“Adults should sleep 7 or more hours per night on a regular basis to promote optimal health.
Sleeping less than 7 hours per night on a regular basis is associated with adverse health outcomes, including weight gain and obesity, diabetes, hypertension, heart disease and stroke, depression, and increased risk of death. Sleeping less than 7 hours per night is also associated with impaired immune function, increased pain, impaired performance, increased errors, and greater risk of accidents.
Sleeping more than 9 hours per night on a regular basis may be appropriate for young adults, individuals recovering from sleep debt, and individuals with illnesses.”
– American Academy of Sleep Medicine and the Sleep Research Society (1)
I think we can all attest to the effect of poor sleep on our day to day health: we crave higher sugar and higher fat foods, we eat more in general, we have low energy and don’t feel like exercising, we can’t focus as well, we feel irritable, we’re more easily stressed, etc. (2,3)
Most of us know that we feel better when we’re well-rested, however, 65% of us don’t get 8hrs of sleep and 35% don’t even get 7hrs of sleep. (4) How much sleep each of us needs varies, but 7hrs is the minimum requirement for most people to reduce disease risk and premature death.
Sleep couldn’t be more important. We often oversimplify what sleep has to offer and view it as a time when our body sort of “shuts off” rather than what it actually is – a critical time when our body is actively repairing itself.
What happens during sleep:
Growth and repair of muscles and tissue
Hormones for growth and repair are released
Hunger hormones are suppressed (which helps you eat less the next day)
Memory integration (better memory recall)
Waste is flushed from the brain (basically, your brain detoxes itself)
Repair and growth of brain cells
Your body does things during sleep that it really can’t do while you’re awake when it’s using up energy for your daily activities. It makes sense that if you’re body can’t repair itself or can’t complete the repair cycle due to insufficient sleep or poor quality sleep that you’d be more at risk for disease.
Insulin Resistance and Diabetes
Turns out, not getting enough sleep (short sleep) can cause insulin resistance and greatly increase diabetes risk, even if you are healthy and of normal weight.
In fact, just one night of short sleep (4hrs) can induce insulin resistance in healthy people. (5) Similar results were produced in studies with healthy people who were sleep deprived (4-5hrs of sleep) for 5 days or a week. (6,7)
The good news is that, by catching up on sleep and resuming a normal schedule afterwards, these people can recover, but what about people who are chronically sleep deprived or are already insulin resistant and are trying to lower their blood sugars and HbA1c? Not getting adequate sleep will only hinder their efforts and likely continue to worsen the problem.
When it comes to the risk for developing full blown diabetes, sleeping less than 6 hours on a consistent basis increases the risk for Type II diabetes by an astonishing 50%. (8,9) Sleep all on it’s own has a huge impact on our risk for disease.
Getting up to 7hrs of sleep also increases diabetes risk as compared to people who get 8hrs. (10)
How does poor sleep cause insulin resistance? Likely due to the well-established fact that not getting enough sleep causes inflammation in a number of metabolic pathways and we know that inflammation is a cause of insulin resistance and diabetes. (11)
How Much is Enough and Can You Get Too Much Sleep?
There is some evidence that getting too much sleep is possible. The research trends suggest that sleeping 9 or more hours can be problematic, with general health outcomes worsening as you approach 10hrs of sleep. It also suggests that sleeping for longer periods of time also increases your risk for Type II diabetes. (12,13)
While most studies on longer sleep do their best to account for other factors like health, weight, age, diet, exercise, etc. there is a general agreement among experts that people who sleep longer may already be unhealthy and need a longer period of sleep to complete the repair processes described earlier. They may also have such poor sleep quality that they have to make up for it by sleeping longer. (14, 15) In which case, the goal would be to get healthier so that you have better sleep quality and require less sleep.
One study showed that sleeping more than 9hrs was only detrimental in people who did not exercise. (16)
Verdict: The research on short sleep is very strong and directly links sleeping less than 7hrs per night with poor health outcomes. Short sleep can cause insulin resistance and increased risk for type II diabetes. The research on poor health outcomes for those sleeping 9 or more hours is weaker, though there does not seem to be an advantage to longer sleep.
There are always going to be outliers – people who do really well on 6hrs of sleep, have no health issues, have lots of energy, etc. There are also people who may sleep a bit more and creep above 9hrs per night. But generally speaking, you’ll want to shoot for 7.5-8.5hrs. That appears to be the sweet spot.
Can you make up by sleeping more on the weekends? No. You don’t benefit from playing sleep catch up on the weekend and you’re risk for obesity jumps 63% just by having huge swings in sleep periods. The same amount of sleep every night is ideal. (17, 18)
What if you’re a night owl? Can you get 8hrs on the later end, say 12-8am? Studies show that your risk for obesity doubles if you’re a “late to bed, late to rise” person, even if you get enough sleep. Early to bed, early to rise is best. (19)
Tips for Better Quality Sleep
How long you’re in bed is different from how much of that time you’re actually asleep is different from how WELL you sleep (sleep quality).
While there is no official definition, sleep quality can best be defined as getting deep, restorative, mostly uninterrupted sleep (note that it is normal to have a few brief wakings each night). Quality is more important than quantity and better quality sleep will help you feel better and stay healthy or get healthy. Here are some simple strategies…
10 Keys to getting better sleep:
1. Get to sleep no later than 10 – you get your deepest, most restorative sleep in the earlier part of the night. To achieve this, you’ll need to start winding down 30min to an hour before bed. Get in bed at 9 or 9:30 at the latest to read, relax, have a cup of tea or just turn out the light. It’s not the time to ramp up activity or your nervous system by watching intense shows or movies. We also have a rule in our house where no one can bring up really emotional or intense conversations after 9pm. There’s nothing like a late night argument to completely throw off your sleep! Save those for when the sun is out.
Don’t freak out if it takes you 30min to fall asleep. It’s normal to take 30-60min to nod off, though this time shortens if you get to bed when you’re starting to get tired in the evening, about an hour after sunset. Don’t ramp yourself up by staring at the clock and obsessing over the fact that you’re still awake 20min after you got into bed. Just relax, it’s normal.
2. Get more potassium. New research shows that the neurons in our brain that regulate sleep are flooded with sodium by day to make them more excitable when we’re awake and are then flooded with potassium by night to help calm them for sleep. (20) Many people are potassium deficient and good sources include avocado, beets, Brussels sprouts, broccoli, sweet potato (all of these have more potassium than a banana!). You can eat these any time of day to reap the benefits at night.
3. Daytime stress worsens nighttime sleep. This is so important. If you’re taking something to help you sleep at night, it would be way more effective and beneficial to put your efforts towards better adapting to stress during the day, which will help balance stress hormones and maintain that healthy sleep/wake cycle. There are countless natural strategies and methods for helping your body better handle stress, even if you can’t change the stressors. This has been my key to better sleep for the last 10 years after suffering from insomnia for so many years prior, so it works. Work with someone who can properly guide you on this and help you take your sleep to the next level. You can also look into this program called Rest Assured that has helped many of my clients manage stress and get better sleep.
4. Have a small bedtime snack if you tend towards hypoglycemia and blood sugar issues. It may take a few different snacks to figure out what works for you, but many people find that a tablespoon of honey with a bedtime snack actually helps them sleep better by replenishing stored sugar in the liver for use during the night, preventing overnight hypoglycemia.
5. Try magnesium – most people are deficient anyway. It can also be hugely beneficial for people who have muscle cramps at night. Find magnesium glycinate or malate. If you tend towards constipation, a product called Natural Calm, found in healthfood stores, can help encourage healthy morning movements and help you sleep. Doses are individual, so start small and slowly increase, then stop when you reach the desired outcome.
6. Keep your room as dark as possible – get blackout curtains if you need to. Keep your room free of blinking or glowing lights. That means your phone might be best left charging in the living room, rather than right next to your bed. If your phone is your alarm clock, find the most soothing sounds to wake up to and turn your phone over so that no lights are showing.
7. Avoid computer, TV and phone lighting an hour before bed. These lights at night reduce melatonin production (your sleep hormone). Your body regulates sleep best when it can clearly distinguish between day and night. To achieve that, get outside by midday if you work in an office since indoor lighting is not compatible with your internal clock and confuses your wake/sleep rhythm. So, get sunlight during the day and dim light at night before bed. You can also use red or yellow colored light bulbs in your home to support melatonin production. The blue colored light bulbs shown in the same link help in areas where you spend most of your time indoors, such as your desk at work.
8. Keep your room cold. Studies have shown that temperatures near 65 degrees are best, but for most of us in areas with hot summers, that just seems way too cold and expensive to maintain. Just keep your room as cold as you can. The lower temperature assists in maintaining your body’s ideal temperature for sleep and will prevent unnecessary wakings and ensure deeper sleep.
9. Exercise during the day can help support melatonin production at night and a balanced sleep/wake cycle. Exercising outside is even better to help get more natural light into your eyes. If you can, avoid intense cardio in the evening. This can drive up cortisol levels, encourage that “second wind” and make it difficult for you to fall asleep. Some can adapt to evening exercise and have no trouble sleeping, so do what your body likes best.
10. Get healthy – healthier people have healthier sleep. This is where it’s important to work with a healthcare practitioner who can help you address the root causes of your health conditions, reducing your need for medications that often compromise good sleep. Also, healthy, restorative sleep is highly dependent on how well your cells are functioning. That level of deep wellness will require changes in diet, movement and stress management that work for you, so seek out help if you need it.
Interested in tracking your sleep?
Many people think they sleep better or longer than they actually do, so it may be beneficial to actually assess what your sleep is like. There are lots of trackers out there, including the popular FitBit, an iPhone app called Sleep Cycle and what seems to be the macdaddy of all trackers, the Oura.
I learned about the Oura at a recent health conference and it sounded pretty revolutionary (as the price might suggest). It’s supposed to more accurate than other devices, measures heart rate, sleep cycle, even tracks sugar consumption, calories, body temperature (a lesser known valuable measurement of health), etc. I like that you can turn off the bluetooth function to avoid introducing electrical disturbance while wearing it in bed. The iphone app requires you to sleep with your phone near your body, so that one may introduce more electrical disturbance, though I haven’t looked into whether or not turning off the wifi signal would remedy that.
I can’t vouch for any of these tools since I have not tried them personally, but if tracking is of interest to you, check them out and see what works for you.
Sleep is so important! Please share this post with your friends and family. Leave a comment below with any thoughts or questions. Or drop me a line if you’re interested in exploring this more for yourself.
To your sleep!
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