PART 3

The Dangers of Sleep
Deprivation and Its
Impact on Your Health

The Three Pillars of Health

Sleep, diet/nutrition, and exercise are the three most crucial factors for maintaining good health. While there is an abundance of information available on diet/nutrition and exercise, there is surprisingly little education about the negative effects of inadequate or poor sleep. This lack of awareness is puzzling.

Not getting enough oxygen while sleeping can lead to various health problems. Sleep apnea, a condition where breathing stops and disrupts your sleep, is often caused by the tongue being positioned too far back in the throat due to underdeveloped jaws and incorrect tongue posture. This is a common issue that we frequently encounter at the Julian Center.

Imagine if you were in a race, but every minute you blocked your mouth for more than ten seconds with your hand, stopping you from breathing correctly. With that kind of blockage, it would be really hard for you to get enough air. You wouldn’t be able to run very far, and you would quickly feel exhausted.

When you have something blocking your airway, it stops the proper flow of oxygen. This means that not only are you lacking sleep, but you’re also lacking oxygen. When people have this problem, they can stop breathing more than thirty times in an hour for ten seconds or longer. That’s over 240 times in just eight hours of sleep!

When you’re not getting enough oxygen to your brain, it’s likely that you’re not able to reach the deep stages of sleep. These are crucial for your body to restore its cells and immune system. It’s also during this time that the brain’s lymphatic system (known as the glymphatic system) eliminates toxins and consolidates memory.

Your brain and body need oxygen to function properly. This is because oxygen is necessary for the chemicals in your brain, called neurotransmitters, to send signals to the rest of your body. These signals tell your body how to work. In addition to neurotransmitters, there are also neurochemicals in your brain and body that help regulate your nervous system. Hormones, on the other hand, act as messengers in your body. They control a wide range of functions, including emotions, mood, hunger, sleep, circulation, and immunity. Without oxygen, these important chemicals and messengers cannot do their jobs effectively.

When you’re asleep, your body makes a hormone called growth hormone. This hormone helps control things like how your body is made up, how much water is in your body, how your muscles and bones grow, how your body uses sugar and fat, and maybe even how your heart works.

Lack of sleep doesn’t just make you tired, it also prevents your brain from rejuvenating. Sleep cycles are necessary for the brain to regenerate its chemistry. When you’re stressed, hormones like cortisol, epinephrine, and adrenaline can disrupt the quality of your sleep. Over time, this can even weaken your immune system, making you more susceptible to colds, flu, and other viruses if you don’t get enough sleep. A poor night’s sleep can also result in a reduction of lymphocytes (white blood cells).

The Vital Importance of Energy Sources for the Brain

Our body’s cells are adept at deriving energy from various fuel sources, such as sugar and fatty acids from fat. However, when it comes to brain cells, they have distinct preferences. Glucose is their primary source of energy, essentially their favorite fuel. In times of need, such as during fasting or in cases of diabetes, brain cells can also utilize amino acids and ketones for sustenance.
The brain’s reliance on glucose is crucial, given its unique metabolic requirements and the protective nature of the blood-brain barrier. Unlike the body’s other tissues, the brain’s blood vessels limit the passage of large molecules, serving as a protective shield against potentially harmful substances. Even during sleep, the body diligently ensures that the brain remains supplied with glucose, with the liver storing and gradually releasing glucose as glycogen to regulate blood sugar levels.
While the body can harness energy from fats and proteins, the brain operates by its own set of rules, emphasizing the indispensability of glucose and glycogen. This intricate process underscores the significance of maintaining a steady supply of glucose to support optimal brain function and overall cognitive health. The regulation of glucose and stored glycogen reserves happens while we sleep.
Since an abundance supply of oxygen is necessary to convert glucose into energy (ATP), when the brain doesn’t get enough oxygen, it can’t recharge and function properly. This can lead to various symptoms, ranging from mild to severe. These symptoms include temporary memory loss, trouble concentrating or making decisions, muscle weakness, seizures, and even brain death.

The Four Stages of Sleep

    1. During the sleep cycle, the body goes through four stages to recharge itself. In the first stage, known as N1 or the alpha stage (8 – 13 Hz, a person is just starting to fall asleep and can wake up easily.
    2. Then, in the second stage called N2 or Theta stage (4-8 Hz), eye movements and brain waves slow down as the person enters a deeper sleep (which helps convert short-term memory into long-term memory).
    3. Moving on to the third stage, called N3, brain waves become synchronized and slow down even more to what’s called delta waves or Slow Wave Sleep (1 -4 Hz).
    4. Finally, the sleeper reaches the REM stage, which is part of the deepest sleep stage. During REM, the brain is active like when we are awake, but the body is mostly paralyzed except for rapid eye movements during dreaming.

The amount of time spent in different stages of sleep varies throughout the night. In the beginning, there is less REM sleep, but as the night progresses, REM sleep increases. Each sleep cycle lasts around ninety minutes. While the four stages of sleep are the same for everyone, regardless of age, the amount of REM sleep decreases as we get older.

The main difference between infants, adolescents, and adults is the number of hours of sleep required. Infants need about nine to twelve hours, adolescents need eight to ten hours, and adults need seven to nine hours. Because infants need more sleep, they go through the sleep cycle more frequently than adults. For a restful and rejuvenating sleep, adults should aim to go through about five cycles, which adds up to at least seven and a half hours of sleep. We know that adults who get less than 7 hours of sleep each night might experience more health problems compared to those who sleep for 7 hours or more.

It’s interesting how waking up during the deep sleep or REM stages of your sleep cycle can leave you feeling tired all day. That’s why people often feel awful when they wake up. They may have woken up in the middle of a cycle or went back to sleep and then woke up again before completing the next cycle. Have you ever woken up really early and thought you had enough rest but discovered you had less sleep than normal? You probably woke up at the end of a sleep cycle.

For restful, regenerative sleep, adults need to go through about five cycles at ninety minutes per cycle. That’s a minimum of seven hours of sleep.

Lack of deep sleep can lead to a range of ongoing issues, some of which can be life-threatening. I will discuss more about the different stages of sleep and the restorative effects it has in future articles. But for now, let me provide you with some background on how sleep-breathing problems have become widespread like an epidemic.

The Early Stages of Sleep Disorders: A Closer Look At The Development of Sleep Apnea

Sleep disorders can start at an early age due to poor growth and development of the jaws. It is possible for everyone to have a properly functioning jaw size, which is determined by genetics. Jaw sizes can differ depending on race and geographical location. Some individuals have flatter faces, while others have a facial structure where both the upper and lower jaws protrude forward. There are also those who have a more sunken appearance on their face.

The development of the jaw begins even before a baby is born and can be influenced by the mother’s diet. These issues can even be traced back through several generations. If a mother consumes the right nutrients before and during pregnancy, it can help the maxillary jawbone develop a wide and flat palate. This allows for the teeth to come in without any obstructions. However, if a mother lacks these nutrients during this crucial period, it can lead to stunted jaw growth. This can result in narrow jaws that prevent the teeth from erupting properly, causing problems like under-bites or overbites, a high-arched palate, poor tongue posture, and difficulties with speech, swallowing, and breathing.

Improper jaw formation can be caused by a lack of nutrients, but the main reason for stunted growth and development of the infant’s jaws is not breastfeeding for at least eighteen months. When breastfeeding is inadequate, the neuromuscular and oral facial muscles do not receive the necessary stimulation for proper arch development. Without the muscle contraction that occurs during breastfeeding, the upper jaw does not grow sideways to create a wide, flat palate. Instead, it bows, resulting in narrow upper and lower jaws. This can also be a result of tongue-tie preventing proper latching of the breast during feeding.

Narrow jaws not only make teeth more crowded, but they also reduce space for the tongue. When sleep problems are caused by an enlarged tongue blocking the airway, the real culprit is often a small jaw. The pressure from the teeth can cause scalloping on the edges of the tongue. While genetics play a role, poor nutrition and lack of breastfeeding are more significant factors.

When the jaw is narrow, the tongue can get crowded and go in different directions: forward, sideways, or towards the back of the throat.

Forward: When a person talks or eats, their tongue sticks out of their mouth. It’s a noticeable feature that can sometimes cause problems like an open bite and tongue thrusting. However, the good news is that a forward tongue rarely blocks the back of the throat.

Sideways: When the tongue is positioned sideways, it means that there is not enough space in the jaw. This causes the tongue to press against the teeth on both sides of the mouth, resulting in scalloping or indentations along the outer edges of the tongue. This may also result in a lateral open bite. People who experience this may even find themselves frequently biting their tongue.

Back of the Throat: A back-of-the-throat tongue can be a big problem as it can constrict the airway. This issue worsens when a person lies down at night because the tongue falls further back into the throat, especially when lying on their back. During deep sleep, the tongue muscle can completely block the airway due to muscle paralysis during the REM cycle.  When this happens, a person may experience what is called a microarousal or gasping for air. This occurs because of an increase in carbon dioxide, which causes the person to wake up briefly to take a breath of oxygen. However, they often go back to sleep without realizing they were awake. Many patients deny having any problems because they don’t remember these episodes. Instead, it is usually their spouse, family member, or someone nearby who witnesses these disruptive moments and seeks help out of concern for their loved one’s life.

Have you ever noticed how someone in your family suddenly wakes up with a loud gasp while sleeping in their chair after a big meal? It can be a bit scary to witness, especially if they had stopped breathing for a while before waking up. But usually, family and friends just find it funny or make jokes about this strange and worrisome occurrence.

The good news is that these anatomical abnormalities can be corrected with dental appliances and their ability to stimulate epigenetic predisposition.

Can Sleep Apnea Cause Memory Problems?

You know, sometimes people snore and they don’t even realize it. It’s not because they’re trying to hide it or anything, but because of this thing called sleep apnea. Sleep apnea can make you forget things, like when you have trouble breathing or wake up in the middle of the night. It’s like your brain just erases those memories. But here’s the thing, even though you might not remember it, you still feel tired during the day. It’s weird, right? When I talk to my patients about snoring or waking up during sleep, they usually have no recollection of it at all. It’s like their brain is playing tricks on them!

Common Challenges in Breastfeeding

There are various factors that can lead to difficulties in breastfeeding, resulting in a narrowing of the jaw. For example, babies may be born with a condition called tongue tie, where the tissue connecting the tongue to the floor of the mouth is too short. This condition hinders the tongue from properly pressing against the nipple and palate during breastfeeding, often leading parents to switch to bottle-feeding at an early stage. Fortunately, there are now treatments available to release the tongue, which I will discuss further in upcoming articles.

If breastfeeding is stopped too early, it can cause a narrow jaw because bottle feeding doesn’t support proper jaw development. When using a bottle, the milk flows forcefully from the nipple, causing the infant to use their tongue to slow down the flow instead of pressing it against their palate. This pushes the tongue backward into the throat, leading to problems with tongue posture, swallowing, and breathing. The result is a high-arched, narrow palate that can block the nasal passages and cause mouth breathing.

Mouth breathing can contribute to various health issues, including allergies, food intolerances, asthma, chronic ear infections, and inflammation of the tonsils and adenoids. Nasal breathing is important for dehumidifying the air, facilitating cell communication through nitric oxide production, reducing infections through filtration, and preventing fight-or-flight responses triggered by perceived threats. The reduction of nitric oxide can result in high blood pressure.

When the tongue tie or early cessation of breastfeeding occurs, it prevents the proper development of the swallowing reflex. At the Julian Center, we often come across individuals of all ages who pucker their lips while trying to swallow. This is not how it should be – the lip muscles should be relaxed during swallowing. However, when the tongue pushes outwards, the lip muscles strain and cause the lips to pucker. This can result in the development of an anterior open bite, as mentioned before. Furthermore, improper development of the tongue reflexes can also affect speech. Additionally, due to the faulty swallowing reflex, the body must adapt in ways that may lead to facial, neck, and shoulder pain.

When young kids and babies don’t get enough sleep while they’re growing, it also affects their hormones, especially the ones that control growth. This can alter how they grow and develop. Additionally, children with sleep apnea might wet the bed. This happens because their brain is working harder to get oxygen and can’t focus on controlling their bladder and other bodily functions. As a result, children with sleep apnea may have problems with the hormone that controls urine production.

When the brain doesn’t get enough oxygen, it can’t develop properly. This can affect a child’s mental capacity and lead to issues like autism, ADD, and ADHD. In teenagers, these problems can then cause learning disabilities, poor school performance, prediabetes, or even diabetes. Sleep problems can also result in depression, anxiety disorders, or thoughts of suicide. All of this adds to the challenges of hormonal changes, peer pressure, and the stress of keeping up with school and extracurricular activities.

Orthodontic treatment, sleep therapy, and lifestyle changes can help resolve some of the issues that young people face. For example, adjusting school start times to match the sleep requirements of children and teenagers would be a logical solution. Unfortunately, traditional medicine often relies on prescribing drugs to address symptoms. This means that teens, adolescents, children, and even infants are given medication because their behavior is not considered appropriate. However, it is important to remember that their behavior is influenced by both getting enough sleep and getting the right kind of sleep to regulate the body’s biochemistry.

The Hidden Crisis of Sleep Disorders

When it comes to adults, just like children, lack of oxygen can have a significant impact on their development. Think of your brain as the central processing unit (CPU) of a computer. If it’s not working properly, nothing else will work either. Your screen won’t light up, your programs won’t cooperate, and your hard drive might even crash. Similarly, if your brain is deprived of oxygen and not functioning well, other parts of your body will also suffer from improper functioning.

When we sleep, our brain functions differently, but most of our other organs work the same way as when we are awake and resting. However, when our body doesn’t get enough oxygen during sleep, it affects these organs negatively. Oxygen is essential for our existence and keeps our body functioning properly.

A recent study spanning fifteen years and involving over ten thousand adults has discovered mounting evidence linking obstructive sleep apnea (OSA) to various cardiovascular diseases. These include conditions such as coronary artery disease, hypertension, left ventricular dysfunction, and arrhythmias.

For the past four decades, the American Heart Association has been extensively studying heart disease, which remains the leading cause of death. Factors such as diet, lack of physical activity, stress, and smoking have been identified as contributors to heart disease.

Despite many individuals making positive changes to their eating habits, engaging in regular exercise, practicing stress-relief techniques like meditation, and quitting smoking, heart disease continues to claim countless lives in America. This begs the question: why haven’t the numbers decreased?

It is disheartening to hear about seemingly healthy individuals suddenly succumbing to a heart attack. With so much focus on cardiovascular health, why is sleep not receiving the same level of attention? Could this be the missing piece of the puzzle?

I think there is a widespread problem with sleep disorders. This problem is causing serious health issues that can be fatal, and yet it is not receiving enough attention. I believe that sleep apnea leads to heart disease that can result in death either during sleep or shortly after waking up. It not only contributes to long-term health problems but can also be deadly.

Dementia is becoming a more common issue for adults these days. Some studies have suggested that the lack of oxygen and deep sleep in adults might contribute to or worsen dementia in elderly patients who are already affected by the disease. It’s not difficult to understand this connection, as we all know how our brains can feel foggy after a night of poor sleep.

Sleep apnea can potentially lead to cancer due to the interference it causes in the duplication sequence of the genes, specifically the DNA and RNA. Our body’s genes are constantly duplicating, but before this happens, they “capture an image” of the current script or DNA, which is then used to create new and healthy cells. However, when there is a lack of oxygen, this duplication process may get disrupted, resulting in the duplication of unhealthy cells instead of healthy ones.

In 2012, a study discovered a connection between sleep apnea and death caused by cancer. Insufficient oxygen allows cancer cells to flourish as they develop more blood vessels to obtain additional oxygen, a process known as angiogenesis. As the tumor spreads, the blood vessels grow alongside it. To prevent cancer from thriving, certain countries now provide hyperbaric oxygen treatment, which floods the body with extra oxygen.

Insufficient deep sleep can also disturb the production of insulin and glucagon, which are hormones that regulate the body’s glucose levels. When you consume food, your pancreas releases insulin to help your cells absorb glucose for energy. If the body doesn’t need the glucose right away, it stores it as glycogen for later use. This whole process gets disrupted when you don’t get enough quality sleep.

Sleep deprivation can have serious consequences on our health, leading to various issues such as insulin resistance and the potential development of diabetes. Lack of sleep often results in constant fatigue, causing individuals to seek energy from food. This often leads to increased consumption of carbohydrates, which triggers the release of insulin. Over time, this excessive intake of high-glycemic foods can contribute to weight gain and the thickening of the neck, narrowing the airway. Consequently, individuals may experience interrupted sleep as their tongue obstructs the airflow. Additionally, consuming the wrong types of food at inappropriate times can result in high blood sugar levels, leading to frequent urination during the night and further disruption of sleep.

It’s a never-ending cycle that can seriously harm your health. This cycle is the reason why you might experience a range of diseases and symptoms that don’t seem related at first. Things like high blood pressure, diabetes, cancer, Alzheimer’s, and early dementia can all be affected by one main cause: a decrease in oxygen levels to your body and brain due to sleep disruptions.

Instead of finding the root cause, most medications only focus on treating the symptoms. For example, if you have a poor diet, it can lead to plaque buildup in your arteries, which can result in heart disease and diabetes. In cases of Type 2 diabetes, patients are prescribed medication to increase receptors, while those with Type 1 diabetes are given insulin. However, by addressing breathing problems and ensuring the body receives enough oxygen, both diabetes and cardiac function can be improved.

Sleep disturbances can create a dangerous cycle that puts the sufferer at risk of experiencing a major health event. If that event happens to be a heart attack or stroke, there may not be any opportunities to address the underlying problems. Sadly, many people do not survive their first heart attack. It is often only when someone witnesses the devastating effects of sleep disturbances on a close friend or family member that they truly understand the severity of the issue.

It’s important to find out what’s causing your snoring right now, not later!

Snoring Is Nothing to Laugh At

We all know Uncle Joe snores. Whenever he joins us for Thanksgiving dinner and a football game, he’s in the lounge chair making a lot of noise with his snoring.

It’s quite amusing to everyone, but what they don’t realize is that Uncle Joe actually has a sleep disorder called sleep apnea. He’s completely unaware of it due to the amnesic effect.

He might insist that he sleeps perfectly fine, but it’s important to note that sleep disturbances can lead to cardiovascular disease, which is the leading cause of death in the United States.

One clear indication of this condition is how easily one falls asleep, whether it’s sitting in a lounge chair or lying in bed. Normally, it should take around ten to twenty minutes to fall asleep.

Here are some questions that can help you determine if someone you know might need to be checked for sleep apnea:  1. Does anyone in your family snore?  2. Is there someone you care about who always seems tired?  3. Do you know anyone with a chronic illness like high blood pressure or insulin resistance, a history of heart disease or stroke, atrial fibrillation, early signs of dementia, cancer, depression, irritability, anxiety, thoughts of suicide, or erectile dysfunction?  By asking these questions, you can get a better idea of whether someone may be at risk for sleep apnea.

I someone snores but tested negative of OSA, they still may need to be treated. Continuous snoring will eventually result in OSA.

Other Important Factors That Affect the Quality of Your Sleep

The Impact of Weight Loss on Sleep Apnea

The hormones leptin and ghrelin play crucial roles in controlling appetite. Leptin, produced by fat cells, signals the brain when the body has had enough food. This will then regulate energy balance and reduce appetite. On the other hand, ghrelin, produced in the stomach, stimulates appetite and promotes the intake of food.

Recent research on the relationship between sleep apnea and weight loss has shed light on the crucial role of leptin, and ghrelin. Studies have revealed that individuals with obstructive sleep apnea (OSA) often exhibit elevated levels of leptin, which are positively linked to the severity of the condition, as measured by the apnea-hypopnea index (AHI) and oxygen saturation levels during sleep.

Furthermore, sleep deprivation has been shown to increase ghrelin levels while simultaneously reducing leptin levels in the bloodstream, indicating a strain on the brain’s energy supply. This provides insight into the challenges faced by individuals with sleep apnea, as the condition can significantly slow down metabolism, making weight loss more difficult and potentially leading to further health complications.

Interestingly, clinical data has highlighted the positive impact of weight loss on sleep apnea severity, with reductions of just 10-15% in body weight resulting a 50% decrease in the severity of OSA for moderately obese patients. While weight loss can lead to meaningful improvements in OSA, it is important to note that it often does not provide a complete cure, necessitating additional therapeutic interventions for many patients.

The Bodies Internal 24-Hour Clock and Sleep Apnea

When considering the relationship between circadian rhythm, chronotype, and obstructive sleep apnea, it is crucial to understand the impact of these factors on an individual’s overall health and quality of life. The circadian rhythm, which regulates the body’s internal clock, dictates the timing of various physiological processes, including sleep-wake cycles. This natural rhythm varies among individuals, influencing their chronotype, or preferred timing of sleep and wakefulness.

Understanding the interplay between circadian rhythm, chronotype, and obstructive sleep apnea is essential for healthcare professionals in diagnosing and treating sleep disorders effectively. For instance, individuals with a late chronotype, or “night owls,” may be at a higher risk for obstructive sleep apnea due to the mismatch between their natural sleep patterns and societal demands, such as early work start times. This mismatch can lead to sleep deprivation and exacerbate the symptoms of obstructive sleep apnea, potentially impacting their daytime functioning and overall health.

By recognizing the significance of aligning an individual’s sleep schedule with their circadian rhythm and chronotype, healthcare providers can tailor their treatment approaches to address the specific needs of each patient. This personalized approach can improve treatment outcomes and enhance patient compliance with therapy, ultimately contributing to better management of obstructive sleep apnea and improved overall well-being.

In summary, acknowledging the relationship between circadian rhythm, chronotype, and obstructive sleep apnea is critical for optimizing the diagnosis and treatment of sleep disorders. By factoring in these individual differences, healthcare professionals can offer more effective and tailored care, ultimately improving the quality of life for individuals affected by obstructive sleep apnea.

Hormones That Support Healthy Sleep

Adenosine and melatonin play crucial roles in helping you sleep. Adenosine is a natural sleep-inducing chemical that builds up in your brain throughout the day, making you feel increasingly sleepy as the day progresses. On the other hand, melatonin is a hormone that regulates your sleep-wake cycle, signaling to your body when it’s time to wind down and prepare for sleep.

Understanding the functions of adenosine and melatonin is essential for anyone seeking to improve their sleep quality. By recognizing the impact of adenosine in promoting drowsiness and the role of melatonin in regulating the body’s internal clock, individuals can make informed decisions about their sleep habits and overall well-being.

For example, knowing about adenosine’s influence can prompt individuals to adopt strategies that promote its natural build-up, such as maintaining a regular sleep schedule and avoiding excessive caffeine consumption. Likewise, understanding how melatonin works can encourage people to create a sleep-conducive environment by minimizing exposure to bright lights and screens before bedtime.

By acknowledging the significance of adenosine and melatonin in sleep, individuals can make proactive choices that support their natural sleep processes and ultimately improve their overall sleep quality.

Next Article: Part 4-Mastering the Art of Effortless Sleep

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 JULIAN CENTER FOR

 EFFORTLESS SLEEP

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