There’s more to healthy sleep than just spending a certain amount of time in bed. Even if you regularly get the seven to nine hours a night that’s recommended for adults, you could still be falling short in the sleep department.
There could be many reasons why you feel tired even after what seems like a full night’s rest. We look at how you can tell if you’re actually sleeping well and delve into the details about sleep quality, including why it’s important and why it can get disrupted.
Signs You Slept Well
While there are no hard and fast rules that determine whether you’ve slept well, examining certain signs can give you some hints.
- Energy after awakening: Feeling refreshed when you wake up can be an important indicator that you had solid, restorative sleep.
- Ease in falling asleep: The amount of time that it typically takes you to fall asleep can be a reflection of quality sleep patterns. Not struggling to doze off at bedtime can be evidence that you’re sleeping well.
- Continuous sleep: Waking up multiple times during the night can detract from getting good sleep, so having uninterrupted sleep is one sign of sleep quality.
- Total sleep time: Although sleep quantity isn’t everything, getting enough hours of rest is a factor in determining whether you have slept well.
Sleep Quality vs. Quantity
If you want to get sufficient nightly rest, it’s important to think about both sleep quantity and quality.
Many people know that sleep deprivation can occur when you don’t sleep enough, whether it’s from just one night or consistently sleeping less than you need. But spending eight hours in bed every night isn’t enough. Poor sleep quality can also lead to sleep deprivation.
Getting high-quality sleep is just as important as getting enough sleep. Two main factors determine sleep quality: how many times you wake up during the night and how your sleep is structured.
There are two categories of sleep: rapid eye movement (REM) and non-REM (NREM). NREM sleep consists of three stages. Each stage affects the brain and body in different ways, facilitating a good night’s sleep.
Properly moving through the different stages and types of sleep plays an essential role in key benefits from sleep, including:
- Feeling rejuvenated in the morning
- Learning
- Memory formation
- Cell growth and healing
- Healthy hormonal function
- Immune health
You typically cycle through all the stages of NREM and REM sleep about four to five times each night. However, if you repeatedly wake up during the night, you may not spend enough time in some stages, which can affect your sleep quality.
Often, you may not be aware that you have fragmented sleep. With each awakening, it may only take a few seconds before you go back to sleep. But these interruptions can break up your sleep enough to lead to daytime drowsiness.
Signs You May Not Be Getting Quality Sleep
There are many signs that your sleep quality might be poor. You may have trouble waking up in the morning or find yourself nodding off in the daytime. You might struggle to pay attention or remain focused when you need to.
Poor quality sleep can lead to sleep deprivation. Sleep deprivation can cause symptoms such as:
- Problems with thinking
- Mood problems
- Poor work performance
- Difficulty remembering information
- Poor judgment and risky behavior
Over time, insufficient sleep can heighten the risk of developing certain health conditions, such as:
- Type 2 diabetes
- High blood pressure
- Cardiovascular problems like stroke or heart disease
- Obesity
Why Do I Have Poor Sleep Quality?
Quality of sleep depends largely on the amount of nighttime awakenings and whether enough time is spent in each stage of sleep. Many factors can disrupt sleep cycles and lead to fragmented and lower-quality sleep.
Older Age
Sleep patterns change with age. As people get older, they spend less time in stage 3 NREM sleep. Known as deep sleep, stage 3 is necessary to wake up feeling well-rested.
Because they spend less time in deep sleep, older adults generally sleep more lightly than younger people. They tend to wake up more frequently at night. As a result, older adults may get less of both REM and NREM sleep.
Some older people experience poor-quality sleep as a consequence of other health problems, or they may take medications that alter their sleep patterns. Older people are also more likely to develop sleep disorders, including sleep apnea.
Sleep Disorders
Sleep disorders are common causes of nighttime awakenings. These disorders disrupt sleep cycles in a number of ways, including by causing a significant increase in transitions between sleep stages. People may briefly awaken during these transitions, causing repeated sleep interruptions.
Many sleep disorders cause fragmented sleep, including:
- Obstructive sleep apnea
- Central sleep apnea
- Restless legs syndrome
- Periodic limb movement disorder
- Insomnia
- Jet lag and other circadian rhythm sleep-wake disorders
Mental Health Conditions
Many mental health conditions can negatively impact sleep quality.
As many as 80% of people with depression also experience insomnia. People who have depression are more likely to wake up earlier than they would like to in the morning. Their sleep cycles may be thrown off, and even when they get sleep, they may feel as though they didn’t rest at all.
Other mental health conditions that can interfere with sleep patterns include:
- Anxiety disorders
- Schizophrenia
- Bipolar disorder
- Post-traumatic stress disorder
- Substance use disorders
Stress can also detract from sleep quality by reducing time spent in the most restorative stages of sleep. Stress may worsen sleeping problems by provoking sleep disruptions and making it harder to get back to sleep.
Other Medical Conditions
Around 40% of people with a medical condition experience insomnia. A variety of illnesses and health problems can affect sleep quality in different ways.
- Lung problems: Trouble breathing can make it hard for people with conditions like asthma and bronchitis to sleep through the night. Insomnia is also common among people who have chronic obstructive pulmonary disease (COPD).
- Diabetes: People with diabetes may wake frequently in the night, often because of complications like nerve pain.
- Cancer: Up to 50% of people with cancer have trouble sleeping. Symptoms of the disease, strong emotional reactions to having cancer, and treatment side effects may all influence sleep quality.
- Chronic pain: Conditions involving ongoing pain, such as arthritis and fibromyalgia, are frequently associated with sleep problems.
- Heart failure: Central sleep apnea affects many people who have heart failure, causing them to wake often in the night because of irregular breathing.
Some other conditions associated with sleep difficulties include:
- Skin disorders
- Kidney disease
- Urinary problems
- Acid reflux
- Hormone abnormalities or changes
Medications and Medication Withdrawal
A wide range of medications can affect sleep. Many over-the-counter pain relievers contain caffeine, which can keep you awake or interrupt your sleep. Over-the-counter steroids and decongestants can also make it hard to get quality rest.
Some prescription drugs, including many beta blockers, stimulants, and antidepressants, can also keep you awake or lower your sleep quality. Sleep disruptions may also occur from withdrawal after stopping certain drugs, including some medications used to enhance sleep.
Menstruation and Menopause
People who menstruate may find that their monthly cycle affects their sleep quality. Some people may have trouble sleeping just before their menstrual period begins.
Hormonal changes due to menopause can also disrupt sleep, and these sleep problems may be linked to night sweats from menopausal hot flashes.
Tips to Improve Sleep Quality
Getting low-quality sleep can drag down your energy, focus, and quality of life during the daytime. Fortunately, you can take steps to improve your sleep quality and feel better when you wake up in the morning.
- Address sleep disorders: If you think you might have a sleep disorder, contact a health professional. Let them know about symptoms like loud and frequent snoring, daytime sleepiness, or trouble breathing at night. A doctor can assess your symptoms and develop a personalized treatment plan.
- Talk to your doctor about medication: Tell your health care provider if you think a prescription medication or over-the-counter drug is affecting your sleep quality. They may be able to offer an alternative or change your dosage
- Skip the nightcap: Alcohol might make you feel drowsy, but it also prevents you from entering deep sleep. It can also cause you to wake up in the night.
- Create a relaxing environment for sleep: External factors like noise, light, and temperature affect how well you sleep. Make sure your sleeping environment is quiet, dark, and not too hot or too cold. If noises frequently wake you up at night, try wearing earplugs.
- Reduce stress: Find ways to relax and unwind before you go to bed. Taking a hot bath may help you fall asleep more easily. Talk to a professional if stress or anxiety is keeping you up at night.
References
Ask the Sleep Doctor
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