The Insomnia Blog - Sleep Doctor Michael Breus, PhD

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

 

Snoring in Children Link to Poor Academic Performance?

A recent observation made in Australia could have significant meaning in the United States: children who snore and have a bad night’s sleep could be lowering their IQ.

The domino effect goes something like this:

• A child has trouble breathing at night, which explains the snoring and sparks a bad night’s sleep.
• The labored breathing ultimately leads to a lack of oxygen.
• A bad night’s sleep translates to being constantly tired and unable to concentrate or learn new things easily.
• This in turn exacerbates developmental delays, poor memory, and behavioral problems in terms of attention, low frustration tolerance, and poor impulse control. 
• Over time, prolonged poor sleep can affect a child’s IQ and education.

I get asked about snoring children on a regular basis. Is it normal? Is it considered the same as an adult who snores?

Between 10 and 20 percent of normal children snore on a regular or intermittent basis, making the line between “normal” snoring and “abnormal” snoring seem a bit fuzzy. It’s when snoring hampers restful sleep that it should be addressed, as in adults. But there are a few things unique to snoring children.

In 2002, the American Academy of Pediatrics recommended that all children be screened for snoring and that a diagnosis be conducted to determine if a child is experiencing normal (primary) snoring or obstructive sleep apnea (OSA) syndrome. About one to three percent of children not only snore, but also suffer from breathing problems during their sleep.

First, speak with your pediatrician to get an accurate diagnosis. Though obstructive sleep apnea among adults is commonly discussed, it’s true that children can suffer from the same condition. And they won’t necessarily grow out of it.

Although most younger children with OSA are not overweight, which is typically associated with OSA, it’s key to determine if weight is a contributing factor. Now that childhood obesity is growing at an alarming rate—with 1 out of 3 kids today considered overweight or obese—it’s no surprise to me that more kids are getting diagnosed with OSA. Other underlying medical conditions, especially allergies or asthma, could also be to blame, in which case a nasal steroid spray could help improve nasal obstruction and OSA symptoms in children that also have allergies. If GERD (gastroenterological reflux disorder) is a factor, this condition could also be treated.

There could be other reasons, though, that are unique to children. A child could have been born with a small jaw or a small airway that makes it hard to breathe fully. There's also the possibility that the muscles and the nerves controlling those muscles are not well integrated during sleep and therefore do not open the airway enough. And then there’s the chance that a child has enlarged tonsils and adenoids that prevent normal breathing. This last possibility, in fact, is very common among youngsters. When the problems are significant enough, parents can choose to have their child’s tonsils and adenoids removed. According to the National Center for Health Statistics, more than 263,000 children in the U.S. have tonsillectomies each year and sleep apnea is a major reason.

Getting to the bottom of a child’s constant snoring that affects his or her quality of life is critical during those early developmental years. But aside from addressing any medical conditions triggering the problem, it’s also important to instill good sleep habits—or hygiene—in your children from as early an age as possible. If you teach your children how to prepare for sleep and to embrace it as an healthy component to life (and that they need their sleep to enjoy their days maximally) then they will naturally lower their risk for sleep disorders and grow into adults who experience restful, rejuvenating nights on a routine basis—maybe more so than their own parents!

No one likes a cranky, overtired child. Or an adult in that same state for that matter!

Here’s another way to look at it: If your kids can increase their mood and happiness, and possibly even their IQ, through more restful sleep, wouldn’t you want to encourage that?

Sweet Dreams,

 

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

Treating OSA in Truckers: A Good Thing

Well, it’s really no surprise. A recent study indicates that treating sleep apnea in truckers lowers health care costs and disability rates. We’re talking about obstructive sleep apnea (OSA), a common sleep disorder I’ve blogged about several times. People with OSA briefly stop breathing multiple times during the night when the muscles in the back of the throat fail to keep their airway open. 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.

The findings of this latest study:

• On average, treatment for OSA led to more than $6,000 in total health plan and disability cost savings per treated driver.
• Total costs decreased by 41 percent in drivers treated for OSA (compared to an eight percent decrease in untreated drivers).

That’s a significant cost savings. But what about cost savings for other industries? Since treating OSA has been shown to lower accident rates, I would guess that other industries that carry a high risk for accidents could benefit as well. Think about pilots, captains of cargo ships, commercial fishermen, and just about anyone who drives a lot (attention: anyone who lives in a commuting city!).

Treatment for OSA is pretty straightforward. There’s no magic pill, but there’s the Continuous Positive Airway Pressure machine, or CPAP.   This device, which forces the airway to stay open so breathing is possible, is the best we have right now for treating sleep apnea.  Sleep becomes much more restful and solid; it also quiets the snoring that frequently accompanies that apnea. People who sleep with a snorer often rejoice, as data shows that sleeping with a snorer can steal about 1 hour of sleep. CPAP has others ways of saving lives; I’ve written about the life saving benefits of CPAP in earlier blogs.

Because people who carry extra weight are more prone to OSA, it often helps to drop a few pounds. (I know, easier said than done.) Sometimes, just eliminating the weight factor can cure OSA. I don’t dare suggest that the cliché rings true about truck drivers, but in a brief study conducted by the American Dietary Association back in 2007, 86 percent of the truck drivers surveyed were overweight with more than half tipping the obese scale.

So it wouldn’t surprise me to see OSA being problematic among this group of people. It doesn’t help that truckers typically keep erratic schedules, sleep in less-than-ideal settings, and often fall under the category of being a shift worker, which carries its own set of risks.

But for anyone—trucker or not—who has been diagnosed with OSA, seeking treatment can result in measurable results that go far beyond monetary rewards. There’s something to be said for an enhanced quality of life. A better night’s sleep. A more vibrant sex life. A stronger heart. An easier time controlling weight. And yes, all those things are related to an OSA-free life.

Sweet Dreams,

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

http://www.twitter.com/TheSleepDoctor

Click here to order Dr. Breus's book, Beauty Sleep, on Amazon or Kindle, or here to buy it for the Barnes & Noble Nook.

Link Between Sleep Apnea and Eye Disorders

Like severe back pain or battling a bad stomach flu, your world can stop dead in its tracks when you’ve got an distressing eye disorder. What if the problem in your eyes, however, were associated with your sleep habits?

That’s what one recent study has found with regard to a rare eye disorder called floppy eyelid syndrome (FES). A British study points to a strong link between FES and obstructive sleep apnea (OSA), implying that when doctors see FES in a patient, they should also look for OSA, and vice-versa.

A Snor-Chestra of Song

Tired of the Christmas carols? Sick of holiday songs and jingling bells?

Well, as you pack up those holiday decorations, I suggest you check this out: a group of musicians got together and created a montage of snorers from around the United Kingdom to the tune of, well, let’s just say a very odd sounding “Silent Night.”

Now that’s not what I call a “silent” night!

What Do Snoring Kids and Urine Have in Common?

Answer: a clue to whether or not your child’s snoring is a sign of obstructive sleep apnea or not.

New research from the University of Chicago shows that proteins found in the urine samples of children with sleep apnea are different than those found in children without the disorder.

Snoring is typically a sign of obstructive sleep apnea (OSA), a common sleep disorder I’ve blogged about several times. People with OSA repeatedly stop and start breathing during sleep when throat muscles relax and block the airway. 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.

OSA gets a lot of attention in adult sleep circles, but not so much when it comes to children. It’s been estimated that only about 20 to 30 percent of children who snore actually have sleep apnea. But that’s enough to warrant closer inspection. Given this new study, screening can become the norm to separate out the kids with a serious sleep disorder so their problem can be addressed and successfully treated.

After all, children need as much quality sleep they can get as they continue to mature and develop. No parent wants to set a child up for a lifetime of health challenges by letting a common sleep disorder go under the radar (and under the disguise of seemingly harmless snoring). And, not to scare you, but I’ll add that another recent study showed that kids with sleeping problems are at higher risk for manic depression. They need their sleep as much as you do, if not more so.

Sweet Dreams,

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

Click here to see Dr. Breus's list of recommended sleep products. Click here to order his book, Beauty Sleep, on Amazon or Kindle.

Tee Off on This: Sleep Better, Golf Better

I don’t know any avid golfer who isn’t looking for tips to improve his or her game. Some of my golfing friends are real fanatics, incessantly talking about ways to reduce the number of strokes it takes to get through eighteen holes. And now I finally have proof to make a case for my area of expertise: better sleep. Equipment, weather conditions, athleticism, and technique aside, if you can get your game on at night, you can get your game on over the greens. Seriously.

When Power Snoring Exceeds a Power Saw

Think you’ve got it bad putting up with a snoring bed partner? Well, think again. This month a British woman has been recorded as one of her country’s loudest snorers. Her snore is so loud that from a decibel standpoint, it’s louder than a jet plane!

Impossible? Not at all. Though snoring rarely exceeds 85 decibels, sixty-year-old Jenny Chapman comes in at 111.6 decibels, which could drown out a spinning washing machine, diesel truck, and speeding express train.

Sleep on the Government’s Agenda

Has someone been falling asleep in Congress?

I was delighted to hear that Florida Congressman Gus Bilirakis has just introduced a sleep apnea awareness resolution to the House of Representatives. The goal is to raise public awareness of this serious condition and encourage all Americans to educate themselves—and others—about the consequences and potential treatments of sleep apnea. Perfect timing given the fact the President is about to focus on health care.

Trouble Keeping Up with Your CPAP?

It’s widely known in sleep medicine circles that the most common—and helpful—treatment we have these days for patients with Obstructive Sleep Apnea (OSA) is the CPAP machine, short for Continuous Positive Airway Pressure. If you’ve been diagnosed with OSA, then you know exactly what I mean.

The problem with CPAP therapy is that not a lot of people are good about using it on a routine basis. Or, like trying to start a ambitious exercise program, they are compliant at the start and then slowly drop off. Within a few months, they are rarely found using their CPAP. And sleeping poorly as a result.

But there’s hope: new research that just surfaced and was presented last week at a conference in San Diego has revealed that when patients are prescribed just a two-week course of a certain sleep aid (the one marketed as Lunesta), they are more apt to be using their CPAPs in six months.