x Abu Dhabi, UAESaturday 22 July 2017

UAE lifestyle enough to keep us awake at night

A good night's rest is one of the keys to staying healthy and happy in life. But the 'work hard, play hard' lifestyle that many people fall into can have devastating effects on our physical and mental well-being.

The daily commute on Sheikh Zayed road can be long and exhausting and a lack of good-quality sleep means an increased risk of falling asleep at the wheel. Pawan Singh / The National
The daily commute on Sheikh Zayed road can be long and exhausting and a lack of good-quality sleep means an increased risk of falling asleep at the wheel. Pawan Singh / The National

A study has revealed the sorry state of sleep quality in the UAE - and experts say our fast-paced, high-stress lifestyles are to blame.

But it is not only our productivity that suffers as a result of bad sleep; science has proven it has much more serious ill effects.

Poor sleep quality and insufficient sleep have been linked to a range of health problems, including depression, cardiovascular disease and diabetes.

According to Dr Hassan Al Hariri, an American Board-certified sleep and respiratory specialist at Rashid Hospital in Dubai, primary physicians in the UAE rarely ask about a patient's sleep despite his estimate that about 50 per cent of Dubai's population suffers from regular disturbed sleep.

"It should be on everyone's list of things to check with background," he says. "Sleep is very important. It is not an issue to take lightly. This is something that greatly affects a person's life. If they are not getting enough good sleep - and that is the key - they will not be functioning well. There is a lot of bad consequences to this.

"There are many reasons. Part is the culture, and also the weather. There's a lot of activities open 24 hours."

A recent study by the University of Surrey in England revealed that the quality of sleep can even have an impact on a genetic level. It found that getting less than six hours a night affected the activity of more than 700 genes associated with controlling responses to stress, immunity and inflammation.

An article in the Cleveland Clinic Journal of Medicine reported that a chronic lack of sleep contributed to the risk of type 2 diabetes, a condition that the population in the UAE is already predisposed to.

Dr Al Hariri, who runs a sleep clinic at Rashid Hospital, estimates that as much as half of Dubai's population suffers from some sort of sleep disturbance on a regular basis.

The figure is significantly lower in Europe and the US, where only about 10 to 20 per cent of the population is thought to be affected.

"There are many costs associated with a community that doesn't sleep well," he says. "When they drive they might lose consciousness, so there's an increased risk of accidents, which is then associated with further costs.

"Poor sleep also has a big impact on someone's mental health, and if someone sleeps badly for a long time, they will certainly suffer. They will not be able to perform well at work or socially.

"Sleep is very important but underestimated here. Doctors need to start giving it more attention."

Dr Al Hariri recently published an in-depth study into obstructive sleep apnea syndrome (OSAS), one of the more severe sleep disorders.

It occurs when someone repeatedly stops breathing during sleep. It is caused by the collapse of the upper airway and is commonly associated with obesity and other chronic conditions such as hypertension.

Of the 1,214 people studied, one in five met the criteria for high-risk of sleep apnea, based on a questionnaire used around the world that has a positive predictive value of about 90 per cent.

Dr Al Hariri's academic paper, which was printed in the International Journal of General Medicine last month, states: "The population of Dubai is at high risk for OSAS and this is a serious public-health issue. Patients may benefit from proper screening, evaluation and appropriate counselling for those at high risk of sleep apnea by the primary health-care physicians/workers."

Dr Al Hariri says evaluating the most severe forms of sleep disturbance is just the tip of the iceberg.

"There are many problems here in this country with sleep. Of the people we surveyed, about 200 admitted to have fallen asleep while driving. What is the cost of this?

"The costs of having a population which doesn't sleep well are very high. But do we look at the culture or do we look at the general health? The answer is to look at both."

Laura Johnson, a 26-year-old recruitment consultant living in Dubai, says her nights have become much more disrupted since she moved to the UAE three years ago.

"I feel much more tired here than I used to," she says. "I commute a few times a week to Abu Dhabi, which doesn't help I'm sure.

"I don't know what it is, but I struggle to get up. During the night I'm not aware that I'm not sleeping well, but during the day I always feel tired and like I could have more sleep."

America's National Sleep Foundation says most adults need between seven and nine hours of good sleep. The younger you are, the more sleep you need.

Hazel Lintag, a respiratory therapist who works with Dr Hariri at the Dubai sleep clinic, says it is important for people to make sure their sleep hygiene is up to par and that they are getting "good sleep rather than bad sleep".

"Sleep is the repair of cells in our body and if we don't get good sleep, we will feel bad in the morning," says the mum of twin girls. "It's not just about sleep, it's about good sleep.

"You need to think about the air conditioning, it shouldn't be too hot or too cold. Try to block out any noise, such as traffic or the call to prayer in the morning. The lighting needs to be right too, not too light or too dark."

Drinking before bedtime can also cause disruption, she says, but the worst cause of a bad night's sleep is a long afternoon nap.

"There's a lot of napping here," she says. "A nap should be 15 or 20 minutes, not one or two hours. That's not a nap, that's a sleep. It's very common."

Carey Kirk, a counselling psychologist at the LightHouse Arabia in Dubai, says the fast-paced lifestyle of the country certainly contributes to increased levels of disrupted sleep. The "work hard and play hard" ethos, she says, is a major contributor.

"I always ask about a person's sleep because it has a huge impact on our mental health," she says. "When I ask how much sleep someone gets, a lot of times it's a lot less than the recommended amount.

"Poor sleep can have a huge impact. A lot of times people mention a lot of stress, and that naturally makes it very difficult to sleep. That's compounded by being in a new place or doing a new job, or facing a lot more pressure at work.

"Expats can face a lot of pressure if they are not happy in their work and they are sponsoring their family's visas. There's also a lot of pressure to maintain the lifestyle they are used to.

"It's the lifestyle in Dubai. It's a very fast-paced lifestyle and there's a lot of pressure business-wise to be high-achieving and maintain a certain lifestyle."

There is also an attitude of "I can sleep when I die" prevalent in the UAE, Ms Kirk says.

"People want to go to parties and they want to go to work. That sets up an environment where we don't have enough time to sleep - and even when we do have time to sleep, we think about the things we could or should be doing."

Children also suffer from a lack of good sleep, she says, and technology is partly to blame.

"There are a lot of different environmental factors that impact a child's ability to sleep," she says.

"Technology is a huge one. The availability of the internet, especially for adolescents and teenagers, is a big factor. They can be very addicted to being online or playing games until the early hours. A lot of technologies keep the brain stimulated so it's very difficult for them to even realise they're tired. This is something we see a lot.

"If you want good mental health, you need good sleep."

munderwood@thenational.ae