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SLEEP AND HEALTH EFFECTS: MORE THAN WE THOUGHT IT WAS

Oxford dictionary defines sleep as “a condition of body and mind which typically recurs for several hours every night, in which the nervous system is inactive, the eyes closed, the postural muscles relaxed and consciousness are practically suspended”.

Mirriam-Webster sees it “as the neutral periodic suspension of consciousness during which the powers of the body are restored”.

The MacMillan dictionary for students defines sleep as “a naturally recurring state characterised by reduced or absent consciousness, relatively suspended sensory activity and inactivity of nearly a voluntary muscle”.
A slightly more scientific definition can be found in Stedman’s Medical Dictionary which sees sleep as “a natural periodic state of the mind and body, in which the eyes usually close and consciousness is completely or partially lost, so that there is decrease in bodily movement and responsiveness to external stimuli”.
The common threads in these descriptions, which appear to be necessary element in the definitions of sleep, are:
• It is a naturally occurring state
• It is periodic and recurring
• It involves both the mind and the body
• It involves the temporary suspension of consciousness
• It involves relaxation and inactivity of muscles
We can see how sleep is an integral part of our overall health and mental wellbeing. Sleep helps our brain to function well. When we are sleeping, a lot of healing goes on, our brain gets ready for the following day. But when we do not sleep, we create health problems that are acute and chronic. When we do not sleep, we are susceptible to taking very wrong decisions; we become so irrational in thinking, leads to accident and business failure through inability to make the right decisions. We most times feel we are supermen when we burn candles into late nights working, most of us even brag about it “you cannot believe I slept at 2.00am this morning”. Bravo to you! Your friends see you as a hardworking superman but you can never quantify the cumulative harm you are doing to health.
It is important to know that adequate sleep improves:
• Learning
• Problem solving and decision making
• Emotional health
In terms of physical health:
• It keeps our organs healthy
• It regulates hormones. Some people feel hungry when they are not sleeping
• Sleep deficiency can also make people more prone to infections and reduce their immunity, this makes infection last longer
• Daytime performance and safety is also impacted by lack of sleep. Productivity and reaction time slows down as well.
• There are also evidences of micro sleep – people sitting in classes, meetings or conferences and dosing off. With this, you lose touch with details and this affects your decisions and your ability to learn new things.
• Inadequate sleep increases accidents on the roads and even in workplaces mostly amongst machine operators and those doing night rotation shifts.
So which ever balances the issue of sleep are weighed, it is safer to have adequate sleep knowing that our body will surely malfunction by the absence of sleep. We always think we have cheated nature by using the night meant for sleep and rest for the work we brought home from our offices. The body always have a way of demanding for it and we struggle with repayment, it is like paying for a loaf of bread already eaten. How difficult this always turns out. But we need to know there is a regulator called the “circadian rhythm” which is often referred to as the “body clock”. This is a 24-hour cycle that tells our bodies when to sleep and when to be awake. So this body clock waits for you in the day time to demand for the sleep owed during the night hours, this is why you see most people having micro sleep and dosing off at intervals during work.

WHO IS AT MOST RISK FOR INADEQUATE SLEEP?
• People with limited time to sleep – Busy business men and Chief Executives
• People whose schedules conflict with their internal body clocks. Examples are shift workers or people who travel throughout the night
• Lifestyle choices that prevent people from getting enough sleep, examples are people who use drugs, caffeine and alcohol to stay awake
• Medical problems such as anxiety, stress and sleep disorders
• When we are on medications that interferes with our sleep

HOW MUCH SLEEP DO WE REALLY NEED?

These are the recommended hours of sleep based on age classification, but you will realised we are never able to meet these hours of sleep. The more we drift out of these brackets, the more our immunity is affected making us vulnerable to infections and even making infections last longer than necessary. Getting enough sleep is very crucial to our overall well-being.

LONG AND SHORT TERM EFFECTS OF SLEEP
• Inability to concentrate
• Lack of patience
• Increased intake of high fat and high sugar food
• Increased risk for heart disease, heart attack, hypertension and stroke
• Increased risk of Type 2 Diabetes
• Clinical depression
• Increased risk of hormonal changes leading to lose of muscle and bone mass with aging

IMPROVING YOUR SLEEP
Maintain sleep hygiene: Make your bed room a place for sleep and not an extension of your office. Go into the bed room only when you are ready to sleep, go in with a conscious mindfulness that you are going to sleep. Leave every work and task behind and switch off the lights before getting into the bed.
You must make conscious efforts to make your bed room and your bed look attractive and inviting, do not treat your bedroom without concern and see it as a very important place where you end your day. Some people sleep better in hotel rooms than they do in their homes, the difference is only the sleep environment. You can make yours also relaxing.
You need to develop a sleep pattern, maintain roughly the same bed time and wake time throughout the entire week. Your body over time gets used to this timing.
Keep your bedroom dark and cool, keeping all kinds of lights out. If you must use light, use “sleep friendly” light bulbs. Television in the bedroom is a great source of distraction leading to sleep deprivation.
Do not use the bed as a dining table or desk; it defiles the term “BED”. This makes our bed attractive to ants and other crawling insects that in turn disturb our sleep.
Most importantly, do not bring in your gadgets or phones into your bed room when you are ready to sleep. If you must bring them in, you either switch them off or put them on silence mode. One email or an sms that drops into your phone can deprive you of sleep the entire night. Yes, global economies but your health must not be made to melt with it.

SCHEDULING YOUR MEALS AND PHYSICAL ACTIVITY
• Avoid caffeine 4 – 6 hours before bed time. It is advisable to avoid coffee after lunch time.
• Avoid alcohol 3 – 4 hours before bed time
• Do not eat large or high fat meals within 2 – 3 hours of bed time
• Include some exercise every day but avoid vigorous exercise 2 – 3 hours before bed time
• Learn mindfulness and meditation techniques to help you relax.

TRACKING SLEEP
Sleep diary: Popularly known as written log. You can use this to know the number of hours you sleep every day. Keep a sheet by your bed side, when you are ready to sleep write the time down, each time you wake up to use the convenience write wake up time and sleep time. This will help you know how many hours of sleep you are getting and how consistent it is.
Tracking device: These are electronic devices worn on the wrist, ankle, chest or head. It depends on the one you find convenient. It helps you track your hours of sleep, some of them also track both your stress level and your heart beat.
Smart Phone Apps: A number of these sleep tracking applications are on Play Store in your mobile phones, you can download them and use them to track your sleeping pattern.
Medical Evaluation is necessary if you suffer from severe sleep deprivation or disorders.

WHAT IS POOR SLEEP
When we talk about poor sleep, we are talking about a number of sleeps and sleep related disorders. Prominent amongst these are insomnia and chronic insomnia.
Insomnia is defined as a state of habitual sleeplessness or inability to sleep. This affects about 10% of a population.

Sleep Apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. This ultimately affects your ability to getting good enough sleep. Sleep apnea affects 20% of a population; many people have sleep apnea without knowing. It is important to always seek a Physician’s review.
Restless Leg Syndrome: If you have followed us in our blog www.ohsmcomng.blogspot.com, you will see the article we had written on restless leg syndrome. It is a must read. Restless Leg Syndrome popularly known as RLS, is a neurological disorder characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them. One of the causes of RLS is excessive use of excess high heels shoes; this has become a global concern at workplace. This has a strong interaction with the duration of use, frequency of use and height of heels. Ladies are more involved in this, it makes them look really elegant but we must look at the health risk. When these unpleasant sensation starts, it will surely deprive you of sleep, 5% of a population suffer from RLS.
Circadian Rhythm disorders have 2% prevalence in a population group and this also leads to sleep lose or sleep deprivation.
Narcolepsy is another condition that is prevalent in 2% of a population. Narcolepsy is a condition characterized by an extreme tendency to fall asleep whenever in relaxing surroundings. This is witnessed every day in our environment, it is most common amongst new born. But this also tells us the relationship between a relaxed environment and sleep, so we must strive to make our bedroom more relaxing for the sake of good sleep leading to improved health outcomes.
Mild and moderate sleep complaints. This has 50% prevalent in a population, most people complain of these but they are never sure of what the real causes are but I am sure you will know that a number of factors are responsible after reading this article.
There is also a condition called dysomnia which is a diametrical opposite of insomnia. We will not be able to take all that now; I will need you to follow us in the next edition for the continuation of these issues bothering on sleep and health. We will be taking the concluding part in the next edition focusing on chronic insomnia, National Sleep Foundation Guidelines on Sleep and a number of other concepts.
I can be reached using ehi@ohsm.com.ng
Stay tuned!

Ehi Iden
Chief Executive Officer
Occupational Health and Safety Managers

MEMBER: International Commission on Occupation Health (ICOH)
World Safety Organisation (WSO)
Society for Occupational Health Psychologists (SOHP)
Initiator: 7.2 Initiative – A Not-For Profit Social Venture on Preventive Health

Reference: Dr. Punam Ohri-Vachaspati’s presentations in Arizona State University
http://www.howsleepworks.com/what_definition.html