Lack of sleep- a growing global epidemic!

4 Sept

Written by Wendy Hutt

A study by the RAND Corporation 2016 (1) found startling results around the lack of sleep for employees, less than seven hours a night and the cost to the UK economy of £40 billion a year. Putting this in perspective that is 1.86% of GDP which is as much spent on the UK’s military. Imagine if we put that money into our education system instead and had a national focus on Sleep. Matt Walker in his book 'Why we sleep' states “the World Health Organization now labels the lack of societal sleep as a global health epidemic.” (2) Of course, this is not confined to big business, I am sure we all know someone who has sleeping difficulties and it is not just sleep deprived parents.

So, lets discuss all things sleep related. I believe adamantly in the benefits of good sleeping habits for our overall health and wellbeing. During the Covid Pandemic I retrained as a Sleep Consultant for young children but I am sharing the knowledge here to help parents and adults who may be experiencing sleeping issues. I am very passionate about my own sleeping routine and guard it fiercely!

I am going to cover some areas of sleep physiology and healthy sleep associations. Many of the tips I use for children can also help adults but they take a degree of self-control, discipline and breaking of old habits.

Reset your circadian rhythm (24-hour internal body clock) every morning within 30 minutes of waking either through natural, outdoor daylight or turning on artificial lights. Those lie ins in the darkness do not help.

Dimming lights an hour before bedtime is hugely beneficial as it allows the melatonin (sleepy hormone) to develop. Modern day LED ceiling lights and bare light bulbs play havoc with night-time sleeping, they are far too bright and stimulating. Try to have a couple of dim lights around the house/flat ideally with an orange/red glow. Getting 20 minutes or so of natural light around sunset can help protect the eyes/retina against late night light.

If you need to get up in the night aim to have a small, dim, portable night light to take with you instead of turning on bright lights which can disrupt your sleep cycles and may stimulate and wake you. In a normal sleep period, we usually have four to six sleep cycles, each lasting between 70 to 120 minutes, the average is 90 minutes. You may be aware as you pass in and out of these through the night, waking slightly, rolling over, sticking your arms/legs out the bed. (3)

This tip is one where self-control is key, not looking at electronic devices- mobile telephones, iPhones, portable computers/iPads, laptops for an hour before bedtime. I know this is controversial and difficult, as so many of us are ‘addicted’ or rely on them for a much-needed mental break, they run and often contain our whole personal and professional lives! However, the blue screen delays the development of melatonin, crucial to helping us fall asleep. Much like bright lights, they activate the brain, precisely at the time you want it to become inactive Try picking up a book when you go to bed, I am lucky if I manage two pages. I took the TV out of my bedroom over ten years ago.

Certain foods are beneficial in the evening- including cheese, WHAT I hear you say - all those tales of nightmares from eating cheese. Cheese contains tryptophan’s (found in plant and animal products). Our bodies need tryptophan’s, they are essential amino acid needed for general growth and the development of Serotonin, a hormone that effects our mood and helps to regulate sleep. It is converted into the sleep hormone melatonin which helps regulate the sleep-wake cycle whilst serotonin helps regulate appetite, sleep, mood, and pain. (4)

Foods containing tryptophan’s include milk, canned tuna, salmon, chicken and turkey, oats, nuts and seeds, tofu, soyabeans, tempeh, legumes, bread, chocolate, some fruits- banana, apple and prunes.

A hot bath or shower, taken before bedtime is beneficial because it pushes heat to our extremities, our hands and feet, drawing our core body temperature down which in turn helps the production of melatonin. As our temperature drops it helps us feel sleepy. (5)

Chamomile tea can help ‘turn your thoughts’ off at night, so have a cup of herbal tea, making it with warm milk and honey can be really relaxing too.

Alcohol and sleep are an interesting area, many people say having a drink, relaxes them and helps them sleep better. Yes, with alcohol you may crash straight out and feel like you are in a deep sleep, but you have actually sedated yourself heavily. You are missing the quality of the NREM -deep sleep stage where the important physiological benefits happen including the restorative stage our body need to recover and repair itself. And it affects your REM stage (rapid eye movement) important for emotions, consolidating memories and clearing away things the brain does not need. Alcohol may make you frequent the bathroom more often, causing you to lose more fluids making you dehydrated. It can also make you snore! So, if you are drinking more than the recommended units a week to help you sleep, for prolonged periods, chances are it is causing detrimental effects and some longer-term disadvantages to your sleep and general health. (6)

I cannot talk about alcohol and not mention caffeine. Many people use caffeine to help them feel perky and keep them awake. Walker (7) discusses caffeine and how it works by blocking adenosine. This chemical builds up throughout the day, it acts as sleep pressure, the longer you have been awake the more it makes you feel sleepy, as it peaks towards the end of the day. Caffeine blocks adenosine in the body. It is a stimulant and tricks your body into feeling like it is alert and awake. Caffeine has an average half-life of five to seven hours. So, if you have a cup of coffee early evening, around 5:30p.m. This means that by 11:30 p.m., 50% of the caffeine may still be active and circulating through your brain and body affecting your sleep.

The diagram below shows an experiment on spiders by NASA in 1995. (8) The effects of caffeine are by far the worst, affecting the spider’s ability to build its web. Caffeine being a legal, psychoactive stimulant fared the worst for the spider over illegal drugs!

For ladies of a certain age, half the Global population, this discussion cannot forget to mention the Menopause. Research shows as women move into their late 40s to early 50’s, as many as 40 percent report changes in their sleeping habits. (9) This can have a real impact on sleep routines, levels of cortisol have been shown to rise at a disproportionate rate at night-time, which can lead to increased feelings of stress and anxiety. (10) There are many herbal, non-medical, complementary alternatives available. But I think there needs to be more sympathetic understanding of Hormone Replacement Therapy HRT by our doctors. (11) For me, HRT was a life-changing solution to my insomnia of over 3 years! I would also advocate discussions with your friends and partners, sharing your problems and getting much needed support.

There are other many factors that can help with sleep including temperature of your bedroom, darkness of room, sounds, pillows, bedding, natural daylight exposure, the list could be endless. But sometimes tweaking a few issues can have remarkable results.

Walker (12) talked, with caution, about using alarms to wake us up. I confess to having at least three with 15-minute intervals, the first so I get a 15-minute lie in, the second, I make a cup of tea and return to bed with my partner, the third is the final ‘get out of bedtime!’ Walker warns against the use of a sudden loud alarm as it raises our blood pressure and puts us in our fight or flight mode with our nervous system and body flooding with cortisol and adrenaline. He warns that constantly doing this takes its toll on our hearts and central nervous system over a lifetime. Try to find a gentle sound to wake up with so you are not startled and, in that fight or flight mode before you begin your day!

The benefits of having a good routine and restful sleeps cannot be overexaggerated. We know the consequences of failure to sleep. It pervades all aspects of a person’s life. During sleep your body gets the chance to rest and repairs itself and the immune system, it improves your attention and concentration, your brain organises and processes all the information that has taken place during the day. Short-term memories are consolidated and converted to long-term memories, your central nervous system returns to homeostasis- your heartbeat lowers, your body temperature drops, your body is replenished, it regulates your metabolism, controls your weight. Sleep, is indeed, a miraculous phenomenon.

References

1 Lack of Sleep Costing UK Economy Up to £40 Billion a Year | RAND

2 Walker, M. (2017) ‘Why we sleep. ‘The new science of sleep and dreams.’ (p 294-297)

3 Light & Sleep: Effects on Sleep Quality | Sleep Foundation

4 Tryptophan: MedlinePlus Medical Encyclopedia Food For a Good Night's Sleep – Sleep Corp

5 Try a Hot Bath Before Bed for Better Sleep (healthline.com)

6 Alcohol and sleep | Drinkaware

7 Walker, M. (2017) ‘Why we sleep. ‘The new science of sleep and dreams.’ (p 26-29))

8 When NASA gave spiders drugs to see how it affected their webs, 1995 - Rare Historical Photos

9 How Can Menopause Affect Sleep? | Sleep Foundation

10 The menopause is a time of huge hormonal upheaval in a woman’s body, so it’s not surprising that the process can have a big impact on your sleep. (sleepstation.org.uk)

11 Hormone replacement therapy (HRT) - NHS (www.nhs.uk)