Dr. Laura Lillo: “Street light reduces the duration and quality of sleep in the cities” .
(Madrid. Lucila Rodríguez)
Summer is one of the worst times of the year to sleep as a result of changes in routine, the time change, the heat and even light pollution, which has been shown to reduce the duration and quality of sleep in cities, according to Laura Lillo, neurologist and co-director of the Sleep Medicine Unit of the Neurology Service of the Ruber Internacional Hospital in Madrid. poor sleep in summer
Although each person should sleep the hours their body needs to be rested, the average to ensure a good rest is between 7 and 9 hours in adults, between 14 and 17 hours in infants, 11 to 14 hours in children up to two years of age and between 8 and 10 hours in adolescents.
During this period of time, and to ensure a good rest, two sleep phases must occur: NREM and REM.“Deep slow sleep is the last NREM phase and is the most restorative, it also participates in the consolidation of memory and in the endocrine control of the secretion of numerous hormones,“explains the doctor.
In fact, between 20% and 25% of nocturnal sleep is spent in this phase, which occurs mainly in the first half of the night, while REM sleep predominates in the second half, which occupies about 20% of total sleep time and serves for emotional and affective control of behavior.
However, both phases are not always achieved due to multiple factors that often go beyond heat, light pollution or noise, such as snoring, apneas, restless legs syndrome or another type of disorder or disease.
Health risks of poor sleep (in summer)
Although sleeping poorly for a short period of time does not entail significant risks, it does pose a problem when you sleep less than 7 hours for more than three months. After a night of sleep deprivation, attention and memory capacity are reduced, increasing the risk of having an accident at work, a traffic accident or problems with impulse control.
“If the reduction in sleep is maintained over the long term, the sensation of drowsiness disappears, but our cognitive capacity continues to be affected,” warns Dr. Lillo. Likewise, prolonged poor sleep leads to metabolic problems because it alters the secretion of hormones, which favors an increase in cardiovascular risk, weight, insulin resistance and hypertension.
In addition, the body’s immune response is altered, which favors a pro-inflammatory state that can negatively affect the evolution of autoimmune pathologies and reduce the response to vaccines. In these cases, an assessment by a sleep specialist is essential to diagnose and correctly treat the pathologies associated with poor sleep and, therefore, to achieve a good quality of sleep.
Treatment of sleep problems
In this regard, Dr. Lillo explains that when a person comes to the Sleep Medicine Unit of the Neurology Service of the Ruber International Hospital, a complete medical history is taken by a neurologist or neurophysiologist to learn about his or her history, sleep habits, the time of onset of the sleep disorder, its characteristics, evolution and clinical repercussions.
With the data obtained in the anamnesis, together with the physical examination, a diagnostic suspicion is established and, based on this, the necessary tests are requested, such as, for example, the nocturnal polysomnogram (PSG), a method performed in the hospital that consists of the structured recording of brain, ocular, respiratory and muscular activity during sleep.
“We also have more simplified studies that can be performed at the patient’s home and allow us to study respiratory disorders (sleep apnea). In cases of insomnia or circadian rhythm disorders, we can use actigraphy studies that consist of a clock that measures movements and exposure to light throughout the day and records sleep over several weeks. In certain pathologies it may be necessary to perform a brain imaging test (cranial MRI) to evaluate the encephalic structures or their iron content,” the doctor explains.
Once the diagnosis has been made, pharmacological treatment can be initiated in patients with restless legs syndrome, narcolepsy, idiopathic hypersomnia or REM sleep behavior disorder, among others. However, if the patient suffers from insomnia, and although drug treatment can also help temporarily, the approach is complemented in the long term with sleep hygiene education and a series of cognitive-behavioral measures.
Tips for a good night’s sleep
In order to prevent sleep problems from becoming a health problem, the doctor stresses the importance of maintaining a regular schedule, going to bed and getting up at the same time every day of the week, without making large gaps during the weekends. It is also important to reduce the consumption of alcohol, caffeine and tobacco, as well as to keep the room in optimal conditions of temperature, silence and complete darkness.
“Toavoid light pollution, we should lower the blinds completely or use a blind. High temperatures also make it difficult to fall asleep, since to fall asleep we need to reduce our body temperature by approximately 1ºC. Lowering the blinds and awnings during the day will help us to reduce the temperature of the room, and we should also encourage a current of air to circulate, avoiding keeping the air conditioning on all night, as too low a temperature also interrupts sleep,” argues the doctor.
Other tips include avoiding large, high-fat dinners; hydrating well during the day and avoiding excessive drinking during the hours before sleep; regular physical exercise, preferably in the morning and with exposure to natural light; and not using electronic devices that emit blue light such as cell phones, computers or television in bed.
