Sleep health education

Ordinary people do not need to pursue various complicated sleep methodologies. They only need to avoid the three most common cognitive misunderstandings and adjust their habits according to their own conditions - not everyone needs to sleep for 8 hours, it does not mean that catching up on sleep after staying up late is completely useless, and it does not mean that insomnia requires drug intervention.

Last week, I met a 27-year-old girl who works as an Internet operator in the clinic. She carries three different amounts of melatonin in her bag and two sleep monitoring apps on her phone. She sets seven segmented alarm clocks before going to bed every day. She lies on the bed and starts counting "I can still sleep for 6 hours and 47 minutes." The more she counts, the more energetic she becomes, and finally she opens her eyes until dawn. In fact, her problem is not that she sleeps less at all, but that she regards sleep as a KPI that must be completed, and she becomes extremely anxious if she deviates even slightly from the so-called "standard."

Many people have a deep-rooted belief that "sleeping eight hours a day is healthy." In fact, this statement has long been updated. In the sleep guidelines updated in 2023 by the American Academy of Sleep Medicine, the recommended range for adults is clearly between 7 and 9 hours. The "Individual Sleep Threshold" theory proposed by the Stanford University Sleep Research Center in recent years also points out that 1% to 3% of the population are born with short sleep genes. They only need 4 to 6 hours of sleep a day to fully meet their body's needs. As long as they wake up without fatigue or lack of concentration, there is no problem. I once met a 68-year-old retired teacher who slept for 5 and a half hours a day all his life. After retirement, he listened to a health class and said that he must sleep for 8 hours to live a long life. He forced himself to sleep for 8 hours a day. As a result, he suffered from mild insomnia and his energy was not as good as before. To be honest, the sleep anxiety caused by lying down in order to make up for 8 hours is much more harmful than missing an hour of sleep.

Speaking of this, I have to mention the stereotype of staying up late. Many people think that "staying up late is a chronic suicide, and catching up on sleep is completely useless." This view actually depends on the situation. Traditional sleep research does emphasize that sleep quality is the highest when circadian rhythm and natural light are synchronized. However, a 3-year follow-up study of 2,000 shift workers by the University of Surrey in the UK in 2022 showed that as long as a fixed sleep rhythm can be formed, even if you go to bed at 3 am and start at 11 noon every day, as long as you sleep enough to meet your own threshold, there will be no significant difference in metabolic level, cognitive ability and those of people who go to bed early regularly for 3 consecutive years. Many of the doctors in the emergency department of our hospital have worked the night shift for five or six years. Everyone has figured out the rules: don't check your mobile phone randomly after the night shift, sleep for 6 hours at a time, and bask in the sun for 5 minutes after getting up. Normally, your body parameters are quite normal. On the contrary, for people who stay up until 3 o'clock, go to bed at 9 o'clock, and sleep for 14 hours on weekends, their biological clocks are completely messed up, and they are more likely to suffer from dizziness and fatigue.

When many people encounter insomnia, their first reaction is to buy melatonin and find a doctor to prescribe sleeping pills. In fact, there is really no need to be so urgent. For short-term insomnia that lasts less than 3 months, Western medicine clinically recommends cognitive behavioral therapy (CBT-I) as the first intervention plan. That is to first adjust the misperception of sleep, and then cooperate with behavioral adjustments such as sleep restriction and stimulus control. The effective rate can reach 70%-80%, and no medication is needed. Traditional Chinese medicine has a more gentle view. Most people will recommend adjusting bedtime habits first, such as not drinking ice drinks or watching irritating short videos. Many people have made significant improvements after just one or two weeks of adjustment. There was a young man who was doing back-end development. He suffered from insomnia for more than a month and was about to start taking alprazolam. I asked him to change the cold light in the bedroom to a warm yellow night light. He should not touch milk tea or coffee an hour before going to bed. Put his mobile phone in the living room to charge. If he can't fall asleep in bed, get up and sit for a while instead of lying down. Two weeks later, he came to me specifically and said that he could fall asleep within 20 minutes of lying down without taking any medicine at all. Of course, this does not mean that you cannot take medication at all. If you have been suffering from insomnia for more than 3 months, and you are obviously distracted and out of control during the day, which even affects your normal work and life, then you should take the medication as directed by your doctor.

I have been working the night shift for almost 10 years, and I have found some tips that suit me: when I get home from the night shift, I drink half a cup of warm pure milk, close the black curtains that are completely opaque, wear soft silicone earplugs, and set an alarm clock for 6 hours. When I wake up, I will never lie in bed and check my phone. I will go to the balcony to bask in the sun for three to five minutes. I will wake up quickly and will not fall asleep all afternoon. By the way, there is another question that many people ask: Can exercise before bed help you sleep? This really varies from person to person. I have seen some people do yoga for half an hour before going to bed and fall asleep, while others go for a run before going to bed and are so excited that they still have their eyes open at 2 or 3 o'clock. There is no standard answer. You can know whether it is suitable or not by trying it twice.

In fact, after all, sleep is an instinct engraved in human genes. The more you stare at it, count the time, and worry about whether it is good enough, the more it will work against you. There is no need to follow the perfect sleep list on the Internet, finding your own comfortable rhythm is better than anything else.