Steps Toward High-Quality Sleep

Written by: Deepika Miryala

Edited by: Ayush Halder

(Image from: https://www.mdanderson.org/cancerwise/how-sleep-affects-your-health-and-how-to-get-more-of-it.h00-159621801.html)

Abstract

Many individuals in this day and age struggle with getting an adequate amount of good sleep. Sleep simply has not been prioritized enough in modern life. However, getting high-quality sleep is vital to our health, and researchers are delving into the world of sleep to help people maximize rest. High-quality sleep is efficient and leaves people feeling refreshed, with ample time spent in deep sleep and few arousals. There are a number of simple behavioural and environmental changes that people can make to ensure they get optimal sleep. Many of these changes are adaptable to different lifestyles and can be implemented to each individual’s discretion. Getting proper rest yields noticeable mental and physical benefits. The simplicity of these sleep hygiene practices, combined with their undeniable efficacy, makes it clear that more attention must be given to sleep science and medicine. 

The Current State of Sleep Quality

Sleep, like food, water, and exercise, is one of the foundational pillars of human health. Unfortunately, modern society consistently neglects adequate sleep, with between 50 and 70 million Americans facing sleep-related issues and 40% getting less than 8 hours a night, leading ⅜ to face consequences due to inadequate rest (Strine & Chapman, 2004). In fact, sleep-related issues have a prevalence similar to that of more widely recognized conditions, such as arthritis and cardiovascular disease (Strine & Chapman, 2004). This is largely due to habits that many people slip into that are actually detrimental to sleep quality, such as “drinking too much coffee or alcohol or doing less exercise” (Chow, 2022). Studies from Hong Kong and Taiwan show that even children and adolescents have degraded sleep quality due to reasons such as television exposure and substance abuse (Pakpour et al., 2020). The tragic effects of this global sleep problem are undeniable. Unfortunately, almost two-thirds of adults report that a physician has never inquired about their sleep health (Strine & Chapman, 2004). Thankfully, in recent years, sleep has become a more prominent discussion topic in the health field, leading to breakthroughs in sleep medicine. 

What Does High-Quality Sleep Look Like?

Before getting into proper sleep habits, it is important to understand what health experts consider a “good night’s sleep.” Some of the commonly measured variables include “sleep latency, number of awakenings, time awake, and amount of Stage 1 sleep” (Akerstedt et al., 1994). Healthy sleep also generally aligns with the body’s circadian rhythm, or natural physiological clock (Mukherjee, 2015).

Slow-wave sleep (aka deep sleep/stage N3) leads people to perceive their sleep as being deeper in quality (Akerstedt et al., 1994). Rapid-eye movement (REM) sleep - a sleep stage characterized by increased brain activity and vivid dreams - has similar effects, and it also makes people feel more alert in the morning (Akerstedt et al., 1994). 

It is important to understand what an ideal night’s sleep should look like. First and foremost, the duration should be within the scientifically recommended range, which an article from the Journal of the National Sleep Foundation states is between 7 to 9 hours for adults (Hirshkowitz et al., 2015). Moreover, studies have shown that the most important indicator of subjective sleep quality is sleep efficiency, defined as the proportion of time spent asleep relative to the time spent in bed (Akerstedt et al., 1994). Most importantly, good sleep should leave one feeling refreshed and rejuvenated. Enforcing sleep practices that maximize quality of rest is known as “sleep hygiene” (Pasquale et al., 2024; Chow, 2022). These can include changes in the environment, behavior, or other variable factors. 

Tips on Getting Good Rest

Thankfully, modern research has allowed health experts to curate targeted approaches to improving sleep quality and duration. The first one is fairly intuitive, but often disregarded: only sleep when genuinely tired (Howard, 2023). This helps regulate when we sleep and ensures that we minimize the time we spend awake in bed. Additionally, it is helpful to mitigate stressful emotions, as they can trigger certain hormones (such as adrenaline) that make falling asleep difficult. This can be done through a variety of simple practices, such as breathing exercises and relaxation/mindfulness practices (Harvard Health Publishing, 2023). 

In terms of eating, it is best to avoid sleeping while hungry, though being too full can also make it hard to fall asleep (Howard, 2023). Exercising regularly is another effective intervention that naturally tires the body, though it is best to do it in the morning or afternoon rather than near bedtime (Pasquale et al., 2024). 

Additionally, it is essential to create an optimal sleep environment. This means making the space comfortable, removing distractions, and keeping it dark, quiet, and at a regulated temperature (Harvard Health Publishing, 2023; Chow, 2022). Limiting screen time before bed is important, since devices can be overstimulating and are known to decrease sleep duration and efficiency (Chow, 2022). Further, it is essential to use the sleep environment primarily for actually sleeping, rather than working, watching television, etc. This helps the brain associate the environment with rest, making it easier to fall asleep in that area (Harvard Health Publishing, 2023). 

Avoiding toxin ingestion near bedtime is also important. Specifically, smoking may negatively impact sleep, with smokers reporting that they have a harder time falling/staying asleep and feel tired throughout the day more frequently than their non-smoking counterparts (Strine & Chapman, 2004). Similarly, caffeine consumption, which is physiologically stimulating, should be reduced near bedtime (Pasquale et al., 2024). 

Lastly, in order to measure sleep quality, many individuals have turned to sleep tracking devices, which are useful for measuring both sleep quantity and quality (Ohayon et al., 2017).

Benefits of High-Quality Sleep

Implementing these tips on getting better sleep can provide a plethora of positive effects. For example, a good night’s rest has been shown to improve brain health, including mental health, cognitive functioning, and emotional processing (Pakpour et al., 2020). This can have effects such as improved academic performance and alertness, the latter of which is particularly important considering how many car accidents are caused by impaired alertness from sleep deprivation (Hirshkowitz et al., 2015).

Good sleep can also aid memory and learning, as well as physical conditions such as recovery efficiency, energy levels, “cardiovascular and metabolic function, and cellular toxin removal” (Mukherjee, 2015). Importantly, getting better rest reduces one’s risk of developing psychiatric illnesses and helps mitigate the impacts of chronic illness (Strine & Chapman, 2004). Overall, it is evident that getting proper rest is a crucial component of general physiological wellbeing.

Conclusion

In a busy, ever-innovating world, rekindling our relationship with sleep is of the utmost importance. To do so, both sleep duration and sleep quality must be addressed, with individuals actively identifying factors that harm and factors that contribute to their subjective sleep quality. If targeted practices are implemented to maximize sleep quality, real physiological benefits are inevitable.

---

References

Åkerstedt, T., Hume, K. E. N., Minors, D., & Waterhouse, J. I. M. (1994). The meaning of good sleep: a longitudinal study of polysomnography and subjective sleep quality. Journal of sleep research, 3(3), 152-158.

Chow, C. M. (2022). Sleep hygiene practices: where to now?. Hygiene, 2(3), 146-151.

De Pasquale, C., El Kazzi, M., Sutherland, K., Shriane, A. E., Vincent, G. E., Cistulli, P. A., & Bin, Y. S. (2024). Sleep hygiene? What do we mean? A bibliographic review. Sleep Medicine Reviews, 75, 101930.

Harvard Health Publishing. (2023, November 20). 8 Secrets To A Good Night's Sleep. Harvard Health. https://www.health.harvard.edu/newsletter_article/8-secrets-to-a-good-nights-sleep

Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., ... & Ware, J. C. (2015). National Sleep Foundation's updated sleep duration recommendations: final report. Sleep Health. 2015; 1 (4): 233?43.

Howard, L. (2023, July 10). Try these 13 tips to help you sleep better. News. https://health.ucdavis.edu/news/headlines/try-these-13-tips-to-help-you-sleep-better/2023/07

Mukherjee, S., Patel, S. R., Kales, S. N., Ayas, N. T., Strohl, K. P., Gozal, D., & Malhotra, A. (2015). An official American Thoracic Society statement: the importance of healthy sleep. Recommendations and future priorities. American journal of respiratory and critical care medicine, 191(12), 1450-1458.

Ohayon, M., Wickwire, E. M., Hirshkowitz, M., Albert, S. M., Avidan, A., Daly, F. J., ... & Vitiello, M. V. National Sleep Foundation's sleep quality recommendations: first report. Sleep Health. 2017; 3 (1): 6?19.

Pakpour, A. H., Griffiths, M. D., Ohayon, M. M., Broström, A., & Lin, C. Y. (2020). A good sleep: The role of factors in psychosocial health. Frontiers in neuroscience, 14, 520.

Strine, T. W., & Chapman, D. P. (2005). Associations of frequent sleep insufficiency with health-related quality of life and health behaviors. Sleep medicine, 6(1), 23-27.