The Ultimate Sleep Guide
Table of Contents
II. How Sleep Works
III. Sleep Disorders
IV. Losing & Catching up on Sleep
V. Sleep Tips
VI. The History of Sleep
Introduction
How Sleep Works
💤 Importance of Sleep
😴 Stages of Sleep
Stage 1 is considered the lightest sleep where eye and muscle movement slow down considerably. This is that moment where you find yourself drifting in and out of sleep, only semi-conscious.
Stage 2 lasts about 20 minutes. This is the stage where eye movement stops and the brain begins to produce very short periods of rapid, rhythmic brain wave activity known as Sleep Spindles. Breathing and heart rate are regular, but body temperature drops and you become completely disengaged from your surroundings.
Stage 3 is the transitional period between light and very deep sleep. Slow brain waves, known as Delta Waves, begin to emerge in this stage, blood pressure drops but blood supply to muscles increases, and breathing slows down. Hormones are also released, helping to facilitate tissue growth and produce energy.
Stage 4 is referred to as Delta Sleep and it lasts about 30 minutes. Known as the deepest and most restorative sleep, many reparative processes take place in this stage. But being in such a deep state of sleep has its downsides - if sleepwalking and bedwetting are going to happen, they’ll happen at the end of Stage 4.
Stage 5 is the famous REM Cycle, short for Rapid Eye Movement, which is characterized by the eyes rapidly moving back and forth behind the lids. We first enter into the REM cycle after about 70 to 90 minutes of non-REM sleep. We go through about 5 cycles of sleep each night, with each cycle of REM lasting longer than the previous one. The REM Cycle is the most active stage of sleep for the brain, in fact, electrical activity during REM is very similar to waking consciousness. Both the brain and body are energized, but oddly enough, the body becomes immobile and relaxed. Muscles are actually turned off to prevent the body from physically acting out dreams.
The REM cycle is crucial. It provides critical restoration to support daytime brain activity and facilitates brain connections that are necessary for problem solving, complex thought, and procedural memory. During REM, the brain actually processes and synthesizes memories and emotions critical for learning and higher-level thought.
A lack of REM sleep simply isn’t healthy. It results in significantly slower cognitive and social processing, memory problems, and difficulty concentrating. And even though only ¼ of sleep is REM sleep, most of our dreams occur during this stage. REM dreams are more bizarre, vivid, and emotionally charged than dreams during the other stages of sleep. These are the dreams that you are most likely to remember (and regale to your friends), especially if you’re woken up during this stage.
☁️ Dreaming
While it’s commonly believed that dreams only occur during the REM cycle, dreams actually occur in every stage of sleep. Dreaming is definitely rare in Stage 1, but it does happen.Those sudden twitches called Hypnic Jerks (sudden and short micro-awakenings followed by a falling sensation) are considered dreams. Short dreams appear intermittently between Stages 2-4 of the sleep cycle. REM is where dreaming becomes more frequent, complex, and intense with more vivid imagery and more bizarre events. In REM we are most aware of our dreams, and if woken during this stage you are very likely to remember some dream fragments. Dreams can last up to 60 minutes. It’s like our minds are directing little (bizarre) movies in our heads every night.
Sleep Disorders
There are hundreds of sleep disorders caused by a variety of factors. Stress, illness, physical makeup, sleeping environment, and extreme temperature are all relevant. The three most common disorders are Sleep Apnea, Insomnia, and Restless Leg Syndrome. Approximately 50 to 70 million Americans suffer from sleep disorders. No amount of sleep nor new mattress will be able to make up for the poor rest you get with a sleep disorder. If you think you might be suffering from a sleeping disorder, definitely take the time to visit your doctor.
➡️ Sleep Apnea
All 3 forms of Sleep Apnea are characterized by very similar symptoms. The most common symptom is loud snoring, which is usually more prominent in Obstructive Sleep Apnea. Another common symptom is a temporary cessation of breathing, usually only lasting a few seconds. Both of these symptoms are usually noticed by another person since you’re asleep when you’re displaying them. Other symptoms, ones that you yourself might notice, include waking up abruptly, difficulty staying asleep, excessive daytime sleepiness, irritability, and difficulty paying attention. You also might wake up with shortness of breath, sore throat, headaches, and/or a dry mouth.
While Sleep Apnea can take a significant toll on your overall health, there are many treatments out there that have been successful. For mild cases, especially Obstructive Sleep Apnea, the treatment can be as simple as making a lifestyle change like losing weight, exercising more, avoiding alcohol and sleeping pills, or quitting smoking. Sometimes it can be as simple as adjusting your sleeping position. Lastly, since the throat and nose play a large role in the symptoms of Sleep Apnea, simply using a nasal solution, such as saline, can improve snoring. A more drastic treatment for moderate or severe Sleep Apnea, is having your tonsils removed to help clear the airway. Some more severe cases may require the use of a CPAP machine to deliver air pressure throughout the night. If you have any of these symptoms, you should seek professional medical attention to identify your options and implement treatment - a simple change might make all the difference.
➡️ Insomnia
The Symptoms
There are many symptoms of Insomnia. The major ones include difficulty falling, and falling back, asleep, waking up multiple times throughout the night, waking up too early, and ongoing anxiety around sleep. Other symptoms include grogginess, lingering fatigue, difficulty paying attention or focusing, and slowed mental processing.
The Cause
Acute Insomnia is usually caused by temporary stress, illness, or a traumatic event. Chronic Insomnia cases exhibit a much wider variety of causes which include, but are definitely not limited to, travel and work schedule, medications and medical conditions, mental health disorders, symptoms of other sleep disorders, and caffeine, nicotine, drug and/or alcohol use and abuse. One thing that is super interesting is the relationship between how you use your bed and how your mind perceives that. Believe it or not, improper use of your bed can actually cause Insomnia. If you use your bed for working, watching TV, eating, and other “day” activities, your body actually struggles to associate it with sleep. This dissonance can make it very difficult to fall asleep.
The Treatment
There are several treatments to combat the terrible, and common, curse of Insomnia. Some treatments include stimulus control therapy, relaxation techniques, sleep restriction, remaining passively awake, and light therapy. Some simpler at-home remedies that are easy to implement include tea, yoga, defining and sticking to a sleep schedule, avoiding nicotine, controlling alcohol intake, limiting caffeine and naps, staying active, and making your bed a sleep-only zone.
➡️ Restless Leg Syndrome (RLS)
The Symptoms
Symptoms of RLS usually occur at night when a person is simply trying to lay down, or when someone is actively trying to fall asleep. They tend to increase in severity throughout the night. The oddest thing about RLS is that relaxing - either sitting or lying - activates the symptoms. If left untreated, the condition can cause extreme exhaustion and daytime fatigue. And while RLS appears in both men and women, it is found in two times as many women than men.
The Cause
In most cases, the cause is unknown. There is enough significant evidence, however, to suggest that RLS is related to a dysfunction in the brain’s basal ganglia circuits. This misfiring disrupts the transmission of dopamine, which is required for smooth muscle movement, and results in involuntary movements similar to those exhibited by individuals with Parkinson's disease. There may also be a genetic component to the syndrome since RLS often runs in families. In fact, some variants of DNA have been associated with RLS. Though chronic diseases such as kidney failure and diabetes have been linked to RLS, researchers do not know if these factors actually cause RLS. Pregnancy, particularly in the 3rd trimester, can sometimes bring about RLS symptoms. Additionally, certain medications, alcohol use, and sleep deprivation may trigger symptoms, but there is no evidence to clearly link these factors to RLS.
The Treatment
Unfortunately, no single medication has proven to effectively manage RLS for everyone, but medications that increase dopamine, such as gabapentin enacarbil, can be helpful in lessening symptoms. Lifestyle changes such as establishing a bedtime routine, frequent exercise, and a decrease in alcohol and caffeine have been effective for some, in addition to simple at-home remedies like relaxing baths, massages, yoga, and warm or cool packs have been effective in managing RLS.
Restless Leg Syndrome (RLS) is a neurological disorder characterized by throbbing, pulling, and unpleasant sensations in the legs, combined with an uncontrollable and overwhelming need to move them.
Losing & Catching Up On Sleep
😩 Sleep Deprivation
Usually we know when we’re sleep deprived. You recognize the symptoms easily - you fall asleep immediately when you get into bed, you’re more impulsive, you’re irritable, you’re unable to concentrate and forgetful over and over again, and you're hungrier than usual.
Skipping just one night of sleep negatively affects the body. Unreal right? Your memory, ability to focus, and decision making capabilities all suffer the day after a bad night. It happens that fast. Luckily, the short term effects of sleep deprivation can be easily combated by simply getting a good amount of sleep over the the next few nights.
While most of the short term effects are reversible, the long term effects can do permanent damage to your health. Sleep deprivation has been linked to depression, memory problems, overall weakening of the immune system, increased perception of pain, weight gain, blurry vision, loss of brain tissue, obesity, diabetes, and heart disease. Additionally, sleep deprivation can be extremely dangerous as it relates to daytime activities. Sleep deprived people perform as badly, and often worse than intoxicated people in driving simulation tests and hand-eye coordination tasks. Driving fatigue, bought upon by sleep deprivation, causes about 83,000 motor vehicle accidents and about 850 deaths each year, according to the National Highway Traffic Safety Administration. To avoid sleep deprivation, it is recommended that adults get at least 6 to 9 hours of sleep per night.
In times of stress, we should actually strive to make sleep a priority. It allows us to function properly, see clearly enough to make decisions, and transforms that overwhelming feeling into something manageable.
🥱 Midday Fatigue
This feeling is referred to as midday fatigue. While it is completely natural and happens to everyone, it can be heightened by sleep deprivation. Within our natural sleep cycle, humans are programmed to sleep not only at night, but also for a short period of time in afternoon, a temporary, quick energy boosting rest. Unfortunately for most of us, our busy and fast-paced work culture fails to offer a reprieve for midday fatigue.
While the absolute best solution to midday fatigue is napping, there are still several other ways to combat that familiar tired feeling. First, pay close attention to other factors causing your midday fatigue. Our energy output is directly correlated with our dietary input. It makes sense right? Healthy eating habits lead to longer sustained energy throughout the day. Since the body’s energy level is largely regulated by blood-sugar levels, avoid simple carbs (white bread, sugary pastries, candy, etc.). These foods will give you an immediate spike in energy because your body can process them rapidly, but that spike means a crash not long after. Complex carbs (whole grains, oats, brown rice), healthy fats (olive oil, avocado, nuts, etc.) and fruit will provide a longer steady stream of energy without a later crash. While coffee and other caffeinated drinks help maintain energy, it’s important not to rely on them solely to get you through the day. Instead, try eating an apple. Apples (and similar foods) contain fiber and vitamins that will give you the same rush as a cup of coffee, but none of the downsides.
Additionally, midday fatigue hits strongest when you’ve been sitting at your desk staring at your computer for too long. Your body associates sleeping with stillness, so you are more likely to doze off while sitting down for long periods of time. Physical activity, though it might seem counterintuitive since the last thing you want to do during midday fatigue is waste energy on physical movement, helps ward off that sleepiness. So, get up and step away from your work! Go for a walk, do some light exercises, or stretch. You’ll feel more awake and you’ll find you’re productive for longer.
💡 Blue Light Blues
While it is suggested to stay away from blue light starting at least 2 hours before falling asleep, this expectation is pretty unrealistic for most people. Luckily, there are some alternatives. Try switching from blue lights to red lights, which produce less energy and have less of an effect on melatonin. Some examples of red lights are soft lighting light bulbs, candles, and some e-readers. Blue light blocking goggles, which turn blue light into red light, can be used to avoid blue light. If wearing the goggles seems too excessive, trying switching out LED light bulbs. Additionally, utilize the night shift filter on your cell phone, or get f.lux for your to help adjust the spectrum and reduce the screen brightness on your TV or laptop.
😴 Napping
Napping gives your brain and body a temporary rest, providing the benefits of sleep in a much shorter pocket of time. A nap can restore alertness, both directly after waking, and for hours afterwards. Naps also enhance performance, reducing the chance of mistakes and poor judgement. They essentially serve as a mini-sleep-vacation providing the rest and relaxation we need in the middle of the day.
There is a common misconception that naps actually make your groggy and interrupts your nighttime sleep. This, though true, only occurs if you nap incorrectly. Yes, there is a proper way to nap, and if practiced correctly, napping can actually restore and re-energize the mind and body for the rest of the day without either of these negative side effects. The key is taking short “power-naps” that avoid deep sleep (Stage Three, Four, and REM). Naps to boost alertness immediately should last for at least 10 to 20 minutes, but no more than 30 minutes in order to avoid deep sleep and REM. Napping for longer than 30 minutes results in the infamous nap grogginess upon waking.
However, if your goal is to improve cognitive memory processing, try taking a 60 minute nap to experience slow-wave sleep. Just be aware that napping for this long increases your chance of grogginess. This is more beneficial in the long term, rather than the short term.
If you are extremely exhausted or coming off a few nights of missed sleep, take a 90 minute to reap the benefits of a full cycle of sleep. To get the most out of napping, make sure to pick a peaceful and comfortable place to lay down so your sleep isn’t interrupted.
While there are many benefits to napping, long and frequent naps can pose some issues for nighttime sleep. If your naps are too long, they could affect your ability to fall asleep later at night. Additionally, if you have insomnia or generally have a difficult time falling and staying asleep, it’s advised to stay away from napping.
Sleep Tips
➡️ Sleep on a comfortable mattress (we recommend a personalized Helix!)
➡️ Stick to a schedule, even on the weekends. Go to bed around the same time and wake up the same time.
➡️ Pay attention to what you eat and drink. This means staying hydrated, avoiding large meals at night, and moderating alcohol.
➡️ Don't go to bed either hungry or stuffed. Try to find that middle ground between the two.
➡️ Create a bedtime ritual - this helps let your body know that it’s time to sleep.
➡️ Limit napping - especially long naps. Naps should only be about 10 to 30 minutes to avoid issues falling asleep at night and grogginess upon waking.
➡️ Add exercise or physical activity to your daily routine
➡️ Create an environment for sleep - try to block out as much light and noise as possible, use a sleep mask and earplugs if necessary and avoid blue light close to bedtime.
➡️ Keep your bedroom at the optimal sleep temperature - between 60° and 67° (ideally at 65°).
➡️ Only use your bed for sleep.
➡️ Avoid electronics before sleeping and if you wake up in the middle of the night. Keep your phone either away from you or on silent - this way you won’t be woken up if it vibrates in the middle of the night.
➡️ Do yoga and/or meditate before bed to rev down.
➡️ Take a bath or try aromatherapy if you have trouble relaxing before bed.
➡️ Visualize sleep - just like in sports, if you visualize sleeping it will come easier to you.
➡️ Keep a journal - it helps to destress you before bed, especially if you write down your to-do list for tomorrow. This also allows you to get out your thoughts before trying to fall asleep so your mind will be quieter when you lie down.
➡️ If you wake up in the middle of the night and can’t get back to sleep, don’t look at your phone. Rather, busy your mind with mental exercises. Try the updated “counting sheep” exercise by focusing on an item and describing it with as many details as possible, recite song lyrics, or try doing division and multiplication in your head (this last one will definitely put you to sleep)!
The History Of Sleep
📚 Sleep Through History
William Shakespeare was fascinated with sleep; in fact, many of his characters suffered from insomnia, night terrors, or enchanted dreams.
King Louis XIV had 400 beds distributed throughout his various properties so he was never far from a place to lay his head. He was also known to hold court from his bed.
Voltaire only slept for 4 hours per day and was known to consume 40 cups of coffee each day to keep himself awake. Yikes!
Napoleon Bonaparte said “6 hours sleep for a man, 7 for a woman, and 8 for a fool”. He took his own advice, only briefly sleeping until 3AM, and then napping several times throughout the day. Historians believed that he may have suffered from sleep apnea because of the combination of his obese frame later in life and his short thick neck.
Benjamin Franklin coined the famous saying “early to bed, early to rise makes a man healthy, wealthy, and wise”. On average he slept for 6 hours a night and would resume work at 4AM.
In 1898, Archibald Primrose, Prime Minister of England, resigned due to chronic insomnia.
Winston Churchill was known for taking sporadic hour and a half naps, and famously kept a bed in the House of Parliament. He even credited his victory in leading the British army through the Battle of Britain to his napping habit.
Margaret Thatcher became infamous for sleeping only 4 hours a night, making herself available for civil service at almost any hour of the day.
Former President Barack Obama valued the importance of a good night’s rest, sleeping more than one would think. He reportedly goes to bed at 1AM and rises at 7AM.