The Insomnia Blog - Sleep Doctor Michael Breus, PhD

Is Technology Stealing Your Sleep?

Have you ever noticed that in so many iPad and tablet ads people have their feet up while they use their devices? The idea must be that the product is so easy, so relaxing, you could even use it in bed.

People love to use their electronic devices in the bedroom—and who can blame them, when we have so many small gadgets that offer us news articles, e-books, and games in one tiny package? And if you use your smartphone as an alarm clock, chances are high you’re literally going to bed with some form of electronic device—and you aren’t alone. 

 

In fact, the latest National Sleep Foundation poll found that 95% of Americans use some kind of electronic device within an hour before going to bed. Beyond those annoying blinking lights, using technology can interfere with getting good sleep in a couple of ways:

• The light from screens from electronics like netbooks and phones could prevent your body from producing melatonin, the hormone that is produced naturally in darkness and helps regulate sleep
• Reading exciting news articles or playing games keeps your mind very active, making it difficult for you to relax and be ‘ready’ to fall asleep
• Using these devices brings the rest of your life into the bedroom, and as I’ve said before, the bedroom should be a sanctuary reserved for sleep

Teenagers are almost twice as likely as their parents to use something like their phones before bed—over half of the teenagers in the poll said that they text right before bed. Some people send so many text messages right before bed that they even begin to text in their sleep!

 

How often do you use a smartphone or computer right before bed or even in bed? Do you think it may be impacting your quality of sleep or your ability to fall asleep? If so, try limiting your use before bedtime and put the computer and phone to bed in another room and see if that helps. If you have a teenager in the house, try to limit their use of their cell phones as much as possible before bedtime—the poll also showed that teenagers are the most tired group, and most sleep specialists recommend teenagers get as close to 9 hours of sleep a night as possible. Institute an electronic curfew - for everyone.

 

It’s hard, I know - so much of what we do every day involves using one or more of these devices, and it’s really amazing what they can do for us, including making our lives productive and efficient. We just need to make sure that they aren’t stealing our sleep in return.

 

 

Sweet Dreams, 

 

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

Everything you do, you do better with a good night’s sleep™

twitter: @thesleepdoctor

Facebook: www.facebook.com/thesleepdoctor

Teen Sleep and Mood, Texting and Emailing

As if we really needed anything else affecting a teen’s mood and sleep, recent research shows that of internet use and texting can have a serious detrimental effect on both sleep and mood.  At a conference in Canada, US researchers explained that:

• More than half of kids and teens who text or surf the internet:
  • Have problems falling asleep (77.5%)
  • Have trouble staying asleep - all participant reported being woken up at least once per night by an electronic device
  • Experience mood, behavior and cognitive problems during the day
    • including ADHD, anxiety, depression, and some learning difficulties.

The study showed that on average, a teenager sends a total of 3400 electronic message per month - that is more than 100 per day! When exactly are they in school? And here was the kicker:  author of the study, Dr. Peter Polos, said that on average, kids were texting or emailing 33.5 times per night to more than 3 different people (3.7)! And these electronic messages would occur anywhere from 10 minutes to 4 hours after the child’s bedtime!

While this is not the first time I have written about this, the data in this study are pretty amazing. What can a concerned parent do?

1. Education is key-letting children know how the use of these electronic devices can affect their sleep and their performance the next day is critical in monitoring of their own behavior.
2. Setting a electronic curfew- 1 hour before bed, kids need to turn off all of the electronic devices that they normally use, and participate in the Power Down Hour™:
   • 20 min of finishing up things to be done for tomorrow (e.g., getting clothes ready, packing up their backpack for school, etc.)
   • 20 min for hygiene-nighttime bath, shower, brushing teeth, washing face, etc. (remember to do these in a dimly lit environment)
   • 20 min for a relaxation ritual: reading a book with a parent, saying nighttime prayers, spending time talking with a parent about their day, etc.
3. Have the device in question out of reach- Charge cell phones in a special room and computers can be turned off or placed on a timer.

Yes, the information superhighway is a great tool for education and communication, and yes, cell phones can keep us in touch with our friends and loved ones, but when these devices begin to invade our sleeping world, as parents we need to adjust access for our kid’s better health. And parents, we can take a tip, and apply these rules to ourselves as well -  my guess is our sleep and mood is also affected by nighttime emailing and texting….

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com 

Are You Afraid of Sleeping?

Nightmares are a research and clinical area that has always fascinated me. While I have experienced nightmares myself, they have been quite rare in my life. However both a recent article and patient has piqued my curiosity. Nightmares can be defined as a frightening dream that will awaken an individual from REM sleep. Most people, when asked, will recall the content of the dream, in some cases even days after it occurred. If you ask people, almost everyone can recall having had a nightmare, but there are some unfortunate souls who have them with great regularity.

I see some of these patients in my practice, and it is often hard to know what can be done for them.  When is a nightmare just a really bad dream, and when does it cross the line into potentially something else? To try and answer one of these questions a recently published research study in the journal Sleep showed some very interesting results. In a community based population (not just college students, or a psychiatric population –where nightmares are prevalent) researchers at The Chinese University of Hong Kong observed:

• Once a week nightmares were found in 5% of the population
• Women were more likely than men to have nightmares
• In fact 71% of those with nightmares 3 times per week were females
• Those in a lower income bracket were the most likely to have nightmares
• 40-50% of those with some form of insomnia have nightmares

The finding that 5% of people have weekly nightmares was in line with previous studies. Why women have more nightmares than men may be due to the fact that women are better at recalling their dreams than men. Another theory posed by the researchers was that in their population women had a greater tendency for depression, anxiety and other forms of psychopathology. Most importantly those with insomnia appear to have a greater tendency to have nightmares but the next question would be which comes first? The insomnia or the nightmare? I have had several patients come to me with stories of both nightmares and insomnia. These patients will often present in clinic with:

• An inability to fall asleep
  • This can often be due to fear of having a nightmare.
• An inability to stay asleep
  • This can occur when they are woken up in the middle of the night, from a nightmare and do not want to go back to sleep for fear that the nightmare will continue.
• Restless Sleep
  • This is often the accumulation of both of the above situations.

So what are some of the current nightmare treatments available?
Unfortunately this topic is one that does not have a tremendous amount of research available but here is what we have seen:

• Medication: medication has been shown to be both a cause and a treatment of nightmares.

  • While in other cases certain anti-depressant medications (SSRI’s and tricyclics) can reduce the frequency of nightmares by reducing the amount of REM sleep you are getting.

• Talk Therapy: Work has been done where the person having the nightmare will wake up and write down everything that they can remember about the dream.

  1. In as much detail as they can, even with the potential horrible endings (people getting killed, or loved ones getting hurt, or persecuted).

  2. Next they collect these dreams over the course of a week or so and create a script as though it were a play or movie scene.

  3. Finally they CHANGE THE ENDING so that whatever is the horrible consequence is changed so that they become the hero of the dream!

  4. This new version of the dream is then read by the person several times right before they go to bed, to influence their dreaming.

So what can you do if you are having nightmares?

• First, realize that this may be more common than you think.  
• Next speak to your doctor about any medication you are taking and be sure to read the package inserts on any medication to see if vivid dreams or nightmares may be a side effect.
• Consider that a drug interaction (two medications together, or a glass of wine before taking a medication) could be causing the effect. Consider speaking to a psychiatrist or your general practitioner about a medication to help reduce nightmares by reducing your REM sleep
• Consider speaking to a therapist about how to begin the journaling process

Sweet Non-Scary Dreams,
Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

Olympics Got Your Sleep—Again?

Watching the Olympics in Beijing less than two years ago kept a lot of us up late at night, waiting and waiting for the events to be shown. The teasers kept us high on alert and anticipation: Coming up, in about 45 minutes, Michael Phelps goes for his 6^th gold… But before that, we’ll turn to women’s gymnastics where the Chinese are determined to beat the Americans…

Now we’re back at the games again, this time in Vancouver where the adrenaline is pumping both at the competition and at home on the couch as we watch these crazy wintertime athletes strut their stuff.

Getting Paid to Sleep…in Public

Now this is downright bizarre. Imagine being on display in a museum. Correction: Imagine getting paid to sleep for an exhibit…and be on display.

That’s what the New Museum of Contemporary Art (hey, you knew it’d have to be contemporary) in Manhattan is offering. This past week the museum sought women ages 18 to 40 to participate in a new exhibit that would have them taking sleeping pills so they can be in bed between noon and 6 pm daily for the artist Chu Yun. (Yes, the sleeping pills are doctor-prescribed.)

I wouldn’t bother trying to be one of these women at this point. I hear the museum has been inundated with volunteers. Talk about the perfect job for someone who recently got laid off or is so depressed about the state of affairs in the world that she only enjoys the blissfulness of sleep.

Get Real: College Isn’t for Sleeping Sissies

If you had to take a test after getting a really bad night’s sleep, what do you think the chances are of acing it? Okay, so maybe you’re able to put yourself together for the hour or so (thank heavens for that adrenaline brought on by your anxiety) that you need to wrack your brain. But then you have another test to take soon thereafter, and then there’s the next day, and the day after that…

The Arizona Daily Star recently published an article sharing how detrimental poor sleep habits are having on students living on campus at the University of Arizona. (Which assumes the study can relate to any college student on any campus.) Not only does a lack of good sleep cut into one’s grades, but it’s so severe that many students would qualify for a clinical sleep disorder diagnosis.

Acupuncture and Sleep Apnea

I saw an interesting news clipping by Alien Sheng in the 17 April 2007 issue of the American Chronicle,  entitled Acupuncture and Sleep Apnea.

In it she described sleep apnea quite well, and then went on to explain that there is only one article on the control of sleep apnea with acupuncture.  I too question why we have not seen more on Eastern Medicine and sleep disorders.

The article stated quite well that:

The basic assumption made in Traditional Chinese Medicine is that the body is supposed to function properly. When all is in harmony, it will do so. It is necessary to live in a certain way to make this harmony more likely. There are important environmental considerations such as diet, exercise, and even the mental and spiritual well being of a person that contribute to harmony. When something gets out of whack, there is a definite reason and cause. It is the pursuit of this underlying cause rather than a concentration on symptoms that makes acupuncture and sleep apnea such a good match.

While I have read a good bit on insomnia and Eastern medicine, I think that we would all like to see more on the subject. Especially with the recent FDA recommendation that for all medications in the sleeping pill category, explicit descriptions of even unusual side effects must be made known to those using these prescriptions.

I think what we need would be a good set of empirical research studies looking at topics like acupressure/acupuncture and sleep disorders, yoga and sleep, etc.

New York Times Article: "These Salons Forgo Beauty Sleep"

This New York Times article talks about a new trend out of New York -- beauty salons that are open late to accommodate night owls.

This is one more step toward a total 24-hour culture that may make it challenging for people to find a good reason to go to sleep.

One exception may be the Osaka Health Spa on West 46th Street. According to the article:

The spa is open until midnight Monday through Saturday. But the place was empty on Friday evening — not because it was late, said Joseph Lee, the spa’s consulting physician, but because it was too early.

“We get Broadway actors, actresses and dancers who come in after their performances,” Mr. Lee said. “Acupressure is great for insomnia.”

Sleeping Sickness -- New Advances

Now there are times, especially on Saturday mornings when the kids are up at the crack of dawn, that my wife tells me she wants me to “deal” b/c she must have contracted African sleeping sickness over the course of the evening and just cannot get out of bed.  (By the way, I get up with the kids every morning, just thought I would throw that in.)

But there is some recent news on this disease.  African trypanosomiasis, aka sleeping sickness, is a serious disease spread by the bite of tsetse flies. It's found only in Africa and it is fatal. 

The symptoms include: fever, headache, and extreme tiredness. The disease progresses to attack the central nervous system, and, ultimately, results in death several months or years after infection.

The chances of my wife having contracted this overnight are in fact quite slim (thank goodness). A new study appears in the Public Library of Science's journal PloS Clinical Trials shows some promise. They think that a particular drug combination may work on those infected with the disease, but there does not seem to be any inoculation for it as of yet.

Sleep-Deprived Call Center Workers

A recent article in the The Hindu, the online edition of India’s National Newspaper, caught my eye in that it mentions sleep -- specifically, sleep deprivation and insomnia. Those working in IT call centers and BPO’s can suffer from these sleep problems for the following reasons:

• They keep odd hours to be able to service the US.  (They are often better from a health perspective when working with companies from the UK, based on time zone differences.)

When they deprive themselves of sleep, we see several things happen -- everything from cognitive dysfunction (They answer questions poorly, and do not come up with creative solutions.) to health problems (Mainly, immunosupression -- they get sick more easily since they cannot fight disease -- and this means higher absenteeism.)

• They drink caffeine throughout the night to stay awake. This causes several problems, from autonomic nervous system side effects (the jitters) to not being able to relax once they are off of work.

In the past year, N. Ramakrishnan, director of the Nithra Institute of Sleep Sciences, claims to have treated over 200 people in the IT/BPO sector of India for sleeplessness.

So the next time you are speaking to a customer service rep and you think they may be talking to you from another country, consider the possibility that they could also be giving you a sleep deprived answer to your problem!