The Sleep Health Framework (Buysse, 2014) helps us to understand sleep health in a multidimensional way, in which the sleep-wake cycle is broken into six important components that together optimizes our health and functioning.
These sleep components include:
- Sleep Regularity
- Sleep Satisfaction
- Daytime Alertness
- Sleep Timing
- Sleep Efficiency
- Sleep Duration
In this post, I discuss each of these components in turn and provide strategies to optimize these areas to improve your sleep and overall wellbeing.
Sleep regularity means keeping to a consistent rise and wake time. Regularity in our schedule is very important to keeping our circadian rhythm attuned to the clock on the wall. This is helpful for hormone regulation and keeps the signal strong in terms of when we feel alert and when we should feel sleepy (as well as other functions, like hunger). When our internal clock is out of sync, we tend to feel symptoms similar to jetlag.
When we have a strong signal, our body naturally feels sleepy and more alert at appropriate times which helps support proper sleep health and functioning.
To support strong regularity, we should do our best to keep to a consistent bed and rise time using an alarm if needed. Beyond the nighttime, regular routine (such as when we eat and exercise) and getting exposure to light can be helpful to strengthen our circadian clock.
Everyone sleeps, but many people are not happy with the quality of their sleep. The lack of satisfaction in sleep can be a result of a couple reasons.
First, people may not be producing enough deep (slow wave) sleep. Deep sleep is what is needed to produce the consolidated sleep that we find refreshing and it is built through developing our ‘appetite for sleep’. This appetite increases the longer we stay awake and active throughout the day. On the other hand, staying relatively inactive (e.g., sitting on the couch) and spending extra time in the bed awake can affect our drive for deep sleep.
A second explanation for the lack of satisfaction is that some individuals, especially those with insomnia, sometimes have unhelpful beliefs about sleep. They may incorrectly believe that people should fall asleep the moment their head hits the pillow (they shouldn’t), stay asleep the whole night (they won’t), and wake up feeling rested after 8 hours (which is unlikely).
In fact, even good sleepers can take up to 30 minutes on average to fall asleep, wake up a couple times throughout the night, and feel a little groggy when they wake up in the morning. To learn more, here’s a helpful post on common sleep norms.
Sleep timing refers to when we prefer to go to bed at night. Some of us are early birds and others are more evening owls.
Finding out your own ideal sleep window of when we prefer to go to bed and wake up is like finding the right shoe size. It fits well and feels comfortable.
For some people, they may notice that their window is not great fit for their lives and routine. For, example people with Delayed Sleep Phase Disorder might prefer to sleep very late and wake up later in the morning/afternoon. In this case, this might not be a good match for their job or responsibilities. In this case, light therapy can be a helpful strategy to shift our bedtime closer to a more socially normed period.
Daytime functioning and sleepiness
People are often most concerned about how their poor sleep affects their day ahead. They may worry that they won’t be able to focus on important work tasks, lack concentration, or feel excessively sleepy.
Getting consistent and adequate sleep is important to improve our daytime functioning. However, it is not the only answer. There can be many reasons why we are lacking in energy throughout the day: dehydration, inactivity, caffeine rebound, poor diet, hormonal issues, underlying medical conditions, among many more. To support your energy levels, consider areas in your life that may be affecting energy levels and experiment with tackling these issues.
To feel better in the morning, here’s a post on how to reduce sleep inertia.
Sleep efficiency is the proportion of time we spend sleeping compared to how much time we spend in bed. For example, if a person sleeps for a total of 5 hours but spend 10 hours in bed, their sleep efficiency is 50%.
Typically, you should aim for a sleep efficiency between 85 to 90%. If your sleep efficiency is too low, this can affect how consolidated our sleep is (i.e., you might toss and turn in bed) and makes the sleep much less refreshing.
Sleep efficiency can be supported by using our bed only for sleeping (to establish an association between sleep and bed in our brain) and getting out of the bed if we are not sleepy. Over time, this creates a strong signal that our bed is a place for sleeping and our body naturally prepares itself for sleep when you enter the bedroom environment.
When we do not get the hours of sleep our body needs, we feel sleep deprived. This may increase our risk of accidents, be harmful to our health, and lead to excessive sleepiness during the day.
However, the right number of hours differs from person to person – not everyone needs 8 hours of sleep (some need more, some need less). Determining this magic number for you and giving yourself a consistent opportunity to reach this target can be immensely helpful for improving your sleep.