¿Estamos durmiendo menos y peor que nunca?

0:06 I' m Roberto Pombo. Welcome to my questions. An average rush program sponsored by KFAM, family compensation box. Sleeping is as important as drinking water, exercising, or eating well, but it seems to be becoming a serious problem for many people in the world. Sleeping little or bad is a public health problem that keeps us from falling asleep. For this chapter we spoke with neuroradiologist Germán Arango, with neuroscience doctor Luis Guillermo Duque, with somnologist Sandra Zavala, with neurologist Carlos Mario Chavarría and with Steve, beloved somnologist and president of the Colombian Association of Dream Medicine. I am Roberto Pombo, and this is chapter ninety- six of my questions. Welcome. He' s been up a night. It is one of the most distressing experiences one can have while others rest and the world is dark and silent. The necessity and desire to fall asleep in the face of the impossibility of doing so is torture. Romanian philosopher Emil Horn dedicated several texts to this subject. Oran said, for example, that in insomnia all things lose their breath or are suspended in a strange silence. For Chorán, those who can sleep at night have an advantage and it is the feeling of a new beginning every morning, while insomnes live with

1:38 a long and perverse continuity that extends as if it were a single day that never ends sleepless nights. Those dawns in which sleep is not achieved, despite feeling tired, are no longer time to work or read. As many people will believe, they are vigils in which it is not possible to think clearly. The mind and body are tired and still cannot rest. It is the ultimate paradox, but beyond poetics, sleeping is a basic necessity, along with feeding and hydration. There' s three of them. At the base of the pyramid of Muslow' s needs. The human body can spend more than a month without eating, about three or five days without drinking water, and the maximum sleep time is about ten days. Of course, the after- effects of spending all this time without rest are hard, and not sleeping is literally torture. For a while, the CIA used sleep deprivation as a way to force its prisoners in interrogations to speak loud music 24 hours a day, with extreme temperatures or simply slapped. The officers kept their prisoners from sleeping for up to 90 hours. The most extreme case is that of the Roman consul Marcuatilio Regulu, who, according to some historical records, is the first person in recorded history to die of Insomnia in about two hundred and fifty- six BC, was handed over to his enemies in Rome, the Carthaginians, who

3:13 apparently tortured him to death, amputating his eyelids and forcing him to stare at the sun. And now, so many centuries later, insomnia, sleep deprivation and bad sleep came back, but not in the form of torture, but as a public health problem. He has thought why we sleep at night and are active during the day, in part because the sun gives us the light to do the basic activities that initially were home and agriculture. Of course, sunlight and the noise of day activities make it better and easier to sleep at night. But not only because of evolutionary issues, but because it is only at night that the human body is added meratonin, a hormone that releases emotional disorders, protects the immune system and has high antioxidant power. For years, millions of years, humans have experienced a constant pattern of exposure to light, with minimal variability from day to day at the time of bet and sunrise.

4:15 This is why our genes prepared us to be active during the day and rest after dark. But as we evolve and over the centuries, human beings have changed their sleep through productive night activities such as exchanging cultural information for social and individual learning, observing predators, and strengthening ties with other members of our group, from singing and speaking around a frigate to a nocturnal reign with friends. This has had evolutionary benefits and led to natural selection to favor shorter sleep durations. However, humans are athepic because, unlike other animals in the same family, we need to sleep only seven hours, much less than the nearly ten hours that a primate with features similar to ours requires, only that there is a big difference between the present human and our ancestors. While for our evolutionary ancestors, sleeping was costly and dangerous because it ran the risk of being vulnerable to predators and limited the time for productive activities. Today, for us it is a lack of a dream that comes out expensive, because sleeping is fundamental.

5:25 Why we sleep, what happens in our brain while we search for German doctor and neuroradiologist Arango to tell me, and this was his answer. Sleep plays a crucial role in various brain functions and is essential for overall health and well- being. Below is a list of the most important reasons. One, memory consolidation during the phases of deep sleep and rem the brain consolidated the information learned, two, brain restoration. During sleep metabolic waste is eliminated, three emotional regulation. Lack of sleep can lead to irritability, aging and depression, four creativity and problem solving, particularly during sleep rem the brain can improve creativity and ability to solve problems without general cognitive function. Insufficient sleep can negatively affect attention in decision- making, reaction time, and other cognitive functions.

6:18 Six brain development. In children, sleep is especially important for brain development, physical growth, and learning. Seven. The user also has a significant impact on the production and regulation of various hormones in the body, such as growth hormone, melatonin, cortisol, leptin and agrelin, insulin, testosterone and thyroid hormones. In short, sleep is fundamental to brain health, influencing memory, brain restoration, emotional regulation, creativity, overall cognitive performance, and the production and regulation of many key hormones for proper organic functioning. We often hear that we need to sleep eight hours. This number is actually a close average.

7:05 According to the American Academy of Dream Medicine and the Dream Research Society, it is advisable to sleep a minimum of seven hours per night to maintain optimal health. Sleeping between five and seven hours is not excellent, but it works if it is only one night or two, and sleeping less than five hours for any period of time can have serious consequences. Although, as in almost everything, there are exceptions to the rule and for this case there are two. The first is older adults because they produce less maratonin. Sleep- promoting hormone and tend to have more medical conditions that can interfere with sleep. The second exception is a small number of people who have a genetic mutation that allows them to sleep only six and a half hours and function perfectly without being affected.

7:53 However, it is a rather rare genetic mutation, and experts are estimated to affect only about one in twenty- five thousand people. The rest of the mortals who are not in the elderly or who do not have this mutation must sleep seven hours each night. The bad news here is that sleeping that minimum time isn' t making the norm. According to the World Health Organization, forty percent of the world’ s population sleeps badly or suffers from some kind of sleep disorder. Different measurements support this terrible statistic. For example, in the United States, for the first time, in a poll by Galoub from two thousand one, more than half of the respondents, fifty- seven percent, said they would feel better if they slept more forty- two percent said they slept as much as they needed. That is quite the opposite of the figures that resulted from the poll of two thousand thirteen, when fifty- six percent of Americans slept what they needed forty- three percent. No. Those numbers, moreover, are radically different from those measured several decades ago in a thousand nine hundred forty- two, when fifty- nine percent slept more than eight hours, while only three percent reported sleeping five hours or less. In nineteen hundred and ninety, the percentage that reported sleeping eight hours or more had fallen to twenty- seven percent, while the proportion that reported five hours or less rose to fourteen percent. Today, a quarter still sleeps more than eight

9:26 hours, but the percentage that does five or less has increased to twenty percent. Ah and young women are a group especially affected by sleeplessness. According to this same Gaul measurement, only thirty- six percent of women, compared to forty- eight percent of men, say they sleep what is necessary. Both figures show significant decreases compared to those of two thousand thirteen and two thousand four and are the lowest that Garro has measured for each group to date. In Spain, the situation is not better according to the survey x- ray of the dream done by forty of b for the chain the newspaper the country. Almost half of Spanish adults do not sleep well every day and most sleep less hours than they would like. And, according to figures from the Spanish society of neurology, ten percent of Spaniards have some sleep disorder and another thirty percent wake up every day with the feeling of not having a restful sleep. Or the day ends very tired. In Asia and Africa, sleep problems and conditions have also become a growing problem. A study that sought to estimate the relationship between sleep problems and low- income environments in Africa and Asia found that sixteen comas six percent of participants reported severe extreme night sleep problems, with a surprising variation ranging from three coma nine percent to more than forty percent, with a consistent pattern of higher prevalence of sleep problems in women and older groups. They

11:03 also found a direct relationship between the lower educational levels not to live as a couple a worse self- evaluated quality of life with a higher prevalence of sleep problems and if it does not rain in Colombia in the rest of the world. Contrary to what a former President says to the country, laziness is not killing him. Colombia is being killed by laziness. According to data from the Colombian Association of Dream Medicine, more than half of the people in the country, fifty- nine percent, are not sleeping well. Between ten and thirty - three percent of Colombian adults suffer from insomnia and between nineteen and twenty- nine percent of sleep amea, a disorder in which breathing stops several times while sleeping. Another fact given by this association is that more than forty percent need to take some medicine to rest. Moreover, in Colombia, the average time we sleep has decreased in the last 80 years from an average of seven nine hours in nine hundred forty- two to six eight hours. Only this, although perhaps not related, should be added that Colombia is the country that gets the most up early and works the most in the world, according to the OCD, but let us return for a moment to one of the sleep disorders that most affect us and it is the already mentioned abnea. There is a sound that has already become so normal for many people and that is still a nightmare for their sleep companions, the snoring. These snoring are a reflection of

12:37 Landa' s sleep, though not the only one. According to a study by doctors, in Colombia, the national records report fifteen hundred cases of sleep measurements between the two thousand seventeen and two thousand twenty- one. This means a prevalence of this problem of twenty- one cases per hundred zero inhabitants. In two thousand nineteen, the year with more cases four thousand seven hundred sixty - nine, the number of cases decreased by two thousand twenty- two thousand twenty- one. Although this could have an obvious connection with the effect of the 19- year- old pandemic, in which sleep medicine services around the world had to temporarily shut down to focus human resources and infrastructure on the pandemic.

13:20 The research showed a concentration of cases in the most developed departments of the country, but these wide differences between regions of the country in prevalence or related to difficulties in patients' access to health services. Some of the departments with fewer cases of AMEA have in common a low population density of less urban development. The graphical distribution of prevalence could also show a concentration of sleep medicine services in major and developed cities, which could hinder access to diagnosis of this problem for patients living far from the center of the cities. All this could lead to a sub- diagnosis in the most vulnerable and neglected part of the Colombian population, leaving them at risk of suffering health and quality of life consequences.

14:09 I read all these numbers and wonder what we can do to improve sleep health. This is what the sonologist Sandra Zavala told me. We humans must understand that sleep is vital to our health. It' s as important a function as eating or breathing. So worrying about our dream and having a better quality of sleep is very important that we should do as individuals. We should try to keep a regular sleep schedule, avoid electronic devices inside our computer room, cell phone some kind of device that mimics light that causes us to not be able to start properly in our sleep. If we use these types of devices at night, we have to try to pass them to the night mode, avoid abundant meals close to bedtime. The last meal should always be very light and at least two hours before bedtime, maintain a proper weight, try to be exercise always in the morning hours, avoid doing evening exercise after four o ' clock in the afternoon, because it is an activity that will also have us more active and will prevent us from properly starting our sleep. The activities to be done at night are always relaxing activities, activities that prepare us to go to bed. Human beings. We sleep a third of our life,

15:39 that is, a person of sixty has slept about twenty years of his life and it is the time when we repair our entire organism. That is why it is so important that we worry about maintaining healthy sleep habits in order to have an adequate quality of sleep that allows us to restore ourselves properly and that the next day we can have the functions of our organism and our activities in the best way possible. Sleep problems are not new, for ten years now the U S Center for Disease Control and Prevention described sleeplessness as a public health epidemic and linked it to a wide range of medical problems, such as hypertension, diabetes, pressure, obesity, and cancer. And it is at this point that I want to give you a fact that a little contradicts what I have said so far. According to an analysis done by the Washington Post in April this year, Americans have started to sleep longer than at any other time in the last twenty years, and you will say, we' re not supposed to be sleeping any less. Well, this is a classic case of yes but no. The analysis of the Washington Post shows that minutes of sleep have been earned by teleworking and other factors, but also that this does not necessarily translate quality sleep. The U S National Institute of Health estimated that at least fifty million Americans, more than one in seven, have no restorative dreams because they fight some kind of sleep disorder, including the aforementioned sleep amnea.

17:15 Sleeping very little and good quality is related to serious health problems such as cardiovascular diseases, diabetes, dementia, but wait for a galop survey says that we are more stressed and sleep less and up to here you will wonder why this is a public health problem, how it can affect us, besides feeling tired, because it is so much or more serious than you imagine. If at first I told them it was used as a method of torture by the CIA. Deprivation or sleep problems result in many physical and mental health problems. In two thousand twenty- two, the U S association El Corazón recommended doctors and asked patients how many hours they sleep why it is as important as controlling their blood pressure, smoking, diet, and exercise habits. Many neuroscientists are also beginning to understand how we can work with the rhythms of our bodies when we sleep rather than do it against them. For example, new research suggests that these rhythms can play a role in patients' responses to cancer treatment and there are more effects of sleep problems, according to Time Joe Syreffsky, Vice President for Research and Scientific Affairs of the National Dream Foundation. If you sleep less than the recommended seven hours regularly, it is very possible and you experience physical, psychological and social consequences. But let' s not get ahead of the

18:45 consequences of bad sleep. Although if it is possible that one can survive with less than seven hours of sleep per night in the short term, in the long term, it is definitely not a good idea. More specifically, not sleeping well or enough promises our performance, attention, decision- making and memory. We run the risk of industrial and road accidents, psychiatric illnesses, dementia and cardiovascular diseases. Many researches have already shown that lack of sleep impairs communication between regions of the brain and its blood flow damages the angry brain and makes a young brain look like an aged brain. On the other hand, according to the American Heart Association. Sleeping badly can cause important risk factors for cardiovascular diseases, such as obesity, high blood pressure, and diabetes, and as if all of the above were poop. According to the American Psychology Association, sleeplessness makes us less happy, more anxious. It can undermine our emotional functioning, decrease positive moods, and put us at greater risk for anxiety symptoms.

19:55 Colombia could eventually face a public health problem for bad sleep. This told me beloved steam doctors, somnologist and president of the Colombian Association of Dream Medicine. Well as for bad sleep, we can have a health crisis in a country for bad sleep. Of course I do. In many countries, they have already faced it in the pandemic, where, due to changing schedules, changing sleep habits and hygiene, we had problems with increasing the incidence of insomnia and increasing the incidence of circadian rhythm disorders, secondary to changes in habit and people ' s wages. Today, to think that this can be exacerbated by other causes. Of course it is, especially in the adolescent population, in the young population, which is increasingly using night hours and sleep hours to be connected to technology. The use of lights, tablets, screens, all these technologies that can lengthen that sleep start time, can generate that a specific population can begin to present more sleep disorders, that leads to a public health crisis, by the consequences of insomnia, of sufficient sleep time, of the debt of sleep and of other sleep disorders associated with work wages, shifts and the poor quality of it. Why the numbers and research show all this deterioration of sleep over time. The answers are many. One of them is that the demands of modern society can increasingly shorten the rest time and worsen its quality. Times

21:30 have changed and life is now more agitated than it was several decades ago. According to the gallop measurement that if you have minutes back, Americans are more stressed? Today, three decades ago, health and well- being research has shown a direct relationship between stress and quality of sleep, which, according to the American psychology suociation, is two- way. Those who sleep less are more stressed and those who are more stressed sleep less. A real vicious circle, in fact, a Gaul survey. He found that sixty- three percent of those who say they want to sleep more say they experience stress often, compared to thirty- one percent of those who sleep what they need. How it looks like insomnia problems show no signs of disappearing. This is partly because our economy is increasingly organized around sleep- deprived work. In the United States, production workers are most likely to suffer from sleep disorders, possibly because of shift work. Cities are increasingly densely populated and transport times are becoming longer.

22:42 In the 21st century, the lifestyle added two new sleep disturbers. We take large amounts of caffeine to stay alert and be able to keep pace, and we also sleep with portable devices, with their bright lights and constant doses of dopamine that stimulate us and prevent us from sleeping. But we' re going in parts. Coffee or tea or energizing drinks. It depends on where you get your caffeine. It is one of the most popular measures in the world. In fact, the second most popular after water, and about four hundred billion cups a day are consumed worldwide and it is estimated that in two thousand twenty- three, approximately ten four million hectares of coffee were grown worldwide.

23:27 It is the first thing we think about when we wake up, the first thing we long for, but precisely its high consumption is making sleep quality worse. We take it to stay awake, but its frequent consumption reduces total sleep time and its effect remains in our body several hours after we take it. And if during the week we drink coffee to stay awake, on weekends, we look for liquor to relax. But alcohol also impairs the quality of sleep and makes the stage rem the deepest and most restorative sleep phase, less profound and repair. Find the neuroscience doctor, Luis Guillermo Duque, to explain to me better how much the quality of sleep affects substances such as coffee and alcohol.

24:11 This answered me. Coffee is a nervous system exciter. Therefore, the amount of coffee ingested and, in turn, the amount of caffeine ingested, as well as chocolate, tea and energizing drinks that usually have other nervous system exciters, will affect the quality, the quantity and the possibility of having a restful sleep. The recommendation for those who have insomnia, for example, is to avoid all black drinks, all drinks that have caffeine content and, in other cases, that those who have difficulty falling asleep, I took maximum four cups of coffee a day, maximum until three or four in the afternoon.

25:03 With regard to alcohol, alcohol interferes with sleep phases and will produce an interrupted sleep. Initially it produces sleep that is what happens to drunkards, but later it affects the general cycle of sleep and the dream that produces is a non - repairing sleep, It is a dream that does not fulfill the cycles and does not finally reach the sleep rem or, to the sleep mor that is the dream in which you rest in a real way. And one last factor that is helping to worsen the quality of sleep is the screens. By that I mean the time we use cell phones, tablets, computers or watch TV, but especially this is taking on children of teenagers. It would not be enough to cite the number of studies that have concluded that excessive screen time in terms of sleep quality and therefore has numerous adverse physical and psychological manifestations. How the use of screens affects the quality of sleep that gives this restlessness to neurologist Carlos Mario Chavarría, and this he told me, we have to start from the fact that sleep is important in processes of consolidation, of learning memory and that it also has vital neuroendoken functions. In this way, it has been increasingly demonstrated that the use of screen is associated with less sleep, which contributes to an insufficient sleep and, moreover, was a moment in sleep latency understood

26:36 as that interval between that we lay down and fell asleep. Both can potentially present memory failures and learning consolidation failures. Precisely because of this it has also been related to a moment in anxious symptoms and the wavelength of screens, cell phones and tablets. Specifically, it has been seen that it can interfere with the secretion of hormones that regulate sleep, on the one hand, and also that they are related to processes, for example, obesity. The recommendation, especially in adolescents and children, is that screens should not be used within two hours before sleeping as a measure of sleep hygiene and that, in addition, the use of screens should not affect mealtime, routines, sleeptime and physical activity.

27:29 Humanity has dedicated poems, films and even sciences to understanding what happens in our dreams, to understanding them, to interpreting them, to bringing something from them to the world we live in. When we are awake, we call it dreams that which we long for and nightmares to uncomfortable or distressing situations. Dreams are important, they affect our real life. That' s why we have to take care of sleep, try to get enough sleep and good. I hope this chapter helped consider the dream. That' s not while listening and paraphrasing the topollillo until the next week, if God wants and rest well I am Roberto Pombo, and this was chapter ninety- six of my questions.

28:14 See you in the next chapter from now on. This chapter of my questions is available on all podcast platforms. This episode was made possible by Kafan. Family compensation box. Dirección Roberto Pombo, Producción General Juan Abel Gutiérrez, editorial advisor, Daniel San Pedro Espina, scripts juan Abel Gutiérrez and Johnny Rodríguez. Field production Marcela Salazar and Lucía Beltrán Audio production Carlos Bernar