What do the Chernobyl nuclear explosion, the Three Mile Island partial nuclear melt- down, and the Exxon Valdez oil spill have in common? Aside from being unprecedented catastrophes, they have each had their causes linked, in part, to the missteps of sleep-deprived workers.
Of course, these are extreme examples of the impact of inadequate sleep. Still, every day in this country, the effects of drowsiness are felt: Experts cite excessive sleepiness as the second leading cause of car crashes and a major cause of truck crashes in the United States. Sleep-deprived workers are 70 percent more likely to be involved in accidents than nonsleepy workers, according to the National Sleep Foundation.
Not getting enough sleep—generally six hours or less a night—has also been linked to a reduced quality of life and health complications that include increased risks for cardiovascular disease, diabetes, a weakened immune system, and obesity. Sleep deprivation affects performance and reaction times—which elevate the risk of accidents and death—and mental health.
“People trying to improve their health make time to exercise and prepare healthy meals, but what many don’t improve is their sleep—and getting enough good-quality sleep is crucial for overall health and quality of life,” says Ana C. Krieger, M.D., M.P.H., the medical director of the Center for Sleep Medicine at NewYork-Presbyterian/Weill Cornell Medical Center in New York.
What is ‘enough’ sleep?
In 2015 alone, several major organizations—including the American Thoracic Society (ATS), the NSF, and the American Academy of Sleep Medicine (AASM) along with the Sleep Research Society (SRS)—weighed in on the amount of nightly sleep healthy adults should get—and all agreed that most people should aim for at least seven hours a night.
The ATS and the AASM/SRS expert panels recommend a sleep duration between seven and nine hours for most healthy adults, narrowing that range to seven and eight hours for adults 65 and older. The groups point out that sleep needs may not be the same for all individuals. Some people may function normally with less—or more—sleep than recommended. Further- more, the amount of high-quality research on adequate sleep duration is slim.
“While sleep duration is important, quality plays a critical role, too,” Krieger says. “If you’ve ever woken up groggy after getting what you thought was a full night’s sleep, you’ve probably been the victim of poor sleep quality.”
It’s a also myth that the older you get, the less sleep you need. However, your sleep patterns may change as the rhythm and timing of your internal body clock changes. Older adults may typically find themselves rising earlier, going to bed earlier, spending less time sleeping overall and having difficulty maintaining sleep at night.
“Sleep complaints are common in adults over age 65,” Krieger says. “You may sleep less soundly, achieve a lower amount of deep sleep and your sleep may become fragmented—that is, you wake up more often and for longer periods.
Some changing sleep patterns related to age are normal. But a pattern of sleeping poorly, waking up tired, and experiencing daytime sleepiness is not, especially when it affects basic activities of daily living or cognitive abilities.”
Such age-related changes in sleep patterns may be chalked up to various factors, including a decrease in the production and secretion of melatonin (a hormone that’s key in regulating sleep/wake cycles and that promotes drowsiness) and increased sensitivity to noise and other distractions while sleeping. Chronic conditions, such as heart or lung disease, prostate problems, arthritis, and dementia, can also affect slumber.
Obstructive sleep apnea is another common cause of nocturnal awakenings. It has been connected to increased risk of stroke and cognitive defects and estimated to be undiagnosed and untreated in more than 80 percent of people who have it. Unfortunately, sleep apnea worsens with age.
Over time, sleep disturbances can lead to depression, attention and memory issues; daytime dozing; and increased risk for falls—especially at night and when using sleep-inducing medications.
Too much sleep
People who sleep more than nine or 10 hours a night may also experience adverse health outcomes, reports the ATS. The group points to research that shows a consistent association between too much sleep and heart disease, stroke, diabetes, high blood pressure, and obesity. However, says the ATS, research hasn’t shown a direct cause between long stretches of sleep and poor health. It could be that oversleeping may be a result of poor health or physical inactivity instead of the cause of ill health.
It’s important to note, Krieger says, that a longer sleep duration may be normal in some individuals, which may be genetically based or related to age and physical activity, as seen in the younger population and athletes. If your need for sleep has increased over time to more than nine or 10 hours of sleep a night, tell your doctor, who may want to check for an underlying cause, such as sleep apnea, depression, anxiety, or other health problems.
A better bedtime
Sometimes, improving your sleep boils down to simply tweaking your sleep routines and making some lifestyle changes such as the following:
• Stick to a sleep schedule. This includes weekends when you’re likely more tempted to sleep in.
• Exercise, but not close to bedtime. Two to three hours before bedtime is a good cushion.
• Avoid alcohol. A nightcap can wreak havoc on sleep patterns and leave you stuck in lighter—or less refreshing—sleep stages. Pass on the nicotine and caffeine, too.
• Skip big meals and beverages right before bed. These can trigger indigestion and nighttime bathroom trips.
• Ask your doctor about properly timing your medication. Certain drugs, such as those used to treat high blood pressure and asthma, as well as over-the-counter cold medicine, can disrupt your sleep cycle.
• Avoid late naps. Don’t nap after 3 p.m., and keep nap lengths to no more than 20 minutes.
• Relax. Reading, listening to music or taking a hot bath can help you unwind.
• Adjust your sleep environment. This may include removing electronic distrac- tions such as smartphones, TVs or computers (the blue light they emit can interfere with melatonin production); adding room-darkening curtains; getting a new mattress; or lowering the thermostat to keep your bedroom cool and comfortable.
• Get up if you can’t fall asleep. Staring at the clock while you lie awake will likely only lead to anxiety. Instead, try a relaxing activity until you feel tired enough to sleep, and turn your alarm clock around so you can’t focus on the time.
If you still can’t shake that tired feeling, it’s probably time to seek professional sleep help. Your doctor can help rule out possible underlying causes, help you draft a treatment plan for a better night’s sleep or prescribe a sleep study to check for a sleep disorder.
You may also want to ask your doctor about a low-dose melatonin supplement to help enhance sleep, Krieger says. But beware of over-the-counter melatonin supplements, she adds, because dosages tend to be inconsistent. Seek your doctor’s advice before choosing a supplement.
Prescription sleeping pills may be beneficial for some people suffering from acute sleep loss or anxiety. If you’re considering a sleep aid, have an in-depth discussion with your doctor about all possible adverse effects and drug interactions. Work with your doctor to find a minimally effective dose.