The dangers of not getting enough sleep

Saturday night, after everyone in my house was snug in bed, I read a just-published analysis of more than 100 peer-reviewed studies on the relationship between sleep and sleep health. It persuaded me that one of the first questions your doctor should ask during your next appointment is "How well did you sleep last night?"

Now, it's not exactly news that Americans don't enough sleep. In fact, Consumer Reports' sleep survey in 2012 is just one of many reports to make that point. The modern daily demands of school and work on all of our lives, and the continuous assault on our minds from a never-ending collection of electronic devices such as smart phones and tablet computers, has helped create a pretty sleep-deprived and exhausted society. And over the last decade, many studies that have crossed my desk have linked poor sleep with poor health.

Want to sleep better? Read our reviews of mattresses and our advice on how to treat insomnia.  

But this new study, out this week in the journal Lancet Diabetes & Endcrinology, was convincing in its thoroughness. It found that observational research has strongly linked a lack of sleep to an increased risk of:

• obesity
• high LDL (bad) cholesterol and low HDL (good) cholesterol
• high blood pressure
• premature death.

And pretty rigorous laboratory studies in humans suggest that insufficient sleep causes:

• poor glucose metabolism and an increase in insulin resistance, which can lead to type 2 diabetes
• increased appetite and caloric intake
• reduced physical activity and energy expenditure
• reduced cognitive ability.

Moreover, poor sleep can often indicate other underlying health problems, such as depression and sleep apnea. Ongoing research will show whether interventions to improve sleep duration and quality can prevent or even reverse the adverse effects I've noted above.

There's no magic number of "hours of sleep" that is right for everyone. Individual needs do vary. But I think many of us know when we're clearly not sleeping enough.  

If that's you, before asking your doctor for a prescription for one of the many drugs advertised on TV, try some of the time-tested, and often evidenced-based, lifestyle changes that we've written about over the years:  

• Set a bedtime and wake-up time. That trains your body to expect sleep at a certain time each night.
• Use your bed only for sex and sleep. If you don't doze off within 20 minutes of trying to sleep, leave the room and do something relaxing in dim light until you're sleepy.
• Curb napping. A 30-minute snooze before 3 p.m. can be refreshing, but naps later in the day have been shown to hinder sleep at night.
• Avoid large, late night meals. They can cause sleep-disturbing indigestion. But a bedtime snack consisting of a carbohydrate and a protein—such as cheese and crackers or yes, warm milk—has actually been shown to induce drowsiness.
• Limit alcohol, caffeine, and nicotine. Refrain from smoking 2 hours before bedtime. Eliminate caffeine at least 6 hours before then, and avoid alcohol 4 to 6 hours before going to bed.
• Establish a soothing bedtime routine. Wind down with a warm bath, a book, or mellow music. Watching TV or using a computer or other electronics can discourage sleep.
• Keep your bedroom cool, dark, and quiet. Try a sleeping mask or heavy curtains to shut out light. Use earplugs, a fan, or a sound machine to block noise.
• Use natural light. It keeps your body clock on a healthy schedule. Open shades to wake with the sun, and spend at least 30 minutes outside daily.

If you think you really do need a sleeping pill, see our Best Buy Drugs advice on the best ones, and how to use them safely.

And don't forget your mattress. If it's more than seven years old, or you find that you tend to wake up achy or sleep better in hotels, it may be time to buy a new one. Read our mattress buying guide for more information.

—Chris Hendel