What keeps sleep researchers up at night?
They are probably worried about the growing problem of sleep disorders.
Collectively, we’re getting 1 to 2 hours less sleep now compared to the 1960s, with 20% of us experiencing one or more sleep disorders. During the pandemic, this figure doubled to 40%.
And that still may be an underestimate – experts say 80% of sleep disorders go undiagnosed.
Inside the World of Sleep Research – How do Sleep Research Laboratories Conduct their Studies?
Sleep researchers are trying to understand our growing problem with sleep – and the health implications of being sleep-deprived.
But it’s a challenge because a significant number of us have more than one sleep condition (such as insomnia combined with restless leg syndrome or sleep apnea).
This makes it more difficult to identify whether any related health conditions (comorbidities) are causing sleep problems or the other way around.
To better understand what’s going on, sleep researchers historically relied on written sleep logs, where patients self-reported the quality of their sleep. However, thanks to the widespread availability of smart wearable devices (such as an Apple Watch) with built-in accelerometers (or actigraphs as they are known in sleep lab circles) can measure the quality of sleep directly, including sleep latency (the time needed to fall asleep) and sleep disturbances.
As smart wearable devices proliferate, researchers can tap into larger actigraphy data sets to identify large trends.
But when it comes to understanding sleep issues for an individual, there is still the classic sleep lab setup where patients spend the night while lab technicians measure the patient’s brain activity during sleep through sensors attached to the head and body. This approach, known as Polysomnography, or PSG, is more accurate, allowing researchers to measure real-time electrical activity in the brain, breathing rates, heart activity, as well as limb and eye movements.
But this PSG approach does have shortcomings.
There will always be a limit to the number of sleep lab beds available (due to cost constraints). Concerns also exist about whether patients present the same sleep behavior in a strange bed where they are wired up. However, as wearable devices (such as the Oura Ring, smart headbands, and earphones) become increasingly powerful and more widely available, sleep researchers are hoping to get more insight into the causes of sleep disorders and related health conditions.
Understanding the Purpose of Deep Sleep – How Does it Help Protect the Brain?
Chronic sleep disorders can lead to serious health conditions, ranging from memory and learning problems, obesity, type 2 diabetes, and lowered mood states, to lower immune responses and reduced vaccine efficacy.
For healthy patients, productive sleep usually involves three to seven full cycles, each lasting between 90 and 110 minutes.
In each of these sleep cycles, we first “drift off” (NREM Stage 1), followed by a period with minimal eye movement and slower brain waves (NREM Stage 2), then we enter deep sleep, also known as slow wave sleep, where the brain wave activity slows the most, and the body performs many of its nightly recuperative processes (NREM Stage 3). To complete the sleep cycle, we begin to wake again as we enter REM sleep; this is where the muscles relax, the heart rate and blood pressure rise, and we experience the characteristic rapid, fluttering eye movements. This is when we often memorize and reprocess information as well as experience more intense dreams.
Shiftwork and Circadian Rhythms – How Much Sleep Do We Need and When?
The consensus of the AASM (American Academy of Sleep Medicine) and Sleep Research Society is that, on average, adults need between 7 and 7 ½ hours of sleep for optimal health – although the exact time needed varies by the individual (women need more than men, and older people less than younger adults). Sleep requirements can also vary depending upon whether you are wakeful in the mornings (“Larks”) or prefer to go to bed late at night (“Owls”).
However, less than 7 hours of sleep is associated with increased negative health consequences and reduced mental and physical performance.
Unfortunately, the demands of modern life often interrupt or cut short our natural sleep patterns, with many of us trying to get by with 6 hours of sleep or less – perhaps promising ourselves we will “catch up” on sleep over the weekend. Changing time zones (jet lag) and shift work also interfere with our natural clock, the circadian rhythm.
The consequences of poor sleep can be devastating.
Researchers believe that 20% of automobile accidents can be attributed to insufficient sleep, as well as many consequential industrial accidents, including the grounding of the Exxon Valdez tanker and the nuclear reactor meltdown in Chornobyl.
Possible Connections Between Sleep Disorders and Conditions such as Heart Disease
Sleep researchers are drawing a direct connection between sleep issues and cardiovascular disease, including hypertension (high blood pressure) and arrhythmias. There are also indications that sleep disorders might contribute to higher incidences of cancer (including breast cancer) as well as neurodegeneration and dementia, including Alzheimer’s disease.
Disrupted sleep can affect our metabolism, hormone regulation, gene expression, and ability to control inflammation, potentially leading to serious health consequences.
Recent studies indicate that those with healthy sleep patterns (e.g. 7 to 8 hours) have less incidence of arteriosclerosis (fatty plaque in the arteries) than those who slept 6 hours or less.
The American Heart Associate recently added healthy sleep to their checklist of healthy lifestyle factors (the others being eliminating nicotine exposure, increasing physical activity, diet, weight, blood glucose, cholesterol, and blood pressure), bringing the new total to 8.
Of great concern are undetected and untreated cases of obstructed sleep apnea (OSA), a condition in which patients experience constant sleep interruptions due to breathing problems. This condition is most associated with overweight/obese patients who snore, but even patients with normal weight can have congenital defects, such as narrow airways (craniofacial dysmorphism) that can lead to sleep apnea. Opioid abuse can also lead to a related condition, central sleep apnea (CSA), where the breathing becomes shallow and irregular.
Is there a Correlation between “Blue Light” at Night and Serious Health Conditions?
Another question that sleep researchers are trying to resolve is whether exposure to artificial light at night (particularly “blue light) is causing health problems.
We make fun of moths that circle light bulbs at night
But are we that immune to the effects of artificial light at night?
In the pre-industrial age, the light of the setting sun (or burning fire or candle) is generally more in the red part of the spectrum, while the morning light is more “blue.” These color signals are thought to help the body regulate the circulation of melatonin to help ease us into sleep (red light that fades into darkness), followed by the morning sun (blue light) that wakes us.
Unfortunately, the modern bedroom is full of electronic devices with bright screens (such as smartphones), nightlights, and LED power indicators – many of them in the blue spectrum – that could be disrupting our sleep – not to mention updated LED streetlights that shine brightly into our bedrooms.
Recent studies indicate that “Light at Night” (LAN) could be associated with health problems, including obesity, diabetes, and hypertension in older individuals. Another study found that healthy young adults that slept with a TV on at night (sound off) experienced elevated heart rates and blood sugar levels, which could lead to insulin resistance and type 2 diabetes.
Sleep consultants recommend a strict “sleep hygiene” regimen of installing blackout curtains and eliminating any light sources while we sleep.
Health administrators are also evaluating studies of nurses and patients that compare Blue-depleted light environments (BDLEs) with standard hospital light environments (STLEs) to see if changing the lighting could affect health outcomes.
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