friday

29 June 2017Last updated
Search

Features | Health

Are you sleepless in the UAE?

More than 65 per cent of people in the country don’t get enough sleep - a condition that could contribute to strokes, heart attacks, memory loss and mood swings. So how many hours should we be spending in noddy land? Colin Drury finds out

Colin Drury
9 Jun 2017 | 11:28 am
  • Source:Supplied

It is something which many of us in the UAE regularly wear like a badge of honour: surviving on minimal sleep.

A competitive work culture, hectic night life, an ambitious and transient population all mean shut-eye is often considered of secondary importance.

Being the last to leave the party and the first to arrive at your desk tends to be the goal here. Almost two-thirds of us don’t get as much snooze time as we should, according to one estimate.

Sleep, it seems, is for wimps and people in other places.

Except it’s not.

A continual lack of Zs will, doctors warn Friday readers today, result – like malnutrition and dehydration – in irreversible long-term health damage.

Missing just an hour a night over a sustained period has been linked to strokes, heart attacks and cancer. Because even minor sleep deprivation hits the immune system it leaves us vulnerable to more illnesses. The fact it significantly slows the metabolism, too, means it increases our risk of obesity and diabetes – and all the associated health problems.

Mentally, not enough sleep can cause clinical depression, anxiety, memory loss and mood swings. Those effects start taking hold within days. Because it destroys our brain’s ability to function at its optimum, it has been quoted as a contributing factor in industrial deaths and fatal motor accidents alike.

‘It is not an exaggeration to say this is an invisible killer,’ says Dr Irshaad Ebrahim, consultant neuropsychiatrist and medical director at The London Sleep Centre in Dubai Healthcare City. ‘If you don’t sleep enough, you are building up either an immediate or future health crisis. It is that serious. It will affect your life expectancy.’

All of which perhaps raises two major questions: what exactly is the right amount of sleep? And, when we’re all leading such hectic lives, how can we get more of the stuff?

A lack of sleep is by no means a phenomenon unique to the UAE.

Trying to squeeze more hours into the day – which generally means less hours in bed – is a universal trait. The onslaught of screens into our lives has exacerbated things with repeated studies showing that using laptops, mobiles and TVs at night disrupts brain patterns and results in difficulty nodding off. The rise of rich sugary and salty snacks hasn’t helped either. These foods disrupt natural energy cycles, and, if eaten close to bed time, result in disturbed sleep.

Yet, if the above can be considered global factors, there are also more localised considerations which may exacerbate the issue here in the Gulf.

Apart from the work and social culture, global-leading cities like Dubai and Abu Dhabi inevitable come with night time noise and light which makes snoozing harder. The heat of summer and the lack of fresh air can also create less than ideal sleeping conditions.

Because much of the population is from another part of the world, there is a tendency for people here to live by multiple time zones, whether that be for work (arriving early to sync with Asian office times, perhaps) or personal reasons (how many of us have stayed up late talking to loved ones on Skype?).

There is another causation factor too, according to Dr Manio von Maravic, neurologist at the German Neuroscience Center also in Dubai Healthcare City: stress. For many people here, continuing residency is intimately linked with job security – and that can increase pressure at work.

‘The evidence is that certainly impacts on sleep here,’ says Dr von Maravic who has 30 years’ experience working in neurological departments across Europe. ‘It can make it especially difficult to switch off.’

The result of all this, according to a 2015 survey by data research firm Zarca, is that 65 per cent of people in the UAE don’t sleep enough. ‘Sleep deprivation is a neglected area which can cause major health and social issues,’ said Javed Farooqui, executive director, at the time.

And 18 months on, experts reckon the problem is only set to get worse.

‘The figures are worrying,’ says Dr Ebrahim again. ‘Because what it shows is that people do not take this issue seriously. They think they can get away with lack of sleep. They think it affect them. But, if they are human, it will.’

It is a strange quirk of science that for something so important to humans, the exact way sleep works – and the reason we need so much – remains something of a mystery.

What we do know is that there are two broad categories of slumber: Non-Rapid Eye Movement and Rapid Eye Movement.

The former takes up about 75 per cent of our snooze time and is the lighter of the two.

‘During this stage,’ says Dr Ebrahim, ‘the body rests, restores and grows – blood pressure drops, muscles relax, breathing slows and tissues are repaired.’ Broadly, it is about physical rejuvenation.

REM sleep, by contrast, is far deeper. At this point, the body goes into a state of paralysis but the brain becomes active. It is now that we dream.

‘The activity here is geared to supporting the brain,’ explains Dr Ebrahim who runs sleep centres in London, Edinburgh and Pretoria as well as in Dubai. ‘In simple terms, the hardware is defragged, tested and reordered; files are slotted away and information reorganised.’

A process called consolidation simultaneously occurs during both stages. ‘Our brains take in a huge amount of information every day but this is generally stored in a short-term bank,’ continues Dr Ebrahim. ‘When we sleep, the facts and experiences which we consider important are processed and transferred – consolidated – to our long-term store.’

During a good night’s sleep, we will experience both the NREM and REM phases about seven or eight times each in an alternating cycle. It is, however, when the number of these cycles is consistently reduced – because we are not asleep long enough – that the health dangers begin.

As Dr von Maravic nicely puts it: ‘cutting down the cycles means not giving your body and brain the chance to do all the work they need done.’

We are, essentially, waking up and starting again with our hardware still damaged and slowed from the day before.

Indeed, it is for this reason that sleep cannot be ‘paid back’. Catching up on Zs over the weekend is largely considered okay by experts. But if we live off too little slumber for too long, the damage done to our bodies cannot be put right again.

It is permanent.

Seven hours tends to be what people think of when the ideal amount of sleep is raised.

This is both true and false.

True because, broadly speaking and according to the US-based National Sleep Foundation – widely considered the world’s leading authority on the subject – seven or eight hours is typically what an adult should aim for (for children and teenagers, it’s nine to ten).

But false because everyone is different.

Some people need more. Others can genuinely thrive on less. When Margaret Thatcher claimed to live on four hours sleep a night, she wasn’t necessarily exaggerating; she may have just been one of the lucky people whose bodies and brains refresh quicker.

‘As with all such things, this is a liner model,’ says Dr Ebrahim. ‘The exact amount is different for each individual.’

The best way to judge your own requirements is simple: it’s all about how you feel.

If you wake up refreshed and ready for the day, this is a good sign. If you go all day without experiencing sensations of tiredness, fatigue or weariness, even better.

But if either of these things aren’t true, you’re almost certainly not sleeping enough.

Except, of course, in the real world, achieving a good night’s slumber can be easier said than done.

‘Following a good sleep routine and having a healthy sleep environment can make all the difference in, firstly, getting to sleep, and, secondly, ensuring that is really excellent quality sleep,’ says Dr von Maravic.

Key to that is ensuring your bedroom is designed to be sleep-inducing: quiet, dark and cool (60 to 75°F is the ideal). Spend some time getting a mattress and bedding that feels right. Perhaps most importantly, remember the function of this room is to rest. Keeping work materials out will help it become a space of relaxation, while avoiding eating smelly food will maintain its freshness.

Establishing a pre-bed routine is important as well – ‘to ease the transition from wake time to sleep time,’ says Dr von Maravic.

An hour or two relaxing before lights out could include a bath (body temperature rising and falling promotes drowsiness), reading a book or practicing yoga or mindfulness. The latter is a firm favourite with Carmen Benton, founder of Mindful Ed personal development consultancy based in Al Sufouh, Dubai.

‘It clears your mind of all the day’s stress meaning, by the time your head touches the pillow, you’re ready to simply let sleep take over,’ she explains.

Needless to say, avoiding stressful situations – including work projects and social media – is paramount, as these stimulate alertness. Caffeine and nicotine, as well as screens and sugary snacks, should be ditched in this period too.

Along similar lines, it’s worth eating your evening meal early to avoid it still being digested when you turn off the light. Drink enough in the evenings to keep you hydrated through the night but not so much you need to keep visiting the toilet.

And – counterintuitive, perhaps, but key – get up when the alarm goes off. The occasional lie-in will do no harm but if we sleep too long in the morning, it can make getting to sleep at night more difficult, thus creating a vicious circle.

As for precisely when to sleep, this is rather open to debate. Some experts say that snoozing from just before midnight until six or seven is best. But Dr Ebrahim takes a less prescribed view.

‘Each person can build their own sleep architecture depending on their personal preference, cultural norms and social needs,’ he says. ‘So, if a person desires a siesta in the afternoon and to sleep less in the evening, this is fine. It is about creating a pattern that is right for you, that allows you to achieve your optimum.’

There is a final point here too.

If you’ve followed all the above and are still struggling to nod off or simply not feeling fully rested when you wake, it could be there is some kind of sleep disorder in play.

These are many and varied – from insomnia, where one struggles to fall off, to sleep apnoea, where a person’s breathing keeps pausing and, hence, breaking their sleep pattern. Sleep walking, paralysis (feeling conscious but unable to move) and chronic fatigue syndrome also falls into the category of disorder.

‘These issues are all quite different and can be caused by a variety of things from genetic conditions to environmental factors,’ says Dr Ebrahim. ‘But the key thing is that when a person suspects they have a disorder, they should see a doctor and have it diagnosed because then it can all be treated, either with medicines, counselling or even exercises. To not have it treated, on the other hand, is to risk far more serious health problems arising in the future – because you are not having all the sleep you need now.’

All of which makes the conclusion really rather simple: a good night’s sleep is not just something we should dream about. It is something we should all make happen.

Colin Drury

Colin Drury