Impacts of a Good Night's Sleep

"There  has been decades of research showing that poor sleep health is a major causal factor for either the onset of or worsening of physical and mental conditions."

Sleep is really a public health matter. It is a health imperative."

"Historically, we have been neglecting our sleep quite seriously and it is clear now that this has massive impacts on a lot of areas in terms of physical health, mental health and general functioning, including productivity in the workplace. There are a lot of different aspects of life that are affected by sleep."

"We know that sleep contributes to either the onset or worsening of physical and mental health conditions and we know that fixing sleep is also improving these health outcomes. Trying to fix sleep is a modifiable factor to improve health."

"For a long time, the sleep community has been pretty vocal about the damage that daylight time is causing. Not only are we artificially shifting the time, we are not just gaining or losing an hour, we are also messing up the internal clock in our brain that keeps time. The whole idea was to save energy during wartime. This is no longer a valid argument."

Dr. Rebecca Robillard, associate professor, School of Psychology, University of Ottawa

Insufficient sleep has been identified as a causative of, or for worsening chronic physical conditions, including heart disease, Type 2 diabetes along with mental illnesses like depression and anxiety. It can even lead to obesity. It has links to pregnancy complications and is capable of undermining other practices for good health such as exercise and diet. Dr. Robillard, a scientist in the sleep research unit at the Institute on Mental Health at the Royal and co-chair of the Canadian Sleep Research Consortium, feels not enough attention has been paid to lack of adequate sleep and its consequences.

It is her opinion that there is a long-overdue recognition of insufficient sleep as a public-health issue, which it should be. The Canadian Sleep Research Consortium in March is scheduled to assist in the organizing of Canada's first national Sleep Week in an effort to draw attention to the vital importance of sufficient sleep for people of all age groups. Researchers hope to produce a live map to indicate how people across Canada are faring in their need to have proper sleep patterns nightly, hoping the public will respond by tracking their sleep habits.

Researchers in 2015 estimated that 23.8 percent of Canadian adults reported nighttime insomnia. That number is now closer to 40 percent, a 2021 survey reveals. Reports revealed that 6.4 percent of Canadians in 2015 and 2016 were diagnosed by a health care professional with sleep apnea, along with insomnia, the leading sleep disorder among Canadians. Sleep deprivation has significant widespread health, social and economic consequences on health.

Researchers feel that governments would do well for the health of the general public by cancelling the twice-yearly imposition of daylight-saving time, known to contribute to various health and safety issues that erupt in the immediate days following the universally disliked time change, into longer term health impacts. Sleep researchers would ideally like to see a return to permanent standard time.

Increases in heart attacks, strokes, pregnancy issues, traffic accidents and digestive system impacts among other issues have been demonstrated through data accrued from American studies and elsewhere globally, associated with the time changes. In the same token, researchers are focusing on the collection of Canadian data on the twice-yearly time change impacts "to make the case stronger to abolish the practice."

 

People, Dr. Robillard, cautions, should have realistic expectations about the quality and duration of their nightly sleep. Individuals on average, should sleep between seven to nine hours nightly, varying from person to person. Some people manage well with fewer hours of sleep, while the majority of the public requires an average of eight hours of sleep to optimize health effects and normal daily performances. As well, although sleep patterns resulting in a good night's sleep is important, being overly obsessed with sleep quality can be stressful. It's called Orthosomnia.  

Snoring Awareness

"Snoring is very much associated with sleep apnea. But not everybody with sleep apnea snores -- even though the vast majority do -- and not everybody who snores has sleep apnea."

"[Customized mouthpiece or mouthguards pull the jaw and tongue slightly forward; basic versions can be ordered online, but they] tend to have a higher association with tooth movement and jaw pain."

"It's something that really should be made custom to your mouth [by a dentist]."

"[Surgery is generally] considered a last resort, because it's painful."

David Schwartz, president, American Academy of Dental Sleep Medicine 

"We see severe patients all the time, and they have no clue they have sleep apnea."

"They're only coming in because their bed partner told them to."

Kent Smith, founding director, Sleep Dallas, president, American Sleep and Breathing Academy

Even in the absence of obstructive sleep apnea, snoring can still disrupt people's sleep enough to cause sleep deprivation. Not getting enough sleep each night is associated with an increased risk for type 2 diabetes, obesity, high blood pressure and heart disease. Tero Vesalainen/istock.com

 

When something blocks flow of air through the mouth and nose, snoring occurs, as a common condition. As the air struggles to push through, soft tissues vibrate. Sometimes a nasal obstruction, deviated septum or collapsed nasal valve causes people to snore. The sound can also be caused by the tongue. But snoring can also be a symptom of obstructive sleep apnea (OSA), a condition that affects roughly one in five people.

When we sleep, throat muscles relax, blocking the airway. Sleep apnea-caused snoring is frequently loud, and could be followed by shallow breaths, gasping or general restlessness. Other, less-serious conditions can cause snoring; nasal polyps, crooked septum, shape of one's palate or tongue, a cold or allergies. Alcohol consumption, pregnancy or obesity can also contribute to snoring.

When snoring is caused on occasion as a result of having a cold, or imbibing alcohol prior to bedtime, it is generally harmless. Constant snoring might be a good reason to have an appointment with a sleep specialist since research indicates that some 90 percent of people with sleep apnea remain undiagnosed, a condition that can have serious ramifications, including elevated risk of heart problems.

Snoring might pose a risk to health, even in the absence of obstructive sleep apnea. OSA, according to some research, may be associated with cardio-metabolic risk factors like atherosclerosis (artery disease) and endothelial dysfunction (non-obstructive coronary artery disease). People who snored but did not have sleep apnea were examined in a study published in the journal Laryngoscope where researchers found the longer a person snores nightly, the greater the narrowing he/she has in their neck arteries, which has the potential of increasing stroke risk.

Should a sleep study -- where a sleep specialist conducts a study where brain levels, oxygen level, heart rate, eye and leg movements are recorded -- reveal OSA, patients are usually treated with breathing devices -- for example, a continuous positive airway pressure machine, which blasts a steady stream of air into the nose and mouth during sleeping hours.

To prevent snoring not caused by sleep apnea, it helps to lose weight; snoring accompanies weight gain. Even the tongue can gain weight to crowd the airway. "So, weight loss will improve your snoring", explains Steven Holfinger, sleep medicine specialist at Ohio State University's Wexner Medical Center.  Men who lost over six pounds greatly reduced their snoring level, while shedding 15 pounds, eliminated it. 

"Smoking creates a sticky airway", which hampers air from flowing in an optimal manner, which in turn leads to snoring, explained Dr.Smith. Alcohol prior to bedtime causes muscles adjacent the airway to relax, increasing the chances that snoring will ensue, explained Dr.Holfinger, so it makes sense to stop drinking a few hours before turning in to sleep. And when you sleep, adjust sleeping position; optimally not to sleep on your back to avoid tissues in your upper airways drooping, so "you have a much greater chance of snoring", said Dr.Schwartz.

Doctors recommend some therapies such as nasal strips or dilators; the strips are applied to the outside of the nose at bedtime to help open nasal passages, reducing snoring. An older study found dilators to effectively reduce intensity of snoring in a majority of instances, if the snorer is absent a condition such as OSA. Customized mouthpieces (mouth guard) pull the jaw and tongue slightly forward to open the upper airway. Laser assisted uvulopalatoplasty (LAUP), involves shortening soft tissue dangling back of the throat, with small cuts in the soft palate.

More Validation of Exercise Guarding Against Ill Health

"In our study, higher levels of physical activity and fewer hours of TV watching and sitting either at work or away from home were associated with lower OSA [obstructive sleep apnea] incidence after accounting for potential cofounders."

"Our results suggest that promoting an active lifestyle may have substantial benefits for both prevention and treatment of OSA."

"We found that physical activity and sedentary behaviour are independently associated with OSA risk. That is, for people who spend long hours sitting every day, increasing physical activity in their leisure time can equally lower OSA risk."

"Those who can lower sedentary time and increase physical activity would have the lowest risk."

Tianyi Huang, associate epidemiologist, Brigham and Women's Hospital, Harvard University

Man sleeping deeply on his left side without snoring w/breathing apparatus  Getty

A wide-scale study published in the European Respiratory Journal which studied some 130,000 men and women in the United States over an extended period of ten to 18 years, highlighting the potential health hazards of a sedentary life, concluded that moving about more and being less sedentary in one's habitual behaviour to be associated with a diminished likelihood of contracting obstructive sleep apnea.

An earlier study published in 2014 reached an estimate of 5.4 million Canadians having been either diagnosed with the condition of sleep apnea or being at high risk of the disorder, as the most common type of sleep apnea occurring in any population, most commonly caused when the upper airways are blocked, consequent of the soft tissue at the back of the throat collapsing and obstructing  the flow of oxygen to the lungs.

The upper airways passage can on occasion become compromised in people with larger-than-normal tongues, those with 'relaxed' throat muscles, or narrow airways. Generally obstructed airways result in the person affected snowing loudly, followed by choking or gasping for breath during sleep. Symptoms of OSA occurrences are manifested on the following day; when a morning headache persists, fatigue, irritability of mood changes, poor concentration, memory loss, or a lowered sex drive.

In the involvement of serious cases of OSA, the risk of heart issues can increase, including heart failure. Statistical modelling was used by the researchers to compare physical activity and sedentary hours and how they impact OSA diagnoses. Moderate and vigorous physical activity were seperately examined and both found to be tied to a lower risk of acquiring OSA; no difference of note discerned between the intensity of activity.

Women were seen to have the strongest correlation, as well as adults over the age of 65, and overweight individuals. The large sample size of the study and succeeding analysis of various levels of activity gave credibility to the findings the researcher felt, though the self-reported sedentary and physical activity narrative might conceivably not have reflected the most ideal method of data collection.

A step up from reliance on self-reporting would be the use of home sleep apnea tests along with non-invasive monitoring methods in confirmation of the findings. As well, the study focused on recreational physical activity. Sedentary behaviour characterized as being seated while viewing television or sitting outside the work situation. Irrespective of which the associations were sufficiently robust for researchers to encourage doctors to emphasize to their patients the importance of physical activity as an anti-OSA lifestyle tool.

 

The new study by investigators from Brigham and Women's Hospital examined the relationship between active lifestyles and the risk of obstructive sleep apnea (OSA).   (Unsplash)