Deep in the inner recesses of our brain, resides a master clock which guides our daily behaviour throughout the course of a 24 hour day. Termed as Suprachiasmatic Nucleus (SCN), this central pacemaker is synchronised to geophysical time and controls the circadian rhythm among other biological processes. The circadian clock is triggered by external stimuli such as light and dictates many physiological rhythms, including the body’s sleep-wake cycle. We live on a clock whether we want to or not, and maintaining this Mother Nature’s cadence is fundamental for a good sleep.

SLEEP: AN UNDERRATED ERGOGENIC ASSISTANCE
Proper sleep is an essential part of a healthy lifestyle and plays a key role in ensuring optimal growth and well-being throughout your life. Numerous studies have emphasised on the importance of sleep. Like eating and exercising, sleep is a biological imperative. An adequate amount of shut-eye significantly helps memory and mood, keeps you trim, gets your health in check and enhances your looks.

The importance of sleep is also emphasised in the Islamic literature. The topics of the benefits of sleep, good sleep hygiene and maintaining a pattern of light and darkness (also known as ‘circadian rhythm’) is frequently mentioned in the Quran and Hadith. Sleep is nature’s panacea, more potent than any drug in its capacity to revitalise and rejuvenate the human brain and body.

Therein, lies the problem for people who attempt to beat this system by curtailing sleep, hoping to get the most out of their lives. People are increasingly sleeping later and lesser as compared to fifty years ago due to various cultural and social factors. In fact, Singapore is among the top three sleep-deprived cities in the world. Clocking at an average of 6 hours and 32 minutes a day, we are short of the recommended 7 to 9 hours’ sleep. What’s more concerning is that these habits are trickling down to the next generation.

CONSEQUENCES OF SLEEP DEPRIVATION
A research sponsored by Estée Lauder demonstrates that poor sleep is correlated with reduced skin health and accelerated skin ageing. Indeed, inadequate sleep leaves you looking less youthful, but its importance goes way beyond just addressing vanity concerns.

A legion of research publications in recent years have shown that the quality of sleep affects various critical health domains including metabolic, endocrine and neurological functions. Consistent with laboratory evidence, several epidemiologic studies have demonstrated a connection between short sleep and higher BMI, as well as a causative role of chronic sleep loss with diabetes. Lack of sleep rattles the physiological mechanisms in our body and disrupts hormonal secretion, elevating the risk of metabolic disorders such as diabetes and obesity.

Findings from the National Health Survey 2010 reveal that the Malay community in Singapore has the highest prevalence of obesity and diabetes. Figures 1 and 2 show the health profiles of the Malay community as compared to the national average between the years 1992 to 2010. The charts depict an increasing trend that coincides with a widening gap between the Malays and the total population in both obesity and diabetes prevalence.

The mounting evidence on the association of sleep with metabolic disorders is a convincing indication that sleep is a promising target to help curb diabetes and obesity among the Malay-Muslim community. As sleep is a manageable and alterable risk factor, it is useful to address the issue of sleep disorders and identify influential factors that would spearhead the problem of sleep deprivation among the Malay population.

ELECTRIFIED SINGAPORE
One of the distinct factors that have led to the culture of pushing waking hours far into the night is the proliferation of light-emitting electronics. Singapore has transitioned from an underdeveloped nation to a highly industrialised first-world metropolis. Technical innovations attack our eyes with artificial light and because our circadian rhythm is highly influenced by light, these gadgets trick our body clocks into living at a perpetual high noon even at night.

The stresses and lifestyle that accompany our nation’s advancement may have also invaded our ability to sleep well as we trade sleep for more work. As urban dwellers frenzied with social schedules, we have accustomed ourselves to get by with shorter sleeping hours. The escalating amount of activities available round the clock and the expanding 24 hour economic demands are among major factors that have led to sleep deprivation.

THE GRAVEYARD SHIFT

According to Professor Michael Chee, a neurologist who has been studying the association of sleep and brain, one of the predominant culprits behind lack of sleep is work. The rapid acceleration of Asian economies has drawn detrimental ramifications on employee wellness and one of the significant factors associated with increased sleep disorders is shift work. Working at night or during irregular hours goes against the human body’s biology, which is hard-wired to sleep during the night and be active in the day.

Typically many jobs in the services sector require shift work. Figure 3 shows the breakdown of the Malay Resident Working Persons Aged 15 Years and Over by Industry according to the Singapore Census 2010. According to the data, the service sector has the largest proportion of Malays, an indication that majority of them are holding night shifts job and thus, wrestling with getting quality sleep.

While shift workers are victims grappling with misaligned body clocks, they are also builders of the nation who provide necessary services in public safety, healthcare and transportation. It is impossible to abolish shift work altogether, so the challenge is to establish strategies to keep them healthy and everyone around them safe while they work round the clock.

Being sleep deprived undermine productivity so consuming more hours to get things done at the expense of sleep actually makes you get less done; the irony. Indeed catching a good night’s sleep won’t grant anyone immunity. However, the increasing links between sleep and health suggest that investing in quality sleep has a promising remedy.

SO HOW MUCH SLEEP DO WE NEED?
Both the National Sleep Foundation and the Singapore Sleep Society agrees that the amount of sleep we need varies according to age, and are influenced by lifestyle and health. Figure 4 illustrates the optimal sleep duration required across the life span of an individual.

Getting quality shut eye may seem impossible in this era but good sleep is more under your control than you might think. Here are some simple tips to get a good night sleep:

• Stick to a sleep schedule even on weekends to regulate your body’s clock.
• Practice a relaxing bedtime ritual to help disassociate your sleep from activities that elicit stress or anxiety.
• If you have trouble sleeping at night, avoid napping in the day as it might disrupt the normal sleep and wakefulness routine.
• Exercise promotes good sleep provided it is not too close to bedtime.
• Avoid bright light in the evening and expose yourself to sunlight in the morning to maintain your natural circadian rhythm.
• Avoid heavy meals in the evening and stimulants before sleep.
• Associate your bed with sleep. Design your sleep environment to establish the conditions strictly for sleep and rest.
• Sleep on your side and avoid sleeping face down, on your stomach. Choosing the right sleep position influence the quality of your sleep, the health of your skin, and your overall well-being. Islamic literature emphasises on the importance of sleeping on your right side with the hand under the cheek and modern science confirmed the benefits of sleeping in this position.

COPING WITH SHIFT WORK
Additionally, these are some useful tips for shift workers:

• Get plenty of sleep before your first shift. You may also try staying up later the night before to adjust
• Napping during your shift where possible. These naps can be as short as 20-40 minutes but no longer than 45 minutes to avoid waking up during a period of deep sleep
• Reduce your caffeine intake and drink more water. Most shift workers consume caffeine to help them stay awake. As a result, they find it difficult to fall asleep when they get home.

Sleep deprivation is an endemic problem whose best cure is, quite simply, sleep. Allow the daytime to bring us across distance and space, and leave the night time sleep to bring ourselves across time, and awaken our senses of intuition and wisdom. ⬛

Nabilah Mohammad is a Research Analyst at the Centre for Research on Islamic and Malay Affairs (RIMA). She was previously a Research Coordinator for the Cognitive Neuroscience Laboratory (Sleep Team) at DUKE-NUS Graduate Medical School.