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What Causes Sleep?

There are two internal biological mechanisms that work together to regulate wakefulness and sleep referred to as circadian rhythms and sleep-wake homeostasis.

Circadian rhythms direct a wide variety of body functions including wakefulness, core temperature, metabolism, and the release of hormones. They control the timing of sleep, causing a person to feel sleepy at night and creating a tendency to wake in the morning without an alarm. See Figure 12.1[1] for an illustration of circadian rhythms. Circadian rhythms are based roughly on a 24-hour clock and use environmental cues, such as light and temperature to determine the time of day.[2]

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Sleep-wake homeostasis keeps track of a person’s need for sleep. A pressure to sleep builds with every hour that a person is awake, reaching a peak in the evening when most people fall asleep. The homeostatic sleep drive also regulates sleep intensity, causing a person to sleep longer and more deeply after a period of sleep deprivation.[3] Adenosine is linked to this drive for sleep. While awake, the level of adenosine in the brain continues to rise, with increased levels signaling a shift toward sleep. While sleeping, the body breaks down adenosine. When it gets dark, the body also releases a hormone called melatonin. Melatonin signals the body that it’s time to prepare for sleep and creates a feeling of drowsiness. The amount of melatonin in the bloodstream peaks as the evening wears on. A third hormone, cortisol, is released in the early morning hours and naturally prepares the body to wake up.[4]

Factors that influence a person’s sleep and wakefulness include medical conditions, medications, stress, sleep environment, and foods and fluids consumed, but the greatest influence is exposure to light. Specialized cells in the retina process light and provide messages to the brain to align the body clock with periods of day or night. Exposure to bright artificial light in the late evening can disrupt this process, making it hard to fall asleep. Examples of bright artificial light include the light from a TV screen, computer, or smartphone. Exposure to light can also make it difficult to return to sleep after being awakened.[5]

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Night shift workers often have trouble falling asleep when they go to bed and may have trouble staying awake at work because their natural circadian rhythm and sleep-wake cycle are disrupted. Jet lag also disrupts circadian rhythms. When flying to a different time zone, a mismatch is created between a person’s internal clock and the actual time of day.[6]

The rhythm and timing of the body clock change with age. For example, teenagers fall asleep later at night than younger children and adults because melatonin is released and peaks later in the 24-hour cycle for teens. As a result, it’s natural for many teens to prefer later bedtimes at night and sleep later in the morning than adults.[7]

Individuals also need more sleep early in life, when they’re growing and developing. For example, newborns may sleep more than 16 hours a day, and preschool-aged children need to take naps. Young children tend to sleep more in the early evening whereas older adults tend to go to bed earlier and wake up earlier.[8]

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