By Randi Mann, WHNP-BC, NCMP, APNP
“A good laugh and a long sleep are the two best cures for anything.” Irish proverb
Here’s an unfortunate irony: We all need a good night of sleep more than ever to effectively cope with the challenges of these often-stressful times. However, research shows that an increasing number of people are experiencing sleep disturbances since the onset of the COVID-19 pandemic. Even in pre-pandemic times, the importance of sleep in maintaining our mental and physical health is often overlooked, and as much as 43% of the population say they don’t get enough sleep.
We tend to take sleep for granted without fully realizing the complex processes taking place. Through the course of the night, you go through several stages of sleep, each with its own purpose. Generally speaking, sleep is divided into two stages:
Typically occurring after the first 90 minutes of sleep, this is the stage when you’re more likely to have vivid dreams. Your eyes move quickly (hence the name) and your heartbeat raises. Many people experience temporary muscle paralysis. REM sleep supports memory, mood, and cognitive function, and some studies have connected a lack of REM sleep with a reduced coping ability. Interestingly, the amount of REM sleep we get each night tends to decline with age.
NREM is further broken down into three stages:
- NREM 1: the first stage of sleep, which is a very light sleep.
- NREM 2: about half of a typical night’s sleep is spent in this stage, which is slightly deeper than NREM 1.
- NREM 3: this is the deepest stage of sleep, during which heart rate, breathing, and other bodily processes slow down. It can be hard to wake someone up from NREM 3. It’s primarily at this stage that your body performs the restorative functions of sleep, including strengthening the immune system and repairing tissue.
The long-term impact of poor sleep extends far beyond feeling a bit groggy the next day. Some consequences include:
- Hormonal imbalances. Poor sleep can throw numerous hormones off balance in the body, and vice-versa. Proper sleep is important for hormones to function effectively and many depend on the sleep-wake cycle such as cortisol, leptin and ghrelin which are regulators of stress, hunger and fullness.
- Difficulties with weight maintenance: One study found that people who routinely get less than seven hours a night of sleep are over 40% more likely to be obese. One factor that plays a role is that sleep helps balance the levels of ghrelin (the hormone associated with hunger) and leptin (the hormone associated with feelings of fullness).
- Reduced cognitive function: Concentration, memory, and problem-solving are all negatively impacted by poor sleep. (That’s why the effects of driving while sleep-deprived is very similar to driving under the influence of alcohol.)
- Lowered immunity: Poor sleep lowers your immunity to common viruses. Initial studies also suggest adequate sleep improves your response to the COVID-19 vaccine, but more investigation is needed here.
- Heightened risk for cardiac problems: Not getting enough sleep raises your risk for heart disease and high blood pressure. Conversely, however, getting more than nine hours on average also increases your risk. The sweet spot appears to be between seven and nine hours a night.
- More vulnerability to mental health struggles and social problems: A lack of sleep not only makes you more vulnerable to depression, it can also impact social skills like empathy and trust.
As the list above suggests, sleep problems can impact all areas of health. However, it’s difficult to tackle sleep problems when you’re tired. Of course, when we’re tired, we reach for caffeine and don’t have the energy to adopt better lifestyle habits, creating a never-ending cycle.
Many factors can negatively impact sleep, including:
- Poor nutrition
- Sedentary lifestyles
- Blue light from electronic devices
- Medical problems like restless leg syndrome
- Chronic pain
- Hormone imbalances
So how can we prevent these common sleep disruptors from impacting our health? The following tips can help you take a more proactive approach to getting a good night’s sleep.
This simple mindshift can have a big impact. After all, sleep isn’t just something you fit in when you’re not too busy, but an essential function of maintaining good health. As mentioned, aim for 7 – 9 hours of restful sleep a night and prepare for sleep in a routine fashion so that it becomes more of a priority for you (more on that below).
Treat your bedroom like a sanctuary, and avoid doing other things in there, particularly if they are work-related. Keep the temperature moderate (cooler is better), and reduce noise as much as possible. If you have a lot of environmental noise, try a white noise machine.
Your body likes regular hours for sleep. We’re often programmed to stay up later and sleep in on the weekend, but maintaining a regular schedule and protecting your circadian rhythm is better in the long run. You should be able to wake up naturally without setting an alarm – if it takes several repeats of the snooze alarm, adjust your bedtime to an earlier time.
It’s difficult to switch from our fast-paced waking lives to a restful state conducive to sleep. Honor this transition by avoiding stimulating activities right before bed in favor of more restful activities like reading or having a warm bath.
The light emitted from electronic devices is composed of blue wavelengths. This light can slow the production of melatonin, the sleep-inducing hormone. Think of it this way: your eyes associate the blue light of daytime with wakefulness, and as that light fades as the day ends, they send a signal to produce more melatonin. When a device also emits blue light, your eyes are tricked into thinking it’s the middle of the day. Minimize this effect by avoiding LED screens for two to three hours before bedtime. On a similar note, try not to keep your phone beside your bed. (If you use it for the alarm, simply buy an alarm clock.) This can prevent the urge to check notifications and will also reduce EMF (Electromagnetic Frequencies) exposure emitting from your device. Studies are ongoing, but research shows that daily occupational EMF exposure may be associated with poor sleep quality.
Caffeine can keep you awake even if you consume it as much as six hours before bedtime, so avoid anything with caffeine well before you plan to sleep. Similarly, avoid foods that give you heartburn, if you are prone to it. Although alcohol can put you to sleep faster, its effects are short-lived, and it shortens REM sleep, resulting in more disruptions to sleep and poor sleep quality.
Work with your healthcare practitioner if chronic pain is keeping you up at night. If you have chronic sleep difficulties, ask about determining if you have sleep apnea, a common condition in which people experience difficulty breathing while sleeping.
Exercise is one of the most helpful things you can do to improve sleep. Avoid overtraining, which can lead to insomnia, and don’t exercise vigorously too late. Many people find some light stretching or yoga in the evening helps with sleep. Try an inversion yoga pose like “legs on the wall” to help get your body in a restful and relaxed state.
Did you know that a hormonal imbalance can cause your sleep to suffer? Fluctuations of thyroid, testosterone, estrogen, cortisol, progesterone, melatonin and/or growth hormone can all cause sleep difficulties. For example, an imbalance of estrogen can cause waking in the night, night sweats as well as trouble getting to sleep due to increased cortisol. Find out if your hormonal imbalances are keeping you up or waking you up by scheduling a consultation and getting proper testing from a qualified healthcare practitioner. We can help!
Meditation can help train your mind and body’s relaxation response. You can find meditations specifically geared towards sleepiness on many mindfulness apps, or even YouTube.
Don’t overlook the importance of sleep in your overall health. If your sleep is not restoring your body daily, you can be setting your day up for a roller coaster of issues. Need help ensuring your body is balanced and functioning properly? Call us and book a consultation. We can help determine the root cause of your health issues and put you on a plan to help you be restored, vibrant, and resilient.
Chattu VK, Manzar MD, Kumary S, Burman D, Spence DW, Pandi-Perumal SR. The Global Problem of Insufficient Sleep and Its Serious Public Health Implications. Healthcare (Basel). 2018;7(1):1. Published 2018 Dec 20. doi:10.3390/healthcare7010001
Partinen M, Holzinger B, Morin CM, Espie C, Chung F, Penzel T, Benedict C, Bolstad CJ, Cedernaes J, Chan RNY, Dauvilliers Y, De Gennaro L, Han F, Inoue Y, Matsui K, Leger D, Cunha AS, Merikanto I, Mota-Rolim S, Nadorff M, Plazzi G, Schneider J, Sieminski M, Wing YK, Bjorvatn B. Sleep and daytime problems during the COVID-19 pandemic and effects of coronavirus infection, confinement and financial suffering: a multinational survey using a harmonised questionnaire. BMJ Open. 2021 Dec 13;11(12):e050672. doi: 10.1136/bmjopen-2021-050672. PMID: 34903540; PMCID: PMC8671846.
Medic G, Wille M, Hemels ME. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep. 2017;9:151-161. Published 2017 May 19. doi:10.2147/NSS.S134864
Peever J, Fuller PM. Neuroscience: A Distributed Neural Network Controls REM Sleep. Curr Biol. 2016;26(1):R34-R35. doi:10.1016/j.cub.2015.11.011
Krause AJ, Simon EB, Mander BA, et al. The sleep-deprived human brain. Nat Rev Neurosci. 2017;18(7):404-418. doi:10.1038/nrn.2017.55
Benedict C, Cedernaes J. Could a good night’s sleep improve COVID-19 vaccine efficacy?. Lancet Respir Med. 2021;9(5):447-448. doi:10.1016/S2213-2600(21)00126-0
Dorrian J, Centofanti S, Smith A, McDermott KD. Self-regulation and social behavior during sleep deprivation. Prog Brain Res. 2019;246:73-110. doi: 10.1016/bs.pbr.2019.03.010. Epub 2019 Apr 10. PMID: 31072564.
Blume, Christine et al. “Effects of light on human circadian rhythms, sleep and mood.” Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine vol. 23,3 (2019): 147-156. doi:10.1007/s11818-019-00215-x
Liu H, Chen G, Pan Y, Chen Z, Jin W, et al. (2014) Occupational Electromagnetic Field Exposures Associated with Sleep Quality: A Cross-Sectional Study. PLOS ONE 9(10): e110825. https://doi.org/10.1371/journal.pone.0110825