Thursday, August 23, 2012

Review: Sleepwalk With Me

Don't mistake "Sleepwalk With Me" as a story about a man coming to terms with the rare and intriguing REM sleep behavior disorder. Mike Birbiglia's semi-autobiographical new film is a highly personal and often understated account of a struggling comedian in a troubled relationship. The sleep disorder gets little screen time, but those moments are memorable and pivotal to the story.

Birbiglia, a comedian and regular on the popular radio show This American Life, co-wrote, co-directed and stars as his thinly veiled doppelganger Matt Pandamiglio. Matt is a thirty-something who is facing not-so-subtle pressure from his long-time girlfriend and family to get married. He adores his girlfriend, who is played by Lauren Ambrose, but he just can't bring himself to marry her. On top of that, his aspirations to become a stand-up comedian are going nowhere. He spends his evenings bartending at a comedy club, where he occasionally gets to perform.

Matt's anxieties begin to bubble over into strange and vivid dreams, which he acts out in his bedroom. His father is quick to notice that he may have REM Sleep Behavior Disorder, a rare and dangerous parasomnia that gets worse over time.

Instead of seeing a doctor, Matt gets swept away by an opportunity to jump-start his comedy career. While he's on the road, the sleep disorder causes a near-fatal accident, which happened to Birbiglia in real life. A dream about a missile attack caused him to jump out of a second story window of a La Quinta Inn.

"Sleepwalk With Me" succeeds as a small independent release and as an introduction to a very serious sleep disorder. The movie tastefully mixes Birbiglia's joke-laced narrative driven approach to stand-up comedy with the modest, thoughtful storytelling of This American Life. This is no surprise: the film was produced and co-written by Ira Glass, the host and creator of This American Life.

The film provides a fairly realistic view of REM sleep behavior disorder, and the dream sequences involving the disorder are especially imaginative (see below). Also novel is the method in which the film explains REM sleep behavior disorder to the audience. Without spoiling anything, it involves a cameo by Dr. William Dement, the real-life father of sleep medicine. For this reason alone, "Sleepwalk With Me" is worth viewing for anyone with an interest in sleep medicine.

As bizarre as it sounds, REM sleep behavior disorder is a real sleep disorder recognized by the International Classification of Sleep Disorders - Second Edition. People with REM sleep behavior disorder often flail, shout, punch, kick or leap as they act out their vivid dreams. The sleep disorder gets worse over time when left untreated, and injury is likely. In extreme cases, the dreamer may injure or kill themselves or a partner.

A board certified sleep physician diagnoses REM sleep behavior disorder using an overnight sleep study. The disorder is treatable with medications such as Clonazepam combined with bedroom safety precautions. Birbiglia has stated before that he confines himself in a sleeping bag while wearing mittens, so he doesn’t injure himself as he sleeps. People with REM sleep behavior disorder should also move any objects away from the bed, and block any windows.

Sleepwalk With Me opens on August 24, and is showing in a limited run at these theaters.

Thursday, August 16, 2012

Exercise may help alleviate daytime effects of sleep apnea

A daily trip to the gym can help dampen the daytime misery due to sleep apnea, new research shows. A study in the Journal of Clinical Sleep Medicine found that a 12-week exercise program helped improve daytime functioning in a small sample of adults with sleep apnea.

The study randomly assigned 43 sedentary and overweight adults with untreated sleep apnea to an aerobic and resistance training program or a low-intensity stretching routine. Subjects in the training group ran on a treadmill for about 40 minutes a day, four days a week. The group also lifted weights twice a week. The exercises were designed to work each major muscle group, and included shoulder and chest press, row, leg and bicep curls and abdominal crunches.

After 12 weeks, the group that participated in the exercise program reported improved daytime functioning. They were less sleepy, less depressed and in a better overall mood. The results are promising, but due to a relatively small sample size further research is needed on the benefits of exercise for patients with untreated sleep apnea.

Even if you don't have sleep apnea, regular exercise can boost your energy, reduce your stress and improve your mood. Exercise can also help slow or prevent health conditions such as heart disease, stroke and diabetes. Some research has also suggested that it can help you sleep better.

Image by SashaW

Wednesday, August 8, 2012

The danger of Googling for health advice

We're trained as internet users to Google (or Bing) any question we need answered. Thanks to an ever-evolving algorithm, most of the time these search engines return useful websites and information. But don't use Dr. Google to find medical advice. Medical information offered up by search engines can be inaccurate or irrelevant, a study published in the Journal of Pediatrics suggests.

A group of pediatric researchers evaluated the quality of search results related to infant safety issues. Out of 1,300 results from 13 search phrases such as "infant sleep position" and "pacifier infant", only 43.5 percent provided relevant information.

One example the researchers cited was a website that sells infant sleep consulting services that suggested that children can sleep on their stomachs after they have the ability to roll onto their bellies. The American Academy of Pediatrics cautions against this, recommending only supervised, awake stomach time for children up to one-year-old.

Consider the source when you are looking up health information on the web. Credible organizations such as health care leaders, government organization and professional medical nonprofits are more likely to provide trustworthy information than .coms hawking health products or services. There's one source that's always reliable to answer health questions: a board-certified physician. Always consult your primary care physician, rather than self-diagnose, if you think you may have a medical problem based on the signs and symptoms you read about on the web. If you suspect you may have sleep apnea or another sleep disorder, see a board-certified sleep specialist.

Below are some of the more trustworthy patient information websites:

National Institutes of Health
Centers for Disease Control and Prevention
Mayo Clinic
Yoursleep from the American Academy of Sleep Medicine

Wednesday, August 1, 2012

Short sleep reduces effectiveness of vaccines

Sleep length may affect how your body responds to vaccines, increasing your risk for illness. A study published in the August issue of the journal SLEEP found that people who had insufficient sleep were far more likely to be unprotected by a vaccine.

The study involved a sample of 125 healthy people between the ages of 40 and 60. Each subject received a three-dose hepatitis B vaccine over a six month period. Researchers measured the antibody response levels before the second and third vaccination, and six months after the final injection. During that time span, each of the participants kept a sleep diary and many of wore electronic sleep monitors as they slept.

Participants who slept fewer than six hours per night were more 11.5 times more likely to be unprotected by the hepatitis B vaccine compared to people who slept more than seven hours. The researchers found that sleep length, but not sleep quality, affected response to the vaccine.

This study adds to a growing body of research that suggests that quality of sleep has a considerable impact on your immune system. Last month, researchers in the Netherlands and the United Kingdom found that healthy young men in severely sleep-deprived circumstances had compromised blood cell counts.

Insufficient sleep is also linked to obesity, diabetes and reduced workplace productivity. The American Academy of Sleep Medicine recommends that healthy adults get 7-8 hours of sleep per night.

Image by Sanofi Pasteur