Whether you suffer from daytime fatigue or pre-dawn disturbances, these new sleep profiles might help you address underlying problems.
Struggle to nod off at bedtime? Only sleep for short periods each night, or consistently find yourself waking up in the small hours? Researchers behind a new study have identified five sleep profiles and suggested that how our brains are wired could be as important as lifestyle factors in deciding how much rest we get.
The study, published in PLOS Biology this month, examined the nighttime experiences of more than 750 healthy young adults and the relationship between their brain’s wiring, their sleep quality and their physical and mental health.
Valeria Kebets, a Canadian neuroscientist with expertise in brain imaging, is co-author of the study and says: “Most studies usually look at only one type of sleep issue and its outcome – for example, how duration impacts anxiety or depression symptoms, or how the number of times you wake at night alters memory or problem-solving skills.
“We wanted to take a more holistic approach and really look at sleep in its multiple dimensions to see how it is associated with mental health, physical health, cognitive performance and lifestyle factors.”
All participants were asked to complete questionnaires covering 118 biopsychosocial measures (that is, biological, psychological and social factors such as family history, mental health, diet, exercise and substance abuse), and underwent MRI brain scans. Kebets says the results revealed five sleep profiles, each displaying unique patterns of brain function, which the team call “neural signatures”.
“This means our sleep isn’t just linked to our health and behaviour, it actually shows up in how our brain is wired and works. We found brain activity patterns that were unique to each sleep type, and that the brain areas involved in movement and vision weren’t working together as well as they should across all five groups,” she adds.
The 5 problem sleep profiles you need to know
The restless worrier
Takes a long time to drop off, wakes often and generally feels tired during the day.
Key traits: Higher levels of mental-health issues such as depression, anxiety, fear, anger or stress than the general population. More likely to report physical symptoms of illness despite not having a medically diagnosable condition.
“People fitting this profile experienced the widest range of sleep issues and mental-health symptoms,” says Kebets. “But it’s important to note that our findings show correlations rather than cause. We don’t know if lack of sleep is causing the mental-health issues, or if the mental-health issues are causing the lack of sleep. In many situations, it can be both: you have anxiety, so you can’t sleep, then the lack of sleep makes the anxiety worse.
“For this group, it’s important to try to deal with both sides of the problem, which is why cognitive behavioural therapy (CBT), for example, [which works to restructure both thought processes and habits that can contribute to sleeplessness], has high efficacy.”
Sleep psychotherapist Heather Darwall-Smith, author of The Science of Sleep, explains, “With sleep it’s very ‘chicken and egg’ – which came first, poor sleep or poor mental health? Instead of trying to treat one or the other, it can be easier to target our daytime behaviour to put ourselves in the best possible state for sleep.
“Keep well-hydrated, don’t over-caffeinate, and getting outside and getting some light on you first thing will help so that, hopefully, by the evening, your body will change its sleep architecture and get some recovery sleep.
“Designate 10 minutes, a couple of hours before bed, to write down your worries. Getting those thoughts out of your head and onto paper really helps set them aside for a better night.”
The under-sleeper
Clocks fewer than six or seven hours’ sleep each night.
Key traits: Under-sleepers are more likely to be aggressive and less agreeable. They perform poorly in cognitive-function tests on memory, attention and problem-solving, and have slower reaction times in tasks that require processing emotions or decisions about delayed gratification.
Darwall-Smith says: “While there are genetic short sleepers who have no problems with curtailed sleep, they are vanishingly rare. For most of us, getting under six hours is where our break point is, largely due to the lack of REM sleep, which is the stage of sleep that is really important for learning, memory and mood regulation.
“If you’re really sleep-deprived, you need to put some space into your day to slow your reactivity levels down. The tendency is to just keep going because your stress levels are raised, but instead, we need to put the brakes on. Don’t over-caffeinate or turn to alcohol or sugar to get you through – try to give yourself the space you need.
“Pause before sending an email, wait a beat before shouting at someone. If you’re going into a meeting, compose yourself and take some deep breaths,” she adds.
The strategic sleeper
Uses prescription or over-the-counter medication, herbal or nutritional supplements to successfully solve sleep issues.
Key traits: Strategic sleepers perform poorly in memory tests and are less able to read other people’s social cues. Despite this, they report higher satisfaction in their interactions with others.
“This one was quite surprising,” says Kebets. “Sleep aid use was related to worse performance on episodic memory [recollection of everyday events] and emotional recognition, but it seemed to have a positive effect on their assessment of social relationships.”
Darwall-Smith, however, is concerned by the findings. “I find drawing a positive correlation between medication and relationships very worrying, as I wouldn’t want to encourage anyone to look at medication as a permanent sleep solution,” she says.
“Everyone who works in the sleep world is very clear that medication can be problematic. It might get you through a difficult time for a night or two, so it has its place, but it’s definitely not a long-term fix. The body knows how to sleep – it is a natural process that happens on its own, without us having to think about it. So, if you believe you need to medicate every night, what are you masking?
“If someone really believes they can’t sleep without taking something, are we in the realms of addiction? It’s dangerous and you should be seeing a GP in the first instance for help coming off [medication].
“I’ve worked with a lot of people who need to taper off medication, and often it’s something they bought over the counter at the pharmacy, so don’t make the mistake of thinking those tablets are less problematic than prescription pills from your doctor.”
The broken sleeper
Suffers from broken sleep, waking multiple times each night.
Key traits: Anxiety and overthinking. More likely to be aggressive and perform worse in language and memory tests.
“This group experience sleep disturbance due to a broad range of reasons, from being a light sleeper or suffering from pain to breathing issues, temperature changes, needing to visit the bathroom or substance abuse,” says Kebets. “More women were found to fit this profile than men.”
Darwall-Smith says: “In the first instance, you need to work out why you are waking at night. Your GP can help with things like nocturia, when you’re waking more than once to urinate, or menopausal hot flushes.
“You also need to work out if there’s something that is preventing you from falling back to sleep, like worry, that would benefit from talking therapy.”
Darwall-Smith also cautions people not to make problems worse with early nights and lie-ins. “People often think, ‘I only got a few hours, so I’ll sleep for 10 hours to recover,’ but that’s not how sleep works. Keep bedtimes and waking consistent.
“Instead, harness that circadian dip that comes after lunch. Have a 20-minute nap, or sit for 20 minutes with your eyes closed listening to a non-sleep deep rest (NSDR) recording. Allowing your brain to switch off briefly can allow you to reboot for the rest of the day.
“Also, stick to just one coffee in the morning. Our bodies take four to six hours to process a large coffee-shop latte and we can only clear so much caffeine from our system at a time. If you have several cups in one afternoon, that caffeine will still be hanging around when you go to bed, disrupting your sleep.”
The oblivious insomniac
Experiences daytime sleepiness, but never reports nighttime sleep disturbance of any sort.
Key traits: Oblivious insomniacs exhibit all the same mental-health challenges and negative emotions as restless worriers, such as depression, fear, stress and anger issues, but are also more likely to have ADHD, problems focusing on tasks and are generally less conscientious.
If you had an issue with your sleep, you’d know all about it, wouldn’t you? Perhaps not.
Kebets says: “This was a puzzling one. It may be sleep misperception – people who don’t actually notice their night is disturbed because they have something else going on that feels bigger than sleep.”
That certainly ties in with Darwall-Smith’s professional experience. “While I specialise in sleep, I don’t only see clients for sleep-related issues,” she explains. “You would be amazed at the number of clients who casually mention something in passing that hasn’t registered as unusual to them, but makes me think, ‘If I was seeing you in a sleep context, that would be considered seriously problematic.’”
So how would you even know? “If you constantly catch colds and bugs, then your immune system is low and it’s worth asking if you are sleep-deprived, as deep sleep and our immune systems are strongly connected,” advises Darwall-Smith.
“If you have excessive daytime tiredness, it is worth seeing your GP to rule out physical problems that can prevent sleep, including the breathing issue sleep apnoea, which is hugely under-diagnosed and can cause people to wake hundreds of times each night without them knowing.”