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Sleep Doctor Explains Your Restless Sleep and How to Fix It

Published
2021-09-16
Updated
2024-02-29
Written by
Jeff Kahn
Reviewed by
Dr. Chester Wu
Woman experiencing restless sleep.

Tossing and Turning All Night? Here’s What You Need to Know

  • Restless sleep can be caused by caffeine, alcohol, late-night meals, and stress. It can also be a sign of a sleep disorder or medical condition.
  • You can fix restless sleep by improving your sleep hygiene, which eliminates many of the triggers — like caffeine and alcohol.
  • The can guide you through 20+ sleep hygiene behaviors each day.

Waking up once or twice throughout the night is normal. But spending eight hours tossing and turning, and getting restless sleep night after night, can lead to low energy, trouble focusing, and poor health — and that’s not to mention how unenjoyable a night of restless sleep is.

Below, we’ve covered everything you need to know about restless sleep, including the causes, symptoms, and how to fix it. Plus, we’ve shared how the RISE app can help you sleep through the night.

Advice From a Sleep Doctor

“A night of restless sleep every now and again is nothing to worry about," says Dr. Chester Wu. "If it’s happening regularly, look at your sleep hygiene. That includes avoiding caffeine and alcohol close to bedtime, keeping a consistent sleep schedule, and taking time to wind down before bed.”

Dr. Chester Wu is double board certified in Psychiatry and Sleep Medicine, and provides sleep medicine services, medication management, and psychotherapy to adults at his private sleep medicine and psychiatry practice.

What is Restless Sleep?

There’s no clinical definition for restless sleep, but restless sleep can be when you:

  • Struggle to fall asleep
  • Wake up often during the night
  • Don’t feel rested the next day

Is Restless Sleep Normal?

A night of restless sleep every now and again is normal.

It’s also normal to take some time to fall asleep. If you fall asleep instantly it may actually be a sign of sleep deprivation. And it’s normal to wake up once or twice throughout the night, too.

But if you regularly find yourself tossing and turning all night and not getting the sleep you need, this can start affecting your energy levels, productivity, mood, and mental and physical health.

Restless sleep may also be a sign of a sleep issue like insomnia or a medical condition.

How Much Restless Sleep is Normal?

There’s no set amount of restless sleep that’s normal. Waking up once or twice during the night or shifting positions is normal, and a night of tossing and turning every now and again isn’t cause for alarm.

But if you find you’re regularly getting restless nights of sleep or struggling to get enough sleep, speak to a healthcare provider or sleep specialist to determine the root cause and best course of action.

You can check RISE to see if restless sleep is making you sleep deprived. RISE can work out how much sleep you should be aiming for each night (known as your sleep need) and whether you’ve got any sleep debt (the amount of sleep you owe your body).

You can check your sleep debt each morning to assess whether restless sleep is causing sleep loss.

RISE app screenshot showing how much sleep debt you have
The RISE app can work out how much sleep debt you have.

RISE users on iOS 1.202 and above can . 

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What Are the Symptoms of Restless Sleep?

There are no set symptoms of restless sleep. But, in general, the symptoms of restless sleep include:

  • Trouble falling asleep
  • Waking up often during the night
  • Not being able to fall back asleep when you wake up
  • Tossing and turning all night, or frequent movements
  • Being unable to relax or get comfortable in bed
  • A racing mind
  • Feeling like you were only half asleep all night
  • Daytime sleepiness
  • Feeling irritable and unable to focus the next day

Restless sleep isn’t classified as a sleep disorder, so the symptoms are subjective and they may change for you from night to night.

However, (RSD) is a newly described disorder in kids. The symptoms include:

  • Large body movements
  • Changing sleep position throughout the night with at least five body movements per hour
  • Significant impact on daytime behaviors

Restless sleep may be caused by sleep disorders and medical conditions, which will have their own set of symptoms.

For example, if restless sleep is caused by sleep apnea, symptoms may include:

  • Snoring
  • Waking up often during the night (the restless sleep you notice)
  • Waking up gasping for breath
  • Waking up with a dry mouth or sore throat
  • Morning headaches

Restless sleep can also lead to sleep debt. If you need to wake up at a set time each morning, as many of us do, a night of tossing and turning can cut into your sleep time, causing sleep debt.

The symptoms of short-term sleep debt include:

Long-term sleep debt can lead to:

  • Diabetes
  • Weight gain and obesity
  • Anxiety
  • Depression
  • High blood pressure
  • Heart disease
  • Early death

Heads-up: We all need a different amount of sleep each night. When we looked at how much sleep 1.95 million RISE users aged 24 and up needed, the amount ranged from five hours to 11 hours 30 minutes, with eight hours of sleep being the median.

We looked at how much sleep 1.95 million RISE users aged 24 and up needed, the amount ranged from five hours to 11 hours 30 minutes, with eight hours of sleep being the median.
The RISE app calculates how much sleep you need.

RISE users on iOS 1.202 and above can . 

Is it OK to Get Restless Sleep But Enough Sleep Overall?

Even if you’re getting enough sleep overall, restless sleep can still cause symptoms like low energy and poor mood.

is more restorative than broken sleep. And shows sleep interruptions have a bigger impact on your mood than getting the same shortened amount of sleep without interruptions.

Plus, how you feel about your sleep makes a difference to your energy levels the next day. So if you got enough sleep, but felt like you were tossing and turning a lot to get it, this may be enough to make you feel tired.

found how people feel about their sleep had a bigger impact on their daytime fatigue than how much sleep they got. And a found more light sleep and less time awake at night are linked to better sleep satisfaction. A found the more satisfied you are with your sleep, the better your mood and overall life satisfaction will be the next day.

The same goes if you’ve got insomnia — one of the causes of restless sleep. A on those with insomnia found there were no links between fatigue levels and polysomnography (PSG) measures, which are objective measures of sleep done via a sleep study. Fatigue was linked to insomnia symptoms, depressive symptoms, and longer habitual sleep duration (which could mean lots of broken sleep).

Another found more severe fatigue in insomniacs wasn’t necessarily linked to poor PSG-defined sleep. But it was linked to worse health-related quality of life.

Those with insomnia tend to think they slept less than they actually did. So if you feel like you had a night with insomnia symptoms — perhaps restless sleep — this may cause fatigue, even if your sleep was objectively fine.

We’ve covered more on whether it matters what time you sleep here.

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What Causes Restless Sleep?

There are many different causes of restless sleep, including drinking caffeine or alcohol too close to bedtime, having a warm bedroom, or being stressed and anxious.

Let’s dive into the common causes in more detail.

Caffeine

Caffeine doesn’t just keep you up. A found caffeine can:

  • Reduce sleep duration
  • Increase how long it takes you to fall asleep
  • Increase the amount of time you’re awake during the night
  • Increase the amount of light sleep you get
  • Decrease the amount of deep sleep you get

And caffeine can last in your system for more than 12 hours, meaning a seemingly innocent afternoon coffee can cause sleep disruption.

Alcohol

Alcohol acts as a sedative at first, but this effect after a few hours. This leads to fragmented sleep in the second half of the night.

Alcohol can also trigger night sweats, sleep apnea, and the need to pee more often — all of which can add to a night of tossing and turning.

Eating Close to Bedtime

If you have dinner close to bedtime, digestive issues like acid reflux, bloating, or IBS may cause a troubled night of sleep.

And even if digestion goes smoothly, late-night eating can still cause restlessness.

found eating or drinking within an hour of bedtime increases the odds of waking up during the night.

Intense Exercise Close to Bedtime

Exercise can help you fall and stay asleep, but if you do intense exercise close to bedtime, it may have the opposite effect.

shows vigorous exercise within an hour of bedtime can lead to taking longer to fall asleep, getting less sleep overall, and having a lower sleep efficiency (the measure of how long you spend sleeping while in bed, which takes into account falling asleep and waking up in the night).

A Disruption in Your Bedroom

Light, noise, or a too-warm bedroom can make it harder to fall asleep and could be the reason you’re waking up often during the night and struggling to get back to sleep.

Sleep disturbances could come from a snoring partner, noisy neighbor, or hot summer’s night. But there are also disruptions you might not think of.

For example, shows sleeping with the lights on can lead to more nighttime awakenings and a found owning a dog was linked to higher odds of having trouble sleeping. Having a restless dog in bed will certainly lead to a restless night for you, too.

Light Exposure

The light you get, or don’t get, during the day can also mess with your sleep.

One found evening exposure to short-wavelength light — the light you get from screens — can disrupt sleep continuity.

And shows those who get later first exposure to more than 10 lux of light each day had more awakenings the next night.

FYI, an overcast day is about 1,000 lux. So getting outside in the morning, even on dark days, can help improve restless nights.

Comparison of environmental light intensity
Comparison of light intensity in different situations.

Stress and Anxiety

Among RISE users, stress and anxiety are the biggest challenges stopping them from getting a good night’s sleep.

If you’re feeling stressed and anxious, you may struggle to switch off and relax, and racing thoughts may keep you awake either at the start of the night or in the middle of the night once you’ve woken up.

If stress easily affects your sleep and causes insomnia, you may have high . shows once you’ve been exposed to stress and developed insomnia, your sleep reactivity can increase even more and it may not return to pre-insomnia levels.

In short, more stress = more restless nights.

Being Uncomfortable

Pain and discomfort may stop you from falling asleep, wake you up, and cause you to frequently change positions to try and get comfortable.

This can be caused by your body — like lower back pain, an injured shoulder, or arthritis — or something in your bed — like a lumpy mattress or too-firm pillow.

Insomnia

Tossing and turning can be a sign of insomnia.

Types of insomnia include:

  • Sleep onset insomnia: Trouble falling asleep
  • Sleep maintenance insomnia: Trouble staying asleep
  • Early morning awakening insomnia: Waking up too early
  • Mixed insomnia: A combination of the different types of insomnia

If you often have restless nights, you may develop conditioned arousal. This is when your brain makes the link between your bed and being awake at night.

And worrying about restless sleep may cause even more restless sleep.

Counterintuitively, the more you try to control sleep (known as sleep effort), the worse your sleep can get. Sleep effort can even .

You may also suffer from , which is when you obsess over sleep data you get from your wearable device or sleep tracker. It’s easy to get so caught up trying to get a perfect night of sleep that you add to your restlessness.

That’s one reason we keep things simple at RISE and only track sleep debt, instead of time spent in deep sleep or REM. Sleep debt is one of the biggest predictors of how you’ll feel and function on a given day. We measure it over 14 nights, too, as one bad night doesn’t make or break your sleep health.

Obstructive Sleep Apnea

Sleep apnea is another sleep disorder that can cause restless nights. Sleep apnea is when your breathing is cut off during the night and your brain has to wake you up to kickstart it again.

You may be woken up several times an hour and struggle to get back to sleep once you’re awake.

Other Sleep Disorders

Beyond insomnia and sleep apnea, restless sleep can be caused by sleep disorders such as:

  • Restless leg syndrome (RLS)
  • Periodic limb movement disorder
  • Narcolepsy
  • Night terrors
  • Sleepwalking

Medical Conditions

Medical conditions could be waking you up in the night or making it harder to sleep.

These include:

  • Chronic pain
  • Diabetes
  • ADHD
  • Hypothyroidism
  • Allergies
  • Parkinson’s disease
  • Fibromyalgia
  • COVID
  • Leg cramps
  • Mental health issues like anxiety and depression

Medications for certain medical conditions can also cause restless sleep. These include:

  • Antidepressants
  • ADHD drugs
  • Beta-blockers
  • Cold meds and decongestants
  • Diuretics

Hormones

Hormone changes can cause:

  • Hot flashes
  • Insomnia
  • Sleep-disordered breathing
  • Anxiety and mood changes
  • Increase body temperature

And all of these symptoms can get in the way of restful sleep.

You might experience hormone-related restless nights when:

Being Out of Sync With Your Circadian Rhythm

Your circadian rhythm is your internal body clock. It runs on a roughly 24-hour cycle and helps to control your sleep cycle.

If you’re trying to sleep out of sync with your circadian rhythm — i.e. during the day if you work night shifts or at different times each night — you may struggle to sleep soundly.

You might also be out of sync if you’re suffering from jet lag or battling against your chronotype (like when a night owl tries to sleep early).

RISE predicts the timing of your circadian rhythm and shows you when your body naturally wants to go to sleep and wake up.

RISE app screenshot showing your energy peak and dip times
The RISE app can tell you when your body naturally wants to sleep.

RISE users on iOS 1.202 and above can .

We’ve covered more reasons you wake up in the middle of the night here.

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How Is Restless Sleep Different by Age Group?

Restless sleep can look different at every age, and it can be caused by different things, too.

Here’s what restless sleep looks like by age group:

  • Babies and infants: Babies and infants need much more sleep than adults, and they don’t get this sleep in one go. This isn’t necessarily restless sleep, however. According to the , newborns need 14 to 17 hours of sleep, for example, but they don’t sleep in one long 17-hour stretch. One of 6 and 12-month-olds found almost 28% didn’t sleep for six consecutive hours and 57% didn’t sleep for eight straight hours. The good news is there was no link between sleeping through the night and mental or psychomotor development.
  • Children: Young kids may have restless sleep due to being scared of sleeping alone, night terrors, ADHD, overstimulation, and using electronic devices before bed. If your child is regularly waking up, has frequent body movements during sleep, or has daytime impairment, they may have restless sleep.
  • Teenagers: Teens tend to have later chronotypes than adults, meaning they’re more night owls than early birds. They naturally want to go to sleep and wake up later, but set school times often mean they have to be up early. This can lead to sleep debt and, if they try to be morning people, trouble sleeping early and a restless night. Common teen behaviors — like late-night social media scrolling or drinking alcohol — can also add to restless sleep.
  • Adults: During adulthood, many factors may contribute to restless sleep, including working long hours, having children, going through stressful periods of life like losing a parent or getting divorced, and — for women — being pregnant and later going through menopause. Plus, there are all the poor sleep hygiene habits that come into play like caffeine, alcohol, and late-night eating. A found sleep efficiency decreased with age up until 30, stayed consistent from 30 to 60, and then decreased from 60 onwards.
  • Older adults: It’s a myth that older adults need less sleep. Sleep is just harder to get with age. Restless sleep can be more common with age as we develop more pain and medical conditions and take more medication — all of which can disrupt our sleep. We also get and have more nighttime awakenings with age. Our circadian rhythms also “flatten” with age, which means sleep-wake signals become weaker, which leads to more awakenings. Even factors like loneliness can mess with our sleep as we age. A found lonely older adults have more sleep problems.

We looked at how much sleep RISE users got by age group and found 18-to-23-year-olds have more sleep debt on average than any other age group. Those under 30 tend to have more sleep debt than those over 30. And those aged 40 to 49 had the lowest sleep debt on average.

How to Stop Tossing and Turning at Night?

How you stop tossing and turning at night will depend on what’s causing your restless sleep. One of the first things to address should be your sleep hygiene. This is the name for the daily behaviors that can help you fall and stay asleep.

Here’s how to sleep soundly through the night.

1. Avoid Caffeine About 12 Hours Before Bed

Caffeine can last in your system for more than 12 hours. Avoid coffee, tea, energy drinks, and anything else with caffeine about 12 hours before bed. This should give your body enough time to break it all down by bedtime.

We’ve covered more on when to stop drinking coffee here.

RISE can give you a personalized caffeine cutoff time each day based on your circadian rhythm.

RISE app screenshot showing when to limit caffeine intake
The RISE app can tell you when to stop drinking coffee each day.

RISE users on iOS 1.202 and above can .

2. Avoid Alcohol Three to Four Hours Before Bed

Give your body three to four hours to break down any alcohol in your system before sleep.

RISE can give you an exact time to switch to soft drinks. And we’ve covered more on how long before bed you should stop drinking alcohol here.

3. Avoid Eating Two to Three Hours Before Bed

Aim to be done with dinner two to three hours before bed. Avoid anything too spicy, rich, or fatty, too.

If hunger pangs keep you up, eat a small snack like Greek yogurt or fruit and peanut butter. Eating a balanced diet overall can also help to improve your sleep.

We’ve covered more on what time to stop eating before bed here. And RISE can give you a personalized time for when to be done with dinner each day.

4. Avoid Intense Exercise One Hour Before Bed

Prioritize working out during the day — it can help you fall and stay asleep — but be sure to avoid intense workouts within an hour of bed.

If you do want to exercise during this time, opt for gentle physical activity like yoga, and keep the lights as dim as possible.

Planning your workouts for the week? You can learn more about the best time to work out here.

5. Make Your Bedroom Cool, Dark, and Quiet

Before crawling into bed, make sure your sleep environment is cool, dark, and quiet.

Set your thermostat to 65 to 68 degrees Fahrenheit, invest in blackout curtains and use an , and wear or listen to a white noise machine or sleep sounds in the RISE app.

6. Get Comfortable in Bed

Experiment with different sleeping positions and pillow positions (or sleeping without a pillow at all).

Don’t be afraid to switch it up during the night to find a new comfortable sleeping position if you feel some discomfort.

Consider a new mattress that suits your sleeping position or get a new one if yours is old. And make sure your nightwear isn’t too tight or restrictive.

7. Get Out in Sunlight First Thing Each Morning

Morning light can reset your circadian rhythm and help you fall and stay asleep that evening.

Aim for 10 minutes of light as soon as possible after waking up. Get 15 to 20 minutes of light if it’s overcast or you’re getting light through a window.

If it’s dark outside when you wake up, use a 10,000 lux instead.

8. Avoid Light Close to Bedtime

Evening light suppresses the sleep hormone melatonin and pushes back the timing of your circadian rhythm, making it harder to fall asleep at bedtime.

About 90 minutes before bed, turn down the lights and put on blue-light blocking glasses.

Expert tip: If you wake up in the middle of the night, keep the lights off or as low as possible. If you’re regularly up during the night, invest in a red light night light, which can be less disruptive to your melatonin levels.

9. Do a Calming Bedtime Routine

Wind down before bed to stop stress, anxiety, and racing thoughts from causing a restless night.

Your pre-sleep routine could include:

  • Reading
  • Journaling
  • Doing yoga
  • Doing breathing exercises like deep breathing
  • Doing relaxation exercises like progressive muscle relaxation
  • Listening to calming music (save the upbeat music for your morning routine)
  • Taking a warm bath or shower
  • Sipping a cup of chamomile tea

Check out RISE’s audio guides on diaphragmatic breathing and progressive muscle relaxation to help you drift off.

RISE app screenshot showing relaxation sessions
The RISE app can guide you through relaxation exercises.

RISE users on iOS 1.202 and above can go right to their and get started here.

10. Keep a Consistent Sleep Schedule

Aim to go to bed and wake up at roughly the same times each day. Yes, that means resisting the snooze button on weekends.

Regular sleep patterns can help you keep your circadian rhythm in check and help you stay asleep through the night.

If you need to sleep in, keep this to an hour or so. Catch up on sleep with short afternoon naps instead of long lay-ins at the weekend.

To get started with your sleep schedule, you can find out the best time to sleep and wake up for you here.

Bonus: We found RISE users with regular sleep times have lower sleep debt than those with irregular sleep times. So keeping a consistent schedule can help you get enough sleep, which can boost your energy, mood, and productivity.

11. Consider Cognitive Behavioral Therapy for Insomnia (CBT-I)

If insomnia is behind your tossing and turning, cognitive behavioral therapy could help. CBT-I is often a first-line treatment for insomnia. It helps you rewire how you think about sleep.

You can do CBT-I through face-to-face therapy sessions, online, or through a CBT-I app.

12. Speak to Your Healthcare Provider or a Sleep Specialist

If you’re regularly tossing and turning at night, reach out to your doctor or a sleep specialist. They can test you for sleep disorders, like sleep apnea, or health conditions, like depression, and recommend the best treatment options to help.

13. Use the RISE app

RISE can help you stop tossing and turning by:

  • Guiding you through 20+ good sleep habits daily and sending you personalized reminders for when to do them. These include when to avoid caffeine, alcohol, and large meals, and when to get and avoid light.
  • Predicting the timing of your circadian rhythm, so you can sync up with it.
  • Working out your sleep debt, so you can stop worrying about every moment of restless sleep and instead focus on this one important sleep metric.
  • Sending you a gentle reminder to do a sleep reset when you reach for your phone during the night and guiding you through the steps
  • Guiding you through breathing and relaxation exercises
  • Having white noise and other sleep sounds to help you have a peaceful night

What to Do During a Restless Night of Sleep?

Laying in bed tossing and turning, here’s what to do in the moment when you can’t fall asleep or when you find yourself awake at 3 a.m:

Stay Calm

Try not to panic about a restless night of sleep. This only makes it harder to fall asleep.

Remind yourself that it’s normal to have a bad night of sleep every now and again.

Try doing some breathing exercises to take your mind off it, or doing a brain dump, which is when you write down everything you’re worrying about, if racing thoughts are keeping you awake.

Expert tip: Try writing out your to-do list for tomorrow. shows writing about tasks you need to do can help you fall asleep faster than writing about what you’ve already done.

Do your brain dump in RISE and the app can remind you of everything you write down the next day.

Avoid Screens, Light, and Checking the Time

Resist the urge to grab your phone, flick on the lights, or check the time.

These activities, just like panicking, will only wake you up further and make it harder to fall back asleep.

Do a Sleep Reset

If you’ve been tossing and turning for 20 minutes, get out of bed and do a sleep reset.

Do a calming activity with the lights as low as possible until you feel sleepy again.

Think of this time as bonus me-time and choose a relaxing activity to make yourself tired such as:

  • Reading
  • Meditating
  • Folding laundry
  • Gently cleaning your home
  • Organizing a bookshelf

RISE can guide you through a sleep reset when you can’t sleep.

We’ve covered more on what to do when you can’t sleep here.

When to See a Doctor About Restless Sleep?

A restless night of sleep every now and again is nothing to worry about, and waking up once or twice during the night is normal.

But if you regularly find yourself tossing and turning, and improving your sleep hygiene hasn’t helped, seek medical advice.

There are no tests to determine the cause of restless sleep. But a doctor can check for underlying conditions or sleep disorders that may be to blame and suggest the best lifestyle changes or treatment options to help.

Expert tip: Check your sleep debt and see if this is creeping up night after night. We recommend keeping sleep debt below five hours to feel your best. If restless nights are causing you to rack up sleep debt, talk to an expert to stop the problem from getting worse.

Sleep Soundly Through the Night

Restless sleep can be caused by many things, ranging from late-night meals and bright light to sleep disorders and stress.

How you can stop tossing and turning also varies, but improving your sleep hygiene is the best place to start as this addresses many of the common causes of restless sleep.

RISE guides you through 20+ good sleep hygiene habits each day to help you get a good night’s rest. The app also tracks your sleep debt, so you know when restless nights are contributing to sleep loss, and predicts your circadian rhythm, so you can sync up and sleep better.

You don’t have to suffer through restless nights — 80% of RISE users get better sleep within five days.

FAQs

What is restless sleep?

Restless sleep is sleep that’s broken and unrestful. You may struggle to fall asleep, wake up often during the night and struggle to get back to sleep, have trouble getting comfortable, have a racing mind, and feel tired and unrested the next day.

What causes restless sleep?

Restless sleep can be caused by caffeine, alcohol, large meals, intense exercise, and bright light close to bedtime; not getting bright light during the day; stress; anxiety; sleep disorders like insomnia and sleep apnea; and medical conditions like diabetes and depression.

Are restless nights normal?

Experiencing some restlessness at night is normal. Whether it's 30 minutes or even an hour of nighttime wakefulness on a semi-regular basis or the odd night of fitful sleep — restless sleep is not usually cause for alarm. If you’re regularly having restless nights, however, or it’s stopping you from getting enough sleep, look for a solution.

How to stop tossing and turning at night?

Stop tossing and turning at night by avoiding caffeine, alcohol, large meals, bright light, and intense exercise close to bedtime; getting bright light first thing in the morning; keeping a consistent sleep schedule; doing a calming bedtime routine; making sure your bedroom is cool, dark, and quiet; and getting checked for sleep disorders and medical conditions.

Is tossing and turning insomnia?

Tossing and turning can be a sign of insomnia. But tossing and turning at night can also be caused by caffeine, alcohol, light, a warm bedroom, stress, or another sleep disorder like sleep apnea.

Is tossing and turning sleep apnea?

Tossing and turning can be a sign of sleep apnea. But tossing and turning at night can also be caused by caffeine, alcohol, light, a warm bedroom, stress, or another sleep disorder like insomnia.

About Our Editorial Team

Written by
Jeff Kahn
Medically Reviewed by
Dr. Chester Wu
Our Editorial Standards
We bring sleep research out of the lab and into your life. Every post begins with peer-reviewed studies — not third-party sources — to make sure we only share advice that can be defended to a room full of sleep scientists.
Updated Regularly
We regularly update our articles to explain the latest research and shifts in scientific consensus in a simple and actionable way.

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