Shakespeare showed he was partmedical professional when he made guilt-ridden Macbeth utter these words, “Macbeth does murder sleep, the innocent sleep. Sleep that knits up the revell’d sleeve of care, the death of each day’s life, sore labour’s bath, balm of hurt minds, great nature’s second course, chiefnourisher in life’s feast”. Many of us know the importance of a healthy diet and proper exercise, but relatively little attention is paid to the “chief nourisher in life’s feast”.Many  people who may exercise and eat a proper diet treat sleep like a luxury than a necessity.

In  Kathmandu, proper sleep may be difficult to obtain due to excessive noise ( dogs barking, neighbours’ partying, cars and motorcycles zooming by, hawkers selling their wares and so forth). It is difficult  to imagine why some spiritually-inclined  people come to Kathmandu to  meditate in  an environment that is hardly  conducive to peace and tranquility. But back to the subject of sleep.

In our country where hypertension and diabetes are common, sleep deprivation appears to make us even more susceptible to these problems. Indeed, even a single night of inadequate sleep can lead to daylong elevation of high blood pressure. The body’s ability to process glucose is also affected by lack of proper sleep and may lead to diabetes. Healthy young men who are deprived of sleep have abnormal glucose levels in the blood. In general the risks of cardiovascular disease and stroke are higher in people who sleep less than six hours.There  is more bad news. Several studies have shown an association between insufficient sleep and weight gain. The levels of the hormone leptin, which tells the brain when enough food has been consumed are lowered in sleep-deprived individuals so it is possible these people eat more food. Finally with inadequate sleep our immunity goes down and we may be more prone to flu and other infections.

Exactly how much sleep do we need? The usual range is between seven to eight hours for most adults. Getting less than the amount of sleep you need  may build up a sleep debt that may not be erased by sleeping in on Saturday mornings.

Age affects the quality of sleep and the amount of time spent in various stages of sleep. These include rapid eye movement sleep( REM sleep) or dream sleep and the three types of non- REM sleep, the light sleep of Stage 1 followed by relaxed sleep of Stage 2 and finally the restorative, deep sleep of Stage 3. Children spend most of the night in deep sleep ( Stage 3) oblivious to all the problems and surrounding noises. But with age, the time spent in restorative sleep diminishes as we become more aware of distractions.

Trying to sleep in bustling Kathmandu may be a challenge. A dark light shade over our eyes may make a big difference if there is extraneous light in the room which we cannot control. Some find ear plugs very effective even if they do not completely block all levels of noise. If we are overweight and snore during sleep, sleeping on our side or losing weight may also help in achieving that restorative sleep.

Clearly besides noise, night- time sleep is also influenced by levels of anxiety, lack of exercise, excessive daytime naps, medications, and alcohol and coffee consumption. These issues also need to be addressed so that we allow the “chief nourisher in life’s feast” to rejuvenate us.