This article on sleep was written by Daniela Dominguez, second-year medical student at Universidad Internacional del Ecuador Escuela de Medicina.
We all want to wake up and feel refreshed and ready for a new day. One of the keys to a fulfilling life is a goodnight’s sleep. In the past, it was common to think of sleep as a burden or an obstacle. Thomas Edison once commented, “I enjoy working about 18 hours a day. Besides the short catnaps I take each day, I average about four to five hours of sleep per night.”
In the US, we are getting ready for a time change, with daylight savings time ending November 7th. However, it does not necessarily come with improved sleep. Here is a reminder of ways to make every night restful and fulfilling. After all, we spend one third of our lives asleep!
Table of Contents
What happens when we don’t sleep?
When there is sleep deprivation, there are apparent negative effects on our daily performance. It is associated with impaired judgment and decision-making. Deficits can contribute to metabolic issues, like diabetes and obesity, because of an increased craving for unhealthy food and tendency toward weight gain.
Sleep deprivation impairs the immune system leading to a pro-inflammatory state, to name a few adverse effects. Hormone changes occur from a stress response, including decreased growth hormone and increased cortisol.(1-7)
How much do we need to sleep?
Most adults require 7 to 9 hours of sleep per night. (8) Unfortunately, as many one third of US adults get less than what is recommended (CDC). If you are a teenager, the recommended time is 8 to 10 hours.
How is our sleep regulated?
The circadian rhythm regulates sleep; it is our natural clock that, in most individuals, drives us to sleep in the night and be active in the day. When there is poor sleep, there is an interruption of the circadian rhythm, for example, jet lag or night shifts.(9,10)
Since our natural clock is the compass for a good night’s sleep, the key to a good night’s sleep is not some magic pill but having good sleep hygiene, which means having good habits for the time we go to sleep and when we wake up.
Why is it important to be Consistent?
The best way to regulate our circadian rhythms and, therefore, our sleep, is to go to bed at the same time every night and wake up at the same time every morning, including weekends and holidays. Keeping consistency at this is essential to have a regular bedtime routine or ritual to help you relax and prepare your body for bed, including a nice bath, reading, or meditation. Try to get a whole night’s sleep every night, avoiding naps during the day; if you must rest, it should be limited to 1 hour, and avoid naps after 3 pm.
Since light regulates the circadian rhythm, it’s essential to avoid blue light at least 2 hours before bed. Blue light comes from screens like smartphones, laptops, and monitors. Blue light suppresses melatonin production, which makes us sleepy. Also, get bright, natural light upon awakening, preferentially the sun, but a 10,000 lux lamp can work. (11)
If you are younger and are reading this, sleep consistency and better sleep quality equates to improved grades; one study of college students suggested that sleep accounts for nearly 25% of the range in academic performance. (13)
What is the best environment for sleep?
Make sure the bedroom is as quiet and as dark as possible. Keep the room a little on the cool side rather than warm, between 60-70 degrees. Cooling your body temperature may improve sleep, but it’s helpful to keep your hands and feet warm. Check your mattress; they last a maximum of 9-10 years and may have allergens, so buy a new one if it’s time. (12)
Food and Drink intake and Sleep: A nighttime high fat intake and inadequate total daily intake may impair sleep. (11,12). Reduce your fluid before bed, so you don’t get up to go to the bathroom (only if you maintain enough hydration during the day).
Sleep: what not to do
- Do not use the bed for activities other than sleep and intimacy. Avoid watching TV, using your computer or your phone in your bed. Do not read for longer than 30 minutes in preparation for bed.
- Do not drink caffeine if possible, especially after lunch.
- Do not drink alcohol if possible; if you drink, try not to do it right before bed (although it makes you sleepy, it affects a good night’s rest).
- Do not smoke cigarettes or use nicotine, ever.
- Do not do a high-intensity exercise right before bed because high intense exercise raises cortisol and impairs sleep.
- Do not fall asleep with the TV on. Better yet, keep the TV out of the bedroom. Sleep studies show people frequently awaken during the night and have poor quality sleep.
- Do not hit the snooze button.
Rest is not something to take for granted. It is a natural part of the growth and maintenance of our bodies. Our mental and physical health depends on a restful night – each night.
Here are some other YHF articles on sleep:
1. Irwin MR. Why sleep is important for health: A psychoneuroimmunology perspective. Annu Rev Psychol 2015; 66: 143–1722.
2. Killgore WD. Effects of sleep deprivation on cognition. Prog Brain Res 2010; 185: 105–1293.
3. Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB. Association between reduced sleep and weight gain in women. Am J Epidemiol 2006; 164: 947–9544.
4. Morselli L, Leproult R, Balbo M, Spiegel K. Role of sleep duration in the regulation of glucose metabolism and appetite. Best Pract Res Clin Endocrinol Metab 2010; 24: 687–7025.
5. Haack M, Lee E, Cohen DA, Mullington JM. Activation of the prostaglandin system in response to sleep loss in healthy humans: Potential mediator of increased spontaneous pain. Pain 2009; 145: 136–1416.
6. Haack M, Mullington JM. Sustained sleep restriction reduces emotional and physical well-being. Pain 2005; 119: 56–647.
7. Haack M, Sanchez E, Mullington JM. Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers. Sleep 2007; 30: 1145–11528.
8. Kamdar BB, Kaplan KA, Kezirian EJ, Dement WC. The impact of extended sleep on daytime alertness, vigilance, and mood. Sleep Med 2004; 5: 441–4489.
9. Smith RS, Efron B, Mah CD, Malhotra A. The impact of circadian misalignment on athletic performance in professional football players. Sleep 2013; 36: 1999–200110.
10. Srinivasan V, Singh J, Pandi-Perumal SR, Brown GM, Spence DW, Cardinali DP. Jet lag, circadian rhythm sleep disturbances, and depression: the role of melatonin and its analogs. Adv Ther 2010; 27: 796–81311.
11. UCSD Center for Pulmonary and Sleep Medicine. Sleep Hygiene Patient Information Handout [Brochure]. San Diego, CA: University of California San Diego; 201712.
12. Halson S Sleep in elite athletes and nutritional interventions to enhance sleep. Sports Med 2014; 44: 13–23
13. Okano K, et al. Sleep quality, duration, and consistency are associated with better academic performance in college students. NPJ Sci Learn. 2019. 4:16. doi:10.1038/s41539-019-0055-z.