A poor memory, weak immune system, risky decision-making, and increased anxiety and depression are all possible symptoms of sleep deprivation.

It is estimated that about one in three adults are sleep-deprived and 97% of teenagers do not reach the recommended amount of sleep. 

With those statistics in mind, how can individuals fix their poor sleep habits?

Working to help people answer that exact question is Emma Bailey, Director of Clinical Operations at Redwood Pulmonary Medical Associates.

According to Bailey, various factors can impede your ability to get enough sleep. She states it is crucial, first, to understand that sleep loss is not something you can catch up on. 

“There is no bank for sleep. You cannot borrow sleep by sleeping in more on the weekends. It simply does not work like that,” Bailey said. “Sleeping in for one hour on the weekends is okay, but anything more is not beneficial.”

In reality, if you are getting enough sleep, you will not feel the need to sleep in on the weekends. While it may initially help you feel more rested, sleeping in messes with your circadian rhythm, ultimately leading to greater fatigue.

“If you are doing things like getting up later on the weekend, your body clock shifts into that ‘timezone.’ So then at the beginning of the week, you have to shift back,” said Michelle Primeau, a sleep medicine doctor.

Getting up and going to bed consistently helps regulate your circadian rhythm, the 24-hour biological clock controlling wakefulness and sleep. When people do not get consistent sleep, they feel less alert during the day and experience dips in energy. 

“Sometimes the issue is that you are trying to go to bed at a certain time, but your body does not want to. It does not matter how relaxed you are. If your physiology is skewed, there will not be anything that will help at that moment,” Primeau said. 

Primeau emphasizes the importance of building habits that will set you on the path to better sleep. A practice that individuals can implement into their daily lives is getting morning light soon after waking. This practice is effective because the circadian rhythm responds directly to sunlight. As the light enters through the optic nerve, the suprachiasmatic nucleus signals the release of hormones, like cortisol, to wake the body up. The opposite occurs in the evening when darkness triggers the release of melatonin. 

Another science-backed strategy that helps many people who struggle with their sleep is cognitive behavioral therapy for insomnia (CBTI), according to Bailey. Julia Williams has used CBTI and has found a significant improvement in her sleep.

“CBTI is the gold standard for what sleep hospitals or professionals will steer people towards. It is a program that focuses on sleep restriction,” Williams said. 

This procedure reduces how often people wake up in the middle of the night. By restricting the time people spend in bed, people become more fatigued during the day and fall asleep more during the night. 

“They kind of explained it like pizza dough. If you ‘flatten’ your sleep out and spend too much time in bed, you have holes in your sleep through the night. Then you need to squish the pizza dough back together, making your sleep shorter, so you only spend a small amount of time in bed,” Williams said. 

This procedure lasts a few weeks and effectively sleep-deprives patients, building up their sleep drive. This sleep drive balances out when individuals start to get better sleep. Though they are in bed for restricted durations, patients will eventually get more sleep since they are not waking up at night.

“Part of CBTI is also working on your emotions associated with sleep and reframing them. You might believe you can never sleep, but giving yourself another way to look at it is very helpful,” Williams said. 

Patients can break down their negative beliefs about their sleep by discussing their emotions. For instance, some individuals experience anxiety related to their difficulties falling asleep. As their negative experiences accumulate, they continue to reinforce these anxieties. Through CBTI, people can challenge these beliefs. 

“Like any type of therapy, CBTI takes effort from the individual to get benefits. There are no quick fixes. But when you start being unable to sleep, you’ve always got tools to go back to,” Williams said. 

Stress has a significant impact on people’s sleep and can make them feel anxious before sleep. Many experience racing thoughts right before bed that leave them unable to relax. 

“The stress that impacts our sleep is 24-hour stress. Any stress during the day carries over,” Primeau said. “Try setting aside 30 to 60 minutes to relax before bed without screens or social media.”  

Stress hormones, notably cortisol, are the same hormones that trigger wakefulness, making it very difficult to fall asleep.

“When you are stressed while you sleep, the adrenaline is making your heart beat really fast, and the cortisol is stopping you from falling asleep,” Bailey said. 

According to Bailey, the single best way to minimize the impact of stress is meditation. Meditation slows down your heart rate and lowers cortisol levels. Bailey also recommends creating a bedtime ritual that calms your mind and body before sleep. 

“When we look at people’s brain activity while they do rituals before going to sleep, we find that they are in a better state of relaxation,” Bailey said.

Bedtime rituals are also key for those who often wake up in the middle of the night.

“If you find yourself waking up in the night unable to fall asleep, the best thing to do is to repeat your bedtime ritual – reading a book, drinking a cup of chamomile tea,” Bailey said.

While sleep may seem like a simple biological process, so many factors are at play. Learning about these factors gives individuals lifelong strategies to improve their sleep.

“Sleep can be difficult, but if you start building habits right now, they will carry with you for the rest of your life,” Primeau said.