And why “catching up on sleep” can do you more harm than good.
In this excerpt from The Sleep Prescription, Dr. Aric Prather — an expert clinician sleep psychologist at the UCSF insomnia clinic — explains how adjusting one particular sleep habit can significantly improve your zzz’s.
We humans are fairly boring sleepers—most adults need a minimum of seven hours of sleep per night, and unlike hippos, we can’t even swim while we’re doing it. And perhaps more so than hippos, we struggle with sleep. A big reason? Our natural sleep cycles are out of whack.
You have two main “drivers” of sleep: your homeostatic sleep drive and your circadian rhythm. These two natural, internal processes in your body work together to keep you awake when you need to be awake, and asleep when you need to be asleep. Your homeostatic sleep drive is essentially “pressure” for sleep that builds up the longer you’re awake.
Picture a balloon. It’s flat and empty the moment you open your eyes in the morning. As you go through your day, it gradually begins to inflate, filling up with sleepiness. When it’s at this optimal amount — picture a perfectly inflated balloon — you feel the need for sleep. Your eyes get heavy, you climb into bed, and drift off. When you take a nap, you’re basically “letting some of the air” out of the balloon, or relieving some of that sleep pressure.
But your homeostatic sleep drive isn’t the only thing regulating your sleep cycle. If it were, you might just drop off throughout the day and night whenever that balloon filled up, even if that happened to be in the middle of a meeting or while you were driving. Which brings us to the circadian rhythm.
Your circadian rhythm is, most basically, your “master clock” that governs the rhythm of all your body’s processes—including sleep and wakefulness. And if you get up at 6 a.m. some days, and then other days at 9, you’re throwing off your circadian rhythm. You’re putting yourself, intentionally, into a state of jet lag. It’s as if you’re flying through three time zones every Saturday, trying to acclimate, and then flying back.
A lot of patients I work with come in and say, “I know I’m supposed to get up at the same time every day, but . . .” I just can’t. It’s too hard. I’m too tired. My work schedule is unpredictable. I get it. And honestly, if you’re not in a struggle with sleep, maybe sleeping in on the weekend is perfectly fine. Just like that extra glass of wine, slice of pizza, or scoop of ice cream, it can be a delicious indulgence that makes life worth living. But if things aren’t going so well on the sleep front, then this stable wake time is really something you need to try. So when patients have a million reasons why it won’t work, here’s what I say:
The time you choose is up to you. When people come into the lab, I say, “If you had to commit to a time, what would it be?” Answer that question right now. I’m not going to dictate that you have to wake up early, or any particular time at all. Find a time that works with your schedule — if you can manage work, kids, whatever else you have going on, then it’s a great time to wake up as far as I’m concerned. Once you’ve decided, set an alarm.
Don’t stress— there’s wiggle room. If you set your time at 8 a.m., and wake up at 8:15 one Saturday, it’s not going to ruin all your progress. A little flexibility and forgiveness is OK. This is about consistency in the big picture. Mostly what I want is for you to make the effort.
Make it worth it. Sometimes, sticking to this is a little painful. You may be moving your wake-up time earlier as you begin to stabilize your sleep cycles—especially on your days off, if you’re used to sleeping in. Those are going to be the hardest days to stick to this commitment. So reward yourself, immediately, when you get up. This is a classic lesson from behavior change, and it works.
One guy I worked with wanted to improve his sleep, but was really struggling with the idea of the same wake-up time every day. He wanted to sleep in. It felt good to sleep in. He believed his body needed the recovery time. But it was keeping his circadian rhythm confused and his sleep drivers dysregulated. So, we workshopped a new plan. He’d get up with the alarm, and then immediately walk to the coffee shop near his home and order his favorite drink: a dry cappuccino. It ended up being this lovely quiet time for him, away from the house with its myriad responsibilities, away from the demands of kids and family. He’d read the paper, which he never usually found time to do. The extra time he’d carved out, because he kept his wake-up time consistent, felt like a gift.
Another woman I worked with decided to walk down to the beach near her house—it became a morning ritual, and something she found she looked forward to as soon as her eyes opened to the beeping alarm— she was happy to get up. Other people have used different tactics: Preparing a hot breakfast when they usually just quickly eat cereal. Making coffee and playing a sudoku puzzle. Taking a long, energizing shower. Just going out on the porch to enjoy the sunrise.
And finally, picture that sleep balloon. Remember the balloon analogy here. The minute you wake up, that “sleep pressure” begins, slowly, to build. If you get the sleep you need, it’s flat when you wake up—no matter what time you wake up, whether it’s 6 a.m. or noon. Starting from that moment, the balloon gradually inflates. For an easier, more effortless, more natural sleep experience, start inflating that balloon at roughly the same time every day.
From THE SLEEP PRESCRIPTION by Dr. Aric Prather published by Penguin Life, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2022 by Dr. Aric Prather.
