Shafaqna English– The Sleep and Breathing has published the paper “Effect of diurnal fasting on sleep during Ramadhan: a systematic review and meta-analysis” written by Mo’ez Al-Islam E. Faris et al. in 2019.
According to Shafaqna, this meta-analysis aimed to achieve a more stable estimate of the effect size of Ramadhan diurnal intermittent fasting (RDF) on sleep duration and daytime sleepiness. Fasting is an ancient practice defined as voluntary abstinence from food and/or drinks which has been recently adopted as a health and fitness trend.
Ramadhan fasting forbids eating foods, drinking water, sexual activities, and
smoking during daytime and affects daily lifestyle. The predawn meal is taken before dawn (Suhoor), and the main course is taken after sunset (Iftar). This shift in mealtime during Ramadhan might be associated with changes in caloric and nutrient intakes (heavy meals), which are variable according to the variations in dietary and social behaviors practiced during the fasting month. Religious practices can affect sleep and during Ramadhan, many events occur at night.
The findings are mentioned below:
- Ramadhan and associated practices affect sleep duration and daytime sleepiness.
- Baseline total sleep time (TST) across the total studied population was 7.2 h, which decreased by ~1 h during Ramadhan.
- Ramadhan fasting was found to affect daytime sleepiness, reflected by lower Epworth sleepiness scale (ESS) scores during Ramadhan.
- During the Month of Ramadhan, there is approximately a 1-hour reduction in TST and nearly a 1-point increase in the ESS score.
- Different factors can cause TST to decrease in fasting individuals. Firstly, eating habits change during Ramadhan.
- Interruptions in early morning rapid eye movement (REM) sleep are decreased in those who wake up early to consume the predawn meal Suhoor compared to those who may remain awake all night.
- Disruption of mealtimes impacts circadian rhythm.
- Late-night-dinner eating (LNDE) negatively affects circadian rhythm and hormone secretion, regardless of fasting.
- Sleeping with a full stomach causes gastroesophageal reflux and reduced diet-induced thermogenesis, affecting quality of sleep.
- Core body temperature decreases upon sleep onset, while increases promote wakefulness and LNDE may cause an increase, prolonging sleep latency.
- Eating 30 min before bedtime, but not 3–3.5 reduces nocturnal sleep time. Secondly, melatonin, which has a smaller and delayed night peak and flatter slope in serum concentrations and lower nocturnal melatonin levels during Ramadan, also affects circadian rhythm. However, intermittent fasting has no significant influence on the circadian pattern of melatonin.
- A subgroup analysis of age and physical activity (PA) revealed differences in TST. Teenagers, who tend to sleep longer regardless (baseline: 8-9 h) showed the most significant decrease in TST. This may be attributable to lifestyle changes (late-night activities including social gatherings, television exclusives, nightly prayers/recitation). Besides, provided that young adults represent a remarkable part of the reviewed subjects, there is a possible impact for the social media and screen time on sleep, which are known to be significantly associated with disturbed sleep.
- A significant reduction in TST apparently does not negatively affect quality of sleep. TST also significantly decreases by ~1 h during Ramadhan in athletes. TST also decreased in adults during Ramadhan, possibly due to a delay of bedtime because of a delay in the start of work during Ramadhan in some Muslim countries. In spite of a delay in rise time during Ramadhan, the delay in bedtime is more prominent, explaining the decreased TST.
- Increased daytime somnolence during Ramadhan may be the result of reduced TST and changes in lifestyle during Ramadhan.
- Sleep during Ramadhan is usually interrupted by the Suhoor, which occurs late at night in most Middle Eastern countries.
- Studies conducted in the UAE, KSA, and Morocco report significantly delayed rise times and bedtime during Ramadan, which is partially because of the delay in the start of work and also delayed work hours for shopping malls, stores, and restaurants, and the late-night broadcasting of interesting TV programs.
- Excessive eating reported during Ramadhan nights can induce a shift which delays the circadian rhythm, leading to delayed sleep.
Source: researchgate