You may think you’re an insomniac but chances are you’re getting enough sleep

How many times a night can you wake up and still have had what is considered a "good" sleep?

Over the last few years, research pointing to Australia’s collective sleep deficit has triggered a federal inquiry into sleep health awareness and an increased emphasis on the long-term health consequences of insufficient sleep across the community.

We’re told we’re in the midst of a ntaional sleep crisis, but do you need to sleep through to have had a ‘good’ night.Credit:iStock

According to the Royal Australasian College of Physicians, between 33 and 45 per cent of Australian adults don’t get enough, and in 2016-17, inadequate sleep was estimated to cost the Australian economy $66.3 billion.

Yet, despite all this focus on sleep, the myth that we need eight hours of interrupted slumber a night continues to persist, and experts say its prevalence is contributing to our anxiety about sleep.

Research shows that most people still believe that healthy sleep equals unbroken sleep, yet the reality is, we are supposed to wake up multiple times a night as we weave in and out of sleep cycles.

“Sleep is more like a rollercoaster; we go through several sleep cycles each night, and each one is between 90 and 120 minutes, depending on the person,” says Dr Gorica Micic, a research associate at Flinders University’s College of Medicine and Public Health.

“Within an average night, we'll probably squeeze in five sleep cycles: waking, light sleep, deep sleep, light sleep, and waking again.”

But can you wake up too many times in a night? And how many times can you wake up and still consider you’ve had a 'healthy' night's shut-eye? Dr Micic says waking up multiple times a night is not a sign of something going wrong; it’s hardwired into our genes.

“Most sleep is spent in light sleep, and we wake often just like other species,” she says. “This is most likely an evolutionary effect that enables us to check our environment, make sure we’re not in danger.”

However, the age of industrialisation (the 18th century) – followed by the eight-hour work, leisure and sleep mentality – irrevocably changed our sleep patterns.

It’s actually normal to wake up two to four times per night; it’s just that our expectations of sleep have changed over the last 100 years.

“The expectation that we have to sleep solidly for eight hours is a myth, a hangover from the industrial era,” says sleep psychologist and researcher, Hailey Meaklin. “It’s actually normal to wake up two to four times per night; it’s just that our expectations of sleep have changed over the last 100 years.”

And while a third of the population has trouble sleeping – including difficulties maintaining sleep throughout the night – Melinda Jackson, sleep disorders expert and Monash University psychology lecturer says “there is some evidence from our recent past that suggests this period of wakefulness occurring between two separate sleep periods was once the norm.”

“Sleep quality is not just about how much sleep you get, but how long it takes you to fall asleep, how well you can maintain sleep (i.e. how often you wake up), and how rested you feel upon waking,” says Dr Jackson.

In fact, how you cope with sleep deprivation is genetic: 2017 research discovered that some people have a cluster of genes which are resilient to the effects of sleep deprivation.

As for what wakes us up during the night, Victoria University Emeritus Professor and Chair of the Sleep Health Foundation, Dorothy Bruck, says there are two broad categories: internal to the person and external circumstances.

“Internal to the person means things like going to the toilet – which is particularly age-related and affects men if they have an enlarged prostate – being hyper-aroused (stressed or anxious); the expectation that you’re going to have to wake up by a certain time; parasomnia, which includes nightmares; breathing problems such as sleep apnoea; and your individual body clock,” she says.

External, on the other hand, refers to things like babies and children waking you up at night, illness, noises and unexpected light, sleeping with a partner (studies show you have more fragmented sleep if you sleep with someone) the menstrual cycle, menopause and hormonal fluctuations.

Eating food close to your bedtime (or not eating enough food) and alcohol can also wreak havoc with your sleep.

Brain scans of insomniacs show many have had a totally normal sleep.

“While alcohol is a muscle relaxant that induces a quicker sleep, the way it is metabolised in our body produces a lot of chemicals that wake us up during the night and impact sleep quality,” Ms Meaklin says.

But it may also be that we’re waking up a lot less, or for much less time than we think.

Dr Micic says that while brain scans of many insomniacs show they have had a “totally normal sleep”, their perception of not sleeping significantly “impacts how they feel during the day and function”.

“It’s easy to perceive we have not had sleep in a dark room, where you have no way of knowing if you slept except for your alarm clock,” she says.

So what can you do to have a better night’s sleep?

While developing good sleep hygiene (such as not drinking alcohol before bed, taking time to wind down, reducing coffee intake in the afternoon, not forcing yourself to stay in bed when you're not tired and staying away from screens) is a good start, Ms Meaklin says it’s “definitely not the last step if you’re having some trouble sleeping”.

“In clinical treatment, we often talk about being much more flexible with sleep hygiene and not feeling like you have to do all the things religiously, everyday,” she says.

Professor Bruck agrees: “Sleep is really quite flexible, and having a relaxed attitude towards it

“You can't force yourself to sleep; you can only create the right conditions to allow sleep to happen, such as setting up sleep routines (but not necessarily in the eight-hour block period),” she says.

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