Sleep Guide: Part 1

What's Your Sleep Situation?

The quick read

Bad sleep comes in many flavors and impacts different folks in different ways. A doctor may diagnose you as having clinical insomnia: you can't fall asleep or can't stay asleep, most nights, for months. You might find that you suffer from intermittent problems: a few bad nights a week, fine in between. And here's the condition few people understand thoroughly — poor restorative sleep: you get your seven or eight hours and wake up tired anyway. That third state is not often diagnosed. Unless you wear a device like an Apple Watch, Whoop, or another device that measures sleep stages accurately, you might not realize the reason you feel tired or dull in the morning. Read on to find out more.

Where do you see yourself? Insomnia? Intermittent poor sleeper? Or are you not getting the restorative rest you need?

Clinical insomnia

You get into bed tired and your mind switches on. Or you drop off fine, wake at 2 a.m., and that's that. Most nights. For months. You've started dreading bedtime, which doesn't help — dread is wide awake by definition.

This one has a real definition: trouble falling or staying asleep, three or more nights a week, for three months or longer, with a cost you can feel the next day. As many as one in ten adults meets it, and most have never had it named.

Here's the good news hiding in that definition: chronic insomnia is the best-studied problem on this page, and the treatment with the strongest evidence behind it isn't a drug, isn't habit-forming, and keeps working after it ends. It's the one thing here worth a doctor's appointment — and the last article in this series walks you through that appointment and possible treatments, which will likely be less complicated and stressful than you might imagine.

Intermittent poor sleep

Two or three bad nights a week, groggy days after, then a stretch where you sleep like a normal person. No pattern you can see, which is its own kind of maddening.

This is common — and often fixable, because you are able to sleep. Something is interfering with it, and the list of usual suspects is short: caffeine later than you think, alcohol closer to bed than you think, light at the wrong end of the day, a wake time that wanders, an active mind at the end of the day. Many factors that cause intermittent poor sleep are in your control. Article 4 in this series is the checklist of factors that will help you get better sleep — even on those bad days.

Poor restorative sleep

In bed by eleven, up at seven, no lying awake — and somehow you're tired anyway!?! Words come slower than they used to. The gym takes more out of you than it gives back.

Duration isn't your problem. Not getting restorative sleep is. Your time in bed asleep may be long enough and still shortchange you on deep and REM sleep — the two stages that do the actual repair. You might not understand why you wake up feeling unrested and less capable during the day, because by all appearances it was a good night.

Article 3 explains sleep stages, how they work, and why deep and REM sleep are so important.

What else it could be

Three things get mistaken for insomnia but are distinctly different conditions, two of which may require a doctor's care.

If you snore loudly and someone's told you that you gasp, choke, or stop breathing — or you're wiped out after a full night in bed — that points to sleep apnea. Take it seriously: untreated, it carries real cardiovascular risk, and no checklist fixes a blocked airway. It's a doctor's job — and one of the most treatable things on this page once it's caught.

If your legs have an unbearable urge to move the moment you're still in the evening, that's restless legs. Worth knowing: some of the most common drugstore sleep aids can make it worse, so the obvious thing to reach for is the wrong one.

And if you sleep six hours, feel fine all day, and only wish you slept more because you've read that you should — you might be a short sleeper. Feeling fine is the whole test. If you pass it, you're done here; go enjoy the extra two hours.

What next

If any of these sounded like your sleep patterns, the next article maps where bad sleep comes from: the common causes, sorted into four categories, and where in this series each one gets fixed. Read the series at your leisure, in order or as you find them interesting.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. “Up to 2X” deep and REM sleep describes the low-baseline responder subgroup in our clinical trial, measured by wrist-worn actigraphy.