Our 21st century health identity: Where is sleep?

Abstract

That public health affects us is well documented in this issue of the Journal of Public Health. The topics in this issue cover health across the lifespan with six manuscripts discussing in detail the promotion of health of the most vulnerable people; i.e., children, women and minorities. Several dimensions of their health are adversely affected, and the interdisciplinary approach to their health discussed in this issue underscores the importance of a pertinent network of public health worldwide. This is especially the case when vulnerability ‘accumulates’, forming our 21st century health identity. More specifically, a worldwide public health network should not only govern threats to health during the daytime but equally during nighttime. For where we sleep, how we sleep, when we sleep, how much we sleep... or the “sleep-determinants of health” are amongst the many factors affecting our health in general. Thus, our current health, or the health of young adults and the elderly, as well as our future health or our children’s health, should be subject to discussion and debate from a day/night perspective. Whether guidelines are implemented in real life, health care is a highly relevant topic in terms of continued public health education and training of professionals as well as in providing optimum health care. Several reasons for not adhering to guidelines, such as reduced vigilance during our professional endeavors, can be listed. Sleep studies in medical residents suggest impairments in several domains, including attention, cognition, motor skills, and mood (Mansukhani et al. 2012; Reed et al. 2010). Unfortunately, in such a global fast-paced lifestyle, only medical errors or complications may alert us. In their observational study, Boettger et al. recommend improvements in the treatment of patients with impaired renal function. The authors discuss the practice of therapy in these patients and alert us to the negative clinical implications and the legal reasons. Being attentive regarding risk factors for adverse health outcomes can extend to the general population. In adults aged 50+, behavioral risk factors are likely multiple and varied. Linardakis et al. indicate that across European countries, the prevalence rate of multiple behavioral risk factors such as alcohol, smoking habits, physical inactivity is different. Regarding all risk factors studied, inactivity prevailed; thus, one may question the association of inactivity with sleep (Ding et al. 2013). Yet, already at a young age, behavioral risks may accrue; for instance, poor sleep (Spruyt et al.) may further promote health threats. Difficulties initiating or maintaining sleep, or circumstances impeding optimal sleep may increase vulnerability to adverse health outcomes (Spruyt and Gozal 2012; Spruyt et al. 2011). Alternatively, sleep problems such as difficulties staying asleep is commonly reported in subjects with posttraumatic stress disorder (Lamarche and De Koninck 2007; Singareddy and Balon 2002). Haase et al., for instance, report on human trafficking, a violation of human dignity affecting mostly women and children. The report is regarding the three Pparadigm—prevention, protection and prosecution—which was developed by a highly disciplinary group under the framework of the Siena Principles on Human Trafficking and Public Health. The authors emphasize the substantial health and social implications, with long-lasting grave and adverse impact on the individual, public health, human K. Spruyt (*) Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, Brussel 1050, Belgium e-mail: spruytsleep@gmail.com