Transcription:
What Your Sleep Position Says About You

Carl Maronich (Host): Joining us today is Kathleen Gallagher. Kathleen is the manager of the Riverside Sleep Disorder Institute. Kathleen, welcome back to the podcast. You have been with us before.

Kathleen Gallagher (Guest): Thank you, Carl. Thanks for having me.

Carl: You’re very welcome. The first time you were with us, you talked more about kind of general – the importance of good sleep and kind of general aspects of sleep and sleep apnea and getting sleep studies and all that kind of stuff. Today, we are going to talk about another aspect of sleep and that is the position of sleep and what that means or what that can mean to your health if you sleep in different positions.

Kathleen: Yup, that’s a new and upcoming – I shouldn’t even say it’s new. It’s been studied for a long time by different researchers and psychologists and I know people only think about sleep in terms of what’s going wrong as far as breathing issues and such; but I thought this might be something different to think about as well. A little outside the box. But still relevant. Whichever side of the mattress for sure.

Carl: Yeah, well it is interesting because I think, as I talk about it I think of myself and I generally lay in there, when I’m getting serious, okay now I want to go to sleep, I will roll over onto my side and usually it’s the same side and that’s kind of my go to sleep, but you wake up and you are on your back or you don’t stay in that maybe some people do, but there’s probably – for most people, tossing and turning that happens and you end up in different positions.

Kathleen: And just like you said, how you would get into that comfortable position when you are sleeping, so some information I have found, and we will talk about an alpha and an omega position. So, you might be laying there resting, relaxing and you notice you’re about ready to fall asleep and that’s about the time you turn into that omega position which is that position you found to sleep in probably for years. Because when you think about it, you probably haven’t deviated from that position for many years, right? So, the idea is that during the – during our waking hours, we have gestures and behaviors that we have as an adult or even a child, but they say those same things carry over into our sleep world too, going to sleep so that our behaviors when we sleep also mimic things that are going on in our daily lives. Whether we are working something out, whether it is just a position that – the perception of our personalities or it can indicate some discord possibly.

Carl: Sure. Well then what are the most common sleep positions? There are only a few.

Kathleen: I think if you look up online, there’s lots of positions out there and they all have many things to say, but the most common ones are either you are sleeping in the fetal position, side, your back, or your stomach. And then there are many variations of all those. And of course, then if you are sleeping with a partner, you might be some spooning, some cuddling, hugging, you might be sleeping apart of those. Or not. Exactly and maybe those are things you have to think about when if you are somebody who has been very close to your bed partner and all of the sudden you’re not and you have drifted apart; maybe you need to think about what’s going on and why you are sleeping apart. So, that’s why I say sleep can tell a lot about what’s going on in your life.

Carl: Yeah, and not to mention dreaming. I don’t know if the sleep center or the sleep institute gets into dreaming much, but that’s a whole other thing.

Kathleen: That’s a whole other thing. It’s funny, people will say to me, I think I dream all the time or I dream when I’m not possibly in dream sleep. But it’s true, you can actually dream outside of dream sleep. It is just that those dreams I believe are more mundane. They are more about you working things out in your own life. Those dreams you have during dream stage sleep; those are going to be your crazy outlandish dreams.

Carl: Yeah, now the sleep institute does sleep studies and talk a little bit about what a sleep study actually is.

Kathleen: A sleep study is a test, diagnostic test pretty much, where we see what’s going on with you while you are sleeping. So, we are doing an EEG to watch your brain activity, we can see the difference stages of sleep that you are getting into and if you are getting adequate amounts of them. Watching your heart, so we have an EKG we are doing on you. We have a couple belts that wrap around you, so we can watch your respiratory, your breathing in and out, pulse oximetry so we can see how your oxygenation levels are in your blood. We are watching leg movements because some people have leg movements when they are sleeping. Some can actually make their brain activity awake all night long, some might not do anything to upset their sleep. Snoring, there’s snore microphone. We will hear you just fine, but it is so the computer hears you, so, you have a snore microphone on. And then we have a cannula in the patient’s nose that looks like an oxygen cannula, but it is actually showing us pressure and temperature changes as a person breathes.

Carl: So, there’s a lot of stuff involved in that.

Kathleen: A lot of stuff, we wire you all up and we say, okay now go to bed.

Carl: And people are able to do that? They fall asleep eventually?

Kathleen: Well, it might take them a little bit longer, but yes. If you are tired enough, you will fall asleep.

Carl: Now, is there a video camera, there are video tapes them while they are sleeping, back to the position aspect of kind of how they are moving around?

Kathleen: We do have video camera, infrared camera watching patients sleep. I know people like to think that we are behind some big double-sided mirror watching our patients sleep, but that’s not actually the case. It’s actually as small little camera that we can actually see. Mainly, like I said, to see which position they are sleeping in.

Carl: And is that noted as part of the study when they were in different positions?

Kathleen: Exactly.

Carl: So, how do those different positions potentially affect the quality of their sleep and ultimately their health?

Kathleen: Well, I know that in the past, when we met previously, and we talked about sleep apnea, sleeping on your back which is one of the worst positions to sleep in, lends itself more to having apnea than not. So, I know patients will come in and say I never sleep on my back and you watch during the night, they will ultimately go from their side to their back. They might not spend a long time there, sometimes inherently, their body is just like heh, this isn’t a place I need to sleep, and they will want to turn over and sleep in a different position. It’s interesting too that sometimes, a position change actually will signal REM sleep coming on, so a patient will be sleeping just fine, there’s a body movement and then they go into dream stage sleep.

Carl: Yeah, and that’s what REM sleep is, the dream stage.

Kathleen: Yup and dream stage sleep lends itself honestly to having some of the worst sleep too. There are so many changes that go on internally when we do go into dream sleep, so, when we are non-dream sleep, when we first go to sleep, our body temperature decreases a little bit, heart rate changes, it slows, blood pressure lowers. We have a little more resistance to airflow as we breathe. I say to people however you breathe right now, if you took a good inhale through your nose it is not going to be the same air you are breathing when you are sleeping at night, a little more resistance that airflow. When you go into dream sleep, however, heart rate increases, blood pressure increases, there’s even up to 200% more blood flow to your brain when you are dreaming because your brain is so active. Your body is paralyzed. We have rapid eye movement because we are dreaming and that’s what we are looking for. So, differences in what goes on with us while we are sleeping.

Carl: And that’s why you have those dreams where you can’t run.

Kathleen: Exactly.

Carl: Well interesting. Is there a healthy sleep position? Or does that really depend on the person?

Kathleen: I know that researchers will say that ideally the healthiest sleep position for your spine and alignment would be to sleep on your back and with a pillow under your neck not under your head, so that your head is not forced forward. But again, for somebody who has issues with snoring and sleep apnea, the back is not the best place to sleep. So, if you are able to sleep on your back and it’s comfortable for you and you don’t have those issues, I would say continue sleeping that way. The second-best position then would be on your side. So, you would probably not have apnea or snoring most likely, but better spinal alignment than sleeping on your stomach I would say.

Carl: Right. And as you said earlier, sleeping on your back does kind of promote those apnea issues and probably snoring as well in many cases.

Kathleen: Yes. I know and nowadays that with al these fancy beds that actually can adjust and sit you upright, patients are actually even finding that they’re becoming more comfortable sleeping in those positions. We have plenty of patients that sleep in recliners as well for comfort.

Carl: Yeah, my parents – my dad especially often sleeps in the recliner. He’s in his late eighties now and he just finds it more comfortable to sleep that way. But is that, is that healthy?

Kathleen: I wouldn’t necessarily say it’s unhealthy. I mean if somebody finds that to be a good position and they are actually breathing and feeling refreshed and feeling fine, I would say why not, unless we can treat it with some other – if it is apnea that is an issue and they need to be treated with CPAP, there are plenty of people out there who are not interested in what all CPAP can do for them. So, we kind of need to dispel that for some of these people. And I’m sure as you age, and one of the things that with our positions as we sleep, I say pay attention to what your body is telling you. So, maybe it’s not comfortable. Maybe you are feeling bony parts as they are hitting the bed, or your bed is just not comfortable when you are sleeping. We spend a third of our lives sleeping, so you really want to have something comfortable to sleep on.

Carl: Right, well, with the proliferation of mattress stores everywhere, it seems, there should be no excuse to not sleep on a good mattress. So, that’s one thing you can take care of. But what position you sleep on, on that mattress is another thing and as you said, if you wake up and feel like you are not refreshed or suddenly something hurts, maybe you need to look at the sleep positions that you go through to the degree you can, but if you are sleeping, it’s hard to do that.

Kathleen: It’s true, but like I say even if you are paying attention to some new – something new pain, you know you get a cough when you have a cold, you have a sore throat, so you know what that indicates something upper respiratory is coming on. But what if you notice something new, some new pain in your body when you are sleeping. Think about it. You go to bed, you are not really thinking about anything except for sleep, maybe going over your day. But when you have – that’s your quiet time so that’s when you are paying attention to things especially in your body, I would think.

Carl: Yeah, that would make sense. As we have said before, if you are noticing something starting with your primary care provider is probably the place to start.

Kathleen: Certainly. Have a conversation with them. Yup.

Carl: And then if you were going to get a referral to the sleep center, that’s where it come, correct?

Kathleen: Correct. And don’t forget, we have got great sleep specialists here, Dr. Abraham and Dr. Kutty who are our go-to people for sleep.

Carl: Wow, very good. So, there is a lot of sleep resources available right here.

Kathleen: Yes.

Carl: Very good. Well, Kathleen, always interesting stuff and a wealth of information we appreciate you joining us.

Kathleen: Thank you.