On the pyramid of wellness and overall health priorities, sleep very often gets bumped to the bottom. Despite constant reminders like dark circles, puffiness, fatigue, and low energy, many have difficulty sticking to a consistent sleep schedule. Or, if they do manage to get to bed at a decent hour, sleep quality is compromised. Much like other daily routines, a person’s sleep patterns are personal, but recent studies show that consistently getting to a REM snooze state has significant benefits beyond the bed. Dr. W. Christopher Winter, a board-certified neurologist and sleep medicine specialist, explains why REM sleep is crucial to long-term health and how to get the most of each night.
What is REM sleep?
Winter explains that sleep happens in three stages: light sleep, deep sleep, and dream sleep. rapid eye movement (REM) is dream sleep. “Deep sleep and REM often get lumped together, but they’re almost opposite states,” he says. “Deep sleep is quiet body, quiet brain. REM is quiet body, active brain.” In this state, he describes, your brain is nearly as active as when you’re awake, but your muscles are essentially paralyzed so you don’t act out your dreams.
We cycle through the three stages several times a night, roughly every 90 minutes, notes Winter. Deep sleep dominates the first part of the night, and REM gets longer and more concentrated toward the morning. Regarding how sleep habits and this level of insight sleep specialists have been able to home in on, Winter says, “We have come a very long way since Eugene Aserinsky figured out REM sleep from the basement of the University of Chicago, messing around with an old brain wave machine on his 8-year-old son.”
Does everyone experience REM sleep each night?
The term “experience” is subjective in the sleep field. “Most people move in and out of REM sleep without perceiving or experiencing it,” says Winter. “That said, even in those who 'don't dream...or remember it,' they are experiencing REM sleep, probably four to five times each night.” If you're sleeping a normal amount, meaning more than a couple of hours, Winter says you're getting REM. If your marker for REM is remembering a dream or whether or not you had one at all, Winter explains that there's a difference between not having dreams and not remembering them. “For people who truly don't seem to dream or experience REM, it's likely because something is disrupting their REM sleep. That could be alcohol, certain medications, or a sleep disorder like sleep apnea.” According to Winter, sleep apnea patients often have very disturbed REM sleep, which can lead to memory and cognitive issues, more pain, and brain fog.
How long does REM sleep last?
Winter says., “We spend about half the night in light sleep. The other half is some mix of deep sleep and dream sleep, about 50/50, so REM ends up being roughly a quarter of the night. “The first REM period is short, maybe 10 minutes, and later ones can stretch close to an hour. That’s why cutting your night short, with an early alarm, for example, cuts disproportionately into REM. Unlike deep sleep, which steadily shrinks as we age, REM tends to hold steadier across adulthood,” Winter says
What are the benefits of good REM sleep?
REM is more about concentration, focus, and memory. “It’s a little more opaque than deep sleep. If you don't get enough REM, you’ll get through your day okay. You're just going to put your car keys in your refrigerator. That little injury you got at the gym is going to bother you more. You might have more depressive thoughts or lack the motivation to do something,” Winter shares. He describes sleep as similar to a balanced diet: Protein isn’t necessarily more important than carbohydrates. It just does something different in the body. The goal, he says, is properly balanced sleep at night. “For the athletes I work with, REM is sneaky important...it's the difference between a base hit and a foul ball...or a perfect bound pass and one that goes out of bounds just out of reach from a teammate,” he adds.
How does REM sleep affect other health concerns?
Overall, poor sleep has many negative implications. Winter warns that inconsistent REM can affect the cardiovascular system, mood, hormones, blood sugar, and weight, and it can cause inflammation. “The list is almost infinite, so it's not surprising to see a study like this. Researchers followed more than 95,000 people for about nine years. Those who got more REM had a lower risk of 83 conditions, including heart failure, dementia, and Parkinson’s disease,” Winter summarizes.
While these findings are insightful, Winter says to keep two important factors in mind: “First, it's an association, not proof that more REM prevents disease. Second, sleep stages were estimated from a wrist device worn for one week,” he points out. The popularity of biometric wearable devices has peaked; Winter cautions against leaning too heavily into the data gathered from them. “I like trackers, but staging sleep is a tough thing for them to do. My takeaway is simple: People with the lowest risks were sleeping six to eight hours, and the highest risk was among people sleeping under five [hours]. Protect your total sleep, and REM tends to follow,” says Winter.
Findings from this study, he says, are not surprising. “When you think of how foundational sleep is, it should surprise nobody. It's like the Super Size Me experiment...When an individual eats poorly, it would not be a shock to see obesity, diabetes, cholesterol, heart disease, mood, etc. worsen. Sleep is just as foundational, so when it falls apart, many things downstream follow suit.”
Can you tell if you’re getting good REM sleep?
Dreams are the biggest clue as to whether or not you’re reaping the benefits of REM sleep. If you wake up in the middle of a vivid dream, Winter says you were probably in REM. “Many of us naturally wake up out of REM in the morning, which is why morning dreams are the ones we remember. But not remembering a dream doesn't mean you didn't have one, because anything from your alarm to checking your phone can wipe a dream away,” Winter notes.
Sleep trackers can show trends, and Winter points out that they're good at telling you how much you sleep, but he says to take the exact REM numbers with a grain of salt. “The better test is how you function. Are you focused, is your mood steady, are your car keys in the right place?”
Inconsistent sleep patterns are worth seeing a doctor for, but Winter also says that if your sleep is fragmented or if you’re suddenly dreaming more, that’s also a good time to speak to a sleep specialist to see if something deeper is going on.
Are there any downsides to REM sleep?
REM itself isn't bad, and as already established, it's essential. However, according to Winter, nightmares mostly happen in REM. Sleep apnea is often worse during REM because our muscles are so relaxed. “Sleep paralysis happens when that REM muscle paralysis lingers for a moment as you wake up,” he explains. “It's frightening, but usually harmless. There’s also REM sleep behavior disorder, where that paralysis doesn't work, and people physically act out their dreams. That one is worth telling a doctor about,” says Winter.
How can you get good REM sleep?
Certain things can help you get a better night’s rest, but Winter says you can’t really force REM. “There's no magic device or biohack. What you can do is protect the conditions for it.” Pick a wake-up time and stick with it, even on weekends. Seek bright light in the morning and dim the lights in the evening. Keep in mind that alcohol is very disruptive for sleep, so avoid it close to bedtime.
If you have insomnia, Winter says try not to chase sleep. “The secret to great sleep is being as happy in bed awake as you are asleep. If you snore or wake up gasping, get checked for sleep apnea, because it often fragments REM. For chronic insomnia, CBT-I, a talk therapy specifically for insomnia, is the first-line treatment,” Winter concludes.
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