THE DOCTOR IS IN
OP / ED BY DR. ADIL MANZOOR
Have you ever had those mornings where you wake up and feel just as unrefreshed as before you even went to bed? Sometimes you somehow even feel worse in the morning! Yeah, we’ve all been there.
Maybe you had a game to watch late into the night and you couldn’t get your proper hours of sleep. Or you may have gone a tad too hard on the wine bottle the night before. Maybe you even restricted yourself to an hour or two of sleep on purpose because you had work to do. I could go on, really, about those specific scenarios where the morning after sleep just absolutely sucks.
However, many people have these nights and sort of gloss over it as “no big deal.” Well, it is. For some, their sleep hygiene and health are so far compromised that the concept of sleeping early, sleeping long enough, and waking up refreshed is a Genie’s wish. Regardless of the boat you fall into – occasionally having bad sleep nights directly or indirectly due to your actions or persistently having poor sleep quality, you will want to read further.
For starters, sleep quality is a measure of how good your sleep is. Sounds pretty straightforward, but it involves several different factors. Of these factors, the most widely used ones to assess sleep quality are sleep latency (how long it takes to fall asleep), sleep efficiency (ratio of time spent sleeping to time spent in bed), sleep disturbances (how often you wake while sleeping), sleep duration (length of sleep), and the use of sleeping pills to fall asleep.
The desired results for these sleep quality metrics are: a sleep latency of 10 to 20 minutes, a sleep efficiency of 85% or higher, little sleep disturbances, a sleep duration of more than 7 to 9 hours, and the ability to fall and stay asleep without sleeping pills. From these, you can have an idea of how good your sleep is.
Poor sleep, as you already may know, can make you feel physically uncomfortable in the morning. However, besides the grogginess, mild headache, fatigue, and dizziness, there may be more serious health issues associated with consistently having poor sleep quality. These health issues include type 2 diabetes, chronic pain, hypertension, obesity, heart attack, and stroke.
Another dimension to the health effects of poor sleep quality is mental health problems. There are studies that show that poor sleep can alter brain function. How this altered brain function manifests now depends on a whole lot of factors – like the other conditions the person may have, their genetics, and their mental health to start with. Still, studies reveal that depression, concentration problems, poor problem-solving abilities, mood swings, motivation loss, and anxiety are common symptoms that may accompany altered brain function due to poor sleep quality.
Interestingly, there is a stronger association between sleep quality and mental health than there is between sleep quality and physical health. In other words, if you consistently have poor sleep, your risk of mental health problems is higher than of physical health problems, although you may end up having both.
With all of these said, it is pretty clear that the goal should be improving sleep quality. How do you do that? That’s why you have me!
For starters, you need to understand that improving sleep quality revolves around improving sleep hygiene. Now, here’s where things may get overwhelming. If you go online, you’d find so many different principles, theories, and pieces of advice. Incorporating all of these can be very difficult. So, I’d highlight the most important ones for you.
To start with, limit your naps during the day. Please. You don’t need to tell me how enticing a 30-minute power nap can be when the day gets tough. You can still have those, but only if you have to, and not more than once a day. Do not take hour-long naps. The reason for this fight against naps is that sleeping during the day depletes melatonin (the sleep hormone), making it difficult to fall asleep again at night, as your body’s sleep cycle heavily depends on the accumulation of melatonin over the day.
Secondly, ensure you don’t take stimulants close to your bedtime. By close, we’re talking around 6 to 8 hours to your bedtime. So, if you plan on sleeping by 10 pm, you should have no business with coffee after 2 pm. This applies to other stimulants, too, like energy drinks.
Then, get your sleep environment optimized for sleep. What I mean by this is a dark, cool room, free from electronic distractions. No electronic distractions means no phones, no TV, and no laptops on the bed. In fact, as much as possible use your bed only for sleeping, sex, and resting when sick.
There are other relevant sleep hygiene practices like drafting and sticking to a sleep routine, going to sleep early, avoiding big meals and alcoholic drinks hours before sleep, not forcing yourself to sleep (if you are not sleepy, take a break and try again after 30 minutes), and considering meditation and relaxation practices.
A quick rule to follow is the 10-3-2-1-0 sleep rule. Essentially, avoid caffeine 10 hours before bed, avoid alcohol 3 hours before bedtime, quit working 2 hours before bed, stay away from screens and electronics 1 hour before sleep, and hit the snooze button on your alarm 0 times. Follow this rule in addition to the other tips I have listed on here.
This article was written by Dr. Adil Manzoor, DO, a Board-Certified Internist; Board certified Pediatrician who works as a Hospitalist and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice, Mobile Medicine NJ; House Call Doctors. He is also currently pursuing an Executive MBA and a Master’s of Science in Healthcare Leadership at Samuel Curtis Johnson Graduate School of Management and the Weill Cornell Graduate School of Medical Sciences.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7826982/
- https://www.ncbi.nlm.nih.gov/books/NBK19961/#:~:text=The%20cumulative%20effects%20of%20sleep,%2C%20heart%20attack%2C%20and%20stroke.
- https://healthhub.hif.com.au/sleep-hygiene/what-is-the-10-3-2-1-0-sleep-rule
- https://www.mentalhealth.org.uk/explore-mental-health/publications/sleep-matters-impact-sleep-health-and-wellbeing
