You may be getting tired of me using corny acrostics in past articles (SLEEPINESS and COMPASS), but here’s another one: NOSTRILS. You may be asking, “How are my nostrils going to make me feel and sleep better?” Just to review, SLEEPINESS (sleep, light, eliminate toxins, eating, pounds, ingestion, nose, exercise, and sleep position) lists conservative, basic steps to take to improve your health before considering medical or surgical therapy for sleep apnea. COMPASS (conservative (SLEEPINESS), oral appliances, myofunctional therapy, pressure devices, acupuncture, slim down, and surgery) is a list of things to do to formally treat obstructive sleep apnea.
NOSTRILS is an acrostic that you can use to remember the 8 areas to consider to feel better and have much more energy to enjoy life again. These are holistic, conservative, and non-medical steps to be healthier in general.
I know I keep bringing this up, but I can’t emphasize how important this is for optimal health. It’s the first point of potential blockage at various points outside and inside the nose. Once you start to mouth-breathe, you will have higher chances of having fatigue, cavities, poor sleep, increased stress, poor attention, poor digestion, and even bad breath. Most importantly, I believe it’s the single biggest reason why many people can’t tolerate or benefit from CPAP.
So regardless of whatever is bothering you health-wise, it’s important to make sure you’re able to breathe well through your nose, at night as well as during the day.
Action Step: If you have trouble breathing through your nose despite trying everything, see an ENT doctor.
Because so many people have various breathing problems (such as asthma, bronchitis, obstructive sleep apnea, and COPD), it’s a given that your body will be deprived of oxygen due to restricted breathing. It can be a physical obstruction or due to poor breathing patterns (conscious or subconscious).
The one area that’s usually not ever addressed is upper airway resistance syndrome (UARS), which is something I’ve talked about quite frequently. UARS is a breathing-related sleep disorder where you stop breathing multiple times every hour, but without meeting the formal criteria for apneas or hypopneas. Even though you may not have sleep apnea, you’ll still suffer from multiple sleep arousals and fragmentation, which causes a physiological stress response.
The problem with the Western medicine health care model is that we measure oxygen by using a probe on the finger. It measures the absolute level of oxygen in the finger, regardless of much blood is flowing through the finger.
My point is that no matter how “normal” your oxygen levels are, if blood doesn’t go through your vessels at adequate levels, then your tissues will be “starved” for food (glucose and oxygen).
Most people with UARS have normal oxygen levels. However, due to the physiologically raised stress levels from constant micro-arousals during sleep, less blood flow is given the the “unnecessary” organs or areas of the body that are considered unessential then you’re experiencing severe stress. These areas include your gut, reproductive organs, hands/feet, and the higher-level parts of your brain. When you’re being chased by a tiger, the last thing you need to do is to have a meal or have sex.
Mouth breathing also causes a form of hyperventilation, with normal to high oxygen levels but lower than normal carbon dioxide (CO2) levels. Having low carbon dioxide shifts your ability for the red blood cells in your body to release oxygen to the tissues. This is the process that’s seen in Bohr’s effect. This leads to higher levels of stress and anxiety.
Chronic lack of blood flow, oxygen, and glucose cause a low-grade degree of inflammation. This stimulates signals that are released from energy-starved tissues to recruit more blood flow by growing new blood vessels and tissues. Numerous signaling proteins are expressed in times of hypoxia (lack of oxygen), such as hypoxia-inducible factor (HIF-1), and vascular endothelial growth factor (VEGF). These are the same factors that are associated with the growth of tumors and cancers.
Action Step: Learn deep-breathing relaxation techniques to calm your nervous system. Optimize your nasal breathing. Before taking any anti-anxiety medications, see a sleep doctor to rule out upper airway resistance syndrome or obstructive sleep apnea.
You can see it throughout life and nature. From the yearly seasons to night and day, monthly menstrual periods to sleep cycles, and even the tides, it’s all around us. However, modern society has broken these healthy rhythms of life in general. Major disruptors include the invention of the light bulb, shift work, bright LED screens in our devices, and non-stop work without built-in rest periods.
As a result, our sleep patterns are significantly altered, to the point of causing major illnesses, including weight gain, mental illnesses, and even cancer.
Another major timing disruption is the lack of family mealtimes, especially dinner. Many families eat dinner separately, or very late after kids come home after evening sports activities. Then they have to stay up doing homework using bright screens, which delays circadian rhythms, resulting in children having trouble getting up in the mornings.
There are even studies showing that after daylight savings time changes, there is a measurable uptick in motor vehicle accidents.
Overloading our schedules, lack of regular, scheduled rest, and sacrificing sleep have made our society more tired, sicker, overweight, depressed, and not happy at all.
Action Step: Try to schedule in regular routines every day, 7 days per week. This includes going to bed and waking up at the same time every day, including weekends. Schedule your children’s activities around family dinner time and not the other way around.
The stress reduction industry is a multi-billion dollar business. With all the non-stop hustle and bustle of modern life, it’s not surprising that everyone craves more rest and relaxation. We work our butts off for 6 months, then take our 1-week vacation, finally getting to relax on a Caribbean beach without any stress.
This pattern of long and intense work periods and short rest is not making us relaxed. If anything, it’s making us sicker and more stressed. Vacation planning and the travel process are known to be extremely stressful. It shows up in our broken relationships, chronic health problems such as heart disease and cancer, and needing to see doctors full-time after we retire.
Ideally, knowing what we know, we should build in mini-vacations (physical and mental) throughout the day, week, and months. Now that the concept of multitasking has been debunked, experts are telling us to focus on one thing only for short bursts of productive time, whether it’s 60 or 90 minutes, with 5-10 minute breaks. Avoid or shut down all distractions, including email, messaging, notifications, family, colleagues, pets, and even music. If you have the ability, spend time by yourself in an isolated, natural area, with minimal to no technology. If now this may sound too difficult, you can start by doing one small thing at a time. Believe me, it will be worth it.
Action Step: Schedule regular breaks into your routine every day. Choose activities without using any electronic devices, such as reading a real book, or walking outdoors.
This includes everything you eat, drink, inhale or put on your body. It also includes your potential for exposure to numerous toxins in your environment, including smoke, chlorine, fluoride, mold, etc. Dangerous substances in what you eat may take years before the effects are realized. Most of our conventional food supply is laced with pesticides, herbicides, and fungicides. Even our water is treated with reportedly “safe” levels of chorine and fluoride. This is why you should try to eat as organically as possible, within reason. Even then it’s impossible to eat or drink pure food and water entirely.
Add to this the confusion and controversy of what proportion of macronutrients (carbohydrates, protein, fat) is healthiest. One of the most shocking revelations in recent years is the extremely high proportion of carbohydrates in our modern diets (via processed grains and sugar). This is a mind-boggling topic that I will touch on at a later time, since what and when you eat has profound effects on your sleep and weight.
Action Step: Eat organically. Cook at home as much as possible. Eat locally grown foods, not packaged in plastic or paper containers. Cut out sugar entirely. Cut down on carbohydrates dramatically. Incorporate larger amounts of healthy fats into your diet.
This is related to the timing mentioned above, but it needs to be repeated from a different perspective. Our bodies work best when we are in sync with the daily rhythms of day and night. However, due to the invention of the light bulb, and aggravated by screens and technology, most people in modern societies are spending a disproportionate amount of time indoors. Even exercise is performed mostly in indoor settings.
Technology has also disturbed our circadian rhythms. Many teenagers (and adults) have delayed sleep phase disorder, due to using screens before bedtime. Shiftwork has been shown to be a Class 2A carcinogen (probable) by the World Health Organization.
Another major consequence of this phenomenon is the epidemic of vitamin D deficiency. The “normal” level of vitamin D is 30 ng/mL, but this is the level needed to present Rickets (bowing of the legs in children). However, it’s been shown that you need levels of at least 40-50 for your gut to absorb calcium. Once you start researching the benefits and harms of adequate or low levels of vitamin D, it’s an endless rabbit hole.
There are strong studies on vitamin D’s beneficial effects on various areas of health, including osteoporosis, cancer, and even COVID-19 survival rates. This all makes sense since vitamin D is a hormone. Recommendations by dermatologists to avoid sun exposure and to use sunscreen have made things worse. It’s been suggested that lack of sun exposure has lowered the rate of skin cancer, but raised the overall rates of cancer in general.
Action Step: Spend as much time outdoors as possible. Get more total body sun exposure when possible, without sunburning. Try to incorporate exercising outdoors into your workout routine.
It’s a given that most people in the United States are sleep deprived, either due to school, young children, or work demands. Despite the tomes of research and benefits of optimal sleep, solutions are offered to counteract the effects of sleep deprivation. The coffee industry is a $225 billion industry in the US. Add to this the availability of stimulant soft drinks, as well as prescription stimulants such as Adderall, there are countless ways to stay awake.
You’ll find lots of resources on the internet on 10 tips for better sleep or various other sleep hacks, but the most effective way to fall asleep and sleep well through the night is to schedule your activities and routines properly throughout the day. This will work much better than a sleep hack or supplement you can take just before bedtime when you can’t sleep.
Another important aspect of sleep is your sleep position. Most of you will normally prefer to sleep on your side or tummy down, in contrast to over 100 years ago when the majority preferred to sleep on our backs. The reason for this is due to our jaws getting smaller, resulting in smaller upper airway passages. I describe this process in detail in my book, Sleep Interrupted: A physician reveals the #1 reason why so many of us are sick and tired.
Anything that prevents you from being able to sleep comfortably in your preferred sleep position will lower your sleep quality. For example, if you normally sleep on your side, and undergo a hip operation or if you injure your shoulder, then you’ll be forced to sleep on your back. The supine (back) position is the worst position for breathing since the throat muscles (especially the tongue) fall back the most in the supine position. As a result of forced supine sleep, you’ll want to sleep inclined, or use pillows to prop up your body. But this will never be as good as sleeping on your side.
Action Step: Go over and implement the other 7 steps in NOSTRILS. Make sleep your most important appointment of the day. Don’t be late. If you’re still struggling to sleep well after trying everything, it’s time to see a sleep doctor.