Dream on for a good night's sleep

Contrary to popular belief, dream sleep is necessary for the body to achieve complete rest, CHEAH UI-HOON finds out

EVER heard people say that a nightful of dreams means that your brain didn't get to 'rest' well? They are wrong: Dream sleep is good, and it's a longtime myth that dreams indicate that your brain was 'active' in the night and therefore lacked sufficient rest.

'It's good to dream - that's when the body achieves rest. It's ironic but when your brain is in an active state, your body is in complete paralysis,' clarifies Kenny Pang, consultant ENT and sleep surgeon, and director of the first Medical Sleep Spa in Singapore.

Dream sleep - otherwise known as REM (or rapid eye movement) sleep is important for rejuvenation, memory rebuilding, and mental alertness, he says. And this REM sleep occurs usually at the last stage of sleep - just before you wake up.

Which is why people with sleep apnea, who have interrupted sleep and obstructed breathing pathways, wake up very tired even if they spend 10 hours in bed. They sometimes don't get to 'progress' to the last stage of dream sleep, says Dr Pang.

'What we're trying to do is to get patients to understand what sleep patterns they need and which are good for them,' he adds, describing the sleep spa tailored for those who suffer from sleep disorders.

While those with sleep apnea might need clinical solutions, those with problems falling asleep or who have insomnia could benefit from 'gentler' solutions such as spa treatment or doing the right kind of exercises. Hence the combination of the ear, nose and throat centre and the spa.

'Sometimes it's about how to achieve a restful mind, and good sleep hygiene,' he explains.

Sleep hygiene refers to the do's and don'ts of getting good sleep. Issues like insomnia can also be broken down into different categories - there's initiating insomnia which is when people get so anxious they can't fall asleep; and then there's terminal insomnia, which refers to when people wake up prematurely, hours before they have to.

'For such people, we have to train them to cope with that insomnia by getting out of bed to do a calming activity, and try to fall asleep all over again,' says Dr Pang.

There can be a holistic approach to good sleep, he thinks, hence the partnership with The Wellness Lounge to provide de-stressing massage and PowerMoves to provide Pilates.

The centre will offer sleep counselling and enhancement, sleep quality assessments and if necessary, sleep endoscopy for those who snore.

For a sleep assessment ($400-$800), a patient's sleep quality, sleep efficiency, dream sleep, respiratory patterns and oxygen levels will be monitored throughout rest. Endoscopy can also be performed during sleep to better assess the airway and identify areas of obstruction.

What's the definition of a good sleep? Dr Pang says it is when you wake up energised and rejuvenated in the morning. 'There isn't a fixed number of hours you should sleep as some people can already achieve dream sleep in just four hours while others need longer. Different people of different ages need differing hours of sleep, for example.'

Power naps of 10-15 minutes in the day are good, he advises, as it usually is dream sleep. And then another myth is that you can't play catch up on sleep. You can, says Dr Pang, and you should sleep longer in the weekends if necessary. 'There is a sleep debt which you can and should pay if it rejuvenates you.'

Tips for good sleep hygiene

Go to bed at the same time each day.

Get up from bed at the same time each day.

Get regular exercise each day, preferably in the morning. There is good evidence that regular exercise improves restful sleep. This includes stretching and aerobic exercise.

Get regular exposure to outdoor or bright lights, especially in the late afternoon.

Keep the temperature in your bedroom comfortable.

Keep the bedroom quiet when sleeping.

Keep the bedroom dark enough to facilitate sleep.

Use your bed only for sleep and sex.

Take medications as directed. If you are taking prescribed sleeping pills, it's often helpful to take them one hour before bedtime, so they are causing drowsiness when you lie down, or 10 hours before getting up, to avoid daytime drowsiness.

Use a relaxation exercise just before going to sleep - muscle relaxation, imagery, massage, warm bath, etc.

Keep your feet and hands warm. Wear warm socks and/or mittens or gloves to bed.

Don't:

Exercise just before going to bed.

Engage in stimulating activity just before bed, such as playing a competitive game, watching an exciting programme on television or movie, or having an important discussion with a loved one.

Have caffeine in the evening (coffee, many teas, chocolate, sodas, and so on).

Read or watch television in bed.

Use alcohol to help you sleep.

Go to bed too hungry or too full.

Take another person's sleeping pills.

Take over-the-counter sleeping pills, without your doctor's knowledge. Tolerance can develop rapidly with these medications. Diphenhydramine (an ingredient commonly found in over-the-counter sleep medications) can have serious side effects for elderly patients.

Take daytime naps.

Command yourself to go to sleep. This only makes your mind and body more alert. If you lie in bed awake for more than 20-30 minutes, get up, go to a different room (or different part of the bedroom), participate in a quiet activity (eg non-excitable reading or television), then return to bed when you feel sleepy. Do this as many times during the night as needed.

The Medical Sleep Spa is located at #20-01 Paragon, 290 Orchard Road. For appointments, please call 6887 1299

Source: Business Times, 21 April 2007