Sleeping in the Right posture is Extremely Important. The Correct
sleeping position does not only ensure a Sound sleep. It Can Help people
cope with many Chronic diseases and Pains. It may also Improve the
condition of a patient suffering from a common ailment.
This article is aimed to describe the Best Sleeping Positions for
different common medical conditions, ailments, pains, and aches..
*The BEST Sleeping Position for LOWER BACK Pain..
Many individuals in America and not only Suffer from the Lower Back
Pain every year. This pain is usually a Sign that the person is not
ensuring the correct posture while sitting, standing, sleeping, and it
is also could be a sign of accumulations of toxins in the body. The Best
Sleeping position for the Lower Back pain is the one that ensures the
small normal curve of the spine at the lower back.
Lying on the
Back with a pillow Under the knees and a small cushion under the lower
back is the Best posture for the lower back pain sufferers.
The cushion will provide the additional support that the back needs in pain.
Do not forget to place pillow under the head and neck or else you will wake up with a stiff neck.
*The BEST Sleeping Position for NECK Pain..
The neck pain is usually caused by Mental Stress or Muscle Strain.
While addressing these two problems it should also be made sure that the
patient suffering from the neck pain Adopts the Right Sleeping Posture.
The neck pain patients can sleep either way, on their back or on their
side. However, Correct Pillow Placement is Very Necessary (!).
For sleeping on the back, place the head and the neck on a cervical
pillow and rest the knees on a regular pillow. For sleeping on the side,
place a Cervical pillow beneath the head and a regular pillow between
the legs.
*The BEST Sleeping Position for HIP Pain, OSTEOARTHRITIS, and/or SPINAL Stenosis..
The Hip pain, Osteoarthritis, and/or Spinal Stenosis Require that there
should be NO pressure On the Back and the Hips (!). For that sleeping
On the SIDE is the Best. A pillow should support the Head and the Neck.
The legs should be bent and drawn slightly upwards (towards the chest). A
pillow should be kept in between the legs.
*The BEST Sleeping Position for DEPRESSION, ISOMNIA, and HEADACHE..
For the patients suffering from Depression, Insomnia, and Headaches it
is Very Necessary to make sure that the Blood Circulates Easily in all
part of the body while sleeping. It means that the Traditional Postures
sleeping On the SIDE or lying On the BACK remain the BEST. It is Better
(!) if the regular pillow under the head and neck is Replaced with a
CERVICAL pillow. Keep in mind that the depression, insomnia, and
headaches indicate some other medical and emotional issues or problems
with the patient, which should be immediately addressed.
Sleep and pain problems are among the most common complaints in our
society. It is not surprising then that these conditions frequently
occur in the same person. Painful diseases such as backache, osteoarthritis, rheumatoid arthritis, headache, and fibromyalgia
may interfere with sleep. However, poor sleep may also promote pain,
headaches, and fatigue. Studies have shown that several nights of
disturbed sleep in healthy people may cause not only sleepiness, but
also nonspecific generalized muscle aching and fatigue.
This guide will help you understand
- the stages of sleep
- the importance of sleep to your body
- what can cause sleep disturbances
- what treatment options are available
Sleep is defined as the
natural periodic suspension of consciousness during which the powers of the body are restored.
Sleep is a complex process involving several stages. There are changes
in the chemistry and behavior of the body during sleep.
There are many processes in the body that rely on the sleep-wake
cycle. These processes are important in fighting infection, healing our
body, and allowing processing of new knowledge or information. It is
believed that sleep is crucial to learning and intellectual function.
Proper sleep is absolutely necessary for the normal function of the
body. Sleep disturbances can have significant and serious consequences.
Lab rats die after two to three weeks of sleep deprivation.
Anatomy of Sleep
Circadian Rhythm
The
circadian rhythm is a built-in cycle of sleep and wake
times. There are other cyclic changes that occur in your body. These
include changes in temperature, heart rate, blood pressure, hormone
secretions, and lung function. These internal cycles are controlled by a
group of nerve cells called a
circadian pacemaker. This pacemaker is closely related to parts of the
retina (in the back of the eye) and a small organ in the brain called the
hypothalamus.
Humans have a biological clock that is represented by a 24-hour cycle.
Sunlight appears to be the cue that resets this clock on a daily basis.
The Human Sleep Cycle
There is a lot of difference in mammals' need for sleep. Daily sleep
time for man is approximately seven to eight hours. An owl monkey needs
17 hours a day. A bat needs 20 hours a day. Sleeping too little or too
much can be harmful to a person’s health.
Human sleep occurs in cycles that are generally about 90 minutes
long. There are five stages of sleep within each sleep cycle. These
stages are further divided into two separate states,
non-rapid eye movements (NREM) and
rapid eye movement (REM). These stages are defined by brain wave activity using an
electroencephalogram (EEG).
NREM sleep is the lighter stage of sleep. Body movements occur, but
the mind is quiet. NREM is divided into four stages, with each stage of
sleep getting progressively deeper.
REM sleep is deep sleep that is more refreshing. This is because
there is total muscle relaxation except for bursts of rapid eye
movements. The brain is active in REM sleep, dreaming occurs in this
stage of sleep. Ideally, 20 to 50 percent of an adult's sleep should be
in REM sleep. During this phase of sleep, there may be irregularities of
the heart and breathing. These can be recognized by monitoring the
heart with an
electrocardiogram (ECG). REM sleep has been described as a highly activated brain in a paralyzed body.
As sleep continues, the time spent in NREM sleep is decreased and the
amount of time in REM sleep increases. The last third of the night is
mostly REM sleep. It is linked to the circadian rhythm of body
temperature.
There are age-related changes that are predictable. Infants usually
start the sleep cycle with REM sleep. As we approach age 65 and older,
less time is spent in REM sleep.
Causes
What causes this problem?
Some sleep disorders are known to have genetic causes. Others are
caused by illnesses such as Parkinson's disease, depression, lung
disease, or heart failure. Other sleep disorders have an unknown cause.
There are several common sleep disorders.
Sleep-Related Breathing Disorders or Sleep Apnea.
Apnea means
without breath. While sleeping, when a person stops breathing for a minimum of 10 seconds it is called an
apneic
episode. If you have more than five apnea events in an hour, you are
diagnosed with sleep apnea. Oxygen level in the blood or tissues is also
important when making the diagnosis of sleep apnea. Oxygen levels at 95
percent and above are normal. In sleep apnea, levels may drop to 80
percent or lower. Levels below 70 percent are considered dangerously
low. When this low, the heart may beat irregularly and may even cause
death.
There are two main types of sleep apnea.
Central sleep apnea is the interruption of breathing during sleep. The cause may be unknown. Or it can be caused by medications such as
opioids (narcotics). Other causes can be heart failure, stroke, renal failure, lung disease, or being at high altitudes.
Obstructive sleep apnea (OSA) is caused by closing of the
airway when air should be moving into the nose, mouth, and lungs. It may
be as common as two to four of every 100 adults, and three out of every
100 children.
Narcolepsy is a term that is used for excessive
daytime sleepiness without troubled sleep during the night. It is
diagnosed when a person can fall asleep with a short delay (usually
eight minutes or less) to REM sleep. Falling asleep while driving,
hallucinations while sleeping, and sleep paralysis may occur. Narcolepsy
appears to be genetic. A substance called
hypocretin/orexin is found to be decreased in persons with narcolepsy. Narcolepsy is treated with medications.
Sleep-related movement disorders include
restless legs syndrome (RLS) and
periodic limb movement disorders (PLMD).
Restless legs syndrome (RLS) is described as a strong, nearly
uncontrollable desire to move the legs. The sensations are worse at rest
and occur more frequently in the evening or during the night. Walking
or moving the legs relieves the sensation.
Periodic limb movement disorders (PLMD) is the involuntary limb
movements which are often rhythmical that can fragment or interrupt
sleep. Because they are rhythmical, they are thought to originate from a
subcortical region of the brain. Possibly up to 40 percent of persons
over 65 years of age may have PLMD.
Insomnia is difficulty falling asleep, staying
asleep, or sleep that is not refreshing and restorative. It happens in
as many as 30 percent of Americans. Symptoms of insomnia aside from
difficulty sleeping include daytime exhaustion or fatigue, lack of
energy, lack of concentration, forgetfulness, irritability, and
depression. Insomnia can be caused by many different conditions. It
happens more frequently as we age, particularly after 60. It may be
caused by stress, depression and anxiety, or mental illness. Noise or
extreme temperatures in the environment can also cause insomnia. Other
causes of insomnia can be shift work, jet lag, nighttime activity
schedules, and medication side effects. Use of alcohol, tobacco,
and illicit drugs may interfere with sleep. A person with insomnia may
also have one of the other sleep disorders such as sleep apnea,
narcolepsy, or restless legs syndrome.
Unusual behaviors may occur during sleep. These
behaviors include sleepwalking, sleep talking, tooth grinding, and other
physical activities. These can cause arousals and get in the way of
normal sleep cycles. Sleep related tooth grinding is called
bruxism.
Clenching of the teeth may cause tempomandibular joint pain and/or
wearing down of the teeth. An appliance similar to a mouth guard or
retainer may be used to treat bruxism.
Symptoms
What does the condition feel like?
Sleepiness is the most common symptom in people with a sleep
disorder. Sleepiness is caused by the decrease in the amount, the
quality of sleep, as well as the circadian rhythm of the body.
Fatigue and not feeling refreshed after sleeping, may be signs you have a sleep disorder.
Snoring and stopping breathing while sleeping are other symptoms of a possible sleep disorder.
Sleep disorders may be associated with many chronic illnesses such as
high blood pressure, heart attacks, stroke, headache, or depression.
There are many processes in the body that rely on the sleep-wake cycle.
These processes are important in fighting infection, healing our body,
and allowing processing of new knowledge or information. Sleep
disturbances can have significant and serious consequences. Slower
reaction times may decrease driving safety and cause auto accidents.
Poor balance, decreased concentration, and forgetfulness are also noted
in persons with sleep disorders. Mood disorders (irritability or
depression), decreased motivation, and lack of energy may also be
symptoms of chronic sleep problems.
Diagnosis
How do doctors diagnose the problem?
Diagnosis begins with a complete history and physical examination.
Your doctor will ask you several questions to determine if your symptoms
call for a sleep study. You may be asked to fill out a questionnaire
about snoring, sleepiness, stopping breathing during sleep, unwanted leg
movements, medications you are taking and such.
Your doctor may do a physical exam. An examination of your nose,
mouth, throat, and lungs is usually included. Your doctor may request
that you have a chest x-ray. The x-ray is to check for abnormalities of
your lungs, or to measure your heart size.
There are doctors who specialize in sleep medicine. You may be asked to be evaluated by one of them.
Examination of your nose and mouth is done to determine if there is
decrease in the size of your airway, or factors that may interfere with
proper airflow. Swollen sinuses from dryness or allergies, or jaw
deformity are examples. The doctor may also examine your teeth to see if
there are signs of wear from bruxism.
Examination of the throat is done to find out if you have enlarged
tonsils or extra or swollen tissue in the back of your mouth. The piece
of tissue that dangles down from the top of the back of the mouth is
called the
uvula. Uvula means grape cluster, and is shaped
similar to one. In some people, it can be enlarged and can get in the
way of proper airflow.
If lung disease is possible, the specialist may want to assess your
lung function. Some of the risk factors for lung disease include
smoking, heart failure, or asthma. You may be asked to blow into a
device that measures the force, and how much air you can blow. There are
more complex machines that may also be used to monitor airflow in and
out of your lungs. The specialist may also have you do hand-held reflex testing in the office. This also monitors your ability to stay alert.
Your doctor may want to monitor the oxygen or carbon dioxide levels in your blood. This is done with a machine called an oximeter.
The part that measures the oxygen or carbon dioxide levels in your
blood is similar to a clothes pin. It is worn over your finger or ear
lobe. It is connected by a wire to the oximeter. It then measures and
records your oxygen level when sleeping. Normal oxygenation is 95 to 100
percent. In sleep apnea, levels may drop to 80 percent or lower. Levels
below 70 percent are considered dangerously low.
A
polysomnogram is a procedure that is used to diagnose
sleep disorders. It is done at a sleep laboratory or center. It is a way
to record and measure what is going on during sleep. It can measure
biological functions as well as body movement. Information is gathered
from a set of electrodes taped to your skin. Wires from the electrodes
carry signals to a monitoring device where they are recorded. The doctor
then interprets the information. There are no needles. The electrodes
measure electrical activity and do not cause an electrical shock.
The sleep laboratory consists of private rooms with beds. The sleep
room is well insulated and temperature is kept comfortable. You may be
allowed to wear your usual sleep clothes. You will be given a buzzer to
alert the sleep study technician if you need to get up or get
uncomfortable for any reason. Testing in the sleep study center may also
involve seeing how long it takes to fall asleep while reading or
resting.
Brain wave monitoring is done with several electrodes placed on the
surface of the skull. These electrodes monitor and record brain wave
activity. It can tell the different stages of sleep and when you are
awake.
Other electrodes are placed near the outside corner of each eye in
order to monitor eye movements. Electrodes on the chin or throat monitor
jaw muscle tightening. Electrodes on the stomach monitor abdominal
movements. Electrodes on the legs sense leg movements.
The heart rate and rhythm is monitored with an electrocardiogram
(ECG). Sticky patches with electrodes are placed on the chest. There is
an increase in cardiovascular events such as heart attack and stroke in
persons with chronic sleep problems.
Another measuring device is called a
strain gauge. It is a stretchy belt that is worn around the chest to measure chest movement.
Treatment
What treatment options are available?
Non-Surgical Treatment
Treatment of insomnia can include medication and behavioral therapy.
Behavioral therapies are usually done with a psychologist or person with
similar training. Talk therapy may be helpful in decreasing stress and
anxiety.
Quite often, changes in habits are all that is needed to improve
sleep. Poor sleep habits include spending too much time in bed or having
an irregular sleep schedule. Not getting sufficient bright-light
exposure during the day and poor physical functioning are known to
interfere with proper sleep. Sleeping in an environment that is too
bright, too noisy, or too hot or cold can cause sleep problems. Drinking
alcohol or caffeinated beverages too close to bedtime can also
interfere with sleep. Treatment of depression is also important to
consider.
Some recommended sleep medications include some of the
antidepressants. Drugs that stimulate the breathing reflex may be used
for central sleep apnea. Specific medications are also used for
narcolepsy. Medications that treat Parkinson’s disease can be beneficial
for RLS and PLMD. Our bodies make melatonin that helps regulate the
sleep cycle. It is also available as an over-the-counter medication. It
is most helpful for shift work and jet lag. When soft tissue in the nose
or throat is enlarged, it may be recommended that you use decongestants
or other medications that help shrink soft tissue in your nose and
throat.
Behavioral treatments often mean changing the way you act or think.
You may need to learn how to decrease stimulation of the body's system
of alertness. This system is called
fight or flight and can
interfere with proper sleep. When your nervous system is on high alert,
it is especially difficult to fall asleep. Reducing stress, doing
relaxation exercises or other soothing activities can calm the nervous
system. Changing negative attitudes about yourself and sleep can also be
helpful. There are many simple ways that sleep can be improved.
he following tips may be helpful for anyone with sleep problems.
Exercise can increase the core body temperature, which promotes sleep. When vigorous enough, exercise can help the body release
endorphins, which are chemicals that act like morphine, a pain medication.
Increase your body temperature. A hot bath, shower,
or use of a hot tub can affect body temperature. A hot drink will also
warm you. It is recommended that you try to increase your body
temperature within two hours before bedtime.
Bedroom environment should be a comfortable
temperature, quiet, and dark. If there are factors out of your control
such as a noisy neighbor or animal, earplugs may be useful. Eyeshades
may help with unwanted light.
Bedtime rituals such as a bath, reading for pleasure, or listening to soothing music may help decrease your body’s alertness.
Stress reduction and relaxation improve sleep. Relaxation can
include deep breathing exercises. Progressive muscle relaxation involves
slowly tensing and releasing muscles. You usually start with muscles of
the face, then neck. You gradually work your way down until your toes
feel fully relaxed. Meditation, prayer, imagery, and listening to
soothing music are other methods to help reduce stress.
Regular sleep schedule is important. Wake and get up
at the same time each morning, including weekends, even after a poor
night's sleep. This will help with the circadian rhythm.
Daytime naps should generally be avoided.
Get out of bed. If you are awake in bed for more
than 20 minutes, get up and go to another room. Do not watch TV in bed.
The bed should be used only for sleep and sex. Too much time in bed
causes interrupted and shallow sleep.
Heavy meals late in the evening should be avoided. A warm drink or small snack may be beneficial before bedtime.
Exposure to sunlight is important for the circadian
rhythm. Spend some time outdoors especially after awakening. Talk to
your doctor about the use of bright light therapy to help regulate the
circadian rhythm. There are also lighting devices available that imitate
dawn. Light boxes and dawn stimulators may be available at medical
supply stores or on the Internet. It is important to buy the appropriate
light box and use only as directed.
Quit smoking. Withdrawal from nicotine begins two or three hours after smoking. This can interrupt sleep.
Avoid alcohol before bed. Although it may help you fall asleep, sleep is otherwise interrupted.
Avoid caffeine particularly after the middle of the
afternoon. If at all possible, decrease or don't drink caffeinated
drinks altogether. You may have to taper off of caffeine. Most people
will have symptoms of withdrawal. These could include headache and
fatigue.
Avoid medications that may interfere with either
falling asleep or staying asleep. Narcotics for pain may cause a
decrease in the brain's ability to keep breathing during sleep. This can
cause a decrease in oxygen level in the blood.
Aromatherapy is the use of scents such as lavender, chamomile, or vanilla that help to
quiet
the nervous system. These may be sprayed on bedding. Oils may be placed
under your nose, or on your chest, or used in the bath.
Allergies can cause swelling and narrowing of the
airway. This can cause partial blockage of your airway and contribute to
obstructive sleep apnea. Ask your doctor about treatment of allergies. A
mixture of water with a little bit of salt can be used to rinse the
lining of your nose and sinus tissue. This helps to shrink swollen
tissue. It also helps to flush pollen and other allergens. Humidifiers
in dry climates may also help sooth the lining of your nose and sinuses.
Lose weight particularly if you have sleep apnea. You may be asked to see a nutritionist to help with weight loss.
Change in sleep position can also make a difference.
You may have more trouble breathing properly while lying on your back.
Sleeping on your sides can relieve this. There are monitors and alarms
available. Some people have sewn a small ball into the back of their
pajamas.
Dental appliances or retainers may be useful in
bringing the jaw and tongue forward during sleep. This helps to keep the
airway open. Dental appliances are also used to treat
bruxism (grinding the teeth at night).
Continuous positive airway pressure (CPAP) is the
most common treatment for sleep apnea. It is a breathing device. A CPAP
machine is a small machine that can sit on your nightstand. It has a
hose that attaches to a mask that usually covers the nose. The mask is
worn during sleep. Room air is blown through the nostrils, allowing the
airway to remain open during sleep. Some people may also require oxygen
at night. Your insurance will pay for most if not all of the cost.
Typically they are obtained from oxygen or medical equipment companies.
Getting used to the CPAP machine is not always easy. Some people may
experience anxiety from having the mask placed over the face. Others may
not like the way it looks. It may take encouragement to help you
continue with the changes necessary to improve sleep. If you still have
sleepiness or insomnia after using CPAP or after making several
lifestyle changes, your doctor may need to consider more aggressive
treatment.
Surgery
Other treatments for sleep apnea include surgery. There are several
surgeries that may be recommended. If you have trouble breathing through
your nose, the surgeon may decide to cut away some of the soft tissue
in the nose. Sometimes straightening the
septum (cartilage) that divides the nose into two parts is also necessary.
If your airway is small, especially when the
soft palate (top
of the mouth) and the tongue relax during sleep, it may be recommended
that you have reconstructive surgery. The most common type of
reconstructive surgery is called
uvulopalatopharyngoplasty or UPPP. Excess tissue such as the tonsils, adenoids, and uvula are removed. These surgeries are usually performed by an
otolaryngologist, or ear, nose, and throat (ENT) surgeon.
Sometimes surgery to change the structure of the jaw or face is considered.
Ventilators or mechanical breathing machines are needed for some
extreme cases of central sleep apnea. Air is blown from the ventilator
through a hole in the neck called a
tracheostomy. A
tracheostomy is the operation used to make a small opening in the
trachea or windpipe. A small cut is made by a surgeon in the front of
the neck. This bypasses the causes for decreased airflow in the nose,
mouth, and throat. During waking hours the tube is plugged to allow
normal breathing. At night, a tube is inserted that is then connected to
a ventilator or breathing machine.
Stomach banding or bypass is recommended if being overweight contributes to a sleep disorder.
Summary
Regular follow up with your doctor or therapist is recommended to
help make transition into lifestyle changes easier. Trying different
methods for relaxation and other changes in behavior may take some
coaching.
The staff at the sleep center or the staff at the medical supply
store is helpful in answering questions about equipment. They may also
be able to help with making adjustments in equipment that make sleep
better. It may take several weeks or months to adjust to using machines
when sleeping. You may need a repeat polysomnography or a shortened
version of one after you have used your equipment for a while.
Adjustments may need to be made if you continue to experience fatigue or
other symptoms.
Hopefully, treatment of your underlying sleep disorder will improve
some of your other medical problems such as blood pressure, weight,
fatigue, and lowered mood. Your doctor will want to monitor these.
A physical therapist or personal trainer may be able to help you
start an exercise program. Pain and fatigue often lead to inactivity,
which leads to de-conditioning. Starting an exercise program can cause
increased pain at first. The support of a professional may help you
continue with an exercise program.
A registered dietitian may be recommended by your doctor for weight loss.
Some cities have support groups for people with sleep disorders.
Check with your physician or through your local hospital to see what
support groups are available.