A sleep behavior expert explores factors that undermine sleep quality and offers practical solutions.

By Mark S. Aloia, PhD 

The field of sleep medicine has made tremendous headway in creating sleep awareness over the past two decades. At Sleep Number, our smart beds engage people in a “dialogue” around their sleep, so I see the high engagement about sleep reaching the general public daily. But despite this increased awareness, most health professionals need concrete ideas on how to improve the sleep of our patients. 

Here, I outline three of the less commonly recognized disruptors of sleep. These factors are either things we, as a society, generally do not know or things we’ve heard but perhaps have not fully understood.

1. Stress as a Disruptor of Sleep

A recent Gallup poll showed that stress levels are higher than they have been in decades. Stress can wreak havoc on sleep. When I say stress, I am referring to the daily baggage we carry with us and not necessarily disorders of mental health like anxiety and depression, although they can increase stress as well. Stress can lead to replaying the same thoughts repeatedly, which can lead to poor sleep. We can distract ourselves before sleep with television, social media, or other means, but this stress can still affect our sleep throughout the night. 

In fact, this Gallup poll also reported greater sleep problems accompanying the increase in stress. There is even a concept called sleep reactivity, which describes someone’s likelihood of experiencing sleep problems in the face of a stressor. 

What is worse is many of us do not recognize our level of stress. We may think we are handling things just fine, or we may recognize that we are stressed but do not see the effects it has on our bodies or our sleep. There are many ways to help us reduce our stress, and recognizing this disruptor can lead to better sleep in some. 

2. Temperature as a Disruptor of Sleep

If you sleep hot, you probably know it. But did you know that even if you do not wake up throwing off your covers because you are sweating, you may still not be sleeping in a cool enough environment? 

Our core body temperature needs to drop to sleep well. The recommended sleeping temperature for our homes is 68-70 degrees. That can feel cold to some, but cool temperatures help us sleep more soundly. This need for biological cooling is countered by a natural tendency to snuggle into our covers as we prepare for sleep. This is not necessarily bad. In fact, there is evidence that warming your hands or feet can pull heat away from your core, thus cooling your core and helping you fall asleep. 

So, what would I recommend? Go ahead and snuggle, but turn your thermostat down to a temperature that might seem uncomfortably cool. Or open your window when it is cool outside. Also, consider getting bedding, or even a bed, that can keep you cool at night. 

As clinicians, we should also start asking about temperature and sleep. The connection is strong, yet we sometimes overlook it. There is growing literature on menopause and sleep that points to this dysregulation of temperature and how it affects sleep quantity and quality. Ask women in the menopausal transition, and you will see that up to 80% of them suffer from vasomotor symptoms that can disrupt sleep.

3. Snoring as a Disruptor of Sleep

Snoring has been associated with many sleep and potential cardiovascular problems. Admittedly, this statement is a bit controversial in sleep medicine. 

At Sleep Number, we have queried over 20,000 smart bed users who agreed to a survey-based research study and found that 40%-65% of them reported snoring behavior. Even more, snoring in otherwise healthy participants was associated with decreased sleep quality as measured by the smart bed. 

One obvious problem in studying snoring is that snoring is highly associated with sleep apnea, and studies often fail to eliminate snorers who have sleep apnea. However, studies that have examined snoring without apnea have shown some susceptibility to associated consequences. 

What we can say with great confidence is that snoring can be a sign of sleep apnea and can disrupt the sleep of bed partners. This alone suggests that snoring deserves further attention and treatment to optimize the sleep of the snorer and the bed partner. With the increase in methods to monitor sleep nightly, we can imagine that monitoring snoring will serve as an impetus for many to seek medical attention. 

With more access to technology, patients can get real-time insights into their overall health, including their sleep patterns and the impact of disruptors like stress, temperature, and snoring. Over time, this type of health monitoring could also help health professionals detect risk for certain sleep or health disorders and ultimately change how we address preventative health. 

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