Sleep

Curious how close scientists are to being able to decode a person’s dreams? Then you might find this BBC.com article – the first in science writer Ed Yong’s Will They Ever series – enlightening. (Spoiler alert: They’re not very.)

And for more on dream research, there’s this article I wrote for Stanford Medicine a few years back.

Past research has shown that not getting enough sleep may have more serious consequences than feeling groggy in the morning. Trouble sleeping has been linked to heart problems, increased risk of Type 2 diabetes, development of Alzheimer’s disease and weight gain. Despite the health risks of not getting enough sleep, recent statistics from the Centers for Disease Control and Prevention indicate that more than a third of Americans are sleep deprived.

Changes to our sleep schedules, such as the upcoming daylight-saving time change, can cause difficulty falling or staying asleep and trigger sleep problems. To help you spring forward and stay on track, we’ve asked Stanford’s Rafael Pelayo, MD, to field your questions on sleep research and ways for making sure daylight-saving time doesn’t cut into your snooze time. An expert in sleep medicine, Pelayo has long researched and treated sleep conditions, including insomnia, sleep disruptions and sleep apnea. He sees both adult and pediatric patients.

Questions can be submitted to Pelayo about by sending an @reply message to @SUMedicine and include the hashtag #AskSUMed in your tweet. (Not a Twitter user? Then please submit a comment below.) We’ll collect questions until Feb. 29 at 5 pm. In submitting questions, please abide by the following ground rules:

• Stay on topic
• Be respectful to the person answering your questions
• Be respectful to one another in submitting questions
• Do not monopolize the conversation or post the same question repeatedly
• Kindly ignore disrespectful or off topic comments
• Twitter handles and/or names may be used in the responses

Medical school experts taking questions on the @SUMedicine feed will answer a selection of the questions submitted, but not all of them.

Finally – and you may have already guessed this – an answer to any question submitted as part of this feature is meant to offer medical information, not medical advice. These answers are not a basis for any action or inaction, and they’re also not meant to replace the evaluation and determination of your doctor, who will address your specific medical needs and can make a diagnosis and give you the appropriate care.

Previously: Stanford sleep expert Rafael Pelayo featured on KGO, How lack of sleep affects the brain and may increase appetite, weight gain, Can regular exercise improve your quality of sleep?, Helping kids ‘spring forward’, Tips for not losing sleep over daylight-saving time, Study estimates Americans’ insomnia costs nation $63 billion annually, CDC report highlights the dangers of sleep deprivation and Stanford expert: Quality, not quantity, of sleep is what counts
Photo by hang_in_there

Yes, it might seem like sleep researcher William Dement, MD, PhD, and the late Jerry Garcia would make very strange bedfellows. But, that wasn’t the case at a Stanford event on Saturday. There, they blended together – albeit, in a circular way – like a sweet dream in a deep sleep.

More than 60 people with a variety of ties to the Stanford Sleep Disorders Clinic and Research Center came together at the Jerry House (yes, that Jerry) for the unveiling of a long-awaited plaque discussed earlier today. I was one of the people there to honor the Stanford “sleep camps” held there in the 1970s and ’80s.

A wide variety of those involved with the camps showed up at the event to revisit their pasts and talk about their presents. It was a fun, wacky reunion, bringing together 10 years worth of researchers and researchees. Some flew in from distant ports, and their entrances generated hugs and squeals and hearty handshakes. There was a coterie of “campers,” some the progeny of professors and staff, who happily dispensed memories and swapped tales. There were full-fledged doctors who, as undergrads, acted as “sleep counselors.” And there were sleep-research luminaries who were, back then, just getting the sleep-research field powered up.

The plaque, which was concealed under a very ’60s tie-died cloth, was unveiled, and the researchers who led the work at the camps spoke, acknowledging the importance of the research and expressing gratitude to all involved. The remarks of Mary Carskadon, PhD, expanded into a very detailed string of stories – a decade of escapades involving rambunctious kids, stealthy undergrads, and 24-hour-a-day volleyball tournaments.

There was an abundance of delicious food, a terrific Sancerre, a quantity of beer and an enormous, mega-cake with a stunning replica of the plaque laid out in the frosting. It was the perfect fuel for dancing on a sunny, spring-like afternoon, so when the Grateful Dead-inspired band let loose, people were ready. The air was charged, and the past quickly became the present. Gauging by the expressions on many faces, I don’t think I was the only one transported back to college days!

Previously: Thanks, Jerry: Honoring pioneering Stanford sleep research
Photo of Dement by Robert Tognoli

As the writer who has long covered the sleep “beat” for our office, I’m quite familiar with Stanford’s rich history of sleep research. For those in need of some background: The Stanford Sleep Disorders Clinic and Research Center, the first center of its kind, was established in 1970 - by William Dement, MD, PhD, who came here after working in the lab where rapid eye movement was discovered – and numerous advances, like the discovery of the cause of narolepsy, have been made since then. Until recently, though, I wasn’t familiar with the role of a Stanford dormitory in that history.

As it turns out, for a ten-year period starting in the mid-70s, the residence now known as Jerry House served as the site of a series of pioneering sleep studies: Undergraduates and members of the community lent themselves for study during “summer sleep camps” at the house. Until that time, the field of sleep research - still in its infancy – had centered on nighttime events, but researcher Mary Carskadon, PhD, now a professor of psychiatry & human behavior at Brown University, focused these camp studies on the role of sleep in daytime function. The participants’ sleeping and waking were manipulated, recorded and examined; and the end result was important data on sleep restriction and sleep deprivation, and the establishment of clinical protocols still used today.

“Much of the essential, pioneering sleep work at Stanford was done in these camps,” sleep expert Rafael Pelayo, MD, recently told me. “The work had great consequences on the development of the field of sleep research here and around the world.”

This weekend, Pelayo joined Carskadon, Dement and others in honoring this early, important research and unveiling a wood-and-glass commemorative plaque to be housed there. (Writer Patrick May was there and reported on the event for yesterday’s San Jose Mercury News.) The plaque outlines the significance of the studies and highlights the successful careers of Carskadon and Dement, but I like its line of summary the best:

Jerry House at Stanford University was the unique site for seminal research findings that apply to every man, woman and child on the planet.

Photo courtesy of Stanford Residential Education

Stanford professor Rafael Pelayo, MD, was the guest on KGO’s Ronn Owens Show yesterday. During the hour-long interview, Pelayo discussed and took listeners’ questions on mobile applications that claim to help you rest easy, sleep disturbances related to aging, the dream cycle, the importance of sleep environment and the effectiveness of sleeping aids, including various medications.

On the topic of irregular sleep schedules, such as pulling an all-nighter or shift work, Pelayo explained that it could take some time to regain the sleep loss:

If you go one night with zero sleep it takes four to five days to make up that difference. For example, if you normally sleep eight hours a night then you’re not going to sleep 16 hours the next day. You might sleep 10 hours over a series of days to make up the time that you’ve lost.

Previously: Stanford expert: Quality, not quantity, of sleep is what counts
Photo by CraigGrocott

This is an absolutely fascinating patient story from the NHS Choices YouTube channel: Lee is a sleepwalker who began having episodes at the age of four. What makes his case particularly interesting is that he often does artwork in his sleep – despite having no interest in art during his waking hours.

Via Clinical Cases and Images Blog

A growing body of scientific research, including a 2004 Stanford study, shows that sleep duration is an important regulator of body weight and metabolism. Now findings recently published in the Journal of Clinical Endocrinology & Metabolism offer additional insight into the link between sleep deprivation, cognitive function and weight gain.

In the small study (subscription required), a European research team examined how regions in the brain known to be involved in appetite sensation are influenced by acute sleep loss. Using functional magnetic resonance imaging (fMRI), researchers compared the brain scans of normal-weight males while they viewed images of foods both after a night of normal sleep and a night without sleep. The results showed that the region of the brain that stimulates appetite was noticeably more active in participants after losing a night of sleep.

Uppsala University researcher Christian Benedict, PhD, commented on the connection between the findings and obesity rates in a release:

After a night of total sleep loss, these males showed a high level of activation in an area of the brain that is involved in a desire to eat. Bearing in mind that insufficient sleep is a growing problem in modern society, our results may explain why poor sleep habits can affect people’s risk to gain weight in the long run. It may therefore be important to sleep about eight hours every night to maintain a stable and healthy body weight.

Previously: Study shows link between lack of sleep and obesity in teen boys, Study: Staying up late tied to poor eating habits, weight gain and Sleep deprivation may increase young adults’ risk of mental distress, obesity
Photo by Ciaran McGuiggan

When you’re a new parent - or heck, even a veteran one – nothing is worse than a child who won’t sleep. The ensuing sleep deprivation (for the parent) can feel soul-crushing, and there are moments when one would do anything for just a few hours of uninterrupted nighttime quiet. (If only babies took bribes.)

Now, research is showing that a baby’s sleep problems might lead to something other than bleary-eyed, grumpy parents: In a study of 359 children, those who had trouble sleeping as an infant appeared to have a greater risk of developing a sleep disorder when they were older. As reported on Well today:

The new research is a rare look at a problem that many parents and even pediatricians sometimes fail to notice. The study, which looked at children ages 6 months to 3 years, found that sleep problems were common in this age group. But parents did not always perceive red flags like loud and frequent snoring — which can be a risk factor for obstructive sleep apnea, a potentially serious breathing disorder — as problems that warranted mentioning to their pediatricians.

The findings also challenged a widespread notion that children who have sleep troubles early on tend to outgrow them. In the study, children who had one or more sleep problems at any point in early childhood were three to five times as likely to have a sleep problem later on.

The research, which appears in Pediatrics, shouldn’t panic parents – but instead serve as a reminder of the importance of looking for warning signs of a more serious sleep problem (listed here as things like frequent loud snoring, night terrors and taking a long time to fall asleep) and talking to one’s pediatrician. Also from Well:

[Study author Kelly Byars, PsyD] said the best way parents can distinguish a true sleep disorder from a phase is to be on the lookout for problems that persist over time, and to raise any concerns with a pediatrician. “If a child has problems across two consecutive well-child visits” — at the 6-month checkup, for example, then again at 12 months, “then that is likely an indicator that this is a problem that should be addressed, as opposed to saying that it’s a problem the child will grow out of,” he said.

Previously: Lack of sleep can increase a young child’s obesity risk
Photo by poppymaher

People who have trouble sleeping or staying asleep may catch more Zzz’s and feel more alert during the day by working out 150 minutes or more per week, according to findings published in the December issue of Mental Health and Physical Activity.

The study examined the relationship between accelerometer-measured physical activity and sleep among a nationally representative sample of more than 2,600 men and women ages 18-85. According to a university release researchers found that adults who met the national guidelines for physical activity, which is at least 150 minutes of moderate to vigorous activity a week, experienced a significant improvement in sleep quality:

After controlling for age, BMI (Body Mass Index), health status, smoking status, and depression, the relative risk of often feeling overly sleepy during the day compared to never feeling overly sleepy during the day decreased by 65 percent for participants meeting physical activity guidelines.

Similar results were also found for having leg cramps while sleeping (68 percent less likely) and having difficulty concentrating when tired (45 percent decrease).

The findings add to the growing body of research suggesting physical activity can help improve quality of sleep, vitality and mood.

Previously: Study estimates Americans’ insomnia costs nation $63 billion annually, Sleep deprivation more common in the U.S. than Europe and CDC report highlights the dangers of sleep deprivation
Photo by Tulane Public Relations

Women who have trouble sleeping may have a higher risk of developing fibromyalgia, according to findings published online this week in Arthritis & Rheumatism.

In the study (.pdf), Norwegian researchers recruited 12,350 women aged 20 and older and followed them for a 10-year period. Participants were part of a large nationwide health survey that involved completing questionnaires and physical exams first between 1984 and 1986 and again between 1995 and 1997. None of the volunteers had chronic musculoskeletal pain upon enrolling in the study. Medpage Today reports:

A total of 327 women reported having been given a diagnosis of fibromyalgia at follow-up, which represented an incidence proportion of 2.6%.

Women ages 20 to 44 had an incidence proportion of 3.2%; the incidence proportion for those 45 and older was 1.7%.

In analyses that adjusted for smoking, education, physical exercise, body mass index, and education, the researchers found that women 45 and older who had frequent sleep difficulties had a rate ratio for fibromyalgia of 5.41, while the younger cohort had a rate ratio of 2.98.

[Researchers] then compared the 3,949 women who reported sleep problems of any frequency with the 8,401 who had no sleep disturbances, and found a rate ratio for fibromyalgia of 2.10

Previously: How to cope with an “invisible illness” and Can yoga help women suffering from fibromyalgia?
Photo by Ben Seidelman

There’s more evidence today that sleep deprivation can be bad for your health – and your waistline. A Baylor College of Medicine study presented at the annual meeting of the American College of Chest Physicians shows a link between sleeping less than eight hours and weight gain in male teens. Medical News Today reports:

[Author Lata Casturi] and colleagues, including coauthor Anita Rao, presently a 10th grader at Dawson High School in Pearland, TX, surveyed 255 teens (108 males and 147 females) in high school to obtain self-reported measures of height and weight (used for BMI calculation) and both weekday and weekend quantity of sleep. Among males, results indicated the average sleep time on weekdays was 6 hours 32 minutes and on weekends 9 hours 10 minutes. Among females, the average weekday sleep time was 6 hours 30 minutes and the average weekend sleep duration was 9 hours 22 minutes. Teen males who slept 7 hours or less on weekdays had an average BMI that was 3.8 percent higher than those who slept more than 7 hours. Likewise, teen females who slept 7 hours or less had a BMI that was 4.7 percent higher than females who got more than 7 hours of sleep per weekday.

…

Furthermore, after adjusting for potential cofounders, short sleep duration (<8 hours) was associated with obesity in male teens. A negative correlation also was found between weekday sleep duration and obesity in males, with the fewest hours of weekday sleep associated with the highest BMI. There was no evident correlation between obesity and weekday sleep hours in teen females.

The research follows a 2004 Stanford study of more than 1,000 adults that found that sleep loss leads to higher levels of a hormone that triggers appetite, lower levels of a hormone that tells your body it’s full and an increased body mass index. And while the current study doesn’t establish cause-and-effect, it provides further support for the notion that teens – heck, all of us – should get as much sleep as possible.

Previously: Study shows lack of sleep during adolescence may have “lasting consequences” on the brain, Teens and sleep: A Q&A, Sleep deprivation may increase young adults’ risk of mental distress, obesity, Districts pushing back bells for the sake of teens’ sleep and Lack of sleep may be harmful to a teen’s well-being
Photo by David Noah 1

Lately, I’ve noticed that my teenage niece has been frequently posting to Facebook at 2 a.m. Her nighttime behavior wasn’t particularly surprising, considering previous research that suggests adolescents are biologically programmed to go to bed later and wake up later. But I grew more concerned about her nocturnal Facebook habits after reading a new study showing that lack of sleep during adolescence could affect synapses needed for communication and inhibit normal development of the brain.

During the study (subscription required), researchers at the University of Wisconsin-Madison completed a series of experiments involving young mice to better understand how alterations to the sleep-wake cycle affected the anatomy of the developing adolescent brain. The experiments involved using a two-photon microscope to indirectly observe brain impulses in three groups of mice: those that were spontaneously awake for eight to 10 hours, others forced to stay awake and some allowed to sleep. Researchers determined being asleep or awake made a difference in the growth and depletion of the connections between nerve cells called synapses. Results showed overall density of dendritic spines, the elongated structures that contain synapses and thus allow brain cells to receive impulses from other brain cells, fell during sleep and rose during spontaneous or forced wakefulness.

Chiara Cirelli, MD, PhD, a co-author of the study commented on the significance of the findings in a university release:

Adolescence is a sensitive period of development during which the brain changes dramatically. There is a massive remodeling of nerve circuits, with many new synapses formed and then eliminated… One possible implication of our study is that if you lose too much sleep during adolescence, especially chronically, there may be lasting consequences in terms of the wiring of the brain.

Previously: Teens and sleep: A Q&A, Sleep deprivation may increase young adults’ risk of mental distress, obesity, Districts pushing back bells for the sake of teens’ sleep and Lack of sleep may be harmful to a teen’s well-being
Photo by Alyssa L. Miller

Disruptions to your circadian rhythm, which guide the body’s internal clock, can result in a host of sleep disorders and have been linked to diabetes. In light of the growing body of research suggesting circadian-rhythm disorders may play a role in a number health problems, researchers are working to better understand the genetic underpinnings of the sleep-wake cycle.

While researchers know that our bodies, as well as simpler organisms, are synchronized by sunlight and can drift out of phase in darkness, the details of how a population of cells synchronizes their biological clocks remains a mystery. But new research from UC San Diego could yield important clues, reports Medgadget:

To remedy the problem, UC San Diego biology professor Jeff Hasty led a team of researchers to develop a model biological system that is simpler than that of an organism. The scientists created a simple circadian system using a model consisting of glowing, blinking E. coli bacteria. Drawing on their knowledge of synthetic biology, microfluidic technology, and computational modelling, the researchers built a microfluidic chip containing chambers with E. coli.

Researchers were able to simulate day and night cycles by modifying the bacteria to glow and blink whenever arabinose, a chemical that triggered the oscillatory clock mechanisms of the bacteria, was flushed through the microfluidic chip. This approach allowed researchers to replicate periodic day-night cycles over a period of only minutes rather than days providing a better understanding of how a population of cells synchronizes its biological clocks. The work is further described in a paper (subscription required) recently published in Science.

In the video above, the right side of the screen shows periodic pulses of arabinose (shown in red) act like day and night cycles to simulate how the blinking bacteria synchronize their biological clocks. On the left, a simulation of bacteria in constant darkness reveals how the blinking bacteria are unable to synchronize their biological clocks. The bottom two graphs illustrate the in-phase and out-of-phase oscillations of the biological clocks.

Previously: “Blink different:” E. coli engineered to alter blinking rate according to its environment

Americans that show up to work too tired to perform on the job could be costing the nation $63 billion in lost productivity each year, according to findings published in the journal SLEEP.

In the study (subscription required), researchers surveyed 7,428 employees about their sleep habits and work performance as part of the American Insomnia Survey, a research project launched by the World Health Organization and Harvard Medical School in 2008. Results showed 23 percent of participants experienced some form of insomnia, which cost their employers the equivalent of 7.8 days of work in lost productivity each year or roughly $2,280 in salary per person.

Stanford sleep expert Clete Kushida, MD, PhD, commented on the findings in a story published today by CNN:

About one-third of all U.S. adults experience weekly difficulties with nighttime sleep, and an estimated 50 to 70 million people complain of associated daytime impairment, the study notes. And while it’s hard to compare past and present research, insomnia does seem to be on the rise, says Clete Kushida, MD, a neurologist and sleep-medicine specialist at the Stanford University School of Medicine, in Palo Alto, Calif.

“There appears to be more insomnia, given more work and family responsibilities, and more technological improvements and distractions,” says Kushida, who was not involved in the new study. “These result in more stress that can precipitate worsened sleep.”

This study was funded by drug companies Sanofi-Aventis and Merck.

Previously: Stanford sleep expert offers evaluation of science behind one sleep device, CDC report highlights the dangers of sleep deprivation, Sleep deprivation more common in the U.S. than Europe and National poll reveals sleep disorders, use of sleeping aids among ethnic groups
Photo by Warren Noronha

A previous report from the National Sleep Foundation shows that the majority of adults in the United States experience problems sleeping. Americans’ struggle to get some shuteye has fueled a growing industry of products and supplements aimed at encouraging better sleep.

Today, the Los Angeles Times’ Healthy Skeptic column evaluates one such sleep aid, called the NightWave, to determine whether the device lives up to manufacture claims that it calms the mind and induces restful sleep. In the article, Stanford sleep expert Clete Kushida, MD, PhD, offers his perspective on the gadget:

The claims behind the NightWave make some sense, Kushida says. Several well-established sleep treatments – including meditation and guided relaxation with a CD – promote slow, rhythmic breathing. But that’s only one part of the process of falling asleep, he adds. “I don’t know of any evidence that slowing down breathing patterns itself will induce sleep.”

He speculates that the NightWave might help some people fall asleep, but he also thinks there are other, cheaper options. “In my opinion, it’s just a relaxation device,” he says. He believes that anything that calms the mind – even the old counting sheep trick – could work just as well for some people at considerably less cost.

Insufficient sleep has been linked to a host of health problems including heart disease, depression and obesity. To learn more about the importance of sleep, listen to this recent 1:2:1 podcast with Stanford sleep specialist Rafael Pelayo, MD.

Previously: Can a CD lull you to sleep?, Discussing sleep and work performance among health-care professionals, CDC report highlights the dangers of sleep deprivation, Sleep deprivation more common in the U.S. than Europe and National poll reveals sleep disorders, use of sleeping aids among ethnic groups