An unbroken night’s sleep is a myth. Here’s what good sleep looks like

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What do you imagine a good night’s sleep to be?

Often when people come into our sleep clinic seeking treatment, they share ideas about healthy sleep.

Many think when their head hits the pillow, they should fall into a deep and restorative sleep, and emerge after about eight hours feeling refreshed. They’re in good company – many Australians hold the same belief.

In reality, healthy sleep is cyclic across the night, as you move in and out of the different stages of sleep, often waking up several times. Some people remember one or more of these awakenings, others do not. Let’s consider what a healthy night’s sleep looks like.

Bricolage/Shutterstock

Sleep cycles are a roller-coaster

As an adult, our sleep moves through different cycles and brief awakenings during the night. Sleep cycles last roughly 90 minutes each.

We typically start the night with lighter sleep, before moving into deeper sleep stages, and rising again into rapid eye movement (REM) sleep – the stage of sleep often linked to vivid dreaming.

If sleeping well, we get most of our deep sleep in the first half of the night, with REM sleep more common in the second half of the night.

An older man sleeps peacefully in bed.
Deepest sleep usually happens during the first half of the night. Verin/Shutterstock

Adults usually move through five or six sleep cycles in a night, and it is entirely normal to wake up briefly at the end of each one. That means we might be waking up five times during the night. This can increase with older age and still be healthy. If you’re not remembering these awakenings that’s OK – they can be quite brief.

What does getting a ‘good’ sleep actually mean?

You’ll often hear that adults need between seven and nine hours of sleep per night. But good sleep is about more than the number of hours – it’s also about the quality.

For most people, sleeping well means being able to fall asleep soon after getting into bed (within around 30 minutes), sleeping without waking up for long periods, and waking feeling rested and ready for the day.

You shouldn’t be feeling excessively sleepy during the day, especially if you’re regularly getting at least seven hours of refreshing sleep a night (this is a rough rule of thumb).

But are you noticing you’re feeling physically tired, needing to nap regularly and still not feeling refreshed? It may be worthwhile touching base with your general practitioner, as there a range of possible reasons.

Common issues

Sleep disorders are common. Up to 25% of adults have insomnia, a sleep disorder where it may be hard to fall or stay asleep, or you may wake earlier in the morning than you’d like.

Rates of common sleep disorders such as insomnia and sleep apnoea – where your breathing can partially or completely stop many times during the night – also increase with age, affecting 20% of early adults and 40% of people in middle age. There are effective treatments, so asking for help is important.

Beyond sleep disorders, our sleep can also be disrupted by chronic health conditions – such as pain – and by certain medications.

There can also be other reasons we’re not sleeping well. Some of us are woken by children, pets or traffic noise during the night. These “forced awakenings” mean we may find it harder to get up in the morning, take longer to leave bed and feel less satisfied with our sleep. For some people, night awakenings may have no clear cause.

A good way to tell if these awakenings are a problem for you is by thinking about how they affect you. When they cause feelings of frustration or worry, or are impacting how we feel and function during the day, it might be a sign to seek some help.

Weary woman leans against a pole in an empty train carriage.
If waking up in the night is interfering with your normal day-to-day activities, it may indicate a problem. BearFotos/Shutterstock

We also may struggle to get up in the morning. This could be for a range of reasons, including not sleeping long enough, going to bed or waking up at irregular times – or even your own internal clock, which can influence the time your body prefers to sleep.

If you’re regularly struggling to get up for work or family needs, it can be an indication you may need to seek help. Some of these factors can be explored with a sleep psychologist if they are causing concern.

Can my smart watch help?

It is important to remember sleep-tracking devices can vary in accuracy for looking at the different sleep stages. While they can give a rough estimate, they are not a perfect measure.

In-laboratory polysomnography, or PSG, is the best standard measure to examine your sleep stages. A PSG examines breathing, oxygen saturation, brain waves and heart rate during sleep.

Rather than closely examining nightly data (including sleep stages) from a sleep tracker, it may be more helpful to look at the patterns of your sleep (bed and wake times) over time.

Understanding your sleep patterns may help identify and adjust behaviours that negatively impact your sleep, such as your bedtime routine and sleeping environment.

And if you find viewing your sleep data is making you feel worried about your sleep, this may not be useful for you. Most importantly, if you are concerned it is important to discuss it with your GP who can refer you to the appropriate specialist sleep health provider.

Amy Reynolds, Associate Professor in Clinical Sleep Health, Flinders University; Claire Dunbar, Research Associate, Sleep Health, Flinders University; Gorica Micic, Postdoctoral Research Fellow, Clinical Psychologist, Flinders University; Hannah Scott, Research Fellow in Sleep Health, Flinders University, and Nicole Lovato, Associate Professor, Adelaide Institute for Sleep Health, Flinders University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Over 50? Do These 3 Stretches Every Morning To Avoid Pain

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Will Harlow, over-50s specialist physiotherapist, recommends these three stretches be done daily for cumulative benefits over time, especially if you have arthritis, stiff joints, or similar morning pain:

    The good-morning routine

    These stretches are designed for people with arthritis and stiff joints, but if you experience any extra pain, or are aware of having some musculoskeletal irregularity, do seek professional advice (such as from a local physiotherapist). Otherwise, the three stretches he recommends are:

    Quad hip flexor stretch

    This one is performed while lying on your side in bed:

    • Bring the top leg up toward your body, grab the shin, and pull the leg backward to stretch.
    • Feel the stretch in the front of the leg (quadriceps and hip flexor).
    • Hold for 30 seconds and repeat on both sides.
    • Use a towel or band if you can’t reach your shin.

    Book-opener

    This one helps improve mobility in the lower and mid-back:

    • Lie on your side with arms at a 90-degree angle in front of your body.
    • Roll backward, opening the top arm while keeping legs in place.
    • Hold for 20–30 seconds or repeat the movement several times.
    • Optionally, allow your head to rotate for a neck stretch.

    Calf stretch with chest-opener

    This one combines a calf and chest stretch:

    • Stand in a lunged position, keeping the back leg straight and heel down for the calf stretch.
    • Place hands behind your head, open elbows, and lift your head slightly for a chest stretch.
    • Hold for 20–30 seconds, then switch legs.

    For more on all the above plus visual demonstrations, enjoy:

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  • Mango vs Papaya – Which is Healthier?

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    Our Verdict

    When comparing mango to papaya, we picked the mango.

    Why?

    Both are great! But there are some things to set them apart:

    In terms of macros, this one’s not so big of a difference. They are equal in fiber, while mango has more protein and slightly more carbs. They are both low glycemic index, so we’ll call this one a tie, or the slenderest nominal win for papaya.

    When it comes to vitamins, mango has more of vitamins A, B1, B3, B5, B7, B9, E, K, and choline, while papaya has more vitamin C. However, a cup of mango already gives the RDA of vitamin C, so at this point, it’s not even really much of a bonus that papaya has more. In any case, a clear and overwhelming win in the vitamins category for mango.

    As for minerals, this one’s closer; mango has more copper, manganese, phosphorus, and zinc, while papaya has more calcium, iron, and magnesium. Still, a 4:3 win for mango.

    Adding these up makes for a clear win for mango. However, one extra thing to bear in mind about both:

    Both of these fruits interact with warfarin and many other anticoagulants. So if you’re taking those, you might want to skip these, or at least consult with your doctor/pharmacist for input on your personal situation.

    Aside from that; enjoy both; diversity is good! But mango is the more nutritionally dense, and thus the winner here.

    Want to learn more?

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    5 Ways To Make Your Smoothie Blood Sugar Friendly (Avoid the Spike!)

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  • 16 Overlooked Autistic Traits In Women

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    We hear a lot about “autism moms”, but Taylor Heaton is an autistic mom, diagnosed as an adult, and she has insights to share about overlooked autistic traits in women.

    The Traits

    • Difficulty navigating romantic relationships: often due to misreading signs
    • Difficulty understanding things: including the above, but mostly: difficulty understanding subtext, when people leave things as “surely obvious”. Autistic women are likely to be aware of the possible meanings, but unsure which it might be, and may well guess wrongly.
    • Masking: one of the reasons for the gender disparity in diagnosis is that autistic women are often better at “masking”, that is to say, making a conscious effort to blend in to allistic society—often as a result of being more societally pressured to do so.
    • Honesty: often to a fault
    • Copy and paste: related to masking, this is about consciously mirroring others in an effort to put them at ease and be accepted
    • Being labelled sensitive and/or gifted: usually this comes at a young age, but the resultant different treatment can have a lifetime effect
    • Secret stims: again related to masking, and again for the same reasons that displaying autistic symptoms is often treated worse in women, autistic women’s stims tend to be more subtle.
    • Written communication: autistic women are often more comfortable with the written word than the spoken
    • Leadership: autistic women will often gravitate to leadership roles, partly as a survival mechanism
    • Gaslighting: oneself, e.g. “If this person did this without that, then I can to” (without taking into account that maybe the circumstances are different, or maybe they actually did lean on crutches that you didn’t know were there, etc).
    • Inner dialogue: rich inner dialogue, but unable to express it outwardly—often because of the sheer volume of thoughts per second.
    • Fewer female friends: often few friends overall, for that matter, but there’s often a gender imbalance towards male friends, or where there isn’t, towards more masculine friends at least.
    • Feeling different: often a matter of feeling one does not meet standard expectations in some fashion
    • School: autistic women are often academically successful
    • Special interests: often more “socially accepted” interests than autistic men’s.
    • Flirting: autistic women are often unsure how to flirt or what to do about it, which can result in simple directness instead

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  • What happens when I stop taking a drug like Ozempic or Mounjaro?
  • Berberine For Metabolic Health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Is Berberine Nature’s Ozempic/Wegovy?

    Berberine is a compound found in many plants. Of which, some of them are variations of the barberry, hence the name.

    It’s been popular this past couple of years, mostly for weight loss. In and of itself, something being good for weight loss doesn’t mean it’s good for the health (just ask diarrhoea, or cancer).

    Happily, berberine’s mechanisms of action appear to be good for metabolic health, including:

    • Reduced fasting blood sugar levels
    • Improved insulin sensitivity
    • Reduced LDL and triglycerides
    • Increased HDL levels

    So, what does the science say?

    It’s (mostly!) not nature’s Wegovy/Ozempic

    It’s had that title in a number of sensationalist headlines (and a current TikTok trend, apparently), but while both berberine and the popular weight-loss drugs Wegovy/Ozempic act in part on insulin metabolism, they mostly do so by completely different mechanisms.

    Wegovy and Ozempic are GLP-1 agonists, which mean they augment the action of glucagon-like-peptide 1, which increases insulin release, decreases glucagon release, and promotes a more lasting feeling of fullness.

    Berberine works mostly by other means, not all of which are understood. But, we know that it activates AMP-activated protein kinase, and on the flipside, inhibits proprotein convertase subtilisin/kexin type 9.

    In less arcane words: it boosts some enzymes and inhibits others.

    Each of these boosts/inhibitions has a positive effect on metabolic health.

    However, it does also have a slight GLP-1 agonist effect too! Bacteria in the gut can decompose and metabolize berberine into dihydroberberine, thus preventing the absorption of disaccharides in the intestinal tract, and increasing GLP-1 levels.

    See: Effects of Berberine on the Gastrointestinal Microbiota

    Does it work for weight loss?

    Yes, simply put. And if we’re going to put it head-to-head with Wegovy/Ozempic, it works about half as well. Which sounds like a criticism, but for a substance that’s a lot safer (and cheaper, and easier—if we like capsules over injections) and has fewer side effects.

    ❝But more interestingly, the treatment significantly reduced blood lipid levels (23% decrease of triglyceride and 12.2% decrease of cholesterol levels) in human subjects.

    However, there was interestingly, an increase in calcitriol levels seen in all human subjects following berberine treatment (mean 59.5% increase)

    Collectively, this study demonstrates that berberine is a potent lipid-lowering compound with a moderate weight loss effect, and may have a possible potential role in osteoporosis treatment/prevention.❞

    (click through to read in full)

    Is it safe?

    It appears to be, with one special caveat: remember that paper about the effects of berberine on the gastrointestinal microbiota? It also has some antimicrobial effects, so you could do harm there if not careful. It’s recommended to give it a break every couple of months, to be sure of allowing your gut microbiota to not get too depleted.

    Also, as with anything you might take that’s new, always consult your doctor/pharmacist in case of contraindications based on medications you are taking.

    Where can I get it?

    As ever, we don’t sell it, but here’s an example product on Amazon, for your convenience.

    Enjoy!

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  • What’s in the supplements that claim to help you cut down on bathroom breaks? And do they work?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    With one in four Australian adults experiencing problems with incontinence, some people look to supplements for relief.

    With ingredients such as pumpkin seed oil and soybean extract, a range of products promise relief from frequent bathroom trips.

    But do they really work? Let’s sift through the claims and see what the science says about their efficacy.

    Christian Moro/Shutterstock

    What is incontinence?

    Incontinence is the involuntary loss of bladder or bowel control, leading to the unintentional leakage of urine or faeces. It can range from occasional minor leaks to a complete inability to control urination and defecation.

    This condition can significantly impact daily activities and quality of life, and affects women more often than it affects men.

    Some people don’t experience bladder leakage but can sometimes feel an urgent need to go to the bathroom. This is known as overactive bladder syndrome, and occurs when the muscles around the bladder tighten on their own, which greatly reduces its capacity. The result is the person feels the need to go to the bathroom much more frequently.

    There are many potential causes of incontinence and overactive bladders, including menopause, pregnancy and child birth, urinary tract infections, pelvic floor disorders, and an enlarged prostate. Conditions such as diabetes, neurological disorders and certain medications (such as diuretics, sleeping pills, antidepressants and blood-pressure drugs) can also contribute.

    While pelvic muscle rehabilitation and behavioural techniques for bladder retraining can be helpful, some people are interested in pharmaceutical solutions.

    What’s in these products?

    A number of supplements are available in Australia that include ingredients used in traditional medicine for urinary incontinence and overactive bladders. The three most common ingredients are:

    • Cucurbita pepo (pumpkin seed extract)
    • glycine max (soybean extract)
    • an extract from the bark of the Crateva magna or nurvala (Varuna) tree.
    The supplements have common ingredients. Author

    How are they supposed to work?

    Pumpkin seeds are rich in plant sterols that are thought to reduce the testosterone-related enlargement of the prostate, as well as having broader anti-inflammatory effects. The seed extracts can also contain oleic acid, which may help increase bladder capacity by relaxing the muscles around the organ.

    Soybean extracts are rich in isoflavones, especially daidzen and genistein. Like olieic acid, these are thought to act on the muscles around the bladder. Because isoflavones are similar in structure to the female hormone oestrogen, soy extracts may be most beneficial for postmenopausal women who have overactive bladders.

    Crateva extract is rich in lupeol- and sterol-based chemicals which have strong anti-inflammatory effects. This has benefits not just for enlarged prostates but possibly also for reducing urinary tract infections.

    Do they actually work?

    It’s important to note that the government has only approved these types of supplements as “listed medicines”. This means the ingredients have only been assessed for safety. The companies behind the products have not had to provide evidence they actually work.

    A 2014 clinical trial examined a combined pumpkin seed and soybean extract called cucurflavone on people with overactive bladders. The 120 participants received either a placebo or a daily 1,000mg dose of the herbal mixture over a period of 12 weeks.

    By the end of study, those in the cucurflavone group went to the bathroom around three fewer times per day, compared with people in the control group, who only went to the bathroom on average one fewer time each day.

    In a different trial, researchers examined a combination of Crateva bark extract with herbal extracts of horsetail and Japanese evergreen spicebush, called Urox.

    For the 150 participants, the Urox formulation helped participants go to the bathroom less frequently when compared with placebo treatment.

    After eight weeks of treatment, participants in the placebo group were going to the bathroom to urinate 11 times per day. Those in the Urox group were only going around to 7.5 times per day. And those who took Urox also needed to go to the bathroom one fewer time during the night.

    Finally, another study also examined a Creteva, horsetail and Japanese spicebush combination, but this time in children. They were given either a 420mg dose of the supplement or a placebo, and then monitored for how many times they wet the bed.

    After two months of taking the supplement, slightly more than 40% of the 24 kids in the supplement group wet the bed less often.

    While these results may look promising, there are considerable limitations to the studies which means the data may not be reliable. For example, the trials didn’t include enough participants to have reliable data. To conclusively provide efficacy, final-stage clinical trials require data for between 300 and 3,000 patients.

    From the studies, it is also not clear whether some participants were also taking other medicines as well as the supplement. This is important, as medications can interfere with how the supplements work, potentially making them less or more effective.

    What if you want to take them?

    If you have incontinence or an overactive bladder, you should always discuss this with your doctor, as it may due to a serious or treatable underlying condition.

    Otherwise, your GP may give you strategies or exercises to improve your bladder control, prescribe medications or devices, or refer you to a specialist.

    If you do decide to take a supplement, discuss this with your doctor and local pharmacist so they can check that any product you choose will not interfere with any other medications you may be taking.

    Nial Wheate, Professor of Pharmaceutical Chemistry, Macquarie University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • See what other 10almonds subscribers are asking!

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    It’s Q&A Day at 10almonds!

    Q: I would be interested in learning more about collagen and especially collagen supplements/powders and of course if needed, what is the best collagen product to take. What is collagen? Why do we need to supplement the collagen in our body? Thank you PS love the information I am receiving in the news letters. Keep it up

    We’re glad you’re enjoying them! Your request prompted us to do our recent Research Review Monday main feature on collagen supplementation—we hope it helped, and if you’ve any more specific (or other) question, go ahead and let us know! We love questions and requests

    Q: Great article about the health risks of salt to organs other than the heart! Is pink Himalayan sea salt, the pink kind, healthier?

    Thank you! And, no, sorry. Any salt that is sodium chloride has the exact same effect because it’s chemically the same substance, even if impurities (however pretty) make it look different.

    If you want a lower-sodium salt, we recommend the kind that says “low sodium” or “reduced sodium” or similar. Check the ingredients, it’ll probably be sodium chloride cut with potassium chloride. Potassium chloride is not only not a source of sodium, but also, it’s a source of potassium, which (unlike sodium) most of us could stand to get a little more of.

    For your convenience: here’s an example on Amazon!

    Bonus: you can get a reduced sodium version of pink Himalayan salt too!

    Q: Can you let us know about more studies that have been done on statins? Are they really worth taking?

    That is a great question! We imagine it might have been our recent book recommendation that prompted it? It’s quite a broad question though, so we’ll do that as a main feature in the near future!

    Q: Is MSG healthier than salt in terms of sodium content or is it the same or worse?

    Great question, and for that matter, MSG itself is a great topic for another day. But your actual question, we can readily answer here and now:

    • Firstly, by “salt” we’re assuming from context that you mean sodium chloride.
    • Both salt and MSG do contain sodium. However…
    • MSG contains only about a third of the sodium that salt does, gram-for-gram.
    • It’s still wise to be mindful of it, though. Same with sodium in other ingredients!
    • Baking soda contains about twice as much sodium, gram for gram, as MSG.

    Wondering why this happens?

    Salt (sodium chloride, NaCl) is equal parts sodium and chlorine, by atom count, but sodium’s atomic mass is lower than chlorine’s, so 100g of salt contains only 39.34g of sodium.

    Baking soda (sodium bicarbonate, NaHCO₃) is one part sodium for one part hydrogen, one part carbon, and three parts oxygen. Taking each of their diverse atomic masses into account, we see that 100g of baking soda contains 27.4g sodium.

    MSG (monosodium glutamate, C₅H₈NO₄Na) is only one part sodium for 5 parts carbon, 8 parts hydrogen, 1 part nitrogen, and 4 parts oxygen… And all those other atoms put together weigh a lot (comparatively), so 100g of MSG contains only 12.28g sodium.

    Q: Thanks for the info about dairy. As a vegan, I look forward to a future comment about milk alternatives

    Thanks for bringing it up! What we research and write about is heavily driven by subscriber feedback, so notes like this really help us know there’s an audience for a given topic!

    We’ll do a main feature on it, to do it justice. Watch out for Research Review Monday!

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