An exploration of sleep and insomnia, with a single destination in mind:
a good night's sleep.

Thursday, December 31, 2015

Nod by Adrian Barnes (a Book Review for Insomniacs)

Sure, it sucks when you can’t sleep. You're tossing and turning in bed all night long. Your eyes look like they're held open with toothpicks; your mind replays the day in a neverending loop; you feel worn down like a car tire that’s never been changed. But no matter how tired you are, you're unable to sleep. We’ve all had nights like that.

As awful as a night without sleep makes you feel the next morning, imagine what life would be like if you could never sleep again. If the night before was the last time you ever slipped into unconsciousness. If your mind and body never again got its eight—or even four or three or any—hours of necessary rejuvenation. Imagine that it’s not that you don’t need sleep—you do need sleep, you desperately do—and you long for sleep more than you’ve ever wanted anything in your life. The problem is that you can’t ever sleep again.

Nod by Adrian Barnes
Now imagine that the entire world is afflicted with the same sickness, incurable, and endless—or for as long as you can live without sleep. Which isn’t long. It’s about thirty days before you brain and body shut down. And before your thirty day expiration date arrives,madness is your certain fate.

That’s the premise of Adrian Barnes’ debut novel Nod: A world in which suddenly nobody sleeps anymore. Or almost nobody: One out of about every 10,000 people still sleep.

Nod takes place in Vancouver, Canada and follows the lives of Tanya and her husband Paul, an etymologist and writer, who is one of the rare Sleepers. Paul is the novel’s narrator. Early on in Nod, Tanya, an Awaker, desperate for sleep as anyone would be after several days of watching the moon make its slow crawl across the sky, demands sex from Paul, because she hopes that will get her to sleep. Tanya and Paul’s touching is coarse, brutal, and primitive, setting the stage for the rest of the novel.

In Barnes’ world, some children can sleep. As the Awakers’ psychosis grows, the Awakers come to believe that drinking the blood of these children will cure their terminal insomnia. The Awakers, banded together in savage, hierarchical packs, hunt the children.

Can the Sleepers protect these children? How can the Sleepers even protect themselves from desperate Awakers while they sleep? Will the Sleepers be able to ride out these terrifying four weeks until the Awakers, rapidly devolving into their Neanderthal progenitors, finally die?

Violent, frightening, textured, and dystopian are words that aptly describe the short-lived world that Barnes has created. Barnes’ writing is beautiful, but sometimes a little too good; the descriptions, both compelling and creepy, occasionally subtract from the story he’s trying to tell:
What else do I see? Packs of dogs, heads hovering low, roam the periphery of things. The long-standing human-canine alliance has been irretrievably severed, I’m sincerely sorry to report—the gnawed bones and matted chunks of hair scattered along the shores of Lost Lagoon testify to this. It’s sad, but then again those plump collies and German shepherds don’t seem too weighed down by nostalgia for bone-shaped vegan treats and belly rubs from the opposably-thumbed as they wander about, licking their chops.
Nod is a must for every insomniac because it shows you that no matter how bad your night of no sleep is, things could be a lot worse. The usual warnings about not reading a scary novel in bed when you want to sleep don’t apply here. Nod is best enjoyed in the place that you want to sleep because you will eventually fall asleep—unlike the doomed souls in Adrian Barnes' novel.

Monday, December 28, 2015

Belsomra Report Card: Meh

By Ken Mallows

            Readers of this blog know that we're not particular fans of sleep drugs. We're not against the occasional use of prescription medicine for sleeplessness, but the science shows that continual use of sleeping pills may do more harm than good. Plus, they really don't solve your sleep issues; they mask them.
            We think that natural remedies and techniques are best in the long run.
            We're always willing to have our minds changed – we believe in modern medicine – but such is not the case with a relatively new drug known as Belsomra from drug maker Merck. Belsomra is a new type of sleep medicine called an orexin receptor. The chemical name is suvorexant. Most sleeping pills increase GABA a neurotransmitter that slow brain activity so you can nod off.  Belsomra decreases the neurotransmitter Orexin which keeps you up.
            Merck's TV commercials have been a big hit, using an odd (and to me, scary looking) plush creature that is supposed to show the drug gently purring you to sleep. Belsomra has been around a little over the year and doctors wrote 4,000 prescriptions when it first hit pharmacy shelves. It may turn out to be the best selling insomnia medication ever which is saying something because the FDA estimates that docs handed out more than 42 million sleep aids scripts in the U.S. in 2014.
            So what's the problem?
            Clinical tests show that Belsomra may really not work any better than Lunesta and Ambien, which both have their own problems. According to  Dr. Gregg Jacobs, an insomnia specialist at the Sleep Disorders Center at the UMass Memorial Medical Center: "At the 20 mg dose [the highest] that was approved by the FDA, people ... only obtained an extra 16 minutes of sleep. This is meaningless clinically." Participants also only fell asleep an average of six minutes faster than those who took a placebo.
            Consumer Reports also weighed in and commissioned two drug safety experts—Steven Woloshin, M.D., and Lisa M. Schwartz, M.D., both at the Geisel School of Medicine at Dartmouth—to review the research about Belsomra. Schwartz served on an FDA advisory committee of experts that looked at Belsomra in 2013. According to their analysis "people who took a 15 mg or 20 mg dose of Belsomra every night for 3 months fell asleep just 6 minutes faster on average than those who got a placebo pill. And the Belsomra group slept only 16 minutes longer—6 hours and 12 minutes total vs. 5 hours and 56 minutes for the placebo group, Consumer Reports reported.
            Like other pills such as Ambien and Lunesta, users also reported being drowsy the next day not to mention a drop in memory and other cognitive functions. Other tests of the Belsomra showed that it worked about the same as a placebo and that cognitive behavior therapy worked better than all drugs. In fact, CBT works on about 80 percent of those with insomnia. Studies also show other tricks like relaxation, cutting back on blue light before bedtime, exercise and cutting back on caffeine all help to give you a good night's sleep.

            Belsomra's success in the marketplace cannot be denied, however, but it speaks more to advertising and patient pleas to their doctors just to get the good night's sleep that they so dearly want and need – and will do most anything to achieve. 

Saturday, December 26, 2015

Explainer: What Is Jet Lag and How Can You Overcome It?

By Leon Lack

Long flights across many time zones often leave us feeling fatigued, sleepy, irritable and generally out of sorts. And it’s not just because of poor sleep on the plane and dehydration from the altitude – the feelings persist for several days.

Jet lag is caused by our 24-hour body clock lagging behind the rapid change of clock time over the flight. Our body clock has a strong effect on the times across the day we feel alert and when we feel sleepy. The body clock consists of our circadian rhythms.

For a person who regularly sleeps from 11pm to 7am, all of our circadian rhythms will become aligned to ensure best sleep during those times. In the middle of the sleep period, around 4am, the body drops to its lowest body temperature (known as Tmin). This is also the time when melatonin hormone secretion is highest.

The alignment of these rhythms is not caused directly by the timing of our sleep period, but indirectly by the timing of darkness during sleep and visual light stimulation when we are awake.

Once the body clock becomes stabilised, it is resistant to change. So, after less than a day in the air, our body clock is still on home time when we arrive at our destination. This is where the problem arises.

Flying westward

Take the example of flying from the Sydney to London. At this time of year, there is a nine hour time zone difference between the two cities. If you arrive in London at 7am in the morning, your body clock will be telling you it’s 4pm.

By 1pm London time, you’re likely to want to take a nap. But try not to fall into a deep sleep; your body will be telling you it’s 10pm so you’ll have to resist the urge to sleep through until 7am your body clock time. This, of course, would mean waking up at 10pm London time ready to start your “day”.

If you manage to stay awake until early evening, you will still be woken up early the next morning by your early timed body clock and early “wake-up zone”, making you feel tired the next day. Until you can shift the timing of your body clock later by about eight to nine hours, your jet lag will continue to cause extreme tiredness in the late afternoon and disturbed sleep at night.

Lowest body temperature shifts from 4am Australian time to 7pm UK time
 (orange arrow pointed to the left). She must now delay her body clock by nine hours
(bottom orange arrow pointed to right). Leon Lack/The Conversation

Resetting your body clock

The good news is you can re-time the body clock. The strongest effect is from appropriately timed visual light stimulation.

But take care to get the timing right so you move your body clock in the right direction. Light stimulation before your body reaches its lowest body temperature (Tmin), usually about 2 hours before your typical wake-up time, will delay your body clock to a later time. However, light after Tmin will shift your body clock earlier.

For a Sydney to London trip, you would need to delay your body clock by about nine hours to most quickly align your body clock to London time. Fortunately, normal daylight can be used as it occurs before Tmin up to about the Tmin time. So spend the day outdoors if possible. Even a cloudy day is better than staying indoors.

However, after your body clock has been delayed by a few hours from outdoor light, your Tmin will now have moved “out of reach” of the delaying effect of daylight, since only light administered close to Tmin has a strong re-timing effect. Your body clock re-timing may stop well short of the eight to nine hour delay needed for full re-alignment.

In that case, it would be useful to use artificial indoor light stimulation in the later evening to complete the jet lag cure.

Flying eastward

Flying across many time zones in the opposite direction (eastward) can present a more challenging re-adjustment. Flying across seven time zones to the US West coast, for instance, requires an advance of the body clock (re-timed earlier).

This is the same type of change needed when we go onto daylight savings time in the spring. That causes some disruption of sleep and daytime alertness for a few days in many people. Now multiply that change by seven times and it will give you some perspective on this jet lag disruption.

If your trip is short, it may be
less disruptive to not go
through any re-adjustment
olaerik/FlickrCC BY-NC-SA

Upon arriving at your US West Coast destination, your body clock timing will be seven hours too late. The time of your Tmin may be as late as 11am instead of 4am. Your body won’t be ready for sleep until the wee hours of the morning and it will want to sleep most of the day away (an extreme example of the delayed sleep pattern of many adolescents).

Again, light can be used to re-time your internal clock. To maximise the re-timing effect you should avoid very early bright light up until about 10am because being before your Tmin it might shift your clock in the wrong delay direction. Instead you should get bright light preferably for several hours starting around 10am.

Then, as your body clock becomes timed earlier the beginning of the light stimulation can start earlier (8-9am) to complete the re-alignment job.

Overcoming jet lag

One way to reduce the time taken to overcome jet lag in your destination is to do some re-adjustment of your sleep period and light exposure before leaving on your trip. Jet lag calculators can work out the specific times for your light exposure before and after the trip.

Taking melatonin can also assist this re-timing process: a low-dose (0.5-1mg) short-acting preparation (available over-the-counter in the US or by doctor’s prescription in Australia) taken at the desired bedtime in your destination. In conjunction with appropriately timed bright light, melatonin can greatly reduce the duration of your jet lag.

But should you even attempt to re-time your body clock? That depends on how long you’re staying in the new time zone. If your stay is short (one to three days), it may be less disruptive to not go through any re-adjustment but simply keep your body clock on “home” time. That way you also avoid re-adjusting again when flying home. Most airline flight crew follow this rule.

But if your stay overseas is going to be at least a week and if you want it to be more pleasurable, you can minimise jet lag by appropriately timed light stimulation and melatonin.

The Conversation
Leon Lack, Professor of Psychology, Flinders University
This article was originally published on The Conversation. Read the original article.

Thursday, December 24, 2015

How Late in the Day Can You Drink Coffee?

Attention coffee addicts. How late in the day is it safe to have a cup of regular coffee? Will that 7 PM cup of Joe keep you from falling asleep? What about coffee at 4 PM?

Scientists have studied this question in considerable detail and have found that for regular mortals, drinking coffee within six hours of when you want to sleep is a bad idea. Caffeine "6 hours prior to bedtime each [has] significant effects on sleep disturbance relative to placebo." This study, reported in the Journal of Clinical Sleep Medicine concluded, "The magnitude of reduction in total sleep time suggests that caffeine taken 6 hours before bedtime has important disruptive effects on sleep and provides empirical support for sleep hygiene recommendations to refrain from substantial caffeine use for a minimum of 6 hours prior to bedtime."

Summarizing this study, Michael J. Breus, Ph.D, a Clinical Psychologist and both a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine wrote, "Even if you don’t feel that late-afternoon cup of coffee has a negative impact on your sleep, this study suggests that it is likely to be interfering nonetheless. This is one reason that I have long recommended a 2 PM cutoff time for caffeine consumption."

The study's author, Christopher Drake, PhD, emphasises the point that late afternoon coffee is harmful to sleep: "'Drinking a big cup of coffee on the way home from work can lead to negative effects on sleep just as if someone were to consume caffeine closer to bedtime. People tend to be less likely to detect the disruptive effects of caffeine on sleep when taken in the afternoon."

Another study in the journal Science Translational Medicine found that caffeine can alter your body's circadian rhythm and disrupt the production of melatonin, a hormone that helps us fall asleep.

An Israeli study showed that late night coffee can reduce the amount of sleep you get by an hour and a half

So there you have it. Six hours before you want to sleep, definitely stop drinking coffee (and other caffeinated beverages.) Make 2 PM your cutoff time, if you want to doubly ensure a good night's sleep.

Monday, December 21, 2015

Lose Weight - Any Amount - and Sleep Better

By Ken Mallows

The act of losing weight – not necessarily trimming down to your ideal weight  – may help you sleep better, according to researchers from the Perelman School of Medicine at the University of Pennsylvania.

Doctors know that obesity can lead to sleep-robbing factors such as snoring and sleep apnea, but they are not clear on how much weight a person needs to shed in order to see an improvement in sleep. This research shows that mice who lost weight slept fewer hours and showed increased alertness than mice who didn't lose weight despite how much they lost or at what weight they started and ended.

In this research, half of the mice received their normal diet while the other half received a high fat diet. In fact, they ate three times more fat for eight weeks. At the end of that period, some of the mice were switched to the alternative diet for one week causing the high fat content mice to gain weight and the newly fed normal diet to lose weight. The rest of the mice consumed their current diet.

A week later, nine weeks total, mice who ate the high fat diet weight 30 percent more, slept more than one hour longer per day, and showed signs of drowsiness during the day compared to the regular diet mice. The “diet switch” groups, however, had similar body weight at week nine, but completely different sleep/wake profiles when compared to each other.

“Our findings suggest body weight is a less important factor than changes in weight for regulating sleepiness,” said the study’s lead author, Isaac Perron, a PhD student in Neuroscience at the University of Pennsylvania. “Diet-induced obese mice that ate a regular chow diet for only one week showed the same sleep/wake profile as mice that ate a regular chow diet for nine weeks.”

The implications for humans is that losing some weight, no matter how much, can improve sleep quality.

 “The diet consumed during the final week was key to driving the sleep effects, independent of the starting body weight,” said Perron. “If you’re overweight and often feel tired, you may not need to lose all the weight to improve sleep, but rather just beginning to lose that excess weight may improve your sleep abnormalities and wake impairments.”

The research was published in the current issue of the journal Sleep

Thursday, December 17, 2015

Should You Sleep Naked?

What yields a better night's sleep? Wearing pajamas or sleeping naked?

Photo by Vidibio. Licensed under Creative Commons.
The answer, if you haven't tried it, is that for many people sleeping naked does a better job of letting them fall asleep and stay asleep. Less than 10 percent of Americans sleep naked. But maybe they know something that you don't know. There are several reasons why sleeping in the buff is healthy, and one important reason why sleeping naked may not work. Let's start with the reasons why sleeping au natural can help fix your insomnia.

First, if you and your partner sleep naked, you have a slightly --or perhaps considerably-- greater prospect for sex. Sex is often a great soporific. Or, let's put it this way, sex is better at relaxing you than editing that office report in bed. According to Sheenie Ambardar, MD “After orgasm, the hormone prolactin is released, which is responsible for the feelings of relaxation and sleepiness"

Second, sleeping naked reduces the feeling of weight on your body. Pajamas, nightgowns and other bed clothes can twist and that can cause mini-wakings. You know how that works: You turn one way, but your pajama pants turn the other way. The less pressure, even from something as relatively light as a flannel nightgown, the more at ease your muscles will be. The less often you'll wake up at night.

Cooler temperatures are better for sleep: Between 60 and 67 degrees is optimal. Having a blanket on top of you makes you warmer, but it's easy to slip your leg out from under that blanket, or to pull it down or entirely off of you, if you become too hot. But it's harder to achieve the best sleeping temperature if you're wearing pajamas and you have a blanket on top. Lose the pajamas for a cooler environment and a better sleep.

Some people report that when they sleep naked, they wake up more refreshed because they've sweat less during their sleep. Waking up more easily, more refreshed, is a sure sign that you're sleeping better. Waking up refreshed is sleep's mission.

Not sweating also reduces the need for a nighttime glass of water: Sweat, drink. Drink, have to go to the bathroom. Sleeping naked can help break this thirst, drink, bathroom cycle.

Give this experiment a week, or a month if you can. As with many sleep tips, there's no way to know if it's going to work for you or not. The only reason not to sleep naked is that doesn't help you sleep faster or longer. But the only way to know is to try.

Monday, December 14, 2015

Does Exercising at Night Keep You From A Restful Sleep?

By Ken Mallows

The argument about exercising at night and its effect on sleep seems endless. Some health care professionals believe that exercising at night only serves to energize you, raise heart rate and body temperature, releases stimulating epinephrine, and therefore keeps you awake when you want to fall asleep.
Others say exercising, no matter when it’s done, helps promote sleep by tiring the body, calming nerves and producing an overall feeling of health and well being that is conducive to slumber.

Who's right?
The question is an important one because some people can only find the time to exercise after work, after chores, after dinner. At night. And, some folks are just not morning exercise types. They simply can't do it.
A 2011 study published in the Journal of Sleep Research suggests that night exercise may impair sleep, but in ways that may not matter so much. The report stated: "This study showed that relatively short vigorous exercise 2-2.5 hours before bedtime did not influence HRV [heart rate variability] or objective sleep quality but was sufficient to increase HR [heart rate] and stress vector during the first hour of sleep. Thus, our results are consistent with the general view that late-night exercise may impair sleep, and indicate that physiological stress reactions caused by exercise may be reflected in cardiac autonomic variables during sleep." That doesn’t mean that you're getting a bad night's sleep, just that your heart rate may be elevated and that may or may not be an issue for your particular sleeping regimen during the early hours of sleep.
Confused? Hold that thought…
A National Sleep Foundation 2013 poll found that 83 percent of people who exercised any time during the day – including night time – reported sleeping better than those who didn't exercise at all. Sounds simple but keep in mind that unlike the first study, the data here was self reported and subject to people's biases and opinions.
It appears that we're getting mixed messages. So what's the answer?
(There's also discussion in medical circles about what time of day you exercise yields the best fitness results, but that's another story.)
For the most part, exercising at any time will help you sleep better – but with a caveat. If you exercise at night, allow yourself time to wind down before getting into bed. Give your body the opportunity to relax, allow adrenaline levels to drop and give your brain a chance to quiet down. Ditto for your heart rate. You may be still mentally amped up from your exercise session where you were on high alert guarding against injuries, dodging pedestrians or keeping pace with an unrelenting treadmill's movement.
Most important, in this age of personalized medicine, do what works for you. If you find that evening or night exercising keeps you up, then don’t do it. Simple. If it makes no difference, then have at it.
One size does not fit everyone.

Thursday, December 10, 2015

The Pillow Between Your Knees Tip

by Bill Adler

Laying in bed can bring instant relief to an aching back, but if you spend too much time laying down, your back can ache again. And that's not good for sleep at all: When your back hurts, sleep slips away.

Beds are our best friends and our worst enemies. For our backs that is.

What can you do if back pain is keeping you awake, or waking you up in the middle of the night?

Try sleeping with a pillow between your knees. Keeping a pillow between your knees can go a long way toward giving you a more fulfilling and complete sleep. "If you sleep on your side, a firm pillow between your knees will prevent your upper leg from pulling your spine out of alignment and reduce stress on your hips and lower back. Pull your knees up slightly toward your chest," writes the University of Utah Health Care Center.

If you've always thought of a pillow being just for your head, you should expand your vision of what a pillow can do for you. Writes the Mayo Clinic, "If you sleep on your side, draw your legs up slightly toward your chest and put a pillow between your legs. Use a full-length body pillow if you prefer."

For back sleepers, pillows can be a gift, too. Again, the Mayo Clinic: "If you sleep on your back, place a pillow under your knees to help maintain the normal curve of your lower back. You might try a small, rolled towel under the small of your back for additional support. Support your neck with a pillow."

If lower back pain is keeping you awake, you may find that putting a pillow between your knees gives you instant back pain relief, and with it, more sleep. If you've never tried this and you have back pain, you will say to yourself "Oh, ah..." the moment you put that pillow between your knees. What comes next is a longer and more restful night of sleep.

There's one thing you should know about this tip: Anytime you change the physical environment in which you sleep, it may feel odd. A pillow between your knees may also keep you awake just because it's different. But the good news is that everyone who's used this tip has gotten over the oddness of a pillow between their knees in just a few days, and is sleeping soundly.

Monday, December 7, 2015

The YouTube Video That's Putting People to Sleep

By Ken Mallows

A video intended to show off the beauty of Ireland has become an internet phenomenon with more than 10 million views, but that's not why I'm telling you about it.

The video is helping people sleep. Insomniacs and others who have trouble getting to la-la land are using the video and the accompanying audio to help lull them to sleep.

According to the BBC, the video has proven so successful that it’s even being tested in several London hospitals.

The videographer is Johnnie Lawson, an artist from County Leitrim. He told the BBC: "People who were finding it difficult to sleep began writing to me from all over the world North Korea, the Central African Republic, Beijing and across the UK… They started leaving me messages, saying the recordings were helping to relieve their insomnia."

The bucolic scene of a small rapids and stream in Lurganboy forest is accompanied by the sounds of singing birds and gently flowing water. Users report that it's the sounds more than the video that helps them get some shut-eye.

The video is 8-hours long so there's no need to put it into an endless loop mode.

Here are some typical reports from users that were written in the YouTube comments section:

"I read online that this video is supposed to help people sleep the last few weeks I've had very restless night's sleep so I said I try it, thinking this couldn't possibly work. Left the last 20 minutes play in the background on my phone next to my pillow. Fell asleep almost immediately and woke up never feeling more refreshed."

"I listen to this to help go to sleep and if I wake up in the middle of the night, it's still on so I can get back to sleep."

Some people just find the sounds relaxing and conducive to other activities:

"I was so stressed out because of these two tests I have to take tomorrow, but then I found this and it's really helping me to study. Thank you."

"This is healthy - my headache is gone after a while. So I skip the pills. Thx Johnnie!"

To those who study sleep disorders, these comments come as no surprise. Many people respond to the natural sounds of streams and birds and find them soothing. For others, alternative sounds work. You can find a slew of additional sounds designed to relax, comfort and put you to sleep. We like the many choices at Spotify. They're free. Go to the website and sign up, then head over to the 'Browse" area and then click "Sleep." I'm sure you will find a sound that suits you, anything from rain on a tin roof (W.C. Fields's cure for insomnia) to wind, tropical rain forests, ocean waves and more.   

Give it a try, and let us know what works for you.

Thursday, December 3, 2015

Didn't Get A Good Night's Sleep? Take a Sleep Sick Day

by Bill Adler

If you slept badly or not at all, you're going to be worthless at work.

A sleep sick day will do you a world of wonder. Photo by
martinak15. Licensed under Creative Commons. 
Sure, you may be able to go through the motions, but let's face it, without sleep, your nose is going to mostly be planted on your desk for the day. And if you do somehow manage to keep your eyes open, your productivity's going to be subpar. Very sub. Put bluntly, you're going to make a lot of mistakes and embarrass the hell out of yourself. Even normal actions, like being able to read facial expressions fall by the wayside when you're sleep deprived.

The solution? Take a sleep day. Take a sick day. Think of it as a sleep sick day. Being severely sleep deprived is equivalent to being sick as far as your ability to do good work is concerned. And as you know, coffee's power to make transform your body and mind into an energized human being is limited.

But even more significant than failing your employer when you don't get enough sleep are the health problems that sleep deprivation causes. These include weight gain, cardiovascular disease, high blood pressure, a lack of sex drive, accelerated skin aging, and premature death. Do you think that cold's bad? Lack of sleep is even worse for your body because sleep deprivation's adverse health effects are both acute and cumulative. In every way that matters, being sleep deprived is the equivalent of being sick with the potential to become even sicker.

What should you do during your sleep day? Nap, of course. Read in bed and fall asleep reading. Watch a movie and fall asleep watching. Play with your dog or cat and let them cuddle next to you after you fall asleep play together. You don't need to commit to a specific number of hours when you're trying to catch up on sleep: Research shows that some sleep is better than no sleep. You can make temporary use of polyphasic sleep, the practice of sleeping for short intervals during a 24 hour period.

Don't feel guilty about taking a sleep day. Rest, close your eyes, become normal again. You'll not only do your employer a favor, but you'll help keep yourself healthy.

How Much Sleep Do We Need?

By Gemma Paech

The amount of sleep adults need has once again come under the spotlight, with a recent Wall Street Journal article suggesting seven hours sleep is better than eight hours and the American Academy of Sleep Medicine drawing up guidelines surrounding sleep need.

So, what should the guidelines say? Unfortunately, when it comes to the amount of sleep adults require there is not really a “one size fits all”. Sleep need can vary substantially between individuals.
Sleep is regulated by circadian and homeostatic processes, which interact to determine the timing and duration of sleep. The circadian process represents the change in sleep propensity over 24 hours, or our internal “body clock”. The homeostatic process represents the accumulation of sleep pressure during wakefulness and the dissipation of sleep pressure during sleep.

Both the circadian and homeostatic processes are influenced by internal factors, such as genes, and external factors, such as prior sleep history, exercise and illness. Individual variations in sleep timing and duration can be largely explained by these internal and external factors.

Individual sleep need

Genes are important in determining diurnal preference: whether we are “night owls” who prefer to stay up late at night, or “early birds” who prefer to get up early in the morning. Genes may also contribute to whether we are “short” or “long” sleepers.

But although genes form the foundation for sleep timing and duration, many external factors also affect sleep need.

Perhaps one of the more common causes affecting sleep duration relates to sleep history. Many adults, whether they know it or not, experience sleep restriction, often on a daily or weekly basis. Restricting sleep or going without sleep (pulling an “all-nighter”) increases sleep pressure.

This sleep pressure dissipates within sleep, so higher sleep pressure requires longer sleep duration. As such, following sleep loss, sleep need increases.

Restricting sleep increases sleep pressure. Kevin Jaako/Flickr, CC BY-NC

Health, exercise, heavy labour, and even mental workload can affect sleep duration. During times of illness, following exercise, or even following periods of mental stress (such as exams), the amount of sleep needed to recover or restore back to normal can increase. Likewise, individuals who suffer from disease or who have poor health may need more sleep than their healthier counterparts.

Sleep need also varies with age, with elderly people generally sleeping less than younger individuals. Age-related changes associated with sleep duration are thought to be due to changes in the interaction between the circadian and homeostatic processes.

The individual variations in sleep need make it difficult to provide a specific recommendation as to how much sleep adults need. However, most sleep researchers generally agree that seven to nine sleep is what the majority of adults require to function at their best.

Why eight hours sleep?

Sleep restricted to seven hours or less results in impairments to reaction time, decision making, concentration, memory and mood, as well increased sleepiness and fatigue and some physiological functions.

On the other hand, eight hours or nine hours sleep has little impact, either negatively or positively, on performance.

Based on these findings, it would seem that for most of the adult population, somewhere between seven and nine hours of sleep is the “right amount”.

This is not to say that more than nine hours sleep is not good. Rather, extending sleep duration may help to “protect” waking function during subsequent periods of sleep loss. While we may not need ten hours sleep all the time, there are some clear benefits from getting more sleep.

Needing an alarm clock to wake up suggests you may not be meeting your sleep need.
Jim Wall/Flickr, CC BY

But I am fine with six hours sleep…

The first question you need to ask yourself is, are you really?

You may be one of the lucky few with the “right” genetics. However, it’s more likely that you are simply unaware of how sleep loss is impairing your waking functions.

How we feel does not always reflect how badly we may be functioning, which may result in delusions about how much sleep we really need. Needing an alarm clock to wake up and the desire to sleep-in on weekends/holidays suggests that sleep need is not being met.

Critically though, if you have difficulty sleeping for a continuous eight hours, try not to worry too much, as this may make things worse.

Finding your optimal sleep duration

The amount of sleep need can vary significantly and can depend on multiple different factors, making it difficult to work out optimal sleep need. Below is a guide that might help to determine sleep need.
  1. Keep a diary of your sleep. Include the times you went to bed and woke up, how you slept and how you felt during the daytime
  2. Go to bed when you feel sleepy/tired
  3. If you can, don’t use an alarm clock, rather, let your body naturally wake up
  4. Try to get natural sunlight exposure during the day
  5. Keep to a regular sleep schedule all days of the week.
After a while, you should be able to work out the best timing and duration for your sleep. If you are still unsure or concerned, see your general practitioner. Remember, though — sleep need can change with circumstances, so always listen to your body.

The Conversation
Gemma Paech, Research Associate, Centre for Sleep Research, University of South Australia
This article was originally published on The Conversation. Read the original article.