Child Symptoms of ADHD & Sleep Loss Can Be Confused

Australian pediatric sleep expert Dr. Chris Seton recently told the Sydney Morning-Herald that it is very possible to confuse symptoms of ADHD with the effects of sleep deprivation in children.

“A tired five-year-old and a five-year-old with ADHD can both act in the same way," he said. "There's probably a common pathway, but so far researchers have been unable to find what it is."

Last year the Sleep Education Blog reported that children 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 are often hyperactive.

What could be keeping your child from getting enough sleep? Typically, a combination of biological, social and educational factors.

Recently the Sleep Education Blog reported that children and teens between 8 and 18 years old spend more than 7.5 hours a day watching TV and using electronic devices like cell phones and computers.

Homework, extracurricular activities and time with friends also often cut into sleep time.

Sleep deprivation is linked with behavioral problems and mood disorders in children. Students who are not getting the sleep they need also tend to do worse in school.

How do parents know if their child is sleep deprived? Seton said that a child who can wake up in the morning without an alarm clock is probably getting enough sleep.

ADHD is a serious condition that affects a large number of children. And sleep deprivation is a common alternative explanation for a child’s misconduct. You may want to monitor your child’s sleep habits if you notice changes in his or her behavior.

The AASM recommends that school-aged children sleep between nine and 10 hours each night.

Parents should enforce bedtimes and a nightly routine to help their children get an adequate amount of sleep each night. Sleep experts also recommend keeping the TV and other electronics out of the bedroom.

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

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How Much Sleep Do I Need?

UCLA researcher Jerry Siegel addressed this common question earlier in the week.

What’s the answer? One sleep size doesn’t fit all.

“Some people naturally sleep six hours,” he wrote. “And others naturally sleep eight hours.”

The better question is: Do you get enough sleep to remain alert and attentive during the day? And are you able to go to sleep and wake up without using alcohol, caffeine or other drugs?

If so, then you’re probably getting enough sleep.

But he warns that persistent daytime sleepiness is one sign that you may have a sleep disorder. And you should talk to a doctor if you have loud and frequent snoring. This is a common symptom of obstructive sleep apnea.

Last year an editorial by Siegel explored the nature and role of sleep.

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

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Chronic Insomnia: Less Brain Gray Matter in Older Adults

A new study from The Netherlands examined regional brain volume in people with insomnia.

The study involved 24 adults with chronic primary insomnia. They were between the ages of 52 and 74 years. Seventeen of them were women. They were compared with 13 people who had no sleep problems.

Results show that people with insomnia had a smaller volume of gray matter in the left orbitofrontal cortex. This reduction in gray matter was strongly correlated with the severity of insomnia.

The NINDS reports that “gray matter” refers to the cerebral cortex. This is where the brain does most of its information processing. The cortex is a layer of tissue with a gray-colored appearance.

The study also found reduced gray matter volume in the precuneus. This cortical area may have a central role in tasks such as episodic memory retrieval.

A press release noted that the affected brain regions play a role in evaluating pleasure. They also have a role in the brain’s “resting state.”

Most people with insomnia have “secondary” insomnia. It occurs along with another medical problem, mental illness or sleep disorder. It also may result from the use of a medication or substance. In contrast primary insomnia is unrelated to another health problem.

A 2008 study in the journal Sleep linked primary insomnia to low levels of a brain chemical. Results show that GABA levels are reduced by 30 percent in adults with chronic primary insomnia.

Last year a study proposed that “cooling the brain” may be a new way to treat insomnia. Subjective benefits were reported by 75 percent of participants.

Read more about insomnia. Get help for an ongoing sleep problem at an AASM-accredited sleep center near you.

How Does Yoga Help You Sleep?

Yesterday the Globe and Mail examined how yoga helps you sleep.

Harvard assistant professor Sat Bir Khalsa, PhD, told the Globe and Mail that yoga helps reduce the stress that can hinder sleep.

“With time and practice, the stress system begins to quiet down,” he said.

What changes occur in the body during yoga? The NCCAM reports that it is unclear. But there is growing evidence that yoga enhances stress-coping mechanisms.

One study by Khalsa used yoga to help people with chronic insomnia. They had one in-person training session. Then they practiced yoga on their own for eight weeks. They also had brief follow-ups by phone and in person.

Results show that sleep improved in 20 people who completed the study. They fell asleep faster and slept longer.

A review he published found that most yoga research has been conducted and published in India. But researchers in the U.S. and England are starting to conduct more studies.

A yoga instructor also explained to the Globe and Mail that bedtime yoga is easy and convenient. She practices yoga techniques while in bed in her pajamas.

“It’s not a magic button,” she said. “But I know that I’m not just lying down there and tossing and turning – I’m restoring my body.”

The article also described the iRest program. It involves a form of yoga called “yoga nidra.” It reduces stress and promotes deep relaxation.

In 2006 the U.S. Department of Defense began testing the iRest protocol. It has been used to help soldiers who have PTSD.

Learn more about sleep and yoga. Read more about insomnia.

There are a variety of cognitive and behavioral methods that are effective for treating insomnia. Learn more about cognitive behavioral therapy on SleepEducation.com.

Image courtesy of the National Institute on Aging

Can Yoga Help You Sleep Better?

The show eightWest on WOOD TV8 in Grand Rapids, Mich., did a feature on “Yoga for Better Sleep.” The five-minute segment shows some yoga moves that can help you relax for bedtime.



So can yoga really help you sleep better?

Last year the Sleep Education Blog reported on a small study from Northwestern University. It involved 11 adults with chronic primary insomnia. Sleep improved for those who practiced yoga and meditation for two months.

A recent study from India evaluated “cyclic meditation.” This technique combines yoga postures with periods of lying down on your back to rest.

Thirty men practiced cyclic meditation twice during the same day. On another day they had two sessions of rest without the yoga postures.

The study found that the men had more deep, slow-wave sleep after cyclic meditation. They also had fewer awakenings. And they felt that their sleep was more refreshing.

There are a variety of cognitive and behavioral methods that are effective for treating insomnia. Learn more about cognitive behavioral therapy on SleepEducation.com.

Sleep Tips for New Parents

Today MarketWatch reporter Ruth Mantell described how working parents struggle to get enough sleep after the birth of a baby.

“Caring for a newborn is tough on working parents, especially with limited corporate parental leave policies,” she wrote.

She offered advice to help sleep-deprived parents. One tip was to develop a routine that involves a manageable feeding schedule.

"A tremendous amount of sleep is habit driven," AASM member Dr. David Rapoport told Mantell. "So if you set up a routine you better be prepared to live with it."

Another tip was to resist comforting your baby every time he or she cries.

"Once you set limits, babies will generally adapt to them after an initial attempt to get as much comforting as they can out of you," Rapoport said.

Last year the Sleep Education Blog reported that there is an ongoing debate regarding the best way to get a baby to sleep. Some support the “cry it out” technique. Others promote “attachment parenting.”

But one technique that should be a part of any parenting style is the establishment of a relaxing bedtime routine. Last year a study found that a nightly routine helps young children sleep better.

There also is a debate regarding the risks of co-sleeping and bed sharing. The AASM reminds parents to avoid putting an infant to sleep in a car seat. And a recent recall involved more than 2.1 million drop-side cribs made by Stork Craft.

Read more about sleep and infants. On SleepEducation.com the AASM offers these sleep tips for new parents.

How is Your Heart Health?

Last week the American Heart Association published its strategic impact goals for the next decade.

By 2020 the AHA wants Americans to improve their heart health by 20 percent. It also wants to reduce deaths from heart disease and stroke by 20 percent.

Preliminary data indicate that heart disease remained the leading cause of death in the U.S. in 2007. It caused 615,651 deaths.



To reach its 2020 goals the AHA is promoting the “Simple 7” steps to better heart health:

1. Get active
2. Eat better
3. Lose weight
4. Stop smoking
5. Control cholesterol
6. Manage blood pressure
7. Reduce blood sugar

"These seven factors — if you can keep them ideal or control them — end up being the fountain of youth for your heart," Dr. Donald M. Lloyd-Jones told the AP. He is a cardiologist and was the lead author of the AHA statement.

How well are you doing with the Simple 7 steps? To find out you can complete the AHA’s new My Life Check online assessment.

My Life Check will give you a personal “heart score.” It also will give you an action plan to help you improve your heart health.

Improving your “sleep health” also can be good for your heart. It is well known that obstructive sleep apnea is a risk factor for heart disease. A scientific statement published in 2008 urged doctors to pay attention to the link between the two conditions.

The good news is that sleep apnea can be treated. CPAP therapy helps normalize breathing during sleep. And studies show that CPAP therapy for obstructive sleep apnea helps the heart.

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.

Sleep Deprivation & Teens

Recently WDTN TV, Channel 2, in Dayton, Ohio, reported on the problem of sleep deprivation in teens.



Earlier this month the Sleep Education Blog reported on the link between sleep, depression and suicide in teens.

Teens can get help for a sleep problem at an AASM-accredited sleep center. On SleepEducation.com you can learn more about teens and sleep loss. Check out the signs your teen needs sleep.

Read more about sleep and teens.

College Students & Parents: Sleeping in Different Time Zones

Earlier this week Michelle Slatalla wrote in the New York Times about how her sleep was disrupted when her two older daughters came home from college for winter break.

The nocturnal habits that her daughters developed as teens had escalated. At 3 a.m. they texted, made phone calls, played video games and watched TV as if it were daytime.

“It seems as if my husband and I live in a completely different time zone from our children,” Slatalla lamented.

AASM secretary/treasurer Dr. Nancy Collop told Slatalla that these habits tend to reinforce a late-night schedule.

“There are lots of environmental issues that play a role in altering people’s sleep patterns,” said Collop. “The most obvious would be the computer.”

Light is an important timing cue for the brain. It is a signal that tells the brain it is time to be alert. Staring at a brightly lit computer screen at night sends a stimulating signal to the brain.

So will Slatalla ever see her children again?

Sleep researcher Mary Carskadon, PhD, told her not to worry. Their brains are still developing. So their sleep patterns are likely to shift as they get older.

“The brain tends to correct itself,” said Carskadon.

Image by nickestamp

Less Time to Sleep for Media-Savvy Children & Teens?

A new report shows that children and teens are spending more time using media for entertainment. This increase is driven in large part by access to mobile devices.

The report was released by the Kaiser Family Foundation. It involved a 2009 survey of 2,002 students. They were in the 3rd to 12th grades. Their ages ranged from 8 to 18 years.

The study covered TV, movies, computers, video games, music/audio and print Results were compared with a 2004 survey.

Results show that students reported using entertainment media for more than 53 hours per week. Their average daily recreational media usage was seven hours and 38 minutes. This was an hour and 17 minutes more per day than in 2004.



In the past five years the percentage of students who owned a cell phone increased from 39 percent to 66 percent. Ownership of an iPod or other MP3 player increased from 18 percent to 76 percent.

Only about three in ten students reported that they have rules about how much time they can spend using entertainment media. Media usage dropped by nearly three hours per day when parents set limits.

Seventy-one percent of students reported that they have a TV in their bedroom. Fifty percent said they have a console video game player in their room.

“When children are spending this much time doing anything, we need to understand how it’s affecting them – for good and bad,” Drew Altman, PhD, said in a news release. He is the president and CEO of the Kaiser Family Foundation.

Last year the Sleep Education Blog reported that technology may be taking a toll on teens’ sleep. And studies have examined the relationship between TV viewing and sleep problems in children.

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

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

Secondhand Smoke & Sleep in Children with Asthma

A new study examined the relationship between sleep and exposure to secondhand smoke in children.

The study involved 219 children with asthma. They were exposed regularly to tobacco smoke at home. Their sleep patterns were reported by their parents.

Exposure to tobacco smoke was tested by measuring the levels of “cotinine” in their blood. Cotinine is a chemical that the body makes from nicotine.

Results show that exposure to secondhand smoke was associated with increased sleep problems. The children took longer to fall asleep. Their sleep was more disturbed. And they were sleepier during the day.

It also was associated with sleep disordered breathing and parasomnias. Obstructive sleep apnea is a common sleep-related breathing problem in children. Types of parasomnias include nightmares, bedwetting, sleepwalking and sleep terrors.

The NCI reports that more than 4,000 chemicals have been identified in secondhand tobacco smoke. At least 250 are known to be harmful. And 50 of these are known to cause cancer. Living with a smoker increases a nonsmoker’s chances of developing lung cancer by 20 to 30 percent.

Children exposed to secondhand smoke are at an increased risk of sudden infant death syndrome (SIDS). They also have a higher risk of ear infections, colds, pneumonia, bronchitis and more severe asthma. Secondhand smoke may increase the risk of leukemia, lymphoma and brain tumors in children.

Read more about sleep and children.

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Gaines Adams’ Death: Heart Problems & Sleep Apnea in the NFL

The death of Chicago Bears player Gaines Adams has focused attention on heart problems in athletes. The 26-year-old Adams died Sunday morning. The coroner’s report indicates that he died from cardiac arrest due to an enlarged heart.

The Chicago Sun-Times reports that the hearts of healthy athletes tend to be bigger and thicker than normal. So it can be hard to determine if a heart problem is present.

SI.com notes that in athletes the heart chambers tend to enlarge. The heart walls are likely to thicken when disease is present. But there can be a “troubling gray area” when both the chambers and walls are mildly enlarged.



It is well known that obstructive sleep apnea is a risk factor for heart disease. A scientific statement published in 2008 urged doctors to pay attention to the link between the two conditions.

There have been no reports that Adams had sleep apnea. But could OSA have contributed to his heart problems?

Dr. Steven Park raised the question on his Sleep Apnea Blog. He noted that the build of Adams’ body put him at risk for OSA.

“There are many reasons for an enlarged heart but one major risk factor Adams had was his build,” Park wrote. “Just like many NFL players, he had large neck muscles that probably pressed on his upper airway.”

Adams’ death also caught the attention of Steve Gardner. He is the executive director of the Reggie White Sleep Disorders Research & Education Foundation.

“It is possible that sleep apnea played a role in his untimely death,” Gardner wrote on the Sleep Well and Live Blog. “We’ve seen it before… Sadly, we will see it again. We may have just seen it in the case of Gaines Adams.”

Retired NFL star Reggie White died in 2004 at the age of 43. Reports indicate that sleep apnea may have played a role in his death.

Studies have shown that sleep apnea is a problem in the NFL. Last year the Sleep Education Blog reported that OSA is common in retired NFL players.

And a 2003 study of 302 NFL players found that they are more likely to have sleep apnea than other men their age. The risk was highest for offensive and defensive linemen.

NFL officials have taken notice of the problem. In 2007 the NFL and the NFL Players Association began working together to target heart disease and sleep apnea in retired players.

The most common treatment for OSA is CPAP therapy. On SleepEducation.com you can learn how CPAP helps the heart.

Sleep Apnea & Glucose Control in Type 2 Diabetes

A new study examined obstructive sleep apnea and glucose control in people with type 2 diabetes.

The study involved 60 diabetic adults. They were monitored during an overnight sleep study. Blood samples measured glucose control.

Results show that 77 percent of participants had sleep apnea. And increasing OSA severity was associated with worse glucose control.

"Reducing the severity of OSA may improve glycemic control," lead author Dr. Renee S. Aronsohn said in a press release. "Thus effective treatment of OSA may represent a novel and non-pharmacologic intervention in the management of type 2 diabetes."

Only five people in the study had been previously evaluated for sleep apnea. None were undergoing treatment.

It is estimated that about 80 percent of men and 90 percent of women with moderate to severe sleep apnea are undiagnosed. The most common treatment for sleep apnea is CPAP therapy.

The NIDDK reports that diabetes is a disease in which blood glucose levels are above normal. Most food is broken down into glucose, which is also known as “blood sugar.”

Insulin, a hormone produced by the pancreas, then moves glucose from the blood into the cells. There the glucose becomes a primary source of fuel for the body.

Type 2 diabetes occurs when the body fails to use insulin effectively. This is known as “insulin resistance.” Then the body produces less insulin over time.

As a result glucose builds up in the blood and passes out of the body through urine. This deprives the body of its main fuel source.

Preliminary data indicate that diabetes was the seventh-leading cause of death in the U.S. in 2007. A study published last week estimated that in 2007 diabetes cost the U.S. $218 billion.

On SleepEducation.com you can learn more about how sleep loss and sleep disorders are linked to diabetes. Read more about sleep and type 2 diabetes.

Sleep, Exercise & Weight Gain

According to Reuters News, the results of a small study make a common-sense claim: Lack of sleep leads to lack of exercise, which leads to weight gain.

Several studies have found that people who are not sleeping enough tend to gain weight. But a connection was never explained fully.

Last year, the Sleep Education Blog reported that sleep deprivation causes changes in hormones that regulate your appetite. This could eventually lead to weight gain.

The results of this study may point to a simpler explanation.

The study took place in Germany. It involved 15 healthy men who were of normal weight. Participants were observed for four nights in a sleep lab. On two of the nights, the men slept for eight hours. For the other two, they were only allowed to sleep for four hours. During the following days, the men wore wrist devices to track their movement.

On the days following sleep deprivation, the participants’ activity levels fell. After getting eight hours of sleep, the men spent 25 percent of their time awake doing high-intensity exercise. After four hours of sleep, the amount of time spent doing these activities fell to 22 percent.

The men did not report feeling more hungry, and they did not eat more after the nights of sleep deprivation. No changes in blood levels or appetite-regulating hormones were found.

The authors of the study note that their findings do not eliminate a potential link between hunger, appetite-regulating hormones and chronic sleep deprivation. But they do indicate that even a small amount of sleep loss can reduce physical activity. Over time, if you don’t exercise you might begin to put on weight.

Visit Sleep Education.com to learn more about the link between sleep and weight.

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Sleep Talking Man is the Talk of the Internet

Earlier this week The Telegraph reported that a sleep talking blog has become the latest sensation to sweep the Internet.

Karen Slavick-Lennard said she was accustomed to hearing her husband Adam’s unusual comments. She even repeated them to friends for their amusement.

Then she created a simple blog to share his latest quotes with others. Now the world has become his stage.



The blog lists 3,650 followers. The hit counter reports that more than 800,000 unique visitors have stopped by. And t-shirts displaying his aphorisms are being shipped around the world.

One warning: This sleep talker often has a filthy mouth. Adam may be a mild-mannered, British advertising account director by day. But at night? He starts saying things you might expect to hear in a Quentin Tarantino movie.

Here is a brief selection of his sleeping banter:

"You can't be a pirate if you don't have a beard. I said so. MY boat, MY rules."

"Yes I'm sad, but if you stood further away, I'd be happier. No, further away.”

"Please just walk away. I don't want to have to stand here and say something so awesome that I'll have to remember it the rest of the day. Thank you!"

"You can stop clapping now if you want. Really. You'll need your energy for cheering me later. Shhhhhhhh. shhhhhhhh."

"I haven't put on weight. Your eyes are fat."

Adam’s quotes may be unique. But sleep talking is common. The AASM estimates that about five percent of adults are sleep talkers. And about half of young children talk in their sleep.

Often it is simply a normal byproduct of the brain’s activity during sleep. But sometimes sleep talking isn’t so amusing. The SleepEducation.com discussion forum is filled with complaints about it.

Sleep talking also can occur along with a "parasomnia." This is a sleep disorder that involves undesired behaviors during sleep. Examples include sleepwalking and REM sleep behavior disorder.

Sleep talking rarely requires treatment. But you should contact an AASM-accredited sleep center for help if episodes are extreme. You also should seek help if the sleep talking occurs together with unusual actions.

Visit the Sleep-Talkin’ Man Blog for more of Adam’s quotes. Watch Adam and Karen on a recent appearance on "This Morning" on itv 1. Learn more about sleep talking on SleepEducation.com.

Sleepless Nights for Army Wives

A new study examined how deployment affects the mental health of the wives of U.S. Army soldiers. The results were published yesterday in the New England Journal of Medicine.

The study involved 250,626 wives of active-duty U.S. Army soldiers. Their electronic medical records from 2003 to 2006 were analyzed.

Results were compared according to the deployment status of their husbands. Length of deployment also was considered. Deployments included both Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan.

Adjusted results show that the wives of deployed soldiers had more sleep problems than the wives of soldiers who were not deployed. They also had more cases of depression and anxiety.

They had 11.6 excess cases of sleep disorders per 1,000 wives when the deployment lasted up to 11 months. This rate increased to 23.5 excess cases when their husband was deployed for more than 11 months.

“This study confirms what many people have long suspected,” lead author Alyssa Mansfield, PhD, said in a news release. “It provides compelling evidence that Army spouses are feeling the impact of recent deployments to Iraq and Afghanistan. The result is more depression, more stress, more sleepless nights.”

The authors noted that current warfare in Iraq and Afghanistan differs greatly from other recent conflicts involving the U.S. Both operations have involved sustained ground combat. They also have been met by strong insurgent attacks.

As a result the wives of deployed soldiers may fear for the safety of their loved ones. At the same time they face the stress of maintaining a household and caring for children alone.

The authors also suggested that the results may underestimate the severity of the problem. In the military seeking care for mental health concerns may involve a stigma. So some spouses may avoid seeking care.

“The majority of active-duty soldiers are married, so we need to pay attention to the needs of their families,” said Mansfield.

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

Image courtesy of the U.S. Army

Sleep & Performance: The Cost of Sleep Debt

A new study shows that chronic sleep loss has lasting effects on performance even after attempts to “catch up” on sleep.

The study involved nine healthy volunteers. For three weeks they kept to a strict sleep/wake schedule. They remained awake for 33 hours at a time. Then they slept for periods of 10 hours.

Results show that 10 hours of sleep always produced initial performance benefits. But performance quickly fell apart the longer they stayed awake.

“One long night of sleep can restore performance to normal levels for about six hours after waking,” lead author Dr. Daniel Cohen said in a press release. “However, the lingering effect of chronic sleep loss causes performance to deteriorate dramatically when these individuals stay awake for an extended period of time.”

The study found that chronic sleep loss caused reaction times to drop severely. Performance was most affected late at night and early in the morning.

The authors warned that the negative effects of chronic sleep loss are a serious safety hazard.

Get seven signs you need sleep on SleepEducation.com.

Work & Sleep: Are Adults Sleeping Less in the U.S.?

Have adults in the U.S. been getting less sleep over the past three decades? A new study examined time-use surveys to find out. The results were published in the Jan. 1 issue of the journal Sleep.

The study analyzed data from eight time-use surveys. The earliest survey was conducted in 1975. The most recent data came from the 2006 American Time Use Survey.

Surveys were completed by more than 73,000 adults. They were at least 18 years of age. “Short sleep” was defined as less than six hours of sleep, nap or rest in a 24-hour period.

Results show that the overall odds of being a short sleeper have not increased over the past 31 years. The highest proportion of short sleepers was 11.8 percent in the 1998-99 survey. The lowest proportion was 7.5 percent in the 1992-94 survey. The proportion was 9.3 percent in the 2006 survey.

“The assertion that sleep durations have declined drastically in the U.S. population in general over the past 30 years may be inaccurate,” wrote the authors.

But the study did find a significant trend for full-time workers. Their odds ratio for short sleep was increased by 19 percent.

“Longer work times seem to be the most important cofactor for short sleep,” the authors concluded.

Unmarried adults, those with some college education, and African Americans also had higher odds of short sleep. Women, older adults, Asians, Hispanics and married people were less likely to be short sleepers.

The authors noted that the 24-hour time-use surveys split the sleep period. They combined the end of one night of sleep with the beginning of the second night of sleep. Daytime sleep also was added to the total.

And time categorized as “sleep” included activities such as “resting” and “getting up.” Thus the time-use surveys may have overestimated true sleep time.

Dr. Mathias Basner wrote a commentary on the study in the same issue of Sleep. He noted that chronic, partial sleep deprivation remains an important public health issue.

Why do millions of Americans put their health at risk by failing to get enough sleep? One reason may be that short sleepers simply adjust to regular sleep loss.

“Those who do need more sleep simply may have habituated to feeling sleepy,” Basner wrote. “Many of the short sleepers may have ‘forgot­ten’ how well they could feel and perform if they satisfied their individual sleep need.”

In October the Sleep Education Blog reported on new survey data about the sleep of people in the U.S. In May it took a closer look at time-use survey data.

Sleep, Traumatic Injuries & Mental Health

A new study evaluated how sleep problems prior to a traumatic injury may affect mental health. The results were published in the Jan. 1 issue of the journal Sleep.

The study was performed in Australia. It involved 1,033 people who had a traumatic injury. They spent an average of 12.5 days in the hospital.

About 65 percent were hurt in a motor-vehicle accident. Fifteen percent were injured in a traumatic fall. Seven percent had an industrial accident. And six percent were victims of assault.

An initial assessment took place during their hospital admission. This included an evaluation of sleep disturbance in the two weeks prior to the injury. They were re-assessed three months later.

Results show that mental health problems were common at the three-month follow-up. Thirty percent of people who had no prior disorder developed a new psychiatric disorder after the injury.

The most common disorders were major depression and agoraphobia. Other common disorders were PTSD and generalized anxiety disorder.

Data analysis found that sleep impairment prior to the injury was a risk factor for the development of a mental health disorder. People with disturbed sleep prior to trauma were two times more likely to develop a psychiatric disorder.

The risk was even greater for people with no history of mental health problems. They were three times more likely to develop a psychiatric disorder if they had sleep problems prior to the trauma.

The authors suggested that sleep problems may limit your ability to manage stress after a traumatic event. Poor sleep may reduce your emotional, mental and physical resources. This may hinder your recovery.

They also noted that sleep problems may have contributed directly to the traumatic injuries. Disturbed sleep can result in fatigue, poor concentration and slow reaction times.

In November the Sleep Education Blog reported that the higher rate of insomnia in women may be linked to mental health problems such as depression. Read more about sleep and depression.

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

Image by Joe

Restless Legs & Impulse Control Disorders

A new study examined the frequency of impulse control disorders in people being treated for restless legs syndrome. The results were published in the Jan. 1 issue of the journal Sleep.

The study involved 100 people with RLS who were seen at the Center for Sleep Medicine at Mayo Clinic. All of them were being treated or had been treated with “dopaminergic” drugs.

These drugs stimulate the dopamine receptors in the brain. Dopamine is a chemical that acts as a neurotransmitter. It is believed that RLS may involve a dysfunction in the brain’s dopamine system.

The study group completed questionnaires about impulse control disorders. Phone interviews also were conducted.

They were compared with two control groups. One group consisted of 52 people with RLS who had never been treated with a dopaminergic drug. The other group had 275 people with obstructive sleep apnea who did not have RLS.

Results show that impulse control disorders occurred in 17 percent of people with RLS who were treated with dopaminergic drugs. They occurred in eight percent of the RLS control group and six percent of the OSA control group.

Nine percent of the RLS treatment group reported compulsive shopping. Five percent reported pathologic gambling.

Seven percent reported “punding.” This involves purposeless, repetitive actions. Examples include sorting objects and excessive grooming or cleaning.

These rates were significantly higher than in people with OSA. The rate of compulsive shopping was higher than in the RLS control group.

People being treated for RLS were most likely to have impulse control disorders while taking pramipexole (Mirapex). Some RLS patients also struggled with impulse control while taking ropinirole (Requip).

Eight people stopped taking a medication due to an impulse control disorder. Within several weeks the problem ended or improved in all of them.

The authors noted that dopamine plays a role in the brain’s “reward system.” In some people dopaminergic drugs may overstimulate brain areas involved in this system.

They added that doctors treating people with RLS should monitor them for symptoms of an impulse control disorder. These disorders can have devastating effects.

In May 2008 the FDA approved the first generic versions of ropinirole for RLS. Learn more about RLS.

Image by Kevin Labianco

New Year’s Resolution for 2010: Take the Sleep Challenge

Arianna Huffington of The Huffington Post and Cindi Leive of Glamour have made a New Year’s resolution and invited their readers to join in.

The challenge? Get more sleep.

Research shows that women off all ages are sleep deprived. While women know sleep is important for their health and well-being, it becomes less of a priority because of family, professional pursuits and other commitments.

The kids and late-night work e-mail may trump sleep; however, the resulting sleep deprivation makes it difficult to respond quickly, multi-task, think creatively and solve problems at home and at work. Sleep deprivation makes you more prone to illness and stress as well.

In addition to sleep deprivation, many women struggle with sleep disorders that make it difficult for them to get a good night’s sleep. Last year, the Sleep Education Blog reported that insomnia is more common in women than men.

Are you ready to improve your sleep? Follow the Sleep Challenge 2010 online.

Learn more about sleep and women at Sleep Education.com. Visit an AASM-accredited sleep center near you if you are suffering from a chronic sleep disorder.

Image courtesy of The Huffington Post

A Viral Debate About Chronic Fatigue Syndrome

A new U.K. study was unable to reproduce recent findings that suggested chronic fatigue syndrome may be linked to a virus. But U.S. researchers emphasized that there are key differences between the studies.

The Sleep Education Blog reported on the previous research in October. The U.S. study identified DNA from the “XMRV” virus in the blood of 68 out of 101 people with CFS.

The new study was conducted in the U.K. DNA was extracted from blood samples of 186 people with CFS. They were screened for the XMRV virus and for another closely related virus.

Results published on Wednesday show that neither virus was detected in any of the samples. The authors suggested that the results may be a result of population differences between North America and Europe.

“We used very sensitive testing methods to look for the virus,” study co-author Myra McClure said in a news release. “If it had been there, we would have found it. We are confident that our results show there is no link between XMRV and chronic fatigue syndrome, at least in the U.K.”

But the institute behind the U.S. research questioned the methods of the U.K. study.

“This study did not duplicate the rigorous scientific techniques (used by the U.S. research team),” said a group statement. “Therefore it cannot be considered a replication study… Significant and critical questions remain as to the status of patient samples used in the U.K. study.”

Simon Wessely, another co-author of the U.K. study, also cautioned that their results are not conclusive. He said more research is needed to determine the fundamental cause of CFS.

"It is important to emphasize that today's findings do not invalidate all previous research,” said Wessely. “As ever in science, no single study is conclusive.”

CFS occurs four times more often in women than in men. The CDC notes that CFS is neither a form of depression nor a mental illness.

“There is now abundant scientific evidence that CFS is a real physiological illness,” reports the CDC. “A number of biologic abnormalities have been identified in people with CFS.”

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

Read more about hypersomnia.

Final Week to Enter AASM High School Contest

The deadline for the 2009 – 2010 AASM High School Topical Review in Sleep Science Contest is Friday, Jan. 15.

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.

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 the city will host the SLEEP 2010 24th Annual Meeting of the Associated Professional Sleep Societies LLC. 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.

Sleep Apnea in Women: Effects & Treatment Response

A new study examined gender differences in the effects of obstructive sleep apnea. It also evaluated how men and women respond to treatment with CPAP therapy.

The results were published in the Dec. 15 issue of the Journal of Clinical Sleep Medicine.

The study involved 152 men and 24 women with OSA. They had an average age of 47 years. They were obese with an average body mass index (BMI) of 38.

Their sleep apnea was severe; they had an average of 64 breathing pauses per hour of sleep. Follow-up testing was conducted after three months of CPAP therapy.

Results show that age, BMI, and sleep apnea severity were similar between men and women. But women had more problems in their daily functioning. They had lower activity levels and less general productivity.

Excessive daytime sleepiness was reported more often by women than men. Women also reported more overall mood disturbances. And their performance was worse on a vigilance test.

The study also found that CPAP use was similar for both genders. And men and women experienced similar benefits. CPAP improved functional status and relieved OSA symptoms.

The authors noted that a referral bias may have contributed to the low number of women in the study. Many people mistakenly think that OSA only affects men. So women may be less likely to be referred to a sleep disorders center for evaluation.

The authors added that the study excluded people over the age of 60. Women with OSA are usually older than men on average.

In September the Sleep Education Blog reported on women and sleep apnea risk. Read how women may be surprised by sleep apnea. Learn about the signs of OSA in women.

Get more information on SleepEducation.com about snoring and sleep apnea in women.Get help for sleep apnea at an AASM-accredited sleep center near you.

Hypersomnia: Common Features & Effective Treatments

A new study examined the common features of hypersomnia and effective treatment options. The results were published in the Dec. 15 issue of the Journal of Clinical Sleep Medicine.

The study involved 85 people who had been diagnosed with hypersomnia at the Center for Sleep Medicine at Mayo Clinic. They were followed up for an average of 2.4 years. Their medical charts and clinical notes were reviewed and analyzed.

Sixty-five percent of the patients were women. Symptoms tended to begin when they were in their late teens. But typically they weren’t diagnosed with hypersomnia until they were in their mid-30s. Thirty-seven percent reported that at least one family member had excessive sleepiness.

Patients reported sleeping for an average of eight hours per day. Nineteen percent of patients reported sleeping for more than 10 hours per day. But the average sleep time measured by actigraphy was 7.5 hours per day. During an overnight sleep study they fell asleep after an average of seven minutes.

Seventy-three percent of patients reported taking naps. The mean nap duration was one hour and 28 minutes. But in most cases the naps were considered to be unrefreshing.

The authors reported that the majority of patients responded well to treatment with medication. A complete response to treatment was reported by 65 percent of patients.

Twenty-six percent had a partial response to treatment. Only nine percent reported a poor response.

The two medications that were most often prescribed were modafinil and methylphenidate. Both medications are recommended as a treatment option in AASM practice parameters.

Modafinil was most often taken once a day in the morning. The average total daily dose was 367 mg. “High cost” was a common complaint of people who were using modafinil.

Methylphenidate was often taken three to four times per day. The average total daily dose was 60 mg.

Amphetamines were prescribed less often. And one patient reported a complete response to treatment with 200 mg of caffeine per day.

Forty-two percent of patients tried more than one medication. Eight percent were being treated with a combination of medications at their last visit.

Read more about hypersomnia. Learn more about idiopathic hypersomnia with long sleep time and idiopathic hypersomnia without long sleep time on SleepEducation.com.

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

Erectile Dysfunction & Restless Legs in Older Men

A new study shows that older men with restless legs syndrome may be more likely to have erectile dysfunction. The results were published in the Jan. 1 issue of the journal Sleep.

The study involved 23,119 men who were health professionals. They had an average age of 69 years.

Results show that men who reported having RLS symptoms 15 times or more per month were 78 percent more likely to have erectile dysfunction. They had a “poor or very poor” ability to have and maintain an erection for sexual intercourse.

About four percent of participants had RLS. Fifty-three percent of men with RLS reported having erectile dysfunction.

The authors suggested that the two disorders may share common mechanisms. They suspect that both disorders may involve low levels of dopamine in the brain. Dopamine is a chemical that acts as a neurotransmitter.

They also noted that the association between RLS and erectile dysfunction could be related in part to other sleep disorders that co-occur with RLS. For example obstructive sleep apnea may decrease circulating testosterone levels.

The NIDDK reports that erectile dysfunction often is caused by a disease or surgery. It also can be a side effect of a medication.

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

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

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

Read more about RLS. Learn about the genetics of RLS on SleepEducation.com.