Sleep: Why We Need It and How to Get Better Sleep

We all know sleep is important. But simply spending enough hours in bed doesn't always mean we're getting the restorative sleep our bodies need.

Sleep is one of the foundations I come back to again and again with patients because it affects nearly every system in the body. Adequate, restorative sleep supports energy, mood, cognitive function, metabolism, hormone regulation, cardiovascular health, and immune function.

And yet, sleep concerns are incredibly common.

Some people can't fall asleep. Others fall asleep easily but wake at 2 or 3 a.m. and can't get back to sleep. And some people get a full 7–9 hours but still wake feeling exhausted.

So when we're talking about how to get better sleep, we need to think about more than simply how many hours you're in bed.

Sleep Quantity AND Sleep Quality

For most adults, a good goal is 7–9 hours of sleep each night, but quantity is only part of the picture.

Throughout the night, we cycle through different stages of sleep, including light sleep, deep sleep, and REM sleep. Each serves different functions in physical restoration, memory and learning, emotional processing, immune function, and overall recovery.

Repeated awakenings can disrupt these cycles—even if you technically spend eight hours in bed.

That's why I like to think about three different aspects of healthy sleep:

Quantity: Are you giving yourself enough time to sleep?

Quality: Is your sleep restorative, or do you wake feeling like you barely slept?

Continuity: Are you able to move through your sleep cycles without frequent interruptions?

You can have plenty of one and still be lacking in another.

Start With Your Circadian Rhythm

Before reaching for supplements, start with the basics.

Our bodies have an internal clock, or circadian rhythm, that helps regulate when we feel awake and when we feel sleepy. Light is one of the strongest signals controlling this rhythm.

Morning light tells the brain that it's daytime and helps set the clock for the rest of the day. As evening approaches and our environment becomes darker, melatonin production increases and helps prepare us for sleep.

Modern life can interfere with those signals. We spend much of the day indoors, then surround ourselves with bright lights, televisions, computers, and phones after the sun goes down.

One of the simplest things you can do for your sleep is to make your days brighter and your nights darker.

Get outside and see natural light in the morning. Dim the lights in the evening. Give yourself at least 30 minutes without screens before bed.

Small changes can make a surprisingly big difference.

The Foundations of Better Sleep

If you're struggling with sleep, these are the places I recommend starting:

Keep a consistent schedule. Try to go to bed and wake around the same time each day. Consistency helps reinforce your circadian rhythm.

Get outside in the morning. Natural morning light is one of the best signals we can give our internal clock.

Pay attention to your sleep cues. If you're yawning and struggling to keep your eyes open, that's probably not the time to start another episode of your favorite show. Staying up past that initial sleepy window can sometimes make falling asleep more difficult.

Turn down the lights and screens. Start creating a darker, quieter environment as bedtime approaches. Try putting the phone away at least 30 minutes before bed.

Watch caffeine and alcohol. Caffeine can stay in the body for many hours, so afternoon caffeine may affect sleep even when you don't feel stimulated by it. Alcohol may make you sleepy initially, but it can lead to more fragmented and less restorative sleep later in the night.

Move your body during the day. Regular physical activity supports healthy sleep, although intense exercise immediately before bed can be stimulating for some people.

Create a wind-down routine. Our nervous systems don't always transition instantly from a busy day into sleep. Give yourself some time to shift out of "go mode." Reading, gentle stretching, breathing exercises, meditation, a warm bath or shower, or gentle nighttime yoga can all be helpful.

Make your bedroom a place for sleep.A cool, dark, quiet room and a comfortable mattress and pillow can make a difference.

"I'm Exhausted, but I Can't Fall Asleep"

This is something I hear frequently.

When the body is tired but the brain is still going through tomorrow's to-do list, replaying conversations, or thinking about everything that needs to get done, simply telling yourself to "go to sleep" usually isn't very effective.

This is where nervous system regulation becomes especially important.

Try creating a transition period between your day and bedtime. Dim the lights. Put away work and screens. Stretch. Read. Take a warm bath. Practice slow breathing or meditation. This is also a great opportunity to take up journaling and do a "brain dump" to get all those thoughts out!

Some people also benefit from herbs traditionally used as calming nervines, such as chamomile, lemon balm, passionflower, or lavender, or from nutrients such as magnesium. Herbs and supplements aren't appropriate for everyone, however, and should be individualized—especially during pregnancy or when taking medications.

"I Fall Asleep Fine, but Wake Up at 2 or 3 A.M."

Nighttime waking can have many causes, and this is where individualized troubleshooting becomes important.

Nervous system activation can contribute, and we always want to look at stress and cortisol levels, but so can alcohol, hormonal changes, medications, pain, needing to urinate, temperature changes, reflux, environmental disruptions, and sleep disorders such as obstructive sleep apnea.

If you wake occasionally and fall back asleep, that's not necessarily a problem. Brief awakenings can be a normal part of sleep.

But if you're consistently awake for long periods or waking several times every night, it's worth asking why rather than simply adding another sleep supplement.

Try a smalll snack before bed that contains protein and fat to help balance your blood sugar through the night. If you are awake for a while and becoming frustrated, sometimes it's better to get out of bed and do something quiet in dim light until you feel sleepy again rather than lying there watching the clock. But don't pick up those screens!

"I Get 8 Hours, but I'm Still Exhausted"

This is another important clue.

If you're consistently getting enough sleep but don't feel rested, we need to look at sleep quality and also consider whether something else is contributing to your fatigue.

One of the first things I think about is sleep apnea.

Do you snore? Has someone told you that you stop breathing or gasp during the night? Do you wake with headaches or a dry mouth? Are you extremely sleepy during the day despite getting enough hours of sleep?

Those can be reasons to discuss a sleep study with your healthcare provider.

Hormonal changes can also affect sleep. Menstrual cycle changes, pregnancy, postpartum shifts, and the menopause transition can all influence sleep patterns. Hot flashes and night sweats are obvious sleep disruptors, but changing hormones can affect sleep even when those symptoms aren't present.

And sometimes fatigue isn't primarily a sleep problem at all. Iron deficiency, thyroid dysfunction, nutrient deficiencies, blood sugar dysregulation, medications, mood concerns, and other medical conditions can all contribute to feeling exhausted.

That's why persistent fatigue deserves a bigger-picture evaluation.

What About Sleep Trackers?

Wearable devices can be useful for noticing patterns—for example, whether your sleep changes after alcohol, a late meal, travel, stress, or a change in your bedtime.

But don't let your sleep score become another source of stress.

Consumer devices estimate sleep stages rather than directly measuring them the way a formal sleep study does. I tend to care more about the overall pattern: Are you sleeping long enough? Are you waking frequently? Do you feel rested? Are your habits supporting a healthy circadian rhythm?

Use the data as information, not a grade.

When the Basics Aren't Enough

Sometimes sleep hygiene makes a tremendous difference. Sometimes it doesn't.

If you've consistently worked on the basics and you're still struggling to fall asleep, waking frequently, or waking exhausted, that's when it's worth digging deeper.

Sleep concerns can be connected to stress, hormones, medications, pain, sleep apnea, restless legs, digestive symptoms, metabolic health, and other underlying factors.

Rather than endlessly adding sleep aids, the goal should be to understand what is disrupting your sleep in the first place.

Start Small

If this feels like a lot, don't overhaul your entire routine tonight.

Pick one or two things and try them consistently for a week.

• Get outside for morning light.

• Turn off your screens 30 minutes before bed.

• Keep your bedtime consistent.

• Spend 10–15 minutes intentionally winding down your nervous system.

  
  

Then notice what changes.

Sleep is one of our most basic foundations of health, and sometimes improving it starts with surprisingly simple changes.

At Foundations Family Medicine, we take an individualized approach to sleep, fatigue, hormones, stress, and the other factors that may be affecting how you feel during the day. If you're doing all the “right” things and still aren't sleeping well or waking rested, it may be time to look a little deeper.

About the Author

Dr. Jessie Miller is a Naturopathic doctor and founder of Foundations Family Medicine. She specializes in women’s health, advanced lipid testing, hormones, metabolic and blood sugar regulation, digestion, and functional medicine approaches to prevention and chronic disease. Her work focuses on identifying root contributors to cardiovascular risk and supporting patients with personalized, sustainable strategies for long-term heart health.