Personalized Approaches to Better Sleep, With Carleara Weiss, Ph.D.

Carleara Weiss, Ph.D., M.S., RN

Credit: Sleep Research Society

Sleep isn’t just about how many hours you log at night — it’s a critical factor that affects everything from energy and brain function to overall health. Carleara Weiss, Ph.D., M.S., RN, a sleep education expert at Aeroflow Sleep, explains how personalized approaches, including blood tests, wearable trackers and lifestyle strategies, can help patients better understand their sleep and its impact on wellness. While there is no single blood test for sleep, biomarkers such as cortisol, vitamin levels and inflammation markers can reveal how sleep (or lack thereof) is influencing your body and brain.

Weiss also highlights the importance of separating scientifically supported sleep interventions from trends or “smart supplements” hype. She emphasizes starting with behavioral changes, such as consistent sleep routines and optimized sleep environments, before turning to supplements or testing. By understanding their unique sleep patterns and potential health risks early, patients can make intentional choices that support long-term health and daily function.

How can personalized blood tests help patients better understand how their sleep is affecting their overall health?

Carleara Weiss, Ph.D., M.S., RN: Personalized blood tests increase our understanding of health conditions that are impacted by sleep and that can influence sleep. For example, blood tests to check hormones like cortisol and melatonin, vitamin levels, inflammation markers and thyroid function can be used in conjunction with other assessments such as a sleep study to understand sleep health. That should not be confused with a blood test for sleep, because there is no U.S. Food and Drug Administration (FDA)-approved blood test for sleep.

What kinds of biomarkers are most useful today when it comes to sleep quality, energy and brain health?

CW: We do not have a scientifically stablished blood-based biomarker for sleep quality. Instead, we use markers for conditions impacted by sleep. For example, we can look at cortisol levels to understand stress and circadian rhythms. We can look at magnesium and iron (ferritin) to understand fatigue and daytime sleepiness, among other things.

“Smart supplements” for sleep and brain health are everywhere — what should patients know before trying them?

CW: The first thing I caution about smart supplements is safety, and I advise choosing a third-party-tested brand. Second, consult your primary care provider before taking them, or at least let them know what you are taking to discuss potential interactions with other medications.

Another important conversation is understanding what is scientifically proven and what is hype. For example, we have strong scientific evidence to support supplementation with omega-3, B-complex vitamin and vitamin D. Other compounds such as L-theanine and ashwagandha are emerging as smart supplements for sleep, which means that the scientific evidence is still growing for these products. I would refer to the FDA or the National Institutes of Health webpages as reputable sources of dose, duration of treatment and who qualifies to take these.

How realistic is annual sleep testing as part of routine wellness care, and who might benefit the most from it?

CW: Currently, annual sleep testing is not a standard recommendation for a routine wellness care visit. The American Academy of Sleep Medicine (AASM) recommends a sleep study for people experiencing symptoms of sleep disorders such as poor sleep quality, sleep fragmentation, fatigue and daytime sleepiness, and adults with a high-risk profile such as obesity, cardiovascular disorders or lung disorders.

However, primary care providers are encouraged to ask about sleep problems during wellness visits. It is feasible to incorporate sleep screening tests (such as questionnaires) into those visits, although this is not a standard practice yet. I believe that the growing interest in sleep and AASM advocacy will promote this positive change. In addition, the option for home sleep tests covered by insurance may propel the addition of annual sleep testing into wellness checkups. Lastly, wearable sleep trackers can provide a helpful insight into your daily sleep patterns, and you can discuss them with your doctor.

What sleep problems are most commonly missed when patients don’t get tested until symptoms become severe?

CW: Persistent fatigue is often attributed to daily life stress and commitments, although it can be a sign of sleep disorder. Overlooked symptoms of obstructive sleep apnea (OSA) include waking up with a dry mouth, a sore throat and headaches. Over time, untreated OSA impacts cardiovascular health, with increased blood pressure and risk for cardiovascular disease such as stroke.

For patients looking to improve sleep today, what’s one step you recommend before turning to testing or supplements?

CW: Behavioral changes should always be the first step to improving sleep. With that, focus on sleep hygiene by creating a consistent sleep routine, optimizing your sleep environment, staying active during the day, avoiding blue light from electronic devices at least one hour before bedtime and allowing time to unwind before going to bed. Allow one to two weeks of consistency with your sleep hygiene plan until you notice differences in your sleep and daytime function. If you do not notice a difference, contact your primary care doctor and seek sleep evaluation.