TOPIC · HEALTH · SLEEP · EVERYTHING YOU NEED TO KNOW

Every week I am posting about  everything you need to know about hormones. This weeks topic is about sleep

Did you know – sleep

  • Sleep is as important as diet and exercise
  • Sleep is like nutrition for the brain
  • A good night’s sleep empowers the body to recover and lets you wake up refreshed and ready to take on the day
  • Humans spend 1/3 of their life sleeping
  • Sleep deprivation will kill you more quickly than food deprivation
  • Humans are the only mammals that willingly delay sleep
  • Adults between 18 and 64 need 7 – 9 hours of sleep per night
  • Adults over 65 need 7 – 8 hours
  • The average Brit gets 6 hours and 19 minutes sleep a night
  • 20% consistently go to bed after midnight
  • 1 in 4 couples sleep in separate bedrooms
  • Babies need 12-17 total hours of sleep each day, toddlers need 11-14
  • Premature babies sleep 90% of the time
  • Preschool children need 10-13 hours of total sleep daily
  • School-age kids should sleep 9-11 hours
  • Approx. 25% of young children have sleeping problems or experience excessive daytime sleepiness
  • Sleep disorders affect 16 million adults in the UK
  • Between 10% and 30% of adults struggle with chronic insomnia
  • Women’s risk of insomnia can be up to 40% higher than that of men
  • Insufficient and or poor quality sleep can be due to many factors such as, work, jetlag, snoring, sleep disorders, medical conditions, mental health, etc.
  • Approx. 57% of men and 40% of women snore
  • Snoring can be a sign of a sleep disorder – sleep apnea
  • Driving sleepy is just as dangerous as driving drunk
  • 1 in 5 accidents on major roads are caused by tiredness 
  • 1 in 8 (13%) UK drivers admit to falling asleep at the wheel
  • The National Highway Traffic Safety Administration estimates that drowsy driving causes up to 6,000 fatal crashes each year
  • Drivers who miss 2 – 3 hours of sleep a day more than quadruple their risk of getting in a crash, compared to drivers who sleep for 7 hours
  • Sleep problems are linked to infertility due to sleeps powerful influence on the hormones, that controls the menstrual and regulates ovulation and sperm production
  • Up to 66% of people talk in their sleep at some point in their lives
  • 4% of UK adults sleepwalk
  • 1 in 5 children walk in their sleep
  • 1 in 3 adults suffer with nightly trips to the bathroom / Nocturia – more than 1 visit
  • In 2014 over 1.6% of Britons take sleeping pills every day
  • I 2019 there were 2.4 million active prescriptions for sleeping pills
  • The market for wearable devices, including activity and sleep trackers, is expected to reach over $62B in 2021
  • In a study of US adults 28.2% said that they used a smartphone app to help keep track of their sleep.  

Meet Sally and get to know all about sleep

Intro to sleep blog

Is interrupted sleep more concerning than not getting enough hours of sleep?

Nocturia - night peeing

Sleep cycles

The Power of Kegel Exercises

Listen to Sallys radio show about sleep

Sleep Cycles in a Nutshell

  • As you sleep, your brain cycles through four stages of sleep
  • Stages 1 to 3 are what’s considered non-rapid eye movement (NREM) sleep, also known as quiet sleep
  • Stage 4 is rapid eye movement (REM) sleep, also known as active sleep or paradoxical sleep
  • Each has a unique function and role in maintaining your brain’s overall cognitive performance
  • Some stages are also associated with physical repairs that keep your body and brain strong and healthy
  • A sleep specialist can show how your sleep cycles look on what’s known as a hypnogram—a graph produced by an EEG / ElectroEncephaloGram 
  • A sleep cycle lasts about 90 minutes, and during that time you move through these four stages of sleep
  • Time spent in each stage changes throughout the night as the cycle repeats
  • Most of your deeper slow wave sleep happens in the first half of the night, while REM sleep happens more during the second half of the night
  • In a normal sleep period, a person experiences four to six sleep cycles
  • REM sleep makes up between 20-25% of total sleep in healthy adults ie. on average about 2 hours per night dreaming
  • Sleep doesn’t necessarily progress through the four stages in perfect sequence
  • When you have a full night of uninterrupted sleep, the stages progress as follows
  • Sleep begins with NREM stage 1
  • NREM stage 1 progresses into NREM stage 2
  • NREM stage 2 is followed by NREM stage 3
  • NREM stage 2 is then repeated
  • Finally, you are in REM sleep
  • Once REM sleep is over, the body usually returns to NREM stage 2 before beginning the cycle all over again
  • During NREM stage 3 and REM, your cells repair and rebuild, eg. hormones are secreted to promote bone and muscle growth, immunity is strengthened, etc.
  • Getting the 7 to 9 hours of sleep per night is important, but ensuring it’s uninterrupted, allowing your body to benefit from each of these four stages is equally important, if not more so.

The 4 Stages of Sleep

Entering Sleep – Beta to Alpha Brain waves

  • The earliest phase of sleep, which should take 10 – 15 minutes
  • Still relatively awake and alert.
  • Brain producing Beta brainwaves which are small and fast meaning the brain is active and engaged.
  • As the brain begins to relax and slow down, it lights up with alpha waves.
  • Strange and vivid sensations, known as hypnagogic hallucinations, like falling or hearing someone call your name can be experienced
  • Also the myoclonic jerk that startled suddenly feeling for seemingly no reason at all.

N-REM Stage 1 – Theta brain waves

  • The transition period between wakefulness and sleep, which lasts for 5 – 10 minutes
  • The brain slows down
  • Heartbeat, eye movements, and breathing slows
  • The body relaxes
  • Muscles may twitch

N- REM Stage 2 – Theta brain waves

  • Less aware of your surroundings
  • Body temperature drops
  • Eye movements stop
  • Breathing and heart rate become more regular
  • The brain begins to produce bursts of rapid, rhythmic brain wave activity, called sleep spindles
  • Sleep spindles are a part of memory consolidation, your brain is gathering, processing, and filtering new memories acquired the previous day
  • The body slows down in preparation for NREM stage 3 sleep and REM sleep, the deep sleep stages when the brain and body repairs, restores, and resets for the coming day.
  • We spend approx. 50% of total sleep time in NREM stage 2, which lasts for about 20 minutes per cycle.

N-REM Stage 3 – Delta brain waves

  • The deep, slow brain waves begin to emerge
  • This stage is also referred to as delta sleep
  • Deep sleep where any external noises or activity may fail to wake the sleeping person
  • Getting enough NREM stage 3 sleep allows you to feel refreshed the next day.
  • Muscles are completely relaxed
  • Blood pressure drops
  • Breathing slows
  • This is the deepest sleep
  • The body starts its physical repairs.
  • The brain consolidates factual memories eg. general knowledge, facts or statistics, personal experiences, and other things learned the previous day

REM Sleep – Beta brain waves

  • Dream state
  • Your brain lights up with activity
  • Brain’s activity closely resembles its activity during waking hours.
  • Voluntary muscles become immobilized
  • The body is temporarily paralyzed—a good thing, as it prevents you from acting out your dreams.
  • Begins approx. 90 minutes after falling asleep.
  • Your breathing is faster and irregular
  • Your eyes move rapidly
  • You dream
  • Memory consolidation also happens
  • Emotions and emotional memories are processed and stored.
  • Information is cemented into memory, making it an important stage for learning.

Circadian rhythms

  • Are physical, mental, and behavioural changes in the body that follow a 24-hour cycle.
  • Such as sleeping and feeding patterns, body temperature, brain wave activity, hormone production, cell regeneration, and more.
  • The body has a circadian clock, which is synchronized with solar time ie. light and dark.
  • The circadian clock is controlled by a part of the brain called the Suprachiasmatic Nucleus (SCN), a group of cells in the hypothalamus that respond to light and dark signals.
  • When our eyes perceive light, our retinas send a signal to our SCN.
  • The SCN sets off a chain reaction of hormone production and suppression that affects body temperature, appetite, sleep drive, and more.
  • We have circadian CLOCK genes that produce proteins that create and regulate these circadian rhythms.
  • In mice mutations or deletions of these clock genes lead to hyperphagic / increased appetite, obesity and alterations in glucose metabolism.
  • The body’s natural circadian rhythm is 24.2 hours
  • New born babies have not developed a circadian rhythm they require up to 18 hours of sleep, broken up into multiple short periods. circadian rhythm develops 4 – 6 months of age
  • Adolescents / Teenagers experience a sleep phase delay causing melatonin levels to rise later in the evening. As a result, they naturally feel more alert at night, not ready for sleep before midnight. Some school are moving start times to accommodate keeping teenagers more focused during school.
  • Older adults tend to become tired earlier in the evening and wake up earlier in the morning, which may  result in less sleep overall and increasing the risk of cognitive decline. Seniors experiencing Alzheimer’s, dementia, or other neurodegenerative diseases experience even more severe changes in sleep drive.

CAR – Cortisol Awakening Response

  • Is the change in cortisol concentration that occurs in the first hour after waking from sleep
  • important aspect of stress response demonstrating the function of the HPA axis / hypothalamic-pituitary-adrenocortical axis.
  • is used as a diagnostic marker for stress
  • crucial reference point for a healthy cortisol circadian rhythm
  • an increase between 38% and 75% in cortisol levels peaking 30–45 minutes after awakening in the morning is desirable.
  • while its purpose is uncertain, it may be linked to the preparation of the HPA axis in order to face anticipated stress, and increase blood glucose levels for the expected increase in muscle activity, ie. getting out of bed
  • important for switching the brain from sleeping to waking

Causes of Decreased CAR

  • under-active HPA axis
  • excessive psychological burnout
  • seasonal affective disorder (SAD)
  • sleep apnea or poor sleep in general
  • PTSD
  • chronic fatigue
  • chronic pain.

Decreased CAR has been associated with the following conditions

  • PTSD
  • Chronic Pain
  • Systemic hypertension
  • High CIMT /carotid intima media thickness, which is thickening of the carotid arteries in women
  • GI / gut diseases
  • Postpartum depression
  • Chronic Fatigue Syndrome
  • Major depression
  • Insomnia – but not isolated night waking
  • Autoimmune diseases – Cortisol is important for immune cell / antibody selection
  • Atopic and allergic conditions
  • Low frequency noise exposure
  • Low socioeconomic status
  • Perceived high stress
  • Cushing’s Disease
  • Addison’s Disease

Causes of Increased CAR

  • over-reactive HPA axis
  • ongoing job-related stress, anticipatory stress for the day
  • glycaemic dysregulation
  • pain i.e. waking with painful joints or a migraine
  • general depression not SAD

Increased CAR is associated with the following conditions

  • Visceral obesity in men
  • Major depressive episodes
  • Upper respiratory illnesses
  • Bipolar disorder
  • Fibromyalgia in women reporting abuse during childhood
  • Women with borderline personality disorder / BPD
  • Smoking – to a smaller degree
  • Light exposure during waking
  • Chronic stress and worrying
  • Work overload

Interrupted Sleep Cycles

  • Interrupted sleep describes sleep that is not continuous throughout the night
  • This may results in a sleep stage being cut short and or a cycle may repeat before finishing
  • This may happen occasionally or on a chronic basis
  • Any time you have trouble falling asleep or staying asleep at night, your sleep cycle will be affected.

Possible Causes of Interrupted sleep

Older age
Sleep naturally becomes lighter and you are more easily awoken

Nocturia
Frequently waking up with the need to urinate

Stress
Cortisol can disrupt your sleep cycles, causing:

  • fragmented sleep
  • insomnia
  • shortened overall sleep time, which may increase the body’s production of cortisol during the day, perhaps in an effort to stimulate alertness.

Sleep disorders

  • sleep apnea – breathing that stops and starts during sleep
  • restless leg syndrome – a strong sensation of needing to move the legs

Pain
Difficulty falling or staying asleep due to acute or chronic pain conditions

Mood disorders
Such as depression and anxiety

Other health conditions 
including Alzheimer’s disease, Parkinson’s disease, obesity, heart disease, and asthma

Lifestyle habits

– little/no exercise

– cigarette smoking

– excessive caffeine intake

– excessive alcohol intake

If you suffer with any of the above causes making changes to increases uninterrupted sleep is essential. Check some of the solutions further down in the blog.

Nocturia

  • Is a condition in which you wake up during the night because you have to urinate.
  • Nocturnal urinary frequency — having to urinate more than once during the night.
  • This condition becomes more common as people age  
  • About 1 in 3 adults over the age of 30 experience nocturia.
  • It can be caused by a lifestyle habit or an underlying health problem.
  • Occurs in both men and women, for different causes.
  • Waking once during the night to urinate can be common but urinating more frequently may be a sign of an underlying problem.
  • Normally, you should be able to sleep 6 to 8 hours during the night without having to get up to go to the bathroom.
  • People who have nocturia often wake up more than once, which can cause disruptions in a normal sleep cycle.

Types of Nocturia

  • Nocturnal polyuria: when your body makes too much urine during the night
  • Bladder storage problems: when your bladder doesn’t store or release urine well
  • Mixed nocturia: when more than one of these problems are happening

Causes in men

  • Inability to fully empty your bladder due to
    – Bladder obstruction
    – Benign Prostatic Hyperplasia / BPH in men a non-cancerous overgrowth of the prostate that obstructs the flow of urine.

Common causes in women

  • Nocturnal polyuria
    – usually due to fluid retention during the day that often accumulated in the feet or legs. Laying down to sleep, gravity no longer holds the fluid in your legs. It can re-enter your veins and be filtered by your kidneys, producing urine.
    – Sleeping disorders, such as sleep apnea – see article on sleep apnea
    – Certain drugs, including diuretics and vitamin D deficiency or excess.
    – Drinking too much fluid before bedtime, especially coffee, caffeinated beverages or alcohol.
    – High sodium diet.
  • Inability to fully fill the bladder due to
    – Spasms in the bladder
    – Bladder infection or recurrent urinary tract infection – cystitis
    – Bladder inflammation – swelling in the bladder
    – Interstitial cystitis – pain in the bladder
    – Cancer in the bladder

Other Common Causes in Both Men and Women

  • High blood sugar level
    – excess glucose spills into urine, dragging lots of water with it.
  • High blood calcium level
    – Calcium from the blood can get into urine, pulling water along with it
  • Kidney disease
    – Some kidney conditions cause the kidneys to make excessive amounts of urine
  • Too little antidiuretic hormone
    – Without this hormone, the body can’t hold on to water.
    – This condition is called diabetes insipidus.
  • Diuretics and some other medications
    – cause the body to make extra urine.
  • Sleep apnea and restless legs syndrome
    – Both of these sleep-related disorders awaken people from sleep. Such awakenings may prompt them to make a trip to the bathroom.
  • Being overweight
    – Will increase nocturia risk up to 50%

Treatments

  • Restrict fluids, especially caffeine and alcohol
  • Time your diuretics, 6 hours before bedtime
  • Use compression stockings
  • Elevate legs during the day, especially during the evening
  • Afternoon naps can help with the disturbed sleep but also with fluid reabsorption
  • Yoga pose ‘legs up the wall’ in the evening
  • TCM / Traditional Chinese Medicine acupuncture may help
  • Pelvic Floor Exercises also known as kegel exercises may help – see the article on Kegel Exercises
  • ThermiVa treatment designed for stress incontinence may help – 
  • Blood sugar control, such as TRE / Time Restricted Eating
  • Antibiotics for cystitis
  • Anticholinergic medicines for bladder muscle spasms
  • Diuretic medicines to regulate urine production
  • Medication for BHP, enlarged prostate, such as Alpha blockers, which relax muscles of the prostate and neck of the bladder, 5-alpha reductase inhibitors, which help shrink the prostate and prevent additional growth, Phosphodiesterase 5 inhibitors (PDE5 inhibitors), which increase flow rate.

Sleep Prep

  • Set a ‘get ready for bed alarm’ 1-2 hours prior and begin to wind down
  • Stick to a schedule – Regular sleep and wake times also at weekends
  • Bedtime latest 10pm
  • Eat food latest 3 hours before bed
  • Avoid caffeine after 12 noon.
  • Avoid training after 6pm.
  • Get minimum 30 minutes fresh air every day, preferably with sunshine.
  • Careful with alcohol it disturbs sleep quality and increases liver detox, which can wake you up between 1 – 3 am
  • If you have to get up and pee during the night avoid turning on the bright lights and avoid drinking fluids 2 hours before bedtime.
  • Create a bedtime ritual – Take a hot bath with lavender and Epsom salts
  • Supplement with magnesium and or other natural relaxing remedies – see more info under Natural Sleeping Aids further down the blog
  • Turn out the lights  – Careful with the blue light exposure from TV, iPhones, computers etc. – stop minimum 2 hours before sleep – use red light to counteract the blue
  • Empty your head for thoughts by writing a diary or gratitude list or a to do list before bed
  • Meditation or breathing exercises are also good for ‘brain clutter’
  • Keep the bedroom cool during the night – 16 – 19 degrees C
  • Save your bedroom for sex and sleep.

Getting Back to Sleep

The inability to fall back asleep after waking up is medically known as sleep-maintenance insomnia.

Prevention is always better than fixing, so look at Sleep Prep for potential reasons as to why you may be waking up and eliminate as needed

Keep a sleep diary in this way you can see if there is a pattern in your interrupted sleep, eg. it always happens on a Tuesday night. Then ask yourself what happens during the day on a Tuesday?, etc.

Sometimes, waking up in the middle of the night is unavoidable and having a strategy in place to help you get back to sleep can reduce the amount of time you spend staring at the ceiling or counting sheep.

  • Get rid of bright lights or loud sounds – maybe use earplugs and blindfolds
  • Get out of bed and move – maybe to another room to sleep or walk around for a few minutes, read, listen to music until you feel tired
  • Avoid staring at the clock – it frustrates even more
  • Avoid checking your phone or other screens – blue light
  • Meditate or try breathing exercises
  • Relax your muscles – run through your muscles, tightening and relaxing from your toes to your fingers
  • Keep your lights off or dim
  • Focus on something boring – counting sheep, reading a boring article (with a dim light)
  • Listen to relaxing music
  • Try sleeping apps with stories, music, sounds.

Natural Sleeping Aids

  • Melatonin
    Is a hormone produced especially in the pineal gland in the brain, which signals to your brain & nervous system to wind down, by blocking the excitatory neurotransmitters dopamine, noradrenaline, histamine, serotonin, acetylcholine. Especially helpful if you have jet lag or are doing shift work. Can be taken as a supplement but be sure you need it as taking too much can create wild dreams and keep you awake. Doctors can prescribe Circadin and melatonin can be bought through the internet or in the US. Test you Melatonin levels.
  • GABA
    Is a neurotransmitter and the peacekeeper of the nervous system, blocking the excitatory neurotransmitters to bring calm and induce sleep together with melatonin. GABA as a supplement doesn’t pass the blood brain barrier to get into the brain, but works through the Vagus nerve in the gut sending calming messages to the brain
  • Tryptophan / 5HTP
    Are converted to serotonin which is converted to melatonin, supplements especially together with magnesium and B6 can help increase melatonin levels  
  • Magnesium – this mineral is known to relax muscles and induce sleep. A combination of magnesium, melatonin, and vitamin B may be effective in treating insomnia regardless of the cause. Magnesium appears to increase levels of gamma aminobutyric acid / GABA, a the peace keeper of the nervous system. Studies report that insufficient levels of magnesium in your body may be linked to troubled sleep and insomnia. Best magnesium is Magnesium Glycinate or Threonate, both amino acids help with the production of the calming neurotransmitters GABA and Glycine
  • Glycine
    An amino acids is a calming neurotransmitter. Taken immediately before bedtime may help you fall asleep faster and improve the overall quality of your sleep. Glycine is also essential for collage so taking extra can help collagen production during the night
  • Lavender
    Lavender’s soothing fragrance is believed to enhance sleep. Use the oils in a warm bath, spray on your pillow
  • Valerian root
    Is a herbal supplement that may improve sleep quality and anxiety for some.
  • Passionflower
    Tea or extract may help slightly improve sleep quality in some individuals
  • Chamomile
    German chamomile is best taken as a tea. Roman chamomile has a bitter taste and may be taken as a tincture. Both types may have a calming effect, which can help people feel relaxed and more prepared for sleep.
Test you Melatonin levels
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Medical Sleeping Aids

  • Prescription sleeping pills may help you fall asleep easier or stay asleep longer — or both.
  • The risks and benefits of various prescription sleeping pills can differ.
  • Important to find the right prescription medication to help you sleep

Prescirtion Sleeping Pills

Antidepressants
Some antidepressant drugs are very good at treating sleeplessness and anxiety.

Benzodiazepines
These older sleeping pills may be useful when you want an insomnia medication that stays in the system longer. For instance, they have been effectively used to treat sleep problems such as sleepwalking and night terrors. These medications have some serious downsides. They can cause addiction and dependence. Dependence means that you have physical withdrawal when you stop them, which you can have in the case of benzos. Also, there is a black box warning against their use with opioids, because both depress respiration and increase your risk of overdose.

Doxepine
This sleep drug is approved for use in people who have trouble staying asleep. May help with sleep maintenance by blocking histamine receptors. Do not take this drug unless you are able to get a full 7 or 8 hours of sleep.

Eszopiclone
Also helps you fall asleep quickly, and studies show people sleep an average of 7 to 8 hours. Don’t take it unless you are able to get a full night’s sleep as it could cause grogginess. Because of the risk of impairment the next day, the FDA recommends the starting dose of no more than 1 milligram.

Lemborexant
This drug is approved for people who have trouble falling asleep and staying asleep. It works by suppressing the part of the central nervous system that keeps you awake. It may cause you to feel sleepy the next day.

Ramelteon
This sleep medication works differently than the others. It works by targeting the sleep-wake cycle, not by depressing the central nervous system. It is prescribed for people who have trouble falling asleep. Can be prescribed for long-term use, and the drug has shown no evidence of abuse or dependence.

Suvorexant
Works by blocking a hormone that promotes wakefulness and causes insomnia. It is approved by the FDA to treat people that have insomnia due to an inability to fall asleep or to stay asleep. The drug may cause you to feel sleepy the following day.

Zaleplon
Of all the newer sleeping pills, this one stays active in the body for the shortest amount of time. That means you can try to fall asleep on your own. Then, if you’re still staring at the clock at 2 a.m., you can take it without feeling drowsy in the morning. But if you tend to wake during the night, this might not be the best choice for you.

Zolpidem
These medicines work well at helping you get to sleep, but some people tend to wake up in the middle of the night. Zolpidem is now available in an extended release version. This may help you go to sleep and stay asleep longer. The FDA warns that you should not drive or do anything that requires you to be alert the day after taking the extended release pill because it stays in the body a long time. You should not take zolpidem unless you are able to get a full night’s sleep. In rare instances, these medications have been known to cause injuries because of behaviours while asleep or partially asleep such as sleep walking and sleep driving, among others. The FDA has approved a prescription oral spray called Zolpimist, which contains zolpidem, for the short-term treatment of insomnia brought on by trouble falling asleep.

Off-label drugs

  • If the above medications don’t work for you, your doctor may suggest something off-label.
  • These are medications used to treat conditions they weren’t originally made for.
  • Older antidepressants are sometimes prescribed to treat insomnia because they change brain chemicals, which can help regulate sleep.
  • These older medications also tend to have a sedative effect or make you sleepy.
  • They include:
    – Amitriptyline
    – Mirtazapine
    – Nortriptyline
    – Trazodone

Over-the-counter sleep aids

  • Most of these sleeping pills are antihistamines. There is no proof that they work well for insomnia, and they can cause some drowsiness the next day. They’re safe enough to be sold without a prescription. But if you’re taking other drugs that also contain antihistamines — like cold or allergy medications — you could inadvertently take too much.

 

 

Sleeping positions 101

We spend roughly one-third of our lives sleeping — or attempting to sleep and sleep positions dictate more than just a good night’s sleep.

The Various Positions  

  • Foetal – 41% more than twice as many women as men tend to adopt this position.
  • Log – 15% of people lay on the side with both arms down by the side
  • Yearner – 13% of people sleep on their side with both arms out in front
  • Soldier – 8% of people lay on the back with both hands pinned to the sides
  • Free-faller – 7% of people lay on their front with hands around the pillow, head turned to one side can aid digestion
  • Starfish – 5% of people lay on their back with both arms up around the pillow

Sleeping Positions & Health

Foetal position

  • great for lower back pain or pregnancy, reduce snoring.
  • Sleeping Tip – make the foetal position more comfortable, with a pillow between your knees

Left Side Sleeping

  • can reduce snoring
  • great for your digestion
  • can reduce heartburn
  • can reduce acid reflux
  • can lead to jaw tightness
  • bad for wrinkles
  • Sleeping tip – putting a pillow between your lower legs will help better align your hips to avoid low back pain.

Stomach sleeping

  • good to reduce snoring
  • can cause both neck and back pain
  • Sleeping tip – try sleeping with a thin head pillow, or no pillow and pillow under your tummy or pelvis to reduce lower back pain.

Flat on your back

  • protects your spine
  • can relieve hip and knee pain
  • protects against wrinkles
  • can increase snoring and sleep apnea
  • can increase back pain
  • Sleeping tip – try sleeping with a pillow behind your knees to reduce back curvature which may relieve pressure on your spine and decrease pain. An extra pillow under your head can help if you’re congested making breathing easier.

Most popular sleep position

  • 1% sleeping on their side
  • 5% sleeping on their back
  • 3% sleeping on their stomach.

But don’t fix something that’s not broken – don’t change your sleep position if you aren’t having any issues. Do what feels best for you. What is important is you waking feeling rested and ready to go.

 

Sleeping Aids Statistics

  • About 80% of people who take prescription sleep medications experienced residual effects like oversleeping, feeling groggy, or having a hard time concentrating the next day.
  • 8% of adults say they took medication to help them sleep at least four times in the past week.
  • 20% of American adults tried a natural remedies for sleep problems in the last year.
  • Sales of melatonin supplements in the U.S. grew from $62M in 2003 to $378M in 2014, an increase of 500%.
  • The market for wearable devices, including activity and sleep trackers, is expected to reach over $62B in 2021.
  • In a study of adults in the U.S., 28.2% said that they used a smartphone app to help keep track of their sleep. 

Sleeping Positions & Personalities

Foetus
– tough on the outside but sensitive at heart. They may be shy when they first meet somebody, but soon relax.

Log
– easy going, social people who like being part of the in-crowd, and who are trusting of strangers. However, they may be gullible.

Yearner
– have an open nature, but can be suspicious, cynical. They are slow to make up their minds, but once they have taken a decision, they are unlikely ever to change it.

Soldier
– generally quiet and reserved. They don’t like a fuss, but set themselves and others high standards.

Freefaller
– often gregarious and brash people, but can be nervy and thin-skinned underneath, and don’t like criticism, or extreme situations.

Starfish
– make good friends because they are always ready to listen to others, and offer help when needed. They generally don’t like to be the centre of attention.

Sleep Apnea

  • A common sleep disorder defined as the cessation of breath during sleep.
  • Leads to reduced oxygen flow and poor sleep quality.
  • When oxygen levels dip during sleep, the brain signals the body to partially wake up, preventing deep, restorative sleep stages.
  • People with severe sleep apnea can go through this process hundreds of times each night and often don’t remember
  • Wake up feeling exhausted, groggy, and unrested.
  • Decrease in attention, lack of concentration, lack of energy, irritability.
  • Many of mood and concentration issues associated with sleep loss are symptoms of sleep apnea.
  • Decrease in memory, poor sleep quality decreases your recall ability.
  • Prolonged oxygen deprivation can damage your brain.
  • Choking sounds or if you wake up at night gasping is a serious warning sign.
  • Waking up with a dry mouth, sore throat, or headache are all signs of a strenuous night of sleep
  • Strongly correlated with several other health problems, most notably heart disease and high blood pressure.
  • Puts serious strains on the brain, the heart, and the rest of the body.
  • 80% of the people with sleep apnea don’t know they have it, many times their bed partner is the first person to notice a problem.
  • 2 -3 % of children have sleep apnea
  • Is that you? Your bed partner? Your child? Your parent?

2 main types

  • Central – CSA
  • Obstructive – OSA

Central Sleep Apnea / CSA

  • occurs because your brain doesn’t send proper signals to the muscles that control your breathing.
  • is less common than obstructive sleep apnea  / OSA
  • can result from other conditions, such as heart failure and stroke
  • another possible cause is sleeping at a high altitude.

Common signs and symptoms of CSA include

  • Observed episodes of not breathing or abnormal breathing patterns during sleep
  • Abrupt awakenings accompanied by shortness of breath
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Difficulty concentrating
  • Mood changes
  • Morning headaches
  • Snoring – however, snoring may be less prominent with CSA than with OSA.

Treatments

  • treating existing conditions
  • using a device to assist breathing
  • using supplemental oxygen.

Obstructive Sleep Apnea / OSA

  • most common sleep-related breathing disorder
  • repeated stop and start of breathing during sleep
  • occurs when your throat muscles intermittently relax and block your airway during sleep
  • a noticeable sign of OSA is snoring.

Symptoms of OSA

  • Excessive daytime sleepiness.
  • Loud snoring.
  • Observed episodes of stopped breathing during sleep.
  • Abrupt awakenings accompanied by gasping or choking.
  • Awakening with a dry mouth or sore throat.
  • Morning headache.
  • Difficulty concentrating during the day
  • Mood changes, such as depression or irritability
  • High blood pressure
  • Decreased libido.

Treatments

  • using a device that uses positive pressure to keep your airway open while you sleep
  • a mouthpiece to thrust your lower jaw forward during sleep.
  • surgery might be an option too.

Sleep Talking

  • Also known as somniloquy
  • May occur during both the REM and non-REM sleep phases.
  • Most common in children with more than half probably delivering the occasional somniloquy
  • Chronic sleep-talking in adulthood is considered to be a sleep disorder, and may result from stress
  • Sleep talking usually lasts just one or two seconds, though rare examples of sleep speeches hundreds of words long have been recorded
  • Usually gibberish
  • Maybe confessions of wrongdoing, which shouldn’t be taken literally and are inadmissible in court.

Sleep Walking

  • Also called somnambulism
  • occurs during NREM stage 3 sleep
  • usually occurs early in the night — often one to two hours after falling asleep
  • approx.18% of people sleepwalk at some point in their life.
  • more common in children than adults
  • sleepwalking is usually outgrown by the teen years.
  • isolated incidents don’t usually signal any serious problems or require treatment.
  • usually not remembered

Common sleepwalking actions

  • Get out of bed and walk around
  • Sit up in bed and open his or her eyes
  • Have a glazed, glassy-eyed expression
  • Don’t respond or communicate with others
  • Difficult to wake up during an episode
  • Disoriented or confused for a short time after being awakened
  • Don’t remember the episode in the morning
  • Have problems functioning during the day because of disturbed sleep
  • Have sleep terrors in addition to sleepwalking

Uncommon sleepwalking actions

  • Do routine activities, such as getting dressed, talking or eating
  • Leave the house
  • Drive a car
  • Engage in unusual behaviour, such as urinating in a closet
  • Engage in sexual activity without awareness
  • Get injured, for example, by falling down the stairs or jumping out a window
  • Become violent during the period of brief confusion immediately after waking or, occasionally, during sleepwalking.

Sweet Dreams are made of Cheese

The British Cheese boards famous study suggests that cheese doesn’t only create pleasant dreams, but also memorable ones. Different cheeses produce different types of dream

Cheddar cheese

  • tended to produce dreams about celebrities, including sitting in a pub with Katie Price and playing football with Paul Gascoigne. Cast members from popular soaps like Coronation Street and Emmerdale also made appearances in cheddar induced dreams.

Red Leicester

  • caused nostalgic dreams often related to childhood

Lancashire cheese

  • produced dreams about work, which could arguably be termed a nightmare for some people.

Stilton cheese

  • produced the most vivid, unusual and downright strange dreams, such as talking toys, elevators moving sideways, soldiers fighting each other with kittens instead of guns. Not nightmares, but certainly very off the wall dreams.

Cheshire cheese

  • led to a peaceful, night’s sleep without any dreams at all. So, if you want a peaceful night’s sleep with no interruptions, this is the cheese for you.

No nightmares, but plenty of dreams.

Sleep & Menopause

  • Decline of Estrogen contributes to disrupted sleep by causing menopausal symptoms
    – hot flushes and sweats
    – anxiety – can’t fall asleep
    – depressed mood – leads to non-restorative sleep and early morning wakening
    – decline in Melatonin as Estrogen is essential for serotonin production
    – obsessive thoughts and emotions
    – joint aches and pains
    – increased need to urinate, weak bladder control.
  • Decline of Progesterone decline may also be involved in sleep disturbance since Progesterone metabolites increase GABA.
  • Unbalanced Cortisol due to the decline in Estrogen. Cortisol is the ‘wake up’ hormone where increased levels during the night is another cause of poor sleep.
Check your hormone levels here

Sleep, Metabolism, Weight & Hormones

It’s not so much that if you sleep, you’ll lose weight

BUT too little sleep will hamper your metabolism and contributes to weight gain.

  • Lack of sleep increases the hormone Gherlin, which leads to increased cravings for energy-dense, high-carbohydrate foods.
  • Lack of sleep increases the hormone Gherlin which leads to late-night snacking,
  • Lack of sleep causes the hormone Cortisol spikes making you hold on to fat and can decease fat burning up to 55%,
  • Lack of sleep increases the hormone Gherlin, which increases feelings of hunger and leaves you less satisfied after meals
  • Lack of sleep decreases the hormone Insulin sensitivity by more than 30% just after 4 nights of poor sleep, which increases fat storing and risk of Type 2 Diabetes
  • Lack of sleep decreases the hormone Leptin, which deceases the feelings of satiety increases the munchies.

Kegel Exercises

  • Are exercises to  strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum.
  • Also known as pelvic floor muscle training
  • Do anytime throughout the day, such as when you are standing at the kitchen sink, giving a presentation, waiting for the bus, etc.

Many factors can weaken your pelvic floor muscles

  • Pregnancy
  • Childbirth
  • Surgery
  • Aging
  • Excessive straining from constipation
  • Chronic coughing
  • Being overweight

Are Kegel exercises for you?

  • Stress incontinence – Leaking a few drops of urine while sneezing, laughing or coughing
  • Urinary urge incontinence – Strong, sudden urge to urinate
  • Faecal incontinence – Leaky stool

Kegel exercises are less helpful for women

  • Who have severe urine leakage when they sneeze, cough or laugh
  • Who unexpectedly leak small amounts of urine due to a full bladder (overflow incontinence).

How to do Kegel exercises

  • First find the right muscles
    – Identify your pelvic floor muscles, stop urination in midstream.
    – Once you’ve identified your pelvic floor muscles you can do the exercises in any position, although you might find it easiest to do them lying down at first.
  • Perfect your technique
    – Imagine you are sitting on a marble and tighten your pelvic muscles as if you’re lifting the marble.
    – 3 seconds at a time, then relax for a count of 3.

For best results

  • Focus on tightening only your pelvic floor muscles.
  • Be careful not to flex the muscles in your abdomen, thighs or buttocks.
  • Avoid holding your breath
  • Breathe freely during the exercise
  • Aim for at least 3 sets of 10 to 15 repetitions
  • Repeat 3 times a day
  • Consider vaginal weighted cones / jade eggs which you insert into your vagina using pelvic muscle contractions to hold it in place during your daily activities
  • Make Kegel exercises part of your daily routine, discreetly just about any time, whether you’re sitting at your desk or relaxing on the couch, standing in the queue at the supermarket etc.
  • Consider biofeedback, where your doctor or therapist inserts a pressure sensor into your vagina (or rectum), which measures and displays your pelvic floor strength and activity
  • NB! Don’t make a habit of using Kegel exercises to stop your urine stream, as this can lead to incomplete emptying of the bladder, which increases the risk of a urinary tract infection.

What to Expect and When

  • Less frequent urine leakage
  • Within a few weeks to a few months.
  • For continued benefits, make Kegel exercises a permanent part of your daily routine.

Questions? Please don't hesitate to contact me