1. Why is sleep important?

Sleep is a fundamental factor in maintaining health in the physical, emotional, and cognitive dimensions of our lives.
For good reasons, sleep health is presented as a pattern of sleep-wakefulness that promotes physical and mental
well-being (1). Sufficient, high-quality sleep is associated with preventing multiple short and long-term issues.

Some of the many benefits of healthy sleep include the following (2-17):

    • At a physical level, sleep helps regulate hormone levels, repair bones and muscles, and maintain a strong
      immune system. All these functions contribute to weight control, promote sexual appetite, help you feel and look
      younger, aid in faster recovery and healing, fight disease, and allow you to stay more alert. In addition, good sleep
      enhances our ability and motivation to engage in physical activity and improves our performance during physical
      activities. In the long term, good sleep offers a myriad of heart health benefits, such as healthy blood pressure and
      a lower risk for cardiovascular issues.
    • At a cognitive level, it’s during sleep that our brain consolidates memories and goes into dreaming phases,
      enabling stronger memory retention, learning capabilities, and creativity. Also, adequate sleep allows you to be
      more productive, by increasing concentration, focus, and reaction times. In the long term, good sleep is
      associated with a lower risk of cognitive decline, dementia, and Alzheimer’s disease.
    • At an emotional level, good sleep contributes to keeping the amygdala in balance, helping you manage emotions,
      promoting more effective self-control, and leading to better decision making. During REM sleep we process
      difficult memories, helping to cope with pain and stress. Good sleep fosters positive thinking and feelings of
      gratitude and empathy, keeping you happier and fostering human relationships.


    2. Am I getting enough sleep?

    Before addressing if you are getting enough sleep, it is important to identify whether you are experiencing a sleep
    disorder, such as insomnia. If you think it may be the case, please seek medical consultation. You may find more
    resources and information at the American Academy of Sleep Medicine website.

    As stated by the National Sleep Foundation (18), among other organizations (19, 20), and following decades of research,
    adults need somewhere between 7 and 9 hours of sleep per night.

    While that guidance provides a benchmark, the answer of how much sleep each person needs can be more complex.
    How much sleep a person needs will change over the course of their lifespan, with guidelines on sleep quantity
    varying by age group. Additionally, the science-based recommendations are expressed in a range of hours for a
    single age group, implying that individuals of the same age group may need different amounts of sleep. There is also
    an interesting question of WHEN to go to bed, and if the timing of your sleep episode, can affect the amount of your
    sleep. The answer is YES, when you sleep based on your genetically pre-determined sleep schedule called your
    chronotype ( e.g., early bird or night owl).
    Furthermore, sleep performance or quality can be measured by different indicators, such as duration, latency,
    continuity, efficiency (percentage of time sleeping while in bed), and mix of sleep stages (deep versus light sleep
    Assessing your sleep performance against these metrics, adjusted by age group, is a great starting point. You may
    also make use of a sleep diary or any of the available sleep tracking technologies to further track your sleep
    performance. A sleep diary is also a great tool to support a medical consultation, if you feel the need for it. Now, keep
    in mind that simply measuring your sleep against a hard target can create stress, discouraging, even more, a better
    sleep outcome.
    Beyond an objective assessment of your sleep, a complete analysis of your sleep should include your subjective
    evaluation of how you feel during the day and also consider your overall performance as a result of your sleep. This
    step will allow you to discover your individual sleep needs. A subjective evaluation may include asking yourself, to
    what degree do you feel you are getting the benefits of good sleep, as stated in the previous section. Do you feel at
    your best physically, cognitively, and emotionally?

    • Do I feel physically energized?
    • Do I feel cognitively alert & refreshed?
    • Do I feel emotionally balanced or happy?

    As you get familiarized with the sleep quantitative recommendations that apply to you, and ask yourself these or other
    subjective questions about your sleep outcome, you will train yourself to become more conscious of the impact of
    sleep in your life and be able to answer if you are getting enough sleep.

    3. What can I do to improve my sleep?

    Sleep is very personal and complex, as it depends on a large number of factors. Ultimately, an individual will reach
    optimal sleep performance after, first, understanding what enables and what disrupts sleep, and second, once this
    knowledge has been integrated into sleep-promoting habits. Together, they will orchestrate a sleep-favorable routine
    and lifestyle.

    To discuss the most common factors that impact the quality of our sleep, we will group these around three
    dimensions: the physical self, the psychological self, and the environment around us. These dimensions are
    interrelated and must be addressed collectively, but for simplification, let us look at each one separately.

    • The physical self, our body, is configured to follow a circadian rhythm, which refers to the cyclical pattern of many processes in the body and brain that ebb and flow over a typical 24-hour day. Sleep is one such circadian rhythm, with times at which the brain understands it is to be tired and others when it understands it is to be alert. It should be no surprise that the physical self, our body, will respond to our lifestyle choices that will reinforce or disrupt our circadian rhythm. The 2 to 6 hour window before bedtime is critical, where avoiding stimulants (coffee, alcohol, nicotine, or other sources of caffeine such as dark chocolate) and not eating or exercising too much will positively impact your sleep outcome. Consuming excess coffee is a common obstacle to a restful night. Exercising during the day – and ideally under sunlight -, avoiding naps, and sticking to the same sleep schedule every day are impactful ways to promote better sleep.
    • In terms of the psychological dimension, as mentioned, the first step is to become aware of the benefits of a healthy sleep habit, or the risks of neglecting it. Additionally, anxiety, stress, and depression, among other disorders, will prohibit good sleep. Habits that help us steer away from these states will help sleep. Exercise, healthy work schedules, and absence of technology before bed will contribute to calming down and preparing yourself for a restful night.
    • As for the environmental factors enabling better sleep, the basics include a dark and silent room with temperature on the cooler side. These conditions will signal our bodies that it is time to sleep, reinforcing our circadian rhythm and triggering the required hormonal responses. Today we can control all these by using air conditioning, blackout curtains, and noise isolation or white noise devices.

    The bed setup, combination of mattress, pillow, and linens, will help sleep performance as long as it helps reduce
    the chances of experiencing wake events produced by uncomfortable build-ups of pressure points (aka dead arm,
    neck pain), or moments of high temperature. Choosing the right bed setup is a personal decision, as the
    propensity to experience these events will vary significantly among individuals.

    Better sleep will come once all these aspects are understood and collectively incorporated into our lifestyle


    Members of the Sleep Initiative at Global Wellness Institute:
    Allison Howard (co-chair), Founder and CEO, Nollapelli, United States
    Francisco Levine (co-chair), Chief Business Officer, Bryte Labs, United States
    Michael J. Breus, PhD – Clinical Psychologist & Clinical Sleep Specialist, United States
    Dr. Param Dedhia, MD, United States
    Thom Downing, Athletic Trainer, United States
    Tammy Pahel, VP of Spa & Wellness, Carillon Miami Wellness Resort, United States
    Dr. Rebecca Robbins, Instructor, Harvard Medical School, United States
    Brad Tipper, CEO & Brand Founder, Prospect Farms, United States
    JD Velilla, Head of Sleep Experience, Serta Simmons Bedding, United States

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    10. “Cueing newly learned information in sleep improves memory, and here’s how.” (March 8, 2018). Science Daily.
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    12. “IS ADHD really a sleep problem?” (September 4, 2017). Science Daily.
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    14. Yoo, Seung-Schik, (February 2007). “A deficit in the ability to form new human memories without sleep.” Nature, 10: 385-397.
    15. Anderson, Clare and Charlotte R. Platten (March 2011). “Sleep deprivation lowers inhibition and enhances impulsivity to negative stimuli.” Behav Brain Res, 217(2): 463-6.
    16. Ben Simon, Eti et al. (September 2015). “Losing Neutrality: The Neural Basis of Impaired Emotional Control without Sleep.” J Neurosci, 35(38): 13194-13205.
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    19. – How Much Sleep Do You Really Need?
    20. : National Sleep Foundation’s sleep time duration recommendations: methodology and results summary
    21. : Consensus Sleep Diary

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