Sleep: Quality versus Quantity

Dear Anonymous,

Sleep difficulty is both a common and a complex problem. And sleep quality has been extensively studied and they have identified many things that can interfere with sleep quality and several interventions you can undertake to improve your sleep. And it does appear that you can get better sleep quality without necessarily increasing quantity, to a certain degree.

Sleep quality can be broken down into a few dimensions: sleep latency (how long it takes to fall asleep), sleep duration (total time asleep), sleep efficiency (sleep duration as a percentage of total time in bed), sleep disturbance (number of arousals), and daytime dysfunction (daytime sleepiness and impaired cognitive performance).

Sleep can be broken down into stages. Two main stages are non-REM sleep and REM (Rapid Eye Movement) sleep. Non-REM sleep can further be divided into Light Sleep and Deep Sleep. REM sleep is the stage where dreaming occurs. For good quality of sleep, what is important is the depth of sleep or time spent in each stage of sleep. Deep sleep is a time when the body repairs itself and builds up energy for the next day. It is a time where muscles and tissues are repaired and your body's natural immune system does its work. In order to wake up feeling refreshed, you must get adequate deep sleep. During REM sleep, the brain reviews the information taken in during the day, consolidates it and mood related neurotransmitters are produced (http://www.helpguide.org/life/sleeping.htm).

So how do you do that?

1. Keep a regular sleep schedule. People who work different shifts and go to sleep at various times have poorer quality of sleep.

2. Minimize noise to reduce arousals. Fragmented sleep decreases time spent in deep sleep.

3. Avoid working night shifts. It is harder to get quality sleep in the day due to more noise and sunlight.

4. Avoid alcohol and nicotine in the evening. They disrupt sleep. Caffeine also should be avoided.

Some new technology available to help your circadian rhythm run effectively is a dawn simulator. It is a light that slowly increases in intensity, simulating the rise of the sun and it also mimics the setting of the sun. It helps trigger the brain's natural sleep cycles.

There are many other ways to improve your sleep. Consult with your primary care doctor.