How to Sleep to Ensure Good Health – The Excellence Center for Sleep Disorders (Nidra Vej Center) Has the Answers

Thailand’s first Excellence Center for Sleep Disorders (Nidra Vej Center), King Chulalongkorn Memorial Hospital can solve sleep disorders that impair the quality of your life and health.

We all know that sleep is vital to our health and well-being. This is the time when the body heals itself and increases its vitality. But nowadays, sleep has become one of the major health problems for modern people. We sleep less, suffer from insomnia, have difficulty sleeping and experience poor quality of sleep.  These disorders can adversely affect our quality of life, cause illnesses and health problems including death.

“Currently, insomnia is the most common sleep disorder which accounts for 10-20% of the world’s population, and up to 20% of this number are the elderly. There are also other sleep-related disorders, such as sleep apnea, movement disorder, bruxism, periodic limb movement disorder (PLMD), restless legs syndrome (RLS), hypersomnia, parasomnia including sleepwalking, sleep talking, as well as circadian rhythm sleep disorder which is common in people who sleep late and wake up late,” said Assoc. Prof. Naricha Chirakalwasan, M.D., Executive Director of the Nidra Vej Center, King Chulalongkorn Memorial Hospital.

The Nidra Vej Center was founded in 2003.  It is Thailand’s first comprehensive sleep diagnosis center and its services include sleep tests, a sleep disorder outpatient clinic and a behavior modification clinic for insomnia patients. The center also offers a certificate course to train doctors and specialists in sleep disorders and conducts research and innovations on sleep disorders, such as research in sleep apnea. It has been determined that Thais and Asians have sleep apnea when they sleep in the supine position.  Other research and innovation projects include cannabis and sleep, and an application to monitor patients’ sleep, etc.  Each year, the number of patients who come for consultation and services is steadily increasing.  In 2020, there were 3,400 patients aged ranging from 8 months to 105 years.

“Sleep is the best way to rest. We spend a third of each day sleeping. Quality sleep is something we should appreciate and understand.”

Assoc. Prof. Naricha Chirakalwasan, M.D. and Busarakham Chaithasanee, M.D., two experts from Nidra Vej Center offering the following advice on “quality sleep” for good health.

Common sleep disorders

Most Thai people experience sleep deprivation, especially city people of the working age whose lifestyles dictate that they wake up early and sleep late. According to the research results, sleeping less than 5.5 hours or more than 9 hours increases the likelihood of death. Lack of sleep can cause cardiovascular disease and forces the autonomic nervous system to overwork leading to death.

Guidelines for sleep disorders treatment

For obstructive sleep apnea (OSA), the main treatment is to use a machine blowing positive-pressure air to widen the airway which patients wear only while sleeping. There is also a dental device that is inserted to move the lower jaw forward and help expand the airway.  For mild cases, patients are recommended to change their sleeping position, adjust their sleeping habits or use a device to help them sleep on their side to improve their condition.

The treatment of insomnia which is found in up to 20 percent of the middle-aged population, and in more women than men, can be divided into 2 types: behavior modification and drug treatment.  The Center will focus on behavior modification first, such as adjusting bedtime and wake-up times, avoiding light near bedtime, no exciting or scary activities near bedtime. The behavior that should be avoided and reduced is engaging on social media on smartphones near bedtime. Exposure to light reduces the secretion of melatonin, making it difficult to fall asleep.

Who needs a sleep test?

Sleep test is a diagnosis of sleep disorders that are performed when patients are suspected of having sleep apnea, bruxism, a history of sleep talking, twitching limbs while sleeping, etc. For people with insomnia, a sleep test is not required.

Do people who die in their sleep have sleep-related disorders?

The common cause for most people who die in their sleep is arrhythmia, which is caused by other sleep disorders such as sleep apnea or snoring.  These sleep disorders do not directly cause death in patients,  but induce arrhythmia and lead to myocardial ischemia which increases the chances of death.

How much sleep is enough?

Sleep is important for people of all ages. Kindergarten children should sleep 10–13 hours, primary school kids, 9 – 10 hours, secondary school teenagers 8-10 hours, working people, 7-9 hours, and those over 65 years old require less than 7 hours of sleep.

To determine if we are getting enough sleep, we should look at the difference between the number of our sleep hours on workdays vs weekends if the difference is more than two hours. 

How to exercise to help you fall asleep

We recommend about half an hour of aerobic exercise 4-5 hours before going to bed, or even better if you can exercise in the morning because morning sunlight helps with melatonin secretion, which will improve sleep that night.

What to eat, how to eat, to benefit sleep

We do not recommend eating a large meal within 3 hours before bedtime, as this will cause discomfort, increased chances of acid reflux and difficulty in sleeping.

Food that helps you sleep well are those containing tryptophan, such as bananas, milk, etc. Food to avoid 6 hours before bedtime are those containing caffeine such as chocolate, cocoa, tea, coffee, and black-colored soft drinks.

Does frequently hitting the snooze button affect your health?

Frequently hitting the snooze button does affect sleep quality, because most of the time we press the alarm clock when we are about to wake up. Early morning sleep, called REM Sleep or Rapid Eye Movement Sleep, is an important sleep that collects memories that occurred during the day.

Hitting the snooze button during that time can lead to a decrease in memory, and may cause the brain to wake up in spurts. As a result, the autonomic nervous system, heart rate, and blood pressure increase thereby negatively affect the cardiovascular system.

Which position to sleep in?

Most people change sleep positions all night long.  Sleeping in any particular position for a long time will cause aches and pains. Sleeping on our belly is hardly ergonomic, as we have to turn our head to one side to breathe and that can cause muscle aches, neck pain, and back pain.

Sleeping in the back position is the most natural and most comfortable, but it is prohibited in some groups of people, such as people who snore, or those with obstructive sleep apnea because they have narrower airways than normal people. Sleeping in a back position will cause tissues in the pharynx, such as the soft palate, uvula, and the base of the tongue to fall with gravity, and can obstruct the airways during sleep. Therefore, side sleeping is better for this group of people.

Recommendations for people with sleep disorders

For people with insomnia, we do not recommend buying over-the-counter sleeping pills, as some medications can cause addiction or dementia. Any detection of sleep disorders, such as sleep apnea, insomnia, drowsiness, sleep talking, or irregular muscle movements should be consulted with doctors right away, because if not treated, these symptoms may lead to serious diseases such as heart disease, paralysis, diabetes, Alzheimer’s, dementia, etc.

People with sleep problems can contact us for consultation at the Excellence Center for Sleep Disorders (Nidra Vej Center), King Chulalongkorn Memorial Hospital, 5th Floor, Special Clinic Building 14, or https://www.sleepcenterchula.org/index.php/th/.

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