Doctor’s Note: Sleep, Ramadan and the coronavirus

Being up early for prayer and staying up late for iftar may disturb sleep patterns. How will this affect immune systems?

Doctor''s note - 26 Apr
A Muslim boy wearing a protective face mask looks from his home on the first day of Ramadan, amid the coronavirus outbreak, in Bangkok, Thailand [REUTERS/Soe Zeya Tun]

With the holy month of Ramadan upon us, the daily routines of Muslims around the world will change. Although there have been a number of health benefits linked to the intermittent fasting pattern during Ramadan, there is an argument that these may be counterbalanced by the negative effects that disrupted sleep patterns may have on the body.

Traditionally, Muslims fast from sunrise to sunset. This means waking up before the sun rises to have a pre-fasting meal, or suhoor, fasting all day and then breaking the fast at sunset with an iftar – followed by prayers that can go on late into the night.

This year will be different as many mosques remain closed during the coronavirus pandemic and most of these activities will be done from home.

At a time when our immune system is most vital, do these disrupted sleep patterns associated with these early mornings and late nights put us more at risk of catching infections?

A good night’s sleep is vital for good health. As the benefits of high-quality sleep become better understood, many scientists now feel sleep is just as important to good health as nutrition and exercise. Lack of sleep also promotes hunger hormones to go into overdrive, something you can do without when you are fasting.

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Good quality sleep has been linked to a reduced risk of obesity, better concentration and memory, reduced risk of heart disease and stroke, reduced risk of type 2 diabetes, reduced risk of depression and anxiety and, most importantly, healthier immune systems.

For an immune system to work effectively, it must be able to recognise a foreign invader such as a virus or bacteria when it enters the body. It then needs to set off a wider reaction to contain and eventually destroy the invader. T-cells are a part of the immune system that recognise these foreign invaders and trigger that wider immune response. A recent study has shown that sleep enhanced the efficiency of T-cell responses to foreign invaders, thus promoting better immune function.

Proteins known as cytokines are also part of the body’s immune response to infection. As well as recognising an infection is taking hold, cytokines send messages to uninfected cells telling them to prepare themselves for an invasion and promote enzyme production that helps fight off the infection.

Studies have shown that cytokines not only work best during sleep, but are actually produced when a person is asleep. This links to the ancient advice that people need to rest when they are unwell as doing so not only conserves energy but also helps the body to fight off the infection.

Other studies have shown that people who sleep more also have better reactions to vaccines. That is, they have better immunity to the disease the vaccine was given for than those who are sleep deprived. This has been shown for flu vaccines and for the hepatitis B vaccine.

It will be difficult during Ramadan to maintain the eight hours of continuous sleep recommended by experts, but there are ways around it.

If you are struggling to get your usual amount of sleep at night during Ramadan, you can make up for the lost hours through the day. This may involve taking naps or being creative.

Because of lockdown, many people are working from home now so it may be possible to go back to bed for another hour after suhoor as there is no longer a commute to work.

If you find yourself getting sleepy during the day, then take a 20 to 30-minute nap in a quiet, darkened room for the best effects.

Sleep quality may be affected by what you eat. The temptation to over-indulge with unhealthy food when it is time to break the fast can result in the consumption of calorie-loaded, sugar-heavy food. These can reduce your quality of sleep at night. So, as hard as it may be, try to balance these out with healthier alternatives.

It is clear that sleep has numerous benefits, including helping to ward off infections. But will better sleep help in our body’s defence against the coronavirus?

This is a new disease, so it is impossible to say for sure just yet. However, given all the evidence that having a good night sleep does help your immune system recognise and fight off any infection, it certainly can’t hurt when it comes to battling coronavirus.

Source: Al Jazeera