Comments Off on Sleep deprivation: A cause of high blood pressure?
by SadofNE
Is it true that sleep deprivation can cause high blood pressure?
Answer From Francisco Lopez-Jimenez, M.D.
Possibly. Sleep experts recommend that adults get 7 to 8 hours of sleep each night. Getting less than six hours of sleep is known to be bad for overall health. Stress, jet lag, shift work and other sleep disturbances make it more likely to develop heart disease and risk factors for heart disease, including obesity and diabetes. A regular lack of sleep may lead to high blood pressure (hypertension) in children and adults.
The less you sleep, the higher your blood pressure may go. People who sleep six hours or less may have steeper increases in blood pressure. If you already have high blood pressure, not sleeping well may make your blood pressure worse.
It’s thought that sleep helps the body control hormones needed to control stress and metabolism. Over time, a lack of sleep could cause swings in hormones. Hormone changes can lead to high blood pressure and other risk factors for heart disease.
Don’t try to make up for a lack of sleep with a lot of sleep. Too much sleep — although not as bad as too little sleep — can lead to high blood sugar and weight gain, which can affect heart health. Talk to your health care provider for tips on getting better sleep, especially if you have high blood pressure.
One possible, treatable cause of lack of sleep contributing to high blood pressure is obstructive sleep apnea. This sleep disorder causes breathing to repeatedly stop and start during sleep. Talk with your care provider if you feel tired even after a full night’s sleep, especially if you snore. Obstructive sleep apnea may be the cause. Obstructive sleep apnea can increase the risk of high blood pressure and other heart problems.
If you snore the house down, you may be suffering from obstructive sleep apnea, or OSA — a potentially dangerous condition in which people stop breathing for 10 seconds or more at a time.
Yet even if you’re a rock star at snoring, you may not know you have obstructive sleep apnea unless someone tells you about your nocturnal roars. That’s why it’s important for partners and friends to speak up and encourage snorers to get professional help.
But what if you have an odd or quirky symptom besides snoring? You and your loved ones may have no idea that you are in danger, and the condition could go undiagnosed for years.
“Greater than 30 million people have sleep apnea in the United States, yet it’s often underdiagnosed or misdiagnosed,” said sleep specialist and pulmonologist Dr. Raj Dasgupta, an associateprofessor of clinical medicine at the University of Southern California’s Keck School of Medicine.
“It’s really misdiagnosed in women versus men because women may not present with the classic, heroic snoring that men often show,” he said.
Here are five weird signs of obstructive sleep apnea to watch for, according to Dasgupta.
Night sweats
There are many reasons people may sweat at night. It could be too hot, especially with the persistent heat waves in the past few years due to the climate crisis. Certain medications can cause night sweats, as can cancer, thyroid issues, the flu and bacterial infections, and the onset of menopausal symptoms, according to the Mayo Clinic.
But research has shown that about 30% of people with obstructive sleep apnea have reported night sweats, Dasgupta said.
“It’s because your body isn’t getting enough oxygen you fall into this sympathetic fight-or-flight mode, which triggers night sweats,” he said. “The research showed people with OSA that had night sweats were also more likely to have really low oxygen levels on top of having obstructive sleep apnea.”
Sleep apnea can cause you to wake up tired, have difficulty regulating emotions and suffer from brain fog, experts say.
Frequent awakenings
Many people get up at night to empty their bladders — it can be caused by alcoholoverindulgence, diabetes, edema, high blood pressure, certain medications, pregnancy, prostate issues and even drinking too many fluids before bed, according to the Cleveland Clinic.
But getting up at least two times a night to urinate — which is called nocturia — can also be a sign of obstructive sleep apnea, Dasgupta said.
“One study found about 50% of patients with OSA had nocturia, and they noted that treatment for the sleep disorder did cut back on awakenings,” he said.
Nevertheless, frequent nighttime urination is not commonly asked about in screening questionnaires on sleep apnea in primary provider offices, Dasgupta said.
Teeth grinding
Grinding or clenching teeth while sleeping is called bruxism, and it too may be a sign of obstructive sleep apnea, Dasgupta said.
“Certainly, anxiety and other factors can cause bruxism, but a common cause is obstructive sleep apnea,” he said. “There’s a theory on why — the airway becomes obstructed, so the muscles in the mouth and jaw move to try to free the blocked airway. That’s not been proven, but it is an interesting hypothesis.”
Most people who grind or clench their teeth use a mouthguard suggested by their dentist for protection, but it won’t protect the jaw, Dasgupta said.
“So, a person might also develop TMJ (dysfunction), which is pain in the temporomandibular joint, and that may also lead to other issues, such as headaches,” he said.
Morning headaches
Studies have found a link between having obstructive sleep apnea and waking up with a headache, Dasgupta said.
“They typically occur daily or most days of the week and may last for several hours after awakening in the morning,” he said. “The cause of the headaches is not well-established and may be multifactorial.”
Headaches caused by obstructive sleep apnea don’t appear to lead to nausea or increased sensitivity to light and sound. Instead, they seem to be a pressing sensation on both sides of the forehead that lasts about 30 minutes, according to a June 2015 study.
Depression, fatigue and insomnia
Some symptoms of obstructive sleep apnea can disguise themselves as issues of mental health, brain fog or other sleep problems, Dasgupta said.
“Sleep affects our ability to think, react, remember and solve problems,” he said. “Women especially have a tendency to underreport atypical symptoms such as insomnia, fatigue and depression.”
If obstructive sleep apnea awakens you, it may be hard to go back to sleep. A person may suspect insomnia, not realizing that a different issue may be triggering the awakenings.
Symptoms of daytime fatigue include a lack of motivation to accomplish everyday tasks, a lack of productivity at work, memory problems and a low interest in being social, Dasgupta said. Those are also signs of depression, so if the sleep issues aren’t brought up at a health visit, the underlying cause may be missed.
You’ve probably heard that regular exercise and a heart-healthy diet are the most important things you can do for your cardiovascular health. As it turns out, though, the quality of sleep you receive is also critical to your heart’s wellbeing.
In particular, undiagnosed sleep apnea is directly tied to an increased risk in cardiovascular and metabolic health. The scariest part? You might not even know you have this very common problem.
“Sleep apnea happens when upper airway muscles relax during sleep and pinch off the airway, which prevents you from getting enough air. Your breathing may pause for 10 seconds or more at a time, until your reflexes kick in and you start breathing again,” explains Jonathan Jun, M.D. , a pulmonary and sleep medicine specialist at the Johns Hopkins Sleep Disorders Center.
Sleep apnea occurs in about 3 percent of normal weight individuals but affects over 20 percent of obese people, Jun says. In general, sleep apnea affects men more than women. However, sleep apnea rates increase sharply in women after menopause. Sleep apnea is often linked to heart disease and metabolic issues like diabetes.
What are the signs of sleep apnea?
There are two kinds of sleep apnea: obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea happens when air can’t flow into or out of the nose or mouth, although you’re trying to breathe. Central sleep apnea happens when the brain fails to send the right signals to your muscles to make you start breathing. (This type is less common.)
“Sleep apnea may be noticed more by the bed partner than by the sleeper,” says Jun. “Your bed partner might notice that your breathing pauses, or they may complain of your loud snoring.”
That said, snoring itself—though annoying—isn’t the same as sleep apnea. Snoring is just the vibration sound created by airway resistance. You can snore loudly and not have sleep apnea, and you may even have sleep apnea without much snoring.
People with sleep apnea might also suffer from unexplained fatigue and mood swings, because their breathing interruptions continually wake them and prevent them from settling into a deep, nourishing sleep.
The consequences can be significant, Jun says. “We’re talking about car accidents in the daytime, lost productivity at work, mood swings, waking up feeling groggy and falling asleep in class.”
Other sufferers might wake up with a dry mouth, since sleep apnea tends to make you breathe with an open mouth, drying out your saliva. Some awaken with a headache, which may be caused by low oxygen or high carbon dioxide levels during sleep.
How is Weight Control Linked to Sleep Apnea?
“Weight control is very important. There are many studies showing that losing weight can either completely cure you of sleep apnea or at least make it less severe,” Jun says.
Sleep apnea, cardiovascular risk and metabolism
Several studies have shown an association between sleep apnea and problems like type 2 diabetes , strokes , heart attacks and even a shortened lifespan, says Jun. Why this connection? For one thing, obesity is common in sleep apnea patients, and obesity greatly increases risks of diabetes, stroke and heart attack, he says. “In most cases, obesity is the main culprit behind both conditions,” Jun explains.
Still, it’s important to note that not everyone with sleep apnea is obese. Furthermore, evidence suggests an independent link between sleep apnea and diabetes. “Our lab and others have shown that sleep apnea is associated with higher risks of diabetes, independent of obesity, and that sleep apnea can increase blood sugar levels,” says Jun.
For people who are overweight or obese, weight loss is key for treating or avoiding sleep apnea. People who accumulate fat in the neck, tongue and upper belly are especially vulnerable to getting sleep apnea. This weight reduces the diameter of the throat and pushes against the lungs, contributing to airway collapse during sleep.
Women in particular should be careful as they age. While premenopausal women tend to put on weight in the hips and in the lower body instead of the belly, this shifts with time. Weight begins to accumulate in traditionally “male” areas like the tummy, and this leads to a greater chance of sleep apnea.
“After menopause, hormones change and women tend to start looking like men in terms of where the weight gets put on. It’s a time to be paying attention to the risks of sleep apnea because women begin to catch up to men in the rates of apnea after menopause,” Jun says.15
Diagnosing and treating sleep apnea for better health
It’s important to treat sleep apnea, because it can have long-term consequences for your health. While there have been some high-profile deaths linked to sleep apnea—such as with Judge Antonin Scalia —Jun says that the true risk is from damage done over time.
Obstructive sleep apnea can range from mild to severe, based on a measurement system called the apnea-hypopnea index (AHI). The AHI measures the number of breathing pauses that you experience per hour that you sleep.
Obstructive sleep apnea is classified by severity:
Severe obstructive sleep apnea means that your AHI is greater than 30 (more than 30 episodes per hour)
Moderate obstructive sleep apnea means that your AHI is between 15 and 30
Mild obstructive sleep apnea means that your AHI is between 5 and 15
Whether or not you need treatment for sleep apnea depends on its severity, whether or not you have symptoms such as sleepiness and other health conditions. For example, if you have risk factors for heart disease, your doctor might opt to treat you even for mild sleep apnea. On the other hand, if you have a severe case of sleep apnea, your doctor might insist on treatment even if you’re not sleepy.
The main choice of therapy is a breathing device called a CPAP, or continuous positive airway pressure machine. A CPAP machine pipes humidified air through the nose, which creates air pressure to keep your throat open while asleep. This prevents pauses in breathing.
“CPAP is the first-line treatment, and it’s very effective,” Jun says. A recent Johns Hopkins study looked at what happens to metabolism at night when sleep apnea patients don’t wear their CPAP. The study found that the resulting apnea caused a spike in blood sugar, heart rate, blood pressure and stress hormones—a response similar to what might happen if you were asked to get up in front of a crowd to speak. “It’s very similar to that type of a stress response,” says Jun. “I would liken sleep apnea to something like that happening on a nightly basis.”
CPAP is not the only alternative.
Many cannot tolerate the CPAP machine and are able to obtain the help they need from a Sleep Apnea Dental Specialist. Their use of an oral appliance has helped hundreds of thousands resolve their medical issues as they pertain to Sleep Apnea.
Get the Medical Equipment You Need at Home
Many studies show that regular use of CPAP or oral devices reduces blood pressure and improves wakefulness during the day. People with sleep apnea who use sleep apnea therapeutic devices also report improved quality of life. In some observational studies that compare people with apnea who seek sleep apnea remedies versus those who don’t, those seeking treatment have lower risk of stroke and heart attack and lower blood glucose, Jun notes.
If you or your partner has noticed signs of sleep apnea, visit your doctor. A sleep specialist can order a sleep apnea test, which uses equipment to monitor your breathing and oxygen levels while you sleep. Often, you’ll visit a laboratory to spend the night for monitoring. Other times, it’s possible to use a portable, take-home kit. You’ll rest easier knowing the results.
PharmacyTimes: Using a transcranial magnetic stimulation method, researchers have found that reduced sleep alters central nervous inhibition from GABAergic and dopaminergic mechanisms differently in individuals with migraines versus those without.
Migraine is a primary headache disorder with a well-established association with insufficient sleep. According to the study, migraine affects approximately 15% of adults aged 15 to 64 globally and is the leading cause for years lived with disability below 50 years of age. Many patients with migraine report problems with sleep, headaches upon awakening, and using sleep as a way to avoid a headache. Researchers have also found worse sleep quality compared to individuals without migraines, as well as an increased likelihood for insomnia-like sleep patterns among individuals with migraines.
Sleep restriction with about 50% sleep for 2 nights is a human experimental model of insufficient sleep, according to researchers. In healthy subjects, sleep deprivation may alter cortical inhibitory and facilitatory systems, and seems to increase pain sensitivity. Increased sensitivity to pain has previously been discovered in patients with migraine and may be associated with both increased homeostatic sleep pressure caused by increased need for sleep as well as reduced intracortical inhibition.
Despite these findings, both the underlying pathophysiology of the disease and its relationship with sleep are unexplained. In order to investigate this association further, researchers applied transcranial magnetic stimulation to analyze possible mechanisms of insufficient sleep in patients with migraine.
According to the analysis, sleep restriction had an opposite effect on cortical silent period duration in interictal migraines and controls. The cortical silent period refers to an interruption of voluntary muscle contraction by stimulating the contralateral motor cortex. With sleep restriction, this period was reduced from 147.9 minutes to 139.6 minutes. This impact was still significant when replacing sleep condition with measured sleep time in minutes.
Almost one-in-five British people report they don’t get enough sleep each night. The problem is so bad that in total the UK public are losing around a night’s worth of shut-eye each week.
There are a lot of popular beliefs about foods and drinks helping people get a good night’s rest, but many of them are not based on scientific evidence. Here’s what we know.
Chemistry of food and sleep
Our diet has an influence upon sleep patterns by affecting the sleep hormone melatonin. For example, foods rich in the essential amino acid tryptophan are commonly cited as helping sleep, as tryptophan helps produce melatonin. Additionally, some vitamins and minerals may help sleep, such as vitamin D, magnesium and zinc.
Oily fish: Evidence suggests the more oily fish, such as salmon or herring, you eat the better you sleep. Oily fish contain healthy fats such as omega-3 oils which have been shown to improve sleep in children and are involved in serotonin release. Serotonin, a brain chemical linked to mood, also regulates the sleep-wake cycle which may also explain how eating oily fish can help.
Tart cherries: A number of studies have looked at consumption of tart cherries, usually in the form of a drink, and sleep. Evidence suggests that tart cherries improves sleep in older adults, probably due to their ability to increase melatonin levels. And tart cherries are also rich in nutrients, including magnesium, which also may improve your sleep.
Kiwi fruit: The evidence for kiwi fruit helping you sleep is mixed. One study suggested four weeks of kiwi fruit consumption improved multiple sleep measures, while another, admittedly in sufferers of insomnia, found no effect. Based on these findings it is not clear yet that eating kiwi fruit will benefit sleep for most people.
Oysters: In 1888 W F Nelsom wrote “He who sups on oysters is wont on that night to sleep placidly…”. There is some evidence to back up this statement, with zinc-rich foods, including oysters, being reported to benefit sleep. However, on balance eating oysters before bedtime is unlikely to be beneficial to your night’s sleep.
Alcohol and other drinks
Alcohol causes brain activity to slow down and has sedative effects that can induce feelings of relaxation and sleepiness> But consuming alcohol is actually linked to poor sleep quality and duration. Although drinking alcohol may cause more rapid sleep onset, this can affect the different stages of sleep, decreasing overall sleep quality. If you want a good night’s sleep, avoiding alcohol is sound advice. But are there any non-alcoholic drinks that might help?
Warm milk: Research conducted in the 1970s suggested that a glass of warm milk before bed could improve sleep quality. This research was performed in a very small group however, and little research has been done since. Drinking milk does increase melatonin levels which could help. But there isn’t enough evidence to support the claim that a glass of warm milk definitely makes you nod off.
Bone broth: Bone broth commonly crops up in online articles as a food that can aid sleep. This may be due its high content of the amino acid glycine. Glycine has been shown to improve sleep in rodents and humans, possibly by lowering body temperature. There are however no studies specifically looking at bone broth consumption and sleep.
Herbal teas: The range of herbal teas aimed at the sleep market has grown and grown. Evidence for valerian, a common ingredient, to aid sleep is inconclusive. Decaffeinated green tea has been reported to improve sleep quality, which might be linked to the relaxing qualities of L-theanine, an amino acid it contains, but in general, avoiding caffeinated teas is a wise choice. If you like herbal teas, then they can be part of a relaxing pre-bedtime routine – but they are unlikely to improve your sleep quality.
A bedtime routine
Having a bedroom environment and daily routines that promote consistent, uninterrupted sleep are important. These include keeping to the same time to head off to bed, making your bedroom free of disruptions and having a relaxing pre-sleep routine. But many of the foods that have claimed benefits for sleep have little or no evidence behind them, to the point there are no legally recognized health claims for food assisting sleep approved in the UK or Europe.
If any one of these things helps you to sleep well, there’s no reason to stop. But just remember the other basics of a good nights sleep too, including relaxing before bed and avoiding too much blue light from electronic devices.
Comments Off on How to tell if it’s time for a ‘sleep divorce’
by SadofNE
(CNN)He snores until the walls rattle. She gives off a massive amount of body heat. One of you is a cover hog, kicks at night or takes consistent 3 a.m. bathroombreaks. Maybe you sleepwalk or suffer from insomnia. The list of reasons why your bed partner might be keeping you up at night could be long and as dreary as your mood when you drag yourself from bed each morning.
When it comes to your health, that’s nothing to yawn at: Being deprived of a full seven to eight hours of sleep each night has been linked to a higher risk of diabetes, stroke, cardiovascular disease and dementia, according to the US Centers for Disease Control and Prevention.
There’s an emotional toll as well, said sleep specialist Wendy Troxel, a senior behavioral scientist at RAND Corporation who authored “Sharing the Covers: Every Couple’s Guide to Better Sleep.”
“Sleep deprivation can affect key aspects of relationship functioning, like your mood, your level of frustration, your tolerance, your empathy, and your ability to communicate with your partner and other important people in your life,” Troxel said.Poor sleep — and that resulting crummy mood — makes people “less able to engage in ‘perspective taking,’ or putting small adverse events in context,” said sleep specialist Rebecca Robbins, an instructor in the division of sleep medicine for Harvard Medical School, who coauthored the book “Sleep for Success!”
That strain can contribute to depression, anxiety, and other emotional and relationship dysfunction, Robbins said.
Sleep training for adults prevents depression, study findsResearch done by Troxel and her team found that a well-rested person is “a better communicator, happier, more empathic, more attractive and funnier” — all traits that are key to developing and sustaining strong relationships, she said.Sleeping apart can help couples be happier, less resentful and more able to enjoy their time together in bed, particularly on weekends when work demands are lighter, Troxel said.”I tell couples to try to think of it not as a filing for sleep divorce, but as forging a sleep alliance,” she added. “At the end of the day, there is nothing healthier, happier and even sexier than a good night of sleep.”https://www.cnn.com/audio/player?episodeguid=85e00da6-889c-4c66-a203-adb70011ee08&parentOrigin=https%3A%2F%2Fwww.cnn.com&canonicalUrl=https%3A%2F%2Fwww.cnn.com%2F2021%2F12%2F04%2Fhealth%2Fsleep-divorce-wellness%2Findex.html
Rule out underlying sleep issues
Sleep partners are often the ones to flag signs of sleep disorders and encourage their loved one to visit a doctor or sleep specialist. Undiagnosed, sleep disorders may well harm you and your partner’s future health.That’s why experts say it’s best to check with a sleep specialist to rule out and treat any underlying condition before you leave your loved one’s bed — you may well be the key to identifying and treating a true health issue.
Coping skills
Once any serious health issue is ruled out, couples who find it emotionally bonding to sleep in the same bed may wish to try some practical coping tips before making the decision to sleep apart, Troxel said. No alcohol please. If you struggle with insomnia, cut out alcohol well before bed, experts say. It may appear to be helping you sleep, but booze actually causes middle of the night awakenings that can be hard to overcome. Snorers should eliminate alcohol as well, Troxel said, “because as everyone probably knows, if you sleep with a snorer and they have one too many drinks, the snoring will be much worse that night.” That’s because the alcohol further relaxes the throat muscles, encouraging that loud snore.
Keep your brain sharp by finding your sleep ‘sweet spot,’ study saysThis is where partners can be powerful and beneficial sources of what experts call “social control,” Troxel said.”If you’re prone to drinking but you know that the consequences are not only going to bad for your sleep, but your partner’s sleep as well, then maybe you’ll be more motivated to cut back a bit,” she said.Raise the head. For snoring, try sleeping on additional pillows or using an adjustable bed — anything that raises the head to keep the throat open, Troxel said.”For many people snoring tends to be worse when they are flying flat on their backs, so raising the head a little bit can be useful,” she said.If the underlying issue is congestion, try adding a humidifier to the room, she added. “Some people have had success with over-the-counter nasal strips to keep the airway open.”Drown the sound. Survival 101 for dealing with a snoring partner is trying to deafen the noise, Troxel said. Try ear plugs and run a fan or white noise machine.Try sleep scheduling. A snorer who sleeps with a partner with insomnia can help that partner get more sleep by going to bed later than their partner, Troxel said.”For example, a snorer can delay their bedtime by a half an hour to an hour,” Troxel said. “That allows the partner to fall into a deeper stage of sleep and possibly stay that way once the snorer comes to bed.”Turn the snorer. Sleeping on the back is the worse position for snoring, because the soft tissues of the mouth and tongue collapse into the throat. As the sleeper unconsciously forces air past those soft tissues, snores emerge.
How to fall asleep more quickly — the healthy way“If you can keep someone on their side, that can attenuate the snoring,” Robbins said. “I’ve heard of all kinds of creative techniques, such as putting a bra on the snorer in reverse and then putting tennis balls in the cups.”Full support body pillows may be an option, if they stay in place, said sleep specialist Dr. Raj Dasgupta, an associate professor of clinical medicine at the Keck School of Medicine at the University of Southern California.”I’m a fan of the simple things, but if you want to purchase something we’ve come a long way from sewing tennis balls into the back of our pajamas,” Dasgupta said. “You can buy a strap-on to your back that has little protruding foam-like things which are supposed to make you sleep on your side.”And there are some FDA-approved devices that strap to the throat or chest and provide vibrations designed to go off when you are on your back, prompting a move to side-sleeping.”
Time for separate rooms?
You’ve tried it all, and good sleep is still a distant dream. At this point, there’s no reason not to do what is best for each of you to get the quality sleep you need — especially since there are other ways to nurture a relationship besides sharing a bed.
The best alarm clocks of 2021 (CNN Underscored)“Couples can still make the bedroom a sacred space, even if they choose not to actually sleep together,” Troxel said. “You can develop pre-bedtime rituals and use that time to actually connect with your partner instead of being independently on a phone or laptop or whatnot. “She encourages couples to spend quality time together before bed, sharing details of the day and sending positive messages to each other. “We know self-disclosure is good for relationships, it’s good for sleep,” Troxel said. “If you tell your partner you’re grateful for them, that’s a deep form of connection. Gratitude is good for relationships, it’s good for sleep.”
Nor does a “sleep divorce” have to mean separate beds every night, Troxel said. It could be just the workweek, with weekends spent in the same bed. It could be every other night — the options are as unique as each couple. “There truly is not a‘one-size-fits-all’ sleeping strategy for every couple,” Troxel said. “It’s really about finding the strategy that’s going to work best for the two of you.”
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