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- Quantity is important since the body typically cycles through the sleep stages 4-5 times
- The importance of sleep quantity and Alzheimer’s
- But not everyone’s ideal sleep quantity is the same
- Certain OTC sleep aids may help you get more sleep, but it comes at the expense of quality
- Sleep disorders may affect quality
- Proper targets sleep quantity AND quality
When most people try to get better sleep, they immediately try to increase the number of hours. And it makes sense! We’re told time and time again that eight hours is the sweet spot, and that the more sleep you can get, the better. But here’s the thing: quantity of sleep alone doesn’t paint a full picture of your sleep health. Quality matters just as much, if not more. Here’s what you need to know.
The stages are divided into non-rapid eye movement sleep (NREM sleep or non-REM sleep), which is known as quiet sleep, and rapid eye movement (REM) sleep, which is more active.
- In stage 1, which lasts 5-10 minutes, your brain activity begins to slow down. Although muscle twitches can occur, for the most part muscles are relaxing as your brain releases theta and alpha waves. Think of this as the “portal” into sleep.
- During stage 2, which lasts 10-15 minutes, your core body temperature drops and muscles are fully relaxed. It’s a deeper sleep state than N1, but you can still be awoken during this time without heavy stimulation. This stage is particularly important for the consolidation of memories and, after passing through it multiple times, accounts for about 50% of your entire night.
- Stage 3 (20 - 40 minutes) is for deep sleep, during which time it’s difficult to wake up. This is when you get “delta sleep” or “slow-wave sleep” (SWS).
- Finally, REM sleep, which lasts 10 minutes for the first cycle and up to 90 minutes later on, is when brain waves are far more active—it’s the prime time for dreams to occur and benefits cognitive functions like memory consolidation, creativity, and learning.
The progression of sleep stages generally goes from N1 → N2 → N3 → REM, although there is more time spent in N3 sleep the first half of the night and it tends to diminish the second half. Also, REM sleep is shorter the first half of the night and increases in duration the second half. This cycle repeats 4-5 times throughout the night.
N1 → N2 → N3 → REM (multiplied by four or five)
Without a full night’s sleep, you could be cutting your share of REM sleep short.
Read more about the 4 stages of sleep, why they’re important, and factors that influence them >>
In order to understand the effects of sleep on long-term memory function and Alzheimer’s risk in older adults, we have to talk about beta-amyloid. This protein lives in the fluid between our brain’s cells or neurons. A build-up of beta-amyloid plaques has been linked to impaired brain function and Alzheimer’s disease, but there is something we can do to help clear it out: sleep.
In a recent study conducted by the National Institutes of Health, (1) researchers scanned participants’ brains after a night of sleep. The study group was sleep deprived (defined as going 31 hours without sleep), while the control group got a complete night’s rest. The results showed that levels of beta-amyloid increased about 5% for the sleep-deprived group specifically in the thalamus and hippocampus, both of which are susceptible to damage in early Alzheimer’s.
One of the biggest sleep myths out there is that everyone, regardless of age, needs eight hours of sleep per night. Here’s how sleep needs change across different age groups.
- 0 - 3 months: 14 - 17 hours
- 4 - 11 months: 12 - 15 hours
- 3 - 5 years: 10 - 13 hours
- 6 - 13 years: 9 - 11 hours
- 14 - 18 years: 8 - 10 hours
- 25 - 45 years: 7 - 9 hours
- 46 - 65 years: 7 - 9 hours
- 70 - 90 years: 7 - 9 hours
Come adulthood, the amount of time spent in stage 3 (deep sleep, otherwise known as slow wave sleep) decreases while the proportion of sleep in stage 1 and 2 increases. The effect of age on REM sleep, however, is minimal, with researchers finding a 0.6% decrease per decade from age 19 to 75, followed by smaller increases from age 75 to 85. (2)
Read more about how sleep needs change with age >>
Although that knocked-out feeling may lead some to believe that an over-the-counter (OTC) drug is working faster and better, science says otherwise. A Consumer Reports study found that most OTC sleep aids only increase total sleep duration by 20-30 minutes. (3) At face value, that sounds like a good thing (who wouldn’t want 30 more minutes of shut-eye?).
But when you dig deeper, you’ll find that sleep time is only part of the story. The quality of your sleep—the amount of deep and REM sleep—matters, too. When you use OTC sleep aids with antihistamines, quality of sleep suffers.
The reason? Acetylcholine. This neurotransmitter plays a critical role in rapid eye movement sleep, otherwise known as REM. (4) Because antihistamines block acetylcholine, REM sleep suffers, which is one reason why upwards of 40% of people taking OTC sleep aids report feelings of fogginess or drowsiness the following morning. (3)
“Antihistamines may help you fall asleep, but overall sleep quality is usually not very good,” explains Philip Alapat, MD, assistant professor at Baylor College of Medicine. “Using an antihistamine for sleep [also] has no long-term benefit. Most people develop a tolerance quickly.”
This side effect is particularly concerning for older adults who metabolize medications at a slower rate. According to studies from Consumer Reports, 1 out of 10 adults 65 and older who take OTC sleep aids report feeling “uncoordinated, tripping, or falling.” What’s more, they’re 34% more likely to fall than those not taking sleep aids. (3)
Read our deep dive on the safety + efficacy of most over-the-counter sleep aids >>
Obstructive Sleep Apnea
Sleep apnea is marked by temporary pauses in breathing throughout the night. Unlike the less common Central Sleep Apnea, which occurs when the brain fails to send correct signals to the muscles in charge of breathing, Obstructive Sleep Apnea (OSA) causes throat muscles to relax, partially block the airway, and lead to snoring. Obesity is a significant risk factor; however, it’s also particularly common among menopausal women—studies indicate that about 20% develop some form of the condition. (5)
What makes OSA so tricky is that many people don’t know they have it since it doesn't affect one's amount of sleep in a significant way. But it does impede high-quality sleep with intermittent sleep disruptions and awakenings due to snoring or a feeling of gasping for air. That's why, for some, the only symptom is unexplained fatigue.
This chronic neurological condition impacts the brain’s ability to regulate the sleep cycle (also known as the circadian rhythm) and, as a result, causes interrupted sleep throughout the night. Other symptoms include sudden muscle weakness (cataplexy), vivid hallucinatory dreams, and paralysis just before or after sleep.
Read more about sleep + broader health issues that may leave you feeling tired even though it feels like you got enough sleep >>
Our supplements were developed in partnership with leading doctors in integrative sleep medicine, clinical psychology, and nutritional biochemistry. They are specially designed to respond different depending on what stage of sleep you're in:
- GABA: at work during stage 1 (N1)
- L-theanine: at work during stage 1 (N1)
- Valerian: at work during stage 1 (N1)
- Standard melatonin: at work during stage 1 (N1)
- Extended-release melatonin: at work during stage 2 (N2), 3 (N3), + stage 4 (REM)
- Venetron®: at work during stage 2 (N2) + stage 3 (N3)
- Sensoril® Ashwagandha: at work during stage 2 (N2), stage 3 (N3), + stage 4 (REM)
The result isn't just more sleep but deeper, better quality, restorative sleep that will leave you feeling refreshed and well-rested, not groggy. You will NOT feel knocked out and you WILL awake to normal noises (you're not drugged!). However, if you do awake, you'll be able to fall asleep far more easily. Simply put, it will feel like a naturally good night's sleep.
Read more about the seven ways Proper approaches sleep differently >>
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Guide To Circadian Rhythms: What It Is, How It Works, Why It's Important, + Influencing Factors (shift work disorder, jet lag, advanced sleep phase disorder, etc.)
FAQ: What Does "Normal" Sleep Look Like?
Sleep, Nutrition, Or Exercise: What's Most Important To Prevent Weight Gain?
How Stress + Mental Health Affect Your Sleep (+ vice versa)
DEEP DIVE: The Evidence Behind Proper
12 Best Podcasts To Help You Fall Asleep