The Great Sleep Robbery

 

Are you getting enough sleep each night and waking up feeling refreshed in the morning? If you work in the health service, I’m guessing the answer is a resounding NO! If you’re also a parent of young children, then I don’t even need to ask…

In 1924, the average adult slept for 9 hours per night. Fast forward a century and the average number of hours sleep is just 7. So, what happened to those 2 hours? Have humans evolved so dramatically in that time that we now need less sleep? Or is something robbing us of that much needed rest and recovery in these modern times? I’m convinced that the truth lies with the latter…

Perhaps the biggest influence here in the past century has been the advent of electricity, bringing artificial light and various bright screens into every home. Add in our present-day 24-hour culture, multiple sources of stress and shift work – now perhaps we’re starting to identify the thieves who are carrying out this great robbery.

Unfortunately, the consequences of this theft go beyond just feeling a bit tired and weary. Sleep doesn’t just help us recharge and replenish energy stores, it is essential to the normal functioning of every body system. We usually think of sleep as a time of being shut down or inert, but it’s actually a very active period, especially in our brain. Sleep is when memories are consolidated, emotions are regulated, tissue repair happens, and cellular waste products are removed. It’s also when our immune system and bodily metabolism are re-balanced.  Perhaps this helps us understand why poor sleep is associated with low mood, forgetfulness, slow healing and also with a tendency to develop poor immunity to infection, weight gain and Type 2 Diabetes.

Shift work, particularly when it involves sporadic night shifts, has a singularly negative effect on sleep quality. There’s a mounting body of evidence pointing towards an association with night shifts and all of the health consequences above, but also with several chronic diseases including cardiovascular disease and cancer.

When thinking about how to improve our sleeping, it helps to consider what happens in normal, healthy night-time sleeping – the kind probably enjoyed by our great-great-grandparents! Scientists using electroencephalogram (EEG) brain wave monitoring have described 4 distinct wave patterns which make up the various stages of sleep – these can be more simply described as wakefulness, light sleep, deep sleep and Rapid Eye Movement (REM) sleep. While asleep, we pass through the sleep stages in roughly 90-minute cycles, with a healthy night’s sleep having 5 cycles. Each stage is necessary to allow sleep to perform all the functions described above. For example, REM sleep is when we dream, but it is also a time of laying down memories. In children, it is thought that brain growth happens during REM sleep.

So, how can we maximise the likelihood of getting 5 cycles of restorative, quality sleep?

At this point we need to talk about “sleep hygiene,” which is the planning and discipline around getting your body ready to sleep. Humans have evolved over many thousands of years to have a natural day to night cycle, known as our Circadian Rhythm. This rhythm involves a mounting feeling of sleepiness in the evening, which is accompanied by a rise in a hormone called melatonin. This rise is stimulated by darkness and is supressed by light hitting our eyes. Light, particularly in the form of blue-wave light emitted from screens (especially smart phones), is what will keep us awake when it’s dark outside - and make it difficult to fall asleep when we want to. 20 years ago, we might have watched TV late into the evening, but nowadays it’s our smart phones that are shining blue-wave light onto our retinas. Having a period of about an hour before we want to sleep with no screens of any kind is a great habit to get into. This hour is also an excellent time to “decompress” our minds and allow some winding down before sleep. If you tend to wake during the night with your brain full of thoughts, having this time to process what has happened during the day can be therapeutic. Journaling or writing down your thoughts and plans is another evidence-based way to enhance quality sleep.

Here are my Top 5 Tips for getting quality sleep and keeping the slumber thieves at bay:

1.     Keep your smart phone out of your bedroom. Charge it downstairs. If you use it as your alarm clock, buy an alternative. If you absolutely need to have it nearby to remain contactable, place it away from your bedside table. Smart phones are the number one culprit implicated in sleep theft.

2.     When time allows, get outside into fresh air during the day. Natural daylight really aids maintenance of your Circadian Rhythm and helps with getting to sleep.

3.     Life is super busy but try to schedule in some kind of regular exercise. The link between aerobic exercise and quality sleep is well established.

4.     Try to have a routine with a regular bedtime, including at weekends, with regular wake up times too. Our body craves and responds to routine – something we appreciate with toddlers but tend to neglect with ourselves.

5.     Drinks - avoid coffee or other caffeine sources from the afternoon onwards. Try alternatives like herbal tea if you’re in the habit of having a late hot drink. Alcohol might help some people get to sleep (the “nightcap”) but when it wears off a few hours later it usually results in broken, poor-quality sleep.

These are just my thoughts on sleep – if you have a problem with sleep or a related medical condition you should absolutely consult your own doctor.

Some great advice and more tips on getting better sleep is available from the NHS “Every Mind Matters”, found here.

If you’re a shift worker I can recommend the guidance put together by the BMA for night shifts, found here.

Making small changes can make a big difference to how well you sleep. Your mind, your body and everyone around you will thank you!