The benefits of sleep in supporting and maintaining overall health is undisputed. Sufficient sleep aids in healing, improves mood, decreases the level of stress hormones in the body, facilitates learning and memory, and also increases alertness (obviously) and productivity during the awake hours. Unfortunately, so many Americans are sleep-deprived (about one-third of adults get less than six hours a night) that the CDC has labeled insufficient sleep a public health epidemic. Approximately 60 million adults suffer from a sleep or wakefulness disorder. Further, sleep insufficiency has been linked to increased frequency of motor vehicle crashes as well as medical and occupational errors, and it also increases the likelihood that you will suffer from a myriad of chronic diseases such as depression, obesity, diabetes, and high blood pressure.*
Every human being is unique, so sleep requirements are not the same for everyone. However, generally speaking, most adults require between seven to eight hours of quality sleep every night. Truly restorative sleep can be accomplished by tucking it in around the same time each night (constantly shifting your bedtime will lead to sleep that is less restorative even if you sleep for the same amount of time), ensuring you will have a window of at least seven hours of quality time to rest. Quality refers to the different stages that your brain goes through (e.g., deep or delta sleep and REM sleep) during the night. People don’t have control over these unconscious stages, but they should be aware that some medications (e.g., Valium, Benadryl, Restoril, and Zoloft) affect particular phases of sleep acutely to the detriment of your long-term sleep health.
The way to assess the adequacy of sleep is common sense: if you feel tired or sleepy the following day.
Notably, sleep insufficiency is cumulative, but despite its deleterious effects, over time, the human body starts not to feel the deficit. So lack of sleep adds up for a few days, and you feel yourself dragging. If you catch up on sleep, you’ll be fine, but if the deprivation continues, your body adjusts so that although you still exhibit ill effects of the lack of sleep (e.g., cognitive impairment), you just won’t sense the same fatigue as before. Anyone who has raised a child reading this knows exactly what I mean.
In the most dangerous paradigm of sleep insufficiency and a common phenomenon in Western culture is when we begin to accommodate sleepiness. Our person starts to think that being tired is normal, and thus, we become numb to our body’s deep craving for some rest.
In short, your body will start to protect you from experiencing the detrimental effects of lack of sleep even though its toll slowly eats away at all parts of you.
Light serves as the main trigger to regulate your body’s main internal clock; it also promotes wakefulness and inhibits sleep through the suppression of melatonin. Melatonin is a hormone that regulates your sleep, and when it gets shut down, you will stay awake longer because there is nothing in your body persuading you to go to bed. Furthermore, melatonin helps to regulate your circadian rhythms and helps your body know when it’s day (or night) and thus whether to be alert (or fall asleep). Circadian rhythm is the idea that our body operates in sync with the abundance and then the lack of natural sunlight, which is why we are all hardwired to be functional during the day and to be asleep at night. Repetitive and continuous suppression of melatonin, thus, disrupts your sleep cycle and leads to unnatural, nonrestorative, erratic sleep patterns. Hundreds of years ago (with the exception of fire and candles), there were almost no sources of light other than the sun. Now in the electronic age, there is probably something lighted and glowing 24 hours a day in your residence. Televisions, computers, iPhones, and even bedside alarm clocks all provide a small dose of light that tricks our internal watch into thinking it is day when it is in fact night.
With these new sources of light, this actually disrupts and fools your internal timekeeper, which is why checking your e-mail at 11:00 p.m. may not be such a good idea.
The fact that most people in modern Western societies spend most of the day indoors and thus do not get sufficient natural sunlight doesn’t help either. Granted, the intensity of natural, outdoor light far exceeds the intensity of light one would be exposed to by common electronic devices. If one were able to obtain 60 minutes of sunlight daily, this would be ideal, but even as little as 30 minutes will provide the much-needed stimulus to anchor the body’s internal time clock.
This probably explains why people who exclusively work night shifts live shorter lives and have higher rates of some debilitating conditions (e.g., obesity and cancer) compared with people who work during normal business hours.
As a result, most people are not exposed to sufficient natural light during the day and then overexpose themselves to artificial light at night. Both phenomena disrupt our natural clocks and our circadian rhythms.
It’s also interesting to note that not all types of interior light are equally bad; the intensity and color of the light matters. So bright, intense light will cause your melatonin levels to drop much more than subtle, dim light. Also, blue or green light will interfere the most with melatonin levels, while red light will interfere the least. This makes sense from a biological standpoint since people of ages past didn’t have to worry about fire adversely affecting their sleep. The created order has a synchronicity that allows natural processes to work with human beings.
Let’s face reality: life in the modern world is demanding, and we often sacrifice sleep for factors often out of our control. Cognizant of this, we must also not sacrifice our present for the detriment of our long-term health. Here are a few ways anyone can easily improve their sleeping habits and chart a course toward sleep sufficiency:
- Make the area you sleep a haven, set up to maximize sleep, and not a haphazard mess. This means sleeping in a room with little to no light and no devices that will light up and beep when you are asleep. Invest in lightproof blinds so that when the sun does come up, you will stay asleep until your body wakes up or when your alarm clock goes off. Note that even a small amount of light in the room can disrupt your internal time clock.
- Sleep requires cool. If the temperature in your bedroom exceeds 68 ˚F (or is cooler than 62 ˚F), then this is out of the range of comfort for your body and can result either in no sleep or restless sleep.
- Put the face of the alarm clock down. And move it a few feet away from the bed. If it’s 3:00 a.m., the last thing you need to do is flip up the clock and say to yourself, “Gosh, it’s 3:00 a.m., and I’m still awake …” That scenario never ends well.
- Utilize the bed for sleep—and only sleep. This means not reading a book, watching TV, texting, or whatever. If your mind thinks the bed is a productive zone, you’ll have a harder time going to sleep.
- A stable routine is key. Try to go to bed and wake up at the same time each and every day so sleeping would become second nature. Your body will become “trained” into a certain groove, making it easier to fall asleep and also to wake up. If there’s a particular activity that helps you to relax and fall asleep, incorporate that into the routine.
- Keep the hormones in mind. The precursor for melatonin is tryptophan, a protein. So if you eat food high in protein a few hours prior to going to bed, your body will have more than enough fuel to make melatonin and take you to dreamland.
- Don’t eat right before going to bed. This especially applies to carbohydrates and sugars. When we eat, our blood sugar raises. With this rise comes a delay in the onset of sleep.
- Aim to complete work at least two hours prior to going to bed. Work can apply to using the computer, housework, childcare, etc. Give your mind time to gear down.
- Minimize light exposure prior to sleeping. This means you can’t watch your favorite TV show, check scores on your smartphone, or FaceTime your girlfriend and then hit the sack.
- Avoid caffeine. Different people process caffeine differently. I know folks who normally have a cup of coffee after dinner and then still sleep soundly. However, in many people (notably introverts who are more susceptible to caffeine’s effects) and others in whom caffeine is not metabolized well, you can still have its lingering effects up to eight hours after your last dose. So unless you’ve always had late-in-the-day caffeine with no problems, aim not to have any more past midday just to play it safe. Also, be aware that many teas have small doses of caffeine in them as do a number of over-the-counter supplements (especially diet pills).
- Avoid alcohol. Booze may initially make you drowsy in the short term, but alcohol has the adverse side effect of inhibiting your deep sleep. As a result, you may wake up after a short time and be unable to fall back asleep. Alcohol also inhibits the release of ADH, a hormone that tells your kidneys to absorb more water. As a result, you will be inclined to urinate more and may find yourself running to the restroom at 4:00 a.m.
- Regular exercise can improve your sleep cycles. Just don’t work out and then try to go to bed. Your body will still be revved up for some time post workout. For obvious reasons, if you poop yourself out in the afternoon, you should drop like a log at night.
Dr. C.H.E. Sadaphal
* Institute of Medicine. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press, 2006.