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As a sleep specialist, I regularly meet with clients who either don’t think enough about sleep, or cannot stop thinking about sleep. Either extreme is problematic.
Too little
A normal physiological process, sleep occurs effortlessly under normal conditions. Just like we don’t pay much attention to our digestion when it works properly, we don’t pay much attention to sleep when it’s seamless.
In this healthy state, it is tempting to prioritize waking activities over sleep. Since working from home has become a new norm, increasingly more people are having difficulty delineating work and rest and starting to feel the consequences.
Telecommuting provides an opportunity to accommodate schedule preferences of colleagues and partners across all time zones, creating an external pressure to be available essentially any time of day or night. Internally, one may feel guilty leaving an important email or an urgent project for tomorrow for the sake of "unproductive" sleep. Thus, instead of working from home, we end up perpetually living at work.
The first step towards overcoming this difficulty is to recognize that healthy sleep is necessary for optimal daytime performance. This recognition motivates the negotiation of a workflow that allows for consistent sleep timing and adequate duration at least on the majority of days. And with the improved sleep function come worthy rewards of sharper cognition, greater emotional stability, and better decision-making.
Another waking activity that often trumps sleep is digital media. Be it news, entertainment, or social networking, its draw is certainly strong. But just as certain are the alerting effects of the screen light, interactive images, and emotionally triggering content.
A common illusion is that digital media helps one feel drowsy. But then why is one's mind suddenly flooded by ruminations as soon as the screen is turned off? Essentially, for a similar reason scratching a mosquito bite makes it feel even itchier: after habituating to the stimulation, its sudden absence leaves a noticeable "hole" that demands a filler. To make the matters worse, if digital media is used in bed, the bed itself becomes associated with the mental stimulation and automatically triggers heightened alertness.
A better way to prioritize sleep is to organize a comfortable place (other than the bed) for the use of digital media and to stop its use at least 30-60 minutes before getting into bed. A paper book, screen-free audio, or gentle stretching are examples of calm pre-bed activities that occupy the mind without over-stimulating the brain. Building such a winding-down routine requires forethought, but the investment is paid off by better quality sleep.
Too much
If sleep has been temporarily compromised for any reason, a lot of attention is drawn to it — understandably! When something disrupts any aspect of our normal physiology, e.g., a food allergy, we have to pay attention to determine the culprit and develop a coping strategy.
Unfortunately, when this perfectly sensible approach is applied to sleep, it may turn into a major source of disturbance. As identified by Dr. Colin Espie and his colleagues (2006), heightened attention and intentional effort are not compatible with sleep. Attention and effort demand alertness, whereas sleep comes when control is relinquished and effort is ceased.
One type of disruptive thought that fuels hyper-focusing on a single night is known in cognitive psychology as catastrophizing — preoccupation with disastrous consequences that are perceived as impending and obligatory. Thus, the conviction that without the requisite amount of sleep physical health and mental function will fail leads to a great effort to try and solve the problem immediately.
This effort is by itself alerting, and also drives behaviors that hurt sleep in the long run, e.g., spending a lot of time awake in bed waiting for sleep, or trying to sleep at variable times depending on the immediate sensation of drowsiness. The recommended strategies of building a consistent winding-down routine and keeping a tight bedtime schedule feel too gradual and are quickly dismissed as inadequate.
Sleep-related catastrophizing typically relies on statistical (i.e., probabilistic) evidence for various negative effects of insufficient sleep. However, always thinking of the gravest possible consequence as an unavoidable imperative creates the kind of performance anxiety that by itself causes sleeplessness. For those who aim to let go of this unhelpful way of thinking about sleep, a study published in January 2020 in Sleep, the journal of the Sleep Research Society, provides a valuable insight.
Dr. Jennifer Zitser of the University of California, San Francisco, with an international team of researchers, followed 613 participants separated into 4 groups according to their self-reported sleep time: approximately 5 hours, 6 hours, 7 hours and 8 hours per night.
For 28 years, the sleep time remained stable within each group. At the end of this long follow up, participants showed no differences in cognitive performance on an extensive battery of tests, and no structural differences on the brain MRI. Only about 5% of participants were in the 5-hour sleep group, and all participants were free from major psychiatric, neurological, or sleep disorders, which factors limit the generalizability of the findings.
Nonetheless, those who for 28 years consistently reported sleeping, on average, about 5.4 hours per night performed practically the same as those averaging 7.9 hours per night on a wide range of verbal, visual, memory, and executive function tests. While warning against a rush conclusion that sleep duration is unrelated to cognitive function, the authors point out that their results do not support the current sleep duration guidelines.
This study may come as a welcome relief for people who approach each night thinking they must do something immediately to force sleep — or suffer devastating consequences. But this study is not helpful for people who already think that sleep is for the birds.
Just right
If by now it seems like I’m speaking out of both sides of my mouth, it’s because I am. The saying “different strokes for different folks” in this case means that sleep, on the one hand, needs to be a higher priority for some, and, on the other hand, should not be an object of constant preoccupation for others.
Similar to a physical exercise and a healthy diet, a healthy sleep pattern takes time and effort to establish. A screen-free winding down period and a consistent necessary-yet-sufficient sleep schedule require attention, customization, and daily practice. Making healthy sleep practices part of daily life takes weeks, sometimes months, and relies on long-term motivation. But once turned into self-reinforcing habits, these practices improve function and longevity and help get through various life challenges.
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