You land in your body with a start, or else it slowly comes into groggy focus: either way it’s night-time, but you are now awake. Why? Alice Gregory, a psychology professor at Goldsmiths, University of London and the author of Nodding Off, says it’s quite normal to wake up during the night.
After dropping off, we move through different stages of sleep, a cycle that takes the average adult about 90 minutes to complete and speeds up towards morning.
“The night is also punctuated by brief awakenings,” says Gregory. “Typically, people return to sleep without realizing that they had ever been awake.” But sometimes we might at least be more aware of it, or pulled entirely awake. Reasons range from the fairly obvious (being too hot or cold, needing the loo, having a nightmare, a crying baby) to the medical (disordered breathing such as sleep apnea, or nocturia: excessive night-time urination).
Waking up during the night does not necessarily mean you have insomnia, which, says Gregory, is diagnosed alongside other criteria such as the frequency of this occurrence and how long it has been happening. “If you find yourself waking regularly during the night, certainly flag this with your GP so they can consider any possible underlying causes.”
Still, sleep deprivation takes its own toll, from irritability and reduced focus in the short term, to an increased risk of obesity, heart disease and diabetes. If you do find yourself regularly waking up without any apparent reason – what can you do about it?
“It’s a misconception that we sleep the night through – nobody ever does,” says the sleep coach Katie Fischer. Waking as much as five or seven times a night is not necessarily a cause for concern – the most important thing is how you feel when you get up. “In the morning, do you feel refreshed, or groggy and unable to function, 30 minutes after waking?”
If there is nothing to suggest an underlying medical issue, Fischer will look at the bigger picture with a patient. “It’s really important to know if they have children. Do they have a partner who snores, or works shifts?” she says. “They might not have their own sleep issues but they might be sleeping next to someone who does.”
Lifestyle changes can make a big difference, even for people suffering from sleep apnoea (although that should be treated by a specialist). It is hackneyed to point the finger at caffeine, but people tend to underestimate how long its effects can last – Fischer says to stop consuming it by 2 p.m. or 3 p.m. Water intake during the day is also a factor: “Even going to bed mildly dehydrated can disrupt our sleep.”
Similarly, although people commonly turn to alcohol to help them fall asleep – Fischer says one in 10 use it as a sleep aid – it has a disruptive effect beyond the initial crash, causing spikes in blood sugar and cortisol levels. Diet can function in the same way, with “anti-sleep foods” that are high in sugar or cause flatulence or heartburn (such as broccoli and cabbage).
A “pro-sleep” bedtime snack is a small amount of complex carbohydrates and protein, such as wholegrain cereal with milk, or toast with peanut butter, says Fischer. An “anti-inflammatory” diet favouring fruits, vegetables, lean protein, nuts, seeds and healthy fats (and limiting processed foods, red meats and alcohol) has been shown to improve sleep apnea.
As for exercise, although being active during the day aids sleep, anything strenuous is to be avoided before bedtime. A lot of advice for preventing night-time “awakenings” falls under the umbrella of what has come to be known as “good sleep hygiene”: restrict the bedroom to sleep and sex, ban screens emitting blue light, keep to regular bedtimes and so on.
Our bedrooms – even our beds – have come to double as home cinemas, offices, “a dining room, maybe,” says the sleep consultant Maryanne Taylor. “You would be amazed at how significant that is for sleep. You’re training to associate your bed with wakefulness.” For that reason, if you do struggle to fall back asleep on waking up during the night, the advice is to get up for a bit. “Don’t just lie there – it’s counterproductive.”
So, too, is looking at the clock, especially if it doubles as your phone. “As soon as your brain has registered that it’s 2 a.m., you convince yourself that that’s your lot,” says Taylor. Such worry loops might be waking you up in the first place.
For many of us, bedtime might be our first opportunity of the day to be alone with our thoughts, she says. “It’s connected to waking in the night because, if we haven’t had any processing time during the day, it’s the first time we stop and just be.” Managing stress and anxiety during waking hours and learning how to relax body and mind are key to a good night’s sleep – but ironically, fixating on getting your full eight hours can make it harder to achieve. “You get this awful self-fulfilling prophecy that’s quite hard to break,” says Fischer.
A mindset change may be what’s needed. “People might have this belief that they are a ‘bad sleeper’ and there is nothing that they can do about it. Sometimes it’s about changing people’s perceptions of what good sleep looks like.” Taylor says she “really cannot bear” fitness trackers, which monitor sleep, for focusing people’s minds on often inaccurate data. It is wrong to assume that you must sleep through the night, every night, she says. “We all have blips in our sleep – it’s never going to be that you sleep brilliantly all the time.”
But accepting that – even as you lie awake, hours before dawn – might be the first step towards it.
Athletes are always looking for ways to improve performance and take goals to the next level. Efforts for doing just that are often limited to waking hours: nutrition, hydration, recovery protocols, supplement routine and, of course, training itself. And despite all this, research shows that, on average, athletes neglect a critical performance tool: sleep. So how does inadequate sleep affect athletic performance? Interestingly, the oversight of sleep can impact performance, both directly and indirectly, and the effects largely differ by sport.
The impact of sleep quality on overall health
Before moving into the impact of sleep on performance, it is important to understand how sleep affects overall health and wellness. Both the amount and quality of sleep impacts our mood and energy levels, our metabolism, and immune system health. Inadequate quality sleep can be linked to a variety of serious health problems, including an increased risk of depression, obesity, type II diabetes, and cardiovascular disease. It can even increase an individual’s risk for illness and infection.
Athletes as a population do not get adequate sleep, contributing to overtraining syndrome
Adequate rest and recovery are considered key components of improving athletic performance and preventing sleep disturbances commonly reported in overtraining syndrome. Sleep provides the body with an opportunity to rest from both the physiological and cognitive stressors many athletes face throughout the day. However, despite the body of evidence on the benefits of sleep in athletes (and the potential for sleep to alleviate fatigue), sleep duration and quality are often neglected by athletes.
It is well-reported that, on average, athletes do in fact get less than seven hours of sleep per night, often of poor quality. This falls below the recommended eight hours to combat the negative effects of sleep deprivation. Despite some research limitations, the British Journal of Sports Medicine consensus statement on the topic states that sleep deprivation does affect recovery, training, and performance in elite athletes and that these athletes as a population do not get enough sleep.
Athletes are, in general, a highly motivated group—the type of people who may willingly restrict sleep to fit more activities into waking hours. But even if you’re someone who ‘gets by just fine’ on a restricted sleep schedule, such a lifestyle can have immediate detrimental effects; evidence shows that restricting sleep to six hours per night for just four consecutive nights can impair cognitive performance and mood, glucose metabolism, appetite regulation, and immune function.
Effects of sleep deprivation on different types of athletes
Before we jump into the research of the effects of sleep deprivation in athletes, a disclaimer: Despite the recognized importance of sleep in athletes’ routines, the research on sleep in athletic populations is sparse at this time. The available research on this topic has specific limitations, including the underrepresentation of female subjects, inconsistent research methods across studies, and small sample size.
Now, the science. Current research does show a number of potential performance implications of poor sleep that should be considered in both endurance and power sport athletes. Among the subjects that have been studied, individual sport athletes appear to be more susceptible sleep deficiency and had poorer sleep efficiency than their team sport counterparts.
Two main detrimental effects of sleep deprivation on performance in all sport types are cognitive impairments and mood disturbances. Blumert et al. looked at the effects of just 24 hours of sleep deprivation in collegiate weightlifters (so, for a single night’s sleep). While they saw no difference in performance tasks, training load or intensity, there was a significant difference in mood state including fatigue and confusion in the sleep deprived athletes.
There are also observed direct effects of sleep deprivation on physical performance. Oliver et al. studied endurance running performance in a 24 hour sleep deprived state and found that thatsubjects who were sleep deprived ran fewer miles in the same amount of time as well-rested athletes but with the same perception of effort. Athletes should also be mindful of the non-direct consequences of sleep deprivation on their performance including but not limited to metabolism, hormone regulation, immune health, and limiting recovery.
Much like everything related to health, wellness, and performance, each individual will have different sleep requirements. These requirements may also vary depending on phase or training season, sex, training volume, intensity, and type of sport.
Biomarkers related to sleep and performance in athletes
Adequate sleep helps to regulate cortisol levels, and inadequate sleep can cause cortisol levels to rise above optimized levels. Cortisol is a catabolic steroid hormone that breaks down muscle, so chronically-elevated cortisol can directly combat progress to become stronger or faster in our athletic performance.
Sleep also helps to regulate testosterone levels. This hormone is anabolic, meaning it helps build muscle (the opposite of cortisol). But, as you might have guessed, insufficient sleep can reduce testosterone levels.
Research shows that sleep deprivation can also cause chronic inflammation, as indicated by high hsCRP levels. As athletes, inflammation and muscle damage are to be expected with any sort of training—after all, we need to cause slight damage to our muscles to make them stronger. But chronic inflammation, the kind that’s caused by overtraining or insufficient rest, can leave an athlete prone to poor performance, illness, and injury.
Actions for athletes to take to improve sleep
While the benefits of adequate sleep are well-documented in healthy individuals, the research specific to athletes and different athlete types continues to emerge. That being said, there are well-established actions you can take right now to improve your sleep. Here are some actions to optimize your sleep habits:
. If you have trouble getting the recommended amount of sleep at night, consider taking regular naps.
. Begin tracking your sleep with a wearable activity tracker. While research has displayed varying accuracy of these devices for sleep management, they can help you establish a healthy and regular bedtime routine.
. Work on implementing good sleep habits or a bedtime routine that reduces stress and promotes a good sleeping environment.
. Consider adjusting your exercise routine and incorporate more rest and active recovery in times of sleep deprivation or high life stress to help support your overall health and prevent injury or illness.
But while the research on the need to get enough sleep is as convincing as it is terrifying, I’m pretty sure that the reason so many busy professionals don’t get the recommended amount of shut-eye isn’t lack of motivation to sleep. Instead, if a newborn baby or a frantic deadline isn’t involved, I suspect psychology is often to blame.
We stay up too late because those dark, quiet hours after both the boss and the kids have quieted down for the night are the only ones that are truly ours. Or we behave and go to bed only to find pandemic stress means our minds are whirring too fast to drift off. A great many of us want to get to bed earlier, it’s just that our bodies and minds fight back against our good intentions.
A new find for my grab bag of sleep solutions
Finally getting to sleep at a reasonable hour will require different interventions depending on your particular circumstances. Which is why I always keep an eye out for tips and tricks to help sleep deprived professionals calm down and actually get the rest they crave, from essential sleep hygiene advice to mind tricks to shut off your whirring brain. Hopefully, if I round up enough of these tips, some combination of them can help every reader improve their sleep at least a little bit.
Today I’d like to add one more idea to this grab bag of better sleep advice that seems particularly well suited to our anxious times. It comes from Dr. Andrew Weil, the director of the University of Arizona Center for Integrative Medicine via Vogue, and all it requires is a few seconds and a set of lungs.
The trick is known as the “4-7-8 Method,” and while its origins lay in ancient traditions of yoga, Weil says it’s thoroughly scientifically vetted. The simple breathing technique works to calm stress by activating your parasympathetic nervous system, also known as “rest and digest mode.” Here’s all you have to do, according to Vogue:
Breathe in through your nose for a count of four seconds.
Hold your breath for seven seconds.
Exhale for eight seconds, making a “whoosh” sound through pursed lips.
Repeat up to four times.
The 4-7-8 method can be used to kill stress and calm your body any time of the day, not just at bedtime. And the more consistently you use the technique, the better it works. So give it a try and see if this might be the answer to your sleep challenges.
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Everything about our day impacts our sleep. How many minutes we spend outside, what and when we eat, what’s happening with our hormones, our habits, emotions, stress and thoughts – all this feeds into the sleep we end up with at night. All of which I was completely oblivious to when battling chronic insomnia for years on end.
Sleep anxiety can create a very real and vicious circle. I would spend hours lying in bed, increasingly wired, anxious and exhausted as time ticked by, with prescription sleeping pills within reach for those 3am nights when I had to be up first thing. The problem is that the more we worry about sleep, the higher our stress hormones go – and too much of the stress hormone cortisol, whatever the trigger, disturbs our sleep.
We’re left in a state of fight or flight, when we need to be in the opposite state of rest and digest. When my insomnia was at its worst, I’d start my day exhausted, running on empty, and have recurring burn-out days, where an overwhelming fatigue would stop me in my tracks, forcing me to lie down and recharge.
I realise now that the various sleep tips I tried over the years were like sticking plasters on a broken leg – there’s only so much that lavender, earplugs or herbal teas can do when your sleep is disrupted and out of control. Fortunately a eureka moment came along, when I was reading a book by my great great uncle, Richard Waters, a pioneer in cognitive therapy and clinical hypnosis and a protégé of the French pharmacist and self-help guru Emile Coué.
Waters wrote just a couple of pages about insomnia – how the words we use and having an understanding of sleep biology affects our mind, body and our sleep – but they were intriguing enough to set me thinking, researching and experimenting. I interviewed various experts and tried out all the sleep science and tactics I came across, while considering sleep in a much wider context than usual.
Waters also wrote a short, first-person sleep script, about what should be going on in the mind and body in the countdown to sleep. And I recorded myself reading this one-minute sleep script on my phone, which I listened to every day, when fixing my own insomnia and researching my book Teach Yourself to Sleep.
Listening to a sleep script allows us to harness the power of suggestion, using self-talk and clinical hypnosis to change our habitual thoughts, physiology and behaviour. I discussed this at length with clinical hypnosis expert Professor Peter Whorwell, whose hospital department at Manchester University NHS Foundation Trust creates bespoke scripts to help treat a wide range of disorders, including insomnia, phobias, pain and debilitating IBS symptoms, with a 75-80% success rate, where other treatments have failed.
Following the thread from Waters and Coué to now, and exploring the fascinating world of sleep, light and habit science, experimental psychology and more, it became clear that it pays to have a basic grasp of the biology and science of sleep and to appreciate the extraordinary power of the mind-body loop. Getting results that last makes life easier on so many levels – quality sleep not only improves our physical and mental health but also our energy levels, cognitive function and overall wellbeing.
I now instinctively remove obstacles that will get in the way of my sleep and set up sleep habit cues throughout my day. This means I can go to sleep without being up half the night, and wake up refreshed and able to get the most out of the following day. Here are seven sleep tips I used to dismantle my insomnia.
1) Stop calling yourself a bad sleeper!
Our words have an immediate effect on us physically and mentally – and you can see this in action if you consciously choose diametrically opposed words to describe the same situation. The words we choose alter our feelings, perceptions, hormones and behaviour, including our sleep.
There are some astounding studies on this and the mind-body loop, and how this can be manipulated to improve our health. As Professor Brooks of the Harvard Business School told me: “Our words codify and solidify our thoughts” – and, in turn, they change how we feel.
2) Embrace the biological fact that your body responds to too much light
Our body is hard-wired to line itself up with the light and dark of nature’s 24-hour clock. As with everything that influences your sleep, it makes all the difference if you’re aware of the simple biology taking place. In this instance, it’s understanding that the extremely light-sensitive cells in your eyes help keep your sleep-wake cycle turning as it should.
I use a light box on certain mornings, to give my office light some extra clout. At the other end of the day, a screen break before bed, moving away from bright, stay-wake signals and towards the darkness of night, helps boost sleep-inducing melatonin levels.
3) Weaken the negative fallout from stress
Stress is a huge sleep disrupter with nearly 50% of sleep issues blamed on stress. To help balance the body’s chemical cocktail in favour of sleep, it’s invaluable if we lean on science-based stress busters, to bring down our cortisol levels, which the pace, anxiety and overstimulation of modern life is forever increasing.
Effective stress busters I’ve found include “forest bathing”, aka walking among trees, as well as reframing my emotions and changing my perception of stress to weaken its hold. I regularly make use of these tactics among others if I feel my stress levels spiking during the day.
4) Know your DIY sleep habit science
Bad sleep habits, like any other, can be systematically intercepted and replaced with good ones, once you know how they take shape in the brain. Our bedroom is our sleep habit context, and making certain changes here, behavioural and content-wise, helps to break automatic sleep behaviour. Displacing negative rumination by listing the things you’re grateful for gets measurable results.
Another thing you can do is remove sleep-sabotaging cues from your bedroom (eg, work and screens), while loading in sleep-promoting cues (eg, sleep-inducing scents), to help new, desirable sleep habits stick.
5) Listen to a sleep script
Habitual thoughts set off a chain reaction that changes your emotions, body chemicals, behaviour, expectations and your sleep. A sleep script, which is a positive affirmation of how well your mind and body are preparing you for sleep, helps with this by gradually shifting your habitual sleep-related thoughts. This taps into the power of self-talk and clinical hypnosis, which are increasingly being explored by scientists, neuroscientists and medics.
Also, by listening to a sleep script during the day, you give yourself a moment to pause, creating a window for any stress to subside. I listened to myself reading a short sleep script daily, when sorting out my chronic insomnia and still rely on one as a very potent sleep habit cue.
6) Have an armchair offload
If your mind is full of worries, or all the jobs you need to do tomorrow/this week, have an armchair offload some time before bed, to let your mind think about it all and perhaps write it down. Ideally this would involve sitting in a relaxed space that isn’t your bedroom, giving you time to reflect before heading to bed, once the rush of the day, and/or TV shows are over.
Once again, it’s more impactful if you have an inkling of the biology and science going on. By giving yourself this time to think, or jot down any notes, what you’re really doing is moving worries or preoccupations from your brain’s emotional HQ, the amygdala, to your problem-solving pre-frontal cortex. What’s more, your brain will look for solutions while you dream.
7) Stare into the darkness of a pitch-black bedroom
Staring into the darkness last thing, while lying in bed, will help to increase your sleep-promoting melatonin levels, as the “hormone of sleep” is released at night when those light-sensitive photoreceptors in your eyes see that it’s dark out there.
Among other things, melatonin is also an immune system booster, so allowing your body to release as much of it as possible throughout your evening by avoiding too much bright light the closer you get to bed, is a plus in more ways than just enjoying easier, more restorative sleep.
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As activity tracking goes mainstream, an arsenal of consumer technology is rolling out for sleep. But how much do these interventions help?
At 2.16am, I stumble to the bathroom. I catch a glimpse of myself. The light from the red bulb is flattering – I’ve been told to eliminate all blue light on my nocturnal trek – but the sleep-tracker headband, currently emitting the sound of gently lapping waves, kills any woke-up-like-this vibe. I adjust its double straps and feel my way back to bed.
The next time I wake is at 6.30am – after fractured dreams in which the Dreem 2 headband makes many cameos – to birdsong, also from the headband. When I check the app, I see I have slept six-and-a-half hours of my anticipated eight. Anxious to remedy this, I head out for my first coffee. In his new book Blueprint: Build a Bulletproof Body for Extreme Adventure in 365 Days, athlete Ross Edgley warns that this sort of overriding behaviour can bring about “biochemical bankruptcy”. Not now, Ross.
Health influencers like Edgley are all over sleep lately, and no wonder, when so many of us obsess over it. A 2021 report released by the Sleep Health Foundation estimates around one in 10 Australians have a sleep disorder, while a report from 2019 found that more than half are suffering from at least one chronic sleep symptom. Studies have suggested that sleep deficiency can lead to weight gain and a weakened immune system and that poor sleep patterns may contribute to later dementia risk.
In recent years, sleep-fretting has intersected with fitness-tracking, with the latest bio-hacks regularly featured on the podcasts of personal-development heavyweights such as Joe Rogan, whose Whoop Strap – worn around the wrist – told him he was getting four or five hours a night, not the seven or eight he’d thought; and Aubrey Marcus, whose Oura ring measures various biomarkers overnight and gives him a total score in the morning. “If I can get close to 80%, I’m golden for the day,” Marcus told the authors of My Morning Routine.
Wearables, such as watches, rings and headbands, appeal to those of us who enjoy geeking out on our stats, but could they also be cultivating anxiety and feeding into insomnia? Associate Prof Darren Mansfield, a sleep disorders and respiratory physician who is also deputy chair of the Sleep Health Foundation, thinks some balance is needed.
“These devices in general can be a good thing,” he says. “They’re not as accurate as a laboratory-based sleep study, but they are progressing in that direction, and technology enables the person to be engaged in their health. Where it can become problematic is people can become a bit enslaved by the data, which can lead to anxiety or rumination over the results and significance. That might escalate any problems, or even start creating problems.”
As a clinician, Mansfield thinks that the most useful role of these devices is monitoring routine, not obsessing over the hours of good-quality sleep. “There will be some error margin, but nonetheless when we’re looking for diagnostic information, like timing of sleep and duration of sleep, they can capture that,” he says.
Since Mansfield admits his sleep doesn’t need much hacking, I seek out an insomniac-turned-human guinea pig. Mike Toner runs the dance music agency Thick as Thieves, and has been on a mission for five years to fix the sleep issues earned from a decade of late nights in Melbourne clubs and reaching for his phone to answer international emails at 3am.
“I tried everything,” he says. “Magnesium capsules and spray, melatonin and herbal sleep aids. I even signed up for treatment at a sleep centre. You sleep in this room with all these wires connected to you, things coming out of your nose, cameras trained on you. Ironically, I slept better that night than I have any other night.”
He decided to start monitoring his body in earnest, learning about the latest devices from the Huberman Lab Podcast and The Quantified Scientist. Sleep-monitoring wearables have progressed from having an accelerometer to track movements which are fed through an algorithm to predict when a person is asleep, to being able to track sleep latency; sleep efficacy; heart-rate variability; light, deep and REM sleep and sleeping positions.
Toner’s accumulated a few as the technology becomes more sophisticated. He estimates having spent around $1,500 on them, and a further $3,500 for the sleep-centre treatment.
Then there are the cooling devices. Toner beds down on a Chilipad as soon as the weather gets warmer – a hydro-powered cooling mattress.
The idea is that lying down in a cool room – perhaps after taking a warm shower – tricks the body into slumber, since our body temperature drops when we’re asleep.
Non-techy strategies include having hands and feet out from under the covers, or using a fan. Lifestyle guru and entrepreneur Tim Ferriss recommends a short ice bath before bed. Be warned, though: Dave Asprey – founder of Bulletproof, which sells high-performance products – once tried putting ice packs on his body right before bed. As he told MensHealth.com: “I ended up getting ice burns on about 15% of my body.”
Mansfield says that ensuring you’re cooler in the evenings may help with sleep. “Generally, a lower-level temperature is better tolerated at night … 25C can make a beautiful, comfortable day, but can be unbearably hot at night when our own core temperature drops, so 18C or 19C is more tolerable.
“Then in the last two hours before getting up, your temperature rises again – you might have thrown off the blanket in the night and then might wake up at 5am feeling freezing cold.”
And what about the new frontiers of technology? According to neuroscientist Matthew Walker, in his influential book Why We Sleep, in the future, we can expect the marriage of tracking devices with in-home networked devices such as thermostats and lighting.
“Using common machine-learning algorithms applied over time, we should be able to intelligently teach the home thermostat what the thermal sweet spot is of each occupant in each bedroom, based on the biophysiology calculated by their sleep-tracking device,” Walker says. “Better still, we could program a natural circadian lull and rise in temperature across the night that is in harmony with each body’s expectations.”
Mansfield thinks this kind of integration is feasible, and that a thermostat linked to a device measuring circadian rhythms offers plausible benefits in preparing people’s sleep, but he predicts that automated control of room lighting will wind up being manually overridden, because technology can’t necessarily gauge when we’re in the middle of reading a book or having a conversation. “It’s liable to just irritate people,” he says. He’s more interested in technology that will track conditions like sleep apnoea.
As Toner has concluded, no device is a silver bullet. Ultimately, it was a $70 online cognitive behavioural therapy (CBT) course that his GP referred him to that fixed his sleep over three months of strict adherence. Now he just uses technology to make sure he’s not drifting off track.
The key lessons? Only use your bedroom for sleep and sex. Set your alarm for the same time, no matter how late you get to bed. Screens off early. No day-napping. Alcohol is a bad idea. All of these things are easily monitored yourself using a good old notebook, and they don’t cost a cent. They just take persistence.
With those good habits in place, Toner is now mindful of how he will put the CBT pointers he’s learned during lockdowns into practice once his life picks up its pace again.
“I used to put this obligation on myself to be there all the time with my artists, but interestingly, coming out of this pandemic, a lot of the artists are having the same train of thought as I am, wanting to avoid late nights,” Toner says.
He’s even coaching some of them for a charity run – quite the lifestyle change for many. “I’ve spent so long fixing this that one of the things I’ve realized, when we eventually go back to work routines, is I’m going to be fiercely protective of my sleep.