Preventing Parasomnias: Get Plenty of Sleep

Parasomnias such as sleepwalking involve actions over which you have no deliberate control. You remain asleep or in a sleep-like state during an episode. As a result you are unaware of what is taking place. You are unable to make conscious decisions during the event.

This makes it important for you to act before an episode occurs. Preventing parasomnias will reduce unwanted sleep disturbances for you and those in your household.

One way to prevent parasomnias is to get plenty of sleep. Episodes of a parasomnia may be triggered by sleep deprivation.

Try to get a full night of sleep every night to keep your body and mind well rested. Most adults need about seven to eight hours of sleep per night.

Teens need a little more than nine hours of nightly sleep. Toddlers and schoolchildren need about nine to 14 hours of total daily sleep, depending on their age.

Get more tips for preventing parasomnias on SleepEducation.com.

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

Obstructive Sleep Apnea & Daytime Sleepiness

Excessive daytime sleepiness is a common warning sign for obstructive sleep apnea. But not everyone with sleep apnea feels sleepy during the day.

Sleep apnea involves a wide range of severity levels. A person with mild sleep apnea may stop breathing five or ten times an hour during sleep. In contrast a person with severe sleep apnea may stop breathing 30 or more times per hour.

Each breathing pause ends when the body briefly wakes up to take a breath. The more times this occurs, the more fragmented and disrupted your sleep will be.

Mild sleep apnea should be taken seriously even if you don’t have daytime sleepiness. It can increase your risk of other health problems such as high blood pressure. It also can progress to more severe sleep apnea over time.

Answer these questions on SleepEducation.com to learn more about your risk for obstructive sleep apnea.

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

Insomnia: When Should You Get Help?

Insomnia is the most common sleep complaint; everyone has trouble sleeping at times. So how do you know when your insomnia is severe enough that you should seek help?

This is what sleep specialist Dr. Donna Arand told the AASM:

“You should seek help when these three statements all describe your insomnia:
1. The insomnia has lasted more than three weeks.
2. It is not improving.
3. It is interfering with your ability to function during the day.”

“Insomnia is often a typical response to a stressful situation. It should disappear as the stress decreases. But bad sleep habits can develop during the period of stress. This prolongs and establishes the insomnia. It is easier for you to re-establish good sleep if you eliminate these habits early.”

Get more insomnia advice from Dr. Arand on SleepEducation.com.

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

Violent Dreams: Who Has REM Sleep Behavior Disorder?

People who have REM sleep behavior disorder act out vivid, action-packed dreams as they sleep. Who is likely to have RBD?

It is most common in men over the age of 50. But a new study from London confirms that it can occur in other people as well.

The study reviewed a sleep center’s case files from the previous seven years. Ninety-one people had been diagnosed with RBD during that time: 62 men and 29 women.

The average age of people with RBD was 52 years; 39 of the people were under the age of 50 years.

In people with RBD over the age of 50, the ratio of men to women was 3:1. The male to female ratio dropped to 1.4:1 in people under 50 years of age.

RBD occurred together with narcolepsy in about 38 percent of people in the younger age group. In the older age group, about 29 percent of people also had a “synucleinopathy.” These are neurological disorders such as Parkinson’s disease and dementia with Lewy bodies.

A person with RBD may punch, kick, jump or get out of bed and run - all while he or she is still asleep. Cuts, bruises or broken bones may occur to the dreamer or to a bedpartner.

Contact an AASM-accredited sleep center if you or someone you know acts out dreams during sleep.

Wired: Technology, Caffeine Keeping Teens Awake at Night

Technology-savvy teens can excel at multi-tasking. They can send text messages, surf the Internet and watch their favorite TV show all at the same time.

But a new study shows that technology may be taking a toll on their sleep. Many teens are staying up too late and consuming too much caffeine. As a result, they’re not getting enough sleep to remain alert during the day.

The study involved students between the ages of 12 and 18 years. They reported how much time after 9 p.m. they use various technological devices.

WebMD reports that watching TV was the most common activity; 82 percent of participants watched TV after 9 p.m. Fifty-five percent reported being online; 44 percent reported talking on the phone; and 42 percent reported listening to an MP3 player. Other common activities were watching movies, text messaging and playing computer games.

Multi-tasking was high; teens used an average of four technological devices after 9 p.m. Teens who did more multi-tasking tended to drink more caffeine.

Only 20 percent of participants got eight to 10 hours of sleep per night; these teens tended to do less multi-tasking after 9 p.m.

Thirty-three percent of teens reported falling asleep in school. Students who fell asleep in class consumed 76 percent more caffeine.

The AASM reports that most teens need a little more than nine hours of sleep each night to feel alert and well rested during the day. But a shift in the timing of their body clock causes teens to feel sleepy later at night. This explains why it can be hard for them to fall asleep before 10 p.m.

The AASM recommends that parents keep the TV and computer out of their teen’s bedroom. Parents also should set a “communication curfew” at night; set a time after which your teen can no longer talk on the phone or send text messages, instant messages or e-mails.

Learn more about teens and sleep loss on SleepEducation.com. Parents can get more tips for teen bed times.

House Resolution Raises Awareness of Sleep Apnea

Rep. Gus Bilirakis, R-Fla., recently introduced a resolution in the U.S. House of Representatives to raise awareness of sleep apnea. The resolution “encourages all Americans to educate themselves and others about the consequences of sleep apnea and its potential treatments.”

What are these consequences? The resolution points out that “untreated sleep apnea can lead to high blood pressure, heart attack, stroke, obesity, and diabetes.”

The resolution also notes that anyone can suffer from sleep apnea. It “can strike anyone, at any age, at any time, including children.”

But the good news is that sleep apnea can be treated. The resolution states that “lifestyle changes, mouthpieces, surgery, and/or breathing devices can successfully treat sleep apnea.” These breathing devices – called CPAP – are the most effective treatment for sleep apnea.

The resolution has been referred to the House Committee on Energy and Commerce. The AASM sent a letter of support and thanks to Rep. Bilirakis.

Read the full text of H. Res. 384 online.

Learn more about obstructive sleep apnea and central sleep apnea on SleepEducation.com. Get help for sleep apnea from an AASM-accredited sleep center near you.

Image: The U.S. House rostrum

People with Kidney Failure Get Help While They Sleep

Treatment for renal failure – kidney failure – can be exhausting. Blood is drawn from the body, cleaned and pumped back into the body.

This grueling process is called dialysis. It can take three to four hours and can cause severe fatigue. Then the treatment has to be repeated three times each week.

But ABC 7 in Denver reports that some dialysis clinics now offer to perform the treatment while patients sleep. This is improving the quality of life for people with kidney failure.

The process is gentler when it is performed at a slower pace during an eight-hour night of sleep. Nocturnal dialysis also allows patients to work normal hours and maintain their daily routines.

The challenge with overnight dialysis is being able to fall asleep around other people and in a new environment. But it appears that the benefits are well worth the effort.

Restless Legs Syndrome in the “Phantom” Leg of an Amputee

A recent report provides an unusual look at restless legs syndrome. The report describes an amputee who developed RLS in his “phantom” leg.

The 54-year-old man had his left leg amputated 22 years ago. He developed RLS in his remaining leg. Episodes of RLS also occurred to the leg that had been amputated.

Treatment with medication improved his symptoms. Movement of his leg and “phantom movement” of the amputated leg also provided relief.

The authors conclude that this case provides support for the important role of central nervous system dysfunction in the development of RLS.

The drugs most commonly used to treat RLS are “dopamine agonists” such as pramipexole (Mirapex) or ropinirole (Requip). Dopamine is a neurotransmitter. It acts within the brain to help regulate movement.

A 2005 study found that phantom pain often occurs after the amputation of a limb. The study involved 914 people who had a limb amputated. Eighty percent reported experiencing phantom pain in the previous four weeks.

Phantom pain also is a long-term problem. A 2008 study reported that phantom pain and phantom sensation often occur 12 months or more after amputation.

Learn about the genetics of RLS on SleepEducation.com.

Sleep & Memory: “That Face Looks Familiar”

Studies show that there is a strong link between sleep and memory. A new study even examines how sleep affects memory for face identity. Does sleep help you recognize a familiar face?

The study involved 112 volunteers; their average age was 25 years. Each participant was shown 60 computer-generated faces in random order.

The heads were bald, and the faces had no unique features such as a mole or a scar. Each face was shown on a computer screen for two seconds at a time. The entire set of faces was shown five times.

Recognition was tested after varying periods of time. Some people were tested after getting sleep; others were tested before getting any sleep. Sixty faces were shown; 30 faces had been seen earlier, and 30 were new faces that had never been seen before.

The results do not show that sleep enhances memory strength. But they do suggest that time spent awake during the retention period impairs memory for face identity.

Wakefulness of 12 hours or more had a detrimental impact on recognition memory strength; it made participants less likely to feel familiar with a test face.

The authors suggest that ongoing sensory stimulation when awake may interfere with visual memory. Sleep may not actively enhance visual memory; but it may temporarily prevent memory loss by “sheltering” visual memory from interference.

Read the full text of the study online.

Undiagnosed Sleep Apnea is Common in People with Diabetes

A new study confirms that undiagnosed obstructive sleep apnea is common in people with type 2 diabetes.

The study involved 306 obese adults with type 2 diabetes. Each participant was monitored during an overnight sleep study.

Results show that almost 87 percent of participants had undiagnosed sleep apnea. Almost 23 percent of participants had severe sleep apnea; they stopped breathing at least 30 times per hour of sleep. Severe sleep apnea was most common in people with a higher body mass index (BMI).

“The high prevalence of undiagnosed, and therefore untreated, sleep apnea among obese patients with diabetes constitutes a serious public health problem,” study author Gary Foster, PhD, said in a Temple University statement.



Diabetes is the sixth-leading cause of death in the U.S. as of 2006. The NIDDK reports that people who are overweight and inactive are more likely to develop type 2 diabetes. Excess weight also is a major risk factor for sleep apnea.

“Doctors who have obese patients with type 2 diabetes need to be aware of the possibility of sleep apnea, even if no symptoms are present,” Foster added.

Diabetes can be treated with insulin and oral medications. CPAP is the most effective treatment for sleep apnea. Diet, exercise and weight loss also can play a role in managing both conditions.

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

Losing Weight with CPAP for Sleep Apnea

Excess body weight is a major risk factor for obstructive sleep apnea. Treating sleep apnea with CPAP helps some people bring their weight under control.

In some cases the change is dramatic. NorthWest Cable News in Seattle reports that CPAP helped one woman lose more than 100 pounds in a little more than a year. She used to weigh more than 300 pounds.

Then she was diagnosed with sleep apnea and started using CPAP. She began to notice that she had more energy. So she started working out regularly and eating better.

CPAP also played a role behind the scenes of the TV show “The Biggest Loser: Couples.” Each contestant was evaluated during an overnight sleep study.

Sixteen of the 22 contestants were diagnosed with sleep apnea. Sponsor Philips Respironics provided treatment for each of them.

But a 2008 study shows that there is no guarantee that CPAP will lead to weight loss. The study was published in the Journal of Clinical Sleep Medicine.

The study involved 228 adults with sleep apnea. They had an average age of 55 years.

Results show that using CPAP for one year did not produce a significant drop in body mass index (BMI). Some participants initially lost weight after starting CPAP. But they gained the weight back during the year.

The authors conclude that CPAP alone is unlikely to produce weight loss; CPAP users still need to take an active role in losing weight.

Using CPAP is likely to increase your daytime alertness and energy level. This can help you lose weight if you become more active and get more exercise.

You should talk to your doctor to develop a healthy weight-loss plan that is right for you.

Learn more about the benefits of CPAP on SleepEducation.com.

Image by Chris

Combining Cognitive Behavioral Therapy with a Medication to Treat Insomnia

For people with insomnia, taking a medication can help break the cycle of sleepless nights. And cognitive behavioral therapy can lead to long-lasting improvements with little risk of side effects. But what happens when you combine these two treatments?

A new study helps to answer this question. The results were published today in The Journal of the American Medical Association.

The study involved 160 adults with chronic insomnia. For six weeks they were treated with either CBT or CBT combined with 10 mg of zolpidem at bedtime. Zolpidem is the generic name for Ambien.

Then the study continued for six months. Some of the people treated with only CBT attended monthly treatment sessions; others had no further treatment. Some participants in the combined treatment group continued with CBT and zolpidem; others continued only with CBT.

Results show that for the first six weeks, both CBT and CBT combined with zolpidem reduced insomnia symptoms. About 60 percent of participants in each treatment group slept better. Treatment eliminated insomnia symptoms in 39 percent of the CBT group and 44 percent of the CBT with zolpidem group. The combined treatment also produced a larger increase in total sleep time.

What was the best long-term treatment? CBT with zolpidem for the first six weeks, followed by ongoing CBT without medication. This method eliminated insomnia symptoms in 68 percent of participants.

The study suggests that a combined approach may maximize the strengths of both common insomnia treatments.

You should never take a sleeping pill without first getting approval from your doctor. A sleep specialist at an AASM-accredited sleep center can develop a treatment plan for insomnia that is best for you.

Do the Babies of Depressed Moms Have More Sleep Disturbances?

A small study in the journal Sleep examined the sleep of babies born to mothers who struggle with depression.

Results show that these babies are more likely to have disturbed sleep at 2 weeks of age. These sleep problems remain present at the age of 6 months.

The study involved 18 healthy, full-term babies. Seven “low-risk” infants were born to women with no history of depression. Eleven “high-risk” babies were born to women diagnosed with depression or with high levels of depression symptoms.

Babies born to depressed moms took an hour longer to fall asleep at night. They also had shorter periods of sleep. Their average total sleep time during a 24-hour period was similar to the “low-risk” babies. But their nightly sleep was 97 minutes shorter; during the daytime they had more sleep episodes of a shorter average duration.

Are these sleep problems directly linked to the mother’s depression? Is it the mother’s hormone levels that affect the infant’s sleep? This is still unclear, study author Roseanne Armitage, PhD, told the AASM.

“Whether it is maternal hormones that ‘cause’ the sleep problems in infants is not yet known,” she said. “It could be genetic, hormonal, or both.”

But Armitage thinks that it is possible to improve the sleep of babies born to depressed moms. A behavioral or environmental intervention may be helpful.

Learn more about how to help your infant sleep better on SleepEducation.com.

Study Links ADHD to Sleep Problems in Older Children & Teens

A study in the journal Sleep examines sleep problems in older children and teens with attention-deficit/hyperactivity disorder.

Results show that older children and teens are more likely to have a variety of sleep problems if they were diagnosed with ADHD when they were younger. These problems include insomnia, sleep terrors, nightmares, bruxism and snoring.

Study author Dr. Susan Shur-Fen Gau told the AASM that in children some symptoms of ADHD and sleep problems often overlap. These symptoms include inattention, hyperactivity, behavioral problems and impaired academic performance.

“In some patients with ADHD, symptoms are caused or exaggerated by primary sleep disorders,” Shur-Fen Gau said. “Therefore treatment of the sleep disorder will improve ADHD symptoms.”

The study involved 281 children with ADHD. They were between 10 and 17 years of age; they had been diagnosed with ADHD at an average age of 6.7 years. They were compared with 185 children who did not have ADHD.

Nightmares and lifetime nightmare disorder were more common in girls. Snoring was more common in boys.

Learn more about sleep problems and ADHD.

Treating Nightmares with Imagery Rehearsal Therapy

It’s bad enough to have your sleep disrupted by a nightmare. It’s even worse when recurring episodes of disturbing dreams turn into a nightmare disorder.

This is a common problem for soldiers and other people who have post-traumatic stress disorder. Their dreams often replay a disturbing event in a way that seems shockingly real.

But the Pittsburgh Post-Gazette reports that treatment can help break the cycle of recurring nightmares. This can help your sleep, and your daytime life, return to normal.

One of the most effective treatments for nightmares is “imagery rehearsal therapy.” According to the article, it is effective in more than 90 percent of people who try it.

“You train your brain to have a new set of images,” sleep researcher Anne Germain told the Post-Gazette.

Germain also said that the high blood pressure medication prazosin is another treatment option. The drug is effective at eliminating nightmares.

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

Learn more about dreams and nightmares on SleepEducation.com.

Image by Vanessa C

Do Dentures Affect Sleep Apnea?

Obstructive sleep apnea is common at all ages. But it occurs even more often in the transition from middle-aged to older-aged adults. For older adults with sleep apnea, do dentures affect their breathing during sleep?

A new study from Japan found mixed results. The study involved 34 adults who wear complete dentures. Their average age was 72.5 years. Twenty seven of the participants had at least mild sleep apnea with five or more breathing pauses per hour of sleep.

Sleeping without dentures, participants stopped breathing an average of 17.7 times per hour during one night of sleep. With dentures, breathing pauses during sleep decreased in 19 of the 27 participants. The average number of breathing pauses per hour of sleep with dentures dropped to 13.3. But in eight of the older adults, breathing pauses increased when sleeping with dentures.

Dentures certainly are no cure for sleep apnea in older adults. And the study did not measure how dentures may affect the use of CPAP therapy.

But older adults with sleep apnea should discuss denture use with their sleep doctor.

Get sleep tips for older adults on SleepEducation.com.

STOP to Find Out if You Are at Risk for Sleep Apnea

A new study confirms that the "STOP questionnaire" is a useful tool for predicting your risk of obstructive sleep apnea. So what’s your risk?

To find out, answer these four simple, yes or no “STOP” questions:

S: Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?

T: Do you often feel TIRED, fatigued, or sleepy during daytime?

O: Has anyone OBSERVED you stop breathing during your sleep?

P: Do you have or are you being treated for high blood PRESSURE?

You have a high risk of sleep apnea if you answered “yes” to two or more of these questions. You have a low risk if you answered “yes” to less than two questions.

The questionnaire has an even higher predictive value when you answer four more questions in the “STOP-Bang” version:

B: BMI more than 35 kg/m2?

A: Age over 50 yr old?

N: Neck circumference greater than 40 cm (15.75 in)?

G: Gender male?

You have a high risk of sleep apnea if you answered “yes” to three or more of the eight STOP-Bang questions. You have a low risk if you answered “yes” to less than three questions.

Why is this important? It is estimated that about 80 percent of men and 90 percent of women with moderate to severe sleep apnea are undiagnosed. You could be one of these people.

The STOP-Bang tool was designed for people who are about to undergo surgery. You may have increased complications during surgery if you have undiagnosed sleep apnea.

But it is a useful tool that anyone can use. Yet no screening tool is perfect. And the only way to confirm that you have sleep apnea is with a sleep study. Contact an AASM-accredited sleep center near you for help.

Learn more about your risk for sleep apnea on SleepEducation.com.

Image by Brandi Tressler

How Sleep Disorders May Affect Your Dreams

Sleep disorders can reduce both the quantity and quality of your sleep. Can they also affect your dreams?

A new review examined the current research. Only a small number of studies have focused on this subject. But results suggest that a couple of common sleep disorders may have an impact on your dreams.

People with insomnia are more likely to recall their dreams. The content of their dreams tends to reflect current stressors.

Breathing-related dreams are rare in people with sleep apnea.

People with narcolepsy tend to have bizarre dreams with a negative tone. This may be related to their disrupted sleep cycles.

The complex process of sleep involves multiple stages that make up a sleep cycle. Each complete cycle lasts about 90 to 110 minutes. Most adults will go through four to six cycles in a full night of sleep.

Most dreams occur during rapid eye movement (REM) sleep. This tends to be the final stage of the sleep cycle in normal adult sleep.

But people who have narcolepsy tend to go quickly into REM sleep. These events are called sleep-onset REM periods (SOREMPs).

Overall, the studies in the review support the “continuity hypothesis” of dreaming. This states that dreams reflect the issues and concerns of your life.

Image by Magdalena Swebodzinska

The “Don't Let the Bed Bugs Bite Act of 2009”

Earlier this year the Sleep Education Blog reported on the recent resurgence of bed bugs. Now Rep. G.K. Butterfield of North Carolina is sponsoring federal legislation to fight back.

H.R. 2248 was introduced in the U.S. House of Representatives on May 5. It is called the “Don't Let the Bed Bugs Bite Act of 2009.” The bill would “establish a grant program to assist States in inspecting hotel rooms for bed bugs.” It has been referred to the House Committee on Energy and Commerce.

The bill has eight cosponsors. Among them are Rep. Corrine Brown of Florida, Rep. Bobby Rush of Illinois and Rep. Eddie Bernice Johnson of Texas.

The bill reports that the population of cimex lectularius – or bed bugs – has increased in the U.S. by 500 percent in the past few years. Lodging facilities are most vulnerable.

According to the bill, bed bugs can travel through the ventilation systems in multi-unit housing. And female bed bugs can lay up to five eggs in a day and 500 in a lifetime. The bill also cites a study of 700 hotel rooms between 2002 and 2006; 25 percent of hotels needed treatment for bed bugs.

The bill would authorize $50 million in annual grant money for fiscal years 2010 to 2013. States would be eligible for grants to inspect lodging facilities for bed bugs; to qualify a state would have to inspect at least 20 percent of rooms each year. “Lodging facilities” are defined as hotels, motels and inns that have at least 10 rooms for commercial lodging.

The bill also calls for the CDC to “investigate the public health implications of bed bugs on lodging and housing.” Specific concerns include how bed bugs may affect mental health, spread disease or contribute to problems such as asthma. The CDC would have to submit a report to Congress by Dec. 31, 2010.

Image by louento.pix

“Brain Music”: Sleeping Better by Listening to the Music of Your Mind

According to the U.S. Department of Homeland Security, your brain has its own music soundtrack. And this “brain music” just might help you sleep better.

The DHS wants to help emergency responders sleep well when they end a stressful shift. So it is studying the use of “brain music.”

How is this music recorded? The Loudoun Times-Mirror in Virginia reports that you wear a skullcap that contains EEG sensors. For about five minutes these sensors record your brain waves.

Then a computer analyzes the data. It finds the rhythm of your brain waves and transforms the unique pattern into two musical compositions. One has a fast tempo to boost alertness; the other has a slow tempo to promote relaxation.

You listen to this music at scheduled times according to your needs. It is believed that this musical feedback triggers a natural response in your brain. The fast-paced music gives you a burst of productivity and energy; the relaxing music helps you recover from a stressful situation. You can listen to a brain music sample provided by the DHS.

Does it work? It is still being tested as part of the DHS Readiness Optimization Program. But the idea has intriguing possibilities.

There is some support for using music to sleep better. A small study in 2008 showed that music therapy may reduce insomnia symptoms in older adults. Music relaxation improved their sleep and reduced their anxiety.
Another study of young adults between 19 and 28 years of age found similar results. They listened to relaxing classical music for 45 minutes at bedtime. This improved their sleep quality and reduced depressive symptoms.

There also is strong evidence that supports the use of cognitive behavioral therapy to treat insomnia. CBT is effective and has long-lasting results. Treatment methods include relaxation training and biofeedback.

“Brain music” therapy combines some elements of both music therapy and CBT. Should it be included as one of the techniques used in CBT? The evidence is not in yet.

But a sleep specialist at an AASM-accredited sleep center can determine which insomnia treatment is best for you.

Image by Michael Summers

Can You Treat Sleep Apnea with Tongue and Throat Exercises?

Obstructive sleep apnea involves pauses in breathing during sleep. These breathing pauses occur when the tongue and soft tissue of the throat collapse and block the airway.

What if you exercised the tongue and the throat muscles each day? Would strengthening and toning these muscles prevent your airway from collapsing?

This idea gained support from a small study in 2006. Sleep apnea severity improved in people who learned to play the didgeridoo.

A new study from Brazil used an exercise regimen to put this theory to the test. The small study involved people with moderate sleep apnea; 16 participants performed daily exercises for three months.

The British Medical Journal Group reports that the exercises were developed from speech therapy. One technique was to repeatedly press the tongue up against the roof of the mouth. Participants also practiced sucking in the cheeks. Another technique was to repeatedly blow up a balloon after breathing in through the nose.

Results show that sleep apnea symptoms improved after performing the exercises each day for three months. Snoring intensity and frequency decreased. Daytime sleepiness and sleep quality improved. Neck circumference even decreased by about 1 cm.

Sleep apnea severity also improved; the average number of breathing pauses dropped from 22.4 pauses per hour to 13.7 pauses per hour.

"These data suggest that the exercises were able to promote remodeling of the upper airways," study author Dr. Geraldo Lorenzi-Filho said in a prepared statement. “This indicates to us that these exercises have significant potential to improve symptoms in sufferers of OSA.”

It is important to note that the treatment was not tested on people with severe sleep apnea. And 14 of 16 participants still had mild or moderate sleep apnea at the end of the study.

Lorenzi-Filho noted that it is unclear if all of the exercises were essential. One of the techniques may have been more effective than the others.

The most effective treatments for sleep apnea are CPAP and oral appliances. A sleep specialist at an AASM-accredited sleep center can determine which treatment option is best for you.

Mother’s Day: Restless Legs, Sleepless Moms

Every mom deserves a good night of sleep for Mother’s Day. But good sleep can be especially hard to come by for women with restless legs syndrome.

RLS involves a strong, almost irresistible urge to move your legs. This urge gets worse at night and eases in the morning. The need to move your legs increases when you lie or sit still. Temporary relief can be found by walking or moving the legs.

Often RLS also involves an uncomfortable feeling in the legs. It may be hard to describe what this feels like. It might be a burning, prickling, itching or tingling sensation.

RLS can have a severe effect on your sleep. It may prevent you from falling asleep. It also may keep you from returning to sleep if you wake up during the night.

Women are more likely than men to have RLS. It also is common during pregnancy.

There are many drugs that can help treat RLS. Mirapex and Requip are both FDA-approved for RLS. Reuters reported recently that Lyrica also may be a helpful treatment for RLS.

Last week the Dallas Morning News shared one woman’s story of what it’s like to suffer from RLS. “It's as if everything from the waist down wants to dance when everything from the waist up wants to sleep,” she says.

You can get help for RLS from an AASM-accredited sleep center near you.

NHL Playoffs: Is Sleep the Secret to Vancouver’s Success?

The NBA’s Portland Trail Blazers weren’t the only pro sports team getting advice from a sleep doctor this year. Canada’s CBC Sports reports that the NHL’s Vancouver Canucks followed a similar sleep strategy this season.

The results for both teams were positive. The Blazers took a 54-28 record into the first round of the playoffs. The Canucks finished the regular season 45-27-10. Then they swept the St. Louis Blues out of the playoffs in four games.

The Canucks were 3-0 on the road in the playoffs before losing in Chicago on Thursday. Now their series with the Blackhawks is tied at two games each. Has sleep been their secret weapon this season?

Each player’s sleep was monitored early in the season. Then the team’s sleep doctor made recommendations for flight times, practice times and days off.

The Canucks will try to take the series lead tonight in Vancouver. Then the series will return to Chicago on Monday.

Image by Kate Harrington

New Study Suggests that Narcolepsy is an Autoimmune Disorder

Scientists have made another major breakthrough in understanding the sleep disorder narcolepsy. A new study suggests that it is an autoimmune disorder.

Results show that people with narcolepsy are more likely to have a unique variant of a specific gene belonging to T cells. These cells play an important role in the response of the immune system.

“Our discovery clearly shows narcolepsy is an autoimmune disease,” study author Dr. Emmanuel Mignot said in a Stanford statement. “We’re now getting the main pieces of what’s happening in narcolepsy.”

The NIH reports that one of those pieces involves a human leukocyte antigen (HLA) gene. People with narcolepsy are likely to have a variant of an HLA gene. Along with T cells, HLA proteins help the immune system identify invaders such as bacteria and viruses.

Another piece of the puzzle was the discovery that people with narcolepsy lack brain cells that make hypocretin. This is a hormone that helps promote wakefulness. The finding helped explain why people with narcolepsy have episodes of uncontrollable sleepiness.

But the loss of hypocretin-producing brain cells occurs over time; narcolepsy typically appears after 15 years of age.

Why do these brain cells die in people with narcolepsy? The new study suggests that the immune system attacks and destroys the brain cells by mistake.

So is the case closed? Not yet. The HLA and T-cell variants fail to fully explain narcolepsy. Some people with these genetic variations never develop the disorder.

Why? That is still unclear. But Dr. Mignot believes that a chain reaction is involved.

"Narcolepsy is probably the result of a series of unfortunate events,” he told BBC News.

Mignot said that the genetic variations “predispose” you to have narcolepsy; they put you at risk. But it may take some kind of “trigger” - such as in infection - to set the disorder in motion. This trigger may activate the immune system response that kills hypocretin cells.

There is still more to learn about narcolepsy. But this new discovery may help doctors learn how to stop the disorder from developing.

Sleep Around the World: What about Children?

As the Sleep Education Blog reported, the OECD recently compared the sleep times of people in 18 countries. It found that people in Korea and Japan get the least sleep; people in the U.S. have the second-highest daily sleep time. The U.S. time use survey involved people who were 15 years of age and older.

But what about children? Are there differences around the world in how long children normally sleep?

A study abstract presented last June at SLEEP 2008 provided some insights. It focused on 17 countries that were primarily Asian or Caucasian.

The study involved parents of more than 21,000 infants and toddlers; the age range of the children was from newborn to three years of age. The parents completed a questionnaire about their child’s sleep.

The study found a pattern that is similar to the OECD report. Results suggest that young children in Asian countries get less sleep each day than young children in Caucasian countries. Asian children also have later bedtimes. There were no differences in night wakings or napping behaviors.

Hong Kong children are up the latest with an average bedtime of 10:10 p.m. Children in Indonesia, Taiwan and Korea also go to bed after 10 p.m. Children in New Zealand go to bed the earliest; their average bedtime is 7:16 p.m. Children in Australia and the U.K. also go to bed before 8 p.m. U.S. children have the seventh-earliest bedtime of 8:52 p.m.

An early bedtime helps New Zealand children get the most sleep; they sleep for an average of 13.3 hours per day. This total combines nightly sleep and daytime naps. Children in Australia and the U.K. also get more than 13 hours of daily sleep. U.S. children rank fifth with an average of 12.9 hours of total sleep time per day. Japanese children have the lowest total sleep time of 11.6 hours per day. Children in Indonesia and Korea also get less than 12 hours of sleep per day.

The AASM reports that newborns up to three months of age need about 16 to 20 hours of total sleep time per day. Infants between three months and 12 months of age need about 14 to 15 hours of sleep per day. Toddlers between the ages of one year and four years need about 12 to 14 hours of total sleep time.

Image by Fui

Sleep in America: A Closer Look at the Time Use Survey Data

Yesterday, the Sleep Education Blog described a new OECD report. It states that the U.S. ranks second in the world in average daily sleep time. Today, let’s take a closer look at the survey data.

The OECD report states that survey methods may vary to some degree between the 18 participating countries. In the U.S., the American Time Use Survey includes people 15 years of age and older.

The survey is conducted by telephone. Respondents report how long they slept between 4 a.m. on the previous day and 4 a.m. on the day of the survey.

So the survey doesn’t measure a person’s typical sleep duration. And “sleep time” includes both nighttime sleep and daytime naps.

The average self-reported sleep times in the survey vary by age. The 2007 American Time Use Survey shows that teens and older adults get the most sleep. Teens report sleeping about 9.5 hours per day; adults age 65 and up get about 8.9 hours of sleep per day.

People in the U.S. also tend to sleep in on the weekends. The 2007 survey shows that Americans sleep about 9.2 hours on weekend days; this is almost an hour more than the 8.3 hours they report sleeping on weekdays.

But these numbers don’t tell the whole story. The broad strokes of this survey fail to paint an accurate picture of sleep problems in the U.S.

Another survey by the NCHS shows that many U.S. adults get much less sleep on a regular basis. About 21 percent of adults reported that they usually sleep for only six hours; another eight percent usually sleep for less than 6 hours.

The OECD report and the American Time Use Survey also fail to take sleep disorders into account. It is estimated that 50 million to 70 million people in the U.S. suffer from a sleep disorder.

Common disorders such as sleep apnea can ruin your sleep quality. This can impair your health and alertness no matter how many hours of sleep you get.

Sleep Around the World: France Ranks First, U.S. Second

A new OECD report compares 2006 time use surveys from 18 countries. Results show that people in France report getting the most sleep at about 8.8 hours per day.

The U.S. ranks second, just 12 minutes behind at about 8.6 hours of sleep per day. People in Korea and Japan get the least sleep at about 7.8 hours per day.

Why do the French get more sleep than Americans? One reason may be that they work less.

The report indicates that Americans work an average of 41.3 hours per week. People in France work an average of 37.3 hours per week.

A 2007 study in the journal Sleep analyzed data from previous American Time Use Surveys. Results suggest that work time is the strongest indicator of sleep time.

Tomorrow we’ll take a closer look at the survey data. We’ll see what it does and doesn’t tell us about the sleep of people in the U.S.

Image by Mirko Garufi

Sleep & the H1N1 “Swine Flu” Virus

The H1N1 flu virus, or “swine flu,” has infected people in 20 countries. This includes people in the U.S., Canada and Mexico.

How can you protect yourself from this new virus?

The CDC advises you to get plenty of sleep. This will help your body to maintain a strong immune system.

In January the Sleep Education Blog reported on a study linking sleep and the immune system. Participants were exposed to a “rhinovirus” – the common cold.

People who reported sleeping less than seven hours per night were three times more likely to develop a cold. The AASM recommends that adults get seven to eight hours of sleep each night.

To keep from getting the flu, the CDC also recommends that you wash your hands often. Keep active, eat a healthy diet and drink plenty of fluids. Avoid close contact with people who are sick.

The CDC advises you to stay home from work or school if you develop symptoms of the flu. These include a fever, sore throat, body aches, chills and fatigue. Stay home for seven days after your symptoms begin or until you have been symptom-free for 24 hours.

If you feel sick you may want to contact your doctor. He or she will determine if flu testing or treatment is needed.

Your doctor may prescribe an antiviral drug for you. This type of medicine can make your illness milder and help you feel better faster.

The two antiviral drugs approved by the FDA for treating the H1N1 flu virus are Tamiflu and Relenza. Currently there are no licensed vaccines for the H1N1 flu virus.

The FDA, FTC and Health Canada all report that some Internet sites may sell products with the false claim that they will prevent or cure the H1N1 virus. You should contact your doctor before buying any of these products online.

Image by Robert Terrell

An Early Bedtime May Improve Your Heart Health

A new study shows that going to bed before midnight may be good for your health. You may be less likely to have hardened arteries.

The study involved 251 healthy men. They were all younger than 61 years of age. They had an annual check up to measure their health. They also reported their typical bedtime and sleep duration.

The men were put into three groups based on their self-reported sleep duration: less than six hours, six to seven hours, and seven hours or more. In each of these groups, the men who reported going to bed before midnight had more relaxed arteries.

“We speculate that going to bed late somehow disturbs our habitual, biological sleep patterns,” study author Dr. Yu Misao said in a prepared statement. “We should consider getting our sleep habits as close to what our bodies biologically demand as much as possible.”

Misao noted that “arterial stiffness” is the first sign of hardening of the arteries. Having hardened arteries is also known as “atherosclerosis.”

The NHLBI reports that this form of heart disease occurs when plaque builds up on the inside of the arteries. These blood vessels carry oxygen-rich blood to the heart and other parts of the body.

Plaque build-up makes the arteries hard and narrow. This reduces the flow of blood to your organs. A heart attack, stroke or even death can result.

Violent Sleep: Acting Out Dreams & Nightmares

CBS 2 News in Los Angeles reports on REM sleep behavior disorder, or RBD. Note: Parents should be aware that the video on the CBS Web site may not be appropriate for children.

People who have RBD act out vivid dreams and nightmares as they sleep. The dreams tend to be action-packed. The dreamer may punch, kick, jump or get out of bed and run. All of this occurs while he or she is still asleep.

Injuries are common. Cuts, bruises or broken bones may occur to the dreamer or to a bedpartner.

"It is violent, moving nightmares,” Dr. Carlos Schenck told CBS. “It is what happens during sleep, and they end up hurting themselves or bed partners."

Schenck and colleague Dr. Mark Mahowald first identified RBD, reporting on it in the journal Sleep in 1986. Sixteen years later they filed a follow-up report.

Schenck also is executive producer of the documentary Sleep Runners. It tells the true stories of people who suffer from RBD and other parasomnias.

Contact an AASM-accredited sleep center if you or someone you know acts out dreams during sleep.

Help Your Infant or Toddler Sleep with This Simple Bedtime Routine

The solution to your child’s sleep problems might be a bedtime routine. A new study in the journal Sleep shows that a nightly routine helps young children sleep better.

What was the routine? The first step was for mothers to give their child a bath. The second step was to give a massage to infants or apply lotion to toddlers. The third step was to engage their child in quiet activities. This might involve cuddling or singing a lullaby. Finally the mothers turned out the lights within 30 minutes of the end of the bath.

This simple, nightly routine made a big difference. Children fell asleep faster, and they had fewer and shorter night wakings. Toddlers were less likely to call out to their parents or get out of their crib or bed.

The study involved 405 children between 7 months and 3 years of age. Mothers completed a daily sleep diary that included details of their child’s sleep patterns.

Go to SleepEducation.com to get more details about how this routine helped children sleep – and improved the mood of mothers.