2023-07-17 16:15:26
Sleep disorders have become an obsession that worries many members of society, while the causes and risks of this condition are unknown to many, who may not care about the results that may result from it.
Risks highlighted by the newspaper «Ajel», in its interview with Dr. Ahmed Bahmam, consultant chest diseases and sleep medicine and director of the University Center for Sleep Medicine and Research in the Medical City of King Saud University.
And to the text of the dialogue:
What is sleep?
There is a prevailing belief that sleep is lethargy in the physical and mental functions of the body that a person needs to renew his activity, but the scientifically proven reality is otherwise, during sleep the body performs many complex activities, in addition to that it is exposed during sleep to some diseases that may occur only during sleep and disappear as the patient wakes up.
Sleep is not a loss of consciousness or a coma, but rather a special state that a person goes through, during which certain activities take place. When a person is awake, the brain has a certain electrical activity, and with sleep, this activity begins to change.
A sleep study helps us pinpoint this precisely. The sleeper goes through several stages of sleep during his sleep, each with its own role. In the first two stages of sleep, the body is in a state of light slumber, while the third stage is called deep sleep.
The lack of this stage of sleep results in light uncomfortable sleep, fatigue and stress during the day. After about ninety minutes, the stage of dreams begins, or what is known as the rapid eye movement stage.
This stage of dreams is important for restoring the mind, getting rid of bad feelings, as well as enhancing memory, and passing through all stages of sleep is known as a complete sleep cycle, which is estimated at 4 to 6 complete sleep cycles, during a normal human sleep (6 to 8 hours).
Why do we sleep?
Sleep is one of the important functions of the body, which means that depriving it, depriving it, or shortening its period at night results in increased sleepiness during the day, and important physiological changes in all the vital organs of the body.
What are the causes of lack of sleep?
Lack of sleep may be due to a lack of duration or hours of sleep resulting from staying up late, for example, or a lack of sleep quality due to some diseases that affect sleep quality, such as snoring and sleep apnea.
The main reason for lack of sleep in our society is staying up late. More than one local research has shown that we sleep less than many other societies, and this applies to all age groups, as our society of all age groups loves to stay up late.
The reason for this is twofold: the first part is the exaggerated staying up late at night, and this is clear and obvious to all readers, and the second part is that schools in the Kingdom start very early.
A recent study of more than 1,000 primary school students showed that more than 71% of Saudi schoolchildren did not get enough of the recommended amount of sleep at night.
A local study has estimated that the prevalence of sleep deprivation and its associated factors within a nationally representative sample of adolescents (more than 1,200 youth), in Saudi Arabia is very high, as sleep deprivation (sleep less than 7 hours/day) has been reported. By 46% on weekdays and 33% on weekends. And three-quarters of teens reported feeling unrefreshed upon waking.
A recent Saudi study aimed to characterize sleep among adolescents with normal development in the Kingdom of Saudi Arabia, and to compare their sleep profiles with adolescents with normal development in the United Kingdom.
The results of the current study reported that the sleep duration was shorter for the Saudi group compared to previous studies and the UK group, which may be attributed to poor daytime behaviors that affect sleep.
What are the risks of lack of sleep?
Lack of sleep results in a lack of concentration and memory, slow reaction and correct decision-making. It also causes increased daytime sleepiness, irritable mood, stress and depression.
More than one research, one of which we conducted on school students in Riyadh, has shown that lack of sleep affects students’ academic achievement. Parents and teachers of primary school students surveyed in the city of Riyadh stated that 13.5% of boys and 6.9% of girls slept in classes, and this is undoubtedly due in large part to the lack of hours of sleep.
Lack of sleep affects the academic achievement of students at various stages, including the undergraduate level, and this is proven in local and international research.
Research has also shown that fatal car accidents increase in the late hours of the night, not at peak times, and this is due to the driver’s sleepiness and sleep while driving.
It is believed that many of the recent disasters that occurred to humanity, such as the Chernobyl accident in the Soviet Union and the Bhopal accident in India, were caused by poor judgment and decision-making by workers due to sleepiness and fatigue.
Research indicates that continuous awake for 24 hours leads to the mental ability to make quick and correct decisions in humans to the same degree as when drunk. Lack of sleep is a cumulative process, for example, not getting enough sleep for several nights affects a similar effect as staying awake for twenty-four hours straight.
Staying up late and lack of sleep causes an imbalance in the secretion of many important hormones, and the body loses the regulatory ability and daily rhythm of hormone secretion. Among the hormones that are affected: cortisol and adrenaline, the growth hormone that is very important to the body; As it is important for the growth of children and important for repairing and multiplying cells in adults, and staying up late affects sexual hormones.
Lack of sleep may increase the body’s resistance to insulin, especially in patients with diabetes, which leads to an increase in the level of glucose in the blood. It has recently been proven that chronic lack of sleep increases weight for many reasons, including those related to hormones such as leptin and ghrelin.
What should parents do?
This is very important for children and young people; Parents should monitor this. The results of field research on high school students in one of the US states, published in the Journal of Sleep and Breathing, showed that 90% of high school students sleep less than eight hours a day, and 19% sleep less than 6 hours a day.
The results of the study concluded that there is a strong relationship between excessive drinking of coffee and a decrease in the number of hours of sleep on the one hand, and weight gain on the other hand. The researchers found that students who slept less than five hours a day were 8.5 times more likely to be obese than students who slept more than 8 hours.
While the other odds were 2.8 times for those who slept 5 to 7 hours and 1.3 for those who slept 7 to 8 hours. That’s why we say: if you want the perfect weights, get the perfect sleep.
Recent research shows that staying up late and lack of sleep may result in a weakening of the immune system and the ability of immune cells to deal with foreign bodies and microbes. Specialists believe that lack of sleep increases the odds of catching colds and viral infections, including Corona.
In a previous study, researchers found that lack of sleep hours for two weeks increased the risk of infection with the common cold virus (Rhinovirus) by placing drops in the nose, compared to a control sample who slept enough hours at night. Those who slept less than seven hours had a three-fold increased risk compared to those who slept eight hours or more.
For people with chronic breathing problems, staying up late may exacerbate some symptoms. Research has shown that sleep apnea increases with snoring when staying up late or stressed. As for the heart and the circulatory system, some evidence indicates that staying up late may raise blood pressure.
Also, staying up late may directly affect the heart. Medical teams from the British Universities of Warwick and University College London examined the sleep patterns of 10,308 government employees and compared them to death rates.
The researchers found a doubling of the risk of heart disease among those who slept less from seven hours to five per night, or those who slept more than eight hours, compared to those who committed to seven hours each night. And recently (2023), the American College of Cardiology added “sleep duration” to the seven other key measures of heart health.
Research also indicates the importance of sleep to maintain cognitive abilities and reduce the risk of dementia and Alzheimer’s in the elderly. Here, I will review two studies that studied the relationship of lack of sleep with dementia (Alzheimer’s disease).
The first study was conducted on a sample of young people (15 volunteers), and was published in the “Sleep” magazine, where the researchers found that not sleeping for one night raised the level of a vital molecule found in neurons in the brain by 20%, and the level of this molecule, known as the (NSE) molecule, increased. & S-100B) usually when there is damage to brain cells or a defect in the blood-brain barrier. Another study conducted by researchers from Johns Hopkins University on a group of elderly people showed that a lack of sleep duration or poor quality of sleep resulted in an increase in beta-amyloid, a protein that is a hallmark of Alzheimer’s disease. The results of the two studies show that healthy and adequate sleep is important for the health of brain cells for all ages. And animal studies have shown that during deep sleep (the third stage of sleep), the brain may be able to remove metabolic waste products, such as beta-amyloid, more effectively.
During sleep, damaged cells in the body and cancer cells are eliminated, and a lack of hours of sleep has been linked to an increased risk of some diseases.
The above is only the tip of the iceberg, and medical research shows us every day new evidence of the importance of sleep and of the great miracle in the verse of sleep. Sleep seems to be the first thing most people prioritize when they are busy; The first step to healthy sleep is to set aside time to sleep.
How does the body and brain interact at bedtime?
Many may think of sleep as the negative time of the day, when nothing on your daily to-do list gets done. But the brain and many other systems in the body see it very differently.
Sleep is important for a number of brain functions, including how nerve cells communicate with each other. In fact, the brain and body remain remarkably active while we sleep.
Recent findings indicate that sleep plays a housekeeping role that removes toxins in your brain that accumulate while you are awake; Everyone needs sleep, but its biological purpose remains a mystery.
Sleep affects nearly every type of body tissue and system—from the brain, heart, and lungs to metabolism, immune function, mood, and disease resistance.
Research shows that chronic poor sleep, or poor sleep, increases the risk of disorders including high blood pressure, cardiovascular and metabolic diseases, diabetes, depression, and obesity. Sleep is a complex and dynamic process that affects the way we function in ways that scientists are only just beginning to understand.
What sleep cycles and how long? How many cycles does a person need during his sleep?
With the advancement of science, especially in the field of neuroscience and electroencephalogram (EEG), we have some knowledge of the miracles that occur during sleep, and much is hidden from us. And from the information that we knew that sleep consists of brain activities through which many biological processes occur, such as activating brain cells (neuronal plasticity) and supporting and enhancing memory.
What happens during normal sleep?
Sleep can be broadly divided into:
The stage of absence of rapid eye movements (NREM), which represents 75% of the total sleep and consists of three stages: the first (about 5%), the second (45-50%), and the third, which is known as deep sleep (20-25%).
The rapid eye movements (rarely known as the dream stage) (REM) stage, which accounts for 25% of all sleep and consists of one stage.
The proportions of the above stages change in different periods of life. The percentage of the dream stage may exceed 50% in newborns. It also decreases, and the deep sleep stage may disappear in the elderly or those with some diseases that affect the quality of sleep.
Scientists also concluded that a person passes through four to six sleep cycles during his sleep, the duration of each of which varies between ninety minutes and one hundred and ten minutes of sleep.
Normally, a person sleeps between seven and nine hours a day, that is, an average of approximately four to six sleep cycles. In the first hours of sleep, the first three sleep stages (NREM) are longer during one cycle than the dream sleep stage (REM). As sleep continues, the NREM phases begin to shorten to account for the longer REM dreaming phase.
Why don’t sleep specialists and doctors recommend work that requires staying up late and nightshift?
The nature of modern civilian life requires 24-hour work; The shift work system has become a reality that we must live with. There is a doctor who must work at night, and there is a nurse, a security man, and many others.
In general, the older we get, the more difficult it becomes to adjust to the shift system, but there are general strategies that can help a worker get better sleep.
The shift system affects our lives in many ways; An employee who works at night and sleeps during the day usually sleeps two to four hours less than an employee who works during the day and sleeps at night. There is a big difference between the quality of sleep during the day compared to the night.
Daytime sleep is usually light (the employee may not get his need of deep sleep) and intermittent, which results in the body not recovering its activity and then fatigue, lethargy and tension, and sometimes insomnia, and this in turn is reflected on the employee’s productivity and focus in his work, and sometimes it may It causes some organic symptoms.
For example, the secretions of the digestive system follow the circadian rhythm system. When the employee eats in the late night hours, he fills his stomach with food at a time when his digestive system is not ready for that, and leaves it empty during the day while it is at the peak of its activity and acidic secretions. This relatively explains the frequent complaints of night workers from acidity.
Those working in the lip system may be more vulnerable than others to some health disorders, including weight gain, where a defect occurs in the secretion of hormones, so hormones that increase appetite such as ghrelin increase and hormones that reduce appetite such as leptin decrease.
The researchers also found that women who worked in the shift system exercised less than those who worked in a comfortable working hours system, and some studies linked the system of shift work to disorders of the circulatory system, heart and other diseases.
shift workers suffer from a lot of family and social pressures that they have to cope with; They have to work when most people are asleep and sleep when everyone else is at work, or spend quality time with their relatives and friends.
These employees usually complain of not being able to spend enough time with their children or friends, or even arranging some recreational activities.
Therefore, the shift system (or shift) must be organized to help the employee sleep better. This can be accomplished so that the shift shift time follows clockwise, meaning if the employee works during the day, the next shift will be in the evening, and the third will be at night, and so on. This direction at the time of changing shifts is more suitable for human nature, and helps the employee quickly adapt to the new daily rhythm.
What is the importance of rest periods?
Rest periods must be found during working hours, and this may help increase concentration and awakening of the employee. This system has proven effective in many companies that require work around the clock.
Also, increasing the period before changing the shift time may help the worker adapt to the new shift, meaning that changing the shift time every three weeks is better than changing it every week.
The work atmosphere must help activate the employee and increase his sensory awareness. The lighting must be good and strong, and the temperature must be appropriate, noting that the warm atmosphere leads to inactivity.
Some employees like to drink caffeine-containing drinks to increase their activity, and I do not see any objection to consuming these drinks, such as coffee, for example, provided that they are not consumed three to four hours before bedtime, because it may increase the problem of insomnia in the employee.
Shift employees should start adjusting their bedtime as the current shift period approaches to adapt to the next shift period; In the last days of the current shift, the employee begins to gradually change his sleep schedule to adjust to the new period.
For example, if the current shift is during the day and the next shift is in the evening, then the employee should delay his sleep by one to two hours each day and then his waking time if possible in order to help him adapt to the new sleep time.
But if his shift is at night and he sleeps during the day, he should try to create a night atmosphere in his bedroom, meaning to make it dark and quiet without any noise. Daytime noise can be difficult to eliminate.
In order to overcome this, what is known as white noise can be used, which is when there is a constant and continuous sound in the background, such as the sound of a fan or air conditioner. This sound gets used to the ear and at the same time covers other sounds that may affect sleep.
The shift employee must adhere to the sleep-wake schedule of his shift as much as possible even on weekends. He tries to find a specific time to spend with his family and relatives without making a major change in his sleeping and waking regime.
The reader should know that changing the sleep regime during the weekend under the pressure of social obligations affects the employee’s sleep during the following week.
And employees who work in jobs that require them to get up frequently during the night, such as doctors, may benefit from short periods of sleep during the day.
How does food affect human sleep?
Food affects human sleep, so shift workers should eat meals rich in protein and carbohydrates and avoid fatty and fried meals. The reader is not advised to go to sleep when hungry or after a heavy meal.
How many people with sleep disorders globally and locally?
There are more than 87 sleep disorders, and the International Classification of Sleep Disorders has included them under 7 large groups, namely:
Insomnia
Sleep-related breathing disorders
Central disorders of hypersomnia
Sleep and wake disorders due to the circadian rhythm
Parasomnias (“parasomnias”, including sleep walking and talking, behavioral dream disorder, nightmares, sleep terrors, sleep whining, etc.)
Sleep-related movement disorders
Other sleep disorders
Which one is more susceptible to it.. women or men?
Two previous studies that assessed the prevalence of the risk of obstructive sleep apnea and related symptoms among Saudi men and women in primary care patients using the Berlin questionnaire indicate that 3 out of 10 Saudi men and 4 out of 10 Saudi women are at high risk of sleep apnea.
In a subsequent study, comprehensive sleep monitoring by sleep monitoring was used to objectively assess the prevalence of sleep apnea in a sample of 346 Saudi school employees in the age group of 30 to 60 years. Sleep apnea was 11% in men and 4% in men. Women.
Another study conducted to evaluate obstructive sleep apnea using the Comprehensive Objective Sleep Study Type II in Saudi patients admitted to a cardiac intensive care unit with acute coronary syndrome during the acute period and after six months, and it was found that 56% of these patients had obstructive breathing during sleep.
Obesity, which is an important risk factor for sleep apnea, is also prevalent among both sexes and across all age groups in Saudi Arabia. In a national survey conducted between 1995 and 2000, it was reported that nearly half (50%) of Saudi women between the ages of 40 and 49 were obese (BMI ≥ 30).
Obesity is more prevalent among middle-aged Saudi women than in Western countries. Obesity is also widespread among children and adolescents and has become a common problem in most countries of the world, including Saudi Arabia.
Sleep apnea also appears in Saudi children at rates similar to those in the West, in addition to the increase in obesity rates in childhood in the Kingdom of Saudi Arabia, as obesity rates among children in the Kingdom may be higher than children in the West or East Asia.
The prevalence of restless legs syndrome among Saudis is between 5-8%, which is within the previously reported ranges for prevalence of the syndrome in other countries (3%-12%).
A national study showed that none of the patients with restless legs syndrome were diagnosed with the disease during their review of primary care centers, which reflects the lack of information of some health practitioners about the disease.
A recent study reported the prevalence of insomnia with disturbed daytime function in patients attending primary care centers at 57%, while another recent study assessed the prevalence of insomnia (defined as difficulty with falling asleep and waking up early in the morning or frequent awakenings with abnormal daytime function) in staff and visitors at a medical center reached 78% (75-79%), with a higher prevalence in women (89%), compared to men (70%).
What do we know about narcolepsy?
Compulsive sleep disease, which is an immune disease that causes irresistible bouts of sleep, and other symptoms such as wakefulness paralysis, sleep-onset hallucinations, intermittent sleep at night, and gattoos. It usually affects adolescents, and is expected to be 40 in every hundred thousand Saudis, according to the results currently available.
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