We all know how rare quality sleep is today. After the hustling around, it feels great to put your head down on your pillow and finally rest. What is coming to light now, though, is how valuable sleep is to restore your skin.
Skincare, and especially care that protects against aging of the skin, is a multibillion-dollar per year industry. Anti-aging research, products, and treatments are ubiquitous. What is just as effective as many anti-aging skincare technologies on the market may be right in front of you: your bed.
Caring for our skin is critical. Skin is an organ, just like the heart and lungs. Skin is our first line of defense against dangers, and it needs to be maintained and protected. Additionally, healthy skin is a long-standing sign of beauty, cleanliness, and age.
Some physical effects of lack of sleep are dark circles or baggy skin under the eyes (as anyone unable to stay asleep the entire night knows). However, there is much more damage, in addition to the immediately visible, that happens when people neglect sleep. According to a 2016 study published by the Centers for Disease Control and Prevention (CDC), one-third of Americans are poor-quality sleepers. There are over 80 identified sleeping disorders, affecting more than 70 million Americans!
While skincare professionals can direct patients to various positive treatments and products, people are ultimately in control of their skin’s fate: through diet, lifestyle, stress management – and sleep.
Over and over, lack of sleep is being identified as a major culprit for aging skin. The more we understand the science of sleeping, the more we can protect and care for our skin.
For most of us, sleep is straightforward. Lay down, close eyes, wake up. However, a lot is going on when we sleep.
Sleep happens in cycles. There are four main stages that we go through during the shuteye cycle, ranging from light sleep to deep sleep to Rapid Eye Movement (REM) sleep. A typically healthy sleeper will go through this cycle five times in a night. Most of our sleep is spent on non-REM sleep stages: in fact, only 20-25% of our sleep overall is REM sleep. Going through these cycles keeps our skin healthy. Lacking sleep or breaking these cycles, however, can lower our skin health.
Stage N1 (Non-REM 1) in the cycle is “light sleep.” This is when we are easily awakened, when we are not quite out yet: think “falling asleep.” This lasts only 7 minutes or so per cycle, and only for 5% of total sleep time, but none of the other stages happen without this one.
Stage N2 (Non-REM 2) sleep is still considered to be “light sleep.” However, you begin to feel more asleep than during N1. Your heart rate and breathing are similar to the awake state, but your body temperature drops a degree or two. This is where most sleep happens, as this stage makes up almost 50% of the total sleep cycle.
Stage N3 (Non-REM 3) in the cycle is very important to skin health and aging. This is where most restorative processes happen. Hormonal regulation, cellular repair, and rejuvenation all happen in this stage. People who are awoken in stage N3 are often groggy and confused. This often lasts from 45 to 90 minutes, slowly shortening through each successive cycle.
REM is the final stage in the sleep cycle. This is when dreams occur. The muscles of the body become motionless, except for the eyes, while brain activity and breathing increase. This stage tends to lengthen throughout each cycle during the night, lasting around 10 minutes at first.
Interruptions in the cycle, or these individual stages, can directly impact the aging of our skin. Without the ability to restore and rejuvenate, the health of our skin will begin to deteriorate.
Sleep, Hormones, and Skin
Interruptions in sleep, or failing to allow the body to go through the cycles, can cause significant damage to the body – including the skin. This is because hormone production shifts and metabolism is altered.
Hormones affected by sleep include melatonin, cortisol, insulin, DHEA, estrogen, progesterone, and testosterone. All of them play a big role in skin aging, and all of them change with sleep deprivation. Proper levels of these hormones help the skin stay young-looking and healthy.
Melatonin is a hormone mainly produced in the pineal gland with anti-aging properties. It protects against UV damage and repairs UV-damaged skin.
Cortisol is a tricky hormone. High levels of it are released when we experience stress, which leads to negative skin health results, such as wrinkling, thinning, reduced elasticity, and lines. However, cortisol also reduces inflammation and regulates metabolism. Excessive cortisol can also lead to increased sebum production, which can worsen acne. Healthy sleep cycles can maintain proper cortisol levels, so our skin is not negatively impacted.
Insulin also must remain at a naturally balanced level. It maintains glucose metabolism and cellular energy, but too much can lead to obesity and aging. When people don’t get enough sleep, cortisol is overproduced, leading to insulin surplus. Too much insulin released in the body can cause glucose intolerance and insulin resistance.
DHEA is a steroid hormone that produces other hormones. Adequate levels of DHEA help the body produce collagen, which is a well-known component of healthy skin. DHEA is the main structural protein found in hair, bones, connective tissue – and skin. It also helps the production of sebum, which moisturizes and fortifies skin.
Neglecting sleep can lead to a reduction in estrogen, which can result in a decrease in dermal and epidermal thickness. This can increase the skin’s vulnerability to damage from free radicals and oxidative stress. Decreased estrogen also leads to lower collagen levels, which causes the skin to wrinkle and thin. Estrogen levels begin to drop in women in their mid to late 30s, but sleep deprivation speeds this drop along.
Progesterone supports skin elasticity and circulation. Like estrogen, this hormone naturally begins to decline in women in their mid to late 30s. Impairment of sleep cycles can exacerbate the drop, which quickly decreases the glowing of the skin.
Testosterone is a hormone that needs to be perfectly balanced. Sleep deprivation and poor-quality sleep cause testosterone levels to drop. Too little testosterone can cause a loss of elasticity, dermal thickness, and density.
Sleep and Skin Aging
Skin aging is two-pronged. On one hand, there is intrinsic aging. Intrinsic aging is related to the internal process of the creation of energy within cells, including skin cells. Then there is extrinsic aging, which involves external factors like sun exposure, pollution, blue light exposure, and environmental toxins.
Both intrinsic and extrinsic aging increase with a lack of sleep. A 2013 study, conducted by the University Hospital Case Medical Center, analyzed the impact of sleep on skin health among 60 pre-menopausal women aged 30 to 49. Participants were put through non-invasive skin challenges such as skin barrier disruption and UV light exposure tests. They also recorded their sleep habits for a week. Using the SCINEXA skin aging score system, the poor-quality sleepers had an intrinsic age score of 50% older than good sleepers! Visual assessments showed uneven pigmentation, fine lines, slackening of the skin, and reduced elasticity in poor-quality sleepers.
Extrinsic aging – from lifestyle and environmental factors – makes up 80% to 90% of all aging. People have much more control over extrinsic aging.
So how can quality sleep slow down the aging process? Sleep, especially deep sleep stages, promotes cellular repair and renewal. Recovery against UV damage also takes place during the sleep cycle. DNA repair processes need to occur to combat photo-aging and increased skin cancer risk. These DNA repair processes happen during sleep.
Incorporating Sleep Knowledge into Aesthetics
A lot of research is out there supporting the link of poor-quality sleep to skin aging. But how can skincare professionals incorporate this into their practice?
Sleep quality information should be completed during the initial consultation process or on intake forms. This is critical for the overall picture of a patient, to determine best treatment options. Patients should also be given ample information about the importance of sleep to their skin health. Impaired sleep can affect skin today and can lead to more problems down the road.
For example, a patient undergoing a series of chemical peels usually goes 4 weeks between each procedure. However, if sleep impairment or deprivation is an issue with that patient, the timeline may be extended to 6 weeks. The extra two weeks would help account for the lack of skin recovery time that the patient would normally get with good sleep.
Tips to Improve Sleep
Sleep is very important to skin health. Here are 10 tips that can help ensure a good night’s sleep.
Avoid blue light in the evening
Devices like smartphones and laptops give off blue light, which energizes the brain and interferes with sleep. Avoid using personal devices for 3 to 4 hours before going to bed.
Create a comfortable sleeping environment
Rooms should be comfortable and cool, without a lot of distractions such as TVs, laptops, and cell phones.
Stimulants, such as caffeine, disrupt the body’s natural cycles. Caffeine should be avoided for more than 4 hours before bedtime.
Even though people may feel tired after consuming alcohol, it can be very disruptive to the circadian rhythm. Alcohol has been linked to poor-quality sleep and interruption of the sleep cycle. Avoid consuming alcohol for 4-5 hours before bedtime.
Regular exercise is a natural way to tire your body out, including the muscles. This can lead to a night of higher-quality sleep. Try to exercise 3 hours before bed for maximum benefit.
Avoid consuming calories at least 3 hours before going to bed. Consuming calories decreases growth hormone levels. As much as 75% of growth hormone is released during sleep. Low growth hormone may lead to poor skin turgor, wrinkling, and thinning of the skin.
A hot bath before bed
A hot bath before bed – 102° to 106° – can help relax muscles, leading to a better night’s sleep.
Stress can interrupt and disrupt the sleep cycle. Use whatever stress management method you may have available.
Napping can cause people to drop into the deeper stage of the sleep cycle quickly when napping. This will impair the ability to fall easily into regular sleep at night.
Write it out
Make a list of things you still need to do, or other thoughts, before bed. This will help clear your mind so that you can sleep more soundly.