Dubai: Sleep is not just an act of shutting one’s eyes, but also an important physiological function of the body that is meant to restore, heal and repair tissues and regulate the body’s metabolism. That is the reason why doctors insist that people must not stay awake for long hours during Ramadan. Instead, people must make it a point to get a total of seven to eight hours of sleep throughout the day, if continuous eight hours of night-sleep is difficult during the fasting month.
Commenting on the importance of sleep and the impact sleep deprivation can have during Ramadan, Dr Arun Sharma, medical director and specialist neurologist, Emirates Hospital Clinics, said: “Sleep is undeniably important in maintaining a fine metabolic balance. The circadian rhythm [the internal biological clock regulated by the sunrise-sunset cycle of the day] of the body, when disturbed, leads to an array of downstream hormonal and biochemical consequences, including glucose intolerance and obesity.”
Stages of sleep
Giving an insight into the phases of sleep during the night, Dr Vivek Karan, consultant neurologist, Thumbay University Hospital, said there are four stages of sleep:
Stage 1: Transition from wakefulness to sleep — duration roughly five minutes.
Stage 2: Body temperature drops and heart rate slows — duration roughly 20 minutes.
Stage 3: Muscles relax, blood pressure and breathing rate reduces — deepest sleep.
Stage 4: Eyes move rapidly, body becomes relaxed and dreams occur.
He added: “During stage three and four of the sleep phase, the body undertakes cell repair and rebuilding and hormones are secreted to promote bone and muscle growth. The human body also uses deep sleep to strengthen immunity, so you can fight off illness and infection.”
How much sleep is enough?
There are multiple cycles of stages two, three and four, before complete wakefulness. Sleep required by school-going children averages to around ten hours. For teens it is anything between eight to ten hours; for young adults around eight to nine hours; for adults and the elderly, it is roughly seven hours, added Dr Karan.
How sleep deprivation can trigger hormonal imbalance
Dr Sharma elaborated that while intermittent fasting has proven to be a healthy option to detoxify our body, it was important to understand our hunger mechanism and what triggered it, especially when people are skipping regular bedtime hours.
“The appetite centre is located in the brain, but it is influenced and regulated by peripheral hormones such as leptin and ghrelin. The former promotes a sense of satiety and the latter induces hunger. During consecutive days of prolonged fasting, an incremental reduction in leptin levels has been documented with a concomitant increase in ghrelin levels. Our mind responds to this altered equation between the two hormones by displaying a distinctive propensity to consume food rich in carbohydrates and salt.”
Dr Sharma added that by regulating sleep it helps regulate these hormones and discourages the unhealthy pattern of eating. “Sleep deprivation can trigger unhealthy eating. During Ramadan, people who are fasting must get their eight hours of sleep, so that unhealthy eating patterns are not triggered,” he said.
People must be mindful of avoiding high-carbohydrate and high-glucose food items. The cycle is vicious. Lack of sleep will trigger a hormonal imbalance, which in turn will trigger an unhealthy pattern of eating, which in turn may cause fluid retention, weight gain and an increased risk of incurring diabetes.
However, Dr Sharma pointed out that when fasting was observed in the right manner, it proved to be very beneficial for overall health. “Studies conducted in the Middle East, employing modern tools of sleep-studies like actigraphy (an electronic gadget worn as an armband) and polysomnography, have revealed that during Ramadan, although the quantity of sleep is curtailed, the quality remains unaffected, which somehow fine-tunes the metabolic processes and the internal clock.”
Art of intermittent sleeping
Just as we follow a pattern of intermittent fasting, during Ramadan, Dr Sharma said it was possible to follow a pattern of intermittent sleeping to ensure that one was able to get a total of eight hours of sleep throughout the day and night. This year, with 14 hours of fasting and only eight hours to end the fast, pray, eat and rest, it is all the more important that people get the balance right.
One can practise intermittent napping, which can be helpful in regulating the circadian rhythm of the body. Dr Sharma explained: “Although intermittent napping takes some time to get used to, if done right, one can ensure optimal energy levels and well-coordinate the regulation of one’s metabolism. There is a pattern of sleeping that people can adopt to ensure they feel well-rested, even with an intermittent sleep schedule.”
Advising on the manner in which intermittent napping can be practised, Dr Sharma said: “It is advisable for people who are fasting to sleep for a couple of hours in the afternoon to cover up for the reduced nighttime sleep. A shorter session of sleep after suhoor is highly recommended to boost daytime energy levels. One should adjust easily into this changed routine, earlier on during Ramadan to facilitate adaptation by the body in a seamless manner. A frugal iftar should be followed by a brisk walk or light exercise. Those fasting must to go to bed latest by 11pm, so as to catch approximately five hours of good sleep before waking up for the Fajr [dawn] prayers,” he added.
How to manage your sleep hours during Ramadan
• Make adjustments to your bedtime gradually to avoid any stress and migraine issues.
• Split your sleep: Try and catch about three hours of sleep after suhoor and then get a power nap of about an hour in the day and a minimum of four hours after iftar, in the night leading to suhoor time. This would be best for optimum restfulness and help achieve optimal work efficiency.
• Be mindful of eating smaller meals when you end your fast during Iftar. Do not go for a big meal immediately, but do it gradually and do not sleep immediately after eating a meal. It is advisable to do some light exercise and go for a walk prior to the nighttime sleep.
• Avoid eating spicy and oily meals as body has to work overtime to digest and does not get enough rest.
• People who suffer from comorbidities such as diabetes and are observing the fast are advised to get their insulin dose adjusted with their physicians and regularly check glucose levels before taking the afternoon nap.
• Ensure that your room is dark, comfortable and your clothing is very relaxed so that your sleep is not interrupted. Also make sure to keep away from blue light emitted by electronic gadgets when you are trying to sleep at night.
• Consistency and sleep hygiene key to restfulness: Observe a consistent sleep time during Ramadan and be mindful of sleep hygiene, such as wearing soft, loose cotton clothes, washing well and brushing teeth before bed to induce a super restful night.
Source: Dr Vivek Karan