Jun 11, 2010
Sleep May Not Be the Number One Factor In staying Young and Healthy
“Early to bed, early to rise, makes a man healthy, wealthy and wise.”
This short proverb can be traced as far back as 1496, and even earlier if you count all its variations. It seems that people have always understood the necessity of a good night’s sleep, but these days quality sleep has become a luxury rather than a necessity. But going without sleep may not be so easy since it’s not something your body can easily do without.
The Growing Sleep Deficit
According to a recent Harvard Health Publications survey, “more people are sleeping less than six hours a night, and sleep difficulties confound 75% of us at least a few nights per week.” Most people are shown to be getting inadequate sleep, and as a result chronic fatigue is a major problem for millions of Americans.
But even with the sleep “catch up” on the weekends there are still those who are tired and listless no matter how many hours of sleep they get. In these circumstances, something else may be awry: the sleepiness patients feel is usually the end result and not the actual cause of their sleepiness. In fact, it may be their poor breathing at night and not the quantity of sleep they’re deprived of.
Breath Well To Sleep Well
Whenever you undergo any form of exercise training, you’re almost always reminded to take long deep breaths and to focus on your breathing. From Pilates, to yoga to running and Tai-Chi, exerting control over one’s breath, especially as it pertains to one’s stamina and endurance, is key to maintaining good form and gaining mastery.
But think what would happen if you couldn’t breathe well while you slept. You’d get more than a flabby body. You’d be headed for some serious health problems. But if you’re suffering from obstructive sleep apnea, or OSA for short, this is exactly what’s happening.
Having Trouble Breathing While Sleeping?
Although all humans have varying degrees of airway narrowing, those with sleep apnea, or its milder variant upper airway resistance syndrome (UARS) have anatomies that are more prone to collapse than others. If you have a triangular facial structure or if you have a long neck or if you have a thick, stocky neck, like a football player, or if your tongue happens to sit higher up on your arches (see diagram), all of these anatomical factors can predispose you to airway obstruction or breathing problems while you sleep. Obesity, or one’s weight is not the primary indicator as once believed for having sleep apnea.
This is why for some OSA and UARS patients, sleeping on their sides or stomaches is an important prerequisite for getting a good nights rest. The reason being that this position, as opposed to sleeping on their backs, gives the tissue around their airway a bit more openness, and their tongues don’t tend to collapse as easily if they were lying flat on their backs, especially in deep sleep when throat muscles tend to relax more.
Although many OSA and UARS patients think they prefer to sleep this way just because this is how they’ve always slept, they may very well have made a choice to sleep this way for very good reason. It’s almost like a reflexive survival mechanism, since these preferences to sleep on our sides or stomachs, may have been formed not by any conscious effort, but as a reflexive coping mechanism for something that’s ailing us. This is why oftentimes when patients come to me with sinus and or chronic fatigue issues, I always ask: “Which position do you prefer to sleep in?” It’s almost a given that if patients like to sleep on their sides or stomaches their airways will look like the opening of a coffee stirrer when I look at their airway with my video endoscope.
Breathing For Life
Although many of us intuitively know that breathing is necessary for life, those with sleep apnea and UARS aren’t breathing for their lives. Even though they’re sleeping and therefore should rest allowing time for their brain, muscles, and organs to reset and replenish, their apneas or frequent breathing cessations are constantly interrupting this process. It’s like their “fight or flight” response is on all the time, even though it needs some time off. Think what would happen to your car if the ignition was never turned off. Well, this is what’s happening with sleep apnea patients.
Problems with Sleep Apnea
There are many serious consequences to having sleep-breathing problems—many of which are preventable yet as I’d mentioned before, this is not very likely because so many people who have this condition are unaware.
For one thing, research has found that sleep apnea is inked with a higher incidence of high blood pressure and heart disease. Many patients that come to me already on high blood pressure medications or have a history of heart disease are found on examination to have some sort of a sleep-breathing disorder.
Some other chronic conditions related to sleep apnea are diabetes, depression and many anxiety issues. Many fatigue and attention deficit problems like ADHD (attention deficit hyperactivity disorder) in children have also been linked to sleep apnea. A recent study showed that some children having undergone tonsillectomies (where a high percentage of them present with obvious symptoms of OSA) showed significant improvement in their ability to focus and pay attention in schools if not a significantly noticeable decrease in their behavior problems as a result. As you can see, not breathing well while you sleep can have serious consequences for both the old and the young.
When Being Young Is Not Enough
Because sleeping well is almost synonymous in people’s minds with feeling well, looking young and healthy, many people neglect their breathing as a simple fact of life. Little do we realize that this is wherein life originates.
People don’t often ask themselves, “How well did I breathe last night” when they feel groggy and listless in the morning. Instead, most people fixate on the amount of sleep they got or not. This may be the reason why sleeping pills and anti-anxiety medications are so popular in America today.
Moreover, as everyone jumps on the latest new anti-aging rage, breathing is becoming not a secondary, but a tertiary issue in the medical community. In the scheme of holistic or preventative medicine, breathing is often taken as a matter of fact. Although many proponents of these therapies often tout breathing exercises as a means to reducing stress and improving mental wellness they nonetheless overlook this matter when they provide dietary regiments or herbal supplements as sleep aids with little or no regard to the fact that none of these regiments are all that effective unless the mechanism that allows for efficient sleep is working well too. It’s almost like an auto shop owner shoving premium gasoline at customers with cars with broken fuel lodges. Sooner or later, that car is either going to break down or stop dead in its tracks, or at the very least, waste the very good thing you put in to it to make it work better. Similarly, if your sleep problems originate from an anatomical issue, like your airway, no amount of pills or supplements, no matter how potent, can effectively cure your problems with sleep. These problems need to be addressed from the source where it originates—the airway.
Your Breathing Problems Solved
In lieu of giving out bottles of air to my OSA and UARS patients, there are simple measures you can take on your own to improve your breathing while you sleep if you suspect that this may be the source of your problems.
The first most obvious thing I recommend to all my patients who suffer from fatigue issues is to avoid sleeping on their backs. This is one of many reasons why snoring sometimes ceases when people turn over while they sleep. The next best thing to do, if you’re not able to change your sleep position in this way due to an injury or habit, is to lose any excess weight you’ve gained recently. Yet, if you’re still feeling tired or having trouble maintaining focus at work my recommendation will be to get a formal sleep study or polysomnography to determine the root cause of your day time fatigue or exhaustion.
You Want Me To Sleep Where?
A typical “sleep study” takes place in a sleep laboratory where a sleep technician can hook you up to a monitor while you sleep, and a “sleep doctor” can use the readings to objectively measure and quantify the real source of your sleep problems. (Watch meundergo a sleep study.)
Although you may or may not be officially diagnosed with OSA even after the sleep study, I’ve seen many if not a great majority of these patients gain useful information to address any other sleep problems they may be having. Yet, most if not in all cases, patients who I suspect have these conditions, are found to have some mild to moderate breathing component that goes along with their sleep problems. And for these patients, in lieu of treating the underlying breathing problem, no amount of sleeping pills will cure the airway blockage that’s at the root of their sleep problems.
Decelerating the Aging Process
To understand how essential it is to get the sleep you need, it’s equally if not more important to understand how you can get the restorative sleep you need as well.
Essentially, sound sleep offers vital services to your body. After spending a full day learning new skills and having new experiences, sleep allows your brain to shut down its learning mode and consolidate and commit the newly acquired information to memory. Adequate sleep also allows the body to produce the right balance of hormones to help stabilize weight and use carbohydrates efficiently (this may be why research studies show that inadequate sleep is often linked with weight gain). Getting enough sleep also helps to ensure your safety by keeping your brain more alert and in tune with your reflexes preventing injury, and keeping you happy and well adjusted.
Sleep also helps keep the body healthy by boosting your immune function, reducing your chances of getting certain cancers and lowering your blood pressure too. In a nutshell, if you’re not sleeping well, you’re missing out on one of the most valuable methods for keeping you young and healthy for a very long time.
However, ensuring that your good night’s sleep isn’t impaired by breathing problems like Obstructive Sleep Apnea may be more important than sleeping that extra hour of shut eye. As the new-age gurus of aging are telling us, it’s not how old you are chronologically as how old you are biologically. Similarly, if your breathing is impaired while you’re sleeping, your health may not depend so much on how much you sleep every night but how well you’re sleeping through the night, and moreover, how well you’re breathing while you’re asleep. In short, take a closer look at what’s happening on the inside and not on the outside for the answers to your sleep problems. You may be surprised by what you find.
Steven Y. Park, MD is a surgeon and author of the book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. Endorsed by New York Times best-selling authors Christiane Northrup, M.D., Dean Ornish, M.D., Mark Liponis, M.D., Mary Shomon, and many others. http://doctorstevenpark.com