Saturday, October 30, 2010

Baby Keeping You from Sleep? Wait a Few Months

Parenting seems a lot less rewarded when you’re waking constantly to tend to a crying child. Consistent fatigue can suck the joy out of one of life’s most gratifying milestones. The good news is the end is in sight, and it’s a lot closer than you might think.

More than half of babies sleep through the night after about two or three months, researchers have discovered. A much smaller number of parents won’t be so lucky. Less than 15 percent of babies won’t stop waking or crying until after their first birthday.

The study looked at the sleep patterns of 75 healthy newborns over 12 months. During that timeframe, parents kept sleep diaries for their child and installed a camera where the baby slept to make time-lapse recordings. Researchers used the video to check the accuracy of the sleep logs.

The study reports the largest change in uninterrupted sleep came after the first month. The average child sleeps an extra three hours without waking. At three months, half of babies began sleeping from midnight to 5 a.m. One month later the same group slept from eight hours.

Parents also reported better rest after five months. Half of the new parents reported sleeping six hours or more.

A small number of the babies still regularly woke after their first birthday.

Parents may be able to help children who frequently wake late in their infancy. Make sure the baby’s sleep environment is comfortable, quiet and dark. Babies should be on a consistent sleep and feeding schedule.

Other factors, such as health problems can keep children awake. Consult a doctor if your child’s sleep doesn’t significantly increase after a year.

Friday, October 29, 2010

Dedication to CPAP Takes a Positive Personality

Do you view CPAP as the machine that can save your health or is it a consequence of your lifestyle choices? How you answer may predict whether you’ll stick with CPAP or become the 25-50 percent of obstructive sleep apnea patients who leave their condition untreated.

A study in the journal Sleep and Breathing examined what types of personalities adhere to CPAP, the front-line treatment for obstructive sleep apnea.

A positive outlook plays the biggest role, researchers discovered. The ideal patient is optimistic and responsive to the rewards from treatment, such as increased energy and improved mood.Pessimists and people with strong feelings of fear and anxiety will likely have a much more difficult time in the initial stages of CPAP therapy.

The study involved 31 men and 32 women previously diagnosed with sleep apnea. Their personalities were classified using a series of personality inventories completed at the beginning of the study.

Researchers referred to each of the patient’s medical records to look at CPAP adherence. The study defined adherence as using CPAP for at least 4 hours a night for about 5 nights per week.

By comparing personality types to medical records, researchers discovered positive or negative outlook predicted CPAP adherence 3 out of 4 times.

The findings are great news for the type of people who look at the bright side of things. There’s still hope even if you see the glass as half empty. It just might take some extra work.

Doctors are increasingly referring CPAP patients to behavioral sleep specialists who can help you improve your outlook and tackle the challenges of changing your lifestyle.

Thursday, October 28, 2010

Sleepy Gene Worsens Effects of Sleep Deprivation

Some people are naturally wired to be tired. About 25 percent of people carry a gene variant that makes them sleepier than their peers, researchers have discovered.

The breakthrough explains why you might feel exhausted for staying up a half hour past your normal bedtime while your coworker in the next cubical has no problem regularly burning the candle at both ends.

People with a gene variant called DQB1*0602 are generally more fatigued whether they are rested or not because their sleep is more fragmented, researchers discovered. They spend less time in deep sleep compared to their peers. When they are fully rested, people with the gene variant have less desire to sleep.

The gene variant is closely related to narcolepsy, yet experts say anywhere from 12 to 38 percent of carriers are healthy sleepers who don’t develop the sleep disorder. Some people without the gene variant also develop narcolepsy, although it’s not as common.

The study compared 92 healthy adults without the gene variant to 37 healthy adults with DQB1*0602. Each participant spent a week at a sleep laboratory. For the first two nights they were allowed full rest, with a ten hour scheduled sleep period.
Sleep restriction followed for five nights. Each subject was allowed only four hours in bed and spent the rest of the time reading, playing games or watching movies.

Throughout the study, researchers measured the participants’ sleep quality and tested their memory, attention and ability to stay awake. Each person also reported how sleepy they felt.

When they were allowed full rest, people with the gene variant spent 34 minutes in stage three sleep compared to 43 minutes for people without the trait. After five nights of sleep deprivation people with the variant spent 29 minutes in deep sleep compared to 35 minutes for the control group.

While people with the variant were sleepier and more fatigued, they performed similarly in memory attention and daytime sleep resistance tests.

The findings may lead to changes in the way we look at sleep deprivation. AASM Member and medical director of Minnesota Sleep Disorder Center Dr. Mark Mahowald suggests doing away with sweeping statements about sleep deprivation.

“The implication is that everyone is sleep-deprived and sleep-deprivation does the same thing to everyone, but the tolerance and range of sleep is so different for different people,” Dr. Mahowald told ABC News.

"Our society has equated sleepiness with defects of character, like laziness and depression, but really, some people are generally sleepier during the day. They're more prone to naps, and to sleeping in. We have to accept the fact that sleep duration is genetically determined and not a sign of defect."

Tuesday, October 26, 2010

Real or Hoax? Photographer Spends 40 Days Without Sleep

Tyler Shields did something this October that most medical experts would consider highly dangerous, irresponsible and most likely impossible. The 28-year-old Los Angeles photographer claims he went 40 days without a wink of sleep. Friends tasked with monitoring Shields insist he was awake the entire time, and never felt the urge to close his eyes and drift away.

If you have your doubts, you’re not alone.

“In all likelihood he has slept, even if he does not think he has,” AASM member Dr. Michael Breus told AOL News. “Many people have what we call ‘microsleeps’ where our brain will go into sleep for even a few seconds.”

Shields claims he’s different than most people. He keeps a busy 24-hour work and social schedule and only needs to sleep a couple nights per week.

It all sounds either an early case of the devastating and impossibly-rare fatal familial insomnia or, in all likelihood, a sham for publicity. After all, Shields makes a living by taking suggestive photos of Lindsay Lohan and other young actresses.

Hoax or not, going long periods without sleep is still extremely unhealthy, which is why the Guinness Book of World Records refuses to recognize records for sleep-deprivation. Extreme sleep deprivation can lead to psychiatric problems such as irritability, depression and even hallucinations. Physical problems can range from elevated blood pressure, to obesity, stroke and heart failure.

Shields says most of the first month was no problem. The symptoms began after day 25 when he began having a bad fever, which he initially fought by eating “like 50 popsicles.“ When the fever came back he sat in a bathtub filled with ice. Then he lost feeling in his legs and then his entire right side. Then the numbness went away and he had to pee every 10 minutes.

He went the entire time without caffeine or stimulants. And he kept productive, taking dozens of photos inspired by sleeplessness.

The photographer says it took more than eight hours to fall asleep after the 40th day was complete. After only six hours of sleep he woke up starving and ate a half loaf of bread sitting on the kitchen floor.

“My head felt like it was going to explode almost as if a tank was driving through a wall and the only think stopping it was my head,” Shields blogged. “I still feel a bit like a balloon floating in space my feet dont feel like they are on the ground”

If this sounds ridiculous, that’s because it is. The entire story must be a hoax. It has to be.

Photo by Tyler Shields

Sunday, October 24, 2010

Sleepwalk with Me: Comedian Mike Birbiglia's Sleep Disorder Scare

Meet Mike Birbiglia. He claims he jumped out of a second-story hotel window to avoid a missile attack. Witnesses say a madman crashed through a window in the middle of the night and then stumbled badly injured into the hotel lobby.

Birbiglia was as surpised as the hotel guests when he woke up covered in gashes. The guided missile attack was a nightmare but his actions were anything but a dream. 33 stitches and an overnight sleep study later Birbiglia was diagnosed with REM sleep behavior disorder, a parasomnia that causes the body to physically act out dreams.

The series of encounters leading up to his diagnosis are the subject of a series of memoirs titled Sleepwalk with Me.

Birbiglia makes his living by standing in front of an audience recounting long, embarrassing stories about his life. His darkly humorous accounts of REM sleep behavior disorder have earned him a Nathan Lane produced one man show, several Comedy Central specials and a spot as a semi-regular contributor to NPR’s This American Life.

Along the way he’s become the unofficial face of REM behavior disorder. Fans have approached Birbiglia to tell him they’ve had similar sleepwalking experiences and won’t repeat his mistakes.

In an interview with Time Magazine, Birbiglia admitted he sleepwalked for years before he was diagnosed.

“I [often] remember thinking this, ‘This seems dangerous. Maybe I should see a doctor.” And then I would think, “Maybe I’ll [just] eat dinner.’ And I went with dinner for years.”

Birbiglia limits the frequency of these episodes by taking clonazepam, a drug used to treat seizures by activating parts of the brain to produce a calming effect. Because there is no cure, he sleeps in a makeshift cocoon. He wears a sleeping bag up to his neck with mittens so he can’t open it and get up.

Sleepwalk with Me is on bookshelves now. Look for the film version written and acted by Birbiglia coming soon.

Hear Mike Birbiglia's live full-length performance of how he leaped through a hotel window on This American Life or listen to a in-depth interview on NPR's Fresh Air.

Friday, October 22, 2010

Use CPAP, Limit Heart Failure Risk

It may not seem like it, but how you deal with sleep apnea is a life-or-death decision. CPAP therapy can help you avoid heart failure, and reduce your risk of death.

A study published in the October issue of Sleep and Breathing looked at how patients with heart problems and sleep apnea responded to CPAP treatment.

The study included 18 patients had suffered advanced heart failure at least three months before the start of the study. Eleven patients elected to use CPAP for at least four hours per night, 70 percent of nights. The remaining seven patients were part of the control group because they refused treatment after a two-week trial with CPAP.

During follow-up every two months, researchers compared death and hospitalizations from heart failure. The study lasted a year.

Overall heart function improved after 12 months for the CPAP patients. The authors of the study report treatment had a noticeable positive impact on exercise tolerance and quality of life after only six months.

Two of the eleven patients who used CPAP were hospitalized during that time, but neither died.

Among the control group, four of the seven patients were hospitalized and two died.
Though it can save lives, the reality is some people may never accept CPAP. The study demonstrates why you should never leave sleep apnea untreated.

If CPAP doesn’t work for you, consult a sleep specialist at an AASM-accredited sleep center, and ask about alternatives such as oral appliance therapy or surgery.

Tuesday, October 19, 2010

Acid Reflux, Heartburn and Your Sleep

There’s a reason why doctors say you should avoid eating spicy foods before bedtime. The pain and discomfort from indigestion can make getting to sleep a real challenge. People with acid reflux disease (GERD) may struggle with this problem on a daily basis.

Several study abstracts presented at the annual meeting of the American College of Gastroenterology explored how upper gastrointestinal problems such as acid reflux disease and indigestion affect sleep.

People with an upper GI condition are more than three times more likely to have a sleep disorder, researchers discovered. Women appear to have twice as many sleep problems as men.

The authors of the study determined mental and physical factors such as overall fitness were related to sleep disorders in patients with an upper GI condition, but not age or substance use. The principal investigator believes depression and anxiety are major contributing factors.

Two other studies looked at how treatments for nighttime heartburn impact sleep. One small pilot study addressed the problem of drowsy driving, a serious public health concern according to the U.S. National Highway Traffic Safety Administration (NHTSA).

A small group of patients with sleeplessness from acid reflux disease practiced driving on a simulated roadway. When they were treated with the drug esomeprazole, otherwise known as Nexium, the drivers’ performances greatly improved. Daytime sleepiness ratings decreased by an average of two points on the Epworth Sleepiness Scale. Researchers intend to further explore these findings with larger, blinded control studies.

The final study presented compared the drug baclofen to a placebo. Acid reflux patients slept nearly an hour longer with far greater sleep efficiency after they took the drug. The average number of acid reflux events per night dropped from four to just over one per night. The drug is currently prescribed to treat central nervous disorders causing uncontrolled movement.

Upper gastrointestinal conditions affect 1 in 10 U.S. adults. Common symptoms include chronic pain, pressure and the feeling of fullness in the abdomen.

Monday, October 18, 2010

Sleep Complaints Common for Arthritis Sufferers

More than 10 million Americans with arthritis have regular sleep disturbances. National survey data shows an especially high rate among arthritis patients – nearly 23 percent. Only about 16 percent of people without arthritis have sleep-related complaints.

The study published in the October issue of Arthritis Care & Research analyzed findings from the 2007 National Health Interview Survey. More than 23,134 American adults answered a variety of health-related questions. Topics ranged from diet and exercise, to substance use, sleep and chronic health problems.

Nearly 1 in 5 survey respondents said they had been diagnosed with arthritis. The study did not differentiate the two types of arthritis, inflammatory and non-inflammatory. Non-inflammatory arthritis is more common and is most often caused by aging and injury.

Patients with uncontrolled pain, depression and anxiety had the highest risk, the study found. Complaints included inability to fall asleep, interrupted sleep and daytime fatigue. The authors suggest pain and joint mobility limitations related to arthritis may predict sleep problems, rather than just a diagnosis.

Sleep disturbances are often neglected as symptoms of arthritis, the study concluded. The authors contend that doctors should ask arthritis patients about sleep problems, and provide treatment.

Friday, October 15, 2010

Fibromyalgia Linked to Restless Leg Syndrome

Constantly exhausted but unable to sleep, the complaint is common among fibromyalgia patients. Until now doctors have had a difficult time treating sleep disruption from the chronic condition. Researchers have discovered restless leg syndrome is often the culprit, and medication for the sleep disorder may greatly improve patients’ quality of life.

A study published in the October issue of Journal of Clinical Sleep Medicine reports restless leg syndrome is about 10 times more prevalent in people with fibromyalgia compared to normal, healthy populations.

About 2 percent of people in the United States have fibromyalgia, a condition that causes you to feel fatigued with pain in your muscles, ligaments and tendons and tenderness all over your body. The condition occurs mostly in women and the cause is unknown.

Medications and therapy can minimize the symptoms, but can’t cure fibromyalgia. Authors of the study report the antidepressants often prescribed for patients may be causing restless leg syndrome cases. This may explain the higher than normal rate of restless leg syndrome.

Treatment for restless leg syndrome may help fibromyalgia patients' fatigue. Restless leg syndrome is fully treatable with medications such as pramipexole or ropinirole. See your doctor for treatment if you think you may have restless leg syndrome.

Thursday, October 7, 2010

Study Finds Long-term CPAP Causes Subtle Facial Changes

Canadian researchers have discovered a slight side-effect associated with the front-line treatment for sleep apnea. Long-term CPAP use can lead to nearly undetectable changes in facial structure. The changes won’t cause any health problems and the benefits of CPAP for sleep apnea outweigh any concerns, the researchers report.

Investigators at the University of British Columbia in Vancouver used X-rays to examine 46 Japanese patients with obstructive sleep apnea. The average patient had used CPAP for about three years. None said they noticed any facial changes.
The X-rays showed the patients upper and lower jaws were less prominent because of slight shifts in dental arches and incisor teeth. The change was so subtle it couldn’t cause any health concerns.

Extensive research shows CPAP can effectively treat obstructive sleep apnea and eliminate symptoms such as daytime fatigue, cognitive impairment, and erectile dysfunction. Some sleep apnea patients have a hard time getting used to wearing a CPAP mask each night, and may give up on therapy. Sleep apnea is a serious condition that should never be left untreated.

There are effective alternatives to CPAP. A special oral appliance that appears similar to a sports mouth guard helps with moderate sleep apnea. Surgical procedures can also open up the airways and eliminate sleep apnea. Weight loss and change in sleep position may reduce the symptoms of less serious sleep apnea cases. Be sure to consult a sleep specialist at an AASM accredited sleep center before taking action.

Wednesday, October 6, 2010

Workplace Disability & The Value of Sleep

The business cost of insomnia goes beyond loss of employee productivity. Workers with regular sleep disturbances go on disability more often and take longer to return to work.

A study published in the October, 2010 issue of the journal SLEEP investigated how insomnia impacts workplace health. Researchers found sleep disturbances predicted later workplace disability for mental disorders, physical illnesses and musculoskeletal disorders.

The study followed more than 56,000 active public employees in Finland for more than three years. Each of the government and public hospital employees was surveyed about sleep disturbances and preexisting health conditions at the start of the study. The authors used national records to identify which employees went on disability during the follow-up after three years.

Workers who had existing medical conditions, used prescribed pain killers or regularly performed manual labor were most likely to report severe sleep disturbance which occurred more 5-7 days per week.

Over the course of the study, 7 percent of the employees went on disability. About 1 in 3 never returned to work. Statistical analysis shows people who reported sleep disturbances had a higher likelihood of going on work disability and not returning to work. The results were adjusted for complicating factors such as shift work, depression and preexisting health problems.

Worker disability is only one of the business costs of sleep disturbances. Insomnia can also make you worse at your job.

Sometimes your job may be the source of the sleep problems. In 2009 the Sleep Education Blog reported on studies that tied high stress work and low social support at the workplace to long-term insomnia.

Tuesday, October 5, 2010

Inadequate Sleep Undermines Dietary Fat Loss

Dieting sometimes just doesn’t work out as hoped, despite your best intentions. Before you reexamine your exercise routine or diet, consider your sleeping habits.

A small study conducted at the University of Chicago suggests sleep is the third vital element in the battle to shed fat. Exercise and dietary efforts may be less effective without a regular 7-8 hours of shuteye.

Dieters in the study shed the same amount of weight with less sleep, however when they had adequate sleep they burned off more body fat. An abstract is available on the website of the journal Annals of Internal Medicine.

A group of 10 overweight study participants with an average BMI of 27.4 adopted a diet with 90 percent of calories required to maintain weight without exercise. The volunteers dieted in two 14-day intervals. One involved sleep restriction with only 5.5 hours per night compared to 8.5 hours in the control portion of the study.

The subjects lost an average of 6.6 lbs during each 14-day dieting period. Half of the weight lost was body fat with adequate sleep. In the sleep restriction condition, the dieters lost only 1.3 lbs of fat and 5.3 lbs of lean body mass.

They also felt hungrier. The “hunger hormone” Ghrelin increased during sleep loss, causing a spike in appetites. Ghrelin also promotes the retention of fat, the study authors report.

"If your goal is to lose fat, skipping sleep is like poking sticks in your bicycle wheels," said Plamen Penev, MD, PhD, the study’s principal investigator. “One should not ignore the way they sleep when going on a diet.”

The authors intend to further investigate how sleep loss affects diet results. They plan on conducting similar, lengthier studies with larger samples of dieters.

Monday, October 4, 2010

Can Congressional Hearings Cure Insomnia?

When was the last time you watched CSPAN? Was it when congress debated about health care reform or political campaign contributions. Or was it when comedian Stephen Colbert lambasted congress or when a congressional panel questioned Major League Baseball's top stars about steroid use?

There's a reason why people tune in to see the unusual and entertaining but choose to read about important policy issues in the news later. Congressional procedure is about as entertaining as an early morning accounting seminar in college.

That said, its hard to blame a young boy for falling asleep during his grandfathers floor speech. The CSPAN video (seen below) has become a viral sensation.

The man speaking is U.S. Rep. Joe Poe, a Republican from Texas. In this blogger's opinion, the address about domestic violence was brief and not that boring by Washington's standards. Yet even a congressional aide couldn't keep the boy from drifting to sleep.

It's not just children who can't stay awake through the endless and sometimes pointless posturing. Even presidential candidates have been caught napping at the capitol.

Think you can stay awake through congressional hearings?

Friday, October 1, 2010

Irregular Sleep in Early Pregnancy Linked to Hypertension Later

Adopt healthy sleep habits early in pregnancy and your body will thank you later. Research shows too much or too little sleep during near the beginning of pregnancy can lead to hypertension and potentially serious complications during the third trimester.

Women who sleep about nine hours night have significantly lower systolic and diastolic blood pressure compared to pregnant women with unhealthy sleep habits, researchers at the University of Washington report.

Abnormal sleep duration is also associated with preeclampsia, a condition linked to pregnancy induced hypertension and excess protein in urine. Preeclampsia can lead to serious or fatal complications if left untreated.

The study published in the October 2010 issue of the journal SLEEP measured the blood pressure of more than 1,200 healthy, pregnant women immediately after childbirth. During early pregnancy, each answered the question, “since becoming pregnant, how many hours per night do you sleep?”

About 1 in 5 women said they slept nine hours per night - the normal sleep duration for pregnant women. More than half the women slept seven to eight hours per night. About 14 percent of women slept less than six hours, and around 10 percent of women slept 10 hours or more.

Short sleepers and long sleepers had an average systolic blood pressure of 118.05 mm Hg and 118.90 mm Hg, respectively. Healthy sleeping pregnant women had much lower average blood pressure, at 114 mm Hg. The National Heart, Lung, and Blood Institute reports a systolic blood pressure reading of 140 mm Hg or more is considered high.

Short sleepers also had a 10 times higher preeclampsia rate. Overall, about 6.3 percent of study participants were diagnosed with preeclampsia or pregnancy induced-hypertension.

Sleep patterns tend to change throughout pregnancy due to shifting hormone levels. Pregnant women tend to sleep longer than normal adults.

Read more about Sleep & Pregnancy at
Photo by Bethykae