Dubai the Big Apple of Mideast: gripped by Insomnia epidemic
For long Dubai has prided itself as a city that never sleeps. And now it's paying a price for it. Dubai is in the grip of an insomnia epidemic as a vast majority of residents cannot afford a good night's sleep. A survey showed that 68 per cent of UAE residents do not notch up enough hours of slumber. Experts reckon the statistics could be much higher for Dubai, given its frenetic pace of life.
Sleep disorders are behind car accidents, job sackings and even divorces. They are also linked to deadly illnesses like heart disease, hypertension and diabetes.
"There is sleep restriction," said Dr Hassan Al Hariri, sleep medicine consultant, Rashid Hospital, Dubai. He attributed the modern curse to a daily grind packed with work, rush hour traffic, shopping lists, and social commitments. "A lot of people have to work long hours. Then you're out till midnight - what's going to happen to your sleep? In the US, the malls close at 9pm; by 11pm you're back in bed," Dr Al Hariri said. The "shisha culture" - where tobacco water-pipes and coffee or tea are part of socialising - doesn't help either. Shisha and caffeine have stimulants that make it difficult to sleep.
He added that even the local climate plays a part with long summer days eating into the night hours.
Canadian expat Roger sleeps an average of only four hours during week nights. He works in a property business where he can't decline client meetings no matter how late or early. His work takes him to Sharjah, Ajman and Hatta - often on the same day.
"I'm always ‘on call.' The business isn't doing well; I'm getting complaints from clients all day and night. I'm too stressed out to sleep," the 35-year-old said. "On weekends I want to get away from it all and find myself partying till morning. I sleep in, but then I'm not tired at night. It's back to work again soon; it's a cycle I can't break."
An Indian manager in a vehicle trading company is also on the brink of exhaustion. The manager, in his mid-30s, used to get up at 5am to beat the rush hour from Sharjah to Dubai. He would then nap in his car - in the office parking lot - before doors opened for business. But though he was on time at work, the extreme routine was affecting his performance. After pleading with his boss, he has been allowed flexible office hours. However, a recent complication with his wife's pregnancy has made him sleepless again.
He said: "I'm not getting any rest at night; I've nightmares. I'm up before the alarm rings."
Dr Amro Al Astal, sleep medicine expert and pulmonologist at American Hospital Dubai, said: "Sleep disorder patients push themselves to the edge in their work and social life - and then the whole system starts to fail. Their personality changes, tempers fly, and accidents can happen."
A salesman from Pakistan knows the dangers only too well. He has had two near-fatal accidents in Dubai because he wasn't sleeping well. "Never take sleep lightly. I thank God for being alive today," he said.
But many other motorists have paid the cost of "driver fatigue" with their lives. And it's all down to "sleep starvation".
People's jobs and relationships are also at stake.
A 34-year-old British expat said he almost got fired for being routinely late for work and "not putting in my 100 per cent".
"I was too embarrassed to tell them I'm on medication for anxiety and insomnia. I'd stay up till 6am sometimes, nap for two or three hours, and rush to work. It did my head in, I wasn't really awake," the UK national said.
His fiancée also suffers from sleeplessness and the problems are straining the relationship. She naps during the day to make up for lost sleep at night. "It's very frustrating. I feel like calling her during the day, but realise she must be sleeping. I'm too tired to give her time at night. It's bad for the relationship," he said.
There are many others facing similar challenges.
Dr Al Hariri said, "People are being forced to take unpaid leave to get treatment for sleep disorders. They are forced into resignation or early retirement, blamed by bosses as lazy or incompetent … When you spend about 30 per cent of your life sleeping, poor sleep is bound to reflect on the rest of it."
He said roughly 35 to 40 per cent of UAE residents have suffered from a sleep disorder at some point in their life. Many of the cases are related to apnoea, which interrupts normal breathing during sleep, and insomnia which has been linked to higher risks of suicidal thoughts and bitter relationships in a new study. Dr Al Hariri said: "If insomnia is left untreated, people can fall into chronic long-term insomnia even when the stress is gone. Bad ‘sleep hygiene' is also responsible, like TVs or laptops in the bedroom. Insomnia's not easy to treat."
He said psychiatric patients here are sometimes referred to sleep specialists because of an underlying sleep disorder. "Many people with bipolar disorder [for example] cannot confront the symptoms because of a sleeping problem. And night terrors, where people act out violent or frightening dreams, often have some childhood trauma behind, like abuse," he said.
Many residents are unaware that their sleeping problems are clinical diseases that need medical attention, said Dr Al Astal. Others are simply too embarrassed - people who suffer from bed-wetting or sleep-walking are often too shy to step forward. He pointed out that in countries like the US and UK, flagging and treating apnoea, for one, is a legal must for lorry drivers.
Dr Al Hariri added: "Here drivers will deny the symptoms out of fear for their job. Despite the health risks, sleeping problems are under-diagnosed, under-treated, and under-estimated in the UAE.
"Many insurance companies don't recognise obstructive sleep apnoea as a disease; they see it as ‘just snoring' or ‘a waste of time'. But they don't realise there are much higher health care costs - million of dollars more - to spend on hypertension, heart failure and diabetes, all because sleep disorders are not treated."
This leaves patients to foot the bill of up to Dh13,000 in tests and treatments, doctors estimated.
Apnoea is thought to be the most common sleep disorder here - and the most dangerous too, said Dr Asif Sattar, sleep specialist and pulmonologist, City Hospital Dubai. It has been linked to heart disease, hypertension and diabetes. The problem seems to get worse with another rising health threat - obesity.
Dr Al Astal said a change in attitude is needed to change the situation around. "Lifestyle can make sleep disorders worse. Stress will only add to the problem - then you'll still have that problem on the quietest place on earth. Sleep disorders have been there for hundreds of thousands of years, and they'll continue to be there.
"Public awareness plays a big role, the point needs to get out … It can take years for people to come for help, when they cannot work around sleeping problems any more. They don't come because ‘I couldn't sleep last night'.
"But it can be 20 years too late."
You may be suffering from a sleep disorder if you:
- Snore loudly
- Stop breathing while sleeping
- Doze off while driving
- Have unexplained high blood pressure
- Have poor focus and concentration during the day
- Feel tired even after a long sleep
- Try to retire early
- Don't dwell on your worries
- Don't have drinks with caffeine in the evening; try to have a warm milky drink instead
- Don't exercise too late - but an early workout seems to help in night sleep
- Make sure the room isn't too hot (or cold)
- Steer clear of TV and the computer; read something boring instead
Did you know?
Some people have "misconceived insomnia" - they think they haven't slept "for days" but do in fact sleep deeply!
On the flip side
The Kleine-Levin Syndrome makes patients sleep for almost 24 hours a day - for weeks at a stretch - waking up for food or bathroom breaks only. They often sleep right though important dates and commitments, like job interviews, college exams and anniversaries. A cure has not been found yet.
- 40 per cent of UAE residents have suffered from a sleep disorder at some point in their life.
By Faisal Masudi