First, we know from numerous studies that the problem of sleeplessness caused by pain is preventable with appropriate strategies. When pain is first experienced, most people do not experience sleeplessness. However, when pain becomes a problem, it can be a vicious cycle. If someone experiences poor sleep due to pain one night, he or she is likely to experience more problems the next night and so on. It gets worse and worse every night. Also we know that pain triggers poor sleep. For instance, someone experiencing lower back pain may experience several intense microarousals (a change in the sleep state to a lighter stage of sleep) per each hour of sleep, which lead to awakenings. However, microarousals are innocuous for a person not experiencing chronic pain. Pain is a serious intrusion to sleep. Pain is frequently associated with insomnia and these coexisting problems can be difficult to treat. One problem can exacerbate the other.
By Dr. Mercola
Depriving your body of sleep can lead to some very serious—and surprising—health effects, including widespread pain, which is a primary feature of fibromyalgia.
According to recent research from Great Britain, poor or insufficient sleep was actually the strongest predictor for pain in adults over 50. Other predictors for widespread pain included anxiety, poor physical health, cognitive problems, and osteoarthritis. Senior author Ross Wilkie told Reuters Health:
“In older adults, widespread pain, that is pain that affects multiple sites in the body, is common and is associated with morbidity and disability including poor mental health and reduced physical functioning…Non-restorative sleep was the strongest predictor of new onset widespread pain…”
Poor sleep can actually impact virtually every aspect of your health, and the reason for this is because your circadian rhythm (sleep-wake cycle) actually “drives” the rhythms of biological activity at the cellular level.
Hence disruptions tend to cascade outward throughout your entire body. For example, besides making you more susceptible to physical aches and pains, interrupted or impaired sleep can also:
- Increase your risk of heart disease and cancer
- Harm your brain by halting new neuron production. Sleep deprivation can increase levels of corticosterone (a stress hormone), resulting in fewer new brain cells being created in your hippocampus
- Contribute to a pre-diabetic state, making you feel hungry even if you've already eaten, which can lead to weight gain
- Contribute to premature aging by interfering with your growth hormone production, normally released by your pituitary gland during deep sleep (and during certain types of exercise, such as high-intensity interval training)
- Increase your risk of dying from any cause
Three Factors to Determine How Restorative Your Sleep Is
There are many reasons for why you might not sleep well through the night or get enough sleep. Among the most common culprits are not getting enough natural sunlight during the day, combined with too much artificial light well into the evening.
Something as simple as keeping your bedroom too warm is another frequent mistake that can lead to tossing and turning. Then there's the issue of being overweight, which increases your risk of sleep disorders such as sleep apnea, which I'll discuss more in a moment.
Earlier this year, I interviewed Dan Pardi on the topic of how to get restorative, health-promoting sleep. Pardi is a researcher who works with the Behavioral Sciences Department at Stanford University and the Departments of Neurology and Endocrinology at Leiden University in the Netherlands. According to Pardi, the following three factors are key to determining how restorative your sleep is:
- Duration— i.e. the number of hours you sleep. Sleep requirements are highly individual, and can change from one day to the next, depending on factors like stress, physical exertion, illness, and pregnancy, just to name a few. But, on average, most people need about eight hours of sleep per night.
- Timing—i.e. the habit of going to bed at approximately the same time each night. Even if the duration of sleep is the same, when the timing of your sleep is shifted, it's not going to be as restorative.
- Intensity—This has to do with the different stages that your brain and body goes through over the course of the night, the sequence of them, and how those stages are linked.
Some medications will suppress certain phases of sleep, and certain conditions like sleep apnea will lead to fragmented sleep. With these scenarios, even if you're sleeping for an adequate duration and have consistent timing, your sleep will not be as restorative.
One of the easiest ways to gauge whether you've slept enough is to assess your level of sleepiness the next day. For example, if you had the opportunity, would you be able to take a nap? Do you need caffeine to keep you going? Answering yes to these two questions would indicate you need more and/or better sleep.
The Importance of Getting Bright Light During the Day
I believe that a MAJOR part of why so many people are sleeping so poorly is linked to modern day living, which keeps you indoors for the greater part of the day, and allows you to spend long evenings in brightly lit rooms. The natural cycle of light and darkness plays a critical role in your waking/sleep cycle, and deviating from this natural rhythm can have serious health ramifications.
Studies have shown that poor lighting in the workplace triggers headaches, stress, fatigue, and strained watery eyes, not to mention inferior work production. Conversely, companies that have switched to full-spectrum lights report improved employee morale, greater productivity, reduced errors, and decreased absenteeism. Some experts even believe that “malillumination” is to light what malnutrition is to food, and spending the larger portion of each day indoors essentially puts you in a state of “light deficiency.”
When full-spectrum light enters your eyes, it not only goes to your visual centers enabling you to see, it also goes to your brain's hypothalamus where it affects your entire body. Your hypothalamus controls body temperature, hunger and thirst, water balance, and blood pressure. It also controls your body's master gland, the pituitary, which secretes many essential hormones, including those that influence your mood.
Light also serves as the major synchronizer of your “master clock.” This master clock is a group of cells in your brain called the suprachiasmatic nuclei (SCN). As a group, these nuclei synchronize to the light-dark cycle of your environment when light enters your eyes. You also have other biological clocks throughout your body, and those clocks subsequently synchronize to your master clock. In essence, there are two levels of synchronizations taking place within your body in response to sunlight:
- Your master clock synchronizes with the environment
- Your other body clocks synchronize with the master clock
To maintain healthy “master clock” timing, you want to make sure you're getting bright light exposure during the day. Many indoor environments simply aren't intense enough to maintain the needed synchronization. So-called “anchor light” anchors your rhythm, causing it to be less fragile, so that light at night has less of an ability to shift your rhythm. As for how much light exposure you need, Pardi says the first 30-60 minutes of outdoor light exposure creates about 80 percent of the needed anchoring effect.
Nighttime Light Exposure Is Also Detrimental for Sleep and Health
Just as your body requires bright-light exposure during the day, it requires pitch-blackness at night to function optimally. When you turn on a light at night, you immediately send your brain misinformation about the light-dark cycle. The only thing your brain interprets light to be is “day.” Believing daytime has arrived, your biological clock instructs your pineal gland to immediately cease its production of the hormone melatonin – a significant blow to your health, especially if you're ill, as melatonin produces a number of health benefits in terms of your immune system.
In addition, melatonin helps you fall asleep and bestows a feeling of overall comfort and well-being, and it has proven to have an impressive array of anti-cancer benefits. Needless to say, suppressing this essential hormone by excessive light exposure before bedtime is the last thing you want to do if you have trouble sleeping, or struggle with any kind of health problem or illness.
Moderate Weight Loss Can Help Prevent Sleep Apnea
Certain health ailments can certainly affect your quality of sleep. Sleep apnea, for example, is a very common problem that can hinder any attempts at getting more restorative sleep. Apnea is a Greek word that means “breathe.” Sleep apnea is the inability to breathe properly, or the limitation of breath or breathing, during sleep. There are three general types of apnea described in the literature:
- Central sleep apnea (CSA), which typically relates to your diaphragm and chest wall and an inability to properly pull air in
- Obstructive sleep apnea (OSA), which relates to an obstruction of your airway that begins in your nose and ends in your lungs
- Mixed apnea is a combination of both
Obstructive sleep apnea consists of the frequent collapse of the airway during sleep, making it difficult to breathe for periods lasting as long as 10 seconds. Those with a severe form of the disorder have at least 30 disruptions per hour. Not only do these breathing disruptions interfere with sleep, leaving you unusually tired the next day, it also reduces the amount of oxygen in your blood, which can impair the function of internal organs and/or exacerbate other health conditions you may have.
The condition is closely linked to metabolic health problems such as obesity and type 2 diabetes, and according to recent research, even a modest weight reduction can halt the progression of obstructive sleep apnea. Shedding excess pounds might even cure it, according to this five-year long study. As reported by Medical News Today:
“The study focused on the effects of weight loss on OSA [obstructive sleep apnea] and demonstrated, for the first time, that a sustained weight loss of just five percent was enough to prevent the disease from worsening and even cure it in a long-term follow-up.”
You Don't Have to Be Obese to Suffer from Sleep Apnea
While sleep apnea is thought to be primarily associated with obesity, many patients diagnosed with sleep apnea today do not have a weight problem. As it turns out, the shape and size of your mouth, and the positioning of your tongue, can also play a significant role.
According to Dr. Arthur Strauss, a dental physician and a diplomat of the American Board of Dental Sleep Medicine, our mouths have progressively gotten smaller through the generations due to lack of breastfeeding and poor nutrition. Breastfeeding actually helps expand the size of your child's palate and helps move the jaw further forward – two factors that help prevent sleep apnea by creating more room for breathing. Diet is also important. Dr. Weston Price's pioneering work showed how diet can affect your entire mouth, not just your teeth.
If your sleep apnea is related to your tongue or jaw position, specialty trained dentists can design a custom oral appliance to address the issue. These include mandibular repositioning devices, designed to shift your jaw forward, while others help hold your tongue forward without moving your jaw. However, sleep apnea relief may also be found in the form of speech therapy treatment called oral myofunctional therapy, which helps to re-pattern your oral and facial muscles. For more information about this, please see my previous interview with Joy Moeller, who is a leading expert in this form of therapy in the US.
Quick Tips for Improving Your Sleep Quality
Small adjustments to your daily routine and sleeping area can go a long way to ensure uninterrupted, restful sleep. I suggest you read through my full set of 33 healthy sleep guidelines for all of the details, but to start, consider implementing the following changes:
- Get some sun in the morning. Your circadian system needs bright light to reset itself. Ten to 15 minutes of morning sunlight will send a strong message to your internal clock that day has arrived, making it less likely to be confused by weaker light signals during the night.
- Get at least 30 minutes of BRIGHT sun exposure mid-day. Remember, your pineal gland produces melatonin roughly in approximation to the contrast of bright sun exposure in the day and complete darkness at night. If you work indoors, make a point to get outdoors for at least a total of 30-60 minutes during the brightest portion of the day.
- Avoid watching TV or using your computer in the evening, at least an hour or so before going to bed. These devices emit blue light, which tricks your brain into thinking it's still daytime. Normally your brain starts secreting melatonin between 9 and 10 pm, and these devices emit light that may stifle that process.
- Sleep in complete darkness, or as close to it as possible. Even the slightest bit of light in your bedroom can disrupt your biological clock and your pineal gland's melatonin production. This means that even the tiny glow from your clock radio could be interfering with your sleep, so cover your alarm clock up at night or get rid of it altogether. The ideal light tone for any clock you keep on all night is a reddish amber, certainly not blue or green. The red and amber will interfere least with your melatonin production. I also recommend covering your windows with thick drapes or blackout shades if you can afford them. Alternatively, wear an eye mask while you sleep.
- Install a low-wattage yellow, orange or red light bulb if you need a source of light for navigation at night. Light in these bandwidths does not shut down melatonin production in the way that white and blue bandwidth light does. Salt lamps are handy for this purpose.
- Keep the temperature in your bedroom at or below 70 degrees F (21 degrees Celsius). Many people keep their homes and particularly their upstairs bedrooms too warm. Studies show that the optimal room temperature for sleep is quite cool, between 60 to 68 degrees F (15.5 to 20 C). Keeping your room cooler or hotter can lead to restless sleep.
- Check your bedroom for electro-magnetic fields (EMFs). These can also disrupt your pineal gland's production of melatonin and serotonin, and may have other negative effects as well. To do this, you need a gauss meter. You can find various models online, starting around $50 to $200. Some experts even recommend pulling your circuit breaker before bed to kill all power in your house.
- Move alarm clocks and other electrical devices away from your head. If these devices must be used, keep them as far away from your bed as possible, preferably at least three feet.