8 Common Sleep Questions and Answers (From the Experts)

September 20th, 2021

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Do you have burning questions about sleep that you’ve always wondered about and wanted answered by some of the leading sleep scientists and experts in the field? You’ve come to the right place.  We’ve put together some of the most frequently asked – and curious – questions that you may (or may not yet) have thought about. From when it’s appropriate to take melatonin, to why we dream, all through the mysterious role of genetics in determining sleep patterns and chronotype – our resident sleep expert and scientist Dr. Elie Gottlieb has got you covered! Let’s dive in.

1. There’s so many melatonin options at the store. Should I be taking melatonin?

Answer: Melatonin is a hormone that is secreted in response to darkness by a pea-sized area deep within the brain called the pineal gland. As a result, it’s often referred to as the “hormone of darkness” – and for good reason. For most people, melatonin its naturally released between 2-4 hours before bedtime after the sun has set. This signals to the rest of the body that it’s time to prepare for sleep. Melatonin itself isn’t responsible for initiating sleep, and as such, there are generally only 2 instances where over the counter melatonin supplementation may be recommended by your doctor.

• For the prevention and treatment of jetlag. Jet lag occurs when the body’s internal clock (or circadian rhythm) is misaligned with the day and night cycle of your travel destination. Melatonin may be effective when taken close to the target destinations bedtime (approximately 10PM to midnight) to decrease the effects of jet lag. Studies show that dosages between 0.5mg and 5mg are similarly effective, so there’s no need to splurge on high dosage supplements. Remember, timing is essential – if taken at the wrong time (such as too early in the day), it may cause sleepiness and worsen how you adapt to the local time.
• For those with low amounts of melatonin. For most healthy people, there is no need to take melatonin supplements since the body is more than capable of naturally producing it itself. However, as you grow older, the pineal gland responsible for releasing melatonin may calcify and the body’s ability to release melatonin may become impaired. In fact, it’s one of the first organs in the body to do so. One study found that 62% of patients with an average age of 58 showed pineal gland calcification. If you’re concerned about your levels of melatonin, speak to your doctor so they can determine whether you have a melatonin deficiency and prescribe the best treatment option for you.

 

2. Why do we dream?

Answer: The jury is still out on the exact function or reason why we dream, but some research has pinpointed several potential explanations. First, dreams may be a way for our brain to integrate new experiences from short term memories into more stable, long-term memories. In other words, dreaming may be the brain’s way of de-cluttering itself after a long, active day of acquiring new information. Dreams may also be a way for us to process intense emotional or traumatic events as a way of regulating mood. Another theory is that dreaming functions as a sort of rehearsal space where the brain readies itself for future real-life experiences and events. Finally, some argue that dreaming is nothing more than the result of random electrical impulses that occur during rapid eye movement (REM) sleep – the stage of sleep where dreams are most likely to occur. The truth is, dreams may have several important functions, and scientists are still learning more about the wonderful world of dreams and how they impact overall health and wellness.

3. Is it better to be a morning person or a night owl?

Answer: There’s no “better” or “worse” chronotype (our natural inclination to go to bed and function at peak performance at a certain time). Our chronotype is largely influenced by our genetic makeup. It’s often said that the “early bird catches the worm”, and unfortunately that’s to the detriment of night owls. Unfortunately for night owls, they live in a morning person’s world – engrained at an early age with early morning alarms for 7AM school start times, all the way through to adulthood which includes long morning commutes for a traditional 9 to 5 work-week.

Fortunately, most people have “intermediate” chronotypes. This means they tend to function optimally when they don’t fall asleep too late or wake up too early. If you’re a night owl thinking about blindly waking up at 5 AM in order to be productive, think otherwise. Although the typical 9-5 workday may favor early birds, lean into your natural chronotype and seek flexible work arrangements that help you get the most out of your day. Advocacy groups like B-Society are also on a “chrono-leadership” mission to create equitable opportunities for both early birds and night owls alike.

4. Can I get tested for OSA without going to a sleep lab?

Answer: Let’s first explain what OSA is. Obstructive sleep apnea (OSA) is a breathing-related sleep disorder characterized by pauses or periods of shallow breathing throughout the night. It’s also remarkably underdiagnosed and untreated – up to 90% of those with OSA will never get treated or diagnosed.

In order to be tested and treated for OSA, an at-home sleep apnea test needs to prescribed by your doctor after they have checked your symptoms. Once your doctor has ordered an at-home sleep apnea test, the required measurement tools can be sent through mail – no need to visit a sleep lab. Once received, the at-home sleep apnea test can be easily set-up at home as it usually relies on 3 self-applied devices to help collect data on overnight breathing:

1. Nasal and oral airflow. A thin tube placed near the nose helps monitor your airflow throughout the night.
2. Respiratory efforts. Elastic bands that easily clip onto your chest and abdomen monitor how much effort it’s taking to breathe throughout the night.
3. Oxygenation. A pulse oximeter that attaches to your fingertips measures the levels of oxygen in your blood while asleep.

In short, sleep apnea testing can be completed in the comfort of your own home after a sleep specialist or primary care physician has prescribed you an at-home sleep apnea test.

5. What’s the perfect amount of time for a nap?

Answer: While naps can’t replace a great night’s sleep, they may help you feel refreshed, energized, and alert. Naps are also highly individualized and many factors can influence their benefits (including age and even culture – think Spanish siestas!). But if naps are too long they may cause sleep inertia – that dreaded feeling of grogginess after waking up in the middle of deep or REM sleep. So, in order to limit sleep inertia while still providing some rejuvenation, we recommend a 10 to 20 minute nap, but not any longer! Studies show that 30 minute naps, but not 10 or 20 minute naps, may cause sleep inertia without any added benefits. Also, remember not to nap too close to bedtime as this may throw off your circadian rhythm and your body’s internal sleepiness (known as sleep pressure) that may help you fall and stay asleep.

6. What’s considered a healthy amount of time to fall asleep?

Answer: On average, most healthy people fall asleep between 10 to 20 minutes after turning off the lights to try and fall asleep. These averages may wax and wane over time for a variety of reasons. Some common reasons for experiencing longer than usual sleep onset latencies (the time it takes to fall asleep) include stress and anxiety; naps too close to bedtime; excessive bright lights before bed; caffeine, nicotine or other stimulants too close to bed; or even trying to fall asleep at an unusually early time. On the other hand, if you’re falling asleep within minutes of turning off the lights this may indicate extreme sleepiness as a result of sleep deprivation.

7. Can hitting the snooze button give you extra meaningful sleep?

Answer: Unfortunately, setting multiple alarms and hitting the snooze button multiple times is generally not recommended. When you’re hitting the snooze button multiple times in the morning, you’re increasing the amount of sleep fragmentation throughout the night. You’re also likely interrupting important sleep stages, particularly REM sleep, which is more common during the second half of the night. Instead of hitting the snooze button, set your alarm for as late as you possibly can. For example, if you need to be at work by 9AM, set your alarm for 7AM and wake up exactly when the alarm comes on – even if you’re groggy – rather than setting up multiple alarms at 6:30, 6:45, and 7.

8. Is more sleep always better?

Answer: Sleep, like most behavior, is heavily influenced by genetic and environmental factors. Sleep also drastically changes throughout the lifespan, so it’s important to take a personalized approach to the amount of time you or a loved one spends sleeping. While not sleeping enough is known to have a negative impact on various physiological functions, sleeping too much has also been shown to be associated with a range of problems. Some scientists agree that there may be a “goldilocks zone” for sleep duration – where getting both too little and too much sleep may be pathological. For example, hypersomnia is a sleep disorder that is characterized by excessive daytime sleepiness and/or prolonged nighttime sleep with severe sleep inertia (feelings of grogginess once awake). If you’re constantly oversleeping and still feel tired and unrefreshed, you may have an underlying condition that should be discussed your doctor.

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