Sleep Disorders : Can’t Sleep? What’s Your Problem?

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One of the aspects of health we all have in common is the need for restful sleep. And aside from the rare few who are genetically wired to need less, without 7-9 hours on a regular basis, we mentally and physically suffer.

When it comes to the food that supports optimal health, the amount and type of exercise needed, likes and dislikes, and those things that feed the soul, we are as individual as our fingerprints. But when it comes to sleep, without it, we all will eventually become a hot mess.

It is no accident sleep deprivation is used as a form of torture and a tool utilized for the purpose of brain washing, yet when new parents, medical interns or shift workers are faced with it, society passes it off as a rite of passage or a test of mental toughness or just part of life.

I agree; there are times when you just have to deal, but too often an inability to sleep is viewed as a passing phase or a minor health issue that will eventually resolve itself.  After all, everyone has to sleep eventually, right?

The unfortunate reality is while a person is struggling through this “passing phase,” their life and health are taking a major hit. Sleep deprivation is now linked to nearly every chronic disease including cardiovascular disease, diabetes, stroke, obesity, depression, anxiety, and high blood pressure. 

According to the National Heart, Lung and Blood Institute, 50 – 70 million people have chronic or ongoing sleep disorders and 1 in 3 adults world-wide don’t get the recommended amount of undisturbed sleep needed to protect their health.

What is going on?

 

Identifying Sleep Disorders

Ironically, many people who have a sleep disorder don’t even realize it.  They have suffered with it for so long they become used to living in a fog, with low energy, and no longer know what it feels like to be well rested.

Many look to caffeine or other artificial stimulants to boost their energy, all the while sinking deeper into the health challenges a lack of sleep creates. They become focused on finding the right medication or supplement that will restore their energy which often just adds to the problem.

There are several types of sleep disorders, but the two most common are insomnia and sleep apnea.

 

Insomnia

Insomnia is defined as either have trouble falling asleep (sleep onset insomnia), staying asleep (sleep maintenance insomnia), or when the sleep you do get is not restful (just plain miserable insomnia), resulting in daytime complications, such as sleepiness or lack of focus, which gets in the way of your daily activity.

  • Chronic insomnia: It’s estimated about 10% of adults have chronic insomnia defined as having difficulty sleeping at least three days per week for more than three months and can’t be fully explained by another health issue. Symptoms are usually severe enough to affect performance in school, at work, as well as social or family life.

 

  • Short-term insomnia: 15% to 20% of adults are thought to experience short-term insomnia which is sleep difficulties for any duration and frequency less than that defined by chronic insomnia. It also can often be traced to an external cause for stress such as divorce, illness, death of a loved one, work.  The primary concern regarding short-term insomnia is that it can become chronic if not corrected as a result of disturbing the innate circadian rhythm.

 

Sleep Apnea

There are two primary types of sleep apnea, obstructive sleep apnea (OSA) and central sleep apnea (CSA). Both are characterized by abnormal or interrupted breathing during sleep.

  • Obstructive Sleep Apnea (OSA): The most common and serious form of sleep apnea, OSA could affect up to 30% of adults, mostly men. OSA is when the muscles in the back of the throat relax, causing the airway to narrow or collapse all together.  This not only disrupts sleep, but reduces blood oxygen levels which then triggers the brain to send a signal to wake up, often resulting in a sudden gasp for air. This can happen 30 times or more per hour.

 

  • Central Sleep Apnea (CSA): Less common than OSA, it is estimated to affect under 1% of the population over 40 and more men than women. CSA takes place when the brain stops sending signals to breathing muscles or those muscles stop responding to brain signals.  This results in short periods of time when breathing stops.

 

Causes

People develop sleep disorders for various reasons.

Age, gender, prior health conditions, medical issues such as restless leg syndrome (RLS) or gastroesophageal reflux disease (GERD),  life stressors, diet, weight, genetics, and lifestyle habits can all impact the quality and consistency of sleep.

Temporary insomnia can turn into chronic insomnia simply from the anxiety that can develop over the loss of sleep which can then create a difficult-to-break cycle of sleeplessness.

Jet lag and shift work can throw off the natural rhythm of a person’s internal circadian clock leading to hormonal changes that lead to an inability to get restful sleep at any time.

Sleep apnea is probably the most easily diagnosed and can be a result of genetic heritability or obesity. Medical conditions such as congestive heart failure, high blood pressure, metabolic syndrome, or chronic lung disease such as asthma can also increase the risk of developing the disorder.

 

Solutions

Sleep apnea has various treatments, depending on the type and severity.

Some people can manage it with lifestyle changes.  Reducing alcohol consumption, losing weight and quitting smoking can reduce sleep apnea. Sleeping on the side or stomach and using breathing strips can also help.

For those able to adapt to the masks worn while sleeping, continuous positive airway pressure (CPAP) therapy, adaptive servo-ventilation (ASV) or bilevel positive airway pressure (BPAP) can all be used, depending on a person’s health status. 

If breathing devices are not an option, some people find relief through mouth appliances provided by a dentist which prevents the tongue from blocking the throat or repositions the jaw to keep airways open.

As a last resort some may even undergo surgery.  There are various options, all designed to open or widen airways.

Insomnia can be more difficult to treat as it can be more challenging to identify the root cause. However, paying attention to sleep hygiene can provide relief from insomnia even if the cause remains elusive.  It has also been shown to support optimal health even for those who don’t struggle with a lack of sleep.

 

The Cleveland Clinic suggests  the following ways to optimizes chances for restful sleep:

  • Create an optimal sleep environment by making sure that your bedroom is comfortable, cool, quiet and dark
  • Think positive. Avoid going to bed with a negative mind set.
  • Avoid using your bed for anything other than sleep and intimate relations. Do not watch television, eat, work, or use computers in your bedroom.
  • Try to clear your mind before bed time by writing things down or making a to-do list earlier in the evening.
  • Establish a regular bedtime and a relaxing routine each night by taking a warm bath, listening to soothing music, or reading. Try relaxation exercises, meditation, biofeedback, or hypnosis. Wake up at the same time each morning, including days off and vacations.
  • Stop clock watching.  Leave your bedroom if you cannot fall asleep in 20 minutes. Read or engage in a relaxing activity in another room.
  • Avoid naps. If you are extremely sleepy, take a nap. But limit naps to less than 30 minutes and no later than 3 p.m.
  • Avoid stimulants (coffee, tea, soda/cola, cocoa and chocolate) and meals for at least four hours before bedtime.
  • Avoid alcohol and tobacco.
  • Exercise regularly, but not within four hours of bedtime if you have trouble sleeping.

 

Suggestions from Dr. Ritamarie

There are two things I would add to the Cleveland Clinic’s list:

  • Avoid screen time two to three hours before sleep.
  • Take a sleep vacation.

I encourage all students in my Nutritional Endocrinology Practitioner Training (NEPT) program, plus the clients in every program I offer, to take a sleep vacation.  This involves three days of complete rest, staying in bed the entire time, waking and falling asleep according to their own natural rhythm.

Most people don’t even know what it feels like to be completely rested. It’s restorative, energizing, and helps to reestablish a healthy sleep pattern.

The fact is it’s rare a person doesn’t occasionally struggle to get a good night’s sleep. It becomes problematic when it consistently impacts a person’s quality of life and impairs their ability to function during the day. The longer this continues, the greater the chances of it developing into a serious disorder.

If you are struggling with sleep, get help by seeking out a functional healthcare provider. How can you discover your passion when you aren’t awake enough to feel it?

Sleeping does not equate to laziness.  

Take care of yourself.  

This world needs you at your best!

 

Resources:
  1. Sleep Health | NHLBI, NIH
  2. Sleep Science and Sleep Disorders | NHLBI, NIH
  3. Insomnia – What Is Insomnia? | NHLBI, NIH
  4. Sleep Health Topics – National Sleep Foundation
  5. Sleep apnea – Symptoms and causes – Mayo Clinic

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