For half of Americans, stress over the past year is negatively impacting the quality of their sleep, according to the results of a nationwide survey of 1,000 adults commissioned by ResMed. What’s more, many are ignoring sleep challenges that could point to a larger underlying health concern.
ResMed published the survey in conjunction with National Sleep Awareness Week (March 14-20) and World Sleep Day (March 19), and as part of Sleep for a Better Tomorrow, an education and outreach initiative to build awareness of the critical role good sleep plays in physical and mental health—and how to get our best sleep.
“COVID-19 has impacted all aspects of our lives, including our sleep health, leading many people to struggle to get the recommended 7 to 9 hours of sleep at night,” says Carlos M. Nunez, MD, chief medical officer for ResMed, in a release.
Beyond the pervasive effects of stress, the survey found the impacts on sleep vary across gender and working arrangements.
Thirty-five percent of women reported worse sleep quality in the past year compared to just 26% of men. Women selected stress and anxiety as the most significant impacts on their sleep.
More individuals working from home reported improved sleep quality since the pandemic began vs those who haven’t worked from home (39% vs 21%).
Across all respondents, more than one-third say they are having a harder time falling asleep, and nearly one-third say they are sleeping less over the last year, and one-quarter started taking naps more often.
The survey revealed that more than one in two Americans say they snore, or a bed partner has told them they snore. But 78% of those who snore aren’t concerned it could be related to an underlying health condition, despite snoring being a top symptom of sleep apnea. Additionally, nearly half of survey respondents said their doctor had not asked them about their sleep quality, reinforcing the importance of consumers being aware of the potential health impacts of poor sleep and acting on key sleep apnea symptoms such as snoring.
“While data show that stress and worry are key factors impacting many people’s sleep, now is an opportunity for everyone to take measure of all of the factors that could be impacting the quality of their sleep, which could include sleep disorders that can have negative long-term impacts to overall health,” Nunez says.
“Sleep apnea can impact all types of people from all walks of life, and while some people are more prone to have sleep apnea, it does not discriminate. If you snore, have been told you stop breathing in your sleep, or feel tired each day despite getting enough hours of sleep, ask your doctor if sleep apnea—which is 100% treatable at home—could be the cause.”
The survey was conducted in February 2021 among 1,000 individuals 18 and older in the United States. The survey was fielded using Qualtrics Insights Platform, and the panel was sourced from Lucid.
There’s a lot of discussion these days about sleep gut health—how a healthy gut can support overall health, and the ways a compromised gut may contribute to illness and disease. We’re learning more about the complexity of the vast, dense, microbial world of the human gut and its influence over immune health, hormone balance, brain function, and mental and physical equilibrium. What relationship exists between sleep and this microbial ecosystem within the body? Emerging science demonstrates that there is a very real and dynamic connection between the microbiome and sleep itself.
What is the Microbiome?
The term microbiome can mean a couple of different things. It is sometimes used to describe the collection of all microbes in a particular community. In scientific terms, the microbiome can also refer to the genes belonging to all the microbes living in a community. The microbiome is often seen as a genetic counterpart to the human genome.
The genes that make up a person’s microbiome are far more numerous than human genes themselves—there are roughly 100 times more genes in the human microbiome than in the human genome. This makes sense when you consider that there are somewhere in the neighborhood of 100 trillion microbes living in (and on) each of us—a combination of many different types, including bacteria, fungi, viruses, and other tiny organisms.
This vast array of microbial life lives on our skin and throughout the body. The largest single collection of microbes resides in the intestine—hence the attention to “gut” health. Here, trillions of microscopic organisms live and die—and appear to exert a profound effect on human health.
The Microbiome and Sleep
The human microbiota is a complicated, dynamic ecosystem within the body. It appears to interact in some important ways with another fundamental aspect of living—sleep. As with much about the microbiome, there is a tremendous amount we don’t know about this interaction. That said, there are some fascinating possible connections and shared influences. Scientists investigating the relationship between sleep and the microbiome are finding that this ecosystem may affect sleep and sleep-related physiological functions in a number of ways—shifting circadian rhythms, altering the body’s sleep-wake cycle, and affecting hormones that regulate sleep and wakefulness. Our sleep, in turn, may affect the health and diversity of the human microbiome.
The microbial life within our bodies is in perpetual flux, with microbes constantly being generated and dying. Some of this decay and renewal naturally occurs during sleep. There’s no answer yet, however, to the important question: What role does sleep itself play in maintaining the health of the microbial world inside us, and which appears to contribute so significantly to our health?
There are some important signs of a significant connection: We’ve seen research demonstrating that circadian rhythm disruptions can have negative effects on gut microbiota. (More on this shortly.) There’s also evidence that the disordered breathing associated with obstructive sleep apnea (OSA), a common sleep disorder, may disrupt the health of the microbiome. Scientists put mice through a pattern of disrupted breathing that mimicked the effects of OSA, and found that the mice that lived with periods of OSA-like breathing for six weeks showed significant changes to the diversity and makeup of their microbiota.article continues after advertisement
Sleep and the Gut-Brain Connection
A significant, fast-growing body of research illustrates the far-reaching effects of the microbiome over brain function and brain health—as well as the influence of the brain over gut health and the microbiome. This “gut-brain axis” appears likely to have a profound influence over nearly every aspect of human health and physiological function, including sleep.
The constant communication and interplay between the gut and the brain has the potential to influence and intersect with sleep directly and indirectly. Let’s take a closer look at the ways that might occur:
Mood. Studies indicate that the health and balance of the gut microbiota has a significant influence over our mood and emotional equilibrium. Disruptions and an imbalance of gut microbes have been strongly connected to anxiety and depression. This has potentially significant implications for sleep, as both anxiety and depression can trigger or exacerbate sleep disruptions.
Stress. Research is also revealing a complicated, two-way relationship between stress and gut health that also may exert influence over sleep and sleep architecture. Stress is an extremely common obstacle to healthy, sufficient sleep.
Pain. Studies link gut health to pain perception, specifically for visceral pain. An unhealthy microbiome appears to increase sensitivity to this form of pain. Like so many others, this connection travels the communication pathway between the gut and the brain. The connection between sleep and physical pain or discomfort is significant—the presence of pain can make falling asleep and staying asleep much more difficult.
Hormones. Several hormones and neurotransmitters that play important roles in sleep also have significant influence over gut health and function. The intestinal microbiome produces and releases many of the same neurotransmitters—dopamine, serotonin, and GABA among them—that help to regulate mood, and also help to promote sleep.
Melatonin, the “darkness hormone” essential to sleep and a healthy sleep-wake cycle, also contributes to maintaining gut health. Deficiencies in melatonin have been linked to increased permeability of the gut—the so-called “leaky gut” increasingly associated with a range of diseases. Melatonin is produced in the gut as well as the brain, and evidence suggests that intestinal melatonin may operate on a different cyclical rhythm than the pineal melatonin generated in the brain.
Cortisol is another hormone critical to the human sleep-wake cycle. Rising levels of the hormone very early in the day help to promote alertness, focus, and energy. Cortisol levels are influenced in several ways within the gut-brain axis: The hormone is central to the stress and inflammatory response and also exerts an effect on gut permeability and microbial diversity. The changes to cortisol that occur amid the interplay of the gut and brain are likely to have an effect on sleep.
“Circadian Rhythms” of the Gut?
There is some pretty fascinating research connecting the gut microbiome to circadian rhythms, the 24-hour biological rhythms that regulate our sleep and wake cycles, in addition to many other important physiological processes. A growing number of studies now suggest that the vast and diverse microbial ecosystem of the gut has its own daily rhythms. These microbiome rhythms appear to be deeply entwined with circadian rhythms—research suggests that both circadian and microbial rhythms are capable of influencing and disrupting the other, with consequences for health and sleep.
The rhythms of gut microbes are affected by diet, both the timing of our eating and the composition of the foods we consume. A recent study found that mice eating a healthy diet generated more beneficial gut microbes, and that the collective activity of microbial life in the gut followed a daily—or diurnal—rhythm. That rhythm, in turn, supported circadian rhythms in the animal. Mice fed a high-fat, stereotypically “Western” diet, on the other hand, produced less optimal microbial life. The gut microbes of these mice did not adhere to a daily rhythm themselves, and also sent signals that disrupted circadian rhythms. These mice gained weight and became obese, while the mice that ate healthfully did not.
Scientists bred a third group of mice without any gut microbes at all. These mice had no signals to send from a gut microbiome. Circadian disruption occurred in these mice—but they did not gain weight or suffer metabolic disruption, even when fed the high-fat diet. This suggests a couple of important conclusions. First, that microbial activity is key to normal circadian function—and therefore to sleep. Second, that the microbiome is a key player along with diet in the regulation of weight and metabolism.
Circadian Rhythms and Microbiome: A Two-Way Street
Research in humans has returned similar results: The human microbiome appears to follow daily rhythms influenced by timing of eating and the types of foods consumed and to exert effects over circadian rhythms. Research has also found that the relationship between these different biological rhythms works both ways. Scientists have discovered that disruptions to circadian rhythms—the kind that occurs through jet lag, whether through actual travel or from “social” jet lag—disrupts microbial rhythms and the health of the microbial ecosystem. People who experience these changes to microbial rhythms as a result of circadian disruption suffer metabolic imbalance, glucose intolerance, and weight gain, according to research. And there’s preliminary evidence suggesting that gender may play some role in the relationship of gut microbial health, metabolism, and circadian function: a study using mice found that females had more pronounced microbiome rhythms than males.
New Understanding of Circadian Role in Metabolism?
We’ve known for some time about the relationship between sleep, circadian rhythms, and metabolic health. Disrupted sleep and misaligned circadian rhythms have been strongly tied to higher rates of obesity and to metabolic disorders including Type 2 diabetes. Our emerging knowledge of the microbiome and its relationship to circadian function may in time deliver a deeper understanding of how health is influenced by sleep and circadian activity.
Science has really only just begun to delve into the world of the microbiome and its relationship to sleep as well as health more broadly. All the early signs suggest that this is a profoundly important area of research; it will be fascinating to see where this takes us, and what it means for sleep.
Workaholism or work addiction risk can lead to negative mental and physical health outcomes such as depression, anxiety, from lower sleep quality. Perception of work (job demands and job control) may become a major cause of employees’ work addiction.
An international group of researchers including a Higher School of Economics (HSE) University scientist explored the link between work addiction risk and health-related outcomes using the framework of Job Demand Control Model. The results are published in the International Journal of Environmental Research and Public Health.
Workaholics were defined as people who usually work 7 and more hours more than others per week. There are potential reasons for that: financial problems, poor marriage, or pressure by their organization or supervisor are a few. What can differentiate a workaholic behavior from similar behavior like work engagement? Workaholism is also known as a behavioral disorder, which means the excessive involvement of the individual in work when an employer doesn’t require or expect it.
The scientists aimed to demonstrate the extent to which the work addiction risk is associated with the perception of work (job demands and job control), and mental health in four job categories suggested by Karasek’s model or Job Demand-Control-Support model (JDCS). The JDCS model assumes four various work environments (four quadrants) in which workers may experience a different level of job demands and job control: passive, low-strain, active, and tense/job-strain. Job control is the extent to which an employee feels control over doing work.
“Passive” jobs (low job control, low job demands) might be satisfying to a worker as long as the workers reach the set goal. “Low strain” jobs have high job control and low job demands. Individuals in this category are not particularly at risk of mental health problems, and it corresponds typically to creative jobs such as architects. “Active” workers have high job demands and high job control. They are highly skilled professionals with responsibilities, such as heads or directors of companies. Those highly skilled workers have very demanding tasks but they have high levels of decision latitude to solve problems. Finally, workers at risk of stress-related disorders are those within the “job strain” group (high demand and low control). For example, healthcare workers from emergency departments are typically in job strain because they cannot control the huge workload.
The study was conducted in France because it is one of the industrial countries with growing numbers of occupations. The authors of the research collected data from 187 out of 1580 (11.8%) French workers who agreed to participate in a cross-sectional study using the WittyFit software online platform. The self-administered questionnaires were the Job Content Questionnaire by Karasek, the Work Addiction Risk Test, the Hospital Anxiety and Depression scale, and socio-demographics. The authors of this study divided all the participants based on their occupational groups and investigated the link between work addiction risk and mental and physical health outcomes.
Vulnerable Occupations for Workaholism
“One of the novelties of this research was to introduce vulnerable occupational groups to organizations or job holders. For example, if we find that work addiction risk can be found more in some occupations and may result in negative outcomes for the health situation then we can give this information to decision makers in this organization or, for example, to the ministry of health. And they could intervene to prevent this problem,” says Morteza Charkhabi, associate professor at the Institute of Education at the HSE University, in a release.
The results show that high job demands at work are strongly associated with work addiction risk but the job control level does not play the same role. The prevalence of work addiction risk is higher for active and high-strain workers than for passive and low-strain workers. These two groups of workers appeared to be more vulnerable and therefore can suffer more from the negative outcomes of work addiction risk, in terms of depression, sleep disorder, stress, and other health issues.
“We found that job demands could be the most important factor that can develop work addiction risk. So this factor should be controlled or should be investigated by the organization’s manager, for example, HR staff, psychologists. Also another conclusion could be the job climate like job demands of each job category can influence the rate of work addiction risk. Thus in this study we actually focused on external factors like job demands not internal factors like the personal characteristics,” says Charkhabi.
The researchers found that people with higher work addiction risk compared to people with low work addiction risk have twice the risk of developing depression. Sleep quality was lower to workers with high risk of work addiction compared to workers with low risk of work addiction. Also women had almost twice the work addiction risk than men.
Comments Off on “Insomnia-Like” Sleep Patterns Can Predict Future Stress
As part of our outreach efforts to our clients, we will often share informative articles related to sleep and sleep apnea. The following is an insightful piece written for Sleep Review by Sree Roy.
Inverse: New research suggests fragmented sleep patterns contain a critical message.
Dipesh Chaudhury is the study’s lead author and an assistant professor of biology at New York University Abu Dhabi. He tells Inverse that this study deepens our understanding of how stress and sleep are related. Typically, we assume that stress leads to poor sleep. But things could also work the other way around, with poor sleep dampening resilience to stress at the same time.
“Our findings also indicate that those mice that exhibit abnormal sleep prior to stress are more sensitive to future stress exposure. In other words, sleep abnormalities can also be a cause of stress-related disorders,” Chaudhury says.
A BAD NIGHT’S SLEEP COMES WITH A HOST OF CONSEQUENCES, some of which aren’t obvious right away. This is especially true when stressful situations — like a year defined by a pandemic — hit. Research suggests specific abnormal sleep patterns may decrease one skill that’s crucial to weathering the storm.
In a mouse study published Tuesday in Frontiers in Neuroscience, scientists found fragmented sleep patterns – a pattern of sleep marked by more awakenings and shorter bouts of non-rapid eye movement sleep –could predict how mice responded to future stress. Mice with regular sleep patterns were resilient to bullying, while those with fragmented sleep patterns weren’t equipped to deal with the abuse.
WHAT DOES A “DISRUPTED SLEEP PATTERN LOOK LIKE?
“Our findings also indicate that those mice that exhibit abnormal sleep prior to stress are more sensitive to future stress exposure. In other words, sleep abnormalities can also be a cause of stress-related disorders,” Chaudhury says.
Chaudhury’s study was based on the sleep and stress patterns of 22 mice who had electrodes implanted into their brains. Those electrodes could measure the amount of time each mouse spent in each stage of sleep.
Every mouse was exposed to chronic social defeat — 15 consecutive days of being attacked by aggressive mice identified at the outset of the study. The researchers found that they could break the mice up into two groups: mice who were resilient, bouncing back from bullying ready to socialize, and ones that succumbed, and retreated from others.
WHAT WAS DISCOVERED
The scientists found there were significant differences in the sleep patterns of each group of mice beforethey were exposed to the bullying.
The mice in the non-resilient group showed signs of fragmented non-REM sleep. They woke up more during sleep periods (mice sleep during the day) and had were shorter NREM bouts, on average, than those seen in the resilient mice.
“In essence, the susceptible mice exhibit insomnia-like traits even before exposure to stress,” Chaudry says.
Ultimately, these patterns could predict which group the mice ended up in with about 80 percent accuracy, suggesting that it could have been one reason they were less resilient when stress took hold.
WHAT DOES THIS MEAN FOR HUMANS?
This study taps into a robust area of research on human mood disorders. Depression and sleep are intertwined in a way that makes it hard to distinguish cause and effect. Disturbed sleep is often seen in depressive patients, but those who experience insomnia are also more likely to develop depression in the first place.
Though this study focuses on stress, it suggests that sleep may pose an even more central role in mood disorders – or in this case, resilience to stress. Before the stressful situation occurs, sleep patterns may contain early warning signs.
These results are early-stage, Chaudhury cautions. A mouse brain (and a mouse’s stress) is quite different from a human’s. But he is optimistic that the idea that sleep signatures could be a prediction of stress — specifically the way the brain transitions in and out of non-REM sleep — will hold true in humans.
He imagines monitoring the sleep patterns of people who have particularly high-stress jobs, like first responders or frontline workers. Even if signs of stress have yet to show themselves, a disrupted sleep pattern could be the sign of a vicious cycle (stress leading to worse sleep, leading to less resilience to stress) about to go awry.
“By having simple non-invasive markers of stress susceptibility, such as EEG sleep patterns, it may be possible to develop strategies to protect the more vulnerable people,” Chaudhury says.
Abstract: There is a tight association between mood and sleep as disrupted sleep is a core feature of many mood disorders. The paucity in available animal models for investigating the role of sleep in the etiopathogenesis of depression-like behaviors led us to investigate whether prior sleep disturbances can predict susceptibility to future stress. Hence, we assessed sleep before and after chronic social defeat (CSD) stress. The social behavior of the mice post stress was classified in two main phenotypes: mice susceptible to stress that displayed social avoidance and mice resilient to stress. Pre-CSD, mice susceptible to stress displayed increased fragmentation of Non-Rapid Eye Movement (NREM) sleep, due to increased switching between NREM and wake and shorter average duration of NREM bouts, relative to mice resilient to stress. Logistic regression analysis showed that the pre-CSD sleep features from both phenotypes were separable enough to allow prediction of susceptibility to stress with >80% accuracy. Post-CSD, susceptible mice maintained high NREM fragmentation while resilient mice exhibited high NREM fragmentation, only in the dark. Our findings emphasize the putative role of fragmented NREM sleep in signaling vulnerability to stress.
Comments Off on Did You Know, Lack of Sleep Can Impact Your Vision?
Are you getting enough sleep? If not, you could be impacting the health of your eyes. At Sleep Apnea Dentists of New England, we realize that today’s fast-paced world typically results in insufficient sleep. Trying to squeeze in a good night’s rest can be difficult with everything that needs to be completed in the course of one day. Dark circles are a dead give away that you are not getting enough sleep, but your overall eye health is being affected more than you know.
Vision Problems Related to Poor Sleep
Studies have proven that the average person requires 6-8 hours of sleep per night in order to replenish. If you are getting less than six hours of sleep, your eyes do not get the restoration they need. Some of the following warning signs are indication that your eyes are not getting enough rest:
Eye spasms. Ever get that rapid twitching of your eye? Those involuntary spasms are called myokymia. They are involuntary eyelid muscle spasms. They are harmless, but they are a good warning sign that you should be paying more attention to getting a good night’s rest.
Broken blood vessels in the eye. Though they are usually not painful, the “bloodied eye” look is definitely not very appealing.
Dry eye. When your eyes are unable to properly lubricate overnight, you may get dry eyes. Dry eyes cause light sensitivity, itching, redness, and sometimes even blurred vision.
A more serious eye condition as the result of sleep deprivation is known as Anterior Ischemic Optic Neuropathy (AION). This is typical for middle-aged individuals who suffer from sleep apnea. Over time, damage to the optic nerve from insufficient blood supply can eventually cause vision loss.
Better Nights for Better Vision
Try to make a routine plan for preparing for bed at night. If falling asleep is a daunting task, here are some suggestions:
Drink chamomile tea approximately 30 minutes before bedtime.
Read a book for fifteen minutes before falling asleep.
Do not exercise just before going to bed. When you exercise, you raise your metabolic rate and falling asleep will be more difficult.
Reduce stress and decompress with essential lavender oil and positive messages to yourself.
A lukewarm bath with some aromatherapy candles and a good book is a great way to unwind your body and mind.
Your eyes are not the only muscle that suffers from insufficient sleep. There are several additional health risks associated with poor sleep. Visit our website for a more extensive list of health risks associated with poor sleep.
Meanwhile, it is important to remember that your eyes are working all day long. Sleep is the only time they have to restore and regenerate. Therefore, it is extremely important to make sure they get their rest so you may continue to enjoy healthy vision.
Want to learn more about better nights for better days? Contact Sleep Apnea Dentists of New England today!
CELEBRATE WORLD SLEEP DAY® ON MARCH 13 TO ADVANCE SLEEP HEALTH WORLDWIDE
ROCHESTER, MN – January 2, 2020—World Sleep Society is issuing a global call to action about the importance of healthy sleep. Friday, March 13, 2020 is the 13th annual World Sleep Day®. Created and hosted by World Sleep Society, World Sleep Day is an internationally recognized awareness event bringing researchers, health professionals and patients together to recognize sleep and its important impact on our health.
World Sleep Day 2020 will incorporate the slogan, ‘Better Sleep, Bette Life, Better Planet,’ highlighting sleep’s important place as a pillar of health, allowing for better decision making and cognitive understanding in even big issues, such as our planet. This focus is purposefully broad in meaning, surrounding the message that quality of life can be improved with healthy sleep. Conversely, when sleep fails, health declines, decreasing quality of life. Sound sleep is a treasured function. World Sleep Society has compiled ten tips for healthier sleep. These recommendations for children and adults can be viewed on worldsleepday.org under resources.
Phyllis C. Zee, MD, PhD, Professor of Neurology and Director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine goes on to suggest, “Actions we can take include prioritizing sleep with exercise and nutrition, maintaining regular sleep and wake timing, averaging 7-9 hours of sleep duration and if suffering from a chronic sleep disturbance, by discussing sleep with your doctor.” Over the past decade, there have been major advances in our understanding of neural mechanisms, linking the important relationship between sleep and cognitive health. Mounting evidence indicates that sleep is an active process in which recently-encoded memories are consolidated and transferred for long-term storage. Dr. Zee adds, “Sleep enhances the ability to remove waste products from the brain—which can harm brain function.”
Professor Fang Han, MD of The Sleep Center, Peking University People’s Hospital in Beijing, China states, “Sleep is important for one’s cognitive health. Sleep can restore your brain function in many aspects, such as learning, memory, and mood.” Sleep disorders may cause impairment of a person’s oxygen supply, disturb your immunological system, or damage your brain structure. Dr. Han states, “World Sleep Day is an opportunity to be aware, sleep regularly, sleep enough, and treat sleep disorders.”
CALL TO ACTION
To participate in World Sleep Day,
Organizing an event to create excitement and generate
interest in World Sleep Day.
Circulating the official press release with sleep experts
and local media.
Distributing sleep patient literature such as booklets,
leaflets and newsletters.
Finding other ideas at worldsleepday.org.
Spreading the word on social media about #WorldSleepDay.
The 13th Annual World Sleep Day has partnered with Arianna Huffington’s Thrive Global and AmLife. More sponsors will be included before March.
Arianna Huffington, founder and CEO of Thrive Global says, “Sleep is central to every aspect of our well-being—our physical health, our mental health, our productivity and our decision-making. Our world is facing huge crises on multiple fronts, and we need all the resilience, wisdom and sound decision-making we can muster. We can’t take care of our world if we don’t take care of ourselves—and that begins with sleep.”
Mr. Lew Mun Yee, the founder of AmLife states, “AmLife is fully devoted in the noble mission of World Sleep Society in advocating better-quality sleep in mankind. AmLife proudly joins the call for Better Sleep, Better Life, Better Planet, this year’s World Sleep Day theme. AmLife’s new tagline—Life. Redefined.—dovetails the 2020 theme. With better quality of sleep, life certainly can be redefined.”
World Sleep Day is organized by World Sleep Society, an international association whose mission is to advance sleep health worldwide. WorldSleep Society hosts a biennial scientific congress on sleep medicine aiming to globally connect sleep professionals and researchers to advance current knowledge on sleep. A job board has also been created for sleep medicine professionals on http://www.worldsleepsociety.org. Follow the excitement on Twitter @_WorldSleep and facebook.com/WASMF.
About AmLife International
AmLife established its sleep healthcare business to help consumers achieve optimal health in their daily sleep as well as enjoy the wonderful health lifting and recuperative effects of its products. AmLife has pioneered the combination of bedding equipment and Japan’s state-of-the-art technology to expand the unlimited potential of the sleep healthcare market, providing a brand-new health solution for modern-day people, which they can use every day.