Beth Ricanati, MD, is a women’s health and wellness physician. Follow her on Instagram or on her website for more prescriptions for healthy living.

I thought that the pillars of optimal health were threefold: nutrition, exercise and stress management. Now I believe in a fourth. Sleep. Sleep – enough of it, and especially enough good sleep (deep, restorative REM sleep). Sleep restores our body clock. It restores our energy levels. It even helps keep us combat chronic disease. I now think of sleep as another tool in my arsenal to stay healthy. Current guidelines recommend adults sleep 7-9 hours every night. Many of us (ahem, most of us) don’t meet these recommended guidelines.

Not getting enough sleep interferes with our hormones. Specifically, we have a built-in good stress response that releases hormones such as cortisol and epinephrine. These hormones help in the moment. Known as the ‘flight or fight’ mechanism (the sympathetic nervous system), this stress response has kept us safe for millennia. Our busy lives today – and accompanying lack of sleep – can cause a chronic stress response. In turn, our adrenal glands’ release of stress hormones, such as cortisol and epinephrine, increases. Too much is too much. As a result, health problems – such as rapid heart rate, a rise in blood sugar and even a rise in blood pressure – occur when this mechanism is chronically engaged.

Getting a good night’s sleep can help.

We don’t usually think about sleep until we haven’t had enough of it! How many times have you found yourself just lying there, watching the clock? How many times have you hit the snooze button in the morning? Repeatedly. Fortunately, there’s a lot that goes into a good night’s sleep, even before your head hits the pillow. Good nightly habits can make all the difference. We doctors call it “sleep hygiene,” and it’s way more effective than counting sheep.

The following are simple steps that I’ve prescribed to patients, and that I try to follow myself:

  1. Go to bed at the same time every night and get up at the same time every day. Go to bed at approximately the same time every night, within a half hour, and you’ll start to train your mind and body that this is bedtime. And yes, getting up at the same time is tough. Of course some people like to sleep in on weekends and/or vacation, but those extra hours don’t make up for the lost sleep. There are no sleep banks to store the hours!
  2. The bed is just for sex and sleeping. Forget reading the next great American novel. Forget watching TV with a bowl of popcorn. Forget checking your phone. Your bed is just for sex and sleep. You want to break any other behavioral associations and reinforce this simple rule. The light from your devices’ screens blocks the production of melatonin, a brain chemical that’s crucial for falling asleep. Keep your devices out of the bedroom at night! Use curtains and/or shades to keep the room dark. Keep the temperature on the cooler side.
  3. Foods can help, or make sleep worse. To avoid: caffeine after mid-afternoon since it is a stimulant. Alcohol near bedtime – although it initially acts as a sedative, it is a known sleep-disrupter. How many of you have woken up at 3am post a few glasses of wine? To try: a calming cup of warm organic milk (grass-fed if possible). Dairy-free? Try turkey, nuts, seeds, oats, chicken and organic tofu. All these foods are high in the amino acid tryptophan, which causes sleepiness.In fact, tryptophan converts to serotonin, which is then converted to melatonin. Melatonin regulates our sleep-wake cycles. Other melatonin-rich foods: try a cup of cherries before bed. Bananas and oranges are also good sources.

The doc said it here and we are listening! Here’s to happy and healthy sleep – a priceless component of good health.