7/27/17. Why Changing Sleep Habits Needs To Be Your Business

Transcription

1 + Why Changing Sleep Habits Needs To Be Your Business Michael Chee Neuroscience and Behavioral Disorders Program Duke-NUS Graduate Medical School 1

2 2

3 Outline n A call to action on changing sleep habits n New facts about the benefits of sleep n Lifestyle changes to ponder and implement 3

4 Overtraining in sports is well known Physiology of Sport and Exercise 5E Kenny, Wilmore, Costill; Data from DC Nieman

5 Economic Impact of Insufficient Sleep 5

6 Distribution of Nocturnal Sleep Duration In Singaporean Adolescents Nocturnal sleep duration Could be enough sleep Not enough sleep Gooley JJ (unpublished data) Daytime sleepiness and fatigue Daytime sleepiness problem Fatigue most or all the time Gooley JJ (unpublished data) 6

7 BMI and overweight ~ sleep duration Higher BMI in shorter sleepers More overweight in shorter sleepers OR = 2.22 (95% CI 1.17 to 4.24) Gooley JJ (unpublished data) Depression scores vs sleep duration Higher depression scores in short sleep Self-harm thoughts in previous week Gooley JJ (unpublished data) 7

8 Sleep factoids and tidbits Sleep stages and electrical activity 8

9 Normal Sleep Architecture In A Young Adult Regular Sleeper with Regular Activity Schedule 9

10 A Person At Risk of Poor Outcomes Sleep Across Life 7 yrs 75 yrs 10

11 Sleep duration across the lifespan Slow wave sleep declines with age Children ~40% Young adults ~20% Old adults ~5% REM declines Incr. sleep fragmentation Overall drop in quality Roffwarg et al., Science, 1966 Functions of sleep Conservation of energy Restoration of energy supply in neurons Brain housekeeping Memory consolidation 11

12 Sleep provides a nightly detox for the brain Memory Consolidation and Evolution with Sleep Sleep also plays an important role in enhancing learning and strengthening memory Performance on a newly learned task is often better the next day if adequate sleep is achieved during the night Information is repackaged during sleep. ACTIVE processes at work! 12

13 Sleep is important for MEMORY consolidation Chan S, Baldeweg T, Cross JH; Epilepsy and Behavior 2011 Consolidation protects memories from forgetting and interference 13

14 REM Sleep May Strip Off Emotions From a Memory Goldestein AN, Walker MO; Ann Rev Clin Psychol (2014) What if I don t sleep enough? 14

15 Sleep is important for all aspects of health Foster RG NRN (2005) 15

16 Starting school late for all not necessary PUBLISHED JUL 21, 2017, 5:00 AM SGT There is no doubt that starting school later for Nanyang Girls' High School has helped the pupils to concentrate better but the Government should not rush into extending this to all schools. (No downside to starting school late; July 19). Anecdotally, a higher proportion of Nanyang Girls' High students are chauffeured to school than in other schools. A later start time would not affect them much. But for those taking public transport, a later start time would inconvenience both students and working adults as they would all be travelling at about the same time in the mornings, which would result in packed buses and trains. Reports about students having to wake up as early as 5am to cross the border from Johor without compromising their academic performance are also not uncommon. Get The Straits Times newsletters in your inbox SIGN UP Ultimately, self-discipline is the key to attentiveness in class, which is also essential when one becomes a working adult. Lim Chee Khiam The Need for Sleep Studies Healthy, no sleep or neuropsychiatric disorders years of age High performing students Regular sleep <8h night, Gap of 1-2h between weekday and weekend sleep times 16

17 Sustained attention Psychomotor Vigilance Task 285 Lo, Ong, Leong, Gooley, & Chee (2016). SLEEP Speed of processing Mental Arithmetic Task = Symbol Digit Modalities Test Lo, Ong, Leong, Gooley, & Chee (2016). SLEEP 17

18 Mood Positive & Negative Affect Scale Excited Lo, Ong, Leong, Gooley, & Chee (2016). SLEEP Impairing effects of multiple nights of sleep restriction were cumulative Fri Mon Lo, Lee, Teo, Lim, Gooley, & Chee; Sleep (2017). 18

19 Incomplete recuperation after two nights of recovery sleep Fri Wkend Mon Lo, Lee, Teo, Lim, Gooley, & Chee; Sleep (2017). Re-exposure to sleep restriction led to further & faster deterioration in performance Wed Mon Fri Wkend Mon Lo, Lee, Teo, Lim, Gooley, & Chee; Sleep (2017). 19

20 Association between self-reported sleep duration on ventricular volume and cognition Average ventricular expansion rate = 3.36% Plus 0.59% for every hour of reduced sleep duration Average cognitive change rate = 0.62% Minus 0.67% for every hour of reduced sleep duration Lo JC; Sleep (2014) Economic burden of diabetes in Singapore Yoong, M; BMC Public Hea 20

21 Short sleep increases risk for diabetes mellitus Confluence of negative effects on glucose tolerance, cortisol, appetitive control and proinflammatory cytokines Risk increase is about 40% for short sleep <6hrs / night Sleep loss increases risks of accidents 21

22 III. Making Sleep Count III. Making Sleep Count Have a pre-bedtime routine Control use of e-devices and sleep time Sleep earlier (if sleeping past 11pm-midnight) Manage stress Allow for afternoon naps Later school start time see *Chen T; Sleep Medicine (2014) 22

23 We need strong action to moderate e-device use ACTIVITIES DONE IN LAST 30 DAYS DO Web Browsing 25 MINS/DAY 90% SAY 40% Social Networking DO 24 MINS/DAY 90% SAY 60% Copyright 2013 The Nielsen Company. Confidential and proprietary. Source: Nielsen Informate Mobile Insights 2013 Chat DO 33 MINS/DAY 90% SAY 50% SMS DO 8 MINS/DAY 50% SAY 90% 20 23

24 Going to bed earlier is associated with better grades Hysing M; J Sleep Res (2016) 24

25 Afternoon naps can make a huge difference to vigilance Lo JC et al;. Sleep 2017 Why Start School Later? Fixing this alone is hard and still insufficient Biological Delay in Sleep Time Academics, Social, Media, Autonomy, Stress 7 hours Start School Later Early Bed Time 6 hours 7 hours 8 hours Early Rise Time 25

26 Sources: Centre for Disease Control and Prevention website, government websites, Wikipedia, BBC news, various school websites, forums and blogs. 26

27 Why you should tell others about sleep If your close friends and loved ones are overweight, you have a 50% chance of also following them I just got to try to rest the maximum now. Just make sure I sleep well, even just tonight and tomorrow, really take it easy, so when I do come out on court on Sunday, I have all the energy and all the resources in my mind to play inspired and creative tennis. That's what I've got to do. 27

28 Acknowledgements National Medical Research Council: STaR Award, Far East Organization Papers available from website 28