Information for Ukrainian refugees / Інформація для українських біженців (click here)
Information for Ukrainian refugees / Інформація для українських біженців (click here)

Sleep Glorious Sleep

 

The Reasons Why We Sleep

Sleep is a commonality of all mammals, it is a necessary daily function of life. Indeed, sleep deprivation is recognised by the UN as a banned form of torture (apologies to all new parents). And yes, even fish such as sharks need to sleep…however they have the rather ingenious idea of allowing only sleeping a half of their brain at a time. How much more productive would you be if half of your brain could catch 40 winks whilst in a work meeting or commuting ? And although there is still much we do not understand about sleep, we do know that sleep has a multitude of important functions for living a long, healthy and happy life. Sleep is important for maintaining a healthy weight, blood pressure, blood glucose and lipid levels, it moderates anxiety and mood issues, prevents lethargy, improves immune function and much much more.

There are 2 main parts to sleep; REM (light) and non-REM (deep). Deep sleep is the part of the sleep earlier in the night where you are rigid and don’t dream. This part of sleep is akin to a ‘washing machine’ whereby the fluid that bathes the brain is washed away and replaced. This is also where short-term memory from the day is dealt with and stored for future reference i.e., what colour of shirt did the shop assistant have on today, what tasks did I leave for tomorrow etc. REM sleep occurs more often at the latter end of the sleep and here we tend to thrash about a little more. In truth we cycle through both phases of sleep and both have significant roles to play in keeping us happy and healthy.

Effects of Chronic Poor Sleep

A lack of sleep quality as well as duration is a risk factor for the majority of chronic diseases including type 2 diabetes, obesity, cardiovascular disease, dementia and more. As well as reducing the activity of your immune system (see below for COVID related details), long-term poor sleep also impairs learning, memory and may contribute to depression and anxiety. In turn poor mental health also lead to sleep disturbance and lead to a vicious circle of low energy and insomnia.

The bad news is that it seems as though every aspect of modern life is conspiring to relieve us of a good nights sleep. Whether it is extended working hours encroaching on down time, use of devices at night, the ever growing size of standard coffee cups or all of the excess worries that a pandemic brings, it can be tricky to find that good night’s sleep. Please see below some tips.

Good Sleep Tips

Practice ‘sleep hygiene’ – your room should be cool, quiet and ideally pitch black (remember how babies like to sleep!)

Avoid caffeinated drinks (soft drinks, tea, coffee) after 2 p.m. or perhaps avoid completely. Caffeine has a half-life of 6 hours. This means drinking a large cup of coffee at 2 p.m. is the same as drinking a small cup at 8 a.m.

Are you reliant on caffeine because of chronic sleep deprivation…which is caused by the caffeine in the first place?

Try to go to bed and wake up at the same time every day

Think how little babies develop good sleep habits, we aren’t that different. We like pre-sleep wind down, we like sleep routine and we can all get a little cranky without sleep.

Avoid TV, phones or other electronics 30-45 minutes before bed.

Some phones and computers may have a blue-light blocking app but better to avoid altogether. There is no filter for stressful news updates, social media posts or late-night work emails.

Try not to eat too close to bedtime, 3 hours before bed would be ideal.

Eliminate, or limit, drinking alcohol in the evenings.

Try to get some natural bright light first thing in the morning. Simply standing outside on waking is enough to tell your brain what time it is and set your internal body clock for the day.

 

 

Do Sleeping Tablets Work?

 

The answer is yes, it depends, not much and not really. Initially they have a strong sedative effect, however this wanes after 2 weeks or so and gradually tapers off. It does depend on which sleeping tablet, as well as interactions with other medications and other substances, especially alcohol. A meta-analysis, see link below, estimates they only achieve an extra 20 minutes of sleep per night. Balanced against the increased risk of falls, driving accidents and general brain fog, good sleep hygiene is a much better idea.

 

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010703.pub2/full?highlightAbstract=sleep

 

Sleep and Immunity

 

 

While there is a paucity of data looking at the effect of sleep and COVID-19, we already know that shift workers had elevated risks of COVID-19 incidence and severity. The below studies highlight how sleep may adversely affect immunity:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5554442/pdf/nihms889580.pdf

Volunteers with insomnia mounted an inferior immune response to the influenza vaccine;

https://academic.oup.com/sleep/article/38/9/1353/2417971 

 

164 volunteers were quarantined for a week then given rhinovirus intranasally, those who were under-slept were twice as likely to get the cold. 

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