Sleep Apnea May Affect Stroke Outcome & Recovery

A new study shows that the effects of a stroke may be more severe in people who have obstructive sleep apnea.

The study involved 174 people who had a stroke. Their risk for sleep apnea was assessed by questionnaire. Results show that 60 percent had a high risk for sleep apnea. Seven participants had already been diagnosed with sleep apnea.

Having a high risk for sleep apnea was a predictor for having a worse stroke outcome. People at risk for sleep apnea also were more disabled at the point of discharge from the hospital. The seven people with confirmed sleep apnea had a higher risk of death in the first month after the stroke.

"In the context of recovering from a stroke, sleep apnea can have a serious impact,” study author Dr. Latha Stead said in a University of Rochester Medical Center statement.

A stroke is a “brain attack” that occurs when blood flow to the brain is interrupted. It can result from either a blood clot that blocks an artery or from a broken blood vessel.



A recent study found that people with sleep apnea have decreased blood flow velocity in the brain’s arteries. Their brains’ blood vessels also have a lower rate of recovery when blood pressure drops. Other studies have shown that sleep apnea increases your risk of death from heart disease or stroke.

Stead added that it is harder for the brain to heal from a stroke when the blood has low oxygen levels. People also do not respond well to stroke rehab programs when they are sleep deprived.

Are you at risk for sleep apnea? Answer these questions to find out.

More than Insomnia: Other Sleep Disorders Are Common in Older Adults

Many older adults struggle with insomnia. Now a new study shows that in older adults other sleep disorders are common too.

The study involved 892 people between the ages of 70 and 89. Results show that 59 percent had signs of at least one sleep disorder other than insomnia.

Data were gathered by questionnaire. Symptoms were reported by a person who sleeps in the same room as the participant.

Sleep-related leg cramps was the most common sleep disorder. Symptoms were present in 32 percent of participants.



The second and third most common sleep disorders were obstructive sleep apnea and periodic limb movements in sleep. Other common sleep disorders were REM sleep behavior disorder, restless legs syndrome and sleepwalking.

“All of these sleep disorders can disrupt a person’s quality of life, because they affect sleep,” lead researcher Dr. Jennifer Molano said in a Mayo Clinic statement. “But if these problems are recognized, an accurate diagnosis could lead to successful treatment.”

Older adults can get help for sleep problems at an AASM-accredited sleep center. Get sleep tips for older adults on SleepEducation.com.

Study Links Sleep Loss to ADHD Symptoms in Children

A new study links sleep loss to behavioral symptoms of attention-deficit/hyperactivity disorder in children.

The study in Finland involved 280 children. They had an average age of 8 years.

Results show that children who slept less than 7.7 hours at night had a higher score for hyperactivity and impulsivity. They also had a higher total score on the ADHD Rating Scale.

The results were significant. But they did not confirm that sleep loss causes ADHD symptoms.

“Intervention studies are needed to confirm the causality,” study author Dr. Juulia Paavonen said in a University of Helsinki statement.

Another recent study found that children with ADHD get about 33 minutes less sleep per night than other children. The AASM reports that children between the ages of 7 and 12 need about nine to 10 hours of sleep per night.

Morning Larks vs. Night Owls: A Circadian Alertness Advantage?

People who are larks function better in the morning. Night owls are more alert in the evening. But which “chronotype” enables people to function better over the length of a day?

A new study in Science takes a look. It involved 16 early morning risers and 15 night owls. They performed alertness tests in a brain scanner after following their normal sleep schedule.

Newsweek and Science report that both groups performed well when they took the test 1.5 hours after waking. But the night owls pulled ahead when both groups were tested after being awake for 10.5 hours. They were more alert and had faster reaction times. Overall their performance improved by about 6 percent.

So do night owls have a natural alertness advantage over morning larks? Not necessarily.

Health News points out that an advantage in the lab may not translate to the workplace. A person who is a “morning type” will be alert during the hours of a normal workday. But “evening types” may struggle to align their natural sleep-wake pattern with their work schedule.

Valerian Fails to Improve Sleep in Older Women with Insomnia

A new study adds to the evidence that valerian is an ineffective treatment for insomnia.

The study involved 16 women with an average age of 69 years. All of the women had insomnia. They were given either 300 mg of valerian extract or a placebo 30 minutes before bedtime for two weeks.

The study found that the effect of valerian was no different than the placebo after one dose or after two weeks. The women were unable to fall asleep faster.

Their wakefulness during the night actually increased after two weeks of nightly valerian. They woke up for about 18 minutes more during the night after first falling asleep.

Other studies of valerian have found similar results. A recent review analyzed the findings of 37 studies. The authors concluded that valerian is “safe but not effective” for insomnia.

Learn more about valerian on SleepEducation.com.

How Children Affect a Mother’s Sleep-Wake Rhythm

Some women may have a natural tendency to be a “night owl.” But a new study shows that their sleep-wake rhythm may change after they have children.

The study involved 179 women. Some were mothers, some were pregnant, and some had no children.

Results show that women with children are more likely to be “morning types.” This means they would have a stronger tendency to go to bed early and wake up early.

The study found that mothers woke up about 1.5 hours earlier on weekends. Women with children also reported falling asleep faster than the other women.

Which group of women got the most sleep? The women who were pregnant had the longest average sleep duration.

Learn more about the many complex factors that can affect a woman’s sleep.

What’s Your Chronotype? Understanding the “Lark” and “Owl” Circadian Sleep Patterns

A New York Times column examines the factors that contribute to your preferred sleep schedule.

This is also called your “chronotype.” It turns out that your DNA has a strong influence on when you like to sleep.

Some people have a circadian clock that makes them “evening types.” These “owls” have a natural tendency to stay up late at night and sleep late in the morning. Children tend to become night owls as teens because of a shift in the timing of their circadian clocks.

Some night owls have delayed sleep phase disorder. This involves a struggle to conform to work or social demands. It can be difficult for them to function well during the day.

Other people are natural “morning types.” These “larks” prefer to go to bed early and wake up early. Adults often become larks as they get older.

Some larks have advanced sleep phase disorder. They fall asleep several hours before a normal bedtime. As a result, they also wake up hours earlier than most people wake in the morning.

So do larks have an advantage over owls? After all, it was Benjamin Franklin who said, “Early to bed and early to rise, makes a man healthy, wealthy, and wise.”

A study in 1998 put these words to the test. It found no evidence that larks were healthier, wealthier or wiser than owls.

Not everyone fits neatly into the categories of morning or evening types. Many people are somewhere in between the larks and the owls.

And many factors such as genetics and light exposure affect when you are sleepy and alert. A new study in the journal Sleep examined some other factors.

It involved 5,720 college students at two universities in Spain and Italy. Results show that females went to bed earlier and slept longer than males.

Nationality also had a significant effect on sleep patterns. On average the Spaniards went to bed and woke up later than the Italians.

The study even found a significant but small “season of birth” effect. Subjects born in spring and summer went to bed later than those who were born in fall and winter. A study in 1999 reported similar findings.

Image by Rachel

Sleep Problems Increase Cancer Pain

A new study in the Journal of Clinical Sleep Medicine shows that sleep problems may lead to increased pain and fatigue in cancer patients.

Previous research has shown that sleep problems are common in people who have cancer. A 2007 study in the journal Sleep found that 41 percent of people with cancer reported having chronic insomnia.

So why are the results of this new study surprising? It was expected that pain would be a cause of sleep problems. But instead the evidence pointed in the other direction; the study found that sleep problems may lead to an increase in pain.

“We believed we would find a bi-directional relationship between insomnia and pain,” study author Edward J. Stepanski told the AASM. “But instead…trouble sleeping was more likely a cause, rather than a consequence, of pain in patients with cancer.”

The study involved 11,445 cancer patients. About 74 percent were women; 29 percent had breast cancer. More than half of the study subjects reported having trouble sleeping; 26 percent had moderate or severe sleep problems. Increases in depressed mood also led to increased ratings of pain.

The average age of participants was 61.5 years. Younger people were more likely to have trouble sleeping. The authors suggest that this may be a treatment effect since younger patients often receive more aggressive chemotherapy.

Stepanski said that cognitive behavioral therapy (CBT) can help cancer patients who have insomnia. Improving their sleep may reduce their pain and fatigue.

A 2007 study in the journal Sleep showed that disturbed sleep can affect your pain threshold. It can impair how the body inhibits pain. It also can increase spontaneous pain.

Sleep and Memory: Remembering & Forgetting

A new article in Newsweek provides an overview of how “sleeping on it” improves memory.

Forming memories. Consolidating memories. Making connections between memories. Sleep appears to play an important role in all these processes.

Another Newsweek article examines whether or not we can learn to forget. New research shows that memory “reconsolidation” may be possible.

Being able to change long-term memories could have practical benefits. In particular it could aid people who suffer from post-traumatic stress disorder.

Nightmares tend to be the most disturbing feature of PTSD. Most people with PTSD also report having disturbed sleep.

Finally, Newsweek offers an online memory Q&A. Find answers to some of the most common questions about memory.

I Have No Control Over My Racing Mind

Many people with insomnia complain that their thoughts race out of control at bedtime. This complaint is typical of psychophysiological insomnia.

This form of insomnia involves a state of “hyperarousal” at bedtime. Often your thoughts focus on your inability to sleep. As a result you may try harder to fall asleep. But this effort may cause you to stay awake even longer.

But the belief that you have no control over a racing mind is one myth about insomnia. You can learn how to relax your mind and your body when you are in bed. Part of this process involves setting aside time to reflect on the day’s events and plan for what lies ahead.

Cognitive behavioral therapy also can help put the brakes on your racing thoughts. It helps you develop positive attitudes and habits that promote a healthy pattern of sleep. One common method is relaxation training.

Read the complete list of 10 Insomnia Myths on SleepEducation.com.

Image by Justin Silles

NBA Fans Can Get a Little More Sleep

Basketball fans can look forward to an earlier bedtime as they enjoy the 2009 NBA playoffs, which tip off today. But only one hour earlier…and only on Sunday nights…and only during the NBA Finals.

Earlier this season the NBA announced a slight change to the playoff schedule. Sunday night games during the Finals will begin around 8 p.m. EDT instead of 9 p.m.

First-round games in the Eastern Conference also will begin no later than 8 p.m. But East Coast fans will lose a lot of sleep trying to watch the first round of the Western Conference playoffs.

Want to see Kobe Bryant, Tim Duncan or Carmelo Anthony try to lead their teams to the second round? Get ready to stay up for tip-off times as late as 10:30 p.m. EDT.

But is this season’s schedule change a sign that there will be a shift to earlier tip-offs in the coming years? Don’t count on it.

Fans of the Celtics weren’t too happy with the 9 p.m. start times during the 2008 Finals. Especially the parents of children who should have been in bed when the games were just getting started.

But NBA Commissioner David Stern made it clear: Start times will be determined by projected ratings and audience sizes…not by sleep needs.

“The ad rates only go up if the ratings go up,” Stern told a Boston sports radio station last June. “The ratings only go up if there are more people watching.”

Image by Adam Pieniazek

Research Catching Up to Jet Lag

Results from a new study in Current Biology may lead to more effective treatments for jet lag and shift work sleep disorder.

Both sleep disorders involve a disruption to your body’s circadian timing system. This system regulates the timing of when you sleep and wake.

The study shows that this disruption occurs in two separate groups of neurons in the brain. It also involves two different sleep stages.

Both groups of neurons are located in the “suprachiasmatic nucleus.” This part of the brain acts as a body clock. It regulates daily functions such as body temperature, hormone levels and sleepiness.

The study found that one set of neurons is closely linked with slow wave sleep. This is also called “deep sleep.” These neurons receive light information directly from the eyes. With these light and dark signals, your pattern of deep sleep can adjust to a new schedule in a couple of days.

Another set of neurons controls rapid eye movement – or REM – sleep. Most of your dreams occur during this stage. These neurons do not receive direct light information. As a result your pattern of REM sleep can be out of sync for a week or more when you cross time zones.

The researchers exposed lab rats to an artificial light-dark schedule. This simulated a trip from Paris to New York.

They also found that the time change disrupted the normal progression of sleep stages. There was an overlap of slow wave sleep and REM sleep right after the simulated jet lag. The rats also were more likely to enter REM sleep earlier than they should.

The study helps explain why it takes the body so long to adapt to a new time zone. After a long flight it typically takes about one day per time zone for your body clock to adjust to the local time.

Researcher Horacio de la Iglesia expects that the study will have a positive impact on treatments for jet lag and shift work.

"We can go back to the treatments that are believed to be effective and see where they might be acting in the circuitry of these neuron centers, then refine them to be more effective," he said in a University of Washington statement.

Image by Kossy

How White Noise & Sound Machines Can Help You Sleep

“White Noise” would have been a great name for an ‘80s rock band. Sort of a cross between Whitesnake and Quiet Riot.

Instead it’s music to the ears of many insomnia sufferers. And like a popular rock band, white noise has a large fan base.

A recent article from Columbia News Service reports that there are 20 white noise-related groups on Facebook. And demand was so high for the eight-sound White Noise iPhone application that a new version with more than 40 sounds was released.



But not everyone relies on such high-tech sounds to help them fall asleep. Many use a simple box fan or an oscillating fan. The article describes one woman who relies on the sound of a hair dryer.

There also are a variety of sound machines available for purchase. Some only generate a constant white noise. Others offer soothing sounds such as rain or ocean waves.

Consumer Reports recently reviewed three models. All three of the units blocked out at least some unwanted sounds.

InventorSpot has a glowing review of a classic white noise machine. And the New York Times recently reported on a “smart” sound machine that responds to disrupting noises by increasing its sound output.

So what exactly is white noise, and what’s the big deal about it?

White noise is a combination of the many frequencies of sound. It’s a soothing noise that can help you relax and fall asleep. It can be a simple treatment for some people who have insomnia.

It also helps raise your “arousal threshold.” This means that you can sleep through noises that would otherwise wake you up. The white noise helps cover up disturbing sounds such as a train whistle or a noisy neighbor. It can be a solution for some causes of environmental sleep disorder.

Research shows that white noise also may benefit other groups of people. A 2008 study concluded that it could be helpful for college students.

A 2005 study found that white noise may reduce sleep disruptions for intensive-care unit (ICU) patients. A 2002 study reports that it may help people with acute stress disorder or post-traumatic stress disorder.

It also can help shift workers who must sleep during the day. A focus group of night-shift nurses found that many used white noise to improve the quality and quantity of daytime sleep.

White noise also may help babies fall asleep. A study of 20 newborns found that infants were more likely to fall asleep within five minutes in response to white noise.

Melatonin Improves Sleep Problems in Children with Autism

A new study in the Journal of Clinical Sleep Medicine shows that melatonin supplements may be helpful for children with autism.

The small study involved 12 children between the ages of 2 and 15 years. Each child had either autistic spectrum disorder, fragile X syndrome, or both problems. The children took 3 mg of melatonin 30 minutes before bedtime for two weeks.

Results show that melatonin improved three aspects of their sleep. The children slept for an average of 21 more minutes each night. The length of time it took them to fall asleep was 28 minutes shorter. And the time of night when they fell asleep was 42 minutes earlier.

The study reports that sleep problems are common in children with autism. Senior author Beth L. Goodlin-Jones, PhD, told the AASM that these problems can affect the entire family.

“Sleep-onset problems at the beginning of the night are very troublesome for children and their families,” said Goodlin-Jones. “Sometimes children may take one to two hours to fall asleep, and often they disrupt the household during this time.”

According to the authors, other studies have suggested that children with autism or fragile X syndrome may have abnormal melatonin levels. This hormone plays an important role in regulating sleep.

The authors also report that other strategies can improve sleep problems in these children. Options include behavior therapy and good sleep hygiene.

The NINDS estimates that three to six out of every 1,000 children have autism. Males are four times more likely than females to have it. Other forms of autistic spectrum disorder include Asperger syndrome and Rett syndrome.



The NINDS also reports that children with autism have a higher risk of fragile X syndrome. This genetic condition can cause mental retardation.

Learn more about melatonin at SleepEducation.com.

U.S. Navy Paying Attention to Sleep Cycles & Sleep Deprivation

The dramatic rescue of Capt. Richard Phillips from Somali pirates has focused the world’s attention on the U.S. Navy and the Navy SEALs. The mission exemplified the Navy ethos of being “disciplined and well-prepared.”

Does sleep play a role in this preparation of Navy sailors and pilots?

An article in the Virginian-Pilot takes a look. It finds that within the Naval ranks awareness of the importance of sleep is growing.

One major issue of concern is the effect that rotating work shifts and missions can have on performance and alertness. The article reports that a squadron in Iraq is experimenting to find the best way to rotate its pilots' flight schedules.

But it’s not just the pilots who need sleep. Crew members often get by on short naps during carrier operations.

There also is concern that sleep deprivation and fatigue can increase mistakes and accidents. In response the Navy is taking a high-tech approach.

It is testing the Fatigue Avoidance Scheduling Tool software, or FAST. This system helps predict performance over time based on sleep and work schedules.

Is this leading to a sea change in how the Navy operates? Not yet.

The article points out that the Navy has been doing things a certain way for a long time. Changes will come in ripples rather than waves.

U.S. Navy photo by Mass Communication Specialist 2nd Class Elliott Fabrizio

Sleep Apnea & the Banana “Cure”

A small study has generated some big claims about bananas and obstructive sleep apnea.

One news outlet proclaims that the “banana may prove to be a life saver” for people with sleep apnea. Another article states that bananas “may help cure sleep disorders and snoring.”

It sounds too good to be true. Is it fact, or online fiction?

The source of the buzz is a study from Australia. The results were presented last week at a scientific meeting. The study abstract (#TP231) is available online.

The study examined the “surface active phospholipids” of bananas. It sought to determine how long the surface tissue of the mouth might retain these oily compounds.

Initial tissue cells were swiped from the inside of the subjects’ cheeks. Analysis found that these cells showed no evidence of phospholipids.

Then participants drank a 200 ml “aqueous suspension” – a fruit smoothie. The drink contained 130 grams of ripe banana. Tissue samples were taken one, two, four and six hours after consuming the drink.

Analysis determined that the majority of these cells showed signs of phospholipids. The intensity was “largely retained” six hours after drinking the banana smoothie.

The authors suggest that a coating of phospholipids on the throat may help prevent the collapse of the airway during sleep. They conclude that this could have value in the treatment of sleep apnea and snoring.

It is important to note that the study involved only eight healthy women with an average age of 20.1 years; none of the subjects had sleep apnea.

The study did not measure any kind of treatment effect. So there is no need to rush to the grocery store just yet. It is far too early to proclaim that bananas have any role in the treatment of sleep apnea.

Although you won’t find it at a fruit stand, CPAP is still the most effective treatment for sleep apnea. And oral appliances are another effective option.

In Control of Sleep

An article in the April issue of The Scientist examines how the body controls the sleep/wake cycle.

Much is now known about the brain’s “master clock.” But studies are showing that this circadian clock isn’t in complete control of sleep. Other molecular mechanisms can override its signals when we are forced to stay awake.

Thus sleep may have biological functions that are beyond the control of the circadian clock. “It is clear,” writes the author, “that there are many factors affecting sleep.”

Read the article to find out more.

Sleep and Memory: Survival of the Fittest?

An article in the April issue of The Scientist takes an in-depth look at a new theory about sleep and memory.

The theory proposes that sleep’s core function is to prune the synapses formed when you are awake. Only the strongest neuronal connections “survive.”

Thus the most important connections remain; unimportant connections are eliminated. This pruning process boosts learning and memory.

The article addresses a number of questions about the theory.

Will it replace the theory that the purpose of sleep is to replay memories and “consolidate” them? What role does slow-wave sleep play in this process? What about rapid eye movement (REM) sleep? And where do memory patterns fit in – are specific memories reactivated and reorganized during sleep?

Also, how does the theory align with another study published in February? That study suggests that sleep strengthens connections instead of weakening them.

Read the article to find out more.

Survivor: Reinterpreting Dreams with the Threat Simulation Theory

In 2000 Finnish researcher Antti Revonsuo proposed a new theory for interpreting dreams. It has become known as the “Threat Simulation Theory.”

The theory proposes that dreaming is a defense mechanism. It serves a biological function by simulating threatening events. The theory suggests that the brain selects waking events that pose a threat to your safety.

Then during the majority of dreams your brain simulates these events over and over again. The threats are replayed in various combinations.

In this way the brain is able to practice how it perceives threats. It also “rehearses” threat avoidance.

A 2006 study tested this theory using a sample of 212 recurrent dreams. It provided some support for the theory. Sixty-six percent of the dream reports contained one or more threats.

These threats tended to put the dreamer in danger. Dreamers tended to take reasonable defensive or evasive actions.

But less than 15 percent of the dreams depicted realistic situations that would be critical for survival when awake. Also, dreamers rarely succeeded in fleeing the threat.

The theory also suggests that your “threat simulation system” would be highly active if you live in a dangerous environment. It would be less active if you live in relative safety.

A 2005 study supported this proposal. It analyzed the dream reports of Kurdish and Finnish children. Results show that severely traumatized children had more dreams. These dreams included a higher number of threatening events.

But a 2008 study contradicted these findings. It tested the theory using 208 people who live in a high-crime area of South Africa. Their dreams were compared with those of people who live in a low-crime area in Wales.

The people in South Africa had more exposure to a recent life-threatening event. But they reported fewer threat dreams. Overall less than 20 percent of dreams featured realistic survival threats. Less than two percent of dreams included an escape from a threat.

A new review analyzed the results of these and other studies. It concludes that there is strong support for the theory.

Learn more about dreams and nightmares on SleepEducation.com.

Getting Help for Sleep Problems – from a Dentist?

CBS 2 News in Chicago reports that a growing number of dentists are practicing “dental sleep medicine.” What does dentistry have to do with sleep?

The most obvious connection between your teeth and your sleep is bruxism. This occurs when you grind or clench your teeth during sleep.

Bruxism can damage your teeth and cause jaw discomfort or pain. It also can briefly disturb your sleep – and wake up your bed partner.

A dental sleep medicine specialist can fit you with a mouth guard that you wear during sleep. This will protect your teeth and reduce the grinding noise.

But dental sleep medicine specialists aren’t just bruxism experts. They also may be able to help you with snoring and obstructive sleep apnea. These problems involve a partial or complete blockage of your airway.

A dentist who practices dental sleep medicine can fit you with an oral appliance to wear during sleep. This is similar to an orthodontic retainer. It keeps your airway open by holding your tongue or slightly moving your lower jaw forward.

The AASM approves oral appliance therapy as a treatment for snoring. It also recommends that an oral appliance may be an effective treatment option for mild or moderate sleep apnea.

Treatment with CPAP therapy is the best option for severe sleep apnea. A board-certified sleep specialist at an AASM-accredited sleep center can help you determine which treatment option is best for you.

The sleep center will refer you to a specialist in dental sleep medicine for help with oral appliance therapy.

Obesity May Increase Your Risk for Restless Legs Syndrome

Over the years research has shown a clear link between obesity and obstructive sleep apnea. USA Today reports that a new study from Harvard also links obesity to restless legs syndrome.

The large study involved 65,554 women and 23,119 men. Results show that 6.4 percent of the women and 4.1 percent of the men had RLS.

The risk for RLS was increased by 42 percent in obese people. Those with the largest waist sizes had a risk that was increased by 60 percent. But the study was unable to determine if obesity causes RLS.

RLS may be caused by low iron levels, pregnancy, a nerve disorder, kidney disease and rheumatoid arthritis. It also is more common in people with type 2 diabetes. Pregnant women and people with arthritis or diabetes were excluded from this study.

RLS involves an intense urge to move the legs. The intensity of this urge increases at night and as you lie or sit still. It is relieved only by walking or moving the legs.

RLS often involves other burning, prickly, itching or tingling sensations deep in the legs. Symptoms of RLS tend to become more intense and last longer over time.

Genetics also appears to play a role in RLS. More than half of people with RLS report a pattern of the sleep disorder in their families.

Learn more about how research is cracking the genetic code for RLS at SleepEducation.com.

Women in the Executive Office: Job Stress & Insomnia

A new study examines the sleep quality of men and women who are executives or managers. Does job stress affect their sleep?

Results suggest that female executives may be more prone to sleep problems than male executives. The risk is greatest for women who have isolated, demanding jobs.

The study also shows that having a high level of control on the job reduces the risk of poor sleep quality. Social support also has a “buffering effect.” Having a strong network of social support promotes good sleep for women with a high-strain job.

According to the AASM, job stress can be a cause of 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.

How can you prevent job stress from disturbing your sleep? One way is to avoid “bedwork.” Never bring any work to bed with you; make your bed a refuge from your job.

Get other helpful tips and learn more about job stress and sleep at SleepEducation.com.

Ongoing Debate: The Best Way to Get Your Baby to Sleep

What’s the best way to get your baby to sleep through the night?

Most new parents are desperate to know the answer. The AASM reports that bedtime problems and frequent night wakings occur in about 20 percent to 30 percent of young children.

But the advice that parents receive can be contradictory. And the subject is a source of debate, both in the U.S. and abroad.

The Herald Sun reports that recent research has stoked the debate in Australia. The research supports using the “controlled crying” technique for babies who are older than six months of age.

This method often is attributed to Dr. Richard Ferber. He advocates teaching infants how to go back to sleep on their own.

This is often called the “cry it out” technique. A more technical term is “graduated extinction.”

On the other side of the debate is Dr. William Sears. Instead of the “cry it out” method, he is a proponent of “attachment parenting.”

A 2006 study in the journal Sleep compared the advice found in 40 parenting books. Sixty-one percent of books endorsed “crying it out”; 31 percent opposed it.

Also in 2006 the AASM published practice parameters for bedtime problems and night wakings in young children and infants. A task force of experts reviewed all of the current research on this topic.

The report recommends graduated extinction as an effective therapy. You can read a summary of the recommendations on SleepEducation.com.

Discuss any ongoing sleep problems with your child’s doctor. He or she may refer you to an AASM-accredited sleep center for help.

Learn more about sleep and children.

Sleep Through the Centuries

Sleep has been around for…well, for centuries. So have sleep disorders. And remedies for sleep problems.

An exhibit at the Folger Shakespeare Library in Washington, D.C., explores 17th-century beliefs and ideas about sleep. “To Sleep, Perchance to Dream” pulls back the covers on sleep in Renaissance England.

Topics include preparing for sleep. (Use a bed and bedding that are less likely to attract “vermin.”) How to sleep. (Sleep was divided into “first” and “second” sleeps.) Theories about sleep. (It may be the product of digestion.) Sleep aids. (There were numerous recipes to treat insomnia.)

And dreams. The exhibit shows that – like today – people in the 17th century were fascinated by dreams and nightmares. What they are. Why we have them. What they mean. How to control them.

A New York Times review calls it an “entrancing exhibition.” The Times also has a slideshow of images from the exhibit.

The exhibition continues through May 30. Visit the Folger Web site for an online tour.

Why Do We Sleep?

An article from the University of Wisconsin takes a closer look at one of the research teams that just published a new study on sleep and memory.

It explains how their research is taking the study of sleep and memory in new directions. It also examines the question that lies at the foundation of their research: Why?

Why do we sleep? It’s a simple question. And progress is being made to answer it. But definitive answers remain elusive.

“Why is it that the brain cells need to sleep?” researcher Chiara Cirelli said in the article. “That’s really what we are trying to understand.”

Cirelli and colleague Giulio Tononi probed this question last fall in the essay “Is sleep essential?” They conclude that there is still no consensus for “the elusive phoenix of sleep.”

Emmanuel Mignot explored this “unsolved mystery” last year in “Why we sleep: the temporal organization of recovery.” He concludes that it is still unclear why sleep is required. But “recent work suggests multiple roles.”

And Jerome Siegel addressed the topic in the 2003 article “Why we sleep.” He writes that “we have no comparably straightforward explanation for sleep.” But sleep research has led to numerous “reasonable proposals.”

A group from Spain offered a more controversial perspective in the 2007 article “The trivial function of sleep.” They argue that “sleep does not provide additional advantages over simple rest.”

So why do we sleep? Researchers are exploring complex answers to this simple question. And the debate is sure to continue.

Sleep & Memory: Lessons from Fruit Flies

Two new studies in the journal Science use fruit flies to examine the link between sleep and memory.

One study shows that the connections between nerve cells in the brain increase during the day. Then these “synapses” decline during sleep. This reduction of synapses is prevented by sleep deprivation.

This suggests that sleep may “prune” less important connections. This may create space for the brain to store more important memories.

Author Paul Shaw said in a statement that these results have practical implications.

“These data suggest the best thing you can do to make sure you stay sharp…is to make getting enough sleep a top priority," he said.

Another study used three-dimensional photos to look at protein levels in the brains of fruit flies. It focused on proteins that carry messages in the synapses between neurons.

These protein levels dropped by 30 percent to 40 percent during sleep. But the same proteins accumulated in the brains of fruit flies that were deprived of sleep by a “fly agitator.”

This suggests that sleep “resets” the brain. It empties the junk mail from the previous day. This prepares the brain for more learning the next day.

"Much of what we learn in a day, we don't really need to remember," author Chiara Cirelli said in a statement. "If you've used up all the space, you can't learn more before you clean out the junk that is filling up your brain."

But can we really learn about ourselves by studying fruit flies? Why are they useful study subjects? And how do we study them anyway?

A TIME article provides some useful insights. Fruit flies are simple enough to study. But with a genome that has 14,000 genes, they are more complex than you may think.

Study Links Insomnia with Suicide Risk

Both Reuters and BBC News report that a new study links insomnia symptoms with an increased risk of suicide.

The one-year study involved 5,692 adults in the U.S. They had no history of mental health problems.

Results show that suicidal thoughts or attempts were more likely in people with symptoms of insomnia. The study controlled for other factors such as depression and substance abuse.

The study measured these three symptoms of insomnia: trouble falling asleep or staying asleep, and waking at least two hours earlier than desired. About 35 percent of people reported having at least one of these sleep problems in the last 12 months.

Results link “waking early” to an increased suicide risk. People who reported this problem were more likely to have had suicidal thoughts. They also were three times more likely to have attempted suicide.

People with more than one insomnia symptom also had a higher suicide risk. They were 2.6 times more likely to try to kill themselves.

A study in the journal Sleep in 2007 reported that sleep problems and nightmares are common in people who have attempted suicide. A 2008 study in the journal Sleep linked suicide risk with a short sleep duration of five hours or less.

A 2005 study in the journal Sleep linked insomnia and nightmares with suicide risk. But after controlling for depression, insomnia was no longer a significant factor.

The CDC reports that suicide is the eleventh-leading cause of death in the U.S. It resulted in 32,637 deaths in 2005. In contrast, there were 18,124 deaths caused by homicide.

Insomnia with Objective Short Sleep Duration Linked to Increased Risk of Hypertension

A new study in the Journal SLEEP found that insomnia with objectively short sleep time is a significant risk factor for hypertension.

The study involved 1,741 men and women randomly selected from central Pennsylvania. Participants were categorized as normal sleepers, poor sleepers and chronic insomniacs based on symptoms of insomnia and objectively measured sleep duration.

Results indicate that the people at highest risk for hypertension were those with insomnia and less than five hours of sleep per night.

Lead author of the study Alexandros N. Vgontzas of Penn State College of Medicine said that both quality and quantity of sleep play a role in determining the risk for high blood pressure. This means that not every person suffering from insomnia is at an increased risk for hypertension.

Hypertension is linked with serious medical conditions, including heart, eye and kidney disease and strokes.

Findings of the study suggest that chronic insomnia is a major public health problem rather than a mere annoyance for otherwise healthy people.

People who have difficulty sleeping or other symptoms of insomnia that last for longer than a month should seek help at one of the 1,600 sleep centers accredited by the AASM.