It cannot be denied that one of the most important aspects of life is “sleep,” as this is the time when our bodies rest and repair themselves. However, with the lifestyles and obligations that most people have today, quality sleep can be difficult to achieve—we often find ourselves going to bed late, whether due to work obligations or other daily activities or habits. The issue of going to sleep late is, in fact, a rather extensive topic of discussion in the medical world, with ongoing research and medical articles on the subject continually published. There are a wide variety of known sleep problems which many people have likely experienced, including poor quality of sleep and sleep disorders such as insomnia, sleep apnea, lack of sufficient deep sleep, and going to sleep late. All of these issues, collectively, are generally referred to sleep deprivation. So what do we do if we have problems with our sleep? Today I want to help answer some common questions about sleep deprivation and poor quality sleep once and for all.
A: There has been a great deal of research showing that when people get insufficient sleep, their risk of health problems is greater than or equal to those who smoke or those who have high blood pressure or heart disease. Let’s take a look at the effects of sleep deprivation on both adults and children.
A: Every individual has differing needs when it comes to sleep. On average, an appropriate amount of sleep is considered to be between 6–7 hours. Less than 6 hours of sleep is considered insufficient, especially for children who actually need significantly more than that. The dividing factor for those in the at-risk group is that those who sleep less than 6-7 hours per day fairly often are considered to be at increased risk of a variety of health problems.
A: Naturally, we tend to think that sleep problems are found in adults, as adults have work and a variety of activities each day that can easily cause stress. Therefore, we expect that adults would have more sleep problems than children who lead largely stress-free lives. In reality, however, sleep problems are found in people of all ages, even kindergarteners. Because of this, pediatricians are now paying greater attention to children’s quality of sleep. Sleep problems have been found to have a direct impact on a child’s learning and growth. We have found that one of the common sleep problems experienced by children is obstructive sleep apnea (OSA) with enlarged adenoids and snoring. Many adults seem to think that a child’s snoring is normal, when, in reality, it is not a good sign as it may indicate that there is an obstruction or narrowing of the airways while the child sleeps.
A: The issue of sleep deprivation is a huge and rather complex one, and the solution requires the help of experts from a variety of disciplines. This is because a person’s sleep mechanisms—why problems occur and, if problems occur, how they can be solved—cannot be explained by science alone. From a medical perspective, we mostly use assumptions and hypotheses to explain what is occurring and to give a preliminary diagnosis of problems. But such a diagnosis is not always completely clear or certain. In addition to diagnostic complexities, there are also many different types of sleep issues and disorders, including difficulty sleeping, waking during the night, an imbalance in sleep habits or sleep hours, etc., and each individual type of problem requires a different method of care and treatment. There are also a wide variety of causes, including mental state, emotional problems, stress, or even physical illnesses such as sleep apnea, all of which can cause a lower quality of sleep. In some other cases, the causes of sleep issues are unknown, and so it must be said that from a medical viewpoint sleep problems can only be treated and resolved up to a certain level; we are, as yet, unable to solve or cure every issue relating to sleep problems.This is a matter that the medical community continues to study.
A: For the most part, sleep problems should be attacked at the source—at bedtime. This means that a person who is accustomed to going to bed late must retrain themselves to go to sleep earlier. For those who must go to sleep late and also need to get up early, it is recommended that they try to rest or nap during the day. For example, they can take a 30-minute or 1-hour long nap during the afternoon, the time when the body’s cortisol levels begin to decrease. If you can do this, the body will begin to adjust its hormonal levels to a proper balance, helping the body to feel refreshed. Eventually you should try to return to a schedule that allows you to go to sleep earlier when possible and not stay up late each night. There are also vitamins that can help, including various B-complex vitamins, as well as other natural extracts such as certain herbs in the adaptogenic herb group (herbs that are known to help the body cope with stress). One very popular herb is ashwagandha, or Indian ginseng, which helps the body feel more refreshed. In cases where a person is under high levels of stress, magnesium, along with other extracts like GABA, can help to improve sleep, reduce stress levels, and help promote balance within the body.
A: Actually, this is not something you should do. The reality is that good sleep quality is not measured only in total sleep hours but is also dependent on whether you are getting sufficient deep and uninterrupted sleep. Many of the hormonal functions affecting our brains adapt according to sunlight and time of day. When your body doesn’t get enough sunlight, it affects the hormonal imbalance within the body. For this reason, staying up late at night is not a good idea. If the body is unable to properly adjust, it can negatively affect your health. You can easily observe the effects in people who often go to sleep late and wake up late. They still feel tired or fatigued, look like they haven’t had a decent sleep, and are not fresh and energetic despite having slept for a good number of hours. They tend to have the appearance of a person traveling abroad who is jetlagged and hasn’t yet adjusted to a new time zone. Going to sleep late causes a number of different hormonal changes. Normally, our bodies begin to feel the need to rest or begin to feel sleepy between 10–11 p.m. This is our body telling us that our work hours are over and it’s time to stop for the day. If we try to force our bodies to stay awake, cortisol, the primary stress hormone, is released in order to stimulate the body to stay awake. The cortisol hormone remains active for about 2 to 4 hours, meaning you won’t be able to sleep for a while until you start to feel sleepy again around 2 or 3 a.m. If, at that time, you continue to keep yourself from sleeping, the body will again release the cortisol hormone, extending your waking hours by another 2 to 4 hours and causing you to feel sleepy once again at around dawn. In this case the body becomes exhausted, leaving some people pretty much knocked out, as the body is no longer able to maintain proper control. Cortisol is a hormone that is essential to our bodies and is important in our lives; when it’s lacking, there is a huge effect on the cells in our bodies, and when too much of it is released, it can cause harm to the body, including decreased immunity, dull skin, increased hunger and a desire to eat more energy-dense foods, and storing fat for energy that can be drawn upon when needed. The body uses this mechanism to compensate for stress-related energy loss, which is why people who go to sleep late are often hungry at night and thus are more prone to weight-gain.
A: In this case, I would recommend that you try to create a night-like atmosphere and environment in order to “fool” your body into thinking that it’s nighttime. To help with this, you may find some accessories like blindfold eye masks or earplugs helpful. You cannot do these things temporarily. You will need to keep them up consistently in order for the body to properly adjust, thus allowing you to sleep deeply and your body to fully relax. That covers the act of sleeping during the day. When it comes to working at night, here too it is important to try to create an atmosphere and an environment that can “trick” the body into behaving as though it was daytime. This could include such things as turning on bright lights and making sure you are in a well-lit space and environment, eating as you would during the day, etc. Basically, if you need to work at night, just do what you would do during the day but simply change the time period. If you do this consistently, with regard to both sleep and work, the body will gradually adjust and will reset your internal clock and, in the end, your body will become accustomed to the new schedule and you shouldn’t experience any problems.
A: For individuals whose work shifts change frequently, such as flight attendants, airline pilots, or businessmen who have to fly abroad often, sleeping problems are difficult to avoid and I must admit that finding a real solution to this issue is problematic. One suggestion I would give that could aid in solving at least some of the problem is to begin to change your time framework from the moment you are on the plane and, as soon as the plane lands, to completely disregard the time zone where you boarded and instead immediately switch to the new time zone. For example, if it is nighttime in the time zone where you boarded the plane but daytime where you land, get out and about and go see the sights and/or work as you normally would during the day, allowing your body to get lots of fresh air and sunshine. Don’t go to sleep even if you feel tired. If, on the other hand, in your original time zone it’s daytime but you land in a time zone where it’s night, finish up any necessary business as quickly as possible, find your accommodations for the night and go to sleep straight away. Try to get as much sleep as you can, even if you don’t feel particularly tired. In some cases, you may also find certain supplements useful, although when it comes to dietary and vitamin supplements, I recommend that these be used only when truly necessary. Additionally, before doing so, it’s always best to first seek the advice of a doctor for your safety, as some types of supplements may have adverse side effects depending on the individual.
A: First, let me explain that the human body is not set up like a machine that must be precise and exact at all times. The working mechanisms of the human body are actually quite flexible and so there is no clear dividing line for exactly what time one must rest, nor will the body stop functioning at a certain time. These things are very much dependent upon the work, lifestyle habits, and use of the body by each individual each day. All of these differ greatly from person to person. Therefore, while it’s true that sleep definitely does affect the functions of the internal organs and systems in the body, it does so perhaps more indirectly as a result of changes in hormonal levels. When hormone levels change, the functions of a wide variety of organs in the body are affected. This can have a negative impact on the cardiovascular system and can weaken the immune system, resulting in frequent or greater risk of sickness. So yes, staying up too late definitely negatively impacts the body, even if in a somewhat indirect manner.
A: This is possible to a certain extent because the temperature or taste of the drink can make the body feel relaxed. Some people really like warmth while others enjoy the cold. This is why, to some degree, some people need to drink warm milk or warm water in order to help them sleep well. When it comes to coffee or other caffeinated beverages I wouldn’t recommend it, even though some people can actually drink it and then fall asleep just because the particular bitter taste and the aroma of the coffee helps the body to relax. The reality is that no matter what, the caffeine contained in coffee can keep us from sleeping well or soundly. Even if some people feel sleepy at first after drinking coffee, once they actually do fall asleep, they may not be able to sleep as deeply as they should, which means that they will feel tired when they wake up since the body has not been able to rest as completely as it needs to.
I hope I’ve been able to provide some valuable information and answer some of your questions about the all-important issue of sleep. In closing, allow me to leave you with 3 great rules to follow if you want to prevent sleep problems or any of the other health problems connected to lack of sleep. I simply ask that you try to put these into practice in your daily life and see the positive change it makes:
If you can put these few simple rules into practice, you’ll be able to sleep more comfortably and have better sleep quality, resulting in better quality of life.
The First Class Honors M.D., Faculty of Medicine , Chulalongkorn University, 2003.