Challenge: Go to Sleep
Are you sick and tired of not getting enough sleep? Make some changes in your lifestyle and routine that could get you the rest you need.
How much sleep do you need?
According to Michael Presti, a neurologist and sleep specialist with Providence Medical Group — Medford Neurology, you need different amounts of sleep throughout the different stages of your life. In general, there is an inverse relationship between age and sleep requirements — the older you get, the less you sleep.
Everyone is different, Presti confirms, which is why an individual's sleep requirements may differ from the norm. Still, it's helpful to know what average sleep times are for different age ranges. The normal approximate sleep times per day are 16-plus hours for newborns, 12 to 14 hours for children aged 1 to 3, 11 to 13 hours for children aged 3 to 5, 9 to 11 hours for children aged 5 to 18 and 7 to 9 hours for adults.
Set yourself up to sleep
When people are unable to get an adequate quantity or quality of sleep because of psychological factors, behavioral techniques collectively referred to as sleep hygiene and stimulus control can be extremely effective, Presti explains.
Sleep hygiene refers to optimizing the sleep environment. It includes measures such as creating a quiet, cool, dark sleep setting. It also entails avoiding potentially stimulating foods, drinks, medications or activities in the hours before your desired sleep time. Daytime napping and irregular morning wake times should also be avoided.
Stimulus-control techniques refer to minimizing time spent awake in bed, eliminating alerting influences from the bedroom and only using the bed and bedroom for sleep and intimacy. These techniques are designed to re-establish the bedroom as a sleep-inducing environment, Presti says.
Michael Schwartz, the insomnia education coordinator at the Rogue Valley Sleep Center, has more sleep-inducing tips starting with turning off cell phones and laptops in the bedroom. Their noise can potentially wake you and electronic blue light is the most stimulating to the brain.
Other tips include getting exercise during the day and limiting caffeine and alcohol, which is not a sleep aid. Also, keep a consistent wake time. "It anchors your circadian rhythm — the natural sleep-wake rhythm produced by the brain," Schwartz, a licensed sleep technologist, says. "That consistency with the sleep schedule is very important." You can't make yourself fall asleep at night, he notes, but you can set an alarm to wake you in the morning.
Give yourself time to wind down in the evenings before bedtime. If you wake in the night, don't look at the clock. It just makes you anxious about falling back to sleep. And if you simply cannot fall back to sleep, get up, Schwartz advises. "You want to allow sleep to return," he says. "Do something low light, low noise and low tech."
If you've tried the sleep tactics for more than a month and they just don't work, Schwartz believes it's time to talk with your doctor about your sleep struggle. There could be a medical problem that needs to be addressed. Your doctor might order a sleep study to assess your quality of sleep and determine the problem.
Presti agrees. If the behavioral strategies are not helpful, he recommends seeing a sleep-medicine specialist who can screen for potential causes of sleep disturbance. There are many potential causes of primary sleep disturbances, he notes, such as sleep-disordered breathing, nocturnal movement disorders, nightmare disorder, medication-related disturbances of sleep or other medical reasons that interfere with sleep such as chronic pain and depression. Or your sleep trouble may be age-related. As people get older, they become sleepier earlier in the day and ready to wake earlier in the morning. "These phase shifts occur because of a shift in timing of our hormonal rhythms," Presti says. "When problematic, both advanced and delayed circadian rhythms can usually be effectively treated with a combination of hormonal and light therapies."
Are sleeping pills the last resort? "It depends on the doctor's approach to the issue," Schwartz says. "Sleeping pills are meant for short-term use." The American Academy of Sleep Medicine does not recommend sleeping pills for chronic insomnia, he notes. Whether your sleep problem is psychological or physiological, you need to get to the root of the problem. "Sleeping pills tend to mask that," Schwartz observes.
Presti says he always recommends pursuing behavioral strategies before hypnotic medications, and studies have shown that such interventions are at least as effective as medication therapy. But many people continue to experience insomnia despite their best efforts with conservative therapy, and, in such cases, hypnotic medications can be highly effective. "Many patients are able to use these medications for a short period, in conjunction with the conservative strategies, in order to re-establish regular healthy sleep schedules," the neurologist says. "But in other patients, long-term treatment with medication is required."
The importance of sleep
Getting sufficient, good-quality sleep is critical for many reasons, Presti explains. First, chronic insufficient sleep shortens lives. Studies have shown that less than seven hours of sleep a night significantly reduces one's life span, and this effect becomes exponentially worse with average sleep times of less than six hours.
Next, quality of life is powerfully influenced by sleep quality. Insufficient or poor-quality sleep can induce or exacerbate conditions such as depression, anxiety, impulsivity and chronic pain. It erodes cognitive abilities such as attention, problem solving and creativity, often limiting work performance and productivity.
Finally, untreated sleep disorders can induce or exacerbate many other serious medical conditions including hypertension, diabetes, obesity and dementia. Lack of sleep can also increase the risk of heart attack and stroke. "In short, good quality sleep of adequate duration is imperative to feeling your best and realizing your potential across a long, healthy life," Presti says.