Two Filipino Sleep Doctors Give Their Advice on How You Can Sleep Better at Night

We talked to two Filipino sleep doctors to find out what’s keeping us late at night and how we can get a good night’s sleep.

In this fast world, there seems to be less time for sleep.

We are connected 24/7 in so many platforms, and many times, the lines between work, school, and personal relationships are blurred.

While the technology has given more room and time to get things done, there is not enough space in people’s routine for a proper sleep of at least 7 hours.

But what are we missing when we don’t get enough sleep?

Sleep experts have many theories on the importance of sleep.

In its barest function, sleep helps the body recover for the next day. It restores the body’s tissues and helps the body conserve enough energy for the day ahead.

When well-rested, you freshen up your brain to its optimal operation. Memories and information worth keeping are made sense of during the night and are preserved for the long-haul.

But here in the Philippines, sleep deprivation has become a big problem. 

According to the Philippine Society of Sleep Medicine (PSSM), about 20% of Filipinos are sleep deprived.

These are caused by “odd-working hours, personal obligations, and relationship worries.”

As the business process outsourcing (BPO) boomed, so did the sleep health of many working professionals decline.

The 24/7 work culture we have adopted had caused weird sleeping habits like sleeping in the morning or not getting sleep at all.

The Philippines also ranked as the 4th most sleepless country in the world in a 2019 survey. We sleep an average of six hours and 30 minutes to six hours and 45 minutes per night.

And while the ideal sleep duration varies among age groups, young adults and older adults need at least 7 hours of sleep, maximum of 9 hours.

According to the head of the Lung Center of the Philippines’ (LCP) Division of Sleep Medicine Dr. Virginia S. Delos Reyes, you probably had a good night’s sleep if it is: uninterrupted, refreshing, and deep.

But when sleep-deprived, you become more irritable, anxious, has less motivation, and may show symptoms of depression.

You are more prone to high blood pressure, heart attack, obesity, and diabetes. You have less attention span for dragging meetings and you can’t even remember why you wrote such and such on your to-do list.

No amount of bad coffee in the morning will counter the long-term effects of sleeplessness.

Delos Reyes also added that lack of sleep leads to increased appetite. “Sleep deprivation makes us want to eat more specially at night,” she says.

This results to a more messed-up body clock and appetite.

Having problems sleeping does not just affect sleeping habits per se. PSSM says it actually “disrupts and disturbs your overall quality of life.”

Sleep disorders are more common to middle and older-age adults. Experts say some of the most common sleep disorders include sleep apnea, insomnia, restless legs syndrome, periodic limb movement disorder, narcolepsy, and parasomnias.

Insomnia, one of the most common disorder experienced by Filipinos, is a subjective perception of difficulty sleeping, and it results to some form of daytime impairment.

It is caused by anxiety and mood disorders— mental disorders that are heightened by trends, gadgets, pop culture, and mass media.

One of the things most people miss in a culture that is working around the clock, is that sleep is part of our body’s rhythm, not a disruption or a sudden lull.

We are not any less active when we sleep.

Sleep is supposed to be repose, Shakespeare wrote, when resting the weary body, our mind begins a journey of its own. But this isn’t just poetic flair, it is founded in the current science of sleep.

Indeed, the mind goes on a journey during sleep, sinking into varying depths of stages as we pass through two states: rapid eye movement (REM) and non-rapid eye movement (NREM).

Throughout the 4 stages of sleep (first 3 stages of NREM and final stage of REM), depth of sleep increases from light to deep sleep while body temperature and heart rate decreases.

In a phone call interview, Dr. Keith Aguilera, the President of Philippine Society of Sleep Medicine, says that sleepers usually go through cycles of NREM and REM sleep.

These cycles have different functions. For example, during stage 3, our brains work on memory consolidation.

When you wake, sometimes you remember flashes of weird dreams, where worlds and information are distorted. That happened during REM sleep.  

It also during sleep that we curate information we acquired during the day and the brain makes intuitive connections we otherwise would not have worked on our own at daylight.

Do you have waking moments in the morning when, after sleeping on a problem at night, you wake up with a fresh and creative solution?

That’s sleep working for you.

Going through all stages, or completing both NREM and REM states, is thus crucial for making sure you are well-rested and prepared for the next day, in every sense of the word.

As Delos Reyes explained, “If someone has a night deprived of REM sleep they tend to become overly sensitive, have bad memory recall, and unable to concentrate…. People who have lost REM sleep have more trouble coping with stress over a long period of time and are irritated very easily.”

On the other hand, people lacking NREM sleep “are clumsy, sluggish, and look to be very tired,” says Delos Reyes.

Not completing the ideal 7-9 hours of sleep will lead to missed stages the consequences of sleep deprivation.

But if you’re working the graveyard shift, can you just “catch up on the 7 hours of sleep” in the morning?

Aguilera, who also heads the Comprehensive Sleep Disorders Center at St Luke’s Medical Center, says the quality of sleep is also affected by which time you sleep, regardless if you actually complete the 7 hours minimum.

Time plays a big role when getting a good night’s sleep. The circadian rhythm—or your body’s internal clock— tells your body when you should be sleeping and doing other vital activities such as eating.

“Nighttime sleep is still the ideal,” advocates Aguilera. “When you sleep during the day, the quality is a little bit different. You have less deep sleep. Paputol-putol sya.”

Aguilera says Filipinos are still lacking a good amount of appreciation and awareness of the value of sleep.

“[Sleep] repairs the body. That’s the main purpose of sleep. It’s a mechanism for us to repair our bodies. You work a third of your day, a third of the night you should be able to recover that.”

And with the added anxiety, grief, and feeling of isolation that the COVID-19 pandemic brought us, people are finding it harder to rest and sleep.

“The pandemic has blurred the delineation between rest and work,” says Delos Reyes.

“The anxieties of these uncertain times had also disrupted sleep and has increased insomnia and depression.” So how do we sleep in times like this? The expert gives us practical advice on how to sleep and find rest.

Keep a routine. Find your “rhythm” for when you should be eating, working sleeping, waking up and stick to the time.

Associate bed with sleep. Don’t work, study, or binge-watch your favorite TV series on your bed.

Delos Reyes advises against using the bed for anything other than sleep and sex.

“Keep the bedroom environment quiet, dark, and comfortable,” says Delos Reyes.

To keep a good sleeping environment, avoid bright lights during bedtime and increased light exposure in the morning. This also means keeping away gadgets at night.

Having a hot shower an hour before bedtime can raise your body temperature, “making you feel sleepy as your body temperature drops again.”

Avoiding late night intake of food and liquid will also help in sleeping well. Around 4-6 hours before bedtime, caffeine and nicotine should not be consumed.

Alcohol must be avoided before bedtime, as it can fragment sleep.

Some specific tips Delos Reyes shared: only go to bed when you’re actually feeling tired and sleepy.

Do something calming or boring if you can’t go to sleep within 20 minutes. Don’t watch the clock too much. A warm glass of milk before bed can act as a natural sleep inducer.

Of course, getting a good sleep hygiene works from a comprehensive approach. Commendable sleeping habits do not only come from the “dos and don’ts before bedtime.”

Exercising regularly and keeping a healthy, balanced diet affect how you sleep and live through the daily, waking hours.  

Delos Reyes actually encourages people with sleep disorders to have themselves checked up, and assures the public that LCP’s sleep division is located away from the hospital’s areas dedicated for the coronavirus.

St. Luke’s, on the other hand, offers teleconsultation if patients are wary of going to the hospital. Sleep studies can also be done through teleconsultation.

In special cases when equipment is needed, like for the sleep apnea test, patients can “drive-thru” by the hospital, pick up the device, and call the doctor before sleeping to properly operate the device.

These are some things to keep in mind for the concerned, sleep-deprived individual. But at its core, it shouldn’t be much to ask for to get a good night’s sleep.

There is no luxury to substitute for the quality rest and recovery sleep gives.

The sooner we realize this, the sooner we can appreciate sleep, and every good thing that comes with it.

As Aguilera has frequently emphasized, you sleep about a third of your life. You have to beat that standard.

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