World Sleep Day 2021 is being marked across the world on Friday 19 March. The theme this year is 'regular sleep, healthy future', to highlight the importance of sleep on someone's mental and physical health.
Quality of life can be improved with good sleep; when sleep is poor then health can deteriorate.
Earl Palas is an advanced nurse practitioner in the Respiratory Support and Sleep Centre (RSSC) at Royal Papworth Hospital, home to the UK's largest sleep centre. Earl outlines the services he and his colleagues provide to patients each day as well as sharing some tips to improve sleep health.
What services are provided by the RSSC team?
- Domiciliary (at home) non-invasive ventilation for conditions such as Motor Neurone Disease, Chronic Obstructive Pulmonary Disease (COPD - chronic bronchitis, emphysema and bronchiectasis), scoliosis, thoracic wall deformity, spinal cord injuries and obesity.
- An invasive ventilation weaning programme – called the Progressive Care Programme - accepting transfers from critical care units at other hospitals on a national basis
- Community care by providing ongoing invasive mechanical ventilation to patients.
- Outpatient clinics and day cases.
Earl runs an patient's arterial blood gas (ABG) through the blood gas analyser
- Specialist opinions about obstructive sleep apnoea (OSA) and other respiratory and non-respiratory sleep disorders.
- If screening sleep studies are required they are performed in the patient's own home with the results available in the clinic.
- Often the team makes recommendations that can be taken forward by the GP, but some patients need to attend the RSSC for a more comprehensive sleep study (polysomnography, multiple sleep latency test) or to start CPAP treatment.
- The RSSC also provides the National Ataxia Telangiectasia service for adults.
- Actively involved in sleep research to examine all aspects of respiratory care.
What is the role of an advanced nurse practitioner (ANP)?
The RSSC ANP team lead the delivery of care to manage and support the growing number of patients require regular respiratory review as well as those using domiciliary ventilation.
Our varied role includes running ANP led day case and sleep disturbance clinics, clerking and discharging routine admissions, supporting the ward nurses and junior medical team with the high acuity ventilated patients.
We share our expertise and knowledge to the members of the multidisciplinary team through formal and informal teaching. We also participate in agreed audits and research projects to improve existing services or to which patient services can be developed.
Why is sleep health important?
Sleep is an essential function that allows your body and mind to recharge, leaving you refreshed and alert when you wake up. Healthy sleep also helps the body remain healthy and stave off diseases. Insufficient sleep can lead to people becoming vulnerable to attention lapses, reduced cognition, delayed reactions and mood shifts. It could even impair to mind’s ability to process memories.
Any tips you can share for how to improve quality of sleep (sleep hygiene)?
Sleep is a passive process and you cannot make yourself fall asleep. Neither is sleep like a light bulb, either off or on. Our body responds more positively when regular daily routines are maintained. Therefore, regular bedtimes and wake-up times are important; we are all likely to sleep better if we maintain a steady pattern of both sleeping and waking.
If you don’t already, you should think about introducing a bedtime routine: dimming the lights reminds your body clock what time it is; have a calming shower or bath; play soft relaxing music or listen to relaxation or meditation records; or reading quietly for a short while can all help.
Try to spend 30 minutes of the evening winding down and avoid late-night distractions from all sorts of gadgets that have screens. These emit bright light and noise which can stimulate your brain and stop you falling asleep, or affect the quality of your sleep.
Moderate caffeine intake during the day is unlikely to disrupt your sleep, but this is a long-lasting stimulant and can remain in your system for several hours, causing disruption to your sleep later in the night. It is best to only consume decaffeinated drinks from mid-afternoon onwards. Nicotine is also a stimulant and can affect your sleep in the same way as caffeine.
Joanne undergoes a complex sleep test to investigate her chronic daytime tiredness
Many of us believe a night-cap or a glass of wine will help us nod-off, but while it might mean you fall asleep as soon as your head hits the pillow, the effects won’t last. Alcohol may help you to feel relaxed and sleepy initially, but it causes your sleep to be fragmented.
It is not helpful to go to bed when you are hungry or when too full. Being hungry makes you desire food and helps to keep you alert. Eating a large meal close to bedtime can make you feel uncomfortable. There is a substance in the brain that makes us feel both hungry and wide awake, or satisfied and sleepy so it’s important to get the balance right.
Taking regular exercise is a good way to maintain general good health and a feeling of well-being, but exercising too close to bedtime (within three hours) can stimulate your body and mind too much.
Lastly, our bedroom should be a place where we feel comfortable and at ease (consider your bed as a haven of rest). It is important to establish a relaxed environment away from daytime activities.
Information on sleep hygiene and improving your sleep health.