Fall Back to Sleep & Standard Time

Tonight marks the end of daylight saving time. The return to standard time officially occurs at 2 a.m. Sunday morning.

This means you get an extra hour in your day. This is a great opportunity to catch up on your sleep!

To get an extra hour of sleep, you should go to bed at your normal bedtime. Then set all your clocks back an hour just before getting into bed.

Lifestyle choices, personal obligations and occupational demands can cause you to become sleep deprived. Ongoing sleep disorders or medical conditions can also cause sleep deprivation. When you are constantly getting less sleep than you need, you develop what is known as a ‘sleep debt’.

Sleep deprivation is linked with increased risk for obesity, illness and death. It can also lead to decreased alertness and performance during the day.

According to a study presented at SLEEP 2009, watching television is currently the most influential cue people use to decide when to go to bed.

Authors of the study say that people can reduce their sleep debt by watching less TV at night and going to bed earlier. You can also eliminate your sleep debt by sleeping for longer time periods each night and improving your sleep hygiene.

Sleep experts recommend that adults sleep between seven and eight hours each night.

Learn more about sleep deprivation at Sleep Education.com.

Visit an AASM-accredited sleep disorders center if you have an ongoing sleep problem.

Sleep Across America

Today the CDC released new survey data about the sleep of people in the U.S. It examined the rate of “insufficient rest or sleep” in 2008.

The Behavioral Risk Factor Surveillance System is the world’s largest, ongoing telephone health survey. It collects data on risk behaviors and health conditions. One question on the 2008 survey was, “During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?"

Nearly 404,000 people participated; they were 18 years of age or older.

Results show that about 31 percent were sound sleepers; they reported no days of insufficient rest or sleep in the preceding 30 days.

Who were these sound sleepers? They were more likely to be male, Hispanic, 65 years of age or older, and retired.

The results also suggest that island life promotes sound sleep. The age-adjusted percentage of people who always got enough sleep was highest in: Puerto Rico (51%), Guam (46%), U.S. Virgin Islands (36%) and Hawaii (36%). Louisiana was close behind at 35 percent.

At the other end of the spectrum were the problem sleepers. About 11 percent of respondents never got enough rest or sleep during the past 30 days.

Almost 26 percent of people who reported being unable to work were problem sleepers. Sixteen percent of people who were divorced, widowed or separated also felt that they never got enough sleep.

Southern states had higher percentages of problem sleepers. The age-adjusted percentage of people who never got enough sleep was highest in: West Virginia (19%), Tennessee (15%), Kentucky (14%) and Oklahoma (14%).

Everyone else had varying degrees of insufficient sleep. About 17 percent reported insufficient sleep ranging from 14 to 29 days; about 41 percent had anywhere from one to 13 days during which they did not get enough rest or sleep.

The authors conclude that doctors should ask patients about their sleep during routine office visits. Then they can make needed interventions or referrals to sleep specialists.

You can get help for a sleep problem at one of more than 1,800 AASM-accredited sleep centers near you.

Earlier this year the Sleep Education Blog reported on two other sleep surveys: the American Time Use Survey and the Sleep in America Poll.

Sleep Duration & Obesity in Children

A new study examined the relationship between sleep duration and obesity in children.

The study involved 5,159 children from 13 schools in Hong Kong; they had a mean age of 9 years. Sleep times and other data were collected using questionnaires.

Results show that children with shorter sleep durations had higher body mass index scores. Children slept for more than 10 hours at night on weekends and holidays; but they slept for only a little more than nine hours on school nights.

Children who slept less than eight hours during weekdays were more than two times more likely to be overweight or obese. The risk was highest in children who did not compensate for weekday sleep loss by sleeping longer on weekends and holidays.

The Sleep Education Blog has reported on a variety of factors that contribute to sleep loss in children. These include family status, prenatal influences, inactivity and watching TV.

Other studies also have linked sleep duration to the risk of obesity. So what is a parent to do?

Don’t wait for your child to “catch up” on sleep over the weekend; help him or her get more sleep during the week to avoid building up a sleep debt.

In July the Sleep Education Blog reported that children who go to bed after 9 p.m. take longer to fall asleep; they also have a shorter total sleep time.

So make sure your child has time to wind down and get in bed before 9 p.m. each night. One way to help is to turn off the TV and the computer earlier in the evening.

What helps your children get to bed early on school nights?

Sleep Apnea & Surgery: Caught on Camera

Surgery is one treatment option for people who have obstructive sleep apnea. Procedures tend to be “site-specific;” they will seek to eliminate the cause of the obstruction.

The challenge is finding the right site for surgery. Problem areas related to OSA include the tonsils, tongue, soft palate, throat, jaw and nose.

As a result, surgery isn’t a “one size fits all” treatment. In fact, the AASM’s clinical guidelines list more than 20 common surgical procedures for OSA.

Yesterday the Baylor College of Medicine reported that one way to address this challenge is to use an “endoscope;” this is a small flexible device with a camera on the end.

Doctors at the BCM are using it to help identify the cause of obstructions that happen during sleep apnea. They insert the endoscope into the back of the nose to view the throat while the patient is sedated and sleeps.

The camera gives them a front-row seat when an episode of OSA occurs. By finding the cause of the problem, they can develop a more precise treatment plan. This helps prevent unnecessary surgery.

The AASM reports that CPAP therapy is the treatment of choice for all severity levels of OSA. An oral appliance and surgery are alternative treatment options that may help some people with sleep apnea.

The AASM clinical guidelines report that “maxil­lary and mandibular advancement” is one surgical procedure that is often effective. Cuts are made into the bones of the upper and lower jaws. The jaws are pulled forward to enlarge the entire upper airway.

Most other sleep apnea surgeries will rarely cure OSA; you may need to continue with another treatment such as CPAP. But surgery may help reduce symptoms and improve quality of life.

Positive results also may not be permanent; symptoms may reappear at a later time after surgery.

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

Sleep Apnea May Trigger Abnormal Heart Rhythms

A new study suggests that episodes of obstructive sleep apnea may trigger two types of “cardiac arrhythmias,” which are abnormal heart rhythms.

The study involved 2,816 people. Their sleep was evaluated during an overnight sleep study.

The sleep study results were examined for two types of abnormal heart rhythms: ventricular tachycardia and atrial fibrillation – or AF.

Results show that the overall rate of arrhythmias was low; 62 abnormal heart rhythms occurred in 57 people.

But the relative risk of an abnormal heart rhythm was much higher after a breathing disturbance; people were nearly 18 times more likely to have an arrhythmia after a breathing pause than after normal breathing.

“Do these events act as a trigger for cardiac abnormalities?" study co-author Dr. Susan Redline said to HealthDay News. “We established that there is a close temporal relationship.”

The study also found that abnormal heart rhythms occurred even when OSA was less severe.

“Most of the arrhythmias occurred in people with mild-to-moderate sleep apnea," said Redline.

AF is the most common type of serious arrhythmia; long-term AF can lead to stroke and heart failure. AF is a very fast and irregular contraction of the atria.

The atria are the two upper chambers of the heart. They collect blood as it comes into the heart.

Ventricular tachycardia is a fast, regular beating of the ventricles. These are the two lower heart chambers. They pump blood out of the heart to the lungs and other parts of the body. Ventricular arrhythmias can be very dangerous.

In June the Sleep Education Blog reported on the link between sleep apnea and abnormal heart rhythms in older men.

Find out more about cardiac arrhythmias on the NHLBI Web site. Get help for sleep apnea at an AASM-accredited sleep center near you.

Infant Sleep Apnea

Obstructive sleep apnea is common in adults; OSA also occurs in children, especially in preschoolers. Central sleep apnea is most common in middle-aged and older adults. But did you know that infants can have sleep apnea too?

Primary sleep apnea of infancy is most common in small, preterm infants; it is rare in full-term newborns.

During the first month after birth it may occur in about 84 percent of infants who weigh less than 2.2 pounds. The risk decreases to about 25 percent for infants who weigh less than 5.5 pounds.

Apneas that occur in larger premature infants and full-term infants tend to be “central” apneas. These apneas occur when the body decreases or stops its effort to breathe.

The majority of apneas that occur in small, premature infants are “mixed” apneas. These breathing pauses involve an obstructive apnea that directly follows a central apnea.

An obstructive apnea involves a halt in airflow despite an ongoing effort to breathe. It occurs when soft tissue in the back of the throat collapses and blocks the upper airway.

Primary sleep apnea of infancy may be a developmental problem; it may be related to the immaturity of the brain.

It also may be caused or made worse by a variety of medical problems. These include anemia, an infection, acid reflux and chronic lung disease.

In most cases short-term treatment is required. The good news is that primary sleep apnea of infancy tends to go away as the child grows and matures. Long-term complications are rare for most children with primary sleep apnea of infancy.

Learn more about primary sleep apnea of infancy on SleepEducation.com.

To Sleep, Perchance to Dream: Or Stroll or Snack...

Former "American Idol" judge Paula Abdul told Fox News that while they were living together, her former co-star Kara DioGuardi suffered from sleep eating and sleepwalking.

Sleepwalking is typically seen as a childhood problem. While it is more common in children (as many as 17 percent of children sleepwalk), up to four percent of adults sleepwalk as well.

Sleepwalking, also known as somnambulism, tends to occur during slow-wave sleep, or when you aren’t dreaming. It is difficult to wake a sleepwalker. Sometimes they wake themselves. Other times they go back to bed, not knowing they ever got up.

Most people naturally outgrow sleepwalking. Those who wake up and find themselves in dangerous or embarrassing situations, however, may need treatment.

Sometimes sleepwalking is harmless. You may wake up somewhere other than your bed and wonder how you got there. It can also be dangerous. Children can fall down stairs and adults might even try to drive!

DioGuardi’s problem, sleep related eating disorder, is unusual. But like other eating disorders, it is much more common in women than in men.

People with SRED often prepare and eat food with no recollection of doing so. They may gain weight. Eventually they can even develop type 2 diabetes.

Sleep eating tends to occur in people with histories of alcoholism, drug abuse and other sleep disorders. People with high levels of stress and anxiety may also find themselves snacking in their sleep.

DioGuardi admits that in the past she had an eating disorder and has received professional help to overcome it.

Visit an AASM-accredited sleep disorders center if you suffer from sleepwalking or have an ongoing sleep problem.

Celtics Getting Sleep for the NBA Season

Boston Celtics head coach Doc Rivers is looking for any advantage that will help his team return to the NBA Finals this year. After winning the 2008 NBA Title, the Celtics were ousted from the 2009 playoffs by the Orlando Magic.

This season the Celtics get All-Star forward Kevin Garnett back from a knee injury. They’re also getting more sleep.

The team is being advised by Harvard sleep researcher Dr. Charles Czeisler. As a result they’re practicing at noon instead of early in the morning. And they’re no longer holding morning shootarounds on game days.

“I think they’re fresh,” Rivers told the Boston Globe. “I think we’ve had better practices.”

The goal is to help the players avoid the sleep deprivation that is rampant in the NBA. The 82-game regular season can be a brutal grind.

Play a late game; fly deep into the night to the next city on the schedule; fight off jet lag for a morning practice. Do it all over again.

As teams criss-cross the country sleep can get lost like checked luggage. That may be one reason why only seven of the 30 NBA teams had a winning record on the road last season.

“What we are trying to do is leverage the power of sleep,’’ said Czeisler. “As pro athletes, they spend so much time trying to practice and master the skills of the game - and sleep turns out to be a very critical part of the process…Teams that take advantage of this can really enhance their play.”

In January the Sleep Education Blog reported that the Portland Trail Blazers were getting help from Czeisler. They had finished the previous season with a mediocre 41-41 record.

The Blazers surged to a tie for first place in their division with a 54-28 record. The turnaround was fueled in part by a seven-game improvement in their road record.

The Celtics hope sleep will be a successful part of their gameplan this year. They’ll get their first test when they open the season against LeBron James and the Cavaliers in Cleveland on Tuesday night.

As for Czeisler, he hopes that we would all get more sleep.

“We are such a sleep-deprived society,’’ Czeisler said. “But the message is beginning to get through, that sleep is important for performance…It’s all about making sleep a priority.”

Learn more about how sleep improves sports performance.

Image by Daniel Go

Biofeedback to Treat Insomnia

A recent article from Health magazine describes the use of “biofeedback” to treat insomnia.

What’s biofeedback? It’s a form of therapy that gives you visual or auditory feedback for certain body signals.

Cues may give you details about your heart rate, blood pressure, breathing or body temperature. Then you learn to control the body in a way that promotes sleep.

Author Leslie Goldman describes how for eight years she struggled with sleep. Then she gave biofeedback a try.

“The change has been dramatic,” she writes. “After nearly a decade of sleeping for no longer than two hours at a time, I can sleep for four hours straight and doze off again after I wake up.”

The AASM recommends biofeedback as an effective treatment for chronic insomnia.

Often biofeedback will be combined with other treatment methods. This is called cognitive behavioral therapy, or CBT.

CBT is a safe and effective treatment option for people who are struggling with ongoing insomnia. It uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep.

Learn more about how CBT for insomnia is safe and effective. Get help for insomnia at an AASM-accredited sleep disorders center near you.

Sleep Deprivation: A Memory-Enhancing Drug?

Researchers report that they have identified the molecular mechanism by which sleep deprivation causes memory problems. They also suggest that drug treatment may be able to prevent the cognitive effects of sleep deprivation.

Their letter was published today in the journal Nature.

“Millions of people around the world suffer from a lack of sleep,” study co-author George S. Baillie said in a University of Glasgow news release. “This research opens the door for effective treatment of the memory loss associated with this debilitating condition."

The research team studied mice that had been deprived of sleep for five hours, reports NatureNews. They detected increased levels and activity of the “PDE4” enzyme in sleepy mice.

Then they treated sleep-deprived mice with the drug rolipram. It is a PDE4 inhibitor. The treatment prevented memory deficits that normally would have appeared after sleep deprivation.

Study co-author Christopher G. Vecsey cautioned that drugs like rolipram do have side effects. He also said that the study targets only one of the negative effects that sleep deprivation can have on the brain.

Study co-author Miles D. Houslay noted that sleep deprivation has many causes.

“People suffer sleep loss not only from disease but also jet lag, looking after young babies, getting old and through types of lifestyle,” he said. “This discovery offers hope for a simple and effective treatment.”

But sleep specialist Dr. Neil Stanley expressed concerns about the potential treatment. He worries that some people may take a drug for sleep loss when lifestyle changes would be a better solution.

“We really need to be thinking about ways to achieve adequate sleep in the first place - not how to deal with the consequences," Stanley told BBC News.

"We are always going to need drugs for people with serious disorders,” Stanley added. “But we don't want to end up medicalising lifestyles. We need to go back to basics and think about the way we as a society lead our lives, and the impact this has on our sleep, rather than looking for a cure."

In March the Sleep Education Blog reported on concerns that many healthy people are taking some medications as “smart drugs.” Learn more about sleep deprivation, and sleep and memory.

Sleep Related Leg Cramps

You wake during the night with an intense feeling of pain in your leg or foot. A muscle suddenly contracted and tightened.

The pain may last for a few seconds or several minutes. Then it ends as suddenly as it began.

This describes a typical episode of a sleep related leg cramp. These leg cramps can be disruptive to your sleep. Lingering soreness from a leg cramp also can make it hard for you to go back to sleep.

Sleep related leg cramps are most common in older adults. They also occur frequently in pregnant women.

You may be more likely to have leg cramps if you have diabetes. They also may be more likely to occur if you are dehydrated.

You may be able to relieve the pain by stretching the affected muscle. Massaging the muscle also may help.

Regular exercise may help prevent sleep related leg cramps; this exercise should include stretching the leg muscles.

The drug quinine has been used to treat leg cramps. But in 2006 the FDA cautioned consumers about serious safety concerns and risks related to the drug.

“Because of the drug's risks, FDA believes it should not be used to prevent or treat leg cramps,” said a FDA news release.

Learn more about sleep related leg cramps on SleepEducation.com.

Sleepless in Brazil

A new study shows that Americans aren’t the only people who have sleep problems. The study surveyed Brazilian adults about their sleep complaints. The results were published last week in the Journal of Clinical Sleep Medicine.

The study involved a random sample of 2,110 adults from 150 cities in Brazil. Surveys were conducted during face-to-face interviews.

Results show that 63 percent of people had at least one sleep complaint. Sleep problems significantly increased with age. Insomnia and nightmares were more common in women; snoring was more common in men.

Insomnia was the most common complaint overall; it was reported by 33 percent of people. Twenty-nine percent of people reported having a problem with snoring.

Nightmares were reported by 22 percent of people. Twelve percent reported having a problem with “kicking legs.” This could be a sign of either restless legs syndrome or periodic limb movements.

Six percent of people complained of “breathing pauses” during sleep. This is a sign of obstructive sleep apnea.

The authors estimate that more than 79 million people in Brazil have sleep disorder complaints.

Image by Kaysha

Positional Therapy: Sleep Apnea & the Tennis Ball Technique

A new study from Australia examined long-term compliance with the tennis ball technique in people with obstructive sleep apnea. The results were published in the Journal of Clinical Sleep Medicine.

What is the tennis ball technique? It is a simple method of positional therapy that helps you avoid sleeping on your back. It was first introduced in the early 1980s.

A tennis ball is fastened to the back with a belt or strap. This makes sleeping on your back uncomfortable.

Soft tissue in the throat is less likely to collapse and block the airway when you sleep on your side. As a result positional therapy may help reduce the breathing pauses that occur when you have OSA.

The study involved 67 people with OSA, mostly men. They were overweight and had an average age of 60 years.

They had an overall apnea-hypopnea index of 29.6 breathing pauses per hour of sleep; an AHI of 15 to 30 is considered “moderate” sleep apnea. Their average AHI soared to 53 when sleeping on their back; it dropped to 14.1 when side sleeping.

They were instructed to use the tennis ball technique. Then they were followed up after an average of 2.5 years.

Results show that only four people reported that they were still using the technique. Nine people claimed that they had learned to avoid sleeping on their back.

The primary complaint was that the technique was too uncomfortable. Another common complaint was that the tennis ball moved around. Some people said the technique was ineffective. Others reported that it caused backache.

A similar study in 2006 followed up 50 people after six months. Nineteen people were still using the technique; 12 said that they had learned to avoid back sleeping.

Other variations of the technique have been used. These include a backpack with a foam ball inside, a vest that contains a piece of hard foam, a thoracic anti-supine band, a triangular pillow, and a posture alarm.

The AASM reports that positional therapy can be an effective treatment option. But some people with OSA will continue to have breathing pauses while side sleeping. Talk to your sleep specialist to see if positional therapy is a good option for you.

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

Image by Tiffany

Use Bedtime Routines and Relaxation Techniques to Sleep Better

A new study in the Journal of Clinical Sleep Medicine examines the strategies people use to reduce daytime sleepiness.

Taking a bath was the most common sleep management practice for both men and women; 59 percent of men and 64.4 percent of women used it. Keeping a regular sleep schedule was the second most popular tactic.

People also wound down for the night by listening to music, snacking and exercising.

The results show that taking a bath and going to bed at the same time every night were the best ways to decrease daytime sleepiness. Snacking at night made people feel sleepier the next day.

One of the study’s authors said that culture influences the way people manage their sleep.

The study, conducted in Japan, includes data from 24,686 adults who completed a national health survey.

Don’t worry if you have a few sleepless nights. It is common to suffer from occasional bouts of insomnia. Stress, irregular sleep patterns and pain can cause you to lose sleep for short periods of time. This is known as adjustment insomnia. Once the problem is resolved sleep usually returns to normal.

What are some healthy ways to get better sleep?

The AASM recommends:

• Go to bed at a regular time each night.


• Wake up at the same time each night, even on weekends.


• Avoid naps if you can during the day.


• Don’t drink caffeine in the afternoon.

Find more tips about good sleep hygiene at Sleep Education.com.

Contact an AASM-accredited sleep disorders center if you have an ongoing sleep problem.

Image by Laura Taylor

Sleep, Infants & Breastfeeding

A new study suggests that nighttime breast milk may help babies fall asleep.

Researchers in Spain analyzed the content of breast milk samples. They found a “circadian rhythm” for some nucleotides in the milk. The levels of some nucleotides rose at night; others rose during the day.

"This made us realize that milk induces sleep in babies," lead author Cristina Sánchez told The Telegraph.

She said the finding is important for mothers who pump and store milk for later. Milk pumped during the day shouldn’t be given to a baby at night.

"It is a mistake for the mother to express the milk at a certain time and then store it and feed it to the baby at a different time," she said.

Another study suggests that a mother’s laughter may be good medicine for a sleepless baby. It found that mothers who watched a funny movie had increased levels of melatonin in their breast milk. Melatonin is a hormone that helps regulate your sleep-wake cycle.

Other studies show that breastfeeding may provide additional sleep benefits.

One study involved 196 habitually snoring children. Results show that the severity of sleep-disordered breathing was much lower in children who had been fed breast milk for at least two months.

In 2006 a study suggested that breastfeeding may protect against bedwetting; infants who were breastfed for longer than three months were less likely to suffer from bedwetting during childhood.

Another study found that breastfeeding also may help parents sleep. Parents of breastfeeding infants slept about 40 to 45 minutes longer than parents of infants who were given formula. They also reported less sleep disturbance.

The U.S. Surgeon General recommends that babies be fed only breast milk for the first six months of life.

Read more about sleep and infants. Learn how to help your baby fall asleep with a simple bedtime routine.

CPAP Therapy: Reducing Nasal Congestion

A new study from Ireland evaluated methods to improve nasal symptoms in people using CPAP therapy for obstructive sleep apnea. The results were published yesterday in the Journal of Clinical Sleep Medicine.

The study involved 112 people; most of the participants were men. On average they were obese and had severe sleep apnea.

They were randomly assigned to one of three CPAP therapy groups: dry CPAP, CPAP with a humidifier or CPAP with a nasal steroid spray.

After one month of treatment, quality of life was improved in all three groups. Fatigue and daytime sleepiness also decreased. All groups used CPAP for an average of more than five hours per night.

People who used “dry” CPAP were least likely to have itchy or watery eyes. But they were most likely to have nasal congestion. At the end of the study 70 percent of this group continued with dry CPAP; the others added a heated humidifier or a nasal steroid spray.

People who used CPAP with a heated humidifier were least likely to have nasal congestion. But eight of these people were unable to tolerate the humidifier; they all switched to dry CPAP. At the end of the study 46 percent of this group continued with a humidifier; the others switched to dry CPAP or added a nasal steroid spray.

The other group used CPAP and a nasal spray with fluticasone, a steroid; they used the spray two times a day. They were most likely to have problems with sneezing and runny nose; but the sneezing stopped within a few minutes of application. At the end of the study only 35 percent of this group continued with the nasal spray; the others switched to dry CPAP or added a humidifier.

The authors conclude that people who use CPAP should be evaluated on an indi­vidual basis; some may benefit from the addition of a heated humidifier or topical steroid spray.

Talk to your CPAP supplier if you have questions or concerns about the treatment. Call your sleep center if you have ongoing problems with CPAP therapy.

Get tips for solving CPAP problems on SleepEducation.com. Contact an AASM-accredited sleep center near you for help with sleep apnea.

Sleep Apnea in Women: Diet, Exercise & Weight Loss

A new study from Australia tested the effectiveness of a 16-week exercise and diet program for people with obstructive sleep apnea. The results were published today in the Journal of Clinical Sleep Medicine.

The study involved 12 people with an average age of 42 years; nine of the participants were women. They had an average body mass index of 36.1; a BMI of 30 or higher is considered “obese.”

They also had an average apnea-hypopnea index of 24.6 breathing pauses per hour of sleep; an AHI of 15 to 30 is considered “moderate” sleep apnea.

The program used Optifast, a very low-energy diet. Participants also followed a supervised exercise schedule; this included both aerobic and resistance training.

Results show that participants lost an average of about 27 pounds. Some typical OSA symptoms also improved; these included snoring, daytime sleepiness and mood.

But weight loss did not cure OSA. It did reduce the average AHI by 25 percent; but participants still had moderate sleep apnea with an average AHI of 18.3

“Although there was some improvement in sleep disordered breathing, it was not seen in all patients and was not proportional to the degree of weight loss,” lead author Dr. Maree Barnes told the AASM.

Follow-up at 12 months showed that all but one person who completed the program had regained some weight. But half of the participants were able to maintain weight loss of at least seven percent.

The AASM recommends dietary weight loss as one treatment strategy for people who are obese and have sleep apnea. But weight loss should be combined with another treatment such as CPAP or an oral appliance.

Read more about weight loss and sleep apnea. Learn more about women and sleep apnea risk.

You should talk to your doctor to develop a healthy weight-loss plan that is right for you. For help with sleep apnea you should contact an AASM-accredited sleep disorders center in your area.

Sleep Apnea Surgery: Is UPPP for You?

Are some people with obstructive sleep apnea more likely to benefit from surgery than others?

A new study involved 63 people with OSA. They had an average age of 42 years, and 81 percent were men. Their average body mass index was 35; a BMI of 30 or higher is considered “obese.”

Each person underwent “uvulopalatopharyngoplasty.” UPPP involves the removal of soft tissue from the throat; this tissue can collapse and block the airway during sleep. The soft palate is trimmed down in size. The tonsils and uvula may also be removed.

The effectiveness of UPPP was measured after an average of about three months; participants were monitored during an overnight sleep study.

Results show that the surgery eliminated OSA in only 24 percent of participants. These people were younger and less obese. They had an average age of 36 years and an average BMI of 31.

They also had less severe sleep apnea. Before surgery they had an average apnea-hypopnea index of 38 breathing pauses per hour of sleep. The average pre-treatment AHI was almost 70 in people who still had sleep apnea after surgery.

“This latest research helps us identify the patients who are the best candidates for surgery,” lead author Dr. Akram Khan said in a press release.

The AASM reports that CPAP therapy is the treatment of choice for all severity levels of OSA. A surgical procedure is an alternative treatment option for some people with sleep apnea. It may be required to correct a physical abnormality; it also may be performed if you are unable to have success with CPAP or an oral appliance.

There are a variety of surgeries that can help correct a specific problem. Targeted areas include the throat, tonsils, jaw and nose. Surgery may not cure OSA; you may need to continue with another treatment such as CPAP. Positive results also may not be permanent; symptoms may reappear at a later time after surgery.

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

Into the Deep: Exploring the Science of Sleep

The Oct. 24 issue of the magazine ScienceNews features four articles that focus on the science of sleep.

“The Why of Sleep” takes a look at current theories that attempt to explain the purpose of sleep. Saving energy. Promoting learning and memory. Regulating emotions. Boosting the immune system.

Sleep must provide some benefits that are preferable to waking activities. But the primary function of sleep - if there is one - remains a mystery.

One certainty is that sleep is necessary. “Dying to Sleep” examines the many health risks associated with sleep loss.

Animals need sleep too. But “All Kinds of Tired” shows that animals have a diversity of sleep styles.

And “Sleep Gone Awry” explores how sleep research is leading to a better understanding of sleep disorders. These studies may lead to the development of more effective treatments for problems such as insomnia and narcolepsy.

Having an Afternoon Energy Slump? Take a Nap!

Do you find yourself feeling sleepy after lunch? If the answer is yes, you are not alone.

A recent article in the News and Sentinel reports that humans’ natural circadian rhythm includes a decrease in energy in the afternoon.

Dr. Barry Louden, a board-certified sleep medicine physician, told the News and Sentinel that in addition to our natural energy decrease, many of us are tired in the afternoons because we are constantly sleep deprived. Work, family obligations and lifestyle choices often come before sleep on the list of priorities.

Even when we do try to get the sleep we need, sometimes it just doesn’t happen.

Is a nap the solution for an occasional sleepless night?

An article published recently in the Guardian makes the case.

The story says that napping for different amounts of time provides different benefits. A 20-minute nap consists mostly of stage 2 sleep, which improves alertness, concentration, mood, and motor skills. Naps of up to 45 minutes may include rapid eye movement (REM) sleep, which enhances creative thinking and information processing. Naps of 90 to 120 minutes usually include all sleep stages, which helps to clear your mind, improve memory recall, and lower your sleep debt.

Although a nap can help you make it through the day, it can not replace a full night’s sleep.

You might not feel the affects right away; but just one day of poor sleep can have negative consequences. People who aren’t getting enough sleep are at higher risk for serious long and short-term medical problems. Last week, the Sleep Education Blog reported that people who sleep less than seven hours a night are three times as likely to get sick.

The AASM recommends that adults get between seven and eight hours of sleep each night.

Obesity & Sleep Apnea Severity

Obesity can increase the frequency of breathing pauses that occur in people with obstructive sleep apnea. Does it also increase the severity of these breathing pauses?

A new study involved 750 adults. Their sleep was evaluated during overnight sleep studies; 37,473 breathing events were recorded.

Forty percent of participants were obese; they contributed 62 percent of the breathing events, reports MedPage Today.

Results show that body mass index (BMI) was associated with the severity of oxygen desaturation during these events. Oxygen levels dropped more severely in people who were more overweight or obese.

“Any increase in weight above a BMI of approximately 25 appears to increase the risk and severity,” lead author Paul Peppard, PhD, said in a press release.

Back sleeping was associated with more severe drops in oxygen saturation than side sleeping. Older age and smoking also predicted greater drops in oxygen levels.

The AASM reports that sleep apnea occurs when muscles relax during sleep. This causes soft tissue in the back of the throat to collapse and block the airway for 10 seconds or longer.

The breathing pause ends with a choking or snorting sound as the body briefly wakes and gasps for breath. Sleep resumes and the cycle repeats itself.

Severe sleep apnea may involve hundreds of breathing pauses in one night of sleep. Oxygen levels go up and down during these repetitive breathing pauses.

CPAP therapy is the treatment of choice for OSA. It eliminates breathing pauses during sleep and restores normal oxygen levels.

On SleepEducation.com you can learn how CPAP therapy can be a life saver for people with OSA. You also can answer these questions to learn more about your risk for sleep apnea.

Contact an AASM-accredited sleep disorders center for help with sleep apnea.

Always Tired: Chronic Fatigue & Hypersomnia

A new study identified DNA from a virus in 67 percent of people with chronic fatigue syndrome.

The “XMRV” virus was found in the blood of 68 out of 101 CFS patients; it was found in only eight of 218 healthy controls. The same virus has been linked to prostate cancer, Reuters reports.

“I think this establishes what had always been considered a psychiatric disease as an infectious disease,” study co-author Dr. Judy Mikovits told the New York Times.

The CDC reports that CFS involves an “all-encompassing” fatigue that is severe and incapacitating. The fatigue fails to improve with bed rest; it persists for six months or more.

Another common symptom is unrefreshing sleep. This can make it hard to distinguish CFS from a group of sleep disorders known as “hypersomnias.”

These sleep disorders all involve excessive daytime sleepiness. This sleepiness is not caused by disturbed sleep or a lack of sleep.

Narcolepsy may be the most well-known type of hypersomnia. It involves repeated episodes of daytime naps; sudden and irresistible “sleep attacks” may occur in unusual situations. Research suggests that narcolepsy is an autoimmune disorder.

Sleep paralysis and hallucinations also are common in people with narcolepsy. Another common symptom is “cataplexy.” This occurs when the leg, arm or face muscles suddenly become weak. It is normally caused by strong emotions.

People with idiopathic hypersomnia with long sleep time sleep for 10 hours or more. They also take long naps for three hours of more. Despite all of this sleep, they still feel unrefreshed.

Idiopathic hypersomnia also occurs without long sleep time. In this case you sleep for about six to 10 hours and take long, unrefreshing naps.

Recurrent hypersomnia involves repeated episodes of excessive daytime sleepiness. These may last for a few days or several weeks. You may sleep for 16 to 18 hours per day; then you sleep for normal lengths of time after an episode ends.

A common complaint of people with hypersomnia is, “I can’t wake up in the morning.” Even multiple alarm clocks may fail to wake you up. This topic has generated more than 175 replies in the discussion forum at SleepEducation.com.

Severe hypersomnia can make it difficult for you to function normally during the day; as a result your work or school performance may suffer.

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

Sleep Apnea & Children: Hurting Heart Health

A new study in the Oct. 1 issue of the journal Sleep examined how obstructive sleep apnea affects heart rate and blood pressure in children.

The study involved 15 boys and 15 girls in Australia; they were between the ages of 7 and 12 years.

Ten children had primary snoring; 10 had mild sleep apnea with an average of 2.5 breathing pauses per hour of sleep; and 10 had moderate to severe OSA with a mean of 15.2 breathing pauses per hour of sleep.

The children were monitored during an overnight sleep study in a sleep lab. Heart rate and blood pressure were analyzed before, during and after obstructive breathing pauses.

Results show that the children had significant changes in heart rate and blood pressure. From the last half of a breathing pause to the 15 seconds after a pause, blood pressure increased up to 26.5%. Heart rate increased up to 28.1% during this same timeframe.

The authors report that the magnitudes of these changes are similar to levels reported in adults. They also suggest that these repetitive changes may contribute to the development of high blood pressure.

Last year a study suggested that sleep apnea is significantly associated with higher levels of “systolic” blood pressure in children. This is the pressure when the heart beats while pumping blood.

Another study found that children with sleep apnea had higher blood pressure than healthy children during sleep and while awake. Children with moderate to severe OSA also had a higher risk for both systolic and “diastolic” high blood pressure at night. Diastolic blood pressure is the pressure when the heart is at rest between beats.

In June the Sleep Education Blog reported that the causes of sleep apnea in children are complex. Common factors include weight, tonsil size and nasal problems.

The AASM reports that OSA can develop in children at any age; but it is most common in preschoolers.

Learn more about obstructive sleep apnea in children on SleepEducation.com.

Drowsy Driving: OSA, Sleep Loss & Alcohol

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

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

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

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

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

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

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

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

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

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

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

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

Learn more about drowsy driving on SleepEducation.com.

Image by Stefan Van der Straeten

Sleep & Dyslexia: Reading Between the Lines

A new study from Italy analyzed the sleep of 16 children with developmental dyslexia. The results were published in the Oct. 1 issue of the journal Sleep.

The children had an average age of 11 years. Their sleep was evaluated during an overnight sleep study in a sleep lab. Results were compared with 11 children who read normally.

The study found that dyslexic children had a higher percentage of light, stage 2 sleep; they had a lower percentage of deep, slow wave sleep. These stages occur during non-rapid eye movement sleep – or NREM sleep. Children with dyslexia also had fewer periods of REM sleep.

Further analysis found additional differences during stage 2 sleep. Children with dyslexia had an increase in the power of fast, “sigma” brain waves; they also had an increased “sleep spindle” density. There were positive correlations between these measures and the children’s performance on reading tests.

A sleep spindle is a brief burst of rhythmic brain activity; it is a unique aspect of stage 2 sleep. “Density” refers to the number of sleep spindles that occur per minute of stage 2 sleep.

Dyslexic children had an average of 6.2 sleep spindles per minute; normal readers had only 3.5 sleep spindles per minute.

The NINDS reports that dyslexia is a brain-based type of learning disability; it involves a reading impairment that occurs in a person who has normal intelligence.

The authors suggest that increases in sleep spindles and sigma power may be markers of dyslexia; these markers may be related to the severity of reading impairment. The results also support the hypothesis that sleep plays an important role in learning and memory.

The authors note that only one other study has measured brain activity during sleep in children with reading disabilities; the results were published in the journal Sleep in 1993. That study found similar changes in the sleep of reading-disabled boys.

Learn more about sleep stages on SleepEducation.com.

Image by Shanubi

Sleep & Teens: New High School Writing Contest

It’s time for teens to do some sleep writing. The 2009 – 2010 AASM High School Topical Review in Sleep Science Contest is a new writing contest for juniors and seniors.

It offers a first-place prize of a $1,000 U.S. savings bond. The winning student also will receive a trip for two to San Antonio, Texas.

To enter, students must write an original topical review paper related to sleep and sleep disorders. They can choose a topic from 12 subject areas. These include sleep deprivation, insomnia and drowsy driving. Entrants must be sponsored by their science teacher.

The first-place student and one parent or guardian will receive a three-day/two-night trip to San Antonio, Texas, in June. Deep in the heart of Texas, San Antonio offers visitors a dynamic experience. Popular attractions include the Alamo, Six Flags and SeaWorld.

Why San Antonio? It’s where the SLEEP 2010 24th Annual Meeting of the Associated Professional Sleep Societies LLC will take place. At this meeting the contest winner will be recognized by the AASM.

What’s SLEEP 2010? It’s an annual meeting where the latest sleep research from around the world is presented. More than 5,500 people attend the meeting each year. This includes doctors, scientists, other health professionals and students.

Prizes also will be awarded for second place, third place and honorable mention. All award recipients will have their paper posted on the AASM Web site at www.sleepeducation.com. All recognized papers also will be considered for publication in the Journal of Clinical Sleep Medicine. JCSM is the official publication of the AASM and a leading scientific journal in the field of sleep.

Want to find out more? Get complete details and a contest entry form online. The submission deadline is Friday, Jan. 15, 2010.

Sleep for your Health this Cold and Flu Season

The cold and flu season is quickly approaching. This year it is more important than ever to protect yourself not only from the seasonal flu, but also from the contagious H1N1 virus or “swine flu”.

So what are the easiest ways to avoid contracting the flu?

It may be as easy as practicing good hygiene. Wash your hands, keep your hands away from your face and avoid contact with people who are sick. The CDC also advises getting plenty of sleep to help your body maintain a strong immune system.

A New York Times blog post found that if you are sleeping poorly you are more likely to catch a cold. Scientists think that this relationship highlights the importance of sleep to your health.

A study published earlier this year in the journal Sleep shows that your immune system can be affected by sleep deprivation. Levels of proteins associated with inflammation increase when you are not getting the sleep you need.

In May, the Sleep Education blog reported that people who sleep less than seven hours per night are three times more likely to get sick.

The AASM recommends that adults get seven to eight hours of sleep each night.

Learn more about how sleep can affect you at Sleep Education.com.

Sleep & Memory: Can a Nasal Spray Help You Remember?

German researchers have tested how a unique nasal spray affects sleep and memory.

The study involved a nasal spray containing “interleukin-6.” IL-6 is a cytokine; it is a signaling molecule that transmits information between cells.

Seventeen young men spent two nights in a lab, reports a FASEB Journal statement. Each time they read either an emotional or neutral short story. Then they were given either the IL-6 nasal spray or a placebo spray.

Declarative memory was tested in the morning after a night of sleep. Participants wrote down as many words as they could remember from the story.

Results show that IL-6 distinctly improved the sleep-related consolidation of emotional text material; participants who received the dose of IL-6 could remember more words from the emotional story.

The authors report that this type of memory consolidation benefits mostly from sleep in the second half of the night. This is when REM sleep dominates the sleep cycle.

A 2007 study in the journal Sleep found a link between IL-6 and REM sleep; higher IL-6 levels were independently associated with a longer latency to REM sleep.

A study abstract presented at SLEEP 2009 examined sleep and emotional memory; it suggested that sleep preserves in long-term memory only what is emotionally important and relevant to future goals.

The study found that emotional items are selectively remembered both 24 hours and four months later; but these memories are retained only if sleep comes soon after learning.

Learn more about sleep and memory.