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70% of Americans aren't getting restorative sleep, new study finds

An analysis of data from more than 1,000 people who took a new type of sleep evaluation questionnaire revealed that sleep quality may be more important than sleep quantity.

While seven in 10 Americans are spending the recommended number of hours in the sack, just three in 10 are getting the right amount of good quality sleep to leave them feeling alert, cognitively sharp and energetic — or simply, “restored” — in the morning, a new study finds.

An analysis of data from 1,055 people who took a new type of sleep evaluation questionnaire revealed that sleep quality may be more important than sleep quantity. The questionnaire, which used different criteria to measure how good a night’s sleep people had, was devised by an international team of experts, according to the report published in Frontiers in Sleep.

The study was partially funded by the Bryte Foundation, which is linked to a sleep technology company called Bryte.

“It was a bit of a surprise,” said the study’s lead author, Rebecca Robbins, an instructor at the Harvard Medical School and a scientist at Brigham and Women’s Hospital in Boston. “Previous studies found that just three in 10 had issues with sleep, but those studies focused on quantity rather than quality. If a person wakes up and feels awful even when their sleep was the right duration, that’s important to capture.”

For the new approach to evaluating sleep, volunteers were asked rate, between one (not at all) and five (completely), nine signs of that they had had restorative night’s sleep: whether the person was feeling grouchy, was in a good mood, was tired, was sleepy, was rested, was refreshed, was ready to start the day, was energetic, was mentally alert. Then the ratings were combined for a total sleep quality score, which ranged from 0 to 100.

Scores of 0 to 49.9 were labeled “low,” 50 to 74.99 were labeled “somewhat,” and scores of 75 to 100 were labeled “high.”  A high score was considered to be a sign of restorative sleep. Just 28.1% of the volunteers fell into that category, meaning that seven in 10 needed help improving their sleep.

 “The main message from this study is that if you don’t feel great after a night’s sleep, that should draw your attention to what happened the night before so you can figure out how you might improve your sleep the next night,” Robbins said.

Some strategies to improve sleep, Robbins said, include:

  • Make sure you are exposed to blue light first thing in the morning
  • Eat a healthy balanced diet spread out through the day so that you get a hearty breakfast, a good lunch and not much for dinner.
  • Keep alcohol and caffeine consumption to a minimum.
  • For 15 to 20 minutes before turning in, do something relaxing.
  • Keep your schedule on the weekends as close as possible to what it is on weekdays.
  • If you tend to wake up during the night and have trouble falling back to sleep, keep a note pad next to the bed and write down your thoughts.
  • If the notepad strategy doesn’t work, then get out of bed and do something relaxing, with the lights turned low, until you feel tired enough to fall back to sleep.

The new study is “interesting,” said Dr. Beth Malow, a professor of neurology at the Vanderbilt University School of Medicine and director of The Vanderbilt Sleep Division. “They did a really nice job of pulling everything together into a very simple nine-item questionnaire and they gave it to a fairly large sample of people.”

The finding that seven in 10 Americans are not getting restorative sleep is “provocative,” Malow said. However, “there are potential limitations,” she added. For example, the quality of sleep might not be 100% correlated with a person’s grouchiness or good mood upon waking, Malow said.

Dr. Sabra Abbott also commended the researchers for devising a method to evaluate the quality of a person’s sleep. But with regard to the finding that just three in 10 Americans have good sleep, “I would take that with a huge grain of salt,” said Abbott, a sleep specialist and an assistant professor of neurology at Northwestern University’s Feinberg School of Medicine.

How someone feels in the morning isn’t necessarily correlated with how well they slept, Abbott said. “Alertness, mood and energy could be related to the quality of sleep but they could also be related to other factors,” she added.

This is especially important if you’re looking at the impact of sleep on other health metrics, such as diabetes and blood pressure, Abbott said.

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