Here’s what you can do for a good night’s sleep

A person sleeps a third of his life. In those hours, your body gets time to relax, waste products in the brain are cleared and the emotions and memories of the day are stored in your long-term memory. While you sleep, a lot of things happen in your head. Chemical processes are started and nerves start to work differently. “Other systems are involved,” says sleep expert Myrthe Boss. She works as a neurologist and somnologist in the sleep center of the Gelderse Vallei Hospital in Ede. “You have a wake and a sleep system and when you sleep, a switch automatically flips. Two important processes regulate sleep: sleep pressure and the biological clock. The biological clock is active during the day and works less at night. As soon as it gets light in the morning, the clock goes back to wake mode and you wake up. Sleep pressure increases during the day. Sleep pressure is highest at the beginning of the night. That is why at the beginning of the night you have a period in which you sleep deeply. The longer you sleep, the less pressure to sleep and the lighter you sleep.” An average adult needs seven to eight hours of sleep per night. Exactly how much varies from person to person. As a child you sleep the best. As you get older, you need less sleep. “Most elderly people are satisfied with seven to seven and a half hours a night. This is a sliding scale, you can’t say from what age this applies.”

Light sleep, deep sleep

In insomnia (insomnia), the sleep/wake switch does not work so automatically. You can’t sleep well, wake up at night and toss and turn for a few hours, or wake up early in the morning and can’t get back to sleep. This can be due to an underlying condition, but also, for example, lifestyle.

About 8 percent of people suffer from chronic insomnia. In addition, the wake system remains a little ‘on’ during sleep. “Then you stay alert in your sleep,” explains Myrthe Boss. “This can manifest itself in sleeping problems such as difficulty falling asleep and staying asleep, waking up early or a combination of complaints. We speak of a sleep disorder if this also leads to complaints during the day, such as fatigue, sleepiness, concentration problems and worrying about sleeping.

In a normal sleep pattern, you go through a number of sleep cycles. Such a sleep cycle lasts one and a half to two hours and you repeat it four to five times per night. It is normal to wake up briefly at the end of a sleep cycle. “Then you go from light to deep sleep or back to light sleep or dream sleep. Still, for some people it feels like a sleep disorder because you have more light sleep and dream sleep at the end of the night. During that sleep, you may think you are awake. However, you know when you are awake, but not when you are asleep, because your sense of time is different. Fortunately, you do rest during that period. If you lie awake for a really long time, you would do well to get out for a while instead of worrying.”

Nice and active

Good sleeping conditions promote a good night’s sleep, such as a comfortable bed and a well-ventilated bedroom. Myrthe Boss: “Make sure that you don’t stay in bed for longer than the necessary sleep time, otherwise there is a risk that you will not sleep well. That’s because your body should make the connection: I’m in bed and going to sleep. Using your bed while awake also weakens that connection and makes you sleep worse. Try to finish the day well. If you just rage on during the day and don’t take the time to relax, not even in the evening, it can negatively affect your sleep.” Lifestyle changes can also help you sleep better. Heavy dining in the evening can negatively affect sleep. If you suffer from this, it can help to eat a warm meal at noon. Sufficient exercise during the day, each at its own level, is also good for a good night’s sleep. Vigorous activity in the evening is not very useful, because it also activates the wake rhythm in your biological clock. It may sound crazy, but waking up well is part of sleeping well. Boss advises seeking out the morning light in the morning. “This really helps to wake up, especially in the winter months when you find it hard to get up.”

Morning person/evening person

People who have trouble waking up in the morning often don’t feel like going to bed at night. These are so-called evening people. On the other hand, there are people who want to get into bed early in the evening and are wide awake early in the morning. This has everything to do with the type of person you are. “The rhythm of your biological clock determines your type. The length of the rhythm is a little over twenty-four hours. If it’s shorter with you, you’re a morning person and wake up early in the morning. If the length is longer, then you are an evening person. Your biological clock determines the best time for you to go to bed. This rhythm changes over the years. In general, adolescents are evening people. As you get older, you tend to become more of a morning person. As the years go by, you usually get less deep sleep and you wake up more often in the night. That is normal. As long as it doesn’t lead to complaints, we don’t see it as a sleep disorder.”

Napping dilemma

If you don’t sleep well at night, you are probably less fit during the day. Is a siesta a good idea then? “A nap is fine,” Boss says. “But it should not replace nighttime sleep. If you have sleeping problems at night, it is not useful to go to sleep during the day instead. This has everything to do with the sleep pressure that increases during the day. If you take a nap, the sleep pressure decreases and you can sleep worse at night. As long as a siesta has no negative effect on deep sleep at night, it is not a problem. But preferably rest at the beginning of the afternoon, not at the end. The closer a nap is to your bedtime, the greater the negative effect on nighttime sleep. Rest no more than twenty minutes during the day. If your nap lasts longer, you can fall into a deep sleep, which in turn reduces the sleep pressure.”

Banned blue light

What you should also avoid: drinking coffee in the evening. After all, coffee contains the stimulant caffeine. It is wise not to drink coffee for six hours before going to bed, but it is also better to avoid tea and alcohol if you have trouble sleeping.

Taking a sleeping pill, such as benzodiazepine, is also a bad idea, according to Boss. “I think it’s dangerous. Because of that pill you are less balanced when you get out of bed to pee, for example. Older people taking benzodiazepines are 60 percent more likely to break their hip than older people not taking this drug. Sleep medication has a certain duration of effect, and in the elderly it often lasts longer. So also being unstable lasts longer. Also, do not use melatonin on your own initiative, this hormone can confuse your biological clock and cause more damage than it helps. In rare cases, melatonin is prescribed by the doctor, but then you use it under supervision and you are closely monitored.”

One last piece of advice: avoid blue light at night. You don’t see it, but this light is emitted by the screens of your television, mobile phone, computer and tablet, among other things. You can neutralize it by using a blue light filter. There is not much blue light in normal lamp light, so reading in bed will have little effect on sleep.

From herbs to heavy blanket

There are quite a few remedies on the market that the makers claim to help you sleep better. Think of herbs, a heavy blanket and devices such as a sleep robot or sleep detector. Sleep expert Myrthe Boss has not yet seen convincing evidence that these remedies help. “Much still needs to be researched more thoroughly. More important is the question: what are the factors that cause the sleeping problems to persist? Your doctor can check that first. If necessary, it can also be checked out in the sleep outpatient clinic. What we want to know is: what kind of sleep disorder is involved? If someone is awake because of worries or a burnout, it is important to see what can be done about it. Sleep problems should not become chronic, and that is the case if they last longer than three months.”

Pattern Break

If you have sleeping problems and cannot solve it yourself, it is therefore best to go to the doctor first. He or she helps to find out what the problem could be, possibly together with a mental health practice nurse, and gives sleep tips. If you have a psychological problem, you can be referred to a psychologist. People can suffer from insomnia for various reasons, such as a major event, a loss or stress at work. In addition, certain people are more at risk of sleeping problems. “These are often people with specific character traits such as control, a neurotic predisposition and perfectionism. If you already go to bed with a feeling of stress, sleeping is usually no longer possible. The link between sleep and bed is then no longer so strong. These are factors that perpetuate sleep problems. But cognitive behavioral therapy for insomnia improves in 70 to 80 percent of patients. Fortunately, there are ways to break through patterns.”

Not too long!

The ultimate sleeping tip from neurologist Myrthe Boss: don’t lie in bed too long. This may mean that you will spend less time in bed than you do now. Go to bed later and get up earlier and keep this up for a few weeks. Are you in bed for nine hours now? Shorten the length of stay by one and a half hours.

This article previously appeared in +Gezond February 2022. Want to subscribe to the magazine? You can do that in an instant!