A Populace Deprived

Deprived on arrival

Hello again friends and family! Sleep has become a media entity all its own. What a time to be alive! Or, time to stay alive??? The importance of sleep has never been more publicized. However . . . everything being said is not necessarily the bread. This blog is dedicated to the multifaceted and recently famous topic of sleep deprivation. The mechanisms of sleep are not household conversations, likewise the understanding of the impact of sleep disturbed breathing is not commonly understood. Sleep deprivation may be due to anxiety, stress, environment, reduced number of intended hours, and sleep disordered breathing (SDB). Anxiety, stress, and environment can play a role in sleep initiation and maintenance. Reduced number of intended hours is obvious guy here. Deprivation due to SDB is the car we a taking on a journey today. Field trip!

How much sleep are you supposed to have? How many times have you heard that question, or asked it yourself?. I am a moderately young pup, so I am not sure when this happened, but someone told all of us in existence that if you achieve 8 hours of sleep, you are good to go. 8 hours of sleep, yep that's the game winner. And for the truth that is in the quantitative representation of "good sleep time", the untruth is in the ease of achieve-ability due to bad quality. The perception of successful sleep has become rigidly 2 dimensional; a number to strive for without taking into consideration the obstacles strewn about that may impede one from truly achieving success. The amount of sleep is dependent on how many hours, yes. Nevertheless, the amount of sleep also depends on if your body is "awake" during your unconscious journey through sleepy town.

A previous blog entitled, "I Got All This Sleep & Nothing to Show For It" speaks the best analogy for sleep deprivation due to SDB. The link is It is a very short read, so don't shortchange yourself by skipping it. You lay down at 10 pm, set your alarm for 6:30 am, noting the 8.5 hour spread. Feeling good to know you are going to successfully obtain at least 8 hours of sleep. Little did you know, SDB is punching in at the factory. The effects of sleep disordered breathing reduce the quality of sleep, and in turn reduce the quantity of sleep. Your sleep GPS tells you 8.5 hours is the sleep destination time to wakey wakey town, however your body may be trying to save itself from impending doom along the course. Sporadic awakenings are like road blocks and stand-still traffic, prolonging the amount of sleep the body desires, all the while shortening the available amount of time for sleep.

What do I mean by impending doom? The sympathetic nervous system (SNS) takes action when the body feels there is danger. Pupils dilate, blood vessels constrict, heart rate accelerates, the stomach and intestines actions are inhibited, cortisol is released without ceasing for hours, glucose is released, function of genitalia is reduced. Fight or flight. The body shuts down blood flow and actions to any organ that is not vital for survival. The ability to escape and survive supersedes proper bodily function. This occurs repeatedly during the night in someone who has SDB. During times of SNS activation, the body is "awake" and we have no idea, because we are unconscious. With every feeling of threat or doom, total sleep time is being reduced. We may question why we wake up feeling like crap, despite having a quantitative 8 hours of sleep. Well, we wake up feeling like crap due to actually having 3 hours of sleep and 5 hours of struggle. This is the sleep deprivation that is not publicized. The dirty villain, robbing us sleep time, memory, cognition, energy, happiness, and overall well-being.

"Well I sleep 4 hours and I'm great, why is that?" Let me assess your sleep in a lab and I can show you why. This has become my go to statement. I can tell anyone they need less sleep time because the body is used to being awake after the war it rages all night, but those words are not easily believed. If I show someone however, the million times they aroused during the night and how many times their heart rate became irregularly high, and how often their sleep stage consolidation was compromised, it is a bit more believable. Quality over quantity. 4 hours of good consolidated sleep is better than 8 of crap sleep. 8 hours of crap sleep will put someone in a grave long before 4 hours of moderately decent sleep. Have you ever felt more rested from a nap than when you actually go to sleep at night? Again, quality over quantity. A diagnostic sleep test can answer many questions and birth solid understanding.

I cringe to my core to know there is an article titled "Sleeping less than 6 hours may raise risk of cancer, even death." Sleeping less than 6 hours does not increase risk of cancer and death. Sleep disordered breathing causes those dangers. Quantitative sleep deprivation may cause joint pain, impaired cognition, memory loss, and impaired immunity, due to not achieving enough deep sleep and REM sleep. Cancer related to sleep is a mechanism that only, ONLY happens because of reduction of oxygenated blood flow to organs. Previously, I stated when the SNS is active, blood flow is shunted away from non-essential organs to what the body feels are the core organs for survival - brain, heart, lungs. The shunting of oxygenated blood away from the non-essential organs causes the body to create new blood vessels around said organs, to increase the amount of available blood flow. This is called neoangiogenesis. The addition of new blood vessels creates an abnormal growth (tumor). Neoangiogenesis is not caused by a quantitative lack of sleep. If only you could see the consternation on my face.

To close, sleep deprivation is not only a quantitative reduction in sleep hours, yet a reduction in sleep quality as well. Let us teach ourselves and our patients to lower defenses when sleep is a topic of well-being.

If you or your patients feel excessively tired during the day, have difficulty focusing, or have difficulty staying asleep, have an evaluation from a sleep physician. You may have a sleep disorder and not realize it.

Better Sleep is a Better You!