The Insomnia Blog - Sleep Doctor Michael Breus, PhD

Police don’t get enough sleep

This news concerns me both as a health issue and an issue of public safety: a survey of nearly 5,000 police officers in the United States and Canada revealed that these law enforcement professionals are frequently suffering from sleep problems—and this lack of sleep is negatively affecting both their health and their performance on the job.

Researchers at Harvard Medical School and Brigham and Women’s Hospital screened 4957 police officers for sleep disorders, beginning with an initial screening and following with check-in screenings every six months for the next two years. Their results showed a significant portion of police officers grappling with sleep disorders, weight problems, and complications from lack of sleep. Among the 5,000 police officers who were screened: 

• 40.0% had some type of sleep disorder
• 6.5%  suffered from moderate to severe insomnia
• 33.0% had obstructive sleep apnea

 The link between obstructive sleep apnea and obesity is clear: being overweight or obese is the single greatest risk factor for sleep apnea. In this study:

• 4 out of 5 police officers were overweight or obese

 Not surprisingly, officers who screened positive for obstructive sleep apnea were more likely to have other health problems as well. Those officers who suffered from obstructive sleep apnea were also:

• 61% more likely to have diabetes
• 148% more likely to report a diagnosis of depression 
• 22% more likely to have an injury while on the job

 These findings echo an earlier, similar study, also conducted at Harvard Medical School. The results also point to the sleep hazards associated with shift work, and the difficulty of these workers in protecting the quality and quantity of their sleep while working frequently changing schedules that often span both day and night shifts. Shift workers generally get about 2 hours less sleep than other types of workers, and as a result are at greater risk for a range of health problems, including cardiovascular disease, diabetes, weight problems, and psychological problems.

 It so happens that these workers are often in high-stress jobs where public health and safety are at stake. In addition to law enforcement officers, health-care workers, members of the military, airline pilots and air-traffic controllers are all frequently working day and night shifts, with changing schedules that make it difficult to establish and sustain a sleep routine. Their health and well being is more than a private matter: it is a matter of concern for all of us, a public safety issue as well as a personal health issue.

 This most recent study indicates that police officers who are suffering from sleep problems are at higher risk for errors on the job. The officers who screened positive for sleep problems had higher rates of several job performance issues than their better-sleeping counterparts. They were more likely to:

• Commit a serious administrative error
• Fall asleep while driving on a shift
• Make an error or commit a violation that was attributed to fatigue
• Demonstrate poor behavior, including uncontrolled anger

There was one group of police officers included in this study that did not conform to the study’s overall results. Members of the Massachusetts State Police had significantly lower rates of obstructive sleep apnea than the general study populations. Not surprisingly, the Massachusetts officers also had much lower rates of obesity.

What made the Massachusetts State Police so different from the overall group? In discussing the study results, researchers point to the agency’s emphasis and encouragement of exercise and physical fitness.

•  Massachusetts requires its state police officers to pass a fitness test
• All state police barracks are equipped with physical fitness centers on the premises
• The agency requires that all its officers spend 60 minutes exercising on each of their shifts. This is paid work time, within a shift, not an extra or unpaid hour of work

This is a great example of how investing in employee health pays great dividends for everyone involved. In this case, that means healthier, more capable officers with fewer health issues—and less risk of workplace accidents, errors or incidents. This is a sleep issue that should matter to all of us, whether we personally know and love someone who works shifts or not. Our law enforcement officers—like our doctors, nurses, soldiers, firefighters and pilots—are people we entrust with our safety and security, and our health. It’s in everyone’s best interest for these people to be well rested and healthy themselves.

Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

 Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 
Facebook: www.facebook.com/thesleepdoctor

 

 

 

 

Another benefit of CPAP: a reduction in pain?

I wrote recently about the relationship between sleep and fibromyalgia, a chronic pain syndrome, and the about important—and complicated—relationship between sleep and pain. Now there’s news that one of the most effective remedies for sleep apnea—CPAP therapy—may also have the benefit of reducing sensitivity to pain. A recent study found consistent use of the CPAP could reduce pain sensitivity in patients with severe OSA. The study tested 12 patients—7 men and 5 women—with severe obstructive sleep apnea. They found that six to eight weeks of regular CPAP use led to significantly reduced pain sensitivity and also to improved continuity of sleep.

The relationship between sleep and pain is one we don’t yet fully understand. What we do know—and what anyone who suffers from chronic pain can attest to—is that each can have a significant effect on the other. The presence of pain can make it hard to fall asleep and stay asleep, and being sleep deprived can make a person feel more sensitive to aches and pains. Studies that have examined the relationship between sleep and pain found these links to be true—and also found that it doesn’t take a lot of lost or disrupted sleep to have an effect on how we experience pain:

• One study showed 12 women who were deprived of sleep for only 3 consecutive nights experienced increased sensitivity to pain. Pain sensitivity began to increase after a single night of disrupted sleep and grew worse each night.
• Another study tested healthy men for pain sensitivity after a short period of total sleep deprivation. Researchers found that total sleep deprivation dramatically decreased the men’s threshold for pain. A recovery sleep period after sleep deprivation restored the men’s pain threshold.
• Recent research info fibromyalgia showed that women who were sleep deprived had as much as 5 times higher a risk of developing the chronic pain syndrome, over a 10-year period, as women who were not sleep deprived.
• A sleep-pain study performed on rats showed that when deprived of REM sleep, the rats experienced a significant increase in sensitivity to several types of pain stimuli.

 The type of sleep we get—or don’t get—may be significant when it comes to pain. Researchers are increasingly focusing on stages of sleep that occur in the later stages of the sleep cycle--REM sleep and delta, or slow wave, sleep—as being critical in protecting pain thresholds. Throughout the night, your sleep unfolds in a recurring and progressive cycle. Over the course of a night, the cycle shifts so that you spend more time in REM sleep and in the later sleep stages that are considered slow wave sleep. If you are sleep deprived, or your sleep is constantly being interrupted, your body does not reach the REM and slow wave-rich sleep that occurs in these later periods.

Here’s where the CPAP may be playing its role in helping reduce pain sensitivity. CPAP works by pushing a constant stream of air through the sleeper’s airway, to keep it from closing. Sleep apnea occurs when muscles in the back of the throat collapse, closing off the airway. This causes a person to stop breathing. It also interrupts a person’s sleep cycle, since those who suffer from sleep apnea are awakened, however briefly, often many times throughout the night by their breathing problem.

It’s possible that the CPAP allows a person to sleep through their full sleep cycle, achieving those later stages of sleep that are so restorative, and also appear to help decrease our sensitivity to pain. This study is just a beginning—we don’t yet know why CPAP might be effective in reducing pain sensitivity. But these results are promising and intriguing, and this is a topic that deserves additional inquiry.

For millions of people who suffer from obstructive sleep apnea, and perhaps other independent conditions that bring about chronic or intermittent pain, the possibility that CPAP could help reduce sensitivity to pain is welcome and important news. It’s also another reason to make sure that patients who have been prescribed CPAP as a treatment actually follow through with the therapy. The CPAP can work very effectively, but only if it’s actually used! This latest research provides yet another very good reason for people with OSA to make sure that the CPAP is part of their nightly routine—every night. The benefits may be even broader than we previously thought.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

 

 

 

 

Team up for CPAP success

Listen up, partners and spouses of people with sleep apnea: Treating obstructive sleep apnea with CPAP works best when it’s a team effort. That’s the takeaway from a recent research review, which examined dozens of studies in an effort to identify the most effective ways to help patients comply with their CPAP regimen. What they found was that having a partner involved and engaged with CPAP treatment increases the likelihood that the patient will stick with their treatment plan.

More than 18 million Americans suffer from obstructive sleep apnea (OSA). It is among the most common sleep disorders. And CPAP—continuous positive airway pressure—is the most commonly prescribed treatment for OSA. Obstructive sleep apnea occurs when the muscles in the back of the throat collapse, blocking the airway. People with OSA stop breathing briefly, anywhere from a handful of times to hundreds of times in a night in severe cases. The health risks associated with sleep apnea are serious: in addition to disrupting sleep and lowering blood oxygen levels, OSA is associated with higher risks of high blood pressure, heart disease, and diabetes, in addition to mood and memory problems. CPAP works by pushing air constantly through the airway, keeping it open and allowing un-interrupted breathing through a night’s sleep. It’s a safe, effective, well-tested treatment for OSA that has proven results. The biggest challenge to CPAP success? Getting patients to use the device consistently.

The CPAP machine delivers the air pressure that keeps the airway open by a face mask that covers the nose, which must be worn by the patient during sleep. Sleeping with the CPAP mask can be a daunting prospect for newly diagnosed OSA sufferers. Some people may find it embarrassing to wear in front of a partner. Others may find wearing it feels uncomfortable or odd at first. As effective as CPAP can be if its used consistently and correctly, there are real risks of patients abandoning the treatment, especially in the very early stages, because they feel it’s too intrusive, disruptive or uncomfortable. Finding the best ways to encourage continued use of the device is a critical area of research.

A group of researchers at Penn State reviewed 80 CPAP-related studies, searching for evidence of the most important factors in successful CPAP therapy. They found that social support increases the likelihood that a CPAP user will continue to use the device. Spouses and partners who provide active support for the CPAP can help a patient feel more relaxed and comfortable with, and also more accountable to, following through with the treatment night after night. And it’s this follow through that makes all the difference in whether or not the CPAP treatment is allowed to work as successfully as it can.

This finding echoes other research that shows CPAP works best when couples work together in support of the treatment, and that—rather than drive partners away from sex and intimacy, CPAP can actually lead to improved intimacy between partners:

•  One study indicated that men whose wives continue to sleep in the same bed with them when using the CPAP are 60% more likely to continue with the treatment than if they are sleeping alone.
• Another study examined sexual and intimate relationships in men with obstructive sleep apnea, and found then whereas OSA had a negative impact on men’s sex lives, regular use of CPAP for three months resulted in improvement in their sexual and intimate relationships. And the more serious the OSA to begin with, the greater the improvement was after using the CPAP.

It’s very common for the snoring that can accompany obstructive sleep apnea to drive partners to sleep in separate beds. So often, when the CPAP treatment begins, couples are already sleeping apart. The initial reluctance to return to the same bed is understandable—both partners may feel self-conscious. There’s no question that it takes work: trust, open communication, perhaps a decision to plan for sex and intimacy in different ways. But this is work that is worth doing—not only for the health of the person with OSA, but also for the health of your relationship.

There is no single right way to approach integrating the CPAP into your life. Researchers in the current review found that CPAP success is best promoted on a case-by-case basis, with individualized treatment regimens that take into account a patient’s life circumstances, the particulars of their disease, as well as their psychological and social circumstances. For example, for patients without partners, telecommunications strategies such as regular phone calls and wireless telemonitoring may be able to provide the social support and connection that appears to be so effective.

The bottom line? CPAP treatment not only can help alleviate OSA, and improve a patient’s health, it can also bring couples back into the same bed—if both patient and partner are willing to accept the device, and not let short-term, initial discomfort or awkwardness become entrenched. The discomfort is fleeting, but the benefits—including renewed intimacy in the bedroom—are long-term.

Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 

www.thesleepdoctor.com

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 
Facebook: www.facebook.com/thesleepdoctor

 

 

Men and women: Different When it Comes to Sleep

This article in the Wall Street Journal caught my eye recently—it’s a great roundup of recent research on the differences between the way men and women sleep. Gender differences in sleep are a fascinating and important area of study. We all know that men and women have different sleep tendencies—think of all those early bird/night owl partnerships out there—but we’re now beginning to understand more about why gender matters when it comes to sleep.

 I was particularly interested in a couple of the most recent studies, which show evidence of some fundamental biological differences between men’s and women’s sleep. One suggests that there are marked differences in the circadian rhythms of men and women. In this study, researchers observed the circadian cycles of 157 men and women between the ages of 18 to 74, measuring melatonin levels and body temperature in order to track the 24-hour sleep-wake cycle. Over the course of a month-long inpatient sleep period, researchers found significant differences between men and women in both the timing of their circadian clocks—which help govern sleep times and wake times—and the duration of the circadian clock itself.  Among those differences:

• Women’s circadian clocks are set to an earlier hour than men’s, making them more inclined to fall asleep earlier and also to wake earlier. Women showed a stronger inclination for activity earlier in the day than men.
• Circadian cycles were actually shorter for women than for men, by six minutes. Even a slight difference can have significant impact on nightly sleep and on energy levels during the day. Think about a clock that runs a handful of minutes behind every day. Over time, those minutes really add up!
• Not only did women’s circadian clocks generally run earlier and shorter than men’s, but also many more women had internal clocks that ran a full cycle in under 24 hours.

 Another recent study found that women tend to perform better than men when low on sleep, and also can rebound more quickly from mild sleep deprivation when they get restorative sleep.  I was really interested in this one because it looks at the question of making up for work-week sleep deprivation with extra rest over the weekend. Women and men were asked to sleep for only six hours per night, over six consecutive nights, to approximate the typical sleep deprivation that many of us experience during a busy work week. The participants then spent two nights “catching up” on their rest with extended overnight sleep. Researchers found that women scored higher on performance tests during the period of low sleep, and that their performance improved more than men’s after two nights of extended sleep.  (Take note: Neither men nor women in the study were able to truly “catch up” on their sleep over the two nights. Both fell short, but women simply came closer than men.) We know that women spend more time than men do in deep, slow-wave sleep stages over the course of a night.  Time spent in deep sleep is restorative and memory boosting, which likely explains the advantage women have in performing under low-sleep conditions.

 Women may reap real benefits from deeper sleep, but there is also evidence that they are in other ways more vulnerable than men to sleep disorders, and to the health risks associated with lack of sleep.

•  The biological phases of a woman’s life—menstruation, pregnancy, menopause—and the hormonal shifts that accompany them make women more likely to experience disruptions to their sleep. Women in general are more susceptible than men to sleep disorders such as insomnia.  Because of their propensity for deep sleep during the first part of their lives, women may receive protective benefits early on. But particularly after the age of 40, women’s sleep often deteriorates.

 

• Research suggests women have a different relationship with sleep when it comes to illness.  One study showed that women who got less than 8 hours of sleep demonstrated an elevated risk for heart problems.  Men in the study who got the same amount of sleep also saw increased risk, but the increase was not as significant as it was for women. The results of a recent study on cancer and sleep found that women were significantly more likely than men to suffer from insomnia while undergoing cancer treatment.

 I’d like to see even more research that sets out to explore differences in the ways men and women experience sleep. The more we understand about how gender influences sleep, the better we’ll be able to develop targeted, effective remedies for sleep problems for both men and women.

 

Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

 

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

 

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 
Facebook: www.facebook.com/thesleepdoctor

 

Sleep Apnea and the War on Snoring

The war against snoring has lately gotten very public. A major hotel chain is marketing “snore absorption rooms” in some of its locations in Europe and the Middle East: sound-proofed rooms filled anti-snoring beds and pillows. The hotel chain has also inaugurated what it calls “snore patrols.” Within designated quiet zones in the hotel, employees monitor the noise from patrons’ snoring—if a guest’s snoring reaches a certain noise level, they can expect a knock on their door!

Meanwhile, there’s talk of this new celebrity trend: the snoratorium, a soundproof bedroom designed for the snorer-in-residence to sleep in luxury and comfort—and away from anyone who might be disturbed by their noisy sleep habits. (Celebrity couples aren’t the only ones retreating to separate rooms in search of undisturbed sleep. Separate bedrooms are an increasingly common choice for couples.)

I’m all in favor of a war on snoring, but I’d rather see a focus on eliminating snoring as a health problem, rather than finding inventive ways to mask the sound, or sending partners to separate bedrooms. Snoring should never be ignored; it is a sign of disordered sleep and can have serious health consequences, especially if the snoring is accompanied by Obstructive Sleep Apnea (OSA). 

Sleep apnea is a serious sleep disorder that causes your airway to close, cutting off your breathing during sleep. In the case of sleep apnea, this can happen a handful of times during the night. People who suffer from moderate to severe sleep apnea stop breathing many times over during the course of a night’s sleep, as frequently as once a minute or more.  Sleep apnea of any degree prevents you from getting restful sleep, and can lead to chronic sleep deprivation, which is associated with a litany of serious health problems, including cardiovascular disease, diabetes, and obesity. 

A new report from the US Health and Human Services Agency for Healthcare Research and Quality focuses on obstructive sleep apnea in adults, it’s related health complications, and the possible options for treatment. The good news is that there are several effective and safe treatment options for sleep apnea. The bad news is that sleep apnea remains significantly under-diagnosed—many snorers out there have no idea that they are suffering from this disorder. The National Institutes of Health estimate that 12 million adults have been diagnosed with OSA—but there are likely millions more who have yet to be diagnosed. 

Not everyone who snores has OSA. But snoring is a key symptom of sleep apnea. Other symptoms of sleep apnea include:

• Waking feeling tired and un-refreshed
• Excessive sleepiness during the day
• Morning headaches
• Difficulty with concentration, memory and focus
• Moodiness
• Chronic congestion
• Someone observes your disrupted breathing

If you recognize any of these symptoms, it’s time to have a conversation with your doctor about an evaluation for OSA. A diagnosis of sleep apnea always starts with a conversation with your physician. In some cases, the process may also include a stay at a sleep clinic, or sleeping at home with a monitor that measures disruptions to breathing.

If you’ve been diagnosed with sleep apnea, what comes next? There are a number of treatments for OSA that have proven effective.

• A CPAP, or Continuous positive airway pressure machine, is the most common treatment option for sleep apnea. Sleepers wear a mask which pushes a constant stream of air through the airway, preventing the airway from collapsing and cutting off breathing. CPAP machines have proven to be very effective in treating sleep apnea—and eliminating the snoring that so often accompanies it. The machine often takes some getting used to for patients, but the rewards—restful sleep, protection against health problems associated with OSA—are worth it.
• A MAD, or Mandibular advancement device, also called an oral appliance, is a mouthpiece that keeps the jaw in a forward position and the airway open during sleep. An oral appliance is custom fitted by a dentist. There are over-the-counter mouthpieces sold as anti-snoring devices, but these are not the same thing as the oral appliance; you should speak  to your doctor before using an anti-snoring mouth guard.
• There is a fairly new treatment available, called Provent, that uses a small disposable one way valve placed over each nostril that can be used as alternative to CPAP.  Provent requires a doctor’s prescription.

These treatment options for sleep apnea have been well researched. We know they are safe, and we know they work. There are a surgical options for sleep apnea, which involves removal of tissue at the back of the throat to widen the airway. It’s not yet clear that surgery is as effective as the other treatment choices available, but we know surgery involves more inherent risk.

Let’s not overlook lifestyle changes—losing weight, exercising, cutting out alcohol—may reduce your sleep apnea, and will absolutely improve your health.

So let’s engage in the war on snoring—but let’s make sure we’re attacking the problem in the right way.

Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 
Facebook: www.facebook.com/thesleepdoctor

 

 

 

Erectile Dysfunction and Obstructive Sleep Apnea

Feeling tired?  There are many reasons why we sleep poorly, from insomnia to obstructive sleep apnea (OSA).  Regardless of the reason, lack of sleep or lack of quality sleep can make us unpleasant people to be around, and sustained lack of sleep has been linked to more serious problems like diabetes.  In fact, difficulties sleeping often point to other underlying issues, even ones that seem to be unrelated to sleep—like impotence, for example.

For men, at least.  A new study links sleep disorders and sexual impotency.  Specifically, the study examined the relationship between obstructive sleep apnea (OSA) and erectile dysfunction.  OSA afflicts more than 12 million Americans and is characterized by repeated stops and starts of breathing during sleep when throat muscles relax and block the airway.  Left untreated, those with sleep apnea suffer from poor quality sleep and chronic sleep deprivation, leading to health issues that can be life-threatening: weight gain, diabetes, and cardiovascular problems.

The study found that

• Men with erectile dysfunction were more than twice as likely to have OSA than those without erectile dysfunction.
• The more severe the erectile dysfunction, the greater the likelihood of having OSA
• Men with erectile dysfunction should probably be screened for OSA

This is bad news for men, but somewhat of a break for women—most studies show quite a  discrepancy between the effects lack of sleep brings men versus women. For instance, if a woman gets fewer than 8 hours of sleep, her risk for heart disease goes up but men don’t seem to show such as great a risk of heart disease from lack of sleep.  This link between OSA and erectile dysfunction is obviously a uniquely male problem—and one that should be noted by men with either condition.

Getting a good night’s sleep can do a world of good for your whole body.  Get screened for OSA and if you have OSA, make sure to use your CPAP machine, oral appliance or other prescribed treatment on a regular basis.  Improve your overall sleep with better sleep hygiene.  After all, everything you do, you do better with a good night’s sleep—everything.

Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™ 
twitter: @thesleepdoctor 
Facebook: www.facebook.com/thesleepdoctor

Learning something new! The Hat Trick for CPAP

If you’re one of the 18 million Americans who suffer from Obstructive Sleep Apnea (OSA), you know that one of the most helpful forms of treatment is the CPAP machine. People with OSA stop breathing repeatedly during their sleep, often for a minute or longer and as many as hundreds of times during a single night. CPAP stands for Continuous Positive Airway Pressure -basically, CPAP works like a vacuum cleaner in reverse by pushing air down a person’s throat while they are sleeping to help keep their airway open, so breathing is possible. Left untreated, sufferers of sleep apnea suffer from poor quality sleep and chronic sleep deprivation, leading to health issues that can be life-threatening: weight gain, diabetes, and cardiovascular problems. The benefits of CPAP use are pretty clear.

It’s critical to regularly use a CPAP machine if you have OSA, but that’s easier said than done for many people. I know from my patients that the trouble many people have with the CPAP is getting a mask that feels comfortable. In fact, a guest editorial by a doctor in Sleep Review Magazine not only describes this problem, it offers an awesome solution—but it might not be what you’d expect. Dr. Edward Michaelson suggests using an ordinary baseball cap as a way to make your CPAP machine more comfortable.

He calls his innovation a ‘hat-trick’ because there are three ways in which it is helpful (just like a person who scores three consecutive goals in hockey is said to have accomplished a ‘hat trick’):

•     The baseball cap helps both the top and back straps of the CPAP mask stay on, particularly for people who are bald
•     The hat adds space, helping to reduce facial strap marks
•     The bill of the cap can help "lock" the position of the CPAP mask-tubing, making the whole system more secure and lessening the likelihood of leaks AND if the cap is worn backwards, it will keep people off of their back, the worst sleeping position for those with sleep apnea

All of this is good news for people who find that their CPAP masks often fall off. In fact, Dr. Michaelson writes that he first looked into this alternate use of a baseball hat because his goatee made most CPAP masks difficult to wear—talk about innovative medicine! I saw this editorial and couldn’t pass up the opportunity to blog about something that made me think about new ways to address old problems—it’s so simple (and sort of funny).

This ‘hat-trick’ sounds like a real score.

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

Can Your Brain Learn to Help You Sleep Better?

One of the most frustrating conditions that keeps people from sleeping well and through the night is Obstructive Sleep Apnea (OSA).  Most people with OSA aren’t aware that they stop breathing multiple times during the night.  This situation results in fragmented, poor sleep, as well as low blood oxygen levels.  OSA has been associated with an increased risk for a myriad of health problems, including hypertension, heart disease, mood and memory problems.

It’s widely known in sleep medicine circles that the most common—and helpful—treatment we have these days for patients with OSA is the CPAP machine, short for Continuous Positive Airway Pressure.  The difference a CPAP machine can make for someone with Sleep Apnea is huge, and benefits go far beyond sleep.

The problem with CPAP therapy is that not a lot of people are good about using it on a routine basis.  While I maintain that continuous use is the best way to utilize your CPAP machine, there may ultimately be another way to help those suffering from OSA: the brain.

We’ve all heard it—some of us have even said it: ‘mind over matter.’  A new study from the University Toronto suggests that not only is this true, it could eventually provide relief for millions of people who face sleepless nights because of their Sleep Apnea.  OSA is called obstructive because it obstructs the airways.  Scientists found that this obstruction might cause you to learn to breathe more effectively.  Humans are remarkably adaptive creatures, and our brains are wired for learning—apparently even from the disruption of normal breathing.

The researchers from the University of Toronto suggest that the brains of people with Sleep Apnea are using the negative effects of OSA to learn to breathe more deeply and effectively.  This is due to a brain chemical called noradrenaline, which is released during times when lung function is obstructed.  This study suggests that in the future this chemical could be used to help those with OSA sleep better and breathe deeper.

This is great news for those who live with OSA, because a CPAP machine is about the least sexy thing you could bring into your bedroom.  Relief that comes in pill form would be much less invasive and much easier to use—and much easier to remember to use consistently.  This type of treatment is still in the dream phase, so until it becomes a reality, I encourage people with OSA to stick with the machines.

Still, it’s pretty amazing what the brain can learn to do, even while we’re asleep.

 

Sweet Dreams, 

Michael J. Breus, PhD
The Sleep Doctor™
Everything you do, you do better with a good night’s sleep™
www.thesleepdoctor.com twitter: @thesleepdoctor
Facebook: www.facebook.com/thesleepdoctor

 

 

More Reasons to Use Your CPAP

For people with Obstructive Sleep Apnea (OSA), a CPAP machine can be a life-changing device. I’ve written about the importance of regularly using your CPAP machine before, but there may be even more benefits to use of a CPAP.

 

Most people with OSA aren’t aware of that they stop breathing multiple times during the night.  This results in fragmented, poor sleep, as well as low blood oxygen levels.  OSA has been associated with an increased risk for myriad health problems, including hypertension, heart disease, mood and memory problems—even difficulties driving.

 

CPAP stands for Continuous Positive Airway Pressure, and CPAP machines are the most effective and helpful treatment currently available for patients with OSA. A new study in the journal SLEEP suggests that CPAP therapy can do much more than improve sleep:

• Patients who regularly use a CPAP machine felt significantly less fatigue throughout the day
• Patients who regularly use a CPAP machine also had much more energy
• Patients felt considerably less daytime sleepiness, particularly patients who had previously been excessively sleepy or fatigued

Scientists aren’t certain how and why CPAP therapy can have these additional positive effects, but they think that CPAP may reduce inflammation, which in turn reduces fatigue. Whatever the reason, this is great news for people who have OSA—and even better news for people who are already using CPAP machines to improve the quality of their sleep.

 

I’ve said before that the CPAP machine isn’t exactly the most attractive or sexy addition to your bedroom. But in addition to completely transforming the way a person with OSA sleeps, it also has the potential to help people feel less fatigued and have more energy throughout the day. We already knew that CPAP improves the quality of sleep of many, many people—and spares their partners hours of listening to the snoring and loud breathing that can accompany OSA. This study just gives us a few more reasons to recommend that patients with OSA use their machines every night.

 

The amazing machine that could.

 

Sweet Dreams,

 

Michael J. Breus, PhD

The Sleep Doctor™

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

www.thesleepdoctor.com

twitter: @thesleepdoctor

Facebook: www.facebook.com/thesleepdoctor

The Sleep Doctor’s Sleep Suggestions from the Top Sleep Stories of 2010 (Part I)

Happy New Year!  As 2011 is here I wanted to look back and think about all of the amazing stories, research and clinical cases that have changed the face of sleep medicine in 2010. The amount of sleep research going on today is one of the very reasons why I got into this field, the changes are constant and exciting. While this does not encompass everything, these are what I considered some of the top stories in sleep medicine in 2010, and I have included a practical sleep suggestion to help you use this research in your everyday life.

January

• Sleep Suggestion: Set your adolescent’s bedtime before 10pm
  
  •  Earlier bedtimes may have a “protective effect” for adolescents against Depression and Suicidal thoughts-in the Jan issue of the journal Sleep researchers found:
    
    • When parents set their kids bedtimes earlier (10pm or earlier), adolescents were less likely to suffer from depression (by 24%) and less likely to think about committing suicide (by 20%). Earlier bedtimes seemed to allow for more total sleep time in these kids. And kids who report sleeping 5 or fewer hours were 71% more likely to suffer from depression and 48% more likely to think about suicide.
• Sleep Suggestion: Make sure your child is getting enough sleep
  
  • High School Kids are not getting enough sleep-In a study published in the Journal of Adolescent Health 12,000 kids were evaluated in grades 9-12 and only 8% of students were found to get enough sleep on average.
  • 10% of Adolescents sleep only 5 hours
  • 23% sleep only 6 hours
  • Nearly 20% more 12^th graders have sleep deficits than 9^th graders

February

• Sleep Suggestion: After a class or lecture or presentation; take a break, close your eyes and rest for 10 minutes - you will remember more.
  
  •   “Wakeful Resting” can improve your memory- when we rest while awake our brains are still at work. One researcher commented: “Your brain wants you to tune out of other tasks so you can tune into what you just learned.
• Sleep Suggestion: Take a 90 minute nap and boost your “Brain Power.”
  
  • Researchers at UC Berkley found that a 90 minute nap can help boost and restore brain power, not only does it refresh the mind, but they think it can make you smarter. It makes sense: a 90 minute nap is about 1 full sleep cycle.

March

• Sleep Suggestion: Those under forty need 7-8 hours a night to keep off that “spare tire” of belly fat
  
  • Research from Wake Forrest University published in the journal Sleep showed that individuals under 40 who slept 6-7 hours a night had far less belly fat than those sleeping less than 6 hours and more than 8 hours.

• Sleep Suggestion: Know your kids friends, if your kids hang out with those that do not sleep, watch out for possible drug issues
  
  • In some fascinating research on social networks influence on teen health researchers at UC San Diego showed that the spread of one behavior in social networks (poor sleep patterns) influences the spread of another behavior, adolescent drug use.  

April

• Sleep Suggestion: Keeping a daily routine helps older adults sleep better. 
  
  • In the April issue of the Journal Sleep, researchers found that when older adults living in a retirement community kept a daily schedule there was a reduction in their insomnia and an improvement in their quality of sleep.

May

• Sleep Suggestion: Find your “sleep need” number and stick to it  
  
  • Sleeping less than 6 hours and more than 8 hours is linked to premature death! Researchers at the University of Warwick in the United Kingdom that those who slept less than 6 hours a night were linked to a 12% higher chance of premature death compared to those sleeping 6-8 hours. Also those that slept for 9 hours or more were linked to premature death, but probably for different reasons.

• Sleep Suggestion: Consider Yoga as a new technique for better sleep
  
  • Yoga helped cancer survivors reduce fatigue and improve sleep quality. A 4 week low-intensity yoga program that included breathing techniques (pranayama), meditation, visualization and special yoga positions (18 different asanas) appeared to help reduce fatigue in cancer survivors, they took less sleep medication, and they reported a better quality of life.

June

• Sleep Suggestion: Use your CPAP at least 4 hours a night - it could save your brain and life!
  
  • CPAP has been shown to reduce the incidence of cardiovascular events and hypertension in OSA patients. There was a 25% reduction of hypertension and cardiovascular events risk with consistent CPAP use (4+hours per night).
  • CPAP therapy was shown to restore brain tissue in adults with OSA. After 3 months of nightly CPAP use there was a significant grey-matter volume increase (in the hippocampus and frontal areas) this is where the brain does most of its information processing.

• Sleep Suggestion: Attention New Parents: Get more sleep and enjoy your relationship
  
  • First time parents’ relationship satisfaction appears to be linked to the amount of sleep they get while caring for their new infant. Research presented at the 2010 APSS convention showed that when you looked at actual hours of total sleep vs. estimated hours of sleep there was a negative relationship (less actual sleep = poor relationship satisfaction). So do not worry about meaningless chores, sleep more and be happy.  

• Sleep Suggestion: If you child was up late studying, drive them to school AND pick them up yourself!
  
  • Earlier school start times were associated with increase in teen auto accidents. This study done in Virginia showed that in Virginia Beach (where school start times were 7:20am ) vs. Chesapeake (where school start times are 8:40am),  there were 20% more teen car accidents. Most of these accidents were in the afternoon when school was out.

Next:  Part II covers what we learned from sleep research in the second half of 2010 and more great sleep suggestions.

 

Sweet Dreams,

 

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

Twitter: @thesleepdoctor

Facebook: www.facebook.com/thesleepdoctor