Because mongodb will index sparse, compound indexes that contain 1 or more of the indexed fields, it is causing my unique, sparse index to fail because one of those fields
https://docs.mongodb.org/manual/core/index-partial/
As of mongoDB 3.2 you can create partial index to support this as well.
db.users.createIndex( { name: 1, email: 1 }, { unique: true, partialFilterExpression: { email: { $exists: true } } } )