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What is healthy sleep?

Sleep is essential for good physical and mental health, but are you getting enough ‘healthy sleep’?

We explore what healthy sleep is, how you can tell if you are getting enough healthy sleep, why it is so important to your overall health, and simple habits to help you on your way to a healthier sleep.

What is healthy sleep?

Healthy sleep is about getting the right quantity and quality of sleep:

  • Quantity refers to the number of hours you are sleeping per night
  • Quality refers to how well you sleep (i.e. healthy sleep patterns)

Healthy sleep can also be measured by ‘Sleep Efficiency’.1 Sleep efficiency is the ratio of the total time spent asleep (total sleep time) in a night compared to the total amount of time spent in bed.1

For example, if you went to bed at 10pm and got up for work at 6am, yet you only slept between midnight and 6am, then your sleep efficiency is 75% (6 hours divided by 8).1  If you spend the majority of your time in bed actually asleep, rather than tossing and turning, then this is a sign you are sleep efficient or having healthy sleep.1

How much sleep is healthy?

We all have different needs when it comes to the quantity of sleep that is healthy.  Below are recommendations made by The National Sleep Foundation on how much sleep is healthy for your age:2

  • Newborns: (0-3 months): 14-17 hours
  • Infant (4-11 months): 12-15 hours
  • Toddlers (1-2 years): 11-14 hours
  • Pre-schoolers (3-5): 10-13 hours
  • School age children: (6-13): 9-11 hours
  • Teenagers (14-17): 8-10 hours
  • Younger adults (18-25): 7-9 hours
  • Adults (26-64): 7-9 hours
  • Older adults (65+): 7-8 hours

Bear in mind that each person’s sleep needs are very individual and the above is only a guide.2 It is not healthy to be hyper-vigilant about the number of hours sleep you are getting per night.  You can quickly find yourself clock-watching and stressing over not getting 8 hours per night, which can lead to sleep anxiety and even less sleep!

How do I know if I am getting a healthy sleep?

Below there are 5 questions about your sleep.  Look at the responses to find out if you are getting a healthy night’s sleep:

1) When you wake up in the morning, do you feel refreshed and energised for the day?4

YES

Great! This is a good indicator you have had a healthy sleep

NO

Uh-Oh! Waking up feeling groggy and exhausted indicates you are not getting a healthy sleep

2) When getting into bed, do you fall asleep within 15-20 minutes of lying down to sleep?3,4

YES

Amazing! Falling asleep within 20 minutes is a sign of healthy sleep

NO

Taking longer than 30 minutes to fall asleep is a sign your sleep health needs improving

3) Do you regularly wake up more than once per night? 3,4

YES

Waking up more than once a night can negatively impact both the quantity and quality of your sleep

NO

Brilliant – going to sleep and staying asleep is a sign you are sleeping well

4) Do you find yourself staying awake for more than 20 minutes after waking up in the middle of the night? 4

YES

Waking up in the middle of the night and not being able to get back to sleep is a sign you are not getting a healthy sleep

NO

Being able to get back to sleep quickly even if you do wake up is a sign that you are on track to a healthy night’s sleep

5) Do you spend most of the time in bed asleep (For example, do you acheive 85 to 90% sleep efficiency when you divide total time sleeping by the total time in bed)?1

YES

Fantastic! Your sleep health is considered to be very good

NO

Your sleep health could be improved. Don’t worry though, there are simple steps you can take to nudge you towards getting more healthy sleep.

Healthy sleep patterns

Your sleep health is not just about the number of hours you sleep per night, it is that you are getting good quality sleep which happens when you are able to cycle through normal healthy sleeping patterns.  Sometimes these patterns can be disrupted by a stressed mind, a full bladder, a crying child, or snoring partner.  What wakes you in the middle of the night?

A normal sleeping pattern, also called ‘sleep cycle’, repeats every 90 to 110 minutes and is made up of a sequence of different stages of sleep (sleep states). If the pattern is interrupted, it must start from the beginning and important stages could be missed resulting in poor quality sleep.

Here is a summary of a healthy sleep pattern:

Stage 1 – you move from wakefulness to sleep

Stage 2 – you are in a light sleep state and easily wakened

Stage 3 – you are in a deep sleep which is an important restorative stage needed to feel refreshed in the morning

Stage 4 – you are in REM sleep which is important for memory and learning.

Have you ever experienced a full night’s sleep, yet you still wake up feeling exhausted?  This is likely to be because your sleeping patterns have been disrupted and you may not have had enough deep restorative sleep to help you feel more energised.

Why is healthy sleep important?

Sleep is fundamental to good physical and mental health.  When you are not getting good, healthy sleep every night then it can have negative consequences on your overall health.

Here are 12 reasons why healthy sleep is important:

  1. Lower your risk of stroke – chronic poor sleeping has been associated with a higher risk of stroke6
  2. Boost your immune system – sleep has an important role in regulating our immune system. When you don’t get health sleep it can impair your immune system and leave you vulnerable to infections.7
  3. Improve concentration and productivity – sleep is important for a healthy, functioning mind. When you don’t get enough sleep, your cognitive (thinking) abilities are impaired.8
  4. Lower your risk of heart disease – deep sleep is particularly important for heart health, so when you don’t get enough sleep it can increase your risk of heart disease.9
  5. Prevent type 2 diabetes – sleep affects your glucose metabolism and insulin sensitivity, and a lack of sleep has been shown to increase the risk of developing type 2 diabetes10
  6. Reduce your risk of obesity – sleep deprived people have a higher risk of gaining weight10
  7. Increase fertility – difficulty conceiving has been linked to poor sleep health10
  8. Increased sex drive – men and women who don’t get enough healthy sleep have lower libidos and less of an interest in sex10
  9. Protect your mental health – poor sleep health (sleep deprivation) has been associated with an increase risk of mental illnesses such as depression and anxiety.8,11
  10. Improved healing – sleep has been shown to be more important to the body than nutrition when it comes to wound healing12
  11. Protect and build your muscles – even one night of sleep deprivation can influence our body’s ability to synthesise muscle
  12. Reduce your risk of some cancers – a lack of sleep has been linked to an increased risk in several types of cancer

Habits for a healthier sleep

If you think you are not getting healthy sleep, it may be time to change some unhealthy habits for some new healthier habits. Here are 10 tips that can help you on your way to a healthier sleep:

  1. No caffeinated drinks within 6 hours of bedtime16
  2. No food within 3 hours of bedtime, unless you want heartburn to potentially wake you in the night15
  3. Reduce your liquid consumption before bed unless you want your sleep cycles disrupted by a full bladder
  4. Quit smoking – nicotine has been found to be worse than caffeine when it comes to a healthy sleep17
  5. Ban devices from the bedroom (phones, tablets, laptops, and TV’s) – your bedroom should only be used for sex and sleeping
  6. Try to wean yourself of social media close to bedtime as all the information can leave your mind racing which can impact how long it takes you to fall asleep
  7. No alcohol – some people might find alcohol gets them to sleep easier but unfortunately is affects the quality of your sleep18
  8. Create a healthy bedtime routine – routine helps program your mind for sleep
  9. Make sure your bedroom is a sleep friendly environment, which is dark, cool, quiet and comfortable
  10. Exercise earlier in the day – if you exercise too close to bedtime it can disrupt your sleep19

References

  1. https://www.verywellhealth.com/sleep-efficiency-3014912
  2. https://www.sleepfoundation.org/articles/how-much-sleep-do-we-really-need
  3. https://www.sleepfoundation.org/articles/5-signs-your-sleep-quality-poor-and-how-fix-it
  4. https://www.sleepfoundation.org/shift-work-disorder/shift-work-you/what-healthy-sleep
  5. What is “normal” sleep? Available at: https://www.ncbi.nlm.nih.gov/books/NBK279322/
  6. Relationship between Sleep Duration and Risk Factors for Stroke. Front Neurol. 2017; 8: 392. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550667/
  7. Besedovsky, L., Lange, T. & Born, J. Sleep and immune function. Pflugers Arch – Eur J Physiol 463, 121–137 (2012). https://doi.org/10.1007/s00424-011-1044-0
  8. Clinical Knowledge Summary Insomnia. Available at: https://cks.nice.org.uk/insomnia#!backgroundSub:4
  9. Mullington, Janet M et al. “Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation.” Progress in cardiovascular diseases vol. 51,4 (2009): 294-302. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403737/
  10. https://www.nhs.uk/live-well/sleep-and-tiredness/why-lack-of-sleep-is-bad-for-your-health/
  11. https://www.sleepfoundation.org/excessive-sleepiness/health-impact/complex-relationship-between-sleep-depression-anxiety
  12. https://www.sciencenewsforstudents.org/article/sleep-helps-wounds-heal-faster
  13. https://www.biorxiv.org/content/10.1101/2020.03.09.984666v1.abstract
  14. Sleep: A Health Imperative. Sleep, Volume 35, Issue 6, 1 June 2012, Pages 727–734 https://academic.oup.com/sleep/article/35/6/727/2709360
  15. Fujiwara Y, Machida A, Watanabe Y, et al. Association between dinner-to-bed time and gastro-esophageal reflux disease. Am J Gastroenterol. 2005;100(12):2633-6. Available at: https://journals.lww.com/ajg/Abstract/2005/12000/Association_Between_Dinner_to_Bed_Time_and.6.aspx
  16. https://www.sleepfoundation.org/articles/caffeine-and-sleep
  17. Impact of Nicotine and Other Stimulants on Sleep in Young Adults. Journal of Addiction Medicine: May/June 2019 – Volume 13 – Issue 3 – p 209-214. Available at: https://journals.lww.com/journaladdictionmedicine/Abstract/2019/06000/Impact_of_Nicotine_and_Other_Stimulants_on_Sleep.8.aspx
  18. Alcohol and sleep-related problems. Current Opinion in Psychology, Volume 30, December 2019, Pages 117-122. Available at: https://www.sciencedirect.com/science/article/pii/S2352250X18302719
  19. https://www.sleepfoundation.org/articles/best-time-day-exercise-quality-zzzs
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