Every athlete knows that mouth breathing is unavoidable while training and competing. It’s when the practice becomes a habit, especially when sleeping, that recovery is impeded. Here’s why...
Human Growth Hormone
Human growth hormone is essential for muscle repair and development. Natural human growth hormone is released into the blood supply when you enter the deeper stages of sleep. To reach REM-stage sleep you must sleep uninterrupted for 20 to 30 minutes.
Breathing through your mouth during sleep can cause sleep arousals that impede your transition into REM-stage sleep, the most restorative part of the sleep cycle. Once you are aroused from sleep you stop the transition into deep sleep and start moving through light sleep again, which reduces your time spent in deep REM sleep during the night.
Nose breathing delivers calm, deep, restorative sleep and is a natural, drug-free way to maximise and replenish human growth hormone every night.
Lactic Acid
Strenuous activity builds up lactic acid that causes tissue hypoxia (cramp) in muscles. Lactic acid build-up is regulated by nitric oxide.
Nasal nitric oxide is produced in the nasal and sinus passages only during nasal breathing. Mouth breathing does not produce nitric oxide.
Nasal breathing also increases circulation, blood oxygen, carbon dioxide/ph levels, lung volume and heart efficiency and decreases water loss by more than 40%, helping to maintain hydration.
Stages of sleep.
There are two types of sleep, namely Non Rapid Eye Movement-sleep (NREM), divided into four stages, and Rapid Eye Movement-sleep (REM). The onset of sleep under normal circumstances in adult humans is through NREM-sleep. Stage-one sleep is light sleep, and generally persists for only a few (one to seven) minutes. Stage two usually lasts from 10 to 20 minutes. The sleeper then moves to stage three and finally into stage four sleep, the stage of deepest sleep. Normal functions such as blood pressure, respiration and heart rate diminish. Stage-four NREM-sleep generally lasts for about 20 to 40 minutes in the first cycle.
After 30 to 40 minutes, REM-sleep begins. The brain reactivates into a fast-activity state. Blood flow, heart rate, respiration, body temperature and blood pressure of the person rise, and the eyes, underneath closed eyelids, dart back and forth as if scanning the environment, which may be accompanied by intermittent small muscle twitching.
REM-sleep episodes become longer as sleep progresses, with the longest REM-sleep episodes occurring in early morning. In normal adults, 20-25% of total sleep time is spent in REM-sleep. Dreams are often experienced during REM-sleep and REM-sleep has also been called “dream sleep”. It has been proposed that memory consolidation occurs during this time. REM-sleep is thus essential when complex techniques or tactics are being learnt or explored and new motor skills are acquired.
In adults, cycles of NREM-sleep and REM-sleep recur within a period of 90 to 100 minutes. NREM- or slow-wave-sleep makes up approximately 75-80% of this time and REM-sleep the remaining 20-25%, occurring in four to six episodes. If sleep loss was experienced for one or more nights, slow-wave sleep will be prominent. REM-sleep will recover only after the recuperation of slow-wave sleep.
Chronic deprivation of nocturnal sleep, an irregular sleep schedule or frequent disturbance of nocturnal sleep can result in changed distribution of sleep stages. It is most frequently characterised by premature REM-sleep: sleep onset with REM-sleep.
Role of sleep for well-being and performance.
Sleep serves multiple purposes. It has been emphasized that sleep helps, for example, with physical and psychological restoration and recovery, conservation of energy, memory consolidation, discharge of emotions, brain growth and maintenance of the immune system. Although the complexities of sleep are not yet fully understood, sleep is essential for physical and emotional health and it plays a significant role in recovery from illness and injury. Sleep loss, on the other hand, leads to a general decline in performance.
Physiological growth and repair.
Although the body is continually in a process of revitalization, this process peaks during stage-three and stage-four sleep. Physiological processes that cause this effect during slow- wave sleep are facilitated by metabolic activity being at its lowest at this point, as well as an increased secretion of growth hormone by the endocrine system. Significant neuro-endocrine activity is present with the release of growth and sexual-maturation hormones.
More than 95% of the daily production of these hormones occurs during NREM-sleep. In normal young adults, the 24-hour profile of growth hormone secretion takes place at low levels, which is intermittently interrupted by large secretary pulses. Major secretion usually occurs shortly after sleep onset in temporal association with the first episode of slow-wave sleep. A large pulse of growth hormone secretion occurs more than 90% of the time during the first slow-wave period, and there is a quantitative relationship between the duration of the slow-wave stages and the simultaneous amount of growth hormone secreted.
NREM-sleep is considered to be the time during which the body can repair and restore itself. Sleep deprivation is therefore regarded as a stressor that has a significant detrimental effect on physiological growth and repair.
(Carskadon, Dement, Drust, Davenne, Samuels, Gunning, Van Cauter, Nadler, Walters, Loehr, Schwartz et al)
Updated August 27th 2017
Less time spent in the rapid eye movement (REM) stage of sleep appears to significantly increase dementia risk, new research shows. The association between REM sleep and dementia may be partially explained by sleep-disordered breathing, the study suggests.
"If you look at our paper in the context of other papers that are coming out, it appears that there's a role for sleep-disordered breathing in possibly increasing the risk of dementia, so it's important to screen and manage this as appropriate," Matthew P. Pase, PhD, senior research fellow, Swinburne University of Technology, Australia, and investigator with the Framingham Heart Study, told Medscape Medical News.
Framingham Heart Study.
The analysis included 321 participants in the Framingham Heart Study (FHS) Offspring cohort. The current study included participants aged 60 years and older (mean age, 67 years) for whom data on incident dementia were available.
At one examination cycle of the study (1995 to 1998), the cohort completed overnight polysomnography. Researchers investigated the percentage of time in stage 1, stage 2, slow-wave sleep (SWS; stage 3 and 4 combined, also referred to as "deep sleep"), and REM sleep. During this dream REM sleep stage, the eyes move rapidly and brain activity increases, accompanied by higher body temperature, quicker pulse, and more rapid breathing.
Sleepers typically pass through the five sleep stages in a cyclical pattern — from stage 1 to REM — and then begin again with stage 1. As the night progresses, time spent in REM sleep increases, so individuals typically spend about 20% of total sleep time in the REM stage, said Dr Pase.
Researchers also examined total sleep time, sleep onset latency, REM sleep latency sleep efficiency, wake after sleep onset, and the apnea-hypopnea index. In the FHS, cognitive screening is performed at each examination cycle using the Mini-Mental State Examination. Extensive neuropsychological testing is performed at selected examination cycles.
Over a mean follow-up of 12 years, there were 32 cases of incident dementia, 24 of which were due to Alzheimer's disease (AD). After adjustment for age and sex, a smaller percentage of REM sleep was associated with an increased risk for all-cause dementia (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.86 - 0.97); P = .004) and for AD dementia (HR, 0.92; 95% CI, 0.86 - 0.99; P = .02).
The results remained significant after additional adjustment for factors that may affect dementia risk or sleep, including body mass index; education; APOE ε4 status; smoking; systolic blood pressure; diabetes; heart disease; depression; and use of sleeping agents, antidepressants, anxiolytics, and antihypertensive medication.The authors found that each percentage decrease in REM sleep was associated with about a 9% increase in the risk for incident dementia.
Sleep-Disordered Breathing.
Excluding cases of mild cognitive impairment and participants who developed dementia within 3 years of follow-up did not significantly change the association. Having an early or late chronotype, a circadian rhythm outside the norm, also failed to explain the association between REM sleep and dementia. However, the authors did not have information on shift work, which might have shed more light on the effect of varying circadian rhythms.
REM sleep latency was also linked to dementia. Compared with the highest tertile of REM sleep latency, the lowest tertile was associated with a lower risk for all-cause dementia after adjustment for age and sex (hazard ratio [HR], 0.37; 95% CI, 0.14 - 0.97) and after additional adjustments for vascular risk factors, depressive symptoms, and medication use (HR, 0.26; 95% CI, 0.08 - 0.85).
"We found that those who took longer to get into REM sleep had an increased risk of dementia, which complements, or goes hand in hand with, our other finding," of a link between percentage of REM sleep and dementia, said Dr Pase.
Greater wake after sleep onset, which is a measure of difficulty maintaining sleep, was also associated with an increased risk for dementia in the fully adjusted statistical model. On the other hand, stages of non-REM sleep were not associated with dementia. "We expected to see a relationship between time in deep sleep and risk for dementia, but that's not what we found. The results suggest that perhaps there's something that we are not quite understanding about REM sleep that is important," said Dr Pase.
REM sleep may be disrupted by an untreated sleep disorder. The authors found that the association between REM sleep and dementia was partially explained by hypopneas. After exclusion of participants with a high number of arousals from REM sleep due to hypopnea, the association between low REM sleep and dementia was reduced (HR, 0.94) but was insignificant (P = .17). "So there might be some role in the association of sleep-disordered breathing, but it doesn't seem to explain the whole picture," said Dr Pase. He stressed the difficulty of examining sleep disorders "in great detail" without very large sample sizes.
Anxiety, Stress May Play a Role
Although the mechanisms linking REM sleep with dementia are not fully understood, loss of cholinergic function may be involved, said the authors. Cholinergic neurons are important determinants of REM sleep, with cholinergic activity low during slow-wave sleep and high during REM sleep. In addition, AD is associated with the loss of cholinergic function. REM sleep may help maintain circuitry within the brain that is disrupted with dementia, said Dr Pase.
The authors originally thought that low REM sleep might be a marker for brain changes that occur in early stages of dementia, said Dr Pase. "But we found that lower REM sleep was predicting risk of dementia well into the future, so this doesn't seem a likely explanation for our findings." The fact that the association between low REM sleep and dementia was not driven by those with mild cognitive impairment does not support the idea that lack of REM is a marker for dementia. Anxiety and stress may play a role in increasing the risk for dementia or curtailing REM sleep. Dr Pase suggested a possible cyclical relationship.
"You might have this effect of, say, high stress levels interrupting sleep and contributing to dementia, and then compromised sleep might further increase the risk for dementia. So there might be a cyclical relationship between stress and poor sleep, and poor sleep and more stress, et cetera."While the findings are interesting from a biological perspective, there are no immediate clinical implications, except for the obvious advice to somehow optimize REM sleep, said Dr Pase.
"It's more in the hands of researchers to understand why we see this association, and to unpack it a bit further; that might then lead to more clinical recommendations for doctors." In the meantime, though, if stress or sleep-disordered breathing plays a role, "managing sleep disorders and controlling stress and anxiety could help" reduce dementia risk, said Dr Pase.
The research team is keen to combine their study group with other similar cohorts to create a larger data pool that would allow more powerful analyses of, for example, the role of sleep-disordered breathing.
Modifiable Risk Factor.
Commenting on the findings for Medscape Medical News, Heather Snyder, PhD, Alzheimer's Association senior director of medical and scientific relations, said the study authors were fortunate to be able to tap into data from the FHS.
"One of the strengths of the study was that the researchers have this really strong group of individuals who have been followed for a long period of time and about whom there is a lot of information." The new study "adds to a body of evidence that we continue to see emerge in the field," said Dr Snyder. The first evidence of a link between sleep and later dementia started to emerge perhaps 5 or 6 years ago, said Dr Snyder.
"Over the years, we have continued to see refinements of those studies, and we are able to get more in-depth information about what it is about sleep" that may affect dementia. Dr Snyder noted research presented at this year's Alzheimer's Association International Conference that linked disrupted sleep to a build up of amyloid and tau, two hallmarks of AD. However, she stressed that the link is still an association and that "we don't know if there's a cause and effect."
Nevertheless, the current interest in understanding the role of sleep in dementia may be kindled by the fact that sleep problems are treatable.
"If you're talking about sleep-disordered breathing, or obstructive sleep apnea, there are potential treatments," said Dr Snyder. "If you can actually treat the sleep disturbance, you may be able to augment your later life risk, if there is that causal relationship there."
Pauline Anderson
Updated 25th August 2017
New research suggests the position you sleep in may tell you a lot about yourself—your health, your age, perhaps even your education level.
The study, commissioned by the Better Sleep Council (BSC), a nonprofit consumer-education arm of the International Sleep Products Association, found those who reported higher levels of education, such as graduate school or more, were less likely to sleep in Fetal position—the most common sleeping position among Americans (47%). Differences between age groups became apparent in reported sleep position preferences as well: Gen Xers and Millennials were more likely to sleep in Freefall position (arms and legs outstretched) than Baby Boomers.
Although sleeping position is largely a matter of perceived comfort and habit, the study found sleep positions affect sleep quality. For example, people who sleep in the Log position report getting a better night sleep than those in the Fetal. Also, people who sleep in the Starfish or Log positions are more likely to sleepwalk.
Our sleep positions can tell us other things about ourselves too. The study found that Log sleepers are more likely to consider themselves to be healthy, while introverts have the strongest aversion to the Freefall sleep position.
Other insights include:
BSC sleep expert Terry Cralle, RN, a certified sleep educator and author, offers these better sleep position tips:
Updated August 24th 2017
A latest UK study has found that deficiency of adequate sleep in children could be linked to their risk of developing diabetes later in life.
The study notes that every extra hour of sleep a child gets per night is associated with a lower body weight and increased lean muscle mass and less blood sugar. There is enough evidence that obesity and increased blood sugar are linked to development of type 2 diabetes. In this type of diabetes the body cannot regulate the blood sugar by utilizing the hormone insulin.
The blood sugar fails to be controlled and this causes a myriad of complications. Type 2 diabetes, which was more of a disease of the middle aged only a decade ago, is now a menace for children as well with the growing rates of childhood obesity, say experts. This is more due to the lack of physical exercise among children and also increase in fat and sugar intake in diet.
In this study the team of researchers looked at data on the sleep habits and the laboratory reports that indicated diabetes risk for 4,525 children aged 9 or 10 in the United Kingdom. They found that children of this age group on an average slept for 10.5 hours on school nights with a range of 8 to 12 hours for the study group.
While connecting the sleep patterns with the diabetes risk, they found that the children who were getting less sleep were the ones more likely to have risk factors for diabetes. Notably they had what is called insulin resistance. Insulin resistance is a state where the pancreas might be secreting adequate amounts of insulin but the body fails to utilize this hormone adequately to convert the sugars in diet into energy. This leads to an accumulation of the sugars and leads to development of diabetes. Presence of insulin resistance markers is a clear indicator of future risk of development of diabetes.
The study revealed that the children who slept less were the ones who were extremely overweight or obese and had more body fat than those who got adequate sleep.
According to the American Academy of Pediatrics recommendations children between ages of 6 and 12 should get 9 to 12 hours of sleep a night. Lack of adequate sleep is linked to high blood pressure, depression, obesity and also increased risk of injuries.
Some of the limitations of this study were the fact that it was not a controlled experiment and the data from the children about their sleep habits was mostly on the basis of recall. This might not be an accurate picture of how much sleep they actually got. Christopher G. Owen, a study co-author and a professor of epidemiology at St. George’s, University of London explained that there has been evidence of this link in the past. This study was a quantified look at the association between lack of sleep and diabetes risk among children.
This study also brings forth the fact that more and more children are not getting adequate sleep he added. He explained that the take-home message from this study was that children should be encouraged to have healthy sleeping habits from an early age.
This could be a low cost and simple intervention that could protect the child from diabetes later in life.
The Sleep Cycle
The sleep cycle is divided into two parts;
Each cycle lasts around 1½ hours and all stages must be experienced to wake up rested. A good night’s sleep means five or six of these cycles. An average adult needs 7-8 hours sleep per night but this may vary from person to person. Older adults tend to sleep less.
New-born babies sleep for 18-21 hours per day while toddler and 3-5 years olds sleep 11-13 hours per day. Children between 6 and 12 years need 11 hours sleep while teenagers need 9-11 hours sleep.
“Sleep hygiene” is a term that describes good sleep habits that help good sleep. Some of the methods that could be adopted for a better night’s sleep include;
Dr Ananya Mandal, MD
Updated August 22nd 2017
Mouth Breathing & Your Oral Health.
Some people mouth breath when they are asleep, have a cold or congestion, or even on a day-to-day basis. Allergies often give way to mouth breathing, as well as issues such as chronic nasal obstruction. Whatever makes it physically impossible for a person to breathe through their nose results in the body’s only other choice – mouth breathing.
Does your child often breathe with an open mouth? How about your significant other? Do they snore loudly and wake up exhausted everyday? Unfortunately, there are other harmful side effects contributed to mouth breathing as well. Many people don’t realize that mouth breathing can actually be a complex health concern, and should be checked out by your dentist and physician.
Signs and Symptoms of Mouth Breathing:
Health Issues Caused By Mouth Breathing.
Improper Facial Growth & Skeletal Deformities.
Mouth breathing can alter your child’s face shape and jaw position. This is most often seen in children because of their continued and generally rapid growth. Facial growth due to mouth breathing often leads to long, narrow faces with regressed cheekbones, lower jaw, and chin. Because of this, teeth may become crooked, while smiles may appear gummier.
Even posture can be affected due to the facial and skeletal issues connected to mouth breathing. In order to breathe more easily, the airway must be open. Hunched shoulders and a forward-leaning head help to open the airways while negatively influencing posture.
Mouth Breathing & Speech Impediments
Many mouth-breathing children between the ages of 4 and 12 have speech alterations and impediments such as sound omissions, lisps, and articulatory disorders. Mouth breathing can change the way the tongue works, known as a tongue “thrust.” This negatively affects speech, swallowing, and chewing. This could lead to a child feeling self-conscious. Depending on the severity of the speech impediment, a speech pathologist may be necessary to correct speech alterations and slurs.
Snoring & Sleep Apnea Caused By Mouth Breathing
Because mouth breathing is most often a result of a nasal obstruction, sleep issues are common. Snoring and nights filled with poor sleep are more prevalent in mouth breathers as well. The fatigue and headaches can be debilitating!
Also, mouth breathing can further affect and aggravate sleep apnea. Untreated obstructive sleep apnea can cause depression, anxiety, weight gain, and high blood pressure. That being said, mouth breathing and sleep apnea can be a deadly combo.
When oxygen is inhaled through the mouth rather than the nose, your blood is not actually getting all of the oxygen that it needs. This can lead to heart problems and other health issues.
What Can Be Done?
Thankfully, mouth breathers can learn to change this habit. Ensure that your child’s presumed “ADD” or “ADHD” is not actually lack of focus caused by poor sleep due to mouth breathing. Look for the previously mentioned signs and symptoms, and take action. Mouth breathing can be corrected, but it is easier to correct when caught early.
sleepQ+ is a simple and effective way to help correct mouth breathing. Read all about it on www.sleepqplus.com.
Updated August 19, 2017
Men should make sure they get proper sleep to reduce their risk of:
Low testosterone
Hypogonadal symptoms (which emerge due to low levels of testosterone) are a side effect of sleep loss over time. Men with so-called “low T” experience a range of hypogonadal symptoms. These include erectile dysfunction, decreased muscle mass, reduced libido, and problems with sleep.
Infertility
As a consequence of low testosterone, men who have poor sleep for whatever reason may also face problems with infertility. Low measures of semen density and “motility” count, which describes the level of activity of sperm once released, can lead to future problems in sleep-deprived men who wish to father children.
Erectile dysfunction
An inability to maintain proper testosterone levels can lead to problems with erectile dysfunction, also referred to as ED. Getting less than 8 hours a sleep nightly changes the hormonal balance in the blood stream, and without the circulation of normal levels of testosterone, blood may not be available to the reproductive organs, leading to ED.
Depression/suicide
Mental health concerns are linked to poor sleep, regardless of gender. Research shows a connection between poor sleep, depression and suicidal thoughts among men who are sleep deprived.
The statistics are alarming:
13 percent of those who struggled with insomnia reported at least one type of suicidal ideation—thoughts of killing yourself, having a plan to commit suicide, intentions of killing yourself, wishing you were dead, or telling people you want to commit suicide. That’s compared to 2 percent of those who slept soundly.” (Men’s Health magazine)
Good sleep as a critical part of good overall health. Try making it a goal to achieve 8 hours of solid sleep per night. This will do more than just make the doctor happy… it will lead to better overall health and wellness, a stable mood, and a better outlook on life.
Updated August 17 2017
Open-mouth breathing during sleep will have you waking up during the night to drink water followed by trips to the bathroom because mouth breathing dries out the mouth and tongue.
The problem is worse for people on some medications (there are over 500 medications that produce dry mouth as a side effect) who spend the night breathing through their mouth. Everybody opens their mouth at some time during the night and many close it again after a short while but as we age our facial and lip muscles weaken and our mouth stays open during sleep. When the mouth opens the tongue drops from the roof of the mouth and falls back towards the throat often causing snoring and waking up with a dry mouth, dry throat, bad breath, stuffy or blocked nose and feeling tired.
About 10 per cent of the general population and 25 per cent of older people have dry mouth syndrome – not enough saliva (spit) in the mouth. A dry mouth is a symptom of an underlying problem, rather than a disease in itself. A number of things may cause a persistently dry mouth, including mouth breathing during sleep, prescription medications, medical treatments and certain autoimmune diseases such as Sjogren’s syndrome.
Dry mouth syndrome is also called xerostomia. Dry mouth symptoms may include:
Waking up during the night with a dry mouth
Waking up in the morning with a dry mouth or throat
Saliva that feels thick or stringy
Rough, dry tongue
The tongue tending to stick against the roof of the mouth
Problems with chewing or swallowing (particularly dry foods such as biscuits)
Bad breath
Mouth ulcers
Dry and cracked lips
Susceptibility to oral thrush infections
High rate of tooth decay
A prickly, burning sensation in the mouth
Depending on the cause, dry mouth syndrome may be associated with symptoms outside the mouth, including:
Dry and itchy eyes
Dry nose or throat
Frequent coughing
Reduced sense of smell
Constipation
Joint pains or stiffness
In women, frequent vaginal thrush infections.
Salivary glands:
The salivary glands are located around the mouth and throat. These glands make saliva, which is pumped into the mouth along tiny channels called salivary ducts.
The protective role of saliva:
A dry mouth significantly increases the risk of tooth decay because saliva:
Contains components that can directly attack the bacteria that cause decay
Has anti-fungal properties
Helps to destroy viruses
Neutralises the acids produced by plaque
Contains phosphorus and calcium. These substances are vital to the ongoing process of remineralisation, which is the rebuilding of tooth enamel (the hard surface layer that protects the tooth)
Moistens food, which enables comfortable swallowing
Helps with the formation of particular sounds in speech
Boosts sensation inside the mouth and allows for the experience of pain, food texture and taste.
You can reduce the incidence of many unpleasant oral conditions just by keeping your lips together all night. You will also look more appealing with a closed mouth.
Visit www.sleepqplus.com to find out about sleepQ+.
Updated August 14th 2017
Snoring is a significant symptom of OSA. Sometimes there is a fine line between snoring and sleep apnea. The following yes/no questions can help you know when to seek medical assistance for suspected sleep apnea.
If you answer “yes” to 3 or more of the following symptoms, it is suggested that you speak with your physician about sleep apnea:
Summary
Snoring is not a normal phenomenon but it is a very common activity that millions of American suffer with. Snoring can be associated with dangerous medical conditions, and it is recommended that treatment be sought to deal with potential dangers and to keep the peace at home.
Snoring can be a symptom of obstructive sleep apnea and treatment should be sought, as OSA is a dangerous, deadly medical condition that can affect every part of the human structure.
Updated August 11th 2017
The word apnea means "no breath" and implies that, for whatever reason, your ability to breathe has been compromised. Apnea is a temporary cessation of breathing, however: if you decide to hold your breath, you are essentially giving yourself an episode of apnea. Eventually, you resume breathing because your brain won't let you hold your breath forever. Breathing is critical to all body functions, after all, and respiratory failure is not an option.
Your brain generally regulates your breathing during waking periods; you also have the option to voluntarily take a deep breath now and again, such as while yawning or in response to an increase in physical activity, like running for the bus. Once you take those breaths, your bloodstream will self correct for any imbalances in oxygen or carbon dioxide; this "gas exchange" is one of primary purposes of breathing.
However, periods of involuntary apnea can also happen. Sleep apnea refers to these pauses in breathing which occur while you sleep. The main difference between apnea and sleep apnea relates not only to the time of day but to "who's in charge" of breathing. During the day, you may enjoy having the conscious choice to take a breath at any time. However, once you're asleep, you do not consciously control your breathing: it is only the brain regulating your breathing at this time.
When you have an episode of sleep apnea, the brain takes note of the changes in oxygen and carbon dioxide in the bloodstream caused by the temporary pause in breathing, just like it does during the day. But since you are asleep, it will now either wake you up or send stress hormones into your bloodstream to inspire breathing in order to fix the problem.
Even though you technically fix your problems by breathing again, it's important to note that, following any form of apnea, you have less oxygen to begin with in your system. This means it will require more work from your heart, your diaphragm, your muscles of breathing, your vascular system, and other organs to bring the oxygen levels in your bloodstream back to normal.
An apnea here or there is not a problem; it's the regular episodes of long-lasting pauses, night after night, and all night long, which lead to negative long-range results from untreated sleep apnea. Ultimately, sleep for someone suffering from sleep apnea is extremely fragmented and of poor quality, which leads to serious consequences, including excessive daytime sleepiness, high probability of developing other chronic disease, and increased risk for motor vehicle accidents.
The Three Types of Sleep Apnea:
Clinically, the term sleep apnea actually applies to three different types of sleep apnea.
Obstructive Sleep Apnea (OSA)
The most common form of sleep apnea is OSA. The word obstructive is key here: something has happened to the upper airway during sleep to obstruct the process of inhaling and/or exhaling. This is an issue of mechanics and it can be caused by a number of things:
Relaxed tissues and muscles in the upper airway. The lining of your upper airway is flexible and pliable. During the day, while you are upright, it remains firm or patent, allowing good clearance for breathing. At night, however, these same tissues and muscles naturally relax; tissues and muscles can collapse, either partially, or completely, as you sleep, leading to episodes of OSA.
An episode of OSA typically consists of a partial or complete pause in airflow for at least ten seconds while you are asleep. During this time, your body continues to try to breathe; the diaphragm at the base of the lungs is still moving up and down per instructions from the brain in a process called respiratory effort. But the blockage in the upper airway won't permit the flow of air until the brain finally recognizes significant changes to the oxygen levels in your bloodstream. Then it sounds the alarm and you wake up choking, coughing, or gasping as you struggle to reclaim your lost breath.
One or two of these episodes a night is not worrisome, but repeated and lengthy pauses in breathing caused by OSA can have a dangerous long-term impact on the body if they are not addressed.
Central Sleep Apnea (CA)
The difference between CA and OSA is simple: the body simply stops breathing. The brain fails to signal to the diaphragm to keep working with the lungs and the muscles of breathing to inhale and exhale. The upper airway could be completely obstacle free, but with a central apnea (called central because it originates in the central nervous system of the brain, in the respiratory center), there is no measurable attempt at respiratory effort.
CAs are temporary, and like obstructive apneas, they also last for long periods of time (from ten seconds to over a minute) and contribute to dangerously low levels of oxygen in the bloodstream. If you experience an episode of central apnea, you will eventually start to breathe again in a state of "recovery" until you have replenished your blood's supply of oxygen. However, unlike obstructive apneas, central apneas may or may not wake you up in the process.
In addition, some people with CA may actually never stop breathing; instead, they breathe in a very shallow cycle that alternates with episodes of exaggerated deep breathing in a unique pattern identified as Cheyne-Stokes respiration.
Why would your brain fail to signal your diaphragm to manage breathing while you sleep?
Mixed Sleep Apnea (MA)
As the name suggests, some people experience both OSA and CA at the same time. When this happens, it is called a mixed apnea. The only way to recognize when a patient has mixed apnea, rather than one or the other, is through an attended overnight sleep study where these events can be recorded and identified.
MA is also sometimes referred to as Complex Sleep Apnea (CompSA). However, MA generally describes the mixture of both OSA and CA events in a patient during a test, whereas CompSA is used as a diagnostic term to indicate a distinct disease separate from OSA or CA. CompSA is diagnosed after OSA is successfully treated with CPAP, only to discover that CA suddenly begins to occur, or continues to occur, even after therapy has cleared up obstructions.
Author: Tamara Kaye Sellman RPSGT CCSH
Updated August 9th 2017
Exercise can give a boost to sleep in several ways. Making time to exercise can:
Improve sleep quality. Exercise can contribute to more sound and restful sleep. Physical activity increases time spent in deep sleep, the most physically restorative sleep phase. Deep sleep helps to boost immune function, support cardiac health, and control stress and anxiety.
Increase sleep amounts. In addition to improving the quality of sleep, exercise also can help you increase the duration of your nightly rest. Being physically active requires you to expend energy, and helps you feel more tired and ready to rest at the end of the day. Research indicates that exercise—in particular, regular exercise that’s part of a consistent routine—can help boost sleep duration, in addition to sleep quality.
Reduce stress and relieve anxiety. A regular exercise routine can help to reduce your stress levels. Stress is a common cause of sleep problems, including trouble falling asleep and sleeping restlessly during the night. Exercise is a potent remedy for anxiety and other mood disorders—just 5 minutes of exercise can trigger anti-anxiety responses in the body. Mind-body exercise such as yoga can help quiet the parasympathetic nervous system, which can help you relax. Research shows that mind-body exercises such as yoga and stretching can help to lower cortisol levels and reduce blood pressure, as well as having positive effects on mood.
Help with insomnia and other sleep disorders.
Scientific evidence indicates that exercise can be an effective natural therapy for insomnia. We have a lot to learn about how exercise may help treat insomnia and other sleep disorders. Studies suggest that aerobic exercise may be particularly effective in helping reduce insomnia symptoms. Research also indicates that for people with insomnia, the benefits of exercise kick in over time, rather than immediately. Studies have also found that exercise can help lower the severity of sleep disordered breathing and may help to reduce the severity of obstructive sleep apnea.
How much exercise is right?
There is no one right answer to this question. The National Institutes of Health and the American Heart Association recommend at least 150 minutes of exercise a week for healthy adults—that’s 30 minutes a day, five days a week. Studies indicate that sleep may receive some of its most significant benefits from exercise that is consistent and routine over time, especially for people who experience difficulty sleeping.
It may surprise you to hear, but too much exercise can pose problems for sleep. Many people don’t give it much thought, but over-training is a common problem—and can lead to sleep difficulties. In fact, one of the first symptoms of over-training is insomnia and difficulty sleeping, according to research.
Bio time can help you exercise and sleep better. You can use bio time to help your exercise routine feel more like fun and less like work, to improve your fitness and athletic performance, and to get the maximum boost to your mental and physical health.
There is no one right time of day to exercise. The best times to be physically active depend on your chronotype. The right time of day for exercise also depends on what you what you want to achieve in your workout.
Here are some strategies for using your body’s bio time to make the most of your exercise:
When exercising, watch out for bedtime
When it comes to the timing of exercise, all chronotypes should be aware that exercising too close to bedtime may interfere with sleep. Working out too late in the day can leave you feeling energized and stimulated right before bed, and delay your transition to sleep.
Body temperature stays elevated for about four hours after you finish exercising. A higher body temperature can interfere with your ability to sleep. What does body temperature have to do with sleep? As your body prepares itself for sleep, you experience a drop in core body temperature—a drop that begins in the late afternoon. Falling core body temperature contributes to feeling drowsy. Exercise too close to bedtime can reverse that downward shift in body temp, and keep you awake. For all chronotypes, it’s a good idea to avoid everything but the gentlest forms of exercise—light stretching, relaxed yoga, and after-dinner stroll—within 3-4 hours of bedtime.
Get out for a jog, cycle around your neighborhood, hit the gym for some weight training or a cardio session on the treadmill. Every bit of exercise you commit can help you feel better during the day and sleep better at night.
Michael J. Breus, PhD
Updated August 9th 2017
Fuelled by digital devices, a reliance on caffeine and bringing work home, people are increasingly flouting sleep health guidelines and paying the ultimate price. A new report by Deloitte Access Economics, commissioned by Sleep Health Foundation, reveals more Australians are dying from causes related to sleep deprivation than on the roads.
In 2016-17, 3,017 deaths were linked to sleep deprivation — including 394 deaths from industrial accidents or road crashes due to lack of sleep. Health conditions linked to lack of sleep including heart disease and diabetes are also killing people with four in 10 Australians suffering from inadequate sleep. Australia’s road toll in 2016 was 1,292.
The problem is being fuelled by digital devices, a reliance on caffeine, and bringing work home. Deloitte says bad sleep cost Australia $66.3 billion in 2016-2017 including $26.2 billion from the financial burden of health care, loss productivity and accidents. The remaining $40 billion has been attributed to “loss of wellbeing” from sleep deprivation.
The foundation’s chair Professor Dorothy Bruck said sleep must be prioritised like diet and exercise. “Sleep affects every single cell of the body in every organ of the body. With diabetes we have seen in studies of otherwise healthy people that when you deprive them of sleep their whole glucose metabolism is compromised and they actually go into a pre-diabetic state,” she said.
The people suffered the “significant” changes in their metabolism after just a week of having five hours of sleep a night. Sleep deprivation also depletes the hormone that makes people feel full causing them to gorge and gain weight. It also wreaks havoc on heart health with about 12 per cent of Australians living with undiagnosed sleep apnoea which restricts oxygen flow and puts a strain on the heart.
“It is getting worse because we are much more of a 24/7 society, always available with technology, taking work home, working later than we should and being on screens before bed,” Prof Bruck said.
“And over reliance on coffee as a stimulant means these things can become a vicious cycle. The light from digital devices suppresses hormones that make people feel sleepy which cuts into the crucial 7.5 — 8 hours of recommended nightly sleep".
3000 deaths were linked to sleep deprivation including 394 from industrial accidents or road crashes due to lack of sleep. The foundation wants a public health campaign about sleep and also called for building design standards that increase natural light and stricter workplace health and safety rules.
The report also called for better policing of tired drivers. Drivers who have had 17 hours of sleep deprivation perform the same behind the wheel as someone with a blood alcohol concentration of 0.05 per cent. “This clearly shows that we have an epidemic of disabling sleep loss affecting a large chunk of our population,” Prof Bruck said. “We have 7.4 million Australians who are not getting the sleep they need to fully function throughout the day.”
Author Rose Brennan.
Updated August 8 2017
There are several types of sleep apnea that exist, but the most frequently diagnosed is obstructive sleep apnea (OSA), which occurs when muscles relax in the throat causing an airway blockage. The blockage causes people to snore and/or wake up during the night multiple times. A victim to this disorder becomes sleepy during the day, turning it into the source of poor performance at work and even car crashes. While day time sleepiness and fatigue are largely reported as the most common symptoms by patients, OSA can have a bad effect on the cardiovascular system that often goes unnoticed.
“The evidence is very strong for the relationship between sleep apnea and hypertension and cardiovascular disease generally, so people really need to know that,” said Donna Arnett, Ph.D., chair and professor of epidemiology at the School of Public Health at the University of Alabama at Birmingham and the president of the American Heart Association. According to an American Thoracic Society study of people with hypertension, about 30% have obstructive sleep apnea. If they have obstructive sleep apnea, there is a 50% chance they also have hypertension.
Why does blood pressure rise due to sleep apnea? When someone who suffers from sleep apnea stops breathing during the night, their oxygen levels fall drastically. The effects of this is that the brain will tell the blood vessels to increase pressure by narrowing or tightening up so that the body can receive more oxygen flow. In a sleep study, a sleep doctor can measure the severity of the sleep apnea and determine whether the patient has mild sleep apnea, characterized by five to 15 episodes per hour; moderate sleep apnea, defined by 15 to 30 per hour; or severe sleep apnea, meaning more than 30 each hour.
Oral appliance therapy can help control the symptoms of sleep apnea and prevent heart-related problems associated with sleep apnea. “The good news is treatment that keeps the breathing passages open and oxygen flowing can yield fast results,” Dr. Arnett said. “Blood pressure comes down really quite quickly.”
Reference sleepfoundation.org, heart.org, thoracic.org, harvard.edu
Updated August 4th 2017
