World Sleep Day is an annual, global call to action about the importance of healthy sleep. The focus of WSD is to bring cognizance to the many burdens of sleep problems, as well as the importance of healthy sleep. WSD publicly displays efforts being taken toward prevention and management of sleep disorders. Created and hosted by World Sleep Society, World Sleep Day is an internationally recognized awareness event bringing researchers, health professionals and patients together to recognize sleep and its important impact on our health.
• Most sleep disorders are preventable or treatable, yet less than one-third of sufferers seek professional help.
• Sleep problems constitute a global epidemic that threatens health and quality of life for up to 45% of the world’s population.
• Better understanding of sleep conditions and more research into the area will help reduce the burden of sleep disorders on society.
• Three elements of good quality sleep are:
o Duration: The length of sleep should be sufficient for the sleeper to be rested and alert the following day.
o Continuity: Sleep periods should be seamless without fragmentation.
o Depth: Sleep should be deep enough to be restorative.
• Research shows that we spend up to one-third of our lives sleeping. Sleep is a basic human need, much like eating and drinking, and is crucial to our overall health and well-being.
• Sleep, like exercise and nutrition, is essential for metabolic regulation in children. There is evidence for a link between sleep duration and childhood obesity. The findings are more apparent in girls. Sleep duration is the effect of day-to-day variability of sleep-wake timing on weight regulation.
• Breathing regularly during sleep is critical to maintain well-being and health. Persistent interruption of the breathing function during sleep is called sleep apnea. This is a pervasive and common disorder that affects 4% of men and 2% of women.
• Sleep apnea causes daytime sleepiness and fatigue, and may lead to conditions such as hypertension, ischemic heart disease, stroke, and diabetes.
• Lack of sleep or poor quality sleep is known to have a significant negative impact on our health in the long and short term. Next day effects of poor quality sleep include a negative impact on our attention span, memory recall and learning. Longer term effects are being studied, but poor quality sleep or sleep deprivation has been associated with significant health problems, such as obesity, diabetes, weakened immune systems and even some cancers.
• Lack of sleep is related to many psychological conditions such as depression, anxiety and psychosis.
• Quality sleep is crucial to ensure good health and quality of life.
Importance of Sound, Restorative Sleep:
• Good quality and restorative sleep is essential for day-to-day functioning. Studies suggest that sleep quality rather than quantity has a greater impact on quality of life and daytime functioning.
• Healthy sleep in children will improve the child’s overall wellness and development. WORLD SLEEP SOCIETY has created the 10 commandments of Healthy Sleep for Children.
• Poor quality sleep has a greater negative impact on health, well-being and satisfaction with life than the quantity of sleep a person gets.
• Quality sleep is responsible for alertness, improved functioning the following day and better quality of life.
Consequences of Sleep Disorders
• Sleep disorders cause significant individual and societal burden and form a serious public health problem.
• Obstructive sleep apnea significantly impacts health and well-being. The drop in oxygen that occurs when breathing stops due to OSA puts a strain on the heart and can lead to a number of serious health conditions.
• Directly or indirectly, disrupted sleep can have a negative effect on family life and relationships by affecting a person’s mood and the way in which they are able to perform daily activities and interact socially.
Extent of the Epidemic
• 35% of people do not feel they get enough sleep, impacting both their physical and mental health.
• Obstructive sleep apnea (OSA) affects approximately 4% of the adult population. If not properly managed, OSA can have a significant impact on a person’s health and well-being.
• Restless Legs Syndrome is a common disorder and occurs in between 3-10% of the population, although the number of people affected and the severity of the condition differs between countries.
• People who have OSA stop breathing repeatedly during sleep. OSA is caused by a blockage of the upper airway. The collapse of the airway may be due to factors such as a large tongue, extra tissue or decreased muscle tone holding the airway open.
• Each breathing pause can last from 10 seconds to more than a minute and is accompanied by a drop in oxygen associated with each event. The events may occur 5 to 50 times or more each hour. This puts a strain on the heart and can lead to a number of serious health conditions (U.S. Dept. of Health & Human Services, NIH, 2009).
Specific Sleep Disorders – Insomnia
• Insomnia affects between 30-45% of the adult population.
• Primary insomnia (insomnia with no underlying condition) affects 1-10% of the general population, increasing up to 25% in the elderly.
• Lack of sleep or poor quality sleep also leaves us more vulnerable to accidents. People who suffer insomnia are seven times more likely to become involved in an accident causing death or serious injury than good sleepers.
• Studies have shown that people with insomnia suffer from more symptoms of anxiety and depression than people without insomnia.
• Insomnia has a negative impact in all areas of a sufferer’s life.
• Insomnia can affect work performance, with a change in character and a drop in the quality of work. If the disorder remains untreated, this may even lead to reduced job prospects and loss of employment.
Sleep Breathing Problems
Obstructive sleep apnea is very prevalent, yet under recognized. The Wisconsin Sleep Cohort Study estimated a prevalence of 17% among men and 9% among women in that state in the United States. In northern India, the prevalence of obstructive sleep apnea and obstructive sleep apnea syndrome is 13.7%. OSA is an independent risk factor for hypertension and other cardiovascular ailments. In children, sleep apnea may be the underlying cause of neuropsychological disturbances. Pediatric sleep apnea is typically associated with adenotonsillar hypertrophy.
Untreated sleep apnea may lead to heart diseases, stroke, and vascular dementia. Both adults and children should be formally investigated in sleep centres if sleep apnea is suspected, because both adult and pediatric sleep apnea is treatable and correctable; a correct and precise diagnosis is always required.
Sleep apnea is diagnosed with polysomnography in the sleep laboratory. Treatment with non-invasive positive airway (continuous positive airway pressure, or CPAP) ventilation is generally successful. For mild forms of sleep apnea, the application of oral devices can be beneficial. Surgery to remove excessive tissues in the oropharynx may be considered for individuals who cannot tolerate non-invasive equipment or who have obvious obstruction to airflow in the oropharynx by redundant tissue growth or large tonsils. There is proof that successful correction of sleep apnea with non-invasive positive airway pressure ventilation lowers mean blood pressure and may reduce the risk of myocardial infarction and stroke. Excessive daytime somnolence generally improves with successful treatment of sleep apnea.
PRINCIPLES OF GOOD SLEEP
Following the guidelines of Sleep Hygiene can help to prevent poor quality nocturnal sleep, short duration of sleep, fragmentation of sleep and serious sleep deprivation in adults.
10 COMMANDMENTS OF SLEEP HYGIENE FOR ADULTS
1. Fix a bedtime and an awakening time.
2. If you are in the habit of taking siestas, do not exceed 45 minutes of daytime sleep.
3. Avoid excessive alcohol ingestion 4 hours before bedtime and do not smoke.
4. Avoid caffeine 6 hours before bedtime. This includes coffee, tea and many sodas, as well as chocolate.
5. Avoid heavy, spicy, or sugary foods 4 hours before bedtime. A light snack before bed is acceptable.
6. Exercise regularly, but not right before bed.
7. Use comfortable bedding.
8. Find a comfortable temperature setting for sleeping and keep the room well ventilated.
9. Block out all distracting noise and eliminate as much light as possible.
10. Reserve the bed for sleep and sex. Don’t use the bed as an office, workroom or recreation room.
Dr. Sourav Das,
MBBS, MD, DNB, CCAM, IBSM.
International Specialist Certification in Sleep Medicine (World Sleep Federation)
Consultant Psychiatrist & Sleep Medicine Specialist Regional Coordinator (Eastern India) for World Sleep Day 2019, World Sleep Society
Dr. Sourav Das, MD, DNB, CCAM, IBSM (Somnos Sleep Clinic):
Sleep problems should not be underestimated in today’s world. Its understandable, we want to squeeze out the maximum productivity from a day, but it shouldn’t come at the cost of sleep, as it will lead to far fetched economic, social and health consequences, which will take away any extra benefits obtained by sleeping less. A healthy sleep is a must for healthy ageing, and preventing the development of a multitude of disorders like diabetes, hypertension, cerebrovascular accidents, heart attack, dementia, depression, cognitive decline etc.Any difficulty in initiating or maintaining sleep, any abnormal behavior while sleeping or any excessive daytime sleepiness should be promptly brought to the attention of the nearest qualified sleep specialist.
Dr. Uttam Agarwal, DLO, DNB, Fellowship in Sleep apnea surgery (Orange Sleep Apnea linic):
Sleep is a basic human need, much like eating and drinking, and is crucial to our overall health And well-being. Research have shown that a poor sleep impacts memory and cognitive function and early skin ageing. A healthy sleep both quantative and qualitative is associated with bettter facial and tissue tone, protects against obesity, diabetes and hypertension, gives better immunity, safeguards against age realted cognitive decline and imparts protection against anxiety, depression apart from other numerous beneficial effects.