Waking up in the middle of the night and being unable to return to sleep is one sign of insomnia. But a recent story on NPR’s “Morning Edition” suggests that this wasn’t always the case.
A period of wakefulness in the middle of the night used to be the norm. At that time there were no lights to turn on at night. When it got dark outside, it was just as dark inside.
A winter night can bring 14 hours of solid darkness. That’s a long time to spend in bed.
So what would happen? There are reports that people would sleep in two shifts through the night. In between, they would lie awake for a period of time.
But this wasn’t a frustrating, anxious, tossing and turning kind of awake. It was more of a relaxing, late-night pause before the early-morning sleep shift.
The story even cites a 1993 study that simulated this long, dark winter night. Fifteen volunteers spent 14 hours in bed in a sleep lab. The lights were turned out from 6 p.m. to 8 a.m.
Sure enough, they slept in two shifts. In the middle was a period of wakefulness lasting a few hours.
"You might think that lying awake for two hours would be a kind of torture," study author Thomas Wehr told NPR. "But it wasn't at all."
This news might be a comfort for older adults who tend to have more fragmented sleep. They may have a more flexible schedule that allows them to spend a long winter’s night in bed.
But 14 hours in bed? That’s close to impossible for most people today.
Yet you can implement a less extreme version of the two-shift sleep method. One proponent of the split-night sleep schedule is Dan Henning, who is 67 years old. He is the offensive coordinator for the Miami Dolphins.
The Palm Beach Post reports that he goes to bed by 9 p.m. Around 2 a.m. he likes to wake up for about 45 minutes of “personal time.” Then he returns to sleep.
So in a perfect world, what would be your sleep schedule?
Saturday, August 8, 2009
Friday, August 7, 2009
Infections May Trigger Narcolepsy
In May the Sleep Education Blog reported that narcolepsy may be an autoimmune disorder. Research suggests that narcolepsy may develop when the immune system attacks and destroys hypocretin-producing brain cells by mistake. Hypocretin is a hormone that helps promote wakefulness.
But what causes this immune system response? A study in the Aug. 1 issue of the journal Sleep shows that bacterial infection may be one trigger.
The study involved 200 people with narcolepsy and 200 healthy controls. They were recruited from the U.S., the Czech Republic, Italy and South Korea. Their blood was tested for antibodies that are markers of bacterial infection.
Results show that the levels of antibodies related to “streptococcus” were much higher in people with narcolepsy. These levels were highest when blood was drawn soon after narcolepsy symptoms began.
Streptococcus is the name of a group of bacteria. Some types of the bacteria can cause disease in humans; examples include scarlet fever, strep throat and tonsillitis.
The authors note that the levels of anti-streptococcal antibodies vary widely across people groups. About 90 percent of the people with narcolepsy in this study were Caucasian; so the study needs to be replicated among other ethnic groups.
But the results show that streptococcal infections are probably an important trigger for narcolepsy.
But what causes this immune system response? A study in the Aug. 1 issue of the journal Sleep shows that bacterial infection may be one trigger.
The study involved 200 people with narcolepsy and 200 healthy controls. They were recruited from the U.S., the Czech Republic, Italy and South Korea. Their blood was tested for antibodies that are markers of bacterial infection.
Results show that the levels of antibodies related to “streptococcus” were much higher in people with narcolepsy. These levels were highest when blood was drawn soon after narcolepsy symptoms began.
Streptococcus is the name of a group of bacteria. Some types of the bacteria can cause disease in humans; examples include scarlet fever, strep throat and tonsillitis.
The authors note that the levels of anti-streptococcal antibodies vary widely across people groups. About 90 percent of the people with narcolepsy in this study were Caucasian; so the study needs to be replicated among other ethnic groups.
But the results show that streptococcal infections are probably an important trigger for narcolepsy.
Thursday, August 6, 2009
Child Sleep Problems May Begin in the Womb
A study in the Aug. 1 issue of the journal Sleep examined prenatal factors that are related to sleep problems in children.
The study involved 289 children born in Finland in 1998; each child was born at term from 37 to 42 weeks of gestation. Sleep was measured by actigraphy for one week when the children were 8 years of age. Parents reported sleep problems and sleep disorder symptoms.
Results link prenatal alcohol exposure to an increased risk of sleep problems in childhood.
Alcohol "exposure" was defined as a mother drinking more than one alcoholic beverage per week during pregnancy.
Children exposed to alcohol before birth were 2.5 times more likely to have a “short” sleep duration of 7.7 hours or less per night. The AASM reports that at 8 years of age children need about nine to 10 hours of nightly sleep.
Children also were 3.6 times more likely to have a low “sleep efficiency” of 77.2 percent or less if they were exposed to alcohol in the womb; sleep efficiency indicates how much of their time in bed was spent sleeping.
“Adverse fetal environment may have lifelong influences on health and behavior,” principal investigator Katri Räikkönen, PhD, told the AASM.
The CDC reports that drinking alcohol during pregnancy can cause a baby to be born with birth defects. About 1 in 12 pregnant women in the U.S. reports alcohol use.
Size at birth also was related to childhood sleep problems; lower weight and shorter length were associated with lower sleep efficiency. The authors report that small body size at birth may reflect disturbances in the fetal environment.
One finding surprised the authors: There was no link between prenatal tobacco exposure and sleep at 8 years of age.
Learn more about sleep and pregnancy on SleepEducation.com.
The study involved 289 children born in Finland in 1998; each child was born at term from 37 to 42 weeks of gestation. Sleep was measured by actigraphy for one week when the children were 8 years of age. Parents reported sleep problems and sleep disorder symptoms.
Results link prenatal alcohol exposure to an increased risk of sleep problems in childhood.
Alcohol "exposure" was defined as a mother drinking more than one alcoholic beverage per week during pregnancy.
Children exposed to alcohol before birth were 2.5 times more likely to have a “short” sleep duration of 7.7 hours or less per night. The AASM reports that at 8 years of age children need about nine to 10 hours of nightly sleep.
Children also were 3.6 times more likely to have a low “sleep efficiency” of 77.2 percent or less if they were exposed to alcohol in the womb; sleep efficiency indicates how much of their time in bed was spent sleeping.
“Adverse fetal environment may have lifelong influences on health and behavior,” principal investigator Katri Räikkönen, PhD, told the AASM.
The CDC reports that drinking alcohol during pregnancy can cause a baby to be born with birth defects. About 1 in 12 pregnant women in the U.S. reports alcohol use.
Size at birth also was related to childhood sleep problems; lower weight and shorter length were associated with lower sleep efficiency. The authors report that small body size at birth may reflect disturbances in the fetal environment.
One finding surprised the authors: There was no link between prenatal tobacco exposure and sleep at 8 years of age.
Learn more about sleep and pregnancy on SleepEducation.com.
Wednesday, August 5, 2009
Sibling Risk for Sleep Apnea in Children
A study in the Aug. 1 issue of the journal Sleep examined obstructive sleep apnea among siblings; it found a high “sibling risk” of OSA in both boys and girls.
The study group consisted of siblings born between 1978 and 1986; follow-up data were gathered from 1997 to 2004. Hospital records were analyzed for the entire pediatric population in Sweden – 2.7 million children.
Children 18 years of age and younger were divided into sibling groups. The study determined which children had a hospital diagnosis of OSA during the follow-up period. Then children were noted as positive for sibling OSA if a brother or sister also had the disorder.
Results found a high risk of OSA in boys and girls who had at least one sibling with OSA. The standardized incidence ratio was 33.2 in boys and 40.5 in girls. A total of 854 boys and 627 girls were diagnosed with sleep apnea during the study period.
The study also examined the sibling risk of having enlarged tonsils and adenoids; this is an important risk factor for sleep apnea in children. The familial risk was elevated; but it wasn’t as high as in the group with OSA. The standardized incidence ratio was 4.53 for boys and 4.94 for girls.
But the problem was much more common than OSA; 13,656 boys and 11,648 girls were diagnosed with enlarged tonsils and adenoids during the study.
The authors report that these sibling risks could have a genetic or environmental basis. In either case, both parents and doctors should be aware of the sibling risk of OSA.
“Early diagnosis and treatment is important to avoid complications,” study author Dr. Danielle Friberg told the AASM.
The AASM reports that OSA can slow a child’s growth rate in early childhood. Cognitive and behavioral problems also are common in children with OSA.
Learn more about obstructive sleep apnea in children on SleepEducation.com.
The study group consisted of siblings born between 1978 and 1986; follow-up data were gathered from 1997 to 2004. Hospital records were analyzed for the entire pediatric population in Sweden – 2.7 million children.
Children 18 years of age and younger were divided into sibling groups. The study determined which children had a hospital diagnosis of OSA during the follow-up period. Then children were noted as positive for sibling OSA if a brother or sister also had the disorder.
Results found a high risk of OSA in boys and girls who had at least one sibling with OSA. The standardized incidence ratio was 33.2 in boys and 40.5 in girls. A total of 854 boys and 627 girls were diagnosed with sleep apnea during the study period.
The study also examined the sibling risk of having enlarged tonsils and adenoids; this is an important risk factor for sleep apnea in children. The familial risk was elevated; but it wasn’t as high as in the group with OSA. The standardized incidence ratio was 4.53 for boys and 4.94 for girls.
But the problem was much more common than OSA; 13,656 boys and 11,648 girls were diagnosed with enlarged tonsils and adenoids during the study.
The authors report that these sibling risks could have a genetic or environmental basis. In either case, both parents and doctors should be aware of the sibling risk of OSA.
“Early diagnosis and treatment is important to avoid complications,” study author Dr. Danielle Friberg told the AASM.
The AASM reports that OSA can slow a child’s growth rate in early childhood. Cognitive and behavioral problems also are common in children with OSA.
Learn more about obstructive sleep apnea in children on SleepEducation.com.
Tuesday, August 4, 2009
Insomnia, Sleepiness & Quality of Life in Older Adults
A study in the Aug. 1 issue of the journal Sleep linked insomnia symptoms and daytime sleepiness with quality of life in older adults.
The study involved 3,078 adults over the age of 40. Their mean age was 62 years at baseline and 67 years at follow-up.
Results show that self-reported sleep problems were related to quality of life. An increase in insomnia symptoms was associated with a decrease in mental quality of life. Both mental and physical quality of life dropped as symptoms of excessive daytime sleepiness increased.
The study also tracked the severity of obstructive sleep apnea. It was measured objectively by overnight sleep study. OSA severity increased slightly over the five years of the study; but this change did not affect quality of life.
“Only subjective measures of sleep were associated with quality of life,” lead author Graciela Silva, PhD, told the AASM. “These findings signal to the importance of perception of quality of sleep on quality of life.”
Scores for mental and physical quality of life were lower in women. The score for physical quality of life was lower in people who were obese.
The authors report that insomnia due to medical condition is common in older adults. Treating other medical problems often will improve sleep quality.
The AASM offers these sleep tips for older adults on SleepEducation.com.
The study involved 3,078 adults over the age of 40. Their mean age was 62 years at baseline and 67 years at follow-up.
Results show that self-reported sleep problems were related to quality of life. An increase in insomnia symptoms was associated with a decrease in mental quality of life. Both mental and physical quality of life dropped as symptoms of excessive daytime sleepiness increased.
The study also tracked the severity of obstructive sleep apnea. It was measured objectively by overnight sleep study. OSA severity increased slightly over the five years of the study; but this change did not affect quality of life.
“Only subjective measures of sleep were associated with quality of life,” lead author Graciela Silva, PhD, told the AASM. “These findings signal to the importance of perception of quality of sleep on quality of life.”
Scores for mental and physical quality of life were lower in women. The score for physical quality of life was lower in people who were obese.
The authors report that insomnia due to medical condition is common in older adults. Treating other medical problems often will improve sleep quality.
The AASM offers these sleep tips for older adults on SleepEducation.com.
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