Overview of sleep
Written by Dr. Raymond Gottschalk, MB ChB; FRCP(C)
Why do we sleep?
The simple answer is that during the day while the brain is active, we are generating byproducts that start accumulating. Sleep provides an opportunity to remove the collection of waste products that build up hence allowing the nerve cells to be clean and connected without any interference.
How much sleep do we need?
The simple answer is, sufficient to allow us to function normally in the day. There is a variation in sleep requirement but generally, we need more than 6–1/2 hours preferably close to 8 hours.
What happens if we do not get enough sleep?
The consequences of this will depend on our demands such as concentration, ability to stay awake under varying circumstances such as while driving, dealing with stress and allowing the repair process that occurs at night to facilitate the body being ready for the next day. With insufficient sleep there is weight gain, blood pressure will tend to go up, as the blood pressure drops during sleep, and in general mental health and well-being seem to suffer.
Some more worrisome features of sleep loss relate to industrial accidents, motor vehicle accidents and decision-making that cannot be relied upon. We often use sleep to solve problems subconsciously hence we report “I am going to sleep on that.”
Does it matter when I get sleep?
It is far better to structure the sleep based on your body’s timing and hence we tend, being diurnal animals, to sleep at night and be awake during the day. Even though we can get excellent deep sleep during the day, it appears physiologically better for us to obtain sleeping hours at the appropriate time which is during the dark portion of the day (which is nighttime).
I like to sleep late on weekends and then I struggle to wake up on Monday morning. Why?
That is common amongst teenagers who have the ability to sleep later than those much younger or much older. The result is it changes the orientation of the sleep rhythm into a delayed bedtime with delayed wake-up time which will result in difficulty waking up earlier when the pattern has been changed.
What tips are suggested to improve sleep?
1. Try and sleep in a quiet and comfortable room where there is little light or distraction.
2. Try and avoid electronics especially exciting electronics such as online gaming close to bedtime.
3. Try to identify a wind-down opportunity prior to going to bed to get your brain into a more conducive mood for sleep.
4. We do not want to spend too much time in bed if we are not sleeping. Get up and leave the room if you struggling to sleep and get back to bed when you are sleepy again.
5. Try and ensure that your wake-up time is the same almost every day if possible. The bedtime follows when the wake-up time is set.
6. Avoidance of caffeine, alcohol or nicotine are all suitable basic recommendations for improvement in sleep.
7. If there are abnormalities of behaviors such as walking around during sleep or very loud snoring with choking noises, that would suggest a referral for a sleep evaluation by a specialist.
Dr. Raymond Gottschalk is a sleep disorders specialist, respirologist and internist. He has been the Medical Director of the Sleep Disorders Clinic since 1994 and is a Diplomate of the American Academy of Sleep Medicine, as well as the American Board of Internal Medicine. His interest in sleep disorders is not limited to breathing disorders of sleep but is wide and varied, including neurological disorders that affect sleep, parasomnias, insomnia, and all other diseases that have an impact on sleep. He is a regular assessor of sleep medicine clinics on behalf of the College of Physicians and Surgeons of Ontario and has co-chaired the guidelines in Sleep Medicine practice for the CPSO IHF program for the past 12 years. His view of the patient as a whole person greatly influences his practice of sleep medicine.
