A Sleep Expert Answers All the Questions You Have About Zzz's
Sleep is essential to our mental and physical health, yet most folks still aren't snoozing enough. Here, Seema Khosla, M.D., the medical director at the North Dakota Center for Sleep, the chair of the American Academy of Sleep Medicine's Public Awareness Advisory Committee, a medical adviser for MedBridge Healthcare, and the host of the Talking Sleep podcast, explains why we need to spend more time in bed.
Why do so many people struggle with sleep?
"In the U.S., the No. 1 reason for sleepiness is simple: We don't get enough sleep. Most of us need seven to nine hours a night. But we tend to minimize its importance. There's this mentality of, I'll sleep when I'm dead. That's not great.
"As a sleep doctor, sometimes the hardest part is getting people to understand that the problem is they're not allocating enough time for sleep and the answer isn't a medication to keep them awake. The answer is to get more sleep. Shift your mindset to realize that it's not a waste of time — your body is doing important things while you're sleeping. Prioritize sleep — it's essential to your health. It affects every organ system."
How exactly do zzz's help our health?
"That seems like an easy question to answer, but we don't really know all the answers. We do know that it's restorative. There are repair processes that happen when we sleep. For instance, debris builds up in the brain all day. Some of that debris is beta-amyloid, which has been linked to Alzheimer's disease. When you sleep, it is cleared away.
"When someone is chronically sleep deprived, we see changes in hormone levels. They produce more of a hormone called ghrelin. It doesn't necessarily make you hungry, but it makes you feel less full. So then you snack and graze throughout the day.
"We also know that sleep is important for immunity, especially during this pandemic, and that it helps with vaccination uptake. There's data showing that if you sleep well the night before your vaccine, you'll probably have a better immune response. And we know that we're not as sharp and that we don't perform as well the next day if we don't get enough sleep." (Related: How Sleep Boosts Your Immune System, According to Science)
How do circadian rhythms affect sleep?
"Most of us go to bed around 10 p.m., and wake up around 6 a.m. Then there are night owls who are up until 2 a.m. and would sleep until 10 a.m. if they could. Other people go to bed at 8 p.m. and wake up at 4 a.m. In the past we vilified people who stayed up late. You had to be at your desk early to be successful. But now there's recognition that if you can schedule your work around your circadian rhythms, you're going to be more productive.
"Working from home has shown that for many of us, if we're allowed to set our own schedules, then we get more done. If you're hurrying to get to the office at 8 a.m. and your first hour is spent waking up, what's the point of that? I hope we keep some of what we've learned during the pandemic."
What's the most important thing we can do to snooze better?
"Get away from your devices 30 to 60 minutes before bed. All of them — phone, laptop, TV. That's crucial. There was a study of people who were on their iPads before bed. While they were sleeping, there were continual three-second shifts in their EEGs that looked as if they were waking up. There are these kinds of arousals in people who are on their devices before bed. And it takes a week of being off your device for them to go away." (See also: 5 Things I Learned When I Stopped Bringing My Cell Phone to Bed)
It's the middle of the night, and we're tossing and turning. Now what?
"We all tend to catastrophize. We lie there thinking, 'If I don't sleep well, I'll be ruined the next day.' The reality is, you're probably going to be okay — unless you're a pilot, in which case you should absolutely not fly the plane. Most of us will be fine if we have one night of bad sleep. The truth is, no one sleeps well every night. So you need to reframe the way you look at it.
"Progressive muscle relaxation is great. Flex and relax your muscles working from your toes to your head. Forget about counting sheep — research has found that if you're doing anything with numbers, it actually activates part of your brain. Instead, visualize your happy place — the lake or the ocean or whatever. I tend to do some deep breathing, some visualization, and something mindless. Sometimes I'll think about what I'm going to wear the next day or what I'm going to have for lunch. The key is not to pressure yourself. Give yourself a little grace and think, You know what, sleep will come. And tomorrow is another chance to get it right." (Related: Prevent Sleep Anxiety with These Tips)
Shape Magazine, October 2021 issue