Less Than Six Hours Sleep/Night Increases Strokes

Lack of sleep and an increase in strokes. According to new research, the two conditions are very connected, even in otherwise healthy adults.

In early June, the University of Alabama at Birmingham released the results of a study that regularly sleeping less than six hours a night significantly increases the risk of stroke symptoms in middle-age to older adults who are of normal weight and at low risk for obstructive sleep apnea (OSA). That’s worth repeating: Less than six hours of sleep per night increases the risk of strokes in adults of normal weight and not at risk for OSA.

It seems that under six hours of sleep per night is the critical variable, but why? Let’s take a look at the study. The University of Alabama researchersfollowed 5,666 people  for up to three years who had no history of strokes or stroke-like symptoms, transient ischemic attacks (when blood flow to the brain stops for a brief period causing stroke-like symptoms), or high risk for OSA at the start of the study.

For a period of three years, the researchers followed and studied the subjects’ first stroke symptoms, stroke risk factors, depression symptoms, demographic information and other various health behaviors. What they found was—after adjusting for body-mass index (BMI)—there was a strong association between 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. Interestingly, the researchers did not find any link between short sleep periods and stroke symptoms in overweight and obese participants.

Still, the connection between short sleep and strokes is worthy of great attention from the medical community and general public. I agree with the Alabama study’s lead author, Megan Ruiter, PhD., who said, “The results of the Alabama study provide a strong argument for increasing physician and public awareness of the impact of sleep as a risk factor for stroke symptoms, especially among persons who appear to have few or no traditional risk factors for stroke.”

It looks like the medical community is taking this message to heart. Another study announced in late July is going on at the Alberta Health Services and the University of Calgary.  There, Dr. Patrick Hanly of the university’s Hotchkiss Brain Institute is leading a study to learn more about the physiological connection between sleep apnea and stroke—specifically, the brain’s blood flow response in people with and without sleep apnea.

For the study, participants with sleep apnea stay overnight in the sleep laboratory at Calgary’s Foothills Medical Centre, where their breathing and cardiovascular responses are continuously monitored while they sleep. The next day, their brain blood flow response to reduced oxygen levels is assessed while they are awake. Then, the participants receive supplemental oxygen during sleep for two weeks, and are tested again to see if their cerebral defense mechanisms have improved. The researchers are also studying people without sleep apnea to see if their cerebral defense mechanisms function better than in those with sleep apnea. Hanly and team’s theory is that it is the lack of oxygen, or hypoxia, that people with sleep apnea experience during sleep that impairs the body’s normal defense mechanisms in the brain. A better understanding of this connection will lead to better prevention and treatment strategies.

I applaud the work of the Alabama and Calgary researchers. It’s time we all wake up to the health benefits of more–and better—sleep.

For more information, read the University of Alabama at Birmingham study, “Under 6 Hours of Sleep Tops Risks for Stroke in a Low-risk Population.”

Heavy Technology Use linked to Fatigue, Stress and Depression in Young Adults

Modern technology is affecting our sleep. The artificial light from TV and computer screens affects melatonin production and throws off circadian rhythms, preventing deep, restorative sleep.

New research out of the University of Gothenburg, Sweden reinforces this fact, specifically relating to young adults. Doctoral student Sara Thomée and her colleagues at the University of Gothenburg's Sahlgrenska Academy conducted four studies to find out the effects of heavy computer and cell phone use on the sleep quality, stress levels, and general mental health of young adults.

For the study, Thomée and her team asked 4,100 young adults between age 20 and 24 to fill out questionnaires. They also interviewed 32 of them who were considered heavy information and communication technology (ICT) users. The researchers analyzed and compiled the data, and the results revealed that intensive use of cell phones and computers can be linked to an increase in stress, sleep disorders and depressive symptoms in young adults.

Some of the more specific findings are:

• Heavy cell phone use showed an increase in sleep disorders in men, and an increase in depressive symptoms in both men and women. 

• Those constantly accessible via cell phones were the most likely to report mental health issues.  

• Men who use computers intensively are more likely to develop sleeping problems.
• Regular, late night computer use is associated with sleep disorders, stress and depressive symptoms in both men and women.
• Frequently using a computer without breaks further increases the risk of stress, sleeping problems and depressive symptoms in women.
• A combination of both heavy computer use and heavy mobile use makes the associations even stronger.

So, what’s behind this link between technology use and negative health symptoms? The researchers have not yet fully determined why heavy technology users are more likely to have sleep disorders, higher stress and mental health issues, but one theory is that people with these symptoms are more likely to reach out and contact friends and family via technology.

I tend to think that the relationship between technology and stress, sleep disorders and depression has more to do with the overuse of technology in our society, especially among young people. If you’re a parent like I am, than you know first-hand how difficult it can be to get children to turn off the computer or put down their phone and stop texting so you can, just maybe, have a real conversation.

This is a growing and serious public health hazard that should be acknowledged and addressed by both the medical community and technology industry. It’s been scientifically proven that the light from TV and computer screens affects melatonin production and melanopsin stimulation, and throws off our circadian rhythms. This interrupts or prevents deep, restorative sleep, causing an increase in stress and depressive symptoms.

In the words of head researcher Sara Thomée, "Public health advice should therefore include information on the healthy use of this technology.” I couldn’t agree more. Just like alcohol ads, so should technology companies carry warnings on their products and in their advertisements. “Text responsibly.” “Don’t surf, then sleep.” You get the idea.

What can we, as individuals, do to protect our health from the negative impact of the ubiquitous technology in our society? Quite simply, turn it off, and get some good sleep. When you are on the computer for any length of time, take more frequent breaks, and impose limits on the amount of time you spend online. Trust me, the world will wait patiently for another Facebook post or text from you.

Remember, people need an average of seven to eight hours of restful sleep to fully take advantage of its restorative power and avoid daytime symptoms of fatigue. So turn off your TV and computer at least one hour before you go to sleep. Don’t sleep with your cell phone on and next to your bed. (Few things are more frustrating than being awakened in the middle of the night by an unimportant text message.)

Re-claim your bedroom for its intended purpose: restful sleep. Move the TV and computer out of the bedroom, or at the very least, don’t watch TV or work on the computer too close to bedtime. Stick to a bedtime routine. Get at least 7-8 hours of sleep every night. Try to go to sleep and wake up around the same time every day, even on weekends. Try to keep to within 20 minutes of the same time each morning and night.

Before bed, do activities that will promote sleepiness, such as a taking a warm bath, or reading a book or magazine. It also helps to maintain a cool temperature in your bedroom. A cool but comfortable temperature is ideal for sleep. Too warm and you will be fitful, too cold however can be uncomfortable and disturb your sleep.

Exercise regularly but not after the late afternoon. Even though exercise helps regulate sleep, rigorous exercise causes endorphins in the body to circulate which can have a stimulant effect, and keep you awake longer at night.

Stay away from caffeine at night. The effects of caffeine are different from person to person, and may last hours after your last cup of coffee, so make your last cup of coffee, regular tea or soda earlier in the day. Avoid alcohol and medicines that make you drowsy. Even if you think it is helping you fall asleep initially, alcohol and medicines that makes you drowsy may affect your sleep throughout the night.

And finally, if you feel that you are suffering from persistent sleep disorder, get checked out by a qualified sleep doctor. Regular, healthy sleep is one of the best things you can do for your mental and physical health.

Read the full report, entitled, “Intensive Mobile Phone Use Affects Young People´s Sleep.”