Back to Sleep for Black Sheep
I’ve posted on sleep a couple of times before but I’ve been concentrating on improving my own sleep (quantity and quality) for the past month or so and I attended the Wellfest pop up ‘The Key to a Good Night’s Sleep’ last Thursday for further inspiration so thought it appropriate to regale you with a review to set you up for the week! I don’t even watch tv so I’m at a loss as to how I habitually used to avoid early beds any evening I wasn’t out… Talking and/or texting shite I suppose if push came to shove!
Respiratory and sleep physiologist (i.e. sleep biology expert extraordinaire) Motty Varghese from St. James’s Hospital, Dublin (my local referring hospital), launched the Wellfest Pop Up with a superb talk on the mechanics of sleep and sleep hygiene. (I’ve already written about the bones of these topics in previous posts in the unlikely event you can be arsed having a gander…)
He emphasised the importance of incorporating some morning sunlight into your routine to keep your circadian rhythm in check and allow time for your sleep drive to develop over the course of the day. As always, it is vital to steer clear of bright lights from any source (including smart phones) for up to 3 hours before your planned bedtime to allow time for adequate production of the sleep-promoting hormone melatonin. He also advised leaving a similar gap between exercise (physical activity being great for sleep-promotion in general people!!) and subsequent bathing/showering to allow time for somnolence to develop. He recommended creating a quiet, cool, dark, distraction-free, cave-like bedroom (#JustHowILikeItAnyway!).
He advised aiming for 7-9 hours of sleep per night and spoke about the roles of each sleep stage (again, I’ve posted about these before if you want to scroll back through skipthescript.com!); the infamous REM (Rapid Eye Movement Stage, a.k.a dream time) is important for memory/consolidating the day’s learning and the deepest stage of sleep is important for cultivating empathy- hugely important as a General Practitioner!
I asked him about the value of those apps that apparently wake you up during the lightest sleep phase so as to optimise your alertness and energy upon getting out of bed, e.g. the Sleep Cycle alarm clock. He wasn’t overly keen on the idea as he believed the recordings would only be accurate in either very ‘good’ or very poor sleepers and anyway, we should really put our phones away for the night and are probably not seeing the wood for the trees if we’re engaging with these apps rather than concentrating on the underlying issues!
His opinion on daytime napping is to restrict naps to half an hour… #JuryStillOut! I’ve posted on napping before and there is evidence for improved performance after naps of up to 90 minutes, although eating into your sleep drive is an obvious potential issue! Anyway, where most of us would get the time for any class of a nap during the working day is beyond my comprehension to be fair!
I also asked Motty about melatonin tablets. Melatonin is a prescription-only medication in Ireland. I’ve crossed paths with many who buy it abroad and/or online and vouch for its efficacy. His belief was that its main use lies with those whose circadian rhythm is constantly being knocked out of kilter (e.g. those who shift work or flit through different time zones on their work jaunts) and with those who suffer from Delayed Sleep Phase Syndrome – a circadian rhythm shift towards going to sleep and waking progressively later. This tends to affect teenagers predominantly and resolves with age, although I appear to be in a stage of arrested development in this regard, sadly.
I didn’t ask for his opinion on sleeping tablets. Requests for these are ten a penny in the land of general practice and while they can sometimes offer a lifeline to somebody who is acutely distressed and unable to sleep at all, they are not a long term solution as your body very readily habituates to them: they lose their effect while rendering your body dependent and result in withdrawals on abrupt cessation. Even for short-term use, they unfortunately provide little in the way of restorative sleep and are associated with a hangover effect. Cognitive behavioural therapy (specialised counselling) zones in on rewiring how the brain perceives sleep in order to fillet out the factors that hinder sleep and modify a person’s behaviours towards the pertinent factors. No addictive potential = winning!
The lovely Jenny Keane then took us through a “take-home yoga flow followed by meditation to assist with mindfulness and relaxation” to sublime effect. If these concepts are alien to you, you should really attend a class or at least look them up.
“Modern life exposes our nervous systems to a vast amount of stimulation… From an evolutionary standpoint, we just haven’t adapted to modern life,” expounds Jess Cook, a highly esteemed Vedic meditation practitioner who practises at Will Williams Meditation in London. Even the most cynical souls need to embrace these concepts for their general wellbeing. I could go on… The evidence for the far-reaching effects of restorative sleep on our mental and physical health is ever-mounting and poor sleep is a public health issue at this stage but I better embark on my own sleep hygiene routine for the evening so I’ll leave further discussion for another day.
On that note, I’ll wish you all a good night’s sleep!
P.S. A patient informed me that our own Dr. Pixie McKenna’s new TV show entitled ‘Awake’ on the science of sleep starts this Wednesday evening on RTE One FYI…