How to Improve Sleep Continuity and Depth

Okay, so the first question, this was a top-voted question by Alina, and the question is: what are the most common causes of fragmented sleep and nighttime awakenings that last over an hour? And which strategies or nutrients do you recommend to improve sleep continuity and depth? Melatonin is one that people turn to a lot of the time, especially older adults who are making less melatonin. You don't want to take a super-high dose of melatonin, but some people can take three milligrams or less, right?

One to three hours before bed. It works for some people. It doesn't work for everyone. It's certainly great when you're traveling and you have jet lag.

That's a great time to take melatonin. Another supplement that people like, and that has a calming effect on the nervous system, is magnesium. So when you're very stressed out, your body uses up more magnesium because magnesium is required to make energy. Stress requires a lot of energy.

So does physical activity, right? All these things use up your magnesium. And so, taking magnesium before bed, that's typically what I do. I take magnesium glycinate.

People do seem to think it helps improve their sleep. Also, L-theanine is another one that might be helpful. So, it's one of those calming amino acids. It's found in green tea.

It doesn't really sedate you, but people think it helps quiet the mental chatter. There was a 2025 review that analyzed 18 clinical trials, and they found very small but meaningful improvements in sleep latency and quality, especially in people with mild anxiety who took L-theanine. The dose range was about 200 to 400 milligrams at night. And again, it does seem to help some people.

Glycine is another big one. I've been hearing a lot of people come back and give me comments on glycine and how, if they take it about 30 minutes to an hour before bed, their subjective sleep quality the next day is much better. Even their sleep-tracking data seems to improve, with fewer nighttime awakenings as well.

And so, the dose that seems to be the sweet spot there is about three grams of glycine. This is something that I'm personally going to experiment with. In fact, I just ordered some glycine. So, stay tuned on that.

And then myo-inositol is another one I've talked about in the past. It's not a sleep aid, and it definitely doesn't have strong evidence as a sleep aid, but again, it helps with some of that mental chatter. Whether or not it's a placebo, it seems to help me. Unfortunately, fragmented sleep is strikingly common. Large data sets suggest that one-third of U.S. adults experience these sleep-disrupting awakenings at least three times per week. So, it's a problem for sure, and there are a lot of different potential causes of nighttime awakenings. There are obviously medical conditions. Barring those, we have insomnia, right?

So, insomnia would be one cause, and a solution would be cognitive behavioral therapy for insomnia, CBT-I. It's a tried-and-true method for improving insomnia. Another medical condition to check off the list would be obstructive sleep apnea. That definitely causes frequent nighttime awakenings.

A CPAP machine is very beneficial and has been shown to help treat those nighttime awakenings in people with sleep apnea. Another condition that people don't often think about, but that plays a role in fragmented sleep, is nocturia. This is where you're frequently having to urinate in the middle of the night. There are medical conditions that can cause this.

So, prostate enlargement definitely is one of them. You hear a lot of older men talking and complaining about this. Another one would be overactive bladder. Some women complain about this, especially after having multiple kids.

But I would say the biggest concern for most people without any medical conditions would be nighttime fluid intake. This is something that I've experimented with pretty extensively. And for me, it's very clear: if I drink fluids close to my bedtime, I will have to wake up to use the restroom at least once. And that does disrupt my sleep.

If I abstain from drinking fluids a couple of hours before bed, maybe I'll have a couple of sips, but I'm not drinking a glass of anything, no glass of tea or water, then I can last the whole night without having to urinate. And it really makes a difference. So that is also something to keep in mind. Another obvious cause of frequent nighttime awakenings would be psychological stress.

Right? So outside of medical conditions, our mental state plays a huge role in our sleep. Anything that's causing you anxiety or depression, if you're having any kind of physiological arousal, it could be as simple as reading an email too close to bed from your boss, or some kind of emotionally arousing email. Obviously, that anxiety can keep you alert and cause frequent nighttime awakenings. So making sure you keep your stress level under control is also extremely important.

Now, let's talk about the environmental causes. I think that's what a lot of people are interested in. One that not a lot of people think about, including myself until I had a discussion with Dr. Andy Galpin a few months ago, was irregular sleep schedules and/or bedtime routines. And it's really true, if you have this irregular, erratic sleep schedule where you're working really late, you've got children, or extracurriculars are getting you home late, or whatever it is.

Let's say you're usually in bed with your eyes closed by 10:00 p.m. If something in your life makes you get into bed an hour later, and you're not closing your eyes until 11:00 p.m., that disrupts your sleep and causes frequent nighttime awakenings. So erratic, irregular sleep schedules are something to consider.

You want to have a routine. You want to try to stick to it as much as you can. Obviously, life gets in the way. You can't always do that, but you want to try as much as you can.

Alcohol consumption, I talked about this last summer when I released the alcohol episode. One of the major things alcohol does is increase nighttime awakenings. Many people consume alcohol in the evening because they think it's helping improve their sleep. They think that because alcohol reduces what's called sleep latency.

So, you do fall asleep more quickly, but the trade-off is that your sleep will be fragmented and you will have frequent nighttime awakenings. And so, you definitely want to try to avoid consuming alcohol within, I would say, at least a few hours of going to bed. The other thing that increases nighttime awakenings is late-night eating. There are a variety of reasons for this.

I've talked to Dr. Satchin Panda about this, and he's mentioned that you don't want to be digesting food while you're sleeping because that's activating the sympathetic nervous system. You're digesting. It's awake time.

Your body's thinking this is awake time. And so that is something that can cause nighttime awakenings as well. It raises blood glucose and insulin levels, which increases your core body temperature. If your core body temperature is up, that's going to cause you to wake up because your core body temperature is supposed to fall, and that is important to help you sleep better.

So that's another thing to consider. You want to stop eating at least three hours before your natural bedtime. Caffeine intake late in the day is something to consider. Excessive exposure to blue light late in the evening also can cause nighttime awakenings.

And certainly, if your room isn't dark and there's ambient light coming in, that also can do it. Then there are things like noise disturbances. Your bedroom temperature isn't right; it's too hot or too cold. All that stuff affects your sleep and causes frequent nighttime awakenings.

Aging is another thing to consider. As people age, they have reduced slow-wave sleep, lower melatonin production, and lighter, less-restorative sleep. So you can be awakened very easily. Let's say you have to urinate just a little bit; that can wake you up, right? There are all these things that can happen. And for women, menopause-related symptoms also disrupt sleep. So let's talk about some of the factors we have control over that can influence the way we sleep. First would be good sleep hygiene. This is always the foundation.

One of the most powerful steps here, I've talked about this for many years, is something Dr. Satchin Panda brought to my attention 10 years ago.

And that is getting early-morning bright-light exposure. You want to get that bright-light exposure within at least 30 minutes after you wake up. This is very important because it resets your circadian rhythm. This is the internal clock that helps you fall asleep naturally at night.

It also helps switch off melatonin in the morning, which makes you more alert. So that is very important for having a normal sleep cycle and schedule and avoiding the erratic sleep schedule that we talked about. On the flip side, it's really important to avoid blue light after sunset. And actually, before I get into that, I want to get back to today's chat question for shift workers.

If you are a shift worker and your daytime is nighttime, you can't walk outside and get early bright sunlight first thing in the morning because your morning is at night, right? In that case, you want to get one of those 10,000-lux blue-light lamps. There are a variety of them on the market. All of them are pretty good.

And essentially, use that within the first 30 minutes of waking up. Get that bright, 10,000-lux light. That's a lot of light. It's really important.

And that will help reset your circadian rhythm because, otherwise, your body is confused. The lights you switch on in your house are not enough to signal to your brain, "This is the morning. The sun is out, and I'm resetting your circadian clock." That doesn't happen, so you end up never really resetting it the right way. You build up sleep pressure and all that happens, but your internal clock is out of whack.

And so you want to reset that clock every 24 hours, every day. The way to do that, if you're a shift worker, is to get one of those blue-light lamps. Very important: 10,000 lux. On the flip side, it's very important to avoid bright blue light at night, right?

So after sunset, we all switch on our lights. We have all this blue light in our houses, and it's basically tricking our brain and telling it, "It's not nighttime. We should still stay awake." And so you're not making melatonin in your pineal gland, and there's no switch to indicate that it's time to go to bed.

So, the solution is to get light dimmers or red lights that don't emit blue light, because blue light is the problem. There are a variety of fixes for that, and they really do help. Obviously, this is something we've talked about before. Keeping your room dark is very important.

I've noticed this every time I travel. It's never dark enough, and I really have problems sleeping. I get frequent nighttime awakenings because there's too much ambient light coming into the room. Some hotels are great and have great blackout shades, but I've stayed in many hotels that do not. Please try to stick to a regular bedtime routine.

We talked about this. Anything that signals a pattern to your brain, whatever it is, even if it's not a calming thing, is just something that you do. My husband does the dishes before bed. I do the cooking; he does the dishes. It's a great collaboration.

So, that's what he does, and I put our son to bed. My bedtime routine is to put our son to bed, wash my face, and brush my teeth. I sit in my bed.

Sometimes I'll read a little bit, but I'll listen to relaxing music. And that's my routine. If you can train your brain, then when you're doing that routine, your body starts to calm down. Your brain starts to calm down.

It knows. It's this anticipation: "Okay, I'm anticipating that it's time to calm down, wind down, and relax." Obviously, we mentioned bedroom temperature as well.

Air conditioning helps with that. If you don't have air conditioning, having a bed that can cool itself, like an Eight Sleep, is another important factor because sleeping in a cooler room is ideal, and it really does make a big difference. Your core body temperature drops at night. It prepares you for sleep.

In fact, melatonin plays a role in doing that. So, you want to make sure that you're sleeping in a cold room. And paradoxically, you may think, "Well, then why would I want to do something like a sauna before bed?" A temporary rise in your body temperature triggers this cascade of hormonal effects that promote deeper, more restorative sleep once your body cools back down.

And so, if you use a hot tub or sauna about two hours before you go to bed, which is what I like to do, it not only doesn't impair your sleep; it improves your sleep. And then we talked about the eating component as well. I have absolutely noticed that if something happens and I have dinner later, closer to my bedtime, I am hot when I'm lying in bed. I'm hot.

I'm like, "Why am I hot?" And I've traced it back to the times when I've had dinner outside my normal time, right before bed. It's terrible. I sleep terribly those nights. And so you want to try to stop eating at least three hours before bedtime.

Your body starts to make melatonin naturally three hours before bed. This is not only important for sleep onset, preparing your body for sleep, and lowering your core body temperature. Melatonin prepares the whole body for sleep, for rest. And so it shuts down the production of insulin in the pancreas because the body is going, "Okay, it's rest time.

We're not going to be eating right now. We don't need to make insulin because we're not going to get glucose." So, if you eat within an hour or so before bed, your melatonin has already risen, and you're not going to make as much insulin. You're going to have elevated blood glucose levels. Yes, it has metabolic effects that are not good, but it also activates your sympathetic signaling pathway. So you're going to have increased body temperature and increased alertness. Both undermine our sleep quality, and I've noticed this on many occasions.

So I think it is really important to stop eating three hours before you go to bed. Try to do that. Caffeine is an obvious no-brainer. You don't want to be drinking coffee.

I hear some people say they can drink a cup of coffee and go right to bed. I don't believe it. I believe they can go right to bed, but I don't believe it doesn't affect their sleep architecture, their sleep awakenings, and all that. Caffeine delays the circadian rhythm.

It's absolutely a fact. So, avoiding caffeine later in the day is always good. And then alcohol, of course. The best option is to skip it altogether. If you are going to drink, drinking at least four hours or more before bedtime can help reduce its impact on frequent nighttime awakenings.