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Sleeping Well

  • 31 Jan 2023
  • 3 mins

Dr. Lau Hung Tuan, ENT specialist, describes the importance of sleep, how the pandemic has changed our periods of rest, and what the criteria for measuring sleep quality are.

Sleep and Overall Health

Sleep is a very active restorative process that gives our bodies the opportunity for rejuvenation, supporting healthy brain function, protecting our physical health, and maintaining our mental well-being, safety, and quality of life.

According to Dr. Lau, when we sleep, the brain is able to convert short-term memory to long-term memory and form new learning pathways.

Our physical health relies on sleep for healing and repair, metabolic and hormonal balance, normal growth and development, especially for children and teenagers.

Chronic sleep deficiency is associated with an increased risk of hypertension, heart attack, stroke, and kidney disease. Even our immune system deteriorates with sleep deficiency.

With all of this in mind, Dr. Lau advises, “Getting a good night's rest is also vital to daily function and emotional well-being. Our ability to make decisions, problem-solve, as well as control our emotions and manage stress, can all be impaired by limited or poor sleep.

“In more serious cases, mental health can suffer, along with possibly experiencing mental illness conditions such as anxiety and depression. Sleep also optimizes our performance and allows us to function safely.”

Impact of the Pandemic on Sleep

The initial phases of the pandemic saw noticeable impact on our sleep patterns.

Dr. Lau explains that for over two years of waves of Covid-19 outbreaks accompanied by various restrictions, a proportion of us had our sleep affected by the drastic changes to our daily routines, the withdrawal of physical social interaction and support, and the fear and anxiety of ourselves or our loved ones contracting the coronavirus.

These factors have led to a few of his patients experiencing difficulty falling asleep or maintaining their sleep.

Also, the rapid pivot to working from home meant that office-home lines of working hours were blurred and a number of people in the workforce were going to bed later than usual as they had to respond to work demands at night.

“Thankfully, the mass vaccination rollout and current policies on living safely with Covid-19 have allayed much of the fear of the illness and allowed us to resume normalcy in our daily lives,“ assures Dr. Lau, “Sleep patterns in the patients I have seen for the last six months seem much less affected.

Sleep Apnea

Sleep apnea, in particular obstructive sleep apnea (OSA) affects 15-20% of our local population.1

This condition poses significant health risks as it is a sleep breathing disorder where there are repeated episodes of partial or complete obstruction of breathing during sleep, due to upper airway collapse.

This leads to drops in blood oxygen levels during sleep and frequent arousals from deep sleep. Those who are more at risk include middle-aged men, overweight or obese individuals, and persons with enlarged tonsils.

In OSA, the repeated stress of blood oxygen level drops and arousals from deep sleep every night results in damage to the body’s blood vessels and heart. Over time, these blood vessels that supply oxygen to vital organs like the heart and the brain narrow and can lead to increased risk of heart attacks and strokes. Chronic conditions like an irregular heartbeat, high blood pressure, and diabetes are also strongly associated with untreated OSA.

Our neurocognitive function (memory, performance) and mental health (anxiety level, mood) can also be affected. In addition, OSA sufferers have increased risk of motor vehicle accidents due to excessive sleepiness.

Quantity or Quality?

Both quantity and quality are important; one without the other can become an issue.

We should strive for both quality and quantity to get the best night's sleep to promote optimal health and well-being.

Dr. Lau recommends that adults between 18-60 years obtain 7-9 hours of sleep a day.

Inadequate sleep is associated with an increased risk of chronic conditions such as high blood pressure, heart disease, diabetes, obesity, stroke, and mental illness.

A YouGov survey conducted this year showed that only 27% of Singaporeans get 7 or more hours of sleep despite 80% aspiring to do so.2

Measuring the Quality of Your Sleep

Sleep quality tells us if your sleep is restful and restorative. This can be subjective as people may associate sleep quality with sleep satisfaction.

Medical professionals tend to look at certain parameters to determine the quality of sleep. This is usually derived from an overnight sleep study where brain wave activity and eye movement recordings are used to derive sleep and wakefulness states. These parameters are:

  • Sleep latency: The duration of time needed to fall asleep.
  • Sleep efficiency: The proportion of time spent in bed actually sleeping.
  • Arousals and wakefulness: The number of awakenings during sleep and the duration awake after falling asleep indicate sleep disturbance.
  • Sleep architecture: The percentage of time one spends in various stages of sleep with adequate deep sleep and rapid eye movement sleep.

Many people now use consumer sleep trackers such as wearable smart watches or smartphone applications to track their sleep.

These usually work by actigraphy (the tracking of body movement) and sound recording to assess sleep quantity and quality. These tools may also assess your lifestyle routines that promote good sleeping habits.

Dr. Lau adds, “Such devices make an educated guess about your sleep but cannot diagnose sleep disorders. These are hence useful to raise awareness about sleep patterns for individuals who may be experiencing sleep issues before seeking professional medical attention.”

1 Tan A, Cheung YY, Yin J, Lim WY, Tan LW, Lee CH. Prevalence of sleep-disordered breathing in a multiethnic Asian population in Singapore: A community-based study. Respirology. 2016 Jul;21(5):943-50. doi: 10.1111/resp.12747. Epub 2016 Feb 29. PMID: 26929251

Contributed by

Dr. Lau Hung Tuan
My ENT Specialist
Farrer Park Hospital