Way to healthy sleep

Catching winks

Way to healthy sleep

It is not just the duration of sleep, but the quality of sleep that matters, enlightens Dr N K Venkataramana.

Sleep takes up one-third of our life. Sleep is not a process where a person is not merely awake.  It is an active phenomena which is essential for the integrity of body and brain functions and health. Sleep is very important for restoration of energy and also replenishment of important substances like neuro-transmitters in the brain.  The sleep cycle is primarily guided by the day and night phenomena called “circadian rhythm”.  

The pineal gland in the brain is capable of sensing the day light to create the sleep cycle. Addition of artificial lighting has caused enough confusion about the day night cycles. In addition modernization and change in the life style is constantly burrowing into the time spent in sleep.  Present day trend is to stay awake as much as possible believing that there are no consequences or tolerable consequences or can be compensated during week ends. As a result many are being drawn into sleep deprivation.

Each sleep cycle consists of several stages. Basically sleep is broadly divided into two types, NREM (non rapid eye movement) sleep and REM (rapid eye movement) sleep.  Each non NREM sleep cycle has several stages. Stage 1 where a person is drowsy can be easily woken up, still in touch with the surroundings. Stage 2 and 3 are deeper sleep where a person looses touch with surroundings. Stage 4 is the deepest phase. REM and non REM alternates in each of these phases with predominant REM sleep in the stage 4.

Sleep needs are quite variable from individual to individual. Though on average everyone needs approximately 8 hours of sleep. Children tend to sleep more (more than 10 hours) than the elderly (less than 6 hours). To maintain optimum health a good proportion of NREM and REM sleep is necessary. If REM sleep is reduced to less than 25% the satisfaction of sleep is lost and one can be restless, or drowsy and tired the next day.
 There are a variety of conditions which can produce disturbances of sleep leading to serious consequences. Some of them are somnolence (excessive sleepiness), insomnia, parasomnia (sleep-walking or sleep-talking), sleep apnea syndrome (“Ondyne curse”). It is important to differentiate the type of sleep disorders in order to identify the underlying cause and treat appropriately. 

Sleep apnea syndrome is a type of sleep disorder associated with breathing difficulty or complete cessation of breathing leading to decreased oxygenation to the brain.

 According to the Greek mythology, the Greek gods have cursed Nymphomaniac following an insult that she will stop breathing once she falls asleep and hence could not sleep for the rest of her life. This is how the term “Ondyne curse” has been given to sleep apnea syndrome. It is important to identify this syndrome. Common symptom could be “snoring”. Snoring occurs as the air tries to pass through a narrow passage. Snoring could be disturbing and embarrassing to the housemates. Nevertheless it should not be ignored and should be investigated for central (brain related) and peripheral (related to air passages and neck muscles) causes. Obesity is another contributing factor. 

One should consult a neurologist to clinically evaluate and identify the underlying cause and treat appropriately.  Lack of proper sleep can lead to tiredness, inability to concentrate, irritability and overall reduction in performance and quality of life. Tendency to fall asleep in day time unintentionally can affect judgement and decision making and also make you more prone to accidents. Apart from this there is increased risk for hypertension, diabetes, chronic hypoxic state, heart attack, brain attack (stroke), and behavioural disorders. With appropriate investigations and medical treatment these complications can be avoided and the airway passages can be corrected surgically. In addition several behavioural strategies like sleep hygiene education, cognitive therapy, muscle relaxation and bio feed back can help induce healthy sleep. 

Tips for healthy sleep* Proper diet* Regular sleeping habits* Regular exercise* Cosy and sleep-friendly environment * Sleep hygiene 

Prevention* Prevent obesity* Avoid excessive use of alcohol* Avoid indiscriminate use of  tranquilizers* Avoid smoking* Avoid fatty foods

Suspect sleep deprivation * If you are not energetic in the day* If you are not satisfied after the sleep* Unintentional sleep in the day time * Tiredness, restlessness, irritability, and fatigue * If you need a lot of coffee or smoking to forcibly keep awake* If you tend to fall asleep while you are sitting, working, or driving

(The writer is a neurosurgeon)

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