Sleep is not a luxury; it is a necessity. And “getting by” on 6 hours of sleep nightly is not getting by unscathed. Sleep loss causes harm, including possibly bumping up the risk of developing type 2 diabetes. For many of us, when we’re extra busy, sleep is the first thing we cut.
For lots of people, getting adequate sleep is the hardest part of their lifestyle reset, and that’s because of their long-held belief that sleeping takes time away from things that are more important or more fun. I felt that way for many years when my children were little. I started my workday much too early, so I could be available when they returned home from school. Even though I frequently wished that it were possible to inject caffeine directly into my tired, foggy brain, I naively believed that being sleep-deprived was about nothing more than discomfort. I had no idea the harm I was causing myself.
Oddly, some people even wear lack of sleep, especially losing sleep from being busy, as a badge of honor. Getting adequate Zs, however, is no less important than eating wholesome foods, being physically active, and maintaining a healthful weight. In fact, regular shut-eye may have a direct impact on our weight, and it certainly affects our energy, motivation, and focus for the work involved in developing and maintaining healthful habits.
What Happens During Sleep
We are meant to spend about one-third of our lives asleep! The American Academy of Sleep Medicine says that adults should get at least 7 hours of sleep nightly. Sleeping is a very productive time that greatly affects the other two-thirds of our lives. Yet, according to the CDC, 23% of adults report sleeping only 6 hours per day, and 12% report getting a mere 5 hours or less. In recent decades, the percentage of adults suffering from inadequate sleep has grown considerably.
Some aspects of sleep are still a mystery, although clearly sleep affects how we feel, look, and perform. It appears that sleep is critical for many normal functions including optimal learning, holding on to memories, rest and recovery of muscles, optimal release and balance of hormones, repair of organs, and adequate immune function. All of these things require actual sleep, not just rest.
It’s not only the quantity of slumber that affects our well-being. Sleep quality is also critically important. In a recent report, the National Sleep Foundation recommends that good sleep quality involves being asleep at least 85% of the time that you’re in bed, falling asleep within 30 minutes of going to bed, awakening for more than 5 minutes only one time nightly or not at all (twice nightly for older adults), and being awake for a total of no more than 20 minutes after initially falling asleep.
There are two basic categories of sleep: rapid eye movement (REM) sleep and non-REM sleep. Non-REM sleep, which accounts for about 75% of your total sleep, includes the deep sleep in which your body rests and recovers. The other 25% of sleep is REM sleep, in which the brain is active in the work of learning and memory. During REM sleep is typically when you dream as well. During a night of good slumber, you will likely go through the stages of sleep about five times—non-REM sleep, then REM sleep, and repeat four times.
Take a Nap
The National Sleep Foundation recommends that sleepy individuals nap for 20–30 minutes to increase alertness and to reduce mistakes and accidents. They recommend avoiding naps close to bedtime when possible, to reduce the likelihood that a nap will disrupt longer periods of sleep.
Effects of Poor Sleep
With this knowledge, it’s not hard to understand that inadequate sleep causes many problems. Among other things, not sleeping enough can lead to daytime sleepiness, mood disturbances, inability to pay attention, cognitive impairment, driving accidents, inadequate growth in children and teens, and a greater risk of chronic health problems.
Obesity
Typically, sleeping too little is associated with gaining more weight. In one study, women who slept only 5 hours per night gained more weight over 16 years than women who slept 6 hours nightly, and those women gained more weight than women who slept 7–8 hours nightly. Adequate sleep helps to maintain a normal balance of appetite hormones. When sleep is poor or short, the levels of ghrelin, a hunger hormone, go up. And the levels of leptin, a hormone that makes us feel full, go down. Not surprisingly, those changes in appetite hormones can lead to poor eating habits. Researchers noted that when men and women of a healthy weight were sleep-deprived, they ate several hundred calories more than when they were allowed to sleep normally. Short sleeping especially leads to more high-fat foods and snacks.
Diabetes
As weight goes up, so does the risk of developing prediabetes and type 2 diabetes. But inadequate sleep may affect diabetes risk beyond its role in weight gain. The balance of growth hormone and cortisol may also be important. Too little sleep and poor-quality sleep affect glucose metabolism. Researchers in the Netherlands found that restricting sleep to 4 hours a night decreased insulin sensitivity by 20–25% compared to sleeping 8.5 hours a night. When scientists reviewed several studies, they found that people who slept 7–8 hours per day had the lowest risk of type 2 diabetes.
Heart Disease
Both weight gain and disturbances in glucose metabolism affect the risk of developing heart disease. Too little or poor sleep likely affects the chances of developing heart disease in additional ways such as causing problems with blood pressure and increasing low levels of inflammation.
Get a Better Night’s Sleep
Sound slumber is such a challenge for so many people. Like any other part of your lifestyle reset, examine what you’re doing well (don’t neglect this important part), what you could do better, and set some goals. Here are 13 tips for a better night’s sleep.
Obstructive Sleep Apnea: A Special Concern
Obstructive sleep apnea is a disorder in which an individual stops breathing momentarily during sleep because the upper airway collapses. These pauses in sleep may occur as many as 100 times per hour. Sleep apnea may result in periods of too little oxygen in the blood, non-restful sleep, inflammation, insulin resistance, an increase in the risk of type 2 diabetes and heart disease, as well as other problems. Not only does obstructive sleep apnea boost the risk of developing type 2 diabetes, but research also suggests that having type 2 diabetes increases the risk of developing sleep apnea. The good news is that treatment for obstructive sleep apnea can improve insulin sensitivity and glucose metabolism in many patients.
Symptoms of obstructive sleep apnea include loud snoring, episodes of not breathing during sleep (observed by another person), excessive daytime sleepiness, morning headaches, and awakening with a dry mouth or sore throat. Obstructive sleep apnea is more likely to affect you if you are male, have a thick neck, smoke, have obesity, use alcohol or sedatives, or have a family history of the sleep disorder. Treatments include weight loss, avoiding alcohol and tobacco, changes in sleeping positions, surgery, and a nighttime breathing device called continuous positive airway pressure (CPAP). In a study of people with prediabetes, using CPAP improved measures of insulin sensitivity.
1. Help your circadian rhythms. Circadian rhythms are the physical and mental changes that follow a near 24-hour cycle and respond primarily to light and darkness. Among other things, circadian rhythms affect sleep-wake cycles. Light stimulates a part of the brain that affects our feelings of wakefulness and drowsiness. Thus, exposing yourself to light during the day and decreasing light exposure at night helps to maintain your body’s natural rhythms. When you get up in the morning, open the blinds to allow the light to get you started on your day. First light stimulates the release of the hormone cortisol, raises your body temperature, and inhibits the release of melatonin, the hormone that invites sleep. Shift workers often have trouble because their schedules oppose their circadian rhythms. Visit the National Sleep Foundation website (nationalsleepfoundation.org) for tips, and talk to your health care provider for specific advice. When possible, scheduled naps during shift work are beneficial.
2. Mind the light at night. Avoid light from TV, tablets, and computers shortly before bed because these lights are enough to stimulate you and thwart an easy slumber. Keep your room dark for sleeping too. Use blackout blinds to block light from outside. If you need a light in the middle of the night, shine a low illumination nightlight in your hallway or bathroom. Turn your clock away or dim its light. If someone else must leave a light on, go to bed with an eye mask.
3. Create a routine. The National Sleep Foundation recommends getting to bed and waking up approximately the same time each day, even on weekends. To ease yourself into bed and into sleep, establish a soothing nighttime ritual such as reading (not on a tablet, computer, or phone), meditating, practicing yoga, sipping on hot decaffeinated tea, or listening to relaxing music.
4. Cool off. A cool room can help you get a more sound sleep. Experts recommend dialing down the temperature to a cool 60–67°F. A warm bath or shower before bed may help too because it will first raise your body temperature and allow you to feel sleepier when your body temperature drops in your cooler bedroom.
5. Silence the noise. If noises disturb you, block them with earplugs, a fan, or a white noise machine.
6. Get comfy. Maybe it’s time for a new mattress, sheets, or pillow. Or maybe it’s time to send your pets or children to their own beds. A cluttered bedroom may also make you uneasy at night.
7. Don’t fret. Instead of lying in bed watching the clock and worrying about losing Zs, relax with deep breathing exercises or meditation. If that doesn’t send you to sleep, get out of bed for a short time to read or listen to soothing music.
8. Be active every day. Regular exercise means more sleep and a sounder slumber.
9. Avoid caffeine. This stimulant increases alertness and can cause insomnia. Although it combats daytime sleepiness, it might be the cause of nighttime wakefulness. One study found that consuming caffeine as early as 6 hours before bed hindered good sleep. However, people vary in the length of time it takes to metabolize caffeine, so some people will need to avoid it for much longer than 6 hours before heading to bed.
10. Eat wisely. Avoid large meals for 3 or so hours before bed. If you’re hungry before bed, eat a very small snack.
11. Drink wisely. Alcoholic beverages may push you into sleep faster, but they will also wake you up sooner and more often. Alcohol might interfere with circadian rhythms, block REM sleep, increase snoring, and send you to the bathroom frequently.
12. Avoid nicotine. It’s a stimulant.
13. Talk with your health care provider. If you lose sleep more than just occasionally, seek help from your health care provider. You may have a sleep disorder or an underlying medical condition that affects your sleep. Treatments are available. If you are waking up frequently to urinate, you may have diabetes. High blood glucose may be the reason you need to visit the bathroom often.
Be Empowered
• Identify your motivators to get enough sleep and to sleep soundly. Think of both short- and long-term benefits of good sleep. Jot them down in your journal.
• Ask yourself, are you are pleased with the quantity of your sleep? The quality of your sleep? If not, commit to getting adequate sleep. Review the 13 tips to getting a better night’s sleep, and implement one or more strategies.
• If you wonder if you have sleep apnea, another sleep disorder, or a medical condition that affects your sleep, make an appointment with your health care provider.
• If after implementing strategies for better sleep, you are still not sleeping soundly or long enough, discuss your sleep habits with your health care provider.