Mornings, for many of us, are often a rude, nightmarish awakening. The day literally breaks with the shrill morning alarm we set the previous night. A good night’s sleep is broken. Waking up to the sound of an alarm – researchers tell us – is not at all good for us: it is linked to increased heart rate, raised blood pressure, undue stress, and grogginess throughout the day, more so if it has not been a good night’s sleep.
The science of sleep
Sleep architecture is based on several cycles of two broad sleep stages – the non-rapid eye movement (NREM) and the rapid eye movement (REM) – in each sleep cycle. Together they constitute seven to nine hours of a full night’s sleep every day and enable a healthy adult to recoup and recharge the body and the brain.
Going to bed marks the beginning of NREM sleep which accounts for almost 80 per cent of a night’s sleep followed by REM sleep for the remaining 20 per cent. During the NREM phase our heart works slower than it does when we are awake, characterised by a drop in blood pressure and heart rate.
In the REM phase the heart rate and blood pressure fluctuate and this is when we get our dreams.
The jolt from the bedside
In general, our heart is at an optimal state during sleep. However, when our body is about to wake up, the heart rate and blood pressure are raised, thus preparing the body for the work day ahead.
The catch here is that a few minutes before we wake up, the heart rate starts rising gradually. Any forced awakening with an alarm going off leads to a sudden rise in heart activity, sometimes beyond the normal threshold.
And it can happen when the body is in deep sleep and is at its most vulnerable state. The same is true when a nightmare suddenly wakes us up with a racing heart.
In a study done by researchers at the National Institute of Industrial Health in Japan, individuals who were forcibly woken up had increased heart rate and blood pressure, a particularly alarming matter in the elderly.
“The morning alarm always wakes you up in a panic mode,” says Dr Abhimanyu Parashar, Safety & Pharmacovigilance specialist, Syneos Health, Bengaluru. “When we set the alarm as a warning sign at night to wake up in the morning, it is fed into our subconscious mind. We ignore this warning sign if there is no morning pressure to wake up. But suppose we have to, say, be on time at the workplace, we wake up in some kind of hysteria,” he explains.
When we suddenly wake up from deep sleep we do not realise what is happening and might go into what is called the `fight or flight’ mode.
However, long-term effects seem to be unlikely if this regime becomes regular, says Dr Neetu Jain, Pulmonologist, Critical Care & Sleep Medicine, PSRI Hospital, New Delhi.
Enter the stress hormones
Dr Parashar adds that suddenly waking up in panic mode is initiated by the release of norepinephrine, adrenaline, and cortisol – the stress hormones that activate the `fight or flight’ mechanism, thus spiking the heart rate and blood pressure.
In a typical night’s sleep, the cortisol level is at its peak between 3 a.m. and 5 a.m.. It is the time when the body prepares to transit from sleep to wakefulness. The sudden sound of the alarm triggers causes vasoconstriction (contraction or narrowing of blood vessels), and the heart gets deprived of oxygen.
A normal person can cope with this situation. But in a person of delicate health, it can increase the risk to the heart over a period of time. For a person with an underlying cardiovascular condition, it can even turn lethal enough to cause a heart attack, Dr Parashar explains.
He also points out that this is why most heart attacks happen in the morning.
In his view, “Though an alarm is essential for most of us to wake up on time, it does not do any good to our health. It is a necessary evil, a double-edged sword.”
How to shake off the habit
Monitoring and regulating our sleep is crucial if we want to wake up without an external aid like an alarm. A healthy adult needs seven to nine hours of sleep every day. However, the time varies age, according to National Sleep Foundation guidelines.
Lifestyle also matters. A construction worker might require a few extra minutes of sleep than a person in a remote setting.
“A constant sleep timing is far more effective in waking you up at the desired time rather than changing your sleep timing every day. It is very important to fix your sleep time, even on weekends. However, once in a while fluctuation of sleep-wake timing is excluded until it is switched to the regular sleep regime within one or two days,” says Dr Jain.
Use an alarm for a few days to build a sleep-wake schedule and in a few days, you can naturally get up at the desired time, she suggests.
Dr Parashar concurs that creating a good sleep routine – and even giving up the dependence on an alarm – can take a few days to a few weeks.
Good vs. bad practices
Morning sunlight also acts as a natural alarm by decreasing the amount of melatonin in the body. Melatonin is a hormone produced by the body in response to darkness and it helps to regulate our circadian or sleep rhythm.
A study has quantified the behaviour of those who meet their sleep needs and wake up to natural light rather than to a ringing alarm.
They are 10 per cent more well-rested, late to work 11 days fewer times, 13 per cent more motivated at work, 18 per cent more productive each day, and are less likely to be stressed, than people who need an alarm, according to an analytic survey of 1,040 respondents by content blog ‘Each night’.
“Over a period of time, waking up to an alarm can make you lethargic the whole day and lead to burnout, making you less efficient and exhausted throughout the day,” says Dr Parashar. Such a schedule can lead to psychiatric issues like anxiety.
Using electronic devices and smartphones before going to bed dupes our internal clock into believing that it is not yet night, so the body delays the release of melatonin.
Dr Jain says people diagnosed with insomnia have intense screen usage timings, which makes them too alert to sleep at bedtime, or they have bad and interrupted sleep.
A pre-sleep checklist
We can train our internal clock according to our need and be up on time every morning without needing to set an alarm. All it needs are a few consistent good sleep protocols before going to bed, says Dr Neetu Jain, pulmonologist at PSRI Hospital, New Delhi.
“We have an internal clock and we do not need an alarm clock to wake up. Just try to go to bed and wake up at the same time every day and let your hormone do the rest of the job,” she elaborates.
Summing up the ideal bedtime solutions, she says, “Ideally a lot of good sleep practices can be tried before going to bed.” Here are her tips:
* Have a light dinner
* Eat three hours before bedtime
* Keep the room dark
* Use the bedroom only for sleeping
* Avoid screen time an hour before sleeping
* Do not watch television in the bedroom
* Do not take a bath before going to bed
* Restrict fluid intake before sleeping
* Do not oversleep during the day
