Sleep Fundamentals
(15 min read)
Sleep unsurprisingly is fairly critical in not just performance, but our general health, both physical and mental.
Most adults need 7-9 hours of sleep per night. A rare few can survive successfully on less sleep than this over an extended period of time however the rule of thumb for most of the population is to achieve between 7 and 9 hours ideally.
Skip to the bottom for the sleep tips!
Some key areas sleep supports include:
Impacts of a lack of sleep
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Sleep is essential for memory consolidation, problem-solving, and decision-making. During sleep, especially in the deeper stages, the brain processes information from the day, strengthens neural connections, and performs repair and recovery. Sleep enhances learning, memory, and cognitive performance, which are critical for professionals who need to make quick and accurate decisions.
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Quality sleep supports immune function, cardiovascular health, and weight management. Sleep is also important in injury prevention, with studies those who achieve over 7 hours sleep far less likely to become injured within 6 months vs those who sleep less than 7 hours on average. Sleep regulates hormones that control hunger (ghrelin and leptin) and stress (cortisol). Consistent sleep deprivation can lead to a weakened immune system, making you more susceptible to illness, and increase the risk of chronic conditions such as hypertension, diabetes, and obesity. We certainly make poorer food based decisions the more tired we become, more readily reaching for snacks, takeaways and junk food when deprived of sleep. Food planning and preparation is of key importance ahead of a period of disrupted sleep such as night shifts or the start of parenthood.
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Adequate sleep helps regulate mood and reduce stress and anxiety. Sleep impacts the production of neurotransmitters and hormones that regulate mood, such as serotonin and dopamine. Poor sleep can lead to increased irritability, mood swings, and a higher risk of mental health issues like depression and anxiety, which can in turn impact your motivation to exercise and eat well, and furthermore can impact those around you.
The Sleep Cycle
There are a few key stages of sleep.
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Light sleep, where you can be easily awakened. This stage lasts only a few minutes as you transition from wakefulness to sleep.
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Deeper sleep, with a decrease in body temperature and heart rate. This stage accounts for about 50% of the sleep cycle and prepares you for the deeper stages of sleep.
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Slow-wave sleep, the deepest and most restorative part of sleep. It is crucial for physical recovery, growth, and immune function.
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This stage is characterized by rapid eye movement (REM), increased brain activity, and vivid dreams. REM sleep is essential for cognitive functions such as memory consolidation, emotional regulation, and problem-solving. It usually occurs about 90 minutes after falling asleep and gets longer with each sleep cycle.
Common Sleep Challenges
Medics and other front-line professionals often get less than the recommended amount due to work, stress and in some cases, the choices we make. Chronic sleep deprivation leads to cumulative sleep debt, which can impair cognitive and physical performance, reduce reaction times, and increase the likelihood of errors at home and at work.
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Shift Work: Rotating and night shifts disrupt the body's natural circadian rhythm, disrupting our internal that regulates sleep-wake cycles and is influenced by light exposure. Working night shifts forces the body to stay awake when it naturally wants to sleep, leading to difficulty falling and staying asleep during the day.
Long Hours: Extended shifts lead to physical and mental exhaustion, making it difficult to fall and stay asleep for some people. The body needs time to wind down and recover from the day’s activities, but long hours can shorten this necessary period, leaving you too wired to relax when you finally get to bed and extending the time it takes to fall asleep, often leading to frustration and stress when unable to sleep ahead of another upcoming shift.
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Job-Related Stress: I don't need to tell you that your job is stressful, but for the purpose of completeness, I'll touch on it here.
The pressures of critical decision-making, and high-stakes environments contribute to elevated stress levels clearly. Added to this can be other stresses including work environment, colleagues, working conditions, pay stress, and much more.
All this stress can cause hyperarousal, making it difficult to relax and fall asleep. The adrenaline and cortisol released during stressful situations can linger, making it hard to wind down. We can also be replaying the stressful situations of the day in our mind when we get home, making it again hard to fall asleep.Personal Life Balance: Balancing family, social commitments, and self-care with a demanding job can be overwhelming, leading to increased anxiety and reduced sleep quality. This is where I often encourage clients to discover the power of saying No, being more selective in how they spend their time to optimize their own wellbeing where possible.
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3. Environmental Factors
Work Environment: Noise, bright lights, and stimulating activities and stress at work can interfere with the ability to unwind.
Home Environment: Finding a quiet and dark space to sleep during the day can be challenging, especially if living with others or in a noisy area. Light sleepers can find this especially challenging compared to those who can normally fall asleep in minutes.
Strategies for Better Sleep
Hopefully, the above has made clear to you just how critical sleep is for health and performance
So, what should you start doing now, you ask?
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Consistent Sleep Schedule: Maintain a regular sleep routine outside of your shift patterns. When not on nights, trying to maintain a consistent sleep schedule, going to bed and waking up at the same time each day to help regulate your internal clock. This consistency helps stabilize your circadian rhythm, even with varying work hours, and can make it easier to fall back into a regular sleep pattern after night shifts or irregular patterns.
Strategic Napping: Short naps (20-30 minutes) can boost alertness without disrupting nighttime sleep. Napping can help reduce the effects of sleep debt accumulated during night shifts. For longer naps, try to limit them to 90 minutes to complete a full sleep cycle and avoid grogginess. Whilst getting in is most important, if you can, try to nap earlier in the day to ensure you feel sleepy again by the time bed time comes around. I would avoid napping at say 4pm for example, as it may impact your ability to fall asleep in the evening at your ideal time.
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Dark and Quiet Room: Use blackout curtains and earplugs or white noise apps/audio to block out disturbances. A dark, quiet environment signals to your body that it is time to sleep. Consider using a sleep mask if blackout curtains are not an option.
Invest in a Great Mattress: Invest in a great mattress and pillows to enhance comfort. An excellent mattress may have an expensive upfront cost but it will last you multiple years and the per day cost over the years of usage will be low. The difference a good quality mattress can make to your sleep and physical condition on waking is enormous.
Comfortable Bedding: The right bedding can make a significant difference in sleep quality. Choose materials that are breathable and supportive to ensure comfort throughout the night. It comes down to personal preference, but I would optimize for temperature and comfort to ensure optimal sleep.Room Temperature: Keep your bedroom cool, ideally between 15-19°C, as a cooler environment can promote better sleep. Use fans, open windows, air conditioning, or appropriate bedding to maintain a comfortable temperature. On the more expensive end, there are products such as Chilli Sleep which will actively cool your mattress to your optimal sleep temperature which can be particularly game-changing for hot sleepers, particularly in summer.
Body Temperature: If you are particularly warm due to ambient temperature, having a hot meal, or any other reason, consider taking steps to cool your body temperature before getting into bed. This could be drinking iced water, taking a cold shower or bath, or going for a walk outside (if cold) to reduce your body temperature and help you sleep.
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Relaxation Exercises: Practice deep breathing, meditation, or progressive muscle relaxation before bed can work for some people. These techniques can help calm the mind and prepare the body for sleep. Apps like Headspace or Calm offer guided meditations specifically designed for sleep (as well as many others out there, I personally prefer the Balance app). It should be noted that this isn't an instant cure and can take some time to learn/get used to this approach. Meditation and mindfulness take practice.
Physical Activity: Regular exercise reduces stress and improves sleep quality. Even limited physical activity such as short walks can be beneficial for improving your ability to fall asleep and a sense of tiredness.
Journaling: Writing down your thoughts, worries, or a to-do list before bed can help clear your mind and reduce nighttime anxiety. This practice can provide a sense of closure and help you relax. Journaling can help reduce how often you may wake up in the early hours with your mind working at full speed worrying/thinking about an issue from work earlier in the day.
Sexual Activity: Sexual activity can often contribute to better sleep. After an orgasm, the body releases hormones, like oxytocin and prolactin, that can induce pleasant and relaxing feelings. Sex also reduces levels of the hormone cortisol, which is associated with stress. Sex with a partner may enhance this hormonal response and facilitate greater feelings of closeness and intimacy that are conducive to sleep.
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Limiting Caffeine and Alcohol: Reduce intake, especially in the hours leading up to sleep.
Caffeine can stay in your system for several hours, and alcohol can disrupt the sleep cycle, leading to fragmented sleep. Whilst some people may feel like alcohol consumption may make them sleepy, the quality of sleep following consumption of alcohol can be lower than if sober.
Sleep Routine: Establish a bedtime routine to signal to your body that it’s time to wind down. This could include activities such as lowering the lights, reading a book, taking a warm bath, or listening to soothing music. Consistent pre-sleep rituals can help condition your body and mind to transition into sleep mode.
Apps: There are many apps available such as the Balance app which provides everything from soothing sleep stories for adults through to nature soundtracks and white noise. Some people may find these beneficial for falling asleep.
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Large Meals before sleep: Eating a large hot meal right before trying to sleep is liley to lead to some stomach/bowel discomfort and a high body temperature. It may also increase the chance of you needing to visit the bathroom midway through the night. Where possible, avoid a heavy meal shortly before bed and instead allow an hour minimum between eating and getting into bed, and ensure adequate hydration alongside and following your pre-bed meal to optimise sleep comfort. If you cannot avoid eating close to bedtime, aim for a lighter and more easily digestible meal.
Intense Exercise: Avoid taking part in intense exercise right before getting into bed. Going for a run for example and then showering and getting into bed immediately after will likely lead to you taking a significant length of time to fall asleep. It may not be avoidable due to shift patterns, but where possible, avoid intense exercise immediately before sleep.
Avoid Getting Into Bed Long Before You Plan to Fall Asleep: If you don't realistically plan to fall asleep until 11pm, I don't typically recommend getting into bed at 9 or 10pm and watching tv or social media scrolling for 2 hours in bed. You'll heat the bed and yourself up, and potentially provide yourself with too much stimulation. Try to reserve the bed for sleeping and sex, not for eating, tv watching or scrolling.