Nearly half of Canadians have tried pills or other sleep aids in the past year, and nearly a quarter have consulted a sleep professional
So why has a decent night’s sleep become so elusive for so many?
“Sleepmaxxing” is trending on TikTok, with videos promoting sleep hacks from mouth taping and masks to red light goggles and “sleepy girl mocktails” (typically tart cherry juice). Millions are going to bed with wearable sleep trackers. The Apple Watch can now detect “elevated breathing disturbances” that could be a sign of sleep apnea. All in, the global sleep aid market is forecasted to surpass US$89 billion by 2030.
But while insufficient sleep and untreated sleep problems can be seriously disruptive and take an enormous toll on health and economies, some sleep scientists worry the obsession with sleep is driving an entirely new disorder, and that startling studies suggesting poor sleep will cause hastened brain aging are making poor sleepers even jumpier.
“People can get too obsessed with this,” said psychologist and sleep scientist Judith Davidson. When people aim for perfection, “when you try too hard to sleep, sleep disappears.”
Untreated insufficient sleep can increase the likelihood of depression, cardiovascular disease, type 2 diabetes and, possibly, the build-up of plaque-forming proteins in the brain linked to Alzheimer’s disease.
The study showed only an association between poor sleep and signs of brain aging, not a cause-and-effect relationship between the two, and people reported their own sleep problems, meaning they may not have reported them accurately, the authors cautioned.
When you try too hard to sleep, sleep disappears
Judith Davidson, sleep scientist
Studies “aren’t showing that if you have insomnia you’re definitely going to age your brain,” said Davidson, an adjunct professor in the department of psychology at Queen’s University in Kingston. But alarming headlines can feed the cycle of poor sleep, because a racing mind, a worrying mind, can perpetuate insomnia.
There is no standard definition of what defines “normal” or ideal sleep, though Canadian recommendations have landed on seven to nine hours of good quality sleep for adults aged 18 to 64, and seven to eight hours for the 65-plus.
But some people are natural short sleepers, and Charles Morin has warned that if people place too much emphasis on getting the recommended number of hours, it can increase pressure to absolutely get that amount of sleep.
Wearable sleep trackers have their benefits, said Morin, Canada Research Chair in behavioural sleep medicine at Laval University. “They make people more aware of the importance of sleep.” But there’s a limit, he said. “Too often these companies are quick to commercialize their gadgets without any validation.
“If I see that a watch is telling me, ‘You need to go to bed now, now is a good time,’ and in the morning it tells me how much deep sleep I’ve had, I think we have to be a bit skeptical,” Morin said. If people thought they’d had a good night’s sleep, but their sleep tracker suggests otherwise, it can warp their perception of their daytime functioning, leaving them feeling more impaired and drained than they really are.
Even in sleep labs, physical measures don’t necessarily map people’s perceived sleep. “Somebody can say, ‘Oh, I tossed and turned all night.’ But if you observe them in a sleep clinic, you’ll see, ‘No, actually, you got six hours,” sleep historian Benjamin Reiss, author of Wild Nights: How Taming Sleep Created our Restless World, told a Vox Media podcast. The phenomenon has been described as “sleep state misperception.”
A decade ago, Samson, the anthropologist, then a post-doc and senior research scientist at Duke University and now an associate professor at the University of Toronto Mississauga, and his co-author published a paper describing how humans are the shortest sleepers among 30 primates studied, packing a disproportionate time in REM, or rapid eye movement sleep. People tend to dream vividly in REM. Our eyes dart back and forth but the body experiences a state of atonia — muscle paralysis. The brain signals for muscles to go limp to keep people from acting out their dreams.
Insomnia is based on a person’s subjective experience of their sleep. Unlike other sleep disorders like sleep apnea, where the upper airway narrows and collapses repeatedly during sleep, restricting oxygen intake, insomnia isn’t measured in a lab with sensors pasted to a person’s head. Why its prevalence, based on self-reporting, is increasing is a puzzle. “The old story is that we have a 24-hour society and everyone is stressed out,” Davidson said. “But people have used that reason over many years, when there was no increase in prevalence.”
For their new study, Morin and other members of the Canadian Sleep Research Consortium surveyed a sample of 4,037 adults who were interviewed by phone between April to October 2023. About one-quarter reported being dissatisfied with their sleep, 20 per cent reported “significant daytime impairments or distress,” and 16 per cent reported symptoms of insomnia disorder — trouble falling and staying asleep at least three times a week for at least three months.
Women had a 24 per cent higher probability of insomnia disorder than men but otherwise, there were no significant differences in prevalence based on age, marital status, education, occupation, work schedule and income.
Roughly a third of the sample reported using natural products or over-the-counter medication in the previous year. Sixteen per cent reported using cannabis. Ten per cent said they’d used alcohol in a misguided attempt to improve their sleep (alcohol leads to more frequent nighttime awakenings).
Morin and colleagues joined other sleep scientists in calling for more attention to what has been considered a neglected public health problem. Some have called on governments to beef up messaging around the importance of sleep starting as early as kindergarten.
“I get very interesting referrals now of people who are probably sleeping just fine but want to optimize,” Sinai Health sleep medicine specialist Dr. Jennifer Hirsch told the University of Toronto Med Magazine.
“There’s this sort of obsessiveness, like, ‘Am I getting enough deep sleep? I’m getting seven or eight hours, but is it a good seven or eight?’”
National Post
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