Poor sleep can affect health and quality of life
Sleep is not only a normal phenomenon, but it is also considered a vital physiological process for the overall health of human beings. Sunlight at sunset activates certain cells in the retina, and upon receiving this signal, the body increases its levels of melatonin, the hormone of darkness. Consequently, we feel sleepy, our reactions slow down, and we notice a slight chill. The brain prepares to take care of itself; fast brain waves gradually weaken and give way to slow waves, allowing us to relax. Shortly after falling asleep, the growth hormone kicks in; it is a time of recovery. Muscles regenerate, skin and hair grow, wounds heal, and the brain performs a general cleanse.
While we sleep, irrelevant memories fade into oblivion and important ones are stored in long-term memory. The brain dreams intensely (people who wake up during this phase vividly recall the content of their dreams or daydreams). Blood pressure and heart rate increase, while metabolic activity and body temperature remain at a minimum. In the morning, the secretion of cortisol, the stress hormone, increases, making sleep lighter. While we are still in bed, different regions of the brain begin to awaken, each in its own time.
What are the functions of sleep?
Although we don't have a clear understanding of why we sleep, it's evident that several very important physiological processes are closely related to, or even determined by, sleep or its periodicity. In this regard, there are various theories about the functions of sleep, such as: energy restoration or conservation, elimination of free radicals accumulated during the day, regulation and restoration of cortical electrical activity, thermoregulation, metabolic and endocrine regulation, synaptic homeostasis, immune activation, and memory consolidation, among others.
What is insomnia?
Although most people sleep at night, up to 10% of the population suffers from insomnia. According to the International Classification of Sleep Disorders, published in 2014, insomnia is defined as a persistent difficulty initiating, maintaining, or consolidating sleep, despite adequate circumstances and opportunity, and accompanied by a significant level of distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.
This inability to sleep is the most common sleep disorder in the general population and one of the most frequent reasons for seeking medical attention in psychiatric consultations. Both the diagnosis and treatment of sleep disturbances are challenging; insomnia often goes unnoticed or untreated, which contributes to the worsening of the medical and psychiatric conditions of those who suffer from it. Furthermore, it significantly impacts the patient's subsequent waking hours and can cause multiple disorders that affect quality of life and work capacity.
There is no single, ideal treatment for patients suffering from insomnia, and in any case, it is always the professional's task to design a personalized treatment plan for each patient, relying on theoretical knowledge, daily practice, and experience.
What is sleep hygiene?
In modern life, the role of sleep has been relegated, and the time dedicated to sleeping has been decreasing over the years. For many, sleep is essentially seen as a waste of time. It is common to consume various substances (coffee, energy drinks, tobacco, alcohol, among others) that, in one way or another, affect the physiology of normal sleep. This, coupled with a series of poor sleep habits (irregular sleep schedules, poor dietary habits, sedentary lifestyle, nighttime use of technological devices, etc.), has resulted in a large percentage of people reporting poor sleep quality.
Sleep hygiene measures are a series of recommendations regarding desirable behaviors and habits, as well as modifications to environmental conditions and other related factors, aimed at improving sleep quality in people who already suffer from a sleep disorder such as insomnia, or that can be used as measures to prevent sleep disturbances. There is no global consensus on what these sleep hygiene measures should include, and several of them overlap with some forms of non-pharmacological behavioral treatment. Generally speaking, we can consider the following, based on the publication by Mastin et al.
- Avoid prolonged naps (longer than 1 hour) during the day.
- Go to bed at the same time every day.
- Waking up at the same time every day.
- Avoid vigorous activity before bed.
- Avoid consuming alcohol, cigarettes and caffeinated beverages: coffee, chocolate, tea, cola or energy drinks (at least 4 hours before sleeping).
- Avoid engaging in highly stimulating sensory activities before going to bed (video games, internet, television).
- Avoid going to sleep stressed, angry, anxious, or worried.
- Do not use the bed for other activities (reading, studying, working, eating, etc.).
- Sleep in a comfortable bed.
- Avoid thinking about the activities done during the day, or planning and organizing future activities while trying to sleep.
- Sleep in a room with low lighting, a comfortable temperature, and little ambient noise.
We know that the consequences of poor sleep quality extend far beyond simple discomfort, drowsiness, or poor academic performance; hypertension, obesity, diabetes, various cardiovascular and cerebrovascular diseases, and depression are just some of the long-term health problems most frequently observed in people with sleep disorders. The importance of addressing sleep disorders lies in the fact that most of these disorders arise from external factors or poor habits, and are therefore potentially modifiable. All of this should lead us to reflect on the importance of sleep as a physiological process and on sleep hygiene practices as a long-term investment in preventing chronic diseases.
Ramona Ávila Núñez, PhD
References
Martínez Hernández, Olivia, Montalván Martínez, Olivia, Betancourt Izquierdo, Yandy. (2019). Insomnia disorder. Current considerations . Electronic Medical Journal , 41 (2), 483-495. Retrieved March 9, 2021, from http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1684-18242019000200483&lng=es&tlng=es .
Carrillo-Mora, Paul, Ramírez-Peris, Jimena, & Magaña-Vázquez, Katia. (2013). Neurobiology of sleep and its importance: anthology for the university student. Revista de la Facultad de Medicina (México) , 56 (4), 5-15. Retrieved on March 9, 2021, from http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0026-17422013000400002&lng=es&tlng=es .
Mastin D, Bryson J, Corwin R. (2006). Assessment of sleep hygiene using the Sleep Hygiene Index. Journal of Behavioral Medicine , 29(3), 223-7.