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Snooze Away

From birth, we spend a third of our lives asleep. After decades of research, we’re still not sure why.

There is a rare disease called Fatal Familial Insomnia. Patients are unable to sleep and they ultimately die usually in their 50s. The thalamus gland in our brains, which plays an important part in blocking input from our senses whilst asleep, is damaged by proteins called prions in FFI. We still don’t know why it happens, how to treat or stop this rare disease.

Experiments depriving rats of sleep for two weeks result in their deaths. Sleep is so important! A recent study looking at people who sleep an average of 5 hours a day versus people who sleep an average of 7 hours a day showed a much higher incidence of hypertension, heart disease, depression and even suicides in the group with less sleep. What a difference a shortening of sleep time of just 2 hours made!

Different parts of our brain play different roles in maintaining sleep.

Hypothalamus

  • Governs Circadian Rhythms which promote Sleep and Arousal

Pineal Gland

  • Produces Melatonin
  • Sensing Darkness
  • Prepares Brain to Sleep

Hippocampus

  • Dreams

Pons

  • Arousal
  • Activation of Dreams in REM
  • Blocks Signals to Spinal Cord

Cerebral Cortex

  • Activated by Pons in REM
  • Creating a story from info from waking Hours

Retina of the Eye

  • Arousal Signal to Brain
  • Senses Light

We still don’t know why we need to sleep. We do know of the severe consequences if we don’t get enough sleep. Is sleep a period where the brain’s activity goes very quiet and thus it gets it ‘rest’? The answer is an emphatic No! Sleep is NOT being Unconscious. It is a dynamic state with shifting levels of electricity and ebbing and flowing of chemicals in the brain.

Stages of Sleep

At night we cycle several times through ever deeper phases of sleep. In Stage 1(light sleep), we drift in and out of wakefulness. Brain waves then slow down in Stage 2 and become extremely slow in Stage 3. Dreams then occur in REM (Rapid Eye Movement) stage of sleep where heart rate and breathing grow more rapid.

How much sleep should I get ? What time should I sleep?

  • Babies sleep between 12-18 hours a day. Interestingly 50% of their sleep time is in REM dream sleep.
  • Children usually sleep from 8pm to 6am averaging about 11-13 hours. 25% of their sleep is in REM sleep. Studies have shown that children who sleep less are more prone to gaining more weight and also resulting in poorer school grades and lower IQs.
  • Teenagers usually have a natural sleeping time from 1am to 10am and they require about 9 hours of sleep. Less sleep again has been implicated in poorer school grades. Also, early school hours i.e. usually most schools start at 8 a.m., often clash with their natural sleeping times.
  • Adults typically require 6.5 to 7.5 hours of sleep a night and their sleeping times are usually between 11 pm to 6 am. Again, both sleeping shorter or longer than these normal 7 hours result in higher morbidity, higher rates of depression and obesity.

Weight gain and sleep

It is actually a myth that people who sleep more put on more weight. In fact, the opposite is true! Studies have shown that people who sleep enough have a better chance of staying slim than people who sleep less than the normal required hours of sleep. So, go on and sleep to a slimmer you!

People who do not sleep enough often eat more because they are tired and they eat to obtain energy to battle their fatigue and to stay alert and awake.

Diabetes and Sleep

Short sleep, poor sleep are also novel risk factors for obesity and for type 2 diabetes. Studies have shown that sleep restriction damages the body’s ability to regulate eating by lowering levels of leptin, the hormone that tells the body when it has had enough of food resulting in overeating. Sleep disruption also causes an increase in insulin resistance in humans (thus causing the body to need higher levels of insulin).

Do we need naps?

The Spanish are famous for their siestas (cat naps). The timing of the traditional siesta corresponds to a natural post-lunch dip in our circadian rhythms, and studies have shown that people who catnap are generally more productive and may even enjoy lower risk of death from heart attacks.

Common Sleep Problems

There are to date 86 sleep disorders known. The most common of which is Obstructive Sleep Apnea (OSA). Typically these patients are either overweight or obese and men outnumber women by a ratio of 4 to 1. They snore loudly during sleep and have episodes of chocking, gasping and breathing stoppages (apneas) usually witnessed by their sleeping partners (Witnessed Apneic Spells). During sleep, their airways collapse and they suffer from oxygen deprivation resulting in hypertension, heart attacks, strokes and also have higher incidences of road traffic accidents due to excessive daytime sleepiness.

In the UK, the Department of Vehicle Licensing (similar to our JPJ) makes it mandatory for all drivers of commercial vehicles with OSA to undergo treatment for their OSA before their licences are renewed annually.

Insomnia is when somebody cannot sleep or has difficulty falling asleep. Women have more problems with insomnia than men. Narcolepsy is the entire opposite. Here, patients sleep at the drop of a hat, anytime throughout the day. Sleepwalking or somnambulism is when a patient engages in activities that are normally associated with wakefulness (such as eating or dressing), which may include walking, without the conscious knowledge of the subject.

Sleep problems, especially insomnia, are definitely getting more common these days with the increasing workloads put on us. Not to mention, the myriads of distractions that abound ranging from the internet, computer, TV and late-night rendezvous with friends at our 24 hours-a-day-open mamak stalls!

How do we overcome sleep problems and get a good sleep?

Recognise the fact that sleep is a valuable commodity. Guard it religiously.

  • Sleep at the recommended hours, for the recommended hours.
  • Keep computers/TVs/CD players/radios out of the bedroom – potential sleep distracters.
  • Keep the bedroom comfortable, neat, clean and quiet.
  • Remember to ‘cool down’ to sleep. Relax for half an hour before sleeping by soaking in a warm tub, do a bit of light-reading or listen to some slow, easy music. We cannot just switch off the computer or TV and jump into bed to sleep. Our minds would still be a beehive of activity and many would find it hard to sleep.
  • Do not take substances like teas, coffees, carbonated drinks, chocolates just before sleeping. They are stimulants because they contain caffeine which prevents us from falling asleep.

Does melatonin help in insomnia?

Melatonin is a hormone produced by the pineal gland in the brain and light directly inhibits the release of melatonin. That is why melatonin is sometimes called the “Dracula of hormones” – it only comes out in the dark. Overall, research indicates improved sleep when melatonin is taken at the appropriate time for jet lag and shift work. However, more research needs to be done to see whether melatonin helps in the treatment of insomnia.

Facebook/Twitter and Sleep Deprivation

The combination of Facebook/Twitter on internet-connected smartphones creates a perpetual state of being able to log into this social media site 24 hours a day. A recent study done on 201 volunteers showed that except for sleep and sex, the urge to log into social networking sites was stronger than almost any other urge – including the urge for a cigarette, coffee, food or alcohol. This obsessive-compulsion behaviour borders on addiction and ‘steals’ a lot of people’s time and unsurprisingly eats into their sleep time too resulting in sleep deprivation.

In conclusion, I would say that while there is still so much we need to find out about sleep, what we do already know is that sleep is very important and we should guard our sleep fervently!

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