Dr Noor

Sleep - Its Dangerous transitions and vulnerable life

Written &  compiled by :

Dr Noorul Hasan MBBS., MD in Psychiatry (NIMHANS) Consultant, Sneka Mind Care, Tirunelveli.

Introduction :-

Sleep is a state of rest for the entire body including brain. Every living creature enjoys sleep. What protects those migratory birds from fatigue, flying all day long with average less hours of sleep per day. Fish sleep in water while swimming. So it only takes mental rest and not physical. When do fishes rehabilitate their body? Aquatic mammals like seal, dolphin sleep with one lobe of brain functional and other lobe at rest. So, irrespective of their anatomical make up and adversity in living pattern, nature makes sleep as an immense cyclical phenomenon in every living macro-organisms for better mental-physical rest and to liaise the body functions with nature.

Ancient Tradition of Early Morning Rise:-

Nearly every ancient religions ranging from the west to east, have legislated prayers & rituals in fixed hours. Islam insists on Pre-dawn prayer called Fajr. Eastern religions such as Hinduism, Buddhism and Jainism promote the practice of Surya Namaskara. As quoted by Benjamin Franklin, “Early to bed and early rise makes a man healthy, wealthy, and wise”. Our ancestors were found to have a healthy & long life span. This can be greatly attributed to their Biological Sleep Pattern.

Man has accustomed his day for work and nights for sleep. The agricultural communities cherish their routine even before dawn. None of the archeological inscriptions and old paintings testify social activity at late night excluding festive occasions and reading. Notably, busy readers and researchers alone utilize night hours with candles in search of wisdom. The discovery of artificial light (i.e. Electricity) sparked man to work in the absence of sunlight. Sleeping at right phase of day is as important as sleeping adequately.

Chronobiology ?

The term Chronobiology literally means “study of life in relation to time”. Human requires an average sleep of 8 hours a day (varies depends upon the individual biological make up). The sleep-wake cycle is regulated by Supra-Chiasmatic Nucleus (SCN) in association with Reticular activating system (RAS) which causes sleep onset and wake up. This rhythm at which the sleep operates can be termed as ‘circadian rhythm’. Circadian Rhythm is an in-built clock in the human body operated by myriad of complex mechanisms. It works in accordance with temperature and light. It drives the pattern of change in behavior, body temperature, feeding, sexual drives and hormone balance.

 On the basis of eye movement and electrical activity of brain, human sleep is divided into Rapid Eye Movement (REM) sleep and Slow Wave Sleep. After the initial

90 minutes of rest, REM sleep begins. And it occurs at regular intervals in between slow wave sleep. The entire muscles remains relaxed during REM sleep where a man dreaming of kissing the Miss world won’t even acts out physically for it, however the consolidation of memory takes place during the same phase (1).

Precision in Sleep :-

The range of sleep-wake cycle is determined by number of polyglutamate repeats(…Q) in a gene named  CLOCK located in chromosome number 4 for humans. The genetic code repeat is constant for every human being irrespective of his/her surviving locality. The constant genetic code repeats depicts amount of sleep required by a particular genus on earth. For example, number of CAG repeats in CLOCK gene of humans is 6 whereas the non-human primates have more CAG repeats, Drosophila has 25-33 repeats, numbers inversely proportional to the sleep duration (8).

The protein produced by this gene is believed to affect both persistence and period of circadian rhythms.

Researchers often differentiate and name genes specifically. When the gene responsible for sleep in rats was silenced, it resulted in aggressive and coarse nature of the rat. The rat lived a short span. Genetic researches in PER and other genes showed altered morbid sleep patterns when silenced. This gives strong insights about our sleep patterns and circadian rhythms. Sudden onset of sleep while your spouse speaking to you in bed  is neither due to the musical rhythm of his/her speech nor due to a chill breeze from A/C, but the sentinel operation by your genes (1)(4).

Sleep, melatonin & Cancer:-

 Melatonin, a hormone secreted by Pineal gland. Its secretion occurs from 8 p.m. to 4 a.m. in coordination with exposure of retinal cells to light. When the retinal cells get triggered by light, it reduces Melatonin secretion of Pineal Gland. So, Pineal gland functions effectively only when the retinal are inert. It happens only when we sleep in dark. Ultimately, those who sleep at 12 a.m. constrict their Melatonin secretion to half. And places where even nights are brighter, compel it’s dwellers to generate ineffective Melatonin. Hence, cancer rates soar. How?

In order to attain maturity a cell must pass through four main stages namely, G1 > S > G2 > M. Between each two stages researchers found that, Melatonin hormone regulates apoptosis (programmed cell death) by its regulatory actions at check points. Those check points ensure the cells for correct composition of chemicals before DNA synthesis and cell division. Melatonin restricts the cells from being abnormal and consequently causes the death of abnormal cells. So those people who sleep at right time will enjoy healthy melatonin concentration which thwarts the emergence of cancer cells (2)(3).

Obesity and Sleep:-

Modern man has developed fitness apps, footsteps counter and a lot more. But still the obesity rates soar. Highlighting that overeating is not the lone factor of weight gain.

Researchers have reported a disorder named Night Eating Syndrome (NES). NES is characterized by improper feeding time especially at night. The victims are used to a heavy meal after 7 p.m. Their 25% of their food intake would be at night. Studies have proved the positive association between NES and Body Mass Index (BMI). People affected with NES consume more at night and wake with lack of appetite in the morning (Anorexia). They feel a strong hunger in the evening and eat more at latter half of the day (Hyperphagia). As the dinner gets late, so will the sleep. The Circadian rhythm changes and leads to late morning wake with stress. Researches prove that weight gain through NES is 6 times more than the weight gained through non-NES obese persons. Our sixty years fathers are observed to be more healthy with erect physique than us  even though we are  technologically ahead. The difference is their scheduled sleep habits which is a lost treasure for our generation (5).

Sleep & Mental health :

Sleep is the prerequisite for mental health & stability. Sleep deprivation acts both as vulnerability factor and consequence of a mental illness. Social rhythm therapy is still a well proven strategy for prevention of bipolar episodes (7). Sleep deprivation is one of the strong criteria to assess the severity of any major or minor mental illnesses and effective management of sleep with both behavioral / medical techniques will obviously delay the psychiatric episodes. Altered sleep rhythm impairs memory, alertness, concentration, planning and decision making leading to occupational dysfunction. Consequently, constructing a stressed sleepless life ending with alarming mental illnesses.

Students are advised to sleep early and have a good sleep on the examination night. REM sleep plays an important role in effective functioning of brain. It is responsible for the transformation of information in short term memory to long term memory called Consolidation. This depicts the importance of having a good sleep for those who  race through the pages on examination eve.

Have Good Sleep:-

The international sleep hygiene (6) has made a protocol for sleep to lead a peaceful life. Here are some tips that make your sleep beneficial.

  • Set a Sleep Schedule

Have a fixed sleeping time which may range for 7 – 8 hours.

Remember to backtrack from all duties and tasks about 30 minutes ahead of bed.

  • Conductive Bed

Make your bedroom dark, quiet and calm. Use it only for sleeping.

  • No Electronics and Technology

Turn off all the electronics may it be phone, TV, computer, earphones and place them away.

  • Have a Bedtime Routine

Before bed you can have a hot shower, read book, color, listen to natural sounds and practice some stretching which relaxes your body.

  • Cut off Caffeine

Avoid having caffeine or bitter tasting foods before sleep, generally after 7 p.m.

  • Avoid Night Sessions

Conclusion:-

Every soul on earth is obsessed with something till the eleventh hour. Men and women busy with commerce, students with studies, doctors with casualties, some with women and wine, drivers with logistics, editors with hot news and everyone one is busy and every eyes are in lighted mobile screens. Moreover the COVID lockdowns  almost confused our innate circadian make up and at times we sleep very less like a drosophila . Consequently, alarming proportion of industrial development and technology growth had deviated human beings away from their own ‘fithra’ (meaning ‘natural disposition/innate’ in Arabic).

Technologies are meant to ease our life and not our extinction. Life becomes meaningful, when we enjoy it. Life is enjoyable when we discover the gifts bestowed on us i.e. good pattern of sleep.

Our transition from healthy sleep pattern makes our life dangerous and vulnerable to unknown complications and hence “Dangerous transition and vulnerable life.

                                                                                                                                                                                                                                            ……Dr Noor

References :-

  1. Chronobiology .,Comprehensive textbook of psychiatry by Kaplan & Saddock., 10th edition
  2. Melatonin & the sleep-wake state : Ganong’s review of medical physiology. 26th
  3. Melatonin for the prevention & treatment of cancer : Ya Li et al. Oncotarget. 2017 Jun; 8 (24) : 3989639921
  4. Genomics of circadian rhythm in health & disease : Filpa & Joseph. 17 december 2019 (11: 82) , Genome medicine
  5. Night Eating Syndrome (NES) : Jillon S vanderwal. Clin Psychol Review. 2012 Feb;32(1):49-59. PMID : 22142838
  6. Sleep hygiene practices as per American Sleep Association
  7. Interpersonal & Social rhythm therapy in Bipolar disorder : Ellen et al.2007 sept, v.9(3)325-332, Diagnosis in clinical neuroscience, PMID -17969869
  8. Bellivier F. Biologie et génétique des rythmes circadiens [Biology and genetics of circadian rhythm]. Encephale. 2009 Jan;35 Suppl 2:S53-7. French. doi: 10.1016/S0013-7006(09)75534-4. PMID: 19268171.

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