Operation Slumber

The Long And Short Of Insomnia Today

Wide awake even before your alarm goes off? We take a deep dive into sleep issues and remind ourselves why we should make quality sleep a priority, especially during the pandemic.

The Long And Short Of Insomnia Today
Image: Getty Images

Articles about poor sleep have mushroomed all over the Internet now more than ever, reflecting how the pandemic has affected the way we sleep. According to the 2021 global sleep survey by Philips, 60 percent of Singaporeans’ sleep quality has suffered as a result of the pandemic, with three in 10 saying they are now sleeping less each night. The American Psychological Association also reported a rise in sleep disorders since the pandemic began, with two in three Americans clocking inconsistent hours of sleep due to pandemic-related stress. 

Philips’ sleep survey ranked Singapore fourth among 13 most sleep-deprived countries, after Japan, the US and UK respectively. The question is, would we not be sleep-deprived without a pandemic?

Living In A Digital World

According to researchers, evidently not. Those who have been studying the science of sleep for decades suggest that sleep issues are prevalent, pandemic or not. 

Mary Lyn Besmonte, respiratory therapist and polysomnographic technologist at Easmed Singapore, considers digital devices the main culprits for sleeplessness, even more so now that we’re living in the digital age. 

To Besmonte, digital devices are a double-edged sword. On one hand, they make our lives more convenient by connecting us to the world. On the other, they open a portal to numerous distractions when it comes to getting quality sleep. Not only do functions like email, social media and on-demand TV overstimulate our brains after work hours, the blue light emitted from phone screens and tablets also affect our melatonin production, which mess with our circadian rhythm as a result. 

Melatonin is a hormone produced by the pineal gland when the surroundings get dark and signals your body to sleep. According to sources, including a 2020 article on Harvard Medical School’s website, blue light suppresses melatonin production more powerfully than other wavelengths of light. Exposure to this results in wakefulness, which could disrupt your circadian rhythm. Given that fiddling with digital devices has become second nature in modern times, this is possibly something that many of us overlook.

Image: Getty Images

Don’t Snooze On This

Homemaker Sharon Heng shares that she clocks about seven hours of sleep every day, a duration sleep experts often recommend. However, she admits that she has trouble falling asleep and remaining in a state of peaceful slumber. 

In her case, it’s less about exposure to digital devices and more about her daily choices and activities. She consumes tea daily to “keep her engine going” and occasionally has coffee as a midday pick-me-up. For the light sleeper, the caffeine intake doesn’t help; the stimulant keeps her mind and body active for long hours. This disrupts her sleep quality when she tries to catch some shut-eye. She shares that she experiences sleeplessness on days when she has coffee.

Heng also mentioned that rushing from place to place for appointments and social engagements stresses her out, and more so now during the pandemic, with the many measures and restrictions in place. Dubbed “adrenal fatigue” by Dr James L Wilson in his book “Adrenal Fatigue: the 21st Century Syndrome,” this frequent state of anxiety can cause our bodies to overproduce adrenaline.

What’s worse is that adrenaline’s stimulating effects can linger in one’s system and cause sleep issues. Not surprisingly, Heng experiences frequent headaches, poor concentration and reduced mental clarity during her waking hours — and she isn’t alone in this.

Besmonte characterises this condition as insomnia, a sleep disorder where falling and/or staying asleep is difficult. 

“There are short- and long-term cognitive effects from sleep deprivation, and none of them are positive,” warns Besmonte. Short-term consequences, such as those that Heng experiences, increases risks when performing daily tasks. 

Besmonte adds that studies have shown that the behaviour of a sleep-deprived individual is akin to that of a drunk. “Being awake for 24 hours wires our cognitive function to act similarly as having a blood alcohol content of 0.10 percent,” she shares.

Chronic sleep deprivation also brings about a whole slew of problems, including hypertension, weight gain, obesity, depression, anxiety, memory loss, immune system deficiency, even decreased fertility over time.

A three-year study by researchers at the University of Alabama in Birmingham has shown that consistently sleeping less than six hours a night increases the risk of stroke by up to 4.5 times. In severe cases, chronic sleep deprivation can also cause death due to complications from the above mentioned factors. 

“Sleep deprivation is considered a stressful event for our body. Sleeping helps to regulate our hormones, promote healing and repairs our DNA. Hence, lack of it will disrupt our metabolic processes,” Besmonte says. A scientific study published by the International Journal of Endocrinology has linked sleep deprivation to diseases such as diabetes and obesity, as it affects the production of hormones related to our appetite and metabolism.”

The Power of Quality Sleep

Our bodies undergo three different phases when we sleep. It shifts from light sleep to deep sleep, and finally a dream state. 

In the third phase, the body experiences rapid eye movement (REM), where the body heals on a cellular level. Some studies have even suggested that during REM sleep, the body clears itself of hormones such as adenosine accumulated throughout the day. Adenosine, like melatonin, induces sleepiness. When the body fails to do so, whether it’s through sleep deprivation or disrupted sleep, cognitive functions such as memory retention, attention span and thought processing are affected. Ideally, the body should undergo this sleep cycle four to five times a night for it to function optimally during our waking hours. 

A well-rested mind is one that’s sharper and more alert. This makes daily activities much easier to perform. According to an article published by the Sleep Foundation last year, hormones including cortisol, leptin and ghrelin help regulate metabolism, appetite and boost the immune system. 

To maintain their health, former lawyer Karen Ong-Tan and her family practise high-quality sleep habits. She used to travel frequently for work while juggling various investment projects that spanned different time zones. When both she and her husband were planning for a family, they knew some lifestyle changes had to be made at home. Improving on their sleeping habits was one of them.

“Learning about cognitive psychology and sleep sciences was a journey that began around 10 years ago, when my husband and I were planning to start a family,” Ong-Tan shared. The objective was to customise a healthy lifestyle that was sustainable for their then prospective young family, while taking their frequent work-related travel plans into consideration. They began making sleep regulating habits such as morning and evening strolls, careful dinner timings and screen time reduction among others a norm in the household.

When the pandemic struck, Ong-Tan took the forced hiatus from the family’s usual travel schedule as the perfect opportunity to further reinforce their sleep quality without the usual interruption of overseas trips. She continued practicing those sleep regulating habits as they were particularly important for their daughter, Kara, whom she home-schools since her birth. She believes that children learn primarily from watching their parents’ actions, so putting healthy sleep habits is paramount in their household. This way, both she and her husband hope that Kara will continuously build a genuine belief in sleep health and take those healthy sleep practices with her as she grows older.

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Approaching Sleep Differently 

“Reprogramming your sleep pattern is not that easy,” Besmonte shares. “It involves a lot of planning, evaluation and, the toughest of all, discipline. On top of that, existing issues such as stress, anxiety and even depression could play a role in one’s sleep quality.”

In short, it is not impossible. But it will take some time to adjust. Besmonte strongly suggests immersing yourself in relaxing activities a few hours before bed.

In Ong-Tan’s case, she mentioned that her family practices watching sunsets, as well as sunrises, during their daily jaunts to promote a healthy and regular circadian rhythm. To complement this sleep regulating habit, they also minimise screen time at home, and have anti-blue light options installed.

On top of that, Ong-Tan shares that sensible and deliberate dietary practices in the evening are helpful. For example, finishing dinner as early as by 8pm allows the gradual release of relaxing hormones such as seratonin from carbohydrate digestion. This gives the hormones ample time to help ease her into a state of greater relaxation by bedtime.

As for Heng, she practices nightly rituals that involve soaking her feet in warm water, having a glass of warm milk and utilising aromatherapy to relax and unwind. 

Both methods get Besmonte’s nod of approval. She points out, though, that one shouldn’t go to bed inebriated or with a full stomach, as these will affect your sleep quality. One should also stop consuming caffeine at least six hours before bedtime, as it stays in your system for about three to six hours.

If physical activity is your method of destressing, do it in the morning to wake your body up. Then opt for more relaxing practices like meditation, yoga and breathing exercises in the evening. In her experience, these are the activities that people find most sustainable and effective.

Besmonte advises keeping gadgets away from the bed, keeping it silent or even switching it off one to two hours before bedtime. 

“Not only does this eliminate blue light exposure, cutting yourself off from a virtual life also prevents you from developing thoughts that might disrupt your sleep,” she concludes.

What Else Can We Do?

Mary Lyn Besmonte shares some tips to encourage a good night’s sleep.

Jot down your plans
Dedicating at least 5 minutes of your bedtime ritual to making a to-do list for the next day could help you achieve the onset of sleep faster. For those with anxiety, this also helps add a feeling of accomplishment and security that you have planned something for the next day to look forward to.

Listen to sounds from nature
We all know about white noise, but did you know there’s also something called pink noise? If achieving deep sleep is an issue for you, sounds of nature like beach waves or rainfall have been found in some studies to increase deep sleep and even improve memory in
older adults.

Consider cuddling
Cuddling or kissing your partner before bedtime releases oxytocin, which helps you relax.

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