Sleep composition and what to do about it?

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This is a repost from the "Other" forum where I posted this message a week ago.  I plan on starting experiments this week and hope to entice a bit more discussion related to that and the below original post:

 

Greetings,

 

I've been using the Zeo for a little over 3 months now and am satisfied that I have a reliable baseline.  It's actually remarkable how steady my results have been (hopefully proof that the Zeo works!)

 

On average, my sleep is 35% REM (2-3hrs), 8-10% Deep (45-60min) and the rest is light sleep.  I get 7-8 hours of sleep a night and my average Z score is 85-95.  Right off the bat, it's evident that I'm above average on REM sleep and below average for Deep sleep (given the numbers for a 27yr old male).  The reason why I bought the Zeo in the first place was because most of my life, I've felt like my sleep hasn't been as fulfilling as it should be.  I'm regularly sleepy during the day and sometimes flat out exhausted.  After finally getting fed up with feeling this way, I went to a sleep lab.  Unfortunately, the results revealed nothing was wrong with me (weird to actually WANT something to be wrong, right?).  Honestly, I don't know how they think they can get an accurate result with 30 wires hooked into the patient while he/she tries to sleep on a tiny prison sized bed that plastic sheets on it.  

So anyways, upon seeing from the Zeo that my sleep composition was a bit abnormal, I thought I finally had an explanation.  Well, as most of you reading this probably have figured out by now, it's not so simple from here.  I've done my fair share of research which has yielded few answers.  Admittedly, I've been super busy lately and haven't been able to experiment as much as I'd like, but still nothing has jumped out at me from reading these forums and other sources that seem like easy answers.

So I'd like to try to unite some of the forum readers and Zeo staff to get some relief to us sleepy folk!  First though, we need to answer some basic questions.  As I said, I have read the forums and some of the blog articles, but I might've missed or forgotten something so forgive me if any of these questions have already been addressed.

- Is all sleep created equal?  It is apparent that we all have different sleep compositions to some degree, but is our body's reaction to a sleep composition also different?  ie, do different people require different amounts of deep sleep to feel rested?  Would my 45 minutes of deep sleep feel glorious instead of unsatisfying to someone else?  Are there people out there currently receiving my 45 minute avg but feel fine during the day instead of unrested (like I do)?  If so, what are some of the determinants for these differences?  As a related anecdote, my girlfriend scored 90minutes and 2 hours of sleep from using the Zeo twice and hasn't really ever complained of sleep problems or daytime fatigue.  Could this support the thought that we do all need a minimum amount of deep sleep, etc?

- Are there any correlations between sleep composition profiles and personality types/living conditions?  ie, do people who are more stressed get less deep sleep?  People more creative get more REM?  

- Are our sleep ratios tied together in any fashion?  For example, if I managed to increase my deep sleep by 30 minutes, is it more likely the 30 minutes would come from decreased REM or light sleep?  Or would I need to sleep 30 more minutes total to obtain an increase?

- What impact does sleep length play on our ratios?  Some have mentioned that they need a certain amount of sleep to experience 2 deep sleep cycles instead of 1.  

- Finally, what can we do to tweek our sleep composition?  Thus far it seems like supplements have had little effect, or even negative effects.  Whether exercise has an impact is a topic of debate, and perhaps needs to be explored further.  I know Zeo recommends a series of coaching tips that help in the areas of sleep ettiquette, but I'm not sure these are designed to change your sleep composition, and rather to help you fall asleep and stay asleep.  If we pool our experiments together and share our experiences, the results could be literally life changing.  So feel free to chime in with anything that has or hasn't improved your sleep and we can build a little database.  

With this technology and community we have an incredible opportunity to be on the forefront of answering some of sleep's most important questions.  Everywhere I look, I see sleepy people who have simply accepted that this condition is just part of life and the presence of so many other tired people has convinced them that it's even normal.  America has already tackled the obesity epidemic, I think it's time sleep gets some love!  

This is a topic near and dear to my heart!  And one that I've discovered is not easily answered.

I'm still relatively near the beginning of my sleep journey, having discovered that being diagnosed and treated for obstructive sleep apnea (OSA) is just the beginning of getting good sleep.  This is the story of my personal journey to better sleep. 

I have a lifetime of poor sleep, and can remember not sleeping well even as a child. I don't remember a time in my life when I was not tired and exhausted, and even though I didn't let that stop me from doing things, everything became more and more difficult as I grew older and continuing to push through was becoming almost impossible as I approached my mid-50s.

I've now been using APAP (an adjustable version of a CPAP machine) for a little over 5 months now. The first few months were abject

misery in adjusting to the machine, claustrophobia issues, mask problems, etc. etc. etc. etc.  It was unmitigated hell for the first two to three months.  

Getting the pressures tweaked and my AHIs (average number of apneas per hour) lowered was easy, and once the claustrophobia and

panic issues resolved, I started sleeping more hours and was up to sleeping about 5 to 7 hours most nights. The numbers were good, mask leaks were very low, everything said that APAP therapy was working for me. I had become religious about sleep hygiene and it did

help to extend the number of hours I was sleeping. 

But I still didn't feel awake and was still pretty tired most days…not nearly as bad as before, but still not very good. My gut instinct told me that while I was sleeping, I wasn't getting enough deep or REM sleep. So in order to try and get some idea of what was happening there, I bought a Zeo sleep monitor. While it isn't as accurate as a sleep study, I hoped to get some idea of what was happening on a regular basis night after night. It does  work! The first several nights I used it confirmed that the bulk of my night was in light sleep, with less than 10 minutes of deep and REM sleep. I was also waking up 10 or more times per night, even if I didn't stay awake for long.

So….even though my OSA was well controlled, I still wasn't sleeping well.

Tried hypnosis; helped some but not much. Tried self hypnosis–same thing. Tried calcium/magnesium with no luck. Can't take

Ambien–makes me totally whacko the next day. Lorazepam cut down on the awakenings, but did nothing to help the sleep stage issue and I don't want to take it long term.  Even if they had worked, I don't want to take prescription drugs to sleep on a long term basis.

Started researching serotonin issues…I know I've had serotonin issues throughout my life and anything that has increased my serotonin immediately decreased the crazy carb cravings I've fought my entire life. However, in the past whenever I've taken any kind of antidepressant that increases serotonin, it seriously messed up my sleep and I would only sleep about 2 hours–even the ones that weren't supposed to do that. I wasn't willing to try those again.

In researching medicate databases regarding serotonin/insomnia issues, I found studies linking tryptophan to lessening/improving

insomnia. So I thought what the heck–can't hurt, might even help and I would quickly know if it made my insomnia worse. Most of the studies used anywhere between 1000 and 3000 mg of pharmaceutical grade tryptophan. So I got some and started at 1000 mg per night.

WHAT A DIFFERENCE! The first night my deep sleep jumped to about 20 minutes; REM went to almost an hour. I had half the number of

awakenings. Still only got about 6 hours total sleep, but I felt a lot better. Stayed at this level for several nights, with the same results.

Decided to try 2000 mg one night and bingo–deep sleep at about an hour; REM at about 1.5 hours. Every night I take it is similar. Decided to try cutting back to 1500 and see what happened and it still works just as well.  Going down to 1000 mg doesn't work.

AHIs (the number of apneas occurring per hour)  haven't changed and are still very good in the .2 to .5 range most nights, although there seem to be more nights at the .1 to .2 level. Weirdly enough, the nights with the most deep sleep and REM sleep seem to have

the least number of recorded apneas.

I'm now going on about 4 weeks of sleep with more normal amounts of deep sleep and REM, and wow, do I feel the difference! Energy level is getting up there too, but I still have more tired days than I'd like.

Still working on extending the actual number of hours sleep a bit and cutting down on awakenings.  I started at a Zeo number in the low 30s…after settling on 1500 mg. of tryptophan every night, I'm now consistently in the upper 60s and low 70s with REM averaging about 14% and deep sleep about 10% of my night. Some nights these percentages are higher and those are the days where I feel the most energetic.  Last night I had an 83!  (but the card corrupted so I don't know what the breakdown was).

I'm still trying to nail down the details so that I can consistently sleep well, but I also know that I need to accept some variations night to night.  

So the bottom line for me was that APAP therapy was only the starting point; for many people they assume that it is the beginning and ending point, even though they don't feel much better. While OSA  is obviously a major player in my lifelong sleep issues, I've discovered that other areas needed support in order to achieve better sleep. I'm hoping that over time as I continue to sleep well and my body starts to recover from the chronic and decades-long sleep deprivation, I'll be able to achieve good sleep without the tryptophan. The journey

is probably far from over, but for the first time I'm feeling like I'm well on my way and beginning to enjoy the benefits of sleeping.

Geez….I've learned more about sleep and sleep architecture than I ever thought possible!   Confused

 

BTW, one thing I've learned on this journey is that sleep apnea affects more people than most realize...it is NOT a condition limited to overweight, middle-aged men.  Recent studies are discovering that jaw and facial structure has as much or more to do with whether or not a person has or will get OSA than does weight.

 

Weezy

DocWeezy, what a great story!  Thanks so much for adding your story to our thread.  It's people like you whose contributions can truly make a difference in other people's lives.

While I don't think I suffer from some of the issues you do, I will certainly do some research on tryptophan to see if it's a viable treatment for me to try.  

It's been awhile since I've posted (there is another thread of mine in a different subforum with some replies), so here is the latest on my sleep journey.

Heavy drinking definitely increases my % of deep sleep lol.  However, any gains in deeper sleep are of course offset by the hangover the following day.  So obviously this is not a viable nor safe approach to solving sleep issues, but somewhat interesting nonetheless.

I've also tried several dosage combinations of magnesium and zinc with little success.  Has anyone else used this supplements to any effect?

Finally, the most interesting happening was getting the results back from a micronutrient blood panel.  The company that administers it is called SpectraCell, and they basically test your nutrient levels against normal ranges and highlight any deficiencies you might have.  I was interested to find out if maybe being deficient in something could be causing my lack of deep sleep, or even lack of energy (or both?).

Sure enough, I'm deficient in something called coenzym q10.  Since the doctor didn't seem patient or knowledgeable enough to walk me through what this meant, I was stuck with going off of the diagnostic report and google (a role I'm actually quite comfortable with at this point :).  After some research, it seems that this is a very important enzyme which plays several critical roles to our body's healthy functioning.  Specifically it is crucial for healthy heart function and aiding in the synthesis of all sorts of other nutrients.  The cause of deficiency doesn't seem to be well understood, but typically it happens in people who use beta blockers (I do not), are older (I'm  28) or already have a heart or liver condition (I don't).  Furthermore, there is serious debate as to whether or not supplementation is an effective way to replenish your levels.  So left with more questions than answers (another situation I've become comfortable with unfortunately), I decided to give it a shot.  I bought a 60 day supply for $28 and will try it for at least the 2 months.  I also bought a bottle of melatonin from a reputable brand because I had tried melatonin in the past but I'm pretty sure it was a generic brand and possibly even expired.  So between these 2 pills, hopefully I can get back to some experimentation and see some results!

The next thing I really want to try is meditation.  The appeal of meditation is the mind-body approach and also the other various benefits it can provide.  I'd vastly prefer to find a natural solution to my sleep/energy issues than having to rely on pills, and I've heard meditation has a wide spectrum of benefits, with improved sleep being a big one.

Anyways, if you're reading this, please feel free to post any of your own trials and tribulations! I guarantee if nothing else, you'll feel better about getting it of your chest Smile

Interesting about the co-Q10...can't wait to see what you think.

 

Re the melatonin:  if it doesn't work for you, try tryptophan.  I've taken melatonin off and on for years with no results except for really weird and disturbing dreams.  What I learned during my research was that tryptophan is a precursor to melatonin, and that it will sometimes work for people when melatonin doesn't.

 

So you get more deep sleep when you drink?  What do you consider heavy drinking?  I find that my sleep cycles get really whacky if I have more than a couple glasses of wine in the evening.  If I want to have anything more, I need to make sure I drink pretty early in the afternoon and it's pretty much out of my system by bedtime.  Of course, some of that may be due to the differences in our ages--who knows how my body reacted when I was in my 20s.  I thought being tired all the time was just because I was doing too much and playing too hard!  Smile

 

Weezy

Hey there, sorry for the late reply but life (work) got busy!

Anywhoo, some updates: I ordered and received Melatonin and Tryptophan along with the Co-Q10 a few days ago.  So far I've tried 1000mg of the Tryptophan and last night I tried 500mg of the tryptophan and 3mg of the melatonin.  The night I took 1,000mg of tryptophan I woke up feeling pretty groggy and was very tired all day.  According to Zeo, things looked fairly normal, except I had several awakenings above my average of 0-2.  After checking my results today after taking both supplements last night, my composition was also pretty normal but at least I feel much better so far today than the morning I took the 1,000mg of tryptophan.  

What does this all mean?  Probably not much yet.  I will continue to experiment with different doseages and combinations between the two.

Weezy, to answer your question about drinking, I think the night I had referenced in my post, I had probably consumed 6-8 drinks over 4-5 hours prior to bed. 

Another update!

Since the last time I posted, I actually have not tried melatonin or typtophan again.  I've been concerned about the groggy feeling it left me after the 1,000mg dose of trytophan, and I've been too busy at work to risk feeling that way.  But I do plan on experimenting a bit more this weekend, so I'll post another update about how that goes.

In other news, there has been an interesting development in my sleep composition.  My deep sleep has seen a minor improvement from previous avg of 55min/9-10% to 1hr 10min or 15% of total sleep.  While not a huge jump, still something to take notice of.  The only things that I can attribute this improvement to are either the coenzyme q10 that I started taking, or the more likely possibility that buying a new down blanket and new pillows have helped improve my sleep.  We replaced a down blanket that was just a bit too small for our queen size bed, so occassionally my feet would stick out and I'd wake up with cold feet.  Besides those obvious disturbances, it seems plausible that maybe the old blanket didn't regulate my temperature as well as the new one does.  The old one was pretty beat up and lumpy in places, so I think its pretty likely that this is the case.

It's interesting that such a simple change can have a greater effect than all these fancy supplements out there on the market.  Not to say that they're not worth checking out (as I'm doing currently), but I guess it just goes to show that the fundamentals (ie comfortable sleep environment) of good sleep hygeine really should be addressed before further action is taken in other areas in the mission to improve sleep.

Great info in this thread. I'll continue to monitor it with interest.

I've notice a pattern in my (disordered) sleep...the higher my Deep the lower my REM and vice versa. Occasionally they're similar which makes for a tough next day but that could be caused by low numbers in general.

I've been using the Zeo for about 2.5 months to monitor my sleep as I taper off sleep meds for PLMD. Since the Zeo can't monitor micro wake-ups, the hallmark of PLMD, I'm monitoring the rise and fall of Deep and REM. Both are low but I'm seeing improvement in Deep and a decline in REM. Initially the first few weeks Deep was between 8 & 15 minutes with REM between 1 & 2 hours. After acupuncture and other naturopathic treatments, Deep is now pretty consistently in the mid 20s with one 30 and one 31. Last week I saw a 41 and felt like shouting it from the roof top!!! REM has slipped to the 30s with an occasional 60-70.

Low Deep causes me a lot of muscle pain. The pain was almost gone the day after 41; an amazing difference. That same night REM was down to 32 which left me exhausted and unmotivated to do anything with my pain-free muscles! Last night Deep slipped to 14 (after a nap yesterday) and REM rose to 71. Today I was in pain but fairly refreshed and clear. One night I got a 30 Deep and a 60 REM. That was a decent balance for me. My goal is to be more consistently in the 40s for deep and over an hour for REM. My highest REM is 2 hrs. 24 min. so I know I'm capable, altho' my sleep doc called it "REM rebound". PLMD isn't curable so it will be interesting to monitor what happens.

As I taper the sleep med my total sleep time is diminishing. I feel lucky to get 7 hours of interrupted sleep now while the first 6 weeks on the Zeo showed at least 8+ hours of interrupted sleep.

One mg of melatonin hasn't made a difference. And a word of caution about melatonin. Several years ago a friend and I, unbeknownst to each other, started using this hormone. We both had the exact same reaction to it; the morning after the 5th night of use in a row, a physical depression, for lack of a better explanation, hit. Both of us became so physically "heavy" with exhaustion that we had to go back to bed and sleep it off. I was unable to drive or go to work. It was an effort to get from the kitchen to the bedroom. A few hours later that effect was gone. It was a scary feeling. IIRC, we both took the 3mg dose.

Meditation is something I've done daily for almost 40 years. It doesn't help with sleep for me. Just the opposite! I meditate in the morning so it doesn't impact my sleep. I think it helps to offset low REM nights so that I can at least function during the day.

The Power Down Hour wasn't what I'd expected. I normally have no problem falling asleep but did with the PDH. I was already doing that when the Zeo arrived. Then, 6 weeks later, the March 11 tsunami hit and I was in the inundation zone. That experience interrupted my routines and I found myself returning to a decades long practice of going to sleep with the tv on with auto-off set for 30 minutes. The noise was comforting. I actually saw an improvement in falling sleep at that point.

At some point I'll try the trytophan. And, I'll keep my eye on this thread to see what all of you are doing! Wink

Thanks for your post, Paradise.

Maybe I'm missing something, but I didn't think pain was a symptom of PLMD?  Can you clarify what is causing you this pain in the daytime and what kind of pain you're experiencing?

I find it pretty interesting that you can directly correlate increases/decreases in a given type of sleep with increases/decreases in mental clarity or physical well being.  That's very fascinating that they are so closely linked like that.  Although I can't say I'm in the same situation as you, I have noticed that my body doesn't recover as quickly from strenuous exercise if I'm not sleeping well.  I should check to see if it changes with fluctuations in deep sleep (I consistently get 2.5+ hours of REM).  

Anyways, keep on keeping on and let us know how things progress!

Hi chrismv48,

You're right, pain isn't a symptom of PLMD in and of itself. But, PLMD can cause extraordinary sleep deprivation. According to my sleep doc, constant sleep deprivation, regardless of the cause, can cause muscle pain similar to fibromyalgia. Close to 14 years ago I was diagnosed with fibro. At that point my sleep had been a problem for close to 10 years. Sleep issues are also a symptom of fibro. My rheumatologist had me try various meds for the fibro; meds that were also known to cause drowsiness, a good side effect. I had negative side effects with all and after 7 years of complaining about my sleep, the

rheumy sent me to a sleep doc. That's when I had a PSG and PLMD was diagnosed. I got to see the PSG graph and why I was tired all the time…NO stage 3 or 4 sleep. Sleep doc told me in no uncertain terms that I'd be on sleep meds for the rest of my life. Period. No mention of how dangerous they are. There was one in particular that works well for PLMD…Klonopin. I had an unacceptable side effect to a low dose after 4 nights so was switched to generic Restoril; again, a low dose. As I slept better the fibro pain started to improve. The standard trigger points were no longer sore. Strange.

After about 3 years on Restoril 7.5mg the pain started creeping in again. The sleep doc asked me to try the klonopin .5mg every 3rd night and the restoril on the other nights. Pain diminished again! About this same time I added a naturopath to my medical arsenal. She felt I didn't have fibro; that sleep, or the lack of it, was the pain culprit.

A little over a year ago I realized I wasn't sleeping as well as I had been, pain was creeping in again and I started getting weird symptoms that the docs couldn't diagnose. There's a lot more to it but I'm not ready to write the next "Gone With the Wind"!!!

At that point I was told to increase my sleep med dosage which I refused to do. I researched the new symptoms and they all pointed to either side effects and/or "tolerance withdrawal" of the sleep meds. The docs didn't believe me and told me to test my theory by stopping the meds. I knew better than to just stop them so I've been in the process of tapering off of them for the past year. Needless to say, my sleep is impacted. I asked the sleep doc if there was any way to monitor my sleep at home. "No"!

It was during my research that I learned about the Zeo. And while it's frustrating to not be able to monitor micro wake-ups at least I have an indicator of what's going on. My aha! moment came after by Deep-41 last week. The sleep journal confirmed reduced pain when Deep was over 28. It also confirmed the correlation between my REM and mood, motivation & energy. The correlation between lack of Deep and pain now has me believing that fibromyalgia is a misdiagnosis.

None of this understanding would've been possible without the Zeo. And I no longer dread going to bed in anticipation of sleepless nights. Instead, I can't wait to see how I've slept!

Hi guys, this is great information!  I'm in the same boat as chrisv:  my sleep doesn't appear disordered according to Zeo or a sleep study but I feel tired or exhausted the next day no matter how much I've slept.  It's been this way all my life.  I generally wake up more tired than when I went to bed.  Also like the original poster I have noticed that I get way more REM sleep than deep sleep.  An average night for me is about 30-45min of deep and 2.5-3hr of REM.  I wake up feeling exhausted.

 

I know I also have Delayed Sleep Phase Syndrome.  My sleep appears normal on a graph... just shifted back several hours from most people.  It's really more of a societal problem than an actual sleep problem:  it makes if far more difficult to adhere to "normal" work or sleep hours.  That's the obvious problem that anyone I show a sleep log (or now my awesome Zeo spreadsheet data) points out.  I go to bed way later than most people but I'm very lucky in that I have a job that allows me to be flexible in arrival time so I can sleep later if I need to.  The one piece that doesn't fit with DSPS is that if I take a vacation and sleep for a week on my own schedule (typically from about 3:30AM to 1:00PM) I STILL feel exhausted.  Most people with DSPS feel just fine as long as they're allowed to sleep on their own schedule... I don't.  I've been seeing a sleep specialist and I'm going to try Chronotherapy to shift my circadian rhythm to a more "normal" schedule.  I just can't do it for a couple of months as I have some projects at work that have some early-ish meetings I can't miss.  After the projects are complete I'll be free to try the experiment as he has laid it out.

 

I have started to believe that my exhaustion upon waking even after 10hr of sleep with a ZQ over 100 may be due to the skewed sleep composition I see from Zeo.  Could it be too little Deep sleep keeping me from feeling rested and refreshed?  Is all the mental activity of dreaming for 3hr or more a night what is wearing me out mentally?  Maybe a combination; if I increase Deep sleep at the expense of REM would the improved ratio help?

 

In trying to figure it out myself I have tried several supplements I have seen suggested on here and other forums.  I have tried tryptophan, 5-HTP, melatonin, and poppy seed extract.  All of these, with the exception of melatonin, are suggested to improve Deep sleep.  The results haven't been favorable.  Poppy seed extract doesn't seem to have any effect whatsoever.  Tryptophan/5-HTP help improve the Deep/REM ratio somewhat but only at very high doses.  However, they not only don't help with my morning exhaustion, they make it last longer.  Melatonin didn't help with Deep sleep but I wasn't expecting it to.  I was taking it to try to shift my sleep/wake times forward.  It helped a little but again made it even harder to wake up in the morning.  The same goes for any other sleep supplements I've tried over the years:  Ambien, Rozerem, Lunesta, even Benadryl.

 

I've also had a SpectraCell micronutrient test.  No deficiencies except borderline low on Magnesium.  I've started taking 300mg at bedtime but it doesn't seem to help with my sleep.

 

My morning exhaustion seems to be getting worse over the last 6-9 months or so.  I saw the sleep specialist again yesterday and discussed the issues.  He prescribed Xyrem for the daytime sleepiness.  I'm excited about trying it.  Like the original poster I really WANT there to be something wrong.  That means it can be fixed or at least treated.  At least there's hope that things will get better!  I'm also a little leary as it's a kind of inconvenient thing to have to take every night for the rest of my life.  Of course, if the trade-off is waking up feeling refreshed then I'll gladly take the inconvenience.  In researching Xyrem it seems that it increases Deep sleep at the expense of REM sleep so this should be a pretty good test in altering sleep composition to feel more rested.  I'll try to update this thread again once I receive the Xyrem and try it out for a bit.

A group of us including Zeo Bedside Sleep Manager users are starting a website to compare a variety of sleep aids (mostly high tech) as their seems to be a greater interest in using those these days for help sleeping. The website is in the formative stages at this point. We have conducted an experiment with the Zeo and posted are findings. If you'd like to access this new site, and the the Zeo Bedside Sleep Manager page in particular you can go to: http://hightechsleepaids.com/zeo-bedside-sleep-manager.html  Any comments for sleep aids to include would be welcome. Thank you.  -- Joe L.

I keep my zeo data in a spreadsheet, where I can also add some other factors (and do charts!  I love charts).  I am a healthy 44 year old female and I do not have any sleep difficulties, generally speaking.  However, I do want to maximize my deep sleep since I think this is a key factor in aging and health (deep sleep is key to tissue recovery/restoration).

My data shows that there is a strong positive correlation between time of sleep onset after sunset (earlier is better).  However, I am not willing to go to sleep at 6pm in the winter time!  

Moderate alcohol consumption (especially if accompanied by enjoyable social interaction?) is another positive correlation.  But again, I am not interested in increasing the amount of alcohol I consume, and there is some research that shows this might not be as high quality of sleep (however, people who consume moderate amounts of alcohol have better longevity rates than non-drinkers).

Lately I have been experimenting with thermoregulation, and this seems to be the one that I have the most control over.  There is a positive correlation both with heating and then cooling before bed (I love my new hot tub! but a bath also works), and keeping my core cool during sleep.  If I heat up too close to bedtime then I am still overheated and have a very overheated, restless night.  I have a tempurpedic, so it's pretty easy to overheat, and hard to get it to go back down once I am there!  I have put a synthetic wool fleece topper on the bed, and it helps somewhat, unless I am already overheated, and I have ordered a real wool one (wool is supposed to be excellent for thermoregulation).  Also, I find that taking the comforter off has helped, as well as wearing bottoms but no top when sleeping (to cool the core while keeping my legs from cramping if they get too cold).

I can't comment on sleep onset issues, as that is not something I have a problem with unless I am very stressed about the next day, and then I have no solution!