Explainer | Why you need a good night’s sleep every day: not getting any quickly triggers physical and mental problems, study finds

For a woman in Hong Kong, prolonged street protests helped trigger PTSD and sleep loss. A move to an island and other steps helped her overcome insomnia
A study has shown how quickly bad sleep affects your physical health and mental well-being. A psychiatric expert explains how to make sure you get enough

Wellness

Sasha Gonzales

Published: 8:15pm, 12 Aug, 2021

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Beth Dorrough thought she had her mental health in check when she moved to Hong Kong in 2014.

Ten years earlier, while living in Sydney, Australia, she suffered an injury and developed post-traumatic stress disorder (PTSD) and anxiety. Over the next few years, she underwent physical rehabilitation and says she only began to feel “normal” again in 2007.

It wasn’t long after she arrived in Hong Kong that her life was turned upside down once more.

“I had problems adjusting to the culture and experienced problems at work, which triggered my anxiety,” she shares. “Three months after my move, the ‘umbrella movement’ protests occurred, which triggered my PTSD. Subsequently, I went through periods of unemployment and financial insecurity and this left me feeling even more anxious.” The protests in 2014 saw key city arteries blocked for 79 days.

Keep blue light exposure to a minimum – switch off your devices two hours before bedtime. Photo: Getty Images

Her sleep was impacted negatively as a result. The 45-year-old, who works in the events, sales and marketing industry, found it hard to quieten her mind at night. She used over-the-counter sleeping pills and would have some wine or watch television to help her doze off. She often stayed awake until three or four in the morning; sometimes she even had nightmares.

“My sleep quality was poor and I’d wake up in the mornings, groggy and feeling anxious about going to work,” Dorrough says. “I had trouble thinking clearly during the day, had no energy and rarely felt positive about anything.”

Why Hong Kong is one of the world’s most stressful cities

In 2016, Dorrough changed her lifestyle and found a way to curb her insomnia. She moved from hectic Causeway Bay on Hong Kong Island to idyllic Lamma Island – its southwest corner, to be precise. She also turned to meditation.

After starting a job at a wellness clinic, she learned to work through her anxiety, went for counselling for the first time and tried alternative therapies such as Ayurveda. Now, with her anxiety in check, her nights are more restful.

Dorrough’s story highlights the importance of regular and sufficient good-quality sleep. A University of South Florida study, published this July in Annals of Behavioural Medicine, found that it takes just three consecutive nights of sleep loss for your physical and mental well-being to deteriorate.

Dr Joey Chan is an associate professor in the department of psychiatry at the Chinese University of Hong Kong. Photo: Joey Chan Wing-yan

Participants who slept less than six hours a night reported feeling angry, nervous, lonely, irritable and frustrated, and experienced more physical symptoms, such as upper respiratory tract issues, aches and gastrointestinal problems.

Another study by researchers from Australia and New Zealand found that a month’s bad sleep could lead to mental health problems a year later. The researchers concluded that promoting adequate sleep might benefit one’s psychological well-being. The results of their analysis were published in January 2021 in the journal Sleep Health.

“There’s a close bidirectional relationship between sleep and depression,” says Dr Joey Chan Wing-yan, an associate professor in the department of psychiatry at the Chinese University of Hong Kong.

“In patients with depression, as much as 90 per cent have sleep complaints. Persistent insomnia worsens the outcomes of depression and increases the risk of suicide. Chronic sleep disturbance also increases the risk of developing or having a relapse of depression.”

Dorrough’s move from Causeway Bay to Lamma Island changed her lifestyle and helped to curb her insomnia. Photo: courtesy of Beth Dorrough

Beth Dorrough’s bedroom. She turned it into a relaxing haven, she says. Photo: courtesy of Beth Dorrough

Chan says sleep deprivation can be categorised as short-term and long-term. The former affects our concentration, vigilance and mood the next day. The latter lasts for at least three months, with daytime sleepiness, and has been linked to obesity, cardiovascular problems like hypertension and heart attack, reduced immune function, and a range of mental disorders such as anxiety, depression and neurodegeneration.

The National Sleep Foundation in the United States recommends seven to nine hours of sleep a night for adults. Chan says that shift work and an overwhelming work or social schedule typically prevent us from getting this amount. Other common sleep stealers include stress, insomnia, sleep apnoea (abnormal breathing when asleep) and chronic pain.

Night owls, too, are more vulnerable to sleep deprivation when they have to get up early for work or school. The habit of using electronic devices before bedtime exacerbates the problem, because blue light is known to suppress melatonin, a hormone that’s associated with control of the sleep-wake cycle.

To fall asleep quickly and naturally, Chan recommends going to bed and waking up at the same time every day. This stabilises our biological clock, which gives us the signal to sleep at the right time.

Keep blue light exposure to a minimum, too. That means dimming the lights in your room at night and switching off your devices two hours before bedtime. It’s also important to keep your room quiet, dark and cool to create a restful environment for sleep, and to use your bed only for sleep and/or sex, so that your brain learns to associate your bed with these activities.

Finally, avoid excessive caffeine, alcohol and vigorous exercise close to bedtime, as these stimulate the body and may keep you awake. If you have trouble falling asleep after 20 to 30 minutes, Chan suggests getting out of bed and doing something relaxing and returning to bed only when you feel sleepy.

As part of her pre-bedtime ritual, Dorrough takes “grounding” walks on the beach with her dogs. Photo: Jonathan Wong

As part of her pre-bedtime ritual, Dorrough takes “grounding” walks on the beach with her dogs and uses an aroma diffuser, which fills her home with a soothing fragrance. Once in bed, she rubs essential oils on her temples and covers her eyes with a sleep mask. She says that managing her anxiety has helped her “turn a corner” with her sleep issues.

On rare nights when she awakens, she turns to Australian Michael Sealey’s YouTube channel to listen to a soothing guided sleep hypnosis track to fall back asleep.

“I don’t take sleeping pills or anti-anxiety medication any more, and I don’t have to drink wine or watch television to help me feel drowsy. Moving to a quieter place near the water, learning how to handle my anxiety and transforming my bedroom into a relaxing haven have given me more control over my mental health, and as a result I now enjoy better quality sleep,” Dorrough says.

The big picture we’re not seeing when we obsess about sleep

“Most nights, I go to bed at 9pm and wake up refreshed. I’m calmer, happier and more positive and have plenty of energy to get through the day.”

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