- Routinely getting the recommended amount of restful sleep has many, many health benefits that include more energy, better mental functioning, better mood, a lower risk of some diseases (e.g. cancer) and a longer life expectancy.
- There are many behavioral strategies a person can use to get good sleep that include establishing a regular schedule, avoiding stimulating substances (e.g. caffeine) and activities in the evening, making the bedroom sleep friendly and using relaxation strategies.
- When worries or other distressing and unhelpful thoughts interfere with sleep, cognitive strategies can help.
- Caffeine can’t reverse the negative impact on your performance from staying up late and failing to get sufficient sleep; you will perform better by getting a good night’s sleep than by pulling an “all nighter”.
- Sleeping pills are not a cure for sleep problems and should be used only in specific circumstances and for a short period of time.
Getting enough, good-quality sleep is one of the most important things you can do to enhance and maintain optimal health.
This section summarizes the most important information you need to know about sleep. For additional information consult the "For Those Who Want to Know More" section below.
Even though we all sleep, it can be challenging to explain exactly what sleep is. Briefly, sleep is a period of reduced activity when you are not conscious. During sleep, you pass through four phases that progress in a cycle from stage 1 to REM sleep, and then re-start. During these stages, you experience specific brain wave activity and body functions that are vital to survival. Your memories and learning from the day are consolidated, your brain recovers from its daily work, and your body heals and grows.
The amount of sleep a person needs varies from person to person, but most adults need 7-8 hours of uninterrupted sleep a night. The right amount of sleep is the amount of sleep it takes for you to wake up feeling rested and refreshed, and feel alert throughout the day.
Am I getting enough sleep?
Are you getting 7-8 hours a night? More? Less? You are likely not getting the sleep you need if:
- you feel tired or drowsy during the day
- you regularly fall asleep within 5 minutes of getting in bed
- you fall asleep in class, at work, watching television, after a heavy meal or after drinking a small amount of alcohol
- you have difficulty waking up in the morning, need an alarm to get up, or sleep through your alarm
- you sleep significantly more on weekends or days off
- you need a nap to get through the day
- you rely on caffeine, energy drinks or over the counter medications to keep you awake
- you have difficulty concentrating or remembering
- you are irritable, impatient
- you are angry
- you are more clumsy than usual
Try the Modified Pittsburgh Sleep Quality Index (M-PSQI), which is a self-rated questionnaire that assesses sleep quality and disturbances.
You know your sleep is good-quality if you are:
- satisfied with your sleep,
- able to sleep at appropriate times, for an appropriate amountof time,
- efficient and alert during the day.
You may need more than nine hours per night on a regular basis if you are recovering from sleep debt, or if you are living with an illness.
- Sleep helps you feel rested, alert, and energized each day.
- Sleep allows your mind, memory, body, and immune system to all work the way they are intended to.
- During sleep, your mind consolidates and reorganizes your memories, spurring creativity and problem-solving.
- Sleep allows your body to perform well when you exercise or compete.
- Sleep plays a role in emotion regulation; when you sleep, your brain sorts through the stresses and negative emotions you experienced during the day, in order to lessen their negative impact. This can enable you to cope better with stress in the future.
Healthy sleep habits, sometimes called sleep hygiene, are behaviours and routines that help a person to have quality sleep and feel fresh and alert during the day.
A lot of these behaviours are 'common-sense', but click on each one to learn more about how it can look in your life. And be truthful with yourself - are you really, sincerely, consistently practicing these behaviours? If you realise that you are not, you can set them as a health goal, and work through the steps of goal-setting, just as with any other health goal!
- Establish a regular sleep routine
- Ban screens from your bed
- Avoid substances that stimulate, especially in the evening
- Avoid late meals and liquids in the evening
- Avoid alcohol in the evening
- Avoid long naps
- Take time to wind down before going to bed
- Make your bedroom sleep friendly
- Use your bed only for sleep, sex and when your sick
- Manage your worry
- Use relaxation techniques
- Engage in good health habits
- Associate your bed with sleep
Examining your thinking can help you:
- Identify unhelpful and unrealistic automatic thoughts (called "cognitive distortions") that affect your ability to sleep. These cognitive distortions include:
- Misunderstanding the cause of your insomnia (E.g. “My sleep problems are due to a chemical imbalance”).
- The belief that the consequences of disturbed sleep will be more severe than they actually are (E.g. “If I don’t get 8 hours of sleep I won’t be able to function tomorrow”).
- Unrealistic expectations about sleep (E.g. “I must have 8 hours of sleep to function”).
- The belief that you can't change it (E.g. “There is nothing I can do to make this better”).
- Learn how to replace these thoughts with thoughts that support good sleep. You explore the validity of your automatic thoughts by exploring the evidence that support them and the evidence that refute them. Then a new thought that supports good sleep can be developed. Eventually, it replaces the old thoughts and leads to better sleep.
- Address other mental factors that contribute to disturbed sleep, such as excessive worry, depression or anxiety.
A structured treatment program called Cognitive Behavioral Therapy for Insomnia (CBT-i) uses these approaches to help you get better sleep; check out this section to learn more and even try out some of the exercises involved.
Another important cognitive strategy is to change your attitude toward sleep, to make sleep a priority and find ways to protect and defend your sleep time! You can learn more about building commitment to your health goals, including the goal of getting the sleep you need, by taking a look at our Behaviour Change section.
A variety of prescription medications are available to help a person fall and remain asleep. Unfortunately, sleeping pills do not address the reason for the sleep difficulties. There may be a medical or mental disorder, a sleep disorder, poor sleep hygiene, excessive worry or other reasons for poor sleep. It is best to address the cause of sleep problems rather than medicate. Sleeping pills do not cure insomnia. In fact, they can make it worse. These medications are meant to be used for a short period of time.
Research shows that cognitive behaviour therapy and other problem-solving approaches are more effective in the long run than medications. If the underlying problem has not been resolved by the time a person stops taking sleeping pills, the sleep problem will likely return.
Using medications to help with sleep (either prescription or non-prescription, such as Gravol or antihistamines) can have some negative consequences including:
- Drug tolerance. You may have to take more and more of the sleep aid for it to work, which can lead to more side effects.
- Drug dependence. You may come to rely on the medication to sleep, and will be unable to sleep (or have even worse sleep) without it.
- Withdrawal symptoms. If you stop the medication abruptly, you may have withdrawal symptoms, such as nausea, sweating and shaking.
- Side effects. Side effects of sleep medications include drowsiness the next day, confusion, forgetfulness and dry mouth. These side effects can be severe and can have tragic effects, such as an increased risk for car accidents.
- Drug interactions. Sleep medications can interact with other medications you are taking. This can worsen side effects and be dangerous with medications like prescription painkillers and other sedatives.
- Rebound insomnia. When you stop taking the medication, sometimes the insomnia can become even worse than before. There is no evidence to support the use of supplements such as melatonin to improve sleep.
There is no reliable evidence to support the use of supplements such as melatonin to improve sleep.
Our society treats sleep as a luxury, an indulgence. It's time to start looking at sleep—and other healthy lifestyle behaviours—differently. Getting the sleep you need is not about being your "best". Rather, sleep allows your body and mind to function at your baseline, your 'normal'. When you are sleep deprived, you go through your day with the burden of exhaustion on your body and mind, and can't accomplish what you could otherwise have.
Check out these resources to learn a lot more about sleep.
- If you are doing your own research on the Internet, make sure you know how to evaluate the reliability of information on the Internet
- How to effectively set, achieve and maintain your health goals
- Healthy Sleep from Harvard's Division of Sleep Medicine is a site that aims to help the general public understand sleep and to get the sleep they need.
- Before going to see a health professional or a cognitive therapist, it may be helpful to keep a sleep diary to share with them.
- Learn about sleep disorders from the National Sleep Foundation
- Sleep and the Social Determinants of Health
- What about "short sleepers"?