Blinking rate can help determine sleepiness level

People's pupil response has been used to objectively measure sleepiness, but I don't think the research is conclusive. Here is an article discussing research showing that measuring blink rate in addition to pupil response can be a better measure of sleepiness.

Sleep and memories

This article discusses research about how our brain processes memory while asleep, even during anesthesia. This is new information and goes against how sleep researchers thought the process worked.

Melatonin may improve sleep in patients taking beta-blockers

Beta blockers are a class of high blood pressure medications that have been around for decades. It is well known that beta blockers can disrupt sleep, possibly contribute to nightmares, and cause daytime fatigue. Beta blockers (along with non-steroidal anti-inflammatory medications) can reduce melatonin secretion, the hormone that is produced at night to help us sleep.

In the October edition of the Journal Sleep is a study about melatonin use in patients with high blood pressure on chronic beta blocker use. This study was a randomized, placebo controlled double blinded assessment. Patients' sleep was measured objectively in a sleep lab and at home for 3 weeks wtih actigraphy. Results showed statistically significant improvement in total sleep time, sleep efficiency, and onset to sleep with the melatonin in the sleep lab and at home. There was no sign of tolerance or side effects to the melatonin, or rebound sleep problems after stopping the melatonin.

These results are promising, as many patients need to take beta blockers for their long term cardiovascular health. Since this study was only three weeks long, we don't know the long term effects of melatonin use, so caution is warranted. Also, getting quality is difficult, since the FDA does not regulate the production of melatonin.

Removing tonsils and adenoids improves obstructive sleep apnea and bed-wetting

This article discusses research showing that removing tonsils and adenoids in children can resolve obstructive sleep apnea (OSA) and bed-wetting.

Insomnia can affect relationships

Here is an article about research on effects of insomnia... "The research showed people with insomnia were four times as likely to have relationship problems, three times as likely to feel depressed and three times as likely to suffer from a lack of concentration."

I believe it, as chronic insomnia, can be an all consuming problem. The insomniac may not be able to focus on anything or anyone else but their sleeping difficulties. I don't think this is a problem unique to insomniacs, however, but would be seen in any number of chronic medical illnesses.

Insomnia and workplace accidents

This article discusses research about insomnia and work place accidents. Since I don't have access to the article, I have to go on what the article say, and this is confusing. I'm confused because the author describes the condition as sleep loss and insomnia at the same time. People with insomnia are generally not sleepy - they may be fatigued, but don't doze off. That's why we say they have insomnia - they can't fall asleep (or fall back asleep after waking up). Insomniacs want to sleep more, but can't. This condition is very different from those that can sleep fine, but choose not to sleep enough. Those folks will be sleepy at work, but it's from sleep deprivation. Also, people with other sleep disorders, like obstructive sleep apnea (OSA) can have insomnia and sleepiness from the OSA.

I agree with the authors conclusion that sleep aids are not the best treatment for many with chronic insomnia - cognitive behavioral therapy is a better option. I also agree with screening workers for sleep disorders - but doing that is challenging and would probably be a topic for another post.

Benzodiazepines and dementai

This article discusses a research study showing that older adults who take certain medications called benzodiazepines (like Valium) are at increased risk of developing dementia. Benzodiazepines are often used for the treatment of sleep difficulties. However, the researchers did not assess for sleep problems in these patients. Obstructive sleep apnea (OSA) can cause sleep problems and could impact memory. Therefore, the benzodiazepines could be linked to dementia because the patients were taking them for the OSA. Thus, we need more studies to determine if there is a true link between these medications and cognitive disorders.

Sleepiness predictive of cognitive decline in the elderly

This article from the Sleep Journal discusses a study to see if sleep complaints are associated with declining memory in the elderly. Researchers asked older participants how they slept, if they were sleepy in the daytime, and what medications they took, and followed them over an 8 year period.

Results showed that there was a positive association between self-reported sleepiness and memory decline. This was the case even after adjustment for the study center location, gender, age, educational level, baseline memory, insomnia severity, and prescribed sleep medicine.

The authors speculate that excess sleepiness may result from early stage brain lesions in those with cognitive decline. They also mentioned that obstructive sleep apnea (OSA) may contribute. The authors did not perform sleep studies, so some of the participants could be sleepy solely from untreated OSA.

More on sleep loss and bone health

This article discusses research showing that sleep deprivation in rats resulted in weakened bones. This finding could hold true for humans, meaning that sleep loss could contribute to osteoporosis.

Sleep problems in young adulthood and Alzheimer's Disease

This article discusses research in mice showing a potential link between sleep problems in young adulthood and development of Alzheimer's Disease later in life.

Obstructive sleep apnea and pregnancy

This article discusses research about obstructive sleep apnea (OSA) and pregnancy. Pregnant women have a higher chance of developing pre-eclampsia, a condition that leads to protein loss in the urine and high blood pressure in pregnancy. OSA also increases the risk that the newborn will require neonatal care in an ICU. Screening for OSA when pregnant may help prevent some of these problems.

Poors sleep quality linked to high blood pressure

This article discusses research demonstrating a link between self-reported poor sleep quality and resistant high blood pressure (HTN) in women. The artcle does not discuss possible causes. I think the common factor may be obstructive sleep apnea (OSA), which is a known cause of poor sleep quality and is linked to HTN. Because the research did not ask about OSA, I would guess that many of the women have that condition. Since OSA is treatable, and a reversible contributor to HTN, men and women should talk to their doctor about poor sleep quality.

Sleep loss affects bone health

This article discusses research showing that sleep loss can affect bone health, including changes to bone marrow in animals. If the results are also true for humans, than it supports studies showing sleep loss increases inflammation and possibly artery clogging.

Snoring and obstructive sleep apnea severity

Most people with obstructive sleep apnea (OSA) snore regularly. But not all snorers have OSA. And screening those individuals is tough. In the Sleep Journal, researchers studied the acoustical properties of snorers, to see if they could predict sleep apnea severity. They used a microphone that was placed near the patient and used sophisticated software to analyze the signals. They then compared the snoring qualities to actual sleep study results and found that they could predict OSA severity based on those snoring acoustics. The authors suggest that this method could be used as a screening tool to help distinguish those that snore with from those without OSA.

Obstructive sleep apnea did not statistically improve with weight loss surgery

Interesting study showing that weight loss from weight loss surgery did not significantly improve obstructive sleep apnea (OSA) severity compared to those on a standard weight loss program. The surgery patients lost more weight and had a greater reduction in OSA severity. But statistically, it was not different. I am not so sure about these results. It seems like the study was underpowered to show a significant effect. My experience is that weight reduction can reduce OSA significantly. I agree that these patients should not assume their OSA is improved just because they have lost weight. It is better to have a repeat sleep study to see if they still have OSA.

Women and men and their pets

Not sure why I am posting this other than to mix up the topics a little. Apparently, this survey showed that women are more likely to sleep in bed with their pets compared to men. Not really surprising though.

Restless legs syndrome and heart disease

This link discusses research showing a potential link between restless legs syndrome (RLS) and heart disease. This was based on an observational study in thousands of women. The results showed that heart disease was twice as likely in those with RLS than in those without. This does not mean that RLS causes heart disease, only that the two conditions are related somehow. It could be that some of these women also have other conditions, like obstructive sleep apnea, that increases risk of heart disease.

Sleepiness in third trimester common, but may signal underlying obstructive sleep apnea

This article discusses research showing that sleepiness during the third trimester is common, but may not be normal. Some of the sleepiness could be due obstructive sleep apnea (OSA). The authors conclude that screening for sleep related breathing disorders should be done in pregnant women, and I agree. Especially if a pregnant woman has known OSA but is not using CPAP. Untreated OSA can increase risk for a small baby, called intrauterine growth retardation.

Smoking associated with disturbed sleep.

Here is a link to an article about a study showing how smoking is linked to reduced sleep amounts and more disturbed sleep compared to non-smokers. It could be the nicotine, but also other factors could disrupt sleep.

Asthma linked to daytime tiredness in children

This article discusses research showing that kids with asthma may be more sleepy during the day. However, the results showed that the asthma does not affect sleep quality, sleep duration, or bedtime. The researchers are not sure why asthma is linked to feeling tired in the daytime. It may be due to increased work of breathing at night, but this may not be reported by parents - just experienced by the child. More research is needed to determine if better control of the asthma results in less daytime tiredness.

Puberty and deep sleep

This article discusses research showing that deep sleep is necessary for adequate hormone levels in puberty. Insufficient or disturbed sleep may impact development by interfering with this process. So make sure your tweener is getting enough sleep - adequate sleep is competing these days with screen time from iPads. iPhones, etc.

Snoring not associated with increased mortality, cardiovascular disease, or stroke

As I have mentioned before, snoring has been implicated in cartoid artery blockages in animals, but not in humans. Obstructive sleep apnea (OSA), however, has been associated with cardiovascular disease and strokes. Here is a study from the Sleep Journal about snoring in humans. Researchers studied 380 subjects by having them undergo a home sleep study to assess snoring and OSA. The subjects were then followed for 17 years and their mortality information, cardiovascular disease incidence, and stroke incidence were recorded.

The results showed no association between snoring and mortality, cardiovascular disease, or strokes, when controlling for OSA and other factors. The results help us appreciate the importance of sleep studies, as they allow us sleep physicians to distinguish snoring from OSA.

Sleeping pills do not always work for insomnia

This article discusses a survey done in the UK showing that 4 out of 10 people said sleeping pills do not help their insomnia.

Crying to sleep safe for babies emotional health in the long term

This article discusses research showing that modern day approaches to helping your infant to sleep on their own, do not cause long lasting emotional or physical problems. The methods monitored were controlled comforting, where the parent(s) gradually lengthen the time interval to respond to baby's crying, and camping out in the bedroom.

Insomnia may be genetic

This article discusses how sleep research is beginning to demonstrate a genetic component to some insomnia. This really isn't brand new, as we always knew that only some people are prone to insomnia. However, it may one day help in treating this disorder. And it give some hope to insomnia suffers by quoting Dr. Espie, an insomnia expert across the pond. He mentions that psychological treatment for insomnia, even "genetic" insomnia is effective - I agree. If you're struggling with insomnia, find a sleep clinic that does cognitive behavioral therapy for insomnia.

Sleepwalking can continue into adulthood

Many children sleepwalk and in most cases, this is normal and they will outgrow this. This article discusses how sleepwalking can continue into adulthood, and is more common than we used to think.

Acupuncture may increase deep sleep

This article discusses research showing that acupuncture may increase deep sleep. I have heard from some patients and friends anecdotally, acupuncture has helped their insomnia.

Obstructive sleep apnea increases cardiovascular mortality in the elderly

Obstructive sleep apnea (OSA) has been shown to increase risk of cardiovascular disease and mortality, and CPAP has been shown to reduce that risk. Studies have focused mainly on younger or middle age patients. This study discusses research showing similar results in elderly patients.

Nighttime eating and restless legs syndrome

Over the past few years, nighttime eating has been studied more. We are only beginning to understand this problem. It's been in the news some since there have been cases of patients eating in their sleep while taking certain sleep aids. There is a good article in the August edition of the Journal of Clinical Sleep Medicine that reviews nighttime eating and its association to restless legs syndrome RLS).

In summary, the study authors explain that nighttime eating is common among RLS patients. In some cases, sleep aids contributed to the nighttime eating. Medications used to treat RLS may improve the nighttime eating as well. Finally, in patients with insomnia but without RLS typically do not have nighttime eating while taking sleep aids. Therefore, the authors concluded that there is something about RLS that triggers the nighttime eating in patients taking sleep aids.