Sleep Benefits and Sleep Deprivation Risks

There have been countless “cures” proposed for those who have trouble sleeping. A cursory internet search will suggest anything from sipping warm milk to taking melatonin supplements. However, researchers from the University of Colorado Boulder have a much more recreational answer: go camping for a weekend.

Doctor Kenneth Wright, an integrative physiology professor and lead author of a paper covering two studies, explains how going camping in an environment with natural light and dark cycles can reverse the damage of living everyday life in an artificially lit environment.

"These studies suggest that our internal clock responds strongly and quite rapidly to the natural light-dark cycle. . . Living in our modern environments can significantly delay our circadian timing and late circadian timing is associated with many health consequences. But as little as a weekend camping trip can reset it," he said.

Managing our internal clocks

This is not the first paper that Wright has published on the beneficial effects of camping. In 2013, he conducted a study where participants were sent to camp for a week in the summer without the use of headlamps or flashlights at night. When they returned, Wright found that their levels of melatonin – a hormone that prepares the body for nighttime and promotes sleep – had synced with sunrise and sunset, a change of almost two hours.

To build on that previous study, Wright set out to find how quickly our internal clocks could change based on the lighting of our environment and the time of the year. The first study consisted of 14 participants – nine of which were asked to camp for a weekend during the summer while the other five stayed home. After the weekend, participants who went camping had melatonin rise 1.4 hours earlier than those who hadn’t gone, suggesting that their internal clocks had altered.

In the second study, five participants camped for an entire week around the time of the winter solstice. Statistics showed that they were exposed to 13 times more natural light than usual and that their melatonin levels began to rise 2.6 hours earlier.

"Weekend exposure to natural light was sufficient to achieve 69 percent of the shift in circadian timing we previously reported after a week's exposure to natural light," Wright stated.

Getting back in sync

So, what does all of this mean for sleep? Essentially, the two studies showed that not being exposed to artificial light allowed participants’ bodies to alter according to the time of the year and their bodies’ natural needs.

When living life normally with artificial light, the body’s internal clock and natural rhythms are often thrown off, which can impact when hormones are released, when we sleep and wake up, and even our appetite and metabolism. However, the studies show that just one weekend of camping away from that environment is enough to put our bodies back in sync. Wright hopes the results will help guide building and city design to help encourage natural light to promote health.

"Our findings highlight an opportunity for architectural design to bring more natural sunlight into the modern built environment and to work with lighting companies to incorporate tunable lighting that could change across the day and night to enhance performance, health and well-being," he said.

The full study has been published in Current Biology.

Numerous studies have extolled the benefits of getting a full night’s sleep; those who do so have been found to have more energy and better overall health due to better body self-regulation. Unfortunately, many of us continue to not get enough sleep at night, and new research suggests that health deficits are not the only thing we have to worry about.

Researchers at RAND Europe – a not-for-profit organization – have found that sleep deprivation costs the U.S. economy an average of $411 billion every year. They say this is due to higher mortality risk and lower productivity levels from employees who go to work tired.

“Our study shows that the effects from a lack of sleep are massive. Sleep deprivation not only influences an individual’s health and wellbeing but has a significant impact on a nation’s economy, with lower productivity levels and a higher mortality risk among workers,” said Marco Hafner, lead author and researcher of the study.

Economic losses

The study, entitled “Why Sleep Matters – The Economic Costs of Insufficient Sleep," analyzed the economic impact of insufficient sleep in five countries. While Canada, Germany, Japan, and the U.K. are all burdened with billions in losses due to lack of sleep, the U.S. beats them all with a loss of $411 billion, 2.28% of the country’s GDP.

The researchers note that if workers get up to one hour of extra sleep per night, it could make a huge economic difference. They say that individuals who get between seven and nine hours every night – dubbed the “healthy daily sleep range” -- can lower their mortality risk by 7%.

“Improving individual sleep habits and duration has huge implications, with our research showing that simple changes can make a big difference. For example, if those who sleep under six hours a night increase their sleep to between six and seven hours a night, this could add $226.4 billion to the U.S. economy,” said Hafner.

Recommendations

The researchers make several recommendations that they believe would improve sleep outcomes. For individuals, they say that setting consistent wake-up times will help the body stay regulated. Limiting the use of electronic items before bed and getting physical exercise during the day are also key points.

Further, they suggest that employers design and build brighter workspaces, provide facilities for daytime naps, monitor and assess psychosocial risks connected to sleep loss, and discourage the use of electronic devices after the work day has concluded. Public authorities can also help by encouraging health professionals and employers to provide sleep-related help.

You can view the full report of the study here.

We recently reported how poor sleeping habits could lead to an increased risk of diabetes in men, but new findings suggest that there are additional consequences that can affect everyone.

Researchers at the Cousins Center for Psychoneuroimmunology at the University of California have found that getting too much or too little sleep can increase markers for inflammation, a serious health concern.

“It is important to highlight that both too much and too little sleep appears to be associated with inflammation, a process that contributes to depression as well as many medical illnesses,” said Dr. John Krystal.

Higher risk of inflammation

Experts have long suspected that poor sleeping habits contributed to medical problems with inflammation. Prior studies have, for example, found associations between sleeping disorders, such as insomnia, and increased risk of inflammatory disease. Other adverse health conditions, like hypertension and type 2 diabetes, have also been connected.

In this study, the researchers examined information on over 50,000 people who had participated in other clinical studies. In order to gauge indicators of inflammation, they looked at levels of CRP and IL-6 in the body; high levels of each of these factors would indicate high levels of inflammation.

Additionally, the researchers checked records to assess how much sleep each participant was getting. After analyzing the information, they found that participants who had regularly interrupted sleep, insomnia, or long sleep durations (over 8 hours) had higher levels of CRP and IL-6 compared to those who slept normally (7-8 hours per night).

Assessing risk

The researchers believe that their findings should change how the medical community assesses risk with sleeping disorders. One researcher, Michael Irwin, believes that these kinds of problems should be regarded as behavioral risk factors for inflammation.

Irwin also states that having targeted therapies that address sleep behavior may go a long way towards reducing risk for inflammation. “Together with diet and physical activity, sleep health represents a third component in the promotion of health-span,” he said.

The full study has been published in the journal Biological Psychiatry. 

Experts have long expounded on the benefits of getting the proper amount of sleep, as well as the negative impacts that come along with not getting enough or getting too much.

Now, a new study from the Endocrine Society shows that men in particular could face some serious consequences by not getting a good night’s sleep. The group’s findings suggest that men who sleep too little or too much have a greater risk of developing diabetes, a disease that affects 29 million people across the U.S.

Importance of sleep

In general, the amount of sleep that Americans are getting has gone down in recent years. On average, the amount of sleep that people say they get at night is 1.5 to 2 hours lower than it was 50 years ago. Perhaps not coincidentally, the prevalence of diabetes has doubled over the same timeframe.

For the purposes of the study, researchers examined nearly 800 participants and analyzed the relationship between sleep duration and glucose metabolism. Special attention was given to the gender of participants to assess its importance as a major factor – and apparently it is.

“In men, sleeping too much or too little was related to less responsiveness of the cells in the body to insulin, reducing glucose uptake and thus increasing the risk of developing diabetes in the future. In women, no such association was observed,” said Dr. Femke Rutters, senior author of the study.

Differences between genders

The results of the study carry some significance, since it is the first of its kind to find opposite connections of sleep loss and diabetes between genders. However, the researchers are quick to note that the study will need to be validated through repetition, since their study utilized primarily healthy individuals and used instruments that were much more sensitive than those used in past studies.

Nevertheless, the researchers believe that their work represented an important step towards understanding the health consequences behind sleep.

“Even when you are healthy, sleeping too much or too little can have detrimental effects on your health. . . This research shows how important sleep is to a key aspect of health – glucose metabolism,” concluded Rutters.

The full study has been published in The Journal of Clinical Endocrinology & Metabolism. 

Parents with teenagers know very well that they can be moody at times, but is that grumpy attitude being caused by lack of sleep? Researchers from the American Academy of Sleep think this might be the case.

In a new study, the researchers found that adolescents who don’t get enough sleep are more susceptible to sudden changes in mood and energy. Specifically, they say that feelings of sadness and anger, along with low energy and sleepiness, are increased when sleep is restricted.

Emotional and mental fatigue

The researchers examined 97 health adolescents between the ages of 14 and 17 for the study. Participants were put on two different sleep cycles in a randomized, counterbalanced order. Five nights of this schedule included restricted sleep of 6.5 hours in bed, while the other five nights included extended sleep, or 10 hours in bed. A two-night “wash-out” period was placed in between each sleeping condition.

Each participant was asked to report on their feelings throughout the study to see what impact sleep had on their mental and emotional state. Specifically, they asked about factors like sadness, anger, nervousness, energy, fatigue, ability to concentrate, and sleepiness each day.

Of these factors, the researchers found that restricted sleep led to more variability in sadness, anger, and sleepiness compared to periods of extended sleep. They also found that a worsened mood due to restricted sleep had a negative impact on the following night’s sleep.

Promoting healthy sleep habits

The researchers believe that these results might explain some of the real problems that adolescents face on a day-to-day basis.

“These results are important because variability in mood and emotional dysregulation can interfere with social, school, and behavioral functioning, and may contribute to the development of more severe psychopathology,” said Dr. Dean Beebe, senior author of the study.

“The promising aspect of this finding is that sleep can be modified and by promoting healthy sleep we could potentially prevent the development and/or maintenance of more serious mental health problems for some teens.”

The study’s abstract has been published in the journal Sleep, but the researchers will be presenting the full study at SLEEP 2016, an annual meeting of the Associated Professional Sleep Societies LLC (APSS).

Most everyone knows how important sleep is to infants and children, but there are still many adults out there who only get a few hours of sleep per night. While these same people might reach for coffee in the morning to counteract a poor night’s sleep, a new study shows that caffeine can only help so much.

In a double-blind, placebo-controlled study, researchers found that caffeine was only able to help improve alertness and performance in adults for two consecutive days before lack of sleep took over.

Temporary benefits

The researchers utilized 48 individuals who were restricted to five hours of sleep per 24-hour period over the course of five days. Participants were split into two groups for the study – one group received 200 mg of caffeine twice daily while the other received a placebo.

Over the five-day period, all participants also took part in a range of tests to measure their alertness and overall cognitive performance. The researchers found that while the group receiving caffeine did better on these tests over the first two days of the trial period, the lack of sleep eventually caught up with them and their scores suffered over the final three days.

“We were particularly surprised that the performance advantage conferred by the two daily 200 mg doses of caffeine was lost after three nights of sleep restriction,” said Dr. Tracy Jill Doty, lead author of the study.

Prioritizing sleep

The results indicate that caffeine may not suffice if a person is repeatedly not getting enough sleep at night. For consumers who need to stay alert during their waking hours, which pretty much includes everyone for one reason or another, this could mean prioritizing sleep in the future.

“These results are important, because caffeine is a stimulant widely used to counteract performance decline following periods of restricted sleep. The data from this study suggests that the same effective daily dose of caffeine is not sufficient to prevent performance decline over multiple days or restricted sleep,” said Doty.

The abstract for this study has been published in the journal Sleep, but the research team plans to present their full findings on June 14 at SLEEP 2016, an annual meeting of members of the Associated Professional Sleep Societies LLC (APSS).

Are you getting enough sleep at night? If you’re not, then you may have more problems than being groggy at work the next day. Sleeping habits are closely associated with your metabolism, so if you aren’t getting enough then you can expect symptoms like increased appetite and insulin insensitivity.

As a result, many people who don’t get enough sleep end up developing serious health problems, like obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Understanding that this link is problematic is important, but why are sleep and these issues connected in the first place?

It’s a question that researchers from Florida Atlantic University have been trying to answer, and it’s possible that they may have figured it out. In a study that examined fruit flies, the researchers found that a conserved gene called translin was responsible for modulating sleep in response to metabolic changes.

Altering genes and behaviors

The researchers point out that, up to this point, there have not been many answers when it came to linking metabolic problems with lack of sleep. “Despite widespread evidence for interactions between sleep loss and metabolic dysfunction, little is known about the molecular basis of this interaction and how these processes integrate within the brain,” said corresponding author Alex C. Keene.

So in order to fill in that knowledge gap, researchers began studying fruit flies, who are shockingly similar to humans when it comes to their sleeping habits. For example, if fruit flies do not get enough sleep then their memory performance drops. Their sleep can also be negatively affected by stimulants like caffeine, which any person who has mistakenly drank a cup of regular coffee late at night can also attest to.

Like humans, fruit flies also have trouble going to sleep if they are hungry; the tiny insects will often sacrifice sleep time in order to go out and scavenge for food. Knowing this, researchers created scenarios for the fruit flies that would either encourage them to sleep or go out and forage for food. During these scenarios, the researchers tested and manipulated gene levels to see if they could provoke an abnormal response.

Eventually, the researchers found that altering translin in the fruit flies led to atypical actions. When the number of neurons were decreased in translin, the insects were able to sleep despite being on an empty stomach.

Important evidence

The results of the study indicate that translin is not needed in order to experience feelings of starvation, but it does have a large effect on our inability to go to sleep if we are hungry.

“While many genes have been identified as genetic regulators of sleep or metabolic state, mounting evidence from our study indicates that translin functions as a unique integrator of these processes,” said study co-first author Kazuma Murakami.

“The identification of genes regulating sleep-feeding interactions will provide important insight into how the brain integrates and controls the expression of complex behaviors,” added Keene.

The full study has been published in the journal Current Biology.

America has a sleep problem. So says the Centers for Disease Control and Prevention (CDC), reporting that its research shows more than a third of American adults are not getting enough sleep on a regular basis.

The American Academy of Sleep Medicine and the Sleep Research Society recommend adults between 18 and 60 years old sleep at least seven hours each night to promote optimal health and well-being.

People who can't fall asleep, or have their sleep interrupted by periods of restlessness, are at greater risk of developing chronic conditions such as obesity, diabetes, high blood pressure, heart disease, stroke, and even mental distress.

The proliferation of television commercials for special mattresses and pillows suggests there is a significant market for these products among people who find it hard to get enough sleep.

“As a nation we are not getting enough sleep,” Dr. Wayne Giles, director of CDC’s Division of Population Health, said in a release.

Lifestyle changes

He recommends lifestyle changes such as going to bed at the same time each night and getting up at the same time each morning. Turning off or removing televisions, computers, mobile devices from the bedroom, can also help people get the healthy sleep they need, he says.

Some people may find it hard to get the proper amount of sleep because they suffer from one of any number of sleep disorders. The National Sleep Foundation says delayed sleep phase disorder (DSPD), officially called circadian rhythm sleep disorder, delayed sleep phase type, is among the more common disorders. It's an inability to fall asleep at a desired, conventional clock time and awaken at a socially acceptable morning time.

Insomnia

Insomnia is perhaps the most common sleep-related disorder. A brief episode of difficulty sleeping is called acute insomnia, and is usually caused by a stressful life event. Chronic insomnia is a long-term pattern of difficulty sleeping. Insomnia is usually considered chronic if a person has trouble falling asleep or staying asleep at least three nights per week for three months or longer. It can have many causes.

The CDC is urging healthcare providers to routinely assess patients’ sleep patterns and discuss sleep-related problems such as snoring and excessive daytime sleepiness. It would also like providers to do more to educate patients about the importance of sleep to their health.

To learn more about sleep and its effect on your health, check out this CDC resource.

We have become a data-driven culture. We desire information about all aspects of life, including the eight hour or so a day when we're not awake. Some of the new wearable health monitors provide sleep data.

Here's a non-wearable monitor that does the same thing – the REM-Fit, from Protect-A-Bed, introduced at the Consumer Electronics Show (CES) in Las Vegas. It even comes with a pillow.

The company says the device uses sensors to monitor heart rate, breathing, and motion. The next morning you can open an accompanying mobile app and take a look at your sleep analysis. It will show, among other things, how often and when you tossed and turned during the night, along with a SleepScore based on how efficiently you slept.

Fits under the sheet

To use the device, you place it under the fitted sheet directly on the mattress. Featuring a thin design, the tracker is designed to go undetected while a user sleeps. The REM-Fit is the result of collaboration between Protect-A-Bed and Sleepace, which produces products to help people sleep.

"When we first entered the sleep technology industry last year with our REM-Fit Active sleep and activity tracker, we couldn't anticipate the level of enthusiasm we would receive," said Warrick Bell, director of product development for REM-Fit and Protect-A-Bed. "The Sleepace partnership allows us to utilize their technology to provide insights for users to get a better night's sleep."

REM-Fit is just the latest product designed for consumers to help them sleep. Cable TV viewers know there is no shortage of commercials promoting beds, pillows, and other items to promote a more restful sleep.

Smart Hat

Other somewhat unusual sleep aids include the Smart Hat Sleep System, available through Sharper Image. It's billed as a natural, drug-free sleeping device that monitors your brainwaves, and then plays specially engineered biofeedback tones to help you relax and fall asleep.

This product consists of a stretchable nylon hat that includes a pair of high-fidelity speakers. The tones reportedly fade away once you have reached a sleep state, but come back on again should you awake during the night.

With all these products designed to promote and analyze sleep – and we haven't even touched on sleeping pills – it would be easy to conclude that Americans have a sleep problem. And apparently we do.

A 2015 poll by the National Sleep Foundation found that people who suffer chronic or acute pain have the most trouble with sleep. But 35% of those without pain reported at least some sleep problems.

“Sleep quality and duration should be considered a vital sign, as they are strong indicators of overall health and quality of life,” said the foundation's Kristen Knutson. “Extremely long or short sleep durations are associated with more specific conditions, but for many people who are close to getting the recommended seven to nine hours of sleep, getting just 15 to 30 minutes more sleep a night could make difference in how they feel.” 

Amid all the diet fads and weight loss advice is this often-overlooked bit of wisdom: going to bed at a decent hour will likely make it easier to keep the pounds off.

A study by researchers at the University of California, Berkeley say they have found a correlation between sleep and body mass index (BMI). BMI is the measure of a person's weight in kilograms divided by the square of height in meters. A healthy adult BMI range is estimated to be 18.5 to 24.9.

After examining data from a national sample of 3,300 youths and adults, the researchers found that for every hour of sleep the subjects lost, they gained 2.1 points on the BMI index. Granted, it was a slow process, with the weight gained over a five-year period.

Getting exercise and reducing screen time didn't seem to matter. Neither did getting more hours of sleep – going to bed late and rising late as well. What seemed to matter is what time the subjects hit the hay.

Total sleep time not a factor

"These results highlight adolescent bedtimes, not just total sleep time, as a potential target for weight management during the transition to adulthood," said Lauren Asarnow, lead author of the study.

The Berkeley study focused on three time periods - the onset of puberty, the college-age years, and young adulthood. The researchers were able to compare the bedtimes and BMI of teenagers from 1994 to 2009.

Adolescents in the study reported their bedtimes and sleep hours while researchers calculated their BMI based on their height and weight.

Cause not suggested

The study did not pinpoint a potential cause for the correlation between bedtime and BMI. It's possible that more late night activities lend themselves to snacking and unhealthy eating habits.

Other research shows many teenagers do not get the recommended nine hours of sleep per night and report having trouble staying awake at school.

Then again, it might be a matter or metabolism. The researchers say the human circadian rhythm, which regulates physiological and metabolic functions, typically shifts to a later sleep cycle at the onset of puberty.

Is your middle or high school-aged child getting enough sleep? Not according to data published by the Centers for Disease Control and Prevention (CDC).

The agency's Morbidity and Mortality Weekly Report says fewer than 1 in 5 began the school day at 8:30 AM or later during the 2011-2012 school year, the start time recommended by the 2011-2012 Schools and Staffing Survey of nearly 40,000 public middle, high, and combined schools.

The American Academy of Pediatrics says too-early start times can keep students from getting the sleep they need for health, safety, and academic success.

Consequences of too little sleep

Schools that have a start time of 8:30 AM or later allow adolescent students the opportunity to get the recommended amount of sleep on school nights -- about 8.5 to 9.5 hours. Insufficient sleep is common among high school students and is associated with several health risks such as being overweight, drinking alcohol, smoking tobacco, and using drugs -- as well as poor academic performance. The proportion of high school students who fail to get sufficient sleep (2 out of 3) has remained steady since 2007, according to the 2013 Youth Risk Behavior Surveillance Report.

“Getting enough sleep is important for students’ health, safety, and academic performance,” said Anne Wheaton, Ph.D., lead author and epidemiologist in CDC’s Division of Population Health. “Early school start times, however, are preventing many adolescents from getting the sleep they need.”

Study findings

• 42 states reported that 75-100% of the public schools in their respective states started before 8:30 AM.
• The average start time was 8:03 AM.
• The percentage of schools with start times of 8:30 AM or later varied greatly by state. No schools in Hawaii, Mississippi, and Wyoming started at 8:30 AM or later; more than 75 percent of schools in Alaska and North Dakota started at 8:30 AM or later.
• Louisiana had the earliest average school start time (7:40 AM), while Alaska had the latest (8:33 AM).

In 2014, the American Academy of Pediatrics issued a policy statement urging middle and high schools to modify start times to no earlier than 8:30 AM to aid students in getting sufficient sleep to improve their overall health.

School start time policies are not determined at the federal or state level, but at the district or individual school level. Future studies may determine whether this recommendation results in later school start times.

What to do

The authors report that delayed school start times do not replace the need for other interventions that can improve sleep among adolescents. Parents can help their children practice good sleep habits. For example, a consistent bedtime and rise time, including on weekends, is recommended for everyone, including children, adolescents, and adults.

Health care providers who treat adolescents should educate teens and parents about the importance of adequate sleep in maintaining health and well-being.

Many parents may remember a time when they dreaded putting their child down to bed. When they are young, many children go through a sleepwalking phase or experience night terrors that make them inconsolable.

While these problems are fairly common, the scientific community has never pinned down exactly why these things happen in the first place. Well, a new study conducted in Canada says that it may have to do with genetics.

Dr. Jacques Montplaisir, of Hopital du Sacre-Coeur de Montreal, has theorized that children may inherit their sleeping problems from their parents. His study analyzed sleep data from 1,940 children born in the province of Quebec.

All children were born between 1997 and 1998, and their sleep patterns were studied from 1999 to 2011. The researchers assessed sleepwalking and night terrors through questionnaires and parental sleepwalking was taken into account.

Sleepwalking, sleep terrors

The results of the study revealed correlations between sleepwalking and sleep terrors. The data showed that children who had sleep terrors during early childhood (1 ½ to 3 ½ years old) were about 15% more likely to sleepwalk later in childhood.

These odds increased dramatically if the child’s parents had a history of sleepwalking when they were young. Children who had one parent who was a sleepwalker were three times more likely to sleepwalk themselves. If both parents were sleepwalkers, children were seven times more likely to be sleepwalkers.  

The study concludes by offering an explanation about the root cause of sleepwalking. Researchers believe that their data points to “a strong genetic influence on sleepwalking and, to a lesser degree, sleep terrors. This effect may occur through polymorphisms in the genes involved in slow-wave sleep generation or sleep depth.”

They caution that parents who have been sleepwalkers in the past should count on their children to be sleepwalkers as well. The full study has been published in JAMA Pediatrics, and contains detailed statistics on the researchers’ findings.

In the 19th century people often went to bed when the sun went down and rose before dawn. After all, there was no TV to watch or web to surf.

Besides, it was thought that every hour of sleep you got before midnight was worth 2 hours of sleep after that hour. Modern research suggests there might be some truth in that.

Korean researchers writing in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolismhave concluded that people who stay up late are more likely to develop diabetes, metabolic syndrome and sarcopenia than people who turn in early, even when they get the same amount of sleep.

Sleep-wake cycle

The study focused on a person’s natural sleep-wake cycle. It found that staying awake later at night is likely to reduce the amount and quality of sleep. Maybe even more important, it connected staying up late with strange dietary patterns, with subjects tending to eat the wrong kinds of food at the wrong times.

“Regardless of lifestyle, people who stayed up late faced a higher risk of developing health problems like diabetes or reduced muscle mass than those who were early risers,” said Nan Hee Kim, of Korea University College of Medicine in Ansan, Korea and one of the study’s authors. “This could be caused by night owls’ tendency to have poorer sleep quality and to engage in unhealthy behaviors like smoking, late-night eating and a sedentary lifestyle.”

Night owls less healthy

In the study, some subjects stayed up late and others went to bed early. Even though the people who stayed up late were younger, they had higher levels of body fat and triglycerides, or fats in the blood, than the older subjects who both turned in and rose early.

The night owls also were more likely to have sarcopenia. That’s  a condition where the body gradually loses muscle mass. Late night men were more likely have diabetes or sarcopenia while late night women tended to have more belly fat and a significant risk of metabolic syndrome.

“Considering many younger people are evening chronotypes, the metabolic risk associated with their circadian preference is an important health issue that needs to be addressed,” Kim said.

The Korean study adds to the growing body of research stressing the importance of sleep to health.

Other research

 “Sleep affects almost every tissue in our bodies,” said Dr. Michael Twery, a sleep expert at the National Institutes of Health (NIH). “It affects growth and stress hormones, our immune system, appetite, breathing, blood pressure and cardiovascular health.”

According to NIH, a good night’s sleep consists of 4 to 5 sleep cycles. Each cycle includes periods of deep sleep and rapid eye movement (REM) sleep. It’s during that time that you have dreams.

“As the night goes on, the portion of that cycle that is in REM sleep increases. It turns out that this pattern of cycling and progression is critical to the biology of sleep,” Twery said.

How much sleep do you need? It will vary by age but Twery says – in addition to the number of hours – the quality of the sleep is just as important.

There is an old expression that, when someone is especially disagreeable or in a bad mood, that they “got up on the wrong side of the bed.”

There might actually be something to that.

Most people have very set patterns for how they get their shut eye, and that extends to which side of the bed they lie down on and which direction they face. It stands to reason they would get up on the same side of the bed most of the time.

A survey by mattress maker Saatva suggests something as simple as picking the right side of the bed or facing or not facing your partner actually make a difference in how well you sleep. The survey quizzed consumers on their bedside practices and how it affects their sleep and mood the following day.

Creatures of habit

Not surprisingly, it found that 40% of adults have always slept on the same side of the bed. Perhaps more of a surprise, more than half said they don't ever remember making a conscious decision about the side of the bed on which to lie down.

When asked to think about it and actually pick on one side of the bed or the other, 20% ended up choosing the opposite side of the bed from their normal side.

The survey-takers discovered that more Americans sleep on the right side of the bed than the left. Men prefer the right side by 58%, with only 50% of women choosing the right side.

When asked why they chose the right side of the bed, 71% of men said it made them feel more relaxed.

Sleepers of both sexes appear happier with their partner facing away from them in bed as compared to sleeping towards them but women appear to prefer it the most. Seventy-two percent of women said they need their space and prefer they face away from their partners.

Practical choices

Sometimes people choose a side of the bed, not because of how it makes them feel, but for more practical reasons. Among reasons for choosing, 75% of respondents said being close to an electrical outlet, to plug in a clock or other devices, determines where they settle in for the night.

Other practical considerations include proximity to the bathroom or to a door or window.

"Americans need to be more conscious of every aspect of the sleep choices they make today," said Ron Rudzin, CEO of Saatva Mattress. "Making a concerted effort to understand each factor of sleep wellness – even having open conversations about which side to sleep on – can make a difference in a good night's sleep."

Tips for better sleep

Americans spend billions of dollars on special mattresses, pillows and other sleep enhancement tools in an effort to get the right amount of restful sleep. Sleep problems are particularly common among older people.

The National Council on Aging suggests following a regular sleep schedule and to avoid napping during the day, if you find it hard to sleep at night. While there is some research that suggests short naps can be healthy, they can also disrupt nighttime sleep patterns.

Other tips include a bedtime routine, such as reading or listening to soothing music. Bedrooms should be dark and at a moderate temperature.

Things to stay away from just before bedtime – caffeine, large meals and alcohol. All 3 are sleep disruptors, making you cranky the next day, regardless of which side of the bed you got up on.

Have you noticed how many commercials there are on television promoting mattresses? Not just any mattresses, but super bedding designed to help you sleep better.

There are even pillows that promise a better night's rest. Whether these products really help can be debated, but it's clear many people are finding sleep is elusive and are looking for ways to get more of it.

That may be a good thing.

In a world of increasing stress, sleep is sometimes a casualty. When we're young we might stay out all night partying or pull an all-nighter to complete a school paper.

When we're older the stresses of family life and a competitive and uncertain workplace can rob us of sleep.

Health consequences

Whatever the stage of life and whatever the reason for it, doctors now recognize that not getting enough sleep has real health consequences.

“In the short term, a lack of adequate sleep can affect judgment, mood, ability to learn and retain information, and may increase the risk of serious accidents and injury,” according to the Division of Sleep Medicine at the Harvard Medical School. “In the long term, chronic sleep deprivation may lead to a host of health problems including obesity, diabetes, cardiovascular disease, and even early mortality.”

But how much sleep is enough? The exact number varies depending on age. But Dr. Lydia DonCarlos of the Loyola University Chicago School of Medicine is a member of a National Sleep Foundation panel that has just issued new recommendations.

New recommendations

She says newborns need 14 to 17 hours of sleep per day while senior adults aged 65 and up need 7 to 8 hours per day. Teens, who perhaps need sleep the most yet get it the least, are urged to get between 8 to 10 hours of sleep each night.

To reach their conclusions DonCarlos said the panel looked at the findings of more than 300 previous studies of sleep.

“We still have a great deal to learn about the function of sleep,” DonCarlos said. “We know it’s restorative and important for memory consolidation. But we don’t know the details of what the function of sleep is, even though it is how we spend one-third of our lives.”

What you need

Here the panel's sleep-time recommendations:

• Newborns (0-3 months): Sleep range narrowed to 14-17 hours each day (previously it was 12-18).
• Infants (4-11 months): Sleep range widened two hours to 12-15 hours (previously it was 14-15).
• Toddlers (1-2 years): Sleep range widened by one hour to 11-14 hours (previously it was 12-14).
• Preschoolers (3-5): Sleep range widened by one hour to 10-13 hours (previously it was 11-13).
• School age children (6-13): Sleep range widened by one hour to 9-11 hours (previously it was 10-11).
• Teenagers (14-17): Sleep range widened by one hour to 8-10 hours (previously it was 8.5-9.5).
• Younger adults (18-25): Sleep range is 7-9 hours (new age category).
• Adults (26-64): Sleep range did not change and remains 7-9 hours.
• Older adults (65+): Sleep range is 7-8 hours (new age category).

A 2011 study found U.S. teenagers weren't meeting the old sleep recommendations, much less the new ones. It found that 68.9% of adolescents responding to a survey got less than 8 hours of sleep on the average school night.

If you are in the habit of curling up in bed with a good book before dropping off to sleep, you might consider sticking with old fashioned books and not a tablet or e-reader.

There's new evidence that exposure to the e-reader's lighted screen may interfere with your circadian clock, interfering with your sleep.

"Electronic devices emit light that is short-wavelength-enriched light, which has a higher concentration of blue light -- with a peak around 450 nm -- than natural light," said Anne-Marie Chang, assistant professor of biobehavioral health at Penn State. "This is different from natural light in composition, having a greater impact on sleep and circadian rhythms."

iPad vs. book

Chang and her colleagues base their conclusion on two week observations of 12 adults. Participants read each night before going to bed, sometimes from an iPad and sometimes a printed book. The researchers monitored the participants' melatonin levels, sleep and next-morning alertness, as well as other sleep-related measures.

They found that their subjects took nearly 10 minutes longer to fall asleep and had a significantly lower amount of REM -- rapid eye movement -- sleep after reading from the iPad than they did after reading from a printed book,

Surprise

"Our most surprising finding was that individuals using the e-reader would be more tired and take longer to become alert the next morning," said Chang. "This has real consequences for daytime functioning, and these effects might be worse in the real world as opposed to the controlled environment we used."

And it wasn't just an iPad that interfered with shut-eye. The experiment measured the amount of brightness coming from several devices, including an iPad, iPhone, Kindle, Kindle Fire and Nook Color.

The Kindle e-reader does not give off light, while the iPad, Kindle Fire and Nook Color emit similar amounts of light. However, the iPad is the brightest of the devices measured.

The study lasted 14 days and was conducted in a hospital setting. Each of the subjects read from an iPad before bedtime 5 consecutive nights, then switched to a printed book for five straight nights. Hourly blood samples measured melatonin levels.

Sleep-restricted society

"We live in a sleep-restricted society, in general," said Chang. "It is important to further study the effects of using light-emitting devices, especially before bed, as they may have longer term health consequences than we previously considered."

In a poll released earlier this month the National Sleep Foundation discovered that 45% of Americans said poor or insufficient sleep affected their daily activities at least once in the past seven days.

Despite sleeping within the recommended number of hours a night, 35% of Americans report their sleep quality as “poor” or “only fair.” Twenty percent of Americans reported that they did not wake up feeling refreshed on any of the past seven days.

Over the weekend the U.S. returned to standard time. Clocks turned back one hour. It's something we do every year.

But if you find you are having a hard time readjusting to standard time, you aren't alone. Millions of us are dealing with changes to our sleep pattern. Experts say the readjustment may require some effort.

These problems are not unusual. Our bodies -- our circadian rhythms, actually — need a little time to adjust. These daily cycles are run by a network of tiny, coordinated biological clocks.

Vanderbilt Sleep Disorders Center specialist Kelly Brown says part of the problem is that the time change always falls on a weekend. In many cases, we tend to alter our sleep patterns on weekends, time change or no time change.

“A lot of people like to stay up late on the weekend and then sleep in, but it’s important to stick to your regular schedule,” Brown said. “Mondays are already hard when you shift your sleep schedule on the weekends, and the time change makes it even harder.”

Let there be light

The key to adjustment may be light. Brown says light is the most powerful way to control the internal clock.

“Getting sun exposure in the morning helps us feel more awake, and avoiding light at night, especially blue light from electronics, helps us fall asleep,” Brown said.

So a walk first thing in the morning might be a good way to promote adjustment to the new time. Brown says light travels a direct pathway through the eye’s retina and regulates the hormone melatonin, which controls the sleep-wake cycle, among other functions.

When you are exposed to light, your body produces less melatonin. Melatonin, a natural substance in your body, makes you feel sleepy. Exposure to darkness usually leads to more melatonin.

This may explain why we often feel more tired or groggy in the fall and winter months, when days are shorter and there are fewer hours of sunlight.

Don't ignore sleep problems

It’s very important to note that if you are feeling sleepy during the day or having difficulty falling or staying asleep, you should talk to your primary care provider and consider an evaluation by a sleep physician. Sleep disorders are highly treatable and their treatment can make a dramatic change in your health and daytime functioning,” Brown said.

Mike Sesma of the National Institutes of Health (NIH) tracks circadian rhythm research being conducted in labs across the country. He says knowing more about your biological clock make help you adjust to that extra hour in the day.

The good news is, while they might get temporarily thrown off by changes in light or temperature, our internal clocks can usually reset themselves.

Internal control

Sesma says our internal clocks will affect our alertness, hunger, metabolism, fertility, mood and other physiological conditions. So it's not surprising that clock dysfunction can be associated with various disorders, including insomnia, diabetes and depression. Sesma says even drug efficacy has been linked to our clocks: Studies have shown that some drugs might be more effective if given earlier in the day.

For that reason Brown says you should establish a relaxing pre-sleep ritual, such as taking a bath, reading or listening to calm music. Your bedroom should be quiet, dark and at a comfortable temperature.

In the morning you don't want to produce melatonin, but at night you do. So avoid he bright lights and stimulation of TVs, computers and other electronics before bed.

Other common sense practices may also promote a good nights sleep. Don't eat a big meal before bedtime, or drive alcohol or coffee. Exercise in the morning, not the late afternoon or evening. And try to keep the same bedtime, even on weekends.

If you think you have trouble sleeping, try being a bird in the city. The lights from shopping centers, stadiums and homes are turning birds' internal clocks cuckoo! It's really messing with a lot of different things -- their songs, mating and reproduction.

Davide Dominoni, an ecologist at the Max Planck Institute for Ornithology in Radolfzell, Germany, investigated whether the birds’ activity patterns were merely behavioral responses to busy cities or were caused by an actual shift in the animals' body clocks. 

Dominoni and colleagues used European blackbirds, attaching radio transmitters to birds that lived in Munich and to birds that lived in the forest. Then they watched the birds for three weeks. They found that the forest birds started getting a little rowdy at dawn but city birds started 29 minutes earlier and they were active for about 6 minutes longer in the evening.

Altered state

Similar studies support the idea that city lights are altering the basic physiology of urban birds even to the point of suppressing their estrogen and testosterone, changing mating behaviors. One experiment showed that male blackbirds did not develop reproductive organs when they were exposed for two years to light at night.

An Avian sleep biologist at the Max Planck Institute who was not involved in the study commented: “You have to wonder — if these city birds are not compensating by napping during the day or sleeping more deeply at night, is sleep deprivation reducing their cognitive abilities or shortening their life spans?”

People may be in the same fix. There have been numerous studies on shift work and how it alters humans sleep patterns and deprivation of sleep. There are countless ramifications from turning your world from night to day literally.

"We don’t see a lot of people who do fine on shift work," says Sally Ibrahim, M.D., of the Cleveland Clinic’s Sleep Disorder Center. "They have trouble sleeping, trouble waking. And they’re drowsy when they’re awake."

Anyone with a teenager knows getting them up and going for school can seem like you have spent 6 hours on a rowing machine in the gym.  It's a grind and it's not the way you want to start your day. 

You now have back-up. The American Academy of Pediatrics has a new recommendation -- it suggests starting middle and high schools no earlier than 8:30 a.m. 

They caution that teens need their sleep and if we don't give it to them we are creating another generation of sleep-deprived people. The science supporting a return to later school start times is clear, and has been since the 1990s, the researchers say.

Not just pimples

Pimples are not the only right of passage in puberty, after all.  In puberty we see a shift in circadian rhythms, or "body clocks,"  that pushes optimal sleep time forward. Most teenagers simply can't fall asleep before 11 p.m. even if they're lying in bed for hours. When the sun comes up  they haven't gotten close to the 8½ to 9½ hours of sleep their brains and bodies need.

What we start to see are all the signs of sleep deprivation, like mood swings, weight gain, immune disorders and depression. Following all of those things is the fall-out in school -- not being able to concentrate, which results in poor grades. Not to mention new drivers and lack of sleep -- it's an accident waiting to happen.

According to sleep expert  James B. Maas of Cornell University, "Almost all teenagers, as they reach puberty, become walking zombies because they are getting far too little sleep."

Why no action?

So maybe school starting times should reflect this?

After all, there is some pretty strong evidence that really rings a bell with the experts. Besides the ones already mentioned, studies from the University of Minnesota, Brown University, and the Children's National Medical Center provide evidence that running schools at developmentally appropriate hours not only improves health and academic performance but actually results in teenagers getting significantly more sleep. Community life adjusts to school schedules, not vice versa.

So why does high school still start at such ungodly hours as 7 a.m. around the country?

Well, one argument holds that sports would suffer. And then there's traffic. Putting all those school buses on the road later would clog up streets. And besides, we've done it this way forever.

The Academy of Pediatrics calls this "one of the most common -- and easily fixable -- public health issues in the U.S. today." So perhaps we ought to wake up and do what is best for our kids.

People who have a hard time falling and staying asleep (insomnia) have a new option.

The Food and Drug Administration has approved Belsomra (suvorexant), an orexin receptor antagonist -- the first approved drug of its kind. Orexins are chemicals that are involved in regulating the sleep-wake cycle, and play a role in keeping people awake. Belsomra alters the signaling action of orexin in the brain.

“To assist health care professionals and patients in finding the best dose to treat each individual patient’s sleeplessness, the FDA has approved Belsomra in four different strengths – 5, 10, 15, and 20 milligrams,” said Ellis Unger, M.D., director of the Office of Drug Evaluation I in the FDA’s Center for Drug Evaluation and Research. “Using the lowest effective dose can reduce the risk of side effects, such as next-morning drowsiness.”

Belsomra should be taken no more than once per night, within 30 minutes of going to bed, with at least seven hours remaining before the planned time of waking. The total dose should not exceed 20 mg once daily.

Impairment possible

The most commonly reported adverse reaction reported by people taking the drug in clinical trials was drowsiness. Medications that treat insomnia can cause next-day drowsiness and impair driving and other activities that require alertness. People can be impaired even when they feel fully awake.

The FDA asked the drug manufacturer, Merck, Sharpe & Dohme Corp., to study next-day driving performance in people who had taken Belsomra. The testing showed impaired driving performance in both men and women when the 20 mg strength was taken.

As a result, the FDA recommends that patients using the 20 mg strength be cautioned against next-day driving or activities requiring full mental alertness. Patients taking lower doses should also be made aware of the potential for next-day driving impairment, because there is individual variation in sensitivity to the drug.

Like other sleep medicines, there is a risk from Belsomra of sleep-driving and other complex behaviors while not being fully awake, such as preparing and eating food, making phone calls, or having sex.

Chances of such activity increase if a person has consumed alcohol or taken other medicines that make them sleepy. Patients or their families should call the prescribing health care professional if this type of activity occurs.

Effective use

The effectiveness of Belsomra was studied in three clinical trials involving more than 500 participants. In the studies, patients taking the drug fell asleep faster and spent less time awake during the remainder of the night compared to people taking an inactive pill (placebo).

Belsomra was not compared with other drugs approved to treat insomnia, so it is not known if there are differences in safety or effectiveness between Belsomra and other insomnia medications.

Belsomra will be dispensed with an FDA-approved patient Medication Guide that provides instructions for its use and important safety information.  

Parents aren't getting -- or are ignoring -- the message that infants should always be placed on their back to sleep and that they shouldn't share their parents' bed.

A new study finds that about 4,000 babies die each year from sleep-related deaths involving suffocation and strangulation in beds. According to the study, these deaths from SIDS or SUID (sudden unexpected infant death) are seen more often among black families.

"We found that many infants are not placed to sleep on the back, and many still routinely share a bed during sleep," said lead author Eve Colson, M.D., professor of pediatrics at Yale School of Medicine.

Colson and her colleagues collected data from 1,276 mothers recruited from 32 hospitals across the country, which were chosen to provide a nationally representative sample of behavior. The participants completed an in-depth survey about infant care practices including bed sharing and infant sleeping positions.

The team found that 28% of Hispanic parents, 18% of black parents, and 13% of white parents share a bed with their infants.

"The estimated national prevalence of bed sharing is quite high at 18.5%," said Colson. "It is clear that more needs to be done to provide safe environments for all infants while they sleep."

Prone (stomach) sleeping, which has an even higher risk of leading to SIDS and SUID, was particularly common among black infants, with 22% of those infants being placed on their stomachs.

The findings will be presented at the Pediatric Academic Societies (PAS) Annual Meeting taking place May 3-6, 2014 in Vancouver, BC.

Why is it your partner gets a good, solid night of sleep while you toss and turn, unable to get any shut-eye?

Researchers at Johns Hopkins think it has to do with more plasticity and activity in the part of the brain that controls movement.

"Insomnia is not a nighttime disorder," says study leader Rachel E. Salas, M.D., an assistant professor of neurology at the Johns Hopkins University School of Medicine. "It's a 24-hour brain condition, like a light switch that is always on. Our research adds information about differences in the brain associated with it."

“Excitability” is a factor

Salas and her team, according to a report in the March issue of the journal Sleep, found that the motor cortex in those with chronic insomnia was more adaptable to change -- more plastic -- than in a group of good sleepers.

They also found more "excitability" among neurons in the same region of the brain among those with chronic insomnia, adding evidence to the notion that insomniacs are in a constant state of heightened information processing that may interfere with sleep.

Researchers say they hope their study opens the door to better diagnosis and treatment of the most common and often intractable sleep disorder that affects an estimated 15% of the U.S. population.

The sleep study

To conduct the study, Salas and her colleagues from the Department of Psychiatry and Behavioral Sciences and the Department of Physical Medicine and Rehabilitation used transcranial magnetic stimulation (TMS), which painlessly and noninvasively delivers electromagnetic currents to precise locations in the brain and can temporarily and safely disrupt the function of the targeted area.

TMS is approved by the U.S. Food and Drug Administration to treat some patients with depression by stimulating nerve cells in the region of the brain involved in mood control.

The study included 28 adult participants -- 18 who suffered from insomnia for a year or more and 10 considered good sleepers with no reports of trouble sleeping. Each participant was outfitted with electrodes on their dominant thumb as well as an accelerometer to measure the speed and direction of the thumb.

The researchers then gave each subject 65 electrical pulses using TMS, stimulating areas of the motor cortex and watching for involuntary thumb movements linked to the stimulation. Subsequently, the researchers trained each participant for 30 minutes, teaching them to move their thumb in the opposite direction of the original involuntary movement. They then introduced the electrical pulses once again.

The idea was to measure the extent to which participants' brains could learn to move their thumbs involuntarily in the newly trained direction. The more the thumb was able to move in the new direction, the more likely their motor cortexes could be identified as more plastic.

The “aha moment”

Because lack of sleep at night has been linked to decreased memory and concentration during the day, Salas and her colleagues suspected that the brains of good sleepers could be more easily retrained. The results, however, were the opposite. The researchers found much more plasticity in the brains of those with chronic insomnia.

Salas says the origins of increased plasticity in insomniacs are unclear, and it is not known whether the increase is the cause of insomnia. It is also unknown whether this increased plasticity is beneficial, the source of the problem or part of a compensatory mechanism to address the consequences of sleep deprivation associated with chronic insomnia.

Patients with chronic phantom pain after limb amputation and with dystonia, a neurological movement disorder in which sustained muscle contractions cause twisting and repetitive movements, also have increased brain plasticity in the motor cortex, but to detrimental effect.

Salas says it is possible that the dysregulation of arousal described in chronic insomnia -- increased metabolism, increased cortisol levels, constant worrying -- might be linked to increased plasticity in some way. Diagnosing insomnia is solely based on what the patient reports to the provider; there is no objective test. Neither is there a single treatment that works for all people with insomnia. Treatment can be a hit or miss in many patients, Salas says.

She says this study shows that TMS may be able to play a role in diagnosing insomnia, and more importantly, she says, potentially prove to be a treatment for insomnia, perhaps through reducing excitability.

Is there anything more annoying at the end of a busy day, or in the grocery store -- or anywhere for that matter -- than a cranky kid? Maybe he needs more sleep.

Researchers from University College London (UCL) have found that children with irregular bedtimes are more likely to have behavioral difficulties.

According to the study, published in the journal Pediatrics, irregular bedtimes could disrupt natural body rhythms and cause sleep deprivation, undermining brain maturation and the ability to regulate certain behaviors.

"Not having fixed bedtimes, accompanied by a constant sense of flux, induces a state of body and mind akin to jet lag and this matters for healthy development and daily functioning," said UCL Epidemiology & Public Health Professor Yvonne Kelly. "We know that early child development has profound influences on health and well-being across the life course. It follows that disruptions to sleep, especially if they occur at key times in development, could have important lifelong impacts on health."

Bed-check

Analyzing data from more than 10,000 children in the UK Millennium Cohort Study, the team collected bedtime data at three, five and seven years, as well as incorporating reports from the children's mothers and teachers on behavioral problems.

The study found a clear clinical and statistically significant link between bedtimes and behavior as irregular bedtimes affected children's behavior by disrupting circadian rhythms, leading to sleep deprivation that affects the developing brain.

As children progressed through early childhood without a regular bedtime, their behavioral scores -- which included hyperactivity, conduct problems, problems with peers and emotional difficulties -- worsened. However, children who switched to a more regular bedtime had clear improvements in their behavior.

Cumulative, but reversible

"What we've shown is that these effects build up incrementally over childhood, so that children who always had irregular bedtimes were worse off than those children who did have a regular bedtime at one or two of the ages when they were surveyed,” said Kelly. "But our findings suggest the effects are reversible. For example, children who change from not having to having regular bedtimes show improvements in their behavior."

Irregular bedtimes were most common at the age of three, when around one in five children went to bed at varying times. However, by the age of seven, more than half the children went to bed regularly between 7:30 and 8:30 pm. Children whose bedtimes were irregular or who went to bed after 9:00 pm came from more socially disadvantaged backgrounds, and this was factored into the study findings.

"As it appears the effects of inconsistent bedtimes are reversible, one way to try and prevent this would be for health care providers to check for sleep disruptions as part of routine health care visits,” Kelly concluded. “Given the importance of early childhood development on subsequent health, there may be knock-on effects across the life course. Therefore, there are clear opportunities for interventions aimed at supporting family routines that could have important lifelong impacts."

If you watch much cable TV you no doubt have seen plenty of commercials for special pillows to help you get a better night's sleep. Some regulate the surface temperature, others conform to the shape of your head.

But getting a good night's sleep is about more than having a special pillow, or even an adjustable bed. A number of sleep disorders could be depriving you of the rest you need.

Among the most common sleep disorders is insomnia. Suffers may have trouble falling asleep at night or they may wake up in the middle of the night and not be able to go back to sleep. In some cases, both may occur.

According to the National Institutes of Health (NIH) Symptoms of insomnia include lying awake for a long time before you fall asleep; sleeping for only short periods; being awake for much of the night; feeling as if you haven't slept at all; and waking up too early. 

Sleep study

If you see a doctor about this problem he or she may conduct a physical exam and look at your medical history. They may also suggest a sleep study. A sleep study measures how well you sleep and how your body responds to sleep problems. Treatments include lifestyle changes, counseling, and medicines.

Sleep problems may also be due to a condition called sleep apnea. This common disorder causes your breathing to occasionally stop or get very shallow. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour, according to NIH.

There is usually some physical cause of sleep apnea. An obstruction causes your airway to collapse or become blocked. Sleep apnea is often associated with loud snoring. Being overweight is a risk factor. Doctors usually diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results.

People with sleep apnea often don't realize they have a sleep disorder because they might not become fully awake. However, their sleep is constantly interrupted throughout the night, often making them tired and drowsy the following day.

Accident prone

People with sleep apnea can be at higher risk for auto accidents, on-the-job mishaps, and other medical problems. If you think you are suffering from sleep apnea, it is recommended that you get treatment. Lifestyle changes, mouthpieces, surgery, and breathing devices can treat sleep apnea in many people.

Restless Leg Syndrome is less common but can be an impediment to a good night's sleep nonetheless. It produces a powerful urge to move your legs and your legs become uncomfortable when you are lying down or sitting. The condition can make it hard to fall asleep and stay asleep.

Restless Leg Syndrome may be caused by disease or various health conditions. Caffeine, tobacco and alcohol may make symptoms worse. Doctors sometime prescribe relaxation exercises as a treatment.

The U.S. Centers for Disease Control and Prevention has taken a closer look at sleep, and its effect on overall health, since the mid 1990s. Its 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey including questions about sleep patterns and found that 35.3% of adults reported seven hours or less of sleep during a typical 24-hour period and 48% reported snoring.

Nearly 40% reported unintentionally falling asleep during the day at least once in the preceding month, and 4.7% reported nodding off or falling asleep while driving at least once in the preceding month.

Sleeping pills

To help with sleep consumers for decades have turned to prescription and over-the-counter sleeping aids. According to the Mayo Clinic, over-the-counter sleep aids can be effective for an occasional sleepless night. 

“There are a few caveats, however. Most over-the-counter sleep aids contain antihistamines,” the clinic says on its website. “Tolerance to the sedative effects of antihistamines can develop quickly — so the longer you take them, the less likely they are to make you sleepy.”

If you decide to take an over-the-counter sleep aid, don't start without discussing it with your doctor first. Also, be aware of side effects and avoid using alcohol.

Okay, so you've been struggling with insomnia for the past several months, and you've finally decided to do something about it.

First you hit the Internet to see what steps you can take. Then you talk to your family and friends about your problem and they give you all kinds of advice.

After that, you head to your doctor and he tells you the same thing the Internet and your family said. "Start to exercise, and once you begin, it'll help you with your insomnia tremendously."

So you wake up the next day and go for a jog. The day after that, you do a little aerobics from an old DVD you found. And on day three, you go for a brisk walk.

You continue these exercises for the rest of the week and you do the same the following week. And what happens after that? Absolutely nothing. You still haven't gotten one wink of sleep.

And why is that?

According to researchers from Northwestern University's Feinberg School of Medicine, it'll take at least four months of exercise before it helps your insomnia.

Not a quick solution

Kelly Glazer Baron, director of Northwestern University's behavioral sleep program, and lead author of the study, said using exercise as a fast solution to a health problem isn't the answer. You'll have to be more patient.

"The message here is that exercise is not a quick fix, which I don't really think is discouraging at all," she said. "Our previous work found that exercise over a 16-week period is very effective in promoting sleep, on par with any kind of medication. But like with weight loss or any sort of behavioral chance, it doesn't happen immediately. You have to measure progress over months, not day-to-day."

Which is why Baron and her team began this study. She said many of her patients were coming back discouraged after they started to exercise but still couldn't sleep. 

"Where the idea to explore this came from is that my patients were coming in and saying that they heard that exercise is good for sleep," explained Baron. "But people generally want a quick fix. And they weren't seeing improvements right away. So they were getting discouraged."

Plan ahead

In addition, researchers found that many people with insomnia go through a bad cycle of not being able to sleep and being too tired to work out the next day. So Baron said insomniacs will really have to fight through those tired feelings if they expect to turn their condition around. 

"So, what this means is that patients need to plan ahead," she said.

"They need to schedule exercise. Make it premeditated and part of one's routine, especially on those days when they feel tired or fatigued or didn't sleep well, because even if the sleep benefit doesn't come quickly, with time and commitment it may eventually come."

Phyllis Zee a neurology professor, who also worked on the study, said people with insomnia are completely removed from their normal routine and getting back that routine doesn't happen in a day or two.

"And although exercise is more of a long-term solution for insomnia, it's still healthier than taking medication," she said. "Patients with insomnia have a heightened level of brain activity, and it takes time to reestablish a more normal level that can facilitate sleep."  

"Rather than medication, which can induce sleep quickly, exercise may be a healthier way to improve sleep because it could address the underlying problem," Zee said.

Dr. James Pagel, director of the Sleep Disorders Center of Southern Colorado in Pueblo, said for many people with insomnia, exercising won't do any good, because folks have to learn how to take their minds off of overdrive.

"I have a large group of patients who run marathons," he said.

"I have people who are insomniacs and run many miles a week. And they still can't sleep, because insomnia is an abnormality of arousal, and for some people you're not just unable to sleep, but you're also hyper-aroused during the day and often committed to a very intense exercise pattern."

"And for these individuals, and those with a genetic form of insomnia, for example, exhausting themselves with exercise will not induce sleep," Pagel said.

Have you ever slept next to a noise that sounds like part broken fog horn, part wild animal?  Meaning, does your partner keep you up with a bunch of loud snoring every night?

If so, you're not alone, because according to a National Sleep Foundation study, 67% of U.S. adults say their partner snores. Aeparate study conducted in the UK found that the average married person loses about 730 hours of sleep each year because their spouse snores or moves around.

And in yet another survey that shows what people are doing about it, 30 to 40% of couples choose to sleep in different beds.

"People will say they sleep better [together], but when we actually monitor their brains we see that their brain is not getting into deeper stages of sleep because they're continuously being woken up by movement or sound," said Dr. Colleen Carney, director of Ryerson's Sleep and Depression Laboratory, in a published interview. "It creates a lot of problems."

Lot of problems

In addition, Carney says couples shouldn't feel their relationship will suffer because they sleep in separate beds. In fact, she said oftentimes it can improve the relationship, because both people are getting enough sleep.

"People can have very good and satisfying relationships sleeping apart," said Carney. "Some people might be headed to divorce and then they actually sleep apart and find this new way to connect."

Social beings

Wendy Troxel, a clinical psychologist and behavioral scientist, at the RAND Corporation, said it's hard for a lot of couples to sleep alone, because wanting someone next to you during the night is a natural feeling.

"Humans are inherently social beings and we derive a sense of safety and security from our social environment," said Troxel. "This fundamental need for safety and security at night may explain why we generally prefer to sleep with another human being, even when sharing a bed may not always result in the best quality sleep."

But it's not only snoring and movements that will keep a couple awake, it's other things too.

In the UK survey, 40% said their partner hogged the bed and 30% said they fought over the covers. Plus, 47% said they would put up with it, because they feared sleeping in separate beds would harm their level of intimacy.

Pre-sleep intimacy

But that's not necessarily true, said Troxel. She said the few hours before bed is actually a better time to be close with your partner. 

"Ultimately, the time couples spend together before falling asleep may be the most important time for connecting, being intimate and just being alone together, without all of the other distractions of the day" she said.

"Whether couples sleep in the same bed or separate beds, they need not give up on that important and satisfying pre-sleep time together. Perhaps the real benefits of sleeping together are realized in the precious lull before sleep comes."

The folks at the National Association of Home Builders said by 2015, 60% of homes in the U.S. will have two master bedrooms and experts say couples shouldn't feel like there's anything wrong with their relationship if they want to sleep apart. 

"People don't like to talk about sleeping in separate beds because there's a stigma that there must be something dysfunctional in the relationship," said marriage therapist Allison Cohen in a published interview. "But for those people who put tremendous value on getting a good night's sleep, which I think most of us do but are afraid to say, it can be an incredibly creative solution that is really effective for the relationship."

Just not possible

One woman, who goes by the user name Dollbaby 710, told MSN that she'd love to share a bed with her spouse, but it just isn't possible. And she has no regrets about it.

"I would love to sleep in the same bed with my husband but it is pretty much impossible," she wrote. "He starts snoring loudly the minute he falls asleep and it continues all night long. After about four months of me not getting much sleep after we married, we came to a mutual decision to sleep in separate rooms. We are both happier now because now I am not so grouchy from being sleep deprived every night."

This might be the answer for you, if you've been going back and forth about sleeping in separate rooms, but it's different for each couple.

"There is no one-size-fits all approach," said Troxel. "Couples need to decide what works best for them and consider how to optimize their sleep as well as their time together so that they can be the best possible partner for their loved one."

Have you ever felt sad or depressed during the day and weren't sure why?

The next time that happens ask yourself how much sleep you got the night before. Better yet, ask yourself how much sleep you've been getting overall.

And if you suffer from sleep apnea, you really want to ask yourself these questions.

Exploring the link

Researchers at Ohio State's Wexner Medical Center recently took a closer look at the link between sleep apnea and depression and looked into how even small amounts of light can throw off a good night's sleep a great deal.

Dr. Ulysses Magalang, director of the Sleep Disorders Center at the Wexner Medical System, said nearly 50% of folks with sleep apnea live with depression.

"We know that approximately half of all patients with obstructive sleep apnea also suffer from depression and anxiety," he said. "And we aren't exactly sure why."

Magalang and his research team conducted an experiment using lab mice, to get a better understanding of how sleep apnea patients can sleep better.

At the conclusion of the experiment the researchers said even the dimmest of lights can cause a sleep apnea patient to suffer. And they're not just talking about the TV and laptop being kept on.

Magalang and his team said even the small dots of light on your cable box or other electronics can throw off sleep and cause depression.

In addition, people with sleep apnea should avoid using digital alarm clocks, since most give off light and can cause a distraction. In fact, anyone who wants a good night's sleep should follow these instructions.

"Light at night -- even low levels of light -- might actually suppress the secretion of melatonin," said Magalang.

Sleep preparation 

Dr. Shelby Freedman Harris, director of the Behavioral Sleep Medicine Program Sleep-Wake Disorders Center at Montefiore Medical Center in New York City, says in order for your brain to release melatonin, you'll have to make some preparations.

"In the sleep field we like to call [melatonin] the 'hormone of darkness,' " said Harris in an informational video. "Melatonin helps us to get sleepy and fall asleep at night. So when the sun goes down and it gets dark, melatonin starts to come out and we start to get sleepy."

And there are a lot of things that can disrupt that sleepy feeling, she says.

"If you are sitting in bright light in your bedroom or you're just playing with a computer or an iPad or you're watching TV, all those things can inhibit the ability for melatonin to come out and therefore make you not as sleepy when you want to go to bed at night," Harris explained.

The seriousness of apnea

According to the American Sleep Apnea Association, there are more than 20 million adults who are living with sleep apnea but don't know it, and besides depression, sleep apnea can lead to diabetes, heart attacks, strokes and other serious conditions.

If you're not sure if you have sleep apnea, Dr. Rod Willey, of the Illinois Institute of Dental Sleep Medicine, says getting someone to monitor your sleep is your best bet.

Wiley says that it's often a family member who observes that a spouse or partner stops breathing or snores loudly. Both can be signs of apnea.

In addition, Willey says it's not the snoring that people should be concerned about when it comes to sleep apnea, they should be worried about what happens after the snoring.

"Snoring is usually followed by a moment of silence," he said. "It's that moment of silence that we have to worry about, because that's when you actually must start breathing again. And after that moment of silence is over, that's usually followed by a cough or a gasp or a snorting or something -- or more snoring."

Willey says the snoring, followed by the silence and coughing can happen hundreds of times throughout the night for a person with sleep apnea, so grabbing a family member to watch you sleep is the best route that you can take. If you live alone, recording yourself sleeping might not be a bad idea.

Magalang says his team isn't 100% sure of how strong the link is between sleep apnea and depression, but the link does exist.

A good night's sleep

By just removing some of the small and subtle lights in a room, sleep apnea patients, and other folks, will be able to sleep better and lower the chances of depression setting in.

"Although it is unclear at the present time whether sleep apnea causes depression, both conditions are commonly seen together in patients," said Magalang. "Our research suggests that sleeping even with a minimum amount of light may increase symptoms of depression in those with sleep apnea.

"The combination of dim light exposure and sleep apnea appears to result in increased depressive and anxiety-like behaviors in mice, so limiting exposure to light at night could be a very simple strategy to help patients with sleep apnea. We're currently exploring further testing."

In addition, Magalang says for the best sleep, use drapes that will completely darken the room, as some drapes still allow a little light to get through. And obviously, all electronics should be turned off as you're getting ready to shut down for the night.

Lastly, Magalang says to choose clocks or night lights with red lighting instead of blue or green lighting, since blue and green lights can cause more distraction.

Look, most of us can use a little extra sleep, but with today’s fast-paced way of doing things sometimes it can be a real challenge.

And with work, family and household pulling you in multiple directions, not to mention trying to keep up a social life, a good night’s sleep can be as elusive as an NFL running back.

And many times when we think of the people who may be sleep-deprived, we think of ourselves, our co-workers and other adults, but what most of us don’t think about, at least not usually, are teenagers.

But Dr. Lisa Meltzer, a sleep psychologist at National Jewish Health center in Denver says that adolescents need more sleep than anyone else, since their melatonin—the hormone that regulates sleep—shifts by about two hours compared to others, and requires them to get more Z's than the rest of us.

“When adolescents go through puberty, their circadian rhythm (or internal clock) moves later by about two hours,” said Meltzer in an interview with ConsumerAffairs.

“This is due to a change in the timing of their melatonin, the hormone that controls our internal clock."

"In sum, this makes it harder for teens to fall asleep early and wake early. For example, if you have a child who was sleeping from 9 p.m. to 6 a.m., when they go through puberty their internal clock may now want to sleep from 11 p.m. to 8 a.m. For most people, the internal clock moves back in the early twenties.”

Class times

Meltzer and her research team examined the sleep habits of 2,612 students, and among those studied, 500 students were home-schooled. The findings showed that students who were home-schooled slept about 90 minutes more than kids who either went to public or private school and those same students were in class about 18 minutes before home-schooled kids even woke up.

Meltzer believes that schools should take another look at what time classes start, as students being sleep-deprived can lead to a host of problems like poor school performance, behavioral issues and unsafe driving.

The results of the study also showed that 44.5 % of students in private and public schools lacked the proper amount of sleep, which may cause some to ask if establishing stricter sleep times and going to bed earlier would help bring some of those percentages down?

“Yes and no,” Meltzer says.

“Having a consistent bedtime and wake time seven days a week helps to regulate the internal clock, making it easier to fall asleep and wake up. If this set schedule includes an earlier bedtime, then teens may be able to get more sleep. However, if teens stay up late and sleep in on weekends, this makes it difficult to fall asleep early on school nights.”

“Also, if teens try to go to bed too early, they may lie in bed for prolonged periods of time, putting them at risk for insomnia. It is also important to understand that there are a number of factors that contribute to later bedtimes and deficient sleep, including homework, jobs, extracurricular activities, social media and technology.”

In addition, Meltzer says there are clear signs parents should look for when it comes to determining if their teens are getting enough sleep and although it’s considered pretty normal for teenagers to sleep until noon on the weekends, it could be a clear indication that they’re not getting enough sleep during the week.

“Weekend oversleep (sleeping more than two hours later on weekends than week days), difficulties waking in the morning (children should be up moving within 15 minutes of being awakened by a parent or alarm clock), falling asleep in school or other inappropriate places and behavior or mood changes following a poor night of sleep,” are all signs parents should watch for, says Meltzer.

Sleep therapy

In addition, she says that sometimes sleep therapy is needed for serious cases of improper sleep and the main goal in therapy sessions is to change all of the specific behaviors that contribute to one not sleeping enough.

“Behavioral sleep medicine is a specialty field that uses evidence-based interventions to address difficulties with falling asleep and/or staying asleep, as well as issues with poor sleep quality and daytime sleepiness,” Meltzer explains.

“Following a comprehensive evaluation, behavioral interventions focus on changing the habits, behaviors and other environmental factors that interfere with quality sleep. There is sometimes a need for cognitive interventions as well that address thoughts and beliefs that make it difficult to sleep. Interventions are usually brief, with most patients seeing improvements in 2-8 weeks.”

And sleep therapy should be sought when parents notice that a child’s daily functions are being affected, Meltzer says.

“Parents should seek treatment for their children when deficient or poor quality sleep interferes with daily functioning. This could include chronic tardiness, regular reports of falling asleep in school, a decline in grades or negative changes to mood or other aspects of functioning,” she says.

But isn’t there something parents and teens can do immediately to help with a sleeping problem?

Meltzer says yes, and one of the first things families should do is establish a consistent sleep time for everyone in the house, as this can directly shift one's behavior and help them develop better sleeping habits.

“Parents and teens need to go to bed and wake up at the same time seven days a week,” says Meltzer.

“If teens are going to stay up late and sleep in, this should be on Friday night/Saturday morning, but parents should make sure teens are awake early on Sunday morning in order to facilitate falling asleep Sunday night.”

“Everyone needs a consistent, relaxing bedtime routine, shutting technology off at least 30 minutes before bedtime [and] remove all technology from the bedroom by having a central charging station for smart phones, tablets, laptops and gaming devices,” Meltzer advises.

U.S. consumers buy millions of dollars worth of prescription and over-the-counter sleep aids each year but maybe all they need to do for a good night's rest is lose a little weight.

Researchers at Johns Hopkins have completed a study in which they determined that weight loss, whether it’s from dietary changes alone or from diet combined with exercise, can help improve the quality of sleep among people who are overweight or obese.

Weight loss and sleep quality

“We found that improvement in sleep quality was significantly associated with overall weight loss, especially belly fat,” says Kerry Stewart, Ed.D., professor of medicine at the Johns Hopkins University School of Medicine and director of clinical and research exercise physiology.

Stewart and colleagues presented their findings this week at the American Heart Association Scientific Sessions.

For the six-month study, the researchers enrolled 77 people who had type 2 diabetes or pre-diabetes. The participants, all of whom also were overweight or obese, were randomly assigned to one of two groups.

One group went on a diet. The other combined a healthy diet with exercise. Then their sleep patterns were recorded.

20 percent improvement in sleep

Although a variety of sleep problems were reported by the participants, none stood out as being the most common, so the researchers analyzed a composite score, which reflects overall sleep health. What they found was that both groups improved their overall sleep score by about 20 percent with no differences between the groups.

“The key ingredient for improved sleep quality from our study was a reduction in overall body fat, and, in particular belly fat, which was true no matter the age or gender of the participants or whether the weight loss came from diet alone or diet plus exercise,” Stewart said.

Sleep may be an underestimated component of good health. It's important in general for good physical and mental health, as well as for a healthy cardiovascular system, Stewart says.

Depending on the cause, chronic sleep disruptions increase the risk of high blood pressure, heart attack, stroke and irregular heartbeats. Obesity, Stewart says, increases the risk of sleep problems.

Pills may not be the solution. Hitting the gym might be.

The U.S. national campaign to reduce the risk of sudden infant death syndrome has entered a new phase and will now encompass all sleep-related, sudden unexpected infant deaths, according to the National Institutes of Health.

The campaign, which has been known as the Back to Sleep Campaign, has been renamed the Safe to Sleep Campaign.

SIDS reduction effort

The NIH-led Back to Sleep Campaign began in 1994, to educate parents, caregivers, and health care providers about ways to reduce the risk of sudden infant death syndrome (SIDS). The name was derived from the recommendation to place healthy infants on their backs to sleep, a practice proven to reduce SIDS risk. SIDS is the sudden death of an infant under one year of age that cannot be explained, even after a complete death scene investigation, autopsy, and review of the infant's health history. Sudden unexpected infant death (SUID) includes all unexpected infant deaths: those due to SIDS, and as well as those from other causes.

Many SUID cases are due to such causes as accidental suffocation and entrapment, such as when an infant gets trapped between a mattress and a wall, or when bedding material presses on or wraps around an infant’s neck.

In addition to stressing the placement of infants on their backs for all sleep times, the Safe to Sleep Campaign emphasizes other ways to provide a safe sleep environment for infants. This includes placing infants to sleep in their own safe sleep environment and not on an adult bed, without any soft bedding such as blankets or quilts. Safe to Sleep also emphasizes breast feeding infants when possible, which has been associated with reduced SIDS risk, and eliminating such risks to infant health as overheating, exposure to tobacco smoke, and a mother’s use of alcohol and illicit drugs.

"In recent years, we've learned that many of the risk factors for SIDS are similar to those for other sleep-related causes of infant death," said Alan E. Guttmacher, M.D., Director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute which sponsors Safe to Sleep. "Placing infants on their backs to sleep and providing them with a safe sleep environment for every sleep time reduces the risk for SIDS as well as death from other causes, such as suffocation."

Available materials

A new one-page fact sheet, "What does a safe sleep environment look like," shows how to provide a safe sleep environment, and lists ways that parents and caregivers can reduce the risk for SIDS. 

The NICHD's new brochure, Safe Sleep for Your Baby, provides more detailed information on ways that parents and caregivers can reduce the risk of SIDS and other sleep-related causes of infant death. The Safe Sleep for Your Baby brochure, as well as the one-page fact sheet, are available for order at 1-800-505-CRIB (2742). 

In the next month, new Safe to Sleep materials will be available in Spanish. Additional materials will be available for the black and American Indian/Alaska Native communities, which have had higher SIDS rates. Also, a Safe Sleep for Your Baby DVD will be available for order and the new Safe to Sleep campaign Website will be launched in October.

Seniors who have trouble getting a good night's sleep may be headed for a nursing home sooner than their sounder-sleeping peers.

That's the conclusion of a new study by researchers at the Johns Hopkins Bloomberg School of Public Health. They say fragmented or interrupted sleep could predict future placement in a nursing home or assisted living facility.

“Sleep disturbances are common in older people,” said Adam Spira, PhD, lead author of the study and an assistant professor with the Bloomberg School’s Department of Mental Health. “Our results show that in community-dwelling older women, more fragmented sleep is associated with a greater risk of being placed in a nursing home or in a personal care home.”

Compared with women with the least fragmented sleep patterns, those who spent the most time awake after first falling asleep were three times more likely to end up in a nursing home or assisted living facility. The linkage may have something to do with disease.

Linked to diseases

In previous research the Centers for Disease Control and Prevention (CDC) has found not getting enough sleep is associated with a number of chronic diseases and conditions -- such as diabetes, cardiovascular disease, obesity and depression.

Research has established that lack of sleep is responsible for an increased risk of motor vehicle and other accidents. Previous studies have also linked disturbed sleep with disability in older adults and impairment in activities of daily living and mobility.

The latest study found that senior adults who suffer from insomnia are at risk of requiring institutional care within five years.

More research needed

“It’s important to remember that this is an observational study, so our findings cannot demonstrate a conclusive causal link between sleep disturbance and placement in long-term care facilities,” Spira said. “We need more research to explain how sleep disturbance might lead to this outcome, and whether interventions to improve sleep might prevent it.

Here are some tips for increasing your chances of a full night's rest:

• Get on a regular schedule: Varying your bedtime radically will disrupt your sleep pattern
• Don't eat or drink a lot just before bedtime: When you go to sleep your stomach should not be full but it shouldn't be empty either.
• Avoid alcohol and tobacco: Using tobacco is never a good idea, but especially in the evening. Having a drink just before bedtime is also to be avoided.
• Keep the room dark: Exposure to light may disrupt your sleep.
• Consider a white noise generator: Many people find this sound restful, plus it helps disguise other sounds that may be in the house.

If sleep disruption consists, discuss it with your doctor.

We generally think that high blood pressure and being overweight are the main contributors to stroke risk. But researchers at the University of Alabama Birmingham (UAB) say they have found another – too little sleep.

The researchers on the project say older adults who regularly get less than six hours of sleep a night have significantly higher risk of stroke symptoms. The study included more than 5,600 people who were followed for three years.

The participants in the study had no history of stroke or stroke symptoms at the start of the study. The researchers then recorded the first stroke symptoms, along with demographic information, stroke risk factors, depression symptoms and various health behaviors.

After adjusting for body-mass index (BMI), they found a strong association with daily sleep periods of less than six hours and a greater incidence of stroke symptoms for middle-age to older adults, even beyond other risk factors.

The study found no association between short sleep periods and stroke symptoms among overweight and obese participants.

Takes a toll

"In employed middle-aged to older adults, relatively free of major risk factors for stroke such as obesity and sleep-disordered breathing, short sleep duration may exact its own negative influence on stroke development," said lead author Megan Ruiter, PhD. "We speculate that short sleep duration is a precursor to other traditional stroke risk factors, and once these traditional stroke risk factors are present, then perhaps they become stronger risk factors than sleep duration alone."

The researchers say their findings mean physicians should discuss sleep habits with their middle aged and senior patients. It's especially important, they say, to have this conversation if the patient appears otherwise healthy and displays no other risk factors.

"Sleep and sleep-related behaviors are highly modifiable with cognitive-behavioral therapy approaches and/or pharmaceutical interventions," Ruiter said. "These results may serve as a preliminary basis for using sleep treatments to prevent the development of stroke."

• The sleep-deprived group, who slept one hour and 20 minutes less than the control group each day consumed an average 549 additional calories each day.  
• The amount of energy used for activity didn’t significantly change between groups, suggesting that those who slept less didn’t burn additional calories.
• Lack of sleep was associated with increased leptin levels and decreasing ghrelin — changes that were more likely a consequence, rather than a cause, of over-eating.

Federal agencies are expressing support for the new infant safe sleep recommendations issued by the American Academy of Pediatrics (AAP).

The AAP announced the expansion of its recommendations for reducing the risk of sudden infant death syndrome (SIDS) to include recommendations for a safe sleep environment for all infants.

Many of the sleep environment risk factors for SIDS — bed sharing and soft bedding materials, for example — have accounted for the accidental suffocation observed in many cases of sudden unexpected infant death (SUID), which describes any sudden and unexpected death of a child under 1 year of age, whether explained or unexplained.

The new recommendations were developed to reduce the risk of infant death from SIDS as well as death from known sleep-related causes, such as suffocation from soft bedding materials and entrapment from inappropriate sleep situations, such as becoming lodged between a mattress and headboard. Providing a safe sleep environment has the potential to reduce SIDS risk as well as reduce the risk for SUID.

International studies

In 1992, after several international studies showed that SIDS rates were lower in societies in which infants were place for sleep on their backs, the AAP recommended that all healthy U.S. infants be placed to sleep on their backs.

The U.S. Food and Drug Administration (FDA) also expressed support for the new recommendations -- and cautioned parents to be aware that there are no federally approved or recommended products that have been shown to reduce the risk of SIDS.

"Parents and caregivers should beware of products that make SIDS prevention claims because the FDA has never cleared or approved a device to prevent SIDS or reduce the risk of SIDS," said Susan Cummins, M.D., M.P.H., chief pediatric medical officer at FDA's Center for Devices and Radiological Health.

Ask any teen just about anything and you're likely to get a mumbled reply.  Chances are good the kid's not rude, just sleepy.

A new study finds that almost 70 percent of high school students are not getting enough sleep on school nights, a problem that's linked to a variety of health-risk behaviors, including physical inactivity, drinking alcohol, smoking cigarettes, fighting, and being sexually active.

The study is the first to examine the effect of aerobic exercise on middle-aged and older adults with a diagnosis of insomnia. About half the people in these age groups complain of chronic insomnia symptoms.

The aerobic exercise trial resulted in the most dramatic improvement in patients' reported quality of sleep, including sleep duration, compared to any other non-pharmacological intervention.

Need for sleep

"This is relevant to a huge portion of the population," says Phyllis Zee, director of the Sleep Disorders Center at Northwestern University and senior author of a paper to be published in the October issue of Sleep Medicine.

"Insomnia increases with age," Zee says. "Around middle age, sleep begins to change dramatically. It is essential that we identify behavioral ways to improve sleep. Now we have promising results showing aerobic exercise is a simple strategy to help people sleep better and feel more vigorous."

The drug-free strategy also is desirable, because it eliminates the potential of a sleeping medication interacting with other drugs a person may be taking, says lead author Kathryn Reid, research assistant professor.

Sleep is an essential part of a healthy lifestyle, like nutrition and exercise, notes Zee.

"By improving a person's sleep, you can improve their physical and mental health," Zee says. "Sleep is a barometer of health, like someone's temperature. It should be the fifth vital sign. If a person says he or she isn't sleeping well, we know they are more likely to be in poor health with problems managing their hypertension or diabetes."

Sweating with the oldies

The study included 23 sedentary adults, primarily women, 55 and older who had difficulty falling sleep and/or staying asleep and impaired daytime functioning. Women have the highest prevalence of insomnia.

After a conditioning period, the aerobic physical activity group exercised for two 20-minute sessions four times per week or one 30-to-40-minute session four times a week, both for 16 weeks. Participants worked at 75 percent of their maximum heart rate on at least two activities including walking or using a stationary bicycle or treadmill.

Participants in the non-physical activity group participated in recreational or educational activities, such as a cooking class or a museum lecture, which met for about 45 minutes three to five times a week for 16 weeks.

Both groups received education about good sleep hygiene, which includes sleeping in a cool, dark, and quiet room, going to bed the same time every night, and not staying in bed too long, if you can't fall asleep.

Overall benefits

Exercise improved the participants' self-reported sleep quality, elevating them from a diagnosis of poor sleeper to good sleeper. They also reported fewer depressive symptoms, more vitality, and less daytime sleepiness.

"Better sleep gave them pep, that magical ingredient that makes you want to get up and get out into the world to do things," Reid says.

"Exercise is good for metabolism, weight management, and cardiovascular health and now it's good for sleep," Zee says.

A from booklet the National Institutes of Health. (NIH) available with suggestions to help you get to sleep.

September 10, 2010
People who sleep fewer than six hours a night may be three times more likely to develop a condition that leads to diabetes and heart disease, according to new research.

A study by a team of researchers from the University of Warwick and the University at Buffalo finds short sleep duration is associated with an elevated risk of a pre-diabetic state, known as incident-impaired fasting glycaemia (IFG). Details were reported recently in the Annals of Epidemiology journal.

The condition means that your body isn't able to regulate glucose as efficiently as it should. People with IFG have a greater risk of developing type 2 diabetes and are at an increased risk of heart disease and stroke.

The researchers looked at six years of data from 1,455 participants in the Western New York Health Study.

All participants were between the ages of 35 and 79 years of age and all completed a clinical examination that included measures of resting blood pressure, height, and weight. They also completed questionnaires about their general health and well-being and sleeping patterns.

Six-hour threshold

"We found that short sleep -- less than six hours -- was associated with a significant, three-fold increased likelihood of developing IFG, compared to people who got an average of six to eight hours sleep a night," says lead author Saverio Stranges of the Warwick Medical School.

Stranges says there were a number of ways in which sleep loss could lead to disordered glucose metabolism.

"Previous studies have shown that short sleep duration results in a 28 percent increase in mean levels of the appetite stimulating hormone ghrelin so it can affect feeding behaviors," he notes. "Other studies have also shown that a lack of sleep can decrease glucose tolerance and increases the production of cortisol, a hormone produced in response to stress."

More research is needed, Stranges concludes, "but our study does suggest a very strong correlation between lack of sleep and type 2 diabetes and heart disease."

How much sleep do Boomers really need?

You may have grown up being told that eight is the magic number for the hours of sleep you need each night. It turns out there is no absolute number of hours. Everyone requires more or less sleep depending on a variety of factors including your individual makeup as well as your lifestyle. What counts is that you are getting enough sleep for your body and mind to be replenished, whether that is six, seven, or eight hours or more.

How do you determine how much sleep is enough for you? Start with a weekend or a day when you sleep in and dont set an alarm. That will give you a more natural time for sleeping so you wake up refreshed. Then try to duplicate that number of hours every day.

We Boomers also need to know that as we age, our biological clock resets. Sleep expert and physician Matthew Edlund, M.D. says that from the ages of 20 to 70, there is a 90-minute move forward in the typical biological clock. Dr. Edlund, author of The Power of Rest (HarperCollins) and The Body Clock Advantage (Circadian Press), points out that as we age, we go to bed earlier and wake up earlier. He calls it s a genetic biological clock phenomenon.

Sleep apnea on the rise

If youre a Boomer still looking for a reason to lose weight, heres a two word reason: sleep apnea. Overweight Boomers have a significantly higher likelihood of developing this condition that causes you to stop breathing while asleep. In fact, one of the first recommendations for treating someone with sleep apnea, especially if someone is obese, is to lose weight. Kathleen Myer, a registered respiratory therapist and sleep technician at HealthBridge in Manhasset, Long Island, New York, sees a lot of obstructive sleep apnea with Boomers, and that it is definitely life threatening.

A recent study conducted by Dr. Daniel Gottlieb, an associate professor at Boston Universitys School of Medicine, as reported by the National Sleep Foundation, found that men between the ages of 40 and 70 were 68% more likely to develop coronary heart disease than those who did not have obstructive sleep apnea as a predicting risk factor.

Unfortunately, only 10% of sleep apnea cases are even diagnosed. If it is diagnosed, the primary treatment is a nasal continuous positive airway pressure (CPAP) device.

Denver-based 50-year-old Barbara says shes had sleep apnea most of her life. I can remember my sister waking me up in the middle of the night when I was in my early teens because I was snoring loudly enough to wake her, she said. My first husband claimed I would shake the walls down. Finally, someone who shared a room with me suggested a sleep study. From that sleep study, Barbara learned that she was waking up 152 times an hour. I was so tired during the day that I would fall asleep at work or in the car when I stopped at a light.

A CPAP device has made all the difference in Barbaras life.

I wake up far more rested. I can stay awake during the day and work on the computer or watch TV two activities that I would fall asleep after a few minutes when I tried to do them before the CPAP. Now I sleep much more solidly, and actually have dreams and uninterrupted sleep. Using the CPAP for the past 11 years has extended my life. I have often suggested a sleep study to people who are tired all the time or talk about snoring. My life got much better when I could sleep! said Barbara.

If you or your bedroom partner have sleep apnea, it is important to comply with the doctors request to use a CPAP device. Myer points out, however, that this can be especially challenging for single men and women who are dating and prefer not to allow their romantic partner to see them using a CPAP device. To go without the CPAP machine for even one day, however, can have grave or even fatal consequences. Myer says there are CPAP devices called nasal pillows that have a strap and small cushions that just go into the nostril so that much less of the face is covered by that device.

Insomnia

There may also be an increase in insomnia with Boomers. One cause can be the frequent awakenings that are due to a male having to go to the bathroom during the night due to prostate enlargement or a female who suffers from incontinence. Fortunately, both conditions are treatable.

Anxiety is another cause of insomnia. These days more boomers are worrying about money, job loss, and foreclosure and thats causing us to toss and turn rather than get a good nights sleep. If this describes you or your bedmate, you need to work on solving those problems that are keeping you up at night. There are other reasons for insomnia and some of those factors are, fortunately, easier to correct than the financial, career, or real estate challenges. Here are 10 tips to help you to get a better night of sleep:

What to do

Here are 10 tips for a good nights sleep

1. Be as consistent as possible about how much sleep you get as well as about when you go to bed and when you wake up, including weekends.

2. Attend to the physical aspects of your sleep environment that you can change such as a comfortable bed, pillow, temperature that is not too hot or too cold, and minimal noise or interruptions.

3. If you take long or too many naps, that can interfere with your nighttime sleep so adjust accordingly.

4. If you have temporary insomnia due to stress or other transitional situations, including medications, pains, or illnesses that may be causing sleep problems, deal with the underlying causes of your insomnia.

5. If you find you have a chronic sleep-related issue, consider going to a sleep center staffed by trained sleep experts to have it properly diagnosed so you can be treated. (For a list of sleep centers, go to the American of sleep which maintains a free updated database.)

6. Watch your coffee or alcohol consumption immediately prior to sleep.

7. Exercising early enough in the day may help you to fall asleep at night but too close to your bedtime may act as a stimulus that keeps you up.

8. Some of the old-fashioned natural solutions for falling asleep include warm milk, taking a hot bath, or counting sheep. You might want to try one or all of those techniques before seeking out pharmaceutical help, such as sleeping pills, which need to be used with caution because of any possible side effects or the potential for becoming dependent whether over the counter or prescription. (See What about sleeping pills? below.)

9. Be careful about what TV programs, movies, or books you read at bedtime. Upsetting or riveting plots can keep you reading or watching long after you really wanted to go to sleep.

10. You might find writing a to do list of what you need to accomplish the next day will help you get to sleep since you wont be constantly mulling over in your mind all those things you need to do.

What about sleeping pills?

As pointed out in The Encyclopedia of Sleep and Sleep Disorders," sleeping pills are medications that induce drowsiness and facilitate the onset and maintenance of sleep. Some of the more well-known hypnotics include Lunesta (eszopiclone), Sonata (zaleplon), and Ambien (zolpidem).

Consult with your physician about whether or not a hypnotic medication is the right treatment for your insomnia. Make sure you are fully aware of any potential side effects to any prescribed or even over-the-counter sleep aids including the possibility of developing a tolerance, dependence, or addiction to a specific sleeping pill. (See, for example, FDA Wants Stronger Warnings on Sleep Disorder Drugs.)

Rest is More than Sleep

Recently sleep experts have found that in terms of rejuvenating our mind and bodies, rest may be more important the sleep. In his book, The Power of Rest: Why Sleep Alone is Not Enough, Dr. Edlund says that sleep is only one form of rest and non-sleep rest is so much more than relaxing and watching TV. Other ways to feel replenished include: mental rest, which enables you to obtain calm and relaxed concentration quickly and effectively as you concentrate attention on something beyond your body social rest, which means you are using the power of social connectedness to relax and rejuvenate; spiritual rest, the practice of connecting with things larger and greater than ourselves; and last, but not least, physical rest, by focusing your body and its simplest physiological processes, provokes calm, relaxation, mental alertness, and surprisingly better health.

Here are some of the techniques that Dr. Edlund discusses in greater detail in his book:

Mental rest
• Self-hypnosis
• Focusing the eye
• Walking to music
• Ear popping (According to Dr. Edlund, you simply put both your index fingers in your ears deep enough to stop outside noise. Leave your fingers there for ten seconds if you have the time, five if you dont. If youre in a place where its socially acceptable, also close your eyes.
• Garden walks

Social rest
• Sex
• Social touch
• Social networking and social support
• Making a special connection
• Visiting a neighbor of coworker you dont know well
• Walking to lunch with a colleague, friend, or neighbor

Spiritual rest
• Meditating
• The power of prayer
• Following the ways of the Zen Buddhist teachings, Contemplating suchness, all the world where we live
• Simple observational meditation

Physical rest
• Deep breathing
• Yoga techniques including the mountain pose or the gravity pose
• Napping (a short nap, as quick as six minutes, can improve your concentration).

Dr. Edlund recommends a daily approach to life that is typified by the acronym: FAR using food, activity, and rest in a sequence that is repeated throughout the day. The above rest techniques will help you to be more rested during the day and able to sleep better at night.

The Importance of Dreams

Sleep and dream specialist Rubin Naiman, Ph.D., author of Healing Night and Clinical Assistant Professor of Medicine at the Arizona Center for Integrative Medicine at the University of Arizona in Tucson, says, Good sleep can help us age very well. Naiman advocates not just looking at sleep as a necessary evil. Its not like flossing your teeth. Instead, says Naiman, We need to restore the sacred or spiritual side to sleep and to help increase dreaming.

Dreams are important because your dreams can help you deal with issues you cant face consciously. Sometimes, if youve been wrestling with a problem, the solution will come to you in a dream.

So start getting enough sleep and rest so youll feel rejuvenated, start dreaming more often, and making the next third of your life a long and healthy one.

New research shows that educating students about the importance of sleep and offering feedback on sleep patterns can persuade them to catch some much-needed zzz's.

For the research -- the first large-scale study of sleep in college students to include both subjective and objective measures -- Cornell University psychology professor James Maas used the Zeo Personal Sleep Coach. The new technology records a sleeper's time in light, deep and REM sleep through a small, wireless headband sensor.

Maas distributed 300 devices to volunteers in his psychology class at the beginning of the fall 2009 semester. The students kept a written sleep log and recorded six nights of sleep data at each of three time points during weeks two, six, and 12 of the study.

Between the second and third time points, students heard Maas lecture on the importance of sleep and got personalized e-mail feedback based on their own sleep patterns.

Not surprisingly, says Maas, the students initially reported sleeping just an average of 7 hours 24 minutes a night -- much less than the 9 hours 15 minutes recommended for college students.

But in comparing the students' sleep logs with the Zeo measurements, he also found that the students overestimated their sleep time by 47 minutes -- meaning they were actually getting an average of 2 hours 28 minutes less sleep than they should.

The study also shows that the combination of sleep education and direct feedback from the Zeo motivated students to sleep better. By the end of the semester, students had increased their total nightly sleep time by an average of 15 minutes; and more than three out of five students had started sleeping almost an hour longer.

The percentage difference was most dramatic for the students who began the study in the bottom quartile for total hours of sleep. Those students increased their total nightly sleep time by an average of 51 minutes, or 15 percent.

And students with the best sleep scores -- those who spent the longest total time asleep and the most time in deep sleep -- were also the ones with the highest grades in the class.

"Students in the past have said, 'I'm not going to change my sleep-wake schedule unless you can prove to me that it's going to make a significant difference in my grades,'" Maas says. "Now we have very good evidence that if you want to improve your general well-being, this is the key; and it's the key that some Cornellians use, and they're the ones who are getting the high grades."

Dale Pescatore, an undergraduate student at Cornell, agrees. "I used to consider sleep a luxury, and it largely fell to the wayside when I was too busy balancing the other aspects of my life," Pescatore admits. "Since using the Zeo, I have realized that when sleep becomes a priority, everything else will fall into place."

Lack of sleep has been linked to a number of ailments, including excessive weight gain and heart ailments .

There may be greater consequences to short-changing yourself on sleep than falling asleep at meetings.

According to a report in the November 10 issue of Archives of Internal Medicine, sleeping less than seven and a half hours per day may be associated with future risk of heart disease. In addition, a combination of little sleep and overnight-elevated blood pressure appears to be linked to an increased risk of the disease.

Getting enough sleep is essential to preventing health conditions such as obesity and diabetes as well as several risk factors for cardiovascular disease including sleep-disordered breathing and nighttime high blood pressure.

Researchers at Jichi Medical University, Tochigi, Japan, monitored the sleep of 1,255 individuals with high blood pressure (average age 70.4) and followed them for an average of 50 months.

Researchers noted patients' sleep duration, daytime and nighttime blood pressure and cardiovascular disease events such as stroke, heart attack and sudden cardiac death.

During follow-up, 99 cardiovascular disease events occurred, and there was evidence that sleep duration of less than 7.5 hours was associated.

"The incidence of cardiovascular disease was 2.4 per 100 person-years in subjects with less than 7.5 hours of sleep and 1.8 per 100 person-years in subjects with longer sleep duration," the authors write.

Patients with shorter sleep duration plus an overnight increase in blood pressure had a higher incidence of heart disease than those who got more sleep and had no overnight increase in blood pressure.

However, the occurrence of cardiovascular disease in those with a longer sleep duration vs. those with a shorter sleep duration was similar in those who did not experience an overnight elevation in blood pressure.

"In conclusion, shorter duration of sleep is a predictor of incident cardiovascular disease in elderly individuals with hypertension," particularly when it occurs with elevated nighttime blood pressure, the authors note. "Physicians should inquire about sleep duration in the risk assessment of patients with hypertension."

A popular cholesterol-lowering drug appears to disrupt sleep patterns of some patients, researchers reported at the American Heart Associations Scientific Sessions 2007.

The findings are significant because sleep problems can affect quality of life and may have adverse health consequences, such as promoting weight gain and insulin resistance, said Beatrice Golomb, M.D., lead author of the study and an associate professor of medicine and family and preventive medicine at the University of California at San Diego School of Medicine.

In the largest study of its kind, researchers compared two types of cholesterol-lowering drugs called statins -- simvastatin, which is soluble in fats, and pravastatin, which is soluble in water.

Because simvastatin, the generic name for Zocor, is fat-soluble it can more readily penetrate cell membranes and cross the blood brain barrier into the brain. The brain controls sleep, and many of the brains nerve cells are wrapped in a fatty insulating sheath called myelin.

The results showed that simvastatin use was associated with significantly worse sleep quality. A significantly greater number of individuals taking simvastatin reported sleep problems than those taking either pravastatin or the placebo, Golomb said. On average, the water-soluble statin had a greater adverse effect on sleep quality.

Earlier studies

In past studies and case reports, some people on statins reported having insomnia or nightmares.

Several small studies were done early on, including those focused on fat-soluble versus water-soluble statins, Golomb said. Most (researchers) didnt see a difference in sleep, but they had short durations of follow-up and enrolled just a handful of people -- often fewer than 20, which was not enough to see a difference unless it was very large.

One of these studies did report a significant difference between pravastatin and simvastatin. But without more and bigger studies, an effect was not considered to be established.

In this study, researchers tested 1,016 healthy adult men and women for six months in a randomized, double-blind, placebo-controlled trial using simvastatin, given at 20 milligrams (mg), pravastatin at 40 mg, or a placebo.

They assessed outcomes with the Leeds sleep scale, a visual analog scale of sleep quality, and a rating scale of sleep problems. Both scales were measured before and during treatment.

Those who reported developing much worse sleep on study medication also showed a significant adverse change in aggression scores compared to others, Golomb said We should also point out that although the average effect on sleep was detrimental on simvastatin, this does not mean that everyone on simvastatin will experience worse sleep.

Researchers did not include patients with heart disease or diabetes due to concerns about assigning these people to placebos.

Patients taking simvastatin who are having sleep problems should consult with their doctor, Golomb said. Sleep deprivation is a major problem in a minor number of people.

A: Seniors need about the same amount of sleep as younger adults -- seven to nine hours a night.

Unfortunately, many older adults don't get the sleep they need, because they often have more trouble falling asleep. A study of adults over 65 found that 13 percent of men and 36 percent of women take more than 30 minutes to fall asleep.

Also, older people often sleep less deeply and wake up more often throughout the night, which may be why they may nap more often during the daytime.

Nighttime sleep schedules may change with age too. Many older adults tend to get sleepier earlier in the evening and awaken earlier in the morning.

Many people believe that poor sleep is a normal part of aging, but it is not. Sleep patterns change as we age, but disturbed sleep and waking up tired every day are not part of normal aging. If you are having trouble sleeping, see your doctor or a sleep specialist.

Here are some pointers to help you get better sleep:

• Go to sleep and wake up at the same time, even on weekends. Sticking to a regular bedtime and wake time schedule helps keep you in sync with your body's circadian clock, a 24-hour internal rhythm affected by sunlight.

• Try not to nap too much during the day -- you might be less sleepy at night.

• Try to exercise at regular times each day. Exercising regularly improves the quality of your nighttime sleep and helps you sleep more soundly. Try to finish your workout at least three hours before bedtime.

• Try to get some natural light in the afternoon each day.

• Be careful about what you eat. Don't drink beverages with caffeine late in the day. Caffeine is a stimulant and can keep you awake. Also, if you like a snack before bed, a warm beverage and a few crackers may help.

• Don't drink alcohol or smoke cigarettes to help you sleep. Even small amounts of alcohol can make it harder to stay asleep. Smoking is dangerous for many reasons, including the hazard of falling asleep with a lit cigarette. Also, the nicotine in cigarettes is a stimulant.

• Create a safe and comfortable place to sleep. Make sure there are locks on all doors and smoke alarms on each floor. A lamp that's easy to turn on and a phone by your bed may be helpful. The room should be dark, well ventilated, and as quiet as possible.

• Develop a bedtime routine. Do the same things each night to tell your body that it's time to wind down. Some people watch the evening news, read a book, or soak in a warm bath.

• Use your bedroom only for sleeping. After turning off the light, give yourself about 15 minutes to fall asleep. If you are still awake and not drowsy, get out of bed. When you get sleepy, go back to bed.

• Try not to worry about your sleep. Some people find that playing mental games is helpful. For example, tell yourself it's five minutes before you have to get up and you're just trying to get a few extra winks.

If you are so tired during the day that you cannot function normally and if this lasts for more than 2 to 3 weeks, you should see your family doctor or a sleep disorders specialist.

All Rights Reserved © 2007 by Fred Cicetti

A health diet, plenty of exercise and staying away from cigarettes are all important to maintaining a healthy heart. But so is getting a good night's sleep, according to the American Academy of Sleep Medicine (AASM).

According to Lawrence Epstein, MD, AASM past president, medical director of Sleep Health Centers and instructor of medicine at Harvard Medical School, treating sleep disorders and getting an adequate amount of sleep are pillars of good cardiovascular health.

"Sleep apnea is a known risk factor for the development of hypertension, heart disease and stroke," said Epstein.

"Also, chronic sleep deprivation has been shown to change metabolic function in a way that promotes weight gain and diabetes, two risk factors for heart disease." Dr. Epstein's remarks support recent studies that link sleep apnea to cardiovascular disease.

A study published in the December 1, 2006, issue of the journal SLEEP, showed that daytime sleepiness brought on by obstructive sleep apnea (OSA) may subtly impair cardiac function. Patients with OSA commonly complain of daytime sleepiness because of the fact that OSA causes their bodies to stop breathing during sleep the night before and can disturb sleep numerous times.

Further, data from the "Sleep Heart Health Study" show that people with sleep apnea have a 45 percent greater risk for hypertension, a major predictor for cardiovascular disease, than people without the sleep disorder.

Ralph Downey III, PhD, of the Sleep Disorders Center at Loma Linda University Medical Center in Loma Linda, Calif., says he is amazed at the high percentage of patients who have both sleep apnea and cardiovascular disease.

Research has built a compelling case that those with sleep-disordered breathing are at increased risk for hypertension, said Downey, adding that there is also a well-established connection between sleep apnea and heart failure.

"It makes not only scientific sense that such a relationship exists, but common sense as well," said Downey. "If someone were to suffocate you with a pillow several hundred times a night, you would call the police. In the case of patients with sleep apnea, the airway blocks off due to obstruction and they stop breathing for 10 seconds to a minute, which is repeated hundreds of times in a night."

Dennis H. Nicholson, MD, medical director of the Sleep Disorders Center at Pomona Valley Hospital Medical Center in Pomona, Calif., says that more public education needs to be done in order to reach out to as many people as possible about cardiovascular disease, and notes that a good night's sleep is critical to maintaining good health.

"Public education is an important and often neglected component in the overall strategy to improve sleep, cardiovascular outcomes and general well being," said Nicholson, who added that reaching out to people about the importance of sleep may result in a decline in the number of reported cardiovascular diseases.

October 20, 2006
Soaring levels of obesity might be linked to children sleeping fewer hours at night than they used to, according to a British researcher writing in the Archives of Disease in Childhood.

Dr. Shahrad Taheri of the University of Bristol, blames the increasing availability of computers, mobile phones, TVs and other gadgets on the diminishing nightly quota of sleep, and suggests they should be banned from childrens bedrooms.

Taheri cites the emerging body of research on the impacts on the body of a fall in the nightly quota of sleep, which reflects circumstances in real life, rather than sustained sleep deprivation, which tends to be more extreme.

This research shows that shorter sleep duration disturbs normal metabolism, which may contribute to obesity, insulin resistance, diabetes, and cardiovascular disease. Even two to three nights of shortened sleep can have profound effects, the laboratory data suggest.

One study indicated that insufficient sleep at the age of 30 months was associated with obesity at the age of 7, suggesting that this could program the part of the brain regulating appetite and energy expenditure. But it is also a problem for teenagers in whom the need for sleep increases during this critical developmental period, Taheri said.

Another piece of research shows that levels of leptin, a hormone produced by fat tissue when energy stores are low, were more than 15% lower in those sleeping five hours compared with those clocking up 8. Similarly, ghrelin, a hormone released by the stomach to signal hunger was almost 15% higher in those with a five hour sleep quota.

Taheri says sleep loss also disturbs other hormones, including insulin, cortisol (stress hormone), and growth hormone, and that hormonal changes could boost the desire for carlorie rich foods.

And poor sleep sets up a vicious cycle. It leads to fatigue, which leads to reduced levels of physical activity.which leads to lower energy expenditure..which leads to obesity, which itself leads to poor sleep, he adds.

"Sleep is probably not the only answer to the obesity pandemic, but its effect should be taken seriously, as even small changes in energy balance are beneficial," Taheri said.

"Good sleep could be promoted by removal of gadget distractions from bedrooms and restricting their use."

Highways crowded with large trucks are much less safe if the drivers haven't had a good night's sleep.

A new study says truck drivers who have severe sleep apnea or who sleep less than five hours each night while at home are more likely to suffer from sleepiness, performance impairment and decreased task vigilance while behind the wheel.

The results of the study appear in the second issue for August 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Allan L. Pack of the University of Pennsylvania and six associates tested 247 commercial drivers at high risk for sleep apnea and 159 at lower risk for sleep impairment.

They evaluated the role of short sleep duration at home over one week in 340 drivers, with 55 sleeping less than five hours. Of the 406 drivers examined for sleep apnea, 118 had mild to moderate forms of the disease, and 28 had severe sleep apnea.

"In the United States, approximately 5,600 people are killed annually in crashes involving commercial trucks," Pack said. "Falling asleep while driving is an important factor in serious crashes involving commercial vehicles, prompting the question, why?"

According to the authors, the two culprits are chronically insufficient sleep and obstructive sleep apnea.

The researchers defined mild to moderate sleep apnea as "from 5 to less than 30 temporary breathing pauses per hour of sleep," a process that decreases the amount of oxygen in the blood. Severe sleep apnea, on the other hand, involves more than 30 breathing pauses per hour.

However, the investigators also found that 77 percent of those with mild sleep apnea and 56 percent of with moderate sleep apnea did not have what could be termed "pathologic sleepiness" as a result of their problem.

The authors used the Epworth Sleepiness Scale to assess subjective sleepiness, the Multiple Sleep Latency Test to objectively determine the driver's propensity to fall asleep, and the Psychomotor Vigilance Task to assess behavioral alertness and define vigilance lapses. These tests were administered in addition to a normal sleep test (polysomnography) to measure breathing pauses and movement disorders in the sleep laboratory.

"In this study, we showed that both subjective and objective sleepiness, as well as performance impairments are common in our sample of commercial driver's license holders," Pack said. "Our analyses reveal that chronic short sleep duration is a risk factor for subjective sleepiness, objectively measured sleepiness and performance impairments. The results for sleep apnea are less clear."

Despite major decreases in the incidence of SIDS over the past decade, the syndrome is still responsible for more infant deaths beyond the newborn period in the United States than any other cause of death during infancy.

In an updated policy statement, the AAP said it no longer recognizes side sleeping as a reasonable alternative to sleeping while fully supine (lying on back).

Studies have found that the side sleep position is unstable and increases the chances of the infant rolling onto his or her stomach. Every caregiver should use the back sleep position during every sleep period, the academy said.

Bed Sharing

Bed sharing is not recommended during sleep. Infants may be brought into bed for nursing or comforting, but should be returned to their own crib or bassinet when the parent is ready to return to sleep.

However, there is growing evidence that room sharing (with the infant sleeping in a crib in the parent's bedroom) is associated with a reduced risk of SIDS. The AAP therefore recommends a separate but proximate sleeping environment.

Research now indicates an association between pacifier use and a reduced risk of SIDS, which is why the revised statement recommends the use of pacifiers at nap time and bedtime throughout the first year of life.

The evidence that pacifier use inhibits breastfeeding or causes later dental complications is not compelling enough to discredit the recommendation.

However, it is recommended that pacifier introduction for breastfed infants be delayed until one month of age to ensure that breastfeeding is firmly established. In addition, if the infant refuses the pacifier, it should not be forced.

There is a slight increased risk of ear infections associated with pacifier use, but the incidence of ear infection is generally lower in the first year of life, especially the first six months, when the risk of SIDS is the highest.

The following have been consistently identified as risk factors for SIDS:
• prone (lying on stomach) sleep position,
• sleeping on a soft surface,
• maternal smoking during pregnancy,
• overheating,
• late or no prenatal care,
• young maternal age,
• preterm birth and/or low birth weight and
• male gender.

Consistently higher rates of SIDS are found in black and American Indian/Alaska Native children -- two to three times the national average.