Are you getting enough sleep?
Sleep is a biological process that is essential for life and just like a poor diet or lack of exercise, poor sleep can have a measurable effect on our health.
It important to first explain what I mean by ‘poor sleep’ as I use it to refer to three things: 1. A lack of sleep, so this is simply when we are not getting the required number of hours sleep to function the next day, 2. Disrupted or fragmented sleep, this is when our sleep is interrupted over the course of the night (for example waking every two hours to feed a baby), and 3. Sleep cycle dysregulation, this is when our natural sleep cycle is disrupted so we may not be getting enough time in specific stages of sleep. For example, stage 4 is typically considered a restorative stage, so a lack of time in this stage may impact on physical and mental restoration.
Estimates suggest that 1 in 5 adults in the UK are not getting good quality sleep (either enough sleep or enough quality sleep) (mentalhealth-uk.org), and new parents (particularly mothers) are more at risk. Research has shown that in new parents men lose, on average, 13 minutes of sleep per night, but women lose over an hour. Furthermore, sleep may not return to pre-pregnancy levels until the oldest child is six years old. (Richter, Krämer, Tang, Montgomery-Downs, Lemola, 2019). Ouch!
The risk factors which can contribute to poor sleep are complex and varied and can range from changes in lifestyle to environmental issues. (Medic, Wille and Hemels, 2017).
Take for example the person who gets a promotion at work. They work late into the evening and feel in a permanent state of stress. They consume more caffeine and sugar just to keep going and then switch off at the end of the day by scrolling through their phones with a large glass of wine. When they do get to bed they struggle to get to sleep and spend at least 45 minutes tossing and turning. They have to be up early the next day to get into work, and the cycle repeats.
There are multiple factors at play which will impact on the quality of sleep the person is getting: 1. They are going to bed later, 2. They are stressed, 3. They are drinking more caffeine and eating more sugar, 4. They are regularly drinking alcohol and 5. They are not getting a break from screens before bed. Here is the problem, as time goes on, the situation gets worse as a lack of sleep will start impacting on the persons ability to regulate their blood sugar and stress levels which will result in them consuming more stimulants to keep going and more distractions (alcohol/social media) to unwind which will further disrupt and disregulate their sleep cycle, and so one and so forth. If the spiral continues then the person may start to get ill more regularly, they may start to experience anxiety and low mood, they may gain weight (particularly around the middle) and eventually they will either burnout or breakdown.
This example maybe a bit extreme, but it is not rare, I have used it simply to illustrate how sleep interacts with other areas of our health - it does not exist in isolation. Poor sleep affects different areas of our health, but similarly changes to other areas of our health can impact on our sleep. To reverse the effects of sleep deprivation it is important to take a holistic approach and I will talk more on this later.
How do you know if you are getting enough sleep?
This is a tricky one. It is not a one size fits all approach. Generally speaking adults are advised to get between 7 and 9 hours of sleep at night, but this is an average. It may be that you need less, or even more. So, as a guide here are some pointers to indicate if you are getting enough sleep:
When you go to bed you will typically fall asleep within 30 minutes.
You usually sleep through the night, or wake up no more than once.
You sleep between 7 and 9 hours a night (although this may vary).
If you wake up then you are able to drop back to sleep within 20 minutes.
The next day you feel energised and rested. (Suni, E. 2020)
If these indicators do not feel true to you then chances are you would benefit from improving your sleep. But before we look at how to improve your sleep lets look at the consequences of not getting enough of the good stuff…. then you will be really motivated to change your behaviour!
What are the consequences of not getting enough sleep?
Sleep deprivation not only impacts on our physical health but it also impacts on our brain function. (Medic, Wille and Hemels, 2017)
Poor sleep is associated with an increased activation of the sympathetic nervous system (which triggers the stress response), metabolic effects and a disruption to our natural circadian rhythm. There are short and long term consequences of these associations.
Short Term Effects:
Disrupted or fragmented sleep has been found to be associated with increased activation of the stress response which may offer an explanation between sleep disruption and cardiovascular disease (CVD). As a result of the affect on stress hormones fragmented sleep may have a direct impact on cognitive functions as well as mood and psychiatric conditions. (Medic, Wille and Hemels, 2017)
In addition, a lack of sleep or disrupted sleep has been linked to:
Reduced quality of life
Irritability, Impatience and reduced productivity.
Depression, negative mood and anxiety.
Poor cognitive function, including meneory effects and reduction in performance.
Burnout.
In adolescents, poor sleep is associated with poor psychological health, reduction in school performance and increase in risk taking behaviours. In young children it is linked with behavioural problems and poor cognitive function. (Medic, Wille and Hemels, 2017)
Long Term Effects:
If the short term effects are not enough to make you reflect on the quality and duration of your sleep then lets take a look at the long term consequences of poor sleep…
The following conditions have been associated with poor sleep probably not as a direct effect but as a consequence of the impact that chronic sleep deprivation has on the body. It is also important to note that much of the research looks as associations (not cause and effect). Therefore, we have to be aware that other factors could also play into the conditions listed.
Hypertension (high blood pressure)
Unhealthy levels of fat in your blood
Cardiovascular Disease
Weight problems
Metabolic syndrome
Type 2 Diabetes
Colorectal Cancer
(Medic, Wille and Hemels, 2017)
How can I improve my sleep?
By now you have hopefully come to understand that poor sleep is not something we should ignore, either in ourselves or our children. The consequences can literally be life changing or life limiting.
We live in a culture that, at best, undervalues the importance of sleep but at worse uses sleep deprivation as a measure of how hard someone is working, how much they can cope under pressure or how sociable they are. People are expected to work long hours but still fit in time for the gym, family commitments and engagements with friends - why can’t you do it all? Just sleep less, you don’t need sleep! Add to that screens, mobile phones and social media and you have a recipe for sleep catastrophe and the all the associated consequences.
So what can you do about it? I am guessing that if you have made it this far then you are looking forward to some simple actions you can take to improve your sleep. The good news is, yes, I have some very simple actions you can put in place to improve your sleep, the bad news is you will probably look at each one and say, ‘but I know this!’. So I would ask, what is getting in the way of you doing these very simple things to improve your sleep…. ? Well maybe I can help you answer that in a bit, but first, here are some tips for getting a better nights sleep:
Go to bed 7-9 hours before you need to get up the next day. If you find you naturally wake up earlier than you need to then you can go to bed slightly later, if you find you need more sleep then you may need to go to bed 9.5 or 10 hours before you need to get up. Experiment and find your optimal amount of sleep.
Once you have found your optimal amount of sleep make sure you stick to the same bedtime and wake time every night. Yes, even at the weekends where possible. This will help to regulate your sleep cycle. Your body likes routine and will be more likely to thrive when it can predict your sleep routine.
Reduce caffeine and nicotine, preferably avoiding caffeine at least 8 hours before bedtime. Some people are more sensitive to caffeine than others so you may find you need longer without caffeine or you can actually get away with less time before bed. If it takes you longer that 30-45 minutes to fall asleep then experiment with longer periods between caffeine and bedtime to see if that helps.
Cut down on alcohol. It might help you to unwind but alcohol can deplete of REM sleep which your brain needs for restoration. This can help to explain why, after a heavy night and good nights sleep, you can wake up still feeling sluggish and foggy headed.
Create a bedtime routine. Put aside 30 minutes to an hour before bed to start winding down and switch off from screens and mobile devices. It doesn’t need to be fancy or complex - just an opportunity to be a bit quieter and let your body know it’s almost time for sleep. With that in mind try dimming the lights for the 30-60 minutes before bed - the lower light will tell the sleep centres in your brain that its nearly time to sleep thereby triggering the release of melatonin, our sleep hormone.
As part of your routine, if possible, take a hot bath. In addition to helping you to relax taking a bath can help your body temperature to drop once in bed which signals your body it is time for sleep.
Avoid eating large meals before bedtime. Large meals can cause indigestion which can interfere with sleep. If you need to eat before bed opt for a light snack.
Make where you sleep an electronic free zone and only use it for sleeping or sex. This means leaving electronic devices at the door, getting rid of bright/noisy alarm clocks and only going to bed when you a ready to sleep. Your bed should be a place that you associate with sleep, not work, watching TV or scrolling on social media. All these things stimulate your brain and will interfere with your sleep.
Create a sleep haven. Invest in a diffuser and create a relaxing atmosphere with scents such as lavender or geranium; buy some houseplants which help to oxygenate the room; make your bed with soft sheets and duvet covers; clear away mess and clutter; avoid it being too hot; open a window to let in fresh air. If your bedroom does not make you feel relaxed then it will be more difficult to switch off and unwind.
Keep a note book by your bed. If you find you struggle to fall asleep, or wake up in the middle of the night, because you are worrying or thinking about things then write down your thoughts, ideas or lists in the notepad and then forget about it until the next day.
Get outside and expose yourself to natural daylight for at least 30 minutes a day. Exposure to natural light will help to regulate your sleep-wake cycle making it easier to wind down at the end of the night.
(Masterclass, 2021)
As you can see, all of these tips are relatively simple and easy to follow. You have probably heard of some of them before and perhaps you have even tried implementing some. But the question is, if you are aware of what you could be doing to improve your sleep, why aren’t you doing them? Be honest, did you get a little anxious when I suggested not taking electronic devices to bed?
You see, we humans are actually quite complex when it comes to changing our behaviours - even when those behaviours will benefit us. We are all creatures of habit and habits are very difficult to change or eliminate - particularly when they bring us short term pleasure or have been a part of our lives for a long time.
So, if you are planning to take steps to improve your sleep then I would suggest you start slowly. Don’t try to implement all of the suggestions outlined above all at once. Chances are if you do, you will fail very quickly and you will give up. Instead, pick one or two of your favourite tips, or the ones you think will be easiest to implement, and start with those. Stick with them for a week or so and see how you get on, if you need to adjust them then do so - remember everyone is different. Once you have made a few changes and are successfully keeping them up you will be motivated to continue. At this point choose one or two more tips and do the same again. Over the course of just one month you could bring about at least three to four changes to your routine which will positively impact on the quality and quantity of sleep you get. What is not to like about that!?
Sleep is the best meditation. — Dalai Lama
Sweet Dreams!
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References:
Masterclass (2021). Matthew Walker’s 11 Tips for Improving Sleep Quality. [online] Masterclass. Available at: https://www.masterclass.com/articles/matthew-walker-on-improving-sleep-quality [Accessed 31 Oct. 2022].
Medic, G., Wille, M. and Hemels, M. (2017). Short- and long-term Health Consequences of Sleep Disruption. Nature and Science of Sleep, [online] Volume 9(9), pp.151–161. doi:10.2147/nss.s134864.
Mental Health UK. (n.d.). Sleep and mental health. [online] Available at: https://mentalhealth-uk.org/help-and-information/sleep/.
Richter, D., Krämer, M.D., Tang, N.K.Y., Montgomery-Downs, H.E. and Lemola, S. (2019). Long-term effects of pregnancy and childbirth on sleep satisfaction and duration of first-time and experienced mothers and fathers. Sleep, 42(4). doi:10.1093/sleep/zsz015.
Suni, E. (2020). Sleep Quality: How to Determine if You’re Getting Poor Sleep. [online] Sleep Foundation. Available at: https://www.sleepfoundation.org/sleep-hygiene/how-to-determine-poor-quality-sleep.