Advice to improve your movement, fitness, and overall health from the world #1 in orthopedics.
The quality of your sleep is just as important, if not more important, than the number of hours of sleep. Getting high-quality, restorative sleep — one of the six pillars of lifestyle medicine — can improve your cognition (thinking abilities), reduce pain, decrease stress and give you more energy, among other benefits. Heidi Prather, DO, who leads the HSS Lifestyle Medicine Program, shares guidance for improving your sleep routine so you'll spend more days feeling awake, refreshed and energetic.
The general recommendation is seven or eight hours. There's a mantra in our society that it is stoic to go without sleep and push through to get things done. However, this can really take a toll on your health over the long term.
It is also important to understand how many of the hours you are lying in bed are actually spent going through the four stages of the sleep cycle to attain restorative sleep. Wearable devices can help do this by measuring both the quantity and quality of your sleep. If you're spending nine or 10 hours asleep at night but you're tired the next day, there may be something else going on — such as obstructive sleep apnea, when you actually stop breathing for short spells several times a night.
You'll have the best sleep quality if you experience all four stages of sleep. If you miss even one stage, you won't feel your best the next day. The four sleep stages are:
Musculoskeletal pain can interfere with sleep quality, and not getting good sleep can make pain feel worse. People also report trouble falling asleep, waking up during the night and having difficulty falling back to sleep, waking up too early or feeling tired the next day even though they believed they slept enough hours.
There is ample research reporting the adverse health effects of poor sleep, including:
You can begin by establishing a consistent bedtime routine within 30 to 60 minutes of the time you want to sleep that prepares your body to wind down. I often advise patients to reduce their exposure to sleep-inhibiting stimuli such as:
Your sleep positions can definitely influence how well you sleep. This is especially pertinent for people with arthritis and other musculoskeletal problems. I speak with my patients about what positions make them feel better or worse in bed and how they can achieve better sleep postures. For example, many people with low back pain who sleep on their sides feel better when they place a pillow between their knees.
Some are and some are not. Speak with a doctor to find out what is best for you. Most sleep medications are meant to be taken for a short while, but many people use them long-term. Here are some examples:
Other medications you may be taking can sometimes interfere with good sleep quality. Have a chat with your doctor to see if any of the drugs you take for other conditions may impact your ability to fall asleep or stay asleep or if they make you too sleepy.
The Lifestyle Medicine specialist will begin by asking you questions about what you are experiencing, such as:
You'll also be asked about your daily routines to see if any of them may be getting in the way of a good night's sleep. In addition, your overall health will be assessed to determine if you are at risk for sleep problems. For example, people who are overweight or obese have a greater chance of developing sleep apnea, and losing weight may help resolve sleep apnea.
With more information about your sleep, the specialist will make recommendations about things you can do to create a better sleep routine. If you still have trouble sleeping, you may be referred to a sleep specialist who may perform testing in a sleep lab to gather more information.
Restorative sleep is one of the six pillars of lifestyle medicine, along with good nutrition, physical activity, stress management, avoiding risky substances and social connection. If you are interested in improving your sleep routine, find out how lifestyle medicine may help you. Lifestyle Medicine services at HSS are provided in person and through telehealth. Call 212-774-7653 for more information.