One in 24 people report drowsy driving

This link describes research showing that 1 in 24 people report driving while drowsy. Insufficient sleep and sleep disorders like obstructive sleep apnea are to blame. Drowsy driving was more common in young and older drivers. I imagine the younger ones were sleepy from too little sleep and the older ones from sleep disorders and perhaps sedating medications.

This study highlights the importance of safe driving. Don't drive if you feel drowsy. If you get sleepy while driving, pull over and take a brief nap. Or if your traveling with another person, switch drivers.

Sleeping positions

Here is an article from the Wall Street Journal about sleep positions. There is a part about obstructive sleep apnea and one of the sleep doctors recommends sewing a tennis ball into the back of your pajama shirt to keep from sleeping on your back. That may work, but it may be easier to put pillows behind you to keep you sleeping on your sides.

TV before bedtime can reduce kids sleep duration

This article discusses research showing that increased TV time before bed can reduce total amount of sleep time in children. The study is based on a survey, so has biases but still points to some commonsense things parents need to remember about their children's bedtime rituals. Limiting screen time, especially around bedtime can help kids sleep better and longer. It's not just the content of the TV program that is the problem, but just the light from the screen itself can suppress melatonin.

Insomnia subtype affects daytime functioning

This article discusses research about insomnia. It follows revision of the mental health classification manual (DSM-V) that emphasizes insomnia as a disorder, rather than as a symptom of another mental, medical, or sleep disorder. Researchers surveyed people with insomnia. Results showed that in those with the most sleep disruption - both onset and maintenance problems, coexisting mental health problems, and if it started in childhood, have the most daytime impact. This makes sense to me and fits what I see in my chronic insomnia patients.

FDA recommends lower dose of Ambien for women

This article discusses recent news release that the FDA is lowering its recommended dosage of Zolpidem in women. Zolpidem is active ingredient in Ambien. FDA says women can not metabolize the medicine at full strength quick enough, and still have high levels in their bloodstream when waking in the morning. This could lead to motor vehicle accidents. The FDA is not saying women on full strength Ambien have to have their dose reduced, or that women will not be allowed to take full strength. Just that these patients on Ambien should give themselves plenty of time in bed so that the medicine is fully metabolized and they are safe to drive.

Sleep problems common on simulated space mission

Here is an article about an experiment done to simulate space travel. Astronauts were confined to a pressurized spacecraft in Moscow for 520 days straight. Their sleep was monitored with an actigraph, a type of accelerometer. After a month, some of the crew members began to have sleep problems. It seems that one of the issues is that the low light levels on the spacecraft are not strong enough to simulate the day-night cycle we experience daily. Since our brain's clock depends on light to keep our rhythms regular, exposure to stronger light sources on the spaceship may help in actual space flight.

Pre-eclampsia, fetal activity levels, sleep-disordered breathing, and CPAP

Pre-eclampsia occurs high blood pressure and protein in the urine develops in a woman at least 20 weeks pregnant. It is associated with maternal death and fetal growth restriction. Some studies have shown an association of sleep disordered breathing (SDB), like obstructive sleep apnea (OSA), with pregnancy-induced high blood pressure. Pre-eclampsia goes away with delivery. However, if it's too early, delivery is delayed as long as possible.

Fetal movements are a normal part of pregnancy. Frequent movements are good, lack of movements is bad. In the Journal Sleep is a study where researchers quantified fetal movements in pregant patients with and without pre-eclampsia. They then did sleep studies on those with moderate to severe pre-eclampsia and observed some of them on CPAP for one night.

The results showed that pre-eclampsi reduced fetal movements. CPAP also raised fetal activity in women with pre-eclampsia, even thought the pre-eclampsia did not go away. The results are a little hard to interpret, because both pre-eclamptic and control patients had OSA based on the charts in the study, and the controls did not receive CPAP.

But if the results hold up in larger, better defined studies, treating women with pre-eclampsia with CPAP if they have sleep disordered breathing may allow obstetricians to delay delivery until a safer time.

Effectiveness of insomnia medications

Newer insomnia drugs include Ambien, Lunesta, and Sonata. These are similar, but chemically different than older sleep aids like Valium or Restoril. Here is an article that summarized 13 clinical trials of the newer insomnia drugs as submitted to the FDA. All of these trials were placebo-controlled. The trials involved sleep studies and subjective ratings by the trial participants.

The results showed significant reductions in time to fall asleep in both the drugs and the placebo, but the drugs did reduce time to fall asleep more than the placebo. However, the difference is small and clinical significance is not known. As documented on the sleep study, it took participants 22 minutes longer to fall asleep in the placebo group. As per subjective rating, participants felt it took them 7 minutes longer to fall asleep on placebo than on the drug.

The study authors concluded from their analysis that the placebo response is a major contributor to the effectiveness of these newer sleep medications. In other words, these new drugs work because participants think they are taking a medication for sleep, not necessarily because the medicine actually makes them sleep better.

Asthma linked to insomnia

This article is about research showing asthmatics have a higher rate of insomnia. And the worse the asthma, the more frequent the insomnia. Also, nasal congestion along with asthma increased risk of insomnia. This study was only a survey, but a large one. However, other sleep disorders could contribute to insomnia in asthmatics, such as obstructive sleep apnea. Some asthma medications can also reduce sleep quality.

More research linking obesity to sleep deprivation

Here is an article that reviews a paper that summarizes research studies done on obesity and sleep deprivation over the past 15 years. The study authors concluded that partial sleep deprivation, defined as sleeping less than 6 hours per night can contribute to weight gain. It could be that sleep loss affect certain hormones that can regulate appetite. I'm still not convinced that if Americans slept longer, the pounds would drop off - that's too easy. To me, diet is so much more important than sleep quantity for controlling obesity.

More sleep at night can reduce sports-related injuries in teens

Here is an article about research showing that adolescents were less likely to get injured while playing sports if they got at least 8 hours of sleep.

Vitamin D deficiency and daytime sleepiness

In the last few years, it seems that vitamin D deficiency was present in many patients I saw in clinic. Vitamin D deficiency has been found to be associated with chronic pain conditions like fibromyalgia. Vitamin D deficiency is also associated with fatigue and sleepiness. Dr. McCarty et al at LSU did a study looking at vitamin D levels and subjective sleepiness in patients referred to his sleep clinic. Interestingly, the results showed that vitamin D deficiency was associated with more subjective sleepiness, but only in black patients. The same effect was not seen in white patients. The author did not have an explanation for the racial differences. It could be that the black patients in this study had more obstructive sleep apnea - this sleep disorder was not measured during this study.

Ten percent of young children have sleep-disordered breathing

This article describes a Finnish study that demonstrates that one in ten children, aged 6-8 years old, have sleep-disordered breathing. Hopefully, the word is getting out to parents and pediatricians to increase screening, especially by asking about snoring.