Believe it or not, sleep is not the body and brain shutting down for the night. Rather than the passive process we've often thought sleep to be, it's actually a highly active process. The brain and all the major organs function actively in different ways while we sleep. Probably it's obvious, but the side effect of the sleeping process is—or should be—that we feel recharged physically and mentally after a long period of mostly uninterrupted rest.
Why do we sleep?
It's harder to confirm the reasons behind why we sleep because researchers are still making discoveries in this arena. However, there are some theories which could sensibly explain the purpose of sleep:
- We sleep in order to allow the body to restore itself after a day's worth of stress
- We sleep in order to allow the brain to consolidate all the information it has processed during the day
- We sleep in order to "recharge the battery"
- Human beings possess several "drives" which allow us to survive from day to day, including not only drives for thirst, sex, and hunger, but sleep as well
- The brain requires sleep in order to remain "plastic" or flexible to processing new stimuli
- Anatomical and Biological Activity of Sleep || Sleep Diagnosis and Therapy
- Switch Identified That Says It's Time to Sleep || Medical News Today
- Sleep: The Clean-up Crew of a Dirty Mind || Psychology Today
What happens if we don't sleep well?
If we do not receive good quality sleep on a regular basis, our general physical health can be compromised over time. Listed below are just some of the things that can happen to the human body when it doesn't get the quality sleep it needs to function.
- Cognitive functions such as judgment, multitasking, decision-making, and performance can slip, leading to vehicle or personal accidents of all kinds
- Learning ability and memory can lose functionality
- Sex drive can decrease
- Hunger drive can increase
- Depression and anxiety can develop
- The skin can lose its color, tone, and elasticity prematurely
- Odds for developing significant chronic health conditions can increase exponentially
- Energy needed to perform activities of daily living can be seriously reduced
- Mood swings and general irritability can increase
- Physical efforts can be diminished
- Physical recovery from illness and injury can be delayed
- Amounts of human growth hormone (HGH), necessary to good health, can become severely deficient
- Metabolism can slow down
- Pain can become difficult to tolerate
- Inflammation can be more difficult to treat
- Immune system function can become compromised
Just like sleep quality, if you don't get the proper quantity of sleep, day after day, you develop what is known as sleep debt. This can lead to permanent problems with daytime sleepiness, cognitive function, and many, if not all, of the same problems listed above. Sleep is not optional for human health; it is as critical to daily function as drinking water, eating enough food, and getting an adequate amount of exercise.
Who might be more prone to having a sleep disorder?
Anyone can have a sleep disorder. It is inaccurate to suggest that only older, male, overweight individuals or people with emotional problems are more likely to have sleep problems. Sleep disorders have multiple root causes: imbalances in body and/or brain chemistry; crowded airway physiology; other coexisting conditions; drug interactions and/or side effects; lifespan-related processes like adolescence, pregnancy, and menopause; mental health issues; poor management of stress. Infants and children can and do suffer from sleep disorders. Even healthy, fit individuals can have sleep disorders. The good news is that nearly 100 percent of all sleep problems are treatable.
How can I find out if I have a sleep disorder?
The best protocol for discovering any issues you might have with sleep is this:
- Keep a sleep diary. Include bedtimes and rise times; information about consumption of food, water, caffeine products, medications, nicotine products, other drugs; details about emotional or physical upsets during the day which might impact sleep; daily symptoms that you think might be related to poor sleep; accidents or other incidences which might be traced to a sleep problem; information given to you by loved ones and/or sleep partners such as breathing, talking or movement behaviors while asleep. Be vigilant about updating this daily for at least two weeks. Then,
- Talk to your primary care physician. Show them your sleep diary. Discuss your concerns. You will need their referrals for any kind of investigation into your sleep problems.
- Follow your doctor's lead. You might be asked to perform a home- or lab-based sleep test. You might be asked to have other tests done, or visit other specialists, including pulmonologists, ear-nose-throat specialists, or psychiatrists. You may be asked to switch up some medications or work more closely with your pharmacist to avoid drug interactions or side effects which might be part of the problem.
- Follow through on all tests. This is critical! It seems obvious, but if you don't complete these tests, your doctors will not be able to identify your sleep problems conclusively and, therefore, cannot suggest treatments. You will need a doctor's prescription for nearly every sleep-related treatment out there, not just for medications, but for alternative therapies and medical equipment.
- Adhere to your treatment plan. Work closely with your doctors to make sure you get all its benefits and, if you struggle with compliance, ask for help. There are lots of tips and tricks for making therapies like CPAP or bright light treatment work for you, for instance.
What can I do to improve my sleeping habits?
Sleep hygiene is the first place to start. This involves numerous nonpharmaceutical (nondrug) practices, habits, and/or therapies for improving sleep, including the following:
- Improve your sleeping space. It should be a comfortable temperature, dark and quiet, with little chance for interruption from environmental stimuli or other people or animals.
- Use an eye mask, ear plugs, fans and/or white noise machines to correct for encroaching environmental stimuli in your sleeping space, if necessary.
- Consider the value of sleeping with pets or children if they disrupt your sleep regularly.
- Turn off electronics with screens one hour before bedtime to allow your brain to generate natural sleep hormones (i.e., melatonin) which can help you fall asleep. Electronics like smartphones, iPads, and laptops are typically backlit and emit blue spectrum light, which automatically turns off the pineal gland, the organ responsible for melatonin production. Even 10 minutes spent checking your email can have a major impact on your ability to fall asleep. Also, all of these devices can create stimulating distractions which make it hard to shut the brain down.
- Do not eat heavy meals right before bed.
- Do not exercise heavily right before bed.
- Do not have a nightly "nightcap." Alcohol may help some people fall sleep, but once it is metabolized, the body goes through a withdrawal period. This severely disrupts your sleep architecture in such a way that the body cannot get enough deep sleep necessary for optimal health.
- Avoid caffeinated or stimulant products before bed.
- Don't smoke 30 minutes before bed; nicotine may help you to relax, but it also simultaneously stimulates certain areas of the brain.
- Research shows that marijuana before bedtime has a detrimental effect on sleep quality. It is prudent to avoid using this drug specifically as a sleep aid.
- Taking over-the-counter sleep melatonin may or may not be useful, as it requires careful dosing and timing.
- Taking over-the-counter herbal sleep preparations (chamomile, skullcap, valerian, for example) may or may not be useful and can possibly generate dangerous interactions with your current medications or give you other side effects.
- Make sure you take your daily medications at the right time of day. For instance, it might be better to take a diuretic in the morning while you are awake, rather than at bedtime when you will be more likely to need to use the bathroom. SSRI antidepressants can wreak havoc on your REM sleep, so you might be better off taking it in the morning. Some women report birth control pills taken at bedtime give them morning nausea.
- Avoid stimulating activities and find ways to wind down and de-stress before you go to bed so that you can calm a racing mind well before your head hits the pillow.
- Go to bed at regular times as your lifestyle allows. It is important to go to bed at night when you are tired, but to rise everyday at more or less the same time. Doing so corrects any problems with your circadian rhythms.
- If you have untreated health issues, get help for them. Pain, discomfort, and restrictions to breathing can all have long-term negative impacts on your sleeping habits.
- Make sure your bed and pillow are comfortable and replace mattresses and pillows which are no longer supportive.
- Identify any allergies you have, such as to pet dander or dust mites, and use hypoallergenic products to improve your sleeping environment.
- Avoid napping during the day unless you have been ill or need to sleep to address chronic fatigue. Your wakefulness during the day is one of the key factors in developing your nighttime "sleep drive;" napping cuts into your sleep drive and can mean sleepiness at night will be delayed.
Where can I go for more information?
>>> Here are some great resources for sleep hygiene and other tips for sleeping better:
- SleepyHeadCENTRAL Sleep Hygiene page
- American Academy of Sleep Medicine Sleep Education Sleep Hygiene page
- The Centers for Disease Control Sleep and Sleep Disorders page
- Healthy People 2020 Sleep Health page
- National Sleep Foundation page
- The Sleep Well, Stanford University