Are You Getting Enough Sleep?
How are you sleeping? Do you find yourself waking up throughout the night, or lucky to sleep for a few hours straight? Many patients I see have a sleeping issue. In fact, an estimated 50-70 million U.S. adults have sleep or wakefulness disorder. On top of that, nearly 30% of adults reported an average of ≤6 hours of sleep per day. Regardless of cause, lack of quality sleep has a profound affect on your health and vitality.
The Less You Sleep, The Less You Cope With Stress
The more tired you become, the less you are capable of coping with stress. Moreover, the more stressful life seems, the more you have a problem going to sleep. Many people appear to be caught in this no-win, no-rest cycle, yet they seem unaware that working and stressing too much is actually sabotaging their efforts to get a good night’s sleep.
Research in the 1970’s revealed that stress decreases the time spent in the deepest, most restorative sleep stages and disrupts dream cycle (REM) sleep. In one study, chronic insomniacs reported that during the time their sleep problems began, they also experienced a greater number of stressful life events than in previous years. These problems include marital strife, financial worries, the death of a loved one or loss of job.
Poor sleep in turn makes coping with a stressful lifestyle more challenging. In a U.K. study, volunteers deprived of a good night’s sleep couldn’t think of creative solutions to a stressful challenge and often fell back on rigid approaches that weren’t as effective. In time, trying to get by despite sleeplessness can lead to depression, anxiety and other psychological problems.
Lack of Sleep Kills
A survey of 1.1 million people found that those that reported sleeping about 7-8 hours per night had the lowest rates of mortality, whereas those that slept for fewer than 6 hours had higher mortality rates. Severe insomnia–sleeping less than 3.5 hours in women and 4.5 hours in men–also led to a 15% increase in mortality. However, most of the increase in mortality from severe insomnia was discounted after controlling for co-morbid disorders. After controlling for sleep duration and insomnia, use of sleeping pills was also found to be associated with an increased mortality rate.
So, How Are YOU Sleeping?
- Do you fall asleep within 15 minutes of going to bed, or does it take you ages to go to sleep?
- Do you always need an alarm clock to wake up?
- Do you naturally wake within 15 minutes each day at the same time?
- If you lie down for a nap in the middle of the day, are you fast asleep in no time?
- How are your sleep patterns on the weekends, compared to the working week?
- When you go on holidays, do you sleep a lot for 2-3 days in the first week?
- Does your partner’s snoring affect your sleep?
Make note of your answers, and consider these tips for each question.
1. A healthy person generally falls asleep within 10-20 minutes.
You don’t generally get into a healthy deep-sleep pattern by falling asleep as soon as your head hits the pillow. This is because your mind will first go from the beta brain wave (busy thinking and conscious thought patterns) into the alpha brain wave (relaxed, dreamy, half-asleep/half-awake pattern).
Later on in the night you slide into the very refreshing theta brain wave state, and then into the theta brainwave pattern, called the REM state. This is the important phase as far as feeling great and refreshed when you awake. The delta state is even deeper, and a healthy person is in this state for up to an hour. Those who say: “a bomb could go off and I wouldn’t wake up” are generally in the deeper states such as the delta, because arousal is much more difficult in this state than others.
Healthy sleep consists of a combination and repetitive phase of the four above mentioned brain wave states. Interrupting a cycle can have negative consequences. Remember sometimes just as you doze off that you remember something important? This is because the alpha state allows your mind to be more creative and think “peripherally” about minor and trivial issues.
2. A good indication that you are getting enough sleep is the ability for you to wake most mornings without an alarm clock.
In my experience, most people simply don’t get enough rest. They tell me they sleep fine, but do they really get the quality of sleep they need? If during the week the alarm wakes you and you turn over, you need more sleep! Using your alarm clock is a good measure for this.
3. Healthy sleepers tend to wake up around the same time each morning.
Waking up around the same time, and not waking early (from midnight to 5.00am), tells me that your hormone patterns are well balanced. If you have a problem with energy, or perhaps suffer from adrenal fatigue, then you may well have a sleeping problem. This is a typical presentation in my clinic. (Read more on the connection between sleep disruption and adrenal function)
4. If you collapse into a mid-day nap and fall asleep immediately, you need more rest.
This doesn’t take into account fatigue felt after a meal. If you get tired after eating a meal heavy on carbs like bread or pasta, it could mean you are a bit low in blood sugar and you may naturally feel a bit tired. Try sleeping for 8 hours a night for 1 week. You should find it harder to fall asleep mid-day, and feel less of an urge to nap. Reducing or eliminating heavy simple carbs from your diet can help as well.
5. If you don’t get enough sleep during the week, your brain will want to catch up on the weekends.
If these “catch-ups” continually occur, you may find it harder to function on a Monday morning because your waking and sleeping patterns are shifted by pushing them ahead by an hour or two. It is important to get to bed by around 10 PM at the latest for most people. Go to bed when you feel naturally tired.
Don’t take an evening nap and then stay up until midnight or later. This is very common today, as we try to squeeze every last drop out of our day due to our increasing workloads. What’s worse, we prop these habits up with coffee and tea to keep us “topped up” with energy. Are you starting to fade around 9 PM? Don’t fight it; go to bed.
6. If you find that you need more sleep whilst you are on holidays, you are over-working yourself.
If you feel like you need a vacation just to escape the stress of daily life, you may need to create a “sanctuary.” What I mean by this is a place where you can escape and relax away from phones, kids, computers, and demands from others. How much “you” time do you set aside each day or week? Sleeping more on holidays and weekends indicates an underlying problem with “sleep debt.” Your sleep back account is going into the red fast and you will soon be bankrupt (burnt out) unless you service this debt.
As I mentioned above, your brain needs to be in a combination and repetitive pattern of the four brainwave patterns to allow sleep to be refreshing and restorative. If snoring bumps you out of a deep delta sleep state, it could severely interrupt your sleep cycles.
Deep sleep improves your daytime serotonin cycles, which allows you to wake up feeling positive, happy and motivated. Try separate beds for a week or two to see how the quality of your sleep improves. If there is a marked change for the better, consider getting your partner’s snoring sorted. There is medical help available, and you both will benefit.
It is well worth your time and effort to improve the quality and quantity of your sleep. You will be amazed at how your health can improve. Isn’t it funny how we always want to “take” things to improve our sleep, when what we really need to be looking at is improving the simple things first? Going to bed when we are actually physically or mentally tired, avoiding stimulants (and alcohol) if we have regular sleeping issues, and exercising regularly are good daily habits for us all. Improving quality of sleep is one decision you don’t have to sleep on to make.
This is part 1 of a 2-part series on sleep. Stay tuned for part 2 next week, where I offer my 12 tips to sleeping better and feeling great again.
About the Author: Eric Bakker B.H.Sc. (Comp.Med), N.D, R.Hom. is a highly experienced naturopathic physician who has been in clinical practice for 27 years. Eric is passionate about improving people’s lives through proven wellness and lifestyle principles, natural medicine practice as well as public and professional practitioner education. Eric specialises in candida, psoriasis, as well as adrenal fatigue, thyroid and digestive disorders. Dr. Bakker has written one of the most comprehensive books on yeast infections called Candida Crusher. He has also written what may well be the most comprehensive Natural Psoriasis Treatment Program available. You can find more articles by Dr. Bakker on his blog at www.ericbakker.com
Altun A, Ugur-Altun B. Melatonin: therapeutic and clinical utilization. Int J Clin Pract. 2007;61(5):835-45.
Atkinson G, Davenne D. Relationships between sleep, physical activity and human health. Physiol Behav. 2007;90(2-3):229-35.
Attele AS, Xie JT, Yuan CS. Treatment of insomnia: an alternative approach. Altern Med Rev. 2000;5(3):249-259.
Barion A, Zee PC. A clinical approach to circadian rhythm sleep disorders. Sleep Med. 2007;8(6):566-77.
Beghe C. Review: behaviour therapy is effective for insomnia. Evid Based Med. 2006;11(5):147.
Chasens ER. Understanding sleep in persons with diabetes. Diabetes Educ. 2007;33(3):435-6, 438, 441.
Chen HY, Shi Y, Ng CS, Chan SM, Yung KK, Zhang QL. Auricular acupuncture treatment for insomnia: a systematic review. J Altern Complement Med. 2007;13(6):669-76.
Dolder C, Nelson M, McKinsey J. Use of non-benzodiazepine hypnotics in the elderly: are all agents the same? CNS Drugs. 2007;21(5):389-405.
Epstein DR, Dirksen SR. Randomized trial of a cognitive-behavioral intervention for insomnia in breast cancer survivors. Oncol Nurs Forum. 2007;34(5):E51-9.
Harrington JJ, Avidan AY. Treatment of sleep disorders in elderly patients. Curr Treat Options Neurol. 2005;7(5):339-52.
Harsora P, Kessmann J. Nonpharmacologic Management of Chronic Insomnia. American Fam Phys.2009;79(2).
Herxheimer A, Petrie KJ. Melatonin for preventing and treating jet lag. Cocharane Database Syst Rev. 2001;(1):CD001520.
Kalavapalli R, Singareddy R. Role of acupuncture in the treatment of insomnia: a comprehensive review.Complement Ther Clin Pract. 2007;13(3):184-93.
Krystal AD. Treating the health, quality of life, and functional impairments in insomnia. J Clin Sleep Med. 2007;3(1):63-72.
Krystal A. The changing perspective of chronic insomnia management. J Clin Psychiatry. 2004;65 Suppl 8:20-5.
Mai E, Buyesse D. Insomnia: Prevalence, Impact, Pathogenesis, Differential Diagnosis, and Evaluation.Sleep Medicine Clinics. 2008;3(2).
McCrae C, Dzierzewski J, Kay D. Treatment of Late-Life Insomnia. Sleep Medicine Clinics. 2009;4(4).
McCurry SM, Logsdon RG, Teri L, Vitiello MV. Evidence-based psychological treatments for insomnia in older adults. Psychol Aging. 2007;22(1):18-27.
Ohayon M. Observation of the Natural Evolution of Insomnia in the American General Population Cohort.Sleep Medicine Clinics. 2009;4(1).
Ramakrishnan K, Scheid DC. Treatment options for insomnia. Am Fam Physician. 2007;76(4):517-26.
Ringdahl E, Pereira S, Delzell J. Treatment of primary insomnia. J Am Board Fam Pract. 2004;17:212-219.
Roth T, Toehrs T. Efficacy and Safety of Sleep-Promoting Agents. Sleep Medicine Clinics. 2008;3(2).
Shamir E, Laudon M, Barak Y, Anis Y, Rotenberg V, Elizur A, Zisapel N. Melatonin improves sleep quality of patients with chronic schizophrenia. J Clin Psychiatry. 2000;61(5):373-377.
Vandermeer BW, Buscemi N, Liang Y, Witmans M. Comparison of meta-analytic results of indirect, direct, and combined comparisons of drugs for chronic insomnia in adults: a case study. Med Care. 2007;45(10 Supl 2):S166-72.
Wade AG, Ford I, Crawford G, et al. Efficacy of prolonged release melatonin in insomnia patients aged 55-80 years: quality of sleep and next-day alertness outcomes. Curr Med Res Opin. 2007;23(10):2597-605.
Walsh JK, Krystal AD, Amato DA, et al. Nightly treatment of primary insomnia with eszopiclone for six months: effect on sleep, quality of life, and work limitations. Sleep. 2007;30(8):959-68.
Wolkove N, Elkholy O, Baltzan M, Palayew M. Sleep and aging: 2. Management of sleep disorders in older people. CMAJ. 2007;176(10):1449-54.
Zammit G, Erman M, Wang-Weigand S, Sainati S, Zhang J, Roth T. Evaluation of the efficacy and safety of ramelteon in subjects with chronic insomnia. J Clin Sleep Med. 2007;3(5):495-504.