Why don’t I sleep well?
We all have different sleep patterns, and almost anyone can improve theirs. So let’s begin with the three keys to better sleep which might work for an “average” person.
By Paul Kelley
The first is a healthy life style. You’re more likely to sleep well if you eat healthily, exercise, and have time for a good social and/or family life. Good nutrition and food habits benefit all bodily functions, including sleep and health; exercise helps reduce stress; and good relationships do the same — while also improving mood, and enabling relaxation before sleep.
The second key is the length of time you sleep, with about eight hours a night being a good amount for the average person. Don’t be surprised if you sleep less though. Most working people in modern society are sleep deprived by an hour or two each day. But six hours of sleep is too little. Sleep matters more than we realise, so making time to sleep for about eight hours is good advice for almost everyone.
The third key is the time you try to go to sleep (if you think of shift work and the problems this causes people, it’s obvious that this is important). Most people have two different time patterns — one during the working week, the other for weekends and holidays. It’s no surprise that holiday timing is better for sleep. As a rule of thumb, waking at 8am and going to sleep at midnight is about right for the average person.
You may need to adjust these timings if you’re different from the norm. Some of us are morning types (naturally getting up and going to sleep earlier) and others are evening types (naturally getting up and going to sleep later). These types are formally known as chronotypes. To find out if you are a morning type (“lark”) or evening type (“owl”) it’s worth looking up the MCTQ short questionnaire. This is probably the best way for a morning person to find out accurately if they are an extreme early, very early, early, slightly early or normal type — and find appropriate sleep timings (the same applies for evening types).
These timings are given in the MCTQ results: the average person wakes at 8–9am and goes to sleep at midnight to 1am. In contrast, some extreme early types wake at 5am and go to sleep at 9pm. This shows the huge difference between chronotypes that occur naturally in a large population. These differences can affect many people. For example, some moderate late types would wake up at 11am and go to sleep at 3am, if allowed to adhere to their natural rhythms, and this group makes up more than 5% of the population.
Of course, these MCTQ timings are not rigid rules, only a rough measure of times to guide you to understanding your own sleep better. They might also help you understand people in your family. This is particularly true for teenagers and young adults whose sleep patterns can alter to dramatically later times.
Let’s consider some examples. Ella is in her 30s, and works in a busy office in London. “Until two years ago,” she says, “I could sleep like a baby for 14 hours, but I think stress and the occasional glass of wine have had an impact on my sleep. What I find now is that it’s not hard to get to sleep, but I wake up three or four times during the night, and never feel hugely rested in the morning. I don’t remember the last time I had a full, uninterrupted night’s sleep. And in terms of the times I sleep best, Friday night is definitely always the best, and Sunday night is the worst.”
Ella is typical in many ways. People working in busy office jobs are very frequently stressed, and on Friday nights they sleep best, because there is less stress, while on Sunday night the prospect of a demanding week causes poor sleep. Alcohol tends to lead to disrupted sleep, not to relaxing into good sleep. External pressures from Ella’s work are causing a problem — and drinking before sleep makes it worse.
Annie works in the same office as Ella, and says she’s suffered from insomnia since she was a teenager. “I wake up at 3am, and can’t get back to sleep. This used to stress me out, which obviously exacerbates the problem, so as I’ve got older I’ve stopped worrying about it so much. This doesn’t make the problem better, but it means I just accept that there are nights when I won’t get a good enough sleep. Sunday night is always my worst night’s sleep, and I try to be strict with myself — I stop myself going online for a few hours before I go to bed, and I don’t read anything work-related in that period either. I try to avoid email, especially, because there’s always pressure to get back to emails immediately, and once you’re in that zone, you’re wired.”
Annie took the MCTQ test, and this showed she is an early type, who would, if left to her own devices, naturally wake up earlier than 85% of the population. This would have been particularly striking as a teenager, feeling tired and ready for sleep when everyone else was staying up later and later. She is very perceptive in her acceptance of her sleep patterns, especially her sleeplessness, and when it comes to Sunday nights, her strictness with herself is excellent — we should all do that.
Understanding your sleep can put things in context. The next step is to consider whether there are changes you can make to your daily life that will help you sleep well. You can probably make a list based on the three keys: better lifestyle, making eight hours of sleep possible, and knowing your chronotype.
The benefits of sleep are now understood to include better memory, insight and health
What next? Work or education timings are the biggest barrier to good sleep in modern society. This is because the start times are generally too early. For example, if you are an average person, your wake time would be about 8am. If your current job starts at 8 or 9am, it isn’t possible to keep to this wake time and be on time. These early starts punish almost everyone: the employee (too little sleep leads to poorer performance and greater health risks), the employer (as staff are not at their best), and the shareholders (as productivity won’t be as high as it could be).
Better work times are better for all. Even work shifts can be improved using staff chronotypes, as has been shown recently in Germany, where a brilliant sleep researcher called Till Roenneberg came up with the idea of using the chronotypes of workers in the steel industry to ensure that evening type workers did more night shifts, and early types did more early starts. The result? The workers sleep an hour longer each night and arrive at work feeling better.
Greater flexibility regarding working hours makes sense, and is a growing trend. For example, a company in London called dRMM architects allows employees to manage their work hours — as long as they meet their targets. If you’re struggling with sleep, it might (depending on your situation) be worth asking your employer for a more flexible approach. And if you run a big business, consider flexible hours for employees, to boost productivity, health, mood and performance.
If you work in education, it’s worth actively looking at later start times for secondary students. There is a clear scientific case for later start times and an exciting opportunity to join Oxford’s project Teensleep, which is recruiting 100 secondary schools to try out 10am starts and sleep education in a random controlled trial to improve sleep, health and performance. If you’re based in the US, try looking at Start School Later, a campaign to move school starting times to later than 8.30am. Seattle school district, for example, has just moved all its secondary school starts to a later time, recognising that early starts increase health risks and emotional harm, while lowering academic and sports performance.
There are a number of other things you can do in your daily life to improve your sleep. Direct sunlight, especially in the morning, helps keep your sense of time tuned to the 24-hour day, so try to be outside then. In the last hour or two before your natural sleep time have a routine that helps you settle, such as a quiet, dark, comfortable bedroom. In the last hour, don’t use screen technologies or bright lights. As a general rule, don’t use drugs unless prescribed by your doctor. In the morning, don’t use stimulants like cigarettes to wake you up, or depressants like alcohol and sleeping pills at night. Coffee and tea in the morning are fine.
Sleep is only a part of our daily pattern of work and rest; tiredness and alertness; and the various 24-hour rhythms of our body. We tend to think differently about wake and sleep events, though there is no reason to do so. If you sleep in the day — a nap — we tend to think of it as a treat and wise. If we wake at night — as most of us do — then we can feel as if something is wrong and worry. So if you do wake up and can’t sleep just then, get up and do something until you feel like going back to sleep.
The benefits of sleep are now understood to include better memory, insight and health. Sleep helps clean our brains of toxins, and enables us to create long-term memories (while forgetting trivia).
If you need more help, it’s always worth talking to your doctor and getting their advice. Sleep is your friend: treat it well.
Originally published at www.theguardian.com on January 6, 2016.
Paul Kelley is honorary clinical research associate in the Sleep and Circadian Neuroscience Institute at the University of Oxford.
