Lack of respect for the sleeping space

Ms Mehta had been struggling with insomnia for over six months. I too was perplexed since all her reports were normal and she faced no apparent stressors. Then one day she casually mentioned helping her children with studies, on the bed, and the mystery was solved.

Most of us are ignorant about the importance of respecting our sleeping spaces. The bed should be used strictly for two activities: sleep and sex. Any new activity done on the bed sends a new signal to the brain and confuses it. That’s what happened with Ms Mehta. When she went to bed to ‘sleep’, her brain said ‘study’ and associated it with alertness rather than rest. Within a few weeks of moving her ‘class’ away from her bed, she was able to sleep well.

Arguments before bedtime

The Nakhate couple had become irritable and restless. The couple had long discussions, which ended in fights and all this just before bedtime. Since a disturbed mind leads to a disturbed body, their sleep suffered.

I suggested them to discuss their issues early in the day and inculcate the habit of recalling one pleasant memory right before bed time. They had to relive those memories as vividly as possible engaging all six senses. The sixth sense is the ‘emotional’ feel of the memory. Beautiful memories can soothe the nerves and work like sedatives. Conscious relaxation exercises also neutralise negative states.

Late workouts

Being a busy executive Mr Malkani worked out late at night. What he got in return was sleepless nights. This is because exercise causes the brain to release chemicals that make you feel fresh. The same holds true if you go for an after-dinner brisk walk. Naturally, the option for Mr Malkani was to put at least a few hours between his exercise and bedtime.

Spicy food

I was served a delicious pickle at Mr Salian’s home one evening, which his mother had sent. His wife, however, joked that he was so excited about the pickle that since its arrival, he has lost his sleep. On probing further, I came to know that he suffered burning and hyperacidity after dinner. And this affected his sleep. For most us, dinner is the most indulgent meal of the day. And it affects the quality of our sleep. Skipping spicy and oily food at dinner is worth it.

Bed-time coffee

Ms Sherry just landed a job in a large media firm, which required her to attend off-site meetings, held mostly in a coffee shop, where she had several cups of coffee. This kept her up most nights. To get back her lost sleep, Sherry had to restrict to only two cups of coffee per day and that too before 6pm. Tea/coffee has this effect on many people.

Late-night TV/surfing

Bonita loved her night-time ritual of watching late-night soaps on her new plasma TV and chatting online with her son, who lived abroad. Soon she developed high blood pressure and took a long time falling asleep. I suggested that she go online in the morning and watch TV soaps in the afternoon. It worked, her sleep reverted to normal and her blood pressure too settled. Watching screens before sleeping can cause insomnia in many due to excessive stimulation of the brain.

Night calling

Mr Malhotra got a job paying 30 million rupees a year, but it required him to be available 24 X 7; he could never switch off his cell phone. At first, it seemed harmless but soon one call at night would ruin the whole night’s sleep and this disturbed his sleep. Within a few months he was diagnosed with diabetes.

But this is not just Mr Malhotra’s story, many executives sleep with their phones next to them. That’s a sure cause for disturbed sleep even if it does not ring. Having the phone next to you only reinforces the anticipation that it will ring, not to forget the electromagnetic radiation that interferes with sleep.

Uncomfortable space

The Ranade’s took the advice of their psychologist literally. The school psychologists had urged parents to hug their kids more often. The Ranade’s went a step further and got their kids to sleep with them, hugging them all night. Obviously, the bed wasn’t enough for all of them and this affected their sleep. Children should be gradually weaned away to sleep independently. Parents who are over-involved and critical at home with children lose their sleep.

Lengthy naps

Mr Lahane believed that eight hours of sleep is a must. He distributed it across two sessions as an experiment. As he wanted to work late at night on project proposals, he chose to take a long afternoon nap. His naps lasted 3 – 4 hours and soon he realised the detrimental affect it had on his night-time sleep. He also experienced a lot of exhaustion.

Mr Lahane didn’t realise that to maintain the architecture of sleep, the successive sessions of ‘dream sleep’ and ‘deep sleep’ are a must. Dividing sleep in two sessions is dangerous. This causes decrease in slow wave sleep that may result in dangerous consequences for the body.

Disturbing ambience

Aggarwals new apartment had centralised air conditioning. The children were happy but Mr Aggarwal just couldn’t sleep in the cool temperature. Temperature impacts people differently. So does sound. Though ideally a quiet cool environment is desirable, some may need noise and a warmer room. Improper ambience is a serious sleep wrecker.

This was first published in the June 2012 issue of Complete Wellbeing.

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Clockwise shifts rock

Research has shown that those who work in clockwise shifts do better than those who function in anti-clockwise shifts. Morning shifts followed by evening shifts and then night shifts are better. This is because one can delay sleep, but advancing the rest period is difficult. Shifts that rotate backward [night shift followed by evening then night] harm health and causes psychological problems.

Continuous sleep helps

Many night shift workers sleep for a few hours in the morning, wake up to do household chores, and sleep again after a late lunch. They feel that by doing so they are completing their normal sleep quota. This is not true as they are compromising on the quality of sleep, which is as important as the quantity. Sleep follows a pattern that is controlled by a clock in the brain, the pineal gland and hormones secreted by the body.

Continuous sleep helps maintain this pattern [comprising deep sleep and dream sleep] thereby maintaining health. Disruption in this pattern can lead to diabetes, blood pressure, cancer and a host of other physical illnesses. Inability to bear children and problems in memory are other unhealthy consequences.

The darker and quieter it is, the better

After a night shift, sleep in a dark room. If this is not possible, tie a dark band around your eyes. This cuts out bright light that stimulates the sleep/awake clock in the brain disturbing your sleep. While you sleep, forbid family members from venturing in the room to open cupboards or open the blinds as it affects the light in the room. Similarly, while working at night, bright light helps stay awake and alert. Avoid forgoing sleep to finish housework. This happens often in couples where both husband and wife work in shifts. Typically, the husband takes day shift to be with the children at night and the wife takes night shift so that she can look after the kids and complete house chores during the day without sleeping. This is bad practice.

Power naps work

There is substantial research in favour of power naps. A short, half an hour nap during a night shift enhances alertness. A power nap just before beginning a shift helps too. Naps help in memory consolidation, alertness, and learning and performance. However, the naps should not be long. At the most, they can last 30 minutes to one hour.

By temperament, some of us are ‘larks’ [most active in the mornings] and others owls [most active at night]. Evidence suggests it is genetically determined. I am a lark, and so can never sleep late in the morning even after a late night. A small power nap gives me a lot of energy. So, consider your temperament and adjust your nap accordingly.

Sleep hygiene matters

The bed should be reserved only for two activities: sleep and sex. Using it for other mundane activities may disturb the rhythm of sleep. Also, it’s not advised to use caffeine to stay awake. Drinking many cups of caffeinated beverages harms more than it helps. Many shift workers use alcohol to cope with anxiety and depression and to sleep well. Doing so is counterproductive and actually disturbs sleep. The same holds true for indiscriminate use of sedatives. Those in shifts are more prone to consuming addictive substances that may worsen their situation.

Many people rely on cannabis [also known as pot, weed or grass] to stay awake, often with disastrous consequences. Such drugs hamper work performance and slow down the brain, leading to a condition known as ‘Shift Work Disorder,’ characterised by too little or too much sleep.

A healthy lifestyle is important

Shift work distances a person from family, friends and loved ones. Many appear irritable, sad, and lonely and experience mood swings. I see many break-ups, loss of friends and poor interpersonal relationships in those working in shifts. Exercising before and during a shift has helped many to improve their moods. Eating at odd hours causes increase in juices secreted by the stomach, thereby disturbing sleep. Sleeping during normal hours on holidays may not help.

Smoking also takes its toll. If you are a shift worker, incorporate healthy habits in your routine to minimise the effects of sleeping at odd hours. Also, make time for family and friends whenever possible; it will help you cope with your situation better.

Careful travel prevents mishaps

While returning home from a night shift, it is better not to drive as sudden bouts of sleep can lead to accidents. Some people attempt to keep themselves awake by keeping windows open or by drinking coffee. However, these attempts may not always work. Getting someone to drive you back home is safer. Wearing dark glasses on your way back helps falling asleep sooner after reaching home.

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The mind influences the heart immensely

Negative thoughts and feelings can impair the heart’s functioning, while positive thoughts work for its well-being. People hide their feelings or fail to accept their emotions. Take the example of an executive who has been given the pink slip. When asked how he feels about it, he replies “My boss is partial”. Unfortunately, it takes a while for men to recognise frustrations and disappointments and come to terms with it. It is important to identify emotions, accept, acknowledge, experience and exhaust them fully. This catharsis [pumping out of emotions] is important for health and the heart.

Take another example of a girl who felt that she was perpetually wronged and had a long hate list. Studies have amply indicated that consistent hostility changes the way the heart behaves and can affect the lining of the blood vessels that supply blood to the heart. The pipes can narrow and affect its nourishment.

What happens to us when we are pushed by our bosses to fulfil gruelling deadlines? We exert, strain and put additional pressure on ourselves. If this strenuous situation continues for long, the hypothalamo-pituitary-adrenal circuit gets disturbed causing a load on the heart and other parts of the body. What can help calm the body and mind are breathing techniques of yoga and vippassana. It relaxes the breathing and the heart rate, thereby relaxing the autonomic nervous system.

Unhappy emotions in excess are damaging

Sadness is a positive emotion, normally experienced by everyone. However, when it becomes excessive or continues for a long time, it can lead to depression. Symptoms of depression such as lack of interest in work, or relationships, poor appetite, and unexplained tiredness should never be ignored. They need to be identified early, and treated. Depression is one of the major risk factors that lead to heart illnesses.

Similarly, if grief – following retirement, or death of a relative or close friend – continues over an extended period, the body, especially the heart, is put to risk. Excessive sadness causes the release of negative chemical substances that affects the blood vessels of the heart and its rhythm. Hence, those who take long to recover from a tragedy or to come out of grief should be taken to a counsellor.

I get many patients, who are always on the edge, their emotions see-sawing between anxiety and tension. I remember this teacher who was perpetually anxious about the performance of her students and whether her kids would do well in their exams. Her concern was that if they did badly, the management would not think highly of her. She was wracked by a host of fears. This led to hypertension and borderline heart ailments. Intensive counselling to change her attitude towards life worked.

The mind could be compared to an orchestra, where each piece of music or emotion has a role to play. Each should be experienced as and when it plays. Blocking a tune can cause explosions in different parts of the body. It is important to be normal and accept one’s emotions.

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