By Patricia Geraghty FNP-BC, WHNP
In our culture we treat sleep almost as a luxury, if you’ve made it through your “to do” list, then you can sleep. We might even consider it a badge of honor; “I’ve only slept 5 hours in the past two days.” Even the numbers show we are sleeping much less now than we did in the past. Between 1985 and 2004, the U.S. population went from about 15-20% of people getting less than six hours sleep at night.1 And now—it’s about a whopping 33% of U.S. adults sleeping less than 7 hours. With those kinds of numbers—this is why your New Year’s resolution should be “go back to bed.”
We as a society used to think that the consequence of inadequate sleep was simply fatigue. However, we now know sleep also influences major health issues. The person who gets on average less than 7 hours of sleep daily is at risk of developing chronic conditions such as: diabetes, hypertension, cardiovascular disease, obesity and anxiety symptoms.
It’s also important to note that there’s a high risk of developing chronic conditions from inadequate sleep. The Institute of Medicine (US) Committee on Sleep Medicine and Research refers to the The Sleep Heart Health Study (community-based cohort study/middle-age and older) —adults who get on average less than 5 hours of sleep or less daily has more than twice the risk of developing diabetes.2 Those sleeping 6 hours a night, are about 1.7 times more likely to develop diabetes. Even short term sleep deprivation shows up as insulin resistance, sometimes called pre-diabetes. In a 13 year cohort study of 500 adults, by age 27, people who slept 6 hours or less were 7.5 times more likely to beat risk for developing obesity even when controlling for activity levels and family history.3
This is why your New Year’s resolution should be “Go Back to Bed.” It’s vital for your mind and body. How much sleep is recommended? The Centers for Disease Control and Prevention (CDC) recommends adults —ages 18-60 years—get 7 or more hours of sleep per night. Adults—ages 61-64 years —get 7-9 hours sleep per night, and adults 65 years and older, get 7-8 hours per night. Are you getting the appropriate amount of sleep?
Sleep: A Two Party System
There are two sleep systems in our brain: the circadian system and the homeostatic system. The circadian system is the system that lets us know we humans are day time animals and should sleep at night. It’s the sleep-wake cycle. The homeostatic system is the system that makes us want to go back to bed from the minute we wake up. It’s weak in the morning but hits peak power midafternoon just when the circadian system gives us a boost to keep going a few more hours.
The more time you spend trying to go to sleep or to get back to sleep, the more valuable it is to measure your sleep. Sleep could be measured in a laboratory, but a far easier method is to measure sleep via fitness or smart phone device. Another option is to keep a sleep diary for 2 weeks to track your sleep cycle patterns and monitor for inconsistencies. In addition, talk to your health clinician about your sleeping habits to make sure none of your medications or health issues need attention. Let this serve as a baseline, then look ahead at implementing resolutions to get more sleep.
Can You Remedy Bad Sleep Behavior?
The gold standard for sleep problems is the combination of interventions called Cognitive Behavior Therapy for insomnia or CBTi.4, 5, 6 This approach is effective in all types of sleep disruption, doesn’t have after effects, and remains beneficial even after treatment is completed. No other treatment, especially sleep medications, can make any of these claims.
The cognitive part of treatment is learning about sleep, especially looking at your personal beliefs about sleep, and correcting misunderstandings. The behavior part is two-fold.
First, make sure you sleep in a dark, quiet, comfortable space with a regular schedule, often called sleep hygiene, and use the right mental skills to get to sleep.
Secondly, meditation and mindfulness, for instance, give us the tools to interrupt our stressful focus on that “to do” list, and return to sleep. However, as with all skills, practice is needed to learn and to improve your mental focus. In addition, bedtime routines of a warm bath or limiting exercise or screen time before sleep are commonly recommended, and may help.
When we are exhausted, stressed, and increasingly desperate to get a good night’s sleep, it seems easy to turn to sleeping pills. A national survey showed that 19% of us use a prescription medication each month and when we add the over-the-counter pills and alcohol, it adds up to almost one in three people.7 However, there’s a misuse of sedatives (sleep medications) and there’s a potential for dependency or abuse.
Sleep medications, including the familiar names of temazepam, zolpidem (Ambien®), eszoplicone (Lunesta®) and the off label use of diphenhydramine (Benedryl®), have next day impairment, including feeling as if you haven’t slept. These prescription products have the potential for dependency or abuse. A group of Croatian researchers8 showed that when the nerve receptors of the sleep system were exposed to zolpidem, the shape of the receptor changed within just 7 days. The presence of the drug became necessary to fall asleep. Moreover, the prescription products either act for 2 to 3 hours, not enough to help you return to sleep after middle of the night awakening, or 10-12 hours, too long to allow you to feel refreshed the following day. And, finally, all of them fail to have long term impact on your sleep problems. When the medication stops, the insomnia comes back.
Most importantly, talk with your health care clinician if you’re having problems sleeping.
Make Time to Sleep
Sleeping, and making the time to sleep, may be the key to your accomplishing your New Year’s resolutions. However, when it comes to meeting family and work obligations, along with making time to follow all the other health advice such as exercise and eating healthy, we often sacrifice sleep.
With something this challenging there aren’t going to be easy answers. For instance, try taking a team approach where everyone in your household is as dedicated to meeting overall health goals as well as their own individual goals. Moreover, with a team, you have the support you need to accomplish your goals and everyone might feel as though their effort can only add to the group’s success. In conclusion, getting enough sleep should no longer be a dream. Make it a reality this New Year. This is why your New Year’s Resolution should be “go back to bed.”
Summary in 30 Words
Sleep is essential for your health. It’s good for your mind and body. Insufficient sleep can cause chronic conditions. How much sleep is needed? The sweet spot is 8 hours.Sleep is essential for your health. It’s good for your mind and body. Insufficient sleep can cause chronic conditions. How much sleep is needed? The sweet spot is 8 hours. Click To Tweet
1. CDC. Morbidity and Mortality Weekly Report. 2005; 54(37):933.
2. Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, ed. 2006. Available from: http://www.ncbi.nlm.nih.gov/books/NBK19948/ accessed 5 Nov 2019/9 Jan 2021
3. Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, ed. 2006. Available from: http://www.ncbi.nlm.nih.gov/books/NBK19948/ accessed 5 Nov 2019/9 Jan 2021
4. National Institutes of Health Consensus Statement on Insomnia. Sleep. 2005; 28(9): 1049-57.
5. Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008; 4(5):487-504.
6. Qaseem A Inter, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in Adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016; 165(2):125-133.
7. National Sleep Foundation. https://sleepfoundation.org/sleep-polls-data/sleep-in-america-poll/2005-adult-sleep-habits-and-styles. Accessed 23 Oct 2019
Patricia Geraghty FNP-BC, WHNP — is a Medical Contributor for Healthin30.com. Read about Patricia here.