Sleep is a biological necessity. Adults need 7-9 hours per night, yet studies suggest that 30-40% of adults worldwide report symptoms of insomnia. In the UAE, lifestyle factors such as late-night social culture, high screen time, caffeine consumption, and irregular work schedules contribute to widespread sleep difficulties.
Why Sleep Matters
Poor sleep is associated with significant health consequences:
- Cardiovascular risk: Short sleep (less than 6 hours) is associated with a 48% increased risk of coronary heart disease and a 15% increased stroke risk
- Metabolic health: Sleep deprivation impairs glucose metabolism and increases insulin resistance, contributing to type 2 diabetes risk
- Obesity: Short sleep disrupts hunger-regulating hormones (leptin and ghrelin), increasing appetite
- Immune function: Sleep deprivation reduces immune response and vaccine effectiveness
- Mental health: Strong bidirectional relationship between poor sleep and depression, anxiety
- Cognitive function: Sleep is essential for memory consolidation, attention, and decision-making
- Safety: Drowsy driving causes an estimated 100,000 crashes annually in the US alone
Common Sleep Disorders
Insomnia
Difficulty falling asleep, staying asleep, or waking too early. Chronic insomnia (at least 3 nights per week for at least 3 months) affects about 10% of adults.
Obstructive Sleep Apnoea (OSA)
The airway repeatedly collapses during sleep, causing pauses in breathing. Affects an estimated 10-30% of adults. Risk factors include obesity, male sex, large neck circumference, and Middle Eastern/South Asian ethnicity. Symptoms include loud snoring, witnessed apnoeas, daytime sleepiness, and morning headaches.
Restless Legs Syndrome
An urge to move the legs, often with uncomfortable sensations, that worsens at rest and in the evening. Affects 5-10% of adults.
Circadian Rhythm Disorders
Misalignment between the body's internal clock and the desired sleep schedule. Common in shift workers and during Ramadan.
Causes of Poor Sleep
- Stress and anxiety
- Irregular sleep schedule (varying bedtime and wake time)
- Screen use before bed (blue light suppresses melatonin)
- Caffeine (half-life of 5-7 hours; coffee after 2pm can affect sleep)
- Late heavy meals
- Bedroom environment (too hot, noisy, or bright; UAE air conditioning noise can be disruptive)
- Physical inactivity
- Medical conditions (pain, reflux, prostate problems, respiratory conditions)
- Medications (some antihypertensives, corticosteroids, SSRI antidepressants)
- Alcohol (may help fall asleep but fragments sleep and reduces quality)
Evidence-Based Sleep Improvement Strategies
Sleep Hygiene
- Fixed schedule: Go to bed and wake up at the same time every day, including weekends
- Cool bedroom: Optimal temperature is 16-18°C (challenging in the UAE but achievable with air conditioning)
- Dark room: Use blackout curtains. Important in the UAE where dawn is early
- Quiet environment: Use earplugs or white noise if needed
- No screens: Avoid phones, tablets, and computers for at least 30-60 minutes before bed
- Limit caffeine: No caffeine after early afternoon
- Avoid large meals: Within 2-3 hours of bedtime
- Regular exercise: At least 150 minutes per week, but not within 2-3 hours of bedtime
Cognitive Behavioural Therapy for Insomnia (CBT-I)
The first-line treatment for chronic insomnia according to NICE, the American Academy of Sleep Medicine, and the European Sleep Research Society. More effective than sleeping pills in the long term. Components include:
- Sleep restriction: Limiting time in bed to actual sleep time, then gradually increasing
- Stimulus control: Only go to bed when sleepy; get out of bed if not asleep after 20 minutes
- Cognitive restructuring: Addressing unhelpful beliefs about sleep
- Relaxation techniques
Medication
- Sleeping pills (benzodiazepines, Z-drugs) are recommended only for short-term use (2-4 weeks) due to dependence, tolerance, and rebound insomnia
- Melatonin may help with circadian rhythm issues and in some older adults
- Always discuss with your doctor before starting sleep medication
When to See a Doctor
- Chronic difficulty sleeping despite good sleep hygiene
- Loud snoring or witnessed breathing pauses (possible sleep apnoea)
- Excessive daytime sleepiness affecting work or safety
- Restless legs or unusual movements during sleep
- Any sleep problem causing significant distress
At Jabal Sina Medical Centre, our family medicine and general practice teams can assess sleep difficulties, screen for sleep apnoea, and provide personalised sleep improvement plans.
This article is for informational purposes only and does not replace professional medical advice. Always consult your doctor for personalised guidance.