In the classic fairy tale, Snow White bites into an apple and slips into a state of suspended animation. For another figment of fiction, Rip Van Winkle, a sip of moonshine affords the luxury of sleeping through the American Revolutionary War.
Sleep has long featured in our collective storybook as an enigmatic foreign land, a faraway place where strange things happen and then are forgotten upon our return to reality.
It turns out there’s a reason for the mythology. Left to investigate why humans spend nearly a third of their lives in slumber — and what sleep is — scientists don’t have a simple answer.
“Why we sleep is still one of the greatest unsolved mysteries of science,” says Terese C. Hammond, M.D., pulmonary critical care physician at Keck Medicine of USC and director of the USC Sleep Disorders Center. “No one yet knows the true purpose and nature of the state of sleep.”
We may not know the reasons behind it, but here’s what’s clear: Many of us don’t get enough sleep.
More than a third of Americans get less than the needed seven hours of snoozing a day, according to the U.S. Centers for Disease Control and Prevention (CDC). Over time, lack of sleep takes a toll on our well-being — so much so that the CDC calls it a “public health epidemic.”
What happens to us in those wee hours, as we lie unconscious in our beds? Quite a lot.
After drifting off, we go through several cycles of what’s called non-rapid eye movement (non-REM) sleep, followed by cycles of rapid eye movement (REM) sleep. During non-REM sleep, the body repairs and restores itself — building bone and muscle, healing wounds and bolstering immune defenses. In REM sleep, body temperature drops and blood thickens. Blood pressure and pulse become erratic. Muscles turn off.
The brain, however, buzzes with activity. Cholinergic neurons, which help store memories, fire during REM. REM is also when dreams occur. And it may be during this time that the brain tries to interpret and organize information.
Too Busy to Sleep
With mobile devices that allow 24/7 communication and entertainment, it’s easy to stay up late binge-watching a series or updating a report for the boss. It’s no wonder that so many of us fail to get the recommended seven to nine hours of sleep a night.
“We wear our lack of sleep like a badge of honor,” says Raj Dasgupta, M.D., Keck Medicine of USC sleep specialist.
As a nation, we’re not just losing sleep time — we’re missing the health benefits that sleep brings. Inadequate sleep is linked to nearly a fifth of serious car crashes. It also seems to weaken a person’s willpower to eat normal portions and choose healthful food instead of junk, according to research. Long-term sleep troubles can disrupt metabolism and immunity, leading to potential trouble by spurring diseases like Type 2 Diabetes. Chronic disruption of sleep patterns is also strongly linked to cardiovascular disease and a sharp increase in breast cancer.
Many people come to the USC Sleep Disorders Center after years, often decades, of struggle, Hammond says.
Typically, it should take less than 15 minutes to fall asleep. “If it takes longer than a half hour and impairs your function the next day, it’s considered insomnia,” says Julie Dopheide, PharmD, professor of clinical pharmacy, psychiatry and the behavioral sciences at the USC School of Pharmacy and Keck School of Medicine of USC.
If tossing and turning is part of your nightly routine, don’t just dismiss it, Dopheide warns. Causes range from simple factors like room temperature to serious issues like sleep apnea or depression.
Research shows that some 20 million adults in the U.S can blame apnea for their sleeplessness. Every night, they snore, wake up and gasp for air over and over again, notes Eric Kezirian, M.D., an otolaryngologist with Keck Medicine of USC and an international expert in treating snoring and obstructive sleep apnea.
“Your throat is basically a tube surrounded by muscle,” Kezirian says. “It can collapse during deep sleep and block your breathing.” People with severe sleep apnea may wake 30 or more times per hour, which increases their risk of heart attack and stroke.
Fortunately, innovations are helping doctors like Kezirian treat sleep apnea. While many patients breathe better by using what’s called a continuous positive airway pressure device, or CPAP, others can’t sleep comfortably while wearing one. Some have found relief from a new sleep apnea treatment approved by the Food and Drug Administration last year. Called the Inspire Upper Airway Stimulation System, this surgically implantable device keeps the airway open by electrically stimulating the nerve that controls tongue movement. Keck Medicine of USC was the first group in Los Angeles — and one of the relatively few around the world — to offer the Inspire treatment.
Sometimes apnea is mysterious. Kezirian is an international leader in drug-induced sleep endoscopy, a test in which he uses a tiny camera to observe nasal cavity positioning during a patient’s sleep. “If we can figure out what’s causing the blockage of breathing, we can hopefully give more targeted and effective treatment,” he says.
The USC Sleep Disorders Center treats other related conditions as well, including narcolepsy, sleep walking, sleep talking and sleep-associated movement disorders such as restless legs syndrome.
Through collaboration, patients get the right treatments, from behavioral therapies and medicine to minimally invasive surgeries. That’s The Keck Effect — more treatments to help patients get a good night’s sleep.
“A thorough sleep evaluation can be very good for patients, especially those with long-standing sleep complaints, because it may well identify targets for therapy that will improve daytime functioning and well-being,” Hammond says.
Ultimately, you don’t need the latest wearable technology or mobile health apps to prioritize sleep. “Treat it like you treat exercise and diet,” Kezirian says. “It’s important for your health and for getting the most out of life.”
--Tribune Content Solutions for USC Keck