Getting Some Sleep? Part 1

A question often on people’s mind is ‘How much sleep do I need each night?’ Generally speaking, there is no single amount of sleep that ‘fits’ everyone. Most healthy adults need 7 to 8 hours of sleep per night. However, at the extremes, some people need only 4 hours of sleep and others require 10 hours of sleep. Moreover, a person’s sleep need might change depending upon life circumstances. At this point, it is important to remember that optimal amount of sleep lets us not only feel alert and energetic during the day, but it also allows us to best manage our emotions and reactions to the difficult things going on for us in our lives. It gives us a resilience that helps us navigate the tough things that come up, deal with our stresses, and figure out things we’re struggling to work through. It can also just brighten our spirits and give us relief and positivity during a difficult period of time.

Insomnia is diagnosed when poor sleep is associated with distress and/or daytime consequences, such as impairment in function or mood. Insomnia often begins during periods of stress. About 75% of people with insomnia can identify a trigger that initiated their insomnia. Examples include health issues and/or stress related to family or work situations.

Poor sleep is a common reaction to stress but there are large individual differences in how people react to and cope with stress. These differences likely play a role in the development of insomnia. Most of the time, sleep normalizes after the stress that started it subsides or after the medical condition that caused it is treated. However, in some cases insomnia persists.

This can happen if there are perpetuating mechanisms present such as the following:

  1. The bed and the bedroom become linked with wakefulness, arousal, or negative emotions. This is known as conditioned arousal or conditioned insomnia. The bed and the bedroom become unconscious cues for arousal rather than sleep. For example, many people with insomnia report that they dose off while watching TV or reading in the living room, only to become fully awake when they go to bed. For these people, past experience with tossing and turning while trying to sleep has made the bed a cue for wakefulness rather than sleep. Conditioned arousal can develop even when the main problem is prolonged awakenings in the middle of the night, rather than difficulty in initially falling asleep.
  2. Some people react to poor sleep by trying harder. They extend the time they spend in bed, avoid previously enjoyed evening activities, and spend long periods tossing and turning in bed. These strategies do not solve the problem. In fact, such strategies make it worse. Prolonged time in bed actually promotes wakefulness. The very act of “trying” to sleep produces frustration, increases arousal, and can become a hidden source of stress. This process is akin to a Chinese finger cuff. The harder you try to pull your fingers out, the more stuck they become. When you let go, you can ease your fingers out.
  3. Worry about sleep is another common reaction to having difficulty sleeping particularly in those individuals who are predisposed to worry. After a period of not sleeping well, apprehension and concern that the coming night will be another struggle emerge. When unable to sleep, worries about the negative daytime consequences of insufficient sleep develop and people start to plan their day and evening activities around their sleep. Such worries, though understandable, are mentally activating and end up making sleep even more difficult to achieve.

Many people with insomnia make their problems worse by the things they do to make up for lost sleep. For example, people may go to bed too early or ‘sleep in’ following a poor night’s sleep in order to recover lost sleep. Although these practices seem logical and sensible for good sleepers who are occasionally forced to curtail their sleep (e.g., when sleep is interrupted by a sick child who needs parental attention at night), these same practices often serve to continue or worsen the sleep problems of people with insomnia. In fact, these habits are usually the opposite of what needs to be done to improve sleep.

Some people misjudge their state of sleepiness. They confuse the sense of being sleepy with the sense of being tired, fatigued, and the wish to rest the mind and the body. Being very sleepy means having to almost struggle to stay awake. When you are close to that, you are sleepy. Fatigue and tiredness reflect low energy that signals the need to rest whereas sleepiness signals the need and readiness for sleep.

Sleep scientists have yet to agree on the fundamental biological purpose of sleep. Some sleep experts believe that during sleep the human body restores and repairs cells and tissues that have been damaged or destroyed while we are awake. Other experts think that sleep is necessary to maintain a constant body temperature. Still others believe that sleep is essential to the maintenance of normal human metabolism. Regardless of these different opinions, sleep experts generally agree that to function best we all require consistent, good quality sleep. What is the right amount of sleep? The answer varies from person to person. Moreover, the sleep need of each person may vary depending upon life circumstances and age.

Next week, I will explore some of the reasons why we sleep. If you’re looking for some tips on getting better sleep in the meantime, I shared some tips with Reader’s Digest recently that you can get started with.

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