KUALA LUMPUR, Jan 5 — As Malaysians enter the new year with goals to lose weight, eat better or exercise more, many do not realise that these resolutions often fail due to disrupted and insufficient sleep rather than a lack of discipline.

Consultant Ear, Nose, Throat (ENT) and Head and Neck Surgeon at Sunway Medical Centre Velocity (SMVC) Dr Juani Hayyan Abdul Karaf said late nights, prolonged screen exposure and irregular routines have left many adults in chronic sleep debt, affecting metabolism, immunity and mood, while increasing the risk of hypertension and heart disease.

“Malaysians are aware that sleep is important, but they may not realise how dangerous the long-term effects of poor sleep can be,” she said, adding that lifestyle demands, long working hours and stress have contributed to widespread sleep deprivation.

These concerns are reflected in national findings, with the National Health and Morbidity Survey (NHMS) 2023 showing that two in five Malaysian adults do not get enough sleep, while a separate 2024 survey reported that 87.2 per cent of Malaysians struggle with sleep-related problems such as insomnia, frequent waking or difficulty falling asleep.

“These patterns show why resetting one’s sleep schedule may be the most powerful resolution for 2026. Quality sleep supports physical, mental and emotional well-being, forming the foundation for healthier habits throughout the year,” said Dr Juani.

She said when sleep is consistently disrupted, the body is deprived of rest and its internal systems shift in ways that make healthy habits, particularly appetite control, harder to maintain.

“Leptin, which signals fullness, drops, while ghrelin, which stimulates appetite, rises. This imbalance increases cravings for sugar and carbohydrate-rich foods, making it more challenging to follow a balanced diet or manage weight effectively,” she said.

Dr Juani added that sleep deprivation also elevates cortisol, the body’s primary stress hormone, leading to irritability, low patience and persistent fatigue, which can reduce motivation to exercise or lead individuals to turn to convenience foods for quick energy.

Over time, this creates a loop where tiredness triggers stress, stress further disrupts sleep and the cycle continues into the next day. Irregular sleep schedules exacerbate this strain by disrupting the circadian rhythm, which governs alertness, cognitive performance and metabolic processes, often resulting in reduced concentration, slower reaction times and lower productivity.

Dr Juani noted that despite these effects, many Malaysians misinterpret early signs of sleep disruption, such as morning headaches, daytime fogginess or persistent tiredness, as often being blamed on stress rather than poor-quality sleep.

“How a person feels upon waking is one of the clearest indicators. If someone wakes up feeling heavy-headed, foggy or unrefreshed, it suggests they did not get adequate restorative sleep,” she said, adding that symptoms such as lethargy, irritability and dozing off at inappropriate times indicate long-standing sleep disruption that should not be ignored.

Dr Juani said that while lifestyle factors play a major role in poor sleep, many sleep problems actually originate in the airway, where even mild narrowing can interfere with breathing throughout the night. Snoring is often the earliest sign, yet it is dismissed as normal.

“From an ENT perspective, snoring becomes a concern when it appears together with symptoms such as nasal blockage, frequent nasal discharge, difficulty swallowing or signs of apnoea (a condition in which breathing temporarily stops, usually during sleep),” she said.

She explained that congestion or sinus-related problems may worsen at night due to lying flat, lower temperatures or increased mucus collection, even if breathing feels normal during the day.

As airway narrowing progresses, many individuals subconsciously switch to mouth breathing during sleep, which reduces airflow efficiency and disrupts deep, restorative sleep.

“Nasal breathing activates the parasympathetic system, which helps regulate and settle the body. Mouth breathing does not provide that same benefit, which affects sleep quality,” she said.

Structural issues such as a deviated septum or enlarged tonsils may not cause symptoms when awake, but can obstruct airflow at night and lead to obstructive sleep apnoea.

Repeated breathing pauses during sleep force the brain to jolt the body awake to restore oxygen levels, placing strain on the heart over time and increasing long-term health risks. 

Dr Juani stressed that early recognition allows individuals to seek timely ENT assessment before airway problems develop into more serious sleep disorders.

She added that those who snore frequently, wake feeling unrefreshed or experience blocked breathing at night may benefit from addressing nasal congestion, sinus problems or structural airway narrowing.

Dr Juani said ENT assessment and, where necessary, a sleep study can help determine severity and guide appropriate treatment, including non-invasive options such as weight management or Continuous Positive Airway Pressure (CPAP) therapy.

While some may consider supplements, she advises approaching them carefully, as they are typically intended for individuals with insomnia and should only be used when backed by credible evidence.

A holistic focus on regular movement, exercise and maintaining a healthy weight remains the safest and most effective foundation for better sleep throughout the year. — Bernama