Why lack of enough sleep is dangerous for your health

When Healthy Nation visited the Sleep Diagnostic and Treatment Centre along Gatundu Road in Kileleshwa, Nairobi, an unassuming compound with a black gate, quiet and with little buzz welcomed us.

The compound is tranquil with a few trees and potted plants set on the front porch, and the same repose is found inside.

The centre, established in September 2019, diagnoses and treats sleeping disorders such as insomnia, hypersomnia, obstruction and sleep apnea. It also offers psychotherapy and psychiatry services.

We are walked to one of the two rooms that patients spend the night in while being monitored. The room feels more like a holiday hotel than a therapy centre.

It has a queen size bed that is spread with purple and white covers and two comfy pillows, a closet, a bathroom set with the basic essentials you might need, and yes, a CCTV that is hard to miss.

We are reassured of our privacy in the bathroom and told the camera only monitors the patient while sleeping. The theme is purplish, and a soothing lavender scent wafts through our nostrils, persuading us to just lay down and close our eyes.

It’s time for illustration of how the monitoring works, and having given consent, we are requested to remove our shirts and fold our pairs of trousers to the knee level.

The sleep technician then gets to do his ‘magic’, attaching wires to our heads with what he calls a “skin friendly gel and tape”, chest, finger and legs, explaining what each does.

“Why so many wires for such a small machine, and a lot of money as well to acquire it —  Sh8 million?” We wonder.

He then secures the wires on our heads with a bandage, and the machine with a cotton belt to our chests and waists. He now dashes to his office to check on his laptop if everything is working well before giving us the go ahead to lie down on either side or facing up.

The battery-charged machine is connected to his laptop via Wi-Fi and it monitors our oxygen levels, heart rate, brain activity, leg activity while sleeping, number of snores, and every other tiny detail about our sleeping cycles.

It takes some time getting used to this; we have wires all over and a tube in the nose, not the ideal sleeping state, but we try to calm ourselves and fall asleep, but for a few minutes as per the machine’s recordings.

When the sleep technician comes back to inform us that it is the end of the illustration, we almost tell him to add us 30 minutes for a nap, but we are here for work, and we must save our sleep for the night.

Since its inception in September 2019, the centre has served nearly 2,000 people as of March 24. There are two rooms for monitoring patients, but only one machine.

Sh50,000 is the cost for one night of sleep monitoring. In case you fail to sleep, you are given a smaller machine, for free, that you can take home, but limited in the data it collects.

It is in this centre where hundreds of Kenyans have been trooping in to try to restore their sleep patterns. 

But why aren’t Kenyans sleeping?

Betty Mwaniki, for instance, can’t quite place a finger on the exact date that her first bout of sleeplessness came about but she tells Healthy Nation that one night has led to nine years of chronic insomnia. 

That is almost 3,316 nights that the mother of one has stayed up at night, alert to every eerie sound from her neighbours’ houses. 

For her, watching the sun set and rise again has become part of her daily routines and she finds herself counting the number of rooster crows. 

“If a pin dropped during those wee hours of the night, I would hear it,” says Betty, 39.. 

Betty says her insomnia started in February 2013, around the same time she was diagnosed with fibromyalgia, a condition that causes pain all over the body. 

Before she was diagnosed, she had faced traumatic moments in her life. A bitter divorce raised her blood pressure even as vexatious experiences of the 2007/08 post-election violence kept running in her mind.

“Both events left me with a lot of trauma that I think not only triggered the insomnia but also the fibromyalgia.” 

Before 2013, she acknowledges, sleep would creep into her naturally but since then, even the medication she takes no longer induce a siesta. 

“I cannot sleep like other people no matter how hard I try,” she says. “I now pray to God to restore my sleep patterns, but I am still waiting.” 

And while sleep is supposed to be a natural suspension of consciousness, Margaret Karani, a clinical psychologist at the Nairobi Sleep Diagnostic and Treatment Centre, tells us that specialists at the centre have noticed that over time, more Kenyans are struggling to get proper sleep. 

“Many people have trouble either initiating or maintaining sleep,” she says. “That simply means you end up waking up quite early.” 

A worrying trend exists where more young people are increasingly getting diagnosed with sleep disorders triggered by stressors like joblessness, mental problems, a growing individualised society and the Covid-19 pandemic, she elucidates. 

Insomnia has only worsened during the Covid-19 period as an increasing number of people complained of trouble falling asleep. 

When the Covid-19 pandemic hit, it brought with it a lot of anxieties and uncertainties, as well as changes in people’s social structure, research shows.

With most people spending their days indoors and with limited activities to keep busy with, it meant they had more time on their hands. 

One of them is 22-year-old Imran Lang’at, a student and resident of Kericho County. 

“My sleeping troubles started in March 2020 when schools were closed and a curfew put in place,” he narrates.“There is only so much you can do when you are a student who is out of school indefinitely, and jobless. It was not long before I started having irregular sleep patterns.” 

Watch movies

He would stay up very late into the night using his smartphone to watch movies. Other days he would take long naps during the day as he did not have much to do, and could not go out to interact with people for fear of contracting the virus. 

“I was going through the emotional turmoil of a bad relationship break-up. I tried to find faults or what I could have done differently.” 

Imran’s story is reminiscent of that of Viola*, a mother of two. She says she faced many stressors in her personal as well as professional life, having to work in a mental health institution, attending to many patients ailing from various conditions. 

She recounts: “At first I thought I was strong and I did not need any help. I thought I could separate my work and personal life stress and leave the work at work, compartmentalise, but I was wrong.”  It all started in 2019. She became easily irritable and started harbouring unexplained feelings of anger. “One day I would be in a jovial mood then the next I would be melancholic and huffy.” 

Viola recalls that this started showing at home as she was being violent at her children, screaming and shouting at them at the slightest provocation. She could go days on end without sleep, the effects of it making her manic to the point of sleeping under the bed at times. 

“I knew I needed help and being in the mental health field I did not want to self-diagnose. I therefore sought professional assistance and was put on a dosage of an antidepressant, Amitriptyline, which also acts as my sleeping pill.” 

Over time, lack of sleep can lead to health problems like diabetes, hypertension and weight gain, scientists say. 

It drains your mental abilities and puts your physical health at real risk.

Science has also linked poor slumber to a weakened immune system. 

A recent study, published in the National Center for Biotechnology Information in the United States found that people were more likely to crave sugary, salty and carb-heavy foods when they were sleep-deprived. 

One of the biggest issues related to sleep faced by many is insomnia. The condition can be short-term (acute) or last a long time (chronic). 

It may also come and go from time to time. Acute insomnia, scientists explain, lasts from one night to a few weeks, while chronic insomnia repeats at least three nights a week for three months or more. 

There are also other sleep disorders like obstructive sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts, while others struggle with narcolepsy, a chronic sleep disorder characterised by overwhelming daytime drowsiness and sudden attacks of sleep. 

“The realisation that these are growing issues in our society as much as we might think that sleep is natural led us to set up the sleep and diagnostic centre,” explains Ms Karani. 

Data at the Kileleshwa sleep centre show that at 40 per cent, insomnia is the most common type of sleep disorder many clients have walked into the centre with, followed by sleep apnea at 30 per cent, and narcolepsy and parasomnia at 15 per cent each. 

Parasomnia is a sleep disorder that involves unusual and undesirable physical events or experiences that disrupt your sleep. 

While more men, at 60 per cent, tend to come in with insomnia than women, the statistics show that more women (over 80 per cent) have made inquiry on the treatment of the disorder and have taken a step to go get treatment. Conversely, men will barely seek help or agree to see a doctor.

One explanation for trouble sleeping is that with fibromyalgia, the normal order of brain waves gets messed up. Deep sleep patterns are disrupted by brain waves that signal wakefulness, so you never really settle into good sleep. 

But the condition does not only affect fibromyalgia patients. “Insomnia is a common complaint especially among women due to hormonal shifts during the menstrual cycle and in menopause,” expounds the clinical psychologist. 

“People over the age of 60, travellers who criss-cross different time zones, shift workers who do not have regular schedules, and patients with a mental health disorder or physical health condition are also at risk.” 

While a lot of data is missing on sleep disorders in the country, available global statistics indicate that 30 to 48 per cent of people in the world struggle to sleep. 

“Many people do not realise that struggling to sleep is actually a problem and even when they tell others that they have trouble sleeping, it never looks like it’s a problem,” adds Ms Karani. 

What happens when you sleep? 

There are two main processes that regulate sleep — circadian rhythms and sleep drive. 

Circadian rhythms are controlled by a biological clock located in the brain. One key function of this clock is responding to light cues, ramping up production of the hormone melatonin at night, then switching it off when it senses light, according to Johns Hopkins University. 

People with total blindness often have trouble sleeping because they are unable to detect and respond to these light cues. 

Sleep drive also plays a key role: Your body craves sleep, much like it hungers for food. Throughout the day, your desire for sleep builds, and when it reaches a certain point, you need to sleep. 

Why do you need to sleep? 

Sleep significantly impacts brain function. First, a healthy amount of sleep is vital for “brain plasticity,” or the brain’s ability to adapt to input. 

If we sleep too little, we become unable to process what we have learned during the day and have more trouble remembering it in the future. 

Researchers also believe that sleep may promote the removal of waste products from brain cells—something that seems to occur less efficiently when the brain is awake. 

Migraines worsen when sleep is disrupted. Sleep also plays a role in metabolism: One night of missed sleep can create a pre-diabetic state in an otherwise healthy person. 

Extreme sleep deprivation could lead to potentially fatal accidents or injuries. 

Dr Marx Okonji, a consultant psychiatrist at Nairobi Hospital, tells Healthy Nation that while sleep may not directly cause death, chronic deprivation of slumber can kill.

“When you are deprived of sleep for a very long time, deep depression sets in. You will not eat or feel like doing anything. If that continues for a long time, then you could die, but secondarily because of underlying health problems.

“It reduces your appetite and immunity. Some deprivations could be occupational but others are as a result of illnesses. Even some regimes use sleep deprivation as a torture mechanism, and eventually victims die.”

EFFECTS OF SLEEP DEPRIVATION ON YOUR ORGANS

The brain:

» Mood changes – sleep deprivation can make you quick tempered and moody. Chronic sleep deprivation can lead to anxiety and depression

» Memory issues – during sleep the brain forms connections that help you process and remember new information. Lack of sleep has effects on both short-term and long-term memory.

» Lack of concentration – you will have trouble with concentration, creativity and problem-solving if you do not get enough sleep.

» Accidents – being drowsy puts you at risk of physical harm when driving or operating machinery.

The heart and immune system:

» High blood pressure – sleeping less than five hours a night increases the risk of high blood pressure.

» Heart disease – lack of sleep leads to increased production of chemicals linked to inflammation. This and increased blood pressure puts you at risk of heart disease.

» Weakened immunity – too little sleep weakens your body’s defense against viruses and bacteria such as those that cause common cold and flu, therefore making you more likely to fall sick.

The digestive system:

» Weight gain – sleep deprivation leads to chemical imbalance in the body, such as the chemicals that signal to your brain when you are full. As a result, you are more likely to overeat. It also leads to excessive production of cortisol, which leads to accumulation of fat in the belly area.

» Risk of diabetes – lack of sleep affects the body’s release of insulin, a hormone that lowers body sugar. People who do not get enough sleep have higher blood sugar levels and an increased risk for type 2 diabetes.

The reproductive and exoskeletal systems:

» Low sex drive – lack of enough sleep lowers libido. In men, this decreased sex drive is due to a drop in testosterone levels.

» Poor balance – lack of sleep affects your balance and coordination, making you prone to falls and other accidents.

HOW TO PREVENT INSOMNIA

» Have a sleep schedule the same way you have a work schedule (sleep and wake up at the same time)

» Do not carry your work/research/Netflix to bed 

» Don’t drink alcohol before bed.  Avoid taking stimulants like alcohol, coffee, tea just before you sleep

» Establish a pre-sleep ritual before bed like taking a shower.

» Avoid having heavy meals at night and if you must, eat an hour or two before bed

» If you need to settle an argument, do it during the day, not at bedtime.

» Turn off lights and all electronic devices at least 30 minutes before bedtime

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