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W
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hat is it like to spend a
night in a sleep lab? How easy is it to sleep hooked up to numerous cables? And
is there a link between the microbiome and sleep?
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on PinterestWhat happens during a sleep study?
Sleep is an essential part
of our daily routine and health. Lack of sleep can be detrimental to our
well-being.
Insomnia is
a sleep condition that affects around one-third of the population of the
United States, with 10–15 % of people experiencing "severe and chronic
insomnia."
The National Sleep Foundation describe
insomnia as a condition in which a person experiences unsatisfactory sleep
despite having the opportunity to sleep. In practical terms, this means trouble
falling or staying asleep.
My mother has been living
with insomnia for many years. Sleep is a regular topic in our conversations.
In my role as Research
Editor at Medical News Today,
I come across research studies into sleep regularly.
But, despite our insights
into why sleep is important, what causes insomnia is not entirely clear.
A few months ago, my mom
took part in a study looking into a link between the microbiome and sleep. I
was very keen to speak to both her and the researcher leading the study
afterward.
So, here is what happened
when Mama Martin spent a night in a sleep lab.
A night at the sleep center
I arrive at the Advanced
Sleep Research Institute in Berlin, Germany, at 8.00 p.m. A medical student is
on duty. There are two people here today that she is looking after. She will
stay awake all night to monitor our progress.
The medical student takes
me to a room with a single, hospital-style bed. There is also a TV. When you
lie in the bed, you can see the camera that will record your sleep.
Next, she attaches the
electrodes.
She puts two on my legs and
several on my upper body, which are linked to the ECG. She then places more
electrodes on my upper arms, hands, and a lot on my head.
The student also attaches a
mask to screen for sleep apnea to my face. It's hard, and the indents will
remain visible on my face for a while after I take it off in the morning.
Finally, she attaches an
oxygen monitor to my finger. It has only taken about 5 minutes to get me
prepped, but I find it hard to imagine that I will ever go to sleep like this.
As soon as my preparation
is complete, I lie down.
A few minutes later, the
medical student's voice comes on over the speaker. She asks if I can hear her.
Then she asks me to do a vision test — look left, look right, open eyes, close
eyes.
Next, we do a breathing
test. I breathe in, breathe out, through my nose, through my mouth, hold my
breath. This way, she can check that all the monitors are working correctly.
If I need to go to the
bathroom, I need to call her so that she can detach me from cables. I don't
drink much in the evening so that I won't need to use the bathroom in the
night.
The lights go off at 10.00
p.m.
Once I fall asleep, the
clock starts ticking down the 8 hours allotted sleep time.
The cables are not very
comfortable, and I notice them every time I wake up. But, contrary to my
expectations, I still manage to sleep fairly comfortably.
Surprising results
I have had trouble with my
sleep since 2007. At the time, I had a lot of stress at
work, including some incidences of bullying. Then I lost my husband in 2010.
My insomnia has been the
same since the start. Most nights, I listen to audiobooks when I wake up and
can't go back to sleep.
I listen to stories that I
already know, so they are not too exciting and pick soothing stories.
During my night at the
sleep center, I slept relatively well, but I thought I had slept really badly.
I was awake at around 4.00
a.m. I wasn't allowed to listen to my audiobook that night, so I used a
relaxation breathing technique. I thought I was awake for a long time then.
When I find out the
results, I am surprised. I was, in fact, not awake for long at all. And there
were some unexpected revelations in the data.
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I didn't know that I sleep
on my front. I also apparently sleep a lot on my right side, although I know
that I mostly fall asleep on my left side. I never knew that I move so much
when I'm sleeping.
At the end of my 8 hours of
sleep, the medical student wakes me up. Then comes the rather lengthy job of
washing the sticky residue left over from the electrodes out of my hair. I was
told before my visit to bring shampoo, but I wasn't prepared for quite how long
this would take.
After my night at the sleep
center, I send off my sample for the microbiome analysis.
The results show a possible
imbalance in the composition of my gut microbiome. Specifically, they indicate
that I have a higher risk of leaky gut syndrome and histamine intolerance.
How that links to my sleep
is not clear at the moment.
Studying the microbiome and sleep
After speaking to my mom, I
also caught up with Katharina Lederer, who is a medical practitioner in Berlin.
This study is part of her medical Ph.D. thesis.
Firstly, I asked Lederer if
she had spent a night in a sleep lab herself.
"Yes, I have, and my experience was
surprisingly [good]. Most patients ask how they are supposed to sleep with
cables on their heads, legs, chest, and sensors on their fingers. But most
people, as I did, fall asleep quite quickly."
Katharina Lederer
Lederer also explained that
"most people are surprised how long they actually sleep."
"Our perception of how
long we sleep can be hours off our actual sleep time. Especially, people with
insomnia feel that they sleep [for a much shorter time] than they mostly do due
to the frequent sleep interruptions," she told me.
Is there a link between the
gut microbiome and sleep? Lederer thinks so.
"In my daily practice
in the sleep laboratory, I encountered many patients who don't just have
trouble sleeping but also problems with their bowels, including pain, diarrhea,
or constipation,"
she explained.
"Both conditions have
some common risk factors, such as high stress levels, insufficient movement
during the day, and also nutrition."
Lederer explained that
research links our brains and our bowels via the gut-brain axis.
So, what is happening in
this sleep study?
"The first step was to
find out if people with insomnia suffer from more gastrointestinal problems
than their healthy counterparts. This seems to be the case, but the numbers of
the study are still too small to give a statistical significance," Lederer
said.
"In a second step, we
are examining the microbiota of a group of patients with insomnia and comparing
them to a healthy control group. Unfortunately, this is still in process."
But could changing a
person's microbiome improve their sleep, or would changing their sleep affect
their microbiome?
"There are a few
studies already showing that sleep restriction can have an effect on the
microbiota," Lederer explained. "I suspect that there is also an
influence the other way around, of the microbiota on our sleep, but this has
only been shown in limited studies with mice yet."
Changing perceptions
My final question to
Lederer was whether taking part in a sleep study changes people's attitude
toward their insomnia.
"I hope so," was
her reply. "You can't fix any sleep problem in a day. Most patients suffer
from sleep disorders for many, many years before they come to the sleep
center."
"The brain is so used,
almost conditioned, to wake up in the middle of the night or to connect the bed
with negative emotions that it takes a while until sleep disorders are
treated," she continued.
This was certainly the case
for my mom. She has, in the past, used an activity tracker to monitor her sleep
but was not sure how much she could trust the results.
"Taking part in a
sleep study has clarified for me that I actually sleep much more than I
thought," she told me.
My mom and Lederer also
discussed recommendations for sleep at the initial consultation.
These include no reading or
using a phone in bed, not exercising vigorously too close to bedtime, not
eating or drinking caffeinated drinks for several hours before going to bed,
not watching anything too exciting on TV, and getting up 8 hours after falling
asleep.
Since her night at the
sleep center, mom's sleep hasn't changed.
But she feels more
confident in the amount of sleep her activity tracker shows her.
"I feel better about my sleep after
seeing the results of my night at the sleep center. I am also mindful of the
good sleep hygiene tips that I learned."
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