Sleep: The Optum Store Guide

Adults ages 18 to 64 should be getting 7 to 9 hours of sleep a night, according to the CDC. People 65 and older should get between 7 and 8. But how many hours you need depends on many factors, including your genes. Scientists have discovered genetic mutations that mean some people can get by on just 6 hours of sleep or less and still function well. But for most people, the sweet spot is 8 hours.

But it’s not just the number of hours you spend snoozing. You need quality sleep, too, and you get that by going through the various stages of REM and non-REM sleep every night. REM stands for rapid eye movement, and that’s the stage in which your dreams are typically the most vivid and prevalent. Non-REM sleep has three separate stages, including light and deep sleep.

Sleep scientists think both non-REM and REM sleep help your memory and focus. Deep sleep helps restore the body and brain by strengthening the immune system and helping the brain flush out toxins.

There’s no magic formula for how much time you need to spend in each stage. But it’s important that you get enough sleep to cycle through all 4 stages, several times a night, so you feel refreshed when you wake up. Otherwise, you may show the classic signs you’re not getting enough sleep — exhaustion, irritability, clumsiness and trouble focusing.

Here is what happens to your body when you sleep 7 to 9 hours a night.

• Your immune system gets stronger. Good sleep helps your body repair cells that play a critical role in the body’s immune response, so you’ll likely get fewer colds. Ample sleep may even help fend off certain cancers: There’s some evidence that having sleep problems may raise the risk of colon cancer and stomach cancer, according to the Sleep Foundation. Plus, when you’re short on sleep, vaccines may not work as well.
   
• Your hand-eye coordination improves. That’s good for playing video games, as well as for driving. Nightly slumber boosts all types of thinking skills, from attention, memory and creativity to faster response times.
   
• You’re less likely to gain weight. Sleep isn’t necessarily going to help you lose weight, but it might keep you from gaining extra pounds. When we snooze, the body regulates the hormones that control hunger and feeling full. On the other hand, sleep deprivation is linked to obesity. One reason: The levels of these hormones get knocked off balance, so you have a greater chance of overeating and eating higher-calorie foods.
   
• You reduce your risk of developing diabetes or heart disease. Your blood pressure drops as you sleep. But if you don’t snooze well, your blood pressure stays elevated over time. That can lead to an increased risk of a heart attack or stroke. It’s also harder to regulate blood sugar (aka glucose) when you don’t get enough z’s. That can lead to diabetes.

Here’s how sleeping for 7 to 9 hours a night can boost your brain power and your mood.

You’re calmer. There’s an area deep in the brain called the amygdala that’s involved in regulating emotions. Getting enough sleep can help your brain process thoughts and feelings in a more positive way. The result: You’re less likely to behave badly when you’re angry or upset.

You may lower your risk of dementia. During the deep sleep stage, your brain flushes out toxins. Scientists think this prevents waste buildup that may be a factor in causing Alzheimer’s. And scientists know that sleeping less than 7 hours a night in your 50s and 60s can raise the risk of developing dementia later.

You may be less prone to mental health issues. People develop depression, anxiety and other mental health disorders for many reasons, including family history and trauma. But poor sleep can make depression and anxiety worse. It can also raise the likelihood that you’ll develop these conditions if you’re already at risk.

There are so many. But these are the ones that sleep doctors think get in the way most often.

Taking tech to bed with you. The blue light from your devices messes with melatonin, the hormone that tells your brain when it’s sleepy. Melatonin naturally rises as your bedtime nears and falls when it’s time to wake up. So if there’s too much light in the room, your body thinks it’s still daytime and suppresses melatonin. Plus, fiddling with your smartphone might tempt you to read a few more emails or scroll through Twitter a little longer. These stimulating activities won’t put you in the mood to snooze.

Your partner, kids or pets. Maybe your partner snores, your preschooler gets nightmares, or your cat jumps on the bed in the wee hours. Sometimes it’s the ones you love the most who mess with your sleep.

Alcohol or other recreational drugs. You might think that a glass of wine or a cannabis-laced gummy will help you feel drowsy. And it may at first. But alcohol and marijuana can both interfere with the deep and REM stages of sleep.

Some prescription medications. Taking medications such as beta-blockers (for heart problems) and even some antidepressants can also interrupt sleep. If so, talk to your doctor about possibly switching medications.

Drinking too much coffee late in the day. Caffeine is a stimulant that takes a while to leave your system. Not surprisingly, it interferes with your ability to fall asleep.

Stress and too many obligations. If you lie in bed worrying about what you have to do tomorrow, it can leave your mind racing. Another sleep wrecker: You have to wake up early to go to work and you’re a night owl, so you don’t get enough z’s.

Having a health or sleep disorder, such as:

• Restless legs syndrome. Uncomfortable sensations in your legs can make it difficult to fall asleep and stay that way.
• Sleep apnea. This disorder causes you to stop breathing briefly and then start up again throughout the night. It deprives your body and brain of oxygen and can set you up for all sorts of complications, including heart disease.
• Asthma. Symptoms can get worse at night, meaning you have trouble breathing and wake up often.
• Reflux. Symptoms such as heartburn or burping up stomach acid can interfere with your sleep.

This is when you have trouble falling or staying asleep at least 3 times a week for 3 months or more. You may be hardwired for insomnia thanks to your genes, according to a 2018 study in Molecular Psychiatry. Or you could have underlying depression or anxiety, which can lead to insomnia.

Another culprit: A life-changing event, such as a death or illness in the family, could cause sleeplessness. To deal with it, you may develop bad habits that you think will help but actually make your insomnia worse. These include having a glass of wine to help you nod off or lying in bed tossing and turning (which can increase your anxiety).

The first-line method for treating chronic insomnia is cognitive behavioral therapy especially geared toward insomnia (known as CBT-I). This treatment, usually supervised by a trained CBT-I provider, helps you break old habits and replace them with snooze-promoting ones.

Another biggie that derails sleep? Not being aware of how crucial sleep is for your health. If you don’t make sleep a priority, you won’t develop good habits that lead to better bedtimes.

Sleep hygiene is the regular habits and rituals you do to send yourself off to dreamland. You should aim to:

• Go to bed and wake up at roughly the same time 7 days a week. This helps set your circadian rhythm, the 24-hour biological clock that carries out essential bodily functions. Having a regular schedule cues your body to become drowsy and wake up without much help. You can get away with dozing an hour or so longer on weekends, but don’t let it go longer than that or you’ll confuse your body’s internal clock.
   
• Have a regular bedtime routine. If you’re a parent, you’re used to the bath-snack-brushing-books cycle before bed. But you can benefit from rituals that help you wind down, too. Those could include gentle yoga stretches and meditation, a bath or bedtime reading. Start them about 20 minutes before you’d like to fall asleep. If you’re reading in bed, don’t do it on your phone. An e-reader that doesn’t emit blue light is fine, though.
   
• Create a sleep cave. Aim to keep your bedroom as dark, cool and quiet as possible. Why? Your body temperature drops as you sleep, so if your room is too hot, it’s harder for you to get into that deep sleep you need. Aim to keep the room between 60° and 67° F. Light can interrupt your body’s release of melatonin, the hormone you need to fall asleep. And even if outside noises don’t wake you up, they can raise stress hormones, making it harder for your body to cycle through the normal stages of sleep. That can raise inflammation, which can harm your overall health, too.
   
• Skip long or late-in-the-day naps. A nap that’s longer than 30 minutes taken after 4 p.m. can prevent you from getting quality sleep. It will also make it harder to stick to your regular bedtime.
   
• Resist checking the clock. If you do wake up during the night, don’t look at the time. Checking your alarm clock or smartphone can make you more stressed and anxious, which can keep you from falling back to sleep.
   
• Get out of bed if you really can’t sleep. Finally, if you’re wide awake in the middle of the night for more than 20 or 30 minutes, don’t just lie there. Go into another room and read, knit or do a crossword puzzle (but not on the phone). Then go back to bed when you’re sleepy.

There are things you can do during the day that make for better nights, including:

• Move your workout to at least 90 minutes before bedtime. A moderate-intensity workout at least 90 minutes before bedtime doesn’t have a negative effect on sleep for most people. Working out can increase your body’s core temperature, which signals to your body that it’s time to be awake. That means it’s best to avoid exercising too close to bedtime. It will also flood your body with post-exercise hormones that stimulate you, not wind you down.
   
• Say no to caffeine in the afternoon. Caffeine stay in your system for hours and also blocks a receptor in the brain called adenosine. Adenosine is what lets our bodies know we’re sleepy.
   
• Skip the late-night booze. Sure, alcohol can make you drowsy. But during the night your liver metabolizes it and the sedative effect wears off. This makes you more likely to wake up throughout the night. Overall, alcohol disrupts sleep by interfering with the normal sleep stages.
   
• Avoid big meals 3 or 4 hours before you sleep. Otherwise, your body will be focused on digesting food instead of snoozing. Plus, if you have acid reflux, it can make heartburn worse and wake you up at night. But don’t go to bed hungry either. Have a filling, heart-healthy meal in the evening (no processed foods, lots of complex carbs and veggies). And skip the late-night snacks.
   
• Set a bedtime routine. Try different strategies for winding down, put your smartphone in a different room, and then aim to get those 8 hours.

High-tech devices that track your sleep are big business. But can they actually help you change your habits? The answer, according to sleep experts, is yes — especially when paired with old-school methods.

Sleep trackers tell you how many hours you slept and how often you woke up during the night. Many pinpoint the percentage of time you were in each stage of sleep, too. (Learn more about how technology can improve your sleep.)

But sleep trackers don’t actually monitor brain waves the way a sleep doctor would in a lab. Instead, they rely on sensors that measure your heart rate and body movements, as well as noise and light, to figure out when you nod off and enter each stage.

Then the information is calculated and displayed on your phone. It’s usually displayed in a user-friendly graph that makes it easy to spot patterns. But while sleep trackers are pretty good at giving you the number of hours you were dozing, they only estimate the amount of time you were in each stage.

To really know if you’re getting enough REM and deep sleep, you’d have to go to a sleep specialist. So take that information from your tracker with a grain of salt. And don’t freak out if you seem to be spending most of the night in so-called light sleep or if your sleep scores are in the 70% territory.

The best way to use your tracker? Log the approximate number of hours you slept, along with your own record of when you went to bed and how often you woke up. Then pair it with a sleep journal. In the journal, write down what you ate and drank that day, when you did some sort of physical activity, and the medications you took. That information — along with the objective readout from your tracker — can help you spot triggers for good or bad quality sleep.

There are many supplements that promise to help you sleep better, but sleep specialists advise you to speak to your doctor first. Supplements (and even prescription medication) can help. But it may be better to use them in combination with CBT-I. And they should only be taken short term.

Another reason to get your doctor on board: Supplements can interact with other medications in ways that may be bad for your health. For instance, melatonin can raise blood pressure in people who take blood pressure pills.

That said, the supplements below can help people sleep better. (You can shop for a variety of supplements at the Optum Store. Explore now.)

• Melatonin: Your body produces more of this hormone when it gets dark and less of it during the daylight hours. It follows your natural circadian rhythm. Of course, many things can throw off melatonin production, including too much light, as well as jet lag. In those situations, people often turn to melatonin supplements. They seem to work best when used occasionally, especially for jet lag. You have to get the timing right, though — it’s best to take melatonin 1 or 2 hours before bedtime to give your natural hormones a boost.
   
• Magnesium: This mineral plays an important part in keeping us healthy, including regulating the nervous system. It may also help regulate brain chemicals that make us feel drowsy. You can get magnesium naturally from dark, leafy greens, beans and yogurt. But levels drop as you age, and many people don’t eat enough of these foods to get enough magnesium. Although the evidence for its effectiveness as a sleep aid is mixed, if you’re older, it may help you fall asleep faster and stay that way longer, according to a study published in the Journal of Research in Medical Sciences.
   
• Other supplements: These include valerian root, chamomile, lemon balm and L-theanine (an amino acid that comes from tea leaves). All of these supplements boost chemicals that can relax the body as it prepares for sleep. They’re gentle and generally take a few days or weeks to help you doze off. There’s no harm in trying one after you’ve gotten your doctor’s okay.

If your bedroom is the problem, there are products that can help make it a more snooze-friendly place, including:

• Earplugs to help cancel out noise
• White-noise machines or fans that can block street sounds and make it easier to fall asleep
• An eye mask to block out light if you haven’t gotten around to hanging blackout curtains or shades

Funke Afolabi-Brown, MD, pediatric pulmonologist and sleep specialist and founder of Restful Sleep MD, Philadelphia

Raj Dasgupta, MD, pulmonary critical care and sleep medicine specialist and host of The Dr. Raj Podcast

Sanjay Shah, MD, medical director, Northwest Hospital Sleep Lab, Pikesville, Maryland

Sleep needs: Centers for Disease Control and Prevention (2017). “How Much Sleep Do I Need?”
Sleep poll: Sleep Foundation (2021). “Sleep Statistics”
Sleep basics: National Institutes of Health. “Brain Basics: Understanding Sleep”
Sleep and cancer: Sleep Foundation (2021). “Cancer and Sleep”
Family history of insomnia: Molecular Psychiatry (2018). “Genome-Wide Analysis of Insomnia Disorder”
Magnesium as a sleep aid: Journal of Research in Medical Sciences (2012). “The Effect of Magnesium Supplementation on Primary Insomnia in Elderly: A Double-Blind Placebo-Controlled Clinical Trial”