Mailbag - Questions About Sleep

Q. Is there a difference between being brain-tired (for example if I learned a lot during the day) and body tired (from physical activity)? Does that affect my sleep needs and patterns?

A. Yes. Most everyone has had days that tire them physically but not mentally and vice versa. Exposure to a lot of mental stimulation or learning can increase your sleep propensity. Being muscle tired might contribute to sleepiness, but most of us know from experience this is a different feeling than mental sleepiness.

We define sleepiness and drowsiness as the same thing in day-to-day language, but some sleep scientists make a distinction. Sleepiness is the propensity to get to sleep; it’s a physiological state. Drowsiness is a feeling of not being alert without necessarily the need to sleep.

The word fatigue may refer to muscle tiredness and mental status of low motivation and energy. Lack of sleep can cause fatigue, but so can other things.


Q. What can I do to sleep less?

A. Unless you have hypersomnia, you probably don’t want to sleep less. You need to appreciate sleep more and don’t come here asking how to sleep less.

However, there are ways to spend less time in bed. One metric to consider is sleep efficiency, the ratio of time spent sleeping to time spent in bed. For teenagers this number is typically high; for adults it tends to decline with age. Lying awake in bed doesn’t do you much good, so you want to reduce this middle-of-the-night awake time while maintaining your total sleep time.

The best technique is sleep restriction therapy. Set a firm wake-up time in the morning and slowly advance your bedtime. You might feel sleepy during the day, but if you can handle this sleepiness in the short run, your brain may adjust to the shorter time and bed and increase sleep efficiency for you.

Drugs can get you through sleep maintenance insomnia and increase sleep efficiency, but they will overall tend to get you to sleep more. Stay away from hypnotics or sedatives if you want to sleep less. Stimulant drugs can shorten sleep time, but be careful with them and use only with a doctor’s permission and supervision. (Stimulants are prescribed to people with hypersomnia.)


Q. I have a hard time getting going in the morning, and always have more energy at night. Does that mean I should shift my sleeping time?

A. If you can shift your sleeping time, try that. Many people have work or social obligations that force them to be awake and/or at certain places at certain times, so shifting their sleep time is difficult. But if your schedule permits, try making the shift. It might work, although there are no guarantees.


Q. Sometimes I go the whole night with hardly any sleep at all. I’m in that in-between state between sleep and waking. It’s miserable. Should I take a sleeping pill?

A. You probably are sleeping more than you realize during the night. Repeated tests of people with your complaint have found the insomniacs vastly underestimate the amount of sleep they are actually getting. We agree it can be miserable, though. One question for possible treatment is: do you feel sleepy during the day on a regular basis? If not, apply sleep restriction therapy and spend less time in bed in an attempt to squeeze those nighttime awakenings out. If you are sleepy during the day and the patterns persists, you probably qualify for a diagnosis of sleep maintenance insomnia.

See our page on quick fixes for insomnia for what to do next.


Q. If I fall asleep watching television in the living room, does that count toward my total sleep for the night? I might be asleep for an hour on the couch before I get up and get into bed.

Obama sleeping A. Yes, it “counts” toward your nightly sleep. Your brain gets some benefit from it, and if you are recording your sleep in a diary, you can include the time on the couch. It’s obviously not optimal because you awaken to move into the bedroom and your body’s skeletal muscles probably weren’t as relaxed on the couch as they are in a bed.


Q. I am so groggy in the morning. Is there any way to sleep so I can be perky and alert when I wake up?

A. Some people have sleep inertia bad while others pop right out of bed. To some extent this is constitutional and genetic. Some are morning larks and others are night owls. You can reduce the risk of morning grogginess by making sure you have good sleep hygiene and are getting enough sleep every night. Try an earlier bedtime and keep a sleep diary to see if that makes a difference.

Medications that promote sleep will, if anything, make morning sleep inertia worse. That’s one reason to avoid them and the half-life of the medicine in the body is an important consideration in selecting a type of sleeping pill and dosage. It is also possible that a medication you take for another condition could cause morning grogginess. Coffee is the old stand-by for getting over grogginess, or exercise, but these are responses to try to mitigate the inertia. Addressing your sleep needs directly is the best hope for waking up with more energy, but even then you can’t necessarily guarantee success.


Q. My grandmother’s old home remedy (e.g. herbs, warm bath) works as well as any drug.

A. Great! If you can avoid using a drug, you should. Remember, however, that those home remedies (like drugs) work for some people and not for others. You have to be careful with herbs, too, to make sure you are not consuming a poisonous herb or too much of one that should be taken in only small amounts. Herbs can also have side effects and detrimental effects when taken with certain medications - even if those medications are not for sleep.


Q. I grind my teeth during sleep. Does this mean I am over-stressed?

A. It means you have a condition called bruxism. Stress could be a cause, although it is not always the only cause. There are ways to address bruxism. Ask your doctor or dentist.


Q. I heard having a cell phone near the bed can disrupt sleep because of the radio waves.

A. This is an urban myth. There is no evidence radio waves of the magnitude normally found in the home can affect sleep.


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