Dubai: With eating and sleeping habits changing during Ramadan, many people, especially those who fast, face reduced sleep and insomnia during the holy month. Doctors in the UAE point out that the shorter sleep cycles can upset the biological clock.
“As the circadian rhythm of the body gets disrupted, it results in mood swings and short-temperedness and headaches,” said Dr Raiza Hameed K H, specialist, Pulmonology, Aster Clinic, Bur Dubai.
She highlighted that there is a significant reduction in the amount of REM (Rapid Eye Movement) sleep during Ramadan which will again add to mood swings.
As the circadian rhythm of the body gets disrupted, it results in mood swings and short-temperedness and headaches.
“REM sleep refers to a stage of sleep which processes emotional memories and ensures our psychological health,” said Dr Hameed.
The name comes from rapid movements of eyes behind your eyelids while you are dreaming. In normal adults, REM sleep increases as the night progresses and is longest in the last one-third of the sleep episode.
Shortened sleep cycles
“Studies have shown that duration of REM sleep is reduced during fasting in Ramadan due to shortened sleep cycles. The reduced REM sleep will affect cognitive function, cause mood swings and short temper,” Dr Hameed explained.
Balancing sleep Balancing sleep during Ramadan requires discipline, said Dr Supriya Sundaram, consultant, Pulmonology, Burjeel Hospital, Abu Dhabi. Consuming heavy meals during iftar can disrupt sleep patterns, delaying the onset of rest, she explained.
“Opting for fat-free, moderate portions facilitates quicker digestion, enabling earlier sleep.”
“Opting for fat-free, moderate portions facilitates quicker digestion, enabling earlier sleep.”
Echoing the same, Dr Hameed suggested against feasting, including heavy, sugary foods at iftar.
“Your body gets busy digesting your meal and this can interfere with sleep. Heavy and spicy foods can cause heartburn, also affecting sleep. Avoid caffeine for several hours before bedtime. Eating just before bed can also be a recipe for poor sleep health,” she added.
Achieving deep rest ensures timely awakening for suhoor and the morning prayer, fostering a rejuvenating night’s sleep.
“Following suhoor, a light to moderate meal encourages a brief power nap before embarking on the day’s activities. This balanced approach facilitates spiritual devotion while navigating the demands of modern life,” said Dr Sundaram.
Getting into a rhythm Dr Hameed said the faithful should try to sleep for at least four hours at night after iftar and before waking for suhoor and return to sleep for a couple of hours before getting up for the day ahead. “This will help your body get into a rhythm for more restful sleep.”
She pointed out that a short power nap in the afternoon can revive the energy level. Explaining what not to do to ensure a good night’s sleep, Dr Hameed said people should avoid using electronic devices such as their mobile phone, laptop, and TV close to bedtime.
“A quiet and dark space is ideal for sleep.”
Insomnia in elderly
Dr Hameed revealed that elderly people are more prone to have insomnia during Ramadan.
“They should get a minimum of six hours of continuous sleep every day. They are advised to consult their physician before fasting to plan any changes in medication timings for their pre-existing diseases. Those with diabetes mellitus should be cautious of hypoglycaemia and have their sugar checked if they face any symptoms of the same. They are advised to eat nutritious and easily digestible food during suhoor and iftar as all these can have an impact on their sleep,” she said.
Fasting kids’ sleep Dr Sundaram pointed out that school-going children who are beginning to observe fasting may experience initial difficulties.
“However, instilling discipline in their eating and sleeping habits can greatly assist them in adapting.” Leading by example is crucial in this regard, she said, urging parents to follow good sleep hygiene even during Ramadan.
“Avoiding screen time during late evening and early hours when they are awake for suhoor can also contribute to better sleep for children, facilitating a smoother fasting experience,” she said.
Dr Mitchelle Lolly, specialist pulmonologist at Prime Hospital and Prime Medical Centre in Dubai, said parents should ensure that children meet their requirement of higher sleep duration even during Ramadan.
“This can be managed, for example, with six to seven hours of sleep at night and two to three hours of nap in the afternoon,” she suggested.
As a golden rule to ensure good sleep, she said it is important to avoid eating at least two hours prior to bedtime and using electronic gadgets at least one hour prior to sleep. Working mothers Splitting sleep into two parts is hard, especially for people who work shifts, said Dr Sundaram.
“Furthermore, for young mothers with children, especially those balancing shift work while striving to maintain their faith, the complexity is heightened.”
During this time, she highlighted that it becomes the duty of those around them to provide support.
“Colleagues can offer assistance by sharing responsibilities, lightening the burden on individuals navigating these demanding circumstances. By nurturing a supportive environment, communities can help alleviate the strain and uphold the importance of faith during Ramadan.”
World Sleep Day
Doctors believe sleep health awareness is all the more important now with the World Sleep Day falling during Ramadan this year. Observed on March 15, the day is celebrated to raise awareness about the importance of having a proper shut-eye on a daily basis.
It recognises the importance of a good night’s rest for every human being on the planet and will be held under the theme ‘Sleep Equity for Global Health’ this year. Doctors also offered advice for those who already have sleep difficulties, especially those with sleep apnoea, a disorder where a person’s breathing repeatedly stops and starts while they sleep. It can make them feel tired during the day and affect their overall health.
Since obesity is the main cause, patients with mild to moderate sleep apnoea can try to achieve an ideal body weight with proper diet and exercise thereby helping with sleep apnoea. Ramadan is the perfect time to start healthy habits like this
“For patients with sleep apnoea, sleep during Ramadan is challenging and affects their daily life causing worsening of their symptoms,” observed Dr Hameed.
She advised patients who are on CPAP (Continuous Positive Airway Pressure) treatment to sleep a minimum of four hours a day, preferably six hours a day, at a stretch using CPAP.
“They can plan their sleep accordingly like going to bed early so that they can have a minimum of four to five hours of sleep before waking up for suhoor. They are advised to use CPAP every day during sleep. They should avoid heavy food, and caffeine intake before going to bed.”
Discipline is key
Discipline remains the key during Ramadan for those with sleep apnoea as well, said Dr Sundaram.
“Being disciplined with food times and quantities of food will help both patients with sleep apnoea and others. Regulating meal times and keeping quantities and quality of food under control will definitely help the sleep apnoea. For those sleeping during the day, blocking out the light would help,” she explained.
Obesity is the most common cause for sleep apnoea, pointed out Dr Lolly. It can also be caused by nasal blockages, enlarged tonsils, or jaw structure changes like retrognathia, a condition in which the lower jaw is set farther back than the upper jaw.
“Since obesity is the main cause, patients with mild to moderate sleep apnoea can try to achieve an ideal body weight with proper diet and exercise thereby helping with sleep apnoea. Ramadan is the perfect time to start healthy habits like this,” she said.
Mild sleep apnoea patients who are not on CPAP, are advised to maintain a minimum of four hours sleep without break. “They can sleep in lateral positions instead of supine or prone positions. They should avoid gaining weight; and maintain and stick to healthy food during Ramadan,” said Dr Hameeda.
Dr Lolly added: “Those, who have sleep difficulties, as a standard, should always try to maintain sleep hygiene i.e. try to be consistent to sleep at the same time every day, reduce the use of electronic gadgets, avoid caffeinated drinks and avoid naps to have a good night’s sleep.”
