Sleeping is child’s play, or is it?

Introduction
As a child, almost every new action needs to be explained. This is because you are adapting constantly to
this new world you got dropped into and that means that you have to ask a lot of question about how to
do certain things ‘right’. How to urinate properly, eat food without spilling and learn to play nicely with
others. Though one subject always seems to escape explanation. It is such a basic movement you would
almost think nobody would need help on how to do it: sleep. It seems like the most natural thing in the
world, you lay on your bed and wait until you dose off, but sleep is much more complicated than that. In
this essay a look will be taken at the relevant literature to find the answers to better implement sleep
into daily life. The age range taken for this essay will be between 18 and 25, because most data
referenced made the same distinction. This age range is indicated to be (university) students. Another
distinction that is important is that I will only be speaking about Dutch healthcare (GGZ). This is due to
the fact that psychology practices differ significantly between countries, and that is why I chose one in
particular. Specifically, this essay will explore the subject of mental health through sleep in society. What
is the relationship between sleep and mental health? Is there a ‘right’ way to sleep? And what can we do
to raise more awareness for sleep and better educate students?

First we need to establish the relationship between sleep and mental health. The first distinction that
needs to be made is the difference between sleep quality and sleep quantity. This difference is
important because they both relate differently to changes. A 1997 assessment of two studies focusing
on difference between sleep quality and quantity found that sleep quality is much more important than
quantity. ‘’The current results suggest that sleep quality is better related to measures of health, well-
being, and sleepiness than sleep quantity in a nonclinical population reporting an average of 7-8 hours
of sleep at night. (Pilcher et al., 1997)’’. Furthermore (Pilcher et al., 1997), when comparing the two
separate groups, one during final exam week and one during the first part of the semester, it was found
that poor sleep quality caused increased feeling of anxiety, depression, anger, fatigue and confusion.
(p.592). This is strong data suggesting that sleep quality is more important than sleep quantity, but also
that maintaining sleep quality is vital for (academic) performance. Another study affirming this
hypothesis is a study that looked at how the relationship between mood and sleep predicts academic
functioning, physical health and psychological health. They concluded: ‘’Taken together, the current
study strengthens the claim that specific domains of sleep behaviors can directly or indirectly (through
mood) predict physical and psychological health and academic functioning.’’ (Wong et al., 2013). This is
very problematic, because there is no awareness or even dialogue happening about this topic. The study
(Wong et al., 2013) calls attention to universities to raise awareness and educate students on this
relationship between sleep and sleep hygiene (p.277). To quote the National Sleep Foundation website
for a definition of sleep hygiene: ‘’Strong sleep hygiene means having both a bedroom environment and
daily routines that promote consistent, uninterrupted sleep. ’’(Suni & Vyas, 2022). So the data between
sleep and mental health seems to indicate a positive relationship. When sleep quantity, but especially
sleep quality improves, mental health improves too. So now that we know that ‘sleep hygiene’ improves
sleep, and that sleep quality is very important, what do these terms mean practically? What does it
mean to ‘sleep better’ and have a good bedroom environment?

Healthy sleep habits

Before we talk about sleep quality and hygiene, we need to establish a ‘right’ sleep quantity. The
aforementioned National Sleep Foundation, an American non-profit organization, gathered 28 people to
form a broad representation of leading sleep researches, physicians and experts to come to a consensus
on sleep duration for age groups. The age group discussed in this essay, 18 – 25 years old, was
recommended seven to nine hours of sleep a day. Even though, as the board acknowledges, the sleep
patterns in this group differ greatly based on responsibility and schedule, they still advocate for at least
seven hours. ‘’ The Panel does not advocate sacrificing sleep duration for school, work, or social
responsibilities because short sleep duration is associated with increased fatigue, decreased
psychomotor performance, accidents, poor physical and psychological health, and low academic
performance. In addition, healthy sleep patterns enhance adjustment and performance in college years;
early bedtimes, wake times, and napping correlate with the high academic performance. Finally,
extended sleep leads to substantial improvements in daytime alertness, reaction time, and mood.’’
(Hirshkowitz et al., 2015).

Now we know how long you need to sleep, we can ask the question of sleep quality. How do we sleep
‘better’? We can improve sleep quality multiple ways. The first way is keeping a sleep log, documenting
when you sleep and wake up to get a better understanding about your circadian rhythm. ‘’Circadian
rhythms are 24-hour cycles that are part of the body’s internal clock, running in the background to carry
out essential functions and processes. One of the most important and well-known circadian rhythms is
the sleep-wake cycle.’’ (Suni & Vyas, 2022). Secondly, progressive muscle relaxation exercises. An hour
before you go to bed, dedicate some time getting your muscles to relax before you go to bed is also
indicated to help sleep quality. The third way is meditation. The same as the progressive muscle
relaxation exercises, but instead of the body’s muscles relaxing, it is your mind. And lastly, Tai Chi or
taijiquan . This might seem a little bit strange but the Chinese martial art of Tai Chi has shown promising
results improving sleep quality. ‘’Increases in total mindfulness scores occurred only in
the taijiquan group, not in the control group. All well-being variables showed a pattern of improvement
in the taijiquan group, with either stability or decline over time in the control group’’ (Caldwell et al.,
2011). This increase in total mindfulness causes both better mental health and sleep. ‘’Relative to a
recreation control group, taijiquan classes for college students are associated with increased
mindfulness and improved sleep quality, mood, and perceived stress. . .’’ (Caldwell et al., 2011).
Although there definitely needs to more research and data, the indication in the current data indicates
that Tai Chi seems to have a positive effect. So, good sleep hygiene is crucial to perform optimally in
your daily life, but it is a skill you need to master.

Status quo
After first establishing the relationship between sleep and mental health and then exploring what ‘good’
sleep meant, now we move on to the status quo. What is already out there information wise and how
do we get this important information better out there? Naturally, the first place to start looking would
be healthcare. In the Netherlands, mental healthcare already knows sleep is really important. When you
begin therapy or counseling, psychologists are aware of the dangers that sleep can pose upon daily life
and amongst other guides, have a full book with guidelines to help people with their sleep problems
(Verbeek et al., 2015). So, the professional side of our society already knows this information and tries
to help as many as possible when they find indications of sleeping problems. The bigger problem is
people that do not have as serious sleeping problems as the ones who seek counseling, but still would
benefit greatly of some of the aforementioned habits one could establish to get better sleep quality. And
because this issue is most prevalent amongst students, a place that is very easily accessible to students
that could raise awareness about the relationship between sleep and mental health would be
universities themselves. In retrospect, it is kind of peculiar that there is so little awareness about sleep
hygiene in schools already. According to the Association of Universities in the Netherlands (VSNU) there
are 340.346 Bachelor’s and Master’s students enrolled in 2021-2022 (Facts & Figures - Universities of
The Netherlands, n.d.). Most of these students fall in the category of 18-25. This means that there is an
opportunity to raise more awareness by the universities themselves. But is awareness enough? Or are
there more drastic changes that universities could implement to help students sleep, and thereby
perform even better?

Potential changes for universities

The first thing that universities can do is the aforementioned raising of more awareness. It needs to be
made sure that every student has a basic understanding about sleep hygiene. Every student should
know that nine hours of sleep are recommended and sacrificing sleep for grades is (almost) never a
good idea for your performance. Then making sure that 9 hours of sleep are feasible with classes in the
morning. Assuming most students sleep around 11 pm to 1 am, this means making sure students can get
their seven to nine hours of sleep until 8-10am. This also means educating students on how to keep a
sleep log, so students know how to use them in times of need. The same goes for muscle relaxation
exercises and meditation. Potentially even tai chi, when more affirming evidence is published. It is not
that hard to help students get better sleep and just by raising awareness you would make sure the
people that want and need to seek out help do it more often just by normalizing the conversation
around this subject.

Another interesting idea would be to encourage students to take naps. Especially in the summer,
between 2 and 5 pm, clear out time in classes for students to take naps. In July 2015, a Spanish mayor of
Andor, a little town in Valencia, issued a statement to his town of 1400 people to keep noise down
between 2 and 5pm. This was picked up by national news and made into the story of a mayor
announcing ‘siesta by decree’. Even though there are no policemen in the town, and the mayor did not
intend to enforce this issue, a 2015 paper followed through with the hypothesis. Is it beneficial to have a
siesta to improve your overall performance? The paper states the following: ‘’These epidemiologic
controversies aside, there is solid evidence that napping improves mood, cognitive function, and
alertness and increases work productivity. In response, some businesses are starting to give workers the
space and the time to take power naps when they feel the need’’ (Nieto, 2015). This seems a really
interesting idea for universities as well. Giving students the opportunity to take naps on top of raising
awareness on how to sleep better feels like a win-win scenario, because students that live healthier,
better lives and have less mental health problems will score higher results and improve their overall
academic performances.

Conclusion

So, in this essay the main question ‘How can we improve mental health through sleep into society?’ was
dissected into four parts and answered. Though before answering, two distinctions were made: the first
distinction was the age-group for this research paper, which is 18-25. This was done because different
age groups have different sleep recommendations and we wanted to take a look at university students
for this essay. The second distinction was that we only look at the Dutch healthcare and universities for
the sake of consistency. Then beginning to explore the four dissected parts. First looking at the
relationship between sleep and mental health. This is a positive relationship. The better you sleep, the
better your mental health status is. After having established the relationship between the two, we
moved on to researching the ways in which sleep quality can improve. By keeping a sleep log, doing
muscle relaxation exercises before going to bed and practicing meditation one can dramatically improve
their sleep quality, and thereby their academic performance. The third part was describing the status
quo. It was found that the Dutch healthcare system already knows and implements all these advices in
their guidelines, unsurprisingly. Whereas universities do not seem motivated to raise awareness about
sleep quality and educating students to implement these habits in their daily routines at all. So, we can
conclude that sleeping is not as easy as it seems, and that improving sleep quality is something that can
be taught and learned. It is now the responsibility of our academic institutions to raise awareness by
reading their students a bedtime story, not one about sheep or very hungry caterpillars, but one about
sleep logs, muscle relaxation techniques and meditation.
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