We have turned sleep into something to be sacrificed when life gets busy. Working hours, lengthy commutes, and shift work can push sleep to the bottom of the list. The body does not treat sleep as optional. During sleep, the body repairs tissue, regulates hormones and clears waste from the brain. Regularly getting too little sleep is linked to high blood pressure, heart disease, stroke, weight gain, type 2 diabetes, depression and anxiety. It can weaken the immune system and affect concentration, memory, judgement and emotional control. Sleep is often seen as a matter of personal discipline, although some cannot choose to sleep more. When sleep becomes a health risk Adults aged 18 to 64 are recommended to get seven to nine hours of sleep a night, while those aged 65 and above should get seven to eight hours. Regularly getting fewer than six hours is too little for almost everyone. Short sleep affects appetite hormones and insulin sensitivity, contributing to weight gain and type 2 diabetes. Depression and anxiety are also more common, although the relationship runs both ways. A seriously sleep-deprived driver can have reaction times comparable to those of a drunk driver. International studies have found that adults who sleep for less than seven hours have a higher risk of death from any cause, although this does not prove that short sleep directly causes death. Why people sleep less For many, the problem is not valuing sleep. They have no room left in the day. Someone who leaves home before six and returns after eight has already spent many hours that could have been used for sleep. Others work a second job or study after work, while shift workers may have to sleep when their body clock is telling them to stay awake. Screens can delay the body’s sleep signal through evening light, while their content keeps the mind alert. Caffeine can remain active for hours, making afternoon coffee and energy drinks a problem at bedtime. Alcohol may help someone fall asleep quickly but can fragment the second half of the night. Noise, heat and crowded rooms can make sleeping difficult. So can caring for a newborn or sick relative, or untreated sleep apnoea, chronic pain or anxiety. A culture of boasting about functioning on four hours persists. The cost during the day Concentration suffers, followed by memory. Much of what people learn during the day is consolidated during sleep, so a student who sleeps only four hours before an examination may lose part of what they studied. Judgement deteriorates even when people remain confident in their ability to function. At work, this can mean slower thinking and more mistakes. At home, sleep loss can cause irritability and withdrawal, followed by reliance on sugar and caffeine. What can help Keeping the same wake-up time every day, including weekends, is one of the most effective measures because the body responds to rhythm. Caffeine should be stopped by early afternoon, alcohol should not be used as a sleep aid, and phones put away before bed. A bedroom should be dark, quiet, and cool. If sleep has not come after about 20 minutes, getting up somewhere dim until drowsy can help. Morning daylight and daytime exercise can also support sleep. Loud snoring with pauses in breathing, falling asleep at the wheel or weeks of poor sleep should be assessed. Sleep apnoea and insomnia are treatable but remain badly underdiagnosed. Telling people to sleep more does not always work when a night guard is working through the night, a mother is caring for a newborn, or a worker spends long hours at work and commuting. Getting enough sleep in such situations is not just about discipline. It also depends on having better shift schedules, shorter commutes, and workplaces that do not reward exhaustion. The author is a medical doctor and a passionate public health advocate.
