Unemployed may have trouble sleeping

Here is an article about a survey done at Consumer Reports about how unemployed people expressed more trouble staying asleep. Work-place stresses were a common reason for not sleeping well. A significant part of the article was dedicated to getting a new mattress. While this may improve some people's sleep, I would caution that some insomnia symptoms could be from other sleep disorders, like obstructive sleep apnea - and a new mattress most likely would not help that.

Provigil in the news

ABC News recently did a story about off-label use of Provigil, a stimulant that is approved by the FDA to improve sleepiness in narcolepsy, obstructive sleep apnea, and shift work disorder. Apparently, there is an increasing number of Americans who are taking Provigil, and the article implies that it is being taking for off-label reasons - to improve focus and daytime energy. The article talks about a few people, most of who remain anonymous. They all tout the benefits of taking Provigil. It's not stated whether these individuals have been diagnosed with a sleep disorder or if they received their prescriptions from their doctor or online.

ABC News did an "experiment" on one person - a software company CEO who takes Provigil daily. They had him stop the Provigil for 3 days. He noticed a "very slight" change in his own speech, whatever that means. They had him do cognitive tests off the Provigil. The next day, he took the Provigil, and reports feeling more alert in 17 minutes. This is implausible, as it most likely had not even been absorbed into his bloodstream yet - this makes me think there is a significant placebo effect at work here. After he took the Provigil, he repeated the same cognitive tests and reportedly did much better. ABC News implies the Provigil is what helped - but could he have done better just because he was repeating tests he had taken the day before? In other words, he may have improved due to learning what to expect from the test, not from taking Provigil.

Taking Provigil off-label could be dangerous. Recently, a life-threatening rash has been reported in some taking Provigil. Not discussed in the article is that Provigil, and it's new brother Nuvigil, may reduce the effectiveness of oral contraceptives, making unwanted pregnancy more likely. Finally, the article mentions that there are no studies showing that performance improves with Provigil. In fact, if you take Provigil to offset sleep deprivation, there is a good chance that you will not gain much, as sleep loss itself reduces performance. I wonder how much placebo effect the people in the article are receiving, as they all think they are taking "Viagra for the brain" as stated in the article.

Instead of taking Provigil to give yourself a theoretical edge, it would be better to eat right, exercise daily, get enough sleep, and prepare better for whatever life brings your way.

Acute sleep deprivation can affect immune system

Studies have shown sleep loss could affect the immune system - it can weaken some aspects of it that fight pathogens, and possibly strengthen another part that may attack our own tissues. A study was published in the July edition of the Sleep Journal by Dr. Ackermann and others about sleep loss and the immune system. They studies healthy, young males in the sleep lab for 3 days straight. The first night was an adjustment night, the second night was an 8 hour sleep opportunity, and the participants were kept awake for the entire time during the third night. Blood was drawn every three hours during the study.

The results showed that there was an overall increase in circulating granulocytes (a type of immune cell involved in fighting bacteria) in the blood after the acute sleep deprivation night. The study authors suggest that the increase in circulating granulocytes is a response to the stress of acute sleep deprivation. The health consequence of this are not yet known. However, there is evidence that increased granulocytes are associated with cardiovascular disease. This could provide the missing link between studies showing an association between sleep deprivation and cardiovascular disease. It's not known whether the granulocyte concentration would remain elevated or even be elevated with chronic partial sleep deprivation, versus a night of total sleep deprivation as in this study. It is possible that over the long term, the immune system compensates for chronic partial sleep loss. Apparently this compensatory effect has been demonstrated in long term shift workers.

Obstructive sleep apnea slightly worse in winter months

This article discusses research done in Brazil that showed a small worsening in obstructive sleep apnea during winter months versus summer months. Researchers are not sure why, but speculate that it could be due to more frequent upper airway infections or wood burning stoves during winter months. Also, some patients may be more inclined to seek treatment in the winter months as opposed to the summer months.

REM sleep behavior disorder risk factors

This blogpost from the Huffpo discusses research findings about REM sleep behavioral disorder (RBD). RBD is a form of sleepwalking where patients act out the content of the dreams they have at night - see my prior post about it. We don't know why RBD occurs, but it is most common in older men and is often associated with Parkinson's Disease. This study showed that people who smoke, have a head injury, or exposed to pesticides are at increased risk of developing RBD.

Risk of obstructive sleep apnea in wind musicians

I remember reading an article demonstrating that playing the didgeridoo, an Australian wind instrument (see this Youtube clip), could improve mild obstructive sleep apnea (OSA). More recently, a study came out showing that speech therapy may also improve OSA. These studies suggest that altering upper airway muscle tone may reduced OSA severity.

Last month's Journal of Clinical Sleep Medicine had an article about musicians and OSA. Dr. Ward and others surveyed musicians if they have OSA. The results showed that those musicians that played double reed wood instruments like the oboe, bassoon, and English horn, had a significantly lower risk of having OSA compared to those playing non-wind instruments.

The researchers theorize that plying specific wind instruments may improve upper airway musculature enough to reduce OSA - due to the way the musician has to purse their lips and make a buzzing sound into the double reed. Before you pick up a bassoon though, realize that the musicians surveyed were professionals, playing on average 16.5 hours per week. Apparently, double reed instruments are also notoriously difficult to learn to play properly. Using a CPAP at night while asleep sounds much easier to me!

Learned skills may be enhanced with sleep

Here is an article, representative of several I saw about new research about sleep and memories. The article titles imply you can learn things while asleep. But that is not what the research showed. In this study, participants learned to play two different tunes on a keyboard. Researchers played one of the tunes while participants slept and concluded that the participants better recalled the tune played while they slept. The results do NOT mean you can learn things while you sleep. These participants had already learned the tunes - playing the tunes for them only enhanced their recall.