You have messages.
Subject: "I told you so!!!"
A lone message sat in my inbox last night as I checked my phone before bed. I usually try to avoid email at night, but the subject had me hooked instantly since I'm fairly sure I'm never wrong. I assumed the triple exclamation was meant to send a message of urgency that one or even two exclamation points could not adequately convey.
The email was from an unfamiliar sender. I give out my email frequently, so to see an unknown address is not unusual. I opened the email to find no message, just the familiar underlined blue text of an internet link. I felt like Nicholas Cage in National Treasure!
Clicking on the link, I was immediately confronted with a picture of Dr. Oz smiling and dressed in pajamas (funny, I would have guessed he slept in scrubs) -- behind him, an ominous full moon that would have seemed more at home on a Twilight poster. What does this all mean? I read on:
"Once upon a time, you could sleep like a baby. Now you'd be lucky to get a full eight hours of peaceful, uninterrupted slumber." By Dr. Mehmet Oz
Instantly I knew where this message had come from and what it was about. The message was from an insomnia patient I had seen earlier in the week. He had significant difficulty getting to sleep every night. I was struck by how long it took him to fall asleep when he retired.
"Why do you go to bed at 9:00 p.m. if it takes you an hour to fall asleep?" I asked. "Why not go to bed at 10:00 p.m.?"
"Because I need my eight hours."
Eight hours. This number is spoken like gospel in this country when it comes to sleep. "How much sleep do I need?" Eight hours. "How can I feel like the people in Old Navy ads?" Get eight hours. "Why did that Spanish nun ruin that fresco?" She wasn't sleeping eight hours.
Where did this number come from? Most likely it originated from self-reporting data gathered years ago from young adults who reported sleeping an average of 7.5 hours during the work week and 8.5 during the weekend. As time has passed, this average amount of sleep has somehow morphed into the target we should all strive to achieve. And because everyone likes definitive answers to difficult questions, the answer has stuck. Eight hours. Done. Easy. Simple question, simple answer. What else can I help you with?
Sadly, the answer to that question is far from simple. How much sleep an individual needs is a complicated question to answer because it depends on the individual and many factors including genetic traits. It is no different than asking, "How many calories should I consume?" That depends on a list of factors including age, body size and composition, activity level, medical history, and whether or not the patient is seeking to gain or lose weight. All of these things need to be accounted for before the answer can be given. Imagine the backlash if a sleep doctor proclaimed that we should all be eating 2,000 calories per day. Funny there is no uproar when a cardiovascular surgeon tells the masses that they need to be getting eight hours of sleep.
So how much sleep do you need? At the risk of sounding like Yogi Berra, you need as much sleep as you need. For every person reading this article, the answer is different. The idea that we as a nation are not sleeping as much as we used to is well documented. Medical specialists with a public voice like Dr. Oz should absolutely be encouraging people who are sleepy to sleep more. However, arbitrarily applying "eight hours" to everyone is actually harming people who simply need less sleep, or those who actually need more than eight hours.
So how can you figure out how much sleep you need? Here are some tips to see if your sleep is on the right track, or if a change is needed.
- How long does it take you to fall asleep? We usually consider a normal sleep latency (the time it takes to fall asleep) to be about 15-20 minutes. If you are asleep before your head hits the pillow, you might not be sleeping enough. If it takes you an hour or more to fall asleep, you might be trying to sleep too much.
- Do you awaken during the night? There are many serious sleep conditions that can disrupt sleep, but trying to sleep too much can be equally problematic to sleep continuity. Imaging coming home from work at 5:00 p.m. and immediately attempting to sleep until 7:00 a.m. Most of us cannot sleep for 14 hours straight, so that night would be punctuated by numerous awakenings. Think of it as your brain saying, "Sorry, but I can't stay asleep that long."
- Do you frequently wake up before your alarm? Even if you go back to sleep, it might be your brain's way of telling you that it's gotten what it needs in terms of sleep. Try starting your day when you first wake up instead of continuing to snooze. Patients are often very surprised to find that over time, they actually feel better.
- Finally, and most importantly, how do you feel during the day? Are you sleepy? Try to ignore feelings of fatigue or low body energy and instead focus on how likely are you to fall asleep sitting and reading or working after lunch. If you feel driven to sleep, you might need more sleep. If not, your sleep might be perfect, even if you are only sleeping seven hours.
So with that, I hereby grant anyone reading this article (including the patient who sent me the misguided email) absolute and complete permission to not sleep eight hours every night so long as you feel like your sleep is healthy, and you feel energetic and awake the following day. I furthermore promise never to perform open-heart surgery on a patient. Maybe this will encourage heart surgeons everywhere to back off on the sleep recommendations.
Can't sleep? Find out which home remedies really work:
For more by Dr. Christopher Winter, click here.
For more on sleep, click here.