Alan Frischer, MD, MPH
I’ve heard it all – through the years, my patients have expressed a large variety of misconceptions about sleep. Since we spend about one-third of our lives sleeping, let’s discuss some common sleep myths.
The myth I hear most often is that *adults need less sleep as we age*. The thought is that as we age we are less active, and therefore require less sleep. Actually, sleep experts believe that we need the same amount of sleep that we did when we were younger adults. We often do get less sleep with age, but that may be because we develop sleep disorders such as insomnia or sleep apnea, or find ourselves getting up frequently to urinate. Age leads to fragmented sleep, which results in fewer sleep hours during the night, and that (plus retirement!) results in more daytime naps. The net outcome is that we get less REM, or deep restorative, sleep.
Do we really* all need eight hours of sleep?* According to the National Sleep Foundation, adults need somewhere between 7 to 9 hours of sleep each night. The current national average is about seven hours per night. Studies show that fewer than six hours of sleep is associated with a higher mortality rate. Sleep deprivation has been linked to health problems including obesity and high blood pressure, negative mood and behavior, decreased productivity, and safety issues in the home, on the job, and on the road. While many of us will claim that we do fine on fewer hours of sleep, objective measures of alertness reveal that we do not.
Can we just *catch up on sleep over the weekend?* Studies suggest that it takes more than two days to get back to a rested state. While getting extra sleep is helpful, the pattern of going to bed and waking up at different hours (constantly resetting our circadian clock) may also make falling and staying asleep more difficult.
Many people fall asleep while watching TV. The myth is that the *TV can help us to fall asleep. *The fact is that the bright screen, varying volumes, and changing lighting will more likely prevent us from falling asleep, wake us in the middle of the night, and damage the quality of our sleep. Or, the program might actually be interesting, which will keep us awake. If background noise is the goal, use a fan instead, or a white noise generator. A basic rule of sleep hygiene is to train the brain and body to associate the bedroom with sleep alone.
Another common myth is that *nighttime exercise will help achieve better sleep*. It is indeed true that people who exercise regularly sleep better. However, when we exercise too close to bedtime it prompts our system to release adrenaline, increases the heart rate, and raises the core body temperature – which all work against sleep. As a rule, avoid aerobic exercise within at least one or two hours before bedtime. (Light stretching or yoga is OK.) Please *do* add exercise to your lifestyle, but morning time is generally best.
We have all heard that drinking a *warm glass of milk or herbal tea helps us to fall asleep*. Milk contains tryptophan and herbal teas contain relaxing herbs, including Chamomile, Valerian, St. John’s Wort, and Lavender, so this may be true. A light snack to accompany your milk or tea at bedtime may also be helpful, but don’t go to bed hungry or on a full stomach. Beware of bacon, ham and aged cheeses – they may keep us awake due to tyramine, which promotes the release of norepinephrine. Chocolate, unfortunately, contains caffeine and so is not a good snack before bed either. A balanced snack with protein and complex carbohydrates (like cheese and crackers, or a nut butter on whole wheat bread) may be the best bet for sleep.
Many people believe that *drinking alcohol will put them to sleep*. However, as the body metabolizes alcohol, the chemicals break up the quality of sleep. While a drink or more will generally help us to fall asleep more quickly, chronic use can prevent deep and REM sleep, as well as worsen sleep apnea and gastric acid reflux.
Many assume that *snoring is just an annoyance*. Snoring is usually medically harmless, but it can be a symptom of sleep apnea, a potentially life-threatening condition. If it is accompanied by daytime sleepiness, periods of breathing pauses, or gasping, I urge you to participate in a sleep study to be evaluated.
Driving when tired is clearly unsafe. *Turning up the radio, lowering the window, or turning on the air conditioner is not sufficient to stay awake*. Pull off the road to a safe rest area and take a nap. Caffeine can help in the short-term but takes time to kick in. Plan ahead and get a good night’s sleep before any long drive.
Lastly, do you remember being told to *never wake a sleepwalker*? Well, it is true that it can be quite difficult to wake one, since sleepwalking typically occurs during deep sleep. Also, an awakened sleepwalker would be disoriented and probably not aware that they were wandering. However, there's no danger in waking one if you feel you are protecting them from harm. The best thing to do is to take a sleepwalker by the elbow and carefully lead them back to bed, allowing them to remain asleep if possible.