Everything You Ever Wanted to Know About Sleep

Sleep is the golden chain that ties health and our bodies together.”
– Thomas Dekker

Who needs sleep?

You have too much to do. Nighttime is the only time you have to yourself. Staying up late gives you more time to chill out.

But sleeping well is like eating well. If you don’t do it, your body will pay.

Your body needs sleep like it needs food and exercise. During sleep, your brain does some pretty amazing things. It rids itself of toxic waste, stores new information, communicates and reorganizes nerve cells, and repairs cells and restores energy.

If sleep is that important for survival, why is it such a struggle to get enough sleep? We’ll delve into some of the more surprising reasons in just a bit.

In general, we found that people reported that their sleep is affected by stress (47.1%), an uncomfortable mattress (49.1%), and physical discomfort (48%).

Even though the CDC recommends 7 to 9 hours of sleep a night for adults, nearly half of people report getting that much sleep less than half of each week. Nearly 30% of people report NEVER getting enough sleep.

Interestingly, where you live can affect your sleep patterns. The CDC reports that in the state of Kentucky, anywhere from 37% to 60% of adults get less than 7 hours of sleep per night. In Iowa, people are getting more sleep, with only 24% to 31% of adults getting less than seven hours

It’s safe to say that Americans aren’t getting enough sleep. But why?

Perhaps because we don’t know enough about sleep. It’s time to distinguish the facts from fiction.

Common Sleep Myths

Myth: Drinking alcohol helps to improve sleep.
Alcohol can, in fact, help people fall asleep quicker. But don’t run out and buy a bottle of wine for a nightcap just yet!

Consuming alcohol before bed actually reduces REM (rapid eye movement) sleep. This is the stage of sleep thought to provide much-needed restoration. If you’ve ever woken up from a night’s sleep and felt drowsiness or poor concentration throughout the day, it’s quite possible you did not get enough REM sleep. Drinking alcohol before bed will not improve sleep quality.

Myth: Getting 5 hours of sleep a night is plenty.
Think again! Studies show that the body’s ability to function declines without sleep in the 7 to 8-hour range.

Myth: If you can’t sleep, stay in bed until you fall asleep.
Have you ever tossed and turned endlessly, counted sheep, stared at the ceiling, and anything else you could think of to try and fall asleep? We’ve all been there.

At some point, it makes sense to get up and then try again later. This way, your brain always correlates the bedroom environment with sleep, which will make it easier for you to fall asleep on a regular basis.

If you do get up, focus your attention on relaxing activities like reading, listening to music, meditating, or other relaxation techniques. Then try going back to bed.

What Causes People to Lose Sleep?

Resolving sleeplessness isn’t always as as simple as avoiding alcohol or getting up for a while and practicing a relaxing activity. For some, there are factors that make sleeplessness a relentless reality.

Let’s talk about some conditions and factors that may be keeping you or someone you love from restful sleep.

Sleep Apnea

The Mayo Clinic describes sleep apnea as a potentially serious disorder in which breathing repeatedly stops and starts. There are three main types: obstructive sleep apnea, central sleep apnea, and complex sleep apnea syndrome.

It is necessary to see a doctor to be properly diagnosed with sleep apnea. However, there are some things you can watch out for, like loud snoring, awakening to a dry mouth and headache, insomnia, lack of focus, irritability, and if someone tells you that they noticed you stop breathing at times during sleep.

Sleep apnea occurs in around 25% of men and nearly 10% of women.
People with sleep apnea are at higher risk for car crashes, work-related accidents, and other medical problems.
Sleep apnea is quite common in people with type 2 diabetes. In fact, 80% of people with type 2 diabetes may have obstructive sleep apnea. It’s hard to distinguish cause and effect, as sleeplessness can keep your body from using insulin properly.
Obesity raises a person’s risk factor for both sleep apnea and diabetes. We’ll talk more about the sleep-obesity link in a moment.

RLS

RLS is also known as restless legs syndrome and may be caused by abnormalities in the brain’s production of the neurotransmitter dopamine.

People with RLS often experience a “creeping” sensation in the lower legs and aches and pains throughout the legs. These sensations are often heightened when the legs are still (i.e., when you’re sleeping!) and relieved only when the legs are moving.

Because of the wide range of symptoms, the prevalence of RLS is not fully known, though studies suggest it can range anywhere from 2% to 15% of the population.
We do know that the prevalence of RLS is higher in women than in men and that there is an increasing prevalence with age.
In age brackets from below 30, to ages 30-79, to ages over 80, the prevalence of RLS climbs from 3% to 19%.

While not all people who suffer from RLS have these underlying conditions, it is important to note that in many studies, people with conditions like cardiovascular disease, coronary artery disease, heart problems, and high BMA were twice as likely to have RLS than those without those conditions.

The nature of RLS symptoms can make it difficult to achieve a full night’s rest without interruptions. It is no surprise that there is a distinct association between RLS and insomnia.

Studies show that people with RLS are two to three times more likely to report DIS (Difficulty Initiating Sleep), DMS (Difficult Maintaining Sleep), and NRS (Non-restorative Sleep) than non-RLS subjects.

Fibromyalgia

Fibromyalgia is a musculoskeletal condition that is not easily explained or easily treated. Some scientists believe it is related to heightened activity of the central nervous system or, in other words, how the brain processes information about pain.

Because much is still unknown about fibromyalgia, it can be difficult to diagnose and may be confused with other conditions like hypothyroidism, rheumatoid arthritis, and lupus.

It is believed that somewhere between 1% to 5% of the population, predominantly women, suffer from fibromyalgia.
Women are twice as likely to have fibromyalgia as men, representing 90% of people with the condition.
In a survey of fibromyalgia patients, 67% said they rarely slept well.

Is it the pain that is causing the lack of sleep, the lack of sleep that is causing the pain, or both?

While it’s probably a combination of both, we do know that lack of sleep or poor quality sleep makes it physically and cognitively more difficult to deal with pain.

Weight

Being overweight also has a detrimental effect on sleep quality, and poor sleep quality can have a detrimental effect on weight.

Being overweight or obese is associated with an increase in disease, like diabetes, heart disease, and cancer, and a decrease in mental health and quality of life.
Studies show that the likelihood of obesity is higher for those getting less than 6 hours per night of sleep.
Infants and children who sleep fewer hours are more likely to be obese later in life.

Sleep deprivation changes the way the body reacts to and processes glucose. Studies show people getting less sleep have reduced glucose tolerance, reduced glucose effectiveness, and acute insulin response to glucose. Reduced glucose control in the body can contribute to obesity.

Some researchers believe that ineffective sleep or sleep deprivation may increase hunger and/or decrease the energy that is burned.

One study showed that young men who were deprived of sleep produced higher levels of ghrelin, the appetite-stimulating hormone, and lower levels of leptin, the satiety-inducing hormone. Sleep deprivation made them feel hungry more often and not feel full as quickly.

If you’ve ever been super-tired or sleep-deprived, you can probably relate when we say that lack of sleep can also result in less physical activity and poor food choices. When you’re exhausted, grabbing something on-the-go seems more doable than making a healthy meal. Sticking to an exercise routine can also be more challenging when you are tired.

This is also a relevant issue for people who work swing shifts or rotate day and night shifts. When our sleep schedules are not consistent, especially when it comes to the time of day and daylight present, our circadian rhythm is affected and may increase the likelihood of gaining weight.

Joint Pain

As Dr. Kevin Fontaine from Johns Hopkins University puts it, “There’s a reciprocal relationship between pain and poor sleep.”

People with more pain generally sleep less, and people who sleep less generally have more pain.

There are different types of joint pain. Some joint pain is called arthralgia and defined as joint stiffness. Arthritis is inflammation of a joint. Both may include pain and swelling, but arthritis is most likely to include things like swelling, joint deformation, loss of bone and cartilage, and intense pain.

While rheumatoid arthritis (RA) is a form of arthritis, the cause behind it and the more common arthritis, osteoarthritis (OA), is quite different. OA is caused when the cartilage between your joints deteriorates. RA is an autoimmune disease where your immune system sees your joints as “enemies” in your body and attacks them.

Only 20% of RA patients report getting good sleep.
The reports of sleep disturbance in people with RA are two to three times as high as the rest of the population.
31% of arthritis patients report difficulty falling asleep and 81% report difficulty staying asleep.

While some types of joint pain may cause more difficulty sleeping than others, all joint pain can have a negative effect on sleep quality.

Emotional Trauma

Emotional trauma occurs when unusually stressful events create a sense of fear, helplessness, and insecurity.

Even when there is no physical harm involved, emotional trauma can be present and very powerful. Emotional trauma can occur at any point in life, during childhood or adulthood.

For some, the trauma is so intense that it results in PTSD (post-traumatic stress disorder) that can occur immediately or even weeks or years down the road.

If you or someone you love have ever encountered emotional trauma and/or PTSD, you’ve seen how it affects sleep. Some people sleep more. Others stop sleeping.

A study of Vietnam veterans with PTSD showed that 44% of them said they had difficulty falling asleep at night. In the same study, only 9% of Vietnam veterans without PTSD said they had difficulty falling asleep.
Another study found that 70 to 91% of PTSD patients reported difficulty falling asleep or staying asleep, while 19 to 71% reported sleep disturbances from nightmares.

PTSD symptoms may be worse at night, due to nightmares, flashbacks, increased movement, sleep talking, and/or feeling anxious and on edge.

But we need to sleep after emotional trauma in order to heal. One study concluded that “sleep may have a protective effect on the aftermath of traumatic experiences.”

Another study further validated those results by assessing the quantity and quality of REM sleep after a traumatic event. They concluded a correlation between REM sleep after trauma and the presence of PTSD symptoms later on.

While emotional trauma can have a negative effect on sleep, it is profoundly important to get a good night’s sleep in order to cope, heal, and potentially avoid long term effects.

If you or someone you love have experienced emotional trauma and are having difficulty sleeping, it is important to see a medical professional.

Mental Health Conditions

Thankfully, over the past several years, there has been an increase in social awareness surrounding mental health.

Mental health conditions like depression, anxiety, bipolar disorder, eating disorders, obsessive-compulsive disorders, dissociative disorders and more, can be complicated, because we can’t see them like we can see physical issues.

Just as with anything that puts our normal health and wellness off-balance, poor mental health can cause issues with sleep. Nearly 50% of insomnia cases reported are associated with anxiety, depression, or psychological stress.

Sleep deprivation affects an individual’s psychological state and mental health.
Depressed patients who aren’t getting adequate sleep are less likely to respond favorably to treatment than those who get adequate sleep.
The Office of Women’s Health reports that people with insomnia are 10 times more likely to have depression, and 17 times more likely to have anxiety.
65% to 90% of adults with major depression experience some kind of sleep problem.
During the COVID-19 pandemic, the number of prescriptions filled per week for antidepressant, anti-anxiety, and anti-insomnia medications increased by 21%.

Who Isn’t Getting Enough Sleep?

Seniors

While there are many things that improve with age, sleep is unfortunately not one of them.

The quality of our sleep changes as we age. There are a wide variety of factors that may cause seniors to struggle.

With aging, less time is spent in restorative REM sleep. A lack of REM sleep can result in feeling less rested and energized the following day.

Additionally, because older people spend less time in deep sleep, they also tend to wake up more frequently. Older people wake up an average of 3 to 4 times each night due to light sleeping, need to urinate, anxiety, discomfort, or pain.

Studies suggest that from mid-life until the eighth decade, total sleep time decreases on average by 27 minutes per decade. That means if, at age 50, a person sleeps 8 hours per night, by age 80 they will sleep around 6 and 1/2 hours per night.

While there are many reasons an older person may have difficulty sleeping, disruptions in the circadian rhythm also have a big impact on the sleep-wake cycle.

The two most influential external cues that help keep the circadian rhythm in check are light and melatonin.

With aging comes a gradual reduction of melatonin production. Additionally, studies show that elderly patients spend too little time in daylight. The reduction of exposure to daylight may cause disruptions to the circadian rhythm and therefore disruptions to sleep.

Menopause

Any major hormonal changes can wreak havoc on good night’s sleep. When menopause occurs, a woman’s ovaries stop producing estrogen and progesterone, and sleep problems may result.

40 to 56% of women in the menopausal transition and postmenopause report sleep difficulties.
47% to 67% of postmenopausal women are reported to suffer from OSA.
Women with moderate to severe hot flashes are almost 3 times more likely to report waking up frequently during sleep than women without hot flashes.

There are a few main reasons menopause can have a detrimental effect on sleep.

Hot flashes are a biggie. In some women, hot flashes can last an average of 7.4 years and are a true disruptor of quality rest.

In addition to hot flashes, menopausal women often experience weight gain, RLS (restless leg syndrome), periodic leg movement syndrome, and obstructive sleep apnea. Weight gain after menopause may contribute to significantly increased levels of obstructive sleep apnea in women.

Women

Sorry, ladies, but data shows that women may be more likely than men to have insomnia.

In addition to menopause, women experience a variety of unique hormonal changes throughout life that can contribute to insomnia.

25% of US women experience insomnia symptoms, compared to 20% of men.
Health problems that cause secondary insomnia are to be more prevalent in women, like depression, anxiety, and fibromyalgia.
Many women report sleep disruption in the days leading up to their period, during pregnancy, and then again during perimenopause.

While women may win the insomnia challenge, sociological factors also play a role in gender differences in sleep, including work and family roles, restricted exercise time, and more. Paid work tends to increase for men when they form relationships and/or become parents, which may leave them less time to sleep.

Studies show that men and women value sleep differently. Men often understand sleep as an “unfortunate necessity” while women are more likely to take sleep recommendations into consideration and practice healthy habits.

Parenthood

We’ve all probably heard it said that when you decide to have children, you are giving up sleep for at least 18 years. Parenthood definitely has an impact on sleep.

On average, each new parent loses a staggering 109 minutes of sleep every night for the first year after having a baby.”

Lost sleep may be a result of getting up two to three times each night, for 20 minutes or longer each time, for things like feedings, diaper changes, and soothing a crying baby.

If you are breastfeeding, you may get to enjoy an average of 40 to 45 more minutes of sleep than parents who are formula feeding. That might not sound like a lot, but when you are already losing 109 meetings of sleep every night, that extra 40 to 45 minutes can go a long way.

While both men and women have their sleep patterns affected by a new baby, one study showed that working fathers experience less sleep disruption than non-working fathers.

This could be in part due to mothers protecting the sleep of the working father. In around 15% of cases, working fathers slept in a separate room to ensure sufficient sleep for work the next day.

College Students

College is an exciting time in a young person’s life, but for most it requires an adjustment period that can be difficult.

The college student statistics paint a concerning picture:

44% of college students experience symptoms of depression, 50% struggle with anxiety, and 80% feel overwhelmed by academic responsibility.
36% of young adults get less than 7 hours of sleep per night and 14% average less than 6 hours per night.
For many college students skipping sleep, two weeks of getting 6 hours or less per night have students feeling and performing like they had gone without sleep for 48 hours.

You might have heard the myth that young people don’t need as much sleep as older adults. However, experts recommend 7 to 9 hours of sleep for young adults, just as they do for older adults.

Work

Are you trading sleep for work? Studies show that many people are.

More than a third of Americans report getting less than 7 hours of sleep during the week. That leaves them exhausted by the weekend and sleeping longer hours in an attempt to catch up.

Whether you’re burning the midnight oil on a project with a fast-approaching deadline or laying in bed thinking about how to solve a work-related problem, you are not doing yourself or your work any favors.

In addition to fatigue, poor concentration, and lack of focus, sleep deprivation or insufficient sleep is closely tied with obesity, high blood pressure, diabetes, and an increased risk of fatal automobile accidents.

Work is reported as the activity most likely to compete with sleep, followed by commuting to and from work.
Around half of all CEOs get less than 6 hours of sleep per night. Startup founders get even less.
Shift workers are more likely to have negative effects on sleep, physiological sleepiness, and accident risk

Those who do shift work may also see a negative impact on sleep. As we’ve talked about previously, shift work can have an effect on circadian rhythms and when the circadian rhythm gets out of whack, so does sleep.

A study discovered that shift workers are more likely to have negative effects on sleep, subjective and physiological sleepiness, performance, and accident risk. They are also at increased risk of cardiovascular disease and certain types of cancer.

Teenagers

Have you been struggling with behavioral and/or performance issues from your adolescent child?

While there may be many reasons for these issues, first ask yourself if your child is getting proper sleep.

The American Academy of Sleep Medicine recommends these guidelines: children 6 to 12 years old should regularly sleep 9 to 12 hours every 24 hours, while teenagers aged 13 to 18 should sleep 8 to 10 hours in 24 hours.

57% of middle school students and 73% of high school students do not get enough sleep on school nights
A study of 28,000 high school students showed that each hour of sleep lost per night was associated with a 38% increase in feeling sad or hopeless, and an increase in strong depression symptoms. Even scarier, the lost sleep was associated with a 58% increase in suicide attempts.
Another study shows that teens who get less than 5 hours of sleep a night have an increased risk for obesity, drunk driving, weapon carrying, fighting, contemplated suicide, smoking, alcohol use, binge drinking, marijuana use, sexual risk-taking, and texting while driving.

It may seem like teens just don’t want to sleep! But the data shows that, when given 10 hours of sleep-opportunity, they slept an average of 9 and a quarter hours.

This may be a time when their minds say one thing, but their bodies and health say something much different. It is critical to their growth and success that children get adequate sleep.

How Not Sleeping is Affecting Your Health

We’ve talked about how lack of sleep has many different outcomes on us, mentally, physically, and emotionally. There is no shortage of ways that sleep deprivation negatively affects us. Let’s take a look at the most common.

Life Expectancy

While this doesn’t mean that sleep deprivation will definitely lead to an early death, the risk of early death increases as a result of sleep deprivation.

In addition to the increased risk for diseases that can ultimately affect life expectancy, a 2014 study showed that people getting even 6 hours of sleep per night had a 33% higher chance of having a car crash. In another study, it was found that people who slept less than 7 hours per night had a 24% higher risk for death.

Hypertension

Hypertension (or high blood pressure) can be an effect of sleep deprivation. This is especially tied to individuals who are not getting enough sleep and under pressure or stress in their lives.

Let’s face it, we’ve all had a stressful day followed by a sleepless night followed by another stressful day. Studies show that when participants were fatigued and put in stressful situations, their systolic blood pressures climbed about 10 points higher than when they did the same task well-rested. Hypertension caused by poor sleep is one way that sleep deprivation can lead to cardiovascular disease.

Diabetes

We’ve talked a little bit about individuals with sleep apnea having an increased rate of type 2 diabetes. Research points to the fact that it isn’t the sleep apnea itself causing diabetes, but the poor sleep quality associated with sleep apnea.

Your A1c is a marker of blood sugar control. Even without a condition like sleep apnea, research shows that sleep duration and quality are predictors of A1c levels and that improving those two predictors can improve A1c levels in people with type 2 diabetes.

Weight Gain

Insufficient sleep may cause you to gain weight.

There is a direct connection between sleep and the brain’s regulation of energy expenditure and appetite. Essentially, without proper sleep, your metabolism will not function properly. This may result in increased hunger, less energy expenditure, and then the inevitable weight gain.

The Science of Today’s Sleep Trends

CBD

If you’ve heard much about CBD, or cannabidiol, you are likely familiar with its many reported uses. One of those uses is for sleep improvement.

Your body has an endocannabinoid system, which plays a part in regulating things like mood, appetite, memory, reproductive, fertility, and sleep. CBD is a cannabinoid that many experts believe prevents endocannabinoids from breaking down and thus, improves the regulation of the endocannabinoid system.

Where legally allowed by state law, CBD can be consumed in liquid form through oils and tinctures, inhaled through vaping, taken in pill or capsule form, or eaten in edibles like gummies. If you’d like to give CBD a try for sleep improvement, speak with your doctor first if you are on other medications.

The verdict is still out on CBD’s success in sleep improvement. In one non-controlled study of 72 adults who reported sleep or anxiety issues, 67% of patients had improved sleep scores within the first month after using CBD. Controlled clinical studies are needed to validate that claim.

Melatonin

Your brain produces melatonin on its own. A couple of hours before bedtime, melatonin levels rise and put you into a quiet state that helps to promote sleep.

Melatonin doesn’t cause sleep; it only creates an optimal situation in your body to promote sleep.

Melatonin levels decrease naturally as we age.

When you can’t create the optimal sleep situation – if you have jet lag, an altered sleep schedule, or your body isn’t producing enough melatonin anymore – supplementation may help increase total sleep time, reset the body’s sleep-wake cycle, and reduce the amount of time it takes to fall asleep.

Blue Light Correcting

Is it possible to trick your circadian rhythm into thinking it’s time for sleep by wearing blue light blocking glasses?

Daylight and darkness are triggers for your body’s natural time clock (circadian rhythm). Blue light, which we are exposed to frequently on televisions, laptops, mobile devices, and more, causes your brain to sense daylight and therefore suppresses melatonin production.

Blue light glasses reportedly “stimulate sensors in your eyes to send signals to your brain’s internal clock” by blocking our perception of blue light.

But do they work?

According to one study where the effects of blue light exposure were compared to green light exposure, the blue light suppressed melatonin for about twice as long as the green light. It also shifted circadian rhythms by twice as much.

In another study, one group’s sleep habits with the use of amber (blue-blocking) lenses while the control group’s sleep was assessed without blue blocking. The group using the blue-blocking lenses experienced significant improvement in sleep quality.

Blue light blocking glasses are not FDA regulated, but can be purchased by anyone who wants to try them. Some users report less eye strain during their computer and phone use while using them, while others use them primarily for their sleep time rituals.

Natural Alternatives

Aromatherapy

Aromatherapy is “a holistic healing treatment that uses natural plant extracts to promote health and well-being,” a practice that dates back thousands of years.

One of the many uses of aromatherapy is for sleep improvement. The use of lavender essential oil has been proven to increase sleep quality and reduce anxiety in patients with coronary artery disease. Essential oils can be applied through a diffuser or diluted with a carrier oil and applied to the skin.

Acupuncture

Acupuncture is becoming increasingly popular as a complementary therapy.

Though the quality of the trials is limited and further trials are needed, one study shows acupuncture as superior to medications with increased total sleep duration and even improvement in sleep duration for those taking medications and acupuncture together.

Acupressure

Acupressure is like acupuncture, but without the needles. It operates under the premise that when important channels in the body are blocked that carry energy, pressure to specific points along those channels can help restore homeostasis.

In one study of nursing home residents, acupressure resulted in significant improvement in sleep quality over the control group. The acupressure group also had lower psychological distress levels than the control group.

Sleep Fundamentals

There’s so much more you can do to get a good night’s sleep.

One of the most important things you can do is create the right environment for sleep.

Your bedroom should be a quiet, dark, safe, and comfortable space. Make sure there are no bright lights or blue lights in the bedroom. Remove televisions from the bedroom, keep them covered, or at the very least, keep them powered off at night.

You should also keep the temperature cool and comfortable to promote a better night’s sleep.

Make sure you are sleeping on a mattress that is right for your body. If your mattress is older than 10 years or if you’re experiencing constant discomfort during sleep, it is time to get a new mattress and improve your sleep quality and health.

While there are many sleep treatments available, you may be able to save some time and money by implementing good sleep hygiene.

Good sleep hygiene are habits that promote healthy sleep. It includes things going to bed and waking up at the same time each day, avoiding large meals, caffeine, and alcohol before bedtime, and exercising daily but avoiding exercise close to bedtime.

As we mentioned before, sleep is a biological need like eating, drinking, and breathing.

Our ability to survive and thrive depends on it. Insufficient sleep is detrimental to the human condition in an overwhelming abundance of ways.

By implementing proper sleep hygiene, you can set yourself up for sleep success!

This post was originally published on Slumber Yard.