Chevelle Puts Sleep Apnea on the Music Charts

Sleep disorders had a good year on the music charts in 2009.

First Craig David released the hit song “Insomnia.” Now the rock group Chevelle has given obstructive sleep apnea the lyrical treatment.

Their song “Sleep Apnea” appears on the band’s fifth album, Sci-Fi Crimes. In September the album debuted at number one on the Billboard Alternative Albums and Hard Rock Albums charts.

It also includes the hit song, “Jars.” The song is number 11 on the Billboard Rock Songs chart and one of the Top 10 Rock Songs of 2009 according to AOL Radio listeners.

The lyrics of “Sleep Apnea” weren’t meant to be a literal description of OSA.

Sleep Apnea - Chevelle

“'Sleep Apnea' is really talking about our lack of sleep we get out on the road, written pretty tongue and cheek,” lead singer Peter Loeffler told StarPulse. “It's about the weariness and where you can find yourself at. It's not constant but at certain times you're exhausted.”

But the song may bring some much-needed attention to a serious sleep disorder. In particular the line, “So I gasp and hold my breath,” may strike a familiar chord with listeners who have been unaware that they suffer from OSA:

Try to read off a letter that's
Falling apart
The sun and the moon
I count sheep
Escape like an animal I'm ready for
My sleepless stroll

I’ve felt these shifting hours
Mistakenly used up
So I gasp and hold my breath
These needs have changed so deep
To face you all and say
I've been awake for years

I gasp and hold my breath
These needs have changed so deep
To face you all and say
I've been awake for...

Ever
Ever
Ever
Ever

Do you ever wake up gasping for breath? Does your bed partner hold his or her breath during sleep? It may be sleep apnea.

STOP and find out if you are at risk for sleep apnea. You also can answer these questions on SleepEducation.com to learn more about your risk. Get help for sleep apnea at an AASM-accredited sleep center near you.

So what’s next in 2010? Maybe a song called “Narcolepsy” will be released. Wait, it’s already been done by Ben Folds Five and Third Eye Blind.

Narcolepsy - Ben Folds Five

Narclolepsy - Third Eye Blind

Image courtesy of Chevelle

2009: The Year in Sleep Top 5

The Sleep Education Blog is counting down the Top 25 Posts of 2009. Over the past four days we took a look back at 20 of the blog posts that received the highest number of unique pageviews.

Today we’ll conclude with the Top Five Blog Posts of the year:

5. My Child Bangs His Head in Bed as He Sleeps (Feb. 1)
Sleep related rhythmic movement disorder is one of the most disturbing sleep disorders a parent can witness. But it is common and rarely harmful.

4. Sleep Stats & Facts for National Sleep Awareness Week (March 1)
The AASM provided some interesting facts and stats about sleep.

3. Can You Treat Sleep Apnea with Tongue and Throat Exercises? (May 11)
Will strengthening and toning the tongue and throat muscles prevent your airway from collapsing during sleep? A study from Brazil used an exercise regimen to put this theory to the test.

2. Regis Philbin’s Sleep Study Results: It’s Sleep Apnea (July 10)
For years talk show and game show host Regis Philbin has been complaining about his sleep problems on “Live with Regis and Kelly.” Finally he decided to spend the night at a sleep disorders center to find out what’s wrong. Watch the video clip to see how he did.

1. Morning Headaches & Sleep Apnea (Feb. 18)
A study confirmed that obstructive sleep apnea can be a headache. But treating sleep apnea with CPAP therapy helped eliminate morning headaches.

2009 provided us with a wide range of intriguing stories and studies about sleep. There will be plenty more to come in 2010.

The Sleep Education blog will continue to provide daily updates about sleep and sleep disorders from the AASM. You’ll find breaking news and results from the latest research.

Come back each day to learn more and to provide your own input by adding your comments to the daily discussion.

Image by svenwerk

2009: The Year in Sleep Top 10

The Sleep Education Blog is counting down the Top 25 Posts of 2009. Over the past three days we took a look back at 15 of the blog posts that received the highest number of unique pageviews.

Today we’ll continue with five more of the most popular posts:

10. Violent Sleep: Acting Out Dreams & Nightmares (May 2)
CBS 2 News in Los Angeles reported on REM sleep behavior disorder. RBD is a sleep disorder that can turn your sleep into a living nightmare.

9. Losing Weight with CPAP for Sleep Apnea (May 21)
Treating obstructive sleep apnea with CPAP therapy helps some people bring their weight under control. In some cases the change is dramatic.

8. Michael Jackson’s Death & Prescription Drug Abuse (June 30)
Pop superstar Michael Jackson’s death focused attention on both insomnia and the nationwide problem of prescription drug abuse.

7. Sleep & the H1N1 “Swine Flu” Virus (May 4)
The life and death of Michael Jackson fascinated us. But it was the swine flu that scared us in 2009. The CDC advised us to get plenty of sleep to maintain a strong immune system.

6. Sleep Apnea & the Banana “Cure” (April 13)
A small study generated some big claims about using bananas to cure obstructive sleep apnea. It sounded too good to be true. But was it fact or fiction?

Tomorrow we’ll take a look back at the Top Five Blog Posts of 2009.

Image by draml

2009: The Year in Sleep Top 15

The Sleep Education Blog is counting down the Top 25 Posts of 2009. Over the past two days we took a look back at 10 of the blog posts that received the highest number of unique pageviews.

Today we’ll continue with five more of the most popular posts:

15. Sleep, Caffeine & the Starbucks Effect (Jan. 28)
Starbucks reported that demand for decaf coffee in some of its stores tends to drop after noon. But is your sleep affected if you rely on caffeine in the afternoon to fight off sleepiness?

14. Evidence that Obstructive Sleep Apnea Causes Brain Damage (March 26)
Recent brain imaging studies have shown that sleep apnea causes tissue loss in certain brain regions. This may help explain some of the impairments that often occur in people with sleep apnea.

13. Acupuncture for Insomnia: Is There a Point? (Feb. 19)
Can acupuncture be used to treat insomnia? A scientific review took a look at the evidence.

12. Sleeping Scared: Nightmares & Children (Feb. 21)
As a parent it is natural to be concerned when your child has a nightmare. Parents can follow these tips to help a child who has disturbing dreams.

11. Sleep Apnea & Women: What are the Signs? (Feb. 23)
Sleep apnea isn’t just for men. But a study showed that women may have different symptoms than men.

Tomorrow we’ll take a look back at five more of the top blog posts from 2009.

Image by Corey Holms

2009: The Year in Sleep Top 20

The Sleep Education Blog is counting down the Top 25 Posts of 2009. Yesterday we took a look back at five of the blog posts that received the highest number of unique pageviews.

Today we’ll continue with five more of the most popular posts:

20. Alcohol & Sleep: Nix the Nightcaps (Aug. 20)
Decades of research shows that alcohol disrupts your sleep in a variety of ways.

19. Can a “Sleep Diet” Really Help You Lose Weight? (Feb. 10)
It’s been suggested that you can you lose weight by simply getting more sleep. Seven women decided to take the challenge.

18. Internet Intervention: Online Cognitive Behavioral Therapy for Insomnia (June 1)
A new study added to the evidence supporting online CBT as an effective treatment option for insomnia.

17. How White Noise & Sound Machines Can Help You Sleep (April 16)
The soothing sound of white noise is a simple treatment for some people who have insomnia. And a wide range of both high-tech and traditional sound generators are available.

16. Online CBT for Insomnia: Using the Internet to Get Some “SHUTi” (July 7)
Another study found that sleep improved in adults with ongoing insomnia who completed an online cognitive behavioral therapy program.

Tomorrow we’ll take a look back at five more of the top blog posts from 2009.

Image by Steve Chihos

2009: The Year in Sleep Top 25

Numerous studies and stories about sleep captured our attention in 2009. It was a great year to learn more about sleep and sleep disorders.

Over the next five days the Sleep Education Blog will count down the Top 25 Posts of 2009. These are the blog posts that received the highest number of unique pageviews this year:

25. Unable to Sleep, Unable to Work: Insomnia & Disability (March 25)
A study suggested that insomnia can increase the risk of long-term work disability – at least in Norway.

24. Virtual Reality: Video Games & Sleep Loss (June 12)
A study reported that excessive video-game playing can interfere with your sleep. Gaming addicts also reported feeling sleepier during the day.

23. Do All Animals Sleep? (July 20)
It’s often assumed that every animal sleeps in one way or another. But is this true?

22. Bedwetting & Obstructive Sleep Apnea in Children (July 6)
A study found that 80 percent of children with a bedwetting problem had some degree of sleep apnea.

21. Violent Dreams: Who Has REM Sleep Behavior Disorder? (May 28)
RBD, which involves acting out action-packed dreams as you sleep, is most common among older men. But a new study confirmed that it can occur in other people as well.

Tomorrow we’ll take a look back at five more of the top blog posts from 2009.

Image by David Cohen

Holiday Wishes from the AASM

The children were nestled all snug in their beds,
While visions of sugar-plums danced in their heads;
And mamma in her kerchief, and I in my cap,
Had just settled our brains for a long winter’s nap…

-- From “A Visit from Saint Nicholas” by Clement C. Moore

The American Academy of Sleep Medicine wishes each of you a holiday season filled with peaceful sleep and sweet dreams.

Image by Kris de Curtis

Children & Holiday Sleep Loss

Even the most angelic child may transform into a Grinch during the holiday season. Why?

Children may be free to stay up later at night since they don’t have to wake up for school in the morning. And the excitement of the holidays can make it harder for them to fall asleep.

As a result children may get much less sleep than they need. A new poll by a U.K. bed and mattress company found that children accumulate an average of 25 hours of sleep loss during the holidays.

“Holidays are a time for enjoying family and friends,” said AASM spokesperson Dr. Lawrence Epstein. “But the holiday activities can lead to significant sleep deprivation. Unfortunately, the need for sleep doesn’t change.”

Children often respond to sleep loss in a different way than adults. Sleep-deprived adults tend to be sleepy and sluggish during the day.But sleep-deprived children may be hyperactive. They also may be moody and irritable.

This sets the stage for a classic holiday meltdown. Tantrums. Outbursts. Crying. Let’s just say that “peace on earth and goodwill toward men” will be quickly forgotten.

What can a parent do? One solution is to keep your child on a regular schedule during the holidays.

Our bodies function best when we maintain a routine: Wake times. Meal times. Sleep times.

This schedule should include a set bedtime. 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.

The holidays will be happier for everyone in the house if your child is well rested. And the season will be more enjoyable if you get your sleep too.

On SleepEducation.com you can learn why you should put sleep at the top of your holiday wish list. Get sleep tips for the holidays from the AASM.

Image by Cristian Boldisteanu

Sleep & Airline Safety: Pilot Fatigue

Last week the NTSB opened the public docket on its investigation of the Oct. 21 incident involving Northwest Airlines flight 188. It was the second incident this year to focus attention on sleep, sleep disorders and pilot fatigue.

For 77 minutes the pilots of flight 188 had failed to respond to radio contact from flight controllers. Then the flight overflew its destination by more than 100 miles.

The pilots claimed that they were distracted while discussing airline policies. But had they fallen asleep?

The NTSB has not yet made a determination of probable cause. But the NTSB interview summary reports that Captain Timothy Cheney went to a sleep disorders center about 15 years ago. He was seeking help for his loud snoring.

He was told that he didn’t have obstructive sleep apnea. But he began to use CPAP therapy voluntarily to control his snoring.

The scenario is eerily similar to an incident that occurred in 2008. A plane went 30 miles past its destination when both pilots fell asleep. One of them was later diagnosed with severe sleep apnea.

Earlier this year a plane crashed in Buffalo, N.Y. All 49 people on board and one person on the ground died in the Feb. 12 accident. It raised concerns about fatigue among the pilots of smaller, regional airlines.

In June the FAA responded by announcing an “expedited review of flight and rest rules.” The FAA also vowed to make pilot fatigue a “high priority.”



The FAA reports that regulations limiting flight time and pilot rest have been in place since the 1940s. An FAA proposal to update the rules in 1995 was never adopted based on “industry comments.”

In August the NTSB sent safety recommendations to the FAA. One recommendation was to “implement a program to identify pilots at high risk for obstructive sleep apnea.” Another was to conduct research examining pilot fatigue in “short-haul operations.”

The NTSB noted that these incidents are not isolated events. From 1995 to 2007 there were at least 17 reports of a flight crew member who fell asleep. In five cases both pilots fell asleep. And a 1999 NASA survey of regional pilots found that 80 percent admitted nodding off during a flight.

Image by caribb

NBA Teams Sleeping Like Champions

Previously the Sleep Education Blog reported that both the Boston Celtics and the Portland Trail Blazers have been making sleep a priority. Now it seems like sleep is catching on in the NBA.

As a result the early morning shoot-around may become a casualty of this renewed emphasis on sleep. Over the weekend sportswriter Howard Beck wrote in the New York Times:

For 38 years, the morning shoot-around has been an unquestioned staple of the N.B.A. game-day routine. It may soon be extinct, another dusty exhibit in basketball history, next to the peach basket, the two-handed set shot and John Stockton’s short shorts.

The San Antonio Spurs were the trend setters. Two years ago they stopped holding morning shoot-arounds on game days.

This season they’ve eliminated morning practices altogether. Instead they’re practicing at 4 p.m.

“The shootarounds were the beginning,” Spurs head coach Greg Popovich told the San Antonio Express-News. “The next step was actually giving them more time to get more sleep.”

The Celtics and Blazers aren’t the only teams that have noticed. The Times reports that the New York Knicks, Denver Nuggets and Washington Wizards also are experimenting with changes to their practice schedules.

The goal is to help players overcome the grueling demands of the long NBA season. Late games, early practices and jet lag can be a nightmare for sleep-deprived athletes.

“The general principle is that if you are going to prioritize anything, you should prioritize sleep,” Harvard sleep researcher and NBA consultant Dr. Charles Czeisler told the Times.

But in the NBA the bottom line is that you have to win. Principles can get tossed out the window of the team bus if they don’t translate into victories on the court.

That may explain why sleep is the newest fad in the NBA. The sleeping teams have been winning. So other teams are starting to follow their game plan.

The Spurs have won three out of the last seven NBA championships. The Celtics won the 2008 NBA Title and have a 21-5 record so far this season. And last year the Blazers surged to a tie for first place in their division.

As sleep continues to help these teams win, other teams are likely to start getting more sleep. It’s the new sleep cycle in the NBA.

Learn more about how sleep improves sports performance.

Image by Jack

Sleep Apnea & Nocturia: Nighttime Urination

A new study evaluated nocturia as a predictor of obstructive sleep apnea.

The study involved 1,007 adults. All of them had sought help at a sleep disorders center.

They completed medical and sleep history questionnaires. Their sleep was evaluated during an overnight sleep study.

HealthDay reports that 797 were diagnosed with sleep apnea. Snoring was reported by 777 people, and 839 reported nocturia.

Results show that self-reported nocturia was as effective as snoring at predicting OSA. The authors suggested that doctors should ask about nocturia when screening for sleep apnea.

"I see patients all the time who think they're waking up to urinate because they have prostate trouble or a small bladder," study co-author Dr. Barry Krakow told HealthDay. "About 80 percent of the time we discover that apnea is the cause of their problem."

Nocturia involves excessive urination at night. You may wake up several times during the night to urinate.

Sleep apnea causes frequent awakenings from sleep. Often these awakenings may be attributed incorrectly to excessive urination.

One study involved 80 people who woke up to urinate while being evaluated for a suspected sleep disorder. They were asked why they believed they had awakened.

Participants woke up and urinated 121 times. Sleep study results showed that 79 percent of these awakenings were caused by OSA, snoring or periodic limb movements.

But patients correctly identified the cause of only five percent of the awakenings. The authors concluded that people are poor judges of the reasons why they wake from sleep.

Research also shows that CPAP therapy for sleep apnea reduces awakenings to urinate.

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.

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

Restless Legs & Migraine Headaches

A new study examined the relationship between restless legs syndrome and headaches.

The study involved 1,041 people. They were all patients at a headache clinic in Taiwan.

More than 700 of them were suffering from migraine headaches. More than 200 had tension headaches. Fifty-one people had cluster headaches.

Results show that RLS was present in 11 percent of people with migraines. RLS occurred in 4.6 percent of people with tension headaches. It occurred in only two percent of people with cluster headaches.

People with both migraines and RLS had higher rates of other problems such as neck pain, tinnitus, dizziness and vertigo. They also had higher scores on measures of disability, and anxiety and depression.

Sleep quality also was worse in migraine patients with RLS. The frequency of RLS increased as the number of migraine symptoms increased.

The authors suggested that RLS and migraines may share an underlying mechanism.

RLS involves a strong, almost irresistible urge to move your legs. This urge gets worse at night and eases in the morning.

Often RLS also involves an uncomfortable feeling in the legs. It might be a burning, prickling, itching or tingling sensation.

Women are more likely than men to have RLS. The NINDS reports that migraines also affect adult women three times more often than men.

About 12 percent of people in the U.S. have migraines. These headaches involve throbbing and pulsating pain. Untreated migraine attacks last from four to 72 hours.

Migraines occur most often in the morning. Many factors can trigger the headache process. These include too much or not enough sleep, and caffeine withdrawal.

Earlier this year the Sleep Education Blog reported that many people with obstructive sleep apnea have morning headaches. Another study showed that there may be a link between headaches, naps and insomnia.

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

Life, Death & Sleep

This week the CDC reported that in 2007 life expectancy at birth reached a record high of 77.9 years in the U.S.

Women (80.4 years) had a longer life expectancy than men (75.3 years). There also was a gap between the life expectancy of whites (78.3 years) and blacks (73.7 years).

Hawaii had the lowest age-adjusted death rate of all the states. West Virginia had the highest rate. In general, states in the Southeast had higher death rates than those in other regions of the country.

The three leading causes of death were heart disease, cancer and stroke. This order has not changed since 1980. But it is likely that cancer will overtake heart disease as the leading cause of death in the U.S. at some point in the near future.

Does sleep have anything to do with life expectancy? Research has found some intriguing connections.

Numerous studies have examined the relationship between sleep duration and mortality. A recent review of the evidence linked short sleep duration with a 10-percent increase in the risk of death. Studies also have linked short sleep to an increased risk of diabetes, obesity and hypertension.

In October the CDC released new survey data about the sleep of people in the U.S. The sleep data seem to correlate with the death-rate trends described above.

Hawaii had one of the highest age-adjusted percentages of people who always 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.

A recent study found increased mortality in people with insomnia and a short sleep duration. The highest risk of dying was in men with chronic insomnia who slept five to six hours.

And studies have repeatedly found that obstructive sleep apnea is a serious health hazard. The UCLA Stroke Center reports that OSA is found in almost 50 percent of stroke patients.

People with sleep apnea have a higher risk of heart disease. And having severe sleep apnea has been linked with a much higher risk of dying.

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

Image by Robin Ducker

Steelers Tell Fans About Sleep Apnea

On Tuesday night some players from the Pittsburgh Steelers went to a local mall to tell holiday shoppers about obstructive sleep apnea.

They signed autographs and talked about the warning signs for OSA. While waiting in the autograph line fans could complete a brief assessment to see if they might be at risk for sleep apnea.

Steelers cornerback Deshea Townsend took the assessment himself. After the season ends he plans to go to a sleep disorders center for an overnight sleep study.

At 5 feet 10 inches and 190 pounds, Townsend doesn’t fit the profile of the typical sleep apnea patient.

"A lot of people also think you have to be a certain size, you have to be overweight,” he said to WTAE Channel 4 in Pittsburgh. “But as you can tell, I am not one of those big guys that looks overweight."

Overweight men do have a high risk of OSA. But sleep apnea also occurs in women and children, and in people who maintain a healthy weight. A study presented in June at SLEEP 2009 found a high rate of sleep apnea in non-obese adults.

Tuesday’s event was organized by Mike Thompson. He is the general manager of the local ESPN radio station.

Thompson suffers from sleep apnea and uses CPAP therapy. He said that the benefits of CPAP have been extraordinary.

“I have more energy, more vitality,” he said. “My blood pressure - despite my size - is normal. Since 1992, it changed my life."

The death in 2004 of retired NFL star Reggie White focused attention on sleep apnea and the NFL. White died at the age of 43. Reports indicate that sleep apnea may have played a role in his death.

In 2007 the NFL and the NFL Players Association began working together to target heart disease and sleep apnea in retired players. In March the Sleep Education Blog reported that OSA is common in retired NFL players.

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.

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

Image by wstera2

Insomnia & Headaches in Young Children

A new study links insomnia symptoms with headaches and gastrointestinal regurgitation in young children. The results were published yesterday in the Journal of Clinical Sleep Medicine.

The study involved 700 children. They were between 5 and 12 years of age. Parents completed sleep and development questionnaires for their child.

Results show that 19 percent of children had parent-reported insomnia symptoms. These children had trouble falling asleep and/or woke up often in the night.

Headaches were reported in about 24 percent of children with insomnia. About 13 percent of children without disturbed sleep had headaches. Statistical analysis found that insomnia was 2.3 times more likely in children with headaches.

Gastrointestinal regurgitation was reported in 7.5 percent of children with insomnia. Only two percent of children who were good sleepers had this problem. Insomnia was 3.3 times more likely in children with gastrointestinal regurgitation. It occurs when food or liquid comes back up into your mouth.

The authors noted that the study did not examine causality. But the relationship could be bidirectional.

Medical problems often disturb sleep. And insomnia symptoms may activate the stress response system. This could cause other medical complaints.

Lead author Dr. Ravi Singareddy told the AASM that children with insomnia symptoms should be screened by their doctor for underlying medical problems. Unresolved sleep problems may require further assessment by a sleep specialist.

In July the Sleep Education Blog reported that morning headaches are one warning sign for obstructive sleep apnea in children. Another study found that there may be a link between headaches, naps and insomnia in adults.

Learn more about sleep and children. Get help for a sleep problem at an AASM-accredited sleep center near you.

Sleep Apnea & Obesity in Children and Teens

A new study shows that teens were more likely to have obstructive sleep apnea if they were overweight or obese. But obesity did not increase the risk for OSA in younger children.

The results were published today in the Journal of Clinical Sleep Medicine.

The Australian study involved 234 Caucasian children. They were between the ages of 2 and 18 years. Their height and weight were used to calculate their body mass index. About 62 percent of the children were boys.

The children were suspected to have possible OSA because of parental concerns about their snoring. Their sleep was evaluated during an overnight sleep study.

Results show that the risk for OSA increased 3.5 times for each increase in BMI score in children 12 years of age and older. But increases in BMI score did not raise the risk for OSA in children under the age of 12.

OSA was detected in 34 percent of the children who were between 12 and 18 years of age. About 53 percent of the children in this age group were obese.

The authors suggest that developmental changes during adolescence may explain the results. These changes include reductions in the muscle tone of the upper airway.

They emphasized that the results are specific to Caucasian children. Obesity and OSA may interact at other ages in other ethnic groups.

The authors also noted that tonsil size may interact with obesity to increase the risk of developing OSA. But snoring teens who are obese should be evaluated for OSA regardless of their tonsil size.

The AASM reports that about two percent of healthy young children have OSA. It occurs when soft tissue in the back of the throat collapses and blocks the airway during sleep.

Most children with OSA have a history of loud snoring. This may include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.

In June the Sleep Education Blog reported that the causes of sleep apnea in children are complex. Sleep apnea often occurs when a child has large tonsils and adenoids. But weight and nasal problems also can play a role.

Learn more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

Image by Robert Hruzek

High School Writing Contest: Deadline is Jan. 15

The Jan. 15 deadline is only one month away for the 2009 – 2010 AASM High School Topical Review in Sleep Science Contest.

High school juniors and seniors are invited to submit an original review paper. They can choose a subject from a list of 12 topics related to sleep medicine and sleep research.

“This contest is an excellent opportunity to introduce students to some of the fascinating aspects of sleep and sleep disorders,” said AASM President Dr. Clete Kushida.

The contest offers a first-place prize of a $1,000 U.S. savings bond. The winning student and one parent or guardian also will receive a three-day/two-night trip to San Antonio in June.

Deep in the heart of Texas, San Antonio offers visitors a dynamic experience. Popular attractions include the Alamo, Six Flags and SeaWorld.

San Antonio will host the SLEEP 2010 24th Annual Meeting of the Associated Professional Sleep Societies LLC in June. At this meeting the contest winner will be recognized by the AASM.

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.

Get complete details and a contest entry form online. The submission deadline is Friday, Jan. 15, 2010.

Bipolar Disorder in Children May Be Linked to a Circadian Clock Gene

A new study found that the circadian clock gene RORB may be involved in bipolar disorder in children.

The study analyzed the genetic make-up of 305 children with bipolar disorder. They were compared with 140 controls.

Results show a positive association between bipolar disorder and four variants of the RORB gene. The authors suggest that this gene may be an important target in the search for the molecular basis of bipolar disorder.

The study also notes that bipolar disorder often involves a decreased need for sleep. This symptom helps discriminate children with bipolar disorder from those with ADHD.

The NIMH reports that bipolar disorder is a brain disorder. It is also known as manic-depressive illness.

It causes unusual shifts in mood, energy, activity levels and the ability to carry out daily tasks. These symptoms tend to be severe.

Bipolar disorder often develops in a person's late teens or early adult years. But some people have their first symptoms during childhood.

The disorder tends to run in families. Children are four to six times more likely to develop bipolar disorder if a parent or sibling has the illness.

Currently there is no cure for bipolar disorder. But ongoing treatment can help control the mood swings and other symptoms.

In 2008 FRONTLINE reported that bipolar disorder was long believed to exist only in adults. But in the mid-1990s it began to be diagnosed at much higher rates in children. Now one million children in the U.S. have been diagnosed with bipolar disorder.

Earlier this year the Sleep Education Blog reported that sleep problems in children may predict the future onset of depression. Learn more about sleep and children.

Image by Art & Line

A Book of Sleep for Children

Born in South Korea and educated in London, illustrator Il Sung Na makes his American debut with A Book of Sleep.

“It's the rare picture book that, upon arrival, feels as though it has been around for years already,” noted Publisher’s Weekly.

The opening line sets the stage for the story: When the sky grows dark and the moon glows bright, everyone goes to sleep . . .except for the watchful owl!

This wide-eyed owl proceeds on a moonlit journey to see how the other animals sleep the night away.

“One of the sweetest and most original of the new nighttime picture books,” author Liz Rosenberg wrote in The Boston Globe. “Both children and adults will welcome its…archetypical beauty.”

The book contrasts sparse text with rich, textured illustrations of a starry night.

“So thoroughly does the book inhabit its sleepy world,” author Daniel Handler commented in a New York Times review. Handler is best known for penning the A Series of Unfortunate Events books under the Lemony Snicket pseudonym.

A Book of Sleep is available as a 24-page hardcover book from Knopf Books for Young Readers.

In September the Sleep Education Blog described two other sleep books for children.

Learn more about sleep and animals.

Updating Memories to Prevent the Return of Fear

A new study shows that old fear memories can be “updated” to prevent the return of fear. The discovery is promising for the treatment of post-traumatic stress disorder.

"Our results suggest a non-pharmacological, naturalistic approach to more effectively manage emotional memories," study co-author Elizabeth Phelps, PhD, said in a press release.

The researchers used mild wrist shocks to condition participants to fear colored squares. A day later, the memory was reactivated.

Participants were re-exposed to the feared squares. This was followed by extinction training. They were repeatedly exposed to the colored squares without shocks.

The fear response was banished only if extinction training followed soon after the fear reactivation. This “reconsolidation window” appears to last for about six hours after the fear is reactivated.

During this time an old memory can be “rewritten.” It can be updated with non-fearful information.

"Timing may have a more important role in the control of fear than previously appreciated," said Phelps. "Our memory reflects our last retrieval of it rather than an exact account of the original event."

The study also found that the technique had a long-lasting effect. Fear responses were no longer expressed when tested one year later.

The AASM reports that recurring nightmares tend to be most disturbing aspect of PTSD. In these dreams the event may be relived in a way that seems shockingly real.

Earlier this year the Sleep Education Blog reported that playing the computer game Tetris can reduce unwanted “flashbacks.” Last month the blog noted that imagery rehearsal therapy is helping some people change their nightmares.

Learn more about sleep and memory.

Image by Stu Mayhew

Sleep & Hyperactive Boys

A new study examined the link between sleep duration and hyperactivity in preschool children.

The study involved 2,057 mothers in Quebec. They answered annual questionnaires until their child reached 5 years of age.

Results show that nightly sleep duration and hyperactivity were significantly associated. Highly hyperactive children were five times more likely to have a short sleep duration. Short sleepers were four times more likely to have high hyperactivity.

Boys were more likely than girls to be a hyperactive, short sleeper. Other risk factors included living in a low-income home and having a mother with a low education.

“Hyperactivity problems may interfere with night-time sleep,” senior author Jacques Montplaisir said in a news release. “We found that children who didn't sleep long were generally hyperactive boys who lived under adverse family conditions. On the other hand, short or fragmented sleep leads to sleepiness, which could manifest as hyperactivity in boys.”

He also noted that hyperactivity scores were low in young children who slept for at least 11 hours at night.

In September the Sleep Education Blog reported that living in a “fragile family” can affect how children sleep. Another study linked sleep loss to hyperactivity in children.

Earlier this year the Sleep Education Blog reported that children often respond to sleep loss in a different way than adults. Sleep-deprived adults tend to be sleepy and sluggish during the day.

But sleep-deprived children may be hyperactive. This is one key symptom of ADHD. Children with ADHD also may be inattentive or impulsive.

Learn more about sleep and children.

Image by Nico Cavallotto

Urine Test May Detect Sleep Apnea in Children

A new study shows that obstructive sleep apnea in children is associated with alterations in urinary concentrations of specific protein clusters.

The study evaluated morning urine proteins. It involved 60 children with OSA. They were compared with 30 children who have primary snoring and 30 controls.

The researchers found that the urine concentrations of 16 proteins were altered in children with OSA. Further analysis identified four proteins that have “favorable predictive properties.”

Using cutoff points for these biomarkers they correctly identified 95 percent of the children with OSA. This approach also produced no false-positive results.

"It was rather unexpected that the urine would provide us with the ability to identify OSA," lead author Dr. David Gozal said in a press release. “"These findings open up the possibility of developing a relatively simple urine test that could detect OSA in snoring children.”

Gozal would like to develop a color-based test that could be done in a doctor’s office or by the parents. But first the results need to be confirmed in a larger sample of children from around the country.

About two percent of young children have sleep apnea. In June the Sleep Education Blog reported that the causes of sleep apnea in children are complex.

Sleep apnea often occurs when a child has large tonsils and adenoids. But weight and nasal problems also can play a role.

Most children with sleep apnea have a history of snoring. It tends to be loud and may include obvious pauses in breathing and gasps for breath.

In October the Sleep Education Blog reported that sleep apnea affects heart rate and blood pressure in children. Another study found a high “sibling risk” of OSA in both boys and girls.

Learn more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

Image by Catherine

Infant Sleep: SIDS & Crib Safety

A new study examined trends and factors associated with infant sleeping position.

The study analyzed telephone surveys from 1993 through 2007. Each year’s survey involved nighttime caregivers of infants born within the last seven months. They were asked, “Do you have a position you usually place your baby in?”

Results show that the proportion of babies placed to sleep on their backs steadily increased between 1993 and 2001. But there was no change after 2001.

Maternal concerns about infant comfort and choking reduced the rate that infants were placed to sleep on their backs. Caregivers were more likely to put infants to sleep on their backs if they were advised to do so by a doctor.

“Placing infants on their backs for sleep remains the single most effective means we know to reduce the risk of sudden infant death syndrome," Marian Willinger, PhD, said in a NIH news release. She is the special assistant for SIDS research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The NICHD funded the analysis.

In 1994 the NICHD launched the “Back to Sleep” campaign. It urges parents and caregivers to place infants to sleep on their backs.

The NICHD reports that the rate of infant back sleeping has increased from roughly 25 percent to about 70 percent. At the same time, the SIDS rate has decreased by more than 50 percent.

Last month the U.S. Consumer Product Safety Commission announced the voluntary recall of more than 2.1 million drop-side cribs made by Stork Craft. This included about 147,000 cribs with the Fisher-Price logo. The cribs were sold at major retailers such as Sears and Wal-Mart.



There have been 110 reported incidents of drop-side detachment in the U.S. and Canada. These included 15 entrapments and 20 falls from the crib. Four of the entrapments resulted in suffocation. Fall injuries ranged from concussion to bumps and bruises.

Consumers can contact Stork Craft to receive a free repair kit. It allows you to convert the drop-side on these cribs to a fixed side. Parents and caregivers are urged to stop using the recalled cribs until the repair is made.

Contact Stork Craft toll-free at (877) 274-0277 anytime to order the free repair kit. You also can go online to www.storkcraft.com. For more information on Crib Safety, visit the CPSC's Crib Information Center.

Earlier this year the Sleep Education Blog reported that babies should never be put to sleep in a car safety seat. Learn more about sleep and infants & toddlers.

A Low-Energy Diet & Sleep Apnea

A new study examined the effect of weight loss on obstructive sleep apnea in obese men. The results were published online in the British Medical Journal.

The Swedish study involved 63 obese men with an average weight of 248 pounds. Their average age was 49 years. Sleep apnea was measured using a home sleep test.

All of the men had moderate to severe OSA and were being treated with CPAP therapy. They had an average apnea-hypopnea index of 37 breathing pauses per hour of sleep. An AHI of more than 30 is considered “severe” OSA.

Thirty men were assigned to the treatment group. The other 33 men acted as a control group.

The men in the treatment group were put on the Cambridge Diet for seven weeks. This is a very low-energy, liquid diet. It uses a powder that is mixed with water to replace every meal of the day.

After the seven-week diet normal foods were gradually introduced for two weeks. Treatment also involved group sessions for support and motivation.

Results show that men in the treatment group lost an average of 41 pounds. Twenty-two of the 30 men were no longer obese.

This weight loss produced an improvement in sleep apnea severity. The mean AHI of the treatment group dropped from 37 to 12.

Seventeen percent of the men no longer had sleep apnea. Fifty percent had mild sleep apnea with an AHI of less than 15. Men who initially had severe OSA showed the greatest improvement in AHI.

In a press release the authors noted that a very low-energy diet is not a general solution to weight problems. Typically it is used in the first phase of a long-term treatment program.

They also wrote that the main limitation of the study was its short duration. Weight regain is common after weight loss. Evaluating the long-term effectiveness of weight loss would require at least one year.

The study was funded in part by Cambridge Manufacturing Company Limited, which markets the Cambridge Diet.

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.

In October the Sleep Education Blog reported on another study involving a low-energy diet and OSA. Read more about weight loss and sleep apnea.

Image by Becky Lai