Expert:

Han Fang Director of Sleep Center of Peking University People's Hospital

Qu Miao Chief Physician of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine

Adequate sleep is an important condition for ensuring physical and mental health. With the rapid development of the economy and society, people's life and behavior patterns have gradually changed, and sleep problems have become increasingly prominent, becoming an important factor affecting the health and quality of life of the people. On the eve of this year's World Sleep Day, the National Health Office released the "Core Information and Interpretation of Sleep Health", which mainly introduces the role of sleep, the manifestations of good sleep, the harm of insufficient sleep, the precautions for sleep in key groups, and the classification, identification and coping methods for common sleep disorders.

This issue of "Online Interview" specially invites relevant experts to help the public correctly understand sleep, establish good sleep habits, and guide the public to identify and scientifically respond to sleep problems in the early stage.

Host: Hello everyone! This is the online interview column of the National Health Commission. Welcome to follow! Health is the foundation of people's happiness and social development. The Party and the government attach great importance to people's health and vigorously promote the construction of a healthy China. Each of us must also assume the responsibility for health, be the first person responsible for our own health, establish a correct concept of health, and practice a healthy lifestyle.

Adequate sleep is an important condition for ensuring physical and mental health. With the rapid development of the economy and society, people's life and behavior patterns have gradually changed, and sleep problems have become increasingly prominent, becoming an important factor affecting the health and quality of life of the people. On the eve of this year's Sleep Day, in order to help the public correctly understand sleep, establish good sleep habits, and guide the public to identify and scientifically respond to sleep problems in the early stage, the National Health and Health Office released the "Core Information and Interpretation of Sleep Health". Today we also specially invited two core member experts to participate in the compilation to provide detailed explanations for everyone. They are Han Fang, director of the Sleep Center of Peking University People's Hospital.

Han Fang: Hello, host! Hello, audience friends!

Host: Qu Miao, chief physician of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine!

Qu Miao: Hello, host! Hello, everyone!

Host: Welcome to both of you.

First of all, we ask Director Han Fang to answer you what good sleep means to human health and what kind of sleep can be considered good sleep. Please!

Han Fang: One-third of a person's life is spent in sleep. Sleep is an indispensable basic physiological function for people. Sleep can eliminate fatigue and restore energy, and play an important role in maintaining the stability of nerves, cardiovascular, endocrine metabolism, immunity, mental and psychological functions. Good sleep can also promote growth and development, and improve cognition and memory ability.

So what is good sleep? In fact, it includes three dimensions. The first is the appropriate sleep duration, good sleep quality and regular sleep time. Proper sleep duration is the basis of healthy sleep. People of different age groups have different needs for sleep duration, and there are relatively large individual differences. Generally speaking, our babies aged 0-3 months need 13-18 hours of sleep every day, babies aged 4-11 months need 12-16 hours of sleep, children aged 1-2 years need 11-14 hours of sleep, and preschool children also need 10-13 hours. For primary and secondary school students, they gradually decrease, 8-10 hours, and for adults, we usually only need 7-8 hours. The elderly can sleep shorter, and it also needs 6 or 7 hours.

Second, good quality of sleep is the key to healthy sleep, and is even more important than the length of sleep. The specific manifestations are: First, the time to fall asleep should be within 30 minutes (especially within 20 minutes for children under 6 years old); don’t wake up too many times at night, if it exceeds 3 times, it will be wrong, and you can fall asleep again within 20 minutes after waking up; after a night of sleep the next morning, you will feel full of energy, happy mood, full of energy, and concentration, and be able to revive your work. As the saying goes, "work at sunrise and rest at sunset", means that people's sleep is regular, and this law must be harmonious and unified with nature. Then regular sleep time is also a guarantee of sleep health. We advocate adapting to the four seasons and having regular daily life. Maintaining regular sleep and wake-up time and maintaining a stable biological rhythm is very important. Generally speaking, adults recommend falling asleep at 10 pm and getting up at 6 pm and 7 pm. The elderly recommend falling asleep from 10 to 11 pm and getting up at 5 or 6 pm in the morning. So these three dimensions are important elements of healthy sleep.

Host: You can find that the length of sleep and the time to fall asleep are still very important.

Han Fang: That's right, this is the basis of sleep.

Host: Thank you for your answer. So will long-term poor sleep cause our physical health problems? We ask Director Han Fang to continue to answer the questions for you.

Han Fang: That's right, the most important thing about sleeping is that if you don't sleep well, no matter if you don't have enough or too long, your sleep quality is deteriorated or your sleep routine is disordered, it will cause health hazards. Common manifestations include reduced or extended sleep time, inability to fall asleep on time, or difficulty falling asleep, wake up early, frequently wake up at night, frequent times, and more frequent sleep, light sleep, many dreams, sleepiness during the day, etc. These are all abnormal sleep.

Host: It’s not normal.

Han Fang: Then if this abnormality is not bad in the short term, the harm will be small, but long-term poor sleep will seriously damage physical and mental health.

Host: Psychological?

Han Fang: It’s okay to be mentally. This leads to slow response, including our cognitive functions such as attention and memory, and will also reduce our learning and work efficiency. Even because of the daytime sleepiness, it will increase the safety risks of transportation and production. Many vicious accidents are related to our sleepiness. There are also emotional instability, irritability, and serious cases can induce psychological and mental illnesses such as anxiety and depression. If you have poor sleep for a long time, it will reduce the body's immunity and increase the occurrence of infectious diseases. We all know that continuous fatigue is prone to colds.

Host: That’s right.

Han Fang: Then the best way to have a sleep after catching a cold is enough. Of course, we now have a lot of cardiovascular and cerebrovascular diseases, and the risks of metabolism, obesity, and cancer, will be caused by long-term poor sleep.

Host: So it can be seen that everyone really cannot underestimate their sleep problems.

Han Fang: That's right.

Host: So how can you maintain a good sleep? Next, we will ask Dr. Qu Miao to answer for you.

Qu Miao: OK. Good sleep is an important guarantee for physical and mental health. Bad living habits, life pressure, emotional fluctuations, bad sleep environment, physical diseases, etc. will have adverse effects on sleep. We need to maintain a good sleep through lifestyle and environmental regulation.

First, develop good sleep patterns. Try to go to bed and get up at the same time every day, and don’t be too snooze even on weekends to allow your body to adapt to a fixed sleep rhythm. Adapt to the circadian rhythm and avoid long-term bedtime during the day to avoid affecting sleep at night.

The second is to create a comfortable sleeping environment. It is recommended that the temperature in our bedroom be controlled at 20-24℃, the humidity is between 40%-60%, the ventilation is good and it is relatively quiet. Use blackout curtains and sound insulation equipment to reduce interference from outside light and noise. The mattress should be firmly supported, the pillow height should be moderate, and the bedding should be breathable, clean and dry.

The third is to adjust diet and living habits. Avoid eating in large quantities within 2-3 hours before going to bed, especially spicy, irritating, high-fat, and high-sugar foods. Avoid drinking irritating drinks such as tea and coffee 4-6 hours before going to bed, and avoid drinking alcohol at night. You should not use electronic devices for a long time before going to bed.

Fourth, moderate exercise should be combined with work and rest. Exercising appropriately during the day can help consume energy and reduce stress, but you should pay attention to the exercise time not being too close to sleep time. It is generally recommended to complete exercise 3-4 hours before going to bed, which can not only enhance physical fitness, but also help improve sleep. You can also try some relaxation techniques before going to bed, such as deep breathing, meditation, yoga, etc.

The fifth is to avoid bad living habits and interference factors. Even if you can't fall asleep, you should go to bed and rest on time to avoid disrupting the biological clock. If you wake up halfway, avoid watching the time or turning on the lights. You can adjust your state and fall asleep again by taking a deep breath.

Host: It can be seen that a good sleep requires scientific support, and the choice of food and even mattresses is very important.

Dr. Qu, you just mentioned that a good sleep requires a very good habit. So I think this good habit should run through our entire life cycle, especially for children and adolescents, their growth and development are more important. So I would like to ask you, for children and adolescents, do they need to pay special attention to in their sleep?

Qu Miao: This host asked a very good question. Sleep is crucial for children and adolescents who are in the growth and development stages. The first is a fixed schedule. Try to sleep and get up at a fixed time every day, and don’t stay up late or sleep in for too long even on weekends. According to the "Notice on Further Strengthening Sleep Management of Primary and Secondary School Students", primary school students recommend bedtime no later than 9:20 pm, junior high school students no later than 10 pm, and high school students no later than 11 pm. The second is to create a good sleep environment. Reduce the influence of external factors such as noise and light to ensure that the bedroom is quiet, dim and the temperature should be appropriate. Stay away from electronic devices 1 hour before bedtime. The third is to establish good bedtime habits. Parents can work and prepare schedules with their children to avoid doing activities that are not related to sleep in bed. The fourth is to adjust your lifestyle. Exercise appropriately during the day and avoid strenuous exercise after 8 pm. Do not eat too much or too late for dinner, avoid eating greasy or irritating foods, and try not to eat again before going to bed. Finally, build a support system. Family members should maintain good communication with children and adolescents, help them reduce psychological stress and anxiety, enhance self-confidence and coping, and thus alleviate our sleep problems.

Host: Thank you for your answer. Speaking of sleep, for professionals, due to factors such as fast pace of life and high work pressure, they should also encounter such problems. So what should professionals pay attention to in terms of sleep? Next, we invite Director Han Fang to answer for everyone.

Han Fang: A very good question. Professional people often face problems such as high work pressure, fast pace of life, irregular work and rest, which are more likely to lead to low sleep quality, insufficient sleep time, or even reverse sleep rhythm.

Host: Indeed.

Han Fang: We should pay more attention to sleep hygiene habits and be the first person in charge of your own sleep health. These include properly managing your working hours, trying to avoid staying up late, and preventing excessive fatigue. Maintain moderate physical exercise and avoid sitting for a long time. Avoid smoking, drinking, tea or coffee before going to bed. Do not eat too much for dinner too late, especially for some spicy and irritating things, and do not use your phone before going to bed. It is wrong to move the work to the bed and to the evening. You must also learn to relieve work pressure and keep a calm mind. If necessary, you can request professional psychological counseling or treatment. Employers should also create healthy environments and conditions for workers to ensure the health of their employees.

Host: It can be seen that for adults and working people, being the first person in charge of their own health is to find a self-consistent way, and the combination of work and rest is very important.

When we talk about sleep problems, the first thing that comes to mind is the elderly. The elderly often have problems such as "can't sleep and get up too early". So what should the elderly pay attention to in terms of sleep? Next, we will ask Dr. Qu Miao to answer for you.

Qu Miao: The sleep of the elderly has its own characteristics. Based on the precautions for general populations, it is recommended to fall asleep from 10:00 to 11:00 pm and get up from 5:00 to 6:00 to keep the daily schedule consistent. If you choose to go to bed late or get up too early because of difficulty falling asleep, and take frequent naps or go back to sleep during the day, it may disrupt your routine, causing the brain's biological clock to be disordered, causing a vicious cycle of "not sleeping well during the day and not being able to sleep at night". Second, drinking too much water at night will also increase the number of nocturnal urine. You should reduce your fluid intake by 1 hour before going to bed and reduce the frequency of going to the toilet at night. The third is to maintain reasonable sleep expectations, not pay too much attention to sleep problems, and avoid anxiety caused by occasional poor sleep. The fourth is to perform about half an hour of low-intensity activities every day (such as walking, Tai Chi, etc.) to avoid strenuous activities 2 hours before going to bed. The fifth is to actively treat chronic diseases such as hypertension, diabetes, and arthritis. Certain drugs (such as diuretics, hormones) may interfere with sleep and need to communicate with a doctor to adjust the time or type of medication.

Host: Thank you for your answer. The two experts just mentioned a lot of sleep problems in life. So will these problems form sleep disorders? What exactly is sleep disorder? What are the common types of sleep disorders? Next, we invite Director Han Fang to answer for everyone.

Han Fang: I just talked about a lot of sleep problems. Of course, if you reach a disease state, you will have sleep disorders. Sleep disorders are mainly manifested in a large category of sleep-related clinical syndromes, mainly manifested in difficulty falling asleep, difficulty maintaining sleep, excessive sleep, disordered sleep wake cycle or abnormal behavior in sleep states. Our sleep disorders include more than 90 diseases in three categories: "can't sleep, can't wake up, and can't sleep well". For example, what we are commonly known as insomnia, snoring, and sleep apnea.

With the development of sleep medicine and the popularization of scientific knowledge, it was considered rare in the past, such as the ones we have called restless legs syndrome, narcolepsy, rapid eye movement sleep behavior disorder, sleep-wake rhythm disorder (as the saying goes to sleepwalking), and sleep-awakening rhythm disorders have also been recognized. Insomnia is the most common. Even despite the appropriate sleep opportunities and environment, she is still not satisfied with the length of sleep and quality of sleep, and causes a subjective experience of daytime and daytime functional impairment. It must be that there must be daytime functional impairment. Insomnia can exist alone or for some reason, often comorbid with mental disorders, physical diseases or substance abuse. It is the most common sleep disorder we currently have.

There is another type that is often mentioned by ordinary people. Some of them have obstructive sleep apnea and hypoventilation syndrome. What is it mainly? The upper respiratory tract collapses or even blockages during sleep, resulting in repeated apnea or hypoventilation. This will lead to hypoxia. Its most prominent manifestation is that it snores after falling asleep. It can cause damage to the multiple systems of the body due to lack of oxygen and poor sleep. It is also an important reason for sleepiness during the day. Many people always doze off during the day to see a doctor.

Host: Director Han, I just heard you talk about more than 90 types of sleep disorders?

Han Fang: That's right.

Host: So as an individual, how can I identify and discover early? Is my sleep problem a sleep disorder?

Han Fang: This is also particularly important, so in the core elements of our health information, it is mentioned that although sleep disorders are complex, after everyone has a sense of health, they can fully understand through our self-evaluation.

Host: Self-assessment?

Han Fang: Yes. First, we raise our awareness and understand the importance of healthy sleep. You must not take sleep seriously, nor should you take it too seriously.

Secondly, you must master the core information of sleep health, especially some basic knowledge of common sleep disorders.

If you often have difficulty falling asleep, especially if you have difficulty falling asleep for more than 30 minutes for adults and children under 6 years old can't fall asleep for more than 20 minutes, then there may be problems. Another thing is that you wake up and cannot maintain your sleep during sleep. After waking up, you cannot fall asleep again in a short time. These also lead to frequent dozing and sleepiness during the day, affecting work, study, and even life, and reducing efficiency. Also, if you find that snoring is particularly loud at night and such breathing intervals frequently occur, you should pay attention to whether there is apnea. If you sleep irregularly and you often call sleepwalking, or even bedwetting and other abnormal movements appear in your sleep, you should also consider whether there is any sleep disorder. If this phenomenon occurs at this time, you can seek professional help from the medical institution in time.

Host: So for the family, snoring is really noisy, but you have to pay attention to whether he has such symptoms of pause.

Han Fang: Yes, that's it.

Host: Thank you for your answer. Then everyone must be asking, what should you pay attention to if you already suffer from sleep disorders? We have asked Dr. Qu Miao to answer this question for you.

Qu Miao: First, we must correctly understand sleep. If you don’t feel sleepy during the day, it means that you have enough sleep. There are individual differences in the length of sleep and it varies with the season. So don’t stick to the “8-hour sleep theory”. The second is to use the medicine with caution. Avoid abuse of drugs or health products, avoid taking sleeping pills or other sleep aids on your own. Long-term use may cause dependence or side effects. If medication is needed, it must be done under the guidance of a doctor. The third is scientific records. Record the time of falling asleep, awakening times, daytime status, etc. for several days to continuously help doctors determine the cause of the disease.

Host: Dr. Qu, you just said that you cannot take these health products by yourself. So I would like to ask you, is there any Chinese medicine health care method that can help everyone maintain a good sleep?

Qu Miao: Of course there are, many, and this is also the advantage of our traditional Chinese medicine.

First of all, we must adapt to the daily life of the four seasons: go to bed late in spring and summer, get up early in autumn and winter, and follow the principle of "raising yang in spring and summer, and nourishing yin in autumn and winter". A nap in the afternoon should be between 15-30 minutes, which can nourish the heart, but avoid the long nap time affecting night sleep. The second is diet regulation, which uses food to nourish the spirit. You can use lotus seeds, lilies and japonica rice to cook porridge. This porridge is suitable for people with both heart and spleen deficiency and prone to awakening when they are dreaming. You can also use jujube seeds and millet to cook porridge. This porridge is suitable for people with insufficient liver blood and insomnia. Recommended tea drinks: You can soak longan and red dates in water, which can nourish the heart and spleen, improve poor sleep caused by insufficient qi and blood; you can also soak chrysanthemum and wolfberry in water, which can clear the liver and improve eyesight, and relieve difficulty in falling asleep caused by excessive liver fire. At the same time, be careful to avoid eating spicy and greasy foods for dinner, and eat less bloated foods (such as beans, onions, etc.). Third, we can also listen to the five elements music of traditional Chinese medicine to smooth the five internal organs. Listening to music from Gongtu and Yutu can help you sleep. The main songs you choose include "Good Night", "The Four Gentlemen of Leisure", "The Moon High", etc. Adjust the volume to 40-60 decibels according to your personal situation. The fourth is exercise massage to harmonize qi and blood. Recommended Baduan Jin and Tai Chi. Before going to bed, you can massage the abdomen, rub the Yongquan point, massage the Baihui point, Anmian point, and Shenmen point. Each point is massaged for 3-5 minutes. You can also use ear point to press, Chinese medicine foot bath, etc. These have a good effect of calming the mind and helping sleep. The fifth is aromatherapy, which uses fragrance to help sleep. You can use Hehuan Skin, Night Vinegar, and Lavender to make home-made pillows to calm the mind, which can refresh the fragrance and calm the mind, relieve the light sleep and wake up easily. You can also use essential oil aromatherapy or ignite agarwood before going to bed to soothe your mood and calm your mind and help you sleep.

Host: Thank you for your answer. It can be said that you are full of practical information. From how to eat to what kind of music you listen to, Dr. Qu has provided you with a lot of scientific basis.

Sleep healthy and live healthy. I hope that through today's interview, everyone can recognize the harm of sleep disorders, adopt scientific and effective prevention and treatment methods, and have a healthy sleep. Thanks again to the two experts for their answers!

Okay, I want to say goodbye to you after this interview. Thank you for your attention. See you next time!

[Editor in charge: Li Chen]