Remember the last time you woke up feeling renewed and refreshed, after a full eight hours of solid shuteye? Chances are, it wasn’t this morning, or any morning in recent memory. An estimated 50 million to 70 million people have a sleep or wakefulness disorder, according to the U.S. Centers for Disease Control and Prevention, and a recent poll by the National Sleep Foundation found that more and more people are getting less than six hours of z’s a night (seven to eight is recommended for most adults).
“It’s a national epidemic,” says Rose Franco, an associate professor of pulmonary, sleep and critical care medicine at the Medical College of Wisconsin. Stress, demanding work schedules and an over-reliance on sleep-disrupting gadgets all may play a role. The decline in sleep has led to a host of alarming health issues. Here’s what you need to know to ward them off and wake up feeling refreshed, alert and ready to face the day.
Why Sleep Is Important
The latest data on sleep published in Scientific American shows sleep is even more crucial to good health than once believed. Sleep has been found to be critical in aiding hormone regulation and immune and nervous system function, among other processes, and those who don’t get enough are at greater risk of suffering from hypertension, diabetes, depression and obesity. “There’s a link between sleep and weight,” says Franco. “The people who sleep the least are also the heaviest.” And more than one long-term study shows an increased risk of cancer associated with lack of sleep.
The havoc that lack of sleep wreaks on our bodies can start almost immediately. Studies show that there’s a disruption in the activity of genes that govern the immune system, metabolism and the body’s response to stress after as few as seven nights of sleeping less than six hours. Not to mention the fatigue and lack of concentration we experience when bleary-eyed (particularly behind the wheel). We even make worse food choices when tired, and our ability to metabolize those Big Macs is impaired, too. On the flip side, an adequate amount of quality sleep each night not only helps prevent many health issues but may aid memory, boost emotional intelligence and even lower odds of getting Alzheimer’s disease.
Why You Can’t Sleep
Let’s face it: We as a society don’t necessarily want to sleep. “It’s a very Western notion that sleep is for the weak and not something to be valued,” says Jay Balachandran, a doctor at the Sleep Wellness Institute in Milwaukee. Indeed, the idea that you snooze, you lose, is practically in our DNA. Songwriter Warren Zevon summed up the zeitgeist in his song, “I’ll Sleep When I’m Dead.” You have only to look at success of Red Bull and 5-hour Energy shots to see how Zevon’s analysis endures.
Pair our cultural leanings with our changing lifestyles, and you can see why sleep is fleeting. According to one recent report, 71 percent of Americans now sleep with or next to their smartphones. Says Raj Dasgupta, a fellow of the American Academy of Sleep Medicine: “It’s almost a Pavlovian response to find our phone when we hear an alert. We can’t miss a single tweet.” But using such blue-light-emitting devices at bedtime can mess with our sleep by suppressing the production of melatonin, which interrupts our circadian rhythms and leads to fatigue the next morning.
And then there’s the fact that as we age – and cope with more health issues that both prevent sleep and require more sleep-disrupting medications – we experience more insomnia. Women sleep less than men thanks to hormonal differences (post-menopausal women are particularly prone to sleep problems), but they need more sleep to function – about 20 minutes more a night, according to one study. That’s because women, who tend to multi-task more than men, use more of their brains during the day.
Beyond Insomnia: Sleep Apnea
But sleeping woes can also have a physiological cause. Sleep apnea, in which one’s breathing is repeatedly interrupted during sleep, is one of the most common causes. It affects nearly 18 million people – though up to 95 percent of them may be unaware they have it.
The result – low blood oxygen levels and disrupted sleep – can lead to such health issues as hypertension and heart disease as well as the obvious one: grogginess. If you suspect sleep apnea, consult a doctor, as it’s a potentially serious condition.
The good news: Those old-school masks prescribed for sleep apnea have been replaced by less invasive ones. And some of the newest treatments – such as an implant that stimulates the tongue to keep your airway open as you sleep – don’t involve masks at all.
Apps That Help You Snooze More Soundly
Sleep aids and analyzers so good you might allow smartphones in bed
How to Get a Better Night’s Sleep
Most who have trouble getting enough quality z’s don’t have sleep apnea. Insomnia is the most common sleep disorder, according to Dr. Raj Dasgupta. What’s the solution? Dasgupta and his colleagues are in the vanguard of a whole new discipline called sleep medicine, which has emerged over the past 16 years or so to help people deal with chronic sleep woes.
Sleep medicine uses a variety of treatments depending on the patient and the cause. “Not one answer fits everyone,” says Dasgupta. And while medications are sometimes part of the mix, they generally aren’t recommended for long-term use. Says Dr. Jay Balachandran, “Americans think medications are the answer, and they do work in the short-term, but until you recognize the behaviors that impact your ability to sleep and you adjust those behaviors, you won’t have long-term results.” Start by adhering to what sleep experts call good sleep hygiene. Here’s how:
Avoid nicotine altogether. This is a no-brainer, but if you must sneak a cigarette, don’t do so within two hours of bedtime. Drink caffeine in moderation and never within four to six hours of going to bed. And don’t go for that third glass of wine. As Balachandran notes, while alcohol may seem like a sedative, it increases arousals and suppresses slow wave and REM sleep.
Go to bed and get up at the same time each day, even on the weekends. Keeping to a schedule can help train your body to switch to sleep mode automatically at bedtime.
Engage in soothing bedtime rituals, such as a warm bath, or try reading or listening to soft music before you turn in. And make sure your bedroom is cool (ideally 65-68 degrees), dark, quiet and well-ventilated. Consider ear plugs, a white noise machine, an eye mask or blackout shades if you have trouble with noise or light.
Unplug from electronic devices at least 30 minutes before going to bed and keep all phones, tablets and computers out of the bedroom, unless you’re using a sleep-aid app. And don’t think a blue light filter means you can use your gadgets in bed. Technology is not conducive to sleep.
Try meditating for a few minutes each day to combat stress. One recent study found that a six-week course of mindfulness meditation improved sleep quality for older adults who had trouble falling and staying asleep and who felt sleepy during the day.
Exercise regularly and don’t eat a heavy meal within four hours of hitting the hay. Similarly, drink enough water so that you don’t wake up thirsty but not so much that you need bathroom trips during the night.
Make naps short. Some experts think power naps are restorative, while others believe napping disrupts your sleep/wake cycle. If you find a siesta helps, set your alarm for 20 minutes and time it for between 2 p.m. and 4 p.m. (That’s when most of us flag, and sleeping later than that will affect your ability to do so at night.) Don’t doze more than 20 minutes or you will drift into the sort of deep sleep that affects productivity for up to two hours after you wake up.
Look into CBT. If all else fails, consult with your primary-care doctor or a sleep medicine specialist about addressing the issue with cognitive behavioral therapy, which helps identify behaviors – using bedtime to worry about stressful situations at work, for example – that trigger a sleep-busting response and trains you to unlearn them. One study found that people who used CBT improved sleep efficiency by nearly 10 percent. Moreover, they fell asleep 19 minutes earlier and slept for an average of 8 minutes longer than those who did not.
Illustrations by Janne Iioven.
Freelance writer Hilary Sterne is a former Editor-in-Chief of Martha Stewart Weddings.