This article is meant for informational purposes only. If you have questions about your health, you should consult your physician.
Dr. G. M. Siddiqui, M.D
CEO, Medical Services, Lifeline Healthcare.
What Is Sleep?
Sleep was long considered just a block of time when your brain and body shut down. It is now known, that your brain and body functions stay active throughout sleep, and they form or strengthen the pathways of brain cells needed to perform tasks related to our daily routines of life. Your ability to function and feel well while you're awake depends on whether you're getting enough sleep.
Sleeping is a basic human need, like eating, drinking, and breathing. Like these other needs, sleeping is a vital part of the foundation for good health and well-being throughout your lifetime. Sleep deficiency can lead to physical and mental health problems, injuries, loss of productivity, and even a greater risk of death. Sleep deficiency can interfere with work, school, driving, and social functioning. You might have trouble learning, focusing, and reacting. Also, you might find it hard to judge other people's emotions and reactions. Sleep deficiency also can make you feel frustrated, cranky, or worried in social situations.
What Makes You Sleep?
Many factors play a role in preparing your body to fall asleep and wake up. You have an internal "body clock" that controls when you're awake and when your body is ready for sleep. This clock typically follows a 24-hour repeating rhythm (called the circadian rhythm). The rhythm affects every cell, tissue, and organ in your body and how they work. This clock is in sync with certain cues in the environment. Light, darkness, and other cues help determine when you feel awake and when you feel drowsy. For example, light signals received through your eyes tell a special area in your brain that it is daytime. This area of your brain helps align your body clock with periods of the day and night.
Why Is Sleep Important?
Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety.
- A. Healthy Brain Function and Emotional Well-Being
Sleep helps your brain work properly. While you're sleeping, your brain is preparing for the next day. It's forming new pathways to help you learn and remember information. A good night's sleep enhances your learning and problem-solving skills. Sleep also helps you pay attention, make decisions, and be creative.
Children and teens, who are sleep deficient may have problems getting along with others. They may have problems paying attention, trouble making decisions, solving problems, controlling their emotions and behavior, and coping with change. Sleep deficiency also has been linked to depression, suicide, and risk-taking behavior. They feel angry and become impulsive, have mood swings, lack motivation.
- B. Physical Health
Sleep plays an important role in your physical health. For example,
• Sleep is involved in healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke
• Sleep also supports healthy growth and development. Deep sleep triggers the body to release the hormone that promotes normal growth in children and teens. This hormone also boosts muscle mass and helps repair cells and tissues in children, teens, and adults. Sleep also plays a role in puberty and fertility.
• Your immune system relies on sleep to stay healthy. This system defends your body against foreign or harmful substances. Ongoing sleep deficiency can change the way in which your immune system responds. For example,if you're sleep deficient, you may have trouble fighting common infections.
• Getting enough quality sleep at the right times helps you function well throughout the day. People who are sleep deficient are less productive at work and school. They take longer to finish tasks, have a slower reaction time,and make more mistakes.
- C. Safety
Lack of sleep also may lead to micro-sleep. Micro-sleep refers to brief moments of sleep that occur when you're normally awake. You can't control micro-sleep, and you might not be aware of it.
As a result, sleep deficiency is not only harmful on a personal level, but it also can cause large-scale damage. For example, sleep deficiency has played a role in human errors linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and aviation accidents.
How Much Sleep Is Enough?
The amount of sleep you need each day will change over the course of your life. Although sleep needs vary from person to person, the chart below shows general recommendations for different age groups.
Recommended Amount of Sleep
16–18 hours a day
11–12 hours a day
At least 10 hours a day
9–10 hours a day
Adults (including the elderly)
7–8 hours a day
Common Sleep Disorders
The four most common sleep disorders are
- • Insomnia. This is a sleep disorder that is characterized by difficulty falling and/or staying asleep.
- • Sleep Apnea. In people who have sleep apnea, breathing briefly stops or becomes very shallow during sleep. This change is caused by intermittent blocking of the upper airway, usually when the soft tissue in the rear of the throat collapses and partially or completely closes the airway. People who have sleep apnea generally are not aware that their breathing stops in the night. Their bed partners are likely to notice, however, that they snore loudly and frequently and that they often stop breathing briefly while sleeping.
- • Restless legs syndrome (RLS) causes an unpleasant prickling or tingling in the legs, especially in the calves, that is relieved by moving or massaging them. People who have RLS feel a need to stretch or move their legs to get rid of the uncomfortable or painful feelings. As a result, it may be difficult to fall asleep and stay asleep.
- • Narcolepsy. Narcolepsy’s main symptom is extreme and overwhelming daytime sleepiness, even after adequate nighttime sleep. In addition, nighttime sleep may be fragmented by frequent awakenings. People who have narcolepsy often fall asleep at inappropriate times and places.
Additional sleep problems include chronic insufficient sleep, circadian rhythm abnormalities, and “parasomnias” such as sleep walking, sleep paralysis, and night terrors.
Who Is at Risk for Sleep Deprivation and Deficiency?
Sleep deficiency, which includes sleep deprivation, affects people of all ages, races, and ethnicities. Certain groups of people may be more likely to be sleep deficient. Examples include people who:
- • Have limited time available for sleep, such as caregivers or people working long hours or more than one job
- • Have schedules that conflict with their internal body clocks, such as shift workers, first responders, teens who have early school schedules, or people who must travel for work
- • Make lifestyle choices that prevent them from getting enough sleep, such as taking medicine to stay awake, abusing alcohol or drugs, or not leaving enough time for sleep
- • Have undiagnosed or untreated medical problems, such as stress, anxiety, or sleep disorders
- • Have medical conditions or take medicines that interfere with sleep
Certain medical conditions have been linked to sleep disorders. These conditions include heart failure, heart disease, obesity, diabetes, high blood pressure, stroke or transient ischemic attack (mini-stroke), depression, and attention-deficit hyperactivity disorder (ADHD).
Common Signs of a Sleep disorder
Look over this list of common signs of a sleep disorder, and talk to your doctor if you have any of them on three or more nights a week:
- • It takes you more than 30 minutes to fall asleep at night.
- • You awaken frequently in the night and then have trouble falling back to sleep again.
- • You awaken too early in the morning.
- • You often don’t feel well rested despite spending 7–8 hours or more asleep at night.
- • You feel sleepy during the day and fall asleep within 5 minutes if you have an opportunity to nap, or you fall asleep unexpectedly or at inappropriate times during the day.
- • Your bed partner claims you snore loudly, snort, gasp, or make choking sounds while you sleep, or your partner notices that your breathing stops for short periods.
- • You have creeping, tingling, or crawling feelings in your legs that are relieved by moving or massaging them, especially in the evening and when you try to fall asleep.
- • You have vivid, dreamlike experiences while falling asleep or dozing.
- • You have episodes of sudden muscle weakness when you are angry or fearful, or when you laugh.
- • You feel as though you cannot move when you first wake up.
- • Your bed partner notes that your legs or arms jerk often during sleep.
- • You regularly need to use stimulants to stay awake during the day.
Also keep in mind that, although children can show some of these signs of a sleep disorder, they often do not show signs of excessive daytime sleepiness. Instead, they may seem overactive and have difficulty focusing and concentrating. They also may not do their best in school.
Tips for Getting a Good Night’s Sleep
- » Stick to a sleep schedule. Go to bed and wake up at the same time each day. As creatures of habit, people have a hard time adjusting to changes in sleep patterns.
- » Exercise is great, but not too late in the day. Try to exercise at least 30 minutes on most days but not later than 2–3 hours before your bedtime.
- » Avoid caffeine and nicotine. Coffee, colas, certain teas, and chocolate contain the stimulant caffeine, and its effects can take as long as 8 hours to wear off fully. Therefore, a cup of coffee in the late afternoon can make it hard for you to fall asleep at night. Nicotine is also a stimulant, often causing smokers to sleep only very lightly. In addition, smokers often wake up too early in the morning because of nicotine withdrawal.
- » Avoid alcoholic drinks before bed. Having a alcoholic beverage before sleep may help you relax, but usually robs you of deep sleep, keeping you in the lighter stages of sleep. Heavy alcohol ingestion also may contribute to impairment in breathing at night. You also tend to wake up in the middle of the night when the effects of the alcohol have worn off.
- » Avoid large meals and beverages late at night. A light snack is okay, but a large meal can cause indigestion that interferes with sleep. Drinking too many fluids at night can cause frequent awakenings to urinate.
- » If possible, avoid medicines that delay or disrupt your sleep. Some commonly prescribed heart, blood pressure, or asthma medications, as well as some over-the-counter and herbal remedies for coughs, colds, or allergies, can disrupt sleep patterns. If you have trouble sleeping, talk to your doctor to see whether any drugs you’re taking might be contributing to your insomnia and ask whether they can be taken at other times during the day or early in the evening.
- » Don’t take naps after 3 p.m. Naps can help make up for lost sleep, but late afternoon naps can make it harder to fall asleep at night.
- » Don't discuss emotional issues right before bedtime.
- » Relax before bed. Don’t overschedule your day so that no time is left for unwinding. Stop working on any task an hour before bedtime to calm your brain. A relaxing activity, such as reading or listening to music, should be part of your bedtime ritual. Learn a relaxation technique like meditation or progressive relaxation.
- » Keep pets outside your sleeping area if you can.
- » Take a hot bath before bed. The drop in body temperature after getting out of the bath may help you feel sleepy, and the bath can help you relax and slow down so you’re more ready to sleep.
- » Have a good sleeping environment. Get rid of anything in your bedroom that might distract you from sleep, such as noises, bright lights, an uncomfortable bed, or warm temperatures. You sleep better if the temperature in the room is kept on the cool side. A TV, cell phone, or computer in the bedroom can be a distraction and deprive you of needed sleep. Having a comfortable mattress and pillow can help promote a good night’s sleep. Individuals who have insomnia often watch the clock. Turn the clock’s face out of view so you don’t worry about the time while trying to fall asleep.
- » Have the right sunlight exposure. Daylight is the key to regulating daily sleep patterns. Try to get outside in natural sunlight for at least 30 minutes each day. If possible, wake up with the sun or use very bright lights in the morning. Sleep experts recommend that, if you have problems falling asleep, you should get an hour of exposure to morning sunlight and turn down the lights before bedtime.
- » Don’t lie in bed awake. If you find yourself still awake after staying in bed for more than 20 minutes or if you are starting to feel anxious or worried, get up and do some relaxing activity until you feel sleepy. The anxiety of not being able to sleep can make it harder to fall asleep.
- » See a doctor if you continue to have trouble sleeping. If you consistently find it difficult to fall or stay asleep and/ or feel tired or not well rested during the day despite spending enough time in bed at night, you may have a sleep disorder. Your family doctor or a sleep specialist should be able to help you, and it is important to rule out other health or psychiatric problems that may be disturbing your sleep.
Top 10 Sleep Myths
Myth 1: Sleep is a time when your body and brain shut down for rest and relaxation.
Facts: No evidence shows that any major organ (including the brain) or regulatory system in the body shuts down during sleep. Some physiological processes actually become more active while you sleep. For example, secretion of certain hormones is boosted, and activity of the pathways in the brain linked to learning and memory increases.
Myth 2: Getting just 1 hour less sleep per night than needed will not have any effect on your daytime functioning.
Facts: This lack of sleep may not make you noticeably sleepy during the day. But even slightly less sleep can affect your ability to think properly and respond quickly, and it can impair your cardiovascular health and energy balance as well as your body’s ability to fight infections, particularly if lack of sleep continues. If you consistently do not get enough sleep, a sleep debt builds up that you can never repay. This sleep debt affects your health and quality of life and makes you feel tired during the day.
Myth 3: Your body adjusts quickly to different sleep schedules.
Facts: Your biological clock makes you most alert during the daytime and least alert at night. Thus, even if you work the night shift, you will naturally feel sleepy when nighttime comes. In some cases, over a period of time, it is possible to adjust to a substantial change in your sleep–wake cycle—for example, when traveling across several time zones or switching from working the day shift to the night shift.
Myth 4: People need less sleep as they get older.
Facts: Older people don’t need less sleep, but they may get less sleep or find their sleep less refreshing. That’s because as people age, the quality of their sleep changes. Older people are also more likely to have insomnia or other medical conditions that disrupt their sleep.
Myth 5: Extra sleep for one night can cure you of problems with excessive daytime fatigue.
Facts: Not only is the quantity of sleep important, but also the quality of sleep. Some people sleep 8 or 9 hours a night but don’t feel well rested when they wake up because the quality of their sleep is poor. Additionally, one night of increased sleep may not correct multiple nights of inadequate sleep.
Myth 6: You can make up for lost sleep during the week by sleeping more on the weekends.
Facts: Although this sleeping pattern will help you feel more rested, it will not completely make up for the lack of sleep or correct your sleep debt. This pattern also will not necessarily make up for impaired performance during the week or the physical problems that can result from not sleeping enough. Furthermore, sleeping later on the weekends can affect your biological clock, disrupting your regular sleeping pattern.
Myth 7: Naps are a waste of time.
Facts: Although naps are no substitute for a good night’s sleep, they can be restorative and help counter some of the effects of not getting enough sleep at night. But avoid taking naps later than 3 p.m., particularly if you have trouble falling asleep at night. Also, limit your naps to no longer than 20 minutes, because longer naps will make it harder to wake up and get back in the swing of things. If you take more than one or two planned or unplanned naps during the day, you may have a sleep disorder that should be treated.
Myth 8: Snoring is a normal part of sleep.
Facts: Snoring during sleep is common, particularly as a person gets older. Evidence is growing that snoring on a regular basis can make you sleepy during the day and increase your risk for diabetes and heart disease. Loud, frequent snoring also can be a sign of sleep apnea, a serious sleep disorder that should be evaluated and treated.
Myth 9: Children who don’t get enough sleep at night will show signs of sleepiness during the day.
Facts: Unlike adults, children who don’t get enough sleep at night typically become hyperactive, irritable, and inattentive during the day. They also have increased risk of injury and more behavior problems, and their growth rate may be impaired.
Myth 10: The main cause of insomnia is worry.
Facts: Although worry or stress can cause a short bout of insomnia, a persistent inability to fall asleep or stay asleep at night can be caused by a number of other factors. Certain medications and sleep disorders can keep you up at night Medical conditions with symptoms that tend to be troublesome at night can cause sleeping problems..
How To Discuss Sleep With Your Doctor
Doctors might not detect sleep problems during routine office visits because patients are awake. Thus, you should let your doctor know if you think you might have a sleep problem.
For example, talk with your doctor if you often feel sleepy during the day, don't wake up feeling refreshed and alert, or are having trouble adapting to shift work.
To get a better sense of your sleep problem, your doctor will ask you about your sleep habits. Before you see the doctor, think about how to describe your problems, including:
- • How often you have trouble sleeping and how long you've had the problem
- • When you go to bed and get up on workdays and days off
- • How long it takes you to fall asleep, how often you wake up at night, and how long it takes you to fall back asleep
• Whether you snore loudly and often or wake up gasping or feeling out of breath
• How refreshed you feel when you wake up, and how tired you feel during the day
• How often you doze off or have trouble staying awake during routine tasks, especially driving
Your doctor also may ask questions about your personal routine and habits. For example, he or she may ask about your work and exercise routines. Your doctor also may ask whether you use caffeine, tobacco, alcohol, or any medicines (including over-the-counter medicines).
To help your doctor, consider keeping a sleep diary for a couple of weeks (See a sample sleep diary below).
Sample Sleep Diary