I recently made an arduous but satisfying long-distance trip whose preparations were demanding. However, as the presentations were well received, and I could take a break after working so hard, I had expected to coast along from there.
Unexpectedly a combination of challenges which, in isolation, seemed trivial at the time, befell me: a flu-like illness, cumulative sleep loss from jet lag, and a personal matter. These elements working in tandem sapped my hard-earned health reserves.
Through the leisure portion of the trip and extending to my return home, my heart-rate-related markers showed a gradual but clear loss of exercise capacity, exceeding what I had experienced after contracting Covid-19 some time back. Regardless, I tried to keep life going at my accustomed, fast tempo. Mind over matter, right?
The saying goes that bad things happen in threes, and so it was that I caught another infection soon after. However, the new symptoms appeared only after tests for an annual health review were performed. This could have affected the results, but at the time, without benefit of hindsight, the findings of my health review freaked me out.
My doctors could not provide me with a clear answer as to what was going on, told me to take some medication and to wait a month for the outcome. I who jealously guarded good health, had met with the unexpected.
For life must go on?
The ancients had an expression: “Mens sana in corpore sano” (sound of mind, sound of body), penned by Juvenal over two millennia ago. It urges people to embrace the value of mental well-being and health. Written in Latin, this phrase headlined a pithy and wisdom-filled Roman poem.
In our youth, we often discount such wisdom. For isn’t that a time to pursue dreams with little concern for the impact of our choices on health and well-being? Even when hearing of someone close unexpectedly falling very ill, such news might arrest our attention and elicit sadness, but only for a short time. For life must go on.
We return to striving and the making of inconsequential comparisons between ourselves and others. Such concerns weigh on our hearts and minds, stealing more time than we care to admit.
Many relegate self-care to the back-burner, giving the excuse they have no time. Yet almost anyone who is not in dire straits has some control over his time. Despite this, when we feel well and are doing well, even a poor family health history or concerns about black swans remain buried.
As work eats sleep
While passing time and mulling on the possibility that my health could be compromised, I chanced on, in separate encounters, well-compensated professionals who related how their sleep was impacted by their work.
The first went to bed at 2am on average because his clients wanted him to answer questions till then. They felt that they had a right to his time because they could afford to pay him. He was constantly fatigued but was not shaken enough to change his behaviour.
A second slept an average of four hours a night and fuelled himself with coffee to function, until he developed palpitations and hypertension.
Both these men recognised that sleep was important, but neither was looking to substantively change his schedule, perhaps constrained by keenly felt obligations.
A third person was so affected by job demands, she fell into a depression, which was associated with physical pain that limited her mobility. This also affected her sleep robbing her of the ability to enjoy activities she had previously taken delight in.
Often, it takes a personal scare to awaken our appreciation of health and mental well-being. Additional investigations following my check-up revealed a lesion that, while not life-threatening, carried with it unpleasant possibilities. I was told to try something and wait – advice unsurprisingly poorly received by someone who was adept at navigating challenges and resolving ambiguity promptly.
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A dark place
For weeks after, I found myself in a dark place I could not extricate myself from. Accumulated effects of real or imagined issues, which individually would not trouble me, wrecked my sleep.
An irrational fear of loss started to grossly distort my perception of reality. While my head reasoned that the psychological churn was not justified, feelings trumped rationality when I was at rock-bottom.
Externally, I seemed normal. An outsider would not see through my distress, as decades of experience helped me mask such signs in formal situations. Further, my interactions were mostly brief, and I had some control over them.
However, when alone, my thoughts, what I chose to read, view, listen to, think about, and express were all affected, and the reverberations of these amplified the private torment.
Whatever was distressing me was reflected in resting heart rate and exercise markers. Healthy mind, healthy body and conversely, troubled mind, upset body. Here I was, someone well-equipped with knowledge, but still caught with an exposed Achilles heel and experiencing first-hand, the stark reality of that adage.
During that dark period, there was no achievement, no source of pride that could lift me from the crashing waves of distress that struck, withdrew and then struck again. The thoughts permeating the substratum of my psyche also temporarily transformed me into a younger, unsure version of myself – someone lacking in confidence, with none of the psychological defences one acquires after years of adapting to hard knocks.
Fortunately, almost as rapidly the final fusillade of negative arrows cratered my psyche, the onslaught beat an unexpected retreat. Over the weeks of waiting, my health problem resolved, and I made peace with the reactivated traumatic thoughts. I was both shaken and stirred, but left a fresh appreciation of sleep, health and well-being.
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Nothing new yet everything changed
Looking back, I wonder what if I had dispatched my commission to write by simply admonishing everyone to confine work or work-related communications, unless critical, to work hours as far as possible? Or to encourage each worker to reciprocate in kind to collectively shift the status quo?
Similarly, I could echo warnings about how social media, while connecting us, can also be an inescapable plague if we don’t develop clear ideas on how to deal with upsetting messages, especially those received close to bedtime.
I could also parrot some choice sleep hygiene tips. But there have already been a multitude of advisories. If only these were acted on!
But there is nothing truly new to be said, except perhaps to warn that the business of sleep is heating up to meet a crying need pushing the desire to profit to overtake a beneficent spirit.
I could also proffer some science – like about how, in an extreme mouse experiment in 2023, changes to Prostaglandin D were induced by extreme sleep loss resulting in the annihilation of the immune system and subsequent death.
I could also have expanded and embellished each of these corporate friendly bullet points, but fate hurled this commentary onto a different path.
I leave you with this lesson gained: Facts and principles are good to know, but unless we are truly moved, few of us will change our habits. In promoting mental health, we have been led to think technology makes us exceptional, and that apps, devices and training packages might provide plausible solutions for life’s ills.
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Yet the emotional brain has an ancient and highly conserved architecture that embodies the essence of our humanity. What supports our ascent to dizzy heights of pleasure and satisfaction can also cause us to sink into deep and seemingly inescapable despair. Such a precious thing must be taken care of, not relegated to algorithms, curated workflows and shallow relationships.
If this resonates, pause to consider how you might reapportion your time to care for your health and mental well-being and make provision for sleep. You will be happier, a better companion, as well as a more productive and healthier worker for it. And if you benefit, be sure to pass the good along.
Michael Chee is director of the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine at the National University of Singapore.
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