- What is the significance of World Sleep Day? The goal is to celebrate the benefits of good and healthy sleep and to seek the attention of people to the burden of sleep disorders. We need to look at the medical, social, emotional and educational aspects of sleep disorders. There is a tremendous need to increase awareness about the prevention and management of sleep disorders.
- What is Sleep hygiene? Sleep hygiene refers to actions that tend to improve and maintain good sleep. Sleep as long as necessary to feel rested. Usually seven to eight hours for adults, then get out of bed. Try not to force sleep. Avoid caffeinated beverages after lunch. Avoid alcohol near bedtime. Avoid smoking or another nicotine intake, particularly during the evening. Reduce ambient light, turn off the television or radio. Avoid light-emitting screens before bedtimes such as laptops, tablets, smartphones or eBooks. Resolve concerns or worries before bedtime. Exercise regularly for at least 20 minutes a few hours before going to bed. Avoid day time naps especially if they are longer than 20 minutes.
- What is insomnia? Insomnia was previously viewed as a sleep disorder secondary to a medical condition, psychiatric illness and would improve when the underlying condition was treated. However, evidence over the last 20 years is against this understanding. Insomnia is recognised as an independent disorder.
- What about medicines to induce sleep? Medicines include benzodiazepines, non-benzodiazepines, melatonin agonists, doxepin and suvorexant. The potential benefits of these drugs should be balanced against the risk of side effects as well as physical and psychological addiction with long term use.
- In which clinical setting, the risk of sleeping pills increase? The risk of foetal malformations can increase if sleeping pills are consumed in the first 12 weeks of pregnancy. Sedatives should not be combined with alcohol as the risk of respiratory suppression increases. Most sleeping pills undergo liver or kidney clearance. This may lead to excessive sedation if sleep inducers are taken in the presence of liver or kidney disorders. Many sedatives may increase the severity of obstructive sleep apnea. Those who need to take nighttime decisions like doctors or nurses or single parent managing toddlers, the decision-making process may be affected by sedatives. Older people more than 75 years should avoid sleeping pills as this may result in falls, low blood pressure or drowsy state during the day.
- What are the risks if you continue to get less sleep? Besides emotional lability, people who sleep less tend to eat more and may suffer from obesity. The consequences of this could be hypertension, diabetes, higher cholesterol levels and thus increased risk of cardiovascular and brain disorders. Depression and anxiety can be associated with sleep deprivation.
- In modern day times, adequate sleep may be a luxury for some? What is the remedy? Though a common issue it should be looked into seriously. The consequences of sleep deprivation are much more lethal than the advantages of both economic or social of working more.
- What if you have excess sleep? Every person has a set pattern of sleep. Excessive sleep may be due to depression, hypothyroidism, low sodium levels or serious kidney or liver dysfunction. Certain neurological conditions may cause excess sleep and referral to your doctor is suggested. It is no wonder that quality sleep is at times elusive. Family matters, work stress, extra responsibility may all cause sleep disorders.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.