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What if I cannot sleep more than 5 hours despite my best efforts? How to trick yourself into letting go?

If you thought that four to five hours of sleep are enough to manage your life productively, think again. For if this becomes a habit in your mid-to-late life, you could have an increased risk of developing chronic diseases like cancer, heart disease and diabetes, according to a new study by UCL researchers.

Published in PLOS Medicine, the research analysed the impact of sleep duration on the health of more than 7,000 men and women in the ages of 50, 60 and 70. Researchers examined the relationship between how long each participant slept for, mortality and whether they had been diagnosed with two or more chronic diseases (multi-morbidity) — such as heart disease, cancer or diabetes — over the course of 25 years. People who reported getting five hours of sleep or less at age 50 were 20 per cent more likely to be diagnosed with a chronic disease and 40 per cent more likely to be diagnosed with two or more chronic diseases over 25 years, compared to people who slept for up to seven hours. The study also found that sleeping for five hours or less at the age of 50, 60 and 70 meant a 40 per cent increased risk of multi-morbidity when compared with those who slept for up to seven hours. Researchers further found that a sleep duration of five hours or less at age 50 was associated with a 25 per cent increased risk of mortality over the 25 years of follow-up.

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“What this study does is establish sleep as a critical pillar of health management. Now that researchers have verified the relationship between reduced sleep and death, with 25 per cent increased risk of mortality among those subject with less than five hours of sleep, it is time to reprogramme our lifestyle map as we know it,” says Dr Atul Mathur, Executive Director, Interventional Cardiology, Fortis Escorts Heart Institute.

HOW OUR SLEEP PATTERNS HAVE CHANGED

“Across the globe, sleep is the most primitive and primal aspect that all humans share. Sleep, however, even at this stage of evolution is not adequately understood. Its patterns of quality as well as quantity are influenced by a variety of social, cultural, behavioural and environmental aspects. In modern society, with increasing amount of work hours and work shifts along with easy access to 24X7 digital content consumption, many factors have led to curtailing the duration of sleep, especially among the younger and middle generation. On the other hand, as people get older, their sleep habits and structure changes. This has been noticed as an increase in fatigue, tiredness and excessive daytime sleepiness. Over the last few decades, there has been growing evidence suggesting reduced sleep adversely affects our health, including its contribution to hypertension, diabetes, obesity, cardiac illness and death. With the recent study highlighting importance of sleep and its duration, it should now be considered as an additional behavioural risk factor. The focus of supportive therapies now should be to avoid habitual and sustained sleep deprivation,” says he.

UNDERSTANDING THE NEED FOR A GOOD SLEEP REGIME

Since the study proves that duration of sleep is an essential component for our wellbeing, one can promote a better night’s sleep by inculcating a few good habits in a daily routine. “By switching off all electronic devices 30 minutes prior to sleep, avoiding larger dinner meals and having a quiet, dark, and ambient temperature in the bedroom ensure one can have a sound sleep. Adequate physical activity as well as exposure to sun during the day also help promote a good sleep,” suggests Dr Mathur.

Of course, Dr Sharad Joshi, Associate Director, Pulmonology, and Head, Sleep Clinic at Max Super Speciality Hospital, Vaishali, is working on an easily adaptable regime considering that sleep is often seen as an afterthought by Indians unless we are really troubled and restless in the middle of the night. “Even then, the easiest thing to do is look for a sleep aid of some sort or reach out for the sleep pill,” says he. Increasingly he is seeing sleep apnea cases rising. “That’s because those suffering from the condition ignored it for far too long till it impacted their everyday rhythms. The stress of life is high among Indians with overcrowding concerns, performance pressure at work, and the taut expectation of delivering at all times. That’s why they cannot get sound sleep and wake up with nightmares. Sleep is meant to be regenerative,” says Dr Joshi.

TIPS TO BUILD A SLEEP REGIME

(1) During the day, make sure to devote 45 minutes to an hour to moderate physical exercise and breathe in enough oxygen. Sometimes if there is anxiety about not being able to keep to the recommended activity level, fret not. Sometimes you need to do just simple things that do not demand much from you like trimming plants, rearranging your rooms and books and organising your cupboards. This may seem like “non-work” but keeps you all perked up and focussed. Naturally, your body and mind would be suitably tired and want to settle down by nightfall.

(2) Enough has been said about having a well-balanced and nutrient-rich meal, so it doesn’t need repetition. But avoid eating anything which interrupts your brain activity after sunset. Reduce drinking tea, coffee and all caffeinated beverages after sunset. Even if you have coffee by late afternoon, you’ll still have caffeine in your system by bedtime.

Though dinner should ideally be had between 7 and 8 pm, most of us are not so privileged to get out of the office by that time. Worry not, there are workarounds. So focus on breakfast as the main meal of the day, drawing 50 per cent of your daily calories from it, get 30 per cent from your lunch and allocate 20 per cent to your dinner. Have an early dinner at office if possible. Late dinners should be light. Give a gap of two-and-a-half hours before falling asleep. Allow the food to be broken down completely. A food pile-up in the stomach means you will regurgitate half-digested food in the middle of the night that can affect your sleep patterns.

(3) Impose limits on your viewing time, be it on devices and the laptop. This way you are re-training the body to not prime its alertness levels but wind down naturally. The leftover presentation will be better with a fresh mind early morning. Our hypothalamus, which is responsible for emotions, temperature and sleep, is controlled by daylight and has diurnal rhythms. Follow it and sleeplessness will be a thing of the past.

(4) Also do not binge-watch shows. Choose a show that has a finite time limit. Try watching shows that comfort you, an old comedy show for example. You can then sleep with happy thoughts.

(5) Learn to shed the burden of worries. Disconnect from your usual rhythms two hours after dinner. Devote it to interacting with family members or pursuing a hobby like completing a part of a painting, strumming the guitar or reading a book. These are all brain soothers and help you fall asleep. Often when we place our head on the pillow, we tend to review our day and prepare for the next. So there’s usually a rush of negative emotions, of work undone, of goals not achieved, anxieties about not meeting standards we have set for ourselves. Try journalling as a way of letting your emotions out. As people lead more individualised lives, this self-talk can help you develop fresher perspectives. Do not think of a solution, that gets you into strategic thinking. Just write down your issues.

(6) Definitely do not stalk others on social media. Rather than looking at other people on social media, much of which is posed anyway, prioritise your life and activities that make you feel good.

WHAT IF YOU STILL CANNOT SLEEP

When you can’t fall asleep, don’t reach out for the OTT app or the phone. First take a warm water shower that relaxes the muscles, kills the fatigue and induces sleep. Listen to pleasant ambient music, limit light, pull the curtains and ensure the ambient temperature is comfortable to you.

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If you are still tossing and turning, try a little stroll in the room. Change positions on the bed. The best method is to lie down on your bed, stretch your muscles and limbs in the sleeping position and concentrate on your breathing rather than focussing on your problems. Lie down on a comfortable pillow and focus on your breathing. Empty your mind out and just focus on breathing in and out. This almost always works.

If you do have respiratory ailments or issues, sleep on a raised pillow. Ensure your breathing is just right. Sleep on one side of the body to ensure that airways are not obstructed.

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Finally, Dr Joshi says, we must not work ourselves up over our fragmented sleep patterns. “We should not try to control the way we sleep. It’s okay to have those bad nights in between. Retraining the body takes time. Remember, sleeping is about letting go.”

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