Introduction

There’s a lot of myths out there when it comes to sleep and what is normal sleep. For example, many people fall victim to the idea that everybody needs at least eight hours of sleep to feel good and healthy. This is actually not true. Moreover, for people who are shorter sleepers (e.g., those that only need 6 hours of sleep), this belief can lead to insomnia.

I figured this article would be helpful to understand what normal sleep is from a behavioural sleep medicine perspective as someone who provides cognitive behavioural therapy for insomnia. For some of patients, they have found it quite anxiety-relieving knowing what normal sleep looks like.

This is because people with chronic insomnia often have somewhat exaggerated beliefs about what a good sleeper should look like. For example, they think a good sleeper falls asleep as soon as they go to bed, sleep for 8 hours, and wake up refreshed.

Below, we talk about normal sleep looks like based on different sleep parameters.

#1. Average time to fall asleep   

Good sleepers typically take on average between 10 to 30 minutes to fall asleep most nights. We usually move into the insomnia range if the average time to fall asleep is more than 30 minutes a night.

On the other hand, less than 10 minutes to fall asleep is not necessarily a good thing either. For some, this can be an indicator of excessive sleepiness or sleep deprivation, which is associated with increased risk of accidents and health issues. In behavioural sleep medicine, we usually ask the patient to extend the amount of time they spend in bed by 15 minutes if they are falling asleep in less than 10 minutes. This sleep extension is a component of behavioural therapies for insomnia to ensure that the person is getting their sleep needs met.

#2. Average time awake in the middle of the night

Contrary to popular belief, people actually have dozens of awakenings at night. Most of these are amnestic (i.e., you don’t remember them) because arousal levels are very low, and we don’t encode these events into memory. Usually, people will remember waking up once or twice to go to the bathroom or tossing and turning at night. They will usually go back to bed and fall asleep within a few minutes. We usually move into insomnia territory if a person is spending more than 30 minutes in the middle of the night awake.

#3. Normal sleep efficiency

Sleep efficiency is a fancy term used in behavioural sleep medicine that essentially tells us the amount of time spent in bed compared to the amount of time we actually spend sleeping. To give an example, if you are in bed for 10 hours but you only spend 5 of it sleeping, your sleep efficiency is 50%.

Typically, good sleepers fall between 85 to 90% on average for their sleep efficiency. Too high and we are in the sleepiness range; too low and we are moving towards the insomnia range.

When our sleep efficiency is too high, sleep extension can be a great way to meet our sleep needs and bring sleep efficiency back into the normal range. If our sleep efficiency is too low, then sleep restriction therapy can increase our sleep efficiency by reducing time in bed spent awake to increase our drive for sleep.

#4. Variability in bed and rise times

Variability in our bed and rise times refer to the difference between the earliest time we get in/out of bed and the latest time. For example, if you got out of bed on Wednesday at 7:00am and Saturday at 10:00am, then the variability is 3 hours.

Variability in getting in and out of bed matters because it can lead to jetlag symptoms. If we take the previous example of getting out of bed at 7:00am at 10:00am, that 3-hour difference would be the same as travelling from Seattle to New York. Usually, one- or two-hours’ worth of variability is not likely to be much of a problem, but the more variability there is in our bed and rise time on a week-to-week basis, the stronger the jetlag symptoms become.

The best way to minimize jetlag symptoms is to stay consistent with our bed and rise time routine and get some sunlight when you wake up.

#5. Number of hours sleeping

Our sleep needs are entirely individual from person to person. Some may need 8 or 9 hours of sleep per night; others are short sleepers and may only need 6 or 7 hours to function well.

It’s important to recognize that 8 hour average is simply and average and to not strive for 8 hours if our body is not capable of comfortable producing that much sleep. The reason is because it reduces our drive for sleep, which can affect the quality of sleep and lead to more nighttime awakenings. Moreover, because of the increased time in bed spent awake, we may slowly associate our bed with wakefulness, rather than sleep.

#6. Time a person should sleep and wake up

Similar to the number of hours we need each night, when we prefer to wake up and sleep is also unique. Not everyone is an 11:00pm to 7:00am sleeper. Some are night owls and prefer to be more active during the night, whereas others are morning birds.

I have had patients that tend to go to sleep around 9:30pm and wake up around 4:30am complaining about the fact that they are waking up too early. However, if we look at the numbers, this person would be sleeping around 7 hours a night, which is perfectly within the normal range. In this case, there is no insomnia problem; that is just their body’s natural circadian rhythm.

Unfortunately, preferences for bed and wake times can be difficult for people with an evening chronotype (i.e., night owls), because society operates on a 9:00am to 5:00pm schedule for the majority of individuals. There are some therapies that are helpful to tackle Delayed Onset Sleep Disorder, such as combination of light therapy and melatonin.

#7. How someone should feel when they wake up in the morning

Some people believe that good sleepers should wake up in the morning feeling good and refreshed. They also use how they feel in the morning to gauge how their sleep was the last night. However, you can still feel somewhat groggy after getting a decent night’s sleep because of a phenomenon called sleep inertia. Sleep inertia is the initial feelings of grogginess (‘drunkenness’) that you feel when you wake up in the morning. This is because the body is still flushing out the sleepy chemicals in your body from the night before.

Ultimately eliminating sleep inertia altogether is difficult, there are strategies we can employ to lessen the impact of sleep inertia and get going faster. These include: hydrating yourself with water, getting some light activity in (e.g., yoga), light exposure, taking a quick shower, and consuming caffeine. There are also other fatigue management strategies to feel energized during the day that is not sleep-related.

I hope this post was helpful in normalizing the nighttime sleep process a little more for you!

Best wishes,

P

Featured photo credits:

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