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From ... in Psychology —

Are You Always Waking Up Exhausted? Here's What to Do

Sleep is one of the cornerstones of optimal wellness, and it's recommended that you get anywhere from seven to nine hours of sleep every night.

Are You Always Waking Up Exhausted? Here's What to Do

But have you ever experienced waking up exhausted, even after you made sure to meet this golden rule? You tuck yourself in at 10PM and wake up at 7AM, expecting to feel refreshed and energized. But instead, you feel tired and worn down, as if you just ran a marathon. All throughout the day, you feel tired, irritable and unfocused.

Why does this occur and what's the best way to prevent it? It turns out there's a name for this condition — unrefreshing sleep. It's a common problem, and millions worldwide often go through their day experiencing the repercussions of this sleep issue. The good news is there are ways to address it and bring back the high-quality slumber you need.

According to the Sleep Foundation, 25% of Americans experience excessive sleepiness during the daytime — a significant increase from 12.7% reported in 2012. A major factor that could be causing this is unrefreshing sleep, also called nonrestorative sleep. As its name implies, unrefreshing sleep refers to sleep that does not suficiently recharge your body and brain, leaving you feeling unrested. Those who experience it feel as tired as they did when they laid down to sleep. It's been recently recognized as a major sleep problem that affects anywhere from 2.4% to 42% of people worldwide. However, don't confuse it with other sleep problems like insomnia. People with insomnia usually struggle to fall or stay asleep; their mind is wide awake, and they are fully aware that they aren't asleep, and can even keep track of how many hours of sleep they've lost. With unrefreshing sleep, it's different. You do end up falling asleep, and even get to sleep quickly. However, even if you're sleeping enough hours, the restorative work that needs to occur in your brain during this important part of the night doesn't occur for a variety of reasons.

Health experts are unsure why unrefreshing sleep occurs, although it's been associated with some health problems (more on this later). However, according to an article in Time, in most people this problem doesn't seem to have a medical cause. Rather, it's said to be linked to inadequate, deep restorative rest.

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"During an average night, someone will go through four to six sleep cycles, each one comprising four different stages of sleep. The deep sleep that helps the body and brain recover happens toward the end of each sleep cycle. People who experience unrefreshing sleep may, for whatever reason, not get enough [deep sleep], leaving them fatigued during the day even after hours of shut-eye." Dr. Sonja Schuetz, a neurologist who specializes in sleep medicine at University of Michigan Health, says there is a certain amount of deep sleep that is essential to get high-quality sleep. Not meeting this deep sleep requirement leads to fatigue once you wake up. "A lot of times people feel like, 'It doesn't matter how long I sleep. I wake up and feel like a truck ran over me,'" she said. One reason why a person fails to get suficient deep sleep is related to the "micro- arousals" they experience throughout the night — this means waking up multiple times at night, but very briefiy so you don't remember it in the morning.

Sleep — in particular, high-quality, restorative sleep — is vital to your physical and mental well-being. If you're not getting enough, it raises your risk for chronic disease, including obesity, stroke, dementia and cancer, and even puts you at higher risk of death. Basically, every aspect of your life suffers if you're not getting high-quality sleep. A 2023 Japanese study gives a startling example, as it highlights how nonrestorative sleep specifically affects your risk of diabetes and heart disease. The study, published in the Diabetology and Metabolic Syndrome journal, showed the implications of nonrestorative sleep, stating that it is a risk factor for metabolic syndrome among adults between ages 39 and 75.

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Metabolic syndrome "represents a multicomponent risk factor for cardiovascular disease (CVD) and Type 2 diabetes." According to the authors: "The findings of this large-scale cohort study conducted among middle-aged Japanese adults suggest that NRS [nonrestorative sleep] is positively associated with the incidence of MetS [metabolic syndrome]. Despite the recognized importance of adequate sleep for well-being, most Japanese are not satisfied with their sleep. Therefore, the current results may help design more effective prevention strategies for MetS to ensure adequate amount and quality of sleep." There are other body processes that are affected when you don't get enough rest. A few notable examples include: Memory retention — During deep sleep, the memories you accumulate during the day are transformed into long-term memories. However, being sleep deprived hampers your ability to remember new information. Increased risk of neurological problems — Failing to get high-quality sleep impairs the removal of misfolded neurotoxin proteins involved in Alzheimer's, Parkinson's and other neurodegenerative diseases. Impaired immune function — Sleep is fundamental to your immunity, and if you don't get enough, your risk of immune-related diseases increases.

It's not uncommon to have an occasional night of unrefreshing sleep, especially if there are disruptions or unexpected changes to your routine. However, if it becomes chronic, then it's essential to evaluate your lifestyle habits and sleep hygiene. Schuetz advises getting the recommended seven to nine hours of sleep. Most people think they can get away with less than this, but they are in fact walking around

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chronically sleep-deprived. She recommends doing a simple test to see if you are sleep- deprived: Don't set your alarm on your rest day and see how late you wake up. If you sleep in late, then it means you're sleep deprived. If you struggle with getting enough restful sleep, it could be because your circadian rhythm is off — this is your body's internal clock, which runs in 24-hour sleep-wake cycles. It regulates your body's alertness and sleepiness by responding to the light changes around you. However, many of us have an impaired circadian rhythm because of poor habits, particularly the failure to get enough sun exposure during the day and overexposing yourself to excessive light, especially blue light, at night. To get your circadian rhythm to function normally again: • Get enough sun exposure during the morning — In the morning, bright, blue light- rich sunlight signals to your body that it's time to wake up. Get at least 10 to 15 minutes of natural light first thing in the morning. This will send a strong message to your internal clock that day has arrived, making it less likely to be confused by weaker light signals later on. • Eliminate all sources of light at night — Even the tiniest bit of light from your digital alarm clock or from the streetlight outside your window disrupts your sleep. Invest in blackout shades or wear an eye mask during bedtime. Evaluate your bedroom as well — get rid of LEDs and fiuorescent lights, as they are particularly troublesome because the blue light peaks are not balanced by red and near-infrared. Your gadgets are also notorious sources of blue light, so keep them out of your bedroom.

If you're looking for outdoor activities to help you maximize your sun exposure, gardening is one of the best choices out there. Not only does it allow you to spend time in the sun, but it also allows you to connect with the Earth (grounding), which has

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profound benefits for your health as well. And if you're growing fruits and vegetables, you'll also have fresh food right in your backyard. A recent study highlighted the benefits of gardening for sleep. A survey of more than 62,000 participants found that people who spend time gardening but not exercising had a much lower risk of experiencing sleep complaints compared to other non-exercisers. Not only did they experience improved sleep duration, but they also had a reduced risk of daytime sleepiness, insomnia and sleep apnea. If you need tips to help you start your own garden, I recommend reading my article " Sleep Problems? Gardening May Help ." There's an important caveat about sun exposure, however, especially during peak hours. If you consume a diet high in linoleic acid (LA) , particularly from seed oils and ultraprocessed foods, it's best to avoid going out during peak solar noon, as the LA in your skin oxidizes when exposed to sunlight. As a result, you're more apt to get sunburned and experience skin damage. I recommend purging LA from your diet for about four to six months before enjoying sun exposure during peak hours.

When it comes to having an eficient sleep routine, consistency is key. Try going to bed at the same time every night, and wake up at the same time every morning, to optimize your circadian cycle. You also need to make significant changes to your bedroom, such as eliminating all gadgets and light sources. Avoid screentime during bedtime as well. Here are other helpful tips to help you get high-quality, restorative sleep at night: • Keep the temperature in your bedroom no higher than 70 degrees F — When you sleep, your body's internal temperature drops to its lowest level, generally about four hours after you fall asleep. Studies show the optimal room temperature for sleep is between 60 and 68 degrees F. Keeping your room cooler or hotter leads to restless sleep.

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• Eliminate electromagnetic (EMFs) from your bedroom — These disrupt your pineal gland's production of melatonin and serotonin, and are a significant contributor to mitochondrial damage and dysfunction, which is at the heart of virtually all chronic disease. • Avoid eating at least three hours before bedtime and drinking fiuids at least two hours before — Eating before bedtime raises your blood sugar, delays sleep and raises your risk of acid refiux. As for avoiding drinking fiuids, this will help you avoid trips to the bathroom. • Avoid caffeine and alcohol — In some people, caffeine is not metabolized eficiently, leaving you feeling its effects long after consumption. Meanwhile, alcohol could make you drowsy, but the effects are short-lived; you'll end up waking after a few hours, unable to sleep. • Get regular exercise — At least 30 minutes of exercise per day helps improve your sleep. Just make sure not to time it too close to your bedtime. For more comprehensive tips to help you get better sleep, I recommend reading these articles: Lack of Sleep Can Cancel the Benefits of Exercise Top 33 Tips to Optimize Your Sleep Routine Here's What Losing Sleep Does to Your Heart

Addressing the lifestyle and environmental factors listed above will help you avoid unrefreshing sleep. But what if you address all these issues but are still experiencing nonrestorative sleep and daytime fatigue? In this case, unrefreshing sleep could be a warning that something more serious is going on inside your body. If unrefreshing sleep is a chronic condition that refuses to go away despite making notable changes to your lifestyle habits, it could be linked to issues, such as: Restless leg syndrome Fibromyalgia Chronic fatigue syndrome, also known as myalgic encephalomyelitis (ME) Long COVID Sleep disorders such as sleep apnea, gastroesophageal refiux (GERD), hypersomnia and narcolepsy also lead to extreme fatigue during the day. To rule out more serious issues, consult with a physician and get a full medical workup.

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