Sleep, Glorious Sleep!

Barely a few days go by without some news story about sleep. How much, how little, sleep apnea, dream interpretation, snoring, teeth grinding, night sweats, the right bed, the correct pillow, how to fall asleep, how to stay asleep, the best non-habit-forming medications. Oye.

Sleep is an equal essential as air, water, and food. Unfortunately for most of us, we simply do not get enough of it. Adequate sleep is crucially important for workers in transportation such as pilots, air traffic controllers, train engineers, truck drivers. The Air Force wanted to know how long they could keep their pilots awake and found almost all became delirious after 3 to 4 days without sleep. The conclusion? Without adequate sleep, there was a high probability the pilots would crash their jets.

Even one all-nighter impacts our motor skills to the same degree as being drunk. 

Studies show a direct correlation between lack of sleep and auto crashes by teenagers on their way to school! Teenagers possess a different circadian rhythm than adults and younger children. School administrators are beginning to rethink school start times for our teens.

SLEEPING POSITIONS

Do you know the best sleeping position for you?   Here are the pros and cons of different sleeping positions, the best pillow to use, how to make sleeping more comfortable if you have pain and what your sleep position says about your personality. 

There are three main sleep positions with variations on all three. The primary ones are side-sleepers (fetals, yearners, and logs); back sleepers (starfish and soldiers), and stomach sleepers (the freefallers).  

Side Sleepers

If you sleep on your side, you are not alone as most people are side-sleepers. Some curl up into a fetal position while others look like a log. We have the cuddlers, spooners and those who sleep face to face rebreathing each other's air...hummm. Most people sleep on the same side of the bed for a lifetime. 

PROS: Side-sleeping is good for overall health. Your body is basically aligned with less excess pressure on any organ. It's better to bend your knees slightly and avoid over flexing your neck forward. 

Pregnant women are advised to sleep on their left side with extra pillows. Left-sided sleeping is the perfect birthing position for the baby (left side, head down) and also helps Mom avoid back pain and indigestion. Tucking a small pillow between the stomach and the bed helps to support the belly. Putting another pillow between the knees helps to keep the sacroiliac joint in alignment. 

CONS: The downside of side-sleeping is facial and chest wrinkling, there always has to be a glitch! For women, side sleeping can also contribute to breast sag as the ligaments do stretch. Wearing a soft bra while sleeping could help this.

PAIN: If you have back pain or sciatica, put a pillow between your knees and bring your knees closer to your chest. If you have a bad shoulder, do not sleep on that side! Put a pillow in front of you and drape the bad arm over the pillow to avoid over-stretching the shoulder muscles.

BEST PILLOW: Should be one that maintains your neck and head in a straight line from the base of your skull to your tailbone. One that is about 2" thick at the neck and 1" thick for the head is perfect. Tempurpedic pillows are temperature regulated, the colder the room, the firmer the pillow and vice-versa. Once your head or neck transfers heat to the pillow, it gets flatter. I prefer Talalay pillows, shredded rubber. Naturally antimicrobial, not temperature dependent, super comfy, easily laundered, but more expensive. 

PERSONALITY: Although I don't have an opinion about this, it's interesting to see if you, or more importantly, your partner, have these traits. 

• Fetal: Tough on the outside, sensitive on the inside.
• Log (arms and legs straight down): One study report logs are extroverts and easy going. Another study suggests log sleepers are rigid, stubborn and bossy. Whatever fits.
• Yearners (arms straight out in front): Slow decision makers but chasing life and their dreams, eager to take on the day.

Back Sleepers

PROS: Sleeping on your back is great for your spine. There is no pressure on the organs, and it's good for circulation or if you have night sweats. You should mention nights sweats to your primary care doctor at your next visit. 

Back sleeping is better if you have a cold, GI problems, acid reflux, nasal congestion, or allergies. For these conditions, try turning the pillow length-wise, so your entire back is resting on the pillow and elevated rather than just your head. 

Back sleeping is preferred if you have a shoulder issue or costochondritis (arthritis of the ribs). 

CONS: It's not the best position if you are a snorer or have sleep apnea. Back sleeping causes your jaw to drop open and gravity forces the base of your tongue to fall back into your airway. This can obstruct your breathing and cause you to gasp for breath. A night out drinking can raise the decibel level of your snores and gasps to such levels one could hardly blame the neighbors when filing a complaint! 

If you sleep with a snorer, encourage them to move onto their side (easier said than done), and prop a pillow up against their back. This makes it a bit more difficult to roll and usually gives you enough time to fall asleep. 

PAIN: If you have low back pain or sciatica, put another pillow or two under your knees. This rounds the lumbar region and takes the pressure off the nerves.

BEST PILLOW: The best pillow for back sleepers in ONE that is not too high or firm which forces your neck and head forward - we do enough of this while we are awake! Ideally, we want a continuous smooth curve from the tail bone to the head, no sharp angles. A medium soft pillow, about 2" high is the best, even better if you find one that cradles your head.

I must admit "My Pillow", the one advertised on TV, is quite comfortable. I do have an issue with the polyurethane fill - plastic. Although the pillow is manufactured in the U.S. I highly doubt the fill is made here and breathing in plastic for 7 to 8 hours a day, not a choice for me.

PERSONALITY:   

• Starfish (arms over the head): these folks are good listeners and introverts.
• Soldiers (arms down by their sides): quiet, reserved with high expectations.

Stomach Sleepers

Many, many people love to fall asleep on their stomachs.

PROS: Great position if you have a sunburn on your back.

CONS: There are many problems with sleeping on your stomach regardless of the ingenious pillows now produced for stomach sleepers. 

• It puts undue and excessive pressure on your neck when it is twisted in rotation. Your head should be in a neutral position with no undue flexion, extension, lateral flexion or rotation.
• It puts too much pressure on your chest. Your body weight compresses your rib cage and sternum and impedes your natural breathing motion.
• If you have a large belly, there is simply to much weight on your stomach and GI track.
• Stomach sleeping causes too much extension in your low back.
• If you have allergies, you are inhaling dander, dust mites and allergens directly into your nose and mouth from your pillow.
• Sleeping on your stomach increases facial wrinkles, or speeds up the process of facial wrinkling.
• If your arm is under your head, it causes numbness and tingling (dysesthesia) to your arm and hand.

In 1992 US pediatricians sent out an important mandate: Babies should NOT sleep on their stomachs. As a result of this action, the incident of SIDS (sudden infant death syndrome) decreased by a whopping 50% - a huge number in medical statistics.

In my practice, I can usually tell if a person is a stomach sleeper when reading their x-rays. Typically seen are cervical bone spurs in people as young as 35 with no history of injury to the area. The common cause, in my opinion, and one more anecdotal than empirical: stomach sleeping. This is usually confirmed by the patient. This is what bone spurs look like. 

It's hard to break the habit of stomach sleeping. The best way is to start to sleep on your side with a pillow tucked tightly to your chest. This discourages rolling onto your stomach. It takes about a month to break the habit. 

PAIN: Stomach sleeping increases back and neck pain. 

BEST PILLOW: No pillow for your head. A very soft, low pillow if you tuck your arm under your head.

PERSONALITY: 

• Free Fallers (arms out to each side): sensitive extroverts who dislike criticism, may lack control and have anxiety. Sound like anyone we know?

Other Interesting Sleep facts: 

If your bed looks like you were kickboxing all night, no need to think you didn't get enough sleep. Many people roll around and still attain sufficient REM sleep. Rolling around all night is not so great for your partner but it is far from the worst thing for you. Even when you are fast asleep your body knows what it needs and that may be to move.

For those who swear they don't move a muscle when sleeping and their bedsheets prove that, you are wrong! Studies show everyone moves two to four times per hour, about 20 or more tosses throughout the night. This is completely normal.

Can we get too much sleep? Believe it or not, the answer is yes! Studies show adults who sleep more than 9 hours, consistently, per night can lead to increases in obesity, heart disease, diabetes - pretty much all of the problems encountered in those who overeat with little to no physical activity. This does not apply to children who do need 9 hours or more every day.

If you find your back is stiff in the morning, it is a sign you have arthritis and is a very common complaint. Arthritis gets worse with immobility. So the less you move (sleeping), the greater the symptoms. This is the reason we are stiffer in the morning and much looser when we get moving. There are a few simple stretches to help stiffness before you get out of bed. These stretches wake up your back even before you put your foot on the floor. Here they are. 

I am not convinced one can determine personality traits by sleep positions, but think about this when your partner is snoring up a storm and just before you resist the urge to smother him/her with that feather pillow, think about their personality traits, then roll them onto their side!

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