Sleep Suffers in Wartime Deployment

Despite months or even years of preparation, many troops will struggle to sleep for some time after they arrive in Iraq or Afghanistan. Insomnia affects about 28 percent of deployed American troops, a study in the December issue of the journal SLEEP suggests.

The symptoms may not improve when the tour of duty is over. 21 percent of troops reported difficulty sleeping after returning home to the United States. Troops may have twice the risk of insomnia if they had poor health or mental health problems such as depression or posttraumatic stress disorder prior to deployment.

The study involved 41,225 troops from all service branches and components of the U.S. military, including active duty and Reserve/National Guide personnel. The participants completed a baseline survey with questions about sleep and overall health prior to deployment. About a quarter of the troops responded to a follow-up survey three years later, either in Iraq or Afghanistan, or after returning from either warzone.

Sleep duration was limited even for the troops who did not have insomnia. The average sleep time during wartime was 6.5 hours - slightly less than the recommended amount of sleep for adults. The AASM reports adults require 7 to 8 hours to be fully alert during the daytime.
Insomnia or not, lost sleep may have dire consequences. While military personnel are trained to function on little to no sleep, a single mistake may be fatal.

For us in the civilian world, the findings should come as no surprise. It’s hard to image trying to sleep to the sound of gunfire and explosions or even the prospect of an attack.

As a side note, the study also looked at mothers of young children and pregnant women who served in the military. On average, the women slept less than six hours. The authors speculate that the possibility of future deployment and separation from their families may multiply the normal stress of pregnancy and motherhood.

Photo courtesy United States Marine Corps

Non-stop lifestyle catches up with Diddy, now tortured by insomnia at 40

Sleep can elude even those who appear to have it all. Rapper Sean ‘P. Diddy’ Combs rules over a hip-hop empire valued in the hundreds of millions, throws lavish parties and has an entourage of dozens of people including his own personal barber.

The one thing missing from Diddy’s life is sleep.

"I was proud of working 18 hours a day and sleeping three hours a night," he told ABC’s “Nightline” Thursday. "It's something now that has turned into a problem for me: not being able to sleep.”

Diddy, now 40, once flaunted working like a “machine,” using the hours reserved for sleep to gain an edge on the competition.

He expected the same from his staff. His rule was “Sleep is forbidden.”

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“My mind is always racing, and always going and always working, and it's a gift and a curse,” Diddy told Nightline. “When I was starting out it was something I embraced, and now it’s something that I hate, it tortures – it will torture you.”

He said he's tried everything in his fight with insomnia. He takes sleeping pills, but avoids regular use. He's also tried herbal options, like tea and lavender.

Diddy’s problems appear to be related to his lifestyle. People in isolated, demanding positions like record label executive are highly likely to develop insomnia. Racing thoughts in bed are a common complaint in these cases.

An inconsistent sleep schedule due to late night partying and jet setting also may be the culprit. Drinking alcohol during his many late-night parties may also harm his sleep quality.

Cognitive behavioral therapy is recommended for primary insomnia cases similar to Diddy’s. A sleep specialist would work with him to eliminate the negative racing thoughts that are keeping him awake, and help identify other insomnia promoters.

Learn more about Cognitive Behavioral Therapy at Sleepeducation.com.

Sleep & Epilepsy

A new study evaluated daytime sleepiness in people with epilepsy.

The study involved 83 people who have epilepsy. They were compared with 80 healthy controls. Participants completed the Epworth Sleepiness Scale and an overnight sleep study.

Results show that people with epilepsy had a much higher level of daytime sleepiness than controls. They also spent less time in the stages of deep, slow-wave sleep and REM sleep. These changes were unrelated to the use of antiepileptic medications.

Epilepsy is a condition that involves recurrent seizures. A seizure is a temporary disturbance in brain function. It occurs when groups of nerve cells in the brain produce abnormal and excessive electrical impulses.

The AASM reports that stress and sleep deprivation are two factors that may trigger seizures. Some types of epilepsy tend to occur only or mainly during sleep. This may cause severe sleep disruption. As a result poor sleep quality and daytime sleepiness may occur.

Sleep disorders also may worsen seizures and complicate their treatment. A study in the journal Sleep found that daytime sleepiness in people with epilepsy may be related to obstructive sleep apnea and restless legs syndrome. Treating OSA with CPAP therapy may improve seizure control.

The CDC estimates that more than two million people in the U.S. have epilepsy. New cases are most common among children and older adults.

Conditions that may lead to epilepsy include oxygen deprivation and stroke. But a specific underlying cause is unidentified in about two-thirds of cases.

A recent journal article provided an overview of sleep and epilepsy. Learn more about sleep disorders at Sleep Education.com.

Don’t Let Holiday Stress Disrupt Your Sleep

Although the holidays are a time for joy, they can also cause a great deal of stress. Between shopping, decorating and hosting parties, you may find that sleep has moved to the bottom of your priority list.

You may tell yourself that you will have time to catch up on sleep in the new year, but you may not realize the harm you can do by skimping on sleep.

Dentist and UCSF professor of restorative dentistry Steven Goldman told the San Jose Mercury News that when people are under stress and not sleeping well they are at higher risk for developing bruxism, or night-time teeth grinding.

Bruxism is not always serious. However, severe bruxism can lead to tooth damage, muscle pain and headaches. You can use an oral appliance to protect your teeth while you sleep if you frequently grind your teeth.

Planning holiday activities in advance can help alleviate your stress. Knowing your limits can also prevent you from over scheduling and cutting into your sleep time.

Holidays are a time for enjoying family and friends, but it is also important during this time to manage your stress and health. To make this an enjoyable and healthy season, make sure to leave time for a good night’s sleep.

Sleep experts recommend that adults sleep between seven and eight hours each night. Learn more about healthy sleep habits.

Image by Andreas Nilsson

Work & Insomnia: Sleepless Off the Job

A new study from Japan shows that insomnia may be linked to your job.

The study involved 1,022 workers; they had an average age of 39 years. They were evaluated across two years.

Results show that some workers were more likely to have insomnia for the length of the study. Employees with low social support at work were twice as likely to have persistent insomnia. Those who had an “effort-reward imbalance” also were more than two times as likely to have ongoing insomnia.

The study also found that some workers were more likely to develop insomnia by the end of the study. The risk of having a new case of insomnia was 75 percent higher in people who were overcommitted to work. Good sleepers were 72 percent more likely to develop insomnia if they had high job strain.

In September the Sleep Education Blog reported that people with a low-strain job had the highest sleep quality; exposure to a high-strain work environment was associated with elevated levels of sleep complaints.

In April the Sleep Education Blog reported that female executives may be more prone to sleep problems than male executives. The risk is greatest for women who have isolated, demanding jobs.

How can you prevent job stress from disturbing your sleep? One way is to avoid “bedwork.” Never bring any work to bed with you; instead you should make your bed a refuge from your job.

Get other helpful tips and learn more about job stress and sleep at SleepEducation.com.

Work & Sleep: A Hard Day’s Night

A new study shows that your job may be affecting how you sleep.

The Dutch study involved 1,163 employees. Sleep quality and fatigue were measured across a one-year time lag.

Results show that exposure to a high-strain work environment was associated with elevated levels of sleep complaints. In contrast, people with a low-strain job had the highest sleep quality; they also had the lowest level of fatigue.

The study supports the Demand/Control Model proposed by Karasek and Theorell. This model suggests that high-strain jobs can have a negative effect on both mental and physical health; job strain can cause fatigue, anxiety, depression and physical illness.

A high-strain job is psychologically demanding. It also restricts your “decision latitude;” this refers to the authority you have to make decisions and use all of your skills.

Last week the Sleep Education Blog reported that workplace bullying increases the risk of disturbed sleep. The study measured 45 forms of bullying such as verbal aggression, criticism, gossiping and threats of physical violence.

In April the Sleep Education Blog reported that female executives may be more prone to sleep problems than male executives. The risk is greatest for women who have isolated, demanding jobs.

How can you prevent job stress from disturbing your sleep? One way is to avoid “bedwork.” Never bring any work to bed with you; instead you should make your bed a refuge from your job.

Get other helpful tips and learn more about job stress and sleep at SleepEducation.com.

Back on Campus: Stress, Sleep & College Life

A new study shows that sleep problems will be common as college students return to campus for the fall semester.

The study involved 1,125 students at the University of St. Thomas in St. Paul, Minn. They completed an online survey about their sleep habits, mood, health and related factors.

Results show that more than 60 percent were poor sleepers; these students were much more likely to have problems with their physical and mental health. Taking medications to sleep better also was common.

What was the primary cause of sleep problems? The authors report that students “overwhelmingly stated that emotional and academic stress negatively impacted sleep.” Data analysis revealed that tension and stress were significant predictors of sleep quality.

The study also shows that students were sleep deprived. Only 30 percent of students reported sleeping at least eight hours per night. Twenty percent of students stayed up all night at least once a month; 35 percent stayed up until 3 a.m. at least once a week.

This sleep loss had an effect on class performance; 12 percent of poor sleepers reported falling asleep in class or missing class at least three times a month.

"Students underestimate the importance of sleep in their daily lives,” study co-author Roxanne Prichard, PhD, said in a prepared statement. “They forgo sleep during periods of stress, not realizing that they are sabotaging their physical and mental health."

The AASM reports that stress can lead to adjustment insomnia. This involves disturbed sleep or sleeplessness that may last for a few days or a few weeks. Other symptoms may include anxiety, worry and tension.

The study authors state that intervention programs are needed to help college students prevent and overcome sleep problems. Some schools have already taken action.

In March a UC San Diego program educated students about the benefits of napping. Last fall the Boston Globe reported that schools such as MIT are using seminars, workshops and contests to promote good sleep habits. And at Stanford a “Sleep and Dreams” class has been offered for years.

Insomnia: When Should You Get Help?

Insomnia is the most common sleep complaint; everyone has trouble sleeping at times. So how do you know when your insomnia is severe enough that you should seek help?

This is what sleep specialist Dr. Donna Arand told the AASM:

“You should seek help when these three statements all describe your insomnia:
1. The insomnia has lasted more than three weeks.
2. It is not improving.
3. It is interfering with your ability to function during the day.”

“Insomnia is often a typical response to a stressful situation. It should disappear as the stress decreases. But bad sleep habits can develop during the period of stress. This prolongs and establishes the insomnia. It is easier for you to re-establish good sleep if you eliminate these habits early.”

Get more insomnia advice from Dr. Arand on SleepEducation.com.

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

Women in the Executive Office: Job Stress & Insomnia

A new study examines the sleep quality of men and women who are executives or managers. Does job stress affect their sleep?

Results suggest that female executives may be more prone to sleep problems than male executives. The risk is greatest for women who have isolated, demanding jobs.

The study also shows that having a high level of control on the job reduces the risk of poor sleep quality. Social support also has a “buffering effect.” Having a strong network of social support promotes good sleep for women with a high-strain job.

According to the AASM, job stress can be a cause of adjustment insomnia. This involves disturbed sleep or sleeplessness that may last for a few days or a few weeks. Other symptoms may include anxiety, worry and tension.

How can you prevent job stress from disturbing your sleep? One way is to avoid “bedwork.” Never bring any work to bed with you; make your bed a refuge from your job.

Get other helpful tips and learn more about job stress and sleep at SleepEducation.com.

President’s Address: Economy is the “Source of Sleepless Nights”

Last night President Obama gave his first address to a joint session of Congress. As expected, it was dominated by talk of the economy.

Early in his remarks the president noted one side effect of the struggling economy: It’s keeping us awake at night.

“You don’t need to hear another list of statistics to know that our economy is in crisis, because you live it every day. It’s the worry you wake up with and the source of sleepless nights.”

Research shows that the president may be right. There is a connection between financial struggles and sleep problems.

In January we described how women who report financial strain have more sleep complaints. They also spend a greater percentage of time awake while in bed.

Another study shows that ongoing financial strain has a similar effect on the elderly. They also spend more time awake while in bed.

A study of farmers shows that economic concerns also can be severe for people involved in seasonal work. Many of the farmers suffered from sleep deprivation during peak seasons. This sleep loss was linked to worries about cash flow.

A new study shows that unemployment is another economic concern that can affect sleep. It found a strong independent association between sleep problems and unemployment.

In January the U.S. unemployment rate rose to 7.6 percent. About 11.6 million people were without a job.

Worrying about the economy can cause insomnia, which is the most common sleep complaint. About one-third of adults report having insomnia symptoms.

A stressful event such as a job loss or a pay cut can cause adjustment insomnia. It often occurs along with anxiety, worry, sadness or depression. You also may be unable to stop thinking about the problem.

The good news is that adjustment insomnia tends to last for only a few days. Sometimes it may linger for a few weeks. Normal sleep returns when the stressful event has passed or you have adapted to it.

About 10 percent of adults have chronic insomnia that lasts for more than a month. It can affect how you function during the day.

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

White House photo 2/24/09 by Pete Souza

Tension Headaches, Naps and Insomnia

Maybe it’s not such a good idea to take a nap when you have a headache.

A new study in the Journal of Clinical Sleep Medicine shows there may be a link between headaches, naps and insomnia.

The study involved 32 women who have tension headaches. Their average age was about 22 years. Ninety-four percent of the women reported that stress was a trigger of their headaches.

Eighty-one percent of the women reported using sleep as a coping strategy for headaches. This made sleep the number one self-management strategy.

Sleep also was rated as the most effective intervention. Other common self-treatment methods were:

• Medications
• Relaxation
• Distraction
• Hot or cold compress

So is sleep the best treatment for tension headaches? Not exactly. Fifty-six percent of the women also reported that sleep problems are a trigger of their headaches.

“Insomnia is a common complaint among headache sufferers,” said principal investigator Jason C. Ong, PhD. “While napping may relieve pain, it may also result in poor sleep hygiene, thus triggering sleep disturbance or perpetuating an insomnia episode.”

So taking a nap may provide immediate headache relief. But the daytime sleep may cause you to be more alert that night.

This may lead to an episode of insomnia. Then the insomnia could trigger another tension headache the following day. To break this cycle, practice good sleep hygiene and limit the use of naps as a headache treatment.

The NINDS recommends other treatment options. These include therapies that help you manage stress or relax your muscles. You may want to take a hot shower or apply moist heat to the back of the neck. A massage or gentle neck exercises also may be helpful.