Worried about what is happening in the world? Struggling to sleep? One of the UK’s top sleep medicine experts answers the nation’s most frequently asked questions.
In times of such uncertainty, many of us are feeling increased anxiety and stress and as a result, we’re struggling to get a decent night’s sleep.
Whether you’re having problems ‘nodding off’ at bedtime, or waking up during the night, Dr Karina Patel, a Sleep Medicine expert from The London Sleep Centre answers the most common questions on sleep.
How do you know whether you’ve had a good quality night’s sleep?
There are three main questions to ask yourself are:
1. Do you get to sleep easily?
2. Do you stay asleep?
3. Do you wake rested?
You may be using a sleep app or monitoring device, and they may highlight the problems, but not what to do about it.
So you could also look into having an overnight sleep test. There are a few different types from home sleep testing kits to overnight hospital tests. We offer all of these at the London Sleep Centre.
We would be able to analyse your sleep cycles as well as looking at how much airflow and oxygen you have and which positions you sleep in. We have also a sleep technologist who manually assesses all the data and ensures nothing is overlooked.
Is sleep hygiene important? If so, do you have some top tips to ensure optimum sleep hygiene?
The bedroom should be well ventilated. Phones shouldn’t be kept next to the bed and you should have no screen time before bed. There are blue light filters available on most screens now, however, they just deal with the light.
You also need to allow your brain to start relaxing before you go to bed so any stimulation should be avoided.
The electromagnetic waves emitted from electronic devices can also cause some stimulation so should be kept outside of the room. Other stimulants like caffeine should be avoided in the afternoon.
Alcohol is a depressant but it can cause inflammation so having alcohol directly before bed may allow you to fall asleep but it can also lighten your level of sleep so sleep efficiency is decreased. The spine should be kept well aligned as well so choosing a pillow that keeps the spine as straight as possible is also something that can help.
It is equally important to maintain the potency of the airway. You should ensure that your nose isn’t blocked before you go to bed so things like nasal sprays alongside decongesting exercises are a vital part of the pre-sleep advice we give.
What can you do to open your airways and improve your breathing at night?
Buteyko breathing. Using the breath-hold technique. You can view this on YouTube. You can also use a mouth taping technique where specially designed strips are placed to encourage you to keep your mouth closed.
It is important not to try this at home on your own without a consultation with a specialist to see if you are able to clear your nasal airway first.
Does breathing through your mouth when sleeping affect your quality of sleep? If so, please can you explain why?
In a word – yes.
1. Snoring – due to vibration of the soft tissues of the airway (usually the throat). The airway is impinged and the flow of air to the lungs is compromised.
This can also cause sleep disturbance for your bed partner. Sometimes you can wake yourself up if it is very loud.
2. Dry mouth – can lead to a greater incidence of viruses and bacteria lodging in the back of the throat and causing sore throats and other infections, flu, colds etc.
3. CO2 loss – your body loses too much carbon dioxide. This is one of the main gases that regulates how much air you take in.
When the balance is incorrect mucus is produced to slow the breathing down. Unfortunately, this leads to a greater CO2 imbalance and the cycle repeats itself with more mouth breathing.
The regulation of the gases is important, as CO2 balance is needed for brain and muscle functioning, so you may have problems with memory or concentration if correct functional levels aren’t maintained.
All three will affect the quality of your sleep by disrupting to your sleep cycle stages (usually micro-arousals). You may wake feeling unrefreshed or sometimes like you have a lot of energy as your sympathetic nervous system goes into overdrive.
We should ideally stay in a parasympathetic or calm state throughout most of the day and night. The sympathetic or fight or flight response is intended to be used during times of stress. It is our extra generator/ back up system. It causes shallow, rapid breathing.
If you’re a mouth breather, are you more likely to snore?
Yes, as the throat is closed there is more and more chance the soft tissue rubbing will cause that vibration sound as I have described above.
Is there anything you can do to improve nose breathing and snoring? Are there other tips you have to ensure you don’t snore?
Snoring is multifaceted – it can be nasal or oral. If nasal, we can use a nasal spray such as Xlear (we recommend as a first step to 70% of our patients as it opens up the airways – we know if it will work within 10 minutes).
We can use decongesting exercises as mentioned. We also use nasal strips or cones to help open up the nose. For the throat is the tongue too large, do we have adenoids and tonsils inflamed? We also recommend several things with this situation.
There are a number of oral appliances used for snoring by holding the jaw in a more forward position which opens up the throat. We can also make sure we are using a pillow that doesn’t cause the head to tilt in and close off the airspace.
Please can you explain the link between mouth breathing and sleep apnoea.
Sleep Apnoea is the repeated cessation of breathing during sleep. Obstructive Sleep Apnoea, which is what we are considering here, looks at ways in which the airway can become obstructed either partially or fully and how many times that can happen in a night.
It is normal for this to occur up to 5 times a night. If you have any more than 5 episodes this means that you may suffer from Apnoea. We obviously look at more than just this aspect, but this is a basic rule.
If you mouth breath you cause nasal resistance and increase the collapsibility of the airway. This is due to the fact that the jaw shifts backwards and reduces the space at the back of the throat. This can cause snoring and also CO2 imbalance as mentioned before.
It is worth noting that in the US any child that snores is screened for Sleep Apnoea. The earlier it is caught the more chance you have to help the child develop to their full genetic potential and reduce their chances of developing a sleep breathing disorder later life.
Sleep Apnoea is linked to many other conditions such as diabetes and heart disease, so we need to start looking at sleep as a screening tool for other serious health conditions.
How can you tell if you suffer from sleep apnoea if you live alone?
Again, there are many apps that can be used for snoring and Sleep Apnoea. The snore lab app seems to be the most popular but it is important to note that not everyone that snores has sleep Apnoea and vice versa. Sometimes absence of any sound can be more dangerous as that is a complete blockage, rather than partial blockage, causing a sound.
Here are some of the most popular apps:
1. SleepTracker 24/7 | 2. SnoreLab: Record Snoring | 3. Sleep++ | 4. Sleep as Android | 5. Runtastic Sleep Better | 6. Philips Respironics DreamMapper | 7. ResMed myAir
Studies show that Xlear (pronounced Clear) effectively opens up the nasal airways even for those with chronic rhinosinusitis.
Whilst separate research has shown that those who regularly use the nasal spray, which contains xylitol for its natural bactericidal qualities and grapefruit seed with its toxicity to Covid19, are at a significantly lower risk for contracting respiratory infections.
It is recommended that you use Xlear’s Nasal Spray once in the morning and once at night for ultimate protection against airborne contaminants, and if you do get ill, use Xlear up to 4 times daily to recover faster.
Viruses, bacteria and contaminants cling to the mucous membrane inside your nasal passages putting you at risk for infectious disease or illness.
Xlear works as a cleanser and humectant, coating your nasal passages regularly with xylitol which is clinically proven to reduce the ability for invaders to adhere to the receptor cells in the airways. Xlear Nasal Spray with xylitol is also safe to use in tandem with cold, flu, or allergy medications.
Naturally formulated with non-GMO ingredients, Xlear Nasal Spray with xylitol is the natural alternative for family respiratory care. Application couldn’t be easier; you just pump the applicator and puff the spray into each nostril twice.
Xlear products are available from independent health stores and from Amazon.
Also you can visit www.londonsleepcentre.com for further information.