A consultant neurologist at the University of Ilorin Teaching Hospital, Ilorin, Kwara State, Dr Abiodun Bello, speaks with LARA ADEJORO on how individuals can achieve good sleep without affecting their daily activities

What do quality and good sleep mean?

Quality and good sleep mean when an individual sleeps very well and, by the next morning, is satisfied with the sleep and doesn't feel any effect the next day attributable to not sleeping well. It involves the ability to sleep for almost some minutes when you are ready to go to bed; it means that you can initiate sleep, maintain that sleep, and wake up at your desired time.

When you wake up the next morning, you feel refreshed, and you can carry out your daily activities without having those feelings we have in our bodies when we don't sleep well.

So, it has to do with time and the effectiveness of sleep the next day. Having good sleep varies. It has to do with that person's satisfaction. When some people sleep for five hours, they are satisfied, but some people need to sleep for about eight hours at night to be satisfied. Most adults require about eight hours of sleep per night to sleep well.

How many hours of sleep should an individual have at the very least?

The average baby could sleep for up to 16 to 18 hours per day; children will need to sleep for longer hours, but for adults, eight hours of sleep will be okay for them. Even for older people, the number of hours required for sleep should not reduce, even though it may reduce a little bit, but it should be around eight hours, but that is a general thing.

Many people sleep for five hours, and they are fine; they can carry out their normal activities, and they will not experience fatigue, excessive yawning, or tiredness.

Meanwhile, if an eight-hour sleeper gets six or seven hours of sleep at night, he will not feel good the next day. So, for an adult, you can say that they get an average of about eight hours of sleep.

Does it mean that an adult who doesn't sleep for an average of eight hours hasn't achieved good sleep?

It depends on the usual number of hours that a person sleeps. When we say eight hours, that is just average, because many people do well with five hours, and some require nine hours.

So, anytime you sleep fewer hours than the hours you sleep, you can conclude that you didn't get good sleep. If the average sleep time for an adult is eight hours, and you reduce it by one hour consistently for a few days, there will be some changes in that person, but the person may not know because nobody looks out for those things.

When people don't sleep as much as they need to, they struggle to overcome those challenges throughout the day. So, it depends on the number of hours, but a reduction of two to three hours will affect the individual the next day.

One of the functions of sleep is to rest the body. During the day, the brain is just like a rechargeable battery. Throughout the day, you will discharge its battery, and when you sleep at night, the idea is that you will recharge the battery so it can continue its work the next day. If you don't sleep well, you will come to work the next day with a battery that is not fully charged.

Everybody knows that the night you don't sleep well, you feel tired, you don't want to get up from bed, you will be yawning, you will be irritable, you feel sleepy and unusually tired, and concentration could be tiring and you may fall asleep at work or in the class. Some of the deleterious effects are poor performance in mental tasks, it can be as bad as getting involved in an accident while steering.

With what you have said, why doesn't an average Nigerian get good sleep?

One of the reasons is stress. When you are stressed, you are not able to sleep at night; you are worried and tossing around in bed. These days, people use a lot of gadgets like a laptop and a phone, and at night, when you are exposed to those bright lights from those gadgets, your brain may be thinking it is daytime and you find it difficult to sleep.

When you eat late, your stomach is still bulging, you can't lie down well, and your body is trying to break down those foods, which usually disrupts sleep. Most carbonated drinks contain caffeine, and these days, people take a lot of energy drinks at night. Since caffeine is a stimulant, it doesn't allow the brain to rest. Exercising close to bedtime can disrupt sleep. Alcohol and smoking can disrupt sleep.

A lot of people don't know about sleep hygiene, which is what we do to promote good and quality sleep. The bed in the room has only two functions: sleep and sex. It is not meant to be used for any other purpose. Don't enter your bedroom at night until you are ready to sleep. In some households, people share bedrooms, and a sibling may disturb your sleep.

Sometimes, one person may like the light on and the other doesn't. Generally, the brain wants to sleep in an environment that is dark. Televisions are not meant to be in the bedroom, and people shouldn't put clocks in their bedrooms because it can make them anxious. People also don't sleep because of medical problems.

For instance, if someone is in pain or has a snoring issue, they may wake up frequently and find it difficult to get refreshing sleep at night. Also, heart failure and the use of drugs can disrupt one's sleep. Many drugs interfere with sleep. Illicit drug use and drug abuse are also causes of poor sleep. There are some individual factors that make people just like that. They don't have any medical issues; they just find it difficult to sleep.

Do poor sleeping habits reduce longevity?

Yes, if someone doesn't sleep well, they may not live as long as someone who does. It is said that there is a limit to which you can keep a living organism, whether it is a man, dog, or bird. When people have poor sleep over time, it leads to some medical conditions called cardiovascular diseases, which are the top causes of death worldwide. Those are the people that develop hypertension, diabetes, insulin resistance, and problems with cholesterol; all these can lead to stroke, disability, kidney failure, and dementia, and when patients have dementia, they are likely to die earlier than people that don't.

Also, performance at work or school is immediately reduced. Sleep helps to consolidate memory, which is why we tell students to sleep well before an exam.

How many nights of sleep deprivation will lead to lasting negative health consequences?

It could be as early as one night. For instance, somebody who has epilepsy and is on drugs and misses one night of sleep could convulse the next day. If a person who has high blood pressure doesn't sleep for a couple of nights, the hormones in the body are spiking, and he could have a heart attack or stroke.

How can one achieve good sleep?

The first thing is to avoid buying sleeping pills from a patent medicine store. If you have a problem sleeping, you can try some things on your own, but the best advice is to see a doctor, specifically a sleep specialist. Sleep can also be too much (hypersomnia), and we also have people who don't sleep well (insomnia), some people sleepwalk (parasomnia), people who have nightmares, and people who have night terrors; there are people whose legs shake when sleeping, so that disrupts sleep. So, the first approach is to see a specialist because the treatment for poor sleep is very diverse. But at the individual level, you have to know the rules that have to do with sleeping, like where you sleep (the bedroom), and the regular time you want to sleep.

Don't enter your bedroom at night until you are ready to sleep, switch off your light or have minimal lighting, and if you don't get to sleep 30 minutes after trying to sleep, you should leave the bedroom, do something relaxing, and when you start feeling like sleeping again, go back to the bedroom. If you are someone who sleeps until 10pm, you have to eat two and a half hours before your sleep time because by that time the food should have left your stomach. Since you avoid heavy meals at night, dinner should be light.

Avoid drinks like tea and caffeine. Caffeine should not be taken frequently because it is going to cause slow damage to the brain over the years. Coffee can work in your body for as long as 15 hours, and it is not a good thing to be drinking coffee in the afternoon.

Avoid carbonated drinks, alcohol, smoking, and exercising close to sleep time. To sleep well at night, the best time to exercise is in the morning. If you are sleeping at 10 pm, whatever exercise you are doing should stop at 6pm.

Engage in relaxation exercises like yoga, which can promote sleep. If the temperature is high, you have to find a way to make it cool; taking a shower can help. Don't take assignments to your bed; keep your worries aside and sleep. It's not best to buy sleeping pills over the counter. If you are having pains like arthritis, prostate problems, or joint or bladder problems, you need to see a doctor for treatment to improve your sleep quality. Milk and ice cream can promote good sleep.

At what point should sleeping pills be recommended?

Sleeping pills are not the first thing a doctor will tell you to get; the doctor will determine the best time to introduce the drug to the patient because you can't use many of the drugs for more than two weeks unless you are using the drug to treat another condition like depression.

Do people who have a traumatic brain injury or stroke have sleep problems?

Yes, because the brain is the powerhouse that controls sleep. When you have a traumatic injury or stroke, it can damage some parts of the brain, and sleeping becomes a problem. So, you have many stroke patients who find it difficult to sleep, some get agitated, and some of them sleep too much. When they recover from a stroke, there could be an anxiety issue, and they find it difficult to sleep. The way to control it is to treat underlying conditions, infections, and anxiety. Cognitive-behavioural therapy is one of the first things we do for any problem with sleeping. It does not involve drugs; it's about relaxation techniques.