Appropriate Sleep

From the common fact that we spend 1/3 of our lifetime sleeping, we can suspect how extremely important sleeping is to our health and longevity. The effects that sleep has on our body and mind which are to be listed now proves this importance. These effects include restoring strength and eliminating fatigue, protecting the brain and conserving intelligence, strengthening the immune system to prevent diseases, promoting development and growth during the infantile and adolescence years, and helping in other ways of cell renewal and excretion of waste therefore improving the skin health and esthetics.

As such, reasonable sleeping habits should be adopted to ensure adequate duration and quality of sleep. While there are differences in individual energy level and therefore the duration of sleep that one feels to be adequate, it is generally recommended that we get about 7 - 9 hours of sleep a day for optimal function. The best hour to fall asleep would be before 11pm, around 10pm. This makes 5 - 7am as the best hour to get up in the morning. One sleeping method for life cultivation which has been practiced over time and proven to result in a good quality and efficiency of sleeping is “Sleeping at Midnight and Noon.” This method can be practiced by sleeping at midnight (sleeping between 23:00 to 1:00) and once again at noon (between 11:00 to 13:00). These times were not randomly chosen. At midnight and noon, there is an alternation between Yin and Yang where one reaches its maximum and transforms into the other one. This is easy to imagine when we look at the symbol of Yin & Yang. When we imagine the symbol to be divided into 24 segments (representing 24 hours) with 12th segment (noon) at the top where there is the largest area of white (Yang), we can see that there is a tiny strip of black (Yin) that begins to grow from that point. The opposite is true at the bottom which is the 24th segment (midnight). Qi, Blood, Yin, and Yang inside our body are most imbalanced at these extreme times. Sleeping or peaceful lying at these times can prevent the impairment of Qi and Blood which can easily happen when there is an imbalance. This sleeping method also reduces the rates of cardiovascular and cerebrovascular diseases in elderly people. Another way to practice a good sleeping schedule is to follow the general rule of “rising early in spring and summer, and late in autumn and winter”, which conforms to the change in season and therefore the rise of sun. At the same time, we should also follow the general rule of “don’t rise as early as before the cock crows, or as late as after the sun rises”.

TCM life cultivation texts also mention some taboos for sleeping within “ten forbidden points”. Such actions include being anxious in bed, getting angry before bedtime, ingestion before bedtime, sleeping with the lights on, sleeping with the mouth open, covering the head while sleeping, facing a draft while sleeping, and facing the stove while sleeping. These actions can all reduce the sleep quality and therefore the efficiency of sleeping.  

Sleeping posture can also have significance on our health. Sleeping in a posture like a “bow” has been recommended by TCM and Western medicine professionals. This means to lay laterally. Specifically, sleeping on the right side is recommended. This position can increase the cardiac output, support digestion and therefore absorption of nutrients, and boost metabolism. It also tends to feel more comfortable than sleeping on the left side. Left lateral position is especially not suitable for patients with heart diseases and symptoms of blood stasis as that increases the cardiac workload. An exception where left lateral position is advised is during pregnancy. This is because right lateral position during pregnancy can constrict veins in the lower abdominal cavity and reduce venous return, which would be harmful to fetal development and delivery. Supinated position (facing up) and pronated position (facing down) are also not recommended in general. The former is disruptive to pelvic blood circulation and can give rise to menstrual problems. The latter can increase facial wrinkles. As for infants, their posture should be changed constantly with the help of adults because any one prolonged position can easily cause asymmetrical development of the skull and facial features. They should be turned over every 1 to 2 hours. As for patients with heart failure and respiratory conditions such as cough attacks and asthma, semi-lateral or semi-sitting position with the help of high padding is advised. While these positions are recommended when going to sleep, it is not mandatory to keep them throughout the night as shifting position is natural and impossible to recognize in sleep.

Most people sleep with pillows and so discussion on pillow cannot be left out. The pillow height should be slightly shorter than the distance from the tip of the shoulder to the base of the neck on the ipsilateral (same) side. If the pillow is too high, it disrupts the function of the Liver meridian whose internal pathway ascends the neck to the top of the head, and can also induce cerebral ischemia, snoring, and stiff neck. If it is too low on the other hand, it disrupts the dispersing and descending of the Lung Qi, causes congestion of Qi and Blood flow coming down from the head, and therefore results in edema of the eyelids or the entire face. Pillow width (distance from superior to inferior borders at bird's-eye view) should not be very wide, with the recommended width being 15 – 20cm. Pillow length (distance from left to right borders) can be slightly long, however. The pillow core should be made of a material with proper hardness and slight elasticity so down/feather pillows are actually not advisable. A pillow that keeps its form even when weight is applied is advisable because then the head will not be wrapped by/sunken within the pillow. Our heads should get sufficient exposure to the air (this does not mean draft!) as our head should be kept cool while our feet should be kept warm. TCM life cultivation methods also include the use of medicinal pillows. These pillows have cores made with traditional Chinese herbs. A single herb can be used to make these pillows - e.g. Ju Hua (Flos Chrysanthemum) can be used to make a pillow for patients with headache, conjunctivitis, insomnia, and hypertension – but pillows made with a compound of different herbs have better therapeutic effects. It should also be noted that medicinal pillows only exert therapeutic effects on local diseases such as those of the head, face, five sensory organs, shoulder, and neck. They are not applicable to distal diseases such as those of the chest, abdomen, and limbs. 

Suggestion on bedding is less complicated than that of the pillow. Soft natural fibers should be used to make the underside/inner lining which directly touches our body. Such materials include fine cotton, burlap, and silk. Materials that are artificial and frequently cause static electricity such as acrylic fibers, nylon, and dacron are not advisable. The recommended wadding/filler materials for the blanket are cotton, silk floss, and eiderdown. Although there are inventions like weighted blankets these days, light and big blankets are preferable for the free movement of Qi and Blood. The lining and filler materials should be interchanged throughout the season as it seems fitting with the changes in temperature.   

Clothes that are worn for sleeping should be large and lacking collars & buttons. The materials that are seen as fitting in autumn and winter are cotton velvet and towelling. Ones suitable for spring and summer are silk and muslin. Also, elderly people (usually over the age of 70) are recommended to wear a cotton nightcap that can cover the entire head in winter. Elderly people should also make use of an abdominal wrapper regardless of the season.

There still is so much that can be discussed regarding sleep including the TCM perspective of nap, the best time for napping, and insights on sleep disorders. For instance, people with imbalances in the body such as the syndrome of Yin Deficiency can exhibit symptoms like difficulty falling asleep and staying asleep. On the other hand, people with a syndrome like Yang Deficiency may have lethargy and sleepiness which makes it difficult to get up in the morning. More posts on sleep will be updated in future but for now let's try to keep in mind what we covered above.