In the News, Myths, Sleep
on August 27th, 2013
A Huffington Post piece today surveys a panel of experts on best practices for getting a good night’s rest. The researchers advise on what worked for them (“Do boring yet challenging math”) and which tips they’ve tried and found to be overrated (“memory-foam mattresses”).
Clete A. Kushida, MD, PhD, medical director of Stanford Sleep Medicine Center, is one of the experts interviewed in the piece, which is a quick and fun read.
Previously: Tips for fighting fatigue after a sleepless night, Exploring the effect of sleep loss on health, More sleeping tips from a Stanford expert and Study estimates Americans’ insomnia costs nation $63 billion annually
Cardiovascular Medicine, Pregnancy, Research, Sleep, Stroke, Women's Health
on August 22nd, 2013
Come morning, an extra hour of sleep can seem to make the sun rise (“sprinkle it with dew…”). Likewise, squandering an hour awake in the middle of the night is a major bummer. My heart went out to moms-to-be, an oft-sleep-deprived demographic, when I read about a recent study finding that women with gestational diabetes - between four and eight percent of pregnant women in the U.S. – were seven times more likely to experience obstructive sleep apnea than pregnant women without gestational diabetes. Intermittently pausing the breath, typically in intervals of 20 to 40 seconds, obstructive sleep apnea not only interrupts sleep but also can raise the risk for stroke and hypertension if left untreated.
Researchers of the study, which was accepted for publication in The Endocrine Society‘s Journal of Clinical Endocrinology & Metabolism, monitored sleep disruptions, including sleep apnea, in 45 women: 15 who were pregnant and had gestational diabetes, 15 who were pregnant and did not have gestational diabetes, and 15 who were not pregnant and did not have diabetes.
From a release:
“It is common for pregnant women to experience sleep disruptions, but the risk of developing obstructive sleep apnea increases substantially in women who have gestational diabetes,” said Sirimon Reutrakul, MD, who conducted the research at Rush University Medical Center in Chicago. “Nearly 75 percent of the participants in our study who had gestational diabetes also suffered from obstructive sleep apnea.”
The study found a strong association between obstructive sleep apnea and gestational diabetes in this group of mostly overweight or obese women. Pregnant women who did not have gestational diabetes were able to get an additional hour of sleep and had less fragmented sleep than women who had gestational diabetes.
Previously: Why untreated sleep apnea may cause more harm to your health than feeling fatigued, How effective are surgical options for sleep apnea?, A reminder that prenatal care is key to a healthy pregnancy and Study: Exercise may not stave off gestational diabetes
Photo by quinn.anya
Sleep, Stanford News
on August 16th, 2013
As many of us know first hand, a significant number of Americans are sleep deprived. In an recent Huffington Post piece, Stanford sleep experts offer tips for those looking to fight fatigue after a sleepless night.
Among their recommendations are to resist the urge to repeatedly hit the snooze button and to make time for a short daytime nap:
“The worst mistake I see my sleep-deprived insomnia patients make is staying in bed in the morning to try to reach the magic eight hours,” says Chad Ruoff, MD, a clinical assistant professor of psychiatry at the Stanford University Sleep Center. Sleeping later than normal throws your body off schedule and will make it harder to fall asleep tonight, perpetuating the problem. No matter how tempting it feels to huddle under the blankets, your body won’t react well to a snooze-in — and neither will your boss.
You’ve been feeling pretty good all morning, but now you’re ready to pass out. Research has shown that a short afternoon nap can make up for the loss of one hour of nighttime sleep and can improve alertness, performance and mood, says Clete A. Kushida, medical director of the Stanford University Sleep Medicine Center. (Here’s how to do it right.)
Previously: What are the consequences of sleep deprivation?, Stanford center launches Huffington Post blog on the “very mysterious process” of sleep, Study: Parents may not be as sleep-deprived as they think, Exploring the effect of sleep loss on health and How lack of sleep affects the brain and may increase appetite, weight gain
Photo by William Brawley
Nutrition, Obesity, Research, Sleep
on August 7th, 2013
More than a third of adult Americans are obese and, coincidentally, roughly a third of men and women in the United States are sleep-deprived. Or, maybe it’s not such a coincidence?
Past studies have linked inadequate sleep to obesity, and now new research from University of California, Berkeley offers insights into how not getting enough shut-eye can trigger poor nutritional choices.
In the small study, researchers used functional magnetic resonance imaging (fMRI) to scan the brains of healthy young adults after both a normal night’s sleep and a sleepless night. Study results showed impaired activity in areas of the brain’s frontal lobe that regulate complex decision-making and a boost in deeper brain centers, which respond to rewards. Additionally, sleep-deprived participants favored unhealthy snack and junk foods.
A recent PsychCentral story highlights the significance of the findings:
Previous studies have linked poor sleep to greater appetites, particularly for sweet and salty foods, but the latest findings provide a specific brain mechanism explaining why food choices change for the worse following a sleepless night.
“These results shed light on how the brain becomes impaired by sleep deprivation, leading to the selection of more unhealthy foods and, ultimately, higher rates of obesity,” said Stephanie Greer, a doctoral student and lead author of the paper.
Previously: Want teens to eat healthy? Make sure they get a good night’s sleep, More evidence linking sleep deprivation and obesity, How lack of sleep affects the brain and may increase appetite, weight gain and Study shows link between lack of sleep
Photo by Christian Newton
Cardiovascular Medicine, Sleep, Stanford News
on July 25th, 2013
Today on the Stanford Center for Sleep Sciences and Medicine blog on the Huffington Post, sleep neurologist Mitchell Miglis, MD, explains why individuals with untreated sleep apnea have an increased risk of suffering from heart attack and stroke as well as developing high blood pressure, high cholesterol and diabetes.
Researchers have established that resting blood pressure typically falls by 10 to 20 percent in most individuals during sleep. This is a normal physiological response, mediated by the parasympathetic component of the autonomic nervous system. However, in some individuals, termed “non-dippers,” this does not occur. In others, so-called “reverse dippers,” blood pressure actually increases by 10 to 20 percent. Non-dippers and reverse dippers are at higher risk for stroke than dippers are. And those with obstructive sleep apnea are much more likely to be non-dippers or reverse dippers.
In addition, whenever there is a sudden arousal from sleep, be it due to a nightmare or to upper airway obstruction from sleep apnea, there is a surge in sympathetic activity. As a result, there is a burst of adrenaline released into the bloodstream, blood pressure shoots up (sometimes extremely high), and — especially if there is a corresponding drop in blood-oxygen levels as frequently occurs during an apnea — heart rate can become irregular and dangerous arrhythmias, such as atrial fibrillation may develop.
Furthermore, it is thought that this apnea-induced sympathetic surge carries over into the waking state. Researchers have found that patients with sleep apnea have higher daytime levels of adrenaline and higher resting blood pressure than normal controls. They were, however, able to significantly lower the levels in those treated with continuous positive airway pressure (CPAP), the most common treatment for obstructive sleep apnea.
Previously: How effective are surgical options for sleep apnea?, Experts discuss possible link between sleep disorder and dementia and In mice, at least, uninterrupted sleep is critical for memory
Photo by Becky Wetherington
Public Health, Sleep, Stanford News
on July 11th, 2013
Not getting enough shut-eye each night can have effects beyond making you grouchy and in need of an extra boost of caffeine. As Brandon Peters, MD, an adjunct clinical faculty member at the Stanford Center for Sleep Sciences and Medicine, explains in a Huffington Post piece, changes in mood are one of several ways in which inadequate sleep can negatively affect your well-being.
Not only can someone become cranky or irritable, but difficulty sleeping often contributes to anxiety and depression. Impairment of the frontal lobe of the brain may also interfere with higher level cognitive processes called executive functions. This can undermine judgment, critical thinking, relationships, problem solving, planning, and organization.
Studies have shown that sleep deprivation can profoundly affect memory and performance. Attention, concentration, and vigilance become impaired. People who sleep less than 7 hours per night have reaction times that are similar to those who are completely sleep deprived for one or even two nights. This leads to errors, accidents, and impaired work performance. The scary thing is that when you are chronically sleep deprived, you may not even recognize the level of impairment.
Memory becomes compromised in sleep deprivation, with decreased attentiveness affecting our ability to process information. Immediate recall and short-term memory both become impaired. Research shows that memory processing and consolidation occur in sleep and it has a key role in learning and problem solving. When we don’t sleep enough, this capacity becomes greatly diminished.
Read the full entry to learn how a lack of sleep can also contribute to hormonal shifts that may lead to increased weight gain and stunted growth in children.
Previously: Stanford center launches Huffington Post blog on the “very mysterious process” of sleep, Study: Parents may not be as sleep-deprived as they think, Exploring the effect of sleep loss on health, How lack of sleep affects the brain and may increase appetite, weight gain, CDC report highlights the dangers of sleep deprivation and Sleep deprivation may increase young adults’ risk of mental distress, obesity
Photo by Dan Previte
Sleep, Stanford News, Surgery
on June 28th, 2013
A recent entry on the Stanford Center for Sleep Sciences and Medicine blog on the Huffington Post examines the effectiveness of surgical options for obstructive sleep apnea (OSA), from which an estimated two in 10 Americans suffer.
Robson Capasso, MD, director of sleep surgery and a clinical assistant professor of otolaryngology at Stanford, writes:
Many patients, family members, and even physicians are skeptical and question the efficacy of surgery to treat OSA. This uncertainty arises from somewhat low success rates associated with uvulopalatopharyngoplasty (UPPP), the most commonly performed surgical procedure for OSA in the U.S. In this procedure, the surgery targets only the soft palate, without improving potential collapses in other areas of the upper airway. However, recent developments in this field — in great part pioneered at Stanford University by Drs. Nelson Powell and Robert Riley — provide the opportunity for more complex techniques to evaluate the upper airway and to treat obstructions at sites other than the palate. These cutting-edge approaches maximize airway improvement by reducing the anatomical obstruction or decreasing the collapse of tissue causing the obstruction in the nose, throat, or tongue — or, which is more common, in all of these sites. Currently, these procedures are offered by a limited number of surgeons in the country.
To answer the question if surgery really works for sleep apnea, we can say that if the goal is to decrease the cardiovascular risk associated with OSA and improve the symptoms associated with the disease such as daytime sleepiness, snoring severity, and poor sleep quality, there is convincing evidence showing good results for each one of these problems. There is also a substantial amount of data suggesting improvement in quality of life and, very gratifying for the treating surgeon, frequent restoration of a more harmonious bedtime routine with loved ones.
Previously: Stanford doc talks sleep (and fish) in new podcast, Catching some Zzzs at the Stanford Sleep Medicine Center, Ask Stanford Med: Rafael Pelayo answers questions on sleep research and offers tips for ‘springing forward’ and Catching up on sleep science
Photo by Rachel Kramer Bussel
Nutrition, Obesity, Parenting, Pediatrics, Sleep
on June 21st, 2013
Sleep-deprived teenagers tend to make poor nutritional choices compared to their well-rested friends, according to findings presented at the recent annual meeting of the Associated Professional Sleep Societies.
In the study, researchers explored the connection between sleep duration and food choices using a national representative sample of more than 13,200 teenagers from the National Longitudinal Study of Adolescent Health. A release from Stony Brook University School of Medicine offers more details about the results and their significance:
The authors found that those teens who reported sleeping fewer than seven hours per night — 18 percent of respondents — were more likely to consume fast food two or more times per week and less likely to eat healthful food such as fruits and vegetables. The results took into account factors such as age, gender, race and ethnicity, socioeconomic status, physical activity and family structure, and found that short sleep duration had an independent effect on both healthy and unhealthy food choices.
“We are interested in the association between sleep duration and food choices in teenagers because adolescence is a critical developmental period between childhood and adulthood,” said the first author of the study, Allison Kruger, MPH, a community health worker at Stony Brook University Hospital. “Teenagers have a fair amount of control over their food and sleep, and the habits they form in adolescence can strongly impact their habits as adults.”
The findings add to the growing body of research showing that not getting enough sleep can increase an individual’s risk of obesity.
Previously: More evidence linking sleep deprivation and obesity, How lack of sleep affects the brain and may increase appetite, weight gain, Study shows link between lack of sleep and obesity in teen boys and Study: Staying up late tied to poor eating habits, weight gain
Photo by U.S. Department of Agriculture
Research, Sleep, Technology
on June 4th, 2013
For Mother’s Day, my husband gifted me with an iPad mini. I can’t tell you how much I love my new little toy, but I have noticed that I am going to be bed much later – even after I’ve put away the device.
The light being emitted from smartphones and tablets has long been suspected of suppressing levels of the hormone melatonin, which helps regulate our bodies’ sleep and wake cycles. Now, researchers from the Mayo Clinic suggest you should adjust your device’s screen brightness to the lowest setting and keep it at a certain distance to avoid disrupting sleep. The results were presented this week during the SLEEP 2013 conference in Baltimore.
According to a Medical Daily article:
The researchers investigated how levels of light emitted from mobile devices at different distances from a user’s face compared to the threshold of light that suppresses the secretion of melatonin, 30 lux.
In a dark room, they used a sensitive light meter to measure the light coming from two Apple tablets and a smartphone: an iPad 1, an iPad 3 with retinal display, and an iPhone 4. The emitted light was measured at 0 inches and 14 inches from a user’s face.
The measurements showed that when the brightness was lowered to the minimal setting, the LED lights of all three devices were well below the 30 lux melatonin-suppressing threshold.
“We found that only at the highest setting was the light over a conservative threshold that might affect melatonin levels,” said Dr. Krahn. “If it’s at the mid setting or at a low setting it’s bright enough to use.”
This seems simple enough. Perhaps I’ll give it a try before going to bed tonight.
Photo by ianmunroe
Podcasts, Sleep, Stanford News
on May 14th, 2013
You know that famous song about love by Cole Porter with the lyrics, “Birds do it, bees do it. Even educated fleas do it.” Well, in addition to amour, Porter could have easily been referring to sleep. After all, even fish do it, as Rafael Pelayo, MD, with the Stanford Sleep Medicine Center, told me during my latest 1:2:1 podcast.
I hope you’ll listen in as Pelayo talks more about the mysteries of sleep, an endlessly interesting topic.
Previously: Catching some Zzzs at the Stanford Sleep Medicine Center, Ask Stanford Med: Rafael Pelayo answers questions on sleep research and offers tips for ‘springing forward’ and Catching up on sleep science