Sleep plays a tremendous role in health and overall quality of life. Sleep is vitally important for feeling refreshed and rejuvenated in the morning, feeling energetic during the day, developing memory, learning, determining mood, maintaining concentration, supporting the body's immune system, and more. Most adults need an average of about 7-9 hours of quality sleep per night. Proper sleep habits, also known as sleep hygiene, constitute a major part of preventive health.

Individuals sleep habits naturally vary with respect to timing and duration. Some people are more active and alert in the morning ("morning larks") while others are more wakeful at night ("night owls"). Some people need more or less sleep than the typical 7-9 hour recommendation. But all people require adequate quality sleep to function at their fullest and to prevent the serious consequences associated with sleep problems (see below).

A few other notes about healthy sleep:

• Children and infants have very different sleep patterns and require more sleep than adults. See http://www.sleepfoundation.org/article/sleep-topics/children-and-sleep for more information.
• Adolescents generally require more sleep than adults. In addition, they tend to feel sleepy later at night, and tend to need to wake up later in the morning. See http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2419117/k.2DEE/Adolescent_Sleep_Needs_and_Patterns.htm for more information.
• Older individuals and elderly tend to feel sleepy earlier in the evening, and tend to need to wake up earlier in the morning. Sleep problems are very common in older individuals. See http://www.sleepfoundation.org/article/sleep-topics/aging-and-sleep for more information.
• Circadian rhythms refer to the daily cycle of sleepiness and wakefulness. Light, environmental cues, genetic makeup, ambient temperature, meals, and exercise all affect daily sleepiness and wakefulness patterns.
• Napping can be beneficial for overall health. Natural circadian rhythms often produce feelings of sleepiness in the mid-afternoon, and naps during this time are common.

Unfortunately, many people do not get healthy or adequate sleep, with sleep-related problems affecting 50-70 million Americans. Sleep problems are associated with obesity, high blood pressure, diabetes, stroke, heart attack, motor vehicle accidents, work-related accidents, stress, depression, poor attention, reduced memory, and more. Sleepy drivers are responsible for over 100,000 automobile accidents per year and this leads to over 70,000 injuries and over 1,500 deaths. Sleep deprivation also decreases work productivity. Sleep disruption may be caused by worry, poor sleep habits, medical or mental illness, jet lag, noises, sleep disorders, and many other environmental factors.

For most people, ways to improve sleep include:

• Avoiding caffeine and other stimulants after lunch
• Exercising early or mid-day and avoiding heavy exercise at night
• Avoiding large meals close to bedtime
• Getting enough bright light exposure during the day
• Keeping the bedroom environment very dark
• Establishing regular bedtime routine
• Avoiding stimulating activities such as: TV, radio, reading, computers, and more
• Keeping the sleep environment calm and comfortable

A number of sleep disorders exist that can negatively affect sleep and overall health. Some of these problems are listed below. For more information about these disorders and other sleep disorders, visit http://www.sleepfoundation.org/articles/sleep-related-problems.

• Obstructive sleep apnea: episodes when breathing stops during sleep
• Narcolepsy: uncontrollable daytime sleeping, vivid hallucinations with sleep onset, fragmented sleep during the night, paralysis at the beginning or end of sleep, and for some, cataplexy (sudden loss of muscle tone often brought on by stress or emotion)
• Restless leg syndrome: discomfort usually in the lower legs which only lessens with leg movement. The symptoms usually begin within an hour of going to bed; can lead to difficulty falling asleep and potentially, insomnia
• Periodic limb movement disorder: clustered episodes of highly frequent leg jerking during sleep (jerking occurring usually about every 30s); more common in elderly
• Insomnia: reduced ability to fall asleep; alcohol, caffeine, and smoking can all exacerbate it
• REM behavior disorder: intense movement during dreaming (kicking, punching, yelling, etc.)

   

  Excessive daytime sleepiness, a symptom of poor sleep quantity and/or quality, can be evaluated using a numerical scoring system called the Epworth Scale. A score higher than 10 is worrisome. To calculate your score, rate how likely you are to fall asleep doing the following activites:

  0 = Would never doze; 1 = Slight chance of dozing; 2 = Moderate chance of dozing; 3 = High chance of dozing

  • Sitting and Reading
  • Watching TV
  • Sitting inactive in a public place (i.e. theatre)
  • As a car passenger for an hour without a break
  • Lying down to rest in the afternoon
  • Sitting and talking to someone
  • Sitting quietly after lunch without alcohol
  • In a car, while stopping for a few minutes in traffic

   

  For healthy individuals, maintaining proper sleep hygiene is an achievable aspect of preventive health that offers great benefits to long-term health and quality of life. For people with specific sleep disorders or other conditions disrupting sleep, the underlying problems can be evaluated and treated.

  
  

   

  Citations

   

  
  
  1. "Why Sleep Awareness is Important." National Sleep Foundation. March 2007. http://www.nsart.org.
  2. "Sleep Deprivation: Causes and Consequence." National Ag Safety Database (NASD). April 2002. http://nasdonline.org/document/871/d000705/sleep-deprivation-causes-and-consequences.html.
  3. "Sleep Hygiene." National Sleep Foundation. 2009. http://www.sleepfoundation.org/article/ask-the-expert/sleep-hygiene.
  4. "Narcolepsy." Medline Plus. A Service of the U.S. National Library of Medicine and the National Institutes of Health. November 2009. http://www.nlm.nih.gov/medlineplus/ency/article/000802.htm.
  5. "Restless Leg Syndrome." Medline Plus. A Service of the U.S. National Library of Medicine and the National Institutes of Health. November 2009. http://www.nlm.nih.gov/medlineplus/ency/article/000807.htm.
  6. "Sleep Apnea." Medline Plus. A Service of the U.S. National Library of Medicine and the National Institutes of Health. November 2009. http://www.nlm.nih.gov/medlineplus/ency/article/000811.htm.
  7. "Narcolepsy Information Page." National Institute of Neurological Disorders and Stroke. National Institutes of Health. October 2009. http://www.ninds.nih.gov/disorders/narcolepsy/narcolepsy.htm.

  
  Created: 7/2/2007
  Last Modified: 3/18/2010