It is 6.15 in the morning and Niharika Joshi, a regular walker on Mumbai's Marine Drive, is recounting the previous night's events to her companions. "Our house is like a mela (fair) at night. Everybody is on their own trip and there is no respite from the noise they create. How can I sleep?" she asks, clearly frustrated. Joshi, 53, says that the buzz in her house often keeps her up till 1 a.m. Her elder son is a computer junkie, whose make-up artist wife loves gossiping with her friends on the phone after dinner. Joshi's younger son is passionate about playing the guitar and night is the only time he can do so after a long day working as a sales manager. Her grandchildren are usually fighting with their college-going aunt over which TV channel to watch, even as they are yelling at their mother to give them Maggi noodles after dinner. "One person wants coffee, the other insists on trying a new music CD," cribs Joshi, not realising that she is a common character in the current chapter of Reality India.
Sleep, the poor man's wealth, has truly become a dream for ambitious Indian achievers. They are working longer than ever, and sleeping less. Those who put in eight hours of sleep a day spend 25 years of their lives in bed. They also get a lot less done than those who snooze for six hours.
Earlier, progressive and developed societies slept less, worked more and achieved optimum productivity. Now Indians are doing what the successful other half of the world has been doing all along-battling with time. Instead of curling up and switching off, they switch on the TV or the computer, work longer, party harder, learn a new skill, study for an additional academic degree, paint or write, surf the Net, chat with friends, catch up on precious "me time" to pursue personal hobbies-all at night, much after the work day is over. They are all in the grip of high nervous energy that typically characterises people on the fast track.
Most of them also rise early to exercise before they grapple with another demanding day. Working mothers are up till late either polishing their toe nails or folding laundry, only to get up at the crack of dawn to cook lunch for their children's tiffin box. Then there are the call-centre employees who work through the night, or professionals who travel across time zones and countries, accumulating jet lag and blurring the difference between day and night. The Indian social and work life has changed dramatically in the past few years, making sleep and upward mobility incompatible bedfellows.
| SLEEPLESS IN INDIA |
|THE LONG SHIFT |
Working and waking hours have increased dramatically, with urban India becoming ambitious, global and call-centric.
Purposeful or aimless surfing, chatting on the Internet and checking e-mails keep a majority of people awake past midnight.
Work hard, play hard is the new dictum of urban India. The most rocking parties begin after 10 p.m. and pub-hopping adds to the sleepless hours.
Long chat sessions with friends on the phone well past midnight keep many up.
More people are traveling out of India than they did in the past decade. The jet lag due to different time zones take its toll.
THE LATE SHOW
Films, at home or in theatres, give people a big high. It is one of the main reasons for people battling sleep.
Studying for an additional academic degree along with a full-time job has become a common pursuit. Late night or early morning is the best time to finish assignments.
|CREATIVE CALLING |
Writing, painting, listening or composing music, more and more people are taking out time for themselves.
A recent AC Nielsen study on sleep habits around the world underlines these changing rhythms. According to the study, 64 per cent of India's urban population wakes up before 7 a.m.-highest in the world-and 61 per cent sleeps for less than seven hours a day. The study, conducted on the Internet in 28 countries across Asia-Pacific, Europe and the US, analysed the sleep patterns of more than 14,100 people. As many as 40 per cent of people in the Asia-Pacific countries burn the midnight oil as compared to 34 per cent Americans and 32 per cent Europeans. Indians admit to a remarkable change in sleep patterns in the past decade. Forty per cent Indians go to bed between 11 p.m. and midnight as compared to 27 per cent in Japan and 23 per cent in Australia. The Portuguese are the biggest night owls in the world and the Kiwis and Aussies, the biggest sleep catchers in the region. India is among the top five early-rising nations in the world and the only country where 24 per cent people say family and children determine sleep habits.
The diminishing sleep of Indians is validated by specialists, who say that the condition has increased two-fold in the past five-seven years. "There is a significant rise in sleep deprivation and it is continuously increasing," says Dr J.C. Suri, head of the department of pulmonary, critical care and sleep medicine at Delhi's Safdarjung Hospital, which has the country's oldest sleep laboratory set up in 1991. Others unanimously agree. "To become a part of the 24-hour society, Indians are taking sleep deprivation in their stride without realising it," says pulmonologist and sleep specialist Dr Vikram Sarabhai of Delhi's Escorts Heart Institute and Research Centre. Indians are affected by what William C. Dement, father of sleep medicine who pioneered the sleep study laboratory at Stanford University, called "one of the biggest epidemics in the world".
Sleep, the only natural elixir that repairs the body, has given many scientists sleepless nights, resulting in numerous studies which prove that sleeping hours have decreased across the globe. Every country now sleeps an average of two hours less than it did a hundred years ago. The mapping of sleep deprivation has been associated with Thomas Edison's invention of electricity which dramatically changed people's sleep habits. Developing nations, behind step for many years, are now aping the unwillingness to sleep in pursuit of success and achievement. India particularly so, as uninterrupted electric supply, affordable mobile phones and computers and a more adventurous nightlife are only recent luxuries. Which is perhaps why 45 per cent of Indians say that their work hours determine when they sleep and for how long, compared to 27 per cent in Japan and 40 per cent in China. "We are 'The Great Unslept'. We can survive longer without food and water than we can without sleep, yet we compromise on it," says Dr Zarir F. Udwadia, consultant chest physician at Mumbai's Hinduja Hospital.
| PICTURE SPEAK |
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|"It is my business to party. There is so much to be done that there is no time to sleep." |
23, Director, Red Light nightclub
Mumbai-based Sara goes to bed only at dawn on most days. The commerce graduate who has been running the club since last year realises the harm late nights are doing to his body but hasn't thought of a career switch yet.
|"Four hours of sleep is necessary for survival, six is a luxury. Five hours is just right." |
29, Creative Director, Balaji Telefilms
The queen of soaps never goes to sleep before 4 a.m. because she "thinks best at night". Her day begins at 9 a.m. and if tired at work, Kapoor simply flops on a couch for a power nap. "I've always been like this," says the hyperactive woman.
As phones ring incessantly, TV channels spew out news and entertainment round the clock, partying becomes a part of urban culture and call-centres scramble thousands of body clocks, many Indians are giving sleep a low priority in their daily diaries. So only 4 per cent Indians say that daylight hours-the conventional way to determine sleep schedules-play a role in their sleep habits, compared to 6 per cent in Australia and 27 per cent in Korea.
Dr Deepak Talwar, chief of pulmonary, sleep and critical care at Noida's Metro Hospital, calls such people "high achievers in a race against time". Call them the voluntarily sleepless, their best friend being the caffeine instead of kesar milk. For them, relaxation could mean doing a home pedicure at 12.30 a.m. while watching Veer-Zaara on DVD.
Ask Anjoo Mohun, 39, head of communications, British Council, India. "I need time to unwind, listen to music and do some creative writing and I can do that only at night," says Mohun, who is also pursuing a master's degree in corporate marketing. She often stays up till 1 a.m. studying or writing and is up by 6.30 in the morning. "There just isn't enough time," she says quoting sundry deadlines, 11-13-hour-long work shifts and frequent travelling.
Sunny Sara, the 23-year-old director of popular south Mumbai nightclub Red Light echoes Mohun. He goes to bed only at dawn on most days as it his "business to party". He never sleeps for more than six hours because "there is so much to be done". Busy chasing his next project, a nightspot, Squeeze, to be launched in suburban Mumbai, Sara says his days have only become longer. Like those of Matt Thomas, 26, who has a degree in theology but decided to pursue HRD. Which meant taking extra courses. "I am constantly thinking about the future. This is the time for me to do the big things in life and I don't want to miss the bus. I am in a hurry," he says.
None of these motivated workaholics is an insomniac. Says Dr Rajesh Parikh, neuropsychiatrist at Mumbai's Jaslok Hospitals: "We must make a clear distinction between insomnia, which is a disorder, and short sleep because of work or other needs." Parikh should know-he is a short sleeper too. He reads and watches TV well beyond midnight and can get by with an average of five hours of sleep.
|OTHER SIDE OF MIDNIGHT |
According to studies by sleep researchers across the world, sleep deprivation is detrimental to health.
| Sleep rests and refreshes the brain while its deprivation impairs the mind and dulls the nervous system resulting in neuro-cognitive disorders. Going sleepless for over a day can affect performance to the same extent as blood alcohol level above the legal limit. |
Sleeplessness disturbs the body's biological rhythms, leaving a person with only 80 per cent of functioning capability.
Lack of one night's sleep results in a 30 per cent drop in cognitive performance. Poor decision making, irritability, loss of temper and short-term memory loss follow.
Sleep deficit has been directly linked with susceptibility to coronary heart disease, high blood pressure, diabetes, even heart failure in extreme cases.
Fatigue, the most common side-effect of sleeplessness, often leads to body pains, especially in the lower back and head.
A mounting sleep debt means a weakening immune system. The body becomes more prone to infections and viral fevers.
| Behavioural effects of sleep deficit include depression, anxiety and a low responsiveness to emergency situations. |
One reason why so many people can resist rest and carry on without collapsing is because not everyone needs the same amount of sleep. Some people are fit and fine with just four hours while others feel drowsy even after sleeping for eight hours. "Genetic predisposition, social and personal adaptiveness and habits result in the differences in sleep needs and patterns," explains Parikh. This difference in circadian rhythms is common among all living beings and is amply reflected in myth and reality. Kumbhakaran, the brother of Ravana in the Ramayana, supposedly slept for many months at a stretch, as did Rip Van Winkle in the American tale. Bats hang motionless for weeks and dolphins sleep while swimming, resting half their brain at a time. Napolean had learnt to catch his 40 winks on horseback while Hitler could barely sleep. In the animal world, predators sleep more than preys. The male lion, for instance, can sleep deeply for 12 hours, whereas deer keep twitching in sleep. But in human beings, emotional patterns and social needs determine the quality and need for sleep. Ludwig Maximillians University Professor Till Roenneberg, featured in Newsweek magazine for a study on body clock manipulation, found in a survey of 20,000 people that sunlight and bright lights help kickstart energy cycles for some people, while others are genetically suited to the graveyard shift. They perk up at night.
Like the queen of soaps Ekta Kapoor, creative director, Balaji Telefilms, who never goes to bed before 4 a.m. "People think it's crazy but I think best at night," says Kapoor. If she is ever tired at work, Kapoor flops on a couch in her office to catch a power nap. Naps help, say doctors, whether empowered or boredom induced.
| PICTURE SPEAK |
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|"Sleep must fit into the |
routine instead of the routine fitting into sleep hours."
The Delhi-based advocate believes sleep is highly overrated as a healing tonic. Lekhi has high nervous energy and metabolism rate and thinks sleep is not exclusive but part of the overall lifestyle to be tailored according to one's needs.
|"I can cope with less sleep |
every day without it affecting
my mind or body."
As Asia-Pacific bureau chief, Age Healthcare Foundation, Delhi, Thangsing travels for 20 days a month within and outside India. The less you sleep, the less you need it, he says. Perhaps the reason he does not feel any adverse effects.
Alka Raghuvanshi, 41, Delhi-based writer, also admits to taking daytime naps once in a while. She has pulled her computer into the bedroom to write at night and sleeps with the TV on, the sound on mute. "I am a moon person. The characters of my books come alive at night, just as the toys in the nurseries in Enid Blyton's books." There are others who consider sleep a waste of time like Margaret Thatcher who once said, "Sleep is for wimps." Delhi-based Atul Nanda would agree. The 39-year-old additional advocate-general of Punjab, in charge of Supreme Court litigations, is busy chasing his gadget dreams on the Net well past midnight, surfing for some fancy new product that can add zip to his life. "I am a gizmo freak. I must possess all the new stuff that hits the market, but I also work on new legal systems to improve the way Indian courts function," says the man who sleeps for only three-four hours. Aman Lekhi isn't too far off either. "Sleep is highly overrated," says the lawyer who often completes his pending work at night, doesn't wear a watch and manages his time with his body clock. There is no feasible effect of less sleep on his mind or body, he says.
But sleep researchers all over the world agree that whatever people might claim, lack of sleep dulls the mind and impairs the nervous system. That may just be urban India's new danger-a majority of the population facing neurological and immune problems due to the mounting sleep debt.
"There is enormous wear and tear on the body," says Talwar, adding that lack of proper sleep will sooner than later affect the organs. Sleep deprivation has dangerous long-term effects. It weakens the immune system, hastens the onset of chronic diseases and affects all neuro-cognitive functions. All sleep researchers agree that the brain benefits from sleep, which improves memory, ideas and concentration. Whereas those who suffer from sleep debt function at only 80 per cent of their capability. Dr R.R. Kasliwal, director of cardiology at Escorts Heart Institute, emphasises the proven link between constant sleep deprivation and vulnerability to coronary heart disease. "Shortchanging sleep can hasten the onset of cardio-respiratory problems like high blood pressure, obesity, thickening of arteries, even diabetes," he cautions. Researchers at the University of Chicago studied volunteers who slept for four hours a day and found their hormonal and metabolic systems in disarray.
|5 STAGES OF SLEEP |
Human sleep comprises five recurring stages, during which there is a change in the quality of sleep, leading to unique effects on the mind and body. This can be monitored through polysomnography in sleep laboratories which provide data on the electrical and muscular states during sleep. The period of Non-Rapid Eye Movement (NREM) comprises Stages 1-4 and lasts between 90 and 120 minutes, with each stage ranging between five and 15 minutes. The stages occur cyclically, repeating themselves through the night, and each sleep cycle lasting longer than the previous one. Typically, most people complete five cycles during one night's sleep.
|STAGE 1: LIGHT SLEEP |
Muscles relax and body temperature drops. The person drifts between sleep and wakefulness and is still conscious of being awake.
STAGE 2: TRANSITION
The person's heartbeat and breathing slow down, as does electrical activity in the brain. This is the stage before deep sleep begins.
STAGES 3 & 4: SLOW WAVE OR DELTA SLEEP
Also known as deep sleep. The body does not respond to sound or touch. It is the hardest to wake up a person in this stage.
|STAGE 5: REM OR RAPID EYE MOVEMENT |
Eyes and face may twitch but the muscles are paralysed. Heartbeat and respiration become erratic and cerebral activity increases. Intense dreaming begins but people cannot enact dreams as the muscles are immobilised. The first REM stage lasts 10 minutes, increasing each subsequent time.
According to a new survey by the US National Sleep Foundation, 25 per cent of couples also reported that their sexual relationship had suffered because they were too tired. Little wonder if one looks at their busy lifestyles. Another often-overlooked factor that may interfere with sleep or sex is medication. Anti-depressants and certain blood pressure drugs, for instance, can cause insomnia and sexual problems. Since sleep and wakefulness are influenced by neurotransmitter signals in the brain, foods and medicines alter the balance of these signals and affect alertness and sleep. Diet pills and decongestants stimulate parts of the brain and can also cause insomnia.
Besides, there are the behavioural consequences. The need to sleep keeps burrowing into people's faculties and they start taking bad decisions, become irritable, snappy and forgetful. The Bhopal gas tragedy happened shortly after midnight, as did the Chernobyl disaster which occurred at 1.23 a.m. "The sleep cycle peak hits a high between 4 and 8 in the morning," says Sarabhai, adding that most industrial disasters, fatal traffic accidents and hospital deaths occur in the 4-6 a.m. period. Sleep-deprived people tested on driving simulators or hand-eye coordination exercises fare as badly as those who are intoxicated. Loss of sleep also magnifies the effects of alcohol in the body. So a fatigued person who drinks is under tremendous risk when driving. According to the Delhi Police figures for 2004 on road accidents, driver fatigue is responsible for over half the road mishaps in Delhi each year. Overworked, sleepy surgeons or bone-tired truck drivers, the consequences can be the same, often fatal. Which is why, say doctors, it is important to observe sleep hygiene: keep the tv, computer, fights and arguments out of the bedroom and keep it as uncluttered as possible.
|Sleep mimics wakefulness in many ways and circadian rhythms vary from person to person. Genetic predisposition, along with habits and adaptiveness, determines the duration and quality of sleep. According to studies by American sleep scientists Hartmann and Brewer, people who sleep less are energetic, ambitious, socially adaptive, confident and efficient, while the people who sleep longer are shy and sluggish worriers with low self-confidence. Also, like flowers and animals, human dispositions depend on the time of the day. As the sunflower blooms during daytime and the evening primrose late in the day, people mimic the sleep patterns of owls and fowls. |
They are most productive and vibrant during night. "Don't call me in the morning. I am an evening person," is not just whimsy, it makes sense. Owls hit their creative and decision-making peaks only after late evening and are wide awake well beyond the witching hour.
They rise and shine early, bursting with ideas and energy as soon as they are out of bed. They usually don't suffer from sleep inertia-a condition that causes irritability and long periods of lethargy. Fowls are usually regular exercisers, disciplined and extroverted.
And as Suri reminds, "Let us not omit the burden of sleep disorders, insomnia and sleep apnea being the two giants among Indians." The most common sleep disorder in the world, insomnia affects nearly 12.5 crore Indians. It is the inability to fall asleep or the difficulty to continue to sleep at night. Stress, depression, injury, illness, long working hours, excessive consumption of caffeine or alcohol, irregular sleep hours-the causes are multiple and paradoxical. Says Hansal Bhachesh, a leading Ahmedabad psychiatrist: "People look for entertainment at night to relax and this very relaxation causes sleeplessness."
As common but surely more dangerous is sleep apnea in which the windpipe chokes during sleep, blocking airflow and forcing the sleeper to wake up many times during the night. Loud snoring, gasping for breath during sleep and daytime lethargy characterise it. "Sleep apnea used to affect people in their fifties and sixties. We now have people in their thirties suffering from it," says Udwadia.
Experts say that if you feel drowsy during the day or fall asleep within five minutes of hitting the bed, you haven't had enough sleep. Microsleeps, or very brief episodes of sleep in an otherwise awake person, are another sign of sleep loss. For most adults, seven-eight hours is considered the right amount of sleep but modern lifestyles and work pressures have shrunk this to abnormal levels. Burning the candle at both ends has created so much sleep deprivation that what is abnormal is the norm. In fact, the effects of lack of sleep on physical and mental health are just starting to be realised. Reason enough for those on the edge to wake up. The other side of midnight-a life of constant sleep deprivation-raises some fundamental questions on whether the waking life at the cost of sleep is worth it. Grogginess, red, watery eyes, fatigued limbs, a tired mind that struggles to remember names and numbers and a weak immune system may not lead to heightened productivity. "Wakefulness and restedness are not interchangeable," said Dement. They are equally vital and interdependent. Finally, it is about which side of the bed you want to get off in the morning.
-with Anjali Doshi, Stephen David and Uday Mahurkar
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