Sleep significant for overall health

Calexico resident Gloria Cruz attempts to sleep while attached to equipment that will measure her breathing and brain waves as she sleeps. Chelcey Adami Photo

I hope this article doesn't put you to sleep. Or do I?

When one doesn't get enough sleep, negative health effects ripple throughout your body, according to the National Sleep Foundation.

For example, when you're tired, your immune system weakens, stress hormones rise, memory suffers and you have a harder time focusing while your risk of high blood pressure and heart disease increases.

Gloria Cruz, 70, of Calexico has had sleeping problems for about five months now.

"It makes me feel stressed out and I don't enjoy doing anything now," she said in Spanish. "When you don't sleep well, it's hard to pay attention to what people are really saying. I can't tolerate loud noises and I'm more irritable."

Cruz described her symptoms earlier this month while being hooked up with countless wires to monitor her breathing, heart rate, oxygen levels and more before laying down to sleep in pink pajamas at Imperial Valley Sleep Medicine.

She never thought she would be going through a polysomnography, or sleep study, but said she'll do anything to sleep better.

Polysomnography measures sleep cycles by recording air flow, oxygen levels, body positions, brain waves, breathing effort and rate, electrical activity of muscles, eye movement and heart rate as one sleeps in order to diagnose sleep disorders, according to the National Library of Medicine.

Soon after, Cruz was asleep under the watchful eyes of strangers at Imperial Valley Sleep Medicine.

Zzzzzzzzzzz

Imperial Valley Sleep Medicine is the only sleep lab in Imperial County. There, patients are evaluated and treated for possible sleep disorders, said Dr. Patrick Wolcott, who has been conducting sleep studies since 1995.

Five to six patients a night come stay there several nights a week, sleeping on beds that fold down out of the wall as several polysomnography technologists sit in a separate room, monitoring patients' sleep as information flows in all night.

With many techs filling up cups of coffee around 10 p.m., they settle in to watch the screen that includes a live feed from a video camera in the patient's room.

Patients usually come to the sleep center after a primary care doctor refers them. A wife may have noticed her husband's snoring has become louder or that the snoring has all of a sudden gone quiet at times and he's not breathing. Others are just feeling more tired.

The most common sleep disorder is just not getting enough sleep, Wolcott said; the second is insomnia, and the third is sleep apnea. There are also sleep disorders like restless leg syndrome and narcolepsy.

However, "the one with the greatest health effect is by far sleep apnea," he said, and it's the one he sees here the most.

Sleep apnea is the involuntary cessation of breathing that occurs while the patient is asleep, according to the American Sleep Apnea Association.

It may occur a few seconds to longer at a time and between 500 and 600 times a night. Sleep apnea affects the person's ability to get a deeper level of sleep, Wolcott explained.

Less sleep, bigger waistlines

Studies have consistently shown that not getting enough sleep, whether due to a sleep disorder or lifestyle choice, increases the likelihood of weight gain, according to NSF.

As obesity rates have increased in the U.S., sleep apnea cases have too, according to the NSF.

"Obesity is driving sleep apnea in this country," Wolcott said.

Sleep apnea also increases risk for issues commonly associated with obesity like diabetes, stress, hypertension and cardiovascular disease, Wolcott noted. 

Those who sleep five hours or fewer a night are 15 percent more likely to become obese, according to the NSF. The body's ability to regulate appetite diminishes without enough sleep, and there's less energy to be physically active.

And lack of sleep caused by the sleep apnea only worsens the likelihood of weight gain.

With sleep apnea and obesity, it's a Catch-22.

Night shifts

Ironically, technicians working overnight are at times suffering the consequences of sleeping less.

Heber resident Aldo Arellano has been working as a polysomnography technologist for about five years and normally sleeps between 7:30 a.m. and 3 p.m.

Shortly after he began his new job helping others to get a better night's rest, he began gaining weight as a result of lack of sleep, eventually packing on about 30 pounds.

However, he improved his diet, started sleeping more and lost the excess poundage.

Many studies have shown that despite people with similar diets and activity levels, those getting less sleep saw cortisol and insulin levels rise, Wolcott said, only further underscoring the importance of a full night's rest.

Those who work at night, such as law enforcement and firefighters, solar energy employees and hospital staff are particularly challenged to change their circadian rhythm and ensure they sleep regularly and enough.  

An undervalued problem

“‘Sleep!’ said the old gentleman, ‘he's always asleep. Goes on errands fast asleep, and snores as he waits at table.’

‘How very odd!’ said Mr. Pickwick.”

In Charles Dickens' "The Pickwick Papers," the character "Joe, the Fat Boy" was obese, constantly hungry, snored and always falling asleep.

Dickens was unwittingly describing the condition obesity hypoventilation syndrome, also known as "Pickwickian syndrome," more than 100 years before medicine had a formal title for it, according to a publications by the National Center for Biotechnology Information.

Sleep as a field of research study is still relatively new. There was only one person in the U.S. researching the topic before 1950, Wolcott said, and it wasn't until about 50 years ago that medicine began to systematically study sleep disorders like sleep apnea.

Given that, many don't take the health consequences as seriously as other more established diseases such as high blood pressure, Wolcott said.

The consequences of not getting enough sleep are beyond one's personal medical issues, with lack of sleep also credited with increased absenteeism from work, vehicle accidents from tired drivers and lost productivity, Wolcott said. 

"If your'e not sleeping, you're tired and when you’re tired, you’re actually less efficient," he explained.

Studies have also shown that medical care is higher for patients with untreated sleep disorders, he noted, with overall medical care less even with added costs of testing and treatment.

"Sometimes you just have to accept that it is a real problem, not just just an issue of snoring," Wolcott said.

More convenience, less sleep

Around 1900, researchers looked at how long people were sleeping and nine hours was the average, Wolcott said, and today, people are struggling to get at least seven hours asleep.

"With all the conveniences we have now, you’d think you’d have more time to dedicate to sleep," Wolcott said. "But I think what happens is electronics, TV, social media, it has gotten in the way." 

Many feel that they have to respond to a text message, email or notification on social media, regardless of the time.

Wolcott advises detaching from these devices at least an hour before bed, scheduling out at least seven hours of rest a night, maintaining a regular sleep schedule and providing a restful sleeping environment. With those in place, many health issues will be avoided.

"The more research that is done, the more problems we’re identifying," he said. "(We're) looking at solutions for them and again they are going to affect a larger and larger part of the population."

Arturo Valdovinos, 59, of El Centro also recently spent a night at Imperial Valley Sleep Medicine. He has never had any problems sleeping, but following open heart surgery about a month ago, the hospital noticed that at times he wasn't breathing while sleeping. 

"They say if I don't breath, I can suffer a heart attack. I've already had two strokes, so If I don't take care of myself I could die, and I wouldn't know because I was sleeping," he said. 

Staff Writer Chelcey Adami can be reached at 760-337-3452 or cadami@ivpressonline.com 

Recommendations for a good night's rest ...

- Most importantly, make sure you have a regular sleep schedule, including on weekends, and aim for at least seven to eight hours a night for adults. Children and teens need far more. 

- Avoid caffeine, alcohol and eating too close to bedtime.

- Find ways to have an hour to relax before going to bed. Try to avoid doing work, studying or having stressful conversations with loved ones during this time. 

- Keep electronics like televisions, computers and even phones away from the bed. 

- Make your sleep environment conducive to sleep. Temperature, sound and light all affect our ability to get a deep sleep so try to make it a dark and quiet area. Avoid clocks that display time in the dark.  

- Exercise regularly and avoid exercising too late in the day.

- Sources:  Dr. Patrick Wolcott, National Sleep Foundation

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