While You Were Sleeping...

Sleep is for some a welcomed relief from daily stresses and efforts, yet for others it can be a nightmare about to unfold as they try to get to sleep counting hours as they go past. Whether our experience of sleep is good or bad it’s a daily reality for us all and yet it’s the most under-diagnosed and under-treated area.

Approximately one third of our lives is spent on sleeping. According to the research the reason why we are able to consciously express ourselves, adapt and evolve is due to the events that occur in our sleep. So why do we sleep? What goes on during sleep? Why do we sleep-walk? Why do we snore? What is sleep apnea?

Let’s explore these questions in greater detail.

Why do we sleep?

Energy conservation is not only an important factor for environmental sustainability of our macrocosm but also for the microcosms – our bodies. The body heals itself during sleep and helps you learn and absorb the information you were exposed to during the day.

To do this properly it requires energy. It sounds surprising that we need energy to sleep!

Improper sleep can lead to neurological, biochemical and genetic imbalances.

According to a study “4-6 hours of sleep per night yields a progressive, cumulative deterioration in neurobehavioral function including vigilance, neurocognitive performance and mood. Changes in the endocrine function resemble the effects of advanced age, early stages of diabetes and insulin resistance after less than one week.”[i]

Some of the conditions linked to the sleep deprivation are; depression, aggression, poor concentration, poor immunity, stroke and heart attacks just to mention a few. These conditions are a result of increased blood acidity. When the blood is too acidic its ability to carry oxygen is reduced. Diet also plays a big role in the overall pH of the blood.

What goes on during sleep?

While you were sleeping your body was doing some of its most important work to keep you alive and healthy and wise. This took place in 4 stages of sleep[ii];

1. Sleep onset: The stage between wakefulness and sleep goes on for about 1-7 minutes. If you wake up during this stage you’ll feel as if you haven’t slept.
2. Light Sleep: Eyes slowly roll from side to side and some fragments of dreams may occur. Alpha brain waves are dominant in this stage.
3. Sleep: Occurs 20 min after falling asleep, blood pressure and body temperature drop. At this stage we drop to Delta brain wave frequency.
4. Deep Sleep: Sleepwalking may occur here as the reflexes are intact. This is the deepest stage of sleep. REM: Rapid eye movement starts and this is where the dreams occur. REM is followed by Non-REM which is a combination of all of the stages except rapid eye movement.

It takes less than one hour to go from stage 1 to stage 4. If we manage to sleep between 7-8 hours we go through 3-5 REM episodes. Interestingly our body needs 20% more oxygen during REM stage of sleep than it does during an intense physical exercise!

It takes one and a half to one and three quarter hours for a full sleep cycle to occur (Stage 1- Stage 1). Stages 3 and 4 occur less frequently as we near the end of the sleep period. If we remember our dream, it’s because we woke up during the REM stage of sleep.

Why do we sleepwalk?

Psychological, genetic, physiological and chemical causes can all play a role in sleep walking. The Cause will depend on the age of the person.

In children it’s mostly due to psychological problems they tend to grow out of. In adults it could be due to a biochemical imbalance caused by stress or due to substance abuse, such as alcohol and drugs.

It is also possible that sleepwalking runs in your family. If you have a parent or a relative who sleepwalks, the chances are you may have inherited the tendency[iii].

Sleepwalking can be treated after a thorough investigation which would ascertain if the cause is due to biochemical imbalance, the circadian rhythm, hypoxia/vestibular balance or structural contributors. A multi modality approach may be required, using both naturopathy and chiropractic[iv].

Why do we snore?

Abnormal breathing is caused by partial blockage of the airway, which leads to hypoxia, or a state in which the oxygenation of the blood is inadequate. Not enough oxygen is reaching the cells and other body tissues. Oxygen deprivation leads to muscle weakness, muscle weakness is one of the reasons why the airways constrict the breathing, and so this becomes a vicious cycle.

Snoring points to musculoskeletal weakness surrounding the airways, due to imbalance caused by damage, development trauma or diet.  If the oxygen deprivation continues for a long time it can result in organ failure and even heart attack. 

Snoring can also lead to decreased sex drive and sometimes impotence. Up to 40% of population suffers from snoring. Loud snoring can be a symptom of sleep apneaiv.

What is sleep apnea

Pauses in breathing while sleeping are referred to as sleep apnea. Up to 10-20% of population suffers from sleep apnea. Gasps and arousals during sleep are caused by the obstruction of the airway. There can be up to 300 breathing pauses during a night, which will deprive the body of sleep and valuable oxygen. Symptoms of OSA (obstructive sleep apnea) which stand out the most are tiredness, headache and heartburn.

If OSA doesn’t get treated it can increase the risk of heart disease, high blood pressure and heart attack, fatigue related motor vehicle and work accidents, seriously diminished quality of life, apparent psychotic symptoms, hearing loss and sexual impotence, fatal stroke and even premature death[v].

Ten interesting facts about sleep and snoring

1. Snoring in children is linked to poor school performance and low cognitive function[vi]
2. Snorers may be ruining the health of their partners through chronic fatigue and sleep deprivation[vii].
3. Snoring can reach up to 100 decibels, and contribute to hearing lossiv.
4. After 17 hours without sleep one will feel and start to behave as if the legal blood alcohol limit has been reached. Most fatigue related accidents happen at 3am and 3 pm, when body’s clock is set to “sleep”iv
5. One in every five Australians suffers disrupted sleep because of shift-work, increasing their risk of accidents at work or on the roadiv.
6. Coffee masks an amino acid adenosine, which is released when the body starts to feel fatigued and wants to restiv.
7. One in every six road accidents involves fatigue and research has shown that sleepy drivers are as dangerous as drunksiv.
8. Childhood obesity has recently been linked to lack of sleep in number of studiesix.
9. France is doing further research on the link between sleep and productivity, and should the link be more conclusive than it already is, napping at work will be allowed and encouragedx.
10. Sleeping for only a few hours on a regular basis can hinder metabolism and hormone production in a way that is similar to the effects of aging and the early stages of diabetesxi.

Are you sleep deprived?

This is Epworth Sleepiness Scale developed by Dr. Murray Johns from Melbourne. It measures daytime sleepiness[viii]. If you score 9 or more, you may need professional assistance as you may have a serious sleep disorder.

0 would never doze

1 slight chance of dozing

2 moderate chance of dozing

3 high chance of dozing

SITUATION

CHANCE OF DOZING

Sitting and reading

Watching TV

Sitting inactive in a public space (e.g. theatre or meeting)

As a passenger in a car for an hour without a break

Lying down in the afternoon

Sitting and talking to someone

Sitting quietly after lunch without alcohol

In a car while stopped for a few minutes in traffic

My Total

Sleep Hygiene

What exactly is sleep hygiene? It’s a guideline to a better sleep and a good sleeping routine. Our body loves and needs the routine, especially when it comes to sleep. It takes 16 weeks to establish a proper sleeping pattern in the brain of a newborn. In adults it also takes 16 weeks to reestablish a natural healthy sleeping pattern without sleeping medication and herbs. Sedating medication and herbs can interfere with the important REM stages, by preventing our brain from ever reaching the deep sleep, thus worsening the problem in the long run.

Inflammation, hormonal imbalance, depression, anxiety, poor liver function and pain, just to mention a few can all have an impact on the quality of sleep. Therefore each case needs to be addressed individually as the cause will be different. Following are some useful tips on how to improve your quality of sleep. Please be mindful if you scored high in the “Epworth Sleepiness Scale”, if you snore or have sleep apnea and the sleep hygiene is not helping after a few weeks, that you need to seek professional help as there is a potentially serious underlying problem which needs addressing.

• Go to bed and wake up at the same time each day, even on the weekends, to allow your body to develop a sleep rhythm.
• Don’t do strenuous exercise before bed. Relaxing exercise like yoga or breathing exercises are best.
• Avoid bright lights and emotionally charged TV programs and books before bed.
• Avoid reading and working in bed, train your body to associate sleep with going to bed.
• Make sure your bed and your bedroom are comfortable, airy, dark and cool, around 19 degrees Celsius is optimal.
• Switch off all of the electrical appliances in your bedroom at the wall.
• If you feel hungry at bed time have a light protein snack, avoid starchy food and carbs late at night and as a general rule avoid heavy meals at night. Ideally you don’t want to eat anything for at least 1 hour before going to bed.
• Try not to have naps longer than an hour during the day or late afternoon as this will keep you awake at night.