KEY TAKEAWAYS:
• Sleep is an active process that helps your body recover both physically and mentally.
• Sleep deprivation can lead to health issues like depression, heart disease, obesity and type 2 diabetes.
• The quality of your sleep matters almost as much as the quantity and is impacted by things you can control, like screens, alcohol use and medications.
SUMMARY:
Sleep quantity and quality are not the same, and even when you get the recommended seven to eight hours per night, disrupted sleep can leave you feeling unrested. Fortunately, simple changes to your sleep hygiene and bedtime routine can help you get the recovery you need.
Are you getting your recommended seven to eight hours of sleep every night, and still waking up tired? According to the Centers for Disease Control and Prevention (CDC), one in three adults doesn’t get enough sleep, but even for those who do, there is a difference between sleeping and recovering.
“A common misconception is that sleep is a very passive process, that you’re unconscious and nothing’s going on,” says Richard Ko, DO, a sleep medicine specialist at OhioHealth. “However, when you’re sleeping, your body is recovering. Sleep is one of those things that affects everything, including mental health, cognition, cardiovascular health, endocrine health and even your immune system. All those things are getting reset, and all those things suffer when you’re not getting good sleep.”
What happens to your body when you don’t sleep enough?
Chronic sleep deprivation (when you don’t get enough sleep overnight) affects your overall health, according to the CDC.
Over time, not getting enough sleep can lead to a higher risk of:
- Depression
- Heart disease
- Obesity
- Type 2 diabetes
There is a misconception that shortened sleep isn’t as harmful as getting no sleep, but over time, even shortened sleep can be just as dangerous.
“When sleep is deprived, for whatever reason, you’ll have ‘micro sleeps’ where your brain partially goes to sleep for even just a few seconds,” says Dr. Ko. “But in those few seconds, you could be in a car that moves hundreds of feet. It affects your cognition and executive function: You think you’re fully awake and making a decision, but it’s a bad decision because you’re not well-rested.”
How does sleep deprivation affect the brain?
Poor or not enough sleep can have harmful cognitive effects in adults. A study in Brain Sciences noted that glymphatic clearance, or the process of flushing metabolic waste (including amyloid-beta peptides, which are thought to be associated with Alzheimer’s disease) out of the brain, is impacted by sleep deprivation. As a result, good sleep is good for your brain.
Sleep deprivation and weight gain
Not getting your eight hours can lead to weight gain. An article published in the Journal of the American Medical Association found that improving sleep duration could play a part in obesity prevention and weight loss.
Why am I still tired after eight hours of sleep?
Sleep quality and sleep quantity are two different things. Even when you’re getting enough total sleep, disrupted sleep architecture — how your body goes through the different stages of sleep each night — is linked to elevated cortisol (stress hormone), metabolic issues and other dangers.
Each sleep cycle lasts around 90-110 minutes. However, the duration of each stage varies throughout the night. For example, almost all our deep sleep happens in the first third of the night, while rapid eye movement (REM) sleep picks up in intensity in the early morning hours.
Can you control your sleep cycle?
While it is tempting to aim for a certain stage of sleep, such as more deep sleep or REM sleep, you have no control over how your body cycles through sleep. However, understanding how different factors impact your sleep cycle can help your body get the restorative rest it needs.
How do screens impact sleep quality?
Screens are the most common sleep disruptor and affect sleep in different ways:
- Blue light fools your brain into thinking it’s not time to go to sleep, which can cause insomnia.
- Dopamine, the feel-good hormone that gets released every time you look at your screen, fires a reward circuit in your brain that makes you want to pick your screen up again. Dopamine is also a wake-promoting neurotransmitter that makes you stay awake.
- The content you’re reading, whether it’s funny or politically charged, can get you feeling emotional, which can keep you up at night. Social media use before bed can also cause anxiety.
How does alcohol affect sleep quality?
Alcohol affects sleep in so many different ways. It’s incredibly common (and not healthy) to use alcohol as a “sleeping pill.” While alcohol does help you fall asleep, once its effects wear off, your brain withdraws and wakes you up right away. This often happens before you get to REM sleep.
Alcohol also causes nasal congestion, which makes breathing during sleep more difficult. It can also cause your tongue and the muscles in the back of your throat to relax, which leads to more snoring or obstructive sleep apnea.
How to track sleep quality
To truly stage your sleep, you need a sleep study from a physician. During the study, which is usually done at home, you’ll have special equipment to measure your body’s sleep stages.
Wearable devices use wrist and hand movements, heart rate and body temperature to guess at your sleep stage, but they are not reliable in helping you understand your sleep.
What is restorative sleep?
Rotating through each of the stages of sleep throughout the night is what helps your body recover overnight and what makes us feel refreshed in the morning. Some research suggests that REM sleep is where your short-term memory gets hard-coded to your long-term memory. That’s why, with shortened sleep, one of the first things to suffer is your learning.
Beyond factors like screens, alcohol and medication, medical conditions like sleep apnea play a role in cutting your restorative sleep short.
Sleep apnea and restorative sleep loss
Sleep apnea affects an estimated 30 million Americans, and yet remains significantly underdiagnosed, especially in women, whose symptoms often differ from men’s symptoms.
While men tend to experience loud snoring or gasping in their sleep, women exhibit symptoms like:
- Anxiety
- Fatigue
- Headaches
- Insomnia
A recent study in Frontiers in Public Health found that untreated pelvic floor dysfunction impacts women’s risk of developing sleep apnea. Women also tend to develop sleep apnea when they reach menopause.
“Sleep apnea is far and away the most common sleep-related diagnosis,” says Dr. Ko. “Around 70 to 80 percent of our diagnoses involve sleep apnea in one form or another.”
If you suspect you have sleep apnea, Dr. Ko suggests asking your bed partner if you’ve been snoring heavily or pausing breathing in your sleep. Another common sign of sleep apnea is waking up to use the bathroom regularly overnight.
Fortunately, sleep apnea is treatable. Though most patients need an adjustment period, a continuous positive airway pressure (CPAP) machine helps ease symptoms like snoring and waking up to use the restroom.
How to improve sleep hygiene
If you’re looking for ways to help your body recover while you sleep, your bedtime routine can help:
- Avoid caffeine at least eight hours before your bedtime.
- Cut out alcohol before going to sleep.
- Eliminate screens at least 30 minutes before bedtime.
- Exercise can help your body fall asleep and stay asleep. Try to finish at least an hour before going to bed.
- Remove naps from your schedule, since they can keep you from having consolidated sleep at night.
“We’re trying not just to sleep, but to get really good sleep,” says Dr. Ko. “Look at your sleep schedule, how much sleep you’re getting and how you’re feeling after. If you’re feeling excessively sleepy, it is a sign you may need to investigate further with a sleep evaluation by a sleep medicine specialist.”
Learn how OhioHealth can help you get more restful sleep. Find a sleep medicine physician.
Frequently Asked Questions
What are the signs of sleep apnea in women?
Women exhibit often-missed symptoms of sleep apnea, including anxiety, fatigue, headaches and insomnia.
Can sleep deprivation cause weight gain?
Sleep deprivation can lead to weight gain. Research has shown that improving sleep duration could play a part in obesity prevention and weight loss.
Is melatonin safe for sleep?
While melatonin is safe for occasional use, if you’re taking it every night, it’s important to see if there is another underlying reason that is causing your insomnia that you can address.
Do women need more sleep than men?
Women tend to sleep more than men and experience more insomnia. This is often because women experience hormonal changes like the onset of menses, pre-menstrual syndrome (PMS), pregnancy, breastfeeding, perimenopause and menopause that are all associated with fragmented sleep.
