Decreased sleep quality linked to premature skin aging

Here is an article discussing research showing that decreased sleep quality may increase risk of premature aging and decrease the skin's ability to recover from sun exposure. Sleep quality was assessed with a subjective sleep questionnaire, and it's not clear if the results were linked to decrease total sleep amount and / or reduced sleep quality. Also, I have to assume, but do not know for a fact, that the researchers controlled for other factors that affect skin like tobacco use.

Sharing hotel room with stranger to save money

This article discusses a company that attempts to pair strangers up in the same hotel room to reduce the cost of the room. This would not appeal to me, however. Being asleep means I am vulnerable, and I wouldn't be comfortable with a stranger in the room. For more secure travelers, it may be a way to save money.

Sleep duration may impact concussion test scores

In sports, concussions are a big deal. Trainers, doctors, and coaches need accurate information to determine if a player is ready to play again, or if the player needs to rest due to concussion. This study shows that sleep durations < 7 hours can worsen the tests used for concussion, even when the player has no concussion. This means that players should be getting as much sleep as possible, especially the night before the concussion testing, to make the testing as accurate at possible.

Obstructive sleep apnea and night sweats

Night sweats can be common in certain medical illness like cancer and infections. It's also common in peri-menopausal women. Night sweats can also occur with untreated obstructive sleep apnea (OSA). In my experience, this is usually from severe OSA and typically involved the shoulders, neck, and head.

Here is a case report from the Journal of Clinical Sleep Medicine that describes a patient that had severe night sweats from mild OSA. The night sweats were eliminated by use of CPAP. And this patient happened to also have a form of lymphoma, which would make most physicians think that the cancer is the cause of night sweats. The report author suggest sleep evaluation in patients with regular night sweats to look for OSA.

Sleep difficulties may increase stress in relationships

Life stresses, including relationship stress, can disturb sleep. Seems obvious. And many of my patients with chronic sleeping difficulties report irritability, and attribute that to the poor sleep. If you're more irritable, you may fight more with your spouse. Here is an article about a study confirming that.

CPAP may reduce nightmares in post tramautic stress disorder

Post traumatic stress disorder (PTSD) is becoming more frequent among our soldiers. I have had the honor of working with military personnel and their families at several bases in my career - McConnell AFB, Camp Lejune, and most recently at Fox at the Redstone Arsenal. Sleeping problems are common and many report that sleep issues worsen after returning from deployment. In particular, I hear that snoring and breathing problems tend to worsen after returning home.

This article describes an interesting finding. Soldiers diagnosed with PTSD and obstructive sleep apnea (OSA) present to my office regularly. This study showed that CPAP therapy reduces nightmare frequency in those with PTSD. It makes sense as OSA can be more severe in dream sleep. If your dream sleep is disrupted by breathing events, you may experience more dreams, as you may wake up more often in the middle of, or right after a dream. CPAP will reduce the breathing events and may let you sleep right through, so that you don't remember your dreams (and nightmares) as much. There may be other reasons that CPAP reduces dreams too. When someone stops breathing in their sleep, adrenaline surges. This adrenaline surge may increase nightmares, especially in those with PTSD. So CPAP may reduce the adrenaline surges, thereby reducing the nightmares.

Childhood sleep difficulties contribute to medical expenses

Here is an article about a study done in Australian children. The results showed that one in three children have trouble starting or staying asleep. This included infants to elementary school aged children. Of course you have to keep in mind that this is just a survey of parents observations, and it makes me wonder how difficulty sleeping was defined. What was interesting to me was how the parents tended to seek medical care, and more importantly, medications, for their kids perceived sleep problems. Although giving a child a sleep aid seems easy, it doesn't teach them how to sleep on their own. Good sleep tips are provided at the end of the article.

Cognitive behavioral therapy for insomnia in fibromyalgia

Cognitive behavioral therapy (CBT) is a type of psychotherapy used to treat insomnia. I use it in my practice almost daily. Here is an article about a study of CBT vs sleep hygiene education in patients with fibromyalgia. The results showed that sleep hygiene education did improve subjective sleep quality, but that was it. CBT improved several sleep variables, fatigue, daily functioning, pain catastrophizing, anxiety and depression.

Electronic devices can disrupt sleeping

Here is another article discussing research that shows that the electronic devices that you use in your bed can disrupt your sleep. Even though the screen is not very bright, it still disrupts secretion of melatonin, the hormone normally released to let your brain know it's time to sleep. Also, the devices tend to be stimulating and may increase alertness, rather than allowing you to relax and get sleepy. Finally, the devices strengthen the association of being awake in your bed. This by itself can fuel insomnia. You should only use your bed for sleep only.

Don't use these devices in your bed. You can use them on the couch in the living room - just get a blue light filter or use a blue light blocking program like f.lux.

Sleep deprivation and anxiety disorders

This article describes research that shows that sleep deprivation fires up areas of the brain associated with emotional processing. This pattern is similar to the abnormal neural activity seen in anxiety disorders. The authors conclude that sleep disruption may be a key factor in anxiety disorders. Maybe. But I'm not sure you can make that statement based on the experiment. The researchers took young healthy people with no anxiety or insomnia disorders and subjected them to images after a night of good sleep and then a sleepless night. But applying the results from these healthy subjects may not be realistic for people with anxiety disorders. The authors also suggest that fixing sleep problems in anxious people may improve their anxiety condition. Perhaps, but usually if what they worry about is related to not sleeping well. I'm not yet convinced that helping people sleep better will eradicate a generalized anxiety disorder, panic disorder, obsessive compulsive disorder, or post-traumatic stress disorder. It is true that many anxiety disorders are associated with difficulty sleeping. However, the difficulty sleeping could be just an effect of the anxiety disorder. Fixing the sleep problem is less likely to help the anxiety disorder. I base this on my own experience with patients with insomnia. Some have anxiety disorders too. When I help them sleep better, their anxiety disorder does not necessarily get better. They worry less about not sleeping, but the other parts of the anxiety disorder remain.

CPAP therapy for obstructive sleep apnea may improve migraines

I often get referrals from headache specialists because they know that sleep disorders and headaches often exist together. In particular, obstructive sleep apnea (OSA) has been associated with headache upon awakening. But any sleep disorder that breaks up sleep could increase risk of regular headaches. This article describes a study showing that CPAP use may improve migraines. In particular, regular CPAP use for OSA decreased the frequency of migraine attacks, their duration, and intensity. CPAP also lowered medication use and lost days from work.

Restless legs syndrome and mortality rate

This study is getting alot of press, so thought I would post it. It is about restless legs syndrome (RLS). RLS is a neurological sleep disorder that causes uncomfortable sensations in the legs at night. It makes you want to move your legs to relieve the sensation. This study showed that men with RLS have a higher chance of dying than those without RLS. I don't have access to the full study in the Neurology Journal, so some details can not be provided. It's not clear how RLS increases mortality rate. However, RLS is often present along with obstructive sleep apnea (OSA), and OSA is known to increase mortality rate. The study authors asked patients if they have OSA, but most won't know if they have OSA unless they have a sleep study. So many of these men could have had undiagnosed OSA and RLS - but the OSA would be the factor in the increased mortality rate, not the RLS.

Obstructive sleep apnea increases risk of sudden cardiac death

Here is a study that offers more support for what we sleep physicians already knew - that moderate or severe obstructive sleep apnea (OSA) can increase risk of sudden cardiac death. The study found this association to be especially true if the OSA resulted in deep oxygen level dropoffs. It makes sense to talk to your doctor about getting tested for OSA, especially if you have existing heart disease.

Diabetics and those with high blood pressure should be tested for obstructive sleep apnea

Here is an article from the annual sleep meeting last week. The American Academy of Sleep Medicine recommends evaluation for patients with high blood pressure and type 2 diabetes, since they are at increased risk of having obstructive sleep apnea.