Improving Deep Sleep: A Personal Study

[NewEngland Seeker]

I am building my strength and energy after a rapid loss of both in January 2022 and my melanoma diagnosis. I expected faster progress, so I needed to do a full system analysis. I know that healing occurs best during deep sleep and my sleep has been adequate at best. I already optimized diet and exercise, so the weak point seems to be recovery during sleep. I also snore and suspect mild sleep apnea. Since I was unable to fully understand my inadequate healing sleep, I decided to buy an activity monitor to collect sleep data. With objective data I will understand how to tune up my sleep.

First, a refresher on why sleep is an important aspect of health and why deep sleep in particular is extremely valuable.

Sleep Basics: REM & NREM, Sleep Stages, Good Sleep Habits & More

REM sleep and Non REM

When you sleep, your brain goes through natural cycles of activity. There are four total stages of sleep, divided into two phases:​

• Non-REM sleep happens first and includes three stages. The last two stage of non-REM sleep is when you sleep deeply. It’s hard to wake up from this stage of sleep.
• REM sleep happens about an hour to an hour and a half after falling asleep. REM sleep is when you tend to have vivid dreams.

As you sleep, your body cycles through non-REM and REM sleep. You usually start the sleep cycle with stage 1 of non-REM sleep. You pass through the other stages of non-REM sleep, followed by a short period of REM sleep. Then the cycle begins again at stage 1.

A full sleep cycle takes about 90 to 110 minutes. Your first REM period is short. As the night goes on, you’ll have longer REM sleep and less deep sleep.

​

There three stages make up Non REM sleep.

Stage 1.​

This stage of very light sleeping lasts for five to 10 minutes.​

• Everything starts to slow down, including your eye movement and muscle activity.
• Your eyes stay closed. If you get woken from stage 1 sleep, you may feel as if you haven’t slept at all. You may remember pieces of images.
• Sometimes, you may feel like you’re starting to fall and then experience a sudden muscle contraction. Healthcare providers call this motion hypnic myoclonic or hypnic jerk. Hypnic jerks are common and not anything to be concerned about as this occurrence is unlikely to cause any complications or side effects.

Stage 2.​

• This period of light sleep features periods of muscle tone (muscles partially contracting) mixed with periods of muscle relaxation.
• Your eye movement stops, heart rate slows and body temperature decreases.
• Brain waves become slower. Occasionally, you’ll have a burst of rapid waves called sleep spindles.
• Your body prepares to enter deep sleep.

Stage 3. The healing and rejuvenation sleep stage​

• This stage is deep sleep.
• During this stage, your brain produces delta waves, very slow brain waves.
• It’s hard for someone to wake you up during this stage.
• You have no eye movement or muscle activity.
• If you’re woken up, you may feel groggy and disoriented for a few minutes.

As we age, we get less non-REM sleep. To mitigate the deteriorating effects of aging it is necessary to work at improving deep sleep time.

Necessity of sleep especially stage 2 and more so of stage 3.​

​

In humans, sleep appears to be critical to both physical and mental development10 in babies, children, and young adults. In adults, a lack of sleep has been associated with a wide range of negative health consequences including cardiovascular problems11, a weakened immune system12, higher risk of obesity and type II diabetes13, impaired thinking and memory, and mental health problems like depression and anxiety.​

​

These diverse ramifications of sleep deprivation offer strong support to the view that sleep doesn’t have just one biological purpose but in fact, through its complexity, is an important contributor to the proper functioning of nearly all of the systems of the body.​

• Sleep Deprivation: What It Is, Symptoms, Treatment & Stages
Systems affected
Sleep deprivation has negative effects in multiple ways throughout your body. Those can affect the following body systems, organs and processes:

• Heart and circulatory systems: Sleep deprivation has long-term damaging effects on your heart and circulatory health. People with chronic sleep deprivation are more likely to develop high blood pressure (hypertension) and high cholesterol (hyperlipidemia).
• Metabolic systems: People with chronic sleep deprivation are at a much higher risk of developing Type 2 diabetes.
• Immune system: Your body’s natural defenses against infections can’t work properly if you aren’t getting enough sleep.
• Nervous system: It’s common for people who aren’t sleeping enough to have higher pain sensitivity, which means they feel pain more easily, the pain is more intense or both.
• Brain: Sleep deprivation has very negative effects on how your brain works. While experts don’t fully understand sleep’s role in brain function, they do know it’s a key part of how people learn and remember. There’s also some evidence that sleep deprivation could play a role in the development of Alzheimer’s disease.
• Mental health: Sleep deprivation also negatively affects your mental health, making it harder for you to manage and process your emotions. People with sleep deprivation are more likely to feel symptoms of depression and anxiety.

​

The effects of sleep deprivation depend on why it happens and how long it lasts. The longer a person has sleep deprivation, the greater — and more severe — the effects.
Conditions that can get worse or happen because of sleep deprivation
Sleep deprivation also increases your risk of developing certain conditions or making them worse if you have them. These conditions include:

• Type 2 diabetes.​

• High blood pressure (hypertension).​

• Obesity.​

• Obstructive sleep apnea.​

• Vascular disease.​

• Stroke.​

• Heart attack.​

• Depression.​

• Anxiety.​

• Conditions that involve psychosis.​

​

Symptoms and Causes
Sleep deprivation causes many symptoms. Some of the most common symptoms include:

• Daytime sleepiness.​

• Fatigue.​

• Irritability.​

• Trouble thinking, focusing and remembering.​

• Slowed reaction times.​

• Headaches.​

​

As sleep deprivation goes on for longer, the symptoms become more severe. Many of the more severe symptoms look like the effects of alcohol intoxication. The severe symptoms of sleep deprivation include:

• “Microsleeps” (when a person briefly falls asleep for only seconds before waking back up).​

• Uncontrollable eye movements (nystagmus).​

• Trouble speaking clearly.​

• Drooping eyelids (ptosis).​

• Hand tremors.​

• Visual and tactile (touch-based) hallucinations.​

• Impaired judgment.​

• Impulsive (or even reckless) behavior.​

​

Stages of sleep deprivation
Total sleep deprivation, which is when you aren’t getting any sleep, happens in stages. These stages are:

• Stage 1: This is when you go at least 24 hours without sleeping. In this stage, the effects of sleep deprivation are similar to being under the influence of alcohol to the point where it isn’t safe for you to drive.
• Stage 2: Common symptoms of sleep deprivation intensify. Most people start to experience microsleeps in this stage and have trouble thinking or focusing.
• Stage 3: People in this stage start to show very severe symptoms like hallucinations. They may also struggle to communicate with people around them.
• Stage 4: The symptoms of sleep deprivation are at their most extreme. The above symptoms worsen to severe or extreme levels. Hallucinations are common and you struggle to tell what’s real and what isn’t.

​

How to get more deep sleep.

• Avoid stimulants such as caffeine, decongestants, high dose B-vitamin, adrenaline rush activities, or herbal stimulants.
• Alcohol. Alcohol in small doses may be tolerated but can easily aggravate the body and reduce deep sleep.
• Napping can reduce deep sleep during the night.
• Exercise earlier in the day to give the body plenty of time to return to lower resting heart rate.
• Bright lights in the evening and any lights during the night have a negative effect on deep sleep.
• Computer screens and smart phones just before bed and during the night stimulates the nervous system.
• Consistent sleep schedule has an accumulative effect on sleep quality.
• If you do not fall asleep roughly between 15-20 minutes then get up, go to the bathroom, do stretching, write down what is on your mind and other relaxation activities until you feel sleepy.
• Turn off the brain by writing down what you need to do for tomorrow, make list of what you would like dream about, how you would like to behave in your dreams, problems that you would like help from your dreams.
• Seek professional help if all else fails.

Ways to Monitor sleep patterns
The gold standard of an objective sleep analysis is a clinical sleep study. The following website explains the details of such a study. Sleep Study
Because my sleep problems were mild, I chose a wearable activity monitor that would track my sleep and daily activities instead of doing a clinical sleep study. I chose the Ouraring (Oura Ring: Accurate Health Information Accessible to Everyone) because of its long battery life, low profile design, and multiple integrating features. I have been wearing the ring since July 29 which has given me enough data to work with.
The ouraring tracts the duration of sleep how long it takes to fall asleep, lowest heart rate, average heart rate, the strength of the heartbeat (HRV), respiratory rate, awake time, 3 sleep phases (REM, light sleep, deep sleep), temperature (delta), and restlessness (%). It then uses algorithms to give a sleep score of 0-100. To be sure such devices are not clinically accurate, but they do offer a window into activity trends. Wearable devices does provide a measure of objective analysis of activity and sleep patterns.
The initial data showed that I slept at least 11 hours, 1-3 hours of wakefulness, and less than an hour of deep sleep. I test different exercises, diet, supplementation, and oxygen therapy to change the pattern.
I need to increase the light and deep sleep cycles to 3-6 hours, reduce wakefulness to less than 1 hour, and reduce REM sleep to less than 2 hours. My preferred goal is 6+ hours of combined light and deep sleep with deep sleep more than 3 hours.
The following is the chart of my daily sleep pattern since July.



The chart of the raw sleep data does show a positive trend after the middle of October. I am acutely aware that exercise is the best way to improve sleep. Therefore, I have also been tracking my exercises to help understand what effect it has on sleep.
The following chart shows the time spent on different exercises by date.
EWOT=Exercise With Oxygen Therapy at a clinic with 100% oxygen at 20L flow rate. H-EWOT= Home EWOT with 95% oxygen at 15L flow rate.



Towards the end of October, I added an hour of stairs 3-4 times per week, and it has improved my sleep patterns.
Since exercise has an accumulative effect on the body, I created a chart showing a 3-day accumulative exercise pattern.

 

[NewEngland Seeker]

To further increase the clarity of the pattern and life’s changes I have made I have averaged the sleep data over a 7-day period. For each day I would add the previous 6 days to the values and divide them by 7. I did this because of my experience that the quality of sleep is best measured over a 7-day period. I figured this out by observing that I could avoid the negative effects of a poor night’s sleep by getting extra sleep within that week. If I did not get the extra sleep within 7 days then the negative effects would result in a stress event, such as a cold, or persistent headache, or flu. Weekly headaches, in my late 30’s, that would last from Friday until more sleep on Saturday was the source of my inspiration. I changed my schedule to include extra sleep on Wednesday, and no more headaches.

The following is the data averaged over 7 days, plus individual charts.











Overall, the trendlines are in the right direction and since late October the trend has greatly improved when I increased stair climbing whenever I went to the gym. I also added oxygen at 2 liters/min while sleeping on October 25.

My sleep goal is to reduce the hours of sleep to 8, to get at least 3 hours of deep sleep, the rest of the night to be light sleep. However, 2 hours of REM would be fine. Wakefulness should be as little as possible, but at my age, less than an hour is fantastic.

My current experience shows that I must do at least an hour of strenuous sweaty exercise to improve sleep. Stair climbing is doing that because I start sweating by 10 minutes and drenched by the end of the hour. Now, I just must fine-tune the frequency, intensity and duration to find the sweet spot of efficient effort to best results.

My understanding that exercise is important to increasing the hours of deep sleep. As we age the length of deep sleep decreases. The body becomes more sensitive, it has an increase in chronic persistent pain, it has less circulatory efficiency, and it has less muscle mass.

Aerobic exercises refresh the lungs, increase efficiency of blood flow, improve the immune system, increase physical strength, and help reduce pain and inflammation. The key to the best outcome with exercise is the health of the heart.

The ouraring tracts the lowest heart rate, average heart rate, the strength of the heartbeat (HRV), oxygen level, and respiratory rate during sleep but only tracts the heart rate while exercising. The lowest and average heart rate, and the strength of the heartbeat during sleep is a great indicator of heart health. The strength of the heartbeat or HRV is an excellent indicator of the autonomic nervous system balance. If the HRV score is lower than your average, then the body is in the stress (fight/flight) mode. Conversely if the score is higher than your average that the autonomic nervous system is in the relaxed (rest/digest) mode. The long-term goal is to increase the average HRV score through strenuous exercise thus lowering the nighttime lowest and average heart rate while maintaining a high blood oxygen level.

As a rule of thumb:

• Higher HRV is associated with rest-and-digest, general fitness, and good recovery
• Lower HRV is associated with fight-or-flight, stress, or illness

More about HRV from ouraring website.

You searched for HRV - The Pulse Blog

ouraring.com

With the current data and changes in the data I have decided to do two days of 2 hours-strenuous-exercise, which will put the body in stress mode, followed by 1 day of rest/recouperation mode. Thus, creating a yin-yang affect on the autonomic nervous system, which should result in an increasing HRV score. With the increase in HRV score the body will become less stressed and more relaxed which will result in increased healing energy. This improvement should also result in decreasing nightly average heart rate and the lowest heart rate.

In conclusion, my focus on deep sleep is due to my experience in the past of extraordinary healing after a hard deep sleep. This observation pricked my focus on sleep quality and research into sleep cycles. I have not been getting that wonderful deep sleep with age, even though I have been exercising. This personal study is my taking the bull by the horns and doing an objective detail analysis of the factors that affect sleep quality. This study will reveal my struggles in achieving the goal of healing sleep and provide useful information for others.

 

[NewEngland Seeker]

December’s sleep update.

During December, I dramatically increased the exercises to strengthen the body before the January 3rd melanoma surgery. The surgery was going to be two and a half hours long with anesthesia. Such stress on the body takes a long time to recover plus the anesthesia would have a negative effect on the brain. Because of these future demands on the immune system and mental functions I increased the home exercise with oxygen, H EWOT.

I anticipated that the increased exercise would stress the body thus negatively affecting the sleep pattern but was surprised with the results. The average deep sleep decreased by 45 minutes while light sleep increased by the same. The REM sleep pattern remained unchanged. Overall, no expected sleep disturbance from the significant increase in exercising.

Charts: 1; December's Exercise, 2; December's Deep Sleep, 3; December's Light Sleep, 4; December's REM Sleep, 5; December's Wakefulness, 6; December's Combined Deep & Light Sleep

The dark blue of chart 1 is the amount of time I spent exercising with oxygen. I intensified the EWOT during the last week of December to maximize immunal strength before surgery. What surprised me was the corresponding increase in the healing sleep as seen by the combined increase in light and deep sleep. Plus the decrease in the less healing REM sleep.

This graph shows that oxygen therapy did mitigate the stress response to strenuous exercise from December 23 through the 31st. It shows that that the combined healing sleep, light & deep, improved from 50%-58%.
Dec., 23-31 Deep & Light Sleep


The change in the heart rate, HR, and the heart rate variability, HRV, likewise improved in December. The downswing of the HR and the corresponding upswing the HRV during the last half of December indicates that a stronger heart and more restful autonomic nervous system.
Charts: 1; December's HR, 2; December's HRV

Overall, December’s sleep pattern improved with the increased EWOT. The heart strengthened and the central nervous system also improved during the month which, was a much-needed benefit.

 

[Maya]

I know that healing occurs best during deep sleep and my sleep has been adequate at best. I already optimized diet and exercise, so the weak point seems to be recovery during sleep.

Dear @NewEngland Seeker I wish you a lot of good sleep for speedy and succesful, complete recovery.

 

[NewEngland Seeker]

January’s Update:

January was eventful. The melanoma surgery was on the 3rd and the post-surgical pain lasted a week. I was able to resume H EWOT on the 8th which was very effective in improving deep sleep from the 10-17. The first chart shows a significant increase in deep sleep.

However, the quality of sleep had decreased in January since the surgery. This was due to the increased total hours of sleep, the increased wakefulness of night, the increased REM sleep, and the decrease total of the combined deep and light sleep. Charts 2-5 shows the overall trend of the post-surgical decreased sleep quality.

Exercise was helpful with the recovery but not enough to reduce the body’s stress level. The body’s stress level steadily increased due to multiple factors but mostly because of the increased immune response. The nighttime HR and HRV were the best indicators of the body’s stress level. Charts 6 & 7 shows the stress level has increased as shown by increase resting HR and slight decrease in HRV.

Click on the charts to expand to full screen detail.

The body’s nighttime temperature changed dramatically in January. The chart of the nighttime temperature from August – November shows variations but the overall temperature was normal. December’s nighttime temperature had more variations but overall, it too was normal. However, January’s nighttime temperature shows a significant upswing in nighttime temperatures and is trending above normal. This is another sign of increased post-surgical immune response. Charts 8-10 are self explanatory.

The bottom-line, January’s sleep quality declined due to the surgery and post-surgical immune response. The health issues will complicate this sleep study. However, it will help to find the best methods in improving sleep under stressful conditions.

 

[NewEngland Seeker]

February's Update:

The takeaway for February’s sleep pattern was that the first immunotherapy session on the 15th had a significant negative affect on the healing deep and light sleep. It also increased the REM sleep and wakefulness. Overall, there was very little healing sleep for about 2 weeks after the immunotherapy session. However, after the 50-grams of vitamin C-infusion a week later there was obvious improvement but not back to the needed level. Also, after the 15th, there was a drop in exercise due to the pain and weakness from the chemo. I was able to re-establish the exercise program after 3 days extra rest. The resting heart rate shows rapid increase after the 15th most likely due to the chemo’s effect on the immune system. The HRV decreased prior to the 15th due to increased stress from exercising. The nighttime body temperature was higher than normal until the 50-grams C-infusion.


Overall, my healing deep and light sleep was negatively affected by the immunotherapy. The 50-grams C-infusion had a positive counter effect. My exercise regiment’s effect on the body’s stress level is still in transition and has not reached its balance. I am still in transition toward a stronger and more relaxed system with the exercise regimen and may take 4-6 months before results will be realized.

Furthermore, the immunotherapy has increased the complexity of the multiple factors that affect the healing deep and light sleep because of its unknown effects on bodily functions. It is going to take time to understand how to mitigate chemo’s side effects.

 

[Uperios]

What Is the Best Position for Sleep?​

Story at a glance:

• If you frequently toss and turn during sleep, chances are you’re a side sleeper or stomach sleeper. For sound, healthy sleep, you need to sleep on your back, in a neutral position, with a pillow under your neck, not your head, to maintain proper spinal curve
• Poor sleeping position is a common cause of aches and pains. It can also trigger or aggravate arthritic conditions
• If you’re a chronic side sleeper, it may take up to four months to retrain your body to comfortably sleep on your back. It may take even longer if you’re used to sleeping on your stomach

Dr. Mercola's Comment

I have known Peter for many years and he is always fun to be with. I was really impressed with his rationale for using this sleeping position and have personally been using it for a number of months and really enjoy it. I am not claiming that it is the only way to sleep, but encourage you to consider it and see if it works for you.

I do have three other comments that I think would help, though. The first is to recognize that a large percentage of the population has sleep apnea and if you are going to sleep on your back, this will likely worsen it. A solution for many, and one that I use myself, is to use paper tape over your mouth before you go to bed, thus forcing you to breathe through your nose and stop snoring.

The second, and perhaps most important, is probably one of the single most important things you can do for sleep, and that is to turn off ALL electricity to your room by going to the breaker box and shutting it off. You can have an electrician install a remote breaker for convenience, which is what I have done. This will virtually eliminate most electric fields in your bedroom.

This is important, as exposure to electric and magnetic fields during sleep can seriously impair your melatonin production and deep sleep. I used an expensive gigahertz electrical and magnetic meter to determine that the electrical fields in my bedroom decrease by 1,000 times when I shut off the electricity. It helps to use a battery operated talking clock so you can tell what time it is. I use one with a large button1 that works really well for me.

Lastly, remember to block all blue light once the sun goes down. This includes not only your home lighting but the lighting from your devices, phones, tablets, computers and TVs.