs.
Do you need to wake up your kid in the morning to get ready for school?
s TIP
KID
Then they need an earlier bedtime too! This can be tough because so
many afterschool activities run quite late into the evening. In fact, this
might involve a family conversation as to the best choices to support
lifelong health (and whether or not soccer practice should be allowed to
be at the expense of sleep).
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Cut the Caffeine
TO DO
W
HO
IT
Make a rule to consume no caffeine after noon.
Coffee and caffeinated drinks are another beast of an addiction. It’s a

vicious cycle: we don’t get enough sleep, so we perk ourselves up with
caffeine, then the caffeine stops us from sleeping well, and then it all
starts over again. I definitely recommend seeing what caffeine-free
life is like for you at some point. But, for the purposes of this challenge,
making a noon cutoff is a great place to start. Chances are good that,
as you start to sleep better, you’ll naturally crave less caffeine in the
mornings, which will then help improve your sleep even more! See, the
cycle can go both ways! I would also recommend keeping your caffeine
to tea, coffee and maybe some dark chocolate (woot!) for this challenge.
Soda and energy drinks should just be left out altogether.
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why?! Caffeine is the great destroyer of sleep, and while it can certainly make
us feel more alert and energetic, it can’t replicate all of the necessary
health effects of sleep. It’s a crutch for chronically getting insufficient
sleep, and one that makes ever getting good quality sleep impossible.
Jonesing for a warm afternoon pick-me-up? Try a cup of buttered bone

broth instead. I know it sounds strange, but it’s packed with nutrients,
can curb appetite, and can help calm sugar cravings as well! Warm up
tical
ac a cup of your favorite sipping broth, add a tablespoon of unsalted but-
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ter, ghee, coconut oil or a mixture, blend on high in your blender for 20
seconds and drink away! Find out more about buttered bone broth here.
Need a cold pick me up drink? Try a flavored, unsweetened soda water.
LaCroix sparkling water comes in a bunch of tasty flavors, and you can
add in fresh lemon or lime slices for an extra kick of flavor.
If you already do this, make your cut-off time 10 a.m. Um, and I don’t
o
pr Tip mean just power guzzle all your normal caffeinated beverages in a
shorter amount of time! Try to stay under 100mg of caffeine daily (30mg
is an even better target!). Want to up the ante even more? Go
caffeine-free for the next 3 days!
Well, I’m guessing this is an easy one to implement for the kiddos!
However, be aware that chocolate can contain a surprising caffeine
punch!
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Get Moving!
TO DO
W
HO
IT
Commit to at least 30 minutes of activity
every day.
There is a never-ending list of ways you can move for 30 minutes. I always recommend
doing something that you enjoy, whether it’s a walk, tennis, yoga, or CrossFit, because
loving what you do to move is critical in maintaining this priority! But, if you’re someone
who finds it hard to carve out time for movement, here are some timesavers for busy on-
the-goers who don’t already have a regular workout routine they enjoy. Heck, even if you
already hit the gym a few days a week, these are great tips for days you don’t workout.
••Active
set!
job that keeps you moving all day? You’re ••Inandschool most of the day? Park far away from school
walk 15 min each way.
••Stuck at a desk all day long? Use your lunch break • •Live close enough? Bike to school
to walk, if you are allowed to eat other times at
work ••Combine
possible.
your social time with movement when
••FitDesk Elliptical Trainer

Ask if you can use a treadmill desk, DeskCycle or
••Stay at home mom? Well you’re set, kids will keep
you moving all day!
••Got a long phone call? See if you can take it in a
place you can pace back and forth while you talk. ••Planning a set play time, whether outdoors or in-
Better yet, take the call outside! doors, will have your kids excited and help you stick
to your goal! Plan a trip to the park, a game of
••Shopping/running
some movement.
errands is a great time to get in Twister, a dance party to your kids’ favorite
music, or a hula hoop contest! You get the benefit
Part: of making great memories with your kids at the same
time as getting your movement in!
This step is really a three-for-one. Movement helps entrench circadian

why?! rhythms, reduces stress, and overall regulates just about every hormone
known to affect sleep quality. Bonus: movement by itself improves health
and reduces risk of chronic diseases. Getting this step down today is an
all-round win!
tical
ac Keep it simple and make it fun! Following these two simple rules will
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ensure you move for at least 30 minutes each day, while not feeling like
p
it’s a chore or yet another thing you have to do.
o Tip
pr Try setting up some fun fitness goals for yourself to work towards. May-
be sign up for that fitness race or competition you always wanted to try.
Having a goal will keep your motivation high and your time spent moving
will be highly valued.
Kids just seem to crave activity, so there’s no reason to sign them up for
s TIP
KID
a fitness class every day of the week (although classes for skilled activity
can be a great way to get your kids into hobbies that will increase lifelong
activity levels!). Instead, just send them to the yard or head on over to a
local playground! Or, make an afternoon walk a family activity and share
in this time with your kids!
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Go to Bed Even Earlier!
TO DO
W
HO
IT
Adjust your bedtime even earlier and turn the
lights out 9 hours before the alarm goes off in
the morning.
Yep, that’s right, even more sleep tonight! Lights out 9 hours before
your alarm goes off in the morning. This will put you right on track to
match the yearly average amount of time slept by hunter-gatherers
and other peoples who live in the absence of electricity and in sync
with the sun. Nine hours in bed every single night is a really good goal
for most people (from a health perspective), although I know that it
requires commitment to maintain. You get to decide tomorrow if you
want to stay with this early bedtime moving forward, but I want you to
try it for tonight to see how you feel in the morning!
How can you tell if your bedtime is dialed in? It’s healthiest to get the
same amount of sleep every single night, so if you find that you’re still
enjoying sleeping in on the weekends, that’s an indicator that your
bedtime needs to be earlier during the week!
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“So why 9 hours? I thought 8 was optimal!” Well, first and foremost, 9
why?! hours in bed does actually typically mean 8 hours of sleep for most peo-
ple. And, while this early bedtime may actually be more sleep than you
need, I want you to try it out. Generally, if your alarm has to sound in
order for you to wake up on time, then you’re not yet going to bed early
enough to get the right amount of sleep for your body.
Feeling stressed by yet again working in another 30 min of nonproductive

time? It’s really a matter of mindset. Think about it as a split. 15 minutes
a ctical at night, 15 minutes in the morning. By thinking about it as 15 minutes, it
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all of a sudden becomes an achievable task. Also remember that getting

p
enough sleep will improve your productivity during the day: you’ll get
more done in the same amount of time, freeing up more time to nurture
yourself by getting the sleep your body needs!
o Since you are a Rock Star at getting long, consistent sleep, I would urge
pr Tip you to pick a step you are not such a pro at and try to up the ante on it for
your last day. Can you do better at avoiding afternoon sugars? Can you
reduce caffeine intake even more? How about adding a second meditation
session during the day?
Just like you needing to sleep in is an indicator that your bedtime isn’t
s TIP
KID
early enough during the week, the same holds true for your kids. And yes,
even though 6 am can feel wrong on the weekends, feeling bright-eyed
and bushy-tailed first thing in the morning every single day of the week
is actually a great sign that you and your family are consistently getting
the sleep you need!
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Post-Challenge
Reflection
1. What steps were easy for you?
2. What steps do you want to adjust or tweak? What spe-

cific changes will you make?
3. What steps were the hardest for you?
Part:
4. What are some specific strategies you pl an to try to

make these new habits more realistic for you?
5. What items from the shopping spree are next on your

wish list?
6. How will you maintain your commitment to sleep

moving forward?
Part:
After the Challenge
Congratul ations!
You did it! You made it to the last
day. Take a moment to pat your-
self on the back for all the hard
work and changes you made to
your lifestyle over these past two
weeks. Some of these habits will stick easier than others, and there are sure to
be ones that are always something you have to work at.
So Now What?
Make sure to complete your 14- Day Post-Challenge Sleep Score Survey and
see what kind of improvements you’ve made!
Take a good look at your notes from day 14 and put your new plan into action.
Need help with where to start again?
Did you fully complete the 14 days with each step in place?
If yes, keep it up! All these steps are put in place for you to continue with as a
part of your healthy lifestyle. If you feel up to the challenge start the 14 days
over again and follow along with the Pro suggestions. Also, this may be a good
time to look into other helpful sleep tools from the Go To Bed shopping spree.
Did you fall behind on a few steps?

Start back right where you fell off keeping up with all the steps. Take a hard
look at your journal and identify what tripped you up, making adjustments as
needed. Know, too, that there is nothing wrong with starting all over at the be-
ginning if you feel a fresh start is best.
An important thought to keep in mind: You are not perfect, and life happens.
Just like with anything in life, being 100% perfect all the time is unrealistic.
Be kind to yourself and give yourself time to nurture and grow these healthy
habits, because being too hard on yourself (hello, increased stress!) can also be
harmful to your health. You are going to have a bad day at some point; you are
going to have a crazy busy, overworked, excessive to-do-list day at some point
Part:
too. All the more reason to keep up with these habits as much as you can at
other times. Eventually your healthy habits will just become a part of your day,
like brushing your teeth, so that even on your worst days, getting the sleep you
need just happens.
Finally, stay connected with me! I want to hear your struggles and your suc-
cesses with the Go To Bed Challenge! Your story can be of great help to others,
so staying active on the social media pages is much appreciated and will be a
good reminder and support as you make these new habits a part of your every-
day lifestyle.
Remember, this is where you can find a whole community of people working to
put sleep back on their priority list:
Facebook Community
This community starts a new challenge the first Sunday of every
month, but you can find help and fellow challengers here no matter
when you want to start your challenge.
Instagram
Our Instagram is a fun place to grab sharables, connect with others
and find daily support.
Share with Your Friends

Make sure to use the hashtags #gotobedchallenge #amberselife and #sleep-
ismysuperpower when sharing on social media. Hashtags create a fun way to
connect over a variety of platforms.
Post-Challenge Survey
If you completed the pre-challenge survey, now it’s time to see how your Sleep
Score changed! Click here to fill it out (it’s optional and anonymous). You can
also repeat this survey on Day 30 by clicking here (marked from the start of
your challenge–mark your calendar so you remember!) to see how well you’ve
maintained your sleep priorities and whether it’s time to re-up for another
challenge! The anonymous data that I collect with these surveys will also be
Part:
used to refine this program, create additional levels, and create spiffy graphs
proving just how effective sleep is at mitigating a host of health problems!
There is a separate link for the survey depending on when you take it in rela-
tion to your challenge. For ease of data analysis, please make sure to fill out the
appropriate survey.

Before you start
Any other time
Part:
Part eight
Frequently Asked Questions

Part eight
Frequently Asked Questions; During the
Challenge & After the Challenge
During the Challenge
Q: Should I combine this sleep challenge with a nutrition challenge?
I can’t stop you from doing this, but the Go to Bed 14-Day Sleep Challenge
should be more than enough of a reboot for most people! My recommen-
dation for the best sleep is to follow a strict Paleo diet, which provides the
nutrition needed to support sleep. If you aren’t already following a Paleo
diet, you may wish to make some nutritional changes to help support your
sleep goals (for example, giving up gluten and dairy while working to in-
crease vegetable intake and focusing on overall nutrient-density). However,
if you’re considering combining the 14-Day Go To Bed Challenge with one of
the many rigorous and restrictive Paleo challenges and detoxes touted out
there, my advice is to choose one. And remember that getting good sleep de-
creases food cravings, regulates appetite, and increases motivation (like the
motivation to be active!). It’s quite possible that by the time you’re done your
Sleep Challenge, your perceived need for a nutritional challenge will vanish.
Sleeping well makes it easier to make better choices about food; we know
that sleep deprivation is a huge factor when it comes to making poor food
choices, especially highly palatable foods that are not traditionally Pa-
leo (like potato chips, ice cream, pizza, and the like - generally foods that
are designed and manufactured rather than found in nature), in addition
to increasing appetite overall. That being said, poor sleep might increase
your chances of choosing more sugary Paleo options, such as dried fruit and
honey or maple syrup-sweetened treats, which are generally less nutri-
Part:
frequently asked questions
ent-dense than other options like leafy greens. On the very awesome flip
side, getting enough sleep can have a huge impact on your relationship with
food, decreasing cravings, regulating appetite, and allowing you to be more
inhibited with food choices (meaning that you’re able to resist the tempta-
tion of something you know isn’t great for you).
The 14-Day Go To Bed Challenge is designed to be just that: challenging!

It’s also high reward: the health benefits of sufficient sleep are staggering
(as you’ve already read!), so you get a lot for the effort you put in. Because
of this, I recommend really focusing on your sleep goals and not tackling
too many changes (especially restrictions that can trigger feelings of being
overwhelmed or rebelliousness or make you feel like giving up) all at once.
Plus, the Go To Bed Challenge is designed to get you to sleep better so that
you can get off the challenge roller coaster and instead focus on formation
of healthy habits. If you’re devoting your life to challenges, chances are good
that not getting enough sleep is at least partly to blame!
Finally, and most importantly, I designed this challenge and wrote this mon-
ster book because I think sleep deserves your attention—and engaging in a
nutrition challenge distracts from that. So, I have to encourage you to dedi-
cate yourself fully to this challenge before trying to do something else. I be-
lieve that sleep has fallen way too far down on our priority list as a nation,
and spending this time to get the sleep you need is one of the most import-
ant things you can do to improve your overall health.
Q: I have an important event in the middle of the challenge that is

going to keep me up way past my bedtime. What should I do?
Firstly, make sure to do the challenge during a time when you will be able
to keep a regular routine. One or two unusual nights is manageable, but if
you have near-daily work events in the evenings, you should wait until your
schedule calms down to attempt to make the changes needed to get your
best sleep. If you know that you’re going to be missing some sleep, here
are a couple of tips: firstly, DO NOT skip your routine and other circadian
rhythm-promoting aspects of the challenge—I would worry that you’d get
Part:
worse quality sleep that night, which would exaggerate the potential is-
sues; secondly, you should do you best to plan for a nap during the next day,
because we know that this can help to combat the effects of less sleep. The
most important thing would be to proceed with the challenge after the “off”
night of sleep so that you can get the most benefits from your short 14 days!
Q: What if my child(ren) wake me up at night?
I know first-hand how hard this phase is to get through! My oldest didn’t
sleep through the night until after she turned 5 years old! My biggest tip is
to use the time that the kids are napping to sleep yourself. A lot of mothers
are inclined to be “productive” during this time, but the bottom line is that
you need to care for your own health, too! The dishes or the laundry can
wait.
Q: I’m a shift worker. What can I do?
Working a shift that goes against our natural circadian rhythm can be real-
ly tough on our bodies and hard on our health. One of the most important
things you can do is follow the circadian rhythm guidelines but make modi-
fications for your schedule. So, that would mean using a sun lamp during the
night and potentially supplementing (e.g., with GABA or L-theanine) before
your bedtime after work. Consistently maintaining a routine is absolutely
critical for your health; I know it’s tempting to switch to a “normal” schedule
over the weekend or days when you’re off, but you must maintain a regular
schedule every day for your best sleep (and best health).
Part:
Q: Once I hit menopause, I started having sleep problems. Is there

anything special I can do?
Firstly, know that you’re not alone! Studies have shown that postmenopaus-
al women do have more sleep problems, most of which are associated with
increased hot flashes and night sweats. There are additional things you can
add to your routine, like the herb chaste tree, to help with postmenopausal
sleep issues (and otherwise), which I’m currently still researching.
Q: I have a barrier to one of the steps in the 14-Day Sleep

Challenger? Can I still do it?
Sometimes life gets in the way. Much of this book is about putting our feet
down and protecting our sleep from all those aspects of life that tend to
come first, but that doesn’t mean that we always have complete control. If
there is a step of the challenge that you know will be impossible for you to
implement, read through the Sleep Checklist and pick a different goal for
that day. I encourage you to choose a goal from the same category as the
step you are replacing. For example, if you’re looking to replace a step that
falls under the banner of hormone regulation, check out the other factors
that impact hormones that influence sleep.
Also, don’t let the desire for perfection undermine the importance of putting
in a great effort. If you can’t do everything perfectly every day, focus sim-
ply on doing the best you can. The goal here is to get you enjoying awesome
sleep, not to add an additional stress to your plate. And if an unforeseen
event means you didn’t get to every step one day of the challenge, shake it
off and regroup for tomorrow.
Part:
Q: I’m color blind. Does it really matter if I spend time outside and
wear amber- tinted glasses in the evening?
Yes! A scientific study from the mid-1990s evaluated whether melatonin

suppression in response to blue/white light and green light requires an
integrated response from all photoreceptors in the eyes or from the spe-
cialized subset of photoreceptors that are responsible for reporting to the
brain whether or not it’s daytime or nighttime (green light exposure also
suppressed dim-light melatonin production, just not as much as blue wave-
lengths). They found that red-green color blind individuals have the exact
same melatonin responses to the different colors of light as people with
normal trichromatic vision.
After the Challenge
Q: I finished my 14 Day Challenge, and I’m sleeping great!

What now?
It’s awesome that your sleep improved so much in just 14 days! The goal of
the challenge is for you to make small changes that are sustainable, so don’t
give up on the brand-new habits that you’re forming. Since we know it takes
an average of 66 days to establish a habit for good, I encourage you to keep
up the changes for at least that long. And, since we know that daily journal-
ing is one of the best ways to improve your chances of making a habit last,
I think keeping up a sleep journal is a great idea too. Once every few weeks,
make sure to get an updated Sleep Score just to make sure that you’re stay-
ing on track!
Part:
Q: I finished my 14 Day Challenge, but I’m still not experiencing

great sleep. What now?
Firstly, give yourself some serious credit for making it through the chal-
lenge! Have you looked at your updated Sleep Score yet? My guess is that
your Sleep Score has improved by more than you think. Regardless, I appre-
ciate that you want to sleep even better!
In Part 6 of the Go to Bed book, there is a comprehensive checklist of things

you can do to improve your sleep and not all of these ended up in the chal-
lenge! Take a careful look at the list and see what additional tweaks you
could make to improve your sleep. Also, make sure that you really commit-
ted to the challenge to begin with - one of the reasons that the Go To Bed
Facebook and Instagram pages are hosting Group Challenges every single
month is that sometimes people need a very regular reset, and participants
are likely to get new benefits each time they complete the challenge in full.
My team and I are here to support you, so use us as an additional resource!
Finally, if you’ve tried all of the suggestions included in this book, I believe
it would be completely appropriate to discuss your sleep problems with a
health professional. There are a few different options depending on your
overall health and what sleep symptoms you have. A functional medicine
specialist can evaluate things like thyroid function, adrenal function, and sex
hormone regulation, all of which can interfere with sleep and all of which
can be addressed with medications or supplements (often in addition to diet
and lifestyle changes consistent with the recommendations in this book).
Depending on your symptoms, a health professional may suggest some sup-
plementation or medication specifically for the purpose of mitigating sleep
issues (check out my breakdown of these in Part 5!). Or, it might be time for
you to meet with a sleep specialist to get a sleep study and investigate the
possibility of one of the sleep pathologies discussed in Part 6. I encourage
you NOT to feel defeated if this is what you need!
And you should be comforted by the fact that all of the recommendations in
this book are completely appropriate for people with sleep disorders.
Part:
Q: I started the challenge, but couldn’t keep up with it for the full
14 days. What should I do?
The first step is to reflect back on the challenge and analyze what went
wrong. If the problem is that the steps of the challenge represent a very
large departure from your normal sleep habits, you might benefit from
extending the timeframe of the challenge or modifying some of the steps to
find some middle ground for a first go around of the challenge. For example,
if you routine sleep 4 hours a night, jumping to 8 might be unreasonable. Try
a round of the challenge where you aim for 6 hours a night, give yourself
a few weeks to adapt to that, then do the challenge all over again as pre-
scribed.
Other common problems include the need for more support from family
members, more time spent planning how each step of the challenge will fit
into your day, or an unexpected event that derailed the whole challenge.
Make what changes you can to address these issues and start the challenge
over. Yes, I do recommend starting again from the beginning rather than
where you left off, although that is your prerogative. The reason for this is
that it gives you more time to once again ease into habit formation to sup-
port sleep.
If you find that you are repeatedly starting the 14-Day Go To Bed Challenge
and failing, talking to a health professional, counselor, social worker, or
therapist may help you hone in on what’s holding you back and what a bet-
ter approach for you may be.
Q: I loved how I felt during the challenge, but I’m worried about
maintaining all of these habits. Are there any particularly
important tips that I should prioritize in the long-term?
Considering the length of my Sleep Checklist (in Part 6), you can see that
there are tons and tons of things you can do to improve your sleep quali-
ty--some of them small, some of them pretty significant. So, I really think of
the challenge as a distilled version of the long list that includes some of the
Part:
most important changes one can make to improve his or her sleep - and I
would hope that you could commit to the majority of these changes in the
long term.
Of the 14 days of changes, the very most important is setting a bedtime

that accommodates your sleep needs (at least 8 hours of sleeping plus time
for your bedtime routine and the time it takes you to fall asleep). We can’t
expect to improve our health if we aren’t even sleeping enough to begin
with! From there, the rest of the changes depend very much on your needs.
If you have trouble falling asleep at night, focusing mostly on the steps
that are related to setting your circadian rhythm are key (like giving up
caffeine after noon). If you tend to wake up during the night, you’re likely
having issues with hormone regulation, so pay the most attention to those
tips. However, I encourage you to try to keep all of the steps in your regular
routine to get the absolute best sleep possible.
Q: I loved the 14-Day Go To Bed Challenge! How can I share this

with my family and friends?
You are welcome to share your copy of Go To Bed with members of your
household. However, if you wish to get other family members or friends on
board, it is expected that they will purchase their own copies of Go To Bed.
You can direct them to this website for more information and to purchase
the program for themselves. Alternately, you can purchase a copy of Go To
Bed to gift to them (simply forward them the email with the download link
after purchasing).
Part:
printables
Part:
Before You Begin
Quick-Start Checklist
Read the full Go To Bed book
Make changes to my bedroom environment: dark, cool,
& quiet.
Purchased amber-tinted glasses
Get an awesome new pair of pajamas (not required, but
a great idea!)
Print out the Go To Bed Sleep Journal and place it by
the bed
Talk with family/housemates and gain support
Sign up for support emails
Follow our social media communities on Facebook &
Instagram
Check out the Go To Bed Roadmap
Fill out the pre-challenge anonymous survey here
(http://www.thepaleomom.com/go-to-bed-sleep-score-survey)
Print out the 14-Day Go To Bed Challenge Journal

Sleep Checklist
Routine
Go to bed at a time that allows you to get 7-10 hours of sleep
before you have to wake up
Spend the last hour or so before bed winding down with a book,
crossword, warm bath, stretching, or cuddling
Choose to spend time in blue light (via sunlight or a light therapy
box) around the same time every day, as your schedule permits
Healthy Hormones
Meditate several times a day including one session right before
bed
Socialize during the day
Keep things intimate (family only) in the evenings
Talk to your pharmacist if you are taking any prescriptions that
may affect your sleep
Increase the amount of mild and moderate activity that you get
during the day
Switch to a standing or treadmill desk
Go for walks
Play with your kids, pets, and friends
Eat 2-3 large meals a day

Increase healthy dietary fats, especially omega-3 fatty acids
and medium chain triglycerides
Decrease your consumption of unhealthy dietary fats, like
omega-6 fatty acids and trans fats
Consume a moderate amount of carbs (not too high or too
low)
Focus on organ meats (tryptophan) and seafood (omega-3s)
Eat sulfur-rich foods like onions, garlic, cabbage, broccoli,
cauliflower, and Brussels sprouts to support GABA
production[KP18]
Avoid snacking, especially before dinner
Eat starchy carbs with dinner
Avoid sugar in the evenings (even from fruit)
Avoid eating in the 2 hours before bedtime (4 or 5 may be
even better)
Avoid alcohol
Limit caffeine intake
Stop drinking caffeine after noon
Try a magnesium supplement
Keep a strict Paleo diet
Carve out the time for a nap if you got inadequate sleep the
night before
Talk to your doctor about whether or not to try prescription
sleep aids or melatonin.

Circadian Rhythm
During the Day:
Get blue light exposure via sunlight for at least 20 minutes in the
morning or midday
In winter months or because of shift work, utilize a light therapy
box to acquire your 20 minutes of “sunlight” before the end of
sunlight hours
Use sunlight spectrum light bulbs in your house (for daytime
hours ONLY)
Keep curtains open
Set screens to be at their brightest setting
Drive with the windows down
Take a vitamin D3 supplement in the first half of the day
Set the temperature to 65F or less at night
During the Evening:
Use f.lux on electronic devices
Set devices’ brightness to the lowest setting
Wear amber-tinted glasses if using lights or electronics after
sunset
Keep indoor lighting to a minimum once the sun is down
Pass on sugary snacks
Skip the scary movie
Ditch your night light (or switch to red bulbs)
Stay out of your bedroom until you’re ready for bed activities (sex
and sleep ONLY)
Maintain these rules if you have biphasic sleep
Set the temperature to 75F or more during the day (at least in
the summer)
Sleep Hygiene
Use blackout curtains in the bedroom
Remove or cover up all lights in the bedroom at night (including
LEDs, alarm clocks, and night lights)
Switch to a light alarm clock or ditch your alarm clock altogether
Use a white noise generator if there is a lot of ambient noise
around your house
Use a HEPA air filter if you have difficulty breathing at night
If you get hot at night, use cotton sheets and/or minimal cotton
sleepwear
Try sleeping on your back with your knees and neck supported
with soft pillows
Try sleeping on your side with a pillow between your knees

My Sleep Score
A great way to quantify your success in prioritizing sleep is to take the anon-
ymous survey here before you begin your 14-Day Go To Bed Challenge, after
you finish the challenge, and 30 days after the start of your challenge.
There is a separate link for the survey depending on when you take it in rela-
tion to your challenge. For ease of data analysis, please make sure to fill out
the appropriate survey.

Before you start
Any other time
Write your Sleep Score (a number between 0 and 100) here to track
your progress:
Before I Began:
Day 15:
Day 30:

14-Day roadmap
Before
Create a
1 Wear
2 Get
3
you
Bedtime Your Amber Meditating
begin
Gl asses
Make sure your bed- Turn out your lights Meditate (mindful or
room is dark, cool & 8 hours before your Wear amber tinted guided) for at least
quiet. Get yourself alarm goes off in the glasses for the last 10 minutes
some amber-tinted morning. 2 hours before daily.
glasses, which you’ll bedtime.
need on Day 2!
Get
4 Get a
5 6 Get 30g
7
Don’t Eat
Outside Routine before bed of Carbs
Get 30 minutes Create a relaxing Make a rule not Eat 30g of starchy
bright light bedtime routine to eat for 2 hours carbs with dinner
(sunlight) at least 30 before bedtime. every night
exposure minutes before from starchy
daily. bedtime. vegetables.
Step
8 Create
9 Cut out
10 Get to
11
Away From more Time Afternoon Bed Earlier
Screens to Rel ax sugar
Adjust your bedtime
Start a Make it a rule to
Make it a rule to
avoid screen time
relaxing bed- 1 avoid all added sugars
a little earlier. Lights
out 8.5 hours before
time routine at after 3pm.
for 1 hour before your alarm goes off
least 1 hour before
lights out time. in the morning.
lights out.
12 13 Get to 14
Cut off Get bed even
the Caffeine moving Earlier
Make a rule Commit to 30+ Adjust your bedtime
to consume minutes of even earlier. Lights
no caffeine activity per out 9 hours before
after noon. day. your alarm goes off
in the morning.

1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


1
2
3
4 Somewhat sleepy
6
Tired and worn down
7
9
11 o1 o2 o3 o4 o5
12
13
14

o1 o2 o3 o4 o5


Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:

Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:

Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:

Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:

Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:

Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:

Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:
Lights out:
Wake Time:
Times Awake:
Total Sleep:
how I felt
today:

Post-Challenge
Reflection
1. What steps were easy for you?
2. What steps do you want to adjust or tweak? What spe-

cific changes will you make?
3. What steps were the hardest for you?

4. What are some specific strategies you pl an to try to
make these new habits more realistic for you?
5. What items from the shopping spree are next on your

wish list?
6. How will you maintain your commitment to sleep

moving forward?

Nut r i e n t C at e g o r y o f K n o w n E f f e ct s
F o u n d I n...
Name Nut r i e n t on Sleep
Alpha-Carotene Vitamin Improve sleep latency Yellow, orange, & dark green vegetables
(Vitamin A sub-type) (carrots, sweet potatoes, broccoli,
spinach)
Butyric Acid Short Chain Fatty Improve insomnia/ Butter/ghee, fermented foods
Acid sleep quality
Calcium Mineral Improve sleep Leafy greens, bone-in canned fish (e.g.,
latency, promote sardines)
restorative sleep
Lauric Acid Medium Chain Improve sleep latency Coconut

Triglyceride & insomnia
Lycopene Vitamin/ Improve insomnia/ Tropical fruits, tomatoes, sweet red

Antioxidant sleep quality peppers, asparagus, carrots
Palmitic Acid Saturated Fatty Improve sleep latency Red meat, butter/ghee, palm oil
Acid
Potassium Mineral Reduce daytime Winter squash, beets, leafy greens,

sleepiness sweet potato
Selenium Mineral Improve sleep latency Brazil nuts, liver & seafood
Vitamin C Vitamin Promote restorative Dark green vegetables, citrus fruits,

sleep berries
Vitamin D Vitamin Improve insomnia/ Liver, fatty fish, egg yolks

sleep quality

Fiber Tables
To make increasing fiber intake easier for you, check out this handy dandy table of
plant foods and their fiber content per serving!
TOTAL FIBER SOLUBLE FIBER INSOLUBLE FIBER

P RO D U C E SERVING g/100g g/100g g/100g
NAME SI Z E (Dry Weight) (Dry Weight) (Dry Weight)
Almond butter 1 TBSP 0.6 0.5 0.1
Almonds 1 CUP 15.9 14.3 1.6
Apple, baked with skin, 1 MEDIUM 5.4 4 1.4

unsweetened
Apple, dried 1 CUP 7.5 3.4 4.1
Apple, with skin 1 MEDIUM 3.7 2.7 1
Apple, without skin 1 MEDIUM 2.4 1.7 0.7
Applesauce, canned, 1 CUP 2.9 2 0.9

unsweetened
Apricot 1 CUP 3.7 1.7 2
Bamboo shoots, canned 1 CUP 1.8 1.3 0.5
Banana 1 MEDIUM 2.8 2.1 0.7
Beet greens, cooked 1 CUP 4.2 2.3 1.9
Beet greens, raw 1 CUP 1.4 1 0.4
Beets, canned 1 CUP 2.9 1.5 1.4
Beets, cooked fresh 1 CUP 3.4 1.4 2
Blackberries 1 CUP 7.6 6.2 1.4

Blueberries 1 CUP 3.9 3.5 0.4
Brazil nuts 1 CUP 7.5 5.7 1.8
Broccoflower 1 CUP 2.7 1.5 1.2

(green cauliflower) cooked
Broccoflower 1 CUP 2 1 1
(green cauliflower), raw
Broccoli, cooked fresh 1 CUP 4.6 2.3 2.3
Broccoli, cooked frozen 1 CUP 5.5 2.7 2.8
Broccoli, raw 1 CUP 2.6 1.7 0.9
Brussels sprouts, cooked 1 CUP 6.4 2.5 3.9
Cabbage, green, cooked 1 CUP 3.4 1.9 1.5
Cabbage, green, raw 1 CUP 2 1.3 0.7
Cabbage, red, cooked 1 CUP 3 1.7 1.3
Cabbage, red, raw 1 CUP 1.8 1 0.8
Cantaloupe 1 CUP 1.3 1 0.3
Carambola (starfruit) 1 CUP 2.9 1.6 1.3
Carob powder 1 TSP 0.9 0.2 0.7
Carrots, canned 1 CUP 2.2 0.7 1.5
Carrots, cooked fresh 1 CUP 5.2 3 2.2
Carrots, cooked frozen 1 CUP 4.8 2.8 2
Carrots, raw 1 CUP 3.3 1.7 1.6

Cashew butter 1 TBSP 0.3 0.2 0.1
Cashews 1 CUP 4.9 4.5 0.4
Cassava (yuca), cooked 1 CUP 1.5 0.9 0.6
Cauliflower, cooked fresh 1 CUP 3.4 2.5 0.9
Cauliflower, cooked frozen 1 CUP 4.9 3.6 1.3
Cauliflower, raw 1 CUP 2.5 1.6 0.9
Celeriac or celery root, 1 CUP 1.9 1 0.9

cooked
Celery seed 1 TSP 0.3 0 0
Celery, cooked 1 CUP 2.4 1.7 0.7
Celery, raw 1 CUP 2 1.3 0.7
Chard, cooked 1 CUP 3.7 3.1 0.6
Cherries 1 CUP 3.3 2.3 1
Cherries, maraschino 1 CUP 1.4 1 0.4
Chervil (dried) 1 TSP 0.1 0 0
Chestnuts 1 CUP 16.7 13.2 3.5
Chinese cabbage, Pak-choi, 1 CUP 2.7 1.7 1

cooked
Chinese cabbage, Pak-choi, 1 CUP 0.7 0.4 0.3

raw
Chinese cabbage, Pe-tsai, 1 CUP 3.2 1.5 1.7

cooked

Chinese cabbage, Pe-tsai, 1 CUP 2.4 1.9 0.5

raw
Chinese vegetables, canned 1 CUP 1.4 0.9 0.5
Chives, raw 1 TBSP 0.07 0.05 0
Coconut unsweetened 1 CUP 13 11.9 1.1
Coconut, fresh 1 MEDIUM 35.7 31.8 3.9
Collards, cooked 1 CUP 5.3 2.1 3.2
Collards, raw 1 CUP 1.3 0.5 0.8
Coriander, leaf, fresh or 1 TBSP 0.1 0.03 0.1

dried
Cranberries 1 CUP 4 3 1
Cranberries, dried 1 CUP 6 4.4 1.6

(Craisins)
Cucumber, raw, with or 1 CUP 0.8 0.6 0.2

without peel
Dark chocolate 1 OZ 1.7 1.6 0.1
Dates 1 CUP 13.4 11.2 2.2
Eggplant, cooked 1 CUP 2.5 1.8 0.7
Elderberries 1 CUP 10.2 8.3 1.9
Endive (curly), cooked 1 CUP 5.2 3.7 1.5
Endive (curly), raw 1 CUP 0.9 0.6 0.3
Fennel bulb, raw 1 CUP 2.7 1.7 1

Fennel seed 1 TSP 0.7 0 0
Fenugreek seed 1 TSP 0.9 0 0
Figs 1 CUP 5.8 2.8 3
Figs, dried, uncooked 1 CUP 24.3 16.3 8
Filberts or hazelnuts 1 CUP 8.2 4.8 3.4
Flax Seed 1 CUP 25.5 11.7 13.8
Garlic powder 1 TSP 0.3 0.1 0.2
Garlic, fresh 1 TSP 0.06 0 0.1
Ginger (ground) 1 TSP 0.2 0 0
Ginger root, raw 1 CUP 1.9 0 0
Golden Flax 1 CUP 12.9 9.4 3.5
Gooseberries 1 CUP 6.5 5.1 1.4
Gooseberries, canned 1 CUP 6 4 2
Grapefruit, canned, water 1 CUP 2.8 0.5 2.3

pack
Grapefruit, white, pink or 1 MEDIUM 2.8 0.5 2.3

red
Grapes 1 CUP 1.6 1 0.6
Guava 1 CUP 8.9 7.4 1.5
Hearts of palm, canned 1 CUP 3.5 0 0
Honeydew melon 1 CUP 1 0.7 0.3
Jicama or yambean, cooked 1 CUP 2.6 1.5 1.1

Jicama or yambean, raw 1 CUP 6.4 3.1 3.3
Kale, cooked 1 CUP 2.6 1.2 1.4
Kiwi 1 MEDIUM 2.6 2 0.6
Kohlrabi, cooked 1 CUP 1.8 0.6 1.2
Kohlrabi, raw 1 CUP 4.9 1.5 3.4
Kumquat 1 MEDIUM 1.3 0.8 0.5
Lemon 1 MEDIUM 1.6 0.6 1
Lettuce, iceberg 1 CUP 0.8 0.7 0.1
Lettuce, romaine or cos 1 CUP 0.9 0.6 0.3
Loganberries 1 CUP 7.2 6.5 0.7
Macadamia nuts 1 CUP 12.5 9.9 2.6
Mandarin orange 1 CUP 4.5 2.7 1.8
Mango 1 MEDIUM 3.7 2.2 1.5
Mushrooms, canned 1 CUP 3.7 3.4 0.3
Mushrooms, cooked fresh 1 CUP 3.4 3.1 0.3
Mushrooms, raw 1 CUP 0.8 0.7 0.1
Nectarine 1 MEDIUM 2.2 1.4 0.8
Okra, cooked 1 CUP 5.1 3.1 2
Olives, black 1 MEDIUM 0.2 0.1 0.1
Olives, green 1 MEDIUM 0.1 0.1 0
Olives, stuffed 1 MEDIUM 0.1 0.1 0

Onion, white, yellow, or 1 CUP 2.9 0.8 2.1

red, cooked
Onion, white, yellow, or 1 CUP 2.9 1.1 1.8

red, raw
Orange 1 MEDIUM 3.1 1.3 1.8
Orange juice 1 CUP 0.5 0.3 0.2
Papaya 1 CUP 2.5 1.3 1.2
Parsley, fresh 1 TBSP 0.1 0 0.1
Parsnip, cooked 1 CUP 6.2 2.6 3.6
Passion fruit 1 MEDIUM 1.9 0.5 1.4
Peach 1 MEDIUM 2 1.2 0.8
Peach, canned, water pack 1 CUP 3.2 2 1.2
Peach, dried 1 CUP 13.1 7 6.1
Peach, dried, cooked, 1 CUP 7 3.8 3.2

unsweetened
Pear 1 MEDIUM 4 1.8 2.2
Pecans 1 CUP 8.2 6.6 1.6
Peppers, green – sweet, 1 CUP 2.2 0.7 1.5

cooked
Peppers, green – sweet, raw 1 CUP 2.7 1.6 1.1
Peppers, hot chili, green, 1 CUP 2.4 0.8 1.6

canned
Peppers, hot chili, green, 1 CUP 2 0.7 1.3

cooked fresh

Peppers, hot chili, green, 1 CUP 2.3 1.4 0.9

raw
Peppers, hot chili, red, 1 CUP 1.8 0.6 1.2

canned
Peppers, hot chili, red, 1 CUP 2.1 1.3 0.8

cooked fresh
Peppers, hot chili, red, raw 1 CUP 2.3 1.4 0.9
Peppers, hot chili, sun- 1 CUP 10.6 0 0

dried
Peppers, jalapeno, canned 1 CUP 3.5 1.2 2.3
Peppers, jalapeno, cooked 1 CUP 3.9 2.4 1.5

fresh
Peppers, jalapeno, raw 1 CUP 2.5 1.5 1
Peppers, red – sweet, 1 CUP 2.2 0.9 1.3

cooked
Peppers, red – sweet, raw 1 CUP 3 1.9 1.1
Peppers, yellow – sweet, 1 CUP 1.7 1.1 0.6

cooked
Peppers, yellow – sweet, 1 CUP 1.3 0.8 0.5

raw
Persimmon 1 MEDIUM 6.1 5.3 0.8
Pickles, dill 1 CUP 1.7 1.4 0.3
Pimento 1 TBSP 0.2 0.1 0.1
Pine nuts – pignolias 1 CUP 14.6 13.1 1.5
Pine nuts – pinyon 1 CUP 13.9 12.5 1.4

Pineapple 1 CUP 1.9 1.7 0.2
Pineapple, canned, juice 1 CUP 2 1.5 0.5

pack
Pistachio nuts 1 CUP 13.8 10.4 3.4
Plaintains, boiled or baked 1 CUP 3.5 2.8 0.7
Plum 1 MEDIUM 2.5 1.2 1.3
Pomegranate 1 MEDIUM 1 0.8 0.2
Potato, baked, with skin 1 CUP 2.9 1.7 1.2
Potato, baked, without skin 1 CUP 1.9 0.6 1.3
Potato, boiled, with skin 1 CUP 3 1.8 1.2
Potato, boiled, without skin 1 CUP 2.8 1.2 1.6
Potato, canned 1 CUP 4.5 1 3.5
Prune 1 CUP 12.1 5.6 6.5
Prune, cooked, unsweetened 1 CUP 16.4 12.2 4.2
Pumpkin or squash seeds 1 CUP 8.8 6.4 2.4
Pumpkin, canned 1 CUP 7.1 6.1 1
Radicchio, raw 1 CUP 0.4 0.2 0.2
Radish, raw 1 CUP 1.9 1.4 0.5
Raisins 1 CUP 6.2 4.5 1.7
Raspberries 1 CUP 8.4 7.5 0.9
Raspberries, frozen, sweet- 1 CUP 11 9.8 1.2

ened

Rhubarb, cooked, unsweet- 1 CUP 3.4 2.2 1.2

ened
Rutabaga, cooked 1 CUP 3.1 2.6 0.5
Sapodilla 1 MEDIUM 13.9 9 4.9
Sauerkraut 1 CUP 5.9 3.9 2
Scallions or spring onions, 1 CUP 5.5 2.6 2.9

cooked
Scallions or spring onions, 1 CUP 2.6 1 1.6

raw
Sesame seeds 1 CUP 11.7 8.8 2.9
Spinach, canned 1 CUP 5.1 3.8 1.3
Spinach, cooked fresh 1 CUP 5.4 4.3 1.1
Spinach, cooked frozen 1 CUP 6.1 4.9 1.2
Spinach, raw 1 CUP 0.8 0.6 0.2
Sprouts, acorn, cooked 1 CUP 10.8 4.6 6.2
Sprouts, mung bean, canned 1 CUP 1 0.5 0.5
Sprouts, mung bean, cooked 1 CUP 1 0.4 0.6

fresh
Squash, butternut, cooked 1 CUP 3.3 1.9 1.4
Squash, chayote, cooked 1 CUP 4.5 3.5 1
Squash, hubbard, cooked 1 CUP 6.6 2.8 3.8
Squash, spaghetti, cooked 1 CUP 2.2 1 1.2

Squash, summer (green or 1 CUP 2.5 2 0.5

yellow) cooked
Squash, summer (green or 1 CUP 1.5 1.2 0.3

yellow) raw
Squash, winter (dark green 1 CUP 6.7 2.9 3.8

or orange), cooked
Squash, zucchini, cooked 1 CUP 2.5 1.4 1.1
Squash, zucchini, raw 1 CUP 1.4 0.8 0.6
Strawberries 1 CUP 3.3 2.4 0.9
Sunflower butter 1 TBSP 1.3 0.8 0.5
Sunflower seeds 1 CUP 13.4 10.7 2.7
Sweet potato, canned, vacu- 1 CUP 3.6 2.2 1.4

um packed
Sweet potato, cooked 1 CUP 7.6 4.8 2.8
Tahini (sesame butter) 1 TBSP 1.4 1.1 0.3
Tapioca 1 CUP 1.4 1.2 0.2
Tomatillo, raw 1 CUP 2.5 2.3 0.2
Tomato paste 1 CUP 10.7 8.6 2.1
Tomato puree 1 CUP 5 3 2
Tomato, canned 1 CUP 2.4 1.4 1
Tomato, green, raw 1 CUP 2 1.8 0.2
Tomato, orange, raw 1 CUP 1.4 1.3 0.1
Tomato, raw 1 CUP 2 1.8 0.2

Tomato, sun-dried, dry pack 1 CUP 6.6 6 0.6
Tomato, sun-dried, oil pack 1 CUP 6.4 5.8 0.6
Tomato, yellow, raw 1 CUP 1 0.9 0.1
Turnip greens, canned 1 CUP 3.1 1.8 1.3
Turnip greens, cooked 1 CUP 5 2.8 2.2
Turnip, cooked 1 CUP 3.1 2 1.1
Walnuts 1 CUP 5.8 4 1.8
Water chestnuts, canned 1 CUP 3.1 1.8 1.3
Watercress, raw 1 CUP 0.5 0.2 0.3
Watermelon 1 CUP 1.4 0.8 0.6
Yams, canned, 1 CUP 3.6 2.2 1.4

vacuum-packed
Yams, cooked 1 CUP 7.6 4.8 2.8

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Index
Introduction: Why “Go to Bed”?............................................................ 6
Part One: The Science of Sleep...............................................................10
What is Sleep?.............................................................................. 13
The Purpose of Sleep................................................................. 20
Sleep-Wake Cycles.................................................................... 23
Part Two: Sleep and Health...................................................... 33
Sleep and Disease Risk............................................................. 39
Inflammation............................................................................... 44
Autoimmune Disease................................................................ 48
Weight Gain and Obesity.......................................................... 50
The Hypothalamic-Pituitary Adrenocortical Axis (HPA)................. 60
Cardiovascular Disease.............................................................. 65
Sex Hormones................................................................................ 67
Cognitive Function....................................................................... 70
Mental Health................................................................................ 73
Conclusions...................................................................................... 79
Part Three: Making Sleep a Priority....................................................... 80
Entrenching Your Circadian Rhythm..................................... 84
When to Sleep................................................................................. 90
Sleep Hygiene...................................................................................92
Part Four: Beyond the Bedroom …………………………………....... 97
Dietary Suggestions...................................................................... 101
Fiber: It’s Kind of a Big Deal!...................................................... 110
Nutrients to Improve Sleep........................................................125
Exercise.............................................................................................. 127
Stress................................................................................................... 130

Part Five: Troubleshooting Sleep Problems............................................ 139
Supplements to Support Sleep........................................................ 141
Complementary and Alternative Medicine Treatments ... 147
Pharmaceutical Sleep Aids.............................................................. 148
Sleep Pathologies.................................................................................153
Diagnosing a Sleep Disorder........................................................... 157
Part Six: Now, Let’s Go to Bed!.................................................... 161
Put Sleep at the Top of the To-Do List...................................... 164
Creating Time for Sleep.................................................................. 168
Sleep Checklist.................................................................................... 182
Why a 14-Day Go to Bed Challenge?.......................................... 166
The Power of Journaling for Positive Self Change............... 188
Tracking Sleep Quantity and Quality......................................... 191
Sleep Score............................................................................................ 195
Sleep Aid Shopping Spree............................................................... 197
Part Seven: The 14-Day Go to Bed Challenge....................................... 207
The 14-Day Go to Bed Challenge Roadmap............................. 210
Before You Begin................................................................................ 211
Before You Begin Quick-Start Checklist.................................. 222
Online Support and Inspiration.................................................... 223
What to Expect During Your Challenge................................... 226
The 14-Day Go to Bed Challenge................................................. 232
Post-Challenge Reflection............................................................. 275
After the Challenge.......................................................................... 277
Part Eight: Frequently Asked Questions................................................. 280
During the Challenge....................................................................... 281
After the Challenge.......................................................................... 285
Printables.............................................................................................. 289
Refrences.............................................................................................. 333

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What are the main topics covered in the book?

What are the main topics covered in the book?

What are some lifestyle factors that impact sleep?

What are some lifestyle factors that impact sleep?

14 Easy Steps to Healthier Sleep

BY DR. SARAH BALL ANT YNE, PHD

go to bed by Dr. Sarah Ballantyne 1

© Copyright 2015 The Paleo Mom LLC.

The information contained in this book is for entertainment purposes only.

go to bed by Dr. Sarah Ballantyne 2

10 Part 1 139 Part 5

33 Part 2 161 Part 6

go to bed by Dr. Sarah Ballantyne 3

go to bed by Dr. Sarah Ballantyne 4

That’s right: Sleep. Not diet.

go to bed by Dr. Sarah Ballantyne 6

Getting enough sleep is important for

go to bed by Dr. Sarah Ballantyne 7

This book will motivate you to get enough sleep.

U.S. Gallup poll: hours of Sleep/Night 1942-2013

Hours of Sleep/Night 1942 1990 2001 2004 2013

NET: 6 HOURS OR LESS 11 42 43 40 40

AVERAGE HOURS PER NIGHT 7.9 6.7 6.7 6.8 6.8

go to bed by Dr. Sarah Ballantyne 8

go to bed by Dr. Sarah Ballantyne 9

go to bed by Dr. Sarah Ballantyne 10

•• Non-rapid eye movement (NREM) sleep is characterized by less frequent

•• Rapid eye movement (REM) sleep is characterized by frequent, unsynchro-

pg. 20 2. The Purpose of Sleep

pg. 23 3. Sleep-Wake Cycles

•• Circadian rhythm depends upon proper functioning of the hormones

Click on each number to visit each part!

pg. 27 4. How Much Sleep Do We Need?

•• For people with an autoimmune disease or other chronic illness, 9 hours

•• Keeping honest estimations of the amount of sleep we get, including the

•• Research on modern hunter-gatherers has demonstrated that they also

pg. 31 5. Sleep Debt

The behavioral criteria for sleep are all of the following:

The electrophysiological definition of sleep identifies a specific pattern of

NREM sleep is character-

acterized by brain waves

less synchronized. During

REM sleep. As you might

ment (your eyes are darting

After that, the body begins to transition into established sleep.

In stage 4 (which, again, some scientists characterize as just an extension of

delta sleep. In this stage of sleep, there is no eye

Deep sleep seems to be one of the most critical

Waking may occur after REM,

in REM sleep. Differ-

How does the brain TIME OF SLEEP

control the sleep stag-

The Purpose of Sleep

There appears to be three main reasons for sleep.

The brain uses about 20% to 25% of the total calories we

During sleep, the brain cells (neurons)

The buildup of certain proteins is a normal part of the process of a working,

atively impact cellular health, neurotransmitter systems, hormone systems,

3. Inactivity and Energy Conservation