I tend to sleep badly if I have a stressful day, but otherwise sleep fine. Is this abnormal?
Dr. Lipford: It is completely normal for stress during the day to affect your sleep patterns. Stress can make it more difficult to fall asleep and stay asleep. It is important to develop healthy ways to reduce and alleviate stress to prevent it from having a chronic impact on your sleep. Developing a relaxing bedtime routine and avoiding screens prior to bed can help. Relaxation techniques, a warm bath or shower, or gentle stretching prior to bed can all help alleviate stress so you can get the sleep you need.
Dr. Ramagopal: This is not an unusual problem at all. Stress and poor sleep are closely related. Problems with either one can have adverse effects on the physical and mental health of a person. Poor sleep increases the release of cortisol (a stress hormone) and insulin, which have negative effects like elevated blood pressure and weight gain. If you have had a stressful day, avoid caffeine, alcohol, and eating a heavy meal before bedtime; these can make your sleep worse. Try relaxation techniques like breathing exercises, gentle yoga, and listening to calming music to facilitate sleep. If it becomes a chronic problem, seek medical help.
Dr. Thomas: Stress impacts sleep, but there are strong inter-individual differences, meaning that for the same degree of stress, different people react differently. This “sleep reactivity” is fairly strongly genetic, as identical twins are more similar than non-identical twins. A questionnaire called “FIRST” (Ford Insomnia Response to Stress Test) can assess reactivity. Highly reactive individuals may be at higher risk for insomnia and depression.
I regularly hit the snooze button on my alarm many times. Do I have a sleep disorder?
Dr. Thomas: Maybe, maybe not. Habitual short sleep (less than optimal for the individual) will result in a need to wake up before fully paying off a sleep debt, and the alarm button will suffer. Long sleepers will also likely do so. There probably is not a night owl (people who naturally prefer going to bed late) who has not hit that button many times. This is also likely to happen to people with the long-sleep version of idiopathic hypersomnia, a condition of excessive sleepiness from a not very well understood brain disorder.
Dr. Lipford: Hitting the snooze button on your alarm multiple times can be an indicator that you may not be getting enough sleep or there could be a problem with the quality of your sleep. If you find yourself regularly hitting the snooze button, it might be helpful to evaluate your overall sleep patterns and see if there are simple changes to improve the quality and quantity of your sleep. This could include establishing a regular sleep schedule, avoiding excessive caffeine and alcohol, and avoiding screens prior to bed. If you continue to have difficulty getting up in the morning, it may be helpful to speak to your healthcare provider to rule out an underlying sleep disorder.
Dr. Ramagopal: This could happen due to insufficient sleep, an inconsistent sleep routine, or incurred sleep debt. It could also happen if you are a night owl and your alarm goes off when you are in slow wave sleep or deep sleep, which makes it difficult to wake up. There are ways to counter this problem:
- set several alarms, a few minutes apart
- place your alarm away from the bed, so it is not so easy to hit the snooze button
- use a vibrating alarm clock that delivers a ‘gentle shake’ to help you wake up
If you are getting enough sleep and still find yourself hitting the snooze button a lot, there could be an underlying sleep disorder that needs evaluation.
Is it OK to have pets in bed while sleeping?
Dr. Ramagopal: There are pros and cons to this question. According to Sleep Foundation research, nearly 35% of children share their bed with a pet. Pets provide security at night and service dogs have been shown to decrease posttraumatic stress disorder (PTSD) symptoms. Pets, especially dogs, have been shown to help with anxiety, especially in children with autism. In adults, pets cause cortisol levels to decrease and oxytocin levels to increase, both of which help to induce sleep.
However, there can be some drawbacks to having your pet sleep in your bed. Pets can trigger allergies and other infections that may be present on the fur or elsewhere on their body. Pets change position during sleep and sometimes have noisy breathing and snoring, which could further disrupt sleep.
Pet beds and crates can be used for proximity to ensure that everyone gets a good night’s sleep.
Dr. Lipford: It is a matter of personal preference and what works for you. Some find pets in the bed to be comforting. Others may find the movement and sounds of a pet to disrupt sleep. If you suffer from allergies, having a pet in the bed can also exacerbate symptoms. A quiet and peaceful bedroom environment helps to optimize sleep quality. Ultimately, the decision of whether or not to have a pet in the bedroom should be based on what works well for you and your pets.
I can sleep for a really long time, over 10 hours given the opportunity. Is that abnormal?
Dr. Ramagopal: You may belong to a small segment of the population (about 2%) who are referred to as “long sleepers.” While it is not conclusively shown that long sleep is associated with deleterious health effects, some studies have shown a higher risk of cardiovascular problems in this group. It also puts a person at a greater risk for weight gain. While there is no specific treatment for long sleepers, it is always a good idea to practice good sleep hygiene. If you are concerned about sleeping too much, you should consult a doctor, especially if you have symptoms of daytime sleepiness.
Dr. Lipford: Sleeping over 10 hours occasionally if you are sleep-deprived or ill is not necessarily abnormal. However, consistently needing to sleep over 10 hours nightly could be a sign of an underlying sleep disorder. If this is the case, discuss it with your medical provider.
Dr. Thomas: It may be. Some individuals are capable of long sleep and have no trouble functioning with slightly less, as is the usual demands of life across the working week. These are true long sleepers, but they merge with a condition of idiopathic hypersomnia, where there is daytime fatigue and sleepiness despite any amount of sleep. A visit to a sleep physician is best if sleep is long AND unrefreshing, especially if there is daytime fatigue and difficulty getting up in the morning.
