Intermezzo approved for as-needed treatment of sleep interruptions

The Food and Drug Administration (FDA) has approved a new sleep aid for people who wake in the middle of the night. Intermezzo was approved Nov. 23 for as-needed treatment when nighttime awakening is followed by difficulty returning to sleep. It’s the first drug used to treat insomnia with middle-of-the-night dosing. Intermezzo is to be taken at least four hours prior to awakening, the FDA said.

Driving safety was demonstrated through a driving study. Men and woman were tested. There was no significant effect on driving four hours after taking Intermezzo. However, the FDA said a significant effect was observed after three hours.

The key ingredient in Intermezzo is zolpidem tartrate. Zolpidem tartrate has been marketed as Ambien since 1992, and under several generic formulations. The FDA said the recommended dose for Intermezzo is 1.75 mg for women and 3.5 mg in men.

Other methods are also used to treat insomnia. Read more about sleep disorders and sleep medication from the American Academy of Sleep Medicine.

Rotating Night Shift Work and Type 2 Diabetes in Women

A new study found that the longer women worked rotating night shifts, the greater their risk of developing type 2 diabetes. Researchers also found that extended years of rotating night shift work was associated with weight gain. The weight gain may have contributed to the increased risk of type 2 diabetes.

Women who worked rotating night shifts for three to nine years faced a 20 percent increased risk of type 2 diabetes. Women who worked nights for 10 to 19 years had a 40 percent rise in risk. And women who worked night shifts for over 20 years were 58 percent more at risk. Women who worked rotating night shifts also gained more weight and were more likely to become obese during the follow-up.

Rotating night shift work was defined as three or more night shifts plus day and evening hours each month. The Harvard School of Public Health tracked more than 175,000 U.S. nurses for this study. Findings were published Dec. 6 in the journal PLoS Medicine.

Researchers said the findings need to be confirmed in men and ethnic groups (96 percent of the nurses were white Caucasians). The U.S. Centers for Disease Control and Prevention (CDC) estimates that 15 million Americans work full time on evening shifts, night shifts, rotating shifts or other irregular schedules.

Read more about shift work sleep disorder and women’s sleep needs. More stories about sleep and type 2 diabetes are available on the Sleep Education Blog.

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Snoring in infancy linked to impaired cognitive development

Two studies from Australia associate snoring in the first year of life to impaired cognitive development. Researchers suggest that lower cognitive development could become worse in these infants with age.

In the first study, 16 infants who started snoring shortly after birth were compared with 88 babies who did not snore. Infants were determined to be snorers if their snoring occurred three or more nights a week. Snoring because of a cold did not count. The results found that cognitive development was reduced in frequent snorers from the first month of life to six months.

The second study looked at 13 infants who snored frequently from the first month of birth to 12 months. These babies had significantly lower cognitive scores when compared with 78 infants who did not snore frequently.

Both studies were conducted through the University of Adelaide and University of Australia in South Australia. The research was published in the December edition of the journal Sleep Medicine.

Learn the facts about young children and sleep and about snoring. Additional stories about children and snoring are available on the Sleep Education blog.

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Race, community a factor in CPAP compliance

African-Americans and residents in poor areas are least likely to stick with their prescribed use of CPAP. A study in the December issue of SLEEP compared CPAP use by residents in five U.S. cities. Comparisons were based on ethnicity and socioeconomics.

Researchers interviewed 191 participants from Seattle, Chicago, Minneapolis, Cleveland and Madison, Wis. Ethnicity was determined through a questionnaire. Socioeconomic status was tracked by ZIP code. All participants were being treated for moderate to severe sleep apnea.

CPAP compliance was assessed at one month and again at three months. The average amount of time CPAP was used each night was lower in blacks and in patients who lived in poor areas. Even after age, sex and education levels were adjusted for. Access to CPAP and standardized health care was not an issue since this was a clinical trial study.

Researchers concluded that demographic factors have a definite influence on CPAP adherence. But they could not explain why the participation rate was less among blacks and the poor. They said more research is needed to identify the barriers and to develop intervention measures.

Continuous Positive Airway Pressure (CPAP) is the most common and effective way to treat obstructive sleep apnea. A steady stream of air blows through a mask and into the back of the throat to keep the airway open. Read more about CPAP in the Sleep Education Blog.

Exercise improves sleep apnea in overweight, sedentary adults

Exercise training may be beneficial for the management of sleep apnea in overweight patients who lead a sedentary lifestyle, according to a study in the December issue of the journal SLEEP. Forty-three overweight or obese adults, with at least moderately severe sleep apnea, were selected for the study.

These adults were used to exercising less than two times a week. For the study, they underwent a 12-week session of moderately intense exercise training. The purpose was to see if the exercise would have an effect on previously untreated sleep apnea.

Sleep apnea was improved despite no changes in body weight. However, only about a quarter of study participants saw a 50 percent or more reduction in sleep apnea. But a 20 percent reduction in sleep apnea was experienced by 63 percent of participants. Together, these results led researchers to conclude that exercise training is moderately effective in treating sleep apnea in sedentary, overweight patients.

Continuous positive airway pressure therapy (CPAP) is the first-line treatment for sleep apnea. Visit the Your Sleep website to find out if you are at risk for sleep apnea. Get help for sleep apnea at an AASM-accredited sleep center.

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