Scary thought: even if you're getting 8 hours', it might not be the right kind of sleep. Dr Rangan Chatterjee reveals what you really need to do to wake up refreshed

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When was the last time you woke up feeling well rested and buzzing with energy? Nope, we can’t remember either. GP and author Dr Rangan Chatterjee  is is no doubt that we're in the middle of a sleep deprivation epidemic; we’re sleeping up to 25 per cent less than we did 60 years ago and it’s dramatically affecting our health (not to mention the economy - sleep deprivation is estimated to cost us about £40bn a year).

We know that a good night’s sleep will reward us with more energy, better concentration, better immune systems, a reduced risk of being overweight and better memory to name but a few benefits - so how can we balance our busy modern lives with our seven or eight hours?

Dr Chatterjee, whose most recent book  The Stress Solution: 4 Steps to Reset Your Body, Mind, Relationships and Purpose  i s full of sleep-enhancing stress-relief tips  has called his own change in attitude to sleep as ‘life-changing’. We asked him for his advice on about optimum sleeping habits and how to get a great quality night’s kip…

GTG: You used to have sleep issues, tell us what happened?

Dr Chattergee: I have gone through times in my life where I didn’t sleep that well. At exam times as a medical student, my sleep would suffer as I would be unable to switch my mind off. In fact, unable to ‘switch off’ is one of the most common reasons people to struggle with their sleep. Also, when alternating between day and night shifts as a junior doctor, I found it incredibly challenging to get good quality sleep as I wasn’t very good at adapting to the different shift patterns.

Over the past few years (since I started to really prioritise it) my sleep quality has improved immeasurably. I recommend these techniques to my patients but the key things I have found work for myself are:

  • No caffeine after noon.
  • Expose yourself to natural light every morning for at least 20 minutes.
  • Switching off all technology 90 minutes before bed.
  • A routine. Having a set wake up time and, ideally, bedtime every day is probably the most important sleep tip. A set bedtime ensures your body knows that it is winding down for sleep.
  • Ensure your bedroom is completely dark – so take out electronics and invest in blackout curtains or blinds.

GTG: What kind of sleep issues do you see as a GP?

Dr C: The whole range! I would say that the majority of my patients, when asked about their sleep, will say that they are not getting enough. While primary sleep disorders do exist, such as sleep apnoea which can require specific treatment, it is important to realise that the vast majority of sleep issues are within our own control. Often we are doing something in our own daily lifestyle which is negatively impacting our ability to sleep at night, without us even realising.

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GTG: Which sleep issues are you seeing a rise in?

Dr C: Inability to fall asleep when going to bed, waking up in the early hours e.g. 4am and being unable to get back to sleep and anxiety-related sleep problems.

GTG: Do sleeping tablets help?

Dr C: I rarely prescribe sleeping tablets anymore. They actually sedate you which is not the same as sleeping! We know that they do not provide the deep levels of sleep that we need to recover and rejuvenate. In addition, new research is showing that they may increase the risk of developing other chronic diseases.

GTG: How many hours' sleep do we really need?

Dr C: We need the same amount of sleep that we have always had. We have evolved over millions of years and our biological requirement for sleep has not changed – what has changed, is society’s perception and the priority given to sleep.

It is important to remember that society has never had as little sleep as we do today. Researchers from Oxford University say that we may be getting one to two hours less sleep than we were 60 years ago. This is staggering.

Most of the research points towards eight hours per night but, I prefer to focus on three questions to determine your sleep health. How long does it take you to fall asleep? Do you feel refreshed when you wake up? Do you wake up every morning at roughly the same time without an alarm?

I use these questions as part of my ‘RATE’ questionnaire which many patients find useful to assess their sleep health. [More details in his book  The 4 Pillar Plan]

GTG: Why is a good night's sleep so important for health?

Dr C: Sleep is arguably the most important component of our health. Better sleep has many benefits including:

  • Increased energy
  • Better concentration
  • Better capacity to learn
  • Improved immune system function
  • Reduced stress levels

GTG: What are the effects of sleep deprivation?

Dr C: Even one night’s sleep deprivation will cause you to be more resistant to the hormone insulin. This makes it much harder to control your blood sugar levels. I have some patients with type 2 diabetes  whose blood sugar I am unable to get under control with better diet and movement. However, once I start addressing their sleep health, their blood sugar control improves. We forget that the body is interconnected and improving your sleep has a knock-on benefit on many aspects of your biology including your weight, energy, attention, performance. Good sleep also reduces your risk of diseases such as Alzheimer’s and heart attacks.

GTG: What is ‘sleep debt’ and how do you catch up?

Dr C: The longer we are awake for, the more sleep debt we accumulate. This is one of the key drivers of fatigue, in that, the more sleep debt we have, the sleepier we feel. We think that we can ‘catch up’ on our sleep at the weekend but this is simply not true. In fact, having a lie-in at the weekends starts to play havoc with your body’s daily rhythm which could make it harder for you to fall asleep that evening and get up on time the following morning.

GTG: What are your tips for the perfect sleep environment?

Dr C: The most important thing is that the room is dark. Lots of electronic devices emit light even when off. My tips would be to charge your phone outside your bedroom and buy an old-fashioned alarm clock! I also think a good sleep practice is to remove TV from the bedrooms. Remember, your brain is a highly associative organ. That means you really want to train your brain that a bedroom is for intimacy or sleep… and not for Netflix!

GTG: What is your ideal night time routine?

Dr C: Like many people, I have a busy job and young children – I don’t always manage to stick to my ideal night time routine. Ideally, I start my wind-down for bed around 8pm or 8.30pm. My phone will go off and I will only do relaxing things such as reading a book or having a bath. I try my best to avoid having emotionally stimulating discussions such as talking about financial matters, although this can be harder to control! Also, I NEVER check emails right before bed.

GTG: If you wake in the night, even if only for five minutes, what effect does this have on your sleep cycle?

Dr C: This is not a huge problem. The key is not to overly stimulate yourself if you do wake up. If you need to visit the bathroom, do so with a dim light. (Red light is ideal as it has the least effect on your body’s daily, circadian rhythm.) The last thing you want to do is look at your smartphone to check the time as this exposes you to the bright blue length wavelength of light and can wake your body up.

GTG: Why do we sometimes feel completely unrested even though we’ve been unconscious for 7 hours?

Dr C: It is about the quality of your sleep rather than simply the time spent asleep. Some people will have caffeine before bed and tell you that they can actually fall asleep for the whole night. However, we know that they will not have accessed enough deep, restorative sleep.

In addition, technology before bed can play a role. I have patients and friends who, if they are on their screens right before bed, may actually fall asleep but will not wake up fully refreshed. When they adopt my no tech for 90 minutes before bed idea (#NoTech90) they often report having the same amount of sleep, yet they wake up feeling refreshed.

GTG: Any recommended sleep apps?

Dr C: Switching your mind off is the best way to encourage sleep and my favourite app for this is a meditation one, ‘Calm’.