Sleep is a vital part of our lives, but many of us struggle to get enough of it. According to the American Academy of Sleep Medicine (AASM), 35% of adults in the US report getting less than 7 hours of sleep per night, which falls short of the recommended 7-9 hours for optimal health. Let’s face it, life in the modern age does not make it easy to get enough “Zzzz” on a regular basis. Whether its a busy work schedule, family responsibilities, or electronic devices there seems to always to be a way for life to interfere with sleep. It’s also to important to be aware of certain medical conditions such as sleep apnea or restless leg syndrome that can disrupt sleep. In this article, we’ll explore the science behind sleep and why it’s important, as well as techniques, medications, and supplements that can improve sleep quality.
The Science of Sleep
Sleep is a complex process that involves various stages and cycles. During sleep, our bodies undergo a variety of physiological changes, including changes in brain activity, heart rate, and breathing. The sleep cycle is divided into two main stages: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. During NREM sleep, the body repairs and regenerates tissues, builds bone and muscle, and strengthens the immune system.
NREM sleep is further divided into three stages: N1, N2, and N3. N1 is the lightest stage of NREM sleep lasting 5-10 minutes, during which the brain is still somewhat active, and the person can be easily awakened. In this stage, the body begins to relax, and the breathing becomes slow and regular. N2 is the stage of NREM sleep during which the brain waves continue to slow down, and the body’s temperature drops. Lasting approximately 20-30 minutes, in this stage the person is less responsive to external stimuli and the muscles become more relaxed. N3 is the deepest stage of NREM sleep with a duration of 20-40minutes, during which the brain waves are at their slowest, and the person is difficult to awaken. During the N3 stage the body repairs and regenerates tissues, and growth hormones are released. It is also during this stage that the brain consolidates memories and learns new information.
REM (Rapid Eye Movement) sleep is a stage of sleep during which the brain becomes more active, and the eyes move rapidly. It is characterized by a high frequency of dreaming, muscle atonia (loss of muscle tone), and increased heart rate and blood pressure. REM sleep usually occurs in cycles throughout the night, and its duration increases as the night progresses. REM sleep is a crucial stage of sleep that plays a vital role in many aspects of our physical and mental health. During REM sleep, the brain processes and consolidates memories, regulates emotions, and helps to regulate mood. It is also believed to be essential for brain development and growth, particularly during infancy and childhood. A lack of REM sleep can have significant negative effects on our health and well-being, including impairments in learning, memory, and emotional regulation. REM sleep disorders, such as REM sleep behavior disorder, can also lead to disruptive and potentially dangerous behaviors during sleep.
Mastering your sleep!
With an understanding of the physiology behind sleep let’s take a look at some strategies that can help improve sleep quality and promote better overall health. There are many strategies that can help improve sleep quality; here are some things you can do to get a better sleep tonight:
Sleep hygiene: There are several considerations to make when reviewing your own sleep hygiene and they apply to most people. The following eight suggestions have been proposed from the American Academy of Family Physicians to improve sleep (AAFP): (1) Stick to a regular sleep schedule. Try to go to bed and wake up at the same time every day, even on weekends. (2) Create a sleep-conducive environment. Make sure your bedroom is cool, quiet, and dark. Use comfortable pillows and a supportive mattress. (3) Limit exposure to screens before bedtime. Avoid using electronic devices, such as smartphones, tablets, and computers, in the hour before bed. (4) Avoid large meals, caffeine, and alcohol close to bedtime. Consuming these substances too close to bedtime can interfere with sleep quality. (5) Establish a relaxing bedtime routine. Engage in relaxing activities, such as taking a warm bath or reading a book, to help your mind and body wind down before bed. (6) Get regular exercise. Regular physical activity can help improve sleep quality, but try to avoid exercising close to bedtime. (7) Avoid napping during the day. Daytime napping can interfere with nighttime sleep. (8) Manage stress. Practice stress-reducing techniques, such as meditation or deep breathing, to help manage stress and promote relaxation.
Cognitive behavioral therapy: This type of therapy can help identify and address underlying psychological factors that may be interfering with sleep, especially in those with Insomnia. Cognitive-behavioral therapy (CBT) is a talk therapy that can effectively treat insomnia by identifying and addressing the psychological factors that may be contributing to sleep difficulties. The therapy includes sleep education, stimulus control, sleep restriction, relaxation training, and cognitive restructuring. Research has shown that CBT is more effective than sleep medication in improving sleep quality, duration, and reducing nighttime awakenings. CBT also has longer-lasting effects than medication, and can lead to sustained improvements in sleep up to six months later. CBT is a promising and effective treatment for insomnia that can help individuals address underlying psychological factors to improve their sleep. the American College of Physicians (ACP) recommends CBT as the initial treatment for chronic insomnia in adults, rather than medications. The American Academy of Sleep Medicine (AASM) also recommends CBT as the first-line treatment for chronic insomnia in adults. In addition, the National Sleep Foundation (NSF) recommends CBT as a non-pharmacological treatment option for insomnia.
Supplements: Certain supplements such as melatonin and valerian root may help improve sleep quality, although their effectiveness is not well established. Several dietary supplements have been suggested to improve sleep quality, but their effectiveness is not well established. It is also important to note that the FDA does not regulate dietary supplements in the same way that it regulates medications, so the quality and purity of these supplements can vary widely.
Melatonin is a hormone naturally produced by the body that regulates sleep-wake cycles. A meta-analysis of 19 randomized controlled trials found that melatonin supplementation improved sleep quality in individuals with primary sleep disorders, such as insomnia and delayed sleep phase syndrome. The study concluded that melatonin is a safe and effective treatment for sleep disorders, although optimal dosing and timing require further investigation (Ferracioli-Oda et al., 2013). The Lancet published a randomized controlled trial of 40 individuals with primary insomnia found that 2.5 mg of melatonin per day, administered 2 hours before bedtime significantly improved subjective sleep quality, sleep latency, and total sleep time compared to placebo (Garfinkel et al., 1995).
Valerian root is a plant-derived supplement that has been used for centuries as a sleep aid. A randomized, double-blind, placebo-controlled trial of 27 individuals with insomnia found that valerian root supplementation improved subjective sleep quality and reduced sleep latency compared to placebo. However, the effects were not statistically significant (Leathwood & Chauffard, 1985). A systematic review of 18 randomized controlled trials concluded that valerian root may improve sleep quality and reduce sleep latency in individuals with sleep disorders, although the evidence is limited and conflicting (Bent et al., 2006).
It’s important to note that these strategies should be used in conjunction with advice from a healthcare professional. Certain sleep disorders may require specialized treatment, and some medications and supplements can have side effects or interact with other medications.
Keeping Track
Sleep Tracking and Monitoring: Being aware of how one sleeps can reveal important discoveries. Sleep studies, done both in sleep laboratories and at home, are important for diagnosing sleep disorders and evaluating sleep quality. While traditional sleep studies are conducted in a laboratory where patients stay overnight and a plethora of data is collected about a person’s sleep; at-home studies are becoming more popular due to their convenience and lower cost. The hold up is they require a medical doctor to order and interpret. With modern advancements in wearable technology it is now possible for people to track their own sleep. Tracking sleep can also be an important aspect of maintaining good health and well-being, as sleep plays a crucial role in various physiological and psychological processes. Sleep trackers are becoming increasingly popular as a tool to monitor sleep patterns and improve overall sleep quality. In fact, if you own an Apple Watch then you are already in possession of a powerful sleep monitoring tool. There are other major brand names including FitBit and Garmin offering sleep and health tracking at a range of prices thus making sleep tracking accessible to most. By using a sleep tracker, individuals can gain insight into their sleep patterns, such as the duration and quality of their sleep, the frequency and duration of waking up during the night, and the amount of time spent in different sleep stages. This information can be used to identify potential sleep problems, make lifestyle changes to improve sleep habits, and track the effectiveness of interventions over time. Sleep trackers can also provide motivation for individuals to prioritize sleep and develop healthy sleep habits, which can have positive impacts on overall health and well-being. However, it’s important to note that sleep trackers may not always be accurate, and it’s important to interpret the data with caution and seek professional guidance if needed.
Sleep is a vital part of our lives that plays a critical role in maintaining physical and mental health. By understanding the science of sleep and implementing evidence-based strategies, we can optimize our sleep and improve our overall well-being.
References:
- American Academy of Sleep Medicine. (2015). International Classification of Sleep Disorders – Third Edition (ICSD-3). Darien, IL.
- National Sleep Foundation. (n.d.). Sleep Hygiene. Retrieved from https://www.sleepfoundation.org/articles/sleep-hygiene
- Morin, C. M., & Espie, C. A. (2003). Insomnia: A clinical guide to assessment and treatment. New York, NY: Kluwer Academic/Plenum Publishers.
- American Academy of Family Physicians. (2021). Sleep Hygiene: Tips for Better Sleep. Retrieved from https://www.aafp.org/afp/2021/0115/p121.html
- Ferracioli-Oda, E., Qawasmi, A., & Bloch, M. H. (2013). Meta-analysis: melatonin for the treatment of primary sleep disorders. PloS one, 8(5), e63773. doi:10.1371/journal.pone.0063773
- Garfinkel, D., Laudon, M., Nof, D., & Zisapel, N. (1995). Improvement of sleep quality in elderly people by controlled-release melatonin. The Lancet, 346(8974), 541-544. doi:10.1016/S0140-6736(95)91382-3
- Leathwood, P. D., & Chauffard, F. (1985). Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacology Biochemistry and Behavior, 22(1), 1-4. doi:10.1016/0091-3057(85)90031-X
- Bent, S., Padula, A., Moore, D., Patterson, M., & Mehling, W. (2006). Valerian for sleep: a systematic review and meta-analysis. The American Journal of Medicine, 119(12), 1005-1012. doi:10.1016/j.amjmed.2006.02.026
Disclaimer: The information provided on this website is for general informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The content on this website should not be relied upon as a health or medical advice. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The owners and creators of this website are not responsible for any errors or omissions in the content, nor for any outcomes or consequences arising from the use of the information provided on this website.
