Prof. Dr. Shyam P Lohani

A sound sleep is crucial for a healthy life. It varies as per age, but everyone needs a good duration of sleep for physical as well as mental health. On average, adults need seven to nine hours of sleep but it differs from person to person. Some people feel perfectly well with six hours of sleep with an occasional nap during the daytime whereas some need consecutive eight hours of sleep. Some people may be affected if their sleeping patterns change, whereas for others, it is perfectly alright with changes in their sleep schedule. There are millions of people suffering from sleep-related problems across the world. It is important to have quality sleep to perform optimally in work settings.
Sleep is the basic requirement for overall development and performance among infants, children, and adolescents. Both the duration and quality of sleep are important. The rapid urbanisation is interfering with the people’s natural sleep patterns. The increased sound pollution, shift work, unhealthy food habits, and daily activities have caused a profound impact on the sleep patterns of the urban population. A lack of sleep for a night causes immediate impact on their health the next morning. However, continuous lack or insufficient sleep may cause many physical and psychological health issues.

Issues
Numerous studies have shown that a lack of sleep affects learning and memory. It has been shown that insufficient sleep interferes with decision making and also the learning process. Sleep is also necessary for processing emotions, thus lack of sleep may cause negative emotional reactions. Chronic lack of sleep increases the chances of having a mood disorder. Studies have shown that people with insufficient sleep or insomnia will have more chances to develop depression, anxiety, and panic disorder. Sleep deficiency is linked to many chronic health problems, including heart disease, kidney disease, high blood pressure, diabetes, stroke, and obesity.
There has been a popular myth that people can manage daily activities even with less sleep and without negative consequences. However, a research has shown that for optimum performance at work and all other daily activities, duration of sleep and good quality are vital. Poor quality of sleep is strongly associated with obesity. This increase in weight might be due to a lack of motivation for exercise. The lack of sleep increases appetite-stimulating hormone, ghrelin, and at the same time decreases appetite-inhibiting hormone, lepton, which results in increasing appetite, thus, weight. People who want to lose weight, are, therefore, advised to have a good quality of sleep for an optimum duration.
There have been studies supporting the fact that people who reported sleeping fewer than five hours per night had a greatly increased risk of having or developing type 2 diabetes. However, studies have also found that improved sleep can positively influence blood sugar control and reduce the effects of type 2 diabetes. A meta-analysis of dozens of studies has implicated that people with poor sleep are more likely to have heart disease and stroke than those who sleep 7-8 hours daily. In the long-term, people who lack adequate sleep, are more likely to have a heart attack and die earlier than those who have adequate hours of quality sleep.
Quality sleep has a potential role in the immune system of our body. People with a deficiency in sleep are more susceptible to infections than those with sufficient sleep. People who sleep less than seven hours are three times more likely to get common cold than those who sleep eight hours or more. Poor sleep is associated with a decrease in the social interactions of the people. It also impairs the emotional expression of the individual. Poor sleep is also strongly associated with long-term inflammation of the digestive tract known as inflammatory bowel disease.
Insufficient sleep has been associated with an increased risk of injury in people of all age groups. The injury is often related to driver sleepiness and a fatal car crash. The deficiency of sleep has played a role in human errors linked to tragic bus and truck accidents in Nepal which costs hundreds of lives every year. In the elderly, sleep insufficiency is linked to increased risk of falls and bone fracture. A study has shown that poor sleep has a similar effect as alcohol intoxication.

Strategies
The pieces of evidence show that insufficient sleep is a common problem with large percentage of people throughout the world. The low awareness of poor sleep among the general population, health care professionals and policymakers mingled with the growing burden of sleep-related disorders have made it urgent to develop a national-level strategy for sleep health. The provision of mandatory requirements of two drivers for long route buses is expected to reduce the number of tragic bus accidents. Similarly, Nepal needs to implement the mandatory requirement of at least 30 minutes break after 4 or 6 hours of continuous driving which has proved effective in terms of reducing road accidents in the western countries. The take-away conclusion maybe it is up to you to decide about your health and duration of sleep to have a good quality of life. Lastly, best wishes for good and quality sleep.

(Prof. Lohani is the Founder and Academic Director of Nobel College/ Hospital. He can be reached at lohanis@gmail.com)