Sleep is the single most powerful health-enhancing weapon known to humankind. As a sleep doctor, I’ve spent years reading practically every paper published on the relationship between sleep and health. The results are extraordinary. From your weight to your blood pressure to your emotional wellbeing, our night-time slumber lies at the heart of so many of the things we hold dear. And poor sleep is a cause of so many of life’s ills.
Whatever you have planned for 2022, without a robust sleep regime, you’re unlikely to achieve it. But that begs the question: how do you actually improve sleep? Where do you even start?
The obvious place is official guidelines. For years, health authorities in the UK and across the world have told adults to sleep somewhere between six and nine hours each night. It’s good advice: any less, studies show, and our health is damaged. If you spend 17 hours awake, for example, your mental performance is similar to somebody with a blood alcohol level of 0.05 percent – the legal cut-off for driving in many parts of the world.
So, what can be done about it this year? For many, simply sleeping more isn’t always possible – we have night-shifts to work, or young children for whom we must care. Instead, the key is to walk that delicate balance taking action on factors you can control – your evening routine, your bedroom environment – whilst accepting that other factors might lie beyond your control.
Why is sleep important?
Dig a little deeper and you find the reasons for this. When we are sleep-deprived, action inside our prefrontal cortex – the part of our brain responsible for regulating emotions – dials down. Instead, our thoughts and feelings become governed by the amygdala, the brain’s primitive emotional centre. We become more reactive, more instinctual; anger, sadness, and irritability start to dominate. Research suggests that we view the world more negatively when we’re sleep-deprived. Words and facial expressions are misinterpreted. There’s a reason we have the phrase, “Getting out of bed on the wrong side”.
The health effects of bad sleep get worse. If you regularly sleep fewer than five hours each night, you’re likely to have a higher blood pressure, and greater risk of diabetes. Insomniacs are 17 times more likely to experience anxiety compared with the general population. Men with long-term poor sleep have testerone levels equivalent to somebody 10 years their senior.
Conversely, a good night’s sleep helps to create immune antibodies, protecting us from viruses. Sleep also helps to wash your brain of toxins, such as the beta-amyloid protein, which builds up brain plaque, linked to Alzheimer’s. If doctors could prescribe sleep, we would call it a wonder drug.
Back in early 2020, Britons already weren’t getting enough sleep. Then came the pandemic. For some, sleep improved. Home-workers were often able to wake up later, meaning night-owls could finally sleep according to their chronotype. But for most of us, Covid didn’t help. The endless feeling of uncertainty experienced by many worsened our mental health. Anxiety, loneliness, health and financial worries flared up, making sleep more difficult. Routines were altered or destroyed. Home-workers found it tough to detach from their work.
What kind of sleeper are you?
We tend to fall into three categories. The first group, representing about 44 per cent of the UK population, are the lucky ones. They usually get six to nine hours each night – and it’s high quality sleep, too. They’re content with their nighttime regime and the quality of their sleep.
The second group, making up about 36 per cent of the population, report being unsatisfied with their sleep and don’t get enough sleep, but they don’t have full-blown insomnia. If you’re in this group, small tweaks to your daily life can make a big difference. Your 2022 resolution should be simple: prioritise sleep. Keep a regular routine, getting up and going to bed at roughly the same time. This will keep your internal body clock stable. Lying in on the weekend can help repay the “sleep debt” you might have accumulated over the week, but avoid lying in for longer than an hour (and ideally no longer than 30 minutes). Otherwise, you’re at risk of knocking your sleep cycle out of shape (we call this “social jetlag”; a long lie-in might feel great on a Sunday, but come Monday, it will be difficult to rise).
The third group, representing 20 per cent of the population, are the full-blown insomniacs, very unsatisfied with their sleep. If you’re in this group, it’s possible that none of the quick fixes I mentioned above will help. In fact, it can be frustrating when people recommend them. “I’ve done everything,” clients sometimes tell me. “I’ve been for my run, I haven’t had alcohol. But I still can’t sleep. What’s wrong with me?.” And that mindset proves damaging. It puts you into a tense, obsessive mood; desperate to sleep, you put sleep on a divine pedestal. You think about it constantly. That makes it all the more frustrating when you climb into bed and inevitably struggle to sleep. It’s a vicious cycle.
Struggling to sleep?
Regular exercise does wonders (ideally at least three sessions per week, somewhere between 30 and 60 minutes). It makes us tired, helping us fall into a deeper sleep. Even more importantly, it acts as a neurological calming agent, helping us manage our stress while lying in bed. But avoid exercising too late; this will push up your core body temperature, making sleep more difficult. The research is equivocal about whether aerobic or resistance exercise works best. My advice is to find an exercise you enjoy (or one you don’t mind, at least) – this will mean you actually do it.
Alcohol and caffeine are known to worsen our sleep. I won’t go as far as recommending a total boycott – that’s unrealistic. But I would advise you to avoid caffeine after midday, and to limit alcohol to three nights each week.
Your bedroom environment matters, too. Try keeping the window open or turning on a fan to improve ventilation. Keep the humidity down: try growing plants in your bedroom, and avoid drying clothes in there if you can. Turn off those annoying laptop standby lights.
Often, our efforts to force ourselves to sleep is what ends up pushing sleep further away. That’s why in my book, The Sleep Book: How To Sleep Well Every Night and on the Sleep School App, I recommend a tailored therapy for insomniacs. It’s based on a newer form of cognitive behaviour therapy known as Acceptance and Commitment Therapy (ACT). We teach people to accept the anxiety, desperation, and dread that comes from sleeplessness in order to overcome it. Our instinct is to resist these feelings, but that just fuels them; instead, we teach people how to identify and notice the thoughts and feelings, so they become less scary.
One example is giving your worrisome thoughts shorthand labels. Let’s imagine you find yourself having the common anxious thought, ‘If I don’t sleep I won’t be able to cope’. We would label this “the coping thought”. The next time that unpleasant thought arrives in your mind, instead of buying into it and letting the thought consume you, you would simply greet the thought, by saying something like, ‘Hello, coping thought’. This shifts your perspective, making it feel like you’re looking at the thought from afar. The act of greeting your anxiety subtly informs your brain that you are safe – and with safety comes sleep.
Paradoxically, by accepting these negative thoughts and feelings, you remove the obstacles that are blocking sleep. You create an internal environment in which sleep can emerge.
Some insomniacs try a more traditional form of Cognitive Behavioural Therapy, which uses techniques such as cognitive restructuring to replace negative thoughts with positive and rational thoughts. Others are offered sleeping medication, like sleep hypnotics and antidepressants.
But whatever your relationship with sleep, it’s important to try and prioritise it in 2022. Without sleep, nothing else will fall into place.
As told to Luke Mintz
This article has been updated with the latest information.
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