We were lucky enough to catch up wit Occupational Therapist Paul Faddy after an interesting workshop on sleep deprivation and its impact on our physical and mental health. Forget the notion of ‘sleep is for cheats’ or ‘I’ll sleep when I’m dead’ which we have all gotten accustomed to in the West…sleep is very important in promoting our wellbeing and long term sleep deprivation has now been linked to Diabetes, Cancer and mental health problems. Here Paul puts together some thought about Sleep and how we can promote it.

 

Adolescents are generally the most sleep deprived age group. 

During puberty, the timing of the suprachiasmatic nucleus (the body clock, which controls the Circadian rhythm) shifts back, so sleepiness does not occur until later at night, often later than their parents. This can be exacerbated by teenagers’
use of devices with blue light emitting screens, which tricks the suprachiasmatic nucleus to think the time is earlier than it is. A teenager’s busy after school schedule of homework, sport, extracurricular activities, part-time work and social commitments all cut into their sleeping time. 

The developing brain of a teenager is recommended to have between 8 to 10 hours of sleep per night. The many effects of sleep deprivation on teenagers include: 

* concentration difficulties/shortened attention span * memory impairment
* reduced academic performance
* poor decision making 

* lack of enthusiasm
* depression
* suicidal thoughts and suicide attempts
* risk-taking behaviour, sensation seeking/ addiction * moodiness, aggression, other behavioural problems * increased likelihood of exclusion. 

 

Children diagnosed with attention deficit hyperactivity disorder (ADHD) have symptoms nearly identical to those caused by sleep deprivation. 

If a sleep deprived child is assessed by a doctor and those symptoms are outlined without discussing the lack of sleep, it is possible a doctor would diagnose and subsequently medicate a child for ADHD. 

The rise in diagnoses of ADHD is possibly due to a rise in sleep deprivation. The problem with this incorrect diagnosis is the common types of drugs prescribed for ADHD are Adderall1 (amphetamine) and Ritalin (a stimulant also used in the treatment of narcolepsy), which are two of the most powerful drugs to prevent sleep.This is obviously the last thing a sleep deprived child needs. 

 

Older peoples’ sleep is often fragmented. 

As people age, the more frequently they wake through the night. The primary reason for this
is a weakened bladder. When people wake at night they are often groggy, when standing blood is drawn from the head by gravity, resulting in feeling light headed and unsteady, especially for people who have blood pressure issues. Nocturnal bathroom visits are associated with an increased risk of falls, which can lead to fracture, hospital admission, loss of confidence, need for care cycle. Falls and fractures significantly increase morbidity and decrease life expectancy. 

Tips for safe sleep for the elderly: 1) have a lamp within reach 

2) use dim lights in the bathroom and hallways to illuminate path 

3) remove trip hazards
4) keep a telephone next to the bed or a Careline alarm 5) consider Telecare such as falls or bed sensor 6) consider using a commode/urinal in the bedroom. 

 

Nursing and residential homes are often poorly lit. 

Some common rooms may only have 20 lux light levels. By way of comparison, office lighting is 320-500 lux and direct sunlight is 32k-100k lux. One of the more depressing sights in the job is visiting a nursing home in the morning and seeing residents (and sometimes staff) asleep in the common room with Jeremy Kyle goading on the TV. Neuroscientists in the Netherlands looked at the sleep / wake patterns of nursing home residents with early stage dementia.

Initially the patterns varied wildly, out of sync with the Earth’s day / night cycle (the suprachiasmatic nucleus needs to be reset by sunlight). The neuroscientists then installed bright lights throughout the home, which produced lux levels close to environmental light levels. The residents’ sleep / wake pattern consolidated to the Circadian cycle, improving the resident’s sleep patterns. An added benefit was the residents’ cognition levels significantly improved.

 

** Action for happiness. Sleep your way to happiness – with Professor Russell Foster. You Tube, 2018 

https://www.youtube.com/watch?v=3mvFd2KU57E&t=1228s 

**Walker, M., Why We Sleep. London: Penguin, 2017
** BBC One. The Truth About Sleep [online]. London: BBC, 2017. 

https://www.bbc.co.uk/programmes/b08q8p13 

** Martin, P. Counting Sheep. London: Flamingo, 2003