Are Sleep Problems Making Your Health Problems Worse?

By Dr. Mercola

The importance of sleep is widely ignored, especially in the US where working around the clock is still glorified. The cost is rarely considered, even though it actually includes reduced work productivity and an increased risk of serious accidents.

Tired drivers are as dangerous as drunk or drugged ones, and experts believe sleep deprivation may have played a role in the Exxon Valdez oil spill, the Staten Island ferry crash, and the Three-Mile Island nuclear meltdown.

But it is FAR more than increasing your risk of accidents. You are decimating your health if you regular ignore and not honor your body's need for about 8 hours of sleep to recharge and repair.

There are likely a few rare individuals that have genetic mutations that allow them to thrive on less sleep and this condition is called advanced phase sleep syndrome.

Only one in 10,000 have this rare gift that allows them to sleep a mere four hours per night and be completely rested. I know one personally, Dr. Michael Hollick, who is one of the leading pioneers and experts in vitamin D.

According to the 2013 International Bedroom Poll by the National Sleep Foundation,¹ 25 percent of Americans report having to cut down on sleep due to long workdays.

But even when long work hours aren't an excuse, many fail to get enough rest. According to the featured documentary, "Sleepless in America," 40 percent of Americans are sleep deprived. Many get less than five hours of sleep per night.

Even the Centers for Disease Control and Prevention (CDC) has stated that lack of sleep is a public health epidemic, noting that insufficient sleep has been linked to a wide variety of health problems.

Sleep Is Essential for Good Health

After reviewing more than 300 studies to ascertain how many hours of sleep most people need to maintain their health, an expert panel concluded that, as a general rule, most adults need right around eight hours per night.

Getting less than seven hours has been shown to raise your risk of weight gain, by increasing levels of appetite-inducing hormones.

Getting less than six hours of sleep leaves you cognitively impaired, which can have repercussions both at home, at work, and on the road. Even a single night of sleeping only four to six hours can impact your ability to think clearly the next day.

Over the long term, sleep deprivation has been linked to health effects such as diabetes, cardiovascular disease, Alzheimer's,² and even cancer. In one study, women who got less than four hours of shut-eye per night doubled their risk of dying from heart disease.³

Poor sleep quality can be equally hazardous. As reported by CNN:⁴

"[G]etting bad sleep could be just as harmful as not getting enough sleep. Obstructive sleep apnea... can increase blood pressure... deprive the body of oxygen, cause irregular heartbeat, and make the blood more sticky, all of which can increase the risk of heart disease and stroke...

A study⁵... found that men who had a sleep disorder were between 2 and 2.6 times more likely to have a heart attack and 1.5 to 4 times more likely to have a stroke over the 14-year period of the study."

US Health Disparities May Be Linked to Sleep Problems

According to another recent study,⁶ African-American, Chinese, and Hispanic Americans are more likely than Caucasians to have sleep problems, including snoring, sleep apnea, and insomnia — a fact they say might be part of the health disparities found among different racial groups in America.

African-Americans, for example, were most likely to get less than six hours of sleep each night. And, while Chinese participants were the least likely to suffer with insomnia, Chinese and Hispanics had higher rates of nighttime breathing problems than Caucasians.

According to lead researcher Dr. Susan Redline:

"As sleep apnea has been implicated as a risk factor for cardiovascular disease, stroke, diabetes, and mortality, our findings highlight the need to consider undiagnosed sleep apnea in middle-aged and older adults, with potential value in developing strategies to screen and improve recognition in groups such as in Chinese and Hispanic populations."

That said, regardless of race, sleep apnea and other sleep problems are widespread in modern civilization in general, and anyone — including children — can be affected.

Addressing Sleep Apnea Is Important for Optimal Health

Dr. Arthur Strauss, a dental physician and a diplomat of the American Board of Dental Sleep Medicine, estimates as many as 30-50 percent of the population are affected with some form of sleep apnea, which refers to the inability to breathe properly, or the limitation of breath or breathing, during sleep.

Not only do breathing disruptions leave 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, so it's really important to address it.

The condition is closely linked to metabolic health problems such as obesity and type 2 diabetes, and according to research,⁷ even a modest weight reduction can halt the progression of obstructive sleep apnea. Shedding excess pounds might even cure it, according to one five-year long study.⁸

That said, sleep apnea is by no means limited to those who are obese. According to Dr. Strauss, factors such as the shape and size of your mouth, and the positioning of your tongue, can also play a significant role.

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.

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.

The conventional treatment for sleep apnea is a machine called CPAP (an acronym for "continuous positive airway pressure"), which creates a forceful pressure that mechanically opens up your airway.

But while CPAP is recommended for severe sleep apnea, it's important to realize that it does not address the cause of the problem, although it may relieve your symptoms. So when seeking out a sleep specialist, make sure he or she has the knowledge and resources to help you address your sleep apnea at the foundational level as well.

Improving Your Sleep May Reduce Physical Pain

Pain is another common health problem that may be improved by getting better, more restorative sleep. Recent research suggests sleep is an important lifestyle component to address if you have osteoarthritis, as sleep disruptions alter how your body processes pain.

As reported by MedicineNet.com:⁹

"In conducting the study, the researchers examined the link between the severity of self-reported insomnia, troubled sleep, and pain sensitivity among people with knee osteoarthritis. They assumed those with the worst cases of insomnia would have more pain and less tolerance for it.

The study participants were between 45 and 85 years old... The volunteers completed questionnaires and experimental pain applications. The study, published recently in The Journal of Pain, confirmed that the severity of sleep disruption was associated with changes in how the body processes pain."

A similar study looking at the connection between sleep and pain among the general population also found that sleep problems tend to lower pain tolerance. Those who had the most frequent and severe insomnia also had the greatest pain sensitivity. As reported by Science Daily:¹⁰

"[C]ompared with individuals who reported no insomnia, rates of reduced pain tolerance were 52 percent higher for subjects reporting insomnia more than once weekly versus 24 percent for those with insomnia once monthly... There was also strong joint (synergistic) effect of insomnia and chronic pain on pain tolerance. Patients reporting high problems with both insomnia and chronic pain were more than twice as likely to have reduced tolerance to pain."

National Sleep Poll Highlights Link Between Sleep and Pain

Pain was also the focus of the 2015 National Sleep Foundation poll,¹¹ and it too reveals a symbiotic relationship between sleep and the experience of pain. Among the key findings:

• 57 percent of Americans reported experiencing at least mild pain in the seven days prior to the poll. Both chronic pain and acute pain were associated with worse physical and mental health, greater stress, and lower quality of life
• Those experiencing pain in the past week reported sleeping less and had worse sleep quality than those who were pain free; on average, those with no pain slept 7.3 hours in the past week while those with mild pain got an average of 7.0 hours of sleep, and those with severe/very severe pain got 6.5 hours
• Pain was related to greater sleep debt – the gap between how much people say they need and the amount they're actually getting. Those with chronic pain averaged a sleep debt of just over 40 minutes; those with acute pain averaged just under 15 minutes. No sleep debt was found among those who did not have pain
• Pain is also associated with sleep quality. Sixty-five percent of those with no pain reported good or very good sleep quality, compared to 45 percent of those with acute pain, and 37 percent of those with chronic pain
• Average pain severity is also related to sleep quality. Fifty percent of those with mild pain reported good or very good sleep, compared to 22 percent of those with severe pain

Why Night Shift Workers Are at Increased Risk of Cancer

Sadly, many people don't have much flexibility in avoiding night shift work. My heart goes out to you because the sad reality is that your body has no way of understanding your likely more than valid excuse for working night shifts. However, this practice will likely radically increase your risk of disease and premature death. This is quite well documented as I mention below. I'm also unaware of any antidote to this biological violation. No amount of melatonin supplements will compensate for this type of abuse.

The link between impaired sleep and cancer has been repeatedly confirmed. Tumors grow two to three times faster in laboratory animals with severe sleep dysfunctions. The primary mechanism thought to be responsible for this effect is disrupted melatonin production, a hormone with both antioxidant and anti-cancer activity.

Melatonin not only inhibits the proliferation of a wide range of cancer cells, it also triggers cancer cell apoptosis (self-destruction), and interferes with the new blood supply tumors required for their rapid growth (angiogenesis).

A number of studies have shown that shift workers are at heightened risk of cancer for this reason. Most recently, a study¹² using mice found that shift work and/or maintaining an irregular sleeping pattern may increase your risk of breast cancer, especially if you have a family history of it.

Here, one group of female mice carrying a genetic mutation equivalent to the human BRCA gene were exposed to periods of light and dark in a way that mimicked working the night shift. The second group, which also had the mutated gene, maintained a normal waking/sleeping pattern. In the first group, breast cancer tumors developed about eight weeks earlier compared to the controls. They also gained 20 percent more weight than the normal sleepers, despite having an identical diet.

According to the authors:

"To our knowledge, this is the first study that unequivocally shows a link between chronic light-dark inversions and breast cancer development."

Co-author Gijsbertus van der Horst also noted that women with a family history of breast cancer, or who have the BRCA gene, may want to reconsider taking up a job that requires an erratic sleep schedule, such as a flight attendant, or working the night shift.

Another study,¹³ published in 2012, found that insufficient sleep may be a contributing factor in both the recurrence of breast cancer, and more aggressive forms of breast cancer among post-menopausal women. According to the study's co-author Dr. Li Li:¹⁴

"Effective intervention to increase duration of sleep and improve quality of sleep could be an under-appreciated avenue for reducing the risk of developing more aggressive breast cancers and recurrence."

To Optimize Your Sleep, Stay in Sync with Nature

Download Interview Transcript

One of the key foundational components of sleeping well is maintaining a natural rhythm of exposure to sunlight during the day and darkness at night. This was addressed in a previous interview with researcher Dan Pardi, which I've included again for your convenience. In it, he explains how exposure to bright daylight serves as the major synchronizer of your master clock, which in turn synchronizes all the other biological clocks throughout your body.

If you master clock is "off," it will tend to ripple throughout your system. One reason why so many people get so little sleep, and/or such poor sleep, can be traced back to a master clock disruption caused by spending their days indoors, shielded from bright daylight, and then spending their evenings in too-bright artificial light. As a result, their body clocks get out of sync with the natural rhythm of daylight and nighttime darkness, and when that happens, restorative sleep becomes elusive.

To help your circadian system reset itself, make sure to get at least 10 to 15 minutes of morning sunlight. This will send a strong message to your internal clock that day has arrived, making it less likely to be confused by weaker light signals later on. Also aim for 30 to 60 minutes of outdoor light exposure in the middle of the day, in order to "anchor" your master clock rhythm. The ideal time to go outdoors is right around solar noon but any time during daylight hours is useful.

A gadget that can be helpful in instances when you, for some reason, cannot get outside during the day is a blue-light emitter. Philips makes one called goLITE BLU.¹⁵ It's a small light therapy device you can keep on your desk. Use it twice a day for about 15 minutes to help you anchor your circadian rhythm if you can't get outdoors.

To optimize sleep you also need to make sure you're going to bed early enough. If you have to get up at 6:30am, you're not going to get enough sleep if you go to bed after midnight. Many fitness trackers can now track both daytime body movement and sleep, allowing you to get a better picture of how much sleep you're actually getting. Chances are, you're getting at least 30 minutes less shut-eye than you think, as most people don't fall asleep as soon as their head hits the pillow.

When I first started using a fitness tracker, I was striving to get eight hours of sleep, but my Jawbone UP typically recorded me at 7.5 to 7.75. Since then, I've increased my total sleep time to over eight hours. The fitness tracker helped me realize that unless I'm fast asleep — not just in bed — by 10 pm, I simply won't get my eight hours. If you tend to lose track of time in the evening, consider setting an alarm to notify you it's time to get to bed.

Other Practical Tips to Promote Better Sleep

To improve your chances of a good night's sleep, the National Sleep Foundation recommends the following common-sense tips:¹⁶

• Avoid medications containing pseudoephedrine, found in many cold- and allergy relief drugs. It's a stimulant, so it may be keeping you awake. If you need to take an antihistamine in the evening, opt for a nighttime formula
• Avoid eating right before bed
• Avoid caffeinated beverages. Depending on your sensitivity, you may need to avoid caffeine for several hours, as it can stay in your system for as long as 12 hours
• Avoid watching TV, working on your computer, or using a tablet or smartphone, as the light emitted from these technologies will inhibit the production of melatonin in your brain — a hormone that makes you sleepy. Using an electronic device within one hour of bedtime can result in spending more than an hour tossing and turning before falling asleep.¹⁷

  As mentioned above, it also has potent antioxidant and anti-cancer effects. Normally, your brain starts secreting melatonin between 9 and 10 pm, and these devices emit light that may stifle that process. The following infographic, created by BigBrandBeds.co.uk, illustrates how your electronic gadgets wreak havoc on your sleep when used before bedtime.¹⁸

  To this, I would add the following recommendations. For an even more comprehensive list, please review my 33 Secrets to a Good Night's Sleep. If you're even slightly sleep deprived I encourage you to implement some of these tips tonight, as high-quality sleep is one of the most important factors in your health and quality of life.

• Cover your windows with blackout shades or drapes to ensure complete darkness. Even the tiniest bit of light in the room can disrupt your pineal gland's production of melatonin and the melatonin precursor serotonin, thereby disrupting your sleep cycle. So close your bedroom door, get rid of night-lights, and refrain from turning on any light during the night, even when getting up to go to the bathroom.
• 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.
• Tap away your stress before hitting the sack. One of my favorite tools for resolving anxiety contributing to insomnia is EFT, or "emotional freedom techniques," which combines tapping on certain points of your body with making statements that help pinpoint the underlying issues.

Tapping allows you to reprogram your body's reactions to many of the unavoidable stressors of everyday life, making it easier to take them in stride, and when your stressors improve, you will naturally sleep better. Many people who've learned EFT report excellent results when using it for sleep problems, especially if anxiety is a contributing factor. To learn more, please see my previous article, "Key Strategies for Optimizing Your Sleep".