Sleep- how much and are you getting enough?
/by Karen Chan (Physiotherapist; Acupuncturist)
Did you know that up to 45% of the Australian population are having inadequate sleep (duration or quality)? 17% of people have reported falling asleep on the job; and 17% have reported not going to work due to poor sleep. There is also a strong correlation to decreased work performance, with up to 30% making procedural errors due to lack of sleep (2016 Report to Sleep health foundation, Adelaide).
We’ve all experienced sleep deprivation to some degree and felt the implications. Whether its moodiness, tiredness, inattention or incoordination. However, would you want your doctor performing life saving surgery or your accountant doing your income tax statements knowing they had minimal sleep? (Interestingly, medical error is the 3rd leading cause of death in US after heart disease and cancer!).
figure 1: implications of shift work. from: James et al (2017)
Implications of inadequate sleep:
As we sleep our body cells repair and rejuvenate, thus has a major role in injury recovery. However it is not just recovery rates that are affected.
Our physical and mental wellbeing, memory, quality of life and life expectancy, creativity, energy, functional capacity, alertness/attention, reaction times, weight control, stress levels, moods (eg irritability, depression), academic performance are all affected. There is also associated impaired driving and risk-taking behaviours, impaired social relationships and evidence to show decreased performance in elite and amateur athletes.
Ongoing sleep deficiency is linked to increased risk of cardiovascular/ hypertension and kidney disease, hypertension, type 2 diabetes, stroke, and even cancer
Who is at risk?
We are obviously all at risk of sleep inadequacy however prime groups include:
Students (hard working ones at least)
Parents with newborn/ young infants
Shift workers: disruption of circadian rhythm
Regular travellers, especially regular changes of time zones/ jetlag
Menopausal/ pregnant women
‘Workaholics’
How much sleep is recommended?
figure 2: national sleep foundation’s sleep duration recommendations. From: National sleep foundation (2015)
Interestingly, it seems that the ‘catchup' weekend sleep shows mixed findings in terms of benefits or potential ‘reversal’ of implications. Thus the better approach to have is instead to aim for good sleep hygiene and quantity.
Those that have regularly less than the 7hours of sleep are at risk of those complications mentioned above.
So, that extra hour’s sleep every day can potentially save your life!
Tips for sleeping better:
Destress techniques (eg yoga, meditation, mindfulness, journalling, see my previous blog post)
Relaxation eg warm baths/showers, soft music, white noise, chamomile teas
Avoid blue light emitted by technology (eg laptop, ipad, mobile) (stimulates brain into thinking its day and reduces amount of melatonin (hormone which helps us relax and sleep). Can download software to help reduce blue light emission from these devices now
Avoid stimulants eg alcohol, coffee, tobacco; especially after lunch
Avoid heavy meals 2-3 hours before sleep
Avoid TVs in bedrooms
Exercise (studies shown to help with improving all aspects of sleep), although avoid exercise just before bed though as this can be over stimulating in some
Routine (think of babies!)- aim to sleep and wake at same time daily
Lighting- aim for natural sunlight for circadian rhythm. Curtains/ block out curtains if room is too bright at night, use of eye shades
Noise control- earplugs for unwanted sounds of snoring, traffic etc
Room temperature- ideal is 15-20C
Comfort- mattress, pillow/s. These make such a big difference. Generally if a mattress is older than 10years, it is most likely nearing its endlife. Likewise with a pillow, if you notice change of support and comfort, it’s time to upgrade.
Physical pain? eg sore shoulder or hip. Book in for a physiotherapist review to help potentially alleviate these
Consider a sleep professional and rule out a medical condition eg sleep apnoea, restless leg syndrome
Limit napping during the day- limit to 15-20mins
Ensure exposure to bright light or natural light during the day (helps regulate circadian rhythm)
Consider natural therapies- melatonin, vitamins, Himalayan Salt lamps (anecdotal evidence), lavender oils, Magnesium supplements for muscle relaxation
Parents of young children- have a nap when bubs sleeps (even though the temptation to do the washing/cleaning/cooking etc is there), say yes to babysitting offers, warm baths and milk before baby sleeps, sticking to routines, and encourage self soothing techniques from early on
Acupuncture- As acupuncturists, we see a lot of patients with symptoms of sleep issues. There is currently some research showing moderately strong potential of efficacy with minimal to no side effects, however more quality research is needed in this area to make a conclusive correlation.
Nutritional and Dietary management- seek their expert advice as to what may help or what you may be lacking
So make your sleep a priority- it is so easy to say to yourself ‘i’ll just do that bit of work’ or 'do some more reading’ or ‘watch another episode of games of thrones’ but the detriment to your longterm health could actually be irreversible.
Karen Chan is the chief Physiotherapist, Acupuncturist and Director of Prospect Physiotherapy and Health Plus Clinic in Adelaide. She is also a lecturer at Endeavour College of Natural health and has a keen interest in holistic health and wellbeing. For more of Karen’s blogs, go to: http://prospectphysioandhealthplus.com/blog
Resources:
Adams, R, Appleton, S, Taylor, A, McEvoy, D, & Antic, N (2016) .Report to the Sleep Health Foundation 2016 Survey of Australian Adults. The University of Adelaide. Retrieved 24 September 2018, from https://www.sleephealthfoundation.org.au/pdfs/surveys/SleepHealthFoundation-Survey.pdf
Banno, M., Harada, Y., Taniguchi, M., Tobita, R., Tsujimoto, H., Tsujimoto, Y., … Noda, A. (2018). Exercise can improve sleep quality: a systematic review and meta-analysis. PeerJ, 6, e5172. https://doi.org/10.7717/peerj.5172
Fuller, C., Lehman, E., Hicks, S., & Novick, M. B. (2017). Bedtime Use of Technology and Associated Sleep Problems in Children. Global Pediatric Health, 4, 2333794X17736972. https://doi.org/10.1177/2333794X17736972
James, S. M., Honn, K. A., Gaddameedhi, S., & Van Dongen, H. P. A. (2017). Shift Work: Disrupted Circadian Rhythms and Sleep-Implications for Health and Well-Being. Current Sleep Medicine Reports, 3(2), 104–112. https://doi.org/10.1007/s40675-017-0071-6
Kim, H., Jeong, G., Park, Y. K., & Kang, S. W. (2018). Sleep Quality and Nutritional Intake in Subjects with Sleep Issues According to Perceived Stress Levels. Journal of Lifestyle Medicine, 8(1), 42–49. https://doi.org/10.15280/jlm.2018.8.1.42
Kolling, S., Duffield, R., Erlacher, D., Venter, R., & Halson, S. L. (2018). Sleep-related Issues for Recovery and Performance in Athletes. International Journal of Sports Physiology and Performance, 1–17. https://doi.org/10.1123/ijspp.2017-0746
Kuula, L., Pesonen, A.-K., Martikainen, S., Kajantie, E., Lahti, J., Strandberg, T., … Raikkonen, K. (2015). Poor sleep and neurocognitive function in early adolescence. Sleep Medicine, 16(10), 1207–1212. https://doi.org/10.1016/j.sleep.2015.06.017
Lallukka, T., Sivertsen, B., Kronholm, E., Bin, Y. S., Overland, S., & Glozier, N. (2018). Association of sleep duration and sleep quality with the physical, social, and emotional functioning among Australian adults. Sleep Health, 4(2), 194–200. https://doi.org/10.1016/j.sleh.2017.11.006
National Sleep Foundation (2015). Retrieved 18 January, 2017 from https://www.sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times.
Seravalle, G., Mancia, G., & Grassi, G. (2018). Sympathetic Nervous System, Sleep, and Hypertension. Current Hypertension Reports, 20(9), 74. https://doi.org/10.1007/s11906-018-0874-y
Stepan, M. E., Fenn, K. M., & Altmann, E. M. (2018). Effects of sleep deprivation on procedural errors. Journal of Experimental Psychology. General. https://doi.org/10.1037/xge0000495
