I tried to pretend I was a secret agent on a mission to infiltrate an enemy: the Logan Regional Hospital Sleep Lab. I was nervous but calm as I checked in and nonchalantly changed into my pajamas. But I had a long night ahead of me. Rather than feeling like a suave secret agent, I ended up a miserable lab rat hooked up to dozens of nodes and wires that made me feel more machine than human. After getting all the wires properly attached, they shoved two different tubes up my nose, stuck eight more nodes on my legs and unceremoniously told me to “have a good night.”
Sleep studies are the worst. But they are becoming necessary because of the increasing rate of sleep disorders and an insidious, creeping prevalence of sleep deprivation. “We see upwards of 80-100 people per month in our sleep lab, not including at-home sleep studies,” says Dr. Seth Wallace, medical director for Logan Regional’s sleep lab. In February, I was one of that growing number and wondered why something as basic as sleep had plagued me my whole life—ending with me hooked up to a bunch of machines that could—I hoped—tell me how to sleep better.
- Mild sleep apnea causes 5-15 stops of breathing per hour.
- Moderate sleep apnea causes 15-30 stops of breathing per hour.
- Severe sleep apnea
- is applied to anyone who stops breathing 30 or more times an hour.
The Secret World of Sleep Labs
While Wallace cites a growing number of visitors to sleep labs, there is quite of bit of intrigue about what happens behind those locked doors at night. Most sleep labs treat a series of sleep disorders: sleep apnea, insomnia, restless leg syndrome and narcolepsy. Sleep apnea comes in at first place and is extremely common throughout Utah, affecting as much as 20 percent of the population, says Wallace. But the risk factors for sleep apnea and its potential long-term effects are sobering.
Sleep apnea is a phenomenon where an individual stops breathing during sleep. The airway restricts and the body signals itself to wake up in order to stop suffocation. Sometimes, the body wakes up completely and other times it just moves the individual to a different depth of sleep. The average person stops breathing about 5 times an hour. Mild sleep apnea causes 5-15 stops, moderate 15-30 and the term ‘severe sleep apnea’ is applied to anyone who stops breathing 30 or more times an hour—but Wallace says he’s seen several people who stop breathing up to 160 times an hour. “Obesity often increases the inherent risks of sleep apnea,” says Dr. Krishna Sundar, director of the Sleep Wake Center at the University of Utah. While some other risk factors—like the shape of the nose or an overbite—can impact your airways during sleep, the current obesity epidemic is greatly affecting the number of individuals now dealing with this particular disorder.
Should sleep apnea go untreated, the metabolic and physiological consequences are dangerous. “It leads to everything from hypertension to atherosclerosis, increases your risk of cancer, preeclampsia, glaucoma, metabolic diseases and even diabetes and dementia,” says Sundar. Typically, those with sleep apnea don’t know it—but their sleeping partners often do. “I get a lot of patients whose spouses notice they stop breathing at night, or jerk around when their body notices the suffocation,” says Wallace. Other indications of the disorder are excessive daytime fatigue, frequent nighttime wake ups and chronic morning headaches. There are only a handful of therapies to combat sleep apnea—the most common being a CPAP (continuous positive airway pressure) machine, which requires a mask over the nose and mouth pushing air down the airway to keep it open throughout the night. For those who reject CPAP therapy, and there are many according to Wallace, there are contraptions that keep sleepers on their sides, which allows the relaxed mouth and throat muscles to sag to the side rather than the back, or there’s also the new Inspire implant.
The implant works similarly to a pacemaker, but, rather than stimulating cardiac muscles, it stimulates throat muscles to keep them open and allow consistent airflow during sleep. The contraption lasts roughly 10-15 years, and they are gaining attention from apnea sufferers. While sleep apnea remains the most commonly diagnosed sleep disorder in many sleep labs, it is far from the only disorder plaguing the modern sleeper.
Though it would seem everyone claims to suffer from insomnia, or an inability to sleep, Sundar estimates only about 5 percent of the population suffers from chronic insomnia. Much of the time, insomnia is more of a side effect rather than a disease in and of itself. “It can occur in the setting of chronic pain, a person with a predisposition for anxiety or poor coping mechanisms, and even acute or major stressful events can cause a pattern of insomnia which continues to perpetrate itself because of a variety of factors,” claims Sundar.
On the flip side, narcolepsy, sometimes called hypersomnia, causes sufferers to spontaneously fall asleep during their regular waking hours. This is probably the rarest of the disorders, but statistics on narcolepsy remain unreliable because diagnoses are difficult to come by. “They say that the average person with narcolepsy has symptoms for ten years before they’re diagnosed. The right diagnosis is a real life changer for them because it’s hard to have any quality of life,” says Wallace. “Essentially, their sleep is broken, so they are not recharging their batteries at night. They’re constantly sleep deprived and this causes them to fall asleep when they aren’t trying.” Current estimates indicate one in 2000 people have narcolepsy, but many remain in limbo, cycling through antidepressants or anti-anxiety medications in search of relief.
Utah’s Million Dollar Sleep Tech Giants
While those who have chronic sleep issues may need medical intervention to get their cycles back on track, those who may just toss and turn once in a while instead turn to cutting-edge sleep technology—everything from specialized mattresses to high-quality gel foam pillows promise to transform the average sleeper into a quasi-superhuman capable of unfathomable amounts of daytime alertness and activity.
Though mattress technology has come a long way from the days of hay stacked on wooden planks, humans have slept on mattresses filled with everything from water to feathers, metal springs to air. And, interestingly, Utah is home to many of the top developers of sleep technology innovation.
Intellibed, founded in the early 2000s and headquartered in Salt Lake City, began developing solutions for hospital beds in burn units by creating mattresses that relieve pressure on the skin and facilitate healing. After taking their product to the consumer market, it took several years to hit the mainstream but they’re now a household name. “With the advent of the ‘bed in the box’ industry, we didn’t want to get involved in the fray and compete with everyone else. What makes Intellibed different and unique is our gel matrix,” says CEO Collin House. “When you go to sleep, you need two things: one, a really firm bed, almost like sleeping on a concrete floor to keep your back in alignment, and, two, you need a bed that’s really soft to take out the pressure points you develop when sleeping.”
With the combination of springs and their gel matrix, Intellibed believes they’ve created both the firmest and softest bed on the market today—a sleep leap forward in the mattress tech industry that has seen little innovation since the introduction of Tempurpedic memory foam in the 1990s.
Alpine-based Purple Mattress hopes to challenge Intellibed by introducing another non-memory foam bed option, combining support coils with a “smart comfort grid.” The grid, also made of a stretchy gel material, allegedly relieves pressure for sleepers while minimizing motion transfer and keeping sleepers cool by facilitating airflow through the gel cells. Though aligning more with the “bed in a box” retailers who sell memory foam wrapped in plastic, Purple offers a 100-night trial for those who might not believe in the bold claims offered by their odd commercials (you know, the ones featuring a Swiss maiden and fake skydivers).
While the number of high-end mattress companies might boggle the mind, Logan-based company Malouf wants to help your mattress give you a restful night’s sleep. Though they don’t sell actual mattresses, you can get everything from bed frames to high-end linen sheets, memory gel pillows and cooling mattress protectors to keep your favorite mattress (and your mattress topper) cool throughout the night. “The company started out of a dorm room at USU,” says Krista Karn, PR rep and senior copywriter for Malouf. “The owners felt like there had to be better options for high-quality, affordable sleep accessories than what was currently on the market. So they made it.”
There is no shortage of technology attempting to help us sleep better. Sleep apps populate the iPhone and Android markets promising to help you track and improve your sleep by monitoring your breathing and movement. While sleep tech may endeavor to help us sleep better, it’s actually technology more generally that’s impacting our sleep the most.
The Blue Light Debacle
“Before the advent of technology, blue light helped set our circadian clocks and sleep rhythms,” says Wallace. “The sun would rise in the morning, and set in the evening, and the blue light of the sky would signal to our brains that it was time to be awake. But now, that blue light comes from everything from computers to cell phones and TVs, so our brains never know when it’s time to turn off.”
In fact, the maladaptive behaviors many learn through bringing technology into their bedtime routines can cause problems like delayed sleep phase syndrome, where your body adapts to a shifted sleep schedule and offsets your natural circadian rhythm. “I learned that I had delayed sleep phase syndrome, and the shocking thing was that I’d never heard of this before and yet, here I was, a family medicine physician,” recalls Wallace.
Perhaps the most common bad behavior sleep doctors see are those who need a TV on in order to fall asleep. Many claim that they cannot get their brains to slow down or turn off when trying to fall asleep in a quiet, dark room, so the TV seems like a logical way to distract the brain enough to trigger sleep. “It’s kind of like a security blanket,” says Wallace. “But the problem with TVs and iPads and the artificial light they emit late at night is that it affects people’s circadian clocks, messing with their quality of sleep.”
Similarly, smart phones have caused more disruption than their TV compatriots by creating incessant notifications and bringing them into the bedroom—a place Wallace believes should be reserved for sleep and relaxation only. “It’s a stimulation thing. If you’re texting and messages are coming in, you’re training yourself that bedtime is a time for mental alertness. Work emails or laptops in bed are also a problem because it now means the bed isn’t a place of safety. The bed is a place where the external world is sort of threatening you,” says Wallace.
Trying to break yourself of these behaviors is the first step to improving your quality of sleep. “I would recommend finding good substitutes. Most can do this on their own if they’re motivated—rather than watching TV, listen to some soft music or a book on tape. Maybe not Stephen King, but something like a history book. Even a white noise machine or a fan in the background is enough to distract the mind without stimulating it like a television,” says Wallace.
While some can easily embrace their personal sleep tendencies, like those who choose to work graveyard or swing shifts to start their days later, Wallace believes it’s important to maintain whatever sleep pattern works for you. “The problems come when people try to live two different lives. They have their work life and schedule but, on their days off, they want to be there for their families and be awake during daytime. It’s like traveling to Europe or Asia every few days and back again—you never have the right time. You’re always trying to adjust to a different time zone.”
The Problem with 2018
Though sleep has long been a basic need for practically every being on Earth, it’s becoming a bigger, more challenging struggle for people of any age. Ultimately, sleep doctors and scientists believe, especially in the U.S., sleep deprivation and disorders are the result of increasingly stressful lives. “Culturally, our lives have become completely packed, and there is not enough time for sleep,” says Sundar. “People expect to watch TV until 11 or 12 and go to sleep right away when that’s not a realistic behavior for many. There isn’t enough time for them to prepare for sleep.” And Wallace agrees. “It really boils down to the fact that people have busy, hectic lives and aren’t stopping to wind down in the evening time.”
Ultimately, my results did give me some insight: I have mild sleep apnea—I only stop breathing about 10 times an hour. Though a CPAP machine is a bit extreme for my diagnosis, those with sleep apnea are always at risk of it worsening. For the time being, I’m going to work on remedying my apnea through a combination of humidifiers, wedge pillows and a balanced diet with exercise. Maybe I won’t ever need another sleep study again.
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