Sleep, Millennials & Cell Phones

The Pew Research Center has been studying American teens and twenty-somethings. This week it released a new report: “Millennials: A Portrait of Generation Next.”

The report is based on a survey of 2,020 U.S. adults. It included an oversample of 830 Millennials between the ages of 18 and 29 years.

It should come as no surprise that these young adults are surrounded by digital technology. The report calls them history’s first “always connected” generation.

“Steeped in digital technology and social media, they treat their multi-tasking hand-held gadgets almost like a body part,” stated the report.

The survey even asked: “Have you ever placed your cell phone on or right next to your bed while sleeping?” About 83 percent of Millennials reported sleeping next to their phones.

In January another report found that the percentage of students who owned a cell phone had increased from 39 percent to 66 percent. Is this technology affecting the sleep of Millennials?

Last year the Sleep Education Blog reported on recent studies. Research shows that frequent cell phone use may cause a number of sleep problems.

Read more about sleep and technology.

Are You Sleep Deprived?

First you poured coffee in your breakfast cereal this morning. Then you got in the car before you realized that you were still wearing your slippers.

On the way to work you failed to notice that you had driven right past your exit. Finally when you arrived at the office you got off the elevator on the wrong floor.

Just a bad start to the day? Or are you missing some clear signs that you need more sleep?

Earlier this week Prevention and msn listed five warning signs that you might be sleep deprived. One sign is that it is hard for you to control your emotions.

“If you are chronically sleep deprived, you could act like someone with depression,” AASM member Dr. Lisa Shives told Prevention.

So what about you – are you getting enough sleep? View “Seven Signs You Need Sleep” from the AASM on SleepEducation.com.

Gary Kubiak: Sleep Apnea, Surgery & the NFL

Houston Texans head coach Gary Kubiak is receiving surgical treatment for obstructive sleep apnea.

Nose surgery was performed yesterday, reports The Houston Chronicle. In six weeks another procedure will be performed on his throat.

Sleep apnea is a common problem in the NFL. Last year the Sleep Education Blog reported that OSA is common in retired NFL players. The NFL and the NFL Players Association previously began working together to target heart disease and sleep apnea in retired 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.

Although Kubiak is a retired NFL player, he wasn’t a lineman. He was a back-up quarterback for the Denver Broncos from 1983 to 1991. Kubiak threw 14 touchdown passes in limited playing time behind John Elway, a 2004 inductee in the Pro Football Hall of Fame.

And the 48-year-old Kubiak isn’t obese. He is listed at 6 feet, 192 pounds. This gives him a body mass index (BMI) of 26, which means he is slightly overweight.

His case is a good reminder that OSA can occur in men and women of all body types. It also can occur in children.

Excess body weight is the major predisposing factor for obstructive sleep apnea. But OSA also occurs in people who maintain a healthy weight. A study presented at SLEEP 2009 found a high rate of sleep apnea in non-obese adults.

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.

Surgical procedures tend to be “site-specific;” they will seek to eliminate the cause of the obstruction. Problem areas related to OSA include the tonsils, tongue, soft palate, throat, jaw and nose.

In Kubiak’s case, septoplasty may have been performed on his nose to straighten a bent septum. Or he may have had turbinate reduction to reduce or remove large turbinates and polyps from the nasal passage.

His upcoming surgery may involve the removal of soft tissue from the throat. This tissue can collapse and block the airway during sleep.

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.

Read more about OSA and surgery.

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Insomnia, Sleep Duration & Risk of Death

A new study examined the relationship between insomnia, sleep duration and the risk of death. The results were published this month in the journal Sleep.

The study involved 3,430 ethnic Chinese adults in Taiwan. They answered questions about lifestyle and sleep in 1990 – 1991.

They reported their habitual sleep duration. They also answered the question, “How frequent is your insomnia complaint?” The four response options ranged from “no insomnia” to “insomnia nearly every day.”

The median follow-up period was 15.9 years. Deaths were identified from official death certificates. Home visits also confirmed the deaths.

Results show that 901 participants died, and 420 developed heart disease. The relative risk of death for people who reported sleeping five hours or less was 15 percent higher than in those who slept seven hours. The risk of death was 34 percent higher in people who reported sleeping nine hours or more per night.

“Our data indicate that an optimal sleep duration (7-8 h) predicted fewer deaths,” the authors wrote.

People who reported having “insomnia nearly every day” had a risk of death that was 70 percent higher than those who had “no insomnia.” They also were 78 percent more likely to have had a heart disease event during the follow-up period.

Combining sleep duration with insomnia also revealed elevated risks for “long sleepers.” The risk of death was 2.5 times higher in people with frequent insomnia who reported sleeping nine hours or more. They also were twice as likely to have had a heart disease event.

“This finding may reflect ‘nonrefreshing sleep’ for reasons other than insomnia, such as sleep apnea” wrote the authors.

A study presented at SLEEP 2009 linked mortality risk to insomnia with short sleep duration. That research team also has found that insomnia with short sleep time is a significant risk factor for hypertension and diabetes.

Read more about insomnia.

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Sleep, Weight Gain & Obesity

A large Japanese study examined the relationship between sleep duration, weight gain and obesity. The results were published this month in the journal Sleep.

The study involved 35,247 employees of an electric power company in Japan. They were evaluated at an annual health checkup in 2006 and 2007. Usual sleep duration was self-reported.

Typically obesity in adults is defined as having a body mass index (BMI) of 30 or higher. But in this study a BMI of 25 or higher was considered to be obese. This criterion has been proposed for Asia-Pacific populations.

Results show that about 36 percent of men and 12.5 percent of women were obese. About six percent of the non-obese men were obese at the one-year follow-up.

Short sleep duration was associated with both weight gain and the development of obesity in men. The men who reported sleeping less than five hours per night were 91 percent more likely to develop obesity than men who slept seven to less than eight hours. Men who slept five to less than six hours per night were 50 percent more likely to become obese.

“I believe the data are currently compelling enough to recommend good diet, adequate exercise, AND adequate sleep in people trying to lose weight,” wrote Dr. Najib Ayas in a commentary on the study.

Sleep and weight are interconnected in a variety of ways. A recent study suggested that short sleep may lead to weight gain by reducing exercise. And eating when you should be sleeping may lead to weight gain.

Adequate sleep may be associated with more healthful food choices. But short sleep may cause you to crave more high-calorie, high-carb foods. And it may affect the levels of the appetite-regulating hormones leptin and ghrelin.

Read more about sleep and weight gain and sleep and obesity.

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Sleep & Work: The “Worst-Sleeping” Jobs

No one wants to have a bad-paying job. But what about a “bad-sleeping” job? Are employees in some industries more likely to be sleep deprived?

A new study examined the data. The results were published this month in the journal Sleep.

The study involved 66,099 employed workers in the U.S. They answered questions for the National Health Interview Survey between 2004 and 2007.

Participants were asked, “On average, how many hours of sleep do you get in a 24-hour period?” Short sleep duration was defined as six hours of sleep or less in a 24-hour period.

Results show that an estimated 28.4 percent of U.S. workers had a short sleep duration in 2007. This was lower than the rates of short sleep from 2004 to 2006. But comparisons with older data suggest that the average sleep duration has declined among workers over the last two decades.

The rate of short sleep was about 37 percent in people who worked more than one job or more than 40 hours per week. The following were the five “worst-sleeping” industries. They had the highest estimated rates of short sleep duration:

• Management of companies and enterprises (40.5%)
• Transportation and warehousing (37.1%)
• Manufacturing (34.8%)
• Public administration (33.5%)
• Information (31.4%)

These estimates represent more than 10 million workers who reported getting six or fewer hours of daily sleep. The authors reported that people in these industries are likely to perform shift work. Early-morning start times, night shifts and rotating shifts may be a cause of short sleep duration.

What about “good-sleeping” jobs? These industries had the lowest estimated rates of short sleep duration:

• Agriculture, forestry, fishing & hunting (23.1%)
• Education services (26.7%)
• Other services, except public administration (26.9%)
• Real estate, rental & leasing (27.2%)
• Professional, scientific & technical service (27.4%)

The authors estimated that about 40 million U.S. workers sleep less than six hours per day. Chronic sleep deprivation can increase health risks. It also can impair job performance and raise the risk of workplace injuries.

The study was conducted by the National Institute for Occupational Safety and Health. The NIOSH is part of the CDC.

Another recent study found that the odds ratio for short sleep was increased by 19 percent in full-time workers. Another study found that women who work full time sleep less than men.

Read more about sleep and work.

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Chronic Pain: Cognitive Behavioral Therapy Improves Sleep

A new study found that cognitive behavioral therapy (CBT) can significantly improve sleep for people with chronic neck or back pain.

Many people living with chronic pain have poor sleep hygiene. Common mistakes include sleeping when they are not tired, sleeping in places other than the bedroom and watching TV in bed. These habits may lead to insomnia.

People taking medicine for their pain may be unwilling or unable to use sleep aids to treat their sleep problems. CBT provides a safe and effective alternative.

The study involved 28 people who experience chronic pain. Participants received eight weeks of therapy from a trained nurse therapist.

Therapy sessions established a set number of hours in bed, focused on negative thoughts about sleep and addressed unhealthy sleep behavior. Sleep diaries were used to track sleep. Pain and mood were measured throughout the study. Patients were followed for six months after treatment.

Patients who are interested in CBT but have limited access to face-to-face sessions can receive treatment online. Last year the Sleep Education Blog reported that online CBT programs have the potential to provide long-lasting effects for people who suffer from chronic insomnia.

The AASM recommends CBT as an effective treatment for chronic insomnia in adults. Consult a board-certified sleep expert at an AASM-accredited sleep center if you are suffering from an ongoing sleep problem.

Bill Clinton: The Importance of Sleep

Former President Bill Clinton again emphasized the importance of sleep at a Clinton Foundation event earlier this week.

Clinton was speaking about being admitted to the hospital to have a clogged artery opened. He placed part of the blame on his lack of sleep after responding to the recent earthquake in Haiti.

“I didn’t sleep much for a month,” he said. “And that probably accelerated what was already going on with this failing vein.”

Research does show that sleep can improve your heart health. Last year a study reported that men who went to bed before midnight had more relaxed arteries. Another study found that longer sleep duration was associated with a lower rate of coronary artery calcification. This is a predictor of coronary heart disease.

This wasn’t the first time that Clinton has discussed the benefits of sleep. In December 2008 he appeared on “The Situation Room” on CNN. Anchor Anjali Rao asked if he had any advice for President-Elect Obama.

“In my long political career, most of the mistakes I made, I made when I was too tired, because I tried too hard and worked too hard,” he told Rao. “You make better decisions when you're not too tired. So that would be my only advice.”

And in September 2007 he appeared on “The Daily Show” to discuss his book Giving. He told Jon Stewart that sleep deprivation is part of the problem in Washington politics today.

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“You have no idea how many Republican and Democratic members of the House and Senate are chronically sleep deprived because of this system,” he told Stewart. “I know that this is an unusual theory, but I do believe sleep deprivation has a lot to do with some of the edginess of Washington today.”

Are you sleep deprived? Find out by reading the seven signs you need sleep on SleepEducation.com. Get help for an ongoing sleep problem at an AASM-accredited sleep center near you.

One More Hour of Sleep Could Change Your Life

ABC World News with Diane Sawyer reports that getting one more hour of sleep each night could improve your health, and change your life.

The report cites a study of heart attacks in Sweden. It found that heart attacks rose by five percent in the week after the spring shift to daylight saving time. The researchers suggested that the results are related to sleep deprivation caused by the time change.

ABC cites another study from the University of Chicago. It found that longer sleep duration was associated with a lower rate of coronary artery calcification. This is a predictor of coronary heart disease.


"Most of these findings are so recent that the average physician is unaware of the link between chronic sleep deprivation and cardiovascular disease," AASM member Dr. Charles Czeisler told ABC.

So what should you do to get that extra hour of nightly sleep? Czeisler advised that you allow yourself more time to wind down at night. You also may need to change habits that are having a negative effect on your sleep.

“I think the key is that people need to learn how to sleep,” AASM member Dr. Lisa Johnston told ABC. She is affiliated with the AASM-accredited Northside Hospital Sleep Disorders Center in Atlanta.

Get tips for better sleep on SleepEducation.com. Contact an AASM-accredited sleep center near you for help with an ongoing sleep problem.

Sleepy Teens Need to See the Light

A new study reports that teen sleep patterns may be disrupted by a lack of exposure to morning sunlight.

The study took place at a middle school in Chapel Hill, N.C., that has good daylight design. South-facing skylights allow plenty of natural light to enter nearly all spaces of the building.

Eleven eighth-grade students wore orange goggles for a five-day school week. The goggles prevented short-wavelength, “blue” light from reaching their eyes.

This light plays an important role in helping to set the body’s circadian clock. This timing system helps regulate sleep and wakefulness.

In the evenings the researchers measured the children’s “dim light melatonin onset.” This is the time when the body produces more melatonin.

This hormone is a “darkness signal” for the body. Sleep tends to occur about two hours after melatonin onset.

Results show that melatonin onset was delayed about six minutes per day. This added up to a delay of about 30 minutes by the end of the week.

The authors report that this delay may contribute to later sleep times and shorter sleep durations in teens. Early school start times may contribute to the problem by reducing exposure to morning sunlight.

“These morning-light-deprived teenagers are going to bed later, getting less sleep and possibly under-performing on standardized tests,” lead researcher Mariana Figueiro said in a news release. “We are starting to call this the teenage night owl syndrome.”

Figueiro added that the problem can be solved by designing better school buildings. One sponsor of the study was the U.S. Green Building Council.

“The situation in schools can be changed rapidly by the conscious delivery of daylight, which is saturated with short-wavelength, or blue, light,” she said. “Delivering daylight in schools may be a simple, non-pharmacological treatment for students to help them increase sleep duration.”

Figueiro is the program director of the Lighting Research Center at Rensselaer Polytechnic Institute in Troy, N.Y. At LRC they have created a small device called a “Daysimeter.” It measures a person’s exposure to short-wavelength, blue light.

Read more about sleep and teens.

Finding the Narcolepsy Target

A new study provides evidence to support the idea that narcolepsy is an autoimmune disorder.

A decade ago it was discovered that people with narcolepsy lack brain cells that make “hypocretin.” This is a hormone that helps promote wakefulness. The finding helped explain why people with narcolepsy have episodes of uncontrollable sleepiness.

But why do these brain cells die in people with narcolepsy? Last year the Sleep Education Blog reported on a new study. It suggested that the immune system attacks and destroys the brain cells by mistake. In August another study reported that this attack may be triggered by an infection.

Now Swiss and French researchers report that they may have identified a specific target of the autoimmune attack that causes narcolepsy. It is a protein called Tribbles homolog 2 – or “Trib2.”

They believe that Trib2 is an “autoantigen” in narcolepsy. An autoantigen is the target of an attack by autoantibodies. These antibodies attack a natural protein in the body rather than a protein from an infectious agent.

First they found that Trib2 was enriched in hypocretin-producing neurons in mice. Then they compared people who have narcolepsy with healthy controls. They also compared narcoleptics with people who have other disorders such as idiopathic hypersomnia and multiple sclerosis.

They found that the levels of Trib2-specific antibodies were much higher in people with narcolepsy. These levels of circulating autoantibodies against Trib2 were highest soon after narcolepsy symptoms appeared. They sharply decreased within two to three years.

Then the levels of Trib2-specific antibodies stabilized for up to 30 years. But these levels remained much higher than those of controls.

“These results indicate for the first time to our knowledge that Trib2 is an autoantigen in human narcolepsy,” the authors wrote. “Trib2-specific antibodies specifically target hypocretin neurons, ultimately leading to their disappearance and hypocretin deficiency.”

They cautioned that Trib2 may not be the only autoantigen in narcolepsy. Several autoantibodies may be involved.

But they are optimistic about treating narcolepsy with intravenous immunoglobulins soon after symptoms appear. In 2003 and 2004 they reported success at using IVIg treatment for people with narcolepsy. Last year they reported that hypocretin levels normalized in a narcolepsy patient after immunotherapy.

Read more about narcolepsy.

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Sleep Apnea & Nightmare Recall

A new study examined nightmare recall in people with obstructive sleep apnea. The results were published yesterday in the Journal of Clinical Sleep Medicine.

The study involved 393 consecutive patients at an AASM-accredited sleep center. They were evaluated by an overnight sleep study. Their mean age was 50.5 years with a range of 13 to 82 years. Sixty-seven percent of participants were male.

Severe OSA was common. They had a mean apnea-hypopnea index of 34.9 breathing pauses per hour of sleep. An AHI of more than 30 is considered “severe” OSA.

They were asked about dream and nightmare recall frequency. Recall was considered to be “infrequent” when it was reported once a month or less. Recall was “frequent” when it was reported at least weekly.

Results show that about 52 percent of people reported frequent dream recall. Thirty-four percent reported frequent nightmare recall.

The percent of people with frequent nightmare recall decreased as sleep apnea severity increased. Frequent nightmare recall was reported by 71.4 percent of people who did not have OSA and 43.2 percent of people with mild OSA.

The rate of frequent nightmare recall dropped to 29.9 percent in people with moderate OSA. Only 20.6 percent of people with severe OSA frequently recalled nightmares.

Average sleep apnea severity was much higher in people who reported infrequent nightmare recall. They had a mean AHI of 40.3. People who reported frequent nightmare recall had a mean AHI of 24.6.

“The results were somewhat surprising, since nightmares are frequently reported by patients with sleep apnea,” lead author Dr. Jim Pagel told the AASM.

Pagel suspects that the decline in nightmare recall may be attributed to the sleep fragmentation that is caused by OSA. This leads to a reduction in the nightly amount of rapid eye movement (REM) sleep. REM sleep is the sleep stage when nightmares generally occur.

Treating OSA with CPAP therapy leads to increases in the amount of REM sleep per night. This may cause the frequency of nightmare recall to rise when OSA is treated.

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.

Read more about nightmares and about obstructive sleep apnea.

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Teens & Drowsy Driving

A new study of teen drivers found that sleepiness at the wheel and poor sleep quality increased their risk of crashing a vehicle. The results were published today in the Journal of Clinical Sleep Medicine.

The Italian study involved 339 high school students. Each of them had a driver’s license. Their average age was 18.4 years. Fifty-eight percent of participants were male.

They were surveyed about lifestyle habits, sleep habits, sleep disorder symptoms and daytime sleepiness. Driving habits and sleepiness at the wheel also were evaluated. Questions assessed the frequency and timing of car use and accidents.

Results show that teen drivers who reported having bad sleep or being sleepy while driving were twice as likely to have had a crash. Eighty of the 339 students had already crashed at least once. Fifteen percent of them considered sleepiness to have been the main cause of the crash. Fifty-six percent of students who had at least one previous crash reported driving while sleepy.

Lead author Dr. Fabio Cirignotta said the most effective way to combat drowsy driving is to pull over to a safe place and take a nap.

“Opening the window, listening to the radio, or drinking a coffee, are known to be short-lasting and, essentially, useless,” Cirignotta told the AASM.

The study also found that students suffered from chronic sleep deprivation. They reported that they needed an average of 9.2 hours of nightly sleep. But only six percent of students slept nine hours or more on weeknights. Instead they reported sleeping for an average of only 7.3 hours on weeknights. Fifty-eight percent of students tried to catch up by sleeping nine hours or more on weekends.

Sleep problems also were commonly reported by the students. Forty-five percent woke up at least once during the night with trouble falling asleep again. Forty percent had trouble waking up in the morning and 19 percent reported bad sleep.

The dual problems of chronic sleep loss and poor sleep quality had a negative effect on the students’ alertness. Sixty-four percent complained of excessive daytime sleepiness.

The study also found that male students and smokers were three times more likely to crash a vehicle. The authors suggested that some students may use tobacco to counteract sleepiness.

Last year a study suggested that school start times may be linked to drowsy driving. Crash rates for teen drivers dropped by 16.5 percent in a Kansas county that changed the high school start time from 7:30 a.m. to 8:30 a.m. In the rest of the state teen crash rates increased 7.8 percent during the same time period.

Read more about sleep and teens and drowsy driving.

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New Anti-Energy Drinks May Help you Sleep; Use May Result in an Overdose of Sleep Promoting Hormones

New melatonin-based beverages receive mixed reviews, according to the New York Daily News. They may help you sleep, but they also overload your body with hormones.

Many people who struggle to get the sleep they need look for a “quick-fix”. To them, these drinks may seem like a miracle cure.

But are they safe?

According to the article, these beverages contain between 20 to 50 times more melatonin than the amount that is naturally found in the body.

AASM member Dr. Charles Czeisler reminds consumers that melatonin is a hormone. Czeisler said, “"[Hormones] should not be put in beverages, since the amount people drink often depends on thirst and taste rather than being taken only when needed like any other drug."

While no serious side effects have been linked with the use of melatonin, these drinks should still be used with caution. Long-term effects remain unknown.

Consult a board-certified sleep expert at an AASM-accredited sleep center if you are suffering from an ongoing sleep problems.

AASM-Accredited Sleep Centers: Providing Quality Care

The show eightWest on WOOD TV8 in Grand Rapids, Mich., recently visited a local sleep disorders center. They went to learn more about how you can get help for a sleep problem.

AASM member Dr. William Katz explained the basics of how a sleep disorder is diagnosed. He is the medical director of the Metro Health Hospital Sleep Disorders Lab in Grand Rapids.



Earlier this year the lab received program accreditation from the AASM. It is now one of more than 1,900 AASM-accredited sleep centers and labs across the country.

AASM accreditation lets you know that a sleep center or lab maintains the highest standards of quality. Applicants have to make the grade in areas such as testing procedures, patient safety and staff training.

AASM accreditation also ensures that you receive expert care. AASM-accredited sleep centers and labs are required to have a board-certified sleep specialist as the medical director.

In November the Sleep Education Blog explained more about AASM accreditation. You can find an AASM-accredited sleep center or lab near you by going to www.sleepcenters.org.

Sleep Nutrition

The Web site Big Think recently asked nutritionist and author Dr. Jonny Bowden to describe the importance of sleep.

“I’d consider getting a good night’s sleep is definitely one of the five top strategies you can do to extend you life,” Bowden said. “I don’t think that sleep gets the credit it should get as an anti-aging strategy...I think it’s a very, very important and neglected part of health.”

Bowden also weighed in on the link between sleep and obesity. And he provided his thoughts on how to improve sleep.

One of his tips? Get the electronics out of the bedroom.

“Your bedroom is not a second office,” he said.

Watch the video clips and read the interview transcript on the Big Think Web site.

Image courtesy of Dr. Jonny Bowden.

Recurrent Hypersomnia: British Girl Sleeps for Days

Last Friday on NBC, TODAY told the story of a British girl with a rare sleep disorder that causes her to sleep for days.

Louisa Ball, a 15-year-old, suffers from Kleine-Levin syndrome. It is one form of a sleep disorder called recurrent hypersomnia.

She had flu-like symptoms just over a year ago. Not long after that, she had her first period of severe, extended sleepiness. Her longest stretch of sleep has been for 13 days.



Recurrent hypersomnia involves long periods of severe sleepiness. A person may sleep for as long as sixteen to eighteen hours per day, waking only to eat and use the bathroom.

These sleep episodes can last for a few days or for several weeks. They may occur about one to 10 times a year, appearing weeks or months apart. Before and after the episodes, both sleep and behavior are normal.

“There’s only probably a few thousand people with the disorder,” AASM member Dr. Emmanuel Mignot told TODAY. “They often don’t get noticed.”

A flu-like illness or an infection of the upper airway may occur prior to the first episode of severe sleepiness. So it’s possible that the syndrome is triggered by a viral infection.

“We think that some people are genetically predisposed to having an infection that then doesn’t clear up and seems to relapse regularly,” Mignot said. “That gives the symptoms of sleeping all the time for days at a time.”

Recurrent hypersomnia tends to first appear in the teenage years. Typically the sleep episodes become shorter and less severe over a period of years.

Other types of hypersomnia include narcolepsy and idiopathic hypersomnia with long sleep time.

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

Let’s Sleep: Preventing Obesity in Children

Yesterday first lady Michelle Obama introduced the new “Let’s Move” campaign. She is taking on the issue of childhood obesity.

The campaign is backed by a presidential memorandum signed by President Obama. It establishes a task force on childhood obesity.



One key component of the Let’s Move campaign is to help parents make healthy choices. How can parents help their children maintain a healthy weight?

A new study suggests that one way it to make sure that children get enough sleep. This is one of three household routines that may help prevent obesity in children.

The study involved 8,550 children who were born in the U.S. in 2001. They were a part of the birth cohort of the Early Childhood Longitudinal Study. Data were collected in 2005 when the children were 4 years old.

Obesity was determined by their height and weight measurements. The study also examined their exposure to three household routines:

• Eating the evening meal as a family more than five nights per week
• Sleeping for at least 10.5 hours per night on weekdays
• Watching no more than two hours of TV or videos per day on weekdays

Results show that 18 percent of children were obese. About 58 percent of parents reported that their child slept at least 10.5 hours per night.

The rate of obesity was 36 percent to 37 percent lower in children exposed to any two or all three of the routines. Exposure to only one routine reduced the odds of obesity by 16 percent.

“The routines were protective even among groups that typically have a high risk for obesity,” lead author Sarah Anderson said in a news release. “This is important because it suggests that there’s a potential for these routines to be useful targets for obesity prevention in all children.”

So which of the three routines was most important? Anderson said that each of the three routines appeared to be helpful.

“What this suggests is that you can’t point to any one of these routines,” she said. “Each one appears to be associated with a lower risk of obesity, and having more of these routines appears to lower the risk further.”

In October the Sleep Education Blog reported on sleep duration and obesity in children. A recent study found that children who slept less than eight hours on weekdays were more than two times more likely to be overweight or obese.

Read more about sleep and obesity and sleep and children.

“Flying Cheap”: FRONTLINE Investigates Pilot Safety & Fatigue

Tonight on PBS, FRONTLINE takes a hard look at the regional airline industry in “Flying Cheap.” Are inexperienced, fatigued pilots putting passenger safety at risk?



The industry came under scrutiny a year ago when Continental flight 3407 crashed outside of Buffalo, N.Y. The flight was operated by a regional airline.

The ensuing investigation put a spotlight on the lifestyle of some regional airline pilots: Cross-country commutes. Long hours and low pay. Less experience and training. Sleeping in cramped “crash pads.”

FRONTLINE reports that regional airlines account for more than half of all scheduled domestic flights in the U.S. And they have been responsible for the last six fatal commercial airline accidents. Is pilot fatigue partly to blame?

“Flying Cheap” will be broadcast tonight at 9 p.m. EST on local PBS stations.

In December the Sleep Education Blog reported on sleep and airline safety. Other airline incidents have focused attention on sleep, sleep disorders and pilot fatigue.

Coca-Cola’s Sleepwalker Super Bowl Ad

Coca-Cola scored during last night’s Super Bowl with its “Sleepwalker” ad. It was in the Top 5 of the most popular ads according to the USA Today Ad Meter focus groups.

That may not put the ad in the same elite category as classics like Coke’s ad with Pittsburgh Steeler “Mean” Joe Greene.



But a good showing on advertising’s biggest night has to be considered a success.

In “Sleepwalker,” a sleeping man rises and goes on a sleepwalking safari across the African savanna. He unwittingly survives the perils of the African night to quench his thirst with a bottle of Coke.



The whimsical ad has a playful, humorous tone. But sleepwalking really can be a dangerous problem.

A sleepwalker may climb out a window or walk outside. On rare occasions a sleepwalker may get in the car and go for a drive.

And some sleepwalkers go to the fridge for much more than a Coke. People with sleep related eating disorder have episodes of compulsive binge eating while they are only partially awake.

Other people with REM sleep behavior disorder take sleepwalking to the extreme. They act out vivid, action-packed dreams while remaining asleep. They may shout, punch, kick, run and even jump out a window.

These are examples of a group of sleep disorders called "parasomnias." They all involve undesired behaviors during sleep.

Read more about parasomnias such as sleepwalking. Get tips for preventing parasomnias on SleepEducation.com.

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

Changes in Bedtime Routine and Sleep Environment Can Improve Your Sleep

According to a recent blog post, making small changes in her night time habits and bedroom have helped Glamour Magazine’s Cindi Leive improve her sleep during Sleep Challenge 2010.

Leive said that since she began the sleep challenge, her awareness of her sleep has increased, and that has made a positive impact. She notes that the small changes she made to her night time habits and bedroom have increased the quality and quantity of her sleep. Some of the changes include buying a new pillow, creating a bedtime routine, making her bedroom darker and keeping electronics out of her room. Leive has also given herself a bedtime.

After speaking with several sleep experts, including AASM member Dr. Michael Breus, Leive and Huffington have focused on the factors that were keeping them from getting the sleep they need. They are currently in the process of making lifestyle changes that will allow sleep to be included as a major priority.

Last year, the Sleep Education Blog reported that following a nightly bedtime routine can reduce daytime sleepiness. Research showed that the most effective strategies to feel less sleepy were taking a bath and going to bed at the same time every night.

In order to improve your sleep the AASM also recommends that you:

• Wake up at the same time each day, even on weekends.
• Avoid naps if you can during the day.
• Don’t drink caffeine in the afternoon.
• Don’t read, write, eat, watch TV, talk on the phone, or play cards in bed.
• Make your bedroom quiet, dark, and a little bit cool.

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 courtesy of Glamour Magazine

Getting Young Children to Sleep

Leisa Naples knows how hard it can be to get young children to sleep at night. She is the mother of two sets of identical twin girls.

But the host and producer of “Living Well with Leisa” found a creative way to get her girls to wind down at night. She calls it “Family Spa Night.”



A recent study showed that Leisa’s idea may be a good one. It found that a simple, four-step, nightly routine helps young children sleep better.

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

Another study confirmed that poor “sleep hygiene” has a negative effect on the sleep patterns of young children. The authors concluded that good sleep hygiene helps young children sleep better.

Basic tips that parents should put into practice include:

• Letting children fall asleep independently
• Putting children to bed before 9 p.m.
• Establishing a bedtime routine that includes reading
• Helping children avoid caffeine
• Keeping a TV out of the bedroom

Read more about sleep and children.

Targeting Tonsils to Treat Child Sleep Apnea

A new study examined the genetic basis of enlarged tonsils in children with obstructive sleep apnea.

The study involved 18 children with OSA. They were compared with 18 children who had recurrent tonsillar infections. All of the children had surgery to remove their tonsils. Then the tonsil tissue from each child was analyzed.

"We found that in the tonsil tissues of children with OSA, certain genes and gene networks were over expressed," study co-author Dr. David Gozal said in a news release.

They found that children with OSA had higher levels of a protein called phosphoserine phosphatase (PSPH). This protein almost never appeared in the tonsils of the children who did not have OSA.

Then they experimented with a phosphatase inhibitor to block this protein. It reduced the cell proliferation and increased programmed cell death.

"Together, these observations suggest that PSPH is a logical therapeutic target in reversing adenotonsillar enlargement in pediatric OSA," said Gozal.

Recently Gozal reported that the urine concentrations of certain proteins were altered in children with OSA. The results suggested that a urine teat may be able to detect sleep apnea in children.

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.

Last year 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.

Removing the tonsils is a common treatment for sleep apnea in children. But some children may continue to have OSA even after the procedure.

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

Gallup Survey: Did You Feel Well Rested Yesterday?

New Gallup-Healthways survey data show that 29 percent of U.S. adults said they did not feel well rested the day before the survey.

The survey involved 700,000 adults who were contacted by phone. It was conducted in 2008 and 2009. Respondents were asked, “Did you feel well rested yesterday?”

Women were more likely than men to report that they did not feel well rested. Rest also was more elusive for young adults, lower-income adults and those with at least one child in the household.

Older adults appeared to be the best rested. Only 19 percent of adults who were 65 years of age and older said they did not feel well rested.

Feeling well rested also was related to overall well-being. Fifty-one percent of people who were well rested considered themselves to be “thriving.” But only 39% of people who did not feel well rested were thriving.

A recent study suggested that your sleep may improve when you retire. Another study reported that working women sleep less than men.

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.

So what about you? Did you feel well rested yesterday – or today?

If not, maybe you need to make it a priority to get more sleep at night. Or maybe you need to seek help for a sleep disorder.

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

Solving SIDS: The Serotonin Connection

A new study found low levels of serotonin in the brain tissue of infants who died from SIDS. The study suggests that a brain defect may cause some babies to be more vulnerable to sudden death while they sleep.

The results were published today in JAMA.



The autopsy analysis involved 35 infants who died from SIDS. They were compared with five infants who died from known causes.

Researchers examined small samples of tissue from the medulla. This is a region at the base of the brain. It regulates basic functions such as body temperature, breathing, blood pressure and heart rate.

Results show that serotonin levels were 26 percent lower in SIDS cases than in controls. Serotonin is a brain chemical that helps regulate mood. It also plays a role in regulating vital functions like breathing and blood pressure.

Measurements of “tryptophan hydroxylase” also were 22 percent lower in SIDS infants. This is an enzyme that is needed to make serotonin.

The authors suspect that this defect may hinder an infant’s capacity to respond to breathing challenges. As a result the child may inhale carbon dioxide that was exhaled while sleeping face down.

"Our research suggests that sleep unmasks the brain defect," senior author Dr. Hannah C. Kinney said in an NIH news release. "When the infant is breathing in the face-down position, he or she may not get enough oxygen. An infant with a normal brainstem would turn his or her head and wake up in response. But a baby with an intrinsic abnormality is unable to respond to the stressor."

Kinney hopes that a test will be developed to detect the abnormality. Steps could be taken to protect the infants who are most vulnerable.

She also said parents should continue to follow the Back to Sleep tips for safe infant sleep.

"Until 12 months of age, babies should sleep on their backs in a crib with a firm mattress, and without toys, soft pillows, excessive blanketing or excessive clothing," she told AFP.

An earlier study led by Kinney involved 31 infants who died of SIDS. The brainstems from SIDS infants contained more neurons that make and use serotonin. This suggested that the brain was compensating for low levels of serotonin.

Read more about sleep and infants and SIDS.