Coming to the third pillar of lifestyle medicine that is no less important than diet or exercise, which is restorative sleep.

Poor quality sleep increases the risk of road accidents and work mistakes, and various diseases are associated with poor quality sleep due to increased inflammation in the body, decreased immunity, and the risk of diseases such as cardiovascular disease. hypertension Obesity, diabetes, cancer Psychiatric diseases include increased accumulation of waste products in the brain (beta-amyloid), which is one of the main causes of Alzheimer's disease. On the other hand, Various medical conditions can interfere with sleep, so these two are the result of each other. Cyclic circulation

According to the National Sleep Foundation (NSF), adequate sleep duration There are differences according to the age range. As follows:

• Infants aged 0-3 months should sleep 14-17 hours per night.
• Babies 4-11 months old should get 12-15 hours of sleep per night.
• Children 1-2 years old should get 11-14 hours of sleep per night.
• Children 3-5 years old should get 10-13 hours of sleep per night.
• Children 6-13 years old should get 9-11 hours of sleep per night.
• Teenagers aged 14-17 years should get 8-10 hours of sleep per night.
• Adults aged 18-64 should get 7–9 hours of sleep per night.
• Seniors 65 years and older should get 7–8 hours of sleep per night.

But the duration of sleep is sufficient alone. It cannot be called quality sleep, but it must consist of "sleep continuity", which is not awake during a total of more than 20 minutes of sleep, and "sleep depth" should have a deep sleep period of about 13-23% of the total sleep duration.

The problem of poor quality sleep

                Poor quality sleep makes you feel unrefreshed even though the sleep duration is sufficient. It is considered something that needs to be observed and paid attention to because it will result in fatigue after waking up. Daytime sleepiness, making work or activities inefficient, and accidents may follow. There are 6 related factors as follows:

1. Social factors such as age, gender, marital status, occupation, income, education level, country of residence, etc.
2. Environmental factors such as temperature, noise, mattress bedding, etc.
3. Lifestyle factors such as drinking alcohol, smoking, etc. Caffeine intake, exercise, eating before bed. Activities to do before going to bed, etc.
4. Health factors such as obstructive sleep apnea (OSA), BMI
5. Psychological factors such as stress levels, anxiety Depression, etc.
6. Factors such as waking up and going to bed at the same time Sleep duration Waking up in the middle of the night, etc.

Recommendations for quality sleep

1. Go to bed and wake up every day, even if it's a holiday, to create a good sleep cycle and sleep for an adequate amount of time according to your age.
2. Create a suitable environment for sleep Adjust the temperature to suit sleep. Reduce distractions that may affect sleep, such as wearing earplugs to reduce noise or wearing eyepatches to reduce light.
3. Use the bed only for sleeping. Not to be used for other activities such as work. Watch TV or eat
4. Before going to bed, do activities that create a sense of calm and relaxation, such as meditation, reading, etc. Try to avoid using mobile phones. Watch TV or use the computer a few hours before bedtime, as blue light from screens can interfere with sleep.
5. Maintain a healthy body weight as obesity leads to sleep problems such as sleep apnea.
6. Exercise regularly for at least 150 minutes a week because exercise improves sleep, but avoid exercising 3 hours before bedtime.
7. Avoid caffeinated beverages at least 6 hours before bedtime.
8. Avoid drinking alcohol and smoking because both reduce the quality of sleep.
9. Avoid large meals or foods that are difficult to digest at least 3 hours before going to bed to reduce the risk of bloating, abdominal tightness or acid reflux. As a result, they can't sleep well.
10. If you have a medical condition. Talk to your doctor about any side effects of medication to determine if there are any medications that interfere with sleep.

By the medical team of BDMS Wellness Clinic Institute and the Bangkok Association of Obesity Medicine and Obesity Education Promotion Physicians (BARSO)

Reference List:

1. Ohayon MM. Prevalence and correlates of nonrestorative sleep complaints. Archives of Internal medicine. 2005 Jan 10;165(1):35-41.
2. Consensus Conference Panel, Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Journal of Clinical Sleep Medicine. 2015 Jun 15;11(6):591-2.
3. Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH. The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep medicine reviews. 2015 Aug 1;22:23-36.
4. National Sleep Foundation. What Is Sleep Quality? [Internet]. Washington, DC: National Sleep Foundation; 2020 Oct 28 [cited 2025 Mar 20]. Available from: https://www.thensf.org/what-is-sleep-quality/
5. Shokri-Kojori E, Wang GJ, Wiers CE, Demiral SB, Guo M, Kim SW, et al. β-Amyloid accumulation in the human brain after one night of sleep deprivation. Proc Natl Acad Sci U S A. 2018;115(17):4483-8.