How Much Sleep Do We Really Need?

You hear the advice that people need eight hours of sleep, but does that apply to every person? What about children, teens and older people? Many people seem to get by on less than eight so...

How Much Sleep Do We Really Need?

Ellen Caroll has often asked herself this exact question – especially when it comes to helping her family members get the amount of sleep they need. With a son in preschool and a daughter in high school, a husband who works over 50 hours a week and aging parents, one with Parkinson's disease, Ellen's family runs the gamut when it comes to age and sleep needs. Because all of Ellen's family members have busy schedules, they often forget to put their sleep needs ahead of their other priorities. Not only does Ellen need to convince her family that getting the right amount of sleep is important, but she also needs to figure out how much sleep they really need!

If you're like Ellen and her family, you're probably also confused about how to know when "enough is enough" in regards to your sleep. While news media and health organizations are regularly saying to get more sleep, it might be unclear to you how many hours of sleep you should be getting and how to tell if you are adequately rested. Keep reading and we’ll explore how you can make educated decisions about your sleep and that of your family members'.

What the Research Says About Sleep Duration

The first thing experts will tell you about sleep is that there is no "magic number." Not only do different age groups need different amounts of sleep, but sleep needs are also individual. Just like any other characteristics you are born with, the amount of sleep you need to function best may be different for you than for someone who is of the same age and gender. While you may be at your absolute best sleeping seven hours a night, someone else may clearly need nine hours to have a happy, productive life. In fact, a 2005 study confirmed the fact that sleep needs vary across populations, and the study calls for further research to identify traits within genes that may provide a "map" to explain how sleep needs differ among individuals.

Another reason there is "no magic number" for your sleep results from two different factors that researchers are learning about: a person’s basal sleep need – the amount of sleep our bodies need on a regular basis for optimal performance – and sleep debt, the accumulated sleep that is lost to poor sleep habits, sickness, awakenings due to environmental factors or other causes. Two studies suggest that healthy adults have a basal sleep need of seven to eight hours every night, but where things get complicated is the interaction between the basal need and sleep debt. For instance, you might meet your basal sleep need on any single night or a few nights in a row, but still have an unresolved sleep debt that may make you feel more sleepy and less alert at times, particularly in conjunction with circadian dips, those times in the 24-hour cycle when we are biologically programmed to be more sleepy and less alert, such as overnight hours and mid-afternoon. You may feel overwhelmingly sleepy quite suddenly at these times, shortly before bedtime or feel sleepy upon awakening. The good news is that some research suggests that the accumulated sleep debt can be worked down or "paid off."

Though scientists are still learning about the concept of basal sleep need, one thing sleep research certainly has shown is that sleeping too little can not only inhibit your productivity and ability to remember and consolidate information, but lack of sleep can also lead to serious health consequences and jeopardize your safety and the safety of individuals around you.

For example, short sleep duration is linked with:

* Increased risk of motor vehicle accidents

* Increase in body mass index – a greater likelihood of obesity due to an increased appetite caused by sleep deprivation

* Increased risk of diabetes and heart problems

* Increased risk for psychiatric conditions including depression and substance abuse

* Decreased ability to pay attention, react to signals or remember new information

According to researchers Michael H. Bonnet and Donna L. Arand, "There is strong evidence that sufficient shortening or disturbance of the sleep process compromises mood, performance and alertness and can result in injury or death. In this light, the most common-sense 'do no injury' medical advice would be to avoid sleep deprivation."

On the other hand, some research has found that long sleep durations (nine hours or more) are also associated with increased morbidity (illness, accidents) and mortality (death). Researchers describe this relationship as a "U-shaped" curve (see illustration) where both sleeping too little and sleeping too much may put you at risk. This research found that variables such as low socioeconomic status and depression were significantly associated with long sleep. Some researchers argue that these other variables might be the cause of the longer sleep: the fact that individuals with low socioeconomic status are more likely to have undiagnosed illnesses because of poor medical care explains the relationship between low socioeconomic status, long sleep and morbidity/mortality. Researchers caution that there is not a definitive conclusion that getting more than nine hours of sleep per night is consistently linked with health problems and/or mortality in adults, while short sleep has been linked to both these consequences in numerous studies.

"Currently, there is no strong evidence that sleeping too much has detrimental health consequences, or even evidence that our bodies will allow us to sleep much beyond what is required," says Kristen L. Knutson, PhD, Department of Health Studies, University of Chicago. "There is laboratory evidence that short sleep durations of 4-5 hours have negative physiological and neurobehavioral consequences. We need similar laboratory and intervention studies to determine whether long sleep durations (if they can be obtained) result in physiological changes that could lead to disease before we make any recommendations against sleep extension."

But a key question is how much is too much or too little. Researchers Shawn Youngstedt and Daniel Kripke reviewed two surveys of more than 1 million adults conducted by the American Cancer Society and found that the group of people who slept seven hours had less mortality after six years than those sleeping both more and less. The group of people who slept shorter amounts and those who slept longer than eight hours had an average mortality risk that was greater, but the risk was higher for longer sleepers. Youngstedt and Kripke argue that for those who would normally sleep longer than eight hours, restricting their sleep may actually be healthier for them, just as eating less than one’s appetite may be healthier in a more sendentary society.

What Your Body is Saying About Your Sleep Needs

After looking at the research, the next step in identifying your sleep need is taking a "snapshot" of your sleeping habits. Ellen began this process by looking qualitatively at each family member's sleep habits and their behaviors during the day. Here’s what she found:

Her teenage daughter was a lot of fun to be around at night – she was energetic and in high spirits, chatting with her family during dinner, talking on the phone with friends, playing on her computer and squeezing in an hour of TV. Whenever Ellen would try and get her off to bed, she’d complain that she didn’t feel tired. Nevertheless, when her alarm would usher in another day of high school at 6:30 am, Ellen’s daughter Terri was NOT fun to be around. Irritable, tired and unhappy, Terri would head off to school with a bad start to the day, not to mention the fact that she had difficulty staying awake in her classes. What Ellen and Terri may not know is that Terri's biology and age play a large role in her sleep habits. As a teenager, her circadian rhythms are geared to stay up later in the evening and to wake later in the morning. As a result, a 10 o' clock bedtime may feel too early to her body, and a 6:30 am wake time certainly doesn't fit her current sleep/wake schedule. But the biggest problem is that adolescents still need lots of sleep – at least nine hours every night and it is hard to get that much when biology says "stay up late" and school says "start early."

Ellen never thought that her young son could be sleep deprived. After all, she thought, sleep deprivation occurs when you’re a "night owl" teenager or over-worked adult, not a four year-old! What Ellen may not know is that children need much more sleep than their adult counterparts to be well-rested. Experts estimate that preschoolers (3 to 5 years-old) need 11-13 hours of sleep, while school-aged children up to age 12 need approximately 10-11 hours of sleep. Ellen’s son Josh frequently adapts to his family’s late-night schedule and doesn’t usually take naps – in fact, when he falls asleep in the car, it is usually past his bedtime or the day after getting too little sleep. As a result of "going along with the family routine," he’s often shortchanged on sleep. Unfortunately, it shows up in whiny behavior and even tantrums that he has otherwise outgrown.

As a mother of two in her forties, Ellen is used to sacrificing her own sleep needs for that of her family’s. She squeezes in a busy day at work and has lots to do around the house, not to mention spending time with her children and husband. By day’s end she feels exhausted, but hasn’t had time to herself and doesn’t want to sleep. As a woman, Ellen has also had unique sleep experiences from those of her family members. Ellen’s sleeping habits have undergone many changes throughout her life. As a pregnant woman her sleep needs changed with each trimester, and she battled common sleep problems during pregnancy such as heartburn, leg cramps and snoring. As Ellen approaches menopause, she will face new sleep challenges like hot flashes and may experience insomnia.

Ellen’s husband Roger is a busy executive who often spends early mornings and late nights working. When he’s not working he’s often thinking about working, and this has led to a lot of insomnia and sleeplessness nights. Roger’s sleep deprivation is starting to show – he has difficulty enjoying time with his family and has lost his desire to exercise as he used to. This pattern forms a vicious cycle because the less Roger sleeps the more likely he is to eat. Research has found links between appetite increase and sleep deprivation due to hormones that are produced when you're short on sleep. This can not only lead to gaining weight, but his sleep deprivation and weight gain could lead to serious health problems like the onset of sleep apnea, hypertension, heart attack, diabetes and stroke. Roger knows that most adults need 7-9 hours to feel well-rested, but he has trouble "turning off" his mind at the end of the day to get the sleep he needs.

Ellen's aging father has Parkinson's disease and faces a number of unique challenges related to his sleep. Regardless of his illness, as an older adult his sleep is different than when he was younger. For example, elderly people tend to spend very little time in deep sleep and are more easily aroused or awakened. Nevertheless, their average total sleep time increases slightly after age 65, but many older adults divide their sleep between daytime naps and nighttime sleep. Napping, though, may decrease the need to sleep at night and some older people complain of difficulty falling asleep or staying asleep. Lack of exercise may also take a toll on elder sleep and medications may make a person feel drowsy and wanting to sleep during the day. These problems should be discussed with a physician.

As you can see, sleep needs vary across ages and are especially impacted by lifestyle and health. Thus, to determine how much sleep you need, it's important to assess not only where you fall on the "sleep needs spectrum," but also to examine what lifestyle factors are affecting the quality and quantity of your sleep such as work schedules and stress. To get the sleep you need, you must look at the big picture.

Though research cannot pinpoint an exact amount of sleep need by people at different ages, the following table identifies the "rule-of-thumb" amounts most experts have agreed upon. Nevertheless, it's important to pay attention to your own individual needs by assessing how you feel on different amounts of sleep. Are you productive, healthy and happy on seven hours of sleep? Or does it take you nine hours of quality ZZZs to get you into high gear? Do you have health issues such as being overweight? Are you at risk for any disease? Are you experiencing sleep problems? Do you depend on caffeine to get you through the day? Do you feel sleepy when driving? These are questions that must be asked before you can find the number that works for you.

What You Can Do

To begin a new path towards healthier sleep and a healthier lifestyle, begin by assessing your own individual needs and habits. See how you respond to different amounts of sleep. Pay careful attention to your mood, energy and health after a poor night's sleep versus a good one. Ask yourself, "How often do I get a good night's sleep?" If the answer is "not often", then you may need to consider changing your sleep habits or consulting a physician or sleep specialist. When Ellen's family members began this process, they realized that often they weren't getting what they would call a "good night's sleep." This led each of them to reevaluate how much sleep they needed and whether their sleep habits were healthy ones.

To pave the way for better sleep, experts recommend that you and your family members follow these sleep tips:

* Establish consistent sleep and wake schedules, even on weekends

* Create a regular, relaxing bedtime routine such as soaking in a hot bath or listening to soothing music – begin an hour or more before the time you expect to fall asleep

* Create a sleep-conducive environment that is dark, quiet, comfortable and cool

* Sleep on a comfortable mattress and pillows

* Use your bedroom only for sleep and sex (keep "sleep stealers" out of the bedroom – avoid watching TV, using a computer or reading in bed)

* Finish eating at least 2-3 hours before your regular bedtime

* Exercise regularly during the day or at least a few hours before bedtime

* Avoid caffeine and alcohol products close to bedtime and give up smoking

If you or a family member are experiencing symptoms such as sleepiness during the day or when you expect to be awake and alert, snoring, leg cramps or tingling, gasping or difficulty breathing during sleep, prolonged insomnia or another symptom that is preventing you from sleeping well, you should consult your primary care physician or sleep specialist to determine the underlying cause. You may also try keeping a sleep diary to track your sleep habits over a one- or two-week period and bring the results to your physician.

Most importantly, make sleep a priority. You must schedule sleep like any other daily activity, so put it on your "to-do list" and cross it off every night. But don’t make it the thing you do only after everything else is done – stop doing other things so you get the sleep you need.

Take a tip from Ellen Carol. She said that "After our family made a commitment to getting the sleep we need, it seemed that my husband and I were both more productive with the time we had and the kids seemed a little less grumpy and excitable. Overall, making sleep a priority is something we are going to continue to do."