Ramadan sleep debt: How it accrues and how you can get it back

The quality and length of sleep can change drastically during Ramadan. The effects of fasting, changes to work and school schedules and staying up late or rising early for suhoor are all contributing factors.

When a person gets less sleep each day, with the lost time building up without being recovered, it is called sleep debt. Not only restricted to Ramadan, sleep debt can affect anyone who doesn’t get the recommended amount of sleep or isn’t able to catch up on that lost sleep with daily naps.

“During the holy month, the sudden change of eating habits and sleep timings, are accompanied by some physiological changes in the body,” says Arfa Banu Khan, clinical psychologist at Aster Clinic, Bur Dubai. “The normal circadian rhythm of the body gets affected and makes it difficult to get a proper night's rest and sleep. The social gatherings and prayers later in the evening also add to the improper sleep schedule.”

What is sleep debt?

Sleep debt, also known as sleep deficit, is the difference between how much sleep you need and how much you get. Getting less sleep than you need for a few days won’t be an issue, but when that difference is sustained over a long period of time, the lost hours accrue and become impossible to get back.

“Sleep is an essential part of our lives and the typical person needs seven to eight hours of sleep each night to maintain peak mental and physical health,” says Dr Waseem Dar, specialist neurology at RAK Hospital. “Getting less than adequate sleep is known as sleep deprivation. When an individual has multiple consecutive days of sleep deprivation, they enter 'sleep debt', which is a cumulative effect of insufficient sleep for any period of time.”

It is recommended that adults sleep between seven and nine hours a night; teenagers aged between 14 to 17 years should get eight to 10 hours and school-age children aged between six to 13 years should get nine to 12 hours.

Not getting the full amount of sleep can have a detrimental effect on health, including low energy levels, irritability, anxiety and an inability to concentrate. More serious effects caused by long-term sleep debt can lead to depression, heart disease and risk of stroke.

For an adult, losing two or three hours of sleep a day can result in 14 to 21 hours of lost sleep in a week or the equivalent of two or three full night’s sleep.

How Ramadan and fasting can increase sleep deficit

A 2013 study, The effects of Ramadan fasting on sleep patterns and daytime sleepiness: An objective assessment, found that: “During Ramadan, bedtime and wake-up time were delayed, and there was a significant reduction in total sleep time for Muslims.”

Rem is the deepest level of sleep and is characterised by irregular breathing, elevated heart rate, relaxed muscles and quick eye movements. It is the time when most dreams occur, the brain strengthens its ability to form memories and also rests and repairs. Adults are recommended to get at least two hours of rem sleep a night.

“Fasting has been shown to alter the sleep-wakefulness pattern,” says Dr Dar. “For example, food deprivation has been shown to increase wakefulness and markedly reduce rapid eye movement sleep.”

Adds Khan: “The reduction in total sleep time during Ramadan makes you sleepy during the day and lack energy. Lack of sleep causes hormonal dysregulation and is detrimental to overall well-being.”

Can napping help make up sleep debt?

Making up your sleep debt during Ramadan can be helped by developing new sleeping rhythms and patterns as your day allows. “Try to sleep for at least four hours at night after iftar, before waking for suhoor – and return to sleep for a couple of hours before getting up for the day ahead,” says Khan. “This will help your body get into a rhythm for more restful sleep. A short power nap in the afternoon can revive the energy level. A 20 to 30-minute nap can boost energy and help combat daytime fatigue without interfering with night-time sleep.”

The amount of time taken for a nap should be regulated by setting an alarm so you don’t get too much, which can have a detrimental effect on the rest of the day. “In power naps, a person wakes up from light sleep and feels refreshed and alert,” says Dr Dar. “Waking up from deep sleep can cause a feeling of drowsiness and grogginess, a term known as ‘sleep inertia’. Research has shown that napping for less than 20 minutes improves alertness and functioning right away, with little or no grogginess after waking up.”

Adding: “If a person has had a late night, they might benefit from a longer nap. Snoozing for an hour or 90 minutes can help make up some of that sleep deficit. However, power naps are not the answer for chronic sleep deprivation.”

Making up for lost sleep after Ramadan

When eating and sleeping patterns, along with work and school hours, return to normal, getting back to your natural rhythms may take some time, but there are ways you can naturally facilitate the transition.

Dr Suresh Vassen at Bodytree Wellness in Abu Dhabi suggests partaking in daily walking meditations and reducing exposure to screens and monitors as ways of returning to your previous schedule.

“Maintain a strict routine of rest and activity at the same time every day, with a mild to moderate movement of the body,” he says. “Throughout the day, try low, deep, regulated and gentle alternate nostril breathing exercises hourly for one to two minutes each time.”

Replenishing natural melatonin levels can also help. Try to incorporate foods that are high in melatonin into your meal before bedtime – to be eaten three or four hours before sleeping – such as milk, bananas, cherries and eggs.