Monday 18 September 2017

Sleeping well, a determinant of health








There are some health determinants that we can’t do much about such as those that are marked by our genetic endowment, our family, the place where we have to live and the historical moment that is contemporary to us. Other factors, however, are linked to the lifestyle we decide to lead, such as sleeping well (in quantity and quality) a factor that doesn’t yet occupy a prominent place in the collective imagination. However, many studies aim towards common sense: if one sleeps well, the next day is better, and vice versa. That is why I was not surprised by the finding of a Finnish research that associates sleeping insufficient hours with drowsiness and life quality for adolescents or another collected from Harvard Health Publications that limited sleep to five hours a night for one group of students at the Singapore institute for a week and compared their abilities to another group who had slept for nine hours each night, with predictable results of cognitive impairment due to lack of sleep.

Sleep well and performance at work

A Harvard Business Review article focuses on the link between good sleep and personal performance. The study proves that, if a person is awake for 17 hours (at 11 o'clock at night if she has woken up at 6 o'clock in the morning), her ability to solve problems is reduced in a way equivalent to having a level of 0.05% alcohol in blood. Along the same lines, people who have slept well are twice as effective on several skill tests compared to those who slept less, and even those who have taken a nap score better in creative tests. Given this unsurprising data, it’s strange that we can see very few studies on sleep deprivation and performance among the medical guards. Despite this scientific shortage, work done with the collaboration of a group of Canadian paediatric anaesthetists has proven what we feared: a few simple cognitive tests and mood profiles taken at 7am from anaesthesiologists who came to work from home compared to those on duty have given demolishing results against a model of medical guards that breaks with all physiological logic.

Sleep well and protect against disease

It’s fairly intuitive that sleeping well ought to be healthy, but it’s not until recently that this function to which we dedicate, or ought to, one third of our lives, has attracted the attention of scientists. We have now started seeing published research on the influence of poor sleep as a factor related to the onset of some diseases such as depression, geriatric frailty, falls with fractures, dementia and even tuberculosis, but it has also been noticed that sleep can have an influence (sleep well for positive influence and poor sleep for negative influence) of some treatments such as Parkinson's or chemotherapy for breast cancer.

Tips for Better Sleep

Johns Hopkins experts advise against fighting the myths that many people have about sleep, such as that five or six hours of sleep is enough or the tendency that many people have to seek help from sleeping drugs which create addiction and don’t have a positive impact on the essential circadian rhythms. Harvard, meanwhile, has published 10 tips for sleeping well, which can be found in the original

Science, little by little, comes up with proof that sleeping well or badly is not neutral for people’ health or performance; for this reason, it’s up to the clinical practice to enter everything related to this health determinant into the personal history of the patients, in the health advice that we offer and in the therapeutic proposals that arise from clinical activity. In another order of things, it's obvious that we should change the current model of medical guards and the twelve-hour nursing shifts.


Jordi Varela
Editor

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