Active Health Podcast Ep 3: Sleep Decoded: Tech, Myths, and Science behind Sleep

00:00:15 Speaker 1

Good afternoon, everybody. Welcome to Active Health, Navigating Health and Fitness Challenges podcast series. I am your host, Daphne Goh, an active health coach from Sports Singapore. On your screens right now, you'll be able to see a poll. Please let us know if you're a public service officer or not.

00:00:42 Speaker 1

Yes, click yes or no.

00:00:49 Speaker 1

Alright, so this is the third episode of our podcast series. If you missed our last two episodes on the debate between high protein diet and calorie restriction for weight loss, and on HYROX training tips, we'll be sharing the recorded video links in the Q and A box right over here. Okay, in today's episode, we'll be decoding sleep. I am very excited to have Doctor Panya join us today. Doctor Panya is a specialist in advanced internal medicine and has additional qualifications in sleep medicine.

00:01:18 Speaker 1

She has experience running an independent sleep clinic since 2017, where she manages various sleep disorders for patients. We're here today to discuss a subject that most Singaporeans struggle with, right. How do we sleep better in a world that never switches off? Doctor Panya, thank you for joining us today. Can you give us an introduction as to who you are and what have you been doing until now?

00:01:44 Speaker 2

Thank you, Daphne, for kind introduction and having me here. Thank you to the audience for joining today. So I am an internist and sleep physician. As an internist, I take care of acute and chronic diseases care as well as hospitalisation care. We can provide the broad spectrum care and we can treat the wide spectrum of disorders and symptoms to diagnosis. Nowadays, specialist care is fragmented, so we can provide the one-stop specialist care and with coordination with other specialists if it is needed. As a sleep physician, I do various type of different sleep test, analyse them and I treat all different sleep disorders.

00:02:28 Speaker 1

Thank you, doctor Panya. Okay, so as a disclaimer, this information presented in this podcast is for educational and informational purposes only, this information are not meant to treat any medical conditions. The diagnosis and treatment of medical conditions require the attention of a physician or other properly qualified health professional. If you are seeking diagnosis or treatment of a sleep disorder or other medical or mental health condition, you should consult a sleep specialist physician or mental health professional.

00:02:59 Speaker 1

Without further ado, let's start with basics, doctor Panya. So what exactly is sleep and why is sleep important?

00:03:06 Speaker 2

Sleep is a reversible state of consciousness. It's a natural phenomenon and we spend around one third of our life during sleep, so it is very, very important. As sleep is an active process, all our brain centres are located in. All our body centres are located in brain and they get energy formation, energy conservation, as well as regeneration during sleep.

00:03:33 Speaker 2

So sleep is for the brain and by the brain. Sleep has many functions, such as it helps us in immune boosting. It also helps in the tissue repair, cell growth and muscle recovery. It helps in memory consolidation and waste product removal. So it is a catch for all physical, mental and emotional health.

00:03:58 Speaker 2

Sleep also regulates our emotional processing and stabilisation, which can do in the daytime. So sleep is very, very important.

00:04:08 Speaker 1

Wow, really sounds like there are a lot, many benefits to sleep, right, especially all the restorative benefits that you get from sleep. Okay, so maybe can we discuss about what are the stages of sleep and its? Maybe not its function, but its stage, the sleep, different sleep stages.

00:04:24 Speaker 2

Yeah, so sleep comprises of non rapid eye movement sleep. And the rapid eye movement sleep, non rapid eye movement sleep is known as non REM sleep, and the rapid eye movement sleep is known as REM sleep. So non rapid eye movement sleep is further subdivided in the three different sleep stages. Stage one and stage two are life stage, and the stage three is deep sleep, and the REM sleep is known as dreaming sleep, and each sleep stage has a different different function.

00:04:54 Speaker 2

Usually we start our sleep in the non REM sleep, but we end up our sleep in the REM sleep, and in the 1st half of our sleep, the non REM sleep is more, and in the 2nd half of our sleep, the REM sleep is more.

00:05:11 Speaker 1

So it means we dream in our REM sleep, and then we have three stages of our non REM sleep. That's correct. Okay, right, so what are the average hours of sleep for an adult?

00:05:23 Speaker 2

So that is really very good question. So average hour of sleep usually seven to nine hours, but there are two schools of thought. Some school of thought says that six and half to eight and half hours. Some say seven to nine hours. So we average out is say seven to eight hours of the sleep, and particularly in Singapore is sleep deprived. There was a publication by the Li Kuan Yew School of Public Policy, and Singapore is a third more sleep deprived country, so we really really need to focus on the sleep.

00:05:57 Speaker 1

Right, I am, I am sleep deprived as well. Okay, so what are the effects of ageing on sleep? And is it true that seniors need lesser sleep than regular adults?

00:06:09 Speaker 2

So you, as we age, our sleep hours requirement is going down, which is true. So instead of seven to eight hours as an adult, you can have six to seven hours as an elderly, but the other thing we. You need to think is that as we age, we are at higher risk of sleep disorders, so we have to look at our daytime lifestyle.

00:06:34 Speaker 2

We need to look at our, what are the symptoms happening, and if you cannot get six to seven hours sleep, some adults has a difficulty in sleep onset, so some adults has difficulty in sleep maintenance, so elderly who has some sleep issue, they need to screen them for the sleep disorder. In spite, if they correct their lifestyle, and still it is not effective for them.

00:06:57 Speaker 1

Okay, so that means it's true that seniors would most likely get lesser sleep. Right, ya. Okay, alright, for what about, for what about, What happens when we get insufficient sleep?

00:07:10 Speaker 2

So insufficient sleep can invite a lot of medical problems as well as maybe I can say personal or the social problems. So medical problem wise, we. We are increasing ourselves at the risk of the chronic diseases such as high blood pressure, diabetes, high cholesterol.

00:07:29 Speaker 2

It can also increase the risk for the heart problem such as heart attack or heart failure, and if we have some underlying sleep disorder along with the sleep deprivation, then we are increasing risk of irregular heartbeat, fast heartbeat, or slow heartbeat. Other thing we are doing is increasing some risk for dementia, parkinson's or the st roke, and it can also lead to road traffic accidents.

00:07:58 Speaker 2

It can lead to inflammation, change in the appetite and the selection of the food, so it can lead to the weight gain or the obesity, and many of the people are struggling now for maintaining their weight, maybe they have to also look into their sleep as well.

00:08:16 Speaker 1

I see. Alright, so sleep deprivation is a very serious cause, and you just now already mentioned that Singapore is the third most sleep deprived country. Right, so that's something that we definitely have to try to work on a little bit more. Okay, so what about for parents with who has to juggle sleep, kid, right and work? Right? So sometimes they putting the kids to sleep. They end up sleeping later, right, does the time that they go to sleep matter?

00:08:46 Speaker 2

So here is a, you have to see how it suit to your lifestyle. So and it also depend on the your time at the work. So If you are starting work late and you are sleeping late, you are catching up with your seven to eight hours of sleep. Then I think it's reasonable cause that is the you have the choice with your personal lifestyle at the moment

00:09:12 Speaker 2

But if you are starting work early and going to sleep late, that is an issue. So probably they need a lot of help for the childcare or the some activity for the child so they can sleep early and they can also sleep early early, and maybe they have to look into the different solutions which can help them to sleep better.

00:09:34 Speaker 1

That means their sleep duration it's more important as compared to what time they actually fall asleep. Yes, right, okay, and so talking about sleep technology, right, so nowadays we have sleeping apps, watches, smart watches that can help you to track your sleep. Right, what are some functions that they actually have that we can actually help to get better sleep?

00:09:58 Speaker 2

So there are many consumable device. Some are in the form of mobile apps, some are in the form of rings, or some are some are in the form of the watches, wrist watches, so some are good, some are not good, and some of the consumable devices we have tried to do research and see whether they are good enough or not, so the good good consumable devices.

00:10:27 Speaker 2

They are good in telling you your sleep onset as well as the total duration of the sleep, but they are not accurate for the sleep stage percentage. To find out the sleep stage percentage, we need our brain activity to be monitored, and that one usually we monitor medically by EEG.

00:10:50 Speaker 2

But here, because they, they are just going through the some certain algorithm or AI algorithm to predict your sleep stages, so I would like to say that. Okay, you are getting the good duration of sleep. Your consumable device say “yes, it's good”, but don't focus particularly on the percentage of the sleep for the consumable devices.

00:11:15 Speaker 1

Okay, alright, so it means yes, you can use them, but we can't really obsess over it, is that correct? Correct?

00:11:21 Speaker 2

Okay, yeah, and some of the consumable devices give you the notification that. Oh, your score is high, please see and see the doctor or get the specialist consult. So in that way I can say that they are helpful to guide you that you really need to do something about it, and if you are getting that notification, then you should go and see a doctor.

00:11:47 Speaker 1

Okay, okay, alright. So that's quite interesting. Okay. What about nowadays? I hear, I'm hearing about white noise machines and white noise machines, and ya, mostly white noise machine.

00:12:06 Speaker 2

Yeah, okay, so I haven't seen any white noise machine, so I'm just wondering what does it do?

00:12:13 Speaker 1

A white noise machine is basically played at a certain certain frequency. Right? It's just a noise that helps them to block out the surrounding noise outside. Right. Would that be able to help them to fall asleep better?

00:12:26 Speaker 2

Maybe it may act as a relaxation therapy for the some people who has a difficulty in initiating their sleep, but if they are using that device, make sure that there is no light coming from that device, so they can either cover it or they can put it down and they can listen to the music without looking at any electronic device.

00:12:48 Speaker 1

Okay, okay, alright, so next one right, so just now we talked about a little bit about the obsession over our sleep scores and things like that, right, so what are some other ways that techs can be a disruptor to our sleep?

00:13:03 Speaker 2

Tech is the major disruptor of our sleep nowadays, and majority of us are very busy during the daytime. We don't have any personal time.

00:13:15 Speaker 2

So at bedtime is the normally believe is this is my personal time, and this is my time to connect to the social media or time to connect to the world, so people like to use the all the different type of electronic device just to have the Tik Tok or the YouTube or the Facebook, but this is the one of the most common reason why we don't fall in sleep fast.

00:13:44 Speaker 2

And all the electronic device has the blue light and that blue light will not allow one of the chemical in our brain. We call it Melatonin will not let it go up high, and that melatonin helps to tell the brain. Oh, this is time to fall in sleep, but while it does not go up high, sometimes it's difficult to fall in sleep like that, difficult to fall in sleep. So brain does not have sensation to fall in sleep because it's still the light time for the brain.

00:14:12 Speaker 2

And our brain works on the day night cycle as well as the light dark cycle, so our brain need the signal of the darkness.

00:14:22 Speaker 1

So that means what you're saying is that sometimes we might use tech as a revenge bedtime procrastination. Yes, right, and then the blue light show that we have all installed in our phones are actually not very helpful in helping us to fall asleep.

00:14:38 Speaker 2

Yes, correct.

00:14:39 Speaker 1

Okay, alright, okay, so let's move on. To some common myths and beliefs that we might have heard right, either from a friend or a friend of a friend. Okay, so what I'm gonna do is I'm gonna share with you some five common things that I hear about sleep right, and then you can help me to verify if they are true or not. Okay, so the very 1st one is, there's no point in checking my sleep because there is nothing I can do about it.

00:15:06 Speaker 2

So this is, I can say false belief. We can do many, many, many things for the sleep. We know there are various type of sleep disorder. And we are at high risk.

00:15:16 Speaker 2

Our Singapore population is a high risk of sleep disorders, and many things can be done, but you have to just ask help for it and just approach the nearby polyclinic or GP doctor and ask them to get the referral to the specialist sleep clinic so they can get help. And many treatment options are available nowadays, and we can discuss on that part.

00:15:44 Speaker 1

Wow, okay, that's that's very helpful information. Okay, then next one is sleep debt. Okay, some some people accumulate a lot of sleep debt right on our sleep debt. Sometimes they say, oh, you have a this because you have not been sleeping the recommended amount of time they should be sleeping right. So is it true that they can actually return or repay their sleep debt if let's say they nap more or they sleep in on weekends?

00:16:10 Speaker 2

No, answer is no, because majority time what I have observed that people like to sleep later during the weekdays and they try to catch up over the weekend, but they are not sleeping well for five days and they are trying to catch up in two days. It doesn't work in that way, and it will be not recover with the two days of the weekdays longer duration of the sleep.

00:16:38 Speaker 2

Other thing, our brain need the regularity of the sleep, so if you keep changing the time, it's difficult for the brain to do the active processes, so regularity of the sleep is very important for the brain to do the active processes during sleep. With regards to napping, actually, if you are napping longer hour, then it's not good because it will affect your nighttime sleep duration, and it may not allow you to fall asleep faster during that night.

00:17:08 Speaker 2

And if really, really you cannot, then napping is only fifteen to twenty minutes of the nap is sufficient for the power nap.

00:17:17 Speaker 1

Okay, so for those who like to take naps right, doctor Panja here has says that your nap shouldn't last for more than an hour, should be at least fifteen to thirty minutes, right, so try not to nap that long, because it might affect the onset of sleep sleep, correct, okay, alright. Next one, we get this a lot right, noring is a sign of a good deep sleep. Is that correct?

00:17:44 Speaker 2

No, this is another our Asian disbelief or misconception, but snoring majority of snores, and we think that, oh, it is a normal natural human phenomenon, but it's not like that. Sometimes snoring can be a a symptoms of upper airway blockage, and when there is upper airway blockage, it causes the oxygen level to fall down during night and causes the brain to subconsciously wake up many many times, which we are not aware because we are sleeping, and that wake up is different that what you are fully awake now. So it's subconsciously happening at the brain level, which you think the next day that you are not fresh, you are majority time sleeping in the light sleep, or you feel sleepy or tired next day. So one of the common reason is the upper airway blockage.

00:18:36 Speaker 2

Not allowing have the enough oxygen to our internal organs.

00:18:40 Speaker 1

You mentioned upper airway blockage. Is that the same as obstructive sleep apnea?

00:18:45 Speaker 2

Yes, yes, so it's one of the things physiological changes happening during the sleep, or sometimes it can be the pathological. As well, majority physiology can cause that upper airway blockage and can lead to this.

00:19:01 Speaker 1

I see. Okay, okay, so you mean, snoring is not a sign of a good deep sleep.

00:19:05 Speaker 2

At all, no, not at all. So if you are snoring, please go and do your sleep study.

00:19:12 Speaker 2

Majority people has obstructive sleep apnea, but small percentage of the people they don't have any obstructive sleep apnea. Then it's fine. They are considered as a habitual snorer, rather than they are falling into the obstructive sleep apnea, but sleep study is the answer for that.

00:19:28 Speaker 1

Okay, okay, right, but sleep studies are those very expensive to conduct.

00:19:37 Speaker 2

So it depends. There are four different type of sleep studies and four different type, based on the what are the parameters we are monitoring. So stage one and stage two are level one and level two are the similar. In the level one, we have somebody observing you to sleep as well as somebody recording, while in the level two, there is nobody observing you or the video recording. In the level two and level one, we monitor many many parameters.

00:20:05 Speaker 2

We monitor all the various brain activity. We monitor eye activity, the our airflow, snoring, the chin activity or the muscle activity, breathing movement, oxygen level, heart rate, our heart activity, as well as the muscle activity. So it's a very, very detailed test. And sometimes the level three, usually we don't have the brain activity or the muscle activity.

00:20:36 Speaker 2

And the level four is very basic. It's just based on the heart rate and oxygen that has to put on the special software to come up with the diagnosis. But sometimes it may underestimate your severity, and if you, our suspicion is high enough, you may still need to go for the other type of sleep test.

00:20:56 Speaker 1

Oh, wow, that's very interesting. Thank you for sharing about all the different sleep studies that one can do right. Okay, and then, of course, the very last one.

00:21:07 Speaker 1

This might be quite. This might resonate with quite a bit of people with quite a bit of our audience. Right. The very last one is caffeine doesn't affect my sleep. I can drink coffee at night and I can still sleep perfectly fine.

00:21:23 Speaker 2

So we have to see what is your your usual sleep duration as well as what is the sleep onset. So in general, an adult should take around twenty to thirty minutes to sleep. So if you are taking longer time to fall asleep, more than thirty minutes, then coffee is affecting your sleep. Coffee. Usually we can say you don't take after late afternoon, so it should be avoided eight to ten hours before your sleep time.

00:21:54 Speaker 2

So our brain is like a computer computer connected to connected with the wires, and they usually give the electronic signals. What to do for the brain is having a lot of neurons in the brain and they talk to each other with the chemicals. We call it neurotransmitter. So caffeine is one of the weak promoting neurotransmitter. That means it will tell brain to remain awake and it takes longer time, eight to ten hours time to get it from your body.

00:22:24 Speaker 2

So if you have difficulty in either initiating your sleep or not maintaining your sleep continuously, then you try to avoid caffeine and sleep, see how it affects your sleep.

00:22:37 Speaker 1

So we talked a little bit about the onset of sleep, but what about the quality of sleep in these people?

00:22:44 Speaker 2

So quality of sleep again is usually we are looking. Is your brain waking up frequently during the night time and to monitor it or to find out it is usually through the EEG or the brain activity monitoring, and sometimes the symptoms in the next day you will have is the unrefreshed sleep. Feeling tired or sleepy in the daytime, not able to do your function properly.

00:23:12 Speaker 2

That's how the symptoms, and maybe it is telling you that your quality of sleep is not there, so duration is there, but quality is not there.

00:23:19 Speaker 1

Okay, so I keep hearing you repeat a lot of how you feel when you sleep up when you wake up. That's a very important factor in deciding whether your whether you had quality of sleep or not. Yeah, okay, so that means if you wake up refresh, that means you have quite a good sleep the night before. If you wake up feeling gumpy and things like that might be because you didn't have a good sleep. Yes, that correct. Okay, alright, thank you for clearing some myths and beliefs that some people might have. Okay, so let's move on to some, what are some practical tips you would recommend to our audience to help to balance sleep technology and sleep hygiene?

00:23:56 Speaker 2

Okay, so some of them we already have discussed. We have discussed about the caffeine. We have discussed about the avoiding electronic device.

00:24:05 Speaker 2

Other thing what I have observed, the one of the lifestyle is to have the exercise after the work time, and if you are facing any sleep issue, then it's advisable to do the your exercise four to five hours before your sleep time, and exercise is only the cardio type of exercise. Help us to sleep better like breeze walking, jogging, swimming, cycling, so that type of exercise help us to sleep better, but again it will make adrenaline to go up high, and adrenaline is a chemical which will tell brain not to fall asleep. So if you have sleep difficulties, advisable to change your exercise time to early morning or the in the morning or the afternoon time, and four to five hours before the sleep time.

00:24:54 Speaker 1

Okay, so it means for those who are working, we trying to avoid cardio exercises at night, right, so because if let's say we sleep at ten o'clock, then four to five hours before then we will be have to be working out at like 5 PM. And we are we are still working right?

00:25:08 Speaker 2

So that's how you have to adjust your lifestyle. You have to find out the way how you can do it, and exercise is the best medicine to sleep.

00:25:18 Speaker 1

Yes, alright, alright, so if the any of the people in the audience would like to use exercise as a way to improve your sleep, over here at Active Health, we have a series of exercise workshops from muscle strengthening to cardio exercises to mobility exercises to help you to fall better asleep. Right, okay, other than exercise right, what are some other ways that if they cannot fall asleep at night, what can they do, or what should they avoid doing?

00:25:49 Speaker 2

So there are certain things they can do. One thing is the deep breathing exercise, listening to light music. I think we have discussed that one in the white noise just now, and they can also do reading of the books, but not electronic books, physical books. So if they have any books interest and the books should not be exciting book. If you are excited again, your adrenaline will go up high.

00:26:15 Speaker 2

So you think of something books which are some positive inspirational book or something. You are not excited. Basically, then you try to have some physical book reading. It will help you to fall asleep.

00:26:27 Speaker 1

Okay, so reading books, is it just basically putting away your phone? Which is what we mentioned just now, putting your away your phones at least thirty minutes to an hour before we sleep. Yes, right, okay, and then next question is, how do I know when should I consult a sleep doctor? So just now we mentioned a little bit about sleep apnea, right, so when does it get so bad that we have to go and see a doctor?

00:26:50 Speaker 2

So if you are facing a problem in your sleep initiation or sleep maintenance, some people, and if this problem last three nights. In a week, more than three months, then definitely you should see a doctor. Many times I hear people say it is stress. It is my work. It is some surrounding situations, but it may not be the that reason.

00:27:19 Speaker 2

It may be the underlying sleep disorders causing that problem. Many people have the dry mouth. They keep waking up in the nighttime to drink water again is a symptoms of obstruction, sleep apnea. Many people go to washroom frequently in the nighttime, they need to seek the specialist treatment. Other symptoms are daytime tiredness or sleepiness.

00:27:44 Speaker 2

Exhausted daytime tiredness is very, very common, and many people find it easy to overcome with the caffeine, and caffeine is their best friend, but they should try to avoid it and seek the specialist treatment.

00:27:59 Speaker 1

So we went to touch back on the topic of caffeine. Also, so on another drink that we might have right, it is alcohol. Right. Some people think that feels like alcohol can help them to fall asleep faster. Right. What are your thoughts on that?

00:28:13 Speaker 2

Okay, so this is a common practice. I also see many people who has a sleep issue. They end up drinking alcohol more and more. They think, I think they heard from their friends or they have observed in the society, and they are just following the norm.

00:28:28 Speaker 2

But it's not the right thing to do because alcohol can be sedative initially, but it really disturbs your sleep a lot in the later part, and you keep waking up quite frequently with the alcohol later on, and it also depends on the amount of alcohol you drink. The smaller amount can be sedative, but the medium to higher amount can be disruptive to your sleep. It also increases the risk for the if there is underlying obstruction sleep apnea.

00:28:58 Speaker 2

Alcohol relaxes the muscle a lot, so it makes the underlying sleep apnea worse, which again disrupt your sleep, and it can also cause some leg movements as well because it damages the nerves. So you are inviting two problems. One, your sleep is not good, so you are already having some risk factor for the health issue, and alcohol again, you are adding on to more, which can again affect your heart, affect your nerves and many more functions in the our body. So two risk factors. It depends on the you what you like. You want to really want to go to the underlying root cause and treat it, or just continue with the whatever you find comfortable.

00:29:47 Speaker 1

Okay, so that means no to alcohol.

00:29:50 Speaker 2

Yeah, in general, advisable to avoid alcohol.

00:29:54 Speaker 1

Okay, so for what about for those people who are like, kind of shy to go see a doctor regarding their sleep issues, right. Are there any online questionnairees that they might be able to access for them to check how they are sleeping?

00:30:09 Speaker 2

So yes, there are online questionnaires. There are a stop bank questionnaires, but it was validated in the western population, and one of the point in that is the BMI, which is your how overweight you are. But as we have discussed that Asian population at the higher risk.

00:30:27 Speaker 2

Not because of their high BMI or the overweight, but we are born with the such facial structures that our structures are very narrow, and when we go to sleep, our muscle relax and we block our airway. So it's a BMI is not relevant in the stop bank questionnaire for the Asian population, but all others are. Other questionnaires are the insomnia, insomnia, severity index, or upper sleepiness scale. Any of this is on higher side. Yes, definitely you should go and see the doctor.

00:30:57 Speaker 2

But if it is not higher side, and if an individual is still facing the sleep issue, then they should see the doctor. Being a shy is a different thing, and suffering is a different thing, so you have to choose whether I want to overcome my shyness to be more comfortable and less suffering, or I want to just opt to be more comfortable zone, which is the side.

00:31:24 Speaker 1

Yeah, correct, that's right. Yeah. So you mentioned about facial structures. Wow, that's very interesting. I never like once associated facial structures to obstructive sleep apnea. That's very interesting. Thank you for sharing that. Okay, so right now we're going to look over to the screens for some Q and A questions that they might have. Okay, so the very 1st question is, I have problems sleeping at night, but not during the daytime. What? What problem do I have?

00:31:54 Speaker 2

Okay, so that means. Probably you have changed your circadian rhythm. So circadian rhythm is the internal biological clock, and it is a 24 hour physiological process which controls our sleep cycle.

00:32:10 Speaker 2

So it depends on the what is your daytime activity as well as what are your sleep hours, and maybe if you are sleeping in the daytime, definitely you cannot fall in sleep in the nighttime, so you have to slowly slowly cut down your the daytime sleepiness time and then have more time in the nighttime. It can be done. It is difficult, but can be done, and you need to persist on the regular follow for that.

00:32:38 Speaker 1

That means the circadian rhythm is a little bit not in the correct cycle. Right? Okay, so another question right for this individual. They, they go to bed a little bit later, and they wake up a little bit later. And their total sleep duration is about seven to eight hours. Is that okay?

00:32:59 Speaker 2

Okay, so it again you have to adjust according to your personal requirement. Ideally, our wake up time should be before sunrise time, because our circadian clock or the biological clock, god has adjusted according to day night cycle of the nature, but if your work is in a way that you can fall in sleep late and you can wake up late, it's still okay to catch up with your sleep hours.

00:33:25 Speaker 2

And once you can adjust your working hours, or once you are no more working, then you can again adjust back to your sleep hours.

00:33:35 Speaker 1

Okay, so you mentioned, oh, we actually are supposed to wake up as the sun rises. So are we supposed to go to sleep when the sun sets as well?

00:33:42 Speaker 2

No, so usually our sleep hours are seven to eight hours, so we have to calculate from there by eight hours before the sunrise time.

00:33:51 Speaker 1

Okay, okay, next question is, this person is only sleeping about four to five hours every night, is it bad for their health?

00:34:01 Speaker 2

A lot bad, because again we, what we have discussed that what is the consequence or what are the consequences of the sleep deprivation we have already discussed before. We are invited a lot of chronic disease, heart problem, other brain problem, as well as many of these people also has some mood changes in the daytime. Some of them are very anxious. Some of them are very grumpy.

00:34:25 Speaker 2

So that is a consequence of that. And there are there are there is one nice study done, where they have done the nine years follow up on the people who sleep five hours or less, and they have look at their heart risk health. The people who sleep five hours or lesser, they are more likely 70 percent more likely to have the heart attack than the people who are sleeping well. It's really really very important

00:34:53 Speaker 2

And sleep is essential for the normal function of all vital organs.

00:34:58 Speaker 1

Okay, so in short, it's not enough, right. We have to get at least seven to nine hours of sleep. Right, the average. That's around the average. Okay, next question. Is your REM sleep more important than your deep sleep?

00:35:13 Speaker 2

Okay, so each sleep stage has a certain percentage, normal percentage, and each sleep stage has a different functions. So REM sleep is important for the memory and the memory formation. It also helps in the rest removal, and usually our normal percentage of the REM sleep is around 25 percent in the one night duration where it is sleep hours are seven to eight hours.

00:35:42 Speaker 1

Yeah, then does does the supplements like magnesium and melatonin actually help?

00:35:48 Speaker 2

It does help. It does help. But if it helps initially, after that, the effect goes away. Then I can say that you really need to go and see the doctor and try to get the help, because there may be something underlying sleep disorders, which is disturbing your sleep cycle, and that's why you are facing the sleep issues. So better to go and see the doctor.

00:36:13 Speaker 1

Okay, then another question I have over here is, dreaming right. So you mentioned that dreaming occurs in the REM stage, is that correct? Yes, yes, right. So let's say there are some nights that I feel like Wah. I dream the entire night. Right. Does that mean that I'm not getting enough quality sleep or like? That's just what I remember.

00:36:32 Speaker 2

Yeah, so that's what you remember. So usually we end our sleep in the dreaming sleep, and dreaming sleep is transition from sleep to wakefulness, and during the dreams during that phase, usually we remember. So that is a normal natural physiology.

00:36:54 Speaker 1

Okay, alright, next one. Sometimes some people, their circadian rhythm is a little bit, not say weird, but they wake up at a certain time. Right then, which means that let's say if they sleep late, they end up still waking up at the same timing, right. Should this person go back to sleep like yeah?

00:37:16 Speaker 2

So if they go back to sleep, but what time they go back to sleep? That's the thing. And if they go back to sleep, how many minutes will it take for them to fall asleep? Yeah, so some people has the insomnia is it can be on the sleep onset or the sleep maintenance insomnia or the early morning wake up insomnia, and that there are many many things we can do for that.

00:37:40 Speaker 2

So there are like sleep restriction stimulation control, but they have to go through the special. They have to first go to the, see the doctor and we can guide them what exactly they have to do. They have, there are sleep diaries, we advise to fill up. There are some actigraphy things which we can see their pattern and we can guide from there.

00:38:03 Speaker 1

Okay, okay, that's very interesting. Alright, so next question. Wow, this is interesting. Okay, so how does full body strength training affects sleep? Sorry, can you say body strength training? Full body strength training, so resistant exercises. Resistant exercise.

00:38:18 Speaker 2

Actually, I know more of the cardio exercise helps to sleep. Okay, but other type of exercise may not help. So you have to balance if at least thirty minutes of cardio exercise can help to sleep. So other exercises are helpful sometimes for the muscle and the bone health, so each exercise has a different different function. Yeah, so body need the different different type of exercise, but for the sleep, cardio exercise helps more.

00:38:44 Speaker 1

Alright, okay, okay, next question, right. I am a light sleeper and I'll wake up several times during my sleep, right. My sleeping app shows me that I have too much light sleeps and too little condition, continuous deep sleep. What can the person do about it?

00:39:00 Speaker 2

Then you go to nearby polyclinic or GP. Get referral to the sleep clinic and get yourself tested with the sleep test. Oh, okay, sleep study.

00:39:11 Speaker 1

Yeah, next one, right, is it okay to sleep longer hours? Then the required sleep time. So some people may sleep ten hours, eleven hours, twelve hours.

00:39:22 Speaker 2

No, it's not okay. Okay, so our health goals, go go both way, so I don't have anything during here, but I can say that if you sleep less than six and a half hour, you are also inviting lot of health issues and the higher death risk. You are sleeping more than nine hours. Also, you are inviting lot of health issues and the higher death rate. So in general, we say no, you need certain hours of sleep. That means seven to nine hours of sleep, try not to sleep more.

00:39:51 Speaker 2

Certain nights we are sleep deprived because we have some activity or we have travel, so we are trying to catch up. Maybe that couple of night is okay, but everyday. No, it's not recommended at all because you will be more inactive. You will be more inactive. Your body will not get the full metabolic function. Then you are at higher risk of overweight, and then all the cycle, VCS cycle will go on.

00:40:14 Speaker 1

Oh, okay, I always thought that more sleep is always better. But I guess it's not. So it means even if you sleep a lot more, it's actually the opposite. It doesn't give you any benefits. Yes, alright, I shall not sleep that long. Okay, last question that we have for today is, is there a ideal temperature to help you sleep?

00:40:35 Speaker 2

So there is no ideal temperature, it depends on the individual comfort level. So some people are comfortable in the cold environment, some people are comfortable in the warm environment. So whatever and temperature suits you to fall asleep, you should use that temperature to help you to sleep.

00:40:55 Speaker 1

Okay, so there isn't, so some people like prefer the cold, they can sleep in the cold. They, some people, they prefer the warm, then they can sleep in the warm. It's totally up to personal preferences. Yes, okay, alright, thank you so much, doctor Panya for being here today. So let me just conclude what we have covered for today, right, so we started off with talking about the understand of basics, right. What is sleep? Right, you share with us the importance of sleep. What happens when we don't get enough sleep? Right.

00:41:22 Speaker 1

And then, of course, the pros and cons of tech technology can help us to measure how long we sleep. But of course, they are not very beneficial in terms of telling you exactly how long have you stayed in that certain stages or not. And then, of course, there are also the cons to technologies being disrupted in our sleep. Some of us having revenge bedtime procrastination. There, that affects our sleep and then we end up sleeping lesser.

00:41:50 Speaker 1

Okay, and now, of course, we also have cracked some myths, bust some myths, and some beliefs. So there is no such thing as sleep debt that I have definitely learnt right, and then, of course, snoring is definitely not a good sign of deep sleep. And now, of course, for the very last one is caffeine, both caffeine and alcohol can affect your sleep right, so we want to try to limit that, limit those prior to our bedtime or caffeine, at least eight to ten hours.

00:42:17 Speaker 1

Right then, alcohol is just a no, right, and now, of course, some practical tips that we've covered for today would be no caffeine prior to sleep right, and then the ideal temperature for yourself, based of personal preference, keeping your phones away at least thirty minutes to an hour prior to sleeping. Yes, are those everything that I covered? And exercise. Oh yes, and exercise. That's the most important part. Yes, yup, so making sure that we exercise at least four to five.

00:42:46 Speaker 1

Hours before we sleep right, because a high intensity might cause endorphins, right adrenaline to be pumped in our body, keeping our brain awake, and we can't really fall asleep right. Okay, so Doctor Panya, thank you for your time and sharing your expertise on how to sleep better today. Right, I believe our listeners have deepen their knowledge about better sleep hygiene and might some might sleep better tonight, right for anyone who wishes to visit a sleep physician.

00:43:15 Speaker 1

You may go to your GPs, your polyclinics, like what Doctor Panya has mentioned just now, to get referrals to visit some sleep physician if you have problems relating to your sleep conditions. Okay, so right now on the screen you should be able to see some exercise workshops that we might have to help you to sleep better. You can scan the QR code on the screen, which will bring you to our website, where you can find out more about our programs.

00:43:45 Speaker 1

Okay, and now, of course, you can follow us on our social media accounts for upcoming exciting events by scanning the QR code on the screen, we'll be posting some exercise tips on how to stay, how to live actively and stay strong. And now, of course, in our very last episode, there'll be happening on happening on 14^th November, we'll be discussing on how exercise can help in managing chronic conditions, so stay tuned and look out for it.

00:44:14 Speaker 1

Thank you for your time for being in this podcast and thank you so much once again to Doctor Panya for being here today. Have a great day, everybody.

00:44:22 Speaker 2

Thank you, Daphne , and thank you, audience. Have a nice day.

00:44:27 Speaker 1

Bye.