Michael Jackson’s Death & Prescription Drug Abuse

Soon after Michael Jackson’s death questions arose about his possible abuse of prescription drugs. Five days later those questions remain. Investigators recently took more medications from the rented house where Jackson collapsed.

The controversy has focused attention on the nationwide problem of prescription drug abuse. The risk of addiction extends far beyond the rich and famous.

The National Institute on Drug Abuse reports that millions of people in the U.S. abuse prescription drugs each year. The NIDA estimates that 48 million people have abused or misused prescription drugs in their lifetime.

Which drugs are most likely to be abused? The NIDA warns that three classes of drugs carry the greatest risk.

Opioids are commonly abused. These drugs are used to treat pain. Examples include morphine, codeine, OxyContin, Vicodin and Demerol.

Stimulants also may be abused. These drugs are used for problems such as narcolepsy. Examples include dextroamphetamine and methylphenidate.

Central nervous system depressants also are commonly abused. This class of drugs includes barbiturates such as Nembutal. It also includes benzodiazepines such as Valium and Xanax.

Some benzodiazepines are used to treat insomnia. Examples include Dalmane, Doral, Halcion, Prosom and Restoril.

But newer “nonbenzodiazepines” have a lower risk of addiction. Examples include Ambien, Lunesta and Sonata.

Another low-risk sleep aid is ramelteon. It is marketed as Rozerem. This drug is a melatonin receptor agonist. It targets the part of the brain that regulates the sleep-wake cycle.

The AASM offers these Guidelines for Taking Sleep Medications. Contact your doctor or pharmacist if you have any other questions about taking sleeping pills. You also should ask your doctor about cognitive behavioral therapy for insomnia. It is a safe and effective treatment option.

The NIDA reports that drug addiction is a brain disease that can be treated effectively. Treatments include detoxification, counseling and drug therapy.

To get help call 1-800-662-HELP or go online to http://findtreatment.samhsa.gov/.

Learn more about prescription drug abuse on SleepEducation.com.

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Sleep Deprivation: Your Genetic Vulnerability

Why does sleep deprivation affect some people more than others? A new study found that it has to do with your brain’s response to sleep loss.

The study involved two groups of people. Members of one group all had a short variant of the PERIOD3 gene. The authors report that people with this genetic variant are more resilient to sleep loss; they tend to function well even after a period of sleep deprivation.

Participants in the other group all had a long variant of the PER3 gene. People with this genetic variant are more vulnerable to sleep loss; their cognitive performance suffers when they are sleep deprived.

“The extent to which individuals are affected by sleep deprivation varies, with some crashing out and others holding up well after a night without sleep,” said Dr. Michael Chee, an expert on sleep deprivation who commented on the study in a prepared statement.

To explain this difference, the researchers performed brain imaging during a working memory task.

Results show that the people with the short PER3 gene had increased brain activity when tested after a sleepless night. They compensated for sleep loss by “recruiting” help from other parts of the brain. This enabled them to maintain their performance when sleep deprived.

In contrast, brain imaging showed that people with the long PER3 gene had reduced brain activity after a night of sleep loss. In one brain region, their activity also was reduced when tested at night after a normal waking day. This suggests that people with the long PER3 gene perform better earlier in the day.

“This study and others like it could help in identifying those who may be at risk for performance decline in jobs where sleep deprivation is an integral feature,” said Chee.

Are you sleep deprived? Check out the seven signs you need sleep on SleepEducation.com.

“Bonne Nuit”: Sleep Lessons from France

In May the Sleep Education Blog reported that people in France rank first in the world in getting the most sleep. One reason they get more sleep than Americans may be that they work four fewer hours per week.

Author Mireille Guiliano recently offered her own perspective on the sleeping prowess of the French. Guiliano grew up in provincial France and was educated in Paris. Currently she resides in Manhattan.

She has observed that Americans “seem to think it’s a badge of honor to sleep five or six hours a night.” As a result, she believes that, “Sleep…is the most neglected state of being in American life.”

How do people in France get more sleep than Americans? One key difference Guiliano noted has to do with TV.

“The French don’t watch much television,” she wrote. So while Americans are up watching late-night TV, the French are likely to be in bed by 11 p.m.

A study in the June 1 issue of the journal Sleep examined data from the 2003 to 2006 American Time Use Survey. Results show that watching TV was the primary pre-bedtime activity. People watched an average of 56 minutes of TV in the two hours before going to bed.

Guiliano added that instead of watching TV, the French tend to enjoy a relaxing dinner after work. And in addition to turning off the TV, they shut the computer down too.

What do you think? Do we have some sleep lessons to learn from the French?

Get sleep tips from the AASM on SleepEducation.com.

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Insomnia & HIV

Today is National HIV Testing Day. The CDC estimates that 1.1 million adults and teens in the U.S. were living with HIV at the end of 2006. Twenty-one percent of these people had not been diagnosed.

A review in the June 15 issue of the Journal of Clinical Sleep Medicine reports that insomnia is common in people with HIV. Some studies estimate that as many as 70 percent of people with HIV have insomnia at some point during their illness. Research also suggests that HIV may directly lead to changes in sleep.

Insomnia can reduce the quality of life of people who are HIV positive. It also can have a negative effect on their adherence to HIV treat­ment.

The review reports that few studies have evaluated insomnia treatments in people with HIV.

One study tested a five-week acupuncture intervention. It involved 21 HIV-positive men and women. They received a total of 10 treatments. Results show that sleep activity and sleep quality improved significantly.

Another study examined the effect of caffeine reduction on sleep quality. It involved 88 people who were HIV positive. Half of the participants reduced their caffeine intake by 90 percent or more for 30 days; the other half continued their usual caffeine consumption. Results show that caffeine reduction led to a 35 percent improvement in sleep quality.

The review also suggests that sleep medications may be useful for treating insomnia in people with HIV.

Read more about acupuncture for insomnia on the Sleep Education Blog. Learn more about insomnia due to medical condition on SleepEducation.com.

Sleep & Memory: “Replay” to Remember

A study published yesterday reports that the role of sleep in memory consolidation has been confirmed.

The study involved mice that ran a maze and then slept. Electrodes monitored their brain activity. While awake the brains of the mice “mapped” the pattern of the maze. Results show that their brains “replayed” this pattern during slow-wave sleep.

"Ours is the first study to demonstrate this link between memory replay and memory consolidation,” study co-author Susumu Tonegawa said in an MIT statement. “The sleeping brain must replay experiences like video clips before they are transformed from short-term into long-term memories."

The study identified a specific circuit in the brain that is involved in this process - the “trisynaptic pathway.” It is located in the “hippocampus.” This is a complex brain structure that is shaped like a seahorse.

In some of the mice the trisynaptic pathway was blocked. This impaired the replay process during sleep. Only mice with a functioning trisynaptic pathway were able to form long-term memories of the maze.

"We demonstrated that this pathway is crucial for the transformation of a recent memory, formed within a day, to a remote memory that still exists at least six weeks later," Tonegawa said.

Read more about sleep and memory on the Sleep Education Blog. Learn more about the stages of sleep on SleepEducation.com.

Big Dreams: From Google to Monster

Dreams have no meaning? Don’t tell that to Larry Page. Or Jeff Taylor.

Page recently said that a dream sparked the idea that became the world’s largest search engine. This is how the Google co-founder explained it in his commencement address at the University of Michigan:

You know what it's like to wake up in the middle of the night with a vivid dream? And you know how, if you don't have a pencil and pad by the bed to write it down, it will be completely gone the next morning? Well, I had one of those dreams when I was 23. When I suddenly woke up, I was thinking: what if we could download the whole web, and just keep the links and...I grabbed a pen and started writing! Sometimes it is important to wake up and stop dreaming.

His conclusion? “When a really great dream shows up, grab it!”



Page’s story sounds a lot like Taylor’s. The Monster.com founder recently told Roger Ziegler about his dream:

I woke up from the dream and sketched out the entire idea. The idea for a happy monster logo and the concept of ‘big, not scary,’ the design of the buyer-seller marketplace which is still in place to this day and a really important patent, all came out of that dream.

Ziegler added that Taylor keeps a dream journal next to his bed. This allows him to write ideas down when he wakes up.

How about you? Do you write down “big ideas” that you get from your dreams?

Read more about interpreting dreams on the Sleep Education Blog. Learn more about dreams and nightmares on SleepEducation.com.

Sleep Apnea & Abnormal Heart Rhythms in Older Men

A new study examines the link between sleep apnea and “cardiac arrhythmias” – abnormal heart rhythms.

The study involved 2,911 older men. Sleep apnea was measured during an overnight sleep study. Heart monitoring detected two groups of abnormal heart rhythms: atrial fibrillation or flutter (AF), and complex ventricular ectopy (CVE).

Results show that the general risk of AF and CVE increased as the severity of sleep apnea increased. The specific risks varied according to the type of sleep apnea that men had.

Men with obstructive sleep apnea had a greater risk of CVE but not AF. Men with central sleep apnea were between two and three times more likely to have AF.



The NHLBI reports that the atria are the two upper chambers of the heart. They collect blood as it comes into the heart. The ventricles are the two lower chambers. They pump blood out of the heart to the lungs or other parts of the body.

A person’s heart rate generally slows down during sleep. But AF involves a very fast heart rate that can be irregular (fibrillation) or regular (flutter). AF is the most common type of serious arrhythmia. Long-term AF can lead to stroke and heart failure.

CVE is a term that includes a variety of premature and abnormal heart-beat patterns. Abnormal heart rhythms that start in the ventricles also can be very dangerous.

A 2006 study found that people with severe sleep apnea were four times more likely to have atrial fibrillation; they were almost twice as likely to have CVE.

Learn more on SleepEducation.com: A scientific statement published in 2008 urged doctors to pay attention to the link between sleep apnea and heart disease. Studies show that CPAP therapy for obstructive sleep apnea helps the heart.

Find out more about cardiac arrhythmias on the NHLBI Web site.

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

Taming Violent Dreams: Treating REM Sleep Behavior Disorder

A new study in the Journal of Clinical Sleep Medicine reports that there are effective treatment options for people with REM sleep behavior disorder.

People who have RBD act out vivid, action-packed dreams while remaining asleep. Injuries to the dreamer or a bed partner are common.

RBD often is treated with clonazepam, a long-acting sedative. But the study reports that some side effects of this drug may be more prominent in older adults. Since RBD usually emerges after the age of 50 years, treatment can be problematic.

The small study involved a review of 39 people with confirmed RBD who were treated at a sleep center in the U.K.; 38 of the patients were men. They had an average age of 66 years; the youngest patient was 34 years old.

Thirty-six of the patients began treatment with clonazepam. Fifty-four percent took the medication successfully; but 58 percent reported moderate or severe side effects. The most common side effects were morning grogginess, confusion and cognitive impairment.

Zopiclone, a shorter-acting hypnotic, was used by 11 patients; nine used it alone, while two used it together with another medication. It was effective and well tolerated in eight of the 11 cases.

Two patients used melatonin; one used it while taking two other medications. Both people found it to be effective.

The authors conclude that it is important to consider the potential side effects when treating RBD in older adults. Shorter-acting hypnotics may be a useful treatment option.

Learn more about medications for sleep disorders on SleepEducation.com.

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

Overcoming Jet Lag with the Help of a Computer Program

A new study published on June 19 shows that mathematical models can be used to design effective treatment schedules for jet lag. The tools were used to create optimal schedules for bright light therapy.

The system was tested on a simulated 12-hour shift of a sleep-wake schedule. This is similar to what a person would experience when traveling from New York to Hong Kong. Simulation results show that the computer-generated treatment schedule produced faster performance recovery.

"This work shows how interventions can cut the number of days needed to adjust to a new time zone by half," study co-author Daniel Forger said in a prepared statement.

Properly timed light exposure can reset the circadian body clock to align with a new time zone. But using bright light therapy at the wrong times can be detrimental.

"Timed light exposure is a well-known method for beating jet lag,” Forger told CNN. “But few people realize that if timed incorrectly, it can actually make jet lag worse."

The authors report that it can be hard to create general rules for a treatment schedule. It may take weeks to manually design and test a treatment schedule. In contrast, the program tested in this study can produce an effective treatment schedule on a laptop computer in less than two minutes.

But it may be a while before this program is available to the public. Forger told CNN that it could be five years before the product is ready for release.

The authors also report that their system can be used for other jet lag treatments. Their next step will be to develop modules for interventions such as naps, caffeine and melatonin.

And the system may be useful in developing treatment schedules for people with shift work sleep disorder.

Go to SleepEducation.com to get more details about this study.

Read the full text of the study on the Web site of PLoS Computational Biology.

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

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Shakespeare & Sleep Disorders: To Sleep, or Not to Sleep

An article in the June 15 issue of the Journal of Clinical Sleep Medicine reports that Shakespeare “had a very good eye for sleep disorders.”

The article explores the pages of Othello. It cites passages that contain references to sleep and sleep disorders. One passage describes how sleep deprivation will be used as a tool for persuasion.

Another passage presents a clear description of sleep talking:

There are a kind of men so loose of soul
That in their sleeps will mutter their affairs.

The passage goes on to describe behaviors that resemble a parasomnia.

The play also shows how stress can lead to severe adjustment insomnia. And one line makes it clear that insomnia remedies have been around for a long time:

Not poppy, nor mandragora,
Nor all the drowsy syrups of the world,
Shall ever medicine thee to that sweet sleep
Which thou owedst yesterday.

Other articles also have noted sleep disorders in Shakespeare’s plays. One article points out that both obstructive sleep apnea and a type of central sleep apnea are described in Henry IV.

Another article reports that Shakespeare’s characters suffered from a variety of sleep disorders. These include sleepwalking, sleep apnea, insomnia and nightmares.

It many of Shakespeare’s plays, sleep could be more of a “tempest” and less of a “midsummer-night’s dream.” Perhaps Titus Andronicus summed it up best when he simply stated, “I have been troubled in my sleep this night.”

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REM Sleep Enhances Creativity

A new study reports that rapid eye movement sleep – or “REM sleep” – enhances creative problem solving.

Participants completed a creativity task in the morning. Afterward, some took a nap that included REM sleep; some took a nap without REM sleep; and some simply rested quietly. Then they were tested on the creativity task in the afternoon.

Results show that REM sleep enhanced the integration of unassociated information for creative problem solving. Members of the REM sleep group improved their performance on the creativity task by almost 40 percent. There was no performance improvement for members of the other two groups.

“We found that – for creative problems that you’ve already been working on – the passage of time is enough to find solutions,” study author Sara Mednick, PhD, said in a UCSD statement. “However, for new problems, only REM sleep enhances creativity.”

The AASM reports that there are multiple stages of sleep in a sleep cycle. Each complete cycle lasts about 90 to 110 minutes. REM sleep tends to be the final stage of the sleep cycle in normal adult sleep.

Learn more about REM sleep and sleep stages on SleepEducation.com.

Cooling the Brain to Treat Insomnia

A study presented last week at SLEEP 2009 proposed that “cooling the brain” may be a new way to treat insomnia.

The study states that insomnia is associated with increased metabolism in the brain’s frontal cortex. This occurs during the stage of non-REM sleep. Cooling the brain – “cerebral hypothermia” – has reduced metabolic activity in other medical conditions. Can it work for insomnia?

The small study involved eight people with primary insomnia. They wore a cooling device on the scalp. It covered the area where the frontal cortex is located.

The LA Times reports that the cap contains tubes that circulate cool water. Participants received a mild, cooling stimulus for 60 minutes before bedtime and during the first cycle of non-REM sleep.

Results show that cooling the brain was associated with a drop in core body temperature at sleep onset. It also reduced whole brain metabolic activity in five of the eight participants.

"They had increased slow-wave sleep, which is the deepest sleep," study author Dr. Eric Nofzinger told the LA Times.

Subjective benefits were reported by 75 percent of participants. These included fewer distracting thoughts and better sleep.

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

Surprised by Sleep Apnea: Women, Weight & OSA

Earlier this week Washington Post staff writer Valerie Strauss shared how she discovered that she has obstructive sleep apnea.

The sleep disorder was undetected by some doctors she had seen. And the discovery was a surprise to her. She didn’t fit the description of the typical sleep apnea patient.

Often it is overweight men who have sleep apnea. But as the AASM has reported, women can have sleep apnea too.

And sleep apnea may occur in people who maintain a healthy weight. A study presented last week at SLEEP 2009 found a high rate of sleep apnea in non-obese adults.

What were the warning signs that Strauss had noticed? She often felt tired after waking up. She also was having memory problems. And her husband complained about her loud snoring.

These are common symptoms of sleep apnea. Another recent study shows that people with sleep apnea also may report having fatigue or a lack of energy.

But initially doctors put the blame for her exhaustion on other problems. Maybe she was anxious. Or depressed. Or maybe she was going through a hormonal change.

Finally an overnight sleep study at a sleep disorders center confirmed that sleep apnea was the culprit. During the study she had an average of 27 breathing pauses per hour of sleep.

The diagnosis enabled Strauss to get the treatment she needed. The sleep center ordered a CPAP unit for her and had it delivered to her home; the cost was covered by her health insurance provider.

Now she is able to sleep better, and her snoring has stopped. That’s good news for her and her husband.

Are you at risk for sleep apnea? STOP and find out. You also can answer these questions on SleepEducation.com to learn more about your risk.

On SleepEducation.com you also can learn how a sleep study may be your best investment for long-term health.

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

Diabetes, Sleep Apnea & REM Sleep

A new study in the Journal of Clinical Sleep Medicine links obstructive sleep apnea to type 2 diabetes. It shows that there is an increased risk of diabetes in people who have sleep apnea during rapid eye movement sleep – or “REM sleep.”

The multi-ethnic study involved 1,008 people who were evaluated for sleep apnea; 67 percent were African American, 17 percent were Caucasian and 15 percent were Hispanic. Sleep apnea was diagnosed in 74 percent of participants.

Results show that people with sleep apnea during REM sleep were twice as likely to have type 2 diabetes. The risk of diabetes in middle-aged adults with sleep apnea was increased by almost three times. Overall, 30 percent of the participants with sleep apnea had diabetes.

“Generally, OSA is worse in REM sleep compared to non-REM sleep,” study author Dr. Kamran Mahmood told the AASM. “This may be the reason for closer association of REM-related OSA and type 2 diabetes.”

The study also reports that sleep fragmentation caused by sleep apnea may reduce REM sleep time.

Learn more about sleep apnea and diabetes. Read more about REM sleep and sleep stages on SleepEducation.com.

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

Tired & Fatigued: CPAP Improves Daytime Symptoms of Sleep Apnea

Excessive daytime sleepiness is a common symptom of obstructive sleep apnea.

But a new study in the Journal of Clinical Sleep Medicine shows that many people with sleep apnea have other complaints: fatigue, tiredness or a lack of energy. The study also shows that treating sleep apnea with CPAP therapy can help reduce all of these symptoms.

The study involved 313 people with sleep apnea. They had an average age of 55 years.

Before treatment more than half of participants complained of a lack of energy or tiredness. About 46 percent complained of fatigue; a little less than 40 percent complained of sleepiness. Women were more likely than men to report having a lack of energy.

Results show that these daytime symptoms improved in participants who reported using CPAP for five or more hours per night. The change was statistically significant for every complaint except lack of energy.

“We found that sleep apnea patients who used their CPAP regularly…had much greater success in reducing their fatigue, tiredness and sleepiness,” study author Dr. Ronald Chervin told the AASM. “This suggests that sleep apnea may be the cause of these symptoms, as it is a cause of sleepiness.”

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

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

Sleep Improves Sports Performance

A study that was presented last week at SLEEP 2009 in Seattle, Wash., adds to the evidence that sleep can improve sports performance.

The ongoing study at Stanford involved five members of the women’s tennis team. They maintained their regular sleep routine for two to three weeks during the season. Then they extended their sleep to 10 hours per night for five to six weeks. Performance was measured after ever practice.

Results show that sleep extension was associated with significant performance improvements. The athletes were faster during sprinting drills; their hitting accuracy also improved.

Sleep extension also led to changes in mood. Daytime sleepiness and fatigue decreased, and energy increased.

“Many do not realize that optimal or peak performance can only occur when an athlete’s sleep and sleep habits are optimal,” study author Cheri Mah told the AASM.

Last year at SLEEP 2008 Mah presented results of a similar study involving Stanford swimmers. Sprint times were faster during sleep extension; turn times and kick strokes also improved. Swimmers even reacted faster off the blocks.

At SLEEP 2007 Mah reported that sleep extension improved basketball performance. Sprint times and free-throw shooting improved after extra sleep.

Over the years Mah also has worked with the football, golf, cross country, and track and field teams at Stanford.

“Athletes across all sports can greatly benefit from extra sleep and gain the additional competitive edge to perform at their highest level,” Mah told the AASM.

Mah also said that Stanford coaches have been paying close attention to their athletes’ involvement in the ongoing study.

“Many of the Stanford coaches are definitely more aware of the importance of sleep,” she said. “Coaches have even started to make changes to their practice and traveling schedules to allow for proper sleep habits. For many athletes and coaches, this study was the first time they truly understood how large of an impact sleep can have on their performance and results.”

Image by Marc d'Entremont

Sleep & Marriage

A study that was presented last week at SLEEP 2009 in Seattle, Wash., examined the effect of marriage on sleep.

The study involved 360 middle-aged women with an average age of 51 years. They reported their relationship status at annual visits. Their sleep also was monitored for three nights.

Results show that women who were stably married had better subjective and objective sleep than unmarried women. Women who lost a partner during the eight-year follow-up period had the worst sleep.

The sleep of women who gained a partner during the study was similar to that of women in stable marriages. But study author Wendy Troxel, PhD, told the AASM that newlyweds were more restless.

“We discovered that these women had more restless sleep than the always married women,” said Troxel. “We speculate that these findings may reflect a ‘newlywed effect.’ These women may be less adjusted to sleeping with their partner than the ‘stably married’ women.”

Earlier in 2009 Troxel published a study linking sleep to marital happiness. Results show that happily married women reported fewer sleep disturbances.

Sleep Apnea & Wind Musicians

A study that was presented this week at SLEEP 2009 in Seattle, Wash., adds to the recent interest in wind instruments and obstructive sleep apnea.

The study surveyed a national sample of professional musicians. There were 760 instrumentalists, as well as 87 conductors and vocalists. They had an average of 30 years of experience; they also played for an average of 15 hours a week.

Results show that about 29 percent had a high risk for sleep apnea; 4.3 percent had been diagnosed with sleep apnea.

Musicians who played a high-resistance wind instrument had a lower risk for sleep apnea. The lowest risk was in musicians who played a double-reed, woodwind instrument; examples include the oboe and the bassoon.

The study failed to find the same effect for high-resistance brass instruments; playing the trumpet or horn produced no difference in sleep apnea risk.

Why the difference? The authors suggest that the double-reed woodwinds may promote the natural training of the respiratory muscles.

Results also show that practice time was an important factor.

“The number of hours practiced per week seemed to be the most important variable in lowering risk for OSA,” study author Christopher Ward, PhD, told the AASM.

Double-reed instrumentalists with a low risk for OSA played 17 hours a week on average. Those at high risk practiced for only 8.5 hours per week.

Virtual Reality: Video Games & Sleep Loss

A study that was presented this week at SLEEP 2009 in Seattle, Wash., reports that excessive video-game playing can interfere with your sleep.

The study involved 137 college students. They had an average age of 22 years; 63 percent were women. Casual game players were compared with excessive game players. “Excessive” was defined as playing more than seven hours per week.

Results show that almost 13 percent of participants reported that they are addicted to gaming. These participants slept one hour less on weekdays than other gamers; they also reported feeling sleepier during the day. In general, excessive gaming was associated with more sleepiness.

But study author Amanda Woolems told the AASM that only some of these college students realized that they were losing sleep.

“Of the people who admitted being addicted to gaming, only about a third of them recognized an interference with their sleep,” she said.

Playing video games also can have an effect on the sleep of children. One study involved children between 6 and 12 years of age in Japan. Playing video games had a negative impact on sleep. Children also were more active before bedtime if they had a video game system in their bedroom.

Another study involved teen students in Belgium. Teens with a gaming computer in their rooms went to bed significantly later on weekdays. Those who spent more time playing computer games also went to bed later on weekdays and weekend days. They spent less time in bed on weekdays and reported higher levels of tiredness.

Race, Sleep & Obesity

A study that was presented this week at SLEEP 2009 in Seattle, Wash., examined the link between race, sleep and obesity.

The study involved 29,818 U.S. adults. The data came from the 2005 National Health Interview Survey. Information was collected during face-to-face interviews.

Results show that 52 percent of blacks and 38 percent of whites were obese. Only 23 percent of blacks and 30 percent of whites reported sleeping seven hours per night. Blacks also were more likely than whites to have a “short sleep” duration of five hours or less per night.

So was there a connection between race, sleep and obesity?

Statistical analysis showed that blacks had a 78 percent increased risk of obesity related to short sleep; the risk of obesity related to short sleep in whites was increased by 43 percent.

“Both black and white Americans who were obese tended to have short sleep duration,” study author Girardin Jean-Louis, PhD, told the AASM.

Learn more about sleep and weight on SleepEducation.com.

Who Sleeps Better?

A study being presented today at SLEEP 2009 in Seattle, Wash., examined sleep complaints in the U.S. Results show major differences based on marital status, income, employment and education.

The study examined CDC data involving 159,856 people. They were asked how often they had trouble falling asleep, staying asleep or sleeping too much. “Sleep disturbance” was defined as seven or more days of sleep problems over the last two weeks.

Results indicate that about 19 percent of Americans had disturbed sleep. What were the most important factors?

One was marital status. Almost 31 percent of people who were “separated” and 21 percent of people who had never been married had disturbed sleep; only about 16 percent of married people had trouble sleeping.

Another factor was income. About 26 percent of people who made less than $10,000 per year had disturbed sleep. This rate dropped as income increased; only about 8 percent of people making $75,000 or more had trouble sleeping.

There also were dramatic differences based on employment status. Almost 52 percent of people who were unable to work had disturbed sleep; nearly 32 percent of people who had been unemployed less than a year had trouble sleeping. Only about 16 percent of workers and 17 percent of retired people were sleep disturbed.

Trouble sleeping also decreased with education level. More than 27 percent of people who didn’t finish high school had disturbed sleep; this figure dropped to less than 14 percent for people with a college degree.

Race had less of an effect on sleep. Sleep disturbance occurred in about 19 percent of whites, blacks, Hispanics and Asians. But almost 27 percent of people who are multiracial reported having disturbed sleep.

Treating Insomnia with Yoga & Meditation

A study being presented today at SLEEP 2009 in Seattle, Wash., reports that an effective treatment for insomnia may be “Kriya Yoga.” This is a type of meditation that combines different yoga techniques.

The small pilot study involved 11 adults with chronic primary insomnia. They were between the ages of 25 and 45 years. Seven of them practiced Kriya Yoga for two months; four of them only received health education that included tips to improve their sleep hygiene.

Results show that there were significant improvements for members of the meditation group. They fell asleep faster and slept longer. They spent less time awake in bed during the night. Their sleep efficiency and sleep quality improved. They even had fewer symptoms of depression. Only total sleep time improved for the control group.

“Results of the study show that teaching deep relaxation techniques during the daytime can help improve sleep at night,” study author Ramadevi Gourineni told the AASM.

Learn about cognitive behavioral therapy for insomnia on SleepEducation.com.

Insomnia Linked to Increased Risk of Death

A study being presented today at SLEEP 2009 in Seattle, Wash., links insomnia with short sleep duration to increased mortality. This risk was found in men. The study also found an increased risk in women; but it was not statistically significant.

The study involved 1,741 adults. Their sleep was monitored in a sleep lab. Then they were followed up for 10 to 14 years.

Results show that the highest risk of dying was in men with chronic insomnia who slept five to six hours in the sleep lab. They were five times more likely to die during follow-up; men with insomnia who slept five hours or less were 4.5 times more likely to die. Controlling for depression and sleep-disordered breathing did not change the pattern.

The same research team published a related study in the April 1 issue of the journal Sleep. They reported that insomnia with short sleep time is a significant risk factor for hypertension.

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

Sleep Loss & Performance: Missing the Bull’s-Eye

A new study from England used the game of darts to measure the effect of sleep loss on performance. Sixty people had to throw 20 darts at a target; they were tested five times per day for accuracy and reliability.

They were tested once after a normal night of seven to eight hours of sleep. Then they were tested after a night of partial sleep loss; they went to bed four hours later than normal but woke up at the usual time.

Results show that partial sleep deprivation caused both mood and performance to be worse. Increasing time awake during the day also had a slightly negative effect on performance; this was associated with decreased alertness and increased fatigue.

Are you sleep deprived? Here are seven signs you need sleep from the AASM.

Image by Marius Boeriu

Risk of Depression in “Evening Types” and “Morning Types”

A new study examines how chronotype may be related to depression. Is the risk of depression greater in “evening types” (“night owls”) or “morning types” (“morning larks”)?

The study involved 200 healthy adults between the ages of 18 and 99 years. Results show that people who are “evening types” have a higher risk of severe depressive symptoms.

MSNBC reports that evening types went to bed around midnight; morning types went to bed around 11 p.m. and woke up about 40 minutes earlier. Total sleep time was about the same for the two groups.

The study was unable to show if sleep schedule causes depression. But it suggests that going to bed and waking up a little earlier could improve your mood.

Yet making a change may not be easy; your DNA has a strong influence on when you prefer to sleep.

Learn more about evening and morning chronotypes.

Wii Sleep: A Nintendo Solution for Insomnia?

In January the Sleep Education Blog reported on the benefits of playing the old-school video game Tetris; it can be a visual distraction that may reduce flashbacks and nightmares after a stressful event.

Now Nintendo is developing a video game application that is light years ahead of Tetris; the Wii Vitality Sensor may even help you fall asleep.

Nintendo introduced the device at E3 (Electronic Entertainment Expo). The annual video game industry trade show was held earlier this week in Los Angeles.

A Nintendo press release said that the Wii Vitality Sensor will detect your pulse and other body signals. This will give you information about “the body’s inner world.”

The Telegraph reports that Nintendo President Satoru Iwata envisions the device as a potential sleep aid.

“It may not be long before games help people unwind or even fall asleep,” said Iwata.

Learn more about insomnia on SleepEducation.com.

Image by Nintendo

NBA Finals: A West Coast Advantage for the Lakers?

Game one of the NBA Finals between the Lakers and Magic will tip off a little after 9 p.m. EDT tonight. The Lakers will have the home-court advantage in the seven-game series; a study in the journal Sleep shows that they also may have a West Coast advantage.

The study analyzed 8,495 regular-season NBA games over eight seasons. The researchers did not find that jet lag had a major influence on the outcome of games.

But then they did a sub-analysis of 101 games in which one team traveled across the country to play. In these games, the visiting team did four points better when they traveled west to east rather than east to west.

This may not sound like a big difference. But during the last season studied, there was only a 3.2-point difference between winners and losers in NBA games. Four points could change the outcome of a game.

Why did the West Coast teams have an edge? The authors propose that it has to do with the timing of the games.

Research suggests that athletic performance may peak in the late afternoon. Performance may decline at night as sleepiness increases.

When a game tips off at 9 p.m. in Orlando, the Lakers will be playing at a “body-clock time” of 6 p.m. They may be more alert than the Magic players.

So the Lakers may have a better chance of stealing a game on the road. Then again, it was the East Coast Celtics who won a road game in Los Angeles on the way to a 4-2 series win in the 2008 Finals.

The Magic players aren’t the only ones who face an uphill battle in this series; their fans will be put to the test too.

The Orlando Sentinel reports today that the late tip-off times during the playoffs are depriving Magic fans of sleep. When it comes to sleep, Lakers fans have their own West Coast advantage.

Image by Dale Chumbley

Treating Nightmares in Children with Imagery Rehearsal Therapy

Imagery rehearsal therapy is an effective way to treat adults with nightmare disorder. A new study from Canada shows that it also can be helpful for children.

The small study involved 11 boys and nine girls between 9 and 11 years of age. Each child had a moderate or severe nightmare problem; they had one nightmare or more per week for at least six months. None of the children had post-traumatic stress disorder.

Eleven children were put on a waiting list; nine of the children were treated with imagery rehearsal therapy. This is a way to train your brain to change your nightmares into a new set of images.

Results show that imagery rehearsal therapy reduced the frequency of nightmares. This effect lasted during a nine-month follow-up period. Nightmares became so rare that the researchers were unable to measure post-nightmare distress.

The AASM reports that children tend to begin having nightmares between the ages of three and six. The frequency of these disturbing dreams usually peaks between the ages of six and 10.

Learn more about nightmares and children.

Large Tonsils Aren’t the Only Cause of Sleep Apnea in Children

Excess body weight is a major risk factor for obstructive sleep apnea in adults. In children, sleep apnea often occurs when a child has large tonsils and adenoids.

But a new study in the journal Sleep shows that the causes of sleep apnea in children are complex. You can’t put all of the blame on the tonsils; weight and nasal problems also play a role in child sleep apnea.

The study involved 700 children between the ages of 5 and 12 years. They were randomly selected from 18 public elementary schools.

Results show that 1.2 percent of children had moderate sleep apnea; it was more common in older children between 9 and 12 years of age. Twenty-five percent of children had mild sleep apnea; 15.5 percent had primary snoring.

Body mass index (BMI) and waist size were significant and strong predictors of both snoring and all severity levels of sleep apnea. Nasal factors such as chronic sinusitis, rhinitis and nasal drain were significant predictors of mild sleep apnea. Black and Hispanic children were more likely to have primary snoring and mild sleep apnea.

And tonsil size? Surprisingly, it wasn’t a significant risk factor for snoring or for any severity level of sleep apnea.

This means that adenotonsillectomy may not always be the best treatment for sleep apnea in children. This surgery involves the removal of the adenoids and tonsils.

Study author Edward O. Bixler, PhD, said that other treatments may be better options for some children with sleep disordered breathing (SDB).

“Risk factors for SDB in children are complex,” Bixler told the AASM. “Treatment strategies should consider alternative options, such as weight loss and correction of nasal problems.”

Get help for child sleep apnea at an AASM-accredited sleep center near you; a board-certified sleep specialist will determine which treatment option is best for your child.

Learn more about sleep apnea in children at SleepEducation.com.

Internet Intervention: Online Cognitive Behavioral Therapy for Insomnia

Research has shown that cognitive behavioral therapy is an effective treatment option for chronic insomnia. But can online CBT help you sleep better?

Some health insurers think so. In November the L.A. Times reported that online CBT for insomnia is covered by some insurance providers.

Now a new study published today in the journal Sleep adds to the evidence supporting online CBT for insomnia. Results show that a five-week, online CBT program helped most people in the treatment group; 81 percent reported at least mild improvement in their sleep.

A TIME article reported today that there are many positive aspects of online CBT. It can be available to anyone with Internet access. Users also may be able to proceed at their own pace and repeat material as needed.

But some people may fail to follow through with an online treatment program. In the current study there was a 33-percent drop-out rate.

A few previous studies of online CBT for insomnia provided mixed results. An abstract presented at SLEEP 2008 involved a six-week program. Results show that participants increased their average, nightly total sleep time by 80 minutes.

A 2008 study from Japan evaluated a two-week program. Sleep quality and sleep-related behaviors improved significantly. After treatment participants were able to fall asleep about eight minutes faster. But there was little change in total sleep time.

A 2004 study from Sweden used a five-week program. Sleep improved in both the treatment group and the control group.

So what’s the bottom line? Online CBT programs have great potential for people who suffer from chronic insomnia. But they may need to be fine-tuned to maximize their effectiveness.

Go to SleepEducation.com to get more details about online CBT for insomnia.

Contact an AASM-accredited sleep center near you for help with insomnia.