Why Sleep Matters: Strategies to Improve Sleep and Combat Insomnia

Reviewed by Dr. Jonathan Bonnet, MD, MPH


We all know that sleep is essential to our health. But how do you know if you’re really getting what you need?


Whether we realize it or not, getting good, quality sleep comes down to more than the total amount of hours logged in bed. In order to support our physical and mental health, getting enough sleep requires adequate duration, consistency in timing, and an appropriate balance of the major sleep stages.


Understanding your body’s unique sleep needs and the most common causes of insomnia can help you to identify when lack of sleep may be affecting your health and performance. In those cases, several tested strategies may be effective at improving your sleep and overall quality of life.


Why is sleep important?


Healthy sleep is important for people at all life-stages, including children, adolescents, adults, and seniors.


Though sleep needs change throughout our lifetime, getting good, quality sleep is crucial for cognitive functioning, mood, mental health, cardiovascular, cerebrovascular (blood flow in the brain), and metabolic health.


In fact, recent data from the Center for Disease Control and Prevention (CDC) shows that adults who regularly sleep seven hours or less are more likely to experience certain chronic health conditions, including heart disease, stroke, asthma, and cancer.


What are the different sleep stages?


On average, a person experiences four to six sleep cycles each night. During this time, your body experiences stages of rapid-eye movement (REM) and non REM sleep, including light and deep sleep. Healthy adults will spend around 90 minutes in each cycle, with individual sleep stages lasting anywhere from a minute to an about an hour.


The REM sleep stage is associated with dreaming and atonia, or temporary paralysis, and is important for recharging the brain and optimizing brain function.


The deep sleep stage is the most difficult to awaken from and is associated with body repair, which is when the body regrows its tissues, builds bone and muscles, and strengthens the immune system.


Both REM and deep sleep are thought to play roles in memory consolidation.


How much sleep do you need?


No two people’s sleep needs are exactly the same. How many hours of sleep you need—and how many hours you spend in each sleep stage—will vary depending on your age, health, lifestyle, and genetic factors.


Still, there are specific age-based recommendations for how many total hours of sleep you need, according to the National Sleep Foundation:



  • Newborns: 14-17 hours

  • Infants: 12-15 hours

  • Toddlers: 11-14 hours

  • Preschoolers: 10-13 hours

  • School-aged children: 9-11 hours

  • Teenagers: 8-10 hours

  • Young adults and adults: 7-9 hours

  • Seniors: 7-8 hours


Though many adults may believe they can operate on less than seven hours of sleep, several studies have shown that getting less than seven hours of sleep per night over time can be detrimental to your health, including:



  • Increased blood pressure

  • Cognitive impairment

  • Worsened mood

  • Poor performance


In fact, recent data suggests that only 5% of the population can function on less than seven hours of sleep consistently. (Which means you probably fall in the category of 95% of adults who need more than seven hours of sleep each night.)


Common causes of poor sleep


If you’re worried that you may not be getting the amount or quality of sleep you need, you’re not alone. Nearly half of all Americans reported feeling sleepy during the day for at least three days per week in 2020 and up to 30% of adults are believed to struggle with chronic insomnia.


Many factors, such as temperature (particularly warmer sleeping temperatures), blue-light stimulation, and noise, can interfere with your sleep. A change in your lifestyle or daily routine, such as becoming a new parent or starting a new job, can also cause temporary changes to your sleep.


But if you’re having ongoing difficulties with falling or staying asleep, other conditions, such as depression, anxiety, or stress, may also be exacerbating the problem.


Is stress affecting your sleep?


Emerging scientific literature suggests that certain people may be more susceptible to sleep reactivity, a sign of having a highly reactive sleep system that is more easily impacted by stress.


Genetics, familial history of insomnia, female sex, and environmental stress can increase the risk of sleep reactivity.


Though some people may have sleep systems that are more sensitive to the impacts of stress, stress and the resultant anxiety remains one of the most common contributors to sleep problems and insomnia.


How to improve your sleep naturally


Thankfully, there are several non-pharmacological lifestyle changes, supplements, and treatments that may help you get more restful sleep at night. (Just keep in mind that it can take some trial and error before finding the right strategy for you and your body.)



  • Keep the bedroom cool: If you have an adjustable thermostat in the bedroom, try to maintain the room at a cooler temperature (between 60 and 67 degrees Fahrenheit), which has been shown to help preserve REM sleep.

  • Minimize your exposure to blue light: Research shows that exposure to blue light before bedtime, like that emitted from electronics including your phone or TV, can make it difficult for you to fall and stay asleep. Additionally, checking email, social media, and other alerts before bedtime can trigger a stress response, impeding a good night’s sleep even further.

  • Avoid eating before bed: A midnight snack may sound tempting in the moment, but it can interfere with your circadian and digestive rhythms, leading to a less-than-successful night’s sleep. While large meals should be avoided, a small snack can be okay if you’re hungry.

  • Limit caffeine during the day: Drinking coffee, tea, or other caffeinated beverages can significantly disrupt your sleep. Best practices suggest avoiding caffeine at least six hours before bedtime.

  • Consider wearing a sleep mask or earplugs: If you’re particularly sensitive to external stimuli, like early light in the morning or unpredictable noises from the neighbor or street nearby, wearing a sleep mask and/or earplugs can improve your sleep.


If these lifestyle changes fail to improve your sleep, there are also some non-pharmacological treatment options that may help:



  • Melatonin supplements: This over-the-counter (OTC) supplement has become a popular resource in recent years for those struggling with sleep. Another meta-analysis shows that it can help some people modestly improve total sleep time, sleep quality, and sleep latency (the time it takes to fall asleep). Most promisingly, prolonged-release melatonin may be an effective treatment for insomnia in people over 55 years of age , whose bodies produce less melatonin naturally. All in all—if you find that melatonin helps you to sleep better, great. But if not, there are other options available.

  • Cognitive Behavioral Therapy for insomnia (CBT-I): This is considered the first-line treatment for insomnia. There’s a wealth of evidence showing that CBT-I, a combination of behavioral and cognitive interventions, can be effective at breaking an unsuccessful and unhealthy sleep cycle.

  • Forehead Temperature Cooling: This new treatment approach involves applying a cooling stimulus to the scalp to regulate forehead temperature to a range between 57-61 degrees Fahrenheit. The approach has shown to be effective at improving the time in which people with primary insomnia fall asleep, as well as improving the time it takes to transition from one sleep stage to the next. However, long-term studies have yet to be done to determine the safety of this approach.


Do sleep devices and wearables really work?


Biohacking and personal health tracking have become increasingly popular in recent years, especially since the emergence of COVID-19.


There are several sleep devices and wearables that claim to track your sleep hours, stages, and health metrics to make it easier for you to improve your sleep and sleeping habits.


Evidence on the efficacy of these wearables is mixed and can vary depending on which device you choose and how you read and interpret the metrics they track.


Three popular sleep wearables include the Oura Ring, Whoop, and Apple Watch, which claim to track sleep and stress metrics including time asleep, time spent in specific sleep stages, resting heart rate, respiratory rate, heart rate variability, and sleep latency.


Lack of available evidence means the validity of these claims have yet to be determined. But some of these metrics may be surprisingly accurate: Compared to a medical grade ECG, one device was found to have over 98% reliability when measuring nocturnal resting heart rate and heart rate variability metrics.


The bottom line


Sleep is essential for our health—if you’re struggling to get good, consistent sleep, there are some strategies that can help. If you’re unsure about where to start, Forfend can help. Our whole person wellness exams can help you optimize your sleep.


Sources


Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies. (2021).


Caffeine Effects on Sleep Taken 0, 3, or 6 Hours before Going to Bed. (2013).


Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. (2017).


Effects of thermal environment on sleep and circadian rhythm. (2012).


Effects of sleep deprivation on performance: a meta-analysis. (1996).


Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adults: Methodology and Discussion. (2015).


Meta-Analysis: Melatonin for the Treatment of Primary Sleep Disorders. (2013).


National Sleep Foundation's updated sleep duration recommendations: final report. (2015).


Performance of seven consumer sleep-tracking devices compared with polysomnography. (2021).


Physiology, Sleep Stages. (2021).


Sleep and Sleep Disorders. (2017).


Sleep is essential to health: an American Academy of Sleep Medicine position statement. (2021).


Sleep Statistics. (2021).


Stress and Insomnia. (2021).


The Color of the Light Affects Circadian Rhythms. (2020).


The HRV of the Ring—Comparison of nocturnal HR and HRV between the Oura ring and ECG. (2018).


The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. (2020).

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