Health Care

Sleep | Mark Rippetoe

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Sleep

by Mark Rippetoe | July 18, 2023

Remember when you were
little and went to bed and woke up the next morning without once
having to get up to pee and then try to figure out how to go back
sleep instead of worrying whether or not you needed to sharpen the
lawnmower blade or change the air filters again or mail in your
medicare premium or buy some more eggs or ask the electricity
salesman if your contract was about to expire?

I barely remember that.
But about twice a year I’ll go to bed very tired and stay asleep for
8 solid uninterrupted hours, and wake up actually feeling pretty
good. Most of the time, I wake up feeling like I need to take a nap.
I’m pretty beat up from a lot of injuries, and somewhere along the
way I’ve lost the ability to just relax and turn off the input.

Sleep is the most powerful
anabolic agent for the trainee. Doesn’t matter how much attention you
pay to nutrition or supplementation or drugs – if you are not sleeping
well or enough, your training cannot be optimal. But there are steps
you can take to improve it. I’m not going to repeat the shit you’ve
already heard: dark room, white noise and a fan keeping you cool,
low-enough temperature that you need at least a top sheet, dog(s)
under control, quiet neighbors, telephone ringer off, earplugs
available when necessary – obvious things like that. But a few
things come to mind.

First, if you have a
shitty mattress, you will not be sleeping well. If you wake up with
even mild back pain that was not there when you went to bed, you have
a shitty mattress. It has to be firm enough to hold your ass level
with your feet and shoulders all night. If you’re trying to sleep on
a cheap foam mattress, your priorities are skewed. A firm or extra
firm hotel mattress is not that much money, and a night in a hotel on
a firm mattress will inform your next purchase. Don’t be stupid about
this – a mattress is no place to save money, and sleep is really
important. A decent mattress doesn’t cost $3000, but it costs more
than $300.

Second, make sure you can
breathe after you fall asleep. Sleep apnea is a bad problem for lots
of guys and some women. Doctors like to prescribe a CPAP (continuous
positive airway pressure) machine for this. It essentially pushes air
past a constricted airway into your lungs; it breathes for you. It
has solved the problem of low O2 saturation (a bad situation if it
lasts all night, causing you to wake up every 2 minutes or so) for
many people, and it might be an option if sleep apnea is your
problem.

It very mildly affects me
– I have a badly deviated septum – and I have solved the problem
with the nightly use of oxymetazoline (12-Hour Afrin) and a nasal
steroid spray such as fluticasone propionate (Flonase), and sleeping
on my side. This is seldom recommended by doctors, since both of
these drugs are sold over-the-counter in pharmacies and at Walmart,
although some of them understand why I do it. I have heard it said
that oxymetazoline is addictive, but I have been using it to get to
sleep for 30 years, and if I’m addicted, I’ll skip the 12-Step
Program and just go to bed. What about the alternative is better?

Also, it is absolutely
offensive that buying a CPAP machine requires a prescription. If I
can figure out how to ride a kick-start motorcycle from Wichita Falls
to Cut Bank, Montana and back, I can figure out how to use a CPAP
machine. And anyway, how would a person abuse a CPAP machine? Wait…
don’t answer that.

Third, eating before bed
can be a problem. I have to be careful about the quantity and the
spiciness of my evening meal. If you are prone to gastric reflux and
you eat the wrong meal – or too much of the right meal – shortly
before going to bed, you will have problems. It’s better to eat a
couple of hours before you lie down, if possible. I go to bed very
late because I get home very late, so I usually eat right before bed.
If I eat too much, or if I eat tomato sauce-based foods at night, I’m
probably going to have problems. I think it’s more the quantity,
because I tend to eat too much (the food is good at my house), and
the timing, since I eat so late at night. So, lunch tends to be the
time of day I eat “challenging” foods. At least it should be.

Fourth, if you’re in pain,
it’s hard to relax. I take some medications before bed, because my
intention is to get to sleep and stay that way, and the judicious use
of OTC medications is useful. To address the aforementioned
beat-up-ness is I take two 500mg acetaminophen and two 220mg
naproxen tablets. If I am worried about what I have eaten, I’ll take
a 20mg omeprazole and maybe a 20mg famotidine (since ranitidine has
been withdrawn from the market for my own good), but this is not an
every-night thing. On rare occasions – like once or twice a year –
when I am in a great deal of pain or when I just really need to stay
asleep for 9 hours, I may use a 10mg diazepam (Valium). And for the
sake of completeness I must add that a couple of beers or a whiskey
or two is not at all out of the ordinary.

This little ritual allows
me to sleep fairly effectively, and since this is my purpose I don’t
really care what the medical community thinks about it. Two or three
days without sleep is a huge obstacle for training progress, and let
me assure you that it gets worse as you get older. It may cost some
money, but once again, sleep is important.


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