The state of your overall health and the quality of your sleep are closely connected [1, 2, 3], but the effects of poor sleep quality may go farther than you realize. When your sleep quality is compromised, your immune system, gut microbiome, hormone production, and cognition can all begin to decline [4, 5]. Conditions like hormone and gut imbalances and autoimmune disease can also negatively impact your sleep.
Most of us know that sleep is important, but we don’t necessarily make a conscious effort to prioritize our sleep quality and practice good sleep hygiene. We have seen many patients achieve greater improvements in their health when they start prioritizing sleep hygiene.
Let’s walk through the effects of poor sleep hygiene on your health, how to know you’re not sleeping well, how to get a good night’s sleep step-by-step, and additional sleep hygiene support.
Poor Sleep Hygiene and Your Health
Sleep hygiene refers to the habits, practices, and environment that promote restful sleep. When you have poor sleep hygiene, your risk of developing many conditions increases, including:
- Heart disease [1, 6]
- High blood pressure 
- Metabolic syndrome 
- Type 2 diabetes 
- Obesity [2, 10]
- Irritable bowel syndrome (IBS) 
- Autoimmune disease 
- Psychological and mental health concerns 
- Reduced cognitive function [4, 12]
- Impaired memory 
Sleep has far-reaching effects for your health, from mental health to metabolic health to the immune system [13, 14]. Sleep is so impactful because it allows the body to perform key maintenance and detoxification processes, including removing toxic buildup and waste and organizing and consolidating memories [13, 15].
Sleep Affects Gut Health
Research shows that those with gastrointestinal conditions like IBS or IBD have a higher incidence of sleep disorders like chronic insomnia as well as general poor sleep quality [16, 17]. Poor sleep has also been linked to increased intestinal permeability (leaky gut) .
So which is the causal factor — the disruption to the gut environment causing the poor sleep, or the decline in quality of sleep leading to disease in the gut? The answer is most likely both — either one can affect the other.
One clinical trial found that sleep problems led to lower levels of melatonin, the hormone that makes you sleepy at night. These lower melatonin levels were then connected to increased intestinal permeability . Studies show that leaky gut and inflammation in the gut also contribute to poor sleep quality in IBD patients .
The good news? Probiotics may help improve sleep for those with gut imbalances [20, 21, 22, 23]. Improving your gut microbiome through diet and lifestyle and lowering inflammation can also improve your sleep quality.
Sleep Hygiene Considerations
There are three key elements of sleep hygiene that you should take into consideration:
- Timing of sleep
- Duration of sleep
- Quality and intensity of sleep
Your body likes to know when it should be sleeping and awake. Sticking to a consistent sleep schedule helps normalize and regulate your circadian rhythm, allowing the body to perform its various functions like memory consolidation and detoxification at the optimal time .
You should ideally sleep between seven to nine hours every night. Durations fewer than seven hours and longer than nine hours are linked to negative health effects the next day like daytime sleepiness and mental fatigue .
Lastly, good sleep quality is essential. Having good quality of sleep means that you are cycling through the five sleep stages — one REM stage and four non-REM stages — several times in one night. Each non-REM sleep stage creates deeper and deeper sleep, until you reach the REM stage, where you dream .
This is the process that allows your brain to detoxify from cellular waste produced by the brain’s normal functions during the day. This helps your brain feel refreshed and ready for the next day. When you don’t cycle through all the stages or don’t cycle through them enough times, you may feel that drag of mental tiredness the next day [13, 24].
What Happens When You’re Not Sleeping Well
There are some obvious signs that you’re not sleeping well, like having trouble falling asleep or staying asleep until morning. But what about when you sleep through the night only to wake still feeling mentally or physically tired? This is a sign that your sleep quality may be off.
Signs of poor sleep quality may include:
- You sleep for 7-9 hours but feel unrefreshed the next day.
- You usually breathe through your mouth at night.
- You’ve been told that you snore.
- You wake up very thirsty or with a dry mouth, drool at night, and have a history of cavities and/or periodontal disease.
- You have ongoing, unexplained symptoms, including chronic fatigue, brain fog, or gut issues.
Fortunately, you can get better sleep by incorporating good sleep hygiene and sleep habits, which we’ll explore below.
Poor Sleep Causes
There are many possible causes for poor sleep quality and sleep deprivation. Some causes of poor sleep include:
- Disruptive sleep environment (ex., excessively loud, hot, or bright)
- Irregular sleep schedule possibly caused by shift work [13, 25, 26]
- Blue light exposure (from cell phones, computer screens, etc.) and other bright lights at night 
- Restricted breathing, mouth breathing, or an obstructed oral airway [28, 29, 30, 31, 32]
- Anxiety, depression, and stress [13, 33]
- Gut microbiome imbalances and inflammation 
- Certain medications including antidepressants, corticosteroids, and opioids 
- Consuming caffeine or alcohol 
- Medical conditions including COPD, heart disease, fibromyalgia, and hyperthyroidism [13, 34]
- Sleep disorders including sleep apnea and chronic insomnia 
- Hormonal imbalances 
Get a Good Night’s Sleep Step by Step
Ensuring restful sleep involves lifestyle change, making a commitment to your sleep and sticking to a sleep routine. It’s not necessarily easy to make these changes, but it is possible when you keep the goal of better sleep and better health in mind. Let’s review the steps to take to get healthy sleep.
Your Good Sleep Foundation
There are three key areas to work on when addressing your sleep hygiene: your internal state, external factors, and your schedule/timing.
Step 1: Change your internal state
- Follow a diverse, anti-inflammatory diet, such as the Paleo diet. Lifestyle interventions like improving one’s diet have been shown to improve sleep disorders, including sleep apnea [36, 37]. Eating a healthy diet can also help address other conditions like hormone imbalances, poor gut health, and inflammation that often disrupt healthy sleep.
- Avoid sleep disruptors like caffeine and alcohol, especially later in the day. These can contribute to sleep disruption and sleep disorders like chronic insomnia .
- Address gut imbalances. Given the connection between sleep and gut health, improving your microbiome composition and lowering intestinal inflammation may lead to better sleep quality.
- Take probiotics. Clinical trials have shown that taking probiotics can help improve sleep quality and reduce sleep disruptions for healthy individuals and those with depression, insomnia, and work-related stress [20, 21, 22, 23].
- Exercise regularly. Exercise can help improve your sleep and your overall health [36, 37]. In a systematic review of previous meta-analyses, researchers found that adults who exercised regularly improved their sleep quality by 19% . Exercise also helped those with sleep apnea reduce their symptoms .
Step 2: Address your external environment.
- Minimize bright and blue light. Any artificial light after the sun goes down has been shown to disrupt sleep, but blue light is especially an issue for the body’s circadian rhythm . It can cause wakefulness at night when your body should be winding down to go to sleep, and it can increase daytime sleepiness as well. Getting lots of daylight exposure and reducing your artificial light in the evening can help normalize your sleep cycle. You can block light during sleep by wearing a sleep mask or putting up blackout curtains over your windows. You should also turn off all devices such as computers or cell phones at least one hour before you go to sleep.
- Cool temperatures make for better sleep. Unless you have obstructive sleep apnea, a cooler temperature in your sleep environment supports restful, consistent sleep . You can test different temperatures, but aim for between 60 and 70 degrees Fahrenheit.
- Reduce noise disruptions. Noise in our environment while we’re trying to sleep can easily disturb us and even cause stress to the cardiovascular system . Use earplugs to block noise or create a relaxing soundscape with sleep sounds or a white noise machine.
Step 3: Plan ahead for good sleep hygiene.
- Stick to a regular schedule. Plan to get a full eight hours of sleep per night. As much as possible, try to stick to the same bedtime and wake up time every day.
- Avoid eating 2-3 hours before bedtime. This allows for optimal digestion and restful sleep.
- Avoid intense exercise close to bedtime. Regular exercise is supportive to your health, but completing a difficult workout right before you go to bed could cause sleep disruption and reduce sleep efficiency.
- Create a calming nighttime sleep routine. Before you go to sleep, it’s important to wind down with enjoyable, calm activities like taking a bath, reading, or spending time with family and pets. Don’t try to get a jump on work tasks or check your email.
Additional Sleep Hygiene Support
Once you have these lifestyle changes in place and follow a regular sleep routine, you can add more support if needed.
Melatonin is a sleep hormone that is available as a supplement. It can help you fall asleep faster, improve sleep duration and quality of sleep, and regulate circadian rhythms. It also has much lower risk for side effects than pharmaceutical sleep medications [42, 43, 44].
Wear a Sleep-Tracking Device
Sleep trackers won’t improve your sleep just by wearing them, but they can provide data to tell you where to focus your efforts. The popular Oura Ring has been compared to clinical sleep studies in its ability to track sleep cycles .
You could also try a test like the wearable WatchPAT device, which we offer at our functional medicine center, to look into possible sleep apnea from the comfort of your home.
Improve Breathing and Throat Health
Breathing through your mouth and snoring can have a significant impact on your sleep quality. Snoring occurs in about 32% of adults .
There are several ways to train yourself to breathe through your nose instead of your mouth, like using myofunctional therapy exercises (physical therapy for the mouth). You can also try things like mouth taping to promote nasal breathing, using a wearable product to adjust the jaw, or even playing a wind instrument to improve your breathing [31, 47, 48].
A 2020 systematic review of nine clinical trials found that myofunctional therapy helped to improve sleep quality . Another systematic review found significant improvements in sleep apnea and snoring for both adults and children with myofunctional therapy .
The Bottom Line
Practicing good sleep hygiene is foundational to your overall health and well-being, and it should be a priority in your daily life.
The sleep hygiene practices recommended here will help most people achieve the recommended 7-9 hours of restful sleep. But, if you still aren’t seeing positive results, please reach out to our functional medicine clinic to schedule a consultation with one of our experienced practitioners. We can help you find the root cause of your sleep problems and take action to help you get better sleep.