INVESTING IN SLEEP FOR HEALTH AND WELLBEING DIVIDENDS. A VIEW FROM ONE OF ASIA’S LEADING SLEEP SCIENTISTS.

It is undeniable that the prevalence of obesity and diabetes has increased dramatically in East Asia. While dietary changes and reduced physical activity play a part, the contribution of poor sleep has been insufficiently acknowledged. Experimental evidence from tightly controlled laboratory studies on sleep deprivation reveal a number of physiological changes that could, in the long run, increase the risk of diabetes. Epidemiological evidence shows a clear association between short sleep and increased risk of diabetes. Yet, an April Fool’s joke was made about a programme to incentivize sleep in computer science students who pride themselves as ‘modern day warriors’ in staying up all night to code. It may be cool to ignore sleep but is it advantageous to do so, as many wish to believe?

Clearly not, and happily, the tide is turning. Professional athletes are recognizing the importance of sleep as a contributor to peak performance and speaking out. Burnout has been recognized by the WHO as a medical condition. Sleep is entering the conversation in homes and corporate wellness programmes. And insurance companies are recognizing that improving sleep is a strategy to embrace.

What can we do to improve our sleep? Among the many tips that are circulated in wellness magazines and blogs, only some are supported by scientific evidence. Over a series of articles, I will expand on tips you can trust, but here, I’ll start with the ones that are going to have the largest effect on your life

Persons in East Asia sleep less on weekday nights compared to Westerners, primarily because they go to bed late. Students report homework as a significant issue but privately, a number of students say it’s also about what they do in between homework that delays bedtime. Research has shown that academically stronger students sleep earlier and get more sleep. Perhaps they implicitly know about the competitive advantage good sleep gives. Working adults often have greater discretion over their time-use, but too few persons exercise their choice, resulting in filling up the night with activities that push back bedtime

Explosive growth in mobile phone adoption has been accompanied by the enslavement of multitudes who feel compelled to constantly stay in touch with one another. Among the ~90% of adolescents and young adults in Asian cities who own a smartphone, ‘communications’ through social media is the most common use. Perhaps unsurprisingly, older persons in our region who have not grown up with instant messaging tend to have less sleep deficit, but even they seem to be affected by the community habit of sleeping late. Without doubt, the internet is an important source of information and opens convenient channels for commerce. However, it remains that major internet-related companies are extremely skillful at manipulating behavior and drawing customers’ time and attention to their digital wares. Supporting the notion that giving in to digital temptations, especially in the evening erodes sleep, a recent study conducted in Germany found that the availability of broadband internet services was associated with 25 minutes less nocturnal sleep than in regions where there was no access.

Falling asleep and staying asleep is accompanied by reduced responsiveness to the external environment. To facilitate this, often arousing or stressful mental activity should be curtailed. Examples of such sleep inhibitors include worrying about a family member, thinking of how to compose an email or pondering a challenging issue. An overactive mental state works against falling asleep. When we are still young and sleep signals are strong, such mental activities may not yet be a problem. However, many conscientious persons start encountering difficulty initiating sleep from middle adulthood onwards if they do not make a deliberate effort to disengage themselves from their worldly concerns before bedtime. What serves to relax varies from person to person. Some prefer listening to music, others find reading a book or even taking a stroll prior to bedtime relaxing. Some persons take only a few minutes to shut down, others longer. They key point is to ringfence pre-sleep down time and to stick to that resolution.

High intensity physical training, that previous generations of athletes called ‘interval training’, has found a strong resurgence with young people because if one can tolerate it, it can produce impressive results in less time. If we took this same approach to work or study, we will likely get what we need done and have more time to enjoy some leisure and sleep better. Conversely, persons who do not get enough good quality sleep feel fatigued, sleepy, or both, reducing their willingness to put in the concentrated effort that elevates productivity. Allied with this, sleepy, tired persons are likely to procrastinate, to defer important tasks till they feel better. This could in turn result in staying up later and if the cycle is not broken, not only will productivity be reduced, a person’s expectation of what they are capable of could diminish

If you are health conscious, you’d object if someone smoked a cigarette next to you, so why is it many of us don’t rein in the habit of staying up late to respond to social media posts? Or tell your overseas colleague that they need to think about your wellbeing and productivity when a conference call is scheduled past midnight?

If you frequently feel sleepy the next day, fall asleep when left in a quiet room, if you sleep more than two hours more during days when you don’t have to wake up early in the morning, your body is telling you that it is not getting enough sleep. Over the longer term, that’s going to have negative consequences no matter what your friends or colleagues tell you. As habits are difficult to change, it is important to ingrain a positive attitude to sleep when one is young. When one is older it may be difficult or impossible to get the sleep that one craves.

As sleep gains traction as a status symbol, there will be an emergence of ‘sleep hacks’ and ‘super tips’ that basically tell of shortcuts and ways one can benefit sleep without making significant lifestyle changes. Such advice can be likened to liposuction and facial uplifts – may look good from the outside but don’t actually change the underlying fundamentals. As prudent investors, you need to be wiser.

Investing in good sleep is a wise move. Something to sleep on tonight.