While getting a solid eight hours might be easier for many of us due to the pandemic, there's no guarantee that more sleep = quality sleep. Tossing and turning all night can often leave you feeling worse - so what can you do to ensure that the time you are asleep is regenerating and refreshing as much as possible?
"Sleep is not just a trivial pastime, it’s essential for a healthy mind and body," Dr Deborah Lee, GP at Dr Fox Online Pharmacy tells Cosmopolitan. "Many people do not realise sleep is just as necessary for survival as the need for food and water. In a lifetime, we spend around one-third of our lives asleep. We must ensure we get the right amount of sleep, but also that our sleep has the right quality."
Why do we have broken sleep, and how does it happen?
The dream situation (excuse the pun) is to be the type of person who falls asleep quickly, and not disturb until the next morning. However, few of us manage to achieve this regularly.
That's because, Dr Lee says, there are two stages of sleep: "Non-Rapid Eye Movement (NREM) sleep which accounts for 75% of sleep, and Rapid Eye Movement (REM) sleep which makes up the other 25%," she explains. "Deep sleep takes place during the latter part – stages three and four - of NREM sleep. This is slow-wave sleep, and usually represents between 13% -23% of time spent asleep."
Here's how the stages of sleep work:
Stage one - the initial drowsy period when you first start to fall asleep, which only lasts a few minutes
Stage two - you are lightly asleep
Stage three - this is moderately deep sleep
Stage four - the deepest level of sleep, where EEG recordings show long frequency, delta waves called slow waves
People who have disrupted sleep often have less deep sleep, because they don't reach the latter stages of NREM so often. "Stage four is called deep sleep because it is the hardest part of the sleep cycle to wake anyone up. Passing through these four stages of NREM sleep takes about an hour," explains Dr Lee.
"The second part of the cycle is REM sleep. In REM sleep, brain wave recordings show similar electrical activity to being awake. During REM sleep you often have vivid dreams," she says.
Deep sleep is sometimes confused with REM sleep but the two are actually quite different. "In deep sleep, your heart rate and breathing slow right down, and your body is actively undergoing processes of cellular growth and repair. However, in REM sleep, your heart rate and respirations are at a similar rate to when you are awake, and your brain is busy, actively processing emotions and memories," notes the expert.
Dr Lee explains that reasons for broken sleep include:
Stress, anxiety, and depression – disrupted sleep is common if you go to bed with a lot on your mind. Negative thought patterns either keep you awake or wake you in the night
Poor sleeping conditions – your bedroom may be too hot, poorly ventilated, and/or may allow in too much light. To sleep well you need to lie in the dark – the sleep hormone melatonin is produced in the dark
Preparing your sleep environment for a good night’s sleep is called having good sleep hygiene. The following can affect your sleep hygiene:
Too many stimulants – i.e. caffeine, and/or alcohol in the evenings
Chronic medical conditions
Medication – numerous types of medication can cause sleep disturbance. For example, some antidepressants, steroids, blood pressure medication, and thyroxine
Too much blue light
Sleep disorders – there are many different sleep disorders, such as sleep apnoea, and restless legs syndrome
Ageing - although older people still need 7-9 hours sleep per night, sleep difficulties are common with ageing
How you can improve your chances of entering into a deep sleep?
The good news is, there are steps you can take that can increase the chance of your sleep being deep, so there's no reason to think you're simply the type of person that doesn't sleep well. Dr Lee shares her tips for deep sleep:
Schedule enough time for sleep
"The Sleep Foundation recommends 7-9 hours sleep per day for adults, so make sure you plan to be able to achieve this," she explains.
Sleep in tune with your own body clock
"Get your mind and body into a pattern of going to bed and waking up at the same time every day. This means you are sleeping in tune with your own natural Circadian rhythms."
Practice good sleep hygiene
"You need a cool bedroom, and fresh air - sleep with the window open. Keep your bedroom dark with blackout blinds and/or use a blackout eye mask.
"Ensure you have a comfortable mattress, adequate pillows, and suitable – perhaps anti-allergy - bedding."
"In a 2017 systematic review, 29 out of 34 medical studies published between 2013-2017 reported taking exercise improved the quality and duration of sleep.
"You are currently recommended to take 30 minutes moderate-intensity exercise, five times per week; for example, walking, jogging, or swimming. However, don’t exercise too close to bedtime. Try to exercise in the morning or late afternoon."
Avoid caffeine within six hours of bedtime
"Caffeine is a stimulant, most often ingested in coffee. Many of us drink coffee as a pick me up in the mornings, often after a bad night’s sleep. However, if you drink caffeine by day, you then suffer the effects of caffeine deprivation by night."
Avoid alcohol within four hours of bedtime
"Alcohol is both a sedative and a stimulant. After drinking alcohol, people often report falling asleep more quickly but waking in the second half of the night with increasing amounts of interrupted sleep.
"Even small amounts of alcohol can impair your sleep. The Sleep Foundation has reported than a low alcohol consumption – less than 2 drinks/day for men and one drink per day for women, reduces sleep quality by 9.3%.
"A high alcohol consumption – more than 2 drinks/day for men and one drink per day for women, reduces sleep quality by 39.2%."
Warm your body before sleep
"Sleep specialists believe that warming your body for up to four hours, between one and eight hours before going to bed, results in falling asleep more quickly, and increases the amount of slow-wave, NREM sleep."
Listen to pink noise
"Pink noise is low-frequency noise which has a deeper sound. Examples include the patter of rainfall, the wind in the trees, ocean waves, or a soft background noise for example, of a fan.
"There is some evidence that people sleep better when pink noise is present. In one 2012 study, for example, 40 individuals were studied after exposure to pink noise, or without. The pink noise group exhibited more stable sleep time and better quality sleep."
Mindfulness has been shown in studies to have the capability of improving sleep quality, helping insomnia, depression, and fatigue. Mindfulness is "the ability to be present, undistracted with an open curious mind and a kind heart. The gentle, warm kind of feeling," explains Headspace founder Andy Puddicombe.
Try a sleep app
Try amber-tinted, blue-light blocking glasses
"One small, 2018 randomised controlled trial reported that wearing amber-tinted, blue-light blocking glasses, for two hours before bedtime resulted in significantly improved time spent asleep, improved deep sleep and overall sleep quality, compared to wearing clear lenses."
What happens if we don't get deep sleep?
We all know the negative effects of sleep deprivation - anyone who's returned home after a weekend festival feeling like a zombie will remember the inability to function without a good snooze. Deep sleep is vital for health, and without it, you can increase your likelihood of experiencing:
An increased risk of cardiovascular disease
Negative affects on the immune system
Negative affects on memory
Increased cancer risk
Increased risk of Alzheimer’s Disease, cardiovascular disease – strokes and heart attacks, and diabetes
Can having too much sleep impede your ability to sleep deeply?
The good news is, in this case you can't have too much of a good thing. "According to sleep experts, it’s not possible to have too much deep sleep – your body will automatically adjust how much you get in each sleep cycle," explains Dr Lee.
However, you can have too much sleep altogether. "Having too much sleep is counterproductive," Dr Lee says. "Excess sleep is associated with diabetes, depression, and heart disease. Make sure you set your alarm clock and get up every morning and get on with your day – 7-9 hours sleep is enough."
What other lifestyle factors impact the depth of your sleep?
Of course, sometimes a lack of quality sleep is due to more than just an inability to switch off at night. "Social and lifestyle trends influence our ability to sleep and sleeping patterns," says Dr Lee. Many different lifestyle factors are involved, including:
Blue light exposure
Sedentariness – lack of physical activity
Caffeine, alcohol, and other stimulants
If lifestyle factors are affecting your sleep quality and therefore your daily life, is there a way you can look at altering your routine? If not, and if sleep is becoming a major issue, you can talk to your GP about possible treatments. Here's to a more restful 2021!
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