Articles on sleep

Are You Sleeping Right?

Dr. Rajiv Mehta, Physiotherapist
Sleep is a natural part of the daily biological functions and we spend some time of the 24 hours sleeping. Sleep cycles are different for different persons and while 5 to 6 hours of sleep may be enough for some people, others may need up to 8 hours of sleep to feel refreshed. How you sleep is as important as the duration. This is one area which is often neglected by people.Why sleeping positions are important? Sleeping positions are very important as you stay in a single position for hours at a time every day, and if these habits are bad, they can contribute to spinal problems. Thus, many of the spinal problems can also be alleviated by sleeping correctly.Some of the bad sleeping positions that may adversely affect your spine are as follows.On your stomach - This position is in overall a bad position as it curls up the spine, especially where the neck meets the spine and can cause spinal deformities over a long period of time. Certain adjustments to this position can lessen the effects, but it is important to try to change habits and sleep in a better position.The fetal position - Although this is one of the more natural positions and most babies are crouched up in this form in the mother's womb; as a sleeping position, it has its disadvantages as well. The lower spine is especially put under a lot of stress when someone curls up in this position.On your side - Although this is safer compared to the other two, sleeping on your sides straight would cause blood circulation issues and also put a lot of stress on the relevant organs, depending on the side you were sleeping on.In all of the cases, slight adjustments to these positions will lessen the stress on the spine and also help you sleep better.Some of the adjustments that you can make are:1. Sleep with a pillow between your knees to align your hips and cause less strain on the spine.2. If you don't have sleep apnea, put a pillow under your knees to raise them while lying on you back.3. If you sleep on your back, try to consciously change your position to sleep on the side.4. Try and actively change your posture throughout the day to ensure good sleeping position at night.

Do Women Need More Sleep Than Men?

Ms. Swati Kapoor, Dietitian/Nutritionist
Sleep is a fundamental requirement just like food and diet is for the functioning of a healthy body. Sleep even lays the ground work for a productive day ahead. Although most people need seven to nine hours of sleep each night to function well the next day, the National Sleep Foundation (NSF) 1998 Women and Sleep Poll found that the average woman aged 30-60 sleeps only six hours and forty-one minutes during the workweek.Studies show that women need more sleep than men. "Poor sleep certainly had a more profound effect on women than on men," says Edward Suarez, Ph.D., an associate professor at Duke University School of Medicine "One of the major functions of sleep is to allow the brain to recover and repair itself. During deep sleep, the cortex — the part of the brain responsible for thought, memory, language and so on — disengages from the senses and goes into recovery mode,” Jim Horne, director of the Sleep Research Centre at Loughborough University in England, told The Australian. "The more of your brain you use during the day, the more it needs to recover and, consequently, the more sleep you need. Women tend to multi-task — they do lot at once and are flexible — and so they use more of their actual brain than men do.”It follows that, if men used their brains more during the day, they would need a couple of extra hours too. "A man who has a complex job that involves a lot of decision-making and lateral thinking may also need more sleep than the average male — though probably still not as much as a woman,” Horne said. Getting the right amount of sleep is vital, but just as important is the quality of your sleep. Biological conditions of women are unique, like the menstrual cycle, pregnancy and menopause. All of these conditions can affect how well a woman sleeps. This is because the changing levels of hormones that a woman experiences throughout the month and over her lifetime, like the levels of estrogen and progesterone, have an impact on sleep.Lack of sleep is associated with increased risk of heart disease and obesity because lack of sleep causes increases secretion of the leptin hormone, which leads to excessive food cravings and may cause obesity. This even causes heart disease if left untreated. Lack of sleep leads to diabetes due to increased levels of the stress hormone, which stimulates the production of insulin and causes high blood sugar level, as well as more stress, depression, anxiety, and anger. However, these associations were weaker for men.So go to bed at the same time every day of the week, avoid heavy meals before bed, establish a relaxing bedtime routine, nap occasionally to make up for lost sleep, eat healthy and exercise daily.

Are You Getting Enough Sleep?

Dr. Darpan Kaur, Psychiatrist
Sleep is a an essential physiological function of the human body. Sleep plays a very important function in restoring the wear and tear of daily life and providing the desired rest and restitution to the body and mind. As we grow older, the quality of our sleep may change. When we are younger as in childhood we tend to have more hours of sound sleep but as we  grow older the number of hours we sleep and the quality of sound sleep can deteriorate significantly. Moreover, the demands of work, professional deadlines, travel stress, physical ill health, excessive gadgets usage before bedtime, mental stress, all of these can contribute towards poor sleep! Some of the common sleep problems are difficulty in falling asleep. difficulty in maintaining sleep, sleep disturbances such as bad dreams excessively, night mares, etc, sleeping too less or too much and not feeling fresh after getting up from sleep. In today's life style of travelling across the globe and night shifts can lead to disturbance in our body's natural circadian rhythm which can lead to jet lag, shift work sleep disorder, etc. Poor sleep quality can also be associated with cardiac events and accidents. Poor sleep can make us inattentive , irritable, distracted, restless, sleepy and groggy at our workplace and study place. A person having chronic untreated sleep problems can also have problems with efficiency and work performance.  Insomnia, Hypersomnia, Parasomnia are types of sleep disorders. Certain medical conditions, medications and substances such as alcohol, cannabis, nicotine can also interfere with sleep. Sleep disturbance is also a part of psychiatric disorders such as adjustment disorder, acute stress reaction, post traumatic stress disorder, depression, mania,psychosis, addictions, etc. Children can have bed wetting and night terrors during sleep. I have written some dos and donts which is not a fully comprehensive list, yet can be helpful for getting good sleep.Dos:It is preferable to stop late night use of gadgets, apps, internet, TV viewing if you are having problems in falling asleep. Learn to switch off from all of these everyday at least an hour before you go to sleep. Practice relaxation daily before going to sleep. Deep breathing exercises while lying on your bed with a focus on breathing slowly and being aware of each breath and slowing down your system with use of some positive images in your mind can help in falling asleep.Late Evening prayers can helpful for sleep based on your own belief systems.Eat light meals at bedtime and drinking a cup of warm milk can help in getting sleep.You may add almonds, cashew nuts, saffron, etc based on your preference. Taking a relaxing shower prior to bedtime can help sleep well. Do cut down on daily intake of excessive consumption of sugar, salt, oil,spices in your diet if you are experiencing severe gastrointestinal discomfort while falling asleep and also waking up at night feeling uneasy, bloated, acidity, pain in abdomen, etc.Monitor  daily intake of tea and coffee and cut down intake if you have problems with sleep.Be positive at bedtime. Live for each day to its fullest ! Tell your mind positive self statements at bed time that " Yes, I am doing good! I am doing fine! Things are great! Life has been good to me! I shall conquer all my problems! No need to worry! Things are in control! Situation will get better! I can work something out! Life is beautiful! I am doing well for myself! Things will change for the best! "' These kind of positive statements said to yourself can help you gain  control over negative defeating thoughts which maybe coming in your mind at bedtime while you stare at the ceiling trying to fall asleep at night especially when you are facing difficult stressful times. Try to cut down on smoking and chewing tobacco. Seek professional help for de-addiction from nicotine and tobacco.Try to cut down on alcohol if you are facing problems in sleep  related to alcohol. Seek professional help in quitting alcohol.  Drugs such as cannabis, cocaine, heroin, etc have harmful consequences on sleep and mental health. Seek professional help to quit from them.Try to have a fixed schedule of sleeping at the same time and waking up at the same time everyday. Pay attention to your bed room, clean the bed room regularly, keep changing sheets regularly and keep replacing old bed sheets, pillows, pillow covers regularly. Pay attention to the right temperature settings and dress in comfortable night clothes as per your preference.Donts:Do not drink excessive caffeine, tea, stimulant drinks before going to sleep or  late evening if you are having problems falling asleep.Tobacco  can interfere with sleep and avoid smoking or chewing tobacco just before going to bed. Alcohol can interfere with sleep and avoid drinking alcohol before going to bed.Do not indulge in drugs such as cannabis , cocaine, heroin,etc as they interfere with sleep.Do not eat heavy meals or drink too much water just before going to bed.Avoid excessive TV viewing or internet viewing just before going to sleep. Avoid excessive texting and playing online games just before going to sleep.Do not do excessive rigorous exercise  very late evening if u are having a persistent problem in falling asleep  as it can switch on certain neurotransmitters and can interfere in falling asleep for some individuals.Do not use your bed for eating, drinking, studying, watching TV, working/surfing on your lap top. Do not sleep with lights and gadgets on as it can cause sleep interference.Do not think and worry excessively about how was your day, who upset you, why u did this or that and why you shouldn't have done this or that. All these ruminations, worries, anxiety just before going to sleep will certainly affect your sleep. Do not cry or pick up quarrels with others before going to sleep as it will affect your sleep quality.Do not keep getting up and checking the phone, alarm clock or the watch to see what is the time again and again.Do not have a varied sleeping schedule which is very erratic where in one day you sleep at eleven pm the second day at one am and third day at three am. Do not take long hours of nap in the afternoon or evening as it then interferes in falling asleep at night. If despite your best efforts, you are not able to get good sleep, kindly consult a psychiatrist. The psychiatrist will screen you for a psychiatric disorder where sleep disturbance may be a predominant symptom such as anxiety disorder, stress related disorder, depression, mania, psychosis, etc. They will assess you and provide you treatment for your sleep problems based on whether you have Insomnia, Hypersomnia or Parasomnia related conditions. After clinically evaluating you, they may suggest some tests, teach you relaxation training, sleep hygiene therapy and psychological therapy targeting the cause of your sleep problems. They may also prescribe you medications for the sleep condition you suffer from.  He/She may also refer you to a Neurologist or  a Sleep Physician as per clinical expertise for conditions such as Sleep Apneas, Nocturnal Epilepsy, Narcolepsy, Restless Leg Syndrome, etc which may need a a comprehensive  evaluation with Sleep Lab based assessments and multidisciplinary interventions.

Weight Loss Can Prevent and Cure Sleep Apnea

Ms. Swati Kapoor, Dietitian/Nutritionist
Apnea literally means "cessation of breath." If you have sleep apnea, your breath can become very shallow or you may even stop breathing while you are asleep. This state of not breathing can occur for 10 seconds in an hour, or in severe cases, the frequency of cessation of breath may further increase. The repeated episodes of apnea (lack of breathing) cause frequent night time awakening.Individuals with this disorder often complain of morning headaches, constant fatigue, and moodiness, and can fall asleep almost anywhere. More seriously, they can fall asleep even while driving. Obstructive sleep apnea is much more common in obese individuals. It is believed that the airway of obese individuals get obstructed by large tonsils, an enlarged tongue and increased fat in the neck. This presses airways when the pharyngeal (throat) muscles are relaxed during sleep. A person's neck circumference is a good predictor of sleep apnea. Obese men with a neck circumference of 17 inches or greater, and women with a neck circumference of 16 inches or greater are more likely to have sleep apnea.The worst part is that it is not only obesity that has an association with sleep apnea, but sleep apnea even results in poor sleep which increases food cravings. Lack of good quality sleep increases the chances of hormonal imbalance by increasing the level of ghrelin hormone. Ghrelin is a hormone known for its effects on appetite and disturbed levels of ghrelin hormone leads to an increased appetite which further leads to weight gain.Individuals with sleep apnea often have elevated blood pressure, high fasting glucose, and high cholesterol. Lack of sleep triggers stress hormones which stimulate the cell’s glycogen to get converted into glucose. This suppresses the function of insulin due to which blood sugar levels shoot up leading to diabetes and heart problems, all of which can worsen with further sleep deprivation. So, it's a vicious cycle. Obesity can lead to sleep apnea, which, itself, then causes derangements of hormones that control eating habits, leading to more weight gain, worsened blood pressure, glucose intolerance, worsened apnea and the cycle goes on and on.So, healthy eating with exercise leads to weight loss and not only helps in preventing such a vicious cycle of health problems but also helps in the cure of sleep apnea.

Is Your Child Sleeping Well?

Dr. K R Bharath Kumar Reddy, Pulmonologist
Sleep is an important fundamental need of every child for both mental and physical well being. We underestimate the importance of sleep, which is shown to influence the child's growth, immunity, memory and development. The amount of sleep required varies according to the age of a child.A new born baby requires around 16 to 18 hours of sleep.A pre-school toddler may need around 12 hours of sleep including both night and day time sleep.A school going child, requires around 10 hours of sleep at night.Teenagers are recommended sleep of 9 hours but this obviously never happens.Adult requirement is nearly 7 to 8 hours.But it is important to note, that it is not the quantity or duration of sleep that is important for good health, but the quality of sleep. So we need to always question whether a child is actually sleeping well, even though he/she sleeps for long hours.When do you start suspecting a sleep problem?Nearly 25-30% of children are known to suffer from sleep problems as per international data. Adults when sleep deprived are sleepy during the day, but this is not so with children. They can present with varied symptoms such as:Excessive sleeping during the dayMoodiness and irritabilityTemper tantrumsEmotional surgesHyperactive behaviourGrogginess when they wake up in the morningReluctance to get out of bed in the morning or difficult to awakenNot achieving bladder control at nightExcessive movement of legs during sleepSo in case your child has any of the above symptoms, it is important to consider the possibility of a sleep problem and consult your doctor for the same.

Good Sleep for Good Health

Ms. Swati Kapoor, Dietitian/Nutritionist
Nothing makes you feel more refreshed than a good sleep in night. It is a natural cyclic state of resting for mind and body. There’s more to an ideal 7-8 hrs of sleep than just preparing our bodies for the next day. Adequate sleep is an essential part of good health and plays an important role in all body functions hence ensuring a better mental and physical fitness.The National Sleep Foundation (NSF) reported that good sleep is essential for a person’s health and well being.Lord Chesterfield very well said that “A light supper, a good night's sleep and a fine morning have often made a hero out of the same man, who, by indigestion, a restless night and a rainy morning would have proved a coward."Now, the question is “Can good sleep make good health?”Yes, sleep makes you feel better. Adequate sleep is a key part of a healthy lifestyle. Without it, one becomes more susceptible to health problems, such as heart disease, obesity, depression and many more. Some facts of sleep which lead to a healthy life are -Good Sleep Keeps Heart Healthy: Lack of sleep has been associated with worsening of blood pressure and cholesterol so some experts say that heart will be healthier if one gets between( 7 -9 hours) of sleep each night.Sleep Helps to Make Body Repairs: Sleep is a time for your body to repair damage caused by stress, ultraviolet rays and other harmful exposures. Your cells produce more protein while you are sleeping. These protein molecules form the building blocks for cells, allowing them to repair damage. This is the time when the cells undergo wear and tear and that’s what makes you feel refreshed in the morning.Good Sleep Reduces Stress: When your body is sleeping deficient, it goes into a state of stress. Therefore it is recommended to have good sleep in order to allow your body to cope with day’s stress and manage it in a better way with a relaxed mind. It is found that any amount of sleep deprivation reduces mental performance.Sleep & Weight Loss: Lack of sufficient sleep affects the appetite regulating hormones. It also aggravates cravings for high-fat and carbohydrate rich foods, making a route to weight gain. It also affects the body’s ability to regulate blood sugar levels, a key factor in weight management. So, if you want to be on a healthy weight, make sure you get a good sleep every night.Good Sleep Reduces Depression: Lack of proper sleep and depression is inter-linked. Depression may lead to insomnia and lack of sleep increases depression. Sleep impacts serotonin levels (feel-good hormone) which affect the mood of an individual.Sleep Prevents Cancer: People working for long hours have a higher risk for breast and colon cancer. There is evidence stating that good sleep can alter the balance of hormones in the body which may influence cancer progression.As very well said by Benjamin Franklin, “Early to bed and early to rise, makes a man healthy, wealthy & wise.”

3 Reasons That Are Making You Lose Your Sleep

Ms. Damini Grover, Psychologist
Days turn into weeks and you can do everything except sleep! Isn't it? With a crazy lifestyle that we have, it has become just about normal, to lose our sleep over anything and everything.Before we know it, it turns into a routine affair. One day turns into days and then weeks and our; good night's sleep is eaten away by thoughts, images, events, dilemmas, self-doubt and worry. Gradually, we find ourselves getting more and more into a cycle of anxiety and depression.Just like the idea of switching off our phones for a while seems like a ridiculous thought; the idea of shutting off the mind for a while feels the same.But if we know that we must sleep for at least 6-7 hours every night, why can't we do it?Here's why:We don't know how to take a break! Rather, we don't know what a break means.It's not just about taking time off for a holiday or vacation; it's about taking time off from the routine affairs of life. If the situation demands us to choose between what we want to do and what we should do, we would always go for the former. Why? Heavens will not fall, if we skip some routine activities. Because we don't skip some activities, the mind forgets to differentiate between the important and the not-so-important. Therefore, it becomes a magnet which keeps attracting all kinds of thoughts. Hence, you are up all night thinking about random things.Plan before you go off to sleep, not during!Yes,planning is boring. It's geeky, time consuming and many more things. But what it also is-a helping hand for uncertain situations. We can't plan everything in life and we don't need to plan everything in life. But for the things that we can, it's always smarter to do it in advance so that you can go off to bed comfortably and not worry about what will happen, how will it happen, what will you do etc. Once you know, you have done all that you could, it would take a load off your mind!Not addressing emotional concernsWe all go through anxiety, low moods, anger, irritation etc. We all can handle a certain amount of emotional turmoil. But if the mood states persist for a longer duration and start interfering in other areas of life, they are bound to impact the body's normal functioning as well. Thus, affecting appetite and sleep. Therefore, it's important to talk it out and deal with the emotions instead of deferring them. You can talk to people close to you or you can even seek professional help.We don't know how to relax!Learning how to relax is important. It's important to indulge in activities that keep us closer to ourselves. Pursuing any hobby, socializing, learning relaxation techniques is as important as holding a job, earning money, managing the house, kids, studies etc.The more we progress in life, the less attention we pay to our own biological and natural needs. Since we can't sleep, we might as well wake up and do something that can out us back to sleep!Sleep well. Stay healthy. Feel good!

5 Dangers of Not Sleeping Enough

Ms. Swati Kapoor, Dietitian/Nutritionist
Lack of sleep affects every physiologic function of the body. You already know that lack of sleep can make you irritable throughout the day. What you may not know is what it can do to your memory, health, physical appearance and even your ability to lose weight. Here are 5 dangers of not sleeping enough:1. Sleep Loss makes you DumbLack of sleep may affect the brain development by decreasing cognitive processes like thinking and learning. This makes it more difficult to learn or think efficiently, technically making you dumber.2. Sleep Loss causes DepressionInsomnia has been linked to depression. Sleep loss contributes to cause depression. It may make you lethargic, irritable and stressful throughout your day.3. Sleep Loss ages your skinLosing sleep causes lackluster skin, fine lines and dark circles under the eyes. When you don’t get enough sleep, the body releases more of the stress hormone cortisol which may breakdown the skin collagen that keeps the skin smooth and elastic. Sleep loss also causes the body to release less human growth hormone.4. Sleep Deprivation can lead to serious Health problemThe clinical consequences of untreated sleep disorders may lead you to numerous serious medical illnesses for e.g. heart attack, high blood pressure, obesity, etc.5. Sleep Lose can make you gain weightLack of sleep seems to be related to an increase in hunger and appetite, and possibly to obesity. Losing sleep decreases Leptin levels and elevates Ghrelin levels, which stimulates hunger. It not only stimulates your appetite but also stimulates cravings for high-fat, high-carbohydrate foods.You should hit the snap for at least 7-8 hours every night.