The sleep specialty site Sleepadvisor.org likens sleep deprivation to intoxiction—a condition in which no one would want to go to work. Unfortunately sleep problems are pervasive, and the online sleep mavens have gathered plenty of statistics to support the claim.
For starters, 35% of adults get less than the seven hours of sleep the Centers for Disease Control recommends. In fact, Americans had 7.9 hours of sleep per night on average back in 1942, but by 2013 that had dropped to 6.8 hours, a 13% decrease.
Lack of sleep costs the United States more than $411 billion in productivity annually, Sleepadvisor.org reports, citing Fortune magazine. More critical than the financial costs, however, is the impact on health and safety. Medical errors from sleep deprivation account for more than 100,000 deaths, while almost 20% of all car crash accidents and injuries are linked to sleepiness, according to the National Center for Biotechnology Information. Further, a lack of sleep could be the cause of up to 5% of adult obesity, says the Harvard School of Public Health.
Are you married? You’re more likely to have a healthy night’s sleep, the CDC says, than people who were never married or who are divorced, separated or widowed. Do you have a college diploma or more advanced degree? You’re likely to have more sleep than the unemployed or people unable to work, the CDC adds.
On the following pages, we examine some of the key issues relating to sleep, giving you tools so you can get the rest you need.
Sleep Success Stories
Brooke Nicole Smith , Rochester NY
A good night’s sleep was nearly a lifelong quest for Brooke Nicole Smith, 35, a mindful eating expert, certified yoga instructor and integrative wellness and life coach.
“I struggled with insomnia for 30 years, even as a young kid. Prescription medications didn’t work well or they affected the quality of my sleep,” she says. Trying to resolve her sleep issue created a vicious cycle, as her inability to fall asleep created anxiety, and then the anxiety made it hard for Smith to fall asleep.
Smith began trying various natural remedies for her sleep problems, and eventually settled on a combination of tactics that worked.
Her first line of defense was yoga combined with meditation. She stumbled into yoga on a whim: “I joined a gym and took a Vinyasa class. This style is very fluid,” she says. “The goal is to keep you moving along with your breath. I liked the focus on the movements and how it feels in your body.” She will typically practice restorative yoga to ease tension at the end of the day. “I put on relaxing music, do some gentle stretching and then relax into a supported Supta Baddha Konasana,” or Reclining Bound Angle Pose.
Meditation also became a regular practice and soon began to help her fall asleep. “My mind used to be flooded with worries as soon as my head hit the pillow,” Smith recounts. “Meditation taught me to observe my thoughts instead of getting caught up in them. I usually meditate in the morning, but the effect on how I think, and how I think about my thoughts, stays with me throughout the day and night.”
In addition to yoga, other types of exercise began to impact her sleep in a good way as well. “Any exercise at all works,” Smith says. “Running, hiking, biking, strength training and yoga. I exercise almost every day, usually in the morning or early afternoon.” Now her anxiety over sleep is a thing of the past. “Even if I can’t sleep well, I no longer panic, but am happy to lie in bed.”
Rachel Zuckerman, Silver Spring MD
Rachel Zuckerman tried just about every technique to ease her racing mind so she could sleep. She avoided caffeine and chocolate during the day, and tried not taking vitamins at night and not eating too soon before bedtime.
“I had moderate success,” Zuckerman, 58, says. “I’d also take hot baths and drink chamomile tea to soothe myself. On a good night I’d fall asleep after about 15 to 20 minutes. On a bad night, I could toss and turn for around an hour.” When even a sliver of light coming in through a window kept her awake, Zuckerman would resign herself to sleeplessness, get out of bed and watch TV.
Then she discovered grounding mats. The mats plug into a ground wire port, which allows the earth’s natural electrons to flow up through the ground wire and onto the mat, even if you live many floors up in a building. Several studies show benefits from grounding, also called “earthing,” relating to improved wound healing and the prevention of inflammation and autoimmune disease (Journal of Inflammation Research 2015).
“I first heard about grounding mats at a holistic practice I visited, and pretty much thought it was bunk,” she admits. After speaking with a woman at the holistic studio who said it helped her get the best sleep she’d ever had, Zuckerman decided to give it a try.
It worked the first night she tried it. “It was quite soothing from the start and gives me a real sense of calm,” she says. “Lying on the mat feels soothing, pleasant and relaxing. I fall asleep within five minutes of getting into bed. I lie down, my thoughts quickly diminish, and the next thing I know it’s morning. As long as I have my mat, insomnia is no longer an issue for me.”
Zuckerman also notes an important tip on using the mat. “Use it the shiny side up, and the rougher side down and be sure to wear sleepwear that allows for some skin exposure to the mat; long pajamas prevent the current from working.”
Dane Kolbaba, Chandler AZ
As a business owner, Dane Kolbaba, 40, readily admits work life can be pretty stressful. “I used to struggle with sleeping, but I found that there are many things you can do to be able to sleep better—I call it honing my sleeping skills.”
To sleep better, Kolbaba tried many approaches and adapted the ones that worked best for him. These changes worked together to help him create a sleep routine that allows him to relax into a restful state.
First, he eliminated caffeine and sugary snacks at night. “My body doesn’t need to be processing that extra sugar when I should be in a totally relaxed state,” Kolbaba says. “However, a healthy snack may be beneficial if I’m still feeling hungry after dinner. I wouldn’t want to wake up hungry in the middle of the night.”
He also eases into darkness in preparation to retire for the night. “I turn the lights down low when it’s almost time to turn in, and of course when I do, things should be completely dark. I know that helps my body produce more melatonin [a hormone that rises in the evening and makes you less alert], and helps control my sleep-wake cycles better.”
Kolbaba knows the blue light of devices such as smartphones and tablets can make it harder to fall asleep. “If I have to use a device shortly before sleep, I make sure to use a blue light filter whenever possible,” he says. A variety of blue light filter apps can be found for this purpose.
And while low-level, ambient night sounds aren’t usually a problem, unexpected noises such as a dog barking can potentially disrupt sleep. “For this, listening to white noise from a phone app or a sound machine helps,” says Kolbaba. “White noise masks unexpected noises or other background sounds, helping to ensure I get uninterrupted sleep.”
Lastly, he sometimes downs a glass of warm milk before bed. “Although it may be a placebo effect, it helps me feel more relaxed.” —Linda Melone
When Sleep Becomes Dangerous
Obstructive sleep apnea (OSA) affects 1 in 12 Americans, or an estimated 22 million people, making it one of the most prevalent health disorders, according to the American Sleep Apnea Association. Chronic OSA increases the risk of coronary heart disease by 30%, stroke by 60% and heart failure by a whopping 140%.
“Pick a medical condition,” says W. Chris Winter, MD, president of Charlottesville Neurology and Sleep Medicine in Virginia. “You almost can’t pick something that isn’t related to sleep apnea, including dementia and Parkinson’s disease. Sleep apnea destroys a lot of rejuvenating parts of sleep, such as deep sleep.”
The “obstructive” part of OSA refers to an airway blockage that occurs when the tongue falls against the soft palate, which causes the latter to collapse against the back of the throat during sleep.
Symptoms of sleep apnea include feeling sleepy during the day or when driving, and snoring—or stopping your breathing or gasping during your sleep—which your partner will likely notice before you do.
Even those without sleep apnea typically stop breathing up to five times a night for 10 seconds or more, says Winter, author of The Sleep Solution: Why Your Sleep Is Broken and How To Fix It (Berkley). Anything above six times is considered sleep apnea. Mild-to-moderate apnea includes 5 to 14 stop-breathing events an hour while 30 or more is considered severe. “But there’s a big difference between people who have six episodes a night or 160,” says Winter.
Unfortunately, most people don’t see a doctor to diagnose sleep apnea until after they’ve had a stroke, says Winter. “The risk of heart attack and stroke are both tremendous.”
This stress occurs because people with sleep apnea have much higher blood pressure at night, observes Robert Rosenberg, DO, medical director of the Sleep Disorders Center of Prescott Valley, Arizona, and author of The Doctor’s Guide to Sleep Solutions for Stress and Anxiety (Fair Winds).
“The drops in oxygen and the stress of breathing against closed airways trigger the fight-or-flight system, which is normally quiet at night, but not in people with sleep apnea,” Rosenberg says. “That constricts the blood vessels and puts a lot of stress on the heart.” This process releases inflammatory markers such as C-reactive proteins, plus the low oxygen damages the heart muscles and blood vessels that go to the heart, he adds.
New research on sleep apnea may help resolve the disorder and, subsequently, the associated health issues. For example, it’s been shown that veterans have a much higher chance of sleep apnea, says Rosenberg. “When we treat the sleep apnea, symptoms of PTSD tend to improve, much more than if the sleep apnea is not treated. Sleep is a resolution of emotional processing, especially during REM sleep. It is important for someone with PTSD with poor breathing to be treated.”
New treatments for sleep apnea are also encouraging. “Some studies on the use of a synthetic form of THC are encouraging as it has decreased sleep apnea,” says Rosenberg. “There is some really good research that shows that treating a sleep disorder can prevent or slow down Alzheimer’s disease as well,” he adds.
If you suspect you may have sleep apnea, ask your doctor to do a simple home sleep study, suggests Winter. One way to test yourself is by taking a simple quiz called the Epworth Sleepiness Scale. “Struggling to stay awake or falling asleep while reading a book are signs, as are unexplained weight gain or blood pressure that’s creeping up. It’s a satisfying condition to resolve.” —Linda Melone
Dreamy Environs for Better Sleep
You stopped responding to work emails after hours, banned screens from the bedroom and never have a late-night latte. Still, you spend most nights tossing and turning.
Sleeplessness can lead to a host of health problems, including diabetes, heart disease, stroke, weight gain and mental distress. Despite the risks, one-third of Americans don’t get the recommended seven to nine hours of sleep per night, according to the Centers for Disease Control and Prevention.
If you spend too many hours counting sheep, your bedroom could be to blame.
“People need to consider that their sleep environment is crucial for sleep,” says Rachel E. Salas, MD, a sleep specialist and associate professor of neurology at Johns Hopkins Medicine. “The wrong environment can trigger or exacerbate insomnia.”
Here are five ways to improve your sleep environment:
Turn out the lights: A dark room sends the signal to your body that it’s time to sleep. Too much light hinders the production of the sleep hormone melatonin, which can make it harder to fall into a deep sleep. Sleeping in a dark room might also be better for your mental health.
Research published in the American Journal of Epidemiology found that those who slept in dark bedrooms were less apt to be diagnosed with depression than those who snoozed in light-filled rooms. Since depression is also linked to sleep disturbances, keeping the lights low could be key to getting a better night’s rest.
Lower the temperature: The hotter it is in your room, the harder it’ll be to fall asleep. “We tend to fall into deep sleep best when there is a precipitous decline in body temperature,” explains Lara Kierlin, MD, a psychiatrist and sleep doctor in Portland, Oregon. You’ll also wake up more often and spend less time in slow-wave sleep when the temperature in the bedroom is too high.
Turn the thermostat down to 68 degrees (research shows that bedroom temperatures between 60°F and 68°F are ideal) and you’ll sleep better.
Upgrade the mattress: Waking up feeling achy and exhausted instead of well-rested could be a sign that it’s time to replace your mattress. One study found that sleeping on newer mattresses led to reduced back pain and improved sleep quality compared with sleeping on mattresses that were more than five years old.
“You should be comfortable when you sleep,” Salas says. “Sometimes spending a little extra on your mattress is worth it—and don’t forget to take care of your investment: clean and rotate it regularly and use a mattress cover to prolong its life.”
Choose better bedding: If you have not washed the sheets in weeks and your pillow is from your childhood bedroom, invest in upgrades. Bedding traps allergens and the symptoms—itchy eyes, runny nose, scratchy throat—can make sleep elusive.
“Pillows can collect dander, sweat and dead skin cells [and other allergens], and can double in size over time. That can negatively impact sleep in some people,” Salas says. “I recommend washing or replacing your pillow every six months to one year, using a pillow protector or a hypoallergenic pillow to help with allergens.”
Salas also suggests changing the sheets weekly to reduce allergens in the bedroom. And, if you sleep “hot” and sweat a lot during the night, moisture-wicking sheets might help you drift off into dreamland.
Block distractions: The bedroom should be a screen-free zone, Kierlin says. The blue light can disrupt your circadian rhythm, making it harder to fall—and stay—asleep. A 2019 study found that screen time was also associated with poor sleep quality.
But it’s not just smartphones, tablets and televisions that distract you from sleeping. Kierlin suggests banishing pets from the bedroom and wearing ear plugs if neighborhood noise keeps you awake, noting, “If you’re sensitive to your environment, controlling your surroundings becomes very important for sleep.” —Jodi Helmer
Eating for sleep
Nights spent tossing and turning often don’t start in the bedroom but in the kitchen: What you eat can have a profound effect on your ability to sleep soundly.
For many people, caffeine in the evening is problematic. But it is found in sources other than such obvious culprits as coffee, tea, cola and chocolate, so check labels. And while alcohol seems to promote sleep, it can lead to you waking up in the early morning hours. (Nicotine is another no-no.) And don’t eat too close to bedtime, which can also interfere with sleep.
Looking for a slumber-encouraging nosh? Cherries are a natural source of the sleep-regulating hormone melatonin, bananas provide muscle-relaxing potassium and magnesium, and walnuts contain tryptophan, an amino acid that triggers sleepiness. In addition, chamomile tea is a time-honored suggestion for insomnia.
For children, warm milk is another traditional sleep aid, recommended by no less an authority than the National Sleep Foundation. It contains casein decapeptides, protein components with soothing properties; supplements often pair them with magnesium.
Melatonin is also available in supplement form. Look for products formulated with other sleep aids such as 5-HTP, an amino acid the body uses to create the neurotransmitter serotonin; the calming herb lemon balm; and L-theanine, a green tea component that promotes alert focus during the day while supporting deep, restful sleep at night. (The calming neurotransmitter GABA and herbal sleep aids such as passionflower and valerian also work well with melatonin, as do extracts from Zea mays—corn to you.)
It should be no surprise that hemp, which has been found to provide so many health benefits, also helps to promote restful sleep.
Receptors in the brain for serotonin respond to substances in hemp called phytocannabinoids. That helps to quiet the brain and encourage a sense of calm. What’s more, hemp usage has been found to foster a stage of deep sleep called REM; a lack of REM can result in anxiety, irritability and difficulty concentrating. And hemp’s sleep-promoting effects don’t come with daytime drowsiness and other side effects that can result from the use of insomnia medications. To get the most out of hemp, look for a product that also supplies such absorption factors as sunflower lecithin and a black pepper extract called BioPerine.
Other lifestyle factors besides diet can affect sleep. Experts recommend that you exercise during the day instead of at night, keep to a regular sleep/wake schedule (even on weekends) and avoid napping during the day. —Lisa James
The sizzle of bacon. The crinkle of a snack wrapper. Popcorn popping. Even crickets chirping. All these sounds can give Renee Frances a welcome case of the tingles.
The London, Ontario, resident, 44, says those sounds trigger her autonomous sensory merdian response, or ASMR, that helps her relax and even fall asleep.
“I find myself able to enjoy the journey through the first few stages of sleep,” says Frances, an educator and author who has written the award-winning Avery Sleeps More Readily (Somnus Stuff), with sounds and details that can trigger ASMR when read aloud. The book, she says, was written to help her kids fall asleep easier.
As many as 40% of people may be able to experience ASMR in response to gentle sounds or light touches, says Craig Richard, PhD, a professor at Shenandoah University, the founder of ASMR University and author of Brain Tingles (Adams Media).
Those who do experience ASMR feel a sense of well-being, relaxation and even euphoria. The positive feelings are accompanied by a tingling or static sensation on the skin, on the back of the head or along the back of the neck and spine.
In a study published in BioImpacts, Richard discovered that ASMR activates brain regions also associated with nurturing, bonding and grooming behaviors. “There doesn’t appear to be any side effects or dangers to experiencing ASMR,” he says. “Rather it is likely to be as healthy and as beneficial as spending time with people who care about you.”
This is good news for those who struggle with sleeplessness. ASMR can be a significant sleep aid, without the side effects, says Lauri Leadley, president of the Valley Sleep Center in Mesa, Arizona. “With insomnia, people struggle to escape their thoughts. ASMR allows the brain to focus on something else, which causes relaxation and the initiation of sleep,” she says.
To figure out if ASMR could help you sleep better, tune in to one of the many related YouTube videos or go to asmruniversity.com to see if you experience the tingling sensations. You can then pinpoint the sounds that create the strongest response, Richard says. For some, even watching video recordings of painter Bob Ross triggers the good feelings.
Frances believes one-on-one or small group sessions–like quietly whispering or reading to your child at bedtime–can be the most effective way to help your child experience ASMR. “My youngest daughter has a hard time falling asleep. Sometimes she simply has too much energy or can’t stop thinking about the stresses of the day. I wanted to find a non-invasive organic sleep solution; that’s when I found ASMR.” —Polly Campbell
Don’t Let the Bedbugs Bite
No one wants to think about sharing their bed with small insects that scurry across the sheets and feast on their flesh in the middle of the night, but bedbugs do just that—and you might not detect the blood-sucking parasites hiding between the sheets.
“Many times [bedbugs] are multiplying in cracks or crevices without any indication. There is a proportion of the population that do not react to the bites of bedbugs so they have no adverse skin reactions and don’t know they have bedbugs,” says Jody Green, PhD, urban entomologist at the University of Nebraska-Lincoln. “It’s only when populations get really high and bedbugs are leaving evidence like exoskeletons, fecal matter and dead bodies that it is no longer a hidden issue.”
The National Pest Management Association (NPMA) reports that one in five Americans have had bedbugs in their homes or know someone who had an infestation. Bedbugs are more common in urban areas and are found in homes and apartments more often than hotels.
Green notes that bedbugs do not carry diseases but their bites can cause itchy red welts and emotional distress.
Getting rid of the unwanted houseguests can prove problematic. While pesticides have long been the go-to treatment for banishing bedbugs, the Environmental Protection Agency warns that bedbugs have developed pesticide resistance.
“Over the last few years, bedbugs have been found to be highly resistant to some of the more common pesticides,” says Brittany Campbell, PhD, NPMA entomologist. Bedbugs are a really hard pest to get rid of so I recommend calling a professional if you have an infestation. A professional will have access to many different products, so they will rotate and use different products if they find that one particular one isn’t working very well.”
DIY options can be dangerous, according to Green.
“Many of the over-the-counter products that have bedbugs on the label…are usually not used properly by homeowners and increase the risk of insecticide poisoning,” she says.
While there are not many non-toxic options to control bedbugs, some professional pest management companies use heat treatments, turning on commercial heaters and fans to lethal temperatures. Prevention is the best strategy to keeping bedbugs out.
Green recommends checking for signs of fecal matter on the mattress. Change sheets and linens often and use the high-heat setting on the dryer to kill any insects. Vacuum all soft surfaces, including carpeting and mattresses. And leave luggage in the garage after you come home from a trip so hitchhiking bedbugs cannot get into the house.
“We can’t help what is out there when we travel or go about our daily lives,” Green says, “but we can control what comes into our house, and that is the ultimate goal—to keep bedbugs out of our personal residences.” —Jodi Helmer