Is “Junk” Sleep Making You Sick?

Getting a good night’s sleep is undoubtedly a key component of good health. That's why it is unfortunate that the sleep quality of Americans has steadily declined over the years. This is due to a number of factors, such as poor sleep hygiene (the use of electronic devices and alcohol/food consumption before bedtime) and medical conditions, such as sleep-disordered breathing.

 

 

After having administered hundreds of home sleep studies, it has been interesting to observe that while people may be sleeping for the required length of time, they still end up waking up exhausted. Why is that? Well, even though these patients are asleep, they are not reaching the proper level of sleep to get the full benefits.

 

Think of sleep like food. Look at the two plates of food in the images below; they are completely different in nutritional value. The same is true for sleep!

 

                                       Sleep is like food, which plate resembles yours?

The first part of the night generally consists of a deeper state of sleep. During this period, our body temperature drops, our heart rate and breathing slow, and our muscles relax. This allows for physical regeneration of our body. Failure to reach this level of sleep results in increased inflammation and reduced immune function. The result? A myriad of physical ailments. In fact, recent studies have linked breathing-induced sleep disturbances to fibromyalgia and even cancer!

 

The second part of the night consists of a lighter level of sleep known as rapid eye movement (REM). Restorative sleep during this time of night (when we dream) has been shown to facilitate learning, improve memory and enhance emotional health. Neurotransmitters and stress hormones are balanced during this time, and failure to reach this level of sleep has been linked to an increase in anxiety, phobias and depression.

 

While it is relatively easy to make changes to your sleep hygiene, dealing with a nighttime breathing condition is much more problematic. We tend to think sleep apnea only affects overweight, middle-aged men with necks like NFL linebackers. That’s because in the conventional medical community, diagnosis for sleep apnea is made using the apnea-hypopnea index, which measures how many times an hour you stop breathing for more than 10 seconds. When things get bad enough, health insurance pays for a continuous positive airway pressure (CPAP) machine.

 

The problem is, there are numerous milder forms of sleep apnea (such as upper airway resistance syndrome and inspiratory flow limited breathing) that make up a host of conditions known as sleep-disordered breathing. In those cases, the body still has the ability to compensate for an obstructed airway. Since oxygen is a huge priority, our bodies will do whatever is necessary to ensure an adequate supply. There is, however, a price to pay for doing so.

 

In one scenario, micro-arousals occur (measured in sleep studies as respiratory effort-related arousals) in which you wake up just enough to keep breathing, but not quite enough to fully wake up. This is problematic, because even though you are asleep, you never get into deep or REM sleep and therefore do not get the benefits of sleeping.

 

The other scenario is even worse! Even slight resistance to breathing (like snoring or making any sound during breathing), puts the autonomic nervous system into “fight-or-flight” mode. Not only is sleep quality compromised, but cortisol levels are also elevated. Studies have now shown this to contribute to a host of conditions from Alzheimer’s and diabetes to high blood pressure and unexplained weight gain.

 

So how do you know if you are getting the quality sleep you need? One way is to use a sleep tracker. Even though they lack the accuracy of a home sleep study, devices such as the Ōura ring, WHOOP band, Fitbit and Apple Watch are excellent tools to monitor your sleep. The second is based on symptoms. In deep sleep, our bodies produce antidiuretic hormone, which stops the production of urine. Chances are if you are getting up more than once a night to urinate, it’s because you are not reaching that desired state of deep sleep. Another good indicator of sleep quality is dreaming. The majority of patients in our practice who are being treated for sleep-disordered breathing, report sleeping through the night and a dramatic increase in dreaming. I love to hear that, because it tells me they are now getting the quality sleep they need.

 

Fortunately, technology exists now to not only quickly and accurately diagnose conditions of the airway, but also to treat the root cause!

 

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