We all know the importance of getting enough sleep. However, did you know that the quality of the sleep you’re getting can be just as important as quantity? Furthermore, did you know that there are different stages of sleep? How much sleep you get in each stage can have a big impact on how restorative those ZZZs you’re catching really are.

Brian Meusborn, PA-C, a physician assistant on the medical staff at Texas Health Family Care in Flower Mound, a Texas Health Physicians Group practice, sees increasing numbers of sleep-deprived patients.

“Based on my practice, it’s clear that North Texans are not getting enough sleep, and I believe that deficit is a bigger issue here in the U.S. than in other parts of the world,” Meusborn shares. “I have patients who were born in other parts of the world who tell me they were never tired, overweight or stressed until they came to America. To me, the larger issue is how inadequate sleep causes so many health problems.”

Meusborn says the symptoms of not enough sleep are lengthy. Among them:

• Lack of focus
• Irritability
• Fatigue
• Anxiety
• Depression
• Lightheadedness
• High blood pressure
• Lower cognitive functioning
• Sexual dysfunction
• Lack of motivation
• Higher susceptibility to infections and injury
• Slow healing from illness and injury

In addition, lack of sleep can make chronic illnesses worse, and contribute to slower recovery in those who work out, and slow growth in children, Meusborn adds.

What’s Going on When You Sleep

When you are sleeping, your mind and body are actually hard at work processing and repairing from the day and getting ready for the day ahead.

That’s where sleep stages come in. There are five different stages, and each is responsible for providing unique benefits.

Stage 1

This is the beginning of your sleep cycle when you’re starting to drift off to sleep. This stage is normally pretty short, lasting anywhere from one to seven minutes.

You’re in a relaxed state but your body has not fully relaxed yet, and brain and body activity are starting to slow. If you track your sleep, this stage may be referred to as light sleep or even as “awake,” since it is the default part of actively trying to sleep. 

You can be easily awoken in this stage since it is the lightest sleep stage, which may pose an issue for light sleepers every time their sleep cycle brings them back to stage 1.

There is no minimum amount of light sleep that you should strive for, however, if you’re spending a lot of time in this phase, you might not be getting enough restful sleep in other stages.

Stage 2

Stage 2 of the sleep cycle is still considered light sleep, but you are now drifting into a steadier sleep and it’s harder for you to be jostled awake. Your breathing, heartbeat and brain activity are starting to slow down, your muscles are relaxing, and your body temperature drops. However, your brain does have short bursts of activity that actually help resist being woken up by external stimuli that may have woken you up in stage 1, such as a dog barking next door.

Stage 2 is commonly referred to as “core” sleep, and you may see it referred to this way on sleep-tracking apps. It can last for 10 to 25 minutes and can become longer each time you enter it throughout the night. Again, there is no recommended minimum for sleep in this stage, however, you typically spend about half your sleeping time in this stage.

Stages 3 and 4

Stages 3 and 4 are deep sleep stages, with stage 4 being the deepest sleep stage. In these stages, your breathing, heartbeat, body temperature and brain waves are all at their lowest levels. Your muscles are extremely relaxed and it is difficult to rouse someone awake who is in these stages.

These stages are where the most restorative sleep is happening. This is when tissue growth and repair take place, important hormones are released, memories are consolidated, the immune system and cellular energy are restored and the brain detoxifies.

These stages typically happen during the first half of the night and become more infrequent as you continue to snooze. You should aim for about 13 to 23 percent of your sleep to be in these stages. So, if you get 8 hours of sleep, you should be getting anywhere between an hour and just under two hours of deep sleep.

However, it’s important to note that what time you go to bed can greatly influence how much deep sleep you get. Research shows that sleeping between the hours of 8 p.m. and midnight sets you up for the best chance at restorative sleep, no matter what time your alarm is set to. Keep in mind, it typically takes about an hour to drift into these stages, so the earlier you head to bed before midnight, the best chance you have at getting the hour to two hours of deep sleep typically needed.

REM sleep

REM sleep is the last sleep stage before the cycle starts over. Your first REM cycle of the night begins about 90 minutes after you fall asleep and recurs every 90 minutes. Dissimilar to stages 3 and 4, your breathing, heart rate and blood pressure resemble the same levels you typically experience while awake.

This stage is when you are most likely to dream. Your arms and legs become temporarily paralyzed during this stage to prevent you from physically acting out your dreams. REM sleep is believed to be essential to cognitive functions such as memory, learning, and creativity.

While deep sleep tends to dominate the first half of your sleep, REM sleep tends to take over the latter half, getting longer as you sleep. While the first REM stage may last only a few minutes, later stages can last for around an hour. In total, you should spend about 20-25% of your sleep in REM.

What Affects the Various Sleep Stages?

There are a few things that can affect your sleep and how much you get of it, such as age, recent sleep patterns, alcohol, and sleep disorders.

• Age: Time in each stage changes dramatically over a person’s life. For instance, newborns tend to get the most REM sleep out of anyone and may enter a REM stage as soon as they fall asleep. On the other end of the spectrum, older adults typically tend to need less REM sleep than adults, children and babies.
• Recent sleep patterns: Whether you’re oversleeping, not getting enough sleep, or sleeping during typically abnormal hours for you, your recent sleep patterns can cause an abnormal sleep cycle and make it harder to get back to normal afterward.
• Alcohol: Alcohol and some other drugs can alter how we enter into the various different sleep stages. For example, alcohol decreases REM sleep early in the night, but as the alcohol wears off, there is a REM sleep rebound, with prolonged REM stages.
• Sleep disorders: Sleep apnea, restless legs syndrome (RLS), and other conditions that cause multiple awakenings may interrupt a healthy sleep cycle and make it harder to get restful sleep.

Remedy for a Good Night’s Sleep

If you had a bad night’s sleep, it can be tempting to lean heavily on caffeinated beverages to help sail you through the day until you can sleep again. However, coffee, tea or energy drinks can never replace or replicate the restorative benefits of a good night’s rest.

The good news is that we’re in the driver’s seat and can make choices to re-train ourselves to sleep better. Meusborn offers these tips:

• Mealtime: Avoid eating right before bed. When you go to bed soon after you’ve eaten, your body will spend energy digesting your meal, disrupting sleep and keeping you from getting a good night’s rest.
• Eat healthy meals: Eat healthy foods to promote proper digestion. If you’re eating unhealthy foods and not watching what you eat, your diet will inhibit gut function. You won’t feel well, and the resulting bloating, gas and nausea will keep you from sleeping well.
• Avoid screen time: Stay off all electronic devices — that also means TVs — for a minimum of 30 minutes before bedtime. Keep screens away from the bed. Looking at devices in bed trains our brain to expect a screen and keeps us from falling asleep.
• Get moving: Exercise plays a huge role in promoting good sleep at night by releasing sleep-inducing hormones, inducing fatigue and contributing to weight loss and other health benefits. But people who have trouble falling asleep should avoid working out 2-3 hours before bedtime because it can increase heart rate, blood pressure and hormones that may ‘wire’ them for a couple of hours after exercise.
• Curb your alcohol, caffeine and tobacco use: Avoid alcohol and caffeine within three hours before bedtime. As we mentioned earlier, drinking too close to bedtime disrupts quality sleep, as does caffeine. Quitting smoking or other tobacco use is a must for good sleep. Tobacco is a stimulant and plays havoc with rest.
• Read labels: It’s always smart to read drug labels, and that applies to both prescribed and over-the-counter medicine. Certain medications can affect sleep, so arm yourself with that knowledge when taking meds.
• Strive for good health: Live a healthy lifestyle accented by a diet with plenty of fruits and vegetables, whole grains and lean meats. Drink plenty of water and get some exercise each day. If you don’t currently exercise, start slowly with a short walk and build up the length over time.

By making these choices, you’ll be making important steps toward getting a better night’s sleep! Finding a physician who can partner with you for your health is essential. We can help find a physician that’s appropriate and convenient for you. Call 1-877-THR-WELL (847-9355) or visit TexasHealth.org/FindaProvider today.