Healthier Sleep Magazine Special Edition Global Sleep Health

Healthier Sleep

A publication of World Sleep Society

Your Trusted Source for Improving Sleep

Publisher

World Sleep Society

Editor

Amy Larson

Copy Editor

Emily Neville

Designer

Brook Lanz

Issue Reviewers

Matteo Cesari, PhD

Melissa C. Lipford, MD

Maya Ramagopal, MD

Robert J. Thomas, MD

Contributing Writers

Jason Ellis, PhD, EBSM

Arup Haldar, MBBS, DCH, MD

Sophie Kaplan

Kali Patrick

Joshua Roland, MD, FAASM

Grayson Vidovich

Genevieve Walker, PhD

Sales Manager

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About This Issue

Sleep plays a vital role in how we function throughout the day, allowing us to reset our mind, body and spirit for the day ahead. Discover the power of a good night’s sleep with our “Sleep Matters by Chuan” programme, a global wellness programme by Langham Hospitality Group which features exclusive amenities, soothing treatments by Chuan Spa and bespoke room packages. It’s the perfect way to leave our hotels feeling better than when you arrived.

The Traveler’s Guide to Healthy Sleep Around the World

By Sophie Kaplan

For travelers on the go, creating an environment conducive to healthy sleep can be complicated, especially if the sleep setting is unfamiliar. Fortunately, healthy sleep can be achieved in every corner of the planet.

Global Variations on Sleep Time

When travelling you want to feel your best to enjoy experiences offered by a different environment. To feel your best, you need quality sleep. For travelers, sleep schedules are challenging as they contend with jet lag, new time zones, and other internal adjustments. Add in different customs and foods, and sleeping away from home can seem impossible. While it may not be ideal, there are some things you can do to make your sleep better while travelling.

Intuitive sleep patterns usually follow a day-night cycle. As much as possible, try to keep to this schedule. You may feel like napping to recover from jet lag. If you choose to nap, keep it brief: just 20 to 30 minutes so that you can still sleep later that night. Try to stay active during daylight hours to sleep better at night.

When it comes to sleep around the globe, sometimes the best answer is the simplest: be consistent. Make sure you listen to your body and make adjustments if you’re not feeling your best in the morning.

Food and Drink

Nourishment can also have an impact on your sleep, but food and drink are important to cultural practices and the travel experience. When trying new foods and customs, keep in mind a few key rules to protect your sleep.

• Limit alcohol at least 4 hours before bedtime. Know that if you choose to drink alcohol late into the night it will affect your sleep.

• Be aware of when you eat: a large meal close to bedtime can be uncomfortable and make it difficult to sleep.

• Avoid spicy and sugary foods close to bedtime.

• Avoid caffeine at least 6 hours before bed.

These rules can be challenging while travelling across cultures where it may be common to eat late in the evening or have coffee after dinner, so make adjustments where you can. When eating late, choose light fare and small portions, and order decaffeinated coffee or a non-alcoholic drink.

Plan food adventures earlier in the day so that new, unfamiliar food has time to settle before bed. If you are having difficulty sleeping after trying late/early dining times, try eating closer to your regular schedule and adjust slowly. Sleep is partially triggered by internal cues based on when we eat.

Go ahead and try the local fare. Just be aware of timing and quantity to protect your sleep! While the occasional indulgence won’t ruin your sleep forever, be aware of the potential effects.

Ideal Sleeping Environment

No matter where you are, your sleeping space matters. To cultivate a healthy sleep environment, you should only spend time in bed when you are trying to sleep. Lounging in bed without sleeping trains your body to see the space as a place for activity rather than rest.

Aim to make your sleeping environment as comfortable as possible. As it is impossible to foresee all potential situations you may find, be prepared and pack along items that will help you sleep: an eye mask to block out the light, ear plugs to block out noise, comfortable sleepwear, and any items used for your nightly routine

What We All Have in Common

Whether you’re in the Southern or Northern Hemisphere, closer to the Poles or Equator, there are some universal rules of sleep that every traveler can use: technology before bed is not recommended, consistent sleep is restorative, and it’s important to prioritize comfort. Above all, make time for quality sleep. Travel and compromise go together – enjoy your travels but mind your sleep health!

Sleep Like a Professional Athlete

By Sophie Kaplan

There’s sleep, there’s good sleep, and then there’s sleeping like a professional athlete. When it comes to professional athletes, even good sleep isn’t good enough. If you have poor sleep habits, fixing your routine can feel insurmountable. But at the end of the day, mastering healthy sleep can make all the difference.

The effectiveness of our sleep cycle impacts everything from work performance to mental health, and this is especially true for people with hectic professional lives. Regardless of your career, sleep affects us all. So how do athletes in pro sports manage to sleep perfectly every night and wake up to play their best?

The short answer is they don’t. No one does. In fact, if you want to learn how to sleep like a pro, start by abandoning the idea of “perfect sleep.”

The Problem of Perfect Sleep

Even elite athletes from star gymnasts to professional soccer players set multiple alarms, weigh the risks of a late night, and worry until dawn before a game or competition. Overcoming inconsistent sleep is a human problem, not just one that impacts high-achieving people. To elevate your sleep, start by addressing the way you think about sleep.

Looking to achieve “perfect sleep” every night isn’t just a lofty goal, it’s an unrealistic one. It’s impossible to predict every variable that affects a night of sleep. A party next door, a sick child, a bad storm – the possibilities are endless. Not every night can be perfect, so rather than relying on perfection, real pros cultivate a pro-sleep culture.

Healthier Sleep had the opportunity to speak with neurologist and sleep specialist Chris Winter, MD to learn more about the relationship between sleep and athletics. Dr. Winter works closely with professional athletes and helps them develop lifestyles that lead to higher quality sleep and subsequently higher quality sports performance. Much of Dr. Winter’s advice centers around a core idea: effective sleep is a lifestyle.

A holistic approach to sleep that includes diet, activity, and mental health will always be more effective than attempting sleep “tricks.” Counting sheep might feel like an effective strategy for insomnia, but individuals looking for long term sleep improvement find more success by making broad adjustments to their mindset and daily habits.

When asked about improving the sleep of professional athletes, Dr. Winter recommends focusing on three key areas:

• Cultivate a pro-sleep culture at your organization

• Stay informed about sleep via sleep specialists

• Improve sleep whenever possible but understand that it will never be “perfect”

Pro-Sleep Culture

So, what is a pro-sleep culture? According to Dr. Winter, adjusting how you and your support system view and react to sleep makes a big difference. Dismantling a culture that idolizes non-stop doing, and as Dr. Winter says, “setting a tone where sleep is supported” is the first step towards a better relationship with sleep. A prosleep culture doesn’t vilify getting the rest you need while simultaneously encouraging support and sleep education.

Stay Informed

That leads to his second piece of advice: stay informed. Sleep is like any other science in that we are always learning more about how it works and how to make it work for us. Dr. Winter recommends that athletes consult sleep specialists regularly. In fact, sleep specialists should be a core part of any athlete’s support team alongside dieticians and trainers. Beyond the obvious benefit of having an on-site expert, sleep specialists also help sort fact from fiction as new sleep research becomes available.

“Perfect Sleep”

Finally, perhaps the most vital advice of all: abandon the idea of perfect sleep. Dr. Winter explains that even if your sleep can’t be optimal, it can almost certainly be better. Making your sleep as good as possible is the goal. The occasional sleepless night will happen, but if you take steps to maintain a healthy diet, check in with a sleep specialist, and take care of your body, it won’t make or break your relationship with sleep.

Taking Your Sleep to the Next Level

Dr. Winter’s ultimate takeaway is a great lesson for everyone, train your mind to see sleep as something beyond a problem that needs to be solved. Sleep may come easily some nights and not others, but if you teach yourself to treat sleep as part of your overall health instead of a nightly battle, then you can start to cultivate a pro-sleep perspective. That perspective is what allows professional athletes to master sleep as thoroughly as they’ve mastered their sport. With the right mindset and routine, anyone can learn how to sleep like a professional athlete.

Promoting Sleep Around the World

By Joshua Roland, MD, FAASM

Sleep is a crucial biological process. Humans need an average of 7 to 8 hours of sleep each night to operate at their best. However, studies suggest that up to one third of the population does not achieve this amount.

Lack of proper sleep is linked to many health conditions and can contribute to mood and cognitive issues. Poor sleep has been associated with high blood pressure (hypertension), elevated blood sugar (diabetes), and higher rates of depression. People who do not get good sleep also have an increased risk of heart attack, stroke, and certain types of cancer, and they are more likely to get into a motor vehicle accident.

A growing number of scientific studies continue to show how poor sleep can negatively impact various biological systems. With more appreciation of just how vital sleep is for health and wellness, promoting the importance of getting adequate sleep is paramount for a healthy population across the globe.

Differences Cultures, Different Views

The view of sleep can vary around the world with different cultural and environmental conditions shaping how people sleep. For example, in many cultures, working hard is understandably highly valued. At times there can be such a strong focus on productivity that it takes priority over getting enough rest. In some cultures, it may be seen as a positive quality if someone is clearly sleep-deprived. This can be viewed as a sign of a strong work ethic. However, people who are sleep-deprived are likely to have lower productivity levels and are more prone to making errors. We simply are not as efficient if we are not getting adequate healthy sleep.

Some cultures look favorably on napping and include it in their daily lives while others may view it as a sign of laziness. In some regions, families sleep together in the same space while in other places they sleep apart. People in some parts of the world may be more at risk for sleep disorders such as sleep apnea, which can be a major detriment on sleep quality and health. There are also different levels of access to diagnostic and therapeutic options to treat sleep conditions.

While different populations across the globe may have different habits and views about sleep, no matter what part of the planet you live on, good sleep is integral to good health and well-being.

Trends Around the Globe

Increasingly, much of the world has been undergoing “globalization.” A greater percentage of the global population relies on artificial lighting to extend their wake time than ever before. Throughout the world, there is increased use of electronic devices at night. These increases in light exposure can contribute to the global health issue of inadequate sleep.

In addition, we now operate in a more global workplace and connect with friends and family in different parts of the world. Our natural sleep cycles (or circadian rhythms) are further disrupted, worsening sleep quality and duration as we interact across different time zones.

Growing Attention

Thankfully, awareness of sleep’s role in health has been increasing. Numerous groups across the globe are working hard to change the view of sleep and highlight its importance. This is exemplified by organizations such as the World Sleep Society, which is dedicated to advancing sleep health across the globe. Events such as World Sleep Day aim to bring the world together in awareness of the importance of sleep.

Other groups, such as the nonprofit organization Project Sleep, have been formed to promote patient advocacy and awareness of sleep disorders. Technology, while often cited for its negative impact on sleep, can allow for better access to information on healthy sleeping habits and potentially provide better access to means to diagnose and treat sleep disorders.

The world today may seem divisive at times with our differences often highlighted. But we are all much more alike than we are different. The importance of sleep for health is shared around the planet. Unfortunately, the large portion of the population not obtaining adequate sleep is also a commonality shared across the globe. >

There is still a long way to go toward spreading awareness of the importance of sleep to health. A vast portion of the global population is not getting enough rest. Sleep disorders such as sleep apnea are often going undiagnosed. More studies are needed to help us understand sleep issues in varying populations across the planet. Different habits and cultural attitudes surrounding sleep need to be considered when designing and implementing interventions to promote healthy sleep.

Sleep remains a key target area to improve health worldwide. Optimism and hope for better sleep are abundant due to increased public and medical awareness of sleep health thanks to a growing number of individuals and organizations who have dedicated their time and resources to promoting sleep across the globe.

*Citations available on healthiersleepmag.com

World Sleep Day is an annual public awareness day that celebrates healthy sleep. World Sleep Society members organize local and regional activities that raise awareness of sleep health.

Since the first World Sleep Day in 2008 there have been 92 participating countries and 2,500+ activities organized.

Joshua Roland, MD, FAASM is a sleep medicine physician with the telehealth company Thirty Madison in Los Angeles, California. He has worked in sleep medicine for over five years.

The next World Sleep Day is Friday, March 14, 2025 Sign up for updates at worldsleepday.org for the latest developments.

Dr. Joshua Roland

Soothing Bedtime Routines

By Healthier Sleep Staff

One healthy sleep habit is having a consistent and soothing bedtime routine. Ideally a bedtime routine begins 30 to 60 minutes prior to bed and is consistent. This signals to your mind and body that it is time to prepare for sleep. A routine can be especially helpful when travelling. A person’s sleep routine is personal: what works for one person may not work for another.

Whatever strategies you use, a consistent bedtime routine that relaxes and calms will lead to a better night’s sleep. Whether at home or away, you can prepare for a good night of sleep with any of the suggested routines.

Lighting

Dimming lights or surrounding yourself in soft light can signal to your body that it’s time to prepare for sleep. Light plays a key role in regulating our circadian rhythm, the natural daily changes within our bodies that promote wakefulness during the day and promote sleep in the evening. Light from any screen can increase brain alertness, which delays the onset of sleep. In order to get quality sleep, turn screens off one hour prior to bed and keep them off until arising.

Yoga or Gentle Stretching

Yoga or gentle stretching may help decrease sleep disturbances, the need for sleep medication, and help sleep onset. The gentle stretching relaxes your body, preparing it for rest. Yoga can be especially beneficial for older adults or people who experience pain upon waking up.

Meditation

Mindfulness meditation has been shown to be an effective treatment for insomnia. Stress and anxiety play a major role in poor sleep. Individuals with high stress have a more difficult time falling and staying asleep. Not only can stress and anxiety lead to insufficient sleep, but insufficient sleep can affect mood and lead to stress and anxiety. While yoga relaxes the body, meditating prior to bed relaxes the mind and can aid in relieving stress and anxiety.

A Warm Bath

Why is a warm bath a good choice for a bedtime routine? It’s all about temperature. As the body cools down after a warm bath, it reinforces the 24-hour cycle or circadian rhythm. Each evening, your hands and feet warm slightly signaling the core to cool down in preparation for sleep. Take a long warm bath one to two hours prior to bed for the greatest benefits. A warm shower or foot bath for even 10 minutes can also aid in sleep onset and quality.

Journaling

While stress and anxiety can keep you awake at night, journaling can help you relieve worries. Evidence supports the effectiveness of journaling in reducing mental distress, anxiety, and depression –important components to getting a good night's rest. It can also help to write down your plans for the next day, freeing up your brain for sleep.

5 Ways to Prioritize Your Sleep, Even When You’re Busy

By Kali Patrick

When there are so many people and activities competing for your attention, prioritizing sleep can feel impossible. Here are five tips that can help. Even if you’re busy, you can…

Start each new day brightly. Even if you didn’t get quality sleep that night, get out of bed at the same time daily, and find some light. Notice and counter any Automatic Negative Thoughts (ANTs) about what your day might bring with an opposite (or neutral) statement. Energize your body and clear out any morning brain fog with gentle movement.

Have a macronutrientbalanced meal mid-day. Eat it away from your workspace, ideally in nature or with a nature view. Even 20 minutes (without multitasking) can help you feel nourished and rejuvenated.

Counter mid-afternoon energy slumps with an energizing practice. Need to release stress? Try two or three rounds of healthy breathing. Techniques like this, which open your chest and/or emphasize your inhalation, create energy. They also combat the kyphotic posture caused by too much computer use, which restricts full breathing and can result in tiredness.

Have a ritual that clearly demarcates the end of your workday. This is especially important if you work from home or have a fluid boundary between your roles as a worker doing and person being. Select a time to power down your workstation or close your office door. One client of mine who works from home cleverly places different figurines on her table: one represents working, the other personal business and fun.

Create a supportive, daily rhythm for yourself. The mindbody system is soothed by rhythm. It likes to anticipate what’s going to happen and have that expectation met. (This is why uncertainty often produces anxiety, and why upended plans can feel stressful.) Rhythms can be set by time, light, food / drink, or movement. They reinforce circadian rhythm, and may result in deeper, less fragmented, and more refreshing sleep at night.

Start by selecting one item from the list – ideally the one that is most feasible for your busy life and feels most enjoyable. Do it consistently for at least a month and notice its impact on your sleep and energy.

Kali Patrick is a Sleep Wellness Coach, therapeutic yoga & meditation teacher, and speaker who helps stressed-out, busy professionals learn to sleep better and improve their energy. She also supports corporate wellness programs with 1-1 coaching, classes, and presentations.

The Power of Noise for a Good Night's Sleep

By Genevieve Walker, PhD

When you think about getting a good night’s sleep, you probably imagine a completely quiet room. When that isn’t possible, a little noise might actually help you sleep better. Different types of noise can mask disruptive sounds and help you relax. Here's what you need to know about sleeping with noise.

White Noise – the Soothing Sound of Slumber

Have you ever fallen asleep to the gentle hum of a fan or the steady whir of an air conditioner? That's white noise – a constant, static-like sound that many find soothing.

Studies show that white noise can help you sleep by blocking outside sounds like traffic or loud neighbors. It can be especially beneficial for light sleepers who wake at the slightest sound. White noise may also provide relief for people with tinnitus, masking the ringing noise that is most noticeable – and bothersome –in a silent room.

Other “Colors” of Noise

While white noise is popular, there are many different “colors” of noise that may also help you sleep. Two options are “pink noise” and “brown noise.”

Pink noise mimics the gentle sounds of nature like steady rain or ocean waves. It has more power in the lower frequencies than white noise, which gives it a deep, soothing quality. Research suggests that

pink noise can help people with insomnia fall asleep faster and sleep more soundly.

Brown noise, also called red noise, has even more bass and deeper tones, resembling strong winds or waterfalls. It can mask low-pitched disturbances like buses or machinery. This type of noise may benefit you if you have hearing difficulties or tinnitus.

There are also “colors” like gray, green , blue, and purple noises. Each has a unique frequency balance that creates a distinct sound profile. When experimenting with noises for sleeping, try a range of different types to find what works best for you personally.

Should You Sleep with Noise?

If you want to try sleeping with noise, remember to keep the level low. Anything at 85 decibels or above – about the same volume as a hair dryer –can cause hearing damage.

Experts generally consider noise machines and apps to be a safe option that might help you sleep better. When traveling, a noise device allows you to easily recreate your ideal sleep environment no matter where you are. A noise app is convenient for packing light.

However, noise probably won't be a cure-all for everyone. If you're bothered by any sound at all, complete silence may still be best. But for many, a little background noise could be the key to getting the restful night's sleep you need.

Genevieve Walker, PhD is a freelance writer and editor specializing in patient education, plain language, and consumer health content. She holds a PhD in English and serves on the board of the American Medical Writers Association.

Sleeping at High Altitudes

By Grayson Vidovich

Many bodily functions can be impacted by high-altitude and low-oxygen environments, especially sleep.

High-quality sleep is crucial for mood, memory, and overall health and well-being. When sleep is consistently disrupted, troubles with focus, stress, problem-solving, and energy can arise.

High-altitude environments can cause several health conditions including nausea and confusion as well as acute mountain sickness, characterized by headache, fatigue, weakness and gastrointestinal symptoms.

How Does High Altitude Impact Sleep?

High altitudes impact both sleep quality and sleep quantity and can negatively affect sleep in two ways: by altering breathing patterns and by disrupting the stages of sleep. Dr. Michael Furian, a senior researcher at the University of Zürich, helped us understand these disruptions and how to mitigate them.

Sleep Quality. At higher altitudes, there is less oxygen in the blood. To compensate, we begin to breathe quickly (or hyperventilate). Hyperventilation leads to decreased carbon dioxide (CO2) levels within our blood. Our bodies need a certain amount of CO2 to function properly, so when CO2 levels drop too low, we stop breathing for 15 to 20 seconds. This allows CO2 to build back up to normal levels, and we can breathe again, causing high-altitude periodic breathing. This is a type of sleep-disordered breathing characterized by repeated central sleep apneas, which is associated with daytime sleepiness, headaches, and poor mood. Anyone who ascends to 4,000 meters (about 13,120 feet) or above will likely experience this condition to a certain degree.

Sleep Quantity. High altitude is associated with less deep sleep, increased superficial sleep, and more disruption throughout the night. Superficial sleep is crucial to ensure the overall length of sleep, but the lack of deep sleep is associated with fatigue, memory problems, and decreased focus.

Who Does High Altitude Affect?

Anyone can be impacted by altitude-related conditions; however, some populations are at greater risk than others.

Men. Men are more likely to have highaltitude periodic breathing since they have a stronger stimulus for hyperventilation at high altitudes. Conversely, men generally have less acute mountain sickness than women.

Individuals with Respiratory Disease.

Individuals with pre-existing conditions, such as COPD, obstructive sleep apnea, or other lung diseases, are at greater risk for experiencing intense altitude-related sleep disturbances. Anyone with sleep disturbances at low altitudes will see them increase at high altitudes.

How to Prevent AltitudeRelated Sleep Disturbances

Worried about altitude-related conditions? Fortunately, preventive measures can be taken.

Prescription Medication.

Acetazolamide, a prescription medication, is a preventative treatment against acute mountain sickness and has been shown to stabilize breathing and decrease high altitude periodic breathing. It can also increase a person’s ability to adapt to the elevation more quickly and with less discomfort.

Avoid Alcohol. Avoiding alcohol at greater altitudes can help to prevent sleep disturbances.

Avoid Rigorous Exercise. Perform light exercise rather than moderate or heavy exercise. High-intensity training is a risk factor for developing symptoms of acute mountain sickness and exaggerate disturbed sleep.

Slowly Ascend. Allow your body time to slowly adjust to greater altitudes to decrease the likelihood of suffering from sleep disturbances and altitude-related illnesses. Spending multiple days at a certain altitude before ascending is associated with less sleep disruption.

*Citations available on healthiersleepmag.com

Grayson Vidovich is an occupational therapist who specializes in health promotion and disease prevention.

At higher altitudes, there is less oxygen in the blood. To compensate, we begin to breathe quickly (or hyperventilate). Hyperventilation leads to decreased carbon dioxide (CO2) levels within our blood. Our bodies need a certain amount of CO2 to function properly, so when CO2 levels drop too low, we stop breathing for 15 to 20 seconds.

RU-SATED Questionnaire

Quality sleep is associated with overall health and wellbeing. The RU-SATED inventory uses scientific factors developed by Dr. Dan Buysse, Professor of Psychiatry and Clinical and Translational Science, University of Pittsburgh. Answer the questions below to evaluate your own sleep. If the results concern you, contact your primary care physician.

Do you go to bed and get out of bed at about the same times (within one hour) every day?

SATISFACTION

DURATION

Do you spend less than 30 minutes awake at night? This includes the time it takes to fall asleep plus awakenings during sleep.

Total for all items ranges from 0-12.

0 = Poor Sleep Health

12

Sleep’s Role in Recovery

Don’t Skip This Part of Your Workout!

By Genevieve Walker, PhD

You go to the gym every day. The day isn’t complete without a workout or practice, and your cupboard is stocked with everything you need to rebuild and recover – or so you think. Your energy isn’t what it used to be. You’ve tried eating more protein, and you’re drinking plenty of fluids. What’s missing?

You might be overlooking a key part of training and recovery: sleep. Catching some Z’s may feel like downtime to you, but your brain and body kick into high gear during this time. Everything from brain cells to muscle tissue is repaired and even grows while you sleep, helping you meet the next challenge.

How Sleep Affects Your Muscles

While you sleep, your body makes the hormones that help repair damaged muscle fibers. This includes growth hormones and testosterone (yes, even for women). They also help your body make new protein, the building blocks of muscle tissue. This happens up to 30% faster during sleep than while you are awake.

Good sleep is especially important after hard exercise, which causes more minitears in your muscles than a light workout. If you sleep too little or sleep poorly, your body can’t repair the damage. Building new muscle tissue doesn’t happen either. Eventually, tough workouts without enough sleep hurt your health.

Other Ways Sleep Helps

Lack of sleep affects more than your muscles. It can keep your body from completely refueling the stored sugars in your liver and muscle tissue. This normally happens while you sleep. You need this sugar for quick bursts of energy and to keep your blood sugar stable.

Exercise causes inflammation, leading to soreness, pain, and swelling. Sleep time is when your body’s immune system goes to work treating this inflammation.

Finally, when you don’t sleep well, you are less alert, making injury more likely.

Schedule Your Workout for Better Sleep

Exercise also affects sleep. When you exercise, your muscles make substances called myokines that can help you sleep more deeply. It’s a win-win: good sleep boosts exercise and exercise improves your sleep.

Can the time of day you exercise affect your sleep? Experts recommend avoiding vigorous exercise for at least an hour before bedtime. If you typically have trouble sleeping, four hours may be better.

So, when should you exercise to get the best night’s sleep? It depends. Morning exercise may help you get to sleep faster at night. Afternoon or early evening workouts could help you sleep more deeply. If you wake up often, gentle exercise before bed could help you stay asleep.

...............................................................................

Genevieve Walker, PhD is a freelance writer and editor specializing in patient education, plain language, and consumer health content. She holds a PhD in English and serves on the board of the American Medical Writers Association.

No matter when you work out, going to sleep and getting up at the same time every day is critical for quality rest. Aim for seven to nine hours of sleep each night.

Is Climate Change Hurting Our Sleep?

By Arup Haldar, MBBS, DCH, MD

Sleep is one facet of our health that is impacted by climate change. Sleep is vital for restoring physical and mental health. Sleep deprivation speeds up the aging process and can lead to various cardiometabolic disorders. Not getting enough good sleep used to be seen as a lifestyle problem, but it is now considered as a distinct disease. The current terminology for sleep deprivation is “insufficient sleep syndrome” (ISS). While ISS can be deliberate and self-induced, environmental cues are also a risk factor.

Rising Temperatures

One of the ways the body prepares itself to fall asleep is by cooling the core temperature. Before falling asleep, the temperature of the hands and feet increases slightly and the core temperature drops. The body’s temperature remains low while asleep and then increases again before awakening.

When the environment or room temperature is warmer than usual, it’s more difficult for the body to decrease its temperature for sleep onset and maintain the lower temperature during sleep. That's why it’s harder to fall and stay asleep in warmer temperatures. Because climate change is causing higher temperatures in many parts of the world, people may have a more difficult time getting good sleep.

In the United States, the average temperature has increased 0.8 to 1.0 degrees Celsius since 1895. The rise has been steeper since 1970. Rising temperatures have caused more heat-related events. Higher daytime temperatures are leading to persistently higher nighttime temperatures.

There is evidence that negative effects of higher temperatures are stronger in elderly and lower income populations. The most vulnerable people to climate-sensitive diseases are those least responsible for such a climate crisis.

Air Pollution

The climate crisis can reduce sleep in other ways, such as air pollution. Recent studies show that air pollution can lead to obstructive sleep apnea (OSA). In OSA, there is reduced or blocked airflow to the lungs during sleep. This leads to reduced oxygen saturation in blood. The brain wakes up repeatedly to choking episodes during sleep. OSA impairs sleep quality and daytime functioning and can lead to premature death.

Extreme Weather Events

The climate crisis is responsible for more cyclones and extreme weather events. Since the middle of the 20th century, the frequency of very severe cyclonic storms has increased significantly. These events have negative effects on acute and chronic sleep health due to loss of shelter, anxiety, and posttraumatic stress disorders.

Climate Refugees

Climate changes will lead to more climate refugees. A 2018 World Bank Group report estimated that the impacts of climate change in Sub-Saharan Africa, South Asia, and Latin America could lead to more than 140 million people leaving their homes before 2050. This has a tremendous effect on mental health. Such adverse mental health conditions will cause more sleep problems in the affected population. Sleep problems and mental health problems have a close relationship, and one can make the other worse.

The five pillars of good health are good food, good water, good air, good sleep, and regular exercise. The first four components are directly affected by climate changes. Though much attention has been shown regarding food, water, and air safety, there has been little concern about sleep health. The right to a healthy sleep environment is still a concept in need of attention. Sleep problems are not yet included in lists of climate-sensitive diseases. Given sleep’s importance to maintain a healthy body and mind, it cannot be ignored.

*Citations available on healthiersleepmag.com

Dr. Arup Haldar works for the Department of Pulmonary Medicine, Woodlands Multispecialty Hospital, in Kolkata, India. He completed a fellowship in Epidemiology and Biostatistics and has worked in sleep medicine for 17 years. He has a special interest in obstructive sleep apnea and titration methodologies.

Dr. Arup Haldar

Ways to Get Through the Day on Little Sleep

By Jason Ellis, PhD, EBSM

There are many indicators of poor sleep quality, such as irritability, poor mood, inferior performance, and difficulties concentrating. But these could also be explained by other factors, making it difficult to detect insufficient sleep.

How do I know if I’m not getting quality sleep? One question to ask yourself is, “How do I feel about an hour after waking up?” If you feel tired, sleepy, or drained, then there is likely an issue with the quality, quantity, or timing of your sleep.

Beyond asking yourself this important question and listening to your body’s response, how quickly you fall asleep at night is a second way to discover if you’re not getting enough sleep. While it may sound good to fall asleep immediately upon getting in bed, it can also indicate that you are sleep deprived. If there is a consistent pattern of poor sleep, it should be investigated further. Whether an ongoing problem or an occasional occurrence, everyone has days when they feel tired.

When Poor Sleep Is Present

Unfortunately, there isn’t a quick fix for dealing with poor sleep, but there are a few things that can help.

Try to keep your schedule “as normal” as possible. We are biologically and behaviorally tied to routine. For example, structured food timing can help us keep pace with the day. If you’re tired, you may want to eat at different times through the day, but I recommend doing the same as you would have done if you’d gotten excellent sleep.

Exercise is great for increasing alertness. Though you may feel tired, I would certainly suggest exercise to help get through the day. Because of its positive impact on nocturnal sleep, it makes it a doubly attractive option. I favor the use of caffeine to increase alertness during the day. However, be mindful of the timing so it doesn’t impact sleep.

Avoid clockwatching during the day. Just as it can be detrimental to your sleep to “clock-watch” at night, it can be just as detrimental during the day when you haven’t had enough quality sleep. Whether counting down the hours and minutes until you need to get up or counting down the hours and minutes before you can go to bed, both can leave you feeling anxious.

Do nothing. When I don’t get enough sleep or have the odd bad night, I do the easiest and hardest thing…absolutely nothing! I know from experience that if I try to compensate, then I am likely to make the situation worse, but if I do nothing my sleep will correct itself. We have an amazing biological capacity to self-regulate sleep. It is largely when we focus on it, worry about it, and change our behaviors to try to get more sleep that things go wrong. My main philosophy around sleep is that one poor night does not a sleep disorder make.

Jason Ellis is Professor of Sleep Science at Northumbria University in the United Kingdom. He has been working in the field of sleep medicine and research for over 20 years. Professor Ellis is also author of The One-Week Insomnia Cure: Learn to Solve Your Sleep Problems.

Hosted by World Sleep Society

Around the World rld Sleep Day

World Sleep Day is an annual celebration that brings together sleep medicine specialists and the public throughout the world to highlight the importance of sleep. Since the first World Sleep Day in 2008, thousands of events and activities have taken place around the globe. Dedicated sleep professionals have committed themselves to raising awareness of sleep and all it has to offer. Read on to learn more about World Sleep Day from recent award winners in their own words.

Nigeria

Morenikeji Komolafe, MBBS

Obafemi Awolowo University, Ile-Ife, Nigeria

Our goals for World Sleep Day were to raise awareness of sleep disorders among school children, teachers, and the public; to educate healthcare workers; and to encourage institutions to implement policies in terms of better work schedules to reduce the adverse effects of sleep deprivation.

The awareness activities in the schools have been the most meaningful. The school children have many questions and they are agents of change as they carry the message home to family members. World Sleep Day is an avenue to promote the field of sleep medicine and encourage more doctors to specialize in the discipline.

Morocco

Amal Satté, MD

Moroccan Society of Sleep and Wakefulness

We contacted important TV channels in Morocco who featured members of the SMSV during the TV news and reported on sleep. We also organized activities in different associations and schools for adolescents.

Our main goals were to inform people that sleep issues shouldn't be neglected and there are sleep centers that manage these issues. Many patients came to the different sleep centers because they identified symptoms they heard about on the TV reports we did.

India

Nagarajan Ramakrishnan, MD

Nithra Institute of Sleep Sciences

Sleep health is often ignored. World Sleep Day is a great opportunity to remind healthcare professionals and the public of the importance and educate them on common sleep disorders. The activities help make people aware of the services we provide. Dedicated sleep clinics in India are still far and few. Many people are unaware of whom to approach for their sleeprelated issues.

Thailand

Pornprapa Chindamporn, MD

Sleep Society of Thailand

In 2022, the activity for the public was to compose a song for good sleep and promoting sleep hygiene. The Sleep Society of Thailand had collaborated with the Department of Health, Ministry of Public Health, Thailand. We arranged a press conference to promote sleep hygiene in childhood, middle-aged, and elderly groups and pushing good sleep policy to publication.

Armenia

Samson Khachatryan, MD, PhD

Armenian Sleep Disorders Association, Department of Neurology and Neurosurgery, Armenian National Institute of Health

World Sleep Day is a great occasion to raise awareness among the general population and give attention to the work we have done locally. The population in Armenia now is more aware overall. People frequently find a sleep doctor through the internet and medical specialists are now more likely to refer their patients for sleep consultation and study.

Portugal

Teresa Rebelo-Pinto, MsC

Sleep & Psychology Clinic

World Sleep Day is such an exciting experience, it gives us the chance to build very impactful projects, bring together groups from the community, and invite them to look at sleep from a healthier perspective. It’s an opportunity to educate new researchers and clinicians that become interested in the sleep field.

Many people ask for professional help after these campaigns because they became curious about sleep. Sometimes, they had no idea they had a serious sleep disorder (like narcolepsy or sleep apnea) and this would have stayed a silent issue without this type of awareness initiative.

Spain

Teresa Canet, PhD

Spanish Sleep Society

We collaborated with a school on a week-long program dedicated to the importance of sleep. The students prepared the content of the classes themselves. The school invited psychologists, nutritionists, soccer players, and sleep doctors to assess its contents and talk about sleep. The students prepared a list of practices for a good night's sleep and disseminated it in hair salons, bakeries, and other stores in the neighborhood. They gave conferences to the parents and developed theaters about good sleep hygiene.

México

Montserrat Reséndiz-García, MSc

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Colombia

Leslie Katherine Vargas Ramírez, MD

Instituto

Neumológico del Oriente

World Sleep Day is important because it is an opportunity to spread the importance of sleep, reach healthcare personnel who do not know the area of sleep, and fulfill our social responsibility. The most successful projects are those that reach the general public, who do not know about the importance of sleep, especially in populations with little access to sleep care information. People who attend the events are interested in reviewing their sleep, making changes, and sharing information with others. The next World Sleep Day is Friday, March 14, 2025. Sign up for updates at worldsleepday.org for the latest developments.

World Sleep Day is a date that brings together all of us who work in sleep medicine around the world. It is very exciting to think that so many people work one day together under one slogan. World Sleep Day has increased our excitement and interest in carrying out activities that promote the education of health personnel, patients, and the community in general. It is a day we look forward to year after year.

Hosted by World Sleep Society