This is a guest post written by Daniel Pardi.
As a sleep researcher and sleep educator, the most common question I get is, “How do I know how much sleep I need?” It’s a tricky question because the benefits of sleep are only partially determined by sleep duration. When people ask this question, what they really mean is, “What are the things I need to do in order for me to get all the physiological and behavioral benefits of a perfectly managed sleep-wake practice?” This article will help you answer that question, and one component of that question is understanding how much time you need to spend in bed per night. First, we need to review important fundamentals of sleep and wake regulation, otherwise the guidance here won’t make much sense.
You’ve heard of the importance of personalizing your diet. But what about your sleep? #optimumsleep #sleepcycle
While we don’t know that a single purpose for sleep exists, we do know that many important things take place during that period of time between when you shut your eyes at night and when you open them again in the morning.
In Dr. Borbely’s model, he described that the regulation of these states is based primarily upon the combination of two different processes occurring simultaneously. To understand how to get the sleep you need, let’s explore those two processes further.
Process 1 – Sleep Pressure
The first process of the professor’s 2-Process Model is sleep pressure. From the moment you wake up in the morning, a pressure for sleep mounts continuously until you sleep again. At night, the built-up sleep pressure helps you 1) fall asleep, and 2) stay asleep until the next morning. During sleep, this pressure decreases, and after a night of complete sleep, you start the next day with low sleep pressure. Later in the article, I’ll talk about the concept of “sleep debt,” which happens when you don’t wear down all your sleep pressure before starting the next day.
If sleep pressure builds from morning to night, why don’t we become increasingly sleepy from the moment we wake up? That’s where the second process of the 2-Process Model comes into play.
Process 2 – Wake Drive
This second process is called “wake drive.” You can think of it as the result of multiple brain systems working together—a wake network—to produce an alerting signal that increases in intensity to counteract mounting sleep pressure. The result? While sleep pressure builds from morning to night, wake drive also builds from morning to night, and your alertness stays relatively even across the day (with some within-day oscillations). This process raises another question: If wake drive is high during the night, how do we fall asleep? To understand the answer, we need to discuss how sleep pressure and wake drive differ.
For instance, assume someone typically wakes up at 7 a.m. and goes to bed at 11 p.m. and that his or her wake rhythm is stable and fixed to this time frame. Under these conditions, their wake drive initiates at 7 a.m., builds all day to counteract mounting sleep pressure, reaches its peak at 10 p.m., and plummets at 11 p.m., descending to its lowest point across a 24-hour period. At 7 a.m. the next morning, it begins to build back up all over again.
This rhythm repeats day after day—you awake at the same time and feel sleepy at the same time, on a daily basis. Importantly, the timing of the rhythm can be shifted forward or backwards. In a second example, imagine the wake rhythm is shifted two hours forward: wake drive starts at 9 a.m., builds all day, reaches its peak at midnight, plummets at 1 a.m. to its lowest level, and then builds back up again around 9 a.m. the next morning. It is easy to see that the timing of this rhythm is crucial for daytime alertness and quality night-time sleep. Let’s explore what sets the timing of our daily wake rhythm.
Imagine you live in San Francisco and travel halfway around the globe to Rome, Italy. When you arrive, your internal rhythms are still synced to San Francisco. At the beginning of your trip, you’re awake at night when everyone in Italy is sleeping and sleepy during the day when everyone else is fully awake. But slowly, over the course of multiple days, your body starts to adjust to this new time zone. What signal is the body responding to in order to adjust the timing of its internal rhythms to be in sync with the environment? The primary signal that sets our 24-hour body rhythms, including the timing of our wake rhythm, is light entering the eye.
There is an incredible amount of information regarding this topic, but I’ll get to the bottom line. To set the timing of your wake rhythm, your brain wants to coordinate the timing of your wake signal to daytime. It does this by measuring the intensity and hue of light entering the eye. Indoor light is far less intense than outdoor light and, more than ever in human history, we spend much of our day indoors.
Essentially, by having light enter the eye at night when the brain should be getting exposure to darkness, we are again telling the brain that it should shift the timing of the wake rhythm forward. So, living in the modern world causes a double-whammy—too little light during the day and too much light at night—shifting our wake rhythm forward.
What is one implication of having your wake rhythm shifted forward? Let’s say you need to get up at 7 a.m. and want to go to bed by 11 p.m. Remember, you start to build sleep pressure as soon as you wake up. Not a problem if your wake rhythm starts at 7 a.m. too. Everything works really, really well when these systems are coordinated. But, when your wake rhythm is shifted forward, say, to 9 a.m., now you have a mismatch between sleep pressure and wake drive. There is a gap between the intensity of these two counteracting forces, and that gap is maintained all day.
What do you experience when this happens? Day-long sleepiness and impaired alertness (and a host of other cognitive issues). But it doesn’t end there. Let’s look at what happens to sleep at night. In this scenario, you want to go to sleep at 11 p.m., and you’ve been sleepy all day, but since your wake rhythm is shifted forward, it’s at its most powerful at the time you want to go to bed. This can cause insomnia or it can make the first phase of sleep shallow. Incidentally, the first phase of sleep should be the deepest, and this depth of sleep corresponds with the fastest reduction of sleep pressure. If you don’t wear down sleep pressure efficiently, you have to sleep longer to do so. But if you don’t sleep longer, instead waking by an alarm as most people do, you wake the next day with “sleep debt,” which, as I described earlier, means you carry some of yesterday’s unresolved sleep pressure with you into tomorrow. So, a mistimed wake rhythm can either shorten your sleep by making it harder to go to bed at night or disrupt the depth of your sleep, either of which will cause sleep debt. What this means is that seven hours of sleep will feel more like six the next day. Conversely, you could get nine hours of sleep (which might be a lot for you) and still not feel well rested.
You can see why it’s difficult to directly answer the question, “How much sleep do I need?”
The big lesson you should learn here is to anchor your wake rhythm by maintaining smart light habits throughout the day, evening, and night. To do this, get at least 30 minutes of outdoor light exposure during the day. In the evening, dim all lights and reduce blue or full-spectrum light in your environment. At night, while you sleep, maintain a very dark room.
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Determining Your Ideal Sleep Duration
Given that the timing of your wake rhythm can shift, and that this shift can then influence sleep duration ability and needs, sleep duration is an important part of the puzzle.
A series of early studies put subjects in a stimulation-free environment for 14 to 24 hours per day and then monitored daily sleep quantity. Each day for the first two days, subjects slept up to 12 to 20 hours! Then, on subsequent days, daily sleep times reduced until each subject arrived at a consistent daily sleep amount. Most people settled at an average of eight hours per night, although some settled closer to nine and others closer to seven. Once each subject settled at his or her stable daily average, after they had the chance to wear down additional sleep pressure, this average likely approximated their actual daily sleep requirement.
One way to interpret these findings is to assume that subjects entered these studies with extra sleep debt that built over time and could be attributed to less-than-optimal nightly sleep before they entered the study. When given way-more-than-normal time for sleep in the study, this built-up pressure caused long sleep periods in the first few days, and decreased over time to settle at a unique average for each person. Interestingly, although the volunteers reported feeling perfectly normal when they entered the study, after they reduced this extra sleep pressure, they had notable improvements in mood and energy levels.
More recently, sleep researchers Siobhan Banks, David Dinges, and others have been exploring this topic further. In some of their studies, they restrict sleep time during the week to four or five hours per night, then give subjects recovery sleep for several days in a row. Recovery sleep means that the subjects were allowed to sleep as long as they could, only waking up on their own volition and not by external means. What they found is quite telling. Not only does performance on mental tasks increasingly degrade each day during night after night of insufficient sleep, but when finally given a chance to sleep longer, they do—much longer, in fact. It’s common for these subjects to sleep 125 percent of normal, going from eight hours a night at baseline to ten hours a night during recovery nights. But, their sleep debt wasn’t fully worn down by one long slumber. Subjects had increased sleep duration beyond their baseline needs lasting for about four nights. And this occurred after only five nights of sleep deprivation. In real life situations, people will restrict sleep beyond five days fairly regularly. In fact, one-third of the U.S. population reports sleep less than six hours a night on average. I won’t go into the all the associations that have been found between chronic sleep restriction and disease, but my global impression is that the effects of chronic, persistent sleep loss promote a whole-system pathological response in humans. In other words, lots can go wrong and does.
What If I Can’t Sleep past 7 A.M.?
If you can’t sleep past the time you usually wake up in the morning, does this mean you’re getting all the sleep you need? Well, actually, no. Let’s say you have a fairly strong wake rhythm that starts at 7 a.m. each day. Excellent! But, even if you haven’t worn down all your sleep pressure from the night before, you still may wake up at your usual time. You just might be sleepier than you need to be under this condition. So, one way to evaluate sleep need is to look at how long you can sleep. However, given this potentiality, you might just be experiencing sub-functional mental capacity during the day. In this scenario, try an experiment. Attempt to get complete nightly sleep for three weeks in a row, plus maintaining smart light habits day by day, and then see how you feel. To start, consider how much time you typically spend in bed per night. Tracking sleep manually or with the sleep tracker on Dan’s Plan is very useful for this. One objective measurement to indirectly assess sleep quality is to evaluate reaction time during the day, which is a measure of vigilance. For the first three days of the experiment, at the same time each morning, do 20 tries of a reaction time test at HumanBenchmark.com. Write down your average reaction time across each day, then average those 3 days into one score and file it as “baseline” in a place where you can reference it later.
Example:
- Day 1: 269 milliseconds (ms)
- Day 2: 303 ms
- Day 3: 277 ms
Baseline Reaction Time Score (3-Day average): 283 ms
Now that you have an idea of your average time in bed each night, add 30 to 60 minutes to that time by going to bed earlier. Try not to wake by an alarm during this experiment. Do not spend too much effort in evaluating how you feel during this three-week period. Instead, evaluate how you feel after three weeks have passed. The goal of the Dan’s Plan Restorative Sleeper concept is to wake refreshed and feel alert all day. How do you feel? Noticeably different and better? Also, do another three days of morning reaction time tests at humanBenchmark.com and see if your scores differ from your baseline. If you do see improvements, you’ve identified that you benefit by getting more sleep than your previous “normal.”
If you didn’t sleep any longer and don’t feel much different, then you may be getting all the sleep you need on a regular basis. Either way, you’ve added knowledge to your own sleep practice and can then make corresponding adjustments if need be.
I track my sleep nightly to help nudge me to do the behaviors necessary to get the sleep I need. Here is a screenshot of my last year of sleep data, indicating that I put my money where my mouth is.
Complete Sleep
This is a term I created to describe your ideal sleep duration. When trying to determine how much sleep you need, you also must understand that your own sleep needs can change from day to day, depending on factors like fighting an infection, recovering from a higher-than-normal level of physical activity or stress, and more. So, even if you were to determine a number you felt was representative of your ideal, the reality is that your sleep need can change night to night. My recommendation is the same: allow for more time in bed than sleep you need. If you need eight hours of time in bed, plan to spend 8.5 hours in bed so you can wake under your own volition and not by an alarm clock. If your body needs a bit more sleep that night, you’ll have planned for this to happen. Give your body the chance to get all the sleep that it wants to get, and you will be doing yourself a favor. Wake up on your own volition and not by external means. It’s fine to set an alarm as a stopgap but you should aim, on average, to wake naturally.
My view is that the reality of the modern world requires you to counteract its forces that impair health, and this is very true for sleep. Try the recommendations covered here and leave a comment reporting your findings after you’ve had the chance to let your experiment run for a few weeks.
End Note
This article does not address the all contingencies—especially sleep disorders and other conditions that disrupt sleep—that can alter what I discussed above. Additionally, the actual science is far more complex than what I presented here, but the message this article conveys, and the guidance it confers, is useful to help you view sleep in a healthy way, and ultimately, to maintain a healthy sleep practice throughout life.
About Dan: Dan is an entrepreneur and researcher whose life’s work is centered on how to facilitate healthy behaviors in others. He is the CEO of humanOS.me and dansplan.com, health technology companies that utilize the Loop Model to Sustain Health Behaviors—which he developed—to help people live a healthy lifestyle in a modern world (See Stanford MedX presentation on the Loop Model.) He does research with the Psychiatry and Behavioral Sciences Department at Stanford and the Departments of Neurology and Endocrinology at Leiden University in the Netherlands. His current research looks at how sleep influences decision-making (current list of publications). Dan also works with Naval Special Warfare to help the most elite fighters in the world maintain vigilant performance in both combat and non-combat conditions. Follow him @dansplanhealth.
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Hi Dan,
Fantastic article.
I have always been an early to bed early to rise person. I generally wake between 6 and 6:30 each morning. There are some days though, when I am super tired all day, so will go to bed earlier (9:30 -10:00 pm) but then will toss and turn until midnight. What would be causing this, as I know I need the extra sleep, but I just can’t get there.
What have you tried ?
Have you tried GABA and magtein ?
Hi Melissa,
There are many different things than can disrupt sleep. I listed some of them in the article and believe some of the topics I discussed could be at the heart of your sleep issue. Ensure that your room is quiet, cool, dark, and comfortable, and also consider trying meditation before bed. That can help quiet the mind prior to sleep.
I am one with a sleep disorder, the result of childhood sexual abuse, and I can’t remember ever waking up and feeling really rested. Your article has helped me make sense of what the problem is (excluding the sleep disorder complications). I would like to try your experiment, but am really not certain how to go about reducing light in the evening. I do have f.lux on my computer, but the lights in our bedroom and my bathroom are bright because my old eyes need really good light to function well. Any suggestions you might about ways to accomplish reduced light without impairing my ability to function and/or disrupt my husband’s routines would be greatly appreciated.
Hi Susan,
You can purchase amber glasses that filter blue light. This creates “circadian darkness,” which means you can see but you’re not telling your brain it’s daytime. Check out http://www.lowbluelights.com.
Thanks, Daniel. I’ll check them out.
I have a major sleep Problem. I CANNOT sleep more than 3 hours per night, no matter what time I go to bed. I need 2mg Melatonin just to get to sleep. Up to bathroom 3 hrs later, end of sleep. What can I do??? This has been going on for several months. Thanks
Ben,
I recommend you get a sleep study done.
Ben .
Daniel Pardi is correct . Get a sleep trudy done but make sure that the sleep clinic you choose is able to manually measure the RERAS ( respiratory effort related arousals ) to diagnose UARS ( upper airways resistance syndrome ) . If they only measure the apneas and hypopneas – AHI index , they may miss the UARS diagnosis .
For more information on this syndrome there is a great book Sleep Interrupted by an ENT dr Steven Parker . He interviews many experts on this subject including Dr Christian Guilleminault who first identified this syndrome in 1993 . Check it out on his website http://www.drstevnparker.com or search for this on the Podcast app .
The following is from a flyer on UARS that I prepared and hand out to my patients : A lot of my information was supplied from a paper written on UARS by Dr Clyde Keevy.
Hope this helps
Dr Maureen Allem
UARS is classified under Obstructive Sleep apnea OSA and is a Sleep Breathing Disorder SBD that is associated with numerous FSS Functional Somatic syndromes and Anxiety disorders .
Symptoms of UARS can overlap with OSA . UARS patients are more likely to complain of daytime fatigue rather than sleepiness.
UARS is a form of sleep disordered breathing associated with fragmentation of sleep and is associated with inspiratory flow limitation whilst breathing during sleep . This inspiratory airflow limitation does not drop the oxygen saturation as per OSA .
Chronic insomnias are more common with UARS . These patients find it difficult to fall asleep (Sleep onset) and then find it difficult to stay asleep ( sleep maintainance ) These patients have nocturnal awakenings and find it difficult to return to sleep .
Studies report that Chronic insomnia is more prevalent with UARS than OSA
50% of UARS have cold hands and feet especially in childhood
30 % have light headedness when standing up or bending over abruptly due to parasympathetic over activity
UARS patients have more sleep disturbance than OSA patients
UARS patients have more sleep fragmentation that causes daytime sleepiness/ fatigue
What initiates the UARS ? Any Physical or emotional trauma can sensitize the limbic system which modulates emotions .The limbic system then activates the HPA axis .
The physical trauma can be a Motor vehicle accident , physical abuse, assault , home invasion , hijackings, rape , attempted rape etc . The initial trauma can also be emotional abuse . These traumas activate the HPA axis and sensitize the limbic system thereby altering the brain response to external or internal stimuli .
This activation can also lead to the Functional Somatic Syndromes FSS
Patients with UARS have usually consulted numerous doctors who are not able to diagnose the condition as they are unaware of this newly documented condition . These doctors have not manage to improve their patients symptoms of anxiety , depression, insomnia, ADHD and these FSS disorders .
Antidepressants are usually prescribed to alleviate symptoms but the underlying cause goes undiagnosed until a sleep study is ordered by a doctor who is aware of this new sleep disordered breathing called UARS . The sleep study is usually a last resort .
Once diagnosed, UARS is better treated with a mandibular advancement device which opens the airway and up improves these FSS symptoms .
The sleep study must measure RERAS ( respiratory effort related arousals ) manually . Automated computer analysis of polysonograms PMG do not measure RERAs and are unable to diagnose the sleep disordered breathing of UARS .
PSG have to be manually analyzed to diagnose this condition
What are the Main FSS symptoms ?
Body pain , headaches , insomnias and irritable bowels
What are the main anxiety disorders that UARS is associated with ?
Anxiety, depression, Bipolar , ADHD and Insomnia
Other FSS syndromes that doctors must be aware of that are associated with UARS are:
Insomnia
Chronic fatigue syndrome
IBS
Restless leg syndrome
Gastrointestinal Hyper mobility / Hypomobility
Joint hyper mobility syndrome
Mitral valve prolapse syndrome
Fibromyalgia
TMJ syndrome
Sick house syndrome / multiple chemical sensitivity syndrome
Gulf war illness
Tension headaches / migraines
Problems of concentration and memory
Hyper somnolence / sleepiness
Daytime fatigue
Improvement of sleep disordered breathing with a mandibular advancement device improves symptoms . However one must Identify and manage the the initial trauma that activated the limbic system and HPA axis . There will be little success if the patient continues to suffer emotional/ physical stress
Wow Maureen, this is an incredible resource! I just shared it with 3 people! I lived with an older woman who was diagnosed with sleep apnea and had a CPAP machine but also got a mouth appliance which helped her not need the CPAP when she was traveling. But I have never heard of UARS. Thanks so much!
I would recommend Magnesium. I tried Melatonin 10mg and it did jack squad. Magnesium relaxes muscles and is really calming. http://www.vitacost.com/natural-vitality-natural-calm-orange
what others point out–internal inflammation could be source of sleeplessness. I sometimes take aspirin and it does help, because it also thins the blood, it’s good for sleeping.
Did anybody looked into application Sleep Genius? It’s great too!
My husband has a 4-week rotating schedule: 2 wks on day shift, 2 wks on night shift. If he uses the light method to adjust his rhythm would three nights be enough time to switch? Or should he allow for more time in bed the first couple days on shift? Say an additional hour? On night shift he’ll sleep during the day when he’s working but on his days off he’ll sleep at night with a nap in the afternoon.
Hi Megan,
With shift work, I recommend aiming to schedule your life so that you shift less between shift schedules. In other words, wake up and stay up later when the day shift phase, and go to bed as soon as you can when you get off the night shift. This can narrow the degree that you shift from schedule to schedule.
Otherwise, do your best to stay on top of your sleep pressure. Napping is a good idea.
I currently go to sleep amazingly. Don’t recall dreams. But wake up after about 6 hours, wide awake. I need a regular siesta to keep feeling ok! And alcohol makes my sleep time even shorter.
Thinking of checking cortisol levels and perhaps trying Seriphos if needed, in order to delay cortisol production in the early hours of the morning.
I am 36 yrs old. I was involved in heavy physical stress in a fulltime sports team for about 2-3 years some years back.
I also had two surgeries for a broken vertebrae around the same time, and so feel more comfortable sleeping on my stomach on top of a full-length pillow!
Do you turn in the night, and exacerbate discomfort from your back?
Try sleeping with long couch pillows on either side, they might prevent you turning.
A trick I tried, it didn’t seem to change my sleep patterns, but it was fun anyway – it might help you stay still (distract the muscles you use to turn – if you do turn):
Hold a stress ball in each hand when you fall asleep, see if your brain tries to hold them all night – it may occupy the neuromuscular circuit.
And go read my banana smoothie advice above, as I recommend to anyone with sleep problems,
daniel, please help.
for 30 years i have had such severe insomnia, that i was forced to drop out of college, have spent years of being out of work from the other illnesses the insomnia fostered (depression, cancer, fibromyalgia – all gone, save the depression), and i have almost no friendships. i have in these past 30 years, tried everything, and when i say everything, i mean things that you as sleep researcher have likely never even heard of. i’ve addressed it through trauma work, shamanic work, functional medicine doctors, endless labs tests, gut/adrenal/thyroid/pituitary/brain axis, cutting edge brain peptide supplementation, electrical stimulation, buddhist meditation (i am part of a sangha), biofeedback, and of course, the obvious, like western meds, pot and calming supplements and herbs.
in my heart, i beginning to believe i’ve exhausted all avenues, and am contemplating the worst. life has no meaning without sleep. my buddhist practice can only carry so far when i have such a depleted body and mind. can we talk? i’m looking for any possibility. i am a functional medicine nutritionist, so i’m pretty educated. any thoughts you may have, i would be grateful.
I am a psychiatrist. I would suggest trying Seroquel.
You have a real interesting case. I have no doubt you are informed about a lot of things. I spent decades without any sleep so understand how bad that can be. For me, there were internal infections.
I assume physical pain is not a problem.
One of the weaknesses of sleep research is that it doesn’t include the spiritual aspects. since official science ignores it, they will be severely handicapped in explaining sleep. hence their explanations will be incomplete hence never tell the dull story.
Here is a brainstorm idea
You have looked at the physiological and some spiritual aspects which is good.
Have you thought of seeking out some intuitive healing mediums (not psychic or channeler). Mediums are the creme de la creme of psychic ability. I know you have done some shamanic stuff etc. The right medium may have the tools to get to the root of the problem or point you in the right direction. This may yield some spiritual or intutive information that could help. Extraordinary problems call for extraordinary measures.
That’s my suggestion for your difficult predicament.
i have seen intuitives, healers, light workers, past life regression, yes. no help with the sleep. ancestor work, forgiveness, chanting, meditation, positive thinking, cbt, all given a fair shake.
prescription meds, oddly make me profoundly more depressed the next couple days. but thank you for the suggestions.
if your body is not recharging, you will feel drained energy wise no matter how much sleep you appear to get. i remember i would appear to sleep 20 hours a day and still exhausted. it was like a tse tse bug bit me.
let’s see if we can come at this from different angle
what do you feel inside on a mental and physical level when you are trying to sleep.
do you go to bed with any physical pain
does your mind race
do you dream, nightmares etc
do you appear to sleep but just wake up exhausted. how many hours
any things that you can articulate that stand out
sleep has a physiological and spiritual components. it’s got to be one or the other or both.
i know fms can cause insomnia. i wonder if you truly got over it. how did you resolve that.
i assume you tried magtein, gaba, krill oil (with fat)
just trying to get a feel for where your problem may lie.
I don’t have fibromyalgia. I’ve used, and still do countless supplements, and my diet’s been overhauled numerous times to eliminate food allergies etc.
I even pushed myself hard to finish 5 months of P90X; still no improvement in sleep.
I appreciate your thoughtfulness.
So when you go to bed …
Can I assume your free from physical pains or discomfort ?
Can I assume your mind doesn’t race and that your mind is in a relaxed state when you go to sleep ?
Can I assume no anxiety is involved ?
Can I assume you don’t stay awake the entire night ?
I really need to get a feel for what is happening to start to narrow things down.
Have you ever had a sleep study to rule out sleep apnea or upper airway resistance syndrome ?
I weight a 110. I don’t sleep long enough to even snore.
As other pointed out, sleep has psychological aspect. I think friendships, contact with others, being needed by others produce benefits beyond! I’d say you need to volunteer, really push yourself to go out of yourself and make a party for others, etc. Definitely your knowledge of sleeping issues can help others, don’t give up trying to piece it together. Hugs!!!
Hard to have friends, when you’re chronically fatigued. Been to meeting after gathering after circle. Have had a most difficult time creating friendships.
have you heard of fatal familial insomnia? very rare disorder that i thought/think i may have developed or always had, which comes about in middle age. its a disease like that one that make you age very fast, like robin williams in the movie “jack”.
i haven’t slept without pills/alcohol in months, btw.
Saw the below in Wikepedia FFI. It is what I always suspected. That dream sleep is critical to feeling well rested. That is likely the time that our spirit disengages from the body the most. If we chronically wake up very tired, it means that we weren’t able to get enough of this.
I would experiment like crazy with different supplements.
————
FFI
Normal sleep has different stages that together last 90 to 100 minutes:
Non REM Stages 1 and 2: Light sleep NREM-sleep
Non REM Stages 3 and 4: Deep slow wave sleep (SWS)
REM-sleep when dreams occur
FFI patients cannot go past stage 1 and thus their brains are not getting the rest they need to revive, as most reviving and repairing processes of the body are believed to happen during these deeper sleep stages.[10] For example, psychiatrist Ian Oswald observed that during slow wave sleep (SWS) the pituitary gland increases its secretion of growth hormones. This discovery led Oswald to conclude that SWS restores the wear and tear bodily tissues gain throughout the day.[11] Since a patient with FFI would be unable to reach SWS, and therefore the process of restoration during sleep, their body would become more worn each passing day.
Have you tried LSD, Psilocybin or DMT/Ayahuasca? I’ve heard some quite extraordinary changes in people with depression, CFS and the like. Gabor Mate, a psychiatrist with some different take on things, has some ayahuasca-retreats in the states. Maybe you could check it out.
My own experiences with LSD and psilocybin are that they are potential catalysts of brain plasticity, in the realms of emotions, control/execution, perception, creativity etc. This can mean both good and bad things, depending on the setting. As you said, drastic methods for drastic situations. Be careful though, It’s very powerful stuff.
Good luck!
3 sessions Aya, 5 sessions MDMA, 6 psilocybin, all with excellent shamanic backgrounds. Helpful with resolving some past issues, but not with the sleep.
I like Gabor Mate’s work.
Good, and kind suggestions all of you. Thank you. I wish Mr. Pardi would have responded to my request as well. He did to just about everyone else.
I recommend this treatment modality, Heilkunst. http://heilkunst.com/whatis.html It is a systematic approach to curing conditions holistically, through the use of homeopathic remedies to remove the root cause. Very likely there is a inherited predisposition aspect to your insomnia, (as there generally is to all chronic health conditions.) Removing these predispositions (known as miasms) is a part of the treatment.
Hi Asia
Have you ever done an overnight Sleep Study ?
See my post to Ben in this thread on a Sleep disorder UARS which has to be diagnosed with a sleep study with a manual determination of the RERAS. They will also check for Obstructive Sleep Apnea in the study
I’m curious if beds that have a vibrating function help induce the parasympathetic nervous system? Could this help with someone getting to sleep? Has anyone seen studies on this?
Hey y’all. Good to feel some solidarity with all the other folks dealing with sleep issues out there! In addition to the great tips that have been mentioned so far, I wanted to put my ‘two cents’ in for the Sounder Sleep / Rest Assured program that Michael Krugmen created. Chris recommended it on one his sleep blog posts and it’s been helpful for me. It’s more than a ‘sleep tape,’ as the exercises help to retrain the nervous system to shift into the parasympathetic. hope this helps, Oren
Has anyone tried the use of ‘earthing’ (electrically grounding your body) while sleeping? I have no trouble sleeping but I use this technique anyway and seem to get deeper sleep from it. Yogis in India have their students sleep on bare earth, but you can get the same benefit by using a grounded electrical outlet and an appropriate connection device. See earthing.com for info
I forgot to mention… I have heard that the effects of jet lag can be minimized by grounding your body to the earth upon your arrival… a half-hour going barefoot on grass or dirt is sufficient. This allegedly resets your body clock to the local time using your connection to the earth.
Fantastic article – now I just need a way to package your advice into a viral ‘meme’ that can be injected into the heads of basically everyone around me!
Quick question: Cannabis seems to be a potent sleep modulator with few downsides as regards tolerance. All the more fascinating seeing as it acts upon melatonin as well (apparently). Have your studies led you to find anything worth mentioning with regards to cannabis? Thanks!
PS: I lived in Leiden for a few months 3yrs ago (right on the central square). Say hi to it from me 🙂
Hi Raphael, fellow Leidener.
Research seems inconclusive on this subject:
http://www.ncbi.nlm.nih.gov/pubmed/24726015
Any help or suggestions for a 45 yr old woman going through perimenopause and who also has Hashimoto’s sleep more than 5-6 hours a night would be appreciated. Waking at 4-5:30 every day (alarm to go off at 6:30) for the last 6-7 months. Used to sleep through the night no problem. It’s horrible and I’m about to lose my mind. I take progesterone, NDT, T3, and an AD. I’ve started taking melatonin as a last resort as I’ve heard it’s bad for Hashi’s. My room is darkened and cool and I have a white noise machine. I just usually can’t fall back asleep at that time. HELP!
That’s rough, Heather. There is a gaba-active metabolic of progesterone that lesses during menopause causing many women to feel more anxious and have insomnia. Have you tried napping and / or going to bed earlier?
I’ve tried gelatin at bedtime and also honey (a la Seth Roberts). and those seem to help. Except for the hashi’s, we’re twins!
Hi Heather
See my post on UARS which has to be diagnosed with a sleep study with a manual determination of the RERAS
Very informative article, with a great resource for conducting the popular “n=1” research. My issue lies in the apparent inconsistencies of my wake rhythm. My job requires a 4am alarm, and I do my best to be completely ready for bed by 8pm (lights out, pajamas on). Usually I am exhausted by 4pm, and, regardless if I nap or not (sometimes I force myself to stay awake in order to get to bed earlier), I still have trouble falling asleep. Staying asleep? Never been a problem. But I’ve always found my brain takes a while to “turn off”, and I’ve discovered there’s nothing worse in my life right now than desperately wanting to fall asleep and not being able to.
Hi Jessica,
I highly recommend wearing blue-filtering glasses starting three hours before your bed time, getting outside for at least 30 per day, and even using a philips blue light when you wake up so you get a light signal when you need to wake but while it’s still dark outside. You need to counteract your environment and you probably have substantial sleep debt that you need to wear down. I hope you try this sleep experiment I talked about in the article. I think you will find great benefit from it.
Hi Dan,
Great article, thank you.
I have sleep issues that are beyond what you write about here, and beyond what Dement writes as well. Due to years of waking up several times a night, and extremely early for the day, with a child with a sleep disorder, I developed insomnia. I can no longer reliably go to sleep , stay asleep at night, or wake up as late as I need to (I will be exhausted, yet up at 4am unable to return to sleep). I have severe sleep debt, and yet my body is too keyed up to sleep. Have you researched/written about this phenomenon?
Thank you!
I have a sleep protocol that is very effective.
1. Keep your bed sleep temperature at 65 degrees or lower. I highly recommend a product called the ChiliPad which lets you set your bed sleep at whatever temp you like.(your side could be 65 degrees and your partner’s side could be 90 degrees)
2. Extended release melatonin in whatever dose that works for you. I find 6-9 mg works for most people.
3. Find a good 5% progesterone cream(highest dose without a prescription) and use it before going to bed. Rub it on the inner arms.
4. If someone wakes up at 3 or 4 in the morning they also need to train their mind to go blank.This is the only way to fall back to sleep.
5. In tougher cases I have often used a device produced by New Reality. Listening lowers adrenaline and cortisol and boosts serotonin levels. 15 minutes listening to the device in the afternoon is the equivalent to a two hour plus nap.
I have found the above to be effective in 8 out of ten cases of insomnia I see.
I have heard that taking melatonin orally over the long-term develops an undesirable dependence on it and its effective is reduced.
Jim, can you tell me which product at New Reality is the one you recommend? Thanks.
Hi Ann,
You’re welcome and I’m sorry to hear that. Insomnia is more of an anxiety disorder than a primary sleep disorder (at least the most common form of insomnia is). When we can’t sleep, for what ever reasons, it’s completely normal to start worrying about sleep, which worsens the problem. There are two things I’ll mention here. The best technique to help persistent insomnia is cognitive behavioral therapy (CBT) – it works if you do it and it’s much more effective than standard sleep medications long-term. Check out http://www.sleepio.com/
There is, however, a new sleep medication (Belsomra) that I’m optimistic about. It has a completely different mechanism of action than all previous sleep meds, that were essentially chemical cousins of one another. To understand this better, you could say that previous sleep meds tried to increase the sleep pressure side by amping that signal. This new medication works on suppressing the wake drive signal during sleep. Here is a FDA announcement about it: http://goo.gl/DmEC7s
I highly recommend you test your adrenals. The 24hr saliva test is the most accurate to tel the whole story. I have adrenal fatigue, I’m in a adrenal self help group which I often see people comment something similar to you. I’m very lucky, this rarely happen to me. But I do have to sleep for more 9 hrs per day to feel okay.
Hey Dan – thanks for the informative article. It’s a great compliment to what Chris has written about sleep. Quick question: how can I get the “sleeptracker” app you mentioned? I checked out Dansplan.com and the iTunes app store but no luck… Thanks! – Oren
Hi Oren,
We don’t have an app but you can save our site as a bookmark on your smartphone. That’s what I do. You can manually track time to bed and time awake. That gives you info on sleep timing and in-bed duration. I much prefer tracking that information vs sleep variables, but the former are things you can modify with your behaviors. The later, unless you have validated equipment and are trying to diagnose a sleep issue, just isn’t that useful. Sleep changes from night to night so what meaning will you derive if your REM sleep is 15% vs 18% from one night to the next? But, there are devices (eg., Fitbit) that do track sleep and we integrate with those devices so we can pull that data from fitbit and have it automatically populate your sleep score. That’s what I do. We’ll be integrating with about 30 different apps and devices, some of which do sleep, in the very near future.
Thanks for the interesting article. I am curious about what would be recommended for counteracting interrupted sleep. My son has type 1 diabetes, which means I can’t go to bed earlier than 10 pm due to needing to do a blood test 4 hours after dinner. I also get up regularly at 2am to do another blood test (especially if he had a more active day).
Hi Olivia,
I’d use a similar strategy I recommend for parents caring for a young baby: spend more time in bed (if you can). For example, if you need 8 hours of sleep, I’d usually recommend planning to spend 8.5 hrs in bed. In this case, with regular interruptions, plan to spend 9 hrs in bed so you have more opportunity to get the sleep you need. If you can’t manage that, look for a few opportunities to nap during the week if you’re struggling with sleepiness during the day.
Recently I left my job and thus no longer bother with alarms. I go to bed when I’m tired. Usually around 10pm and have been waking up at about 630 am. To my annoyance. I want to sleep in later. I’m slightly tired but cannot fall back to sleep. Before I have always been more of a night owl and could easily sleep much later. I’m confused.
James, are you sleepy during the day or just the first hour after you awaken?
Just the first hour if even that. I wake up refreshed. Never sleepy during the day unless i go to crossfit in the afternoon. Then i feel like taking a nap. I just figured I would sleep later
Given your original description, if you’re not having daytime cognitive / sleepiness issues, I think you’re getting the right amount of sleep for you.
Great detail about sleep! As a fairly new mother, I’m just starting to get back to somewhat of a normal sleep schedule and have more energy these days. I’m curious if there might be a follow-up article on children and their sleep habits since Kresser’s site has a focus on mothers, babies and nutrition. It would be great to hear a perspective that has research to back it up, which is why this site is so satisfying to read!
http://songofourheritage.blogspot.com
I would be curious too about how much sleep is required for children/teens…
I agree! I would love to see some posts on children’s sleep habits and how those habits effect parents’ sleep habits. My daughter’s 3-4 nightly wakings for over 2 years was very, very hard on my health.
Please find a way to train your child’s sleep. She may need better nutrition and sleep producing nighttime rituals. I nursed my kids and had terrible sleep for an entire with the first child. By the time the second child was born I was smarter. I nursed the child (didn’t use a rocker this time because that will cause dependence on rocking motion to fall asleep) and would lay the baby down and pat the back softly a little but not pick her up. Fussing would stop usually pretty quick and the rest is history. Taking a kid out of their sleeping space or going in too quick or not laying them back down causes sleep problems that can persist. My kids are grown with their own now. One daughter very early on trained her kids for good sleep habits and she is loving motherhood, the other loves motherhood but longs for better sleep. The kids that were not sleep trained are older than the set of sleep trained grandkids, and are still harder to put to bed and are in and out like jack in the boxes. Training kids for good sleep habits if they have no problems and are well, should be easier than potty training. Make sure you and your kids get plenty of good nutrition and turn down all your lights at a good time and put yourselves to bed early. Leave the dishes till morning if you have to, you will have more energy to do them after a good night’s sleep, Too much stress and you will not make enough milk. That is what happened with the daughter who got very little sleep. High stress and sleep deprivation reduces all the milk making hormones. Also my daughters had to stop putting the babies on their backs because their heads were warping and the kids screamed and could not sleep. When mine were born everyone was cautioned not to put a baby on its back for fear they would choke on their spit up or vomit. A safe sleeping area has no pillows or blankets (a blanket bunting is best) and the mattress is firm for the little darlings. Hope you get some sleep.
Love,
Granny
Great article. That sleep tracker looks awesome.
There are those of us who require less sleep. I often find I go to bed at 10:30, and will be up before 5 am naturally, and feel great all day. This only happens when I’m great health and not overtraining, mind. When that happens, I can go back to sleep and sleep until almost 7 am, but then I feel tired and groggy all day! I practice smart light habits and eat very well, so my sleep quality must be great. That’s my only explanation for it.
Lots of information on sleep here too:
http://sustainablebalance.ca/sleep/
Thanks!
Graham,
Yes, there is such a thing as a true “short sleeper” – someone who does just fine on fewer hours than the normal range of 7-9hrs. However, what your description of sleeping in a few extra hours and then being sleep all day is called sleep inertia. It’s a strange and annoying phenomenon. When that happens to me, I feel like the entire day is wasted; that I just have to wait till the next day to get back on track. It probably happens to me a few times a year. I wish more was known about why that happens and how to prevent it but it occurs most frequently, but not predictably, under the conditions of sleep in well past your normal wake up time, as you described.
Hello Dan
Which layman’s book on sleep do you recommend?
Have you written your own?
Matt,
The Promise of Sleep by Bill Dement, the grandfather of modern sleep medicine, is informative and entertaining. He’s a great educator and tells a fascinating story of how sleep research began. Enjoy!
Great article!
I’m curious, Dan, if you have any thoughts or there are studies about about non-western, non-modern sleep patterns and this subject. In hotter climates and more traditional societies, napping was a common social response to the heat of the day. What happens with sleep pressure if you nap?
I’d also like some insight on napping. In my case, I try to avoid napping, because I always feel WRETCHED after waking from a nap. It makes me feel groggy and heavy and foggy, sometimes even a dull headache, and the sensation of malaise lingers for the rest of the day.
I always feel better after a nap.
Same here. All those things.
I also feel better if I sleep later hours. Going to sleep 1-2am and waking about 10am. If I sleep earlier hours I feel like there is something missing – less intuitive.
GH, going to bed later and waking up later is fine. Focus on keeping your daily rhythm consistent and getting enough time in bed to get the sleep you need. The timing example I used was just an example.
You are probably sleeping for too long and are interrupting your nap at the wrong phase in your cycle. You need to find the sweet spot that makes you feel rested without feeling groggy. It can be as little as 15-20 minutes.
Hi Karl,
Thank you! Cultures that siesta (nap in the afternoon) don’t have any observable issues indicating that naps are problematic in any way. Napping does wear down sleep pressure. This can be a great thing if you’re running a substantial sleep dept. Short naps improve vigilant performance (reaction time and a host of other cognitive functions) from 6-10 hours, depending on nap length. The downside of naps is that, sometimes, they can make it harder to sleep at night. Unless I’m very tired, my first aim is to go to bed earlier over napping in the afternoon. But, that’s just a personal preference.