By Professor Dr Moy Foong Ming / Professor Dr Noran Naqiah Hairi / Dr Wan Kim Sui

19 March marks World Sleep Day, a day to advocate and educate the world about the importance of sleep to achieve an optimal quality of life and improve global health.

The slogan for this year is "regular sleep, healthy future." This could not be more suitable as chronic sleep deprivation is associated with obesity and non-communicable diseases (NCDs) such as hypertension, diabetes and cardiovascular diseases.

Chronic sleep deprivation increases stress hormone and inflammation, leading to hypertension and cardiovascular diseases such as heart attack and stroke. Insulin function, which controls blood sugar, is affected and increases the risk of diabetes and obesity.

A review of 20 studies showed that short sleep duration and poor sleep quality were associated with more inadequate blood sugar control among patients with type 2 diabetes.

The 2019 National Health and Morbidity Survey reported that 50.1% of our adult population were overweight or obese, 30.0% had hypertension and 18.3% diabetes.

Meanwhile, cardiovascular diseases are the number one cause of death in Malaysia.

Sleep quality among our population should be studied as it may be one of the factors associated with these diseases.

Most adults need between seven to nine hours of good quality sleep each night. However, the study on Clustering of Lifestyle risk factors and understanding its association with stress on health and well-being among school teachers in Malaysia (CLUSTer) reported that only 21% had at least seven hours of sleep and 19% had no disturbance in daytime function due to sleepiness.

Overall, 61% of them had poor sleep quality. However, 87% of them self-reported that their overall sleep quality was fairly good to very good. This reflects that the participants were not aware of their sleep quality problem.

Chronic sleep deprivation has become a global epidemic with urbanization, modern lifestyle and increasing use of smartphones and electronic devices. It is an important risk factor for NCDs that is modifiable.

However, chronic sleep deprivation is often unrecognized and under-reported. It is not routinely assessed in daily clinical practice or captured in databases. This may represent a missed opportunity for interventions to mitigate the increasing trend of NCDs and improve disease control.

If you feel tired, cranky, and find it hard to concentrate on what you are doing, you may be showing symptoms of sleep deprivation. The World Sleep Society recommends the following ten steps to achieve healthy sleep:

1. Fix a bedtime and an awakening time.

2. If you are in the habit of taking a nap, do not exceed 45 minutes of daytime sleep.

3. Avoid excessive alcohol ingestion 4 hours before bedtime and do not smoke.

4. Avoid caffeine 6 hours before bedtime. This includes coffee, tea, sodas, and chocolate.

5. Avoid heavy, spicy, or sugary foods 4 hours before bedtime. A light snack before bed is acceptable.

6. Exercise regularly, but not right before bed.

7. Use comfortable bedding.

8. Find a comfortable temperature setting for sleeping and keep the room well ventilated.

9. Block out all distracting noise and eliminate as much light as possible.

10. Reserve the bed for sleep and sex. Do not use the bed as an office, workroom or recreation room.

(Professor Dr Moy Foong Ming, Professor Dr Noran Naqiah Hairi and Dr Wan Kim Sui, Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya.)