The Hierarchy of Health, part 1

So, you didn’t exactly ask, but that’s never stopped me from sharing my opinion before.

Here is the hierarchy of good physical health. These four things, in order of importance, will keep you on the road to good living.

1. Sleep

2. Hydration

3. Nutrition

4. Exercise

What’s that? Not the order you expected?

I’m not surprised. We live in a culture that’s all about the doing. Work harder? Work smarter? It doesn’t really matter as long as you’re working. So when we approach our health and fitness we approach it from the reverse order. Over the next few weeks I'll take some time to address each level of the hierarchy. Understanding each one individually helps you see its importance and, hopefully, develop strategies to re-prioritize and implement.

We assume we’re overweight because we don’t do enough. For some of us that may be true, but if you’re averaging less than seven hours of sleep a night - you need sleep more than you need exercise. Many of us who struggle with weight loss and can’t seem to exercise the weight off, may find an additional hour or two of sleep each night melts those excess pounds away. Research published in the American Journal of Epidemiology showed that sleep deprived women are one third more likely to gain 33 pounds over the next 16 years. Other studies have shown that not getting enough sleep can cut your ability to burn fat in half.

Sleep is essential.

It’s during this downtime that all the benefits from your training take place. This is the time you get stronger as the micro damage from exercise is repaired and reinforced. Most of your digestion takes place while you sleep. This essential downtime allows for absorption, assimilation and repair.

If you can’t get your rest, these processes are impaired. Instead of repairing from life’s stressers and coming back stronger, we get worn down and eventually break. Not only do our tissues get weaker - sprains, strains and tears become more likely. Our immune system suffers and we’re more likely to catch colds, get the flu or other illnesses.

Insufficient sleep wreaks havoc on your hormones. Within four days of sleep deprivation (defined as less than seven hours of sleep a night)​ insulin sensitivity drops by more than 30%.  Poor sleep results in decreased levels of leptin, a hormone that tells us when we're full, and increased levels of ghrelin, which tells us that we're hungry. Additionally, not enough sleep increases our general stress levels which causes elevated cortisol production. One of cortisol's functions is increased fat storage. Elevated cortisol levels result in decreased levels of human growth hormone (HGH) which impairs our ability to repair damage and recover from exercise or injury.

Knowing this is all well and good if you can get to sleep. From casual conversation I’m amazed at the number of us who have trouble falling asleep and staying asleep through the night. It’s clear that just about everyone knows about melatonin and I’m even more surprised by the number of people I know with prescriptions for Ambien. And yet, we're still not sleeping.

If you’re one of those who struggle with sleeping at night, here are a few pointers that don’t require a doctor’s prescription:

  • Keep a regular schedule. We are much more subject to circadian rhythms than we realize. Regular bedtime and waking hours go a long way toward regulating our sleep. The body picks up on our rhythms and adapts, making getting to sleep at a regular time easier than a more random schedule.
  • Opt for naps versus sleeping in. If you do find yourself getting to bed late, rising at your usual time and getting in a nap later in the day has been shown to be better for long term sleep regulation. Your routine is less disrupted and you better maintain the balance of your established rhythm.
  • Expose yourself to bright light as early as possible. In keeping with the circadian rhythms, when you wake up, be up. Open up the shades. Let the sun in. We're built to work with the sun. Staying as close to it's cycles as possible helps us regulate sleep and other vital functions. Try and get some sunlight throughout the day as well. Take breaks outside whenever possible.
  • Darken your room. Make sure your room is as dark as possible when you go to bed at night. If there’s a street light outside that leaks light into your room, use a blanket or heavy sheet to help block that window until such time as you can get something more decoratively appropriate. Home decor takes a far second to a good night’s rest in my book.
  • Do not watch TV in your room. In fact, if you have trouble sleeping at night, consider shutting the TV off a good hour before bed. TVs and computer screens emit a blue light that is actually stimulating to the nervous system. For my phone I use an app called Twilight that removes the blue light in time with the setting sun. Minimize the light from bedside clocks and electronic devices. If you can't get your room to total darkness, consider a sleep mask.
  • Consider white noise. The drone of a fan accompanies Samantha and I as we sleep. That steady drone helps block out minor noises like the dogs shifting in their crates or Thalia’s new kitten batting some stupid whatnot across the floor. You can spend a few extra dollars for a white noise generator. They usually have several different settings including things like wind, rainfall, and ocean waves or, again, you can get an app for your phone.
  • Get regular exercise. It seems like this would be a foregone conclusion on a blog about fitness, but I've learned not to skip stating the obvious. For many of us, exercise is stimulating so be mindful when you schedule it. A hard workout right before bed may actually impair your ability to fall asleep. Try to finish your workout a good two hours before attempting to sleep.
  • Limit caffeine. Again, you can file this under stating the obvious, but some of us are much slower at metabolizing caffeine than others. I run through it quite quickly and often take a coffee as late as 4 or 5 pm with no ill affect on getting to sleep. Samantha can't have coffee past noon or she'll have trouble sleeping that night.
  • Limit excess alcohol. This one might not be so obvious, but alcohol can impair your sleep. It may relax you enough that you get to sleep but the quality of your sleep will not be as good and you'll wake less rested.
  • Establish rituals. Having a thing you do each night before bed can be helpful in getting your mind and body ready for sleep. A warm bath, reading, stretching or foam rolling, even a cup of a non-caffeinated herbal tea (Sleepy Time?) can be helpful.
  • Regulate the temperature. Most of us sleep better in a cool room. That's easily shown by the last time you were forced to try and sleep through an Alabama summer night when the power was out.
  • Get a comfortable bed. One of the best pieces of advice I ever received was, "Buy the highest quality bed and linens you can afford." Samantha and I went so far as to spend a not small chunk of our inheritance from my father on a foam latex mattress. (Thanks, Dad!) It's one of the best purchases we ever made. Second to that is the linen sheets we currently sleep on, if you prefer cotton, look for a 400 thread count or higher. 

If after all of this, you still have trouble falling or staying asleep, you may consider supplementation. My first line of support is magnesium. Magnesium helps support muscle relaxation and a dose of 400 to 500 milligrams should be enough to ease you into a restful night's sleep. After that comes melatonin which is usually recommended in one to two milligram doses.

If that doesn't work, come talk to me. We'll discuss specific, individual strategies and I can make recommendations for other professionals who can help get you back on track.

To our perfect imperfection,


Click Here for Part 2...

Bookmark the permalink.


  1. In your experience and research, is it a problem to have a natural sleep cycle that is shorter than seven hours? My normal is a pretty consistent six hours.

    • Good question, Michelle.

      As always my advice comes with the caveat, “Your personal mileage may vary.” We’re all different, some of us thrive on less sleep than others. So I don’t think it’s fair to say with certainty one way or the other.

      What I can suggest is that you do a routine check-in with yourself. If you naturally wake after six hours refreshed and ready to go I’d say that’s all you need. But if you find yourself dragging midday or early afternoon then a nap may be in order. The key is to pay attention to yourself. Your body knows what it needs and will tell you if you are willing to listen.

Leave a Reply

Your email address will not be published. Required fields are marked *