When I was finishing up my internship as a psychologist, a postdoctoral student arrived at work at the VA hospital and announced that she had not slept at all the previous night because she had been working on a presentation for a professional conference. Though she joked that she probably shouldn’t be at work, she reflected that her judgment was poor, not realizing until that moment what a bad idea it had been to drive herself to work that morning.
Sleep is essential to allow the brain and body to rest and repair. As sleep quantity and quality diminish, we experience a number of symptoms, such as slowed thinking, poor concentration and judgment, difficulty with decision-making, slowed response time, and a negative mood.
If it takes you more than 30 minutes to fall asleep or you are awake in the middle of the night or early in the morning for 30 minutes or more, you may suffer from insomnia. Sleep experts refer to these as early, middle, or late insomnia. If you have trouble sleeping on occasion, you can rely on your body to correct this. If you have a long-term pattern of sleep disturbance, it may be time to try to remedy it. Cognitive behavioral therapy for insomnia is a great nonmedicated way to treat insomnia.
Sleep aids may include over-the-counter medications that have drowsy side effects, such as Benadryl or prescription sedatives, like Lunesta or Ambien. Some are prescribed medications for sleep that are antianxiety drugs or sedatives, such as lorazepam and clonazepam, which are in the class of medications known as benzodiazepines.
Prescription sleep aids can have negative side effects, such as a morning hangover effect and potential dependence on the medication. Some people try melatonin, a naturally occurring hormone that increases in our bodies as night falls and impacts the timing of sleep. Melatonin is best used to help with jet lag and in older adults who have a deficiency.
Sleep and Alcohol
Alcohol inhibits and slows the central nervous system, so when people drink, they tend to feel more relaxed and drowsy. Many people turn to alcohol as a way to help them fall asleep. Unfortunately, according to the National Sleep Foundation, alcohol contributes to poor sleep quality. Alcohol blocks REM sleep, the most restorative kind. It can also lead to more wakefulness and fragmented sleep. Alcohol can also lead to snoring and more frequent urination at night.
Sleep and Caffeine
Caffeine suppresses the hormone that induces sleep, leading to temporary wakefulness. Unfortunately, once caffeine wears off, the hormone has built up and is no longer suppressed. We then become very sleepy. Too much or poorly timed caffeine can lead to jitteriness, increased anxiety, and insomnia.
Sleep and Technology
As televisions, smartphones, tablets, and computers continue to make their way into all aspects of our lives, they have established a presence in our bedrooms. Experts advise no screens within an hour of bedtime. The light from these screens can lead to increased wakefulness just as our body is preparing for rest. Creating a charging station for portable electronics outside of the bedroom and keeping a television in another room of the house is helpful.
Sleep experts recommend a number of strategies for maximizing the likelihood of a good night’s sleep.
• Sleep in a cool, quiet, dark room.
• Exercise during the day, but not within the few hours before bedtime.
• Have a bedtime ritual.
• Try to go to bed and wake up at the same time every day.
• Keep screens out of the bedroom.
• If you have trouble sleeping:
· Try soothing bedtime routines, such as a warm bath, a cup of herbal tea or warm milk, and meditation.
· Get out of bed if you can’t sleep and do a calm activity, such as reading until you feel sleepy and ready to go back to bed.
· Eliminate caffeine and alcohol.
· Keep a worry journal next to your bed where you can write down your worries, set them aside, and address them the next day.
· Exercise, but not right before bedtime.
· Talk to your primary care provider, a mental health professional, or a sleep specialist.
Sleep Across a Lifespan
The younger we are, the more sleep we need. Newborns need around 14 to 17 hours of sleep per day, while seniors over 65 typically sleep 7 to 8 hours and feel rested. School age children benefit from 9 to 11 hours of sleep, while teenagers need 8 to 10 hours. Teenagers’ internal clocks lead them to get tired later and sleep in later. This has implications for school start times. Adults typically need 7 to 9 hours. For adults, fewer than 6 hours of sleep is not enough. It’s helpful to determine for yourself what the ideal amount of sleep is for you. How much sleep do you need to feel well rested and ready for your day?
According to sleep scientist Matthew Walker of University of California, Berkeley, “Short sleep leads to a short life.”
Sleep and Shift Work
We all have an internal circadian rhythm, which regulates our sleep-wake cycle. We are born with a natural tendency towards being an owl or lark or somewhere in between. This internal clock shifts somewhat forward and back over our lifespans. For those who have to work during the night, their circadian rhythm shifts, but not completely. It can be difficult to transition back and forth between the demands of being up all night working and participating in the daytime demands of family and business.
Sleep and Mental Health
A hallmark of major depression is sleep disturbance—either an increase or decrease in sleep. Sleep regulation is an important factor in mitigating depression. Sleep deprivation can also lead to irritability and feeling on edge, thereby exacerbating anxiety.
Sleep enables the clutter in our minds to be cleared out and helps organize the information we process each day. Shortened sleep seems to be linked to an increased risk of Alzheimer’s disease, perhaps because there is an increased buildup of a neuroprotein that is implicated in the disease.
A healthy sleep routine has both immediate and long-term implications for wellness, no matter your age or lifestyle. Pay attention to your sleep hygiene—your physical, mental, and social well-being depend on it!
Elizabeth H. Winston, PhD , is a Madison psychologist who provides psychotherapy, psychological assessment, and consultation to businesses and organizations. Find her at shorewoodpsychology.com and consultingcollaborative.org .