Tuesday, August 31, 2010

New Mothers Sleep Plenty, Wake Often

No one ever says they expect to catch up on their sleep after having a kid. Somehow, mothers actually get plenty of rest – a full seven hours, according to new findings. Only those hours are sabotaged by waking to care for a sleepless infant for a total of two hours per night.

New mothers’ total sleep time surprised researchers at the University of West Virginia. The results of the study were published in the August issue of the American Journal of Obstetrics & Gynecology.

Participants wore sleep-monitoring devices on their wrists throughout much of the postpartum period. A group of 50 mothers were monitored in weeks 2-13. Another 24 new moms wore wrist actigraphs between the 9th and 16th weeks.

The total sleep time did not change through the later weeks, but the interruptions became less frequent.

Most mothers reported feeling fatigued during the daytime, despite getting more than the recommended amount of total sleep. Repeat overnight disruptions may prevent them completing full sleep cycles.

Few mothers chose to nap to fight off daytime fatigue. Naps that last less than 90 minutes won’t fully make up for lost REM sleep but may help mothers feel better.

In an interview with Reuters Health, head researcher Dr. Hawley E. Montgomery-Downs recommended moms can make up for lost sleep by napping when their baby naps. She also suggested couples who breastfeed can split the overnight duties by having milk ready in bottles.

Parents may also want to take a close look at their parental style. Last week the Sleep Education Blog reported infants wake less often when their parents are warm and emotionally available.

Always make sleep a priority. After all, couples who sleep well while caring for an infant are likely to last.

Monday, August 30, 2010

Study: Medical Pot Helps Chronic Pain Patients Sleep

Managing sleep can be difficult when you’re in constant pain. A small amount of medical marijuana appears to help patients with chronic neurological pain sleep through the night.

Patients with damaged nerves may experience seemingly unexplainable pain caused by a faulty signal in the body’s central nervous system. The initial pain may begin with a painful accident or medical condition. Untreated pain worsens by causing pathological changes to the brain and spinal cord.

One well-known example is the “phantom limb”, when an amputee feels pain located in a limb that no longer exists. There are several treatments for the physical anguish and sleeplessness from the condition, but there is no cure. The Sleep Education Blog reports cognitive-behavioral therapy can help patients manage pain and get to sleep at a regular bedtime.

The study on medical marijuana and chronic neurological pain appears in the August issue of the Canadian Medical Association Journal.

A group of 23 pain patients smoked three types of medical-grade marijuana with different levels of tetrahydrocannibinol (THC), the chemical compound that can cause a euphoric high. The potencies included 2.5%, 6% and 9.4% THC, as well as a placebo.

Participants were instructed to smoke the drug from a small pipe three times a day for five days. They did not know which type of pot they were smoking. They had a nine-day break before switching potencies.

Patients said they fell asleep faster and had better quality of sleep after they smoked more potent marijuana. Some experienced minor side effects including headaches, coughing, dizziness and dry eyes.

The study is among the first clinical trials investigating the uses and benefits of smoking medical marijuana. Most prior research uses THC extract to test marijuana’s medical effectiveness.

Marijuana is generally not recommended as a sleep aid. The drug can worsen your quality of sleep by reducing the amount of time spent in REM sleep. Regular users may become dependent on marijuana to sleep. Withdrawal from the drug can cause insomnia and strange dreams.

The American Academy of Sleep Medicine has not released a position statement on the use of marijuana as a sleep aid.

Image by Troy Holden

Sunday, August 29, 2010

CPAP Can Reverse Sleep Apnea-Related Male Infertility

A clinical sleep specialist may have the answer for would-be fathers with fertility woes. Infertility is one of the many health problems associated with obstructive sleep apnea. A new study shows it is reversible with the right treatment.

Continuous positive airway pressure (CPAP), the front-line treatment for obstructive sleep apnea, can solve the symptoms of sleep apnea, including infertility.

The study involved 10 men with an average of 57 years of age. All of the men were either obese or overweight with symptoms of sleep apnea. Each subject stopped breathing between five and 28 times per hour of sleep.

Following an overnight sleep study, researchers measured the participants’ secretion of the serum prolactin, a substance that affects male fertility. After 11 to 39 months of CPAP therapy the subjects’ prolactin levels decreased and in some cases normalized.

The findings are encouraging, but further research on the subject is needed due to the relatively small size of the study. Several past studies have investigated the topic but have had mixed results.

More research is needed to determine if alternative approaches including oral appliance therapy and surgery may also possibly help reverse infertility.

Saturday, August 28, 2010

Consumer Alert: Unauthorized Sleep Aid Contains Dangerous, Addictive Sedative

The Canadian government has issued a warning against the sleep aid Fulda Unitang Herbs Sleep Plus. The unauthorized supplement contains high levels of the prescription sedative estazolam.

Health Canada reports the drug poses a serious health risk. Estazolam is a member of the benzodiazepine drug class, which includes Valium and Ativan.

The label-directed dose of Fulda Unitang Herbs Sleep Plus exceeds the maximum recommended dose of estazolam for healthy adults. The sedative can impair mental alertness, leaving unknowing but healthy consumers at risk for an accident. The drug is dangerous for pregnant and breastfeeding women, children, the elderly and people with respiratory, kidney or liver problems.

Worse yet, the drug is physically addictive. Anyone who has taken Fulda Unitang Herbs Sleep Plus should consult a doctor immediately. Withdrawl symptoms can include anxiety, sleeplessness, vomiting, sweating, tremors, cramps and convulsions.

If Fulda Unitang Herbs Sleep Plus is in your medicine cabinet bring it to a pharmacy for safe disposal.

Friday, August 27, 2010

Trapped Chilean Miners Struggle to Sleep

A half mile under the Chilean desert, 33 men are in the early stages of an ordeal no human should ever experience. They’re trapped together in a pitch-black 600-sq-ft mining chamber for at least the next several months.

Weeks ago, the men were presumed dead in a mining accident. Everything changed this week with the bombshell announcement by the President of Chile. Rescuers discovered a note tied to a rescue probe claiming each of the 33 miners survived the cave-in. They were confirmed alive a short time later when the rescue team made contact through a narrow ventilation pipe – a lifeline for food, water and communication.

The unsettling reality of the situation quickly overshadowed the initial celebration. The trapped miners face the next 4-5 months entombed in living hell.

Almost every aspect of the story is grim. The mental toll on the minors has to be unimaginable. The promise of rescue exists, but it’s not definite. Rescuers have no room for error as they dig a new tunnel system to reach the chamber. One mistake could extinguish any remaining hope.

There is always the possibility of violence. A single mental breakdown or hotheaded argument could escalate to a tragic outcome.

The miners’ day-to-day experience is equally as horrifying. The chamber is a stagnant 90°F. It’s boring. The only light comes from flashlights on the men’s helmets.

The miners’ don’t stand a chance at getting restful sleep. The human sleep-wake cycle is regulated by natural light. Circadian rhythms run wild in the absence of sunlight. It’s conceivable that every miner is operating on a different sleep cycle.

The impact on sleep is similar to what astronauts experience on long missions. Unlike astronauts, these men have no way to prepare or adapt to living without natural sunlight.

Similar to how astronauts use work such as experiments to cope with sleep deprivation, the workers are trying to stay busy in their waking hours. They’re spending their time doing menial work and playing cards and dominos.

The comfort issue is another sleep-killer for the miners. The men are crammed together in a small, hot space. Noise disturbances are constant. There are no beds, so the men sleep on the stone floor or makeshift cots made from rocks.

Fortunately, the miners appear to be in good spirits. A video message recorded on a micro-sized camcorder shows the group singing and cheering. Although some appear emaciated, officials are confident they the men can stay alive until rescuers reach them. That could happen as early as next month, or as long as December.

Thursday, August 26, 2010

Emotionally Available Parents Produce Sound Sleepers

Warm caring parents wake less to the sound of a baby blaring. Disposition and parental style appears to influence how infants and toddlers sleep, research shows.

Parental instincts come into play. Basic emotional communication such as talking quietly and gently and responding to a child’s cues helps ease them to sleep. Investigators at Penn State University believe this behavioral lets the children know they are in a safe environment.

Distant, unresponsive or stern parents may find themselves waking to tend a child who is not sleeping.

You don’t have to spend hours tending to your child to be an emotionally receptive parent. Researchers report quality matters, not quantity.

Research assistants rated mothers’ parenting styles and their children’s sleep quality. A group of 35 families participated in the program.

The results are available online at the website for the Journal of Family Psychology.

There’s still no best way to get a baby to sleep. The matter comes down to an ongoing debate between the “cry it out” camp and those who believe in “attachment parenting” similar to what was demonstrated in the study.

The Sleep Education Blog recommends any parenting style should involve a relaxing bedtime routine.

Wednesday, August 25, 2010

Severe Alcoholism Destroys Sleep-Regulating Rhythms

A body clock broken by alcoholism may never tick again. New research shows chronic drinking can permanently damage the genes that regulate our sleep cycle.

It takes hard work and dedication to make a full recovery from alcoholism. It’s unclear if a full sleep recovery may ever follow.

The study was published on the website for Alcoholism: Clinical & Experimental Research. A print version will be included in the November 2010 issue of the journal.

Authors of the small study examined blood samples from 22 male patients who fit the DSM-IV criteria for alcohol dependence. Researchers compared the blood samples to a control group of 12 healthy men.

The alcohol dependence patient’s blood samples had lower baseline levels circadian clock gene expression. This means the patients have an elevated risk for sleep problems, as well as depression and cancer.

Findings show the circadian clock genes did not improve after the patients were put through early alcohol withdrawal treatment.

The findings are in line with a 2005 review by the AASM. Decades of studies show alcohol disrupts the sleep cycle. The relationship is dose dependent; frequent drinking can cause serious, long-term sleep problems.

Moderate drinking can also cause short-term sleep disruptions. Social drinkers may notice that alcohol can help them fall asleep, but they wake up feeling fatigued. Alcohol changes your sleep architecture. Time spent in restful REM sleep is replaced by deep, slow-wave sleep.

As the beer ads on television always say, if you drink, please drink responsibly. Drink in moderation and avoid using alcohol near bedtime.

Tuesday, August 24, 2010

Circadian Signs Found in Hair Samples

You can find out a lot about a person’s health just by taking a hair sample. Employers and police use hair tests to detect traces of alcohol, cocaine, marijuana, meth and many more oft-abused substances. Your doctor can tell you if you have any vitamin, mineral or nutritional deficiencies from a few dozen strands. And now researchers are learning hair tests can show when we are supposed to sleep and whether our body clocks are off track.

Findings published in the Proceedings of the National Academy of Sciences suggest hair sample testing may help specialists in sleep medicine diagnose circadian rhythm disorders. Hair follicle cells from the head or chin hair contain clock gene expressions. In other words, the amount of the genetic material RNA in your hair shows whether you’re supposed to be alert. Your hair has the most RNA during peak hours.

The Japanese authors repeatedly took hair samples from volunteers as they continued their daily routines. Over the course of three weeks they adjusted their schedule by four hours. Hair samples show their peak activity was still about two hours off, meaning their body clocks weren’t adjusted to the new sleep schedule.

The effect was magnified for rotating shift workers. Their body clock differed from their sleep-wake schedule by an average of five hours.

Beard hair worked best for the tests: researchers needed only three strands to detect circadian rhythms. It took about five head hairs for people with thick hair and up to 20 for thin head hair.
The technique is still in its infancy but has potential for clinical use, the authors argue. Hair samples could potentially tell us our chronotype and diagnose circadian rhythm disorder, jet lag and shift work disorder.
Read more about chronotypes and shift work on the Sleep Education Blog.
Image by Sciencehealth

Monday, August 23, 2010

Thunderstorms and Obstructive Sleep Apnea

When the sky opens up and thunder and lightning come crashing down your first priority should be seeking shelter in a safe place. Worry about your CPAP machine or oral appliance later. There’s little evidence strong storms will have a noticeable effect on sleep-related breathing.

The latest newsletter from the Harvard Medical School warned readers about sleep apnea during thunderstorms. The warning is exaggerated to say the least based on the mixed findings of the study cited in the article.

Researchers at University of Washington looked at how weather-related decreases in barometric pressure affected the severity of sleep apnea. Results show only one of three measures related to sleep apnea significantly changed because of the weather.

Large drops in environmental air pressure can cause sleep apnea to worsen. Another study found sleep apnea worsened at high altitudes, where the pressure is lower.

It’s difficult to say that severe thunderstorms won’t influence sleep apnea, but the change probably won’t be great. If you’ve already been diagnosed with sleep apnea, continue to use your CPAP or oral appliance. Otherwise worry about how air pressure causes obstructed breathing only if you’re moving to Denver and you think you have the symptoms of sleep apnea.

Friday, August 20, 2010

CPAP Helps Vets with Gulf War Syndrome, Breathing Problems

A machine and a mask go a long way towards improving the lives of the men and women who fought for their country during the first Gulf War. A small pilot study suggests CPAP can reduce the symptoms of Gulf War Syndrome and sleep-disordered breathing for veterans.

The study, published Friday in Sleep and Breathing, involved a small sample of Gulf War veterans with sleep disordered breathing and gulf war syndrome. Eight veterans were prescribed three weeks of therapeutic CPAP in the double-blind study. Nine others used a fake, non-functional version of CPAP. Before and after treatment, each participant answered questionnaires about pain, fatigue, cognitive function, sleep disturbance and general health.

All of the veterans who received therapeutic CPAP reported significant improvements across the board compared to the control group. More in-depth research with larger samples is needed before clinicians can recommend CPAP for Gulf War Syndrome. Currently there is no treatment.
The Institute of Medicine reports more than one-third of the 700,000 Gulf War vets complain of symptoms associated with Gulf War Syndrome. The symptoms vary from gastrointestinal illness, confusion and numbness, to vertigo, mood swings, fatigue and chronic pain.

The cause of Gulf War Syndrome is still officially unknown. The common belief is exposure to airborne environmental hazards associated with the war including toxic chemicals and dust led to many of the cases. It remains a mystery why some troops developed the chronic illness after only a short tour of duty while others who served for years in the field remained healthy. It’s suspected that some troops were genetically predisposed to Gulf War Syndrome.

Another recent study shows another group of American heroes also have an elevated rate of sleep-disordered breathing. The rescue workers who rushed to the wreckage of the World Trade Center on September 11, 2001 sacrificed their own health to save lives during the country’s darkest hours.

CPAP is the front-line treatment for sleep apnea and sleep-disordered breathing. Whether you are a veteran, rescue worker or civilian you may discover more restful sleep and improve their overall quality of life by seeking treatment at an AASM-accredited sleep center.

Photo courtesy U.S. Army Korea

Thursday, August 19, 2010

“Paralyzing Love” Shuts Off Neuroscientist’s Waking Functions

Oregon neuroscientist Matt Frerking is an extraordinary case of a person suffering from a rare sleep disorder. His narcolepsy with cataplexy prevents him from experiencing intensely positive feelings like joy or love without literally becoming paralyzed. Yet he continues to go about his daily life as a successful researcher and family man. He even drives to work.

Frerking was profiled on ABC’s television newsmagazine “Nightline” on Tuesday. His story will continue Thursday evening in the ABC primetime special “Secrets of Your Mind: Why We Do What We Do.”

The Sleep Education Blog reported earlier this summer that narcolepsy with cataplexy affects only .02 percent of adults in the world. Strong emotions such as surprise, anger or love trigger a sudden loss in muscle tone. Sufferers of the disorder may slump forward or even fall to the ground. They remain lucid throughout the attack, trapped in their bodies.

There is no cure, but Frerkin has adapted his lifestyle to avoid the attacks by suppressing his emotions and avoiding any environmental influences that may trigger strong emotions. A sizable cocktail of prescription medications also helps reduce and delay the attacks.

Frerkin has learned to pull himself out of cataplexy by neutralizing his emotions. He copes with the attacks by dreaming up complicated solutions to complex work problems while his body is paralyzed.

In the “Nightline” interview he regains control by thinking of “Snare Complexes,” whatever that means.

“Secrets of Your Mind: Why We Do What We Do” airs Thursday, August 19 at 8:00 p.m. est. on ABC.

Wednesday, August 18, 2010

Infant Comfort Helps Adults Sleep Slightly Sooner

An infant comfort may lull adults to dreamland. The sensation of being rocked to sleep may help people of any age fall asleep sooner. By manipulating the sense of balance we can replicate the same feeling without ever moving.

The findings were published in the August issue of the Journal of Clinical Sleep Medicine. A sample of 198 healthy normal sleepers laid with their eyes closed, with electrodes attached as researchers tested the experimental technique in a sleep laboratory.

Half of the study participants received an electrical current to stimulate the nerves in the inner ear that that regulate balance. The sleepers claimed they felt like they were floating, rocking and swaying. The currents continued for an hour as the subjects tried to fall asleep.

People who were “rocked to sleep” fell asleep an average of 14 minutes faster than the subjects who received a sham treatment.

Researchers had hoped the experimental treatment would be a cure for short-term insomnia. Data shows the difference in sleep length and quality is fairly minimal.

Home use of the treatment would be impractical even if it made a major difference for insomnia. Sleeping every night while wearing special electrodes is unlikely and physically rocking a grown adult to sleep is ridiculous.

Tuesday, August 17, 2010

REM Sleep Boosts Creative Problem Solving

The sleep stage sometimes characterized by vivid dreams is when your mind goes to work for you. A study presented at the Annual Convention of the American Psychological Association demonstrated how REM sleep can boost memory and creative problem solving.

Sleep researchers at the University of California, San Diego, used a word association test to show the difference REM sleep makes on memory. Participants took the test in the morning and the afternoon, after either a nap with REM sleep, a short nap without REM sleep or a quiet rest period.

The first part of the test resembled SAT word-analogy questions. One sample question was:

Q: Chips:salty::candy:______
A: Sweet

After a 90 minute rest period, the subjects moved onto the second round. That involved using the first round’s answers as a response to three seemingly unrelated words.

Q: cookie: heart: sixteen

The participants who were allowed REM sleep performed better in the afternoon, while the people who didn’t nap or get any REM sleep saw no improvement.

The authors believe REM sleep helped connect networks of previously unassociated information in the brain, which helped creative problem solving.

The findings are similar another recent study involving dreams and memory. Both results suggest REM sleep is when we pull together all the information from the day and turn it into memory.

Monday, August 16, 2010

CPAP for Sleep Apnea Obstructed by Insomnia

A double dose of sleep disorders can disrupt the first option of treatment. Patients who complain of insomnia more often give up on Continuous Positive Airway Treatment (CPAP), researchers at Johns Hopkins University report.

CPAP involves wearing a sealed mask while you sleep. A tube connected to the mask gently blows air into the back of your throat. The sensation may feel unnatural at first. Some patients give up on treatment before they become comfortable with CPAP.

This phenomenon appears to be worse among insomnia patients. People with insomnia may fixate on environmental distractions or sensations like muscle soreness or the urge to urinate while lying awake restlessly. The foreign-feeling CPAP machine might be a big hang-up for this type of insomnia patient.

The study looked at 232 patients’ medical charts at Johns Hopkins Hospital Sleep Disorders Center. Each subject was newly diagnosed with obstructive sleep apnea and prescribed CPAP. Questionnaire data shows 37 percent of participants had at least one form of primary insomnia.

Electronic monitoring data from CPAP shows patients who complained of sleep maintenance insomnia used their device for the fewest overall minutes.

The authors of the study believe more patients may stick with CPAP if their insomnia is first addressed. Cognitive-behavioral therapy is an effective long-term solution to insomnia and may also help CPAP adherence.

The two sleep disorders often coexist and have similar symptoms. A previous study shows 39 to 58 percent of OSA patients have insomnia. Insomnia and sleep apnea can reduce your quality of life, destroy your work productivity and increase your risk of getting in an auto accident.

Sunday, August 15, 2010

Sleep Drug during Depression Treatment can Solve Insomnia Symptoms

Insomnia and depression are often closely related. The relationship can go both ways: depression can cause insomnia, and insomnia can lead to depression.

Depression drugs are the front-line treatment for most patients, but as the bleakness of depression goes away the sleeplessness often stays.

A team of researchers say the insomnia can be easily solved by altering patients’ prescriptions. They found that pairing the hypnotic sleeping pill Lunesta with serotonin reuptake inhibitors (SSRI) may be the ideal approach for depression with insomnia.

The study involved 60 patients diagnosed with depression and insomnia. After one week of taking Prozac, the subjects began combining the drug with Lunesta or a placebo.

Patients who took the sleeping drugs reported a higher health-related quality of life. Depression improved and the patients had less difficulty sleeping.

The AASM reports that insomnia can occur in 85 percent of people with a major depressive episode. Frequent awakenings during the night are typical; waking up early in the morning and being unable to go back to sleep also is common.

Often the insomnia complaint is among the earliest symptoms to appear in a person with a mental health disorder. People often attribute their mental symptoms to poor sleep.

Photo by Max Talbot-Minkin

Saturday, August 14, 2010

Did Jet Lag Contribute to Famed Flight Attendant Outburst?

You’ve heard the story a million times now. Flight attendant gets fed up with passengers, curses them out on the planes PA system, quits job, grabs beers, opens hatch and slides down the emergency chute.

The theatric outburst elevated Steven Slater from anonymous flight attendant to working class hero overnight. He did exactly what everyone dreams of doing but would never dare to carry out: an epic cathartic release of all his job-related frustrations.

He’s been awarded with celebrity status, countless media interviews and eventually the inevitable book deal. Oh, and he’s charged with a federal felony.

What would make someone commit high-profile career suicide and risk going to prison? Exhaustion and jet lag must have contributed.

Jobs at commercial airline are among the worst for sleep. Most flight attendants are familiar with the dreaded rotating shift. Flight attendants are constantly switching shifts and making quick turnarounds. The most desired, exotic gig of working on international flights is the worst of all. International duty means shifts up to 18 hours long and constant battles against jet lag.

Living out of a suitcase doesn’t help either. A constantly changing sleep environment can be difficult even when staying in high-end hotel rooms.

Many of the stresses of the job are inescapable, such as flight delays and rude passengers. Flight attendants do have some degree of control over their sleeping patterns.

Sleep hygiene isn’t just for home. Try to bring your bedtime ritual with you on the road. If you’re a high strung flight attendant try taking a bath a couple hours before bed. Or pack your favorite yoga DVD and practice in your hotel room.

If you’re only staying in the time zone for a short time act as if you never left and sleep when people in your home time zone sleep.

Lengthier stays in other time zones require more preparation. Try gradually adjusting your sleep schedule starting about a week in advance. Go to bed a half hour earlier or later every night. Once you arrive in your destination use light therapy and try to stay awake until the late evening. It’s up to you to determine which approach to jet lag you’ll want to take.

One last piece of advice, take it easy with crew parties at the hotel. Alcohol will only fuel the effects of jet lag.

Friday, August 13, 2010

Parents Irate Over School Start Time Trade-off

A large urban school district’s move to accommodate children’s sleep needs seems to have backfired. Many parents are outraged that the Kansas City public schools decided to flip-flop elementary school and high school start times. Young children will be waiting at the bus stop before sunrise while teens get an extra hour of sleep.

District leaders had the students’ best interests in mind when they decided to make the switch. Extensive research links earlier high school start times to lower grades and more auto accidents. Many leading voices in the sleep field have advocated for schools to adjust for teens’ natural night-owl tendencies. Major school districts that pushed forward high school start times reported better grades, attendance and extracurricular participation.

The problems stem from costs. The Kansas City district would have to spend an estimated $15 million to buy new busses and hire drivers if primary and secondary schools started around the same time. District leaders say that is not an option.

The change resolves teen sleep issues but brings new daycare and safety issues for parents of younger children. Kids would finish school earlier in the afternoon, while many parents would still be at work. Parents are also weary over letting their kids stand outside in the dark, “at that time of the morning with weirdos” as one parent put it.

Although the research is not extensive, from a sleep health standpoint most elementary school children are able to adapt to earlier school start times. Younger children need more sleep than their teenage siblings, but are still wired to sleep easily in the early evening.

Teens need an estimated nine hours of sleep per night. That sleep need is difficult for most teens to achieve natural circadian rhythms combined with distractions such as cell phones and video games prevent them from feeling tired until late in the night. Some estimates show less than a quarter of teens get an optimal amount of sleep each night.

With bussing costs in mind there’s one option that’s rarely considered. What if high schools started mid-morning, after the traditional elementary school start times? The school day could run from about 9:30 a.m. to 5:30 p.m. Teens would have plenty of time to sleep in every day and children would get to go to the bus stop while it’s light outside. The main downside is that athletics and extracurricular activities would run late into the evening. What do you think? Are there any other downsides with starting school in the mid-morning?

Image by dave_mcmt

Thursday, August 12, 2010

Back to School Sleep Tips for Parents

It’s that time of year again when parents have to break the bad habits that keep kids up late during the summer months. The switch to an early morning wake-up call that comes with the start of school is the source frustration for parents. Getting kids to put down the Playstation controller and get to bed at a decent hour can be met with fits of refusal.

This bedtime battle is in the children’s best interest of course. Kids who use technology late into the night have trouble staying awake and alert in the classroom. As the Sleep Education Blog reported earlier this summer, children score higher in school when their parents enforce regular bedtimes.

Children need more sleep than adults for full daytime functioning and healthy long-term development. Individual sleep needs depend on the age. Younger children should get to bed much earlier than their adolescent siblings (see chart below).

If your child won’t sleep at bedtime it may be a sleep hygiene issue. Nearly a quarter of children have some kind of sleep complaint, whether its outright refusal to sleep or frequent trips to the bathroom.

The first step is to set a regular bedtime for your child, and enforcing it even on weekends. Staying up late on Saturdays may throw off their body clock and make bedtime difficult early in the school week.

A transition period may help children change their bedtime. Try putting them to sleep a half hour earlier every night until you have reached the desired bedtime. Then get them outside in the morning and expose them to sunlight. This can help them get used to being awake earlier by regulating their body clock.

Set an electronics black-out an hour before bedtime. Cell phones, computers and video games all have bright screens that can prevent children from feeling tired at bedtime. The stimulation from video games can also make winding down difficult. Try a reading hour instead and encourage a healthy hobby that can last a lifetime.

Chocolate, cola and caffeine in general should be off limits in the late afternoon and evening. There’s nothing more difficult than trying to get a kid on a so-called “sugar rush” to sleep.

Back to school can be a stressful time for families, but introducing these healthy habits can help kids adjust to early school start times, even if young people aren’t suited for early hours.

Tuesday, August 10, 2010

Sleep Apnea in Europe

The cosmopolitan youth of Western Europe share the same sleep-related breathing risks as their Yankee counterparts, medical data suggests.

Whether they live in Europe or North America, overweight male smokers who have a large neck sizes most frequently experience breathing pauses caused by obstructive sleep apnea. People of African descent appeared to have a heightened risk, report the authors of a recent study in the journal Sleep and Breathing.

The study involved 121 patients, age 40 or younger, in Brussels, Belgium. Most of the participants were men. 42 percent were of African origin.

Each of the participants was referred by a physician for an overnight sleep study between 2007 and 2009.

The average male participant experienced 39 breathing pauses per hour, an indication of severe sleep apnea. Africans had nine more pauses on average.

Many of the Belgian OSA patients were diagnosed with additional medical ailments. More than a quarter had high blood cholesterol. 1 in 5 had hypertension. And 13 percent had diabetes, depression or acid reflux.

If left unchecked obstructive sleep apnea lead to serious heart problems or even death. It can also lower your quality of life by preventing you from getting restful sleep.

Luckily there are several treatment options available. CPAP therapy is the front-line treatment for severe cases. Many patients elect to have surgery for OSA. A mouthguard-like device called an oral appliance is effective for light to moderate sleep-disordered breathing.

Monday, August 9, 2010

High Frequency of “Sleep Spindles” in Brain Make Sound Sleepers

Some people have no problem sleeping in the apartment next to the train tracks. Others wake at to footsteps and cricket chirps.

So-called “sleep spindles,” rapid pulses produced by the brain’s hypothalamus, appear to be why some people are prone to suffer from fractured sleep. A high frequency of sleep spindles can blanket the brain, protecting it from noise disruptions.

Researchers at Harvard University say their research suggests light sleepers don’t produce enough “sleep spindles.” The study was published in the August 9 issue of Current Biology.

A group of 12 subjects volunteered to spend three consecutive nights in a sleep laboratory. None of the volunteers had a history of sleep disorders.

After one night of sleeping in silence, the subjects spent two more nights suffering through a barrage of overnight noise interruptions. The sounds ranged from traffic to toilets flushing. The sounds played at 30-second intervals, increasing in volume until researchers noted a reaction.

EEG readings showed people who reacted to the fewest disruptions had produced more sleep spindles, even on the quiet night. Most of the spindles were produced during the second and third stages of slow wave sleep.

Participants often didn’t realize their sleep had been interrupted. As previous studies suggest, environmental sleep interruptions often go undetected and can lead to daytime fatigue even if you thought you had a full night of sleep.

Researchers say their discovery will hopefully lead to new ways to help light sleepers get uninterrupted rest in noisy places such as hospitals.

Image by Amanda G.

Saturday, August 7, 2010

Is Sleep Apnea Risk Higher for Asians?

As obesity rates climb to epidemic levels in nearly every U.S. state, one population may need to be especially weary of a serious sleep disorder linked to weight gain. People of Asian descent tend to have more severe obstructive sleep apnea than Caucasians of similar age and BMI.

The findings are especially alarming because the Caucasians in the sample tended to be much more overweight than their Asian counterparts. Differences in facial bone structure appear to be the reason why Asians have a higher risk for OSA.

The findings were the result of a joint study between University researchers in Australia and China published in the August issue of the journal SLEEP. A sample of 74 Caucasian patients from an Australian clinic and 76 Chinese patients from a clinic in Hong Kong underwent a sleep study and a series of physical and x-ray measures.

OSA prevalence was similar for both populations, but Caucasians with OSA tended to be more overweight with a larger neck circumference. Chinese patients had smaller, more restrictive facial structures. When BMI measurements were similar the Chinese participants suffered from more frequent and severe breathing pauses during sleep.

The study may have some limitations due to the nature of the sample. The patients came from two very different environments and socioeconomic and culture backgrounds. Researchers caution that those factors influence the health and lifestyle habits that lead to OSA.

OSA isn’t the only sleep disorder influenced by race. An abstract presented at SLEEP 2010 showed black, white and Hispanic people all responded differently to sleep deprivation and insomnia.

Friday, August 6, 2010

Acting out Dreams May Signal Dementia Decades Later

The strange sleep disorder that sounds fit for a murder mystery forecasts a not-so-bright future. REM sleep behavioral disorder is a parasomnia that makes people act out their dreams, sometimes violently. A single episode can be an early sign of degenerative brain disorders, such as Parkinson’s disease and dementia, researchers at the Mayo Clinic report.

Their findings were published in the August 2010 issue of Chest. The authors searched the Mayo Clinic’s 2002-2006 medical records for cases where patients developed neurodegerative symptoms at least 15 years after a RBD-related episode.

A total of 27 patients fit the researcher’s criteria. The onset of brain disorders occurred 25 years after symptoms of RBD, on average. Some patients took as long as 50 years to develop Parkinson’s or dementia.

Cases of dementia and Parkinson’s disease were nearly evenly split. One patient was diagnosed with multiple system atrophy. Some patients with dementia had dementia with Lewy bodies, which causes waking hallucinations.

People with RBD can act out their dreams because the brain fails to keep muscles still during REM sleep. Normally the brain paralyzes most muscles during the sleep stage where dreams usually occur.

REM sleep behavioral disorder can be dangerous to the dream or a bedpartner. A person with RBD can do anything from hitting or kicking to running out of the bedroom. AASM-accredited sleep centers offer effective treatment options for people with RBD.

Thursday, August 5, 2010

Sleep Deprivation Impairs Troops’ Moral Decision-making Ability

Military officers are asked to make split-second decisions on the battlefield with life or death consequences. By nature, military operations often involve extended periods with little sleep. A team of researchers in Norway wanted to know whether militaries are risking an international incident as well as the lives of troops and civilians and by allowing key decision-makers to operate under extreme sleep deprivation

The study published in the August issue of SLEEP found soldiers are more likely to go “by the book” when making difficult moral decisions on little sleep.

A sample of 71 first-year officer cadets in the Norwegian military participated in the study. Each had at least one year of military service before the study began.

The cadets were presented with five moral dilemmas. The cadets took the test twice: after five sleep-deprived nights and when they were well rested.

Test results show sleep deprivation impaired the more emotionally intelligent cadets’ ability to make mature moral judgments. The officers tended to fall back on their training and behave in a more rule-oriented manner.

Sleep deprivation didn’t harm everyone’s decision-making abilities. Several sleepless nights had little effect on officers with less mature moral reasoning ability.

Researchers were relieved to find that the sleep-deprived officers did not regress into self-centeredness, but feared the possibility unethical decisions based on military “group think.”
Image Courtesy of the U.S. Army

Wednesday, August 4, 2010

Study: Shorter Medical Resident Shifts Improve Quality of Care

A comprehensive literature review demonstrates why working medical residents past the point of exhaustion is a policy that’s quickly falling out of favor. Residents make fewer mistakes and lead a better quality of life when their shift lasts less than 16 hours, the study reports.

Regular hospital shifts lasting 24 hours or longer are traditionally a rite of passage for future medical practitioners. In recent years a countermovement calling for limits on resident work hours has gained momentum. Last year the Institution of Medicine recommended a maximum of 16 consecutive hours without sleep. The move has been greeted with controversy in the medical community because of high costs and uncertain benefits.

The authors of the study published in the August issue of the journal SLEEP set out to demonstrate the benefits of imposing a cap on resident work hours. Using an online literature search, the authors identified 23 peer-reviewed studies involving the outcomes of reducing shift lengths for medical residents in the United States.

Every study found that reducing or eliminating extended shifts improved residents’ quality of life. Quality of patient care improved in most of the studies after shift lengths were slashed. It’s unclear whether there were benefits to resident education; the findings were generally unchanged after a reduction in shift length.

Tuesday, August 3, 2010

Study Dispels SIDS Suspicion

An Australian study has put to rest one possible contributor to sudden infant death syndrome. Gender differences in arousability are not a reason why male infants are more vulnerable to SIDS, researchers report.

The study published in the August 1st issue of the journal SLEEP concluded that males are initially easier to wake during quiet sleep, but by 2 to 3 months, the peak age for SIDS, there is no difference in arousal.
The study used daytime polysomnography to evaluate 50 healthy infants at 2-4 weeks and 2-3 months after birth. Infants slept on their backs as researchers tested for arousability by repeatedly spraying a burst of air into the child’s nostril until they woke.

Researchers had expected that males would be sounder sleepers. The opposite was the case; boys were easier to wake up at 2-4 weeks of age. In the follow up at 2-3 months the boys and girls had the same response.

Parental response may account for the gender disparity. Researchers suggest that more parents may put boys to sleep on their stomachs because they cry more and wake more often during the night.

SIDS is the leading cause of death in all infants and occurs at a 60 to 40 male to female ratio. The exact cause remains unknown, but recent research suggests some babies may be more vulnerable than others. Infants who died from SIDS have low levels of serotonin in the brain tissue.

Parents can reduce the risk for SIDS by placing babies to sleep on their backs, in a firm but not too warm sleeping environment.

Monday, August 2, 2010

Sleep 7 Hours to Avoid Cardiovascular Disease

Seven hours is the magic number for a healthy heart. Sleeping too little or too much can elevates your risk for heart disease, a new study shows.

Heart attack, stroke, coronary heart disease and angina are twice as prevalent among people who consistently get less than five hours of sleep. Sleeping in isn’t much better. The rate of cardiovascular disease is one-and-a-half times higher for people who sleep nine hours per night.

The conclusions were based on data from a large 2005 survey featuring questions about sleep length and incidence of heart disease. A study that analyzed the data was published in the August 1st issue of SLEEP.

The authors analyzed how 30,307 adults responded to the 2005 National Health Interview Survey. The survey also collected information on demographic factors, socioeconomic characteristics, lifestyle and health. About 2,100 respondents reported some form of heart disease.

Surprisingly, people who slept six or eight hours a night also had a moderately elevated risk. The American Academy of Sleep Medicine recommends the average adult needs seven to eight hours of sleep, though individual sleep needs may vary.

Adults under 60 years of age had the highest association between short sleep and cardiovascular disease. This relationship affects women more than men.
The initial data was adjusted to account for complicating factors such as smoking, alcohol consumption and body mass index. The relationship between sleep duration and heart disease remained high after researchers excluded subjects with diabetes, hypertension and depression.

Short sleep duration is associated with metabolic disease and hardened arteries. Long sleep duration may be related to other underlying problems.

If you’re meeting your sleep needs yet still feel fatigued you may have a sleep-related breathing disorder such as obstructive sleep apnea, a condition that can lead to heart problems or even death. Sleep apnea occurs when excess fatty tissue in the throat periodically interrupts air flow. Anyone can have sleep apnea, even though it’s most common in obese or older populations. There are several effective treatments, but an overnight sleep study is first required for diagnosis.

Sleeping well should be as much a priority as staying physically active in protecting your heart health. Even an extra hour of sleep can potentially save your life in the long term.

Sunday, August 1, 2010

When Sleeping in on Weekends Isn't Enough

Make sleep a priority during the work week. Catching up on your sleep during the weekend may not be enough to stave off the effects of sleep loss.

A study published in the August issue of SLEEP found the impairments caused by sleep-deprivation such as lapses in attention and delayed reaction time remained even after sleeping in for a day. Full recovery after sleep restriction may take multiple nights of extended sleep.

The laboratory-based study involved 159 healthy adults who were about 30 years old. More than half of the participants were African American. All but 17 of the subjects had to sleep from 4 a.m. to 8 a.m. for five consecutive nights. On the sixth night they were randomly assigned to one of six lengths of recovery sleep.

The participants took a 30-minute long computerized neurobehavioral assessment every two hours throughout the duration of the study. The assessment included a Psychomotor Vigilance Test and the Karonlinska Sleepiness Scale. A modified Maintenance of Wakefulness Test was also given at the start of the study, after the fifth night and during the recovery day.

Researchers noticed a reduction in impairment after the night of recovery sleep. The improvements increased for lengthier sleep times, the effects of sleep loss were never fully eliminated. Lapses of attention, subjective sleepiness, reaction times and fatigue scores were above baseline for all 27 participants assigned to 10 hours of recovery sleep.

Solving long-term sleep debt takes more than one night of recovery sleep. Because most people are unable to stay asleep for much longer than 10 hours it’s impossible to close the gap in a single night.

Another interesting finding involved the participants who were assigned to extreme sleep restriction on the sixth night instead of recovery sleep. Performance and alertness significantly deteriorated after a final night with little to no sleep.
The study shows that burning the candle at both ends during the workweek will hurt your ability to perform on the job and the problems may not end when the weekend rolls around.