Sleep is an integral part of life. All animal require sleep, foot, water and oxygen in order to survive. For most of us, 7-9 hours of uninterrupted sleep is necessary to maintain our health. Interestingly, sleep deprivation for 11 days is unsustainable and will result in death whereas we can survive for 3-4 weeks without food. Sleep deprivation can lead to loss of memory, irritability, muscle pain, confusion, car accidents, falls, diabetes, hypertension, weight gain, heart disease and depression. After age 26, people need 7-9 hours of sleep each night. Failure to attain these many sleep hours will result in a “sleep debt” resulting in a state of fatigue and confusion. The ONLY way to reverse one’s sleep debt is to sleep. Medications or stimulants, such as caffeine, will likely interfere with one’s circadian rhythm- the natural sleep/wake cycle, and do little to improve the consequences of sleep deprivation.
The exact amount of sleep one needs can be individualized and quantified using the following questionnaire. Ask yourself the following:
- Are you productive healthy and happy on 7 hours of sleep, or do you need 9 hours of quality sleep to get you into high gear?
- Do you have health issues such as being overweight or do you have diabetes, hypertension, high cholesterol, arthritis?
- Are you experiencing any sleep problems (insomnia, frequent awakenings, difficulty staying asleep, sleep apnea, restless leg syndrome)?
- Do you depend on caffeine to get you through the day?
- Do you feel sleepy when driving?
Also, consider rating your level of fatigue over the past 30 days on a scale of 10. A level 1 is “tons of energy” whereas a level 10 makes you feel as though you could fall asleep at a stop sign when driving. If your level of fatigue is above a 5 you are spending your day in a sleepy state. You will need to either sleep more and/or more efficiently.
Here are some sleep hygiene hints which can improve the quality and quantity of your sleep:
1. Stick to a sleep schedule of the same bedtime and wake up time, even on the weekends. This helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night.
2. Practice a relaxing bedtime ritual. A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound and deep sleep, or remain asleep.
3. If you have trouble sleeping, avoid naps, especially in the afternoon. Power napping may help you get through the day, but if you find that you can’t fall asleep at bedtime, eliminating even short catnaps may help.
4. Exercise daily. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.
5. Evaluate your room. Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool – between 60 and 67 degrees. Your bedroom should also be free from any noise that can disturb your sleep. Finally, your bedroom should be free from any light. Check your room for noises or other distractions. This includes a bed partner’s sleep disruptions such as snoring. Consider using blackout curtains, eye shades, ear plugs, “white noise” machines, humidifiers, fans and other devices.
6. Sleep on a comfortable mattress and pillows. Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy – about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that might cause you to slip or fall if you have to get up during the night.
7. Use bright light to help manage your circadian rhythms. Avoid bright light in the evening and expose yourself to sunlight in the morning. This will keep your circadian rhythms in check.
8. Avoid alcohol, cigarettes, and heavy meals in the evening. Alcohol, cigarettes and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. If you can, avoid eating large meals for two to three hours before bedtime. Try a light snack 45 minutes before bed if you’re still hungry.
9. Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity, such as reading. For some people, using an electronic device such as a laptop can make it hard to fall asleep because the particular type of light emanating from the screens of these devices is activating to the brain. If you have trouble sleeping, avoid electronics before bed or in the middle of the night.
10. If you can’t sleep, go into another room and do something relaxing until you feel tired. It is best to take work materials, computers and televisions out of the sleeping environment. Use your bed only for sleep and sex to strengthen the association between bed and sleep. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine.
If you feel tired, run down, have little energy, or are having any sleep related issues, make sure to discuss them with me at the time of your next visit. I have a special interest in sleep disorders. The better you sleep, the better you will feel overall.
Jeff Unger, MD