We all still remember the months of lockdown we lived through during the first year of the Covid-19 pandemic; and perhaps some recall that the time it took to fall asleep increased, their perception of rest during sleep worsened, or the number of hours they slept decreased. If you noticed any of these things, you were probably right, as numerous studies report a deterioration in various sleep parameters in different populations during the pandemic (Jabakhanji SB et al., 2022). This is due to changes in daily routines and habits, increased screen use that disrupts exposure to natural light and normal circadian cycles, and heightened stress and anxiety levels, among other reasons that reduce sleep quality and quantity (Cajochen C et al., 2022).
These, along with other lifestyle changes, especially in young people and adolescents, are causing sleep problems to become increasingly common in the population. A literature review with data from 20 different countries shows a decrease of one hour in the total amount of sleep in children and adolescents over the last century (Matricciani L et al., 2012).
For many decades, the mystery of sleep has been investigated. Why do we need it? What really happens when we sleep? We now know that it is essential for the proper functioning of several of our most important systems. During sleep, biological rhythms differ from those during wakefulness, and mechanisms of cellular regeneration and consolidation of changes that occurred while performing tasks during wakefulness are activated (Baranwal N et al., 2023; Jabakhanji SB et al., 2022). These are the systems most affected and most in need of sufficient sleep:
– Brain Function: Sleep quality is not only related to memory consolidation and learning, but sleep problems are also highly associated with depression and mental disorders. It appears that during sleep, there is a “cleaning” of metabolites and waste substances generated by the cells of the nervous system, and this cleaning is essential for its proper functioning.
– Cardiovascular System: Sleep is essential for maintaining optimal cardiovascular health. During sleep, the heart rate lowers, blood pressure decreases, and the autonomic balance shifts toward the parasympathetic side, which implies a recovery of the system.
– Immune System: There is a bidirectional relationship between the immune system and sleep. Being ill can significantly affect the amount and quality of sleep, just as poor sleep can reduce the concentration of immune cells and their ability to produce antibodies.
– Hormonal System: The secretion of many hormones follows or is influenced by the circadian rhythm (cortisol, ghrelin, and leptin, and even some like testosterone), and not having healthy sleep habits can alter the necessary hormone levels, which can trigger inflammation system deregulation, appetite changes, or impotence and decreased fertility. Prolonged sleep problems are also associated with insulin resistance and the development of type II diabetes.
– Muscular System: Muscle regeneration after damage caused by physical activity or injury occurs mainly during sleep. If sleep quality is not optimal, musculoskeletal recovery can be compromised.
The advancement of science in the field of sleep highlights the importance of raising awareness and educating the population so that everyone can make the best decisions for their health. Although a large part of the population, including many healthcare professionals, is still unaware of this, good rest and proper sleep hygiene should be another fundamental pillar in our self-care, alongside nutrition, physical exercise, and maintaining adequate cognitive and social activity (Lim DC et al., 2023).
Even in achieving maximum athletic performance, good monitoring and scheduling of rest have become crucial components in sports specialists’ programming (Charest J & Grandner MA, 2020).
Some recommendations to meet your sleep needs, backed by scientific evidence, include (Watson NF et al., 2015; Baranwal N et al., 2023):
– Sleep 7 to 9 hours daily. For children or adolescents, it may be normal to sleep more than 9 hours.
– Maintain a consistent sleep schedule. This keeps the body’s internal clocks and timing regulated, reducing daytime fatigue.
– Exercise. It improves sleep quality and pre-sleep anxiety, especially if done at least 2 hours before bedtime.
– Maintain an optimal body weight. Being overweight can make breathing difficult while lying down, hindering the ability to reach all sleep phases adequately.
– Take naps. Napping for 20 to 30 minutes in the afternoon can help recover lost sleep from nighttime or reduce fatigue after physical or mental efforts.
– Control light exposure. Especially blue light exposure in the hours before sleep, to promote the secretion of sleep-inducing hormones and brain pathways.
– Be mindful of caffeine. In some people, caffeine can take up to 6/7 hours to degrade. Consuming caffeine in the afternoon can worsen your ability to fall asleep and the quality of sleep.
– Limit alcohol consumption. Although alcohol can induce sleep, it can alter its architecture, making it difficult to enter certain sleep phases or causing mid-night awakenings.
– Manage meal timing. It is proven that going to bed at least 2 hours after eating can shorten sleep duration, delay bedtime, or cause weight gain.
– Practice meditation and mindfulness. These can lower sympathetic tone and alertness, improving your ability to fall asleep.
– Prepare for bedtime. Having a pre-sleep routine or creating a relaxing environment can help you fall asleep better.
At UMSS, we encourage you to try to implement as many of these habits as possible and take care of your sleep just as you do with other aspects of your health.
References:
Jabakhanji SB, Lepinteur A, Menta G, Piper A, Vögele C. Sleep quality and the evolution of the COVID-19 pandemic in five European countries. PLoS One. 2022 Dec 28;17(12):e0278971.
Cajochen C, Stefani O, Schöllhorn I, Lang D, Chellappa SL, Influence of evening light exposure on polysomnographically assessed night-time sleep: A systematic review with meta-analysis. Lighting Res. Technol. 2022;54, 609–624.
Matricciani L, Olds T, Petkov J. In search of lost sleep: secular trends in the sleep time of school-aged children and adolescents. Sleep Med Rev. 2012;16(3):203 –211.
Baranwal N, Yu PK, Siegel NS. Sleep physiology, pathophysiology, and sleep hygiene. Prog Cardiovasc Dis [Internet]. 2023;77:59–69.
Lim DC, Najafi A, Afifi L, Bassetti CLA, Buysse DJ, Han F, et al. The need to promote sleep health in public health agendas across the globe. Lancet Public Health [Internet]. 2023;8(10):e820–6.
Charest J, Grandner MA. Sleep and athletic performance. Sleep Med Clin [Internet]. 2020;15(1):41–57.
Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult: A joint consensus statement of the American academy of sleep medicine and sleep research society. Sleep [Internet]. 2015.
