The 2022 Ultimate Guide to Sleep

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Why Sleep is Important

Getting enough sleep is just as vital to your health as eating properly, staying hydrated, and getting enough exercise. We’re naturally programmed to sleep at night to give our minds and bodies a chance to rest and recharge. Depriving ourselves of this rest can cause many essential cognitive, behavioral, and bodily functions to be impaired.

How Many Hours Should I Sleep?

So how many hours of sleep per day is healthy? The amount changes depending on your age. The CDC recommends the following hours of sleep for each age range:

While it’s essential to get enough sleep, it’s also necessary to get high-quality sleep during these hours. Sometimes, bad sleep habits or a sleep disorder can reduce your sleep quality and leave you feeling unrested, or cause you to wake up repeatedly throughout the night. In later sections, we’ll discuss sleep habits and sleep disorders, so you can discover what may be causing poor-quality sleep and how to improve it. 

Stages of Sleep

As we sleep, our bodies cycle through sleep patterns of four stages, or sleep phases. There are two types of sleep experienced in these stages: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. We experience NREM sleep in the first three sleep cycle stages, which makes up 75 to 80 percent of total sleep, while the final stage is REM sleep. You may also wake up briefly during the night, which is referred to as stage W.

• Stage 1 NREM: This is the lightest level of sleep as you transition from wakefulness to sleep. Your muscles relax in this stage, and your heart rate, breathing, eye movements, and brainwaves all begin to slow down. You can easily be awakened while in this stage, but it typically only lasts several minutes. 
• Stage 2 NREM: This is the longest of the four stages and is made up of deep sleep. Your heart rate and breathing continue to slow in this stage, your muscles become even more relaxed, and your body temperature decreases. Brain waves remain slow, though there may be brief moments of higher frequency electrical activity. Eye movement stops entirely. 
• Stage 3 NREM: This stage comprises the deepest, most high-quality sleep level and plays a vital role in waking up feeling rested. In this stage, your heart rate, breathing, and brain waves are at their slowest, and your blood pressure is at its lowest. Your muscles are also at their most relaxed state. This stage is longer at first but will become shorter throughout the night. 
• REM: During the REM stage, the brain's electrical activity is unusually high, and your eyes move rapidly. Your breathing rate increases, and some muscles become paralyzed. The first REM stage typically occurs about 90 minutes after falling asleep, and the stage becomes longer throughout the night. Typically, we experience our most vivid dreams while in this stage. 
• W Stage: These are periods during sleep where you wake up briefly. Typically, you will not be aware of or remember being awake. 

How Long is a Sleep Cycle?

Throughout the night, your body repeatedly cycles through the four main sleep stages. While individual sleep cycles vary from person to person, most people have sleep cycles of about 90 to 120 minutes.

Common Sleep disorders

Sometimes, sleep disturbances or poor quality sleep is caused by a sleep disorder. This section will discuss the most common sleep disorders, their causes, and how they’re typically treated.

Insomnia

Insomnia is the most commonly reported sleep disorder. According to Merck Manual, about 10 percent of adults report chronic insomnia. In comparison, about 30 to 50 percent of adults report experiencing insomnia sometimes.

Those with insomnia find it difficult to fall asleep or stay asleep. They may also wake up several hours early and have trouble falling back asleep. When those with insomnia do get sleep, it may be low-quality sleep that doesn’t leave them feeling refreshed or rested in the morning. This often leads to excessive daytime sleepiness (EDS), characterized by being tired and functionally impaired or even falling asleep during the day.  

Causes

Insomnia can be caused by several different factors or may even have no apparent cause at all. Some common reasons for insomnia include:

• Poor sleep habits
• Mental illness, such as depression, anxiety, and substance abuse disorders
• Chronic pain or diseases that affect the heart, lungs, muscles, or bones
• Outside stressors, such as divorce or job loss (sometimes referred to as adjustment insomnia)
• Excessive worry about losing sleep and going another day feeling tired and impaired (sometimes referred to as psychophysiological insomnia or sleep anxiety) 

Treatments

When being treated for insomnia, your doctor will first give you suggestions on how to improve your sleep habits. They will also determine what may be causing the disorder for you and attempt to treat the cause before treating insomnia itself. For example, if depression is causing your insomnia, they may recommend therapy or antidepressants.

In some cases, sleep habit improvement and treatment for the cause prove ineffective, and insomnia can still interfere with your daily life. Should this happen, your doctor may also recommend cognitive-behavioral therapy with a trained sleep therapist, over-the-counter (OTC) sleep aids, or prescription sleep aids.  

Narcolepsy

Narcolepsy is characterized mainly by severe excessive daytime sleepiness, often causing sudden episodes of uncontrollable sleep. These “sleep attacks” can occur any time, regardless of what the person with narcolepsy is doing, where they are, or the sleep amount they’ve gotten already.

Those with the disorder may also experience sudden episodes of muscle weakness, sleep paralysis, hallucinations while falling asleep or waking up, or sleep disturbances at night. While all people with narcolepsy have severe excessive daytime sleepiness, most people only experience a few other listed symptoms.

Unfortunately, there is currently no known cause of narcolepsy.  

Treatments

For mild symptoms of narcolepsy, your doctor may recommend that you get enough sleep at night and take a short, 30-minute nap at the same time each day. They will likely also give suggestions on how to improve your sleep habits to get the best sleep at night that you can.
Should more treatment be necessary, your doctor may prescribe you medication that keeps you awake. This includes medications such as modafinil, armodafinil, or solriamfetol.  

Restless Leg Syndrome

Those with restless leg syndrome (RLS) experience strange sensations or pain in their legs when sitting still or lying down. Often, these sensations only seem to be relieved by moving the legs.

This can significantly impact sleep, as people with RLS will often feel the need to toss and turn or kick their legs while trying to fall asleep. It can also cause restless sleep or abrupt awakening, as their legs may move uncontrollably while they sleep.  

Causes

RLS's cause is still largely unknown, although abnormalities with dopamine have been associated with the disorder. Additionally, you may be more at risk of RLS if you:

• Smoke
• Have a sedentary lifestyle
• Are obese
• Stop taking certain drugs
• Take stimulants
• Have iron deficiency or anemia
• Are pregnant
• Have a severe chronic kidney or liver disorder
• Have diabetes
• Have a neurologic illness, such as Parkinson disease or multiple sclerosis 

Treatments

There’s no known cure for RLS, but some treatments may help. If your RLS is thought to be caused by an iron deficiency, your doctor may recommend iron supplements. Your doctor may also suggest that you stay away from caffeine, as it can make RLS worse.

Some medications, such as those used to treat Parkinson’s disease or antiseizure medications, are also used to treat RLS. Most often, the antiseizure medication gabapentin enacarbil is used to treat the disorder.  

Sleep Apnea

Sleep apnea is a serious disorder characterized by repeated pauses in breathing throughout the night. There are three main types of sleep apnea: obstructive sleep apnea, central sleep apnea, and mixed obstructive and central sleep apnea.

Obstructive sleep apnea is the most common type of sleep apnea. It is caused by the throat or upper airway closing repeatedly during sleep. These pauses in breathing last more than 10 seconds and can disrupt sleep by causing snoring, episodes of gasping or choking, or sudden awakenings with a snort.

Central sleep apnea is much less common than obstructive sleep apnea. It is caused by an issue with the brainstem’s ability to control breathing. Typically, the brain stem adjusts our breathing depth, depending on how high or low the levels of carbon dioxide are in the blood. With central sleep apnea, the brainstem is not as sensitive to changes in carbon dioxide levels. Therefore, it does not adjust the breathing accordingly. Those with this type of disorder breathe less deeply and more slowly than usual. Their breathing sometimes pauses or is irregular.

As the name suggests, mixed obstructive and central sleep apnea is a combination of the two issues occurring in one episode of sleep apnea.  

Causes

Obstructive sleep apnea typically occurs due to a narrowing in the upper airway. This can be caused by a variety of factors, including:

• Obesity
• Genetics (such as those causing a thick neck or narrow throat)
• Excessive use of alcohol or the use of sedatives
• Hypothyroidism
• Acromegaly
• Stroke

Central sleep apnea may be caused by:

• Opioids
• Being at a high altitude
• Heart failure
• A brain tumor

Treatments

With obstructive sleep apnea, doctors will first attempt to treat factors contributing to the disorder. For example, they may suggest weight loss or bariatric surgery, quitting smoking, or reducing your consumption of alcohol. They will also treat nasal infections, allergies, hypothyroidism, or acromegaly.

If this alone does not help, obstructive sleep apnea is usually treated using a continuous positive airway pressure (CPAP) machine. With CPAP machines, you breathe through a face or nose mask, and the pressure in your airway is slightly increased to open your throat as you sleep. Your doctor will require a follow-up appointment to ensure the mask fits properly and you're receiving the proper amount of pressure for you.

Those with mild or moderate obstructive sleep apnea may also be treated with removable oral devices that prevent the tongue from blocking the throat. If CPAP doesn’t work for you, your doctor might recommend implanting an electrical device that stimulates the upper airway. Suppose none of these treatments work for you. In that case, your doctor may call for head or neck surgery to remove any apparent blockage or tissue around the upper airway.

Central sleep apnea is treated similarly, first, by treating any underlying cause if possible, such as reducing the severity of heart failure. Some people with central sleep apnea may benefit from a regular oxygen flow being delivered through nasal prongs at night. Others may benefit from CPAP or an implant that stimulates the diaphragm. If high altitudes cause sleep apnea, your doctor may prescribe acetazolamide. 

Circadian Rhythm Sleep Disorder

Your circadian rhythm, or internal clock, typically aligns with the earth’s night and day cycle. Your body reacts to the sunlight, or lack thereof, and wakes up in the morning and falls asleep at night. Those with a circadian rhythm sleep disorder experience a disrupted sleep-wake cycle and cannot wake up or fall asleep at these routine times.  

Causes

Internal or external factors may cause circadian rhythm sleep disorder. These include: 

Internal:

• Brain damage (i.e., from a stroke, head injury, or Alzheimer’s)
• Insensitivity to natural night and day cycle

External

• Jet lag
• Frequently going to bed and waking up really late (i.e., going to bed at 3 AM and waking at 1 PM) or really early (i.e., going to bed at 6 PM and waking up at 3 AM)
• Frequently going to bed and waking up at different times
• Being bedridden for a long time
• Prolonged lack of exposure to sunlight
• Blindness
• Taking certain drugs

Treatments

The best treatment strategy for a circadian rhythm sleep disorder is to adjust your behavior. An excellent place to start is by improving your sleep habits, as well as gradually shifting your sleep-wake cycle to a healthier one.

You can also help to reset your internal clock by exposing your eyes to bright light (either naturally or artificially) during times you should be awake. When it’s nearing time to sleep, you should limit bright light exposure. Try to sleep in a room that is as dark and quiet as possible.

Should these treatment strategies be ineffective, your doctor may recommend melatonin or prescription sleep aids to help you fall asleep at appropriate times. They may also prescribe you drugs that stimulate the mind to help you stay awake when you need to.  

Recommended Sleep Aids and Solutions

Sometimes, getting enough sleep can be more challenging than just adjusting your habits, sleep position, and sleep-wake schedule. Suppose you try everything and still have trouble sleeping. In that case, there's a variety of sleep aids and solutions that can help you, depending on your situation. 

If You're a Light Sleeper...

Light sleepers can often have their sleep disturbed by outside stimuli out of their control, such as light and sound. There are a few aids that can help block out these stimuli: 

Sleep masks are comfortable, padded masks that can block out most light while you sleep. Some have additional features, such as aromatherapy or the ability to be chilled or heated up to help you relax.

Earplugs can reduce or block out noise that may be keeping you from falling asleep. They can be made of many different materials, and some block out more noise than others. Be sure to find one that’s comfortable for you while still blocking out the amount of noise you need. 

Sound machines can help those who find earplugs uncomfortable or who need to hear an alarm in the morning. Rather than blocking out sound completely, they play white noise or other relaxing sounds to drown out different outside sounds. 

If You Have Trouble Getting Tired...

There are various natural sleep aids that you can use to help induce sleep when you feel wide awake at night. These include over-the-counter medications and supplements, foods and drinks, plants.

Over-the-Counter (OTC) Medications and Supplements

• Diphenhydramine: This is a sedating antihistamine found in products such as Zzzquil, Aleve PM, and Benadryl. While this can help you fall asleep, it may leave you feeling drowsy the next morning. 
• Doxylamine succinate: This is another sedating antihistamine found in products such as Unisom SleepTabs and Ultra Sleep. Similar to diphenhydramine, doxylamine succinate can make you feel drowsy the following morning. 
• Melatonin: This hormone controls your sleep-wake cycle and signals to your body that it’s time to sleep. Taking a melatonin supplement may help you fall asleep quicker, though the effects are milder than those of antihistamines. Melatonin can also cause you to feel drowsy the next morning and may cause headaches.
• Valerian root: This is an herbal supplement that may help you relax and fall asleep faster. Studies done on its sleep-promoting effects have inconsistent results, but it may be worth a try. There are no known side effects to using valerian root. 
• Magnesium: In addition to being essential for brain and heart health, this mineral can relax the mind and body and help you fall asleep. Insufficient levels of magnesium are even linked to disturbed sleep. 

OTC sleep aids can be beneficial every so often, but you should avoid using them daily. The more often you use them, the more likely you are to develop a tolerance to them, and the less likely they are to make you tired. Be sure to ask your doctor if any of these sleep aids could interfere with your medication before using them.

Foods that Help You Sleep

• Almonds and walnuts: Almonds and walnuts both include high doses of melatonin and magnesium, which can make you sleepy and help you relax. 
• Turkey: Turkey contains tryptophan, which increases melatonin production to signal your body to go to sleep. 
• Kiwi: Kiwis have anti-inflammatory antioxidants, which can help relax you. Some studies have even linked kiwis to promoting sleep.  
• Tart cherry juice: Tart cherry juice contains high levels of melatonin.
• Chamomile tea: Chamomile tea contains apigenin, an antioxidant that promotes sleep and relaxation. 
• Warm milk: A warm cup of milk before bed can be relaxing. It also contains a variety of sleep-promoting compounds, including tryptophan, melatonin, and more.

Plants that Induce Sleep

Although it may sound strange, having certain plants in your room can help induce sleep. Depending on the plant, this may be due to their fragrance, their ability to clear airborne toxins, or their ability to provide you with more oxygen while sleeping.

Some useful plants to have include:

• Lavender: Lavender has a calming fragrance that can help promote sleep. However, be aware that it may be toxic to pets. 
• Jasmine: The scent of a jasmine plant can promote sleep even more than lavender! However, some jasmine plants do not emit a fragrance, so be sure to find one that does. 
• Snake plant: The snake plant can clear a variety of toxins from the air and convert carbon dioxide to oxygen at night. The best part is, it needs very little care to stay alive. Just be sure not to eat it -- or let your pet eat it -- as it can be toxic to humans and animals. 

If You're Restless or Anxious...

It can be incredibly hard to fall asleep when you’re feeling restless, stressed, or anxious. We recommend a few different sleep aids when that’s the case:

Guided sleep meditations guide you step-by-step to count your breaths, scan your body for stress and relax tense areas, and visualize relaxing scenes. This can calm you and get you out of your head enough to fall asleep. Guided sleep meditations can be found on YouTube or apps like Calm and InsightTimer. 

Weighted blankets provide gentle pressure that can relax the nervous system to relieve pain and anxiety. They can also ease sleep issues related to chronic pain, autism, ADHD, insomnia, and other sleep disorders. They should not be used if you have sleep apnea, as the extra weight can worsen breathing problems.

If You Have a sleep Disorder or Unusual Sleep Schedule...

Sleep disorders can disrupt your sleep in a myriad of ways. Luckily, some aids can help relieve the effects of some of these disorders.

Bright Light Therapy

This can be beneficial if insomnia, circadian rhythm sleep disorder, or depression is disrupting your sleep. Bright light therapy lamps expose you to an intense artificial light that mimics sunlight to aid in your body’s melatonin and serotonin production. These hormones control your body’s internal clock, giving you energy when you should be awake and making you tired when you should sleep.

Should you use a light therapy lamp, you will want to use it for 20-30 minutes shortly after waking and start your sessions at the same time each morning. This consistency will best allow your internal clock to adapt to being exposed to the light at your chosen time each day.  

To learn more about bright light therapy benefits and how to choose a lamp, see our 2021 Ultimate Guide to Bright Light Therapy.

LEARN MORE ABOUT LIGHT THERAPY

Prescription Medications

If other sleep aids are ineffective in treating your sleep disorder, your doctor may prescribe you sleep medication. This might include:

• Antidepressants that are also good at treating sleeplessness and anxiety, such as trazodone
• Anti-Parkinsonian drugs (Horizant, Mirapex, Requip, Neupro). These are typically used to treat restless leg syndrome and periodic limb movement disorder.
• Non-benzodiazepine hypnotics (Lunesta, Sonata, Ambien). These are used to treat short-term insomnia.
• Benzodiazepines (Restoril, Halcion, Ativan). These stay in your system longer but can cause addiction and dependence. Typically, they are used to treat parasomnias, short-term insomnia, and sometimes bruxism (teeth grinding). 
• Ramelteon (Rozerem). This is a melatonin receptor stimulator used to treat insomnia.
• Antinarcoleptics (Ritalin, Provigil). These can help shift workers or those with narcolepsy or sleep apnea feel more awake during the day. 

If You Have Sleep Apnea...

If sleep apnea is interfering with your sleep, you might benefit from sleep apnea supplies such as mouth guards and CPAP therapy.

Mouthgaurds

If you have mild sleep apnea, a mouth guard might be all you need. Sleep apnea mouthguards push your lower jaw and tongue forward to keep your airway open throughout the night. These can also help prevent non-sleep apnea related snoring. 

CPAP Therapy

For moderate to severe sleep apnea, your doctor might prescribe you CPAP therapy. CPAP therapy provides you with gentle, pressurized air to keep your airways open and help you breathe while you sleep.

CPAP therapy is the most common pressurized air therapy for sleep apnea. Still, your doctor may also suggest you try automatic (APAP) or bi-level (BiPAP) positive airway pressure therapy. They may also recommend a particular mask that is best for you, such as a nasal mask or full-face mask.

Additionally, there are various CPAP accessories available to provide you with the most comfortable, effective therapy. You may prefer having a wrap on your tubing for added comfort or need a chin strap to keep your mouth closed during the night. Regularly cleaning your mask and tubing and replacing filters and tubing can also ensure your therapy is always as effective as it can be.

What Experts Say About Sleep

We reached out to numerous health professionals including psychologists, sleep experts, and doctors to get their best tips and professional insights into best sleep practices, mistakes, and findings.

Chelsey Poisson, BSN, RN

Co-Founder

https://www.hunterseven.org/

Poor quality sleep is often a symptom of an underlying issue. It is important that the individual discover the root cause dysfunction that is resulting in insomnia or poor quality sleep. For example, among those that suffer from a range of post-traumatic stress and TBI symptoms, insomnia is the most reported complaint. In fact, HunterSeven Foundation, a veteran-founded medical research organization, discovered that 59.1% of veterans suffer from insomnia post-deployment when compared to 12% pre-deployment. However, PTS and TBI are not exclusive to members of the military. On-the-job training and traumatic experiences for emergency responders, law enforcement, and medical providers can increase the risk for PTS and sleep disorders among these populations as well. This is an example of an underlying condition that is resulting in inadequate sleep and is impacting much of the population.

Tamara Houston, LISW-CP, BC-TMH

Clinical Social Worker

https://ptsolutions.com/category/careers/live-clinically/

https://www.renewallifecounseling.com/

Establishing a routine for optimal sleep hygiene is an essential aspect of our overall health. The quantity of hours with your eyes closed does not always correlate to the quality of rest. The body is hard-wired to repair itself from the day's activity; limited and unrestful sleep can have one waking feeling fatigued, as though they haven't slept at all.

One of the main culprits that disrupt our sleep is using devices with a bright light before bed. The blue light emitted from these devices does not communicate that it is time for rest. Our body produces melatonin, a hormone that impacts our ability to sleep. Time of day encourages melatonin production; levels go up at night and decrease during the day.

One suggestion is just to put the devices down when it is time for bed. Read a few pages from that book that you've been working on for the past month, practice gratitude journaling, or listen to nature sounds instead. If you find it challenging to go cold-turkey, work on a plan to minimize the time between perusing your device, and sleep. For instance, if bedtime is 10:00P, close down your device 15 minutes prior, then add 15 minutes to that next week. Continue with this pattern until you have about an hour of phone-free time before bed.  

Dr. Yuliya Rabinovich

Owner

https://www.dental-muse.com/

Waking up groggy after 7 or 8 hours of sleep means the quality of sleep is poor and no matter how many hours one sleeps, it just doesn't seem to be enough. The concept of craving a cup of coffee to jet start our brains in the morning is a popular one. Relying on caffeine to wake up is prevalent, but not normal or healthy.

There may be several reasons for that, one of which is SDB which stands for Sleep Disordered Breathing. Crowded teeth, teeth grinding, fractured teeth, a seemingly large tongue and swollen tonsils are just a few of many signs and symptoms of small jaws that have been linked to SDB and even Obstructive Sleep Apnea (OSA).

It's important to speak to a knowledgeable dentist about diagnosing and treating SDB and OSA with non-surgical and non-pharmaceutical methods. 

Dr. Fran Walfish

Child, Couple, and Family Psychotherapist

http://drfranwalfish.com/

Urinary tract infections and bladder infections can cause increased frequency of urination. Sleep disruptions and being awakened by having to pee can make it difficult to fall back to sleep. Hormonal imbalance can affect sleep. For instance, many menopausal women have reported being awakened by experiencing hot flashes or breaking out in night sweats. Also, both male and female seniors in their late 70’s and 80’s report becoming nocturnal. These folks are awake during the night and sleep/nap during the daytime. Whenever I have a patient who states that they have sleep troubles, I routinely recommend a complete physical examination with their medical doctor to rule out or diagnose a medical reason for their sleep difficulties.

Sleep disruption is rooted in Separation Anxiety. When we are stressed, going through major changes or life transitions the first place we see symptoms is in sleep disruption. Trauma of any sort puts a person in a highly accelerated state of anxiety. Trauma may include the death of a beloved family member or pet, divorce, victim of a crime, change of job or residence, etc. Also, in midlife our bodies go through changes including hormones and bladder retention. You will notice that during midlife suddenly you wake up to urinate when, during your younger years, you could sleep throughout the night. Often, during the senior years there is a nocturnal reversal in which older folks have great difficulty sleeping in the night hours, but rather nap frequently during the daytime.  

Jared Heathman, MD

pHYSICIAN

https://www.yourfamilypsychiatrist.com/

Pink noise machines are not only relaxing but they also help to mask other noises from waking you up. When you have been stressed, you are more likely to sleep in lighter stages which can prompt multiple awakenings from relatively quiet noises. Sleep is incredibly important to make sound decisions and maintain a stable mood. 

Michael E. Platt, md

oWNER

https://plattwellness.com/

The primary cause for sleep disturbances is the presence of excess adrenaline. It can cause the mind to race, preventing falling asleep, and it causes people to awaken throughout the night, especially around 2:30 am when levels peak. It is the cause of restless leg syndrome (RLS), cramps in the calves and feet, tossing and turning, bruxism (teeth grinding), jaw-clenching, and also the need to get up and urinate (nocturia).

In addition, it is also the cause for people to gain weight while they are sleeping - or trying to sleep. The reason is that the body is releasing adrenaline in order to provide fuel for the brain in the form of glucose (sugar).

In addition, the release of adrenaline creates stress to the body which causes the release of cortisol. This is another hormone that raises glucose levels as well. Sugar that is not burned is stored as fat in fat cells. It is a surprisingly
common cause of weight gain that is never mentioned.

Excess adrenaline is also responsible for colic in newborns that can certainly affect the sleep of parents. It is also the only cause of bedwetting in children. It also causes low back pain and pain along the side of the hip (fibromyalgia). 

Chris Norris

CERTIFIED SLEEP SCIENCE COACH AND FOUNDER

https://sleepstandards.com/

Sleep is essential to everyone. It’s when our body rejuvenates and gets ready for the next day. If you deprive yourself of sleep, chances are you’d eventually develop physical and mental health problems. As a sleep medicine expert, I believe no matter what the circumstances are sleep is one of the many things that you should be prioritizing.


Here are 3 tips to get a restful sleep:  

• Try keeping a consistent schedule. Getting into a routine will help ready your body for bed. Make sure to go to bed at the same time every night and get enough hours of sleep. Limit day naps to 15 to 20 minutes just if you really need to. Over time, you’d realize you won’t be needing an alarm clock to wake you up. 
• Make your sleep environment comfortable. Make sure your bedroom is dark and quiet. This would make your body know that it's night time and it’s time to wind down. You should also consider investing in a comfortable bed and pillows. 
• Watch your caffeine intake before bedtime. Caffeine is the most go-to drug if you wanted to stay awake and unfortunately, most food and drinks have caffeine. Make sure not to take any caffeine at bedtime so it won’t keep you up all night.

Stephanie D. McKenzie, MBA, MA, CPC, CSSC

cERTIFIED sLEEP sCIENCE cOACH

http://www.stephaniedmckenzie.com/

Often people think that they are not getting sleep and that's the norm. It's not. However to change that reality requires effort and intentional action. As a certified sleep science coach, I categorize the areas that may affect our sleep as activities, atmosphere and accomplices.

Activities includes what we do or don't do before sleep. Watching high adrenaline entertainment, doing your workouts at night and even drinking tea, milk or other beverages may make winding down harder. Consider watching happy or peaceful shows, if you watch anything. And perhaps trade the HIIT workout for a little yoga.

Atmosphere is the environment that we sleep in. While many experts say that having a tv in your bedroom is bad, it doesn't have to be. However creating an environment for sleep is key. Consider reducing clutter, distractions and limiting light sources to set the mood in your bedroom (to sleep, the mood is for sleep). If you want to spice it up a bit, consider playing a few binaural beats from YouTube or sleep music--whatever strikes your fancy.

Lastly, accomplices. Who or what you sleep with. From people to pets, the affect that their presence has in your sleep is up for evaluation. Though it might seem "weird" sleeping apart from your spouse, is okay, putting Fido out of the bed is okay and co-sleeping may have run its course. A well rested parent is a better parent.

Regardless of what you do or don't do, realizing an normalizing having 7-9 hours of quality sleep allows your body's systems, stress hormones and mental activity to cycle down as they should, giving you the rest to tackle the next day. Consider experimenting with each area--activities, atmosphere and accomplices--for a week and see if you can improve your sleep quality. 

Isaac Smith LCSW

Therapist

https://www.wholewellnesstherapy.com/

If you normally find yourself worrying or having an overactive mind at bedtime, consider downloading your brain, otherwise known as journaling, or in problem solving therapy, externalization. Before those of you allergic to journaling roll your eyes, keep in mind that journaling can take on many different forms: from bullet points in a note on your phone to using that paper napkin beside your bed to list out what’s spinning around in your head.

The point here is to stop the cycle of rumination by putting your thoughts somewhere safe, so your mind does not feel the need to keep remembering. Additionally, you can plan time earlier in the evening to review your day, plan the next day, or deal with any unsolved problems.

If your mind continues to race, try deep breathing, progressive muscle relaxation or other forms of mindfulness meditation that can help activate your body’s parasympathetic state—the literal antidote to your fight or flight system.

Ronit Levy, Psy.D.

Clinical Director

https://buckscountyanxietycenter.com/

Anxiety, stress, and overwhelm impact sleep almost immediately. It becomes harder to fall asleep and/or stay asleep. Most people assume that they can push through the fatigue. Unfortunately, that's not true. Even though there's a lot of adrenalin coursing through our system, we still need to sleep.

We actually need more sleep during stressful times so that our brain and body can keep up with the extra demand. If you cannot fall asleep or stay asleep due to anxiety or stress, consult with a therapist who is an anxiety specialist to learn coping skills that can help significantly improve your sleep and overall health. 

Jessica Bird Hagestedt

Certified Personal Trainer, Nutrition, & Mindset Coach

https://www.balancedbybirdie.com/

• Mistake: I can function at 100% on 4 hours of sleep a night. Although quality of sleep has more impact on your health than the quantity, the amount of time you sleep still plays a major role. There is a fine line between too little (and too much) sleep and only about 5% percent of individuals (functioning at their healthiest capacity) can survive on 6 or less hours of sleep a night without it negatively impacting their health. So cutting back hours of sleep to increase productivity actually is counter productive; in the long run, lack of sleep impacts creativity, mood and memory and is linked with fat retention, macular degeneration and neurodegenerative disease.
• Mistake: Working (or watching television) up until bedtime. Screentime (bluelight) prior to sleep slows down melatonin production negatively affecting sleep cycles and making it harder to fall asleep, negatively impacting the time you are in your most regenerative sleep window (which is on average between 10pm and 2am). To counter this, stopping your screen time 2-3 hours before bed and/or investing in blue light blocking glasses.  
  
• Mistake: I sleep with my window curtains open. Sleep is affected by light in general (our bodies are programed to sleep when dark & rise when light), so having an eye mask, or black out curtains, improves sleep quality as even a street lamp can disrupt sleep efficiency. Light exposure at night, and its consequential adjustment of circadian rhythms, have been shown to lead to diseases of the metabolism as well as cancer, obesity and more, making long term night shift work detrimental to health.
• Mistake: Throughout the week I go to bed and wake up at different times. Creating consistency with your sleep & wake cycles will help increase your quality of sleep. Your body is made to be efficient and by keeping a consistent schedule allows it to adapt, starting and stopping your sleep processes more effectively. If you want to sleep in a little on the weekends, make sure to ease into the transition and keep it within an hour or so of your normal schedule. 
• Mistake: Sleep doesn't affect my weight. Lack of quality sleep can affect your appetite making you hungrier and more likely to reach for high fat and sugary foods. Quality sleep and time spent in REM have shown to decrease leptin levels, a satiety hormone and increase ghrelin levels, a fat retention and hunger hormone. This is why, when you are tired due to poor sleep, you find yourself craving pastries, sweets and fatty foods the next day.

Sierra Dante

Certified Sleep Consultant

https://www.sweetsleepconsulting.com/

Set an alarm on your phone 15-30 minutes before you want to go to bed and spend this time doing something personally nourishing like reading, bathing, or journaling to allow yourself to relax (and get a break from your devices' blue light) before you turn in. This "me time" will help you feel that you really enjoyed your evening and still got to bed on time so you can be refreshed the following day.

If you stay up long enough you will feel hungry again even if you ate a good evening meal. Snacking in the evening gives us an excuse and the energy to stay up later which we usually regret when the alarm goes off in the morning. If you tend to head to the kitchen around 10:00 PM then be sure to brush your teeth and turn off devices before this time so you can go to bed early enough to allow you to get the hours of sleep you need. 

Dr. Jenna Liphart Rhoads

Nurse Educator & Writer

https://www.nursetogether.com/

Create a sleep environment that is peaceful: set the thermostat to 68 degrees Fahrenheit (recommended temperature for sleep), clear your bed and bedroom of clutter, install blackout curtains, invest in comfortable sheets, find a pillow that best supports your head, neck, and shoulders, and use a white noise machine to muffle outside noises.

Dr. Leigha Saunders

Naturopathic Doctor Owner & Founder

https://leighasaundersnd.com/

I always tell my patients "When you're not sleeping, you're not healing." Sleep is the foundation of health; without proper sleep quality and quantity, every other aspect of our health is affective. This is crucial for mid-life women to understand as they age and their risk of chronic disease, like type 2 diabetes, cardiovascular disease, cancer and dementia increases. Here is what your audience needs to know: Women are twice as likely to experience insomnia compared to men Upwards of 60% of women report difficulty sleeping an insomnia as they age Hormonal changes that occur as women age are directly related to sleep quality and quantity Most women are not being treated for the underlying, hormonal causes of their sleep issues I became obsessed with helping women get a good night's sleep after I had to fix my own insomnia. I see women in my practice all of the time who have never slept well since having kids, or assume poor sleep is something they have to live with. 

Dr. Ghassemi

Chiropractor

https://bax-u.com/

The C-curve in your neck is what reduces the amount of pressure accumulated in your spine throughout the day. Loss of the c shape is known as text neck, strain neck, or lower head syndrome.

What happens to the c-curve? The neck begins to turn straight (straight neck), which is caused by cell phones, watching tv, and even working on a computer. It is important to understand that for every inch you slouch that is 10 pounds of pressure to your neck.

Here are some tips to become a smart sleeper!

• Always maintain a healthy posture throughout the day. Poor posture can lead to poor sleep. 
• Invest on a good pillow
• Invest in a good mattress that fits your body type

Dr. Livingood

Owner and CEO

https://drlivingood.com/

When trying to improve sleep quality it is important to find the right mattress that feels good to you! We are all different and when it comes to our bodies and sleep there are thousands of variations of sleep preferences. Finding the perfect mattress that suits your sleeping needs will inevitably help to reduce pain in all areas of your body.

In addition to the right mattress for your specific body, use a proper pillow to support your neck and lumbar outside of the mattress. Test different sizes of pillows to find one of the perfect width for your neck. Also, pay attention to your sleep positions. If you like to sleep on your side, support your neck as well as your legs and back with appropriate placements of additional pillows. I promise you will feel a difference. Lastly, choosing an eco-friendly mattress typically guarantees that the mattress is not sprayed with chemicals. We all spend a lot of time in our beds, making sure you are not breathing in chemicals that are sprayed on most non eco-friendly mattresses is important. Think about how much you sweat and move around in your bed, with all the movement your body is absorbing the chemicals sprayed on your mattress on a nightly basis.

Additionally, napping is a super powerful tool if done correctly. Your body goes into a sleep cycle every time you fall asleep; phase 1, 2, and 3 are non-REM parts of that cycle, after those phases you go into your REM phase. An entire cycle takes about two hours. You never want to sleep longer than 20 minutes for a nap, unless you want to commit to the two hours, which may disrupt night time sleep and cause grogginess in part decreasing work productivity. So the ideal nap time is 10 to 20 mins. A tip is to drink a cup of coffee before taking a nap which will allow you to sleep for 20 to 30 minutes before the caffeine starts to wake you up. Napping is very good for down regulating your stress nervous system and up regulating your healing nervous system. It has been shown to lower blood pressure, support proper digestion and sexual functions.  

Dr. Janet Hilbert

Physician and Assistant Professor of Clinical Medicine at Yale University School of Medicine

https://twitter.com/janethilbertmd

People who are having trouble sleeping often worry about getting to bed on time. They might even get into bed earlier so they have more time available to sleep. Then, if they can’t sleep well, they stay in bed longer. The end result is that sleep becomes less “efficient”, i.e., the percentage of time asleep relative to the time in bed declines resulting in frustration and potentially compounding insomnia. One of the best tips to sleep well is to set and keep a regular rise time - and then get into bed 7-8 hours earlier. Even if sleep is not great on the first night, as long as the individual sticks to a schedule, sleep efficiency will improve over time. This is the basis for one of the cognitive behavioral techniques for insomnia called “sleep restriction”. This technique is not actually meant to restrict sleep but to restrict time in bed until sleep efficiency improves   

Getting a good night’s sleep can be challenging, but it’s an essential function that shouldn’t be overlooked. We hope this guide helped steer you in the right direction toward improving your sleep. Be sure to talk to your doctor or a sleep specialist about your specific situation to determine what might be helpful for you.

About the Author

Stephanie Schwarten is a freelance writer and editor with a Bachelors degree in Professional Writing. She specializes in content marketing as well as both developmental and copy editing. 

About Carex Health Brands

Carex is your one-stop shop for home medical equipment and for products that assist caregivers with providing the best possible support and care for their loved ones. Carex Health Brands has been the branded leader in in-home, self-care medical products for over 35 years. Our goal is to improve the lives of our customers by bring them quality products that bring dignity back to their lives. With our three nationally distributed brands, Carex Health Brands serves national, regional and independent food, drug and mass retailers along with wholesalers, distributors and medical dealers.

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