World Sleep Day 2023: The importance of getting quality sleep at night

Dr Debanjan Banerjee, Consultant Neuropsychiatrist, Apollo Multispecialty Hospitals, Kolkata, India, answers questions related to sleep and its impact on health, while sifting facts from popular myths.

By Toibah Kirmani

Sleep-related Google searches are at an all-time high. How can I fall asleep faster? Why can’t I sleep? How much sleep do I need? These are some of the most-searched questions.

This year, the theme for World Sleep Day - a global event aimed at raising sleep awareness - is ‘Sleep is Essential for Health’. It emphasises the importance of sleep for maintaining good health.

Edited excerpts from the interview:

Does our brain shut down while we sleep?

It is commonly believed that the brain and body entirely shut down during sleep; this is not the case. While you are asleep, your brain processes anything you have gathered or known; factual and non-factual memory which is consolidated in memory-related parts of the brain and a context is provided to your memories. Also, it is a time for the body to rest and get ready for the next day; different functions are subserved.

While you are sleeping, energy conservation and improved neuronal communication take place. Clearance of various substances via our blood and lymphatic systems, hormonal balance, tissue regeneration, and, most importantly, the harmony between our hunger and satiation control are all maintained.

Moreover, memory consolidation is determined. Filtering out unneeded brain storage is a highly crucial process that the brain goes through during sleep. It also presumably develops and solidifies memories that are vital and should be carried forward.

Do we need eight hours of sleep? Does segmented sleep work?

The way we sleep and the sleep-wake cycle have developed over time based on our activity levels, wakefulness, and our occupation. We, typically, advise adults to get six to eight hours of sleep per night.

It’s preferable if it happens on a continuum rather than in fragments. Every time the sleep breaks, the electrical activity in the brain changes, and one of the key roles of sleep is to consolidate memory and emotional processing and allow the body the time to prepare for the next day (whether it’s digestive, metabolic, or other processes), which is disrupted if you have a very fragmented sleep. So continuous but quality sleep at night becomes important.

What are the lifestyle changes that can help quality sleep?

Lifestyle modifications are crucial for sleep hygiene. So, having a regular sleeping and waking time, engaging in adequate physical activity and exercise during the day, and refraining from daytime sleep can all be effective. Many people have the habit of sleeping in late and then waking up late. My advice is to wake up at your regular time, let a sleep debt occur, and you will fall asleep on your own.

Is alcohol a viable sleep aid?

It’s a widely held belief that alcohol aids sleep. If you tell a friend or co-worker that you can’t sleep, they might recommend that you go to a party and drink a glass of wine.

Certainly, alcohol is a central nervous system depressant and it causes sleep. But it is not a sedative. It generates artificial sleep. It interferes with the electrical rhythm of your brain as you sleep, disrupting the sleep architecture. It can result in an increase in sleep apnea, a disturbance of breathing during sleep, frequent awakenings from sleep, intense nightmares, talking while sleeping, limb movements, and a condition known as restless leg syndrome.

It can result in rapid eye movement (REM) sleep behaviour disorder, in which a person acts out their dreams and occasionally moves so aggressively that they injure themselves and their bed companions. Therefore, it goes without saying that alcohol is not a very effective sedative. It can cause addiction, and the day you stop using it, you will experience rebound insomnia.

Does the consumption of certain foods, such as fish, potatoes and bananas, improve dream recall?

The timing of your dreams affects your ability to recall them. Whether you dream something in the early morning or later in the night, you are likely to recall it since that is when you have more rapid eye movement (REM) sleep. It is also known as paradoxical sleep because you sleep yet your body is metabolically active, your neurons are active, and you experience a lot of dreams that you tend to recall.

Any substance or medicine that improves REM sleep may occasionally increase dream recollection. Some studies suggest that substances such as carotenoids, and vitamins C and E may potentially boost your dream memory. Although there is insufficient scientific evidence to support this claim.

Is snoring an indication of deep sleep?

Snoring is not necessarily indicative of deep sleep. Indeed, it relates to specific stages of sleep. Mild snoring or once-in-a-while snoring occurs when a person’s upper airway (posterior pharyngeal wall) vibrates, which occurs most often when they sleep on their backs rather than their sides.

However, severe snoring should be addressed. It is one of the typical indicators of obstructive sleep apnea (OSA), a type of distorted sleep breathing that has a number of negative repercussions. It basically implies that the upper airway closes for an extended amount of time, which causes apnea, which is a time when the brain’s oxygen supply is abruptly cut off for a few seconds. Moreover, it can cause depression, memory challenges, focus problems, daytime sleepiness, an increase in accident risk, lung disorders, as well as a negative impact on cardiovascular health.

If someone who snores excessively has recently been diagnosed with diabetes, hypertension, hypothyroidism, or has gained excessive weight, they need to be assessed by a professional pulmonologist, psychiatrist or sleep medicine specialist to evaluate for OSA. Weight reduction and lifestyle changes are often helpful.