Saturday, January 31, 2009

When Dreams Come Alive: REM Sleep Behavior Disorder

Dreams that come to life are the stuff of fantasy novels and horror movies. But it’s also a reality for people who suffer from REM sleep behavior disorder.

People who have RBD act out vivid dreams as they sleep. The dreams tend to be action-packed. The dreamer may punch, kick, jump or get out of bed and run. All of this occurs while he or she is still asleep.

The disorder may sound funny. But injuries are common. Cuts, bruises or broken bones may occur to the dreamer or to a bedpartner.

Why does RBD occur? Normally your brain paralyzes most muscles during the stage of rapid eye movement (REM) sleep. This is the
stage of sleep when you have most dreams and nightmares. RBD occurs when the brain fails to tell the muscles to remain still.

RBD is similar to
sleepwalking. But a sleepwalker tends to be confused upon waking up. Once awake, a person with RBD usually has clear recall of a vivid dream.

Sleepwalkers also are more likely to get up calmly, have their eyes open and walk out of the room. RBD actions tend to be more intense and dramatic.

RBD was identified and
reported in the journal Sleep in 1986. Sixteen years later a follow-up report was published by the same research team. People with RBD are at risk for developing Parkinson’s disease.

RBD appears to be rare, affecting less than one percent of people. It is more common in older men. A
new study followed 93 people with RBD. Participants had an average age of 65.4 years; 80 percent were men.

But stand-up comedian
Mike Birbiglia is evidence that RBD can strike when you are younger. During his routines he often shares true stories of his RBD episodes. He is even starring in an off-Broadway show called Sleepwalk with Me.

Laughter is good medicine; but people with RBD should seek medical help. Contact an
AASM-accredited sleep disorders center if you act out your dreams while you sleep.

Friday, January 30, 2009

“Footballers” Getting Premier Sleep in England

U.S. athletes aren’t the only ones talking to sleep experts. Sleep is catching on across the pond too. The Telegraph reports that soccer players – “footballers” - in England’s Premier League are getting help from a “sleep coach.”

The focus isn’t on
jet lag. Instead it’s on helping players overcome everyday problems that affect their sleep. Common struggles involve insomnia, injuries and frequent trips on buses and planes.

Mattresses and pillows are designed for a player’s specific needs. This includes his height and weight. Even his injury history is taken into account.

Before an important game the sleep coach helped one team replace the mattresses in their hotel. He also made sure that players who snore weren’t too close to other teammates.

Players are using pillows with imbedded iPod docks and speakers. They’re lulled to sleep by soothing sounds or “white noise.” But instead of an iPod, one player keeps a vacuum turned on for background noise while sleeping.

The sleep coach even gets the players’ wives involved. He counsels them on colors that can make the bedroom more relaxing. (He prefers an all-white room.)

It’s unclear if all this attention is affecting players’ performance on the field - or as they say, “on the pitch.”

Manchester United has won the last two titles and has an unmatched 10 titles overall. They’re in first place again this year. They also have two of the world’s best players in Cristiano Ronaldo and Wayne Rooney. So United just might be the best-sleeping team in the league.

Thursday, January 29, 2009

Happier Marriage, Better Sleep

A new study shows that marriage can affect your sleep – for better or worse. Results show that happily married women sleep better than women who are less satisfied with their marriage.

Women rated their “degree of happiness” with their marriage. They also provided information about any struggles they have with

“We found that happily married women report fewer sleep disturbances,” lead author Wendy Troxel, PhD, told
Reuters. This included difficulty falling asleep, nighttime awakenings, early morning awakenings and restless sleep.

The study involved a racially diverse sample of women. A
Pitt news release reports that there were differences in sleep quality based on race.

Caucasian and African-American women had more sleep complaints. Japanese, Hispanic and Chinese women had fewer sleep complaints. Caucasian and Japanese women reported the highest marital happiness.

The study had controls for other factors that may affect sleep. These included depression, finances and employment. Marital happiness still emerged as an independent risk factor for sleep problems.

earlier study of older couples also linked sleep problems and marital happiness. It found that having a spouse with sleep problems was related to having an “unhappy marriage.”

Japanese study also linked being unmarried with poorer sleep quality.

here for more about women and sleep.

Wednesday, January 28, 2009

Sleep, Caffeine & the Starbucks Effect reports that Starbucks stores are going to stop the continuous brewing of decaf coffee after 12 p.m. The move is part of an effort to save $400 million by September.

You’ll still be able to request a decaf coffee in the afternoon. But you’ll have to wait about four minutes for brewing time. The company reports that demand for decaf coffee in some of its stores tends to drop after noon.

This is likely due to the timing of the body’s sleep-wake pattern. A natural
“dip” in alertness tends to occur in the afternoon. So it is tempting to rely on caffeine in the afternoon to fight off sleepiness.

Caffeine is a drug that is a quick-acting stimulant. It reaches a peak level in your blood in 30 to 60 minutes. But it also can stay in your system for hours. This may cause problems when you try to go to sleep at night.

new review looked at studies of how caffeine affects your sleep. One study shows that people who don’t consume caffeine may sleep longer and have a better quality of sleep. Another study found that people may have less trouble falling asleep on days when they drink decaf coffee.

Choosing decaf is still likely to give you a small dose of caffeine. A
study found that a Starbucks decaf espresso may have 3 mg to 15.8 mg of caffeine. A 16-ounce serving of a Starbucks decaf brewed coffee may have 12 mg to 13.4 mg of caffeine.

In contrast, Starbucks reports that a
regular espresso may have about 75 mg of caffeine. But it’s the 16-ounce, “grande”-size Starbucks coffee that really tips the scales. It may have 330 mg of caffeine. Another study shows that this is the same caffeine content as six, 12-ounce cans of Mountain Dew. It’s also the same as two cans of an energy drink like No Fear.

Starbucks also reports that actual caffeine content can vary greatly. That’s exactly what
another study found. Researchers bought a 16-oz cup of the same type of coffee from one coffee shop for six straight days. They found that the caffeine levels ranged widely from 259 mg to 564 mg.

So in the afternoon you may want to skip the coffee and choose a drink with a lower caffeine level instead. Try a soda or a cup of brewed tea. Better yet, avoid caffeine and take a quick 20-minute nap; a study shows this may be your best option for an afternoon boost.

Tuesday, January 27, 2009

Sleep Apnea: The Leg Link

A new study finds an intriguing link between obstructive sleep apnea and your legs. That’s right, your legs.

The study reports that sitting for long periods of the day causes fluid to accumulate in your legs. When you lie down in bed at night, the fluid then shifts from the legs to the neck. The excess fluid in the neck reduces the size of the upper airway. This makes it easier for soft tissue in the neck to collapse and block the airway.

The study involved 23 healthy men who were suspected of having sleep apnea. None of the men were obese. Researchers measured the changes in their leg fluid volume and neck size from the beginning to the end of the night. They also recorded how much time the participants spent sitting during the previous day.

Results show that overnight changes in leg fluid volume and neck size are independently linked to the severity of sleep apnea. The study provides one explanation for why some people may have sleep apnea even though they are not obese.

The results also provide extra motivation for people with sleep apnea to get more exercise. Get up from your desk and get your legs moving to prevent fluid buildup.

Monday, January 26, 2009

Surgery Helps “Boy Who Couldn’t Sleep”

ABC News and Good Morning America report that a risky surgery has helped a 3-year-old boy who was unable to sleep.

Before the surgery Rhett Lamb was awake nearly 24 hours a day. Although his body was exhausted, his mind remained alert.

The sleepless nights caused plenty of trouble. He had mood and behavioral problems. He couldn’t even speak. Overall he was functioning at the level of an 18-month old.

His problems also took a toll on his parents. They were emotionally and physically exhausted. Caring for him around the clock caused them to suffer from sleep deprivation too.

For years his parents struggled to find the source of his problem. Finally a doctor discovered the cause:
chiari malformation.

CM occurs when the space at the lower rear of the skull is too small. This puts pressure on the brain and pushes it downward. As a result brain tissue may be forced into the spinal canal.

The surgery appears to have been a success. Rhett shocked his parents when he slept through the night for the first time. They rushed to his room in the morning to make sure he was breathing.

Now that he is sleeping well, Rhett’s development has improved dramatically. For the first time in his life he is interacting and playing with other children.

Sunday, January 25, 2009

Sleeping on the Job Proves Costly

ABC News reports that a nuclear power plant was fined $65,000 because security workers were caught sleeping on the job.

Video images of sleeping guards were recorded by a fellow guard at different times of day. A federal investigator also discovered a guard sleeping at his post.

The incidents occurred at the
Peach Bottom Nuclear Plant just outside of Philadelphia. The guards are responsible for protecting the plant from a terrorist attack.

Falling asleep on the job is a clear sign of severe sleep deprivation. This is common when security guards work more than one job.

Excessive daytime sleepiness can be a sign of another sleep disorder. These include
obstructive sleep apnea, restless legs syndrome and narcolepsy.

Sleepiness on the job also is a common sign of
shift work disorder. The problem can be severe for people who work rotating shifts or night shifts. This forces them to be alert at a time when the body is normally asleep.

Then they have to try to sleep during the day. Daytime distractions can make this difficult. In a
recent study of 163 nurses, more than 70 percent of the nurses report that they are unable to get enough sleep.

A recent study in the journal Sleep reports that night-shift workers can benefit from a realistic but strict sleep schedule. It helps them remain alert during the night shift and allows them to stay awake during the day on days off.

Subjects slept in dark bedrooms at scheduled times: 8:30 a.m. to 3:30 p.m. after the first two night shifts. From 8:30 a.m. to 1:30 p.m. after the third night shift. From 3 a.m. to 12 p.m. on the two weekend days off. And again from 8:30 a.m. to 3:30 p.m. after the final four night shifts.

They also were exposed to five, 15-minute sessions of
bright light therapy each night shift. Within two hours after waking up, they went outside for at least 15 minutes of natural light exposure. But they wore dark sunglasses whenever they were outside.

The schedule enabled them to perform well at work and sleep well at home. Contact an AASM-accredited sleep center if you are sleeping on the job or struggling with a shift-work schedule.

Saturday, January 24, 2009

The Phelps Plan: Get on a Schedule

Five months after the Beijing Olympics, Michael Phelps is back on a schedule. In the pool. In the weight room. And in bed by 10:30 p.m.

“I can get to sleep earlier,” Phelps told the
Associated Press. “I have no problem falling asleep now. I was completely worn out my first day back. After two hours or so of working out, I was absolutely dead. I had no problems falling asleep at 10 or 10:30 that night. It feels good to add some scheduling back to my life.”

His experience highlights one key for curing
sleepless nights: You need to get on a schedule.

Your body functions best when you keep to a regular schedule. This includes going to bed and waking up at the same times every day. Yes, even on weekends.

Regular meal times should be another part of your schedule. You also should try to get some exercise at a scheduled time. It doesn’t have to be a Phelpsian workout. Even some light exercise will help.

These routine events act as “timing cues” for your body. They are signals that let your body know what time of day it is.

Another important timing cue is daylight. Letting your eyes see the bright morning light alerts your body that it is time to get moving. In contrast, the dim evening light is a signal that it is time to wind down.

Following a daily routine is one way to help you fall asleep easier at night.

Friday, January 23, 2009

Sleep Prescribed for President Obama

Doctor’s orders: The new president needs to get some sleep.

FOX News reports that
President Obama likely got little more than an hour of sleep Tuesday night. After attending 10 inaugural balls, Obama got to work on Wednesday for his first full day in office.

FOX contacted three doctors to get health advice for the president. At the top of the list? More sleep.

“The 3 a.m. emergency phone call aside, if you don’t get your 7 hours of sleep a night, recent studies have shown your risk of heart disease, stroke, weight gain, diabetes and cancer go up,” Dr. Marc Siegel told FOX. “Lack of sleep interferes with thinking as well."

Dr. Keith Ablow agreed. He warned that cutting back on sleep could cause problems for the president.

“Ultimately, it’s going to be too much of a risk to his health,” he said.

Click here to read the full story.

Thursday, January 22, 2009

You Eat How You Sleep?

A new study adds to the evidence linking sleep duration with the risk of obesity. It finds that how long you sleep may affect how you eat.

The small study at the University of Chicago involved 11 healthy volunteers. Each participant stayed at a sleep laboratory two times for 14 days each time. During one stay they spent 8.5 hours in bed each night. During the other stay they spent only 5.5 hours in bed each night.

They had easy access to food during both stays in the lab. The study measured their intake of calories from meals and snacks.

Results show that they ate similar meals during both sleep conditions. But they consumed more calories from snacks when their sleep was restricted. Their snacks during sleep restriction also had a higher content of carbohydrates. Snacking increased the most between 7 p.m. and 7 a.m.

This was similar to
a previous study that linked sleep restriction to the levels of the appetite-regulating hormones leptin and ghrelin. Other studies also have linked sleep duration to obesity and diabetes.

What about you – do you snack more when you sleep less?

Wednesday, January 21, 2009

Are Musical Instruments the Answer for Sleep Apnea?

Maybe you shouldn’t have dropped out of band class in junior high or high school. There has been some recent interest in using wind instruments as a possible treatment for obstructive sleep apnea.

The theory is that playing a wind instrument makes the muscles in the upper airway stronger. This could prevent soft tissue in the throat from collapsing and blocking the airway during sleep.

The idea gained support from
a small study in 2006 in the British Medical Journal. Fourteen participants with sleep apnea learned how to play an acrylic plastic didgeridoo. They were given lessons and practiced at home for four months. They practiced for an average of about 25 minutes, 5.9 days per week.

Eleven people with sleep apnea were kept on a waiting list as a control. Results show that daytime sleepiness and sleep apnea severity improved in those who played the didgeridoo.

a recent study researchers put this wind-instrument theory to the test. They surveyed professional orchestra members. Their risk of sleep apnea was assessed using the Berlin questionnaire.

A total of 1,111 orchestra members responded. About 31 percent (348) had a high risk of sleep apnea.

And those who play a wind instrument? Did they have a lower risk of sleep apnea?

Actually, they were more likely than non-wind players to be at high risk for sleep apnea. But this was not statistically significant when adjusted for age, body mass index and gender.

So wind instruments may not be the answer for sleep apnea. But each instrument requires a different rate of airflow and air pressure. Future research could find that specific instruments have more treatment potential than others.

But there’s no need to go to an orchestra hall to find a treatment for sleep apnea. A sleep specialist at an AASM-accredited sleep center can determine which treatment option is best for you. Effective treatments include CPAP and oral appliances.

Tuesday, January 20, 2009

A Note to President Obama

Mr. President,

After today’s
inauguration and many inaugural events, the hard work begins. Actually, it continues. During this time of transition you had to hit the ground running.

The days ahead are sure to be long and hard. These times are uncertain. But one thing is for sure: You’re going to need some sleep.

The sleep habits of your predecessor are well known. President Bush made it clear
from the beginning that he likes an early bedtime. This even became known around the world.

Now you may not agree with many of his policies or strategies. But hopefully you see wisdom in making your need for sleep a high priority.

Sleep has such a profound effect on virtually every aspect of your life. Your physical health. Your mental and emotional well-being. Your performance. Your alertness. Your memory.

And America needs you at your best. As you said during today’s
inaugural address, “That we are in the midst of crisis is now well understood... the challenges we face are real. They are serious and they are many.”

There is plenty of
research that could convince you of the importance of sleep. But consider this one scientific review that seems to apply so well to your situation.

It focused on studies of sleep deprivation’s effect on how people make decisions. The review found that sleep loss impairs certain types of decision making.

In fact it reads like a checklist of decisions that a president has to make every day: “decision making involving the unexpected, innovation, revising plans, competing distraction, and effective communication.”

The review also pointed out that these skills are most needed by leaders during emergency situations. Unfortunately emergencies don’t follow a schedule.

Expect the unexpected,” it is often said. Perhaps it should also be said to prepare for the unexpected by being well rested.

You’re going to have some important decisions to make, Mr. President. So get a good night’s sleep. And another. And another. Why don’t you just make it a habit?

Monday, January 19, 2009

Preventing Nightmares and PTSD Flashbacks with Tetris

A new study in the online journal PLoS ONE shows that playing the computer game Tetris can reduce unwanted “flashbacks.”

This is promising for people who suffer from
post-traumatic stress disorder (PTSD). Could it also help other people who suffer from nightmares?

The study involved 40 people who watched a traumatic, 12-minute film. It contained scenes of real injury and death.

After a 30-minute break, half of the group played Tetris for 10 minutes. The other half sat quietly.

Flashbacks were monitored for one week using a daily diary. Subjects then returned to the lab for an assessment.

Results show that Tetris players had significantly fewer flashbacks. They also had fewer clinical symptoms of trauma.

At the one-week follow up, both groups scored the same on a recognition memory test for the film. This indicates that voluntary recall was similar between the groups. It was the rate of involuntary memories – flashbacks – that was different.

Tetris requires you to arrange a falling puzzle of colorful block-like shapes. The authors told
Reuters that the visual aspect of the game may compete with the traumatic, visual memories. It may interfere with how your mind forms and stores the memories.

One of the study’s authors noted that you have about six hours to affect memories before they are stored in the brain. Any type of intervention needs to be done in this window of time.

The AASM reports that nightmares tend to be the most disturbing aspect of PTSD. Often the dreams involve a flashback to the event that seems shockingly real.

Potential implications of the study also extend beyond PTSD. It suggests that a visual distraction like Tetris could reduce nightmares for anyone after a stressful event.

It could be especially helpful for children who are prone to having nightmares after seeing a scary movie or other distressing images.

Sunday, January 18, 2009

Sleep Apnea and Gout: A Painful Connection?

A letter posted in the online Medscape Journal of Medicine on Jan. 5 suggests that there is a clear link between obstructive sleep apnea and gout.

What is gout? It is a painful condition that affects the joints. It occurs when high levels of uric acid build up in the blood.

Uric acid is produced when food is digested. Normally it is dissolved in the blood. Then it goes through the kidneys. Finally it passes out of the body through urine.

But excess uric acid forms salt crystals called monosodium urate. These crystals collect in or around the joints. These chalky deposits are called tophi.

This causes inflammatory
arthritis. The result is intense pain and swelling. Lumps also can appear under the skin around the joints.

Often gout will first affect the big toe. It can also affect other joints such as the ankles, knees, fingers and elbows.

The letter describes research that links sleep apnea to gout. Sleep apnea involves repeated breathing pauses. These pauses cause drastic changes in your oxygen levels.

The low oxygen levels cause a cellular reaction that ends in the generation of excess uric acid. According to the author, this explains why episodes of gout often occur at night.

The author recommends that everyone who has gout should be screened for sleep apnea.

Saturday, January 17, 2009

The Curious Case of the Sleep E-mailer

Add e-mailing to the long list of behaviors that can occur during an episode of sleepwalking.

The journal
Sleep Medicine has an article “in press” that will appear in an upcoming issue. It describes the case of a woman who sent some strange e-mails while she was asleep.

Sleepwalking can involve routine or unusual behaviors. Examples include making phone calls, walking outside or eating. But this is the first reported case of sleep e-mailing.

New York Times reports that the woman was taking Ambien for her insomnia. The sleep e-mailing occurred after she decided on her own to increase her dose.

Like any other drug, sleep medications may cause some side effects. These side effects can include sleepwalking,
sleep eating and other complex sleep behaviors. Some people also may experience memory problems.

AASM Tips for Taking Sleep Medications note that you should follow your doctor’s instructions when taking a sleeping pill. Never increase the dose on your own. You also should only take the sleeping pill for as many days or weeks as your doctor tells you.

The Times article also reports that a new feature from Google could help protect sleepwalkers from sending embarrassing e-mails. It’s called
Mail Goggles.

When enabled, it stops you from sending late-night e-mails on weekends. Before a message is sent, you have to solve a few math problems. The intent is to force you to stop and consider if you really want to send the message.

The math problems are fairly simple. But for a sleepwalker, it might be enough to prevent you from sending a strange e-mail to a co-worker or friend.

Update 03/02/09: The article appears in the February 2009 issue (volume 10, issue 2) of Sleep Medicine.

Friday, January 16, 2009

Drowsy Plow Driving

The snowstorms hitting the Midwest and Northeast are a nightmare for commuters. Driving would be nearly impossible without the armies of snowplows and salt trucks that come out to rid the streets of snow.

But for the plow drivers who work all night, clearing the streets isn’t their only challenge. The
Nashua Telegraph in New Hampshire points out that they also have to fight to stay awake.

Working through the night. Icy streets. Poor visibility. It’s almost a perfect storm for
drowsy driving. Especially for those who are clearing long stretches of empty highways.

What’s the extent of the problem? Clearing streets can involve thousands of people in the states and
cities with the most snow.

Illinois has more than 3,000 employees working to keep state routes clear. The effort involves more than 482,000 labor hours. The city of Chicago deploys a fleet of 274 trucks to clear city streets.

Chicago gets an average of about 39 inches of snow per year. But that’s nothing compared to the 116 inches of snow that falls on Syracuse annually.

Of course it isn’t just snow plow drivers who are in danger of drowsy driving. Any
shift worker is at risk. This includes truck drivers, pilots and police officers.

A shift-work schedule can cause severe sleep problems. The AASM offers these Sleep Tips for Shift Workers as a helpful resource.

Thursday, January 15, 2009

More Young Adults Using Sleeping Pills

The New York Times reports that the use of sleeping pills by young adults has risen dramatically. The biggest increase from 1998 to 2006 came among adults between the ages of 18 and 24.

The report is based on an analysis by
Thomson Reuters. It examined drug claims by adults under the age of 45. Overall sleeping pill use was highest among adults between the ages of 35 and 44.

The most popular sleeping pills were
Ambien CR and Lunesta. The drugs were prescribed for an average of 93 days.

AASM president Dr. Mary Susan Esther told the Times that chronic insomnia often is linked to other problems. These include depression and anxiety. In these cases a sleeping pill won’t address the related problem.

Insomnia also can be caused by disruptions to the sleeping environment. This is called
environmental sleep disorder. Dr. Esther pointed out that a noisy dorm is a common sleep disrupter for college students.

The report did not examine the use of other treatments for insomnia. One of the most effective treatments is
cognitive behavioral therapy. Following the tips of good sleep hygiene also helps some people with insomnia.

Like any other drug, sleeping pills may cause some side effects. These side effects can include
sleepwalking, sleep eating and other complex sleep behaviors. Some people also may experience memory problems.

The AASM offers these Guidelines for Taking Sleep Medications. Contact your doctor or pharmacist if you have any other questions about taking sleeping pills.

Wednesday, January 14, 2009

Finding the Face of Sleep Apnea

Do you look like you have obstructive sleep apnea? The evidence may be in your photograph.

Australian researchers are developing a “photographic analysis technique” to predict a person’s risk for sleep apnea. They take a digital photo of your head and neck from the front and from the side. The photos are examined using image analysis software. Then computations are made to measure specific aspects of the face and neck.

Their study in the Jan. 1 issue of the journal Sleep shows that people with sleep apnea may have distinct features. These include a shorter jaw, wider and flatter mid and lower face, and more soft tissues or fat deposits on the front of the neck. The findings were unrelated to differences in obesity.

another study in the same issue of Sleep they tested their new method to see if it could predict whether or not a person has sleep apnea. They found that it was correct about 76 percent of the time.

They caution that the method needs to be validated further. It also needs to be tested on other ethnic groups; 96 percent of study subjects were white.

Yet the new technique is promising. It is safe and could become widely available. It could help sleep specialists determine who is most at risk for sleep apnea. An
overnight sleep study or a home sleep test can then confirm the presence and severity of sleep apnea.

There is one drawback for some men; the photo technique won’t work if you have too much facial hair.

Tuesday, January 13, 2009

Sleep to Keep from Catching a Cold

It turns out that your mother was right all along. Getting more sleep can help you avoid catching a cold.

A new study shows that sleeping less than seven hours per night may make you three times more likely to develop a cold. There also was a link to “sleep efficiency.”

This is the percentage of time in bed that you are asleep. A high efficiency means that almost all your time in bed was spent sleeping. A low efficiency means that you were awake for much of your time in bed. Maybe you had trouble falling asleep. Or you woke up in the middle of the night and struggled to return to sleep.

To find your sleep efficiency, divide your total sleep time by your time in bed. For example, maybe you slept for 6.5 hours of the seven hours you spent in bed. This would give you a sleep efficiency of 93%.

The study found that those with an average sleep efficiency of less than 92% were 5.5 times more likely to develop a cold. Results remained significant after controlling for other factors.

The study involved 153 healthy men and women. They were between 21 and 55 years of age. For 14 days they reported their sleep duration and sleep efficiency from the previous night.

Then they were given nasal drops containing a rhinovirus. Their symptoms were monitored for five days while they were kept in isolation.

You can improve your sleep efficiency by following the tips of good
sleep hygiene. Seek help at a sleep center if you have an ongoing problem that keeps you from sleeping well.

Now if only someone would do a study to see if Mom was right about chicken soup. Oh wait –
it’s already been done.

Monday, January 12, 2009

Fighting Jet Lag in the NBA

Pro football players weren’t the only athletes fighting the effects of jet lag over the weekend. The Orlando Magic, Indiana Pacers and Miami Heat all played on the road against Western Conference teams on Sunday. Only the Magic won, escaping San Antonio with a 105-98 victory over the Spurs.

Jet lag is simply a part of life in the
NBA. The 82-game regular season schedule forces teams to criss-cross the country on a regular basis. Players can forget what city they’re in, much less the time zone.

But at least one team is fighting back against jet lag.
The Oregonian reports that the Portland Trail Blazers are taking advice from a sleep doctor. It seems to be paying off.

Last season the Blazers were 7-14 in games that were played two or more time zones away. So far this season they are 7-2 in those games. Overall the Blazers are 22-14 and in
second place in the Northwest Division.

The team is changing flight and practice schedules to let players get more sleep. Players also are encouraged to maintain a consistent sleep-wake pattern.

When playing on the East Coast, the Blazers don’t try to adapt to the new time zone. Instead they keep their body clocks set to a West Coast schedule. So a player who goes to bed at 1 a.m. in Portland will stay up until 4 a.m. in Orlando.

The Blazers will apply their new sleep strategy this week during another four-game trip east. It begins this evening with a game in the Central time zone against the Bulls.

Update (1/13/09): Blazers 109, Bulls 95

Update (1/14/09): 76ers 100, Blazers 79

Update (1/16/09): Blazers 105, Nets 99

Update (1/17/09): Bobcats 102, Blazers 97

Sunday, January 11, 2009

Blood Flow May Explain Link Between Sleep Apnea & Stroke

Research has shown that obstructive sleep apnea (OSA) increases your risk of stroke. According to the UCLA Stroke Center, OSA is found in almost 50 percent of stroke patients. But the mechanism by which sleep apnea increases stroke risk has been unknown.

new study may provide an answer. It shows that people with sleep apnea have decreased blood flow velocity in the brain’s arteries. Their brains’ blood vessels also have a lower rate of recovery when blood pressure drops.

These effects may impair the brain’s ability to regulate its blood flow. This may contribute to the increased risk of stroke in people with sleep apnea.

A stroke is a “brain attack” that occurs when blood flow to the brain is interrupted. It can result from either a blood clot that blocks an artery or from a broken blood vessel. Stroke is the third
leading cause of death in the U.S. as of 2005.

OSA involves repeated breathing pauses that occur during sleep. It can result in severe changes in blood pressure and oxygen levels.

Research also has linked sleep apnea to health risks such as high blood pressure, coronary artery disease, heart attack and heart failure.
Recent studies even show that sleep apnea increases your risk of death.

The good news is that sleep apnea can be treated. CPAP therapy helps normalize breathing during sleep. A 2005 study shows that CPAP may help protect people with sleep apnea from stroke and heart disease. In effect, regular CPAP use to treat sleep apnea just might save your life.

Saturday, January 10, 2009

Will Jet Lag Affect this Weekend’s NFL Playoffs?

A story takes an interesting look at this weekend’s NFL playoff games. West Coast teams Arizona and San Diego both must travel to the East Coast to play. Will jet lag affect their performance? Results from this season suggest it might.

Arizona finished 9-7 to win the NFC West Division. But the Cardinals were 0-5 in games on the East Coast. San Diego finished 8-8 to win the AFC West Division. They faired a little better on the East Coast, going 1- 3. The Chargers kept their playoff hopes alive by flying east to beat Tampa Bay 41-24 on Dec. 21.

Why would jet lag affect sports teams? Quickly crossing time zones disrupts the timing of your body clock. This can upset your sleep patterns and your daytime alertness.

It’s harder to adjust when you fly from west to east. You have to convince your body to go to sleep at night, and to become alert in the morning, hours earlier than normal. This is bad news for the Cardinals and Chargers.

Playing in the Pacific
time zone, the Chargers face a three-hour change when flying to the East Coast. Until November Arizona was also three hours behind Eastern Daylight Time since the state does not observe daylight saving time. But until March the state is now on Mountain Standard Time, a two-hour difference.

A study of more than 24,000 Major League Baseball games confirmed a jet-lag trend in sports. Teams with a three-hour time-zone advantage won 60 percent of the time. Teams with only a one-or-two-hour advantage won about 52 percent of the time.

So does the East-Coast advantage make the Panthers and Steelers a lock for this weekend’s games? Not so fast. The Cardinals will play their game at 8:15 p.m. EST. This may give them a slight edge.

Research suggests that athletic performance may peak in the late afternoon. Performance may decline at night as sleepiness increases.

A 1997 study in the journal Sleep analyzed Monday Night Football games from 1970 to 1994. It looked at every one of the games that had a West Coast team playing an East Coast team.

Each of these games began around 9 p.m. Eastern time. This means that games on the West Coast began at 6 p.m. Pacific time. In games played on the East Coast, the West Coast teams played at a 6 p.m. “body-clock time.”

The study found an advantage for the West Coast teams. They won about 64 percent of the games by an average of 14.7 points per game. They even won about 56 percent of the games played on the East Coast. Results remained significant even after controlling for home-field advantage and point spread.

So the “6 p.m.-alert” Cardinals will have a clear advantage over the “8 p.m.-sleepy” Panthers? Well, not quite.

Today teams have a better understanding of jet lag’s effect on performance. It’s common for them to arrive at the host city a couple days early. This gives players time to adjust to the new time zone. In effect the Cardinals may shift their body clocks closer to the East Coast time.

So how will it all pan out? Maybe each game will simply be won by the best team.

Friday, January 9, 2009

No Purple Hearts for PTSD

Does a U.S. soldier who has post-traumatic stress disorder (PTSD) deserve a Purple Heart? The question has sparked a heated debate in the military community.

Stars and Stripes, the American Forces Press Service and the New York Times report that the Defense Department recently rejected the idea.

A Purple Heart is only awarded when a soldier with one of the U.S. Armed Services is wounded or killed by enemy action.
Army Regulation 600-8-22 defines a wound as “an injury to any part of the body from an outside force or agent.” The wound “must have required treatment by a medical officer.”

The regulation lists PTSD as an injury that clearly does not meet these requirements. The Purple Heart has never been awarded for mental or psychological problems.

In a
May article in Stars and Stripes a military psychologist argued for a change in the policy. He said that PTSD is in part a physical disorder because it damages the brain.

The idea got the attention of
U.S. Secretary of Defense Robert Gates. This prompted a review of the policy and stoked the debate.

Common signs of PTSD include feelings of intense fear and horror after a terrifying event. Sometimes this response is delayed. Symptoms may not appear until a few days or even weeks after the event.

nightmares tend to be most disturbing aspect of PTSD. In these dreams the event may be relived in a way that seems shockingly real.

Most people with PTSD also report having disturbed sleep. It can be very hard to fall asleep or stay asleep. This is known as “
adjustment insomnia.”

About half of people with PTSD get better within three months. For others it can be a lifelong problem.

What do you think? Are veterans with PTSD being overlooked?

Thursday, January 8, 2009

Should Teens Start School Later?

The Washington Post reports that Fairfax County in Virginia is the latest school district to join the debate over school start times. A proposal would change the start time of most high schools in the county from 7:20 a.m. to 8:30 a.m.

The goal is to help sleep-deprived teens get more sleep. Research shows that
teen sleep loss is related in part to a biological change that occurs during the teen years.

A shift in the body clock’s timing makes it hard for teens to fall asleep before 11 p.m. As a result teens fail to get enough sleep when they have to get up early for school.

But will teens really get more sleep if school starts later in the morning? Or will they just stay up even later at night?

A new study in the
Journal of Clinical Sleep Medicine examined this question. It focused on a Kansas county that changed the high school start time from 7:30 a.m. to 8:30 a.m. Results show that the change had a positive effect.

A higher percentage of students got eight or nine hours of sleep per night. There was a decrease in “catch-up sleep” on weekends. Daytime sleepiness also decreased.

The study also suggests that school start times may be linked to
drowsy driving. Crash rates for teen drivers in the county dropped by 16.5 percent in the two years after the change. In the rest of the state teen crash rates increased 7.8 percent.

Changing school start times can be a complex decision. It requires altering bus schedules. It has an impact on after-school sports, activities and jobs. It also affects after-school care for younger children.

But the change may be worth the effort. A
study looked at how the change affected more than 12,000 high school students in the Minneapolis Public School District. It found that student attendance and enrollment improved. Students also got an average of five more hours of sleep per week.

So what do you think? Should teens get a later start in the morning?

Wednesday, January 7, 2009

To Go to Sleep, Try to Stay Awake

Sometimes insomnia is a matter of willpower. Where there is a will, there is no way. You may be unable to fall asleep because you try too hard.

This is a type of sleep-onset insomnia. Sometimes it is called sleep initiation insomnia. Once you are asleep, you’re fine. The problem is getting to sleep.

The solution may be to shift your focus in the opposite direction. Don’t try to go to sleep. Instead, try to stay awake.

This method is called "paradoxical intention." It’s a form of cognitive behavioral therapy.

It involves a passive effort to stay awake. The key here is the word "passive." This means you don’t slap yourself in the face or pinch your skin to remain alert. You simply relax and try to stay awake.

The goal is to eliminate performance anxiety that develops when you try to fall asleep. Changing your focus should help you relax. As a result you should be able to fall asleep without even trying.

You can learn this and other methods from a behavioral sleep medicine specialist. Contact an AASM-accredited sleep center to find a certified BSM specialist near you.

Tuesday, January 6, 2009

To Go to Sleep, Get Out of Bed

For some people with insomnia, the key to falling asleep is their bed. They need to get out of it.

And sleep on the floor? No, they can still sleep in the bed. They just need to stop spending so much time in it.

This has to do with psychophysiological insomnia: psycho = mental, physio = physical, logical = study or science of. It occurs when the mind and body interact in a way that keeps you awake.

With this form of insomnia, you may learn to associate your bed with frustration. You toss and turn, unable to fall asleep. So getting into your bed causes feelings of anxiety.

This explains why you may sleep better away from home. You’re in a new bed and in a new environment. The negative associations are absent. So you are able to fall asleep quickly.

What can you do when you suffer from this type of insomnia? One step you can take at home is to practice "stimulus control." This is a form of cognitive behavioral therapy.

First, you should learn to associate your bed only with sleep. Don’t read, watch TV or talk on the phone in bed.

Second, you should go to bed only when you are sleepy. One of the worst things you can do is get into bed when you feel alert. That is a recipe for frustration.

Third, give yourself about 20 minutes to fall asleep. Then if you are still awake, get out of bed. Do something relaxing. Once you feel sleepy, go back to bed again.

You also should practice the healthy habits of good sleep hygiene. Create a relaxing bedtime routine. Try to wake up at the same time every day.

A medication also may help you with sleepless nights. Talk to your doctor before trying to treat insomnia on your own.

Monday, January 5, 2009

Should Drowsy Driving be a Crime?

Is drowsy driving a crime? That is the question that Maryland prosecutors recently faced.

In August a 19-year-old driver fell asleep behind the wheel. She swerved into oncoming traffic on the Chesapeake Bridge and hit a tractor trailer. The crash turned fatal when the truck plunged into the bay, taking the truck driver’s life.

In December prosecutors decided that they would not press criminal charges against the young woman. Instead she would only be cited for motor vehicle violations. Sleep scientist Dr. Charles Czeisler responded with an editorial in the Washington Post on Jan. 4.

Czeisler argues that drowsy driving should be a criminal offense. He writes that drowsy driving is as deadly as drunk driving. Czeisler urges Maryland to develop drowsy-driving legislation.

Together the AASM and the Sleep Research Society crafted model drowsy-driving legislation. It gives states direction on the issue. The model legislation includes exceptions for drivers who have a sleep disorder.

By all accounts drowsy driving is common. A 2002 Gallup survey found that 37 percent of people reported falling asleep or nodding off at least once while driving. Ten percent of drowsy drivers had driven drowsy in the past month.

It is also common for drowsy driving to be deadly. The U. S. National Highway Traffic Safety Administration (NHTSA) reports that drowsy driving is related to more than 1,500 deaths per year.

Yet drowsy driving often goes unreported. Unless the driver admits falling asleep, drowsy driving can be difficult to detect. Czeisler estimates that drowsy-driving crashes take the lives of about 8,000 people in the U.S. each year.

So what do you think? Should it be a crime to drive drowsy?

Do the Winter Blues Make You SAD?

Only 74 more days until March 20. What some people like to call the "vernal equinox." You know, the first day of spring.

But who’s counting, right? Certainly not people in states like Arizona, Nevada or California. There the sun is always shining. Or so it seems.

For the rest of us, there is winter. For some of us, there is a very long winter. Dark. Gray. Dreary. Cold – miserably cold. And depressing.

This kind of winter depression is called seasonal affective disorder (SAD). It may surprise you that SAD has little to do with how cold it is. Instead it’s all about sunlight. Or the lack of it, to be exact.

Sunlight is an important visual cue for your body. It lets your brain know that it is "showtime." Time to be awake, alert and active. Your brain responds by adjusting your body temperature and certain hormone levels.

The long, dark days of winter deprive your body of this signal. As a result, you may feel sluggish, sleepy and depressed. Like other forms of depression, SAD is more common in women.

To combat SAD the best thing you can do is to "see the light." Let your eyes see as much sunlight as possible. Sit by a window during the day. Go outside for a walk on your lunch break.

You can supplement this natural light with bright light therapy. In the morning you sit near a small "light box" at home for a specific length of time. This exposes your eyes to intense but safe amounts of bright light.

A study in 2007 also found that cognitive behavioral therapy can be an effective treatment for SAD. It can be used alone or together with light therapy. Some medications also may help treat SAD.

As with any other medical problem, you should discuss SAD with your doctor. He or she can develop a treatment plan for you.

What are you doing to cope with SAD this winter?

Sunday, January 4, 2009

Talking in Your Sleep

The Romantics climbed the Billboard charts in 1984 with the hit pop song, "Talking in Your Sleep." The lyrics feature the memorable chorus, "I hear the secrets that you keep, when you’re talking in your sleep."

Each night the song comes to life for many people who suffer from sleep talking. The AASM estimates that about five percent of adults are sleep talkers. About half of young children talk in their sleep.

Sleep talking is a "borderline" sleep disorder. It straddles the line between normal and abnormal sleep. Often it is simply a normal byproduct of the brain’s activity during sleep.

Sleep talking can provide a lot of amusement for a sleep talker’s bedpartner or roommate. Strange conversations. Incoherent mumbling. Funny outbursts. Think of a sleeping Dory muttering, "The sea monkeys have my money," in the movie Finding Nemo.

But sometimes sleep talking isn’t so amusing. The discussion forum at is filled with complaints about it.

The frequency of sleep talking can be annoying. The timing of it can disrupt a bedpartner’s sleep. The language can be offensive or embarrassing. The content of the conversation can even cause problems in a relationship.

Sleep talking also can occur along with a "parasomnia." This is a sleep disorder that involves undesired behaviors during sleep. Examples include sleepwalking and REM sleep behavior disorder.

Sleep talking rarely requires treatment. But you should contact a sleep center for help if episodes are extreme. You also should seek help if the sleep talking occurs together with unusual actions.

So what about you? Have you been told that you’re a sleep talker?

Saturday, January 3, 2009

How Much Does Insomnia Cost?

Insomnia is the most common sleep complaint. The burden of insomnia often includes anxiety and frustration. It also involves a high economic cost.

A study in the Jan. 1 issue of the journal Sleep examines the economic burden of insomnia. The study found that the indirect costs of untreated insomnia are much greater than the direct costs of treating it. The specific results may surprise you.

The study shows that the highest cost of insomnia is in lost hours of productivity at work. This accounts for 76 percent of all insomnia costs. The study estimates that a person with insomnia loses a whopping 27.6 days worth of productivity each year.

The second-highest cost of insomnia is attributed to absences from work. The study estimates that people with insomnia miss 4.36 days of work per year because of the disorder.

What about the direct costs of treating insomnia? Again the results are surprising. The study found that the highest direct cost is related to using alcohol as a sleep aid. Alcohol accounts for five percent of all insomnia costs.

(By the way: Alcohol is a terrible sleep aid. It may make you sleepy at first. But it will lead to disrupted sleep during the night.)

Consultations with a doctor account for about three percent of all insomnia costs. In the study less than one percent of the total annual cost of insomnia is related to prescription medications.

Here it is important to put the results in context. The study was conducted in Quebec, Canada. The authors report that Quebec’s centralized health-care system keeps medical costs low. The study also states that most medications used for sleep in Canada are inexpensive generic drugs.

Yet it is clear that the overall economic impact of insomnia is great. So what do you think? Does insomnia cause you to underperform at work?

Friday, January 2, 2009

Are You in a Sleep Recession?

It was no shock when economists finally determined that the U.S. economy is in recession. Our wallets and investments have been taking a pounding. So has our sleep.

Surveys by groups such as Amway Global Wellness Index, Compass Bank and ComPsych Corporation have all reported the same trend: The economy is keeping people awake at night.

A new study in the Jan. 1 issue of the journal Sleep takes a closer look. The study of 370 women links financial strain to decreased sleep quality and lower "sleep efficiency."

Women reporting financial strain had more sleep complaints. They also spent a greater percentage of time awake while in bed. "Financial strain" meant the women had trouble paying for basics like food, housing and medical care.

Economists expect things to get worse in 2009. So how can you fight insomnia during difficult times?

First you need to give yourself a break from the bad news. Turn off the TV and the radio, and get away from the computer. Spend some time relaxing and doing something that you enjoy.

Make sure you follow the principles of good sleep hygiene. Avoid caffeine and alcohol late in the day. Try to go to bed and wake up at the same times every day.

When problems persist, seek help at an AASM-accredited sleep center. A board-certified sleep specialist will determine the best treatment option for you.

One option is cognitive behavioral therapy. It helps you develop habits and a mindset that promotes good sleep. Your doctor also may prescribe a medication that can help you break the cycle of sleepless nights.

How about you? Are your worries about the economy keeping you awake at night?

Thursday, January 1, 2009

Sleep for Seven in 2009

So did you make a New Year’s resolution for 2009? Are you going to lose weight? Exercise more? Stop smoking?

We all know that resolutions can be hard to keep. It takes discipline to keep your commitment for the long haul. It also requires sleep.

Sleep? That’s right. Making sleep your top priority in 2009 will help you achieve all of your other goals. Your mind will be sharper and more focused. You’ll have more energy. You’ll feel better and more optimistic.

So maybe you should make a resolution to "Sleep for Seven." That is, to get at least seven hours of sleep, seven nights a week. The Seven Signs below are a good indicator of whether or not you need more sleep:

Seven Signs You May Need Seven Hours of Sleep in 2009

1. You’re dependent on an alarm clock.
2. You’re
drowsy driving.
3. You’re attached to the
coffee pot.
4. You’re making mistakes.
5. You’re forgetful.
6. You’re cranky, snippy and irritable.
7. You’re frequently getting sick.

How many of these seven signs describe you? What are you going to do to make sleep a higher priority in 2009?