Babies sleeping position

Research shows that putting your baby to sleep on their back reduces the risk of SIDS, or sudden infant death syndrome. This article discusses a study showing that only 77% of moms have their baby sleep on their back. This is despite a 23 year ongoing campaign to educate parents about safe sleeping positions.

Exercise and sleep

Regular exercise has been shown to improve sleep quality. This article discusses that research in the past decade has confirmed that. However, I'm unsure of some of the statements in this article. Specifically, how taking sleeping pills is as dangerous as smoking a pack of cigarettes per day. No studies are cited, which makes it difficult to assess the accuracy of such statements.

Sleep deprivation overview

This link about sleep deprivation is informative and worth a look. It won't tell you how much sleep you need. Given that sleep deprivation is a common problem, getting more sleep may help.

Sleep apnea and pregnancy complications

Pregnancy is a time of rapid change in women's bodies. Sleep apnea can be more common due to weight gain and fluid retention (Restless legs syndrome is also more common - but that is for a separate post). This article discusses research presented at the American Thoracic Society's 2017 International conference. I did not attend this meeting. Researchers studied > 1.5 million pregnant women with a history of sleep apnea. The results showed that in women with obstructive sleep apnea there was a greater risk of serious pregnancy complications, longer hospital stays, and admission to the intensive care unit than mothers without the condition. However, treatment of sleep apnea was not determined, so it's not known if that would reduce the risk.

Sleep quality and Alzheimer disease

Patients with Alzheimer's disease often have poor nocturnal sleep quality and daytime sleepiness. In fact, the sleep difficulties at night are a common reason that Alzheimer sufferers are put in nursing homes. Caregivers are unable to stay up at night to ensure their loved one's safety, and then function in the daytime. This study showed that there is a relationship between individuals' sleep quality and Alzheimer disease markers in spinal fluid. I don't full access to the article, so can only comment on the abstract.

This study has some limitations. Participants sleep quality was assessed only via questionnaire, not by objective sleep testing. So it's unclear what is contributing to the reduced sleep quality. Also, the participants were already at risk for Alzheimer disease, having a family history of it. From this study, we can't conclude that poor sleep quality leads to Alzheimer disease. And it's not clear if improving sleep quality would lead to a decrease in the biomarkers for Alzheimer disease.

"Hacking" your sleep

Yet another article discussing sleep hygiene, but changing the verbiage to make it seem like new information. Using the word "hacks" makes it sound like you can break the sleep "code" and improve sleep quality. Almost all of the items listed are part of good sleep hygiene, and have been around for decades. With that said, I actually think this article is really good, providing useful information in a succinct format that may steer individuals in the right direction to better sleep.

Yoga for sleep

Individuals with insomnia are seeking natural remedies to improve sleep. This article is written by a yoga instructor, as she makes some interesting claims. First, she writes that "sleeplessness" is linked to all sorts of health problems. I wonder if she is confusing sleep deprivation with insomnia. Insomnia, when diagnosed by a doctor, has not been definitively linked to all of the health problems she lists. Sleep deprivation has been studied and data links it to some of the health conditions listed. Sleep deprivation is not the same as insomnia.

Then she writes about her treatment plan for insomnia, which includes yoga poses and breathing. However, no links to studies showing this helps is provided. The one aspect that may help is counting backwards, as this technique may distract individuals from their own thoughts when in bed attempting to fall asleep. The most helpful way to improve insomnia is with a form of psychotherapy, called cognitive behavioral therapy for insomnia (CBT-I).

Carrie Fisher and sleep apnea

I've seen a few articles now on the suspected cause(s) of Carrie Fisher's death (the actress who played Princess Leia). I was hesitant to blog about it, but thought I should as the articles are mentioning sleep apnea. Apparently, the autopsy report did list sleep apnea as a potential contributor. The article I am referencing does a good job explaining what sleep apnea is, the different types, the consequences of untreated sleep apnea and how certain drugs / medications can worsen sleep apnea. I agree with the bottom line that the chance of dying from sleep apnea is low, but gets higher with untreated sleep apnea and drug use.

Improving sleep in children

Normally, articles like this don't impress me. At least the ones written to help adults sleep. But this one for kids is packed full of great advice to help kids sleep better. It's not as applicable for infants...more for toddlers and older children / adolescents.

Sleep apnea and insomnia on the rise in the US Military

This article shows how both sleep apnea and insomnia diagnoses have increased from 2005 - 2014. In my clinic, both conditions make up the bulk of the diagnoses and often exist together. The article states how the rates are higher in more senior personnel. This may be because sleep apnea is more prevalent with advancing age. Also, I frequently see senior personnel who are close to retiring, and have decided to start taking care of themselves. Usually it's because they finally have time to get their medical problems addressed as they approach separating from the military. Some of them wish they had gotten evaluated years prior, as treating their sleep apnea can significantly improve their quality of life.

Float therapy?

I've never heard of float therapy until I saw this article. Apparently, some derive benefit from floating in body temperature, salty water that is inside a sound-proof vessel. The article mentions that "float therapy" may help some with insomnia. I'm not aware of any studies to that effect - the report is only anecdotal. The article states that one reason it may help people sleep could be the same reason why a warm bath is helpful. I just hope people don't fall asleep while in the float chamber.

Netflix vs sleep

This article discusses how the CEO of Netflix doesn't worry about competition from streaming services like Amazon or HBO. Instead, the CEO worries about the human need to sleep a third of our lives. Because when we sleep, we aren't able to watch Netflix. What an interesting perspective. As a sleep-deprived species, I worry about the effect of Netflix on sleep duration! I guess the relationship is bidirectional.

Shutter Island

When I see a child that is having nightmares, I explain to the parents that they shouldn't let the child watch potentially frightening shows or movies close to bedtime. I should have taken my own advice when I recently watched the movie Shutter Island, starring Leonardo DiCaprio. I watched the movie right before I went to sleep, which was a mistake. On that night, my wife and kids were out of the house, so I was home alone. I fell asleep OK, but kept waking with nightmares related to what had happened in the movie. So I guess my advice to parents should be broadened to adults as well.

Obstructive sleep apnea, CPAP therapy, and diabetes

This study involved a large population of veterans diagnosed with obstructive sleep apnea (OSA). The study authors examined CPAP therapy usage and its effect on diabetes. The results showed that metabolic markers of diabetes were reduced in those patients that used the CPAP the most per night. Specifically, usage of at least 6 hours per night. The reduction in diabetes markers was not present in those with less nightly CPAP usage. Also, the risk of developing diabetes was reduced by those that used CPAP at least 6 hours per night. Finally, both of these findings were not influenced by the slight increase in weight observed during the follow up period measured.

CPAP may improve PTSD in Veterans with sleep apnea

This article discusses research about post-traumatic stress disorder (PTSD) and obstructive sleep apnea (OSA). There have been research studies linking PTSD and OSA, possibly because of OSA-related sleep disruption. In particular, OSA can be more frequent in dream sleep, resulting in more dream sleep fragmentation. This could cause more nightmares, or at possibly more awareness of nightmares. In this study, the authors sought to determine if CPAP therapy for OSA also reduced PTSD severity in US Veterans.

The results showed a modest reduction in PTSD symptoms in patients with OSA treated with CPAP for 6 months. And the more nights someone used their CPAP, the less severe the PTSD symptoms. There were also improvements in sleep quality, daytime functioning, and quality of life.

Wearable sleep-tracking devices and apps

This article points out a trend I've seen in my practice with some of my patients. Patient, typically with insomnia, describe their sleep quality based on what their FitBit watch tells them, rather than on their own perception of their sleep quality. The problem with these wearable sleep-tracking devices is that they are not very accurate at measuring sleep - they only record movements. Those movements could be from the patient, their bedpartner, or a pet in the bed.

The article highlights 3 separate patients who put more trust in their sleep-tracking device rather than on more accurate diagnostic tools (like sleep studies) and the sleep therapist who was using validated treatments like cognitive-behavioral therapy for insomnia (CBT-I). The study authors are concerned that these sleep-tracking devices are interfering with CBT-I, reinforcing sleep-related anxiety or perfectionism for some patients. For example, they explained how all three patients were spending excessive time in bed in an attempt to increase sleep duration as measured by their sleep-tracking device. But spending excess time in bed is one of the behaviors that worsens insomnia.

The authors explained what they tell their patients about the sleep tracking devices - that the trackers measure movement and not brainwaves. Therefore, these devices cannot determine light from deep sleep. They explain that the best use of these devices is probably to monitor their sleep patterns, including how much time they are spending in bed, rather than the number of minutes spent awake or asleep.

Living with children may mean less sleep for women

This article discusses research presented at a the annual meeting of the American Academy of Neurology - I didn't attend this meeting. The article surveyed men and women about sleep duration and level of daytime tiredness. Researchers looked at age, race, education, marital status, number of children in the household, income, body mass index, exercise, employment, and snoring as possible factors linked to sleep deprivation. Results showed that living with children was associated with more sleep deprivation in women, but not with men. Also living with children resulted in women feeling more tired in the daytime. One thing not stated was how old the children are in these households. I would imagine that sleep deprivation and daytime tiredness would increase with younger children.

Obstructive sleep apnea without obesity

Obstructive sleep apnea (OSA) is more common in obese individuals. Less is known about OSA in non-obese persons. This study looked at characteristics of OSA in non-obese people and compared them to OSA in obese people. In the introduction, the authors mention that non-obese individuals make up at least 20% of the adult OSA population. The authors also discussed that one reason non-obese people may have OSA is due to a low respiratory arousal threshold. This means that non-obese people may wake up more easily when their breathing tube collapses. In the study, the authors used information from sleep studies to estimate respiratory arousal threshold. The results showed that 25% of their patients were non-obese. And a higher proportion of non-obese patients had a low respiratory arousal threshold. Also CPAP usage was less in non-obese patients than obese patients. The authors concluded that non-obese patients may respond less to conventional OSA therapies (like CPAP) and that research is needed to discover alternative ways of treating OSA in non-obese patients.