Sleep is absolutely essential to your physical and mental health
Sleep’s rhythms underpin everything you do, ensuring your brain and body are working at their best: an MoT every night!
We’re often bad at recognising that, and prioritising sleep in our lives
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#WorldSleepDay
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Most adults in the UK get about an hour’s less sleep than they need each night ... the equivalent of missing an entire night of sleep every week!
rsph.org.uk/about-us/news/…
#WorldSleepDay
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Many of us start our days with a caffeine kick to counter lack of sleep
When we prioritise sleep though, we feel better, we work better ... we make ourselves healthier
Over the course of #WorldSleepDay I’ll hopefully persuade you!
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We’ve long understood sleep’s importance ... Shakespeare’s Macbeth is basically a play-length argument that we need sleep, and things rapidly go off the rails for the Macbeths without it
#WorldSleepDay
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#WorldSleepDay
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“Modern life” has felt pressured for a long time now, and its effect on sleep well-recognised - you don’t get a good night’s sleep if you’re anxious or stressed
#WorldSleepDay
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While that’s partly true (Brexit, Trump...), some things *don’t* change
This is my commute if I get the timing wrong ...
#WorldSleepDay
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Some things *don’t* change that much!
#WorldSleepDay
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In the 19th Century it might have been Dickens’ latest page-turner stealing your sleep time ... in 2019, @netflix consider sleep their biggest competitor!
#WorldSleepDay
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He needs you to sacrifice sleep so his company can make money (a LOT of money!)
Problem is that leaves you sleep-deprived!
#WorldSleepDay
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psychologytoday.com/gb/blog/sleep-…
We’ll come back to *why* screens are bad for sleep later
#WorldSleepDay
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#WorldSleepDay
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I’ll let Reed remind you:
#WorldSleepDay
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(I love old-school textbook writing style!)
#WorldSleepDay
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It’s when our bodies repair ... and, for kids, grow!
#WorldSleepDay
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It affects how we think, how we feel, and likely also increases risk of conditions like Alzheimer’s Disease
#WorldSleepDay
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Every winter, we put a huge amount of effort into making sure @nhs staff have had flu vaccine to protect our patients ...
#WorldSleepDay
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ncbi.nlm.nih.gov/pmc/articles/P…
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Over a lifetime, that is likely, for example, to be one of the factors that means sleep deprivation is a risk factor for diseases like Alzheimer’s
#WorldSleepDay
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We’ll come back later to sleep’s role in learning and emotional regulation but, when you’re sleep-deprived, your brain just isn’t at its sharpest!
#WorldSleepDay
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(More on caffeine and sleep later too!)
#WorldSleepDay
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metro.co.uk/2017/03/16/wha…
It’s essential we look after our staff to be able to deliver safe, efficient, effective care to our patients
#FightFatigue
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bma.org.uk/connecting-doc…
There’s been a great response!
#WorldSleepDay
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aagbi.org/professionals/…
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onlinelibrary.wiley.com/doi/full/10.11…
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#WorldSleepDay
guysandstthomas.nhs.uk/news-and-event…
(launched on #WorldSleepDay in 2017!)
#FightFatigue #GiveUsABreak
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#FightFatigue #WorldSleepDay #GiveUsABreak
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#FightFatigue #WorldSleepDay #GiveUsABreak
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#FightFatigue #WorldSleepDay #GiveUsABreak
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You can hear @docanthea and I talking about issues around @nhs rest, breaks and the impact of fatigue on staff and patients in this @bmj_latest webcast
facebook.com/bmjdotcom/post…
nhsemployers.org/blog/2018/10/t…
Power naps on night shift can be an essential #Recharge tool to #FightFatigue and keep staff and patients more safe
@bmj_latest
#WorldSleepDay #GiveUsABreak
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ep.bmj.com/content/102/3/…
#FightFatigue #WorldSleepDay #GiveUsABreak
How often do you think of them?
#WorldSleepDay @bmj_latest
blogs.bmj.com/bmj/2017/10/06…
So - how do you get a good night’s sleep?
Let’s do some basics
#WorldSleepDay
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Duration: right amount for you
Continuity: no disruption
Depth: good quality
#WorldSleepDay
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If you get 7 hours and you *need* 9 hours though ... you’ll be 2 hours sleep deprived *every* night.
Understanding your own sleep need is essential!
#WorldSleepDay
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If you do, this catch-up sleep is called social jet-lag ... and is a strong marker of sleep deprivation!
#WorldSleepDay
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Bedrooms should be cool, dark, quiet and comfortable. It’s worth investing to get it right!
#WorldSleepDay
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We’ll come back to light and the body clock later!
#WorldSleepDay
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Be careful though ... for some people doing exercise too close to bedtime can make it more difficult to get to sleep (some people like a late-night gym session though!)
#WorldSleepDay
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#WorldSleepDay
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Or that ‘decaffeinated’ drinks still have caffeine in them?
#WorldSleepDay
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(Espressos in the dark not a solution!)
#WorldSleepDay
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#WorldSleepDay
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The @Headspace app works for many: headspace.com
#WorldSleepDay
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@GSTTnhs our staff have free access to Sleepio as part of supporting wellbeing
sleepio.com/work/nhs/
#WorldSleepDay
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This is the hypnogram ... the diagrammatic representation of normal sleep. Understanding it is the key to unlocking many of sleep’s features (and mysteries!)
#WorldSleepDay
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Transitional/Light: nREM 1 and 2
Deep: nREM 3
“Dream”: Rapid Eye Movement (REM)
#WorldSleepDay
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50% in light sleep
25% in deep sleep
25% in REM (dream) sleep
#WorldSleepDay
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After that sleep is more light sleep and REM
#WorldSleepDay
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Deep sleep broadly supports physical growth/repair
Light/REM sleep broadly important for learning, emotional regulation, memory processing
But sleep’s complex, we still don’t understand it all and this is a simplification!
#WorldSleepDay
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Our brains and bodies depend on those rhythms to function properly
#WorldSleepDay
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If sleep is disrupted, children can ‘fail to thrive’ ... not grow as well as they should
#WorldSleepDay
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That has consequences!
#WorldSleepDay
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#WorldSleepDay
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Improving sleep quality can involve a bit of detective work!
#WorldSleepDay
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Improving sleep often needs the source to be identified and treated - which can be v challenging with anxiety!
#WorldSleepDay
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The most fundamental rhythm of sleep is our body clock, our circadian drive, which acts like a master control to keep us awake by day, asleep by night ... unless we choose to fight it!
#WorldSleepDay
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The other - Process S - is our sleep drive.
The longer we are awake, the more tired we feel
#WorldSleepDay
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#WorldSleepDay
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Some cultures encourage a siesta ... in the UK we’re perhaps more likely to go and get a double espresso!
(We also see this post-lunch lull reflected in accident incidence figures)
#WorldSleepDay
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This body clock preference is partly genetic
#WorldSleepDay
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~75% have body clocks >24hrs
~25% <24hrs
We constantly resynchronise our clocks every day.
Light is crucial to that process.
#WorldSleepDay
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It’s going to be a major area of development in 21st Century healthcare, as we tailor people’s medical care better to their own unique biological rhythm
#WorldSleepDay
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Light is the most powerful external influence on our body clocks.
Regular exposure to light and dark entrains our sleep cycle.
We use “zeitgeber” - ‘time giver’ - to describe any factor which can do this
#WorldSleepDay
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#WorldSleepDay
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Day = bright light = wake
Night = dark/dim light = sleep
#WorldSleepDay
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Suddenly ANY time of day could be brightly lit
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#WorldSleepDay
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When your brain is exposed to bright light when it doesn’t expect to be, it is the same as telling your body clock you’ve moved time zones
#WorldSleepDay
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When you then try to go to sleep at 10pm ... your brain thinks it’s 5pm - so, no sleep!
#WorldSleepDay
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journals.sagepub.com/doi/abs/10.117…
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Family docking stations are a good way to remind everyone!
#WorldSleepDay
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bbc.co.uk/news/health-38…
#WorldSleepDay
Babies, for example, sleep longer overall, but in shorter bursts, and spend much more time in REM-like sleep - supporting the huge brain growth in first year
#WorldSleepDay
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Honest truth is children have been disrupting parents sleep since the Stone Age. Often it’s normal variation, and not a medical problem
#WorldSleepDay
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That’s true of babies and children too, and it can be quite a wide range of normal!
At 6 months, normally developing babies may sleep as much as 16.5hrs or as little as 10hrs per 24 hours
#WorldSleepDay
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Only *you* can really work out how much sleep *you* need.
#WorldSleepDay
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At the end of each cycle it’s normal to briefly wake and settle back into sleep; as adults we don’t usually remember these brief wakings
But babies and children need to learn to settle back into sleep
#WorldSleepDay
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Wakings that affect parents sleep can be normal in even quite old children
#WorldSleepDay
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Better advice about sleep earlier can help - the answer is very rarely fancy tests, or sleeping medicines
#WorldSleepDay
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Advice can help, but the key is often support ... and not unnecessarily medicalising what is still usually normal development
academic.oup.com/sleep/advance-…
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That means sticking to a good general routine and sleep habits most nights
#WorldSleepDay
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ep.bmj.com/content/101/4/…
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BabySleep.com - great team of international paediatric sleep experts offering advice
#WorldSleepDay
#WorldSleepDay
(Warning: NOT for young ears!)
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Remember that most deep sleep, which physically recharges us, is early in the night?
Light and REM sleep, which support learning and emotion, are later
#WorldSleepDay
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Sleep empties your cache each night - which allows you to learn new info the next day.
Poor sleep = poor ability to learn
#WorldSleepDay
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If you don’t sleep well, you won’t retain and integrate new knowledge as well - and will score worse on exams!
#WorldSleepDay
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That’s why you can go to bed having not quite “got” a new skill, and wake up the next day able to do it much better
Most of those functions occur in light sleep
#WorldSleepDay
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Dream sleep helps support creative thinking
#WorldSleepDay
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Kekule, puzzling out the structure of benzene, dozed off, dreamt of demon snakes eating their own tails ... and woke up realising the structure was circular (a completely new idea)
#WorldSleepDay
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If both partners in a relationship are REM-deprived, arguments are much more likely to be emotionally hostile
#WorldSleepDay
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theguardian.com/lifeandstyle/2…
pshe-association.org.uk/news/new-pshe-…
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Sleep medicine is a mix of common sense general paediatrics, neurology, respiratory, mental health, neurodisability and community paediatrics.
Sleep affects everything!
#WorldSleepDay
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This, by Thomas Phayre, is from the 16th Century Boke of Chyldren - first English-language paeds textbook!
#WorldSleepDay @RCPCHtweets
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More kids with sleep problems need super nanny rather than a sleep doctor.
#WorldSleepDay
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Most are treatable
#WorldSleepDay
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We do as much public outreach work as we can to try to help as many people as possible
evelinalondon.nhs.uk/our-services/h…
#WorldSleepDay
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#WorldSleepDay @begley_roisin @PriyenShah86 (thanks both!)
I’ve had recurrent episodes of sleep paralysis since my teens; they’re why I ended up a sleep doctor
#WorldSleepDay
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It can also be accompanied by very vivid visual hallucinations - often interpreted as supernatural
#WorldSleepDay
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The original meaning of night-maere relates not to a horse but to a demon ... sleep paralysis
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In medieval times, incubi and succubi were demons who would come and sexually attack men and women in their sleep
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All across the world, and all the way back to the dawn of history, cultures report phenomenon we now recognise as sleep paralysis
#WorldSleepDay
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Often accompanied by visual and other sensory sensations - hypnagogic/pompic hallucinations
#WorldSleepDay
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Normally we’re unaware of this paralysis as it stops as we wake
#WorldSleepDay
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You try to take a deep breath in, but can’t because accessory muscles of respiration are paralysed
Your brain interprets that as pressure on your chest, or a band around it, or choking sensation
#WorldSleepDay
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It’s terrifying as an adult with a detailed understanding of sleep.
Imagine it happening to a 5 year old.
#WorldSleepDay
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#WorldSleepDay
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(From the excellent Prof Bob Morris, first Professor of Parapsychology @EdinburghUni)
@KPUNews
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As with most sleep problems, SP much more likely to occur if you’re not getting enough good quality sleep: focus on improving core sleep routine and habits, cut out usual culprits like caffeine
#WorldSleepDay
- try to stay calm (not easy), focus on slow calm breaths
- focus on ONE part of your body and move that. Once you get ANY movement, paralysis usually breaks. (I usually wiggle my toe)
- external sensory input (eg touch) can help but tricky to do!
It’s also a great example of how sleep is all about science, stories and social lenses
#WorldSleepDay
Every human who’s ever lived, has shared this brilliantly bizarre thing that we all do and all take for granted - and we’re only now beginning to really understand.
#WorldSleepDay
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Every time I come back it it, I take something new away
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Hopefully I’ve not filled up your timeline too much, and you’ve learnt something new or interesting or useful about sleep.
(This was me as a kid...I didn’t need an iPhone to stop me sleeping!)
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Sleep is still full of mystery and magic and wonder.
It’s where science meets story, where medicine meets myth.
It is both rhythmical and random, and it’s a privilege to spend so much of my life delving into it.
#WorldSleepDay
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And, sleep well!
Tomorrow is another day.
#WorldSleepDay
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@neilhimself: The Sandman
@sleepdiplomat: Why We Sleep
@guylesch: The Nocturnal Brain
#WorldSleepDay
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