As answered by our Autumn 2020 Special Issue Reviewers
Q: How do I know if I’m getting enough sleep?
Dr. Thomas
The average sleep requirement is about 7 hours, but shorter and especially longer is normal. The need to sleep in for more than 1-2 hours on an off day suggests inadequate sleep on other days, as does fatigue relieved by a nap.
Dr. Zak
Sleep needs vary from individual to individual. If you feel you are not able to function well during the day, particularly if you awaken feeling fairly refreshed, but get very sleepy later in the day, try experimenting with increasing time in bed and see if getting more sleep helps. If you awaken unrefreshed and/or having difficulty functioning regardless of total sleep time, then seeing someone to address intrinsic sleep disorders would be important.
Dr. Lipford
Most adults need between 7-9 hours of sleep nightly on a regular schedule to feel their best. If you follow this general guideline and you feel rested in the morning and energized throughout the day, you can rest assured you are obtaining sufficient sleep.
Q: How long should it take me to fall asleep?
Dr. Zak
Generally, 20-30 minutes is considered normal, but for some people, lying awake and resting for longer is not distressing and, thus, would not be considered pathologic.
Dr. DelRosso
As a rule of thumb, less than 30 minutes is considered within the normal range. However, this also depends on your “internal clock.” For example, if you are used to falling asleep by 11pm, you can expect to fall asleep within 30 minutes if going to bed at 10:30pm, but not necessarily at 9pm. It’s important your bedtime matches your natural circadian clock time.
Dr. Thomas
Anything more than 30 minutes unless your own choice (e.g., watching a movie, reading something interesting) is probably undesirable. Common reasons include too much light in the 2-3 hours prior to bedtime, and cognitively engaging or activity with high emotion content just before bedtime. All of us have a certain degree of “sleep reactivity,” or how easily our sleep is disturbed by stress.
Q: How do I know if my insomnia is environmental or something I should see a doctor about?
Dr. Thomas
Some “red flags” include insomnia not caused by an obvious trigger, persistence beyond 2-3 months, very unrefreshing sleep, bothersome daytime fatigue or daytime sleepiness, abrupt startled awakenings at night, daytime irritability which interferes with job/relationships or reduction in usual motivated behaviors and feeling depressed or anxious in the daytime.
Dr. DelRosso
I would not call it insomnia until you have been evaluated by a sleep specialist. There are many contributors to difficulty falling asleep. Easy to target environmental causes include: noise, temperature, light and other disruptors at home (smaller children crying, bed partner moving or snoring, among others).
Dr. Lipford
Many of us experience temporary insomnia in the setting of stressful life events. Environmental factors can trigger insomnia (like a noisy bedroom environment, or a partner/roommate who keeps different hours than you). If environmental factors are not present and your symptoms persist, check in with your healthcare provider. They will review your medical and sleep history and may recommend additional tests.
Q: What are some ways to fall back to sleep if I awaken in the night?
Dr. Lipford
One of the most frustrating aspects of insomnia is the harder you try to fall back asleep, the more your mind resists falling asleep. Trying relaxation methods (such as meditation, deep breathing or guided imagery) help calm the mind and allow drowsiness to build.
Dr. Thomas
A common mistake is spending too much time in bed, in part “trying to catch up” for lost sleep. This extra time will reliably make it harder to fall asleep after a major awakening. Other disruptive things to do are eating, light exposure, physical activity or trying to “get some work done.” Sleep is also naturally NOT continuous, so be tolerant to some brief awakenings. Long durations of wake (30-60 minutes) need to be addressed. If you routinely spend time in bed worrying, leave the bed until you feel sleepy and return when ready to sleep to break an association of being awake, rather than sleep, with the bed.
Dr. Zak
The first thing to do is to try to be patient with yourself. A bad night’s sleep is not optimal, but is also not a disaster. Secondly, use the bathroom. When you return to your bed, begin your usual pre-sleep routine. For some people, it can be listening to relaxation apps or calming music.
Dr. DelRosso
The first thing to do is to try to be patient with yourself. A bad night’s sleep is not optimal, but is also not a disaster. Trying to put in perspective your need to return to sleep can help with relaxation and the ability to fall back asleep. Secondly, you will likely feel that your bladder is full, so do use the bathroom and when you return to your bed, begin your usual pre-sleep routine. For some people, it can include slow deep breathing and muscle relaxation, for others it can be listening to relaxation apps or calming music.
