By Ana Krieger, M.D., MPH

What should I do if I can’t sleep? 

Relaxation techniques are easy, effective practices that may help facilitate sleep. On a restless night, deep breathing exercises can help soothe the mind and body to sleep. Inhale completely and slowly, hold at the top for a few seconds, and release audibly and with control. The longer the breath, the better. Trouble falling asleep is sometimes caused by a mind full of the day’s worries. If we are too busy and don’t have time to resolve our concerns during the day, they may surface when it’s time to rest. In this case, keeping a worry list may be an effective relaxation technique. This list should be kept current, and time should be allotted during the day, not at night to review it. During this time, planning and problem solving can calmly take place.

 How much sleep do we really need?

The recommendation for adults is typically seven to eight hours a night, though sleep needs vary individually. It is important to remember that children have longer sleep needs that actually increase during adolescence. As we age, we become less efficient at sleeping, and sleep periods often become more fragmented.

How can I determine if I am getting enough sleep?

Most adults in the U.S. carry a sleep debt, which means that their sleep patterns are insufficient to the needs of their body. Sleep debt is clinically irrelevant at small levels. However, an accumulation of sleep debt over weeks can affect mental and physical performance, including hormonal regulation and immune function. Observe your own sleeping pattern and note whether you wake up frequently during the night, are feeling well-rested throughout the day, and how many hours of sleep you’re getting. 

Can a daytime nap compensate lacking sleep at night?

Daytime naps can be used to offset acute sleep loss and compensate for missed hours. Naps are also used to compensate for a scheduled short sleep. The best nap duration is around 20-30 minutes, as longer naps may involve periods of deep dream sleep. This is referred to as “sleep inertia,” the “tired” feeling after a long mid-day rest. Napping is a culturally acceptable behavior in many countries and there is no evidence that a short nap is problematic. 

Is it true, that a lack of sleep can lead to overweight?

An insufficient sleep cycle may lead to hormonal imbalances and changes in behavior; these include metabolic changes and saturated food cravings. In both extremes of sleep duration, either too much or too little, the metabolism suffers, leading to weight gain, obesity, and other health problems.

Which environment and circumstances can improve my sleep?

A quiet and dark environment free from external stimuli is the ideal. We typically recommend adjusting the bedroom’s noise, light and comfort levels as needed. A dark environment during the rest period enhances melatonin activity. This means that lights from electronic devices should be turned off or covered. Choosing the proper mattress, pillow and covers can also help improved sleep experience. 

What’s the best time to go to bed? 

Sleep is regulated by circadian rhythms that are coordinated by cells in the brain following a 24-hour clock. Frequent changes in bedtime and wake time decrease sleep effectiveness and knock our rhythms out of synch. For this reason, it is critical to have a consistent rest schedule. One should first determine their ideal wake time; be realistic about your goals in order to achieve them throughout the week. Once wake time is established, one should determine their bedtime by calculating backwards to allow for seven to eight hours. Whether you are a morning person or a night owl, a stable rest schedule will strengthen the circadian system and improve sleep.

What are the latest and most surprising news in your field of science?

Sleep medicine is a fascinating field that studies various mental and biological systems. We constantly see interesting developments in our field, from basic molecular discoveries to clinical and behavioral treatment approaches. One of the most interesting on-going scientific developments is an analysis of the gut microbiome’s role in regulating sleep. What does healthy neurohormonal function look like according to the stomach? There will be new and exciting moments ahead!

Dr. Krieger is a clinician scientist, Chief of the Division of Sleep Neurology and the Medical Director of the Weill Cornell Center for Sleep Medicine at Weill Cornell Medicine/New York Presbyterian. 

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