Morning Routines   (Dr. Jennifer MacKenzie BSc, ND)

With a busy schedule and sometimes working late into the evening, building a healthy morning routine has been a challenge for me. In the past when I’ve developed a morning routine, I often felt I was sacrificing sleep. I’ve experimented with meditation, morning exercise, gratitude journals, intermittent fasting all with the goal of creating a healthy morning routine, in order to feel energetic and grounded for my day. Often, I found myself not being able to stick to the routines, since the time demands were too great. I ended up sprinkling in these activities when there was time, but never really sticking to one thing.

During my commute to work one day I was listening to the Podcast Works for Me – “How to Make Yourself a Morning Person” with the hopes of finding inspiration on how to build a healthy morning routine. The podcast discusses the outcomes of the podcast author challenging herself to a new morning routine, with the help of scientific research. The morning routine is called RISE-UP, a method developed by Alison Harveyof the Golden Bear Sleep and Mood Research Clinic. She is a professor of clinical psychology at the University of California, Berkeley. The real take away that I got from the author of the podcast – Francesca Levy, was how she got the feeling of time to herself. In the podcast, she described how having a young child and a busy work schedule left her feeling that she didn’t have any time to herself. This feeling having no time or time to yourself seems ubiquitous in our culture and can lead to frustration, anxiety, and burnout. Creating this morning routine is really about creating time for self-care (Smullens., 2015).

RISE UP METHOD

The RISE UP method aims to help those suffering from severe sleep inertia, also known as morning grogginess. Harvey describes sleep inertia as “the technical term for the normal and natural transitional state of lowered arousal and impaired performance following sleep.” Sleep inertia can last for a period of 5 to 20 minutes of grogginess, this includes the feeling of heavy eyes, body pain and a desire to go back to sleep. Harvey describes sleep inertia as a normal transition from sleep to being awake and recommends it’s best to get up and start moving. So that strong impulse to hit the snooze button is a natural impulse but snoozing doesn’t improve alertness or sense of being awake during the day (Kaplan et al., 2018). Part of this may be due to the fact that snoozing, starts another sleep cycle, but doesn’t allow you enough time to complete a sleep cycle, which typically lasts from 90 to 120 minutes (Natural Patterns of Sleep).

RISE UP Steps
Refrain from snoozing – Avoid hitting the snooze button on your alarm
Increase Activity – Perform physical activity within the first hour of waking
Shower or wash your face and hands – Shower or wash your hands and face with cold water
Expose yourself to sunlight – Expose yourself to natural sunlight first thing in the morning
Upbeat music – Listen to upbeat music, since taste in music is so subjective, choose music that makes you feel energetic and upbeat
Phone a friend – To make this easier, suggest this morning routine to a friend, who you can call to in the morning and they can offer you accountability and vice versa.

Research on the RISE UP method

Refrain from snoozing – Pressing snooze extends sleep inertia/grogginess by delaying physical activity and the physical stimulation that comes with physical activity. Snoozing also affects the sleep-wake cycle, which increases sleepiness (Kaplan et al., 2018).

The sleep-wake cycle or the circadian rhythm is a daily pattern that signals our body when it’s time to sleep and when it’s time to be awake. For most people, the sleep cycle is seven to nine hours and our time awake is 15 to 17 hours (Natural Patterns of Sleep).

These cycles are controlled by a set of hormones, one of them being adenosine. Adenosine is nucleoside, a chemical that our bodies naturally produce, which is important in energy transference and is also a neuromodulator. Adenosine begins to be released and accumulates once awake, the levels continue to accumulate throughout the day, when it binds to specific receptor sites, it causes an inhibitory type action, leading to drowsiness. Which is why the longer you stay awake the sleepier you become. Caffeine and adenosine belong to the same chemical group called xanthines, caffeine can readily bind to the adenosine receptor in the brain. When caffeine binds to the adenosine receptor in neurons of the brain, there is no effect on the receptor, but it does block adenosine from binding. Which is why
caffeine promotes wakefulness, but only temporarily. Once the caffeine is cleared from the body, the adenosine is still there and the feeling of sleepiness will likely return (Urry et al., 2014).

Increase activity for the first hour – Studies has shown that exercising at night can decrease the feeling of sleepiness, and may cause difficulty falling asleep as well as sleep quality. Exercise increases your core temperature, releases adrenaline and increases your heart rate, which promotes wakefulness (Kaplan et al., 2018).

Shower or wash your face and hands with cold water – Cold water applied to the skin causes vasoconstriction, which is the constriction of blood vessels. Cold water causes reduced blood flow in the skin and studies have found that vasoconstriction in the hands and face reduces subjective sleepiness (Krauchi et al., 2006)

Exposure to sunlight – Morning bright light turns off melatonin production and promotes an increase in cortisol levels. Light exposure upon waking can reduce morning grogginess and reset the circadian rhythm (Kaplan et al, 2018).

Upbeat Music – Studies have shown that upbeat music can decrease subjective sleepiness (Kaplan et al, 2018).

Phone a Friend – Greater social contact has been found to reduce subjective sleepiness. A study of flight crews found that when crew members took short breaks that involved socializing, this could mask their sleepiness (Neri et al . 2002).

Practical Tips and My Experience with the RISE UP Method

When living in the pacific northwest, relying on sunshine can be unpredictable, especially in the winter months. One way to ensure that you have exposure to light in the morning is by using a sunrise-simulating alarm clock. I’ve been using the Philips HF3520 Wake-up Alarm Clock. This alarm wakes you up by simulating a sunrise, where the light gradually gets brighter, and if you aren’t awake yet, the sound of soft chirping birds begins. In the beginning, I mainly woke up to the sound of chirping birds but eventually began to wake up before the wake-up time I had set.

Rather than a shower right away, I woke up and washed my face with cold water, then went out for a run with my dog, followed by some stretching. This allowed me to get natural light exposure and exercise within an hour of waking. I really enjoy the quiet in the morning, it almost feels as though you have that little part of the world to yourself. I live by the Fraser River and I noticed that the birds are calm, some still sleeping, the river is calm, almost still and it’s so quiet that the clanging of the tags on my dogs’ collar seam
ed to be the loudest noise on the walkway.

I opted to not play upbeat music in the morning. Personally, I found the upbeat music too stimulating in the morning, I prefer to take that time in the morning as more of a meditation on the natural world, where I listen to wildlife, the river and the rustling of the wind. The last, step is phoning a friend, honestly, I did not do this step. Mainly since who wants to be called at 5:30 am? I did make sure to talk to my partner in the morning, but I didn’t find that conversation made me feel more or less sleepy.

What were my personal results of taking 4 out the 6 steps of RISE-UP? The first thing I noticed is how much I enjoyed that time in the morning that felt like my own, previously it felt like as soon as I woke up, I was on the clock so to speak – making breakfast, putting lunch together, feeding the dog and cat breakfast, etc. Now it feels like I have 30 minutes plus, that are mine, where the world is still and quiet. I also noticed that I had more energy in the morning, so I found myself more productive earlier in the day, although I did find my energy fading at around 4 pm, so those days that I work late into the evening, I found a little challenging. I also found myself sleeping better since I was quite tired and ready to sleep earlier at night.

My dog also benefited from this morning routine, he was more attentive during our walk/run, he also had a calmer demeanor in the evening, rather than the usual boisterousness right after his dinner.

This routine is easy to get in the habit of and you can make it your own by adapting the exercise activity. You can do yoga on the balcony, go for a run, do tai chi, whatever you enjoy.
The other nice part is that it can be as little or as much time as you need, as long as you cover the main steps.

I encourage you to give it a try, throw some cold water on your face, go outside, get some sunshine, get some exercise and set yourself up for an amazing day!

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Sources:
“Natural Patterns of Sleep.” Healthy Sleep, healthysleep.med.harvard.edu/healthy/science/what/sleep-patterns-rem-nrem.

D.F. Neri, R.L. Oyung, L.M. Colletti, M.M. Mallis, P.Y.Tam, D.F. Dinges “Controlled breaks as a fatigue countermeasure on the flight deck Aviation Space & Environmental Medicine, 73 (2002), pp. 654-664

Smullens, SaraKay. Burnout and Self-care in Social Work: a Guidebook for Students and Those in Mental Health and Related Professions. National Association of Social Workers, 2015.

Kaplan, Katherine A., et al. “Rise and shine: A treatment experiment testing a morning routine to decrease subjective sleep inertia in insomnia and bipolar disorder.” Behaviour Research and Therapy, vol. 111, 2018, pp. 106-112.

Urry, Emily, and Hans-Peter Landolt. “Adenosine, Caffeine, and Performance: From Cognitive Neuroscience of Sleep to Sleep Pharmacogenetics.” Sleep, Neuronal Plasticity, and Brain Function, 2014, pp. 331-366.

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