The New Rules on Sleep

Spoiler: You may not need eight hours a night.

February 05, 2021

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In the 1980s, Margaret Thatcher supposedly declared, “Sleep is for wimps.” Thatcher, a former U.K. Prime Minister, reportedly slept less than five hours per night. In the 1990s, President Clinton was known for sleeping less than six hours, while Martha Stewart claimed to need just four hours. Now it’s 2021, and attitudes towards sleep are very different. The National Sleep Foundation recommends that adults get between seven and nine hours each night, and the Centers for Disease Control and Prevention (CDC) has an entire program dedicated to helping Americans sleep better. Still, many people are confused about how and how much they should be sleeping.

The good news is that you can stop stressing about how much sleep you may or may not get. In fact, doing so is probably counterproductive. Here are the new rules on sleep, according to experts and the evidence.

Sleep is not for wimps.

Thatcher may have seen sleep as a waste of time, but it’s actually key to keeping us sharp and focused. In his new book Exercised, paleoanthropologist and professor of human evolutionary biology Daniel Lieberman explains that while we may not be accomplishing new things while we sleep, our sleeping brains do the crucial task of synthesizing and analyzing the things we’ve already seen and done. He uses the example of staying up late to work. “As the night progresses, my brain becomes increasingly muddled, and eventually I give up and go to bed,” he writes. “But then in the morning, almost miraculously, everything seems to make sense.” You’ve probably had a similar experience. While we sleep, our brains consolidate our memories.

Sleep clears our heads literally as well as figuratively. The brain is an organ that burns energy as fuel in order to function, and some metabolic waste is produced in that process. While we sleep, that waste gets flushed away.

Don’t stress if you don’t get eight hours.

The CDC recommends that adults get at least seven hours of sleep. This recommendation stems from evidence that sleeping less than this is associated with increased risk of heart disease, stroke, hypertension, diabetes and other chronic health issues. However, this is based primarily on epidemiological data, which means that while getting less sleep is associated with these poor health outcomes, there’s not clear proof that it causes them. People who sleep less may do so because they’re stressed, which in itself is known to be a risk factor for all the same diseases as lack of sleep.

Ioannis Koutsourelakis, a physician, sleep researcher and the associate medical director at Goodpath, explains that while seven to eight hours is the recommendation for most adults, “sleep is personal and there are always people who will sleep a little more or a little less. It’s in going to extremes and consistently staying there (for example, always less than 6 hours of sleep time) that we start to consider that unhealthy sleep.”

The truth is, you likely know whether or not you’re getting enough sleep. In his book, Lieberman points to five questions that sleep researchers recommend you ask yourself: Are you satisfied with your sleep? Do you stay awake all day without dozing? Are you asleep between 2 and 4 a.m.? Do you spend less than 30 minutes awake at night [between bouts of sleep]? Do you get between six and eight hours of sleep? If you can answer “usually or always” to these questions, you’re likely sleeping plenty. There’s no reason to worry about the occasional sleepless night.

Short naps are good.

While naps don’t count towards your nighttime sleep hours, they still have benefits. “Naps are a good thing, as long as they last less than 20 minutes for adults,” says Koutsourelakis, who recommends power napping to his patients.

“Power naps are beneficial because they work with the body’s circadian rhythm,” Koutsourelakis says. As a refresher, circadian rhythm is essentially an internal 24-hour clock that tells your body when it’s time to sleep and when it’s time to be awake, driven in part by light and darkness. “There is a point in the day when the circadian rhythm naturally ebbs. At that point, a 10 to 15-minute nap can make you more productive and more alert than trying to fight through the sleepiness without a break.” But, he warns against napping for longer than 20 minutes, as you might fall into a deeper sleep and feel groggy when you wake up.

Sleep hygiene is important.

You may have never heard the term “sleep hygiene,” but you likely understand the concept. According to the CDC, it refers to good habits around sleep, all of which can improve your sleep quality and duration.

First, it’s helpful to have a consistent bedtime, and to wake up around the same time each morning (yes, even on weekends). It’s also important that your bedroom is a sleep-friendly environment, which means keeping it quiet, dark, and cool (between 60 and 67 degrees), and keeping electronics like televisions, computers and phones out of the room. If you can’t bear to part with your phone, at least try to keep it covered and out of arm’s reach.

Certain lifestyle habits can be helpful, as well. Avoiding large meals and alcohol within an hour or two of bedtime can help you rest easier, as can cutting off caffeine in the early afternoon. And, regular physical activity can help you fall and stay asleep.

Having a comfortable mattress is also helpful, but there isn’t one type that’s better for everyone. Although old research suggested that medium-firm mattresses were best for sleep quality, a new review of existing literature finds that there isn’t enough evidence to say that certain mattress types are overall better than others. Instead, it’s probably best to sleep on whatever type of mattress is most comfortable for you.

Sleep aids aren’t a cure-all.

If you have trouble falling asleep, you may rely on sleep aids to help you out. That’s probably fine every once in a while, but experts warn against using them regularly. Most over-the-counter sleep aids are antihistamines, the same class of drugs used to treat allergies. As well as combatting the inflammation caused by allergic reactions, antihistamines can make you feel sleepy. However, the overall benefits of using these drugs for sleep is unclear, and they can often make you feel groggy the next day. Suzanne Bertisch, a physician and assistant professor at Harvard Medical School, explains in Harvard Health that research on these sleep aids is limited, that the evidence suggests a very small benefit for sleep quality at best, and that “there appear to be real risks associated with long-term use.” In cases of severe insomnia, a doctor may prescribe a sedative like Ambien, but these drugs can become addictive if used for more than two weeks.

Melatonin may be a better solution, but it too is only meant to be used for short periods of time. Unlike other sleep aids, melatonin is not a drug. Dimple Ghassi, an internal medicine physician at Albany Medical College, explains that melatonin is a hormone naturally produced by our bodies, primarily in response to darkness. Taking supplemental melatonin can enhance the effect of this hormone by supporting your circadian rhythm and sending signals throughout your body that it’s time to go to sleep. However, it’s important to follow proper guidelines when taking melatonin. You should start with a dose of one milligram or less, and take it at least 30 minutes before going to bed. “If that doesn’t seem to help you fall asleep, try increasing your dose to three to five milligrams,” Ghassi says. Going any higher than that could lead to side effects like daytime sleepiness, hypothermia and impaired physical and mental performance. And, you shouldn’t take melatonin for more than a couple of weeks at a time.

If you feel like you’re getting enough quality sleep, you probably are.

The truth about sleep is that only you can really know whether or not you’re getting enough. If you regularly operate on six-ish hours and feel great, there’s likely no need to worry. But, if you find yourself tired and unfocused during the day, you might try improving your sleep hygiene with a consistent bedtime, a sleep-friendly environment — get your phone off of your bedside table! — short naps during the day and possibly a short-term melatonin regimen (talk to your doctor about this one, first). If you have good habits and still feel like you aren’t getting enough sleep, talk to your primary care provider. They might recommend cognitive behavioral therapy, the first line of recommended treatment for insomnia. Try not to stress about it too much, as this will make it harder to sleep. And remember, the worst thing you can do is try to self-medicate.

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