Monday, August 31, 2009

Student Athletes Sleep Better than their Inactive Peers

A new study in the Journal of Adolescent Health found that teenagers who routinely exercise vigorously have higher quality sleep than their peers.

Overall, athletes scored higher in sleep quality and mood and woke fewer times after falling asleep. They also had better daytime concentration and less fatigue. Athletes also scored lower for anxiety and depressive symptoms.

The study, conducted in Switzerland, included 434 adolescents with an average age of 17. Of the total participants, 258 took part in Swiss Olympic classes, which provide intense levels of training for high school students. They averaged about 18 hours of exercise per week. The other participants, recruited from Swiss high schools, averaged about five hours of exercise per week.

Students kept a log for seven days, tracking how much they exercised, how much sleep they got, the quality of that sleep, how tired they felt during the day, how well they were able to concentrate, and how tired they were at bedtime.

Findings suggest that consistent exercising is positively related to adolescents' sleep and psychological functioning. Results also indicate that males with low exercise levels are at risk for increased sleep complaints and poorer psychological functioning.

In July the Sleep Education Blog reported on a smaller study; it also found that regular exercise can lead to multiple improvements in the sleep of teens.

Sunday, August 30, 2009

Working Women Sleep Less than Men

A new study found that women who work full time sleep less than men, reports a University of Cincinnati statement. The study suggests that women often are responsible for most household chores and child care, which can affect their sleep.

The study’s researchers conducted a phone survey in which respondents were questioned about work, family and health status in addition to sleep-related questions.

Results of the study show that in addition to physical differences that cause women to sleep less, gender inequality during the daytime also causes women to lose sleep.

Women were more likely than men to report sleep disruption when they had unstable marriages, worked nonstandard hours or when family and job time overlapped.

Gender differences in health status accounted for 27 percent of the gender gap in sleep disruption, with women more likely to report health effects of sleep disruption. Struggles to balance work and family time accounted for 17 percent of the gender gap in sleep disruption, and parental status was responsible for an additional five percent of the gender gap.

Learn more about how sleep affects women at SleepEducation.com.

Saturday, August 29, 2009

Does Childhood Insomnia Exist?

As children begin to attend school regularly, many become involved in extracurricular and social activities that cut into their sleep time, which may result in insufficient sleep. Although children at any age can have anxiety that affects their ability to sleep, U.S. News & World Report notes that school-age children can develop what may be thought of as "pseudo-insomnia."

Parents may worry if their child is having a hard time falling asleep; however, it may be a problem that is fixed simply by adjusting bedtime. For instance, parents may set a bedtime that allows for 12 hours of sleep for a 7 to 8 eight year old child, who only needs 10 to 11 hours of nightly sleep. Pushing bedtime back by an hour may eliminate the child’s inability to fall asleep.

According to the American Academy of Sleep Medicine, children’s nightly sleep requirements vary by age. Suggested nightly sleep needs for children are:

  • Infants (3 to 11 months): 14 to 15 hours
  • Toddlers: 12 to 14 hours
  • Preschoolers: 11 to 13 hours
  • School-age children: 10 to 11 hours
Parents should help children build healthy sleep hygiene habits, which include avoiding TV in bed, preparing for bed with a routine, avoiding going to bed until sleepy enough for sleep, and waking at the same time each morning—including weekends.

Older children often develop a problematic sleep pattern called delayed sleep phase disorder. By waking late on weekends relative to weekdays, they shift their body clocks late and then have trouble with sleep onset on Sunday to Thursday nights. They may lie in bed and worry about their ability to fall asleep, which compounds the problem for them. This latter difficulty is often termed psychophysiological insomnia and is a common cause of adulthood insomnia as well.

Insomnia symptoms include difficulty falling or staying asleep, waking up too early or poor quality sleep.

Learn more about behavioral insomnia of childhood on SleepEducation.com.

Friday, August 28, 2009

Use of Codeine in Children After a Tonsillectomy Can Be Fatal

According to a new case report, the use of codeine for pain after tonsillectomies can be deadly in children who have a rare gene that causes the body to metabolize the drug at a faster rate than usual.

The gene is found in about one percent of white people, but could be present in as many as 30 percent of people of African origins, notes U.S. News & World Report.

The report was released after the death of a two-year old boy with the gene, who was given codeine after having his tonsils removed.

The child, who had a history of snoring and sleep-study confirmed sleep apnea, underwent a tonsillectomy at an outpatient clinic and was taken home. He died two days after the surgery when his body produced more than twice the normal level of morphine.

Prescribing codeine for children who have tonsillectomies to cure sleep apnea can be dangerous if the surgery does not cure the disorder, as the drug can suppress breathing.

Researchers involved in the study said that the tragedy shows the importance of keeping children in the hospital for observation for at least 24 hours after the surgery to ensure that the sleep apnea is gone.

According to the AASM, obstructive sleep apnea (OSA) is a sleep related breathing disorder that is seen in about two percent of young children. It can develop in children at any age, but it is most common in preschoolers. OSA often occurs between the ages of 3 and 6 years when the tonsils and adenoids are large compared to the throat.

Learn more about childhood sleep apnea on SleepEducation.com.

Thursday, August 27, 2009

Do Ads Influence How Babies Sleep?

A new study in Pediatrics found that more than one-third of photographs in advertisements and articles in magazines geared toward women, expectant parents, and parents of young children show babies sleeping on their sides or stomachs, and nearly two-thirds of the pictures show infant sleep environments that increase risk for sudden infant death syndrome (SIDS).

Pictures that show babies sleeping on their side or stomach create confusion about infant sleep and may lead to unsafe practices.

A total of 391 unique pictures from 34 magazine issues were analyzed for sleep positions, including whether or not the baby was placed on its side or stomach rather than on its back, as well as dangers in infant sleeping environments, including soft bedding. Only 36 (36.4%) pictures showed infants sleeping in safe environments.

Of 122 pictures of infants sleeping, only 64% showed the babies sleeping on their backs. Compared with pictures accompanying news articles, photos in advertisements were more likely to show babies sleeping on their sides or stomachs (39% versus 27%).

To reduce the risk of SIDS, the AAP recommends that babies sleep separately from their parents and be placed in a crib on their backs, without blankets, pillows, or other soft bedding. Soft and loose bedding increases the risk of SIDS about five-fold overall and 21-fold when babies are also sleeping on their stomachs, according to the researchers.

Learn more about SIDS on SleepEducation.com.

Wednesday, August 26, 2009

Snoring & Sleep Apnea: Tips for Bed Partners

The most common warning sign for obstructive sleep apnea is loud and frequent snoring. Often it is followed by silent pauses when breathing stops. Then choking or snorting sounds may occur when breathing resumes.

A person who has sleep apnea is usually unaware of the problem. So the bed partner plays a critical role in the identification of these symptoms.

But noticing the symptoms of sleep apnea is the easy part. The snoring may be too loud to ignore.

The hard part can be convincing a reluctant bed partner to get help. What can you do?

First, describe to your bed partner the sounds you hear as he or she sleeps. Mention that these sounds are indicators of pauses in breathing. People with severe sleep apnea stop breathing more than 30 times per hour.

If a family member or guest hears the snoring, ask him or her to tell your bed partner too. That way you're not the only one pointing out the problem.

Educate yourself about the many
health risks involved with untreated obstructive sleep apnea. Share your findings with your bed partner.

Bring attention to any daytime symptoms of sleep apnea that you notice. These include severe sleepiness and
drowsy driving.

Sometimes hearing is believing. For a skeptical bed partner, you may need to record the sound of his or her snoring.

That’s exactly what one member of the SleepEducation.com
discussion forum did.

“I recorded my husband and then let him try to sleep while it was playing,” she wrote on Aug. 7 in a reply to
a post about snoring. “He went and got a sleep study!”

Go along on your bed partner’s next visit to the doctor. Tell the doctor about the symptoms you’ve noticed.

Ask the doctor for a referral to an AASM-accredited sleep disorders center. You can find one near you at
www.sleepcenters.org.

Get more tips and read more about sleep apnea and the bed partner on SleepEducation.com.

Tuesday, August 25, 2009

Real Wives of Sleep Apnea

It certainly doesn’t involve as much drama as being one of the “Real Housewives of Atlanta.” But being a wife of a man with obstructive sleep apnea can be distressing.

A new
study examined the sleep of 17 OSA wives; they were compared with 17 wives of healthy sleepers. Results were controlled for age and menopausal status.

Data analysis shows that OSA wives had lower sleep quality. There was an increase in their time awake during the night.

They also spent more time in “stage 1 sleep;” during this stage of a
sleep cycle, sleep is very light and can be easily disrupted. These sleep parameters had a substantial correlation with tiredness.

Results also show that OSA wives had higher distress scores than controls. And they had higher scores on the Fibromyalgia Impact Questionnaire. Sleep parameters were moderately correlated with pain and distress.

In February the Sleep Education Blog
reported that there is hope for sleep apnea wives. Studies show that CPAP therapy can treat sleep apnea and benefit the marriage.

Wives also may play an important role in their husband’s CPAP success. A 2008
study showed that husbands were more likely to maintain regular CPAP use over five months when sharing the bed with their wife.

Learn more about
sleep apnea and the bed partner on SleepEducation.com.

Image courtesy of Bravotv.com

Monday, August 24, 2009

Sleep Problems & Kidney Failure

A small study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine examined the sleep quality of people with both kidney failure and obstructive sleep apnea.

The
study involved 30 adults with moderate to severe OSA; 12 of them had kidney failure – also called end-stage renal disease. The other 18 people had normal kidney function.

Results show that people with normal kidney function slept for about 5.5 hours during an
overnight sleep study; but people with kidney failure slept for only 4.4 hours.

Why was their sleep so disrupted? In large part it was because of frequent
periodic limb movements.

People with kidney failure had about 31 PLM per hour of sleep; these movements caused almost 15 arousals per hour. In contrast, people with normal kidney function had only one arousal per hour caused by PLM.

The authors report that OSA is extremely common in people with kidney failure. But sleep disruptions tend to persist even after treating OSA with
CPAP therapy.

The study shows that PLM may contribute to the problem; the authors conclude that treating PLM may improve sleep quality in people with OSA and kidney failure.

The AASM reports that PLM involve simple, repetitive muscle movements. Usually a lower-leg muscle tightens or flexes. A typical movement is for the big toe to extend. Often the ankle, knee or hip also will bend slightly. People with PLM often have
restless legs syndrome too. Medications can treat both PLM and RLS.

Kidney failure commonly is treated by hemodialysis. Blood is drawn from the body, cleaned and pumped back into the body. In May the Sleep Education Blog reported that some dialysis clinics now offer to perform the treatment while patients sleep.

Sunday, August 23, 2009

Race & Daytime Sleepiness

Are African-Americans sleepier than whites?

Both a 2003
study and a 2006 study reported that African-Americans have higher scores than whites on the Epworth Sleepiness Scale. The ESS measures how likely you are to fall asleep in eight common situations.

Why might African-Americans score higher on the ESS? It could be that they are more sleep deprived than whites; or perhaps they are more likely to suffer from sleep-disrupting disorders such as
obstructive sleep apnea.

Or maybe there is another explanation. A
study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine investigated.

The study analyzed the ESS scores of 687 patients who were referred to a hospital-based sleep clinic; 52 percent were African-American. The results were validated in a second group of 712 adults; 57 percent of these people were African-American.

Results show that in both groups, African-Americans had higher average ESS scores than whites. Statistical adjustments were made for factors such as sleep duration, body mass index and sleep apnea severity; they had little effect on the difference.

Further analysis showed that the difference in scores may be explained by two of the ESS questions: African-Americans in both groups were more likely than whites to report excessive sleepiness on questions six and seven.

Question six of the ESS asks how likely you are to fall asleep while “sitting and talking to someone.” Question seven measures sleepiness while “sitting quietly after lunch without alcohol.”

The authors suggest that the ESS is not measuring sleepiness consistently between African-Americans and whites. If one group really were sleepier than another, then their scores should be higher on all eight questions.

So what is it that causes the difference in scores for these two questions? The authors are unsure.

They speculate that there may be cultural differences in how the wording is interpreted. Or different life experiences may cause responses to differ. They cite a 2002
study, which found that culture can affect response patterns.

The ESS was developed in Australia and
published in the journal Sleep in 1991. Since then it has been translated into other languages such as Spanish, Chinese, Greek and Turkish. But the authors report that it has never been validated in an African-American population.

So does an ethnic difference in daytime sleepiness really exist? It remains unclear. But the authors conclude that studies using an objective measure such as the multiple sleep latency test could shed light on the answer.

Saturday, August 22, 2009

OSA, CPAP & Alzheimer’s Disease

A small study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine involved 10 older adults with both obstructive sleep apnea and Alzheimer’s disease.

They had an average age of 76 years and a moderate level of dementia. For six weeks they had used
CPAP therapy to treat their OSA. Then five of the people continued using CPAP therapy for a year; the other five stopped using CPAP.

Results show that sustained CPAP use produced long-term benefits. People who continued using CPAP remained stable or showed improvement on almost all measures; those who stopped using CPAP continued to deteriorate.

Subjective sleep quality improved significantly in the CPAP group. Their depressive symptoms and daytime sleepiness also stabilized.

The CPAP group also showed less cognitive decline. They showed evidence of improvement in executive functioning; CPAP also appeared to have positive effects on their mental processing speed.

The caregivers of people in the CPAP group also seemed to benefit. Their own sleep quality improved; their mood also remained stable.

According to the
NIA, symptoms of Alzheimer’s disease tend to appear after the age of 60. Alzheimer’s disease is the most common cause of dementia among older people. Dementia is the loss of cognitive functioning; this involves thinking, remembering and reasoning.

The AASM reports that OSA can occur in any age group; but it is more common between middle age and older age. The severity of untreated OSA also tends to progress over time.


On SleepEducation.com you can answer these questions to learn more about your risk for sleep apnea. Get help for sleep apnea at an AASM-accredited sleep center near you.

Friday, August 21, 2009

Five Risk Factors for Insomnia

A study in the Aug. 1 issue of the journal Sleep examined potential risk factors for insomnia.

The
study from Quebec involved 464 adults who were good sleepers; they had an average age of 45 years. Participants completed a variety of surveys that evaluated their sleep, mental health and physical well-being. Then they were followed up after six months and again after 12 months.

Results show that more than seven percent of the good sleepers developed insomnia syndrome during the one-year follow-up period; they were troubled by a sleep problem at least three nights per week for a month or longer.

Another 31 percent of the good sleepers reported having insomnia symptoms. They also had trouble sleeping at least three nights per week; but their sleep problem caused less distress or lasted less than a month.

In general, self-reported mental health was worse in people who developed insomnia syndrome; they reported more symptoms of depression and anxiety.

Further analysis identified five variables that increased the risk of developing insomnia.

The strongest risk factor was having a previous episode of insomnia. People with a prior history of insomnia were five times more likely to develop a new case of insomnia syndrome.

Another important risk factor was having a family history of insomnia; this increased the risk of developing insomnia by three times.

A third risk factor was cognitive “arousability;” people were more likely to develop insomnia if they have strong emotions and easily become frustrated or excited.

The other two risk factors were general health and bodily pain; insomnia was more common in people with worse self-reported health and more pain.

The study shows that symptoms of insomnia are extremely common. Often these symptoms are a short-term response to a stressor; this is called
adjustment insomnia. It tends to last for a few days or a few weeks.

Insomnia also may be related to other health problems. It can result from
medical conditions that cause discomfort, pain or breathing problems; it can be caused by a mental health disorder such as depression or anxiety; it also can result from the use of a drug or substance such as a prescription medication.

For an ongoing struggle with insomnia, you should seek help at an AASM-accredited sleep center near you.

Image by Kari

Thursday, August 20, 2009

Alcohol & Sleep: Nix the Nightcaps

A new survey by the Department of Health in England shows that many people fail to realize that alcohol can have a negative effect on sleep; 58 percent of surveyed drinkers were unaware that drinking can cause sleep problems.

One problem is that drinking alcohol may force you to go the bathroom more often during the night. The Department of Health
reports that alcohol stops the brain from releasing vasopressin; this chemical helps regulate the amount of water in your body.

Dehydration also can occur during the night as your body gets rid of too much water; this can cause sleep-disrupting headaches.

According to a 2005
review by the AASM, decades of studies also show that alcohol disrupts your natural sleep cycle. These disruptions tend to be dose dependent; they increase as the amount of alcohol you drink increases.

The review reports that alcohol initially may help you fall asleep. Then for a few hours there may be a short-term increase in deep, slow-wave sleep. But there also may be a decrease in rapid eye movement sleep – or REM sleep.

A 2002
study in the journal Sleep showed that these alcohol-induced changes in REM sleep can cause memory loss. The Department of Health suggests that this may help explain the “foggy” memory that many people have after a night of heavy drinking.

The AASM review also found that a withdrawal effect can occur later in the night. Your sleep may become lighter and more fragmented; the number and duration of awakenings may increase. Overall, it is likely that your sleep will be unrefreshing after drinking alcohol.

The review also reports that alcohol use can worsen
obstructive sleep apnea. Breathing pauses may occur more often and last longer.

Research clearly shows that alcohol can be disruptive to your sleep. Despite this evidence, many people continue to have a “nightcap” before going to bed.

A 2005
study in the journal Sleep found that about 11 percent of normal sleepers reported using alcohol to sleep. Results also show that the use of alcohol for sleep was an independent predictor of insomnia; about 29 percent of people with insomnia reported that in the past year they had used alcohol to help them fall sleep.

So what’s the bottom line? Nix the nightcap: Avoid drinking any alcohol before bedtime.


Effective treatments are available if you are struggling with insomnia. Contact an AASM-accredited sleep center for help.

Image by Craig Baker

Wednesday, August 19, 2009

Sleep Apnea in Adults with Down Syndrome

A small study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine shows that untreated obstructive sleep apnea is common in adults with Down syndrome.

Results show that 94 percent of people with Down syndrome had OSA; 88 percent had at least moderate OSA with an apnea-hypopnea index of more than 15 breathing pauses per hour of sleep; 69 percent had severe OSA with an AHI of more than 30.

This was much higher than the reported rate of OSA in the general population; it is
estimated that at least two percent of middle-aged women and four percent of men have OSA.

“Patients with Down syndrome have a great deal of risk factors for OSA,” senior author Dr. Carole Marcus told the AASM. “It was surprising how severe the illness was, and how the OSA was unsuspected by their caregivers.”

According to the
NICHD, a fertilized egg normally has 23 pairs of chromosomes. Most people with Down syndrome have an extra copy of Chromosome 21; this is called “trisomy 21” because there are three copies of the chromosome instead of two. Down syndrome can affect both mental and physical development.

Nine of the participants with Down syndrome were followed up in the sleep clinic.
CPAP therapy was recommended for all of them.

According to the authors, people with Down syndrome tend to die early. A 2002
study found that in 1997 the median age at death for people with Down syndrome was 49 years.

The authors suggest that untreated OSA may contribute to this early mortality. Yesterday the Sleep Education Blog
reported that severe OSA increases your risk of death.

Learn more about the study on
SleepEducation.com.

Get help for sleep apnea at an
AASM-accredited sleep center near you.

Tuesday, August 18, 2009

Sleep Apnea Increases Death Risk

A new study published today provides strong evidence that severe obstructive sleep apnea increases your risk of death.

The
study shows that the people with severe OSA were 46 percent more likely to die than those who did not have OSA. The risk of death in people with moderate OSA was increased by 17 percent.

The risk of death was even higher in men between the ages of 40 and 70; those with severe OSA were two times more likely to die than men their age who did not have OSA.

“Our study results really raise concern about the potentially harmful effects of sleep apnea,” principal investigator Dr. Naresh Punjabi said in a Johns Hopkins
statement. “Such an increased risk of death warrants screening for sleep apnea as part of routine health care.”

Eight percent of men and three percent of women in the study had severe OSA. High blood pressure, diabetes and heart disease were more common in people with moderate to severe OSA.

Learn more about the study on SleepEducation.com.




Last year a
study in the journal Sleep reported similar findings. People with severe sleep apnea were three times more likely to die during an 18-year follow-up period. The study also suggested that treating sleep apnea with regular CPAP use may prevent premature death.

On SleepEducation.com you can learn how
CPAP therapy can be a life saver for people with OSA. You also can answer these questions to learn more about your risk for sleep apnea.

Contact an AASM-accredited sleep disorders center for help with sleep apnea.

Monday, August 17, 2009

Osteoarthritis: CBT for Insomnia Improves Sleep & Pain

A study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine involved 51 older adults with osteoarthritis and insomnia.

Twenty-three people received
cognitive behavioral therapy for insomnia; they had an average age of 69 years. Each of the eight weekly CBT sessions lasted two hours; class sizes ranged from four to eight people.

CBT uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep. One common technique is relaxation training.

Results show that CBT improved self-reported sleep quality in people with osteoarthritis and insomnia. After treatment they fell asleep faster; they also spent less time awake during the night. Overall their sleep was much more efficient.

CBT also had a long-term effect; they were still sleeping better at a one-year follow-up. They also were sleeping more than 30 minutes longer each night.

Another finding was that people with osteoarthritis reported less pain after CBT for insomnia. The pain reduction was strongest during the month after the CBT sessions ended; a mild reduction in pain was reported one year later.

“Improvement of sleep may lead to improvement in co-existing medical or psychiatric illnesses, such as osteoarthritis or depression,” lead author
Michael V. Vitiello, PhD, told the AASM. “These additional benefits can be seen in the long term.”

The NIAMS
reports that osteoarthritis is the most common type of arthritis. It involves the loss of cartilage around the joints. It affects an estimated 27 million people in the U.S.; most often it occurs in older adults.

Last week the Sleep Education Blog
reported that studies have linked sleep and pain sensitivity. Treatments that improve sleep quantity and quality may make a person less sensitive to pain.

This can be helpful for people with a chronic pain condition. But it is unlikely to solve the problem of pain for them.

“Pain may be an outcome that has only a limited range to change,” wrote Patricia L. Haynes, PhD, in a
commentary that followed the study. “The pain is not going to go away.”

Learn more about insomnia due to medical condition on SleepEducation.com.

Sunday, August 16, 2009

Cognitive Behavioral Therapy for Insomnia: Safe & Effective

A recent article in the Louisville Courier-Journal reminded readers that medications aren’t the only insomnia treatment. Cognitive behavioral therapy is a safe and effective treatment option for people who are struggling with ongoing insomnia.

CBT uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep. One common technique is relaxation training.

“We teach people how to sleep again,” sleep specialist Ryan Wetzler told the Courier-Journal. He has a doctorate in psychology and is
certified by the AASM in behavioral sleep medicine. “We want to just figure out why somebody is not sleeping and get them sleeping again as soon as possible.”

Wetzler recently led a study of 115 people with insomnia; he presented a study
abstract in June at SLEEP 2009. Results show that CBT is effective in a “real world” clinical setting.

“We saw complete remission of their primary symptom in 50-60 percent of people,” said Wetzler.

People who had trouble going to sleep benefited from CBT; they were able to fall asleep 58 minutes faster after at least two treatment sessions. CBT also helped people who had trouble staying asleep; the time they were awake during the night decreased by 30 minutes.

Sixty-four people completed five or more CBT sessions. They woke up fewer times during the night; their total sleep time also increased.

In July the Sleep Education Blog
reported that online CBT programs also may be effective. They make the treatment available to anyone with Internet access. But some people may fail to follow through with online treatment.

Get help for insomnia at an
AASM-accredited sleep disorders center near you.

Image by Justin Silles

Saturday, August 15, 2009

Teen Depression: Sleep Cycle is a Risk Marker

A recent study shows that a teen’s sleep pattern may be a marker of his or her risk for developing depression.

The
study involved 48 teens who were “at risk” for depression; they had a high risk because of a parental history of depression. The at-risk teens were compared with 48 other teens in a control group; these teens had no personal or family history of a mental health problem.

The research team monitored the sleep cycles of the teens for three days. They also used lab tests to measure levels of the hormone cortisol; increased cortisol levels are related to depression in adults. The teens were monitored for up to five years.

Results show that the at-risk teens took less time to enter the stage of rapid eye movement sleep – or REM sleep. They also had more REM sleep and elevated cortisol levels. These teens were more likely to develop depression by the end of the five-year study period.

Previous studies had shown that depressed adults enter REM sleep earlier in the
sleep cycle; but it was unclear if this pattern also occurred in teens.

“This study is an initial step in determining baseline measures that differentiate healthy adolescents from those who are likely to develop depression,” lead author
Dr. Uma Rao said in a UT Southwestern Medical Center statement.

Rao cautioned that REM sleep and cortisol levels are not diagnostic tools; but they are “vulnerability markers” for depression.

“If we can identify factors such as sleep and cortisol and their role, we could start the prevention process,” she said.

The NIMH
reports that depression often occurs along with another disorder in teens; examples include anxiety, eating disorders and substance abuse. By age 15, girls are twice as likely as boys to have had a major depressive episode.

Earlier this year the Sleep Education Blog reported that sleep problems in children may predict the future onset of depression. A study showed that sleep problems at age 8 predict depression at age 10; but depression at age 8 did not predict sleep problems at age 10. The study found a strong genetic link for the presence of sleep problems.

Friday, August 14, 2009

The “Short Sleep” Gene: When Six Hours is Enough

A new study reports the discovery of the first gene involved in regulating the length of human sleep. A rare mutation in the “DEC2” gene enables some people to function well on only six hours of sleep per night.

“Subjects with the mutation are able to live unaffected by shorter amounts of sleep throughout their lives,” senior author
Ying-Hui Fu, PhD, said in a UC San Francisco statement.

Researchers identified the gene mutation in a mother and daughter; both women go to bed around 10 or 10:30 p.m. and wake up at 4 or 4:30 a.m. without an alarm,
reports the New York Times.

"It's not like they have sleep problems, they just don't sleep as much," Fu
told NPR.

But do people with the mutated gene really need less sleep? Or does the mutation prevent them from getting enough sleep?

“Right now all we can say is that they sleep less,” Fu
told Science News. “Whether they need less, we don’t know.”

We also don’t know if the effect of the gene mutation could be replicated by a drug. Could there be a “short sleep” drug in the future? And would it be safe? It could be decades before we know,
reports WebMD.

How common is the “short sleep” gene? USA Today
reports that it is found in less than three percent of people.

In contrast, the CDC
estimates that from 2004 to 2006, about 21 percent of U.S. adults usually slept for only six hours in a 24-hour period; about 8 percent reported sleeping less than 6 hours.

This means that most of the people who try to get by on six hours of shut-eye are depriving themselves of the sleep they need. This is called
behaviorally induced insufficient sleep syndrome. The sleep loss produces daytime symptoms such as fatigue, irritability and poor concentration.

“Many people get only six hours of sleep a night, but we drink coffee and tea to make ourselves stay up,” Fu told the New York Times. “That’s a very different thing.”

The AASM reports that a true
short sleeper will function well on five hours of sleep or less; there will be no daytime impairment. There also will be no need to “catch-up” on sleep during the weekend.

Most adults need about seven to eight hours of sleep per night. In 2008 people in the U.S.
reported sleeping an average of 8.6 hours in a 24-hour period.

Learn more about the study on SleepEducation.com.

Thursday, August 13, 2009

Daytime Sleepiness Can Be a Pain

A study in the Aug. 1 issue of the journal Sleep reports that healthy people may be more sensitive to pain if they are sleepy.

The
study involved 27 healthy, pain-free adults between 18 and 35 years of age. A physical exam, drug screening and lab tests confirmed that they were in good health. An overnight sleep study verified that they didn’t have a sleep disorder such as obstructive sleep apnea.

Participants were grouped as “sleepy” or “non-sleepy” based on the results of a
multiple sleep latency test (MSLT). The 14 people in the sleepy group fell asleep after an average of less than five minutes during the four daytime nap sessions; it took an average of about 13 minutes for the 13 non-sleepy people to fall asleep.

All participants then spent eight hours in bed during a night at a sleep center. The following day another MSLT was conducted. Results show that the healthy, sleepy people remained sleepy even after spending eight hours in bed. They still fell asleep in less than five minutes during MSLT nap sessions.

The day after the eight-hour night in bed also involved two tests for pain sensitivity; tests were conducted at 10:30 a.m. and again at 2:30 p.m. Participants placed their index finger on a radiant heat source; then they withdrew their finger when they felt pain.

For each person a pain threshold was determined; this was the heat intensity that produced a finger withdrawal in less than 21 seconds. Then both index fingers were tested at five different heat intensities.

Sleepy people showed increased pain sensitivity – or “hyperalgesia.” At all five heat intensities they withdrew their finger faster than non-sleepy people. They also had a lower pain threshold than non-sleepy people: 83 degrees versus 90 degrees. People in both groups were more sensitive to pain in the afternoon than in the morning.

Previous studies also have linked sleep and pain sensitivity. A 2007
study in the journal Sleep found that disrupted sleep increases spontaneous pain. A 2006 study in the journal Sleep showed that the loss of four hours of sleep promotes hyperalgesia. In 2000 a study reported that 40 hours of total sleep deprivation increased pain sensitivity.

The authors state that the solution can be simple for healthy, sleepy people: Spend more time in bed each night to get more sleep. But managing sleep can be more complex in people with chronic medical problems. In this case the authors suggest that a medication or cognitive behavioral therapy (CBT) may be needed to increase sleep time.

Wednesday, August 12, 2009

Sleep Loss & Type 2 Diabetes Risk

A new study adds to the evidence that links ongoing sleep loss with an increased risk of type 2 diabetes.

The
small study involved 11 healthy volunteers; they had a mean age of 39 years. They were slightly overweight with an average body mass index (BMI) of 26.5.

The volunteers spent two, 14-day periods in a sleep lab. The two studies were conducted at least three months apart,
reports MedPage Today. During one study period participants spent 8.5 hours in bed each night; during the other two-week study period their nightly time in bed was restricted to only 5.5 hours. In both studies their daytime activities were limited; but they were able to eat as much and as often as they wanted.

Bedtime restriction reduced their nightly sleep duration by more than two hours; during those two weeks they slept for an average of five hours, 11 minutes. Weight gain was similar during both study periods.

Results show that two weeks of sleep loss led to both insulin resistance and impaired glucose tolerance. These are two markers of an increased diabetes risk.


“These results would indicate that a healthy lifestyle should include not only healthy eating habits and adequate amounts of physical activity, but also obtaining a sufficient amount of sleep,” study co-author Dr. Plamen Penev said in a prepared statement.

Another
new study used survey data to link sleep duration with diabetes risk in Korean men; the risk of having type 2 diabetes was twice as high in those who reported sleeping five hours or less per night.

A
study published in May linked self-reported sleep duration with diabetes risk in whites and Hispanics; those who reported sleeping seven hours or less were twice as likely to develop diabetes.

A 2007
study in the journal Sleep analyzed survey data from almost 9,000 people in the U.S.; sleeping five hours or less increased their diabetes risk by nearly 50 percent.

The AASM reports that most adults need about seven to eight hours of sleep each night. Sleep plays an important role in regulating a number of body functions. These include body temperature, hormone production and metabolism.

Learn more about
sleep loss and diabetes on SleepEducation.com.

Tuesday, August 11, 2009

Back on Campus: Stress, Sleep & College Life

A new study shows that sleep problems will be common as college students return to campus for the fall semester.

The
study involved 1,125 students at the University of St. Thomas in St. Paul, Minn. They completed an online survey about their sleep habits, mood, health and related factors.

Results show that more than 60 percent were poor sleepers; these students were much more likely to have problems with their physical and mental health. Taking medications to sleep better also was common.

What was the primary cause of sleep problems? The authors report that students “overwhelmingly stated that emotional and academic stress negatively impacted sleep.” Data analysis revealed that tension and stress were significant predictors of sleep quality.

The study also shows that students were sleep deprived. Only 30 percent of students reported sleeping at least eight hours per night. Twenty percent of students stayed up all night at least once a month; 35 percent stayed up until 3 a.m. at least once a week.

This sleep loss had an effect on class performance; 12 percent of poor sleepers reported falling asleep in class or missing class at least three times a month.

"Students underestimate the importance of sleep in their daily lives,” study co-author Roxanne Prichard, PhD, said in a
prepared statement. “They forgo sleep during periods of stress, not realizing that they are sabotaging their physical and mental health."

The AASM reports that stress can lead to
adjustment insomnia. This involves disturbed sleep or sleeplessness that may last for a few days or a few weeks. Other symptoms may include anxiety, worry and tension.

The study authors state that intervention programs are needed to help college students prevent and overcome sleep problems. Some schools have already taken action.

In March a UC San Diego
program educated students about the benefits of napping. Last fall the Boston Globe reported that schools such as MIT are using seminars, workshops and contests to promote good sleep habits. And at Stanford a “Sleep and Dreams” class has been offered for years.

Monday, August 10, 2009

Parents: Help Kids Go Back to Sleep for School

You have all the school supplies on the list. You have new outfits or uniforms for your child to wear.

(Or you’ve pulled out the clothes that big brother or sister used to wear; they can be “new” again.)

In your head you anticipate all the upcoming changes to your daily schedule. It’s time to go back to school. But are your kids ready to go back to sleep?

Children tend to shift their sleep schedule during the lazy days of summer. They stay up late at night and then sleep late in the morning. So when the first day of school arrives, having to wake up at the crack of dawn can be a shock to the system.

To deal with this problem, sleep experts advise you to help your children begin to adjust their sleep schedule in the days before school starts.

For example your child can start going to bed and waking up 15 minutes earlier each day. This will be much more effective than if he or she tries to go to bed two hours earlier on the night before the first day of school.

Other tips for parents:


- Dim the lights earlier in the evening; let in sunlight earlier in the morning. The brain uses these lighting cues to help set the internal “body clock” that regulates sleep patterns.

- Begin having meals at the times when your children will eat during the school week. Meals are an important timing cue for the body’s sleep-wake cycle.

- Determine what time your child will need to wake up in the mornings for school; then set a
bedtime that will allow your child to get enough sleep. Teens need about nine hours of sleep each night; younger students need up to 11 hours of nightly sleep.

- Start practicing a regular bedtime routine with your child.

- Keep the
TV and computer out of your child’s bedroom.

Get more tips to
help your child sleep better.

Learn more about helping your child go back to sleep for school on SleepEducation.com. Read more sleep tips for students.

Sunday, August 9, 2009

We Sleep to Be Awake

In April the Sleep Education Blog examined the question of why we sleep. Research has been exploring complex answers to this simple question.

But a definitive explanation continues to be elusive; the question remains an “unsolved mystery.”

Now an
editorial by UCLA’s Jerome Siegel suggests that sleep may not fulfill a universal function across all species. Instead sleep appears to be adaptive; its role may be based on “ecological variables” that differ from one species to another.

This would explain why the
sleep habits of animals are so diverse, reports the Origins Blog. For example a brown bat sleeps more than 20 hours per day; but a giraffe only sleeps for about four hours.

Siegel views sleep as “a variant of dormant states” seen in both the plant and animal kingdoms. He proposes that sleep “optimizes the timing and duration of behaviour.”

So how and when an animal sleeps is based on its waking needs. The brown bat wakes up at the time of day when its food source is most plentiful; it’s the optimal time to eat.

Why do we sleep? Perhaps we need to understand why we are awake, Siegel suggests. That may be how we find the clues to the mystery of our need for sleep.


Image by Dhyanji

Saturday, August 8, 2009

Lying Awake & Sleeping in Two Shifts

Waking up in the middle of the night and being unable to return to sleep is one sign of insomnia. But a recent story on NPR’s “Morning Edition” suggests that this wasn’t always the case.



A period of wakefulness in the middle of the night used to be the norm. At that time there were no lights to turn on at night. When it got dark outside, it was just as dark inside.

A winter night can bring 14 hours of solid darkness. That’s a long time to spend in bed.

So what would happen? There are reports that people would sleep in two shifts through the night. In between, they would lie awake for a period of time.

But this wasn’t a frustrating, anxious, tossing and turning kind of awake. It was more of a relaxing, late-night pause before the early-morning sleep shift.

The story even cites a 1993
study that simulated this long, dark winter night. Fifteen volunteers spent 14 hours in bed in a sleep lab. The lights were turned out from 6 p.m. to 8 a.m.

Sure enough, they slept in two shifts. In the middle was a period of wakefulness lasting a few hours.

"You might think that lying awake for two hours would be a kind of torture," study author Thomas Wehr told NPR. "But it wasn't at all."

This news might be a comfort for older adults who tend to have more fragmented sleep. They may have a more flexible schedule that allows them to spend a long winter’s night in bed.

But 14 hours in bed? That’s close to impossible for most people today.

Yet you can implement a less extreme version of the two-shift sleep method. One proponent of the split-night sleep schedule is
Dan Henning, who is 67 years old. He is the offensive coordinator for the Miami Dolphins.

The Palm Beach Post
reports that he goes to bed by 9 p.m. Around 2 a.m. he likes to wake up for about 45 minutes of “personal time.” Then he returns to sleep.

So in a perfect world, what would be your sleep schedule?