Friday, May 31, 2013

Hotels focus on giving good night's sleep

Many of you may have trouble falling asleep, at least on the first night, in a hotel. It's a phenomenon we sleep doctors call the first night effect. Typically this short term sleep problem resolves by second or third night. It's due to being unfamiliar with the sleep environment. Now, hotels are trying to improve their customers sleep. Some chains have "sleep ambassodors" whatever that means. They offer massages, aroma therapy, supplements, or wide choice of pillows. Of course, like the article points out, many of the things offered in these hotels can be done at your home. Maybe I should higher a sleep ambassador for my practice?!

Wednesday, May 29, 2013

How sleep loss may help depression

Psychiatrists know that short term sleep loss can improve mood in depressed people. In fact, in those with bipolar disorder, which used to be called manic depression, sleep loss can trigger a manic event. Sleep deprivation is not used anymore as a treatment because it's so difficult to maintain. The effect only lasts until the person sleeps.

Adenosine is the chemical that builds up in our brain the longer we stay awake. The higher the levels, the more sleepy we get. Adenosine levels rapidly diminish with sleep. Researchers think that the build up of adenosine is responsible for the mood elevating effects of sleep loss. This article discusses how researchers studied mice with depression. They gave the mice a chemical that mimics high adenosine levels. The mice slept normally but they showed improved mood and behavior.

To me this is fascinating because it points to a novel way to treat depression. I also wonder if it would be a way to help insomniacs sleep better.

Monday, May 27, 2013

Sleep loss may impact male fertility

This article discusses how sleep problems may be associated with male fertility problems. Researchers surveyed young men around 18 years old and tested a sample of their sperm. Those that had disturbed sleep (not defined in the article) or slept less than 6 hours had 29% reduced sperm concentrations. They also had reduced sperm quality and smaller testicles. What's not clear is why these men had disturbed sleep - was it from a sleep disorder or voluntary sleep deprivation? If it's the latter, than more sleep may help couples that have trouble conceiving.

Friday, May 24, 2013

Nasal allergies can contribute to sleep difficulties according to survey

This article discusses a survey showing that 59 percent of nasal allergy sufferers surveyed said they have sleep issues as a result of their allergy symptoms, but only 35% take medicine to prevent the allergy symptoms. Nasal allergies can reduce airflow through the nose, which can make snoring and sleep apnea worse. This is particularly true for children. Sometimes, I send my patients to allergists or ear / nose / throat specialists for evaluation of their nasal symptoms.

Wednesday, May 22, 2013

Weight loss in obese type 2 diabetics with obstructive sleep apnea

Obesity, type 2 diabetes, and obstructive sleep apnea (OSA) occur together commonly. Weight reduction has been shown to improve both blood sugar control and OSA severity. There is a study that looked at intensive lifestyle intervention (ILI) versus usual diabetic support (DS) in OSA severity. After one year, the ILI group had greater weight reductions and less severe OSA than the DS group. The researchers then looked at the results after 3 more years, as reported in this paper.

So after the first year, the intensive lifestyle intervention was provided on an individual basis and included one on-site visit per month. There was a second contact by telephone, regular mail, or email. At each session, participants were weighed, self-monitoring records reviewed, and a new lesson presented. The usual diabetes support group had three annual sessions, with each one focusing on diet, physical activity, and social support. Information on behavioral strategies was not presented and participants were not weighed, like in the ILI group.

Results showed that at year 4, >5 times as many participants in the ILI group had total remission of their OSA. The prevalence of severe OSA among ILI group was half that of the diabetes support group. OSA remission occurred in those with mild to moderate OSA at baseline. But in those with severe OSA at baseline, none achieved remission and few changed to mild severity. And in both groups, a similar prportion had a worsening of OSA severity at year 4. Some had mild OSA at baseline and then severe OSA at year 4! A limitation of this study is that almost 38% of participants dropped out by year 4, primarily due to not wanting to repeat PSG.

So what does all this mean? That if you have severe OSA, weight reduction alone is unlikely to get rid of the OSA. However, weight reduction alone may eliminate OSA that is mild to moderate.

Monday, May 20, 2013

Exercise and diet can prevent obstructive sleep apnea from worsening.

Here is a study about obstructive sleep apnea (OSA), exercise, and diet. As you may know, OSA is associated with obesity. Weight loss can reduce the severity, and weight gain can worsen OSA over time. This study is out of Finland. Researchers followed 81 adults with mild OSA and had some follow a diet and exercise program for one year. The others did not. After 4 more years, researchers checked their weight and OSA level. Those that did the diet and exercise program lost an average of 12 pounds. Six had OSA that progressed to moderate, but none were severe. The other group gained one pound on average over the 4 years. 12 worsened to moderate OSA and two had severe OSA.

The researchers concluded that weight loss may lessen the chance of OSA worsening. This is good, as the more severe the OSA, the higher the risk of cardiovascular consequences.

Friday, May 17, 2013

Women are more tired than men

This article discusses research from the CDC showing about 15% of women reported they are very tired or exhausted, while only 10% of men said they were. And the difference was most pronounced in younger women, ages 18 to 44. Now, the article author speculates that the tiredness is related somehow to sleep. It is a fact that women suffer from insomnia at a greater rate than men. But women could be tired for other reasons - thyroid disease, anemia, depression, all of which are more common in women too.

Wednesday, May 15, 2013

A desk you can sleep in

I loved the show Seinfeld. There was one episode, called the nap, where George had his desk remodeled so that he could take a nap in it, and not be caught. Here is an article showing a real desk that doubles as a bed. It could be used by students who need to study and nap in the same space.

Monday, May 13, 2013

How astronauts sleep in space

This is one of the coolest videos about sleep! I never even thought about how an astronaut would sleep in space. Watch the video to learn what they do.

Friday, May 10, 2013

Sleep apnea impairs driving ability

Obstructive sleep apnea (OSA) can increase sleepiness, which can impair your ability to safely drive. Here is an article about two studies showing just that. Both studies involve longer distances on a driving simulator. So keep that in mind, as driving for real may be different. People with untreated OSA were more likely to fail the simulator test than those without OSA. Also, those with untreated OSA were more likely to admit to nodding off behind the wheel than those without OSA. Neither study tested the drivers after they received OSA treatment - those studies will be interesting to see.

Whether you have OSA or not, always use precaution when driving. Do not drive if you feel sleepy. If you get sleepy while driving, pull over to a safe area and take a brief nap. Or if you are with someone else, let them drive so you can nap in the car.

Wednesday, May 8, 2013

CPAP can boost worker productivity

Obstructive sleep apnea (OSA) can reduce worker productivity if untreated. This study showed that workers that regularly used a CPAP when they slept were more productive. And productivity did not improve in those with OSA that did not use their CPAP.

Monday, May 6, 2013

Slow frequency sounds heard during sleep may improve memory

Slow wave sleep is the deepest level of sleep, occurring mostly in the first half of the night. It's called slow wave sleep because the waveforms 1-3 times per second - contrast this with non-deep sleep, where the waveforms occur 4-7 times per second. This article discusses research showing that sounds produced at the same frequency as slow wave sleep, and listened to while asleep, can enhance word associations. Sounds produced at different frequencies did not improve word associations.

The researchers also think these sounds may improve the overall quality of sleep - more studies are needed though.

Friday, May 3, 2013

Sleep duration and adolescent obesity

Another story about sleep duration and obesity. This study looked at 1390 kids from age 14 to 18 years old. They asked them to report their height, weight, number of hours they sleep per night, physical activity level, and amount of time spent in front of a screen (TV / video games / computer) every 6 months. The average amount of sleep per day was about 8 hours and this decreased to 7.5 hours by the time the kids reached age 18. When the researchers crunched the numbers, they saw that longer sleep duration was associated with a lower body mass index (BMI), a ratio of height to weight. The higher the BMI, the more overweight the kid. The association between BMI and sleep duration was stronger as the BMI increased - for each additional hour of sleep past 8 hours, the BMI was lower than the average. This means that more sleep seemed to help the most overweight kids.

From these results, the authors suggest that kids who sleep at least 10 hours per day could reduce their BMI. Interestingly, the association between BMI and sleep duration persisted even when accounting for physical activity and screen time. So even if overweight kids watch TV as much as normal weight kids, increased sleep duration may reduce obesity.

One important limitation in this study is that they did not monitor calorie consumption. So, like I've mentioned in other posts, longer sleep may be associated with less weight because of decreased calorie consumption, not from longer sleep itself.

The authors point out that telling kids to sleep more does not work. But delaying school start time in the morning may allow kids to sleep more. Also, getting all electronic devices out of the bedroom at night may increase sleep duration.

Wednesday, May 1, 2013

Overnight diet claims to lose weight in your sleep

This article is about a new diet book. Ordinarily, I don't post about diet books. This one caught my attention because of it's claim that weight loss is related to sleep. Beware, I am only giving my opinion here about the article. I haven't read the book.

The diet plan consists of 6 days of high protein meals followed by 1 day of liquid meal. Specifics are not given. The book author claims that you will lose two pounds the first night while you sleep. The author also says that you need to get enough sleep, 8 hours, because lack of sleep is what makes you hungry.

If you read the article, there is some criticism about the rapid weight loss. I agree with the statement that the 2 pounds of overnight weight loss is almost entirely water. Basically, this diet is low carb. Of course you will lose weight - but it's mostly water in the beginning. Also, sleep deprivation is not why we get hungry. It's more complicated than that.