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December 2009
Sleep your Way to Health
Dr Savita Date Menon
What's the last item on your agenda for the day? You have bustled around all day running to work or school, grabbing a quick meal, manoeuvring your way through the rush hour traffic, meeting important people, working to earn some good money for the family.

Having started the day on full throttle, the everyday soldier now returns home with the battery quite discharged. Home being haven, you are now looking for some well deserved rest and relaxation.While sleep is the last item on our agenda, it is perhaps one of our healthiest habits. Is sleep really so important? Or is it a habit that parents force their children into, to have some quiet time for themselves?

The Nuts and Bolts of Sleep

How many hours of sleep do you need?
Six to eight hours

How often must you have it?
Every day

What is the best time to sleep?
At night

If I can't sleep eight hours at a stretch, can I break it into two cycles?
You must get one cycle of six hours at least. If your second cycle is an afternoon nap, one hour is more than enough

Which part of the body does it benefit?
The body and mind

How long can one go without sleep?
Usually not more than 72 hours

Is sleep as necessary for survival as food?
Yes, as vital as breathing, eating and drinking etc Well, considering that we spend one third of our lives in sleep (that's right, one third!), it surely is important. Repair, healing and clearing of unconscious emotional conflicts all happen during sleep.

Sleep States

Sleep has two states alternating with each other through the night. Rapid Eye Movement or REM sleep with high physiological activity and Non Rapid Eye Movement or NREM sleep which is a peaceful state with lowered physiological activity. REM sleep is when you dream and remember your dreams, which are usually symbolic in nature. NREM sleep is deep sleep where the body rests and heals.

Short sleepers require less than six hours of sleep and are considered to be energetic and efficient. Long sleepers need over nine hours of sleep and are said to be a little lethargic. Mahatma Gandhi and Napoleon were short sleepers while Einstein on the other hand was a long sleeper. In any case, it is not only important how long you sleep, but how well you sleep. More important though is, how refreshed you are when you wake up.

Sleeping at Night
Day time sleep is physiologically different from the night's undisturbed, rested sleep. Sleeping at night even seems like a luxury the global Indian can't seem to afford! Our biological clock is tuned to sleeping at night. Globalisation of business has resulted in 24 hour communication, making MNC professionals be accessible day and night on the email and mobile. International air travel is now almost as frequent as domestic. Also, India's becoming a major player in the IT, ITES sectors has shifted sleep from night to the day time. A 24x7 work culture has changed people's sleep–wake cycles. These factors may take longer to neutralise but can and must be managed. If not managed, the early changes could be irritability, lethargy and fatigue. And if sleep deprivation is prolonged, disorientation, delusions, hallucinations and ego disorganisation may be seen. There are other factors ranging from the easy-to-fix alcohol, tobacco or heavy dinner to change in routine and old age that cause people to sleep less. Physical ailments and mental illnesses are also known to interfere with sleep.

12 Rules of Sleep Hygiene

Is there any way out of this situation other than popping in sleeping pills? How can one continue to work and live as required and still get good sleep? It's not easy, but definitely not impossible. Follow these rules of sleep hygiene:

Keep your sleep–wake timing fixed and regular. Those of you who work at night must sleep in the day at the same time and wake up at the same fixed time, daily. Irregular timing is known to confuse the circadian sleep cycle (also known as the body clock). Similarly, those of you who sleep at night must fix a particular time to finish your pre-sleep wash, change and other rituals, get to bed, fall off to sleep and a fixed time to wake up, with an alarm if required.

A siesta is not an absolute necessity. A short afternoon nap may help you recover from a bad night. But if you have a problem going to sleep at night, avoid that afternoon nap.

Use your bedroom and bed only for relaxation. Working, eating, talking, arguing, and fighting should all be kept outside. Excluding sex, of course! Good sex, in fact, functions like a sleeping pill.

Following a sleep ritual of bath, brushing teeth, moisturising face, brushing hair, prayer etc, help you unwind before you drop into bed. Children sleep better with cuddly toys in bed, pet in the room, a night lamp, their door slightly open etc. They feel safe and secure making them sleep well.

A warm glass of milk and a warm bath make you feel relaxed and aid in sleep. Coffee and cigarettes are stimulants, best avoided at bed time. Alcohol in large quantities is also a deterrent.

The decor and ambience of your room must be comforting. Take care with colour schemes, lights, sound, privacy, furniture and even your mattress and pillow.

The temperature must be right. Too warm and you may wake up perspiring, thirsty and uncomfortable. Too cold and you will wake up shivering. Set a comfortable temperature once and for all. The room must also be airy, clean and well dusted.

Regular exercise improves sleep. But vigorous exercise at bedtime acts like a stimulant and so is not a good idea. Exercise is best in the morning or evening.

A heavy stomach will only interfere with sleep. So make sure your dinner is light and at least two hours before bedtime.

If trips to the toilet break your sleep cycle, avoid drinking water a few hours before bedtime.

And finally, if you are not sleeping in spite of all your efforts, quit trying. Get up from your bed; try reading (not TV) and then attempt to sleep again. Tossing and turning (and not succeeding) creates conditions of panic, further affecting sleep.
Dr. Savita Date Menon is a clinical psychologist, popular speaker, columnist and a guest faculty at Harvard Medical School, USA

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