Sleep
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Understanding sleep
Sleep is an essential part of life. It’s as important to our bodies as eating, drinking and breathing. Sleeping well is crucial for the recharging and repairing of our bodies and minds. It’s important for maintaining physical, mental, and emotional health in adults. In children and young people, sleep is particularly important for physical, mental and emotional development.
Sleep helps to regulate our mood and helps our brains to remember, memorise, and analyse information. Not sleeping well can impact how we feel the next day. Immediate effects of a lack of sleep may include a poorer memory and poorer reaction times. Without enough quality sleep, over a period of time, our brains can struggle to function properly. Research has also shown that recurring changes to sleep patterns can have an impact on long-term health.
Poor sleep can have a harmful impact on mental health. If we don’t get enough sleep, we can lose patience and react to situations more irritably than we normally would. Over time, poor sleep can trigger mania, psychosis, paranoia, and make symptoms you already have worse.
Many factors can affect our ability to get enough sleep, such as everyday stress, demanding schedules, or a sleep disorder. Experts recommend 7-9 hours of sleep per night, with both quality and quantity of sleep remaining important.
Age, health and personal situations affect how much sleep we need, and some people naturally need to sleep more than others. Teenagers, children and babies need more sleep as they’re still growing, but the time each person needs also varies. On average:
- Adults need 7 to 9 hours
- Children need 9 to 13 hours
- Toddlers and babies need 12 to 17 hours
If you’re constantly tired during the day, you may not be getting enough sleep. However, it’s important to speak to your GP to rule out an underlying cause.
What happens when you're asleep?
When you’re asleep, your brain slows down and engages in recovery, which can help improve physical and mental performance the next day and over the long term. If you don’t get enough sleep, the recovery processes aren’t able to happen, and this can affect thinking, concentration, energy levels and mood.
During normal sleep, you go through 4 to 5 sleep cycles, each one consisting of 4 sleep stages. The 4 stages of sleep are broken into 2 groups:
- Rapid Eye Movement (REM) - occurs several times during the night and is where most dreaming happens
- Non-REM - divided into 3 stages, with each stage progressing to deeper sleep
These categories are important because what happens during REM sleep is different to during non-REM sleep. The first 3 stages of sleep are non-REM sleep:
- Stage 1 is short and involves dozing off and starting to sleep
- Stage 2 is when the body and mind slow down as you enter further into your sleep. You can be woken easily in the first 2 stages
- Stage 3 is known as deep sleep. The body is slowing down more and in recovery mode
During REM sleep, brain activity increases and it reaches a level similar to when you're awake. This explains why REM is linked with the most intense dreams. Although breathing and heart rate increase during REM sleep, most muscles are paralysed which means we don’t act out our vivid dreams.
Several physical changes happen while we sleep including
Breathing: Breathing slows down during non-REM sleep, reaching its lowest point in the deep sleep stage 3, while it increases during REM sleep.
Heart rate: Like breathing, heart rate slows in stage 1 and reaches its lowest in stage 3. However, during REM sleep, heart rate can approach the level it is when awake.
Dreaming: Dreaming occurs most during REM sleep but can happen at any stage. Dreams in non-REM and REM sleep show different patterns.
Brain activity: During REM sleep, brain activity increases, making it the stage most linked to dreaming and memory building.
Muscle tone: Muscles relax during non-REM sleep and energy usage drops. In REM sleep, most muscles stay still, but respiratory and eye muscles remain active. The term "rapid eye movement" refers to the darting of eyes while closed.
Sleep and the body’s internal clock, which is called the circadian rhythm, play an important role in the production of several hormones including:
- Melatonin, the sleep hormone
- Growth hormone, which helps support bone and muscle development as well as metabolism
- Cortisol, which is part of the body’s stress response system
- Leptin and ghrelin, which help control appetite
Hormone levels change during different sleep stages, and the quality of sleep may also affect the levels of hormones produced during the day.
Sleep hygiene
Sleep hygiene is the term used to describe healthy habits and behaviours that help you sleep. Your bedroom environment, your habits during the day, and your habits before you go to bed all play a role and can influence the quality of your sleep.
Practising good sleep hygiene can help:
- Improve your mood
- Improve your concentration and memory
- Prevent you from developing sleep disorders like insomnia
- Help you maintain a healthy weight
- Lower your risk of developing serious health conditions like diabetes and heart disease
- Help your body fight off diseases
Poor sleep hygiene may result in you:
- Finding it hard to fall asleep
- Waking up several times during the night
- Feeling tired during the day
Lifestyle changes can help improve your sleep hygiene. There are simple things that you can do during the day and just before going to bed to help create suitable conditions for sleep, which can then help you get a better night’s sleep. These include:
- Creating a schedule for yourself, going to bed and getting up at roughly the same time every day (including weekends) can help regulate your body clock and circadian rhythm. An alarm clock can help with this
- Creating a peaceful bedroom environment, keeping your room at a comfortable temperature, keeping the room as dark as possible and keeping the room as quiet as possible. You can also use earplugs
- Only using your bedroom for sleep, sex and getting dressed, can help you recognise that your bed is a place for sleeping
- Reducing electronic use before bed, including computers, phones and the TV as they can all stimulate your brain, which makes falling asleep difficult
• Avoiding stimulants like caffeine and nicotine after lunch, as they may take up to 6 hours to wear off, which can make falling asleep difficult
• Having a lighter meal for dinner, if you’re too full, your digestive system may keep working instead of resting. On the other hand, if you go to bed hungry, this can also disturb your sleep
• Getting regular natural light exposure, can help you maintain a healthy sleep-wake cycle. Having too much light in the evening can prevent you from feeling sleepy
• Limiting or avoiding taking naps, taking a late afternoon or evening nap can affect the quality of your sleep
Understanding sleep aids
Sleep aids are licensed medicines for short-term use. These include traditional herbal remedies that contain ingredients like valerian or hops, used for temporary sleep disturbances, and pharmacy medicines which are available to buy over the counter from a pharmacy.
Sleep aids may cause drowsiness, so avoid driving after using sleep aids. Speak to a pharmacy team member for advice on symptoms and treatments for temporary sleeping difficulties. If symptoms persist, consult your GP to rule out an underlying cause.
Sleep & children
From an early age, it is important to establish a good sleep routine for children. Quality sleep is essential for everyone especially for children, as it plays a vital role in the development of their mental and physical health. It affects their alertness, attention, vocabulary, learning, and memory.
During deep sleep, blood flow to your child’s muscles increases, tissue growth and repair take place, and important hormones are released to support their growth.
A good night’s sleep can benefit children at school, enabling them to learn more effectively and solve problems. It can also help make them less prone to colds and other minor illnesses.
Sleep problems can have a big impact on the whole family. A good sleep routine should aim to be the same every night. A good routine for children should include:
- Time for your child to relax and wind down, following the day’s activities
- Sleep cues, signals that help your child understand it’s time to go to sleep
There are different sleep recommendations for different age groups:
- 3 years - daytime: 0 to 45 minutes, nighttime: 11 hours to 12 hours
- 4 years - nighttime: 11 hours 30 minutes
- 5 years - nighttime: 11 hours
Lots of children find it difficult to settle down to sleep and may wake up during the night. Every child is different, so it’s important to find unique techniques that work to help your kid sleep better. Here are some tips that might help:
- Decide a suitable time for bedtime
- Set up a ‘winding down’ bedtime routine, involving bath time around 30 minutes before the time that the child usually falls asleep. You can bring this forward by 5-10 minutes each week
- Set a limit on how much time you spend when putting your child to bed. For example, read only 1 story, then say goodnight
- Give them their favourite toy or dummy before settling into bed
- Leave a dim light on if necessary
- If they get up, take them back to bed with as little fuss as possible
- Try to be consistent
- This routine may have to be repeated for several nights
It can take patience and consistency, but most children’s sleep problems can be helped. If your child is still having problems sleeping, you can speak to your GP to rule out an underlying cause.
Sleep made simple
Frequently asked questions
Good sleep hygiene is all about tweaking your habits to set yourself up for healthy sleep every night. Optimising your sleep schedule, pre-bed routine, and daily routine is part of harnessing habits to make sleep feel more automatic. At the same time, creating a pleasant bedroom environment can be an invitation to relax and doze off.
Too much sleep, as well as not enough sleep, can raise the risk of long-term diseases, such as coronary heart disease, diabetes, anxiety and obesity in adults aged 45 and older.
Over time sleep deprivation can affect your mood, judgement, and ability to focus. Chronic lack of sleep may be linked to diabetes, high blood pressure, stroke, obesity, depression, heart, and kidney disease. If you aren’t sleeping enough, this may also make you more tired, which increases the risk of accidents while driving or operating heavy machinery.
