Using Sleep to Enhance Performance

Sleep is not only important for basic health but is the most potent performance enhancer we know of. I’ll cover exactly how you can test, interpret and improve your sleep. For more on this topic, listen to my podcast episode, “How to Enhance Performance With Better Sleep.”

Sleep: Key to Peak Performance

Many people, especially athletes, underestimate the impact of sleep on performance, often attributing daytime sleepiness to their rigorous training or demanding work schedules. Yet, sufficient quality sleep is crucial for both mental and physical performance and is linked to benefits such as lower risk of illness, reduced injuries and enhanced athletic performance.

Yet, common sleep disorders, such as sleep apnea, insomnia and restless leg syndrome, often remain undiagnosed. Further, chronic suboptimal sleep is all too common and can stem from inadequate sleep duration and/or poor sleep quality. To improve your sleep, there are three key factors to consider:

1. Duration: Many athletes only average 6.5 to 7 hours of sleep each night. Extending sleep from 30 minutes to 2 hours can significantly enhance performance.
2. Quality: Sleep quality can be compromised without you knowing it. Annual evaluations for sleep issues are recommended (more on this below). Remember, even if you don’t meet the criteria for a clinically diagnosed sleep disorder, you may still be experiencing poor-quality sleep.
3. Timing: Aligning sleep schedules with individual circadian rhythms and chronotype can optimize sleep and, in turn, performance.

Prioritizing sleep is one of the most effective, low-cost strategies for enhancing physical and cognitive performance, as well as overall health. Below are practical sleep solutions that can benefit athletes or anyone aiming to perform at their highest level.

Assess Your Sleep

Many people struggle to objectively measure their sleep quality and its impact on their performance. To evaluate potential sleep issues, consider using the following self-screening approach and consult a clinician if needed:

• Screening tools include validated questionnaires designed to identify sleep-related issues. Use the Athlete Sleep Screening Questionnaire (ASSQ) to assess yourself and evaluate your sleep patterns, fatigue and overall sleep quality.
  • If the ASSQ reveals mild sleep issues, consider a more detailed assessment, such as the Athlete Sleep Behavior Questionnaire, to gain deeper insight into your sleep behaviors and habits. Also, incorporate wearables and sleep logs to track your sleep duration and assess how rested you feel.
  • For moderate to severe issues identified on the ASSQ, it’s recommended that you follow up with a clinical sleep specialist or a program such as Absolute Rest (note: This is my company).
• Wearables, such as watches or rings, provide an affordable way to monitor basic sleep metrics (e.g., time you went to sleep, total sleep time, etc.) and are often extremely useful in holding you accountable for maintaining healthy sleep habits. However, do not use consumer wearables for more detailed insights such as time in REM or “deep” sleep, sleep quality and so forth. Furthermore, none are clinically validated for diagnosing sleep disorders.
  • Also be cautious of “orthosomnia,” where anxiety about sleep tracker scores can negatively impact sleep quality, and, in some cases, actually causes the development of clinical sleep disorders. Instead of fixating on daily scores, it’s better to focus on general trends over time.
• Clinical sleep studies are needed to diagnose a sleep disorder accurately. These studies can be conducted in a hospital or home setting using polysomnography (PSG) or cardiopulmonary coupling (CPC) through companies like Absolute Rest.
  • However, these studies can be expensive and often involve long wait times for appointments. Consult with your clinical team to choose the best option for you.

Interpret Sleep Data

It’s important to interpret your own sleep data rather than solely relying on a sleep tracker score. These are key factors to assess when evaluating your sleep. Note, the following recommendations are for those looking to maximize performance, not minimal health requirements. Also, keep in mind these represent your typical daily average. The occasional night of imperfect sleep is normal and nothing to be overly concerned about.

• Sleep Duration: Aim for approximately (~)9 hours of sleep (especially for those with high exercise demands), while recognizing individual needs can range from 7.5 to over 9 hours per night.
• Sleep Latency: Ideally, it should take 5-15 minutes to fall asleep. Falling asleep in under 5 minutes may indicate excessive sleep debt, while more than 15 minutes suggests excessive caffeine intake, poor sleep routines, or a poor sleep environment.
• Sleep Efficiency: If using a wearable, aim for scores greater than (>)85% (ideally >93%). Poor sleep efficiency may be linked to long sleep latency or frequent awakenings during the night.
• Waking Up: Ideally, you should not wake up at night; waking up once is generally considered acceptable, but more frequent awakenings can reduce sleep quality. As people age, they tend to wake up more often at night.
• Subjective Measures: Pay attention to how long it takes you to feel fully awake in the morning and any dips in alertness throughout the day. Excessive daytime sleepiness and a frequent urge to sleep suggest suboptimal sleep quality.
• Sleep Stages: There is no scientific consensus on the optimal distribution of sleep stages. This means that wearables may rely on proprietary or arbitrary criteria when calculating “sleep scores.” Prioritize good sleep behaviors instead of being preoccupied with sleep stage metrics. We rarely use these data as they cause more harm than good most of the time.
• Sleep Perception: Research shows that your perception of sleep has a greater impact on performance than the actual duration of sleep. Your sleep tracker score will affect how well-rested you feel — regardless of its true accuracy.

Improve Your Sleep

To enhance your sleep, choose from the many practical strategies below:

Foundations of Good Sleep

• Sleep Education: Simply understanding the importance of sleep, its direct impact on performance, and good sleep hygiene practices can improve sleep. (If you want to learn even more, listen to the full episode.)
• Sleep Disorders: If needed, work with a clinician to diagnose any sleep disorders and find effective treatment solutions.
• Consistent Sleep Schedule: Stick to a regular bedtime and wake time, with no more than 45 minutes to 1 hour of variation each day. Bonus points for keeping it at 30 minutes most nights.
  • Frequently changing your sleep schedule, such as by sleeping in on weekends, is comparable to shifting time zones each week. This will disrupt your sleep patterns and make Monday mornings particularly challenging.

Prepare for Sleep

• Sleep Opportunity: You will never sleep enough if you don’t allow yourself the chance to sleep enough. Minimize early morning commitments and consider not using an alarm clock when possible. Avoid late-night hard exercise or work and disable email/message notifications. Remember: sacrificing sleep is not a badge of honor.
• Good Sleep Hygiene: To promote relaxation, create a calming bedtime routine with breathwork, meditation or reading. Also, limit screen time, particularly for content that may be stressful or overly stimulating, such as social media, politics or news.

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• Food & Supplements: Avoid caffeine and other stimulants in the ~8 hours before bed and avoid eating large, rich meals too close to bedtime.
  • If you are hungry, try small, sleep-friendly snacks like kiwis to get to sleep faster.
  • For a full breakdown of nutrition & supplements that support sleep, see this brand-new review article by my co-worker, Dr. Federica Conti
• Mindset: Be aware that your concerns about sleep can lead to anxiety. If you struggle with insomnia, create a calming sleep environment and consider removing clocks or wearables that may reinforce negative patterns. Reframe your mindset to view getting into bed as an opportunity to rest and recharge rather than a source of stress.

Nighttime Issues

• Environmental Factors: Keep your bedroom at a cool temperature (a mattress cover like Eight Sleep can be very helpful, particularly if controlling your room’s ambient temperature is difficult), minimize ambient light and keep noise to very low levels (below 35 decibels).
  • Check the volume on sleep machines, as even white or pink noise can be problematic if it’s too loud.
• Nighttime Urination: If you frequently wake up at night with large volumes of clear urine, reduce your fluid intake a few hours before bed.
  • Conversely, waking up multiple times with minimal urine output could indicate a potential sleep disorder. During sleep, your kidneys should reduce urine production. If they don’t, it can indicate poor sleep quality, causing your body to act as if it’s still awake.
• Snoring: Chronic snoring can disrupt sleep for both the snorer and their partner. Try sleeping on your side, using mouth tape and/or nasal strips (nasal dilators), or practice tongue-strengthening exercises to help manage snoring.
  • If those methods don’t work, a sleep study may be necessary, and anatomical issues may require surgery or a custom mouthpiece.

Travel

• Sleep Banking: In the weeks before a high-demand period — such as travel, competition or heavy workload — increase your sleep duration in the 3 to 30 days prior.
• Jet Lag: If you’re planning to travel, prepare by gradually adjusting to the new time zone a few days in advance. Consider using the Timeshifter app to help with scheduling.
• First-Night Effect: If you find it difficult to sleep in a new place, create a familiar sleeping environment by taking a specific scent or pillowcase with you when traveling.

I encourage you to incorporate these tips to improve your sleep and enable you to perform at your best. Remember: in the words of Bill Bowerman, “If you have a body, you are an athlete.”

- Andy