by Susan Murray, MD

With an increasing number of work, family, and social obligations, many Americans feel as though they are burning the candle at both ends. Now researchers are finding that a lack of sleep may be doing more to your body than just making you feel tired the next day. If resting in bed were all it took to recharge body and mind for the coming day, insomniacs could take in their favorite late night television and start the next day fresh. But surprisingly, it is not just how much sleep you get that is important - it is the level of sleep you achieve that truly restores your body and mind.

Sleep is divided into two phases:

  • Non-rapid eye movement (NREM) sleep takes up about 75% of the average sleeper's night. The earliest phase of NREM sleep begins with the general relaxation of muscles. This relaxed state culminates in the deepest sleep level when protein synthesis, growth hormones, immune function, and the mind are given a boost. Delta waves—the slowest and largest waves—signal the onset of this most rejuvenating sleep level.
  • Rapid eye movement (REM) sleep takes up about 25% of an average dreamer's night. Dreams that occur during REM sleep might provide a sorting through of free-floating information. REM sleep is thought to be crucial for mental revitalization.

Consequences From Sleeplessness

In addition to productivity and safety consequences, research shows that people who have insomnia or are chronically sleep deprived may have an increased risk of:

  • Depression
  • Headache and migraine
  • High blood pressure
  • Cognitive decline
  • Behavioral problems
  • Alcohol and drug abuse
  • Experiencing a decreased enjoyment in life

The National Sleep Foundation also found that lack of sleep has a negative impact on heart health. "People who don't sleep enough are at higher risk for cardiovascular disease—regardless of age, weight, smoking and exercise habits. One study that examined data from 3,000 adults over the age of 45 found that those who slept fewer than six hours per night were about twice as likely to have a stroke or heart attack as people who slept six to eight hours per night." Researchers believe this is due to disruptions in underlying health conditions and biological processes like glucose metabolism, blood pressure, and inflammation.

Who Is Most Affected?

Late Shift Workers:

Late or overnight healthcare, military and public safety workers, medical residents, and long-haul truck drivers have work schedules that are contrary to the body's natural circadian rhythm. Circadian rhythms dictate that the longest period of sleepiness occurs between 2:00am - 4:00am. Thus, people who work these shifts lose out on the time that the body is programmed for the deepest and most beneficial sleep.

Older Adults:

Older adults also cope difficulties that keep them from getting the sleep they need. For many, aging brings on a host of health-related problems that interrupt sleep, such as side effects from medications, and pain from arthritis or other conditions. Moreover, a more sedentary lifestyle does not allow for the expenditure of energy that results in restful sleep. Lastly, the brain does not allow for the same degree of deep sleep per night as enjoyed in youth. None of this means that older adults do not need as much rest as everyone else. The combination of conditions that change sleep habits only indicates that adjustments need to be made in order to get the proper amount of sleep.


According to one recent study by a Harvard University pediatrician, "children ages 3 to 7 who don't get enough sleep are more likely to have problems with attention, emotional control, and peer relationships in mid-childhood." The study found significant differences in the executive function of these children, including attention, working memory, reasoning, and problem-solving, as well as some behavioral issues.

Tips for Better Sleep

In general, people are so used to going without enough sleep that they don't recognize that their sleeping habits make sound slumber unlikely. Following these simple tips will help you settle down for a good night's rest. Do the following to improve the quality and restfulness of your sleep:

  • Avoid caffeine, nicotine, alcohol, and exercise at least 4 hours before bedtime - Caffeine and nicotine are stimulants. Since alcohol is a depressant, it can make falling asleep easier, but it interferes with deep sleep later on. Exercise also acts as a stimulant, but a workout earlier in the day can improve nighttime rest.
  • Leave worrying outside the bed - If you stay awake worrying about things you have to tackle the next day, write out a list of "to-dos" to take the pressure off. Then put the list aside to deal with the next day. After all, it is not likely you can deal with these problems in the middle of the night.
  • Keep other activities out of the bedroom - Do not confuse your bedroom with your family room. Keep television viewing and Internet surfing out of sleeping quarters. Associate your bedroom with sleep and not activities that will keep your mind engaged.
  • Do not try to force yourself to sleep - You will just lie awake staring at the clock. After 20 minutes of wakefulness, go to another room to read or perform some other quiet activity. Return to your bedroom only when you are tired enough to sleep.
  • Temperature counts - Keep your bedroom set up for a restful night's sleep with a comfortable mattress and proper temperature setting. A room that is too hot or too cold can keep you awake.
  • Reduce noise levels - Apartment dwellers with noisy neighbors or people living on busy streets can block out noise with a fan, white noise machine, or earplugs.
  • Avoid stimulation before sleeping - Try not to engage in anything that will give you a boost of energy just before bed, such as viewing an action-packed movie or sitting in a brightly lit room. Instead, try listening to soothing music or reading.
  • Slow down - Do not hurriedly get ready for bed at the last minute. Try to stick with an early-to-bed, early-to-rise pattern. That way, you will not need an alarm clock to wake you out of a sound sleep.

If you are troubled with chronic difficulties falling asleep—or staying asleep—see a doctor. Sleep disorders are very common and can be treated.


If you have any questions regarding your general health, please reach out to Dr. Murray, or one of our expert providers at Appledore Medical Group. You can book your next appointment online, and learn about our network of skilled practitioners.

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