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News / Health / Clark County Health

OHSU doctor says we’re starved for sleep but hope isn’t lost

Relaxing nighttime routine paves way to healthful night’s sleep

By Scott Hewitt, Columbian staff writer
Published: January 10, 2021, 6:02am

Feeling pooped?

It’s no surprise. After a year like that, everyone has reason for exhaustion.

Beyond the familiar pandemic precautions — wearing a mask in public, getting that vaccine when available — getting better sleep may be the best thing you can do for your own health in the new year. The Centers for Disease Control and Prevention recommend at least seven hours per night for adults, at least eight hours for teens, and lots more for younger children.

“Sleep is really important for health and wellness,” said Dr. Miranda Lim, associate professor of neurology, medicine and behavioral neuroscience at Oregon Health & Science University. Lim studies sleep trends and problems across the whole human lifespan, from surprisingly dreamy infants (what can they possibly be dreaming about?) to traumatized war veterans to elders suffering age-related insomnia.

The mysteries involved are deep and multifaceted, but research keeps returning to a familiar conclusion: Sleep is “very natural and very necessary, and you feel really badly when you don’t do it,” Lim said.

You’d think that nothing would be easier than sleep, especially for a population that’s desperate for a break from reality — but society is replete with sleep problems and their widespread effects.

According to the CDC, approximately one-third of all adults and more than two-thirds of high school students don’t get adequate sleep. Lack of adequate sleep is associated with everything from individual health problems like depression, cardiovascular disease, obesity and compromised immunity, to public tragedies like car crashes.

The findings of a groundbreaking 2018 study by the AAA Foundation for Traffic Safety were clear: The less you’ve slept, the more likely you are to cause a car accident. Drivers who are deeply sleep deprived — four hours or fewer — are about as risky on the road as drunk drivers.

Darkness and light

Why are we so starved for sleep? There’s no single answer, Lim said, but she’s got some educated guesses.

For one thing, artificial light may be messing up our natural biorhythms in complicated ways. It causes “too little exposure to light during the day and too much at night,” Lim said. Your standard sunny day shines at up to 10,000 lux (a scientific measure of brightness), and even an overcast sky puts out 1,000 lux, but your typical office-environment lighting provides just 300 to 500 lux, she said.

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“We spend the vast majority of our days with not enough light,” she said. And then, after sundown, we not only crank up the artificial lighting, we tend to spend long hours staring at electronic screens that are known to emit blue-white frequencies.

Out in nature, blue-white frequencies come with sunrise and wake us up. When you blast blue-white light in your face at night, you’re suppressing the release of the hormone melatonin, which helps put you to sleep.

“If you suppress melatonin, it’s harder to fall asleep,” Lim said. “The next day at the office, you don’t feel well rested. And the light at the office is maybe just 400 lux, so you never feel awake. Light can play a big part in how we are feeling.”

Lim is involved with an ongoing study of indoor house lighting that mimics outdoor frequencies. Sunny, bright, bluish lighting perks up the daytime hours, then gives way to redder, warmer evening tones that don’t suppress melatonin as bedtime approaches. Scientists like Lim hope that such lighting will not only help people feel sunny in the morning and sleepy at bedtime, but even stave off the onset of more serious health problems associated with too little sleep.


Biorhythms are only part of what’s off, Lim suggested. There’s also the mindset, beloved by a certain kind of hyper-achiever, that rest is for sissies. Perhaps there’s some inherent conflict between the hard-charging American work ethic and our genuine need to be motionless and unproductive for as long as eight whole hours?

It’s an attitude worth unlearning, Lim said, because a sleep deficit is not a reversible thing.

“When you lose sleep, you can’t get it back,” she said.

As part of her training, Lim said, she traveled to Africa and conducted sleep assessments of rural villagers there.

“Nobody reported any sleep problems,” she said.

That might be because they have other things on their minds. But it might be because those folks live in more healthful harmony with the natural world, she said.

“I’m talking about sun, fresh air, physical activity,” Lim said. “Moving around in diverse ways for good circulation, instead of sitting in front of a computer all day.”


You may be motionless, but never think of your precious sleep time as unproductive. While deep relaxation and a slowed-down metabolism are part of the story, sleepers also cycle through busy periods of brain activity — emotional and information processing, memory storage, affecting repairs to the internal wiring and even flushing away waste that can build up during the day.

Each cycle takes time — perhaps as long as two hours — so people who don’t spend sufficient time sleeping don’t finish all those vital chores. In addition to the maladies described above, like a run-down immune system and cardiovascular disease, results can also be brain-specific.

“We know now that poor sleep can be a cause of Alzheimer’s,” she said. “If you don’t sleep enough there may be more build-up of plaque in the brain.”

Unfortunately, Lim acknowledged, sleep problems and other health problems can turn into self-perpetuating cycles.

“Poor sleep can make your mood much worse, and if you are severely depressed it can affect your sleep at night,” she said.

Best practices

For all those reasons, Lim said, it’s worthwhile to put effort into good sleep, including getting your sleep problems diagnosed if necessary.

“I don’t think sleeping pills are the answer,” she said. “Address whatever is affecting your sleep, whether it’s depression or apnea or whatever is going on.”

(Apnea is a common sleep disorder where the sleeper briefly stops breathing. It’s often associated with heavy snoring.)

Meanwhile, try to create optimal conditions and habits for good sleep in your life:

• The right light at the right time. Expose yourself to at least a couple hours of bright light during the daytime, and limit bright light at night. Turn off electronics that emit blue-spectrum light — computers, phones, TVs — two hours before bedtime. Try eyeglasses and apps designed to filter blue light.

• Relaxing routine. Wind down before bedtime. Read a book, take a hot bath or shower, meditate. If you are preoccupied by plans or questions about tomorrow, write them down and let them go for now.

• Consistency. Go to bed at the same time each night and get up at the same time each morning. Yes, weekends too. (But, if you don’t fall asleep after about 20 minutes, get up for a while.)

• Sleepy space. Your bedroom should be quiet, dark, relaxing and a comfortable temperature. Don’t watch TV, work on your laptop or engage with screens in bed. Move them elsewhere in the house.

• Food and drink. Avoid large meals before bedtime. Taking in fluid at bedtime guarantees you’ll have to get up during the night. Alcohol may help knock you out, but it also disrupts deeper sleep cycles.

• Caffeine and exercise. Both tend to rev you up, so separate them from bedtime. Don’t drink caffeine or exercise vigorously after sundown.

• Information overload. “The sheer amount of stress we’ve all undergone … can have major impacts on sleep,” Lim said. “I decided to delete all the news apps from my phone. I found I was doomscrolling right before I went to sleep. It was not relaxing.”

• Melatonin, maybe? There’s strong evidence that the natural hormone melatonin can help some people fall asleep, but over-the-counter versions are unregulated and often misrepresent what and how much is really inside, Lim said.

“It’s not a sedative or a sleeping pill,” she said. “It doesn’t make you feel sleepy or knock you out. It just sends a tiny sleep signal, and all you really need is 0.5 milligrams. If you do use melatonin at night, try it with a bright light in the morning.”