Which discipline in health care has taken the front row approach to sleep wellness and the importance it has to the patient’s overall health? I would suggest that no specific doctor (other than the sleep specialist that prescribes Ambien and C-Pap machines) has made this a key factor in health care. Even worse is the fact that many sleep experts truly do not educate and inform their patients on the importance of sleep on your internal system and overall health.
Wellness is derived from our body’s ability to promote healthy cellular regeneration and maintain balance in systemic homeostasis. Sleep is one of the most integral factors in our ability to perform those duties. Homeostasis (our body’s ability to maintain control and balance of our systems) is managed and controlled by our autonomic (unconscious) nervous system. During our awake hours, our system runs primarily under sympathetic nervous system control which is the catabolic time of the day when tissues are being degraded and broken down due to physical and hormonal stresses. This is the period of biochemical control when hormones such as cortisol are most prevalent as well as C-reactive proteins and cytokines which break down damaged tissues used for functioning. During the deeper stages of sleep, the system switches over to parasympathetic control where the anabolic phase starts to renew and rebuild cellular tissue. This is the period of biochemical control that growth hormone is released for rebuilding as well as when cycles of chemical balancing and glial cells in the brain are refreshed, stabilizing the neurons. What can be taken from this physiological understanding? Ultimately, the body stays imbalanced chemically, functionally and structurally when sleep is deprived or insufficient. The cytokines and CRP lead to massive cell damage and inflammation that are primary causes of type II diabetes, heart disease, brain and neuronal loss, depression, inflammatory disease and even weight gain. Illness can be a direct or indirect cause of the body simply not having the time to repair cells, eliminate toxins (also done during sleep), and complete the emotional processing that is often interrupted during awake hours.
Seven out of ten Americans are sleep deprived primarily due to causes such as chronic pain, alcohol use, medications, stimulants and emotional stress. Medical treatments often involve the use of prescription sleep aids which have been shown to significantly decrease wellness and cognitive functioning. The real solution is in the underlying mental and physical causes of the deprivation.
When looking for a solution, you should start with the equipment you are using to help with sleep. Traditional mattress marketing may be the worst gimmick industry of all. As a practicing physician, I have heard the stories of how well patients often sleep when they travel or sleep on different mattresses. Consumers should do their due diligence in recognizing and understand the physics of how the body is maintained during the regenerative period of sleep. The pillow and mattress combination should be designed to allow the bony pressure points to be absorbed relieving any form of neurovascular compression most commonly experienced in the shoulders and hips. Secondary, the mattress needs to create some degree of support to allow the spine to maintain the curvatures and angles that are physiologically normal. Many manufacturers state that they offer these, but very few truly deliver.
Case Study: Betsy returned to the chiropractor after a long pregnancy approximately 5 months after the birth of her daughter. She had some sciatica and sacroiliac pain during pregnancy that was relieved with chiropractic adjustments and light stretching. She returned complaining of multiple symptoms of headaches, nausea, severe depression, shoulder pain, swelling in both thumbs and right knee pain. The obstetrician told her it was the effect of hormones post-partum and that it was normal. The chiropractor decided to do a more thorough evaluation and history including diet, exercise and sleep history. Nothing was conclusive in the diet and exercise history to reflect the symptoms presented, but the sleep analysis revealed that she hated her mattress because it was sagging in the middle and she was always fighting to stay on her side, and her hips and shoulders would hurt all night causing tossing and turning. Also, her 5 month old still required some nightly nursing and did not sleep well through the night. When asked how many hours of deep sleep and restful sleep she was getting, the reply was none to a half hour of deep sleep and less than 5 hours of restful sleep. She was then educated briefly on how the hormonal balance and emotional processing was being affected and a new mattress was prescribed with neuro-linguistic programming to achieve deeper sleep. Within a week her inflammation was gone, she no longer was considering prescription antidepressants while still nursing and almost all of her musculoskeletal symptoms had been relieved. Simply her body was able to balance and repair itself both physically and biochemically with only one simple suggestion.
Continuing to look at a cause of dis-ease rather than chasing the symptom is the key to wellness. Determine the causes of what disturbs your sleep and what enhances your sleep and you will have solved a significant solution to being vibrant and healthy.
Dement and Vaughn, The Promise of Sleep, Dell Publishing, 1999.
Wiley, Lights Out: Sleep, Sugar and Survival, 2001
Adam and Oswald: British Medical Journal, Nov. 1984