Since we spend about a third of our lives sleeping, it follows that something that takes up so much of our time must be important to our health (1)! It is a matter of concern then, that many people do not get the sleep their bodies need to function at their best. 70% of American adults do not get sufficient sleep at least one night per month, and 11% report insufficient sleep every night (2). In fact, insomnia is the most prevalent sleep disorder among adults, with an estimated 10% of Americans suffering from chronic insomnia (2). To work toward healthy sleep habits and fight against insomnia, we must understand the role sleep plays in our lives, the impacts of poor sleep, and the importance of focusing on proper sleep hygiene.
What causes insomnia?
Insomnia is a condition that causes difficulty falling asleep, staying asleep, waking early, or not feeling rested after a night of sleep (4). Many individuals experience these symptoms at one point or another, but this condition becomes chronic when these symptoms persist at least three nights per week for three months or longer (3). Many factors can cause insomnia, including (4):
Travel or work schedules
Poor sleeping habits
Mental health problems, such as anxiety or depression
Medical conditions such as chronic pain, cancer, diabetes, or asthma
Caffeine, nicotine, and alcohol
Hormonal fluctuations due to menstruation and pregnancy
Gastrointestinal disturbances (intestinal permeability, dysbiosis, food sensitivities, etc.)
Various autoimmune or infectious inflammatory conditions
Environmental toxic exposures
Why is sleep so important?
Sleep affects almost every area of the body, so good sleep is crucial to optimizing overall health and well-being (5). First and foremost, sleep has huge restorative benefits for the brain. While we sleep, our brains sort and store memories, determining which information should be stored for the long term and which is expendable (6, 7). Quality sleep also keeps the brain functioning well, enabling sufficient attention and focus, sound reasoning, and efficient problem-solving skills (6). And, since our brain is a part of the nervous system (which is in charge of our body’s quick response system), good sleep even helps reflexes and response time, helping us avoid accidents (3, 6).
While the link between quality sleep and the many benefits above has long been observed, the reason for it has not. Scientists have recently uncovered that sleep helps to clean the brain through what they call the “glymphatic system”, a partnership between the brain’s glial cells and lymphatic system (6). During our day-to-day functioning, our bodies and brains produce byproducts such as beta-amyloids that end up in our brain and spinal (cerebrospinal) fluid that can become toxic if left to accumulate. To combat this, the sleeping brain signals glial cells to adjust its regulation of cerebrospinal fluid to drastically increase fluid. The body then uses the lymphatic system (made up primarily of lymph nodes, vessels, and fluid, as well as the tonsils, adenoids, spleen, and thymus) to thoroughly circulate cerebrospinal fluid through the lymphatic system, filtering out waste and toxins that have built up during the day. Not only does this lead to a healthier brain and better day-to-day functioning, but it may also help prevent Alzheimer’s disease since Alzheimer’s is linked to a buildup of beta-amyloid (6).
If the argument for sleep isn’t strong enough based on its effect on the brain alone, we can also look to the benefits of sleep on the immune and hormonal systems. Getting proper rest helps our bodies fight infections like the common cold, and improves the efficacy of vaccines (5). Proper sleep also regulates metabolism and appetite, and even affects our growth and stress hormones. If metabolism and hormones are balanced, it can also lead to more regulated emotions and an overall more even, elevated mood (3). In short: good sleep means a happier, healthier you!
How does poor sleep damage our health?
With all of the benefits listed above, it is no surprise that not getting enough quality sleep can be very damaging to our health. Sleep deprivation causes a stress response in the body that increases the production of pro-inflammatory cytokines, which are small proteins released by cells (11, 12). This results in chronic low-grade inflammation throughout the body, which activates nociceptive (pain receptor) sensory neurons (12). Beyond the havoc that inflammation can wreak on every system, this neuron activation can also initiate or worsen chronic pain, affecting your quality of life (12).
Chronic lack of sleep can also affect metabolism, hormones, and mental health, leading to weight gain, imbalanced hormones, and changes in mood, including depression and anxiety (3, 7). Unfortunately, depression and anxiety can also increase insomnia, leading to a difficult cycle of poor sleep causing mental health difficulties, and vice versa (4). Insomnia also causes lower performance in daily tasks at work or school which can affect mental health and impact all of the factors listed above (4).
Research also shows that consistent poor sleep quality indicates a higher risk of developing conditions like obesity, heart disease, diabetes, and infections, and can even cause otherwise healthy people to experience diabetic-like conditions (5). Additionally, as discussed above, our body is hard at work sweeping away toxins that build up throughout the day using the glymphatic system while we sleep. If we don’t get enough sleep, beta-amyloid builds up, leading to a higher risk of “dirty brain” neurodegenerative diseases like Alzheimer’s, dementia, and Huntington’s disease (3). Since almost every system is supported by healthy sleep and a “clean brain”, sleep deprivation is incredibly damaging to the whole body.
Sleep Hygiene to Support Overall Health
Proper sleep hygiene can be the key to supporting overall health, especially if you are struggling with insomnia. It can be helpful to approach new sleep hygiene practices by keeping a two-week sleep journal to get a better idea of your sleep habits (9). In the morning, record when you went to bed the previous night, when you think you fell asleep, any sleep interruptions through the night, and when you woke (9). Throughout the day, track when you drink caffeine or alcohol, take medicine, exercise, or nap. After you have assessed your habits, consider implementing these practices to maximize your sleep and fight insomnia (3, 4, 8, 9, 10):
Aim to get between seven and seven and a half hours of sleep each night.
Ensure your room is quiet, dark, and at a comfortable temperature.
Use your bed exclusively for sleep and sex.
Avoid exposure to bright lights in the evening.
Remove all electronics from the bedroom, as blue light can also interfere with sleep. Additionally, turn off electronics at least 30 minutes before bedtime.
Avoid large meals, caffeine, alcohol, and large fluid intake before bedtime.
Establish a relaxing bedtime routine such as taking a warm bath, reading a book, or listening to music.
Keep a consistent schedule. Go to sleep at the same time each night and wake up at the same time each morning, even on weekends.
Don’t go to bed unless you are tired. If you cannot fall asleep within 20 minutes, get out of bed, do something relaxing, and return only when you are tired.
Stay active. Exercise during the day can help you fall asleep more easily at night.
Aside from proper sleep hygiene, another treatment option for insomnia may include Cognitive Behavior Therapy (CBT), which can help control negative thoughts or anxiety about sleeping (4). Massage therapy can also help treat stress-related insomnia by reducing tension and increasing relaxation.
Proper sleep is crucial to maximizing overall health. If you or a loved one are struggling with insomnia, we can help. At Temecula Center for Integrative Medicine, we offer functional and regenerative medicine, massage therapy, chiropractic care, and nutrition and lifestyle education, all of which can help your sleep and overall health quality. We would be honored to partner together to create a plan to improve your sleep hygiene, treat your insomnia, and consider any other factors that may be affecting your health. Here’s to a healthier, more well-rested you!
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
How much sleep do we really need? Harvard Health. (2019, August). https://www.health.harvard.edu/staying-healthy/how-much-sleep-do-we-really-need.
The State of SleepHealth in America. SleepHealth. (n.d.). https://www.sleephealth.org/sleep-health/the-state-of-sleephealth-in-america/#:~:text=In%20America%2C%2070%25%20of%20adults,report%20insufficient%20sleep%20every%20night.&text=It%20is%20estimated%20that%20sleep,all%20ages%20and%20socioeconomic%20classes.
Worley, S. L. (2018, December). The Extraordinary Importance of Sleep. NCIB. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281147/
Mayo Clinic. (2016, October 15). Insomnia. https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167
The Benefits of Slumber. (2018, April 4). NIH News in Health. https://newsinhealth.nih.gov/2013/04/benefits-slumber
How Sleep Clears the Brain. (2016, March 31). National Institutes of Health. https://www.nih.gov/news-events/nih-research-matters/how-sleep-clears-brain
Peterson, S. M., & Werneburg, B. L. (2018, May 18). Sleep: The foundation for healthy habits. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep-the-foundation-for-healthy-habits/art-20270117?reDate=26042021#:%7E:text=Getting%20at%20least%20seven%20hours,to%20focus%20on%20daily%20tasks.
Tips for Better Sleep. (2016, July 15). Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html
Healthy Sleep Habits and Good Sleep Hygiene. (2017, February 9). Sleep Education. http://sleepeducation.org/essentials-in-sleep/healthy-sleep-habits
Blask, D. E. (2009, August 1). Melatonin, sleep disturbance and cancer risk. ScienceDirect. https://www.sciencedirect.com/science/article/abs/pii/S1087079208000786
Besedovsky, L., Lange, T., & Born, J. (2011, November 10). Sleep and immune function. Springer Link. https://link.springer.com/article/10.1007/s00424-011-1044-0?error=cookies_not_supported&code=624d73e6-9e2c-4664-9ca1-5eac82fc242b#Sec12
Zhang, J., & An, J. (2007). Cytokines, Inflammation and Pain. NCIB. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785020/
Cohen, S., Doyle, W., & Alper, C. (2009, January 12). Sleep Habits and Susceptibility to the Common Cold. JAMA Internal Medicine. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/414701