Tossing and turning when sleeping VS staying still, which is healthier?

Sleep issues have always attracted much attention. We spend nearly one-third of our day sleeping.

As one of the most basic physiological needs of human beings, today we will discuss a topic of sleep that everyone is very concerned about: which one is healthier: tossing and turning while sleeping, changing sleeping positions frequently, or basically staying still and maintaining a stable posture while sleeping?

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Why do people toss and turn when sleeping?

Why do people toss and turn when they sleep? Studies have found that when the pressure on the skin exceeds the micro-arterial pressure, which is 32 mmHg, it will hinder the delivery of oxygen and nutrients to the tissues, leading to tissue hypoxia, accumulation of metabolic waste and the production of free radicals [3]. If you lie on a standard hospital mattress, it can generate a pressure of 150 mmHg (if you are sitting, it can generate a pressure of up to 300 mmHg at the ischial tuberosity).

In other words, whether you lie down or sit for a long time, your body will feel uncomfortable. This "uncomfortable" will act on the "nociceptors" of the skin and nearby tissues, and then the receptors will transmit this unpleasant stimulation through the sensory nerve pathway along the spinal cord to the brain.

You know, even when you fall asleep, your brain is not idle, and it will respond appropriately according to the stimulation of various signals. Even in the deep sleep stage (the most difficult stage to wake up), the brain will have "miniarousals" every 6 to 8 minutes.

Micro-arousals are a protective mechanism of the body[4]. They are awakenings that cannot be perceived at the conscious level, but the EEG shows brief awakening characteristics. These micro-arousals are almost always associated with body movements—perhaps a kick or a roll over.

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I always toss and turn when I sleep.

Does it necessarily mean that you didn’t sleep well?

Let me give you the answer first: Not necessarily. It depends on the situation.

As mentioned earlier, it is normal for the body to move while asleep. According to population data, the average number of body movements per night (including turning over) can reach 40 to 50 times[5].

How to judge whether "loving to turn over and move around" is normal? The easiest way is to observe the daytime state.

If you can maintain a relatively good level of wakefulness most of the time during the day, and your daily life and work are not affected (of course, without drinking coffee), then it means that you sleep well and there is no need to interfere with what you do at night.

If you feel dissatisfied during the day, it means that you did not sleep well at night and you need to further evaluate the reasons for your "hyperactivity" at night.

If a person does not sleep well, it indicates that there is some resistance that affects sleep. In my book "Sleep Formula", I have summarized 6 major types of sleep resistance:

Environment: bad sleeping environment

Action: Wrong sleeping behavior

Body: Potential physical illness

Heart: Stress-related psychological diseases

Medicine: Certain special medicines

Sleep: Specific Sleep Disorders

So, if people around you say that you always move around when you sleep, and at the same time, you are not in a good state during the day, such as being easily sleepy, tired, and emotionally unstable, then I would suggest you see a doctor as soon as possible. In my clinic, I will systematically analyze the possible reasons from these 6 aspects.

①Do you bring your pet into the bedroom?

②Did you drink alcohol before going to bed (yes);

③Whether there are any diseases such as anemia, hyperthyroidism, etc. (physical);

④ Have you been under a lot of pressure in your life and work recently? Do you have uncontrollable worries? Do you feel depressed or depressed? (heart)

⑤ Have you taken any medication recently, including Chinese medicine, herbal medicine and health products (medicine);

⑥Whether there is loud snoring, swearing, punching and kicking while sleeping (special sleep disorders), etc.

Only through a systematic evaluation can you find out the reasons why you "sleep too much" and develop a management plan that best suits you.

For example, many mothers who have given birth find that they tend to sleep restlessly after giving birth. After examination, they find that they are iron deficient (with or without anemia). At this time, as long as they take iron supplements and replenish the body's iron reserves, their sleep will become more stable and they will not move as much while sleeping.

When sleeping, I barely move.

Will you definitely sleep well?

Let me give you the answer first: for most people, maintaining a relatively stable posture while sleeping may indeed mean more peaceful and better sleep.

However, if you sleep in the same position for a long time, the skin in contact with the bed (especially the protruding bones) is easily injured, which is called "pressure injury". You must have heard of the term bedsore. In fact, the more professional term in academia is pressure injury.

A study on healthy adults showed that, when using a standard mattress, lying still for 2 hours may cause skin erythema and ischemic changes. In other words, if a person can really sleep all night without turning over and moving, then when he wakes up the next morning, he will most likely experience uncomfortable symptoms such as "body aches and pains".

Frequent tossing and turning while sleeping VS basically staying still,

Which one is healthier?

After reading this, you must have discovered that there is no definite answer to this question.

For people who often toss and turn when sleeping, whether they sleep well or not mainly depends on their daytime state. As long as their daytime state is not affected, there is no need to worry too much.

For those who sleep very soundly and basically do not move, there is usually no need to worry too much. Because almost no one really does not move when sleeping, but the sleeping posture is relatively stable and they rarely turn over. In this case, it is unlikely that pressure injuries will occur.

References

[1]GefenA.How much time does it taketogetapressureulcer?Integrateddevidencefromhuman,animal,andinvitrostudies.OstomyWoundManage.2008Oct;54(10):26-8,30-5.PMID:18927481.

[2]KnoxDM,AndersonTM,AndersonPS.Effectsofdifferentturnintervalsonskinofhealthyolderadults.AdvWoundCare.1994Jan;7(1):48-52,54-6.PMID:8149048.

[3]ThomasDR.Doespressurecausepressureulcers?Aninquiryintotheetiologyofpressureulcers.JAmMedDirAssoc.2010Jul;11(6):397-405.doi:10.1016/j.jamda.2010.03.007.PMID:20627180.

[4]https://www.abc.net.au/science/articles/2014/01/28/3861788.htm

[5]https://www.mindbodygreen.com/articles/move-around-lot-in-your-sleep-heres-what-it-reallymeans#:~:text=According%20to%20doctor%20of%20chiropractic,to%2050%20times%20per%20night.

This article is a work of Science Popularization China-Starry Sky Project

Produced by: Science Popularization Department of China Association for Science and Technology

Producer｜China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.

Author: Yu Zhouwei, attending physician of neurology, author of "Sleep Formula"

Reviewer: Dong Xiaosong, Deputy Director of the Department of Respiratory and Sleep Medicine, Peking University People's Hospital