Getting a Good Night’s Sleep

Rem sleep is integral for mind, body & spirit.

Sleep is a natural state of bodily rest characterized by unconsciousness. Although we appear during sleep to be passive, the brain remains internally responsive although externally unresponsive, making sleep different to a coma or hibernation.

When you’re asleep, your overworked neurons get time to repair and regenerate. Sleep deprivation leads to drowsiness and decreased daytime performance.

Common sleep disorders
There are as many as 81 sleep disorders, documented by the International Classification of Diseases. The two most common sleep disorders are insomnia and sleep apnea or sleep-disordered breathing.

Insomnia means difficulty falling asleep, staying asleep, early awakening or fragmented sleep. Eight out of 10 insomniacs have secondary insomnia. Psychological triggers include anxiety, depression, stress and medication.

Underlying medical conditions include gastric reflux, pain, thyroid or breathing disorders. Primary insomnia is not triggered by a major condition but may be associated with disruptions to sleep routine such as shift work or travel.

Sleep apnea or sleep-disordered breathing — obstructive sleep apnea (OSA) — is the most common type. It is caused by fat buildup or loss of muscle tone with age. OSA patients struggle in vain to breath during sleep.

Each type of apnea is associated with micro-arousals, chest movements but simply no airflow into the nose. Apnea is defined as absence of breathing lasting more than 10 seconds. Apnea occurring more than five times an hour is abnormal. Imagine the effect of chronic sleep deprivation and lack of oxygen on the brain and the heart.

How sleep disorders are diagnosed
The doctor or ENT (ear, nose and throat specialist) will use one or more of the following tools to determine what is affecting your sleep.
• Detailed medical evaluation is required to detect underlying secondary triggers.
• Imaging studies such as CT have limited value.
• A sleep diary — a meticulous record of sleep history over two weeks — will help the doctor differentiate between dyssomnias and parasomnias, and primary and secondary disorders. It will identify triggers.
• Sleep scoring systems such as Epworth scores estimate the likelihood of falling asleep.
• Polysomnography is the gold standard of sleep studies. It is an overnight study done under medical supervision, measuring EEG (brain waves), EMG (chest and chin muscle activity during breathing, limb jerks during restless leg syndrome), EOG (eye movement in REM sleep), ECG (heart), oximetry (oxygen levels in blood), nasal airflow and snoring. Partial sleep studies can be done at home without medical supervision and are more conveniently.

Common treatments
There are a range of treatments used, depending on the diagnosis.
• Bright light therapy is used to reset the internal clock that malfunctions in jet lag and advanced sleep phase.
• Cognitive behavioral therapy (CBT) teaches proper sleep hygiene measures that promote healthy patterns in sleep.
• Continuous Positive Airway Pressure (CPAP) provides a steady stream of air via a mask to stint the airway open in patients with obstructive sleep apnea.
• Medication.
• Melatonin is a nutritional supplement, found in Stemulite Fitness Formula, which is useful in disorders of circadian rhythm, such as jet lag, shift work and delayed sleep phase.
• Oral appliances are devices similar to sports mouth guards that keep the airway open in obstructive sleep apnea and snoring, and prevent bruxism or teeth grinding.
• Various forms of sleep surgery are available for opening the airway in obstructive sleep apnea.

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Sleep cycles
Sleep proceeds in cycles of REM (Rapid Eye Movement) and non-REM. The American Academy of Sleep Medicine divides non-REM sleep into three stages: N1, N2 and N3. A typical sleep cycle goes from N1 — N2 — N3 — N2 — REM. Each sleep cycle lasts about 90 to 110 minutes. We spend more time in N3 deep sleep in the early part of the night and more time in  REM sleep in the early morning hours.
REM sleep is when a person dreams. EEGs show cortical activation and resynchronization of EEG waves. The eyes jerk, the limbs become paralyzed briefly, the heart races and breathing becomes faster and shallower. If we are awakened during REM, we recall vivid dreams. Paralysis during REM prevents us from acting out our dreams. An infant spends 50 percent of sleep time in REM; an adult 25 percent. About 50 percent of adult sleep is spent in a deep N2 sleep.

The Epworth score: How sleepy are you?

Score > 10 means that you are probably not getting enough sleep.
Score > 18 means that you are very sleepy and will benefit from
seeing a doctor (ENT or Sleep physician)

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

The writer is an ear, nose and throat surgeon at the Singapore Medical Specialists Centre. She obtained her specialist degree in otolaryngology from the Royal College of Physicians and Surgeons of Glasgow, before specializing in Rhinology and Sinus Surgery at the University of Pennsylvania. She is a member of the American Rhinologic society and a fellow of the American Academy of Otolaryngology.

To find out more on how to fall asleep naturally with Stemulite Fitness Formula, and melatonin click here>>