Let’s talk about sleep

Let’s talk about sleep.

I recently travelled quite a bit, purely for pleasure and it was all lovely, except for some flight delays which really disrupted my sleep. When it comes to sleep, both quality and  quantity matter so I thought I would talk about that this month. We have all experienced sleep deprivation, whether due to a long-haul flight to a different time zone, or a very delayed one or because we were burning the candle at both ends. After a good night’s sleep, we feel so much better, our energy is restored, and we are ready to face another day.

Data suggests that over the past several decades, we have been getting less and less sleep and deprivation is extremely common. Work takes priority in many people’s lives, and long work hours mean that social and family life is reduced to late evenings and weekends. Sleep, for many, seems like a luxury that few can afford. In our performance-centred world, sleeping may even be seen as a sign of laziness and weakness. You may believe that you are someone who just doesn’t need a lot of sleep or you might really want to sleep, but for many reasons such as noise disturbance or anxiety and worries you just can’t.

Public health people (like me) commonly spout that we are supposed to get 7-9 hours of sleep every night. But is it really that important? Margaret Thatcher famously managed to run a country on just 4 hours sleep per night.

Sleep is vital for health and wellbeing, and not only do we function less well when we don’t get enough good quality sleep, but it can lead to long-term health problems. The average person spends around a third of their life asleep during which the body can replenish energy stores and make repairs, while the mind organises and stores the memories of the day before.

The amount of sleep you need depends on many different factors such as age, sex, health, and other elements. Plus, our sleep patterns change as we grow older, impacting how we sleep. Research has found that people who frequently get fewer than six hours a night are at significantly increased risk of stroke and heart disease. Evidence suggests that not sleeping enough may ramp up the ‘fight or flight’ response to stress, releasing hormones that speed up heart rate and raise blood pressure.

There is a consensus that around seven to nine hours of sleep per night is recommended for adults but anything between six and 10 hours is normal. Regularly getting less than six hours a night is not ideal. You can gauge how much sleep you need by how you feel the next day - you should feel refreshed. If you sleep 6.5 hours a night and feel great the next day, then that is the right amount of sleep for you, and you don’t need to force yourself to sleep any more.

The benefits of a good night’s sleep are enormous and include feeling more :

• Energetic

• Alert

• Focused

• Motivated

• Calm

• Positive

Whereas too little sleep can have the following impact:

• Irritability - Slower reaction times

• Impatience  - Increased errors

• Lack of concentration

• Health issues – heart disease, obesity, mental health issues

•  Exhaustion

How does sleep work?

Sleep is controlled by two distinctive processes that operate independently of each other but are both needed for quality sleep:

1. Circadian rhythm – the built-in body clock that dictates when we sleep and wake.

2. Sleep cycles - Rapid eye movement (REM) and non-rapid eye movement (NREM)

For quality sleep we need to complete several cycles of each phase. NREM dominates in the early stages of sleep, and REM becomes more dominant in the later stages. During NREM sleep new memories are transferred from short-term to long-term storage, and tissue renewal and repair as well as immune activity occur. REM phases are the dream phases, and the body relaxes considerably.

Sleep issues are incredibly common and may result for a variety of reasons including:

• Health issues – mental health, pain, noisy breathing, coughing, wheezy, bladder issues, narcolepsy (neurological condition where you fall asleep at inappropriate times), sleep apnoea (short pauses in breathing while asleep which may happen many times during the night).

• Menopause -hot flushes, tinnitus, restless legs, insomnia, breathing irregularities, bladder issues

• Following trauma

• Stress, anxiety, worry

• Disturbances from a partner - snoring, duvet hogger, different routines

• Being a parent or carer

• Too much screen time before bed

• Bedroom environment – light, noise, temperature, bed

• Work routine – shift worker, online with others in different time zones

• Ageing – yes you still need sleep because the quality changes and is not as deep

• Retirement – can affect sleep through loss of routine and often less physical activity.

So how do we get good quality sleep? Here are my top tips for getting a good night’s sleep.

1.      Keeping to a routine is one of the simplest ways to improve sleep quality. Set a schedule and go to bed and wake up at the same time each day. Long lie ins at the weekend are not a good idea.

2.      Create a room for sleep – cool, dark, and quiet, avoid bright lights and loud sounds, and don’t watch TV or have digital devices in your bedroom. (Ting a ling alarm clocks are still around to get you up). I always used the excuse that I needed my phone as we no longer have a land line telephone but I recently learned how to keep my phone on silent with an override for the important people who might need to get hold of me so the phone can now stay outside in the hall. Alternatively, if you must have digital devices in the bedroom wear an eye mask to cover any blinking lights.

3.      Be active outside, particularly first thing in the morning to get the morning light to set your circadian rhythm and aim to exercise for at least 20 to 30 minutes a day but no later than a few hours before going to bed.

4.      Avoid caffeine and nicotine after midday and alcoholic drinks before bed. Yes, alcohol at night plays havoc with sleep.

5.      Relax before bed – try a warm bath, reading, or another relaxing routine. A regular wind down routine, sends a signal to the body that it is bedtime.

6.      Go to bed only when you feel tired, don’t lie in bed awake. If you can’t get to sleep, do something else, like reading or listening to music, until you feel tired. Try meditation – pick a quiet spot, wear loose fitting clothing, and use a 10-15-minute guided meditation (there are many available online), making sure to take deep breaths and keep your eyes closed.

7.      Ensure that you feel comfortable. Did you know that if we live to be 75, we will have slept for approximately 25 years of this, so let’s make it comfy! Lovely pillows and bed linen help as does a good mattress. If you share a bed, it might be an idea to have separate mattresses, so you don’t feel each other tossing and turning. What you wear or don’t wear in bed also impacts comfort so make sure you wear what is right for you.

Sleep is hugely important for a healthy and happy life, and I hope this has shed some light on the importance of sleep as part of the balance.

Please see a doctor if you have a problem sleeping or if you feel unusually tired during the day on a regular basis. Most sleep disorders can be treated effectively.

Let me know if you have any questions.