We can sleep when we’re dead, of course, but if we wait until then, we’re likely to die a lot sooner. This is a fact highlighted by two new studies out of Flinders University.
As much as 40 per cent of the population suffers from a sleep disorder, with sleep apnea and insomnia being the most common. About half of the time people suffer both conditions at once.
Sleep apnea affects millions and is linked to an array of health issues.Credit:Getty
The first study, published in the European Respiratory Journal, sought to understand the impact of this. The researchers examined 5000 patients over the course of 15 years and found those with the co-morbid conditions are 50 per cent more likely to die in that time-frame than those without disordered sleep.
A second study, led by the same team, found that there is a “high probability” sleep apnea is regularly being misdiagnosed, and it’s a problem that can affect both our health and life-span.
This is because, like our blood pressure, blood glucose, and mood, our sleep varies from day to day.
As sleep apnea is typically diagnosed based on a one-night sleep assessment, this variation is not captured and people may have more severe sleep apnea than they are being treated for, explain the researchers who say multi-night assessments are much more effective.
The consequences of regular misdiagnosis may be “pretty significant” given sleep apnea involves repeatedly stopping breathing throughout the night, and is linked with an increased risk of cardiovascular disease, depression, traffic accidents, reduced quality of life, and all-cause mortality.
Why does it have such a significant impact on our health and longevity and is there anything we can do to prevent these conditions?
“Sleep is the centre of everything for health,” says the lead author of the studies, Dr Bastien Lechat. “That’s where your brain regenerates, that’s where your cardiovascular system gets a break, that’s where all the metabolic systems are regulated. So, any disorder that impairs [this process] has consequences.”
And sleep apnea, where a person stops breathing up to 30 or 40 times per hour, seriously impairs this process.
“You don’t get the nice waves of sleep that we think are important, and you obviously stop breathing, so your oxygen goes down. That puts a lot of strain on lots of organs in the body, particularly your brain and your heart,” explains Professor Robert Adams, a spokesperson for the Sleep Health Foundation who was involved with the studies. “Your body reacts to what is essentially being strangled for brief periods of time by bumping up your sympathetic drive. You get this hyped-up body response which we think, over time, leads to problems related to cardiac function and blood vessels and your metabolism and probably your brain as well.”
Add insomnia into the mix (it can be hard to sleep when we can’t breathe properly) and the outcomes are amplified. “You’re more likely to die younger and faster,” Lechat says matter-of-factly.
So, what can we do about it?
Quite a lot, thankfully.
Adams explains that 30 years ago, only about 5 per cent of the population had sleep apnea. As people have become collectively heavier and carrying more weight around our necks, this adds pressure to the airways, increasing the likelihood of a sleep disorder like sleep apnea.
For this reason, losing weight “can be very effective”, Adams says, as can exercise: “Part of it is strengthening your muscles and part of it is losing weight.”
There are also “snippets of evidence” that training the upper airway muscles, via musical instruments and various vocalisation and Oropharyngeal exercises, is effective.
Mouth breathing can make sleep apnea worse, Lechat says, as can sleep position (gravity is working against us when we lie on our backs).
Good sleep hygiene – not drinking alcohol before bed; having a consistent bed routine where we go to bed and wake up around the same time; relaxation techniques and waiting until we’re very sleepy to go to bed – can also make a difference to both disorders.
Of the medical treatments available, a continuous positive airway pressure (CPAP) machine reduces sleep apnea by 50-70 per cent and there are a “whole bunch of other treatments”, Lechat says.
Sadly, many people go their whole lives without being diagnosed at all, as their sleep apnea may not wake them up and they attribute day-time tiredness to being a poor sleeper. Others are “frightened” of the treatments or of losing their driver’s license, Adams says, noting this is only a concern if it’s left untreated.
“There are effective treatments,” he assures. The researchers suggest seeing your GP if you have any symptoms including excessive tiredness during the day, snoring, struggle sleeping or waking up choking or gasping.
“Your entire body depends upon the restorative functions of sleep. Every cell really needs sleep to rejuvenate or recuperate every day and if that doesn’t happen, over time, you start to get problems,” Adams says.
“And there’s increasing evidence that [poor sleep] may contribute to cognitive impairment as you get older. It’s a big deal.”
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