Over the past several years, it’s been great to see sleep start to get the attention it deserves in our public conversation. For too long, sleep was overlooked for what it is: a fundamental, primary factor in health, well-being and performance. These days, sleep has people paying attention.
Despite all this welcome focus on sleep, misunderstandings still exist. Sleep has always been a source of mystery; misconceptions about sleep are probably almost as old as human sleep itself. One big one? Until not all that long ago, most everyone—including scientists—thought sleep was an inactive state for the body and mind. Now, of course, we know the opposite is true: sleep is packed with essential activity for the health and maintenance of brain and body.
Today, we know a great deal about how sleep works, the benefits and protections it delivers for physical, mental and emotional health, and the problems that occur when we don’t get enough. But we’re far from knowing everything there is to know about sleep. Amazing as it sounds, scientists have yet to determine exactly WHY it is we must sleep in order to survive.
It’s no surprise that sleep myths persist, even in a society that’s more interested in sleep—and has more access to sleep information–than ever before.
Here’s why this matters: false beliefs about sleep can do real harm. One big part of my mission is to correct the sleep misconceptions out there, so all of you can sleep better and manage your sleep more successfully.
So I was really interested when scientists at New York University released the results of their investigation of the most prevalent “sleep myths” that exist today. For their study, NYU researchers scoured sleep literature, general media and the internet to identify potential false beliefs (aka “myths”) about sleep. With contributions from sleep experts, they analyzed and ranked those myths according to degree of falseness and the potential to do harm to public health.
Can you guess what the most common sleep myths are?
#1: It’s possible to function well on 5 hours or less sleep
People really do want this belief about sleep to be true. It’s not.
Despite all the scientific evidence, this myth is remarkably persistent. I get it. There’s so much we all want and need to do every day. Some people think about sleep as something that stands in the way of productivity, even though the opposite is true. We continue to hear a lot of this attitude about sleep from people in high and powerful places—about how much they can do on so little sleep.
For a lot of people, a full night of sleep is regarded as an option, or a luxury. A full night of sleep is neither. And it’s no surprise that this sleep myth ranked as the most significant and dangerous to public health. The impact of insufficient sleep on our lives—our productivity, mental and emotional wellness, physical health, disease risk, safety and mortality—is profound. When we don’t get the sleep we need, we’re more likely to be fatter, sicker, more forgetful and less able to learn, less grateful and loving in relationships, less interested in sex and intimacy. Our risks for many of the major diseases of our time—heart disease, cancer, diabetes, Alzheimer’s—go up.
It doesn’t take much sleep deprivation to interfere with how we feel and our performance. A just-published study found that a sleep deficit of as little as 16 minutes can impact waking performance and stress levels. The study by scientists at the University of South Florida looked at sleep and work performance in a group of 130 healthy adults. A 16-minute reduction in sleep time was all it took to compromise participants’ cognitive performance the next day, making them more distracted, less able to retain information, and less able to execute good judgment. The lack of sleep also elevated their stress levels.
Think about that 16-minute window the next time you’re tempted to think you can get by with 5 hours of sleep in a night. With the exception of a tiny sliver of the population who appear to be genetically predisposed to need less sleep, none of the rest of us can make a habit of 5 hours or less of nightly rest and stay healthy, emotionally balanced, and able to perform at our best.
Myth #2: Loud snoring is normal
Any snoring—however mild or occasional—is evidence of sleep-disordered breathing, which can disrupt sleep and interfere with the quality of our nightly rest. Loud snoring is often a sign of obstructive sleep apnea, a sleep disorder that may be accompanied by serious health risks if left untreated. For this reason, loud snoring is not normal and should never be ignored.
The risks of sleep apnea are serious, and we keep learning more about them. Recent studies show sleep apnea linked to increased risks for high blood pressure, heart disease and stroke, as well as diabetes and obesity. New research shows that untreated, OSA may elevate risk for Alzheimer’s disease. A 2017 study found sleep apnea linked to higher levels of beta amyloid, a brain plaque that contributes to the development of Alzheimer’s. And just last month, a study was released showing sleep apnea linked to the accumulation of tau proteins in the brain. The presence of tau proteins is a key biomarker for Alzheimer’s.
Loud snoring is one important OSA symptom. But there are others. It’s important to familiarize yourself with the range of OSA symptoms, so you can be attuned to their presence in your sleeping and waking life—or in your partner’s. (It’s often bed partners who see—and hear— the symptoms of sleep apnea before sleepers themselves.
Classic sleep apnea symptoms include:
- Snoring that is loud and frequent
- Gasping, choking, snorting sounds during sleep
- Observable episodes of lapses in breathing (by partners)
- Need to urinate often during the night
- Headaches, dry mouth, and sore throat in the morning
- Trouble concentrating during the day
- Excessive daytime sleepiness
Both men and women can experience these classic OSA symptoms. But there are other sleep apnea symptoms that may occur more often in women. Those expanded symptoms include:
- Insomnia symptoms, including trouble falling asleep and difficulty staying asleep
- Restless sleep with frequent awakenings (even if you don’t need to use the bathroom)
- Symptoms of Restless Leg Syndrome, including the uncomfortable tingling in legs when sitting or resting in the evening
- Changes to dreaming
- Heartburn at night
- Feeling irritable during the day
- Feeling regularly overwhelmed
- Feeling anxious or depressed
- A lack of energy, even after a full night of sleep
- A tendency to be accident prone
Any of these symptoms, along with loud snoring, should be brought to the attention of your doctor. Some good news on the sleep apnea front? Once diagnosed, treatment is often highly effective—and new research shows it can be life-saving. New research studying the impact of CPAP (continuous positive airway pressure) therapy found that when used consistently, it can significantly lower mortality risks, even in the presence of other health complications. In a study of people with severe sleep apnea who were also obese, using CPAP significantly lowered their risk of death. The study tracked OSA patients for 11 years, and found that CPAP use over that time period was linked to a 62 percent lower risk of dying. That diminished risk remained present even among people with other health conditions beyond obesity, including diabetes, heart disease, and high blood pressure.
The takeaway? Don’t let this myth prevent you from bringing loud snoring (and other sleep apnea symptoms) to your doctor. That act—and the treatment that it may provide you—could save your life.
Myth #3 Drinking alcohol before bedtime helps with sleep
Despite all the evidence to the contrary, this is one very persistent sleep myth. Alcohol remains probably the most commonly used sleep aid out there. A recent review of more than two dozen studies highlights what scientists and sleep experts have been saying for a long time: alcohol consumed close to bedtime doesn’t help sleep—it disrupts it. Drinking alcohol reduces the quality of sleep, and causes unwelcome, unhealthful changes to sleep architecture, including reducing time spent in the mentally-restorative REM sleep stage. Having a few drinks in the evening can compromise normal breathing during sleep, and may trigger or increase the severity of snoring or sleep apnea. Alcohol interferes with circadian rhythms, which not only control sleep-wake cycles but also a range of physiological processes, including: liver function, gut health, and regulation of emotional mood.
Scientists continue to actively investigate the relationship between alcohol use and sleep. A 2016 study examined nearly 50 years of research that reveals a strong association between alcohol dependence and insomnia, as well as other sleep disorders including sleep apnea. It’s important to note that scientific research has found this relationship between alcohol dependence and sleep to be a bi-directional one, meaning that alcohol dependence is connected to sleep disorders, and sleep disorders are connected to alcohol dependence.
And a 2018 study found that even a single drink significantly interferes with sleep quality. According to this research conducted by Finnish scientists, moderate drinking diminishes sleep quality by 24 percent—and heavier drinking reduces sleep quality by 39 percent.
Why is this myth about alcohol and sleep such a stubborn one? A lot of the confusion has to do with the timing of how alcohol is metabolized in the body, and how that impacts sleep over the course of the night. It’s true that alcohol initially can have sedative effects. (It’s also true that we quickly become desensitized to these sedating effects, which diminishes their impact—until we drink more to compensate.) This early sedating impact means having even a single drink in the evening can lead people to fall asleep more quickly, and initially spend more time in deep, slow wave sleep. Given what we know about how little alcohol it takes to affect our sleep, I think what’s often taken as “falling asleep” is actually “passing out.”
Once alcohol has been metabolized, what’s known as a rebound effect occurs. With this rebound comes stimulation that leads to restless, shallow, and disrupted sleep, particularly in the second half of the night.
To protect your sleep, you don’t have to give up drinking altogether. I strongly recommend not drinking within 3 hours of your bedtime, to minimize the alcohol’s effects on your night of rest.
Michael J. Breus, PhD, DABSM
The Sleep Doctor™