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Hey everybody, it's Marielle.
So I'm going to be real honest, I was tossing and turning a lot last night, I was having trouble falling asleep, and I got into one of those spirals where I'm thinking, why is it taking me so long?
Like, I'm starting to stress out, and then that makes it even harder to fall asleep.
Oh, I'm not getting good sleep, everyone says you have to get good sleep, what am I doing to myself, what's happening to my brain, oh my gosh, I'm worrying, I'm worrying, I'm worrying, all those things are activating the sympathetic nervous system and that's incompatible with sleep.
Get out of my head, man.
That's Dr. Ravi Aisola, a pulmonary critical care doctor at UCLA and a sleep expert.
Now, maybe like me, you're wondering how a bad night of sleep or multiple bad nights of sleep are going to affect you in the long run if this insomnia might be telling you something about your health, or maybe you're just looking for permission to indulge a little bit after a rough night.
I'm afraid we're not going to be able to help you much there.
Fine, you started off not great, but let's still make good choices.
Let's still drink our water.
Let's still eat in a healthy manner.
Let's, you know, maybe move our bodies around a little bit.
Let's make sure we're ready for sleep tonight without putting undue pressure on ourselves.
And that was Dr. Sima Khosla, a sleep medicine physician and the medical director for the North Dakota Center for Sleep.
LifeKit reporter Andy Tagle talked to Dr.
Khosla and Dr. Aisola.
And on this episode of LifeKit, we have a conversation about what to do when you get a bad night's sleep.
We'll talk about best practices for the night of, bad habits to avoid the day after, and why you might not have to be so jealous of those people who fall asleep the minute their head hits the pillow.
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All right, Andy, what is considered a bad night of sleep?
Like, is there a medical definition for this?
Yeah, so obviously it's a really big umbrella, but the general answer is, you know it when you feel it, right?
You know, you wake up, and you don't feel rested, you're cranky, maybe you're even more tired than you went to bed.
If we're talking hard numbers, the guideline for adults is to get between seven to nine hours of sleep a night.
And getting less than that on a regular basis has been linked to poor health outcomes like high blood pressure, heart disease.
That said, everybody's different.
And there's plenty of people out there who can get a little bit less than that, maybe six or six and a half hours, and wake up feeling fresh as a daisy.
Because there's quantity, and then there's also quality of sleep.
But we'll get into that.
Okay, and I imagine there are a lot of reasons that this happens, right?
Like, for me, it often feels linked to stress.
I'm tossing and turning all night.
For a new parent, it might be having a kid waking up constantly.
Absolutely, absolutely.
There's a huge range of reasons for bad sleep, right?
And insomnia looks different for everybody.
So for some people, it's sleep onset insomnia, which is when you have trouble falling asleep, which is my personal flavor of bad sleep.
There's also sleep maintenance insomnia, which is trouble staying asleep.
And then there's a ton of people who suffer from sleep apnea.
That's when breathing stops and starts as you sleep.
And according to Dr.
Ravi Aysola, he's the pulmonary critical care doctor at UCLA, he estimates that around 10 to 20 % of the US population deals with this condition.
And it is a major contributor to hypertension, diabetes, and risk of cardiovascular disease, heart attack, stroke, heart rhythm problems.
And with age, it can worsen cognitive issues.
And then just like you said, there's everything else going on in our lives, right?
So work, bills, babies, stress and anxiety have a lot of people tossing and turning at night, making it hard to go down.
Okay, what actually happens to our bodies when we do get a bad night's sleep?
So Marielle, the first thing you need to know about a bad night of sleep is that it's totally normal.
I talked to a few sleep experts, and this is the point that they really wanted to drive home.
While it can be really anxiety inducing to toss and turn at night, occasional insomnia is extremely common.
And to put it plainly, just kind of an expected part of adult life, right?
We all have stress, and stress affects sleep.
So this is takeaway one.
If you have a bad night's sleep, don't panic.
No one's going to sleep perfectly every single night.
Of course, losing sleep isn't going to feel good, and it might take your body and your sleep patterns some time to bounce back.
Here's Dr. Isola again.
Probably two nights of recovery after one night of bad sleep.
So one thing that we know experimentally is if someone is sleep deprived, the first recovery night they kind of try to recover slow wave sleep.
And the second recovery night, the pattern is they try to recover REM sleep.
And the goal is to get both of those every night?
Yeah, absolutely. So slow wave sleep is that restorative immune boosting sleep.
And REM sleep plays a role in memory consolidation and emotional processing.
Both very important.
So I used to do the morning shift back when I was a reporter at Marketplace, and I would have to wake up at like, I don't know, 3 .45 or four in the morning.
Ouch. It hurt. It physically hurt me.
Even if I was getting to bed at a somewhat reasonable time, I always felt like my chest felt a little weirdly tight.
I felt my stomach would hurt the whole day and my digestion was just off.
And then obviously I was just tired in the traditional sense that we know of it.
So how do people's bodies tend to feel when they've had a bad night of sleep?
Oh, yeah. It feels awful.
You're going to be tired.
You might feel a little slower on the draw.
You're going to have difficulty paying attention.
Ravi mentioned that drowsy driving can be nearly as dangerous as drunk driving.
So you're going to want to take necessary precautions the morning after a bad night.
Dr. C. McCosla is a sleep medicine physician and the medical director for the North Dakota Center for Sleep.
She says sleep deprivation can sometimes lead to bad judgment.
So here's her rule of thumb after a rough night.
If you haven't slept well, maybe don't make those important decisions.
You know, maybe that's something we put a pin in and maybe not sign a mortgage.
Maybe not sign a contract.
You know, maybe not give up a kidney.
My God, I couldn't even figure out what to have for lunch the next day when I did the morning shift.
So, yeah, that's good advice.
Let's talk about what to do when this is happening, right?
It is the middle of the night.
You keep waking up.
What are some ways to get back to sleep?
Yeah, let's get into it.
So, Marielle, have you ever found yourself wide awake in the middle of the night and just been like, I must stay in bed.
I have work tomorrow.
I have stuff to do.
I have to lay my head on this pillow until sleep comes.
Yeah, constantly. Dr.
Isolla says that's a super common calculation for people, but here's what he has to say about that.
More time in bed does not equal more sleep.
What it typically equals is more time in bed awake becoming increasingly frustrated that you're not getting the sleep that you want and starting to calculate and figure out how you're going to function the next day based on however many hours you believe you're going to be able to get.
And then what happens is with time, you develop a very powerful behavioral association with the bed and the bedroom and bedtime with stress.
One of the things I try to kind of highlight is we don't try to sleep.
We allow sleep to occur once we've put the other things away.
Something that Dr. Isolla told me about this that I really liked was she said that sleep is like a cat.
The harder you try to play with a cat, the faster the cat runs away from you.
But if you just ignore it or pretend that it's not there, the more likely the cat is to come to you.
So this all makes sense now because I don't like cats.
All right, okay, so now we know.
Take away two. If you can't sleep in the middle of the night, don't force it.
You can and should try to use good sleep hygiene practices to get yourself back down first.
Make sure your sleep space is comfortable and dark and cool.
Maybe do some guided imagery or go to your sleepy place in your head.
But as soon as you feel yourself start to get irritated that you're not asleep, just get out of bed.
You want to disassociate your bed from those bad feelings.
Okay, and then after that, you get up and scroll on your phone?
Exactly. That's exactly what I want to do.
You want to give yourself as much light as possible, do things that are really exciting and stimulate you.
No, exactly the opposite thing.
So from there, you want to do things in low, dim lighting that can help you relax.
So nothing productive, nothing exciting.
Dr. Aysola suggested reading a dull book, listening to low frequency, monotonous sounds like maybe on a meditation or a calming app.
Taking a warm bath because lowering your body temperature is a way to help signal to your brain to fall asleep.
And if it's stress keeping you up, he also has another great exercise.
For people who tend to kind of perseverate and make lists in their head, you know, which is a lot of people, what I suggest is, you know, instead of just making the list in your head in bed, get out of bed, you know, get a piece of paper and write that down.
Oftentimes I say that things lose their power once they're on the paper.
But also after doing that, you know, flip the paper over and write down a couple things that you're grateful for.
Okay, got it. So on one side of the paper, make a list of the people who I think are mad at me.
And then on the other side, things I'm grateful for.
Yeah, exactly. And I'm sure you can guess, Marielle, why we do that.
It's something we've talked about a lot here at Life Kit.
You know, just practicing gratitude can help you shift your nervous system into rest and digest mode.
It can help you calm down, and then hopefully ease you back into sleepiness.
Okay, love it. So we get through the night, right?
The next morning, what can we do to feel better?
That is a great question.
The good news is that there are a lot of things that we can do, and they're all things we already know how to do.
They might not necessarily be things that you feel like doing after a night of no sleep or poor sleep, but they're easy.
So are you familiar with the phrase that a good night of sleep starts the moment you wake up?
No, actually never heard that.
Me neither. I hadn't heard it until I started reporting for this, but I like it a lot.
So after a rough night, you're probably going to be grumpy.
Dr. Kosela says you want to nip that in the bud as quick as you can.
Go outside. Go get some sun.
Put your feet on the ground.
Take like five minutes to look around.
You want to get as much natural light as possible.
You want to get fresh air.
It's going to help you wake up.
It's going to help your circadian rhythm.
It's going to signal to your body.
It is daytime now. We are being awake.
The other side effect of this is practicing a little awe and wonder has been proven to reduce anxiety and stress and improve your mood.
So a quick way to counteract some of those wrong side of the bed feelings.
Got it. What else can we do?
Another thing you're going to want to do is hydrate.
Not sleeping enough may cause dehydration, which also affects mood and performance.
So you want to get a lot of water at the beginning of your day and then just keep making sure that you're drinking water throughout the day.
Another thing you're going to want to do is get some exercise, a little bit of movement.
Yeah. Another thing that I can never do if I'm super tired.
I remember going to the park on days when I was doing that early morning show so I would get off at like, I don't know, like 1 p .m.
and I'd try to go for a run in the park and I just would end up stopping midway.
Totally. Like I just was like, I gotta go home.
You just want to plop, right?
Yeah. Like plopping is the only movement you're up for after a bad night.
Yeah. Here's what Dr.
Isola had to say about that.
You know, most of the times when you're asleep you probably have not a lot of energy to exercise.
But that, you know, there's a very direct correlation, the kind of harder you exercise, the more slow wave sleep you'll get.
If you can't exercise hard, is just like walking okay?
Yeah. It's still worth it.
And Dr. Cosa said here, any movement counts.
So you know, like a brisk walk and any exercise that would make you feel good.
She was like, you know, dance in your living room.
Do what you can. Even a little bit is going to help you feel better, it's going to help you get good sleep the next day.
Okay, so the other thing I was thinking about is what to eat after you've had a bad night's sleep, because I always wake up after sleeping badly with an upset tummy.
And I wonder, is there anything that can help with that or just in general to help with your energy levels?
So in general, you just want to eat well, you know, avoid the cheeseburger if you can.
Don't go for the donut.
It's really common to crave those foods, but you're not going to feel better.
You're going to feel more sluggish.
So instead, go for foods that are healthy.
So specifically, foods that are high in the amino acid tyrosine can boost cognitive ability.
So those are things like eggs, meat, tofu, whole grains.
And then there's also foods high in omega 3 fatty acids, such as fish, seafood, nuts and seeds that have been shown to help fatigue.
Take away three. A good night's sleep starts the moment you wake up.
That means the best way to counteract the effects of a bad night's rest and set yourself up for good night of sleep in the future is to practice healthy habits starting first thing in the morning.
Difficult, though that may be.
Okay. So the place you'll find me after a bad night's sleep around, I want to say like one or two PM is face down on my couch sleeping for...
What do you got? I'm a little embarrassed to admit this.
Like four hours. Okay.
All right. Okay. Here is what the doctors had to say about napping after a bad night's sleep.
You want to make sure that you're doing it at least six hours before your night's sleep.
You want to make sure that you're doing it with enough time to be able to build up your sleep pressure again before you go to bed for the night.
Early and brief is what you want to remember for a nap.
So early nap in your day, if you go to bed at, say, around 10 PM, you don't want to nap any later than, say, two or three.
And when I say briefly, you don't want to nap for any more than an hour.
So between 10 minutes to an hour.
So four hours, definitely too long.
So set an alarm, I guess.
So set an alarm. Okay.
And then what about caffeine?
Can you just drink a whole bunch of coffee?
Good question. I can't believe we've gone this long in a sleep episode not talking about caffeine.
I know. Okay. So over -caffeinating is a big no -no.
This one's probably the hardest one for me.
When my kid has been up all night, Marielle, I would take an IV drip of caffeine if you had one, if you offered it to me.
And this one can also be a little bit tricky.
I learned in our Life Kid episode on caffeine that everyone has different sensitivities to caffeine.
So your personal limit, your hard stop on coffee might be different than mine.
But you want to be really careful about this.
Here's Dr. Khosla talking about things she's observed in her sleep lab.
Even though you may be somebody who firmly believes that caffeine doesn't affect you, we do see changes in the sleep lab.
We do see more of these, they're called arousal, where it's a shift in your brainwaves where it looks like you're trying to wake up, right?
We see more legs moving around.
So objectively we do see stuff, and of course not everybody, right?
But some people are more sensitive to caffeine.
Some people may not recognize that the caffeine is disrupting their sleep because they have so much of this sleep pressure that has built up and sort of overwhelms that caffeine.
The answer is yes, it is okay to have caffeine after a rough night's sleep.
And you're probably going to need it, right?
But you want to be careful of the fact that caffeine has a half -life, that caffeine has a quarter -life.
So Dr. Khosla, Dr. Asola, their advice was to stop yourself about midday, whatever your midday looks like, and to be really conscious of that.
Really, you don't want to overdo it, especially because you don't want to have two bad nights sleep, three bad nights sleep.
That compounding effect was going to take a toll.
Take away four. After a night of bad or no sleep, you're probably going to crave caffeine and a nap.
It's okay to go for both, just don't overdo them.
What else can we do to set ourselves up for a good night's sleep the night after?
So another thing that you want to avoid is sleeping in.
It's super tempting, especially if the night of bad sleep you had was a Friday and you're going into the weekend and you have a night off of work.
You want to avoid this because it's basically giving yourself jet lag is what Dr.
Asola said. If you've done any big traveling, if you've done any big trips lately, you know what that jet lag feels like.
You're throwing off your circadian rhythm and that's going to make it that much harder for you to recover.
Those digestion problems that you feel, that crankiness, that slow response time, all of that is going to be thrown off if you let yourself sleep in.
Instead, utilize that good nap that we were talking about early in brief and then just get back to it the next night.
Another thing you're going to want to do is avoid booze.
While alcohol might help get you down, it's known to suppress REM sleep and also some people only have sleep apnea while they drink.
So avoid alcohol and you also don't want to overeat or drink too much liquid, too close to bedtime.
Overeating can cause nocturnal reflex and other digestion problems.
Drinking too close to bedtime can get you up because you're going to have to go to the bathroom.
Take away five, to avoid a bad sleep domino effect, you're going to want to avoid a few things.
Sleeping in. I know.
That one hurts. On this note, Dr.
Asola says one drink might be okay, but you certainly don't want to drink heavily.
And lastly, eating or drinking too much before bed.
So far we've been talking about people who had one bad night's sleep.
How many times does this need to happen until it starts to affect your health overall?
So the longer you go without quality sleep, the worse off you're going to be, plain and simple.
Everything from your immune system to your balance and coordination, your appearance, your appetite, your stress level, can get thrown off.
Of course, everybody is different, and this isn't to say everyone's health will be drastically unalterably changed after, say, a week of bad sleep, but it's hard to find a bodily system that isn't affected by sleep deprivation.
It's going to take a toll.
This is a really hard thing because it's not a matter of choice for everybody.
You know, shift workers, new parents, I was one of them.
Sometimes bad sleep is simply unavoidable, and that can be really, really difficult because we know there are some serious health implications for people who get chronic, bad, or broken sleep.
So if you're in a situation like that, the doctor said that when you can rest, as often as you can rest, go back to your basic sleep hygiene habits.
So make sure that your sleep space is as optimal as possible.
You know, if you have a lot of noise or light pollution, consider a sound machine.
Make sure that your sleep space is cool and dark.
Maybe that means an eye mask or earplugs.
If you work the night shift, maybe that means blackout curtains so the daylight doesn't disturb your sleep.
And finally, both our sleep experts mention the idea of sleep divorce.
This is kind of a negative -sounding term, but it just means if you have a partner who disrupts your sleep a lot, maybe because of sleep apnea or different work schedules, or maybe because you have a newborn at home and you're taking turns being up all night, you might choose to sleep in different bedrooms
to improve your individual sleep.
Not necessarily for everyone, but an option you might consider for your sleep health.
Okay, finally, take away six.
Not all bad sleep can be avoided.
In those cases, do as much as you can to get high -quality rest when it's available to you and make your sleep space as optimal as possible.
From there, if you're worried you might have a more serious sleep problem on your hands like chronic insomnia, there is a clinical definition to start from.
Chronic insomnia is defined as three or more nights a week that last for three or more months and can't be fully explained by another health problem.
Dr. Koselett did add a caveat here though, but it's important to recognize that when we talk about insomnia, there has to be some sort of daytime impairment.
Let's say you wake up four times at night, but you go right back to sleep, and you feel fine the next day, you're probably okay.
Because it's normal to wake up at night.
Nobody sleeps through every night forever.
Oh, that's good to know.
Yeah, and you know, just one more note here before anyone goes too far down a rabbit hole worrying that they have a chronic sleep condition, especially because a lot of people, it takes a long time to go down at night.
I found this factoid really comforting.
On average, adults with healthy sleep patterns take 15 to 20 minutes to get to sleep at night, and 30 minutes is also very common.
Very okay. Here's Dr.
Koselett again. If you fall asleep quicker than that, that suggests that maybe you are a little bit sleep deprived.
And so even though we're jealous of the people that fall asleep the second their head hits the pillow, that's not really quote unquote normal.
Wow. I know, take that sleeping beauty.
Now I'm really curious, Andy, well, maybe you don't have this luxury, because you do have a child at home, but like, what do you spend the 30 minutes that you're falling asleep doing?
List making, perseverating, as Dr.
Isola said, what did I not get done, what grocery list making most of the time, to -do list making, what do you spend your 30 minutes doing?
Sometimes I like to run through my greatest mistakes.
Oh, that's fun. That's a fun flavor.
Mm hmm. Embarrassing moments from seventh grade, yeah, definitely.
That one for sure. Sometimes I imagine happy things that haven't happened yet.
Oh, that's nice. Maybe I should try that one on tonight.
I like that. I remember from when we did a dream episode that the dream researcher told us that you can almost plan a dream.
Like if you tell yourself before you go to bed, I want to dream about eating ice cream on a yacht in 80 degree weather with a handsome stranger over and over and over again before sleep.
Like that ups your chances of actually having a dream about that.
Important, what flavor is the ice cream?
Cookies and cream. I approve of this dream.
Okay, I like that a lot.
Alright, it's time for a recap.
Take away one. One bad night of sleep here and there is totally normal, so don't panic.
You might not feel like your brightest, quickest self the next day, but sleep doctors say the worst thing you can do about an occasional bout of insomnia is stress or obsess about it and end up losing even more sleep in the process.
Take away two, if you wake up in the middle of the night and you're having difficulty getting back down, don't force it.
Remember, sleep is a cat, so the minute you feel yourself getting frustrated, just get out of bed.
Do relaxing activities and dim lighting.
Take a warm bath, read a dull book, listen to meditative music, or if you're stressed try getting those stressors out of your head and onto paper.
Take away three, to set yourself up for a good night after a bad night's rest, start by getting lots of natural light and fresh air to jumpstart your internal clock and help you wake up.
Then, hard though it may be, just practice healthy habits, eat nourishing food, drink plenty of water and get some exercise, the more the better.
Take away four, naps and caffeine are both okay after a bad night's sleep, but be smart about it.
Naps should be early and brief, no more than an hour and no more than six hours before your bedtime.
When it comes to caffeine consumption, don't overdo it and stop yourself at midday to avoid multiple nights of bad sleep.
Take away five, no -no's after a bad night of sleep include sleeping in, alcohol and overeating or drinking right before bed.
Finally, take away six, you can't always avoid bad sleep, but whenever possible, practice healthy sleep hygiene habits.
If you're worried about a chronic sleep condition, remember, chronic insomnia is defined as three or more nights a week of bad sleep that lasts for three or more months and can't be fully explained by another health problem.
Also, it's normal to take a little while to get to sleep at night.
So, you know, you might try laying there and planning out your dreams.
For more LifeKit, check out our other episodes.
We have one on common sleep myths and another on how to get into running.
You can find those at npr .org slash LifeKit.
And if you love LifeKit and want even more, don't sleep on our newsletter.
You can subscribe at npr .org slash LifeKit newsletter.
Also, we love hearing from you.
So if you have episode ideas or feedback you want to share, email us at lifekit at npr .org.
This episode of LifeKit was produced by Claire Marie Schneider.
Our visuals editor is Beck Harlan and our digital editor is Malika Garib.
Megan Kane is our supervising editor and Beth Donovan is our executive producer.
Our production team also includes Andy Tagle, Margaret Serino and Sylvie Douglas.
Engineering support comes from Carly Strange and Quacy Lee.
I'm Ariel Seguera. Thanks for listening.
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