Short sleep, mental health problems predict long-term insomnia

Mental health problems and getting less than six hours of sleep play key roles in the persistence of insomnia. A study in the January edition of SLEEP found these risk factors in people experiencing insomnia for at least 7½ years. Smoking, caffeine and alcohol consumption, and sleep apnea did not predict persistent insomnia.

The study looked at 1,395 random subjects who reported having insomnia 7½ years earlier. Researchers found that 44 percent of them still had insomnia. Nearly a third (30 percent) were sleeping poorly but 26 percent were sleeping normally again. Those who still had insomnia had strong links to mental health problems and short periods of sleep. Depression was the most common mental health problem reported.

Researchers concluded that addressing mental health issues should be a priority in cases of chronic insomnia. They also suggested that people sleeping less than six hours were strong candidates for chronic insomnia. The study was done by Pennsylvania State University, and the universities of Athens and Crete, both in Greece.

Read more about insomnia due to medical condition, alcohol or drugs or mental disorders.

Consider your Sleep Before Springing for Free “Holiday” Coffee or Beer

September 29th is a special day for savvy savers. The date is dedicated to two free beverage-based holidays you’ve probably never heard of until today.

National Coffee Day, presently the top trending topic on Google, is making mainstream headlines because everyone loves a good giveaway. Many Dunkin’ Donuts locations and regional coffee chains are offering free java to commemorate National Coffee Day.

Not to be overshadowed by the bitter beverage, Budweiser is promising free beer for National Happy Hour, starting September 29th. The catch is the brewer can’t say which bars are offering free beer due to some state and local liquor laws.

Did we mention both coffee and beer are terrible for your sleep? Caffeine use, especially at the wrong time of day, can cause insomnia. Some people - especially nurses as a recent survey reported - lean heavily on coffee to make up for lost sleep. That can turn into a vicious cycle that continually steals your sleep.

Alcohol is sneakier about stealing your sleep. Drinking can make you fall asleep faster, but you’ll wake up feeling unrested. Alcohol changes your sleep architecture so you spend more time in deep sleep at the expense of restful REM sleep.

If you must drink coffee, make sure it’s in the morning or early in your work shift. And don’t overdo it or you’ll feel some unpleasant side-effects.

To Budweiser’s benefit, happy hour is the best time to consume alcohol. Drink in moderation in the early evening so your body will process the alcohol before bedtime.

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.

Alcohol Use Risk Rises for Adolescents with Sleep Problems

Teens that develop sleep problems around the onset of puberty are more likely to use alcohol. A new study connects previous findings on adolescent sleep problems and alcohol use to puberty.

Some early-maturing adolescents develop “night owl” tendencies during the sleep pattern transition associated with the onset of puberty. Those individuals are most at-risk to develop sleep problems.

Separate research shows adolescents who hit puberty earlier than their peers are more likely to drink.

Survey data shows a clear link between those two groups. The early-maturing teens that get to sleep later were more likely to use alcohol.

The findings are in line with previous research on adults; Sleep problems can predict the onset of alcohol abuse.

The conclusion was based on questionnaires from a previous study involving Dutch school children. The authors narrowed down the field to only responses from adolescents ages 11 to 14. The findings were consistent across both genders and all education levels included in the study.

The findings will be featured in the September issue of Alcoholism: Clinical & Experimental Research. The abstract is available online prior to publication.

Photo Courtesy Paul Hocksener

Caffeine & Alcohol: “Caffeinated Cocktails” in College

Campus life at college tends to involve poor sleep and sleep deprivation. Often caffeine and alcohol are a part of the problem.

Each substance by itself can be disruptive to sleep. Now a popular trend among college students is to combine the two together.

Some make their own “caffeinated cocktails” by mixing alcohol with high-caffeine energy drinks. Others simply buy caffeinated beer.

A 2007 study surveyed 496 college students. Results show that 54 percent of energy drink users consumed the drinks with alcohol while partying.

In 2008 more than 4,200 college students completed a Web-based survey. Results show that 24 percent of current drinkers reported mixing alcohol with energy drinks.

The belief is that caffeine blunts the negative effects of alcohol intoxication. But is this true?

In a study published last May rats were given rum mixed with a soft drink. The caffeine did not reduce the metabolic effects of alcohol.

In another recent study women consumed an energy drink with alcohol. The mixture had a negative effect on cognitive performance.

A 2006 study found that caffeine had no effect on the degree to which alcohol increased errors. But caffeine did reduce how people perceived their alcohol intoxication.

Earlier this week the FDA reported that it is going to look into the safety and legality of caffeinated alcoholic beverages. It notified 30 companies that make the drinks.

In the past year both Anheuser-Busch and Miller agreed to discontinue their caffeinated alcoholic beverages. They also agreed that they would not produce these drinks in the future.

Earlier this year the Sleep Education Blog reported that adults between the ages of 18 and 24 are using more sleeping pills. Some students also are taking “smart drugs” to improve their academic performance.

Drowsy Driving: OSA, Sleep Loss & Alcohol

Sleep loss and alcohol both have negative effects on driving performance. Are people with obstructive sleep apnea more vulnerable to these effects?

A new study from Australia involved 38 people with untreated OSA. They were compared with 20 healthy controls.

Participants were tested three times in a driving simulator. They drove after a normal night of sleep and after only four hours of sleep.

They also drove after consuming enough vodka to raise their blood alcohol concentration level to 0.05 grams per deciliter; this means they had 50 milligrams of alcohol in every 100 milliliters of blood. For most drivers in Australia a BAC level of 0.05 or higher is considered “drink driving.”

The simulators tracked steering, speed control and other measures of driving performance. These measures have been linked to car crashes, noted a study summary for patients.

Results show that driving ability was much more impaired in people with OSA; 24 people with sleep apnea crashed during simulated driving. In contrast, only one person in the control group crashed.

After only four hours of sleep, people with OSA were four times more likely to crash than after a night of normal sleep; they were two times more likely to crash after alcohol consumption.

People with OSA also had more trouble steering the simulator; after sleep loss and alcohol consumption their steering ability was about 40 percent worse than controls.

But steering wasn’t their only problem. People with sleep apnea also had trouble keeping their eyes open. Prolonged eye closures of more than two seconds and brief “microsleeps” were significant crash predictors in people with OSA.

The AASM reports that daytime sleepiness is a common symptom of sleep apnea. Breathing pauses related to sleep apnea cause brief arousals from sleep. These arousals can occur hundreds of times during one night of sleep.

A study in the March issue of the journal Sleep found that a simulated driving test is a suitable tool to measure daytime alertness in people with OSA. A previous study in the journal Sleep described a number of driving impairments in people with sleep apnea; it found that the poor performance appeared to be related to lapses in attention.

Earlier this year the Sleep Education Blog reported that the alerting effect of roadside “rumble strips” may last for only a few minutes. In July the blog reported that some car makers are using high-tech systems to help prevent drowsy-driving accidents.

Learn more about drowsy driving on SleepEducation.com.

Image by Stefan Van der Straeten

Alcoholism Has Long-Term Effects on Sleep

A study published today in the journal Sleep shows that alcoholics may continue to have sleep problems long after they quit drinking.

The study involved 42 alcoholics with a mean age of 49 years. They had been sober for varying periods of time. Some had abstained from drinking for a few weeks; others had not had a drink in almost two years. Their sleep was compared with 42 controls.

Results show that the percentage of deep, slow wave sleep was lower in alcoholics than in controls. Alcoholics also had more light, stage 1 non-rapid eye movement sleep.

The authors report that these results are reflective of poorer sleep quality. They also suggest that these sleep problems could play a role in alcoholics’ cognitive decline.

The study also found that estimated lifetime alcohol consumption was related to subjective sleep quality; higher lifetime consumption predicted less sleep satisfaction.

Men estimated that they had consumed almost twice as much alcohol as women. But the pattern of alcoholism-related sleep changes was similar in both male and female participants.

The authors report that long-term alcohol abuse causes structural damage to the brain. Sleep measures may reflect these changes in brain structure.

The NIAAA reports that heavy drinking increases your risk of sleep disorders; it also puts you at risk for liver disease, heart disease, depression, stroke and several types of cancer.

In August the Sleep Education Blog reported that drinking alcohol has a negative effect on sleep; decades of research shows that alcohol disrupts your natural sleep cycle.

Insomnia due to drug or substance can result from alcohol use or withdrawal.

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

Child Sleep Problems May Begin in the Womb

A study in the Aug. 1 issue of the journal Sleep examined prenatal factors that are related to sleep problems in children.

The study involved 289 children born in Finland in 1998; each child was born at term from 37 to 42 weeks of gestation. Sleep was measured by actigraphy for one week when the children were 8 years of age. Parents reported sleep problems and sleep disorder symptoms.

Results link prenatal alcohol exposure to an increased risk of sleep problems in childhood.

Alcohol "exposure" was defined as a mother drinking more than one alcoholic beverage per week during pregnancy.

Children exposed to alcohol before birth were 2.5 times more likely to have a “short” sleep duration of 7.7 hours or less per night. The AASM reports that at 8 years of age children need about nine to 10 hours of nightly sleep.

Children also were 3.6 times more likely to have a low “sleep efficiency” of 77.2 percent or less if they were exposed to alcohol in the womb; sleep efficiency indicates how much of their time in bed was spent sleeping.

“Adverse fetal environment may have lifelong influences on health and behavior,” principal investigator Katri Räikkönen, PhD, told the AASM.

The CDC reports that drinking alcohol during pregnancy can cause a baby to be born with birth defects. About 1 in 12 pregnant women in the U.S. reports alcohol use.

Size at birth also was related to childhood sleep problems; lower weight and shorter length were associated with lower sleep efficiency. The authors report that small body size at birth may reflect disturbances in the fetal environment.

One finding surprised the authors: There was no link between prenatal tobacco exposure and sleep at 8 years of age.

Learn more about sleep and pregnancy on SleepEducation.com.

Child Sleep Problems & Early Substance Use

Are children with sleep problems more likely to begin drinking, smoking or using drugs? A new study provides some insight.

The ongoing, longitudinal study involved children selected from a community sample of “high-risk” families; 292 boys and 94 girls participated.

Results show a gender difference; childhood sleep problems were more likely to predict early onset of substance use in boys than girls.

Sleep problems between 3 and 8 years of age predicted the onset of alcohol, cigarette and marijuana use among boys; in girls the only link was between sleep problems and the onset of alcohol use.

The authors conclude that parents should pay close attention to sleep problems in children and teens. Helping children sleep better can improve their health and behavior.

Sleep problems in children are common; about 25 percent of all children have some type of sleep problem at some point during childhood.

How common is substance use by children?

The NIAAA states that 34 percent of 8th-grade students reported drinking in the past year. A recent survey showed that more girls than boys between 12 and 17 years of age reported drinking alcohol.

A 2008 survey found that 6.8 percent of 8th-graders reported using cigarettes in the previous month. According to the NIDA, tobacco use is the leading preventable cause of disease, disability and death in the U.S.

The NIDA also reports that marijuana is the most commonly used illegal drug in the U.S. A recent survey found that 15.7 percent of 8th-graders have tried marijuana at least once.

Get help for your child’s sleep problems at an AASM-accredited sleep center near you. The Cool Spot is an NIAAA Web that provides facts about alcohol for young teens.

Image by Raul Lieberwirth

How Much Does Insomnia Cost?

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

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

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

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

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

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

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

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

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