Ig­nor­ing our body clock

Irish Examiner - Feelgood - - Feature -

LACK of sleep brings with it an ar­ray of ill-ef­fects — it’s been linked with ev­ery­thing from ir­ri­tabil­ity, de­pres­sion, and anx­i­ety to poor mem­ory and con­cen­tra­tion, weight gain, obe­sity, and high blood pressure.

It can even lead to traf­fic ac­ci­dents.

We’re fa­mil­iar with the con­cept that lack of sleep is bad for us — yet re­search shows that just over 40% of Ir­ish peo­ple notch up a bare six hours’ sleep or less on an av­er­age week­night.

We continually sub­ject our­selves to sleep de­pri­va­tion, even though, ac­cord­ing to the World Health Or­gan­i­sa­tion, adults gen­er­ally need be­tween seven and nine hours’ sleep a night.

It’s a big is­sue, warns Pe­ter Coss, head of the res­pi­ra­tory and sleep labs at St James’s Hospi­tal in Dublin, who points to US re­search which found up to a third of peo­ple slept less than seven hours a night.

We’re sim­ply not ac­knowl­edg­ing the im­por­tance of sleep, says Dr Elaine Purcell, con­sul­tant in sleep dis­or­der medicine in the Mater Pri­vate Hospi­tal.

“Peo­ple don’t put enough em­pha­sis on the im­por­tance of get­ting enough sleep,” she says.

“In the western world to­day there is an epi­demic of sleep de­pri­va­tion across all age groups.

“This par­tic­u­larly wor­ry­ing in chil­dren and teenagers be­cause sleep de­pri­va­tion can have a neg­a­tive im­pact on the de­vel­op­ment of chil­dren for ex­am­ple, in terms of their phys­i­cal growth,” says Dr Purcell, who ex­plains that lack of sleep can dis­rupt a child’s pro­duc­tion of cru­cial growth hor­mones which can se­ri­ously af­fect their growth.

Even though many peo­ple are con­scious of the cru­cial role played by diet and ex­er­cise in their over­all health, they will “of­ten ne­glect sleep”, she says.

“We must em­pha­sise the im­por­tance of sleep as a vi­tal part of peo­ple’s health,” she says, adding that she be­lieves any­one who has dif­fi­culty sleep­ing should dis­cuss it with their GP.

As a na­tion we cer­tainly have a prob­lem. Ac­cord­ing to Awake, a re­cent RTÉ doc­u­men­tary on the is­sue, more than 40% of us notch up a bare six hours’ sleep or less on an av­er­age week­night. Around 27% of peo­ple use al­co­hol to help them

sleep, while 18% use sleep­ing tablets.

In­som­nia is a par­tic­u­larly com­mon prob­lem with up to 15% of peo­ple suf­fer­ing from the con­di­tion which leads to dif­fi­culty in fall­ing asleep or stay­ing asleep.

Me­te­o­rol­o­gist Joanna Don­nelly has spo­ken openly about the de­bil­i­tat­ing ef­fects of the con­di­tion while ITV po­lit­i­cal edi­tor Tom Bradby re­cently took an ex­tended break from work to ad­dress his chronic in­som­nia.

“In­som­nia is the most com­mon sleep dis­or­der — re­search shows that it af­fects be­tween 10% and 15% of peo­ple,” ex­plains sleep phys­i­ol­o­gist Breege Leddy, man­ager of the sleep and clin­i­cal phys­i­ol­ogy de­part­ment in the Mater Pri­vate.

Some peo­ple may be more vul­ner­a­ble to in­som­nia as a re­sult of ge­net­ics, fam­ily his­tory, or the menopause, she ex­plains.

For oth­ers, sig­nif­i­cant life events such as be­reave­ment, ill­ness, stress, or med­i­ca­tion can be a fac­tor, while in­som­nia can also be a prob­lem for peo­ple who worry or ru­mi­nate ex­ces­sively.

How­ever, ex­plains Leddy, there is hope. Cog­ni­tive be­havioural ther­apy (which helps you un­der­stand that your thoughts and ac­tions can af­fect the way you feel) has proven to be suc­cess­ful in treat­ing the con­di­tion.

“It’s about chang­ing the way peo­ple think about sleep, as well as about their be­hav­iour and lifestyle,” she ex­plains.

About 10% of peo­ple suf­fer from other sleep dis­tur­bance is­sues such as nar­colepsy (ex­ces­sive day­time sleepi­ness), rest­less legs syn­drome (a strong urge to move one’s legs at night), or sleep ap­nea, a se­vere sleep dis­or­der which oc­curs when a per­son’s breath­ing is in­ter­rupted dur­ing sleep. Peo­ple with the con­di­tion may stop breath­ing re­peat­edly dur­ing sleep, which means the brain and the rest of the body may not get enough oxy­gen.

“If you’re sleep­ing un­der seven hours a night it can lead to psy­cho­log­i­cal and neu­ral deficits, but more and more peo­ple are re­port­ing sleep­ing less than six hours a night,” says Coss.

“When you’re sleep de­prived, your body tries to in­crease the drive to sleep in or­der to re­cover sleep, so you’ll be tired or sleepy, which can mean you are putting your­self at in­creased risk of an ac­ci­dent, for ex­am­ple, when driv­ing.”

If you suf­fer from chron­i­cally in­suf­fi­cient sleep, you’re also at a higher risk of de­vel­op­ing di­a­betes, obe­sity, high blood pressure, and stroke. “Ir­reg­u­lar sleep pat­terns can af­fect mood and lead to de­pres­sive symp­toms,” he says.

For those of us who don’t suf­fer from med­i­cal con­di­tions like sleep ap­nea or nar­colepsy, one of the big­gest fac­tors in achiev­ing a good night’s rest is main­tain­ing a good per­sonal sleep regime.

Ac­cord­ing to Coss, what this means is we need to go to bed around the same time each night — prefer­ably be­fore mid­night to al­low for at least seven hours’ sleep — and not stay up ’til the early hours binge-watch­ing the lat­est boxset.

It also means ban­ning the TV and our beloved hand­held tech de­vices from the bed­room. They emit a blue light which can de­lay the on­set of sleep.

“We are very con­cerned about ex­ces­sive screen ex­po­sure in the lead-up to bed­time in all age groups. This de­lays peo­ple’s abil­ity to fall asleep and re­duces the over­all amount of sleep they get be­cause they are stay­ing up late,” says Dr Purcell, who warns that the gen­eral ad­vice is to shut off all screens two hours be­fore bed­time.

In fact the Amer­i­can Academy of Pae­di­atrics has iden­ti­fied elec­tronic me­dia use along with caf­feine con­sump­tion as some of the main causes of sleep de­pri­va­tion in teenagers. Coss ad­vises peo­ple who have dif­fi­culty sleep­ing to avoid caf­feine af­ter mid­day.

“We need to have a na­tional con­ver­sa­tion about sleep and the im­por­tance of sleep — it’s seen as some­thing that has to com­pete with work and so­cial life, but we should view sleep in the same way as we do a good diet and ex­er­cise,” he says.

One of the main rea­sons we’re not sleep­ing enough these days is that we’re ig­nor­ing the nat­u­ral rhythms to which our bod­ies are at­tuned, be­lieves Or­laith Donoghue, clin­i­cal lead for the Well­ness Re­cov­ery Ac­tion Pro­gramme at St John of God’s Hospi­tal.

“Sleep plays a ma­jor role in our health. It takes up one-third of our time,” she says, point­ing out that, although many peo­ple un­der­stand why we need to sleep, nowa­days they tend to ig­nore it.

Tempted by the many dis­trac­tions and de­mands of mod­ern life, we’re ig­nor­ing our body’s nat­u­ral ‘off’ but­ton, she warns.

And yes, there is a price to pay.

“The ev­i­dence is that too lit­tle sleep is as­so­ci­ated with a de­crease in con­cen­tra­tion and cre­ative think­ing, and there’s an im­pact on mood — we be­come cranky and feel vul­ner­a­ble,” she says.

“Our mem­ory can be af­fected be­cause dur­ing sleep we of­ten process things, which helps us to re­mem­ber. There­fore, when we don’t get suf­fi­cient sleep, it af­fects the pro­cess­ing of these mem­o­ries and that af­fects our abil­ity to re­call things.”

If all of that wasn’t enough, our im­mune sys­tem can also be de­pleted by lack of sleep, says Donoghue, while our bal­ance and co-or­di­na­tion may be af­fected be­cause of tired mus­cles.

So it’s worth pay­ing at­ten­tion to your body and get­ting the sleep it des­per­ately needs.

“As a so­ci­ety we’re very driven,” says Donoghue. “We’re liv­ing in an age where the more you do the bet­ter you are. There­fore the more things you can say you are jug­gling and bal­anc­ing the bet­ter,” she says, point­ing out that the age-old tra­di­tions of Sun­day as a rest-day for ex­am­ple, is al­most ex­tinct, while many peo­ple now don’t even take a lunch break.

Be­cause so many of us keep press­ing that ‘on’ but­ton, the body can for­get how the ‘off’ but­ton works, which means we lit­er­ally lose the knowl­edge of how to sleep. Many peo­ple are jump­ing into bed in fifth gear and then won­der­ing why they can­not sleep, says Donoghue.

about for­get­ting how to wind down. To wind down you need to take breaks dur­ing the day. You have to be able to take rest breaks be why cause they set the blue­print for hav­ing a good night’s sleep.”

We also need to know where we fit on the WHO-in “It’s di­cated range of seven to nine hours of sleep.

“Pay at­ten­tion to your body. Re­mem­ber, sleep is largely about habit and rou­tine,” she says, adding that we not only need to go to bed at a reg­u­lar time, but we also need to get up at the same time ev­ery morn­ing.

“Lie-ins should not last for more than half an hour to an hour later than your nor­mal ris­ing time.”

And watch that caf­feine in­take — we’re of­ten over­stim­u­lated, warns Donoghue, point­ing to stu­dents tak­ing caf­feine tablets and stressed em­ploy­ees drink­ing high-caf­feine drinks to help them push through a long day.

Donoghue, who runs sleep work­shops in the hospi­tal, says the fa­cil­i­ta­tors al­ways ask peo­ple when is the time to start get­ting ready for bed.

“Most peo­ple will say about one hour be­fore bed. How­ever, the re­al­ity is you start get­ting ready for bed when you get out of bed in the morn­ing, be­cause you have to man­age your en­ergy, main­tain your fo­cus, and structure your day around work time, rest breaks, and phys­i­cal ex­er­cise.

“Re­search shows that peo­ple who are rested are more pro­duc­tive and achieve more, not less.”

“Pay at­ten­tion to your body. Re­mem­ber, sleep is largely about habit and rou­tine

Why don’t we treat sleep as im­por­tantly as ex­er­cise and diet? Get­ting enough is es­sen­tial, writes Áilín Quin­lan

Pic­ture: Moya Nolan

WIDE AWAKE: Me­te­o­rol­o­gist Joanna Don­nelly has spo­ken openly about the de­bil­i­tat­ing ef­fects of in­som­nia.

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