The American culture has a hard time with sleep. In clinical practice, it literally is one of the top things I discuss with patients. The struggle is very real: folks have a hard time falling asleep, staying asleep, and then wake up too early. Different factors affect sleep in significant ways: stress, bad habits, relational issues, and just poor planning weigh heavily on a healthy night’s sleep. Many Americans just completely disregard sleep as important. The less the better and when there is a time crunch, we tend to subtract hours from rest and add to our work day.

Why we do this is a subject for an entire book, so feel free to Google away. I want to focus on the dangers, the benefits and then how to sleep better.

Why is poor sleep dangerous?

• Increased susceptibility to the common cold and other viruses
• Increased risk for a heart attack and heart disease
• Increased risk for metabolic dysfunction leading to diabetes
• Increased hormonal imbalances
• Likely association with neurological disease, such as Alzheimer’s
• Increased risk of accidents: motor vehicle being most profound

Given the dangers listed above, NOT getting enough sleep is obviously dangerous, and not helping us live our best life.

Let’s get some definitions out of the way:

• A healthy night’s sleep is 7-9 hours with little interruption
• The best sleep occurs during the night (no sunlight hours)
• Sleep apnea is a real disorder that can be treated: the main symptoms are snoring, having high blood pressure, fatigue most days, and/or having been observed to stop breathing for a period occasionally at night. If you have any of these symptoms, then seek help from your primary care provider.
• Sleep is divided into stages: Deep non REM sleep, light non REM sleep, and REM sleep. Each one is important, and each tends to help the brain heal, process, and recover from the days mental exertions.
• For a full discussion, the NIH has a great website: https://www.ninds.nih.gov/health-information/public-education/brain-basics/brain-basics-understanding-sleep
• A decent book on the subject: Why We Sleep, by Matthew Walker PhD

How to sleep better:

Avoid alcohol, large meals, exercise and smoking at least two to three hours before bed. Turn off from work and technology at least an hour before bed. Go to bed as soon as you feel tired. If you wait too long, it will be harder to fall asleep. Avoid watching TV or reading an exciting page-turner in bed. Go to bed at around the same time each night. Ideally this should be before midnight. Sleep in a dark, well ventilated room. Deep sleep is the phase of sleep where you benefit most. It happens in the first third of your sleep. Avoid environments where you could be disturbed during this phase. Aim for seven to nine hours of sleep per night

Benefits of sleep:

• Improved memory, focus, and learning
• Better mood and emotional regulation
• Stronger immune response
• Balanced appetite and metabolism
• Reduced risk of chronic conditions like heart disease and diabetes
• Faster muscle recovery and tissue repair
• Increased energy and daytime alertness

Honestly, I have always had a tough time with sleep. When I was younger, I literally thought sleep was a waste of time, and often would stay up late and then I would get up early. For a long time in my 20’s, I would just drink caffeine to push the envelope a bit, but then in my early 30’s, I was working the night shift as an ICU RN, and overdid the caffeine. I ended up in a heart arrhythmia, feeling pretty lousy, and seeing a cardiologist who advised me to stop the caffeine, work on getting a day shift job, and sleep regularly. The heart issue has not returned and I have learned to prioritize sleep in the same way that I prioritize exercise. The results are nice because you feel better and that is motivating to keep up the good behavior.

My recommended habits:

• Go to bed at the same time every night, timing it so you have 7-9 hours to sleep before you have to arise for work.
• Work out with an exercise regimen first thing in the morning to energize your day.
• Avoid any screen time in bed.
• Black out your sleeping room: no light.
• White noise is a great tool: trial different things that relax you. Mellow music, a bubbling stream, ocean waves…
• Buy a mattress that works for you and think of it as investment like buying a car.

Please comment if you have further thoughts on habits that have worked for you. Good luck and may you sleep well tonight!