The Five Tools for Optimizing Sleep

By Brian Morris, M.D.


Sleep is something that people sacrifice all too frequently. This is not a good idea as there are significant health benefits to getting enough sleep and significant health problems that stem from insufficient sleep. That’s why getting sufficient quality sleep is essential for health and is one of the habits of The Wellness Code.


For sleep to be truly restorative, most people need seven to eight continuous hours of sleep per night. Remember that these numbers relate to actual sleep time, not just how long you’re in bed. Some people toss and turn or get up and go to the bathroom. Some are woken up frequently throughout the night due to noises, snoring, or body movements such as restless legs. All of these sleep interruptions detract from restorative sleep


In a recent study, men who averaged less than six hours of sleep per night were four times as likely to die over a fourteen year time period. Yes, they were four times as likely to die. In another study, people who slept less than six hours per night had a 48% greater risk of developing or dying from heart disease. These are shockingly disturbing numbers.


Insufficient sleep is also related to weight gain. One of the main reasons for this is that people tend to overeat and overindulge in unhealthy foods when sleep deprived.


In some situations, getting insufficient sleep is unavoidable. If a child is ill, a parent may have to stay up much of the night. If a big project is due the next morning, an all-nighter may be in order. However, sleep deprivation should be avoided whenever possible.


Does everyone really need seven to eight hours of sleep each night? With rare exceptions, the answer is yes. There does appear to be a small group of people who only need about five or six hours of sleep per night. However, this is a very small percentage of people so you’re probably not one of the lucky few who can get by with very little sleep. If you truly are getting sufficient sleep, you should not need an alarm clock to wake you, you should wake feeling refreshed, and you shouldn’t experience daytime sleepiness.


Many of my patients tell me not to worry about their sleep saying, “I already get enough sleep.” However, one recent study showed that people tend to overestimate the amount they sleep by 61 minutes each night. This means that people thought they were getting an hour more sleep each night than they really were.


If you suspect you may have a sleep issue, it can be helpful to perform a home sleep evaluation. There are some fairly accurate machines that can be purchased for home use. If you already own a fitness tracker from FitBit, Withings, Basis, Jawbone, Garmin, or Apple, then you already have an easy way to measure your sleep at home. Of course, these home monitoring devices are not nearly as accurate as an evaluation at a sleep lab at a medical facility, but the fitness tracker technology can provide a good general idea of how things are going. One of the biggest benefits that this offers is being able to track your sleep habits over time. The beauty of this is that you can make one change at a time and see how this change impacts your sleep. For example, let’s say you’re wondering whether your cat is waking you up at night. You can monitor your sleep for a week with the cat in the bedroom and then monitor your sleep for a week with the cat in another room. Having this sort of objective data allows you to carefully assess the impact of each change in lifestyle.


Once you have a good understanding of your current sleep situation, you will know if you are reaching the goal of seven to eight hours of continuous sleep per night. If you’re not reaching this goal, these five practical suggestions can often help.


  1. Within two hours of going to bed, do not consume any foods or beverages. Most people aren’t fully aware of the impact of getting up once or twice each night to go to the bathroom. This is particularly problematic after the age of 50 where an aging bladder can cause such problems. However, even if you don’t get out of bed, the feeling of a full bladder can keep you from achieving deep, restorative sleep. Therefore, it’s important to follow what I call the “two-hour rule” and set a two hour cut-off time prior to bedtime for eating any foods or drinking any beverages. The key is that your bladder should be empty when you go to bed.


  1. Within one hour of bedtime, do not watch TV, use a computer/tablet, or use your smartphone. This is what I call the “one-hour rule.” That means no email, no internet surfing etc. This may sound difficult but it is achievable. This is important because looking at a TV or computer screen stimulates your brain and body and makes it much more difficult to get quality sleep.


  1. Have a regular exercise regimen. Habit 17 explained the importance of regular aerobic exercise. It turns out that regular aerobic exercise is also one of the most important elements of a healthy sleep schedule. It usually works best to exercise in the morning as the stimulation from nighttime exercise can sometimes affect your ability to fall asleep quickly.


  1. Have a consistent stress reduction regimen. Isn’t it interesting how different habits affect each other? Having a daily stress reduction practice (as discussed in habit 20) can help improve sleep in dramatic ways. Examples include short sessions of yoga, meditation, and Pilates. Unlike aerobic exercise (which should ideally be done in the morning), your relaxation practice can be in the morning or evening (or both).


  1. Set a consistent bedtime for yourself. If you don’t have a plan of when you need to get to bed each night, it is easy to get caught up in a project or TV show and realize it’s late at night and you haven’t completed everything you need to do before you go to bed. Do your best to go to bed at the same time each night.


If you’re following these five measures and you’re still having suboptimal sleep (less than 7-8 hours of continuous sleep), speak with your doctor to see if a referral to a sleep lab might be in order. An overnight sleep evaluation in a sleep lab can be a comprehensive, important way to rule out certain medical problems such as sleep apnea and restless leg syndrome.