Sleep and Why It’s So Important
Why do we sleep? Despite decades of research, the fundamental purpose of sleep remains only partially understood. One prevailing theory is that sleep evolved to support biological maintenance—our bodies and brains engage in essential restorative processes during this time. What is clear, however, is that sleep is universal across species and intricately connected to health and survival.
The Sleep-Wake Cycle
Historically, sleep research focused almost exclusively on the night. Today, the conversation has expanded to the broader concept of the sleep-wake cycle. This 24-hour rhythm governs how we manage our energy throughout the day and night, influenced by an internal body clock that regulates when we feel alert or tired.
While “eight hours of sleep” is commonly cited as ideal, research suggests that six hours is a more critical minimum. Falling below this threshold is associated with negative effects on mental and physical health. Some individuals, due to genetic factors, function well on less—these short sleepers are rare and often part of families with similar sleep patterns. Conversely, others require significantly more rest, especially individuals with neurodivergent traits or those recovering from brain injuries or illnesses.
The Genetics and Environment of Sleep
Sleep is not only behaviourally regulated; it is also genetically influenced. Factors such as environment, health status, diet, medication use, and levels of stress and anxiety all affect sleep quality and patterns. Like many biological processes, sleep operates within a complex interplay of internal and external influences.
The Architecture of Sleep
Each night, sleep unfolds in cycles of roughly 90 minutes. A minimum of four full cycles (approximately six hours) is necessary to experience the benefits of both deep and light sleep.
The night typically divides into two halves:
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The first half is dominated by deep sleep NREM (Non Rapid Eye Movement) Stage 3, which is restorative for the body.
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The second half features longer periods of REM (Rapid Eye Movement) sleep, important for cognitive and emotional processing.
Stages of Sleep:
1. Stage 1 (Light Sleep): Transitional phase where individuals may feel awake despite being asleep.
2. Stage 2: Breathing and body temperature drop; waking during this stage reveals clear evidence of having been asleep.
3. Stage 3 (Deep Sleep or NREM 3): Brainwaves slow dramatically. This is when most physical restoration occurs
4. REM Sleep: Dreaming is most vivid here. Muscle paralysis occurs to prevent individuals from acting out dreams.
People often perceive the second half of the night as “lighter” sleep, but it remains critical for overall rest and memory consolidation.
Sleep Disorders and Disruptions
Numerous conditions can interfere with sleep:
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Night terrors and sleepwalking occur during deep NREM sleep and are often linked to anxiety or trauma.
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Sleep paralysis happens when the brain wakes before the body, causing temporary immobility.
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Restless Leg Syndrome (RLS) can range from discomfort to pain, affecting various body parts.
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Obstructive Sleep Apnea (OSA) involves repeated breathing interruptions, leading to poor-quality sleep.
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Hypnic headaches and migraines may have underlying connections to sleep disruption.
Chronic health conditions such as rheumatoid arthritis, fibromyalgia, IBS, and Parkinson’s disease often worsen with poor sleep, suggesting a bidirectional relationship between rest and physical health.
Pain and Sleep: A Complex Relationship
Emerging research suggests that poor sleep may cause pain, rather than the reverse. Sleep disruption increases inflammatory responses, which can exacerbate chronic pain. In children, however, the reverse appears true—pain interferes with sleep.
Rumination—persistent, unproductive worry—can amplify both pain and sleep disturbances. Conversely, contentment and emotional regulation during the day improve rest and reduce discomfort.
Common Influences on Sleep Quality
Several factors can impair sleep:
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Mental stress, trauma, and overstimulation
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Neurodivergence, which often heightens sensory sensitivity and stress responses
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Physical discomfort, such as pain or a disruptive environment
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Burnout or loss of purpose, particularly in caregiving or demanding roles
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Sleep disorders, which may perpetuate a cycle of disruption
Strategies for Better Sleep and Pain Management
Medical and Behavioural Approaches:
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Restless Leg Syndrome: Medications and lifestyle changes can help.
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Sleep Apnea: Seek medical evaluation and consider CPAP therapy.
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Migraines: Use a diary to track triggers. Deep breathing and minimizing overstimulation may reduce frequency.
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Napping: Especially in the early afternoon, naps can regulate pain and support recovery.
Complementary Therapies:
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Chiropractic care may benefit individuals with fibromyalgia or headache disorders.
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Acupuncture and yoga show promise for pain reduction and improved sleep.
Mindfulness and Thought Management:
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Mindfulness meditation, particularly body scans, can improve pain tolerance and sleep quality.
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Journaling helps reduce mental clutter and supports emotional processing. Set aside a time daily to write down all worries, things on your mind.
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Techniques such as “worry time” or “thought stopping” can train the mind to reduce nighttime overthinking.
Physical Activity:
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Regular exercise (20–30 minutes, 3–5 times a week) boosts immune function and reduces inflammation.
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Even weekend-only activity can offer benefits if weekday exercise isn’t possible.
Nutrition and Hydration:
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Time-restricted eating, where more calories are consumed earlier in the day, may aid gut health and sleep.
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A Mediterranean diet supports long-term sleep health, though gradual introduction is advised for those with IBS.
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Avoid caffeine and alcohol near bedtime, and stay well hydrated to avoid cognitive impairment.
Essential Oils and Natural Aids:
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Oils such as basil, patchouli, rosemary, and citrus have various benefits. Always best to consult an aromatherapist before using essential oils.
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Over-the-counter aids like cooling sticks for headaches may offer relief.
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Always consult with a professional before using supplements such as St. John’s Wort.
Building a Healthy Sleep Environment
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Use dim, orange-hued lighting in the evening to support melatonin production.
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Expose yourself to natural daylight during the day to anchor your body clock.
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Avoid vigorous evening workouts; gentle stretching is more appropriate before sleep.
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Ensure adequate Vitamin D levels, particularly in winter.
The DRAMMA Model for Rest and Recovery
To improve well-being and sleep, consider the DRAMMA framework:
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Detachment: Mental disengagement from stress
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Relaxation: Intentional calm, often underappreciated
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Autonomy: Feeling in control of one’s life
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Mastery: Developing new skills and achieving goals
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Meaning: Finding purpose in daily life
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Affiliation: Building and maintaining relationships
Both solitude and social connection can contribute to recovery, depending on individual needs.
Establishing Healthy Sleep Patterns
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Sleep needs vary across the week; consistency matters more than perfection.
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Fixed wake-up times help maintain circadian rhythm, even if bedtime fluctuates.
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While traditionally discouraged, napping can be restorative, especially for those with chronic pain or fatigue.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
While CBT-I can be effective for many, it may not be suitable for individuals with ongoing health conditions.
Final Note: Sleep is an essential component of overall well-being, affecting everything from immune function and emotional health to chronic pain and cognition. Although many questions remain—especially regarding neurodiversity, gender differences, and the microbiome—an individualised, holistic approach offers the best path forward to those suffering with sleep disturbances. With thanks to Dr Sue Jackson for these fascinating insights into the complex world of sleep.
Dr Elizabeth Thompson