Ask any working person the one thing they would do when they get home and more often than not, it is to sleep. Now, ask the same person what is something they would want to do on weekends and you’re likely to get ‘to sleep in’. If Nightmare on Elm Street was ever real, Freddie would have little time to reach his murderous KPI since his Singaporean victims are sleeping so little. While he is not real (thankfully), eye bags and black rings are.
A 2016 study by SingHealth Polyclinic revealed that four out of every ten Singaporeans are lacking in sleep on weekdays while twenty-six per cent face the same problem on the weekends, suggesting many Singaporeans are lacking the full seven to eight hours of sleep per night.
Just recently in mid-2018, Singaporeans were found to be the runner-up in sleep-depravity across 12 countries surveyed in an international poll, according to consultant ENT surgeon Dr Gan Eng Cern at Mount Elizabeth Novena Hospital.
Dealing With Insomnia Isn’t Something To Sleep On
So why are we sleep-deprived? Turns out it is not just about the demands of life that could be making us choose to eat into sleep time, but people are also having trouble falling and staying asleep. And it is only the tip of the iceberg.
“Any sleep disruption that continues for a month without an obvious identifiable cause deserves medical attention,” says Dr Jeeve Kanagalingam, a senior consultant at Mount Elizabeth Novena Hospital’s The ENT Clinic.
Staying away from caffeine and nicotine, minimising blue light emission from mobile screens, reducing fatty food at night and building a cosy sleep environment go a long way in promoting better sleep, but insomnia could also be a sign of more serious medical conditions.
Restless Leg Syndrome
No, this is not about the subconscious urge to shake legs at dinner tables to the ire of people around you. It is actually a nervous system disorder that involves an uncomfortable itch or a creepy-crawling feeling under the skin of the legs that makes you want to keep moving your limbs. The at-times indescribable sensation gets worse when you’re sitting or lying down, especially at night. While the cause is unknown, certain medical conditions or diseases like iron deficiency, nerve damage, kidney failure, alcohol and tobacco consumption, pregnancy and lack of sleep may lead to RLS. The imbalance of dopamine, a brain chemical associated with reward-motivated behaviour, has also been suspected cause of the syndrome.
Polycystic Ovary Syndrome (PCOS)
Progesterone, known as the relaxing hormone, has a mild sedative effect though men have lower levels of it than women. But it’s not always good news for women either. Progesterone levels fluctuate based on a woman’s menstrual cycles, being at its lowest level at the onset of a period and may be why some women find it harder to fall asleep then. However, when insomnia gets serious and chronic, it is advisable for female sleep-loss sufferers to get checked for polycystic ovary syndrome (PCOS), a hormonal disorder that creates prolonged periods. Women with PCOS are at higher sleep apnoea risk – a disorder that causes a person to have irregular breathing during sleep, resulting in poor sleep quality.
Obstructive Sleep Apnoea (OSA)
OSA occurs when muscles in your breathing airway relax during sleep and partially or completely obstruct airflow. A sufferer of OSA can stop breathing or receive inadequate air and choke every couple of seconds in his/her sleep. The choking causes the muscles to contract and open up the passage to breathe again, but the sufferer will experience frequent sleep disruptions, resulting in poor sleep quality and thus receive less rest than needed. Causes of OSA are various, such as allergies, a build-up of nasal fluids, enlarged nasal structures or a deviated nasal septum.
Hypothyroidism, a condition where the body is unable to produce sufficient thyroid and cause a cascade of issues in the airway that obstruct breathing, can be a contributing factor to OSA. As thyroid also affects metabolism, people with a lack of the hormone are at risk of being obese which can contribute to OSA as well. On the opposite end, hyperthyroidism can overstimulate the nervous system, produce night sweat and contribute to nightmares/night terrors, making falling asleep a tall task.
Poor sleep quality has also been associated with heart health, with proven strong relationships with cardiovascular diseases like heart disease, hypertension, irregular heart rhythm and stroke, according to Dr Peter Ting, cardiologist and medical director at StarMed Specialist Centre. In an article by Health Harvard, there is evidence of a link between heart failure and central sleep apnoea; the repeated starting and stopping in your breathing during sleep is not only worrisome but is also highly disruptive to sleep patterns and can make you feel tired and lethargic in your waking hours.
Sleep loss and depression are like the perfect tango partners, going hand-in-hand in a downward spiral. Depression can be so debilitating that sufferers find falling or staying asleep anything but a walk in the park. The resulting sleep deprivation then worsens an already depressed and irritated mood. It also affects your cognitive skills by weakening your ability to process and cope with your feelings, leading to moodiness, increased irritability, negativity, decreased empathy and poorer self-control.