ARE YOU SLEEP­LESS IN THE UAE?

More than 65 per cent of peo­ple in the coun­try don’t get enough sleep, dis­cov­ers Colin Drury

Friday - - Sleep Special -

IIt is some­thing which many of us – in fact most of us – in the UAE reg­u­larly wear like a badge of hon­our: Sur­viv­ing on min­i­mal sleep. A com­pet­i­tive work cul­ture, hec­tic nightlife, an am­bi­tious and tran­sient pop­u­la­tion all mean shut-eye is of­ten con­sid­ered of sec­ondary im­por­tance.

Be­ing the last to leave the party and the first to ar­rive at your desk tends to be the goal here. Al­most two-thirds of us don’t get as much snooze time as we should, ac­cord­ing to one es­ti­mate.

Sleep, it seems, is for wimps and peo­ple in other places. Ex­cept it’s not. A con­tin­ual lack of Zs will, doc­tors warn Fri­day read­ers to­day, re­sult – like mal­nu­tri­tion and de­hy­dra­tion – in ir­re­versible long-term health dam­age.

Miss­ing just an hour a night over a sus­tained pe­riod has been linked to strokes, heart at­tacks and can­cer. Be­cause even mi­nor sleep de­pri­va­tion hits the im­mune sys­tem, it leaves us vul­ner­a­ble to more ill­nesses. The fact it sig­nif­i­cantly slows the me­tab­o­lism, too, means it in­creases our risk of obe­sity and di­a­betes – and all the as­so­ci­ated health prob­lems.

Men­tally, not enough sleep can cause clin­i­cal de­pres­sion, anx­i­ety, mem­ory loss and mood swings. Those ef­fects start tak­ing hold within days. Be­cause it de­stroys our brain’s abil­ity to func­tion at its op­ti­mum, it has been quoted as a con­tribut­ing fac­tor in in­dus­trial deaths and fa­tal mo­tor ac­ci­dents alike.

‘It is not an ex­ag­ger­a­tion to say this is an in­vis­i­ble killer,’ says Dr Ir­shaad Ebrahim, con­sul­tant neu­ropsy­chi­a­trist and med­i­cal di­rec­tor at The Lon­don Sleep Cen­tre in Dubai Health­care City. ‘If you don’t sleep enough, you are build­ing up ei­ther an im­me­di­ate or fu­ture health cri­sis. It is that se­ri­ous. It will af­fect your life ex­pectancy.’

All of which per­haps raises two ma­jor ques­tions: what ex­actly is the right amount of sleep? And, when we’re all

lead­ing such hec­tic lives, how can we get more of the stuff?

Too much to do, no time to sleep

A lack of sleep is by no means a phe­nom­e­non unique to the UAE.

Try­ing to squeeze more hours into the day – which gen­er­ally means less hours in bed – is a univer­sal trait. The on­slaught of screens into our lives has ex­ac­er­bated things with re­peated stud­ies show­ing that us­ing lap­tops, mo­biles and TVs at night dis­rupts brain pat­terns and re­sults in dif­fi­culty nod­ding off. The rise of rich sug­ary and salty snacks hasn’t helped ei­ther. These foods dis­rupt nat­u­ral en­ergy cy­cles, and, if eaten close to bed time, re­sult in dis­turbed sleep.

Yet, if the above can be con­sid­ered global fac­tors, there are also more lo­calised con­sid­er­a­tions which may ex­ac­er­bate the is­sue here in the Gulf.

Apart from the work and so­cial cul­ture, global-lead­ing cities like Dubai and Abu Dhabi in­evitably come with night-time noise and light which makes snooz­ing harder. The heat of sum­mer and the lack of fresh air can also cre­ate less than ideal sleep­ing con­di­tions.

Be­cause much of the pop­u­la­tion is from another part of the world, there is a ten­dency for peo­ple here to live by mul­ti­ple time zones, whether that be for work (ar­riv­ing early to sync with Asian of­fice times, per­haps) or per­sonal rea­sons (how many of us have stayed up late talk­ing to loved ones on Skype?).

There is another cau­sa­tion fac­tor too, ac­cord­ing to Dr Manio von Mar­avic, neu­rol­o­gist at the Ger­man Neu­ro­science Cen­ter, also in Dubai Health­care City: Stress. For many peo­ple here, con­tin­u­ing res­i­dency is in­ti­mately linked with job se­cu­rity – and that can in­crease pres­sure at work.

‘The ev­i­dence is that cer­tainly im­pacts on sleep here,’ says Dr von Mar­avic, who has 30 years’ ex­pe­ri­ence work­ing in neu­ro­log­i­cal de­part­ments across Europe. ‘It can make it es­pe­cially dif­fi­cult to switch off.’

The re­sult of all this, ac­cord­ing to a 2015 sur­vey by data re­search firm Zarca, is that 65 per cent of peo­ple in the UAE don’t sleep enough. ‘Sleep de­pri­va­tion is a ne­glected area which can cause ma­jor health and so­cial is­sues,’ said Javed Fa­rooqui, ex­ec­u­tive di­rec­tor, at the time.

And 18 months on, ex­perts reckon the prob­lem is only set to get worse.

‘The fig­ures are wor­ry­ing,’ says Dr Ebrahim again. ‘Be­cause what it shows is that peo­ple do not take this is­sue se­ri­ously. They think they can get away with lack of sleep. They think it doesn’t af­fect them. But, if they are hu­man, it will.’

Qual­ity over quan­tity

It is a strange quirk of sci­ence that for some­thing so im­por­tant to hu­mans, the ex­act way sleep works – and the rea­son we need so much – re­mains some­thing of a mys­tery.

What we do know is that there are two broad cat­e­gories of slum­ber: Non-Rapid Eye Move­ment (NREM) and Rapid Eye Move­ment (REM).

The for­mer takes up about 75 per cent of our snooze time and is the lighter of the two.

‘Dur­ing this stage,’ says Dr Ebrahim, ‘the body rests, re­stores and grows – blood pres­sure drops, mus­cles relax, breath­ing slows and tis­sues are re­paired.’ Broadly, it is about phys­i­cal re­ju­ve­na­tion.

REM sleep, by con­trast, is far deeper. At this point, the body goes into a state of paral­y­sis but the brain be­comes ac­tive. It is now that we dream.

‘The ac­tiv­ity here is geared to sup­port­ing the brain,’ ex­plains Dr Ebrahim, who runs sleep cen­tres in Lon­don, Ed­in­burgh and Pretoria as well as in Dubai. ‘In sim­ple terms, the hard­ware is de­fragged, tested and re­ordered; files are slot­ted away and in­for­ma­tion re­or­gan­ised.’

A process called con­sol­i­da­tion si­mul­ta­ne­ously oc­curs dur­ing both stages. ‘Our brains take in a huge amount of in­for­ma­tion ev­ery day but this is gen­er­ally stored in a short-term bank,’ con­tin­ues Dr Ebrahim. ‘When we sleep, the facts and ex­pe­ri­ences which we con­sider im­por­tant are pro­cessed and trans­ferred – con­sol­i­dated – to our long-term store.’

Dur­ing a good night’s sleep, we will ex­pe­ri­ence both the NREM and REM phases about seven or eight times each, in an al­ter­nat­ing cy­cle. It is, how­ever, when the num­ber of these cy­cles is con­sis­tently re­duced – be­cause we are not asleep long enough – that the health dan­gers be­gin.

As Dr von Mar­avic nicely puts it: ‘cut­ting down the cy­cles means not giv­ing your body and brain the chance to do all the work they need done.’

We are, es­sen­tially, wak­ing up and start­ing again with our hard­ware still dam­aged and

slowed from the day be­fore.

In­deed, it is for this rea­son that sleep can­not be ‘paid back’. Catch­ing up on Zs over the week­end is largely con­sid­ered okay by ex­perts. But if we live off too lit­tle slum­ber for too long, the dam­age done to our bod­ies can­not be put right again.

It is per­ma­nent.

How much is enough?

Seven hours tends to be what peo­ple think of when the ideal amount of sleep is raised. This is both true and false. True, be­cause, broadly speak­ing and ac­cord­ing to the US-based Na­tional Sleep Foun­da­tion – widely con­sid­ered the world’s lead­ing author­ity on the sub­ject – seven or eight hours is typ­i­cally what an adult should aim for (for chil­dren and teenagers, it’s nine to ten). But false, be­cause every­one is dif­fer­ent. Some peo­ple need more. Oth­ers can gen­uinely thrive on less. When Mar­garet Thatcher claimed to live on four hours’ sleep a night, she wasn’t nec­es­sar­ily ex­ag­ger­at­ing; she may have just been one of the lucky peo­ple whose bod­ies and brains re­fresh quicker.

‘The ex­act amount is dif­fer­ent for each in­di­vid­ual,’ says Dr Ebrahim.’

The best way to judge your own re­quire­ments is sim­ple: it’s all about how you feel when you wake up.

If you wake up re­freshed and ready for the day, this is a good sign. If you go all day with­out ex­pe­ri­enc­ing sensations of tired­ness, fa­tigue or weari­ness, even bet­ter.

But if ei­ther of these things aren’t true, you’re al­most cer­tainly not sleep­ing enough.

Are you count­ing sheep?

In the real world, achiev­ing a good night’s slum­ber, how­ever, is not that easy.

‘Fol­low­ing a good sleep rou­tine and hav­ing a healthy sleep en­vi­ron­ment can make all the dif­fer­ence in, firstly, get­ting to sleep, and, se­condly, en­sur­ing that is re­ally ex­cel­lent qual­ity sleep,’ says Dr von Mar­avic.

Key to that is en­sur­ing your bed­room is de­signed to be sleep-in­duc­ing: quiet, dark and cool. Spend some time get­ting a mat­tress and bed­ding that feels right. Per­haps most im­por­tantly, re­mem­ber the func­tion of this room is to rest. Keep­ing work ma­te­ri­als out will help it be­come a space of re­lax­ation, while avoid­ing eat­ing smelly food will main­tain its fresh­ness.

Es­tab­lish­ing a pre-bed rou­tine is im­por­tant as well – ‘to ease the tran­si­tion from wake time to sleep time,’ says Dr von Mar­avic.

An hour or two re­lax­ing be­fore lights out could in­clude a bath (body tem­per­a­ture ris­ing and fall­ing pro­motes drowsi­ness), read­ing a book or prac­tic­ing yoga or mind­ful­ness. The lat­ter is a firm favourite with Car­men Ben­ton, founder of Mind­ful Ed per­sonal de­vel­op­ment con­sul­tancy based in Al Su­fouh, Dubai.

‘It clears your mind of all the day’s stress, mean­ing, by the time your head touches the pil­low, you’re ready to sim­ply let sleep take over,’ she ex­plains.

Need­less to say, avoid­ing stress­ful sit­u­a­tions – in­clud­ing work projects and so­cial me­dia – is para­mount, as these stim­u­late alert­ness. Caf­feine and nico­tine, as well as screens and sug­ary snacks, should be ditched in this pe­riod too.

Along sim­i­lar lines, it’s worth eat­ing your evening meal early to avoid it still be­ing di­gested when you turn off the light. Drink enough in the evenings to keep you hy­drated through the night but not so much you need to keep vis­it­ing the toi­let.

And – coun­ter­in­tu­itive, per­haps, but key – get up when the alarm goes off. The oc­ca­sional lie-in will do no harm but if we sleep too long in the morn­ing, it can make get­ting to sleep at night more dif­fi­cult, thus cre­at­ing a vi­cious cir­cle.

As for pre­cisely when to sleep, this is rather open to de­bate. Some ex­perts say that snooz­ing from just be­fore mid­night un­til six or seven is best. But Dr Ebrahim takes a less pre­scribed view.

‘Each per­son can build their own sleep ar­chi­tec­ture de­pend­ing on their per­sonal pref­er­ence, cul­tural norms and so­cial needs,’ he says. ‘So, if a per­son de­sires a siesta in the af­ter­noon and to sleep less in the evening, this is fine. It is about cre­at­ing a pat­tern that is right for you, that al­lows you to achieve your op­ti­mum.’ There is a fi­nal point here too. If you’ve fol­lowed all the above and are still strug­gling to nod off or sim­ply not feel­ing fully rested when you wake, it could be there is some kind of sleep dis­or­der in play.

These are many and var­ied – from in­som­nia, where one strug­gles to fall off, to sleep apnoea, where a per­son’s breath­ing keeps paus­ing and, hence, break­ing their sleep pat­tern. Sleep walk­ing, paral­y­sis (feel­ing con­scious but un­able to move) and chronic fa­tigue syn­drome also falls into the cat­e­gory of dis­or­der.

‘These is­sues are all quite dif­fer­ent and can be caused by a va­ri­ety of things from ge­netic con­di­tions to en­vi­ron­men­tal fac­tors,’ says Dr Ebrahim. ‘But the key thing is that when a per­son sus­pects they have a dis­or­der, they should see a doc­tor and have it di­ag­nosed be­cause then it can all be treated, ei­ther with medicines, coun­selling or even ex­er­cises. To not have it treated, on the other hand, is to risk far more se­ri­ous health prob­lems aris­ing in the fu­ture – be­cause you are not hav­ing all the sleep you need now.’

All of which makes the con­clu­sion re­ally rather sim­ple: a good night’s sleep is not just some­thing we should dream about. It is some­thing we should all make hap­pen.

Catch­ing up on Zs over the WEEK­END is largely con­sid­ered okay by ex­perts. But if we live off too lit­tle SLUM­BER for too long, the DAM­AGE done to our bod­ies can­not be put right again

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