Good Night's Sleep: Obesity, Blood Pressure And Cardiovascular Diseases And Other Risks Of Being Sleep Deprived

When we think about measures for achieving a healthy lifestyle, we always think about proper diet and daily exercise. But one of the critical components, which we invariably do not think about is sleep - often neglected, even though, it constitutes one of the essential pillars for a healthy lifestyle. What we must realise is that sleep is an evolutionary phenomenon, and human beings have developed a particular sleep pattern over several thousands of years. So, we may still be able to go around without a healthy dietary practice and irregular exercise regime, but it is nearly impossible to go without any sleep.

Sleep is not a passive phenomenon as it seems so. While we are sleeping, we are conserving our energy. Our immune system and hormone systems are at work to repair and heal our muscles and tissues. The brain tries to consolidate memory, flush out waste products and re-network so that when we wake up, we feel refreshed and energized to carry on with our daily activities. Also, worth noting is that while we are sleeping, our heart rate and blood pressure dips; respiratory rate, digestion, the renal excretory function also reduces. A good nights' sleep makes us more innovative, productive, and healthy.

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Disrupted sleep cycles and why that is an issue

Now, what happens when we have a disturbed sleep cycle. Sleep disturbances due to sleep-disordered breathing or any other issue have a detrimental impact on both physical and mental health. A night of disturbed sleep leads to a decrease in cognition and judgment. We tend to feel fatigued, depressed, irritable and have impaired decision making. On the physical aspect, we may experience palpitations, increased blood pressure, excessive craving for food, etc. Sleep deprivation has also been correlated to various cardio-metabolic disorders like type 2 diabetes mellitus, obesity, and cardiac disorders.

Most commonly, sleep disturbances are seen with sleep apnea or Obstructive Sleep Apnea (OSA). Multiple studies have indicated that over 10% of Indians suffer from sleep apnea. OSA means disordered sleep breathing where an individual experiences an episode (sometimes multiple episodes) of cessation of breathing due to the closure of the upper airway while sleeping.

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As per numerous clinical studies, OSA has been found to be associated with about 52% cases of type 2 diabetes mellitus, 80% cases of resistant hypertension, 77% cases of obesity and 50-60% in various cardiovascular diseases. Newer evidences also suggest that depression and cancer have an association with OSA. Additionally, the prevalence of sleep apnea increases as body mass index, neck circumference, or other measurements of body build increase.

However, it is worth noting that the signs and symptoms are relatively innocuous, ranging from morning headaches, fatigue, daytime sleepiness, snoring or maybe trigger event like a road traffic accident.

Disturbed sleep often leads to workplace productivity loss and is related to major industrial accidents globally and has a high socio-economic burden. Data from the American Society of Sleep Medicine (AASM) reports that undiagnosed sleep apnea in the United States has an annual economic burden of 149.6 million USD. As for India, we are still far away from assessing our economic burden, despite a high prevalence of sleep apnea which is further supplemented by the lack of awareness about sleep disorders, sleep apnea and its consequences. Most of the time, sleep is not a priority subject to be discussed even amongst family members.

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Tips to sleep well

Several treatment options are available to treat OSA. The answer, however, starts from quitting smoking, coming down on drinking habit, reduction of weight, taking a lateral position while sleeping. However, positive airway pressure (PAP) therapy is the gold standard for OSA treatment.

We all can begin by understanding that sleep is not a passive phenomenon but an inseparable aspect of our life which has implications both on physical and mental health. Few sleep hygiene tips like sleeping regularly on the same time, reduction of screen time or cell phone usage, moderate exercise and getting at least 7- 8 hours of sleep will go a long way ensuring good sleep health in our society.

(Dr Sibasish Dey: Head - Medical Affairs, Asia & Latin America, ResMed)

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