Sleep : the undervalued biological health asset

By: Namita Thapar and Dr. Joy Desai

Health is perceived to emanate from dietary discretion and investment in fitness routines. In a culture where 70-hour work weeks are glorified, sleep is the health underdog. When one says that one hasn’t taken a vacation or slept well in months, it evokes respectful glances, and the ‘tag’ of an ambitious overachiever headed for the next unicorn and a gateway to unimagined riches. On the other hand, if one says that they sleep 8-9 hours daily, it’s almost always assumed that the individual is retired, lazy or out of work. A good sleep routine is no longer a badge of honour, and to today’s younger generation nighttime scrolling and sleeping late is the new norm.

The Science Behind Healthy Sleep

Sleep is nature’s biologically complete restorer elegantly conserved by evolution. It makes memories sharper, emotions stable, maintains blood pressure and blood glucose levels, optimises fat storage and enhances skin health associated with youthful good looks. It is a biological washing machine and janitor rolled into one, diligently cleaning the brain of potentially harmful protein fragments generated during daytime activities. The sleep exclusive garbage truck of the brain is known as the glymphatic system. Sleep harmony keeps bones stronger by balancing bony regenerative activity.

For these sleep benefits to be accrued four key elements of sleep need to be maintained: quantity, quality, timing, and consistency. The brain is biologically wired to sleep for at least seven hours and that too with an onset within four hours of sunset and to waken with the sunrise, embodying the well-known concept of “circadian rhythm”. Sleep disorders like insomnia, sleep apnoea, and restless legs syndrome can hamper sleep quality and its restorative benefits. Consistency in optimal sleep timings can enhance sleep benefits over a lifetime.

Inadequate sleep, misaligned sleep, and undetected sleep disorders can all contribute to brain fog, emotional fragility, hypertension, irregular blood sugar control, weight gain, weak bones and osteoporosis, and singularly high risk of developing lifestyle diseases like stroke, heart attacks, Alzheimer’s disease, Parkinson’s disease, and even malignancies (breast, lung, etc)

Quantity:

Our brain is biologically wired to sleep for at least 7 hours — that too within four hours of sunset — and to wake with the sunrise. This is the well-known concept of “circadian rhythm”.

Quality:

Sleep disorders like insomnia, sleep apnoea, and restless legs syndrome can hamper sleep quality and its restorative benefits. Similarly, our environment, internal stress, and other lifestyle choices can affect sleep quality as well.

Timing:

If you're sleeping from 3am to 10am, yes, you're getting enough sleep. But research has linked sleep timing to be an important part of good sleep health. In other words, sleeping from 10pm to 5am is better, even though the duration is the same.

10 Common Myths About Sleep Because of how much we as a society deprioritize sleep, there is a lot of misinformation around its importance. Here is a look at the 10 biggest myths around sleep.

1. The time you sleep doesn’t matter

If you sleep at 2 am and wake up at 9 am, that’s ok as you still got your 7 hours and woke up refreshed. This is the most common myth I hear.

We all need to understand circadian rhythm. Our body’s internal sleep and wake up clock. This is set such that we need to sleep 3-4 hours after sunset which is usually no later than 10:30 pm. The minute we disturb this natural rhythm, we don’t get the full health benefits that sleep has to offer.

2. The number of hours of you sleep doesn’t matter

Friends often say that their body only needs 4 hours of sleep and the proof is

in the fact that they wake up feeling refreshed and have tons of energy the entire

day. This is incorrect. Though they may not feel the impact of less sleep right away, this goes against our circadian rhythm. Eventually, this sleep deficit catches up and increases the likelihood of developing several adverse health conditions.

3. Catching up on sleep over the weekend is good enough

Many say that they sleep less during the week but then sleep extra on weekends and catch up. This is known as paying off your “sleep debt.”

While there is well documented research suggesting that catching up on sleep may have small health benefits compared to those who don’t. But they are still subject to the overall risks that poor sleep brings.

 4. As you grow older you need less sleep

Melatonin, the natural sleep hormone that our body makes, decreases with age. This is why older people have trouble sleeping the usual 8 hours. But this doesn’t mean that your body does not need the bare minimum 7 hours of sleep. Instead of justifying the lesser sleep due to lower melatonin production or other factors, even the 60+ population must work towards a better sleep routine and get their 7-8 hours.

5. Alcohol doesn’t impact sleep

Many use alcohol as a tool to sleep well. But it’s well documented that it fragments your sleep and impacts the overall quality of your sleep, even if it may help you fall asleep. So if you do consume alcohol, it’s best to have it earlier rather than later in the day.

6. Caffeine doesn’t impact sleep

Just like alcohol, caffeine fragments your sleep. You also don’t end up sleeping as deeply as without caffeine. If you consume caffeine, especially coffee, it’s generally best to have your last cup at least 6 hours before bedtime.

7. Heavy workout in the evenings don’t affect sleep

When your body is supposed to slow down so that you can relax, rest and get ready to sleep, overstimulating it at the gym can fragment your sleep, affecting overall sleep quality.

That said, if exercising at night is your only option, getting physical activity in is better than not getting any. But you’ll still want to make sure you’re getting enough sleep and sleeping at a reasonable hour.

8. Melatonin and a sleeping pill are the same

People often take melatonin to regulate their sleep cycle, mostly after heavy travel or deadlines or late shift working. Since our body already makes melatonin, supplementing it has negligible side effects.

Sleeping pills on the other hand, are stronger medications that push your body to shut down and can be addictive. For this reason, melatonin is available over the counter directly for consumers to buy vs a sleeping pill that needs a doctor’s prescription.

 9. Take either melatonin or magnesium, not both

While people think magnesium is good for sleep, scientists are still understanding how magnesium may benefit sleep. Many do report better sleep, likely because magnesium helps with muscle recovery, helping people relax and sleep better without muscle pain.

Since melatonin works differently, by directly helping people fall asleep easily, you can take both melatonin and magnesium. melatonin Plus, magnesium is mostly taken daily, whereas melatonin is taken for short-term use, like after travel or during shift work .

10. Taking naps is good for everyone

Taking short naps at the right time (not too late in the day) is promoted in several cultures, as naps are thought to increase productivity and overall health.

But as a blanket statement, this isn’t true. It’s important that naps are short and not taken too late in the day. Otherwise they can prevent you from getting a full night’s rest.

Also, for people dealing with insomnia and take medication for it, taking naps must be avoided.

What happens if you don’t sleep enough?

Inadequate sleep, misaligned sleep, and undetected sleep disorders can all contribute to a host of issues. These include:

• Brain fog
• Emotional fragility
• Hypertension
• Irregular blood sugar control
• Weight gain
• Weak bones and osteoporosis
• A singularly high risk of developing lifestyle diseases like stroke, heart attacks, Alzheimer’s disease, Parkinson’s disease, and even certain malignancies, like breast cancer and lung cancer

 Simple Habits to Improve Sleep Quality

Now that we have separated sleep facts from fiction and understand the harms of lack of sleep, here are simple evidence-backed and sleep doctor-approved tips to build a good sleep routine.

1. Right before sleeping, dim the lights

Dim lights signal the body that it’s nighttime, while also supporting our body’s natural production of melatonin that nudges our body to sleep.

Bright lights do the opposite and confuses our body’s circadian rhythm. It makes our body still feel like it’s daytime. In turn, this suppresses the melatonin production, which is why we have trouble sleeping.

A good habit to support a healthy sleep routine is getting a lot of natural sunlight first thing in the morning. This suppresses melatonin earlier in the day and spikes cortisol, a hormone that also acts like an “alarm system,” so that you have optimum energy and focus during the day. Early sunlight exposure also allows our body to make melatonin at the right time later in the day, which in turn, signals our body to wind down and sleep at a reasonable time.

2. Right before sleeping, switch off all screens

This means no TV, laptop, or scrolling on your phone. Like bright lights, the blue light from these devices has the same effect on our circadian rhythm. Beyond just the physiological interference, what we consume on these devices also tend to be overstimulating.

Does this mean you give up unwinding with a good watch, completing an important to- do, or using your phone altogether? No. But to the extent possible, avoiding screens 1-2 hours before bedtime can promote better quality sleep.

3. Waking up in the middle of the night

Waking up to use the bathroom is common and not an issue if you fall asleep within 5-10 minutes of waking up. But if you have trouble falling asleep after waking up, it’s important to listen to light music, read something boring, do breathwork and work towards falling back asleep. If this is done routinely with a calm mind, it will help the body to quickly fall back asleep.

4. Keep a worry journal

This is one of my favorite hacks to fall back asleep. Very often our mind has the habit of overthinking, whether it’s a long and unfinished to-do list keeping us up, or unresolved issues that make it tough for us to fall asleep.

Matthew Walker, a sleep scientist from UC Berkeley, talks about keeping a worry journal and dumping all our thoughts in it a few minutes before falling asleep. This is not meant to solve all our problems, but rather to reassure our brain that we have made a list and will not forget and get to it the next day. This simple and small hack calms our mind and helps us fall asleep.

The takeaway

Sleep deficit is nothing short of a national epidemic that is silently harming India’s health. While health awareness is growing in other forms — people paying closer attention to their diet and fitness — sleep unfortunately remains a critically overlooked part of health.

Spreading awareness around sleep myths and practicing a few good habits to create a strong sleep routine is probably the easiest to correct if one puts their mind to it.

I hope this write up is a ‘wake up call’ for many of you and inspires you to proudly declare that “Hey, I sleep 7 to 8 hours daily and it’s been a gamechanger for my health and productivity.” God knows, we definitely need to hear more of that!!