LIFESTYLE MEDICINE: SLEEP
Sleep Better. Live Longer.
The National Institutes of Health describes sleep as a fundamental component of our daily routine, emphasizing the essential role it plays in our ability to function. While sleep health has historically been addressed solely in the context of specific disorders, sufficient sleep is now being recognized as a key lifestyle behavior.
According to NIH sleep experts Dr. Merrill Mitler and Dr. Michael Twery, sleep affects numerous tissues and organ systems, influences intellectual performance and mood, and ultimately impacts our overall health and well-being.
Evidence shows that inadequate sleep increases the risk of developing chronic conditions such as obesity, diabetes, and cardiovascular disease. Sleep deficiency can also cause significant impairment in cognitive function, emotional behavior, and mental resilience. Despite research emphasizing the negative health outcomes of poor sleep, the CDC found that approximately one-third of adults report sleeping less than 7 hours per night in addition to concomitant problems with daily functioning.
The American Academy of Sleep Medicine, Sleep Research Society, National Sleep Foundation, and the Centers for Disease Control and Prevention recommend at least 7 hours per night on a regular basis for adults aged 18 and above. Many individuals, however, struggle to meet this recommendation due to various lifestyle-related factors including occupational stressors, social obligations, and technological distractions. While extrinsic pressures may not always be possible to control, individuals can adapt certain strategies to develop healthy sleep habits.
How do I know if I am getting good sleep?
- Healthy People 2020, a federal initiative from The US Department of Health and Human Services, includes a Sleep Health Objective that promotes sufficient sleep in adults to improve the nation’s health. Both sleep duration and quality of sleep are key to experiencing maximal health benefits. Indicators of high quality sleep include:
- Sleeping more time while in bed (at least 85 percent of the total time)
- Falling asleep in 30 minutes or less
- Waking up no more than once per night; and
- Being awake for 20 minutes or less after initially falling asleep.
The summarized recommendations can serve as simple lifestyle changes to optimize sleep health:
- Follow a consistent sleep schedule. Going to bed and waking up at the same time each day helps to regulate our body’s internal clock. Ensuring adequate light exposure during the day while minimizing bright lights at nighttime also help to maintain a healthy sleep-wake cycle.
- Establish a relaxing bedtime routine. Allow yourself sufficient time to unwind and shift into sleep mode. This could include taking a warm shower or bath, light stretching, or enjoying a warm bedtime drink such as chamomile tea. Meditation and deep breathing techniques can also help balance the autonomic nervous system and promote a state of calmness.
- Maintain an optimal sleep environment. Mattress and pillows should be comfortable and the bedroom should be cool (60-67 degrees). Minimize exposure to bright lights, disruptive noises, and electronic distractions. Avoid stimulating or stressful activities at least 30 minutes (preferably 1 hour) before bedtime.
- Exercise dailyand minimize sitting throughout the day. While vigorous exercise is optimal, even light exercise and increased movement can drastically improve sleep quality. Evening exercise within a few hours of bedtime may hinder sleep quality, however this can vary from person to person.
- Avoid stimulants such as caffeine and cigarettes in the afternoon. Be mindful of alcohol use close to bedtime as this can disrupt sleep quality throughout the night.
- Avoid afternoon naps. If necessary, limit naps to less that 30 minutes and before 3 pm. Although a short power nap (20-30 minutes) can help improve performance during the day, it does not make up for inadequate nighttime sleep and can cause difficulty falling asleep at bedtime.
- Avoid large meals close to bedtime. Heavy foods can trigger indigestion and heartburn that disrupt sleep. Ideally, large meals should be eaten at least 2 to 3 hours before sleep. Light healthy snacks can help satisfy hunger and promote sleep about 45 minutes prior to bedtime.
- If you are having difficulty falling asleep, get out of bed. After about 20 minutes, try doing something relaxing in dim light until you are sleepy. This can help to strengthen the association between bed and sleep.
- If sleep problems persist, consider keeping a Sleep Diary. This can help identify problems with common sleeping patterns, and would be beneficial if you choose to speak with a doctor about your concerns.
Developing a framework to add even small amounts of sleep or restfulness can improve health outcomes and support overall well-being. Health practitioners can guide individuals in managing stressors, implementing lifestyle changes, and balancing medical choices to optimize sleep in the context of a complex life.