• Sleep These are the risks of poor and poor sleep

With a degree in Biology and a PhD in Physiology, María Ángeles Bonmatí bears in her surname ("good morning" in Spanish) an implicit allusion to her main line of research: circadian rhythms and sleep. This researcher from the Chronobiology Laboratory of the University of Murcia, the CIBERES and the Murcian Institute of Biosanitary Research has spent years studying the functioning of our internal clocks and the role that sleeping well fulfills for a myriad of physiological processes. He has just published Que nada de quit el sueño (Review), a work to explain why, far from being a waste of time, sleep is fundamental to our health.

"I'll sleep when I die" and other similar phrases are very common. Why do we give so little importance to sleep? There has been a tendency to think that sleep is a process during which we are wasting time. While we sleep we neither consume nor produce and that, in the world we live in, can seem like a waste of time. However, it is not. Sleep is not only not a waste of time, but it is essential to be able to live and also to be able to perform. Insufficient sleep is associated with many health problems because while we sleep there are many physiological processes that do not occur during wakefulness and are necessary for health and life. But poor sleep is also associated with lower productivity. In some contexts the economic message is the one that penetrates the most, so it is important to remember that a population that sleeps little irremediably will produce less. Sleeping little has a cost.What happens in our body during sleep? Sleep is like putting the brain in airplane mode because we lose the connection with the environment but we continue to function. Our sensory thresholds increase in such a way that a stimulus that would make us react when we are awake does not do so while we sleep, unless that stimulus is intense enough. We are disconnected from the environment, but in the brain a multitude of processes continue to occur. For example, a kind of waste disposal system is set up, the glymphatic system, which cleans those waste products that have been produced during wakefulness as a result of neuronal metabolism. That process is what makes us recover, wake up refreshed the next day. In fact, lack of sleep has been linked to a greater accumulation of waste products, among which is the amyloid beta protein, which is related to the onset of Alzheimer's disease. There are also hormones, such as growth, which are involved in tissue repair, which are only secreted while we are sleeping. And it has been shown that the immune system also works, even more intensely, while we are sleeping. In reality, sleep is essential for everything to work, not even the last cell of the organism is freed from a lack of sleep. In the book he uses a very visual example: when we are awake, the brain eats pipes and it is during sleep that the shells it has left are cleaned. Is it useful if we try to make up for lost sleep over the weekend? Can you clean those shells that we have been leaving during the week? Sleep is not recovered. The health consequences of the sleep we lose every day are going to be there. We cannot sleep five hours a week every day and think that the weekend we can make up for it. Sleeping on the weekend does not compensate for the hours stolen from sleep during the week. It doesn't work like that. It's also not a good idea to go to an exam or a competition having slept little, isn't it? It is an idea that is very widespread. I think everyone has done it and thought they can sacrifice hours of sleep to gain more study time. But it is a bad idea, not only because going with a lack of sleep to a test will mean going with your diminished abilities, but because you are avoiding a superpower that sleep has, which is to fix memories. That saying of dormant lesson, lesson learned has fundamento. With a night's sleep, sleeping enough hours, you will fix better in your memory what you have studied and you will be able to recover it better also at the time of the exam. Beyond the concerns of each one, what is it that keeps us Spaniards up at night? What structural factors conspire to make us sleep worse? There are several. For example, our delayed schedules. We eat and dine very late compared to other countries in Europe. And eating dinner too late can contribute to worsening sleep quality and hindering your ability to fall asleep. Food digestion and nighttime sleep are two processes that should be separated in time. Another factor is prime time television schedules. There are programs, of maximum audience, that many young people and adolescents watch, which end around one in the morning. They are factors that contribute to people going to bed very late and with a certain level of mental activation. How does the time change affect us? It is a very controversial issue, but from the point of view of physiology, there is consensus among the different scientific societies that it would be best to abolish the time change. What we are doing every time the clock is turned forward or delayed is to produce an alteration of our circadian rhythms. It would be best to adopt the schedule we call winter, which is actually the standard time. There is sufficient data to indicate that the energy savings that were initially attributed to the other schedule are not really being generated. It would be necessary to stay in the standard time that is the one that best suits the solar time, although we must take into account, in any case, that in Spain we are already one hour ahead of solar time. Does that advance have to do with our meal times, later than in the rest of Europe? Everything points to yes. In fact, a few months ago we published an article in which we compared different populations in western Spain with populations in Portugal. These populations share a time zone, that is, they would share solar time. And when we compared, correcting for the time difference, we saw that there were no big differences in meal times. Somehow we have adapted our habits to solar time. But working hours are not adapted to that difference and that can mean an asynchrony in the different times by which we are governed. The sleep-wake cycle is the most obvious circadian rhythm of our lives. To keep our circadian system on time, it is essential to correctly expose ourselves to a cycle of light and dark. We need to expose ourselves to natural light during the day and we need darkness at night. That's telling our brain when it's time to be active and when to rest. That is why it is not a good idea to look at the mobile with the maximum brightness in bed when we are about to try to fall asleep. Also because it can contribute to our brain being activated. We don't have an on and off button. We have to prepare the environment and show the brain that the night is coming. We can't have the same level of light at home at 11 a.m. and 11 p.m. On the other hand, to keep the circadian system on time it is also important to carryr regular meal times and regular exercise always away from bedtime.Does this exposure to light influence the way our cities are illuminated? Light pollution is a problem that is often not paid enough attention to, but it can have effects on sleep and human health. Above all, we must bear in mind that public lighting can be put at home, what we call light intrusion. It is common to see windows of houses that have a lamppost right next to it. And that light can get into the bedroom. The solution to protect ourselves is to lower the blind to the maximum, but this also prevents natural light from entering when dawn breaks, which also means we are losing that synchronizing potential of the natural cycle of light and dark. In addition, public administrations often opt for LED technology for street lighting, which is very efficient, but illuminates much more. And in biological terms, with lighting sometimes less is more. It is essential to focus on protecting the environment that allows us to sleep well. It's the same with noise. It cannot be that a sweeping machine spends an hour circling the same square at a time when the population has to be able to have a quiet environment to sleep. Habits and the individual's willingness to sleep well are very important, but so is the will of those who in some way have the obligation to protect environmental conditions and ensure a public health system that deals with sleep. We also see this often: specialized sleep units are scarce and today a primary care doctor does not have enough time to attend to a patient who arrives with a sleep problem whose origin can be multiple. Sometimes there is even a tendency to romanticize insomnia, because there have been many authors who believe that they have taken artistic advantage of it. But what we don't know is what they would have been capable of if they had slept well. Maybe his work and his legacy would have been greater. It's a mistake to romanticize sleep problems. Often a sleep problem is a symptom that something is wrong with mental health. Will they manipulate us through dreams in the future? I raise it in the book because, although today it is science fiction, it is advancing in these things by leaps and bounds. At the moment it has not been achieved, but it must be taken into account because it is possible that at some point it can be achieved. And it can be dangerous. I ask my students in class what they would do if they could take a pill that replaced the need for sleep. A priori many say they would take it, but then they realize the consequences that this would have. We often crave certain scientific breakthroughs and don't think about the implications those breakthroughs might have. I think these are issues on which we should reflect.

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