Welcome to our latest exploration of the world of sleep! As someone deeply immersed in sleep studies and the host of the "Deep Into Sleep" podcast, I'm thrilled to guide you through some common misconceptions about sleep. With insights from Dr. Fiona Barwick, the training director at the Stanford Sleep Medicine Center, we aim to debunk myths and provide you with the knowledge needed for restful nights.

Myth 1: More Deep Sleep is Better?

The belief that deeper sleep equates to better rest is a misconception that needs clarification. Deep sleep, scientifically known as slow-wave sleep, it's the time when the body repairs and regrows tissues, builds bone and muscle, and strengthens the immune system. It actually only constitutes 10% to 20% of our nightly sleep and primarily occurs in the initial three to four hours. So we all should have a more realistic expectation to it.

Imagine Amy, obsessed with increasing her deep sleep based on her sleep tracker. Despite her efforts, she is very concerned that she only gets “18%“ deep sleep on average per night. This is normal, but she does not understand the science behind it, so she perceives herself as a “poor sleeper“. Contrary to popular belief, it's not just about how much deep sleep you get. Balance is key. Research suggests that a healthy sleep pattern includes a mix of both deep (slow-wave) and lighter sleep stages. If you are anxious about your sleep, sleep trackers may make them worse, for the following 2 reasons:

1) Sleep-tracking devices are NOT accurate because they often gauge movement instead of monitoring brain activity, which is essential for precise sleep analysis. Consequently, relying on them to assess sleep quality can be misleading.

2) Moreover, the growing trend of using wearables like smartwatches to monitor sleep can inadvertently turn sleep into a performance. In reality, sleep is an innate process that should unfold naturally. When we perceive sleep as a performance, we may inadvertently introduce stress and effort into the equation, which is counterproductive. 

Rather than trying to force it, we should allow sleep to happen naturally.

Myth 2: A Good Night's Sleep Means No Waking Up or Dreaming?

It is actually normal for adults to experience multiple awakenings throughout the night, though these are often so brief (less than three minutes) that we do not even remember them. The phenomenon of brief awakenings explains why we might have a midnight conversation and have no recollection of it in the morning. So, now you know, if you often wake up at night and worry about your sleep quality, you can tell yourself: these brief awakenings are a normal and healthy part of your sleep. Your sleep is normal!

One major pitfall is that we tend to be unreliable reporters of our own sleep experiences, especially when it comes to dreams. The surreal nature of dreams often combines bizarre content with distorted time perception, making our recollections hazy at best. This unreliability can lead to unnecessary concerns about sleep quality. Dreaming, an integral part of the sleep cycle, occurs primarily during Rapid Eye Movement (REM) sleep, are crucial for our brains to process emotions and consolidate memories. While it is common for individuals not to remember their dreams, it does not mean that they did not occur. Dismissing dreams as unimportant is another misconception. Dr. Barwick emphasizes the significance of all sleep stages, including REM sleep, for learning, memory consolidation, and emotional regulation.

For individuals grappling with insomnia, the classic sign is excessive worry about sleep itself. Paradoxically, the more you worry about sleep, the less likely you are to sleep well. Thus, it is important to address the root causes of sleep disturbances, such as sleep-related anxiety, rather than fixating on sleep itself.

Myth 3: Waking Up Feeling Refreshed is a Given?

That groggy feeling when you wake up, known as sleep inertia, is completely normal. That groggy and sluggish feeling upon waking, is a natural transition state between deep sleep and full wakefulness, and usually disappears as you fully wake up. It is similar to a mental fog that can make us wish that we could roll over and go back to sleep.

It is crucial to understand that sleep inertia does not necessarily reflect the quality of our sleep. It is only a temporary state that typically passes once we get up and start our day. The duration of sleep inertia can vary from person to person, lasting anywhere from 30 minutes to up to two hours for normal sleepers.

One counterproductive habit that exacerbates sleep inertia is hitting the snooze button. While it may seem like a harmless way to steal a few more moments of rest, it can prolong sleep inertia and leave us feeling groggier. Dr. Barwick’s advice is clear: resist the temptation to snooze and get out of bed promptly to kickstart our day.

Myth 4: Early to Bed, Early to Rise Makes Sleep Just Right?

The notion that the key to quality sleep lies in going to bed early is a common but oversimplified belief. While it is true that our bodies go through specific sleep cycles during the night, the timing of these cycles is influenced by individual variability. Human sleep patterns vary widely due to factors like genetics, often resulting in different chronotypes. Genetic studies have found, that our internal clocks dictate whether we're early birds, night owls, or somewhere in between, and these are 50% decided by our genes. Fighting your natural sleep pattern may lead to sleep trouble.

In my own clinical practice, I saw so many patients with insomnia regain a good night of sleep, just by accepting their night owl tendency, and allowing themselves to sleep late if that is what their bodies want. The power of listening to your body could be beyond your imagination.

Myth 5: Popping Pills is the Answer to Sleep Problems?

One of the most pervasive sleep myths is the belief that sleep can be improved through the use of pills, whether they are prescription medications, over-the-counter remedies, or even substances like alcohol. Sleeping pills can help in the short term but don't provide the natural, restorative sleep our bodies need. Clinical research suggests us: these should be a temporary aid, not a long-term solution.

Sleeping pills may sedate you, but they do not replicate the complex and essential sleep cycles that our bodies naturally undergo. When you are under the influence of sleeping pills, you are not experiencing normal sleep stages, including deep sleep and REM sleep, which play critical roles in memory consolidation, emotional regulation, and overall well-being. Furthermore, many sleep medications can disrupt the natural progression of sleep, potentially eliminating stages that are crucial for cognitive and emotional health. 

There is no “magical“ pill that can recreate the intricate and essential process of natural human sleep. The consequences of relying on sleeping pills are both short-term and long-term. In the short term, individuals may experience daytime sedation, impaired cognitive function, increased likelihood of accidents, and heightened confusion. Long-term use of these medications is even more concerning, as emerging research suggests potential links between extended use and conditions like dementia. We can potentially harm ourselves by relying on sleeping pills to address sleep issues. I received a lot of questions about melatonin in my clinic, and I made a video explaining how that may or may not help our sleep.

Remember, evolutionarily, no pills are more powerful than our biology! And that is why CBT for Insomnia (CBTi) is the golden standard treatment of insomnia. This is why Cognitive Behavioral Therapy for Insomnia (CBT-I) is widely recognized as the gold standard treatment for sleep disturbances. It addresses the root causes of sleep problems and provides sustainable solutions without resorting to medication.

Conclusion: Embracing Our Unique Sleep Journeys

Through exploring these myths with scientific backing, we hope to empower you with a deeper understanding of sleep. Remember, every individual's sleep journey is unique. Understanding the science behind sleep can lead to more restful nights and energized days. Share your sleep stories with us on social media, and let's continue to learn and grow together. Here's to achieving not just good sleep, but great, restorative sleep that rejuvenates us for life's adventures!

References:

Ashbrook LH, Krystal AD, Fu YH, Ptáček LJ. Genetics of the human circadian clock and sleep homeostat. Neuropsychopharmacology. 2020 Jan;45(1):45-54. doi: 10.1038/s41386-019-0476-7. Epub 2019 Aug 10. PMID: 31400754; PMCID: PMC6879540.

Patel AK, Reddy V, Shumway KR, et al. Physiology, Sleep Stages. [Updated 2022 Sep 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526132/

This blog article is drafted by Christine Gao, based on Dr. Yishan’s podcast interview and YouTube videos.

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