Improving Sleep Quality for Better Health

Sleep is a fundamental physiological process that plays a crucial role in maintaining overall health and well-being. It is during sleep that our bodies repair and regenerate, allowing us to wake up feeling refreshed and energized. However, sleep deprivation has become a prevalent issue in the modern world. Lack of quality sleep can have detrimental effects on our physical, mental, and emotional health, leading to a decline in cognitive function, mood disturbances, and an increased risk of chronic diseases.

The National Sleep Foundation, the American Academy of Sleep Medicine, and the Centers for Disease Control and Prevention are reliable sources of information on sleep health. These organizations regularly update their guidelines and recommendations based on scientific research and expert consensus [1-3]. Here are some of the reasons why quality sleep is necessary.

Cognitive function and performance

Sleep plays a vital role in cognitive function and performance. Numerous studies have shown that inadequate sleep can impair various aspects of cognitive function, including attention, memory, problem-solving, and decision-making abilities. Lack of sleep affects the brain’s ability to consolidate information, leading to difficulties in learning and retaining new information. Additionally, sleep deprivation can hinder creativity and innovative thinking, as it diminishes cognitive flexibility and impairs problem-solving skills [4-7].

Mood and emotional well-being

Quality sleep is closely linked to emotional well-being and mood regulation [8, 9]. Research has consistently shown that sleep disturbances, such as insomnia and sleep deprivation, can contribute to increased irritability, mood swings, and a higher risk of developing mood disorders, such as depression and anxiety [8]. Lack of sleep disrupts the brain’s emotional processing, leading to negative emotional states and reduced resilience in dealing with daily stressors [10]. Adequate sleep, on the other hand, promotes emotional stability, positive mood, and overall psychological well-being [11].

Physical health and immune function

Sleep is essential for maintaining optimal physical health and supporting a robust immune system. During sleep, the body repairs and rejuvenates itself, allowing necessary cellular and tissue maintenance [12, 13]. Inadequate sleep has been linked to an increased risk of developing various chronic conditions, including obesity, diabetes, cardiovascular diseases, and even certain types of cancer [14-16]. Moreover, poor sleep weakens the immune system, making people more susceptible to infections and impairing the body’s ability to fight off illnesses [12].

Sleep hygiene and age-related diseases

Sleep plays a crucial role in maintaining cardiovascular health, and poor sleep has been linked to an increased risk of cardiovascular diseases in older adults. People with inadequate or disrupted sleep are more likely to develop hypertension, heart disease, and stroke. Lack of sleep can lead to elevated blood pressure, increased inflammation, and impaired glucose metabolism, all of which contribute to the progression of cardiovascular diseases. Therefore, optimizing sleep hygiene is essential for preventing and managing cardiovascular conditions in older adults [16, 17].

Sleep disturbances, such as insufficient sleep duration and poor sleep quality, have been associated with an increased risk of developing type 2 diabetes and other metabolic disorders in older adults. Sleep deprivation can lead to insulin resistance, impaired glucose regulation, and altered appetite hormones, which can contribute to the development of diabetes and metabolic abnormalities. By prioritizing good sleep hygiene practices, older adults can reduce their risk of developing these conditions and improve their overall metabolic health [14, 15, 18].

Emerging research suggests that sleep disturbances may play a role in the development and progression of neurodegenerative diseases, such as Alzheimer’s disease and Parkinson’s disease [19]. Poor sleep has been associated with an increased risk of cognitive decline and the accumulation of beta-amyloid plaques, which are characteristic of Alzheimer’s disease [20]. Additionally, sleep disruptions can worsen motor symptoms and impair cognitive function in people with Parkinson’s disease. Maintaining optimal sleep hygiene promotes brain health and reduces the risk of neurodegenerative diseases in older adults [21].

Sleep and mental health are closely intertwined, and poor sleep can have a significant impact on mental well-being, especially in older adults [22]. Sleep disturbances have been linked to an increased risk of anxiety disorders, depression, and other mental health conditions [23]. Inadequate sleep can disrupt mood regulation, increase emotional reactivity, and impair cognitive function, making it more challenging for older adults to maintain good mental health [24]. By addressing sleep disturbances through proper sleep hygiene practices, older adults can enhance their mental well-being and reduce the risk of mental health disorders [2].

In conclusion, maintaining good sleep hygiene is crucial for promoting healthy aging and preventing age-related diseases. By prioritizing sleep and implementing effective sleep hygiene practices, older adults can reduce their risk of cardiovascular diseases, diabetes and metabolic disorders, neurodegenerative diseases, and mental health disorders. Older adults should seek professional help if they are experiencing persistent sleep disturbances or suspect the presence of a sleep disorder, as proper diagnosis and treatment are vital for overall health and well-being [2].

Principles of sleep hygiene

Sleep hygiene refers to a set of practices and habits that promote good sleep quality and quantity [25]. By adopting proper sleep hygiene practices, people can establish healthy sleep routines and improve their overall well-being.

Maintaining a regular sleep schedule with a pre-sleep routine, even on weekends, helps regulate the body’s internal clock and promotes better sleep [26]. The pre-sleep routine including  engaging and relaxing activities before bed, such as reading a book, taking a warm bath, or practicing gentle stretching, yoga [21], and mindfulness or meditation. Relaxation techniques like deep breathing calm the mind and promote relaxation before sleep [22]. This consistency reinforces the sleep-wake cycle and enhances the quality of sleep. Sleep experts recommended 7-9 hours of sleep each night [26].

Creating a sleep-friendly environment is essential for quality sleep. This includes keeping the bedroom cool, dark, and quiet, using a comfortable mattress and pillows, and ensuring proper ventilation [27]. The right pillows, sheets, and blankets can contribute to a more relaxing and comfortable sleep environment [28]. A cool bedroom temperature, between 60 and 67 °F (15-19 °C), promotes better sleep [27].

Blackout curtains or eye shades block out external light sources that can interfere with sleep. Sleep masks work for people who cannot control the light in their environment [19]. The blue light emitted by electronic devices, such as smartphones and tablets, can interfere with the production of melatonin, a hormone that promotes sleep. Some research recommends avoiding electronic devices at least an hour before bed [29].

Noise disruptions can be minimized with earplugs, a white noise machine, or a fan to create a soothing background noise. A sound machine that plays calming sounds, such as ocean waves or rain, may also be effective [19].

Avoiding stimulants such as caffeine, nicotine, and alcohol close to bedtime can help prevent sleep disturbances. Stimulating activities close to bedtime, such as intense exercise, watching thrilling movies, or engaging in heated discussions can make it difficult to unwind [30].

It is recommended to avoid consuming stimulants at least four to six hours before bedtime [31]. Similarly, while alcohol may initially make people feel drowsy, it can disrupt the later stages of sleep, leading to fragmented and less restorative sleep. It is advisable to limit alcohol intake and avoid drinking close to bedtime [32].

Managing stress and anxiety

Stress and anxiety can significantly impact sleep quality. Stress-reducing activities, such as journaling, listening to calming music, and practicing relaxation exercises, have been found to alleviate stress before bedtime [33-35]. Cognitive behavioral therapy for insomnia (CBT-I) is a highly effective therapy that focuses on changing negative thoughts and behaviors related to sleep [36].

Writing down any worries or thoughts that may be keeping people awake can help them clear their minds and and reduce anxiety before bed. Designating a specific time and place during the day to address worries and concerns can train the mind to associate the bedroom with relaxation and sleep, rather than stress and anxiety [30].

Regular exercise and physical activity

Engaging in regular exercise and physical activity has numerous benefits for sleep. Physical exertion during the day can promote more restful sleep at night. However, exercising too close to bedtime can increase alertness and make it harder to fall asleep. Some experts recommend  finishing workouts at least a few hours before bedtime to allow the body to wind down and prepare for sleep. Additionally, a routine of relaxation exercises, such as yoga or stretching, can help promote relaxation and prepare the body for sleep [37].

Identifying common sleep disorders

There are various sleep disorders that can significantly impact quality of life.

Insomnia is characterized by difficulty falling asleep, trouble staying asleep, or both. It is often accompanied by daytime sleepiness, fatigue, and impaired functioning [38]. Psychologists can treat insomnia and other common sleep disturbances [39].

Sleep apnea is a condition in which a person’s breathing repeatedly stops and starts during sleep. It can lead to loud snoring, gasping for air during sleep, and excessive daytime sleepiness [38].

Restless leg syndrome is a disorder characterized by an irresistible urge to move the legs, often accompanied by uncomfortable sensations. It can disrupt sleep and lead to daytime fatigue [40].

Narcolepsy is a neurological disorder that affects the brain’s ability to regulate sleep-wake cycles. It causes excessive daytime sleepiness and sudden episodes of falling asleep [41].

Diagnosis and treatment

A proper diagnosis from a professional is crucial for understanding the underlying cause of a sleep problem and for developing an effective treatment plan. Sleep disorders can have various underlying causes, including medical conditions, lifestyle factors, and psychological factors.

Untreated sleep disorders can have a significant impact on overall health and well-being. They can affect cognitive function, mood, and physical health [10, 42]. For example, chronic sleep deprivation can impair attention, memory, and problem-solving abilities [5]. It can also contribute to mood disorders, such as depression and anxiety [23].

Sleep disorders can also have consequences on daily functioning, including work and school performance. They can impair concentration, productivity, and decision-making abilities [43].

Sleep medications and other interventions

In some cases, sleep medications may be prescribed as part of the treatment plan for sleep disorders. However, medication should not be the only approach to managing sleep problems. Sleep medications should be used under the guidance and supervision of a healthcare professional, as they may have serious side effects and potential risks [44-47].

Another intervention that can be effective in treating sleep disorders is continuous positive airway pressure (CPAP), which is often used to treat sleep apnea. It involves wearing a mask over the nose during sleep, which delivers a continuous flow of air to keep the airway open [36].

Sleep hygiene and aging

With aging, sleep patterns naturally change. Older adults tend to experience shifts in their sleep architecture, which can result in changes to the quantity and quality of their sleep.

Older adults may have more difficulty falling asleep and staying asleep throughout the night, leading to fragmented sleep. They also tend to go to bed earlier and wake up earlier than younger adults. This shift in the sleep-wake cycle can disrupt their daily routines. Deep sleep, also known as slow-wave sleep, tends to decrease with age. This can result in feeling less rested upon waking and an increased susceptibility to daytime sleepiness [22].

Impact of poor sleep on aging

Poor sleep quality and quantity can have significant consequences for older adults’ health and well-being. Sleep disturbances have been linked to an increased risk of developing chronic conditions, such as cardiovascular disease, diabetes, obesity, and cognitive decline [48].

Lack of quality sleep can impair cognitive function, including memory, attention, and decision-making abilities. This can negatively impact daily activities and overall quality of life [49].

Older adults who experience poor sleep are more likely to experience mood disturbances such as depression and anxiety. Sleep deprivation can exacerbate existing mental health conditions and increase the risk of developing new ones [50].

Literature

[1] S. L. Schutte-Rodin, L. Broch, D. Buysee, C. Dorsey, and M. Sateia, “Clinical guideline for the evaluation and management of chronic insomnia in adults,” Journal of Clinical Sleep Medicine, vol. 4, no. 5, pp. 487–504, Oct. 2008.

[2] “What Is Sleep Hygiene? | Sleep Foundation.” https://www.sleepfoundation.org/sleep-hygiene (accessed Jul. 27, 2023).

[3] “Sleep and Sleep Disorders | CDC.” https://www.cdc.gov/sleep/index.html (accessed Jul. 27, 2023).

[4] T. Csipo et al., “Sleep deprivation impairs cognitive performance, alters task-associated cerebral blood flow and decreases cortical neurovascular coupling-related hemodynamic responses,” Scientific Reports 2021 11:1, vol. 11, no. 1, pp. 1–13, Oct. 2021

[5] M. Roig et al., “Exercising the Sleepy-ing Brain: Exercise, Sleep, and Sleep Loss on Memory,” Exerc Sport Sci Rev, vol. 50, no. 1, pp. 38–48, Jan. 2022.

[6] D. De Clercq and R. Pereira, “Sleepy but creative? How affective commitment, knowledge sharing and organizational forgiveness mitigate the dysfunctional effect of insomnia on creative behaviors,” Personnel Review, vol. 50, no. 1, pp. 108–128, Jan. 2021.

[7] M. A. Opoku, S. W. Kang, and N. Kim, “Sleep-deprived and emotionally exhausted: depleted resources as inhibitors of creativity at work,” Personnel Review, vol. 52, no. 5, pp. 1437–1461, Jun. 2023.

[8] P. P. Chang, D. E. Ford, L. A. Mead, L. Cooper-Patrick, and M. J. Klag, “Insomnia in young men and subsequent depression: The Johns Hopkins Precursors Study,” Am J Epidemiol, vol. 146, no. 2, pp. 105–114, Jul. 1997.

[9] L. Bovy, I. Tendolkar, G. Fernández, and M. Dresler, “Sleep, Emotional Memories, and Depression,” Handb Behav Neurosci, vol. 30, pp. 519–531, Jan. 2019.

[10] A. D. Seelig, I. G. Jacobson, C. J. Donoho, D. W. Trone, N. F. Crum-Cianflone, and T. J. Balkin, “Sleep and health resilience metrics in a large military cohort,” Sleep, vol. 39, no. 5, pp. 1111–1120, May 201.

[11] A. Germain and M. Dretsch, “Sleep and Resilience—A Call for Prevention and Intervention,” Sleep, vol. 39, no. 5, pp. 963–965, May 2016.

[12] L. Besedovsky, T. Lange, and J. Born, “Sleep and immune function,” Pflugers Arch, vol. 463, no. 1, pp. 121–137, Jan. 2012.

[13] C. T. Gómez de León and J. Morales-Montor, “Sleep and Immunity,” Pediatric Sleep Medicine, pp. 87–95, 2021.

[14] R. P. Ogilvie and S. R. Patel, “The Epidemiology of Sleep and Diabetes,” Curr Diab Rep, vol. 18, no. 10, Oct. 2018.

[15] S. Kurnool, K. C. McCowen, N. A. Bernstein, and A. Malhotra, “Sleep Apnea, Obesity, and Diabetes — an Intertwined Trio,” Curr Diab Rep, vol. 23, no. 7, pp. 165–171, Jul. 2023.

[16] M. S. Khan and R. Aouad, “The Effects of Insomnia and Sleep Loss on Cardiovascular Disease,” Sleep Med Clin, vol. 12, no. 2, pp. 167–177, Jun. 2017.

[17] N. Baranwal, P. K. Yu, and N. S. Siegel, “Sleep physiology, pathophysiology, and sleep hygiene,” Prog Cardiovasc Dis, vol. 77, pp. 59–69, Mar. 2023.

[18] M. A. Grandner, A. Seixas, S. Shetty, and S. Shenoy, “Sleep Duration and Diabetes Risk: Population Trends and Potential Mechanisms,” Curr Diab Rep, vol. 16, no. 11, Nov. 2016.

[19] J. A. Palma, E. Urrestarazu, and J. Iriarte, “Sleep loss as risk factor for neurologic disorders: A review,” Sleep Med, vol. 14, no. 3, pp. 229–236, Mar. 2013.

[20] N. Goel, H. Rao, J. S. Durmer, and D. F. Dinges, “Neurocognitive consequences of sleep deprivation,” Semin Neurol, vol. 29, no. 4, pp. 320–339, 2009.

[21] A. Iranzo and J. Santamaria, “Sleep in Neurodegenerative Diseases,” Sleep Med, pp. 271–283, 2015.

[22] B. A. Mander, J. R. Winer, and M. P. Walker, “Sleep and Human Aging,” Neuron, vol. 94, no. 1, pp. 19–36, Apr. 2017.

[23] P. K. Alvaro, R. M. Roberts, and J. K. Harris, “A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression,” Sleep, vol. 36, no. 7, pp. 1059–1068, Jul. 2013.

[24] E. Altena, J. A. Micoulaud-Franchi, P. A. Geoffroy, E. Sanz-Arigita, S. Bioulac, and P. Philip, “The bidirectional relation between emotional reactivity and sleep: From disruption to recovery,” Behavioral Neuroscience, vol. 130, no. 3, pp. 336–350, Jun. 2016.

[25] K. C. Vitale, R. Owens, S. R. Hopkins, and A. Malhotra, “Sleep Hygiene for Optimizing Recovery in Athletes: Review and Recommendations,” Int J Sports Med, vol. 40, no. 8, pp. 535–543, 2019.

[26] J.-P. Chaput et al., “SYSTEMATIC REVIEW Sleep timing, sleep consistency, and health in adults: a systematic review 1 Les nouveautés,” Appl. Physiol. Nutr. Metab. Downloaded from cdnsciencepub.

[27] A. A. Mirjat, A. A. Mirjat, · Muhammad Naveed, F. Majeed, and S. Chong, “Factors Influencing Sleep Quality and Effects of Sleep on Hypertension,” vol. 1, p. 3, June 2020.

[28] G. Caggiari, G. R. Talesa, G. Toro, E. Jannelli, G. Monteleone, and L. Puddu, “What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature,” Journal of Orthopaedics and Traumatology, vol. 22, no. 1, pp. 1–24, Dec. 2021.

[29] “Can Electronics Affect Quality Sleep? | Sleep Foundation.” https://www.sleepfoundation.org/how-sleep-works/how-electronics-affect-sleep (accessed Aug. 24, 2023).

[30] J. Koketsu, “Pre-Sleep Routines in Adult Normal Sleepers,” Encompass Digital Archive: Occupational Therapy Doctorate Capstones, Jan. 2018, Accessed: Aug. 24, 2023.

[31] V. Lohsoonthorn et al., “Sleep Quality and Sleep Patterns in Relation to Consumption of Energy Drinks, Caffeinated Beverages and Other Stimulants among Thai College Students,” Sleep Breath, vol. 17, no. 3, p. 1017, Sep. 2013.

[32] S. Y. Park et al., “The Effects of Alcohol on Quality of Sleep,” Korean J Fam Med, vol. 36, no. 6, p. 294, 2015.

[33] C. L. Drake, V. Pillai, and T. Roth, “Stress and sleep reactivity: A prospective investigation of the stress-diathesis model of insomnia,” Sleep, vol. 37, no. 8, pp. 1295–1304, Aug. 2014.

[34] C. Drake, G. Richardson, T. Roehrs, H. Scofield, and T. Roth, “Vulnerability to stress-related sleep disturbance and hyperarousal,” Sleep, vol. 27, no. 2, pp. 285–291, 2004.

[35] D. C. Slavish et al., “The Cycle of Daily Stress and Sleep: Sleep Measurement Matters,” Annals of Behavioral Medicine, vol. 55, no. 5, pp. 413–423, May 2021..

[36] L. Simon, L. Steinmetz, B. Feige, F. Benz, K. Spiegelhalder, and H. Baumeister, “Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis,” Scientific Reports 2023 13:1, vol. 13, no. 1, pp. 1–11, Feb. 2023.

[37] C. E. Kline, “The Bidirectional Relationship Between Exercise and Sleep,” Am J  Lifestyle Med, vol. 8, no. 6, pp. 375–379, Aug. 2014.

[38] A. Family, K. Ramar, and E. J. Olson, “Management of Common Sleep Disorders,” vol. 88, no. 4, 2013, Accessed: Aug. 24, 2023.

[39] D. R. R. Murtagh and K. M. Greenwood, “Identifying effective psychological treatments for insomnia: A meta-analysis.,” J Consult Clin Psychol, vol. 63, no. 1, pp. 79–89, 1995.

[40] M. Manconi et al., “Restless legs syndrome,” Nature Reviews Disease Primers 2021 7:1, vol. 7, no. 1, pp. 1–18, Nov. 2021.

[41] B. R. Kornum et al., “Narcolepsy,” Nature Reviews Disease Primers 2017 3:1, vol. 3, no. 1, pp. 1–19, Feb. 2017, doi: 10.1038/nrdp.2016.100.

[42] E. F. Pace-Schott and R. M. C. Spencer, “Sleep-dependent memory consolidation in healthy aging and mild cognitive impairment,” Curr Top Behav Neurosci, vol. 25, pp. 307–330, 2015.

[43] C. B. Kristiaan van der Heijden, “Chronic sleep reduction is associated with academic achievement and study concentration in higher education students Sleep deprivation and sleep reduction,” J Sleep Res, vol. 27, pp. 165–174, 2018.

[44] A. Y. Avidan, B. E. Fries, M. L. James, K. L. Szafara, G. T. Wright, and R. D. Chervin, “Insomnia and hypnotic use, recorded in the minimum data set, as predictors of falls and hip fractures in Michigan nursing homes,” J Am Geriatr Soc, vol. 53, no. 6, pp. 955–962, Jun. 2005.

[45] M. J. Tsai, Y. H. Tsai, and Y. Bin Huang, “Compulsive activity and anterograde amnesia after zolpidem use,” Clin Toxicol, vol. 45, no. 2, pp. 179–181, Feb. 2007.

[46] A. J. Roth, W. V. Mccall, and A. Liguori, “Cognitive, psychomotor and polysomnographic effects of trazodone in primary insomniacs,” J Sleep Res, vol. 20, no. 4, pp. 552–558, Dec. 2011.

[47] T. Fitzgerald and J. Vietri, “Residual Effects of Sleep Medications Are Commonly Reported and Associated with Impaired Patient-Reported Outcomes among Insomnia Patients in the United States,” Sleep Disord, vol. 2015, pp. 1–9, 2015.

[48] K. Crowley, “Sleep and sleep disorders in older adults,” Neuropsychol Rev, vol. 21, no. 1, pp. 41–53, Mar. 2011.

[49] D. Foley, S. Ancoli-Israel, P. Britz, and J. Walsh, “Sleep disturbances and chronic disease in older adults: Results of the 2003 National Sleep Foundation Sleep in America Survey,” J Psychosom Res, vol. 56, no. 5, pp. 497–502, May 2004.

[50] M. F. Leblanc, S. Desjardins, and A. Desgagné, “Sleep problems in anxious and depressive older adults,” Psychol Res Behav Manag, vol. 8, pp. 161–169, Jun. 2015.