Earn the Rest You Deserve: How to Sleep Better Every Night
As we go into summer, many of us are beginning to revisit our health and fitness goals. Whether we are trying to slim down for beach season, gear up for a race, or simply get outside a bit more, many of us are looking at our lifestyles to see where change can be found. As a physiotherapist, patients will often divulge these health-related ambitions to me. What I notice is that these goals are often centered around increasing physical activity or diet modifications. While as a physio with a background in nutrition I am always excited for people to have physical activity and nutrition-related goals, I think there is another facet of health that deserves equal attention, and that of course is sleep.
In an age where productivity is rewarded and access to the world is at the tip of our fingers, it is easy to see why sleep is often pushed to the side. While the recommended amount of sleep for adults is between 7 and 9 hours(1), a survey of Canadians found that the average Canadian is just barely hitting the minimum 7.12 hours a night)(2). What is alarming here is that about a third of Canadians were sleeping less than the minimum required sleep for adequate health and as such are chronically sleep-deprived.
While it may feel like the only consequence of missing a full night’s rest is a sense of tiredness and maybe an extra coffee, the effects on our physiology run much deeper and last longer than we realize. When we are in a state of sleep deficiency, we can see dampening across multiple aspects of health as seen below(3):
It’s often after I have explained this information to patients that I get the counterargument of “while this may affect some people, I am fine running on 6 hours of sleep”. While we may think we can escape sleep debt, the vast majority of us are simply unaware of its deleterious effects. In one study, when patients slept six hours per night or less for two weeks, they demonstrated cognitive deficits equivalent to if a person had been awake for 48 hours. What was more astonishing, is that the majority of these patients were not even aware of this cognitive impairment (4)!
Much like a loan from a bank collects interest, our sleep debt cannot be reversed simply by getting one full night’s rest. A night of reduced sleep is going to take several days to completely reverse (5). This exemplifies the importance of making a habit of getting a full 7-9 hours of sleep every night. That said, it is understandable to have a night here and there of reduced sleep, life happens. But you should know that it is going to take more than one good night of sleep to correct.
Beyond making the time for a full sleep, we must also consider the quality of our sleep. When we are in a long and deep sleep, our brain moves through a complete sleep cycle that changes slightly through the night. Achieving deep sleep is critical for optimizing recovery and memory consolidation (3, 6). To set ourselves up for a night of great sleep, there is a multitude of habits we can develop to improve our sleep quality. This series of practices are often referred to as components of sleep hygiene. Much as we regularly brush our teeth to optimize our oral health, we want to get into the practice of regularly attending to our sleep hygiene to optimize our sleep.
To make things easier, I have adapted information from another source into a single page highlighting the most impactful practices around sleep hygiene (7).
How to get better sleep
It can feel overwhelming to read and incorporate all of these components at once. As such, I recommend to patients to start with a single practice that they feel is the most relevant or most obtainable. After a couple of weeks of regularly practicing one habit, try to add on another. Remember, when we are working on our health, we are playing the long game and as such we want to take the time to really consolidate these habits.
References:
Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s updated sleep duration recommendations: Final report. Sleep Health 2015; 1: 233-43.
Chaput J-P, Wong SL, Michaud I. This article provides recent estimates of the duration and quality of sleep of Canadian adults and of the percentage who adhere to sleep duration guidelines (7 to 9 hours per night at ages 18 to 64, and 7 to 8 hours per night at age 65 or older). Duration and quality of sleep among Canadians aged 18 to 79. https://www150.statcan.gc.ca/n1/pub/82-003-x/2017009/article/54857-eng.htm. Published September 20, 2017. Accessed May 25, 2022.
Simpson NS, Gibbs EL, Matheson GO. Optimizing sleep to maximize performance: implications and recommendations for elite athletes. Scand J Med Sci Sports. 2017;27(3):266-274. doi:10.1111/sms.12703
Van Dongen HP, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation [published correction appears in Sleep. 2004 Jun 15;27(4):600]. Sleep. 2003;26(2):117-126. doi:10.1093/sleep/26.2.117
Belenky G, Wesensten NJ, Thorne DR, et al. Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: a sleep dose-response study. J Sleep Res. 2003;12(1):1-12. doi:10.1046/j.1365-2869.2003.00337.x
Acosta MT. Sueño, memoria y aprendizaje [Sleep, memory and learning]. Medicina (B Aires). 2019;79 Suppl 3:29-32.
Siengsukon CF, Al-Dughmi M, Stevens S. Sleep Health Promotion: Practical Information for Physical Therapists. Physical Therapy. 2017;97(8):826-836. doi:10.1093/ptj/pzx057.
