Written by: Thomas Hulme NZ Registered Physiotherapist, BHSc Phty (Hons)
Sleep health is globally well researched, and we have some interesting and insightful data on what a
good sleep looks like and how to get that. Sleep health research generally points towards 7-9 hours
per night as an ideal number. Older adults may require slightly less sleep due to decreased demands
on the body and age-related changes.
People who get less than 6 hours of sleep a night may be more prone to anxiety conditions, and I would recommend aiming for 6 hours minimum to allow the body adequate recovery and help maintain optimal energy levels. People sleeping over 9 hours per night may be prone to feeling more lethargic, and there is an increased risk for depression related mental health conditions. It should also be noted that adolescents require more sleep, and the younger you are, the more sleep you need! School kids ideally should get 9-11 hours, whilst teenagers should aim for 8-10 hours.
Sleep duration may differ depending on training load and activity levels. The body’s demand for sleep
may increase as our activity levels increase. Some athletes require 9-10 hours of sleep per night just
to manage recovery well. So don’t worry if you have a 5 hour sleep due to the road works or a 10-hour sleep because you’re exhausted. I would recommend aiming for 6-9 hours as a general rule.
So how can I sleep better? Maybe you are struggling to fall asleep? Sleep health research highlights
many key factors that will enable you to get a better sleep.
Below are some of my favourite tips to give patients to give them a better sleep.
- Aim for a regular bed time and wake up time to maintain a normal cardiac rhythm. When you get into bed, it gives a signal to the body that its time to settle down for the evening and the
autonomic nervous system can adapt a normal sleeping routine. - Keep the eyes off the phone/T.V. screen. Turn that screen off 30 minutes before sleeping. Try
a book, plan your morning, have a relaxing chat, or maybe do some stretches before bed. - Dark and quiet. Your sleeping place has a relationship with your body and mind. Your body
associates your sleeping location with sleep. Ideally, the bed is used for sleep only, so when
you go to bed at night, your body gets a signal or que from the bedroom environment to tell it
that its time to nod off! - Caffeine – try to have your coffee in the morning and avoid caffeine in the afternoon and
evening if you’re sensitive to this substance. It can really make or break a sleep! - Smoke or vape? If smoking right before sleep, your body might be asking for more nicotine
two hours later which can wake you up. 2-3 hours before bed would ideally be the last puff. - Exercise – yes, I said it, and your physio should be telling you this also! Exercise can improve
your sleep quality significantly, and it’s backed by research. Best practice guidelines may
indicate exercising in the morning or afternoon as opposed to just before bed. Did you know
that people who exercise regularly get better quality sleep? - Food and water – keep that late night snack light and try to stay away from sugar before sleep
time. Spicy food for dinner should be eaten 2-3 hours before sleep. And limit that liquid intake
(try getting your water in during the day rather than just before bed). - Body temperature – feeling hot before bed? Cooling down with a cool shower may help the
body cool off in the summer so you can fall asleep a little easier. This is another reason why
exercising just before bed may not be ideal as it warms us up and the body likes to cool down
before you nod off. - Melatonin – common medication used to help people sleep a little better. Our body produces
melatonin to help it fall asleep, but some people may have lower levels of melatonin. Your GP could help you with a prescription to try and see if an increase in melatonin helps you with your sleep!
- Sleeping position – now this one is controversial for many reasons. There is plenty of
misinformation out there on sleeping positions but there is a way around navigating that. The
easiest way to work out the best sleeping position is to ask yourself, “how does it feel?”. Most
people find either sleeping on the back or on the side is the most comfortable for them. A side
sleeper may need a slightly thicker pillow to get a nice neutral alignment of the neck and
back. A back sleeper may benefit from a slimmer pillow so their neck isn’t propped up too
much. Using a thin pillow in between the knees for side sleepers can be an option to increase
comfort. Back sleepers may find a thin pillow under the knees to feel a little more comfortable.
People that sleep on their front have exceptional neck mobility. I have yet to see a piece of
research with strong evidence suggesting ANY sleeping position if bad. So, if it feels fine,
then its probably fine. Don’t be afraid to try new positions and find that sweet spot!
Sleep health isn’t a one size fits all. It could be as simple as changing a mattress, or moving a late-
night run to an early morning run. If you need advice about sleep, your physiotherapist or GP should
be able to give further advice or guidance so you can wake up in time to make it to your 8am physio
session!
References
- Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, Hazen N, Herman J, Adams Hillard PJ, Katz ES, Kheirandish-Gozal L, Neubauer DN, O’Donnell AE, Ohayon M, Peever J, Rawding R, Sachdeva RC, Setters B, Vitiello MV, Ware JC. 2015. National Sleep Foundation’s updated sleep duration recommendations: final report. Sleep Health.
- Lee CH, Sibley CG. 2019. Sleep duration and psychological well-being among New Zealanders. Sleep Health.
- Siengsukon CF, Al-Dughmi M, Stevens S. 2017. Sleep Health Promotion: Practical Information for Physical Therapists.