Wake-up to managing poor sleep
How well you sleep is just as important as how long you sleep.
- Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
Guidelines recommend getting seven to nine hours of sleep nightly for most healthy adults. But the right amount varies per person.
So, how do you know if you're getting the optimal amount of sleep? Instead of fixating on a specific number of hours, focus on sleep quality, suggests Eric Zhou, a clinical psychologist with the Division of Sleep Medicine at Harvard Medical School.
Sleep quality means how well you slept during the night. Did you sleep straight through? Or did you have periods where you woke up? If so, did it take you a long time to fall back to sleep? How did you feel when you woke up?
"If you awaken refreshed and feel like you have the energy to get through the day, then you are sleeping the right amount for you," says Zhou. "Otherwise, your sleep quality is off, and you need to find out why."
Sleep quality and health
Sleep quality is vital for our overall health. Research has shown that people who sleep poorly are at a higher risk for diabetes, heart disease, and stroke. Poor sleep also increases daytime fatigue.
It's common for people to struggle with sleep, since their sleep patterns change over time. Many of these changes are age-related. For instance, our circadian rhythm — which regulates many bodily functions, including our sleep-wake cycle — is commonly disrupted with age. This means we spend less time each night in restorative slow-wave sleep.
Hormones also play a factor. Production of melatonin, the sleep hormone, gradually declines with age. Older men also produce less growth hormone as they age, which hampers slow-wave sleep. High levels of cortisol (the stress hormone) can disrupt sleep, and declining testosterone makes it more difficult to fall and stay asleep. "As a result of these changes, when we get older, we may start to wake up earlier in the morning than we did when we were younger or wake up more frequently during the night," says Zhou.
Tracking sleep quality
Improving sleep quality starts with recognizing the factors contributing to your poor sleep. One way is to keep a sleep diary where you track details of your sleep experience.
Each day for one to two weeks, record the time you went to bed, an estimate of how long it took you to fall asleep, whether you had any nighttime awakenings (and if so, how long you were awake), and when you woke up in the morning. Also, keep track of how you feel upon waking and at the end of the day. "After a week or two, review the information to see if you can identify any patterns that may be affecting your sleep quality, then make adjustments," says Zhou.
For example, if you have trouble falling asleep, go to bed half an hour later than usual but maintain the same wake-up time. "It is common for people struggling with their sleep to try to get more sleep by staying in bed longer, but this disrupts their sleep patterns and diminishes their sleep quality," says Zhou.
If you wake up a lot during the night, what caused it? If you regularly get up to use the bathroom, cut back on drinking liquids a few hours before bedtime. If it's because you're too warm, make the bedroom cooler than normal before going to bed, wear pajamas of light fabric, and use lightweight sheets and covers.
Other strategies that can help support good sleep quality include maintaining a consistent sleep schedule on weekends, taking regular afternoon naps (see "A short take on napping"), and staying physically active.
A short take on nappingNapping in the early afternoon, when your body experiences a natural circadian dip, is the best way to catch a few winks without disturbing your sleep-wake cycle. Many experts recommend limiting naps to 20 to 30 minutes and napping at least six hours before the desired bedtime. Try to schedule your naps and not wait until you get sleepy, which will prevent you from napping too late in the day. Give yourself 10 minutes after a nap before engaging in mentally or physically demanding tasks. |
Keep it consistent
When it comes to sleep quality, consistency is vital. "People with good sleep quality often have a predictable sleep window," says Zhou. However, it's unrealistic to expect perfect sleep every night. "If you have trouble sleeping one or two nights a week, that can be related to the natural ebbs and flows of life," says Zhou. "You may have eaten a big meal that day, drank too much alcohol, or had a stressful conversation with someone. When tracking sleep quality, look at your overall sleep health from week to week, not how you slept this Tuesday compared to last Tuesday." If you're doing all the right things but still don't feel rested upon waking, talk with your doctor. "They can help you rule out a sleep disorder like sleep apnea or another health issue that can interfere with sleep, such as acid reflux or chronic pain," says Zhou. Other factors that can affect the quality of your sleep include taking multiple medicines, depression, anxiety, loneliness, and light exposure.
Image: © miya227/Getty Images
About the Author
Matthew Solan, Executive Editor, Harvard Men's Health Watch
About the Reviewer
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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