November 17 2017
Five years after admitting defeat during a high school race, this runner reflects on her eating disorder recovery.
The new study from Uppsala University, Sweden, has found that missing a single night’s sleep can have more serious implications than previously thought. The study also reports that missing sleep can alter DNA molecules and change our cellular clocks.
Dr Guy Leschziner, Consultant Neurologist at London Bridge Hospital emphasizes the importance of sleep and outlines common sleep disorders.
Why is sleep important?
Sleep is vital for a variety of bodily functions. We spend about 30% of our lives asleep, and without it death occurs in a few days. It is possible to survive longer without food than sleep.
Sleep affects both psychological and physiological parameters. Lack of it, or disruption of it by sleep disorders, obviously affects sleepiness, but also has important consequences on fatigue, vigilance, mood, learning and memory, as well as motor coordination. It also affects immune function, cardiac rhythm, blood pressure, hormonal function, sensitivity to pain, liability to seizures. There is increasing evidence of its role in heart disease, risk of stroke and risk of dementia.
How much sleep do we really need?
Sleep requirement is largely defined by your genes, and also whether your sleep is disrupted by any sleep disorders. Everyone has a slightly different sleep requirement, but as a general rule, most people need between seven and eight hours a night. If you are lying in for more than an hour or so on days that you are not working, this suggests you are not sleeping enough.
Are there different types of sleep disorders and what are the most common?
Sleep disorders are categorized into the hypersomnias, parasomnias and insomnias. Insomnia is very frequent, affecting 20-30 percent of the population in any one year. Furthermore, about 20 percent of the population is sleep-deprived simply due to not spending enough time in bed. The hypersomnias describe sleep disorders that cause excessive daytime sleepiness. The commonest of these is obstructive sleep apnea, snoring with obstruction of the airway, affecting about 4-8 percent of adult men, and a slightly lower proportion of women. This is a frequent cause of road accidents due to falling alseep at the wheel of a car. Other conditions that can cause excessive sleepiness include neurological disorders such as restless legs syndrome/periodic limb movement disorder, affecting about 2 percent of the adult population, and conditions, such as narcolepsy, affecting 1 in 2,000 to 3,000 people. Narcolepsy causes profound sleepiness, vivid dreams, sleep paralysis, hallucinations as you drift into our out of sleep, and cataplexy, the sudden loss of muscle strength, usually precipitated by strong emotion. The parasomnias describe conditions that cause abnormal behaviors such as sleep-walking, night terrors and REM sleep behavior disorder (acting out of dreams).
How do you know if you have a sleep disorder?
If you or your partner are having disrupted sleep, or you are excessively sleepy during the day, you should seek medical attention. High blood pressure that is not responding to drug treatment should raise the possibility of sleep apnoea.
Can you explain how the stages of sleep—NREM and REM?
Sleep is divided into two categories of sleep. Normal sleep is described as non-REM. This is the part of sleep that is primarily restorative. REM sleep is the stage of sleep in which we dream, and our muscles, except those that allow us to breathe and move our eyes, are paralyzed. The function of dreaming is not precisely understood, but it is thought to have an important role in learning and memory.
Is there a difference between lack of sleep/ sleep deprivation and insomnia?
Generally people who are lacking in sleep are sleepy during the day, whereas those with insomnia have trouble sleeping at night but also trouble sleeping during the day. While there are consequences to insomnia such as psychological issues and fatigue, sleepiness is not one of them. At present, we are not clear if the physiological consequences are different.
Is it true that 65-70% of insomniacs are female?
There is a clear gender effect, in that women are much more likely to suffer from insomnia than men. Some of this is likely to be due to psychological differences, but we are also aware that restless legs syndrome is more common in women due to hormonal effects and due to women being more likely to have low iron levels, a risk factor for restless legs syndrome.
What steps can be carried out at home to get a better night’s sleep?
Keep your bed for sleeping. Don’t work, use a computer or watch TV in bed. Avoid exposure to bright light in the evenings—this lowers melatonin levels, your brain’s signal that it is time to go to sleep. Avoid caffeine after mid-afternoon. Exercise in the day, not directly before you go to bed. Avoid large carbohydrate-rich meals before bedtime; this can cause fluctuations in blood sugar levels at night. Avoid excess alcohol—this can disrupt sleep directly, but also causes bladder distension at night and can worsen sleep apnea. Try to keep your hours of sleep regular.