With all of our emphasis on healthy eating and exercise, it is easy to forget that there are actually 6 pillars of lifestyle medicine. The other four are: not using substances like tobacco, alcohol and drugs, managing stress, good social integration and making sure we are getting a good night’s sleep.  It is this category, sleep, where as a society we are falling very short.  Why aren’t we sleeping enough and what can we do to fix this?

We are coming off a very successful conference for Kosher whole food plant based eating here in Jerusalem.  It was extremely well attended and the presentations by the three physicians were outstanding.  There is no question that in terms of which lifestyle behaviors have the biggest effect on our health, the food we consume is certainly number one. There was a time, more than 30 years ago that I would have told people that exercise is the most important thing, diet is second, not smoking third and then, sleep. Lifestyle is important in its totality, but with all of the research that has come out over the past 4 decades, we know that food is king. It might surprise you, but I would have to say that our sleep hygiene may now be number 2—maybe even more important than exercise.

Society has changed a great deal over the last 150 years. The invention of the electric light bulb changed everything.  As time has moved on, using artificial lighting (not from sunlight) has become the norm.  It has enabled us to stay up later and wake up earlier.  But what has happened over the past 35 years with the advent of accessible rapid electronic communication, is that we can email, message, and voice call anywhere in the world for little or no money.  This has given businesses an opportunity to do worldwide business from one location.  It is now simple and easy to video, email, or call anyone in the world at any time!  Staying up to work or be in touch with relatives and friends has caused havoc due to sleep deprivation and a malfunctioning circadian rhythm.  

There is no question that taking devices such as smart phones and tablets into the bedroom is now a huge contributor to the problem.  In a recent conversation with clinical psychologist Dr. Sharon Slater, who works primarily with older teenage females, she conveyed to me how sleep deprivation from these girls being up much of the night on their devices has contributed in no small way to countless mental health and cognitive issues.

According to research done at the Mayo clinic, not sleeping enough results in impaired memory, slower reaction times, lack of alertness and grumpiness.  Tired people are less productive at work, less patient with others and less interactive in their relationships. According to the National Highway Traffic Safety Administration in the United States, more than 100,000 crashes each year are due to drivers falling asleep at the wheel.  Needless to say, for those of us who exercise regularly, we all know how unproductive a session can be when we have failed to get a good night’s sleep. More recent research shows how sleep deprivation can contribute to both higher cholesterol, high blood pressure, type 2 diabetes and overweight/obesity.

It is imperative for an adult to get 7-9 hours of sleep at night.  If that is impossible (for instance you are a night shift worker), at least find time in the daytime to take an hour nap if needed.  And that sleep should encompass the three stages of pre-REM sleep and then REM sleep. We need to go through 3-5 cycles of that each night and REM sleep—that is that really deep sleep which is restorative to our bodies-should take up about 90 minutes. 

So practically speaking, what can we do to enhance our sleep hygiene? In her book “What’s Missing from Medicine”, Dr. Saray Stancic, a board-certified lifestyle medicine doctor who herself reversed all the symptoms of her Multiple Sclerosis,  has some good suggestions based on her extensive sleep research.

To fall asleep

  • Your bedroom should be cool, dark and quiet
  • Keep the bedroom for its purpose, a place to sleep. Not for reading, working and being on the computer
  • You should have a good quality mattress.  Old isn’t good.  So anything beyond 14-15 years is probably not helping you sleep well
  • Get a bedtime routine.  It can be a shower or bath.  It can be a few minutes of meditation, deep breathing, or other means of relaxation

In order to stay asleep

  • Don’t eat or drink two hours before bedtime
  • Use the bathroom before getting in bed even if you don’t feel an urge to do so
  • If you drink alcohol at all, don’t before bed.  It decreases the length of REM sleep
  • Only drink or eat caffeinated drinks and food in the morning hours
  • Smoking is a stimulant.  If you haven’t quit, it’s time!
  • SCHEDULE YOUR SLEEP! Try as best you can to go to sleep and wake up at the same times daily.


  • Smart phones, tablets and computers are stimulants. Studies show longer screen time equals less sleep
  • Turn off your alerts and notifications when you get in bed—best to turn the phone off one full hour before bedtime

My clinical experience has shown me that when it comes to losing weight, my biggest successes are those who get a good night’s sleep. I have also seen people who had trouble lowering their blood sugar, better able to do it once their sleep hygiene improved. 

Lack of sleep will also disrupt your metabolism and will cause you to secrete more of the hormone cortisol.  This will increase your appetite and cause you to crave fatty foods.  If you try all of the tips we have suggested here over a period of time and you still can’t sleep, seek professional help from a sleep center or a physician that specializes in sleep disorders.  Getting adequate sleep is a key ingredient in order to “add hours to your day, days to your year, and years to your life.” 

Alan Freishtat is a HEALTH and WELLNESS COACH and PERSONAL TRAINER with 23 years of professional experience. He is a graduate of the eCornell University Certificate course on Plant Based Nutrition for preventing and reversing illness. Alan is director of The Wellness Clinic.  He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@alanfitness.com www.alanfitness.com US Line: 516-568-5027