Terry Cralle Sets the Record Straight on What Quality Sleep Looks Like and How To Get It
November 12, 2022
VENTEUR spoke with Terry Cralle, a Better Sleep Council (BSC) spokesperson, about how we can improve our sleep. Cralle is a registered nurse, Certified Clinical Sleep Educator, and Certified Professional in Healthcare Quality who specializes in sleep health and wellness. Her work in the field of sleep medicine has included clinical research in insomnia and advocating for educational initiatives such as healthy school start times and drowsy-driving prevention. As a frequent speaker and guest lecturer on the topic of sleep for schools, universities, corporations, and employee wellness companies, Cralle educates various audiences on the critical importance of sleep to physical and psychological health, growth and development, safety, optimum functioning, productivity, peak performance, and quality of life.
Sleep Health Generally
How many hours of sleep should entrepreneurs get each night, and why?
The vast majority of adults require 7-9 hours of sleep nightly. Only a tiny percentage of the population (some estimates are at less than 1%) are true short-sleepers, meaning they only require 5-6 hours of sleep per night and are healthy and function optimally. It's a common misconception that people can "learn" to get by on less sleep or "get used to" short sleep.
Too often, busy entrepreneurs erroneously believe that spending those hours sleeping cuts into the extra hours they need in the day to get things done—so to do more, they need to sleep less. This formula is a recipe for disaster and can lead to many avoidable physical and psychological problems, suboptimal performance, and decreased quality of life. We get more done and do better when we are fueled with sufficient sleep.
What does healthy sleep look like?
Healthy sleep is described in terms of duration, continuity, and timing. Most adults require 7-9 hours of sleep per night and should have consistent bed and wake times that accommodate sufficient sleep. Falling asleep should take less than 30 minutes. Sleep should be largely uninterrupted with the ability to wake up (ideally without an alarm), feel refreshed and recharged, and be ready to take on the day. Note that with healthy sleep, you can expect a healthy wake.
The achievement of healthy sleep requires the prioritization of sleep and the adoption of healthy sleep habits (often referred to as sleep hygiene). Healthy sleep habits are reasonably easy to adopt and, to the surprise of many, make healthy diet and exercise habits fall into place fairly quickly. Remember, start with sleep!
Here are a few healthy sleep habits that will help ensure healthy sleep:
Make sufficient sleep the first and foremost item on your daily to-do list. Good sleep time is carved out of your 24-hour schedule, with everything else coming afterward.
Maintain a consistent sleep schedule (regular bed and wake times) that provides sufficient sleep every day of the week.
Establish a regular and relaxing bedtime routine. This is essential to help transition your mind and body from wake to sleep.
Invest in a comfortable and supportive sleep surface (mattress, pillows, topper, etc.) and bedding.
Maintain a calm, dark, serene, and quiet sleep environment.
Get some exercise—it helps promote quality sleep while helping to reduce stress, anxiety, and depression.
Monitor caffeine intake and avoid it for at least 4-6 hours before bedtime.
Avoid alcoholic beverages near bedtime—at least 2-3 hours.
If you regularly get sufficient sleep and practice good sleep hygiene but feel sleepy during the day, you should rule out a sleep disorder with your healthcare provider.
What is REM sleep, and why does it matter?
On average, we cycle through the four stages of sleep 4-6 times during the night. Non-REM Stage 1, Non-REM Stage 2, Non-REM Stage 3, and REM, experiencing the first REM sleep cycle approximately 60-90 minutes after falling asleep. Each of these cycles takes about 70-120 minutes to complete, with later sleep cycles having more extended REM periods, leading to more REM sleep taking place in the second half of the night. REM makes up about 25% of our sleep per night.
REM, or rapid eye movement, is a sleep stage essential for optimal daytime performance. In addition to dreaming, REM is associated with memory consolidation and making connections (problem-solving). REM is vital for many functions, including focus, creativity, concentration, and emotional processing—essential for learning and higher-level thought. A lack of REM sleep has been linked to difficulty concentrating and memory problems. Unfortunately, in the context of sleep deprivation, the brain will favor lighter sleep with less REM.
How can someone get on a regular sleep schedule?
A regular sleep schedule helps ensure you get sufficient sleep while conferring numerous health benefits.
Determine a healthy bed and wake time that will give you enough sleep.
Do you have trouble getting to bed on time? Whether you are burning the midnight oil, engrossed in a page-turner of a novel, or scrolling through social media, set a bedtime alarm to let you know it's time to turn off (this will help avoid bedtime procrastination), wind down and get sleep.
Avoid setting your morning (wake up) alarm earlier than required, leading you to hit the snooze button repeatedly. Doing so will wreak havoc on your morning sleep. Instead, set your alarm to allow good sleep until the last minute you need to wake up, and then get up.
The bedtime routine or pre-sleep ritual is not just for kids. A bedtime routine is great for adults, just like kids. It helps transition your mind and body from wake to sleep as well as helps to ensure you get to bed on time.
Our circadian rhythm, the internal clock that regulates periods of sleep and wakefulness, is triggered by light and darkness. Daytime sunlight, as well as nighttime darkness, help maintain a healthy sleep-wake cycle.
How does a lack of quality sleep affect one's mental health, and why?
Research has long shown a correlation between sleep and mental health. Mental health disorders can cause sleep problems, and sleep problems can be the cause of mental health disorders.
Sleep deprivation is associated with numerous mental health problems, including stress, low self-esteem, irritability, anxiety, depression, job dissatisfaction, negative thinking, substance abuse, burnout, hostility, and even suicide. If you are experiencing mental health issues or sleep issues, consult with your healthcare provider promptly.
How does a lack of quality sleep affect one's physical health, and why?
Sleep has been referred to as "a barometer of our physical and psychological well-being."
Insufficient sleep impacts just about every aspect of our physical functioning.
Regularly getting less than 7 hours of sleep can eventually lead to health consequences, including, but not limited to:
Impaired immune function
Sleep and Technology
How can technology prevent entrepreneurs from getting a good night's sleep, and why?
We've heard about blue light from our electronics and how it interferes with melatonin production, which interferes with sleep. Exposure to light at night is problematic for rest and one of the reasons that so many people don't get sufficient sleep. Evening or nighttime light exposure can suppress melatonin secretion, but blue light does much more than other wavelengths.
A study published in 2015 found that using blue light-blocking glasses in the evening in front of a computer screen may help offset the alerting effects of blue light.
Published in 2017, a University of Houston study found that study subjects who wore the glasses showed a 58% increase in nighttime melatonin levels.
If a late evening or nighttime email can't be avoided, pop on blue-light-blocking glasses or switch your devices to "night mode." This setting decreases blue light in favor of red and orange hues, which are less disruptive to sleep onset.
How can technology help entrepreneurs get a good night's sleep, and why?
Sleep trackers have come a long way and can help to manage sleep health. Among other things, these devices record the total hours you sleep and analyze your patterns over time to get helpful insight. For instance, whether you're running on a sleep deficit.
Trackers can make you more mindful about straying from your typical sleep schedule, such as during the weekends. And perhaps, for instance, you'll start to notice that you feel best when you sleep from 10:00 PM to 6:00 AM rather than from 11:00 PM to 7:00 AM. Trackers make it simple for you and help you look at your sleep data in various ways that are more visual and easier to digest. The information gleaned from these devices is always helpful to share with your healthcare provider for assessing sleep health. We track our calories and our steps, so why not follow our sleep?
Is there anything else you would like to share?
Too many of us suffer from an all too common "sleep disorder" called "sleep guilt."
Throughout history, people have associated sleep with negative character traits such as laziness, apathy, or lack of ambition and or work ethic. More recently, in our 24/7 culture, we have held sleeplessness in high regard—as a badge of honor, so to speak—secretly or openly admiring people who claim to be too busy, ambitious, hard-working, or disciplined not to need or get sleep.
People with sleep guilt often feel weak, indulgent, or even embarrassed about needing or getting sleep. They are mistakenly under the impression that sleep is about willpower, work ethic, or ambition and do not consider it a non-negotiable daily biological requirement. They think that they must sleep less to do more, even though the opposite is true. They believe sufficient sleep to be a barrier to success rather than the means to win. They think they can train themselves to get less sleep than they need, get used to, or power through it, but they can't. They may describe themselves as "short sleepers" when less than one percent of the population has the genetic variant that makes them true short sleepers.
No one should be apologetic or guilty about needing or getting the sleep they need any more than they should be sorry about drinking water to quench their thirst. Sleep deprivation has been considered acceptable (and too often admirable) for far too long—similar to smoking. Smoking used to be "cool" and ubiquitous. Homes, public buildings, and even restaurants were smoke-filled, as well as the family car packed with children. But now we know better. And so it is with sleep deprivation—now we know better. And "sleep guilt" can be cured with a healthy dose of knowledge.
The main takeaway here is: Consistently getting sufficient sleep is one of the best things a person can do for optimal health and performance, well-being, and quality of life. Failing to get adequate sleep is self-destructive, unhealthy, and unsafe, if not irresponsible. A person who is knowledgeable about the importance of sleep will prioritize sleep.
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