article written by dr. Bodo Cristina
medical specialist in psychiatry
Sleep is a very important physiological process. Some of us need more hours of sleep, while others need fewer. We’re all different!
Sleep stages
Our sleep has two important phases:
NREM (Non-Rapid Eye Movement) sleep—the restful sleep that consists of several stagesFaza NREM (Non-Rapid Eye Movement) - somnul liniștit ce are mai multe etape
- N1 (light sleep) — the transition phase from wakefulness to sleep; I can be woken up very easily;
- N2 - (intermediate sleep) - heart rate and body temperature decrease
- N3 - (deep sleep) - the most restorative phase, essential for tissue regeneration.
- REM (Rapid Eye Movement) sleep—this is active sleep. Dreams occur during this phase, and breathing may be irregular. Over the course of a night, we need to have 3–4 REM sleep sessions—about 25% of our total sleep time—to feel rested upon waking.
Sleep duration
Throughout life, the amount of sleep decreases. A newborn sleeps nearly 18 hours a day, a 10-year-old sleeps about 10–12 hours a day, and an adult sleeps 6–8 hours a day.
Sleep patterns and distribution undergo significant changes, both in terms of quantity and quality. Older adults tend to have more difficulty falling asleep and staying asleep. This stage of life is often accompanied by a shift in the circadian rhythm toward a morning chronotype, as opposed to the evening chronotype typical of adolescence, which leads to going to bed and waking up earlier.
It appears that the need for sleep does not change with age, but the ability to get the necessary sleep decreases with age.
It's not normal to not sleep well! It's not normal to feel tired all the time!
Sleeping fewer hours than you need, over a period of several days, can lead to fatigue, irritability, and a decreased ability to concentrate at work. Furthermore, chronic sleep deprivation has been linked to negative health effects, such as high blood pressure, cardiovascular disease, obesity, type 2 diabetes, an increased risk of cancer, neurocognitive disorders, and depression.
When can you say you have trouble sleeping?
- Do you have trouble falling asleep—does it take you more than 30 minutes to fall asleep?
- Do you have trouble staying asleep—do you wake up during the night but fall back asleep with or without difficulty?
- You wake up earlier than you'd like.
During the day, they appear
- Fatigue or feeling unwell
- Attention, concentration, or memory problems
- Impaired social, family, professional, or academic functioning
- Mood disorders, irritability
- Drowsiness
- Behavioral problems: restlessness, impulsivity, aggression, low energy and initiative
- Susceptibility to errors and accidents
- Concerns or complaints related to sleep.
The sleep disorder and associated daytime symptoms occur at least three times a week.
Sleep disturbances and daytime symptoms have been present for at least 3 months.
What can you do?
The first step involves a few simple practices known as sleep hygiene.
- Set a bedtime and a wake-up time.
- If you sleep during the day, don't sleep for more than 45 minutes.
- Avoid alcohol, heavy, spicy, or overly sweet foods 4 hours before going to bed.
- Avoid consuming stimulants—coffee, tea, carbonated drinks, and chocolate—6 hours before going to bed.
- Exercise every day, BUT not right before bed.
- Eliminate sounds that might distract you from sleeping and sources of light that might disturb you—the TV, your phone, and the clock.
- If you don't fall asleep within the first 30 minutes, leave the bedroom and do something else. Don't go back until you feel sleepy.
- It's a good idea to keep a sleep journal.
If these changes don't improve the quality of your sleep, you can consult a psychiatrist.
A visit to the doctor. Advice from a specialist.
The doctor will check for a possible organic cause, such as sleep-related breathing disorders, heart problems, or obesity.
Insomnia is treated in stages, in conjunction with good sleep hygiene. Your doctor will prescribe natural supplements that can regulate your sleep patterns — which are helpful for mild, occasional insomnia or insomnia triggered by stress or jet lag—and may then recommend prescription sleep aids.
Over-the-counter supplements
Melatonin: helps regulate the circadian rhythm and helps you fall asleep faster. Take it 30–60 minutes before bedtime.
Plants with sedative effects: supplements and teas containing valerian, passionflower, lemon balm, and hops.
Magnesium and Vitamin B6: They relax the nervous and muscular systems and reduce anxiety.
Prescription-only medications
If insomnia becomes chronic (lasts longer than 2 weeks), a psychiatrist or neurologist may prescribe short-term treatments.
Benzodiazepines - Diazepam, nitrazepam, oxazepam, triazolam, quinolazepam
Medications Z - Zaleplon, zolpidem, zopiclone
Sedative antidepressants - Amitriptyline, doxepin, mianserin, mirtazapine, trazodone
Antipsychotics - Levomepromazine, olanzapine, quetiapine
Antihistamines—hydroxyzine, promethazine
Melatonin receptor agonists - ramelteon
Psychotherapeutic approaches
Cognitive-behavioral therapy for insomnia consists of psychoeducation and relaxation techniques. It is administered over four to eight in-person sessions (either individually or in a group) by a specialized clinical psychologist.
Relaxation therapy. Relaxation therapy involves clinical procedures designed to reduce somatic tension (progressive muscle relaxation) or intrusive thoughts at bedtime (meditation).
Sleep restriction therapy is a method designed to reduce the time spent in bed to the actual amount of sleep obtained. For example, if you sleep an average of 6.5 hours per night, the initial recommended sleep window is 4–6 hours. The time spent in bed will be gradually increased until an optimal sleep duration is reached. It is recommended to keep sleep diaries, both before starting therapy and to monitor results.
Treatment for insomnia is personalized, but the first step in treating it is accepting that there is a problem with sleep quality, followed by an accurate diagnosis.
Bibliography
Liao, J., Shi, Y., Li, Y., & Han, D. (2025). Impact of age on sleep duration and health outcomes: Evidence from four large cohort studies. Sleep Medicine, 129, 140–147. https://doi.org/10.1016/j.sleep.2025.02.024
Chaput, J. P., Dutil, C., & Sampasa-Kanyinga, H. (2018). Sleeping hours: what is the ideal number and how does age impact this? Nature and Science of Sleep, 10, 421–430. https://doi.org/10.2147/NSS.S163071
Peplow, M. (2013). Structure: The anatomy of sleep. Nature, 497(7450), S2–S3. https://doi.org/10.1038/497s2a
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J.G., Espie, C.A., Garcia-Borreguero, D., Gjerstad, M., Gonçalves, M., Hertenstein, E., Jansson-Fröjmark, M., Jennum, P.J., Leger, D., Nissen, C., Parrino, L., Paunio, T., Pevernagie, D., Verbraecken, J., Weeß, H.-G., Wichniak, A., Zavalko, I., Arnardottir, E.S., Deleanu, O.-C., Strazisar, B., Zoetmulder, M. and Spiegelhalder, K. (2017), European guideline for the diagnosis and treatment of insomnia. J Sleep Res, 26: 675-700. https://doi.org/10.1111/jsr.12594