Last updated March 15, 2018 at 3:31 pm
We already have one of the key ingredients for a longer life. On the eve of World Sleep Day, we ask why we aren’t using sleep to its full potential?
In his infamous Odyssey, Homer is quoted as saying “there is a time for many words, and there is also a time for sleep.” The problem is that time for sleep seems to be a low priority, and 50 years of research suggests that has to change if we want to live longer.
In 1971, follow-up results of a large study of the population of Alameda County in California found that those who practiced at least six of the following healthy behaviours lived for up to 11 years longer than those who did not. They are: eating regular meals including breakfast, avoiding snacks, getting adequate sleep (seven to eight hours), maintaining a healthy weight for their height, not smoking, limiting alcohol consumption, and participation in regular physical activity. Subsequent studies have confirmed the importance of the “Alameda 7” in delaying illness and death.
Key studies like the Alameda County study are critical as they help to inform interventions and targeted behavior change in the population. Consequently, we do see change in public health threats over time. Perhaps the clearest changes from the health habits reported as the Alameda 7 are in smoking prevalence and severity, with prevalence of daily smoking in Australian adults as low as 14.5% in recent population estimates in Australia (down from 23.8% in 1995).
Similarly, we have seen a population level decrease in alcohol consumption (17.4% of adults drinking more than the lifetime risk guideline of two standard drinks a day in 2014-15, compared with 19.5% in 2011-12), and increasing focus on the benefits of exercise and appropriate food consumption and timing for health and wellbeing; critical health-related behaviours. Public health messaging has strongly promoted the importance of smoking cessation, moderation in alcohol intake and the avoidance of obesity combined with physical exercise, and national health priorities reflect this focus.
We drink less, we smoke less, but we still don’t use sleep as a tool to promote health.
Of the seven health habits identified in the 1960s study, sleep is still largely overlooked as a factor important for our health. Passed over, or sacrificed for waking activities that are perceived to be more important, sleep is not valued in our society to the same extent as other health habits.
Perhaps in a society where ‘doing’ something proactive to improve health is seen as an important step (exercise and dieting are good examples), we don’t place enough of an emphasis on NOT doing anything – namely, allowing time to get the sleep that we each need.
Indeed, in some contexts the ability to manage on shorter sleep is used as a bragging right, with sleep prioritized differently to exercise and diet. Although there is little evidence that average adult sleep duration has declined in recent decades, sleep in certain groups is affected.
The number of younger adults (18-27) sleeping less than six hours seems to be increasing, and quality of sleep is declining irrespective of age, leading to decreased work attendance and productivity. Most notably, while sleep duration may not be changing too much over time, quality of sleep appears to be declining, and our sleepiness in society is impacting our attendance at work.
So why isn’t sleep part of our routine for health and wellbeing?
Occupational factors (including long working hours, and shift work), social demands, environmental factors (noise and light), and health conditions can all influence our sleep.
While the general population may not have a comprehensive understanding of the physiology associated with sleep, young Australians interviewed in recent focus groups were mostly able to identify the importance of sleep for their wellbeing.
Interestingly, they also expressed a desire to change their sleep behaviours to improve how they feel when they wake, with a focus on improving sleep quality rather than lengthening sleep duration. This is likely a reflection of a broader desire to maximize the shortest necessary sleep opportunity rather than devoting more time to shut eye.
While young Australians seem to want better sleep, the barriers they see to achieving this are an interesting insight into some of the challenges we may face more broadly in our society in changing attitudes to sleep in the short to medium term.
Technology use, particularly in the evenings for social interactions, was commonly cited as a disruption to sleep time. Similarly, competing time demands (including socializing, work requirements and study) were seen as priorities over sleeping. This is further compounded by routines which are not consistent day-to-day or week-to-week; a problem which is unlikely to resolve given the increasing prevalence of unpredictable work schedules, shift work and on-call conditions.
The desire for change we see in young adults suggests an understanding of the importance of sleep, but there is a clear prioritization of occupational and social factors above getting a good night’s sleep. Difficulty unwinding in the evening, use of technology before bed and a desire to get ‘better sleep, in the shortest time’ may all reflect unrealistic expectations around how we achieve enough sleep.
At the end of the day (literally), there really aren’t any short cuts we can take – achieving enough sleep requires a time investment in better conditions in the hour prior to bed if we are going to make the most of our sleep time.
Let’s think of sleep as a solution, not a problem.
Reframing our thinking of, and attitudes towards, sleep is essential if we want to improve individual health and wellbeing, as well as improved community productivity and safety. Rather than seeing short sleep an achievement or ‘feat of strength’, the conversation at home, school and work needs to shift to viewing adequate sleep as one of the essential pillars of good health.
There is a lot to be said for allowing time to close our eyes, and physically ‘do’ absolutely nothing. We’re rewarded for this quality time with important cellular repair, improved learning and alertness during the day, better emotion and appetite regulation, and better memory just to name a few key functions sleep plays.
There is no question that we would do well to reflect on Homer’s words – while our waking hours can be used for a multitude of occupational and social activities, it is time to focus our efforts on making the quality time we each need for sleep. It is time for our national health priorities to reflect this need too.
This article was written by Amy Reynolds, Robert Adams, Sally Ferguson and Doug McEvoy
is Lecturer in Psychology, CQUniversity Australia; is Professor of Medicine, University of Adelaide; is Research professor, CQUniversity Australia; and is Chief investigator, National Centre for Sleep Health Services Research, Flinders University