Is the quality of your sleep making you gain weight?

How many of us would like to lose a few pounds, but look for external ways—outside of our bodies—to lose weight?  Perhaps we should be looking more inward, not only at our personal diet and exercise levels, but the length and level, or phase, of our sleep.

Recently, I read an article in the American Journal of Physiology – Regulatory, Integrative and Comparative Physiology. In it, researchers from St. Luke's-Roosevelt Hospital and Columbia University in New York shed some light on the link between our length and phase of sleep, and hunger and weight gain.

The researchers investigated the effects of “sleep architecture” on hunger to determine whether specific stages of sleep—not just the duration of sleep—affect the appetite and food cravings in healthy adults.

What they found is compelling, and cause for further attention: the length of time of sleep, as well as the percentage of overall sleep in different sleep stages, are associated with decreased metabolic rate, increased hunger, and increased intake of calories, specifically from fat and carbohydrates.

For the study, head researcher Ari Shechter and his colleagues studied a random sample of 27 healthy adults between the ages of 30 and 45. The participants underwent two six-day periods of laboratory observation, during which they were slept different lengths of time.

During a "habitual sleep" phase, they were allowed to sleep for nine hours; in the "short sleep" phase, they were allowed just four hours of sleep. Each of the two sleep phase studies were separated by four weeks to make sure the participants fully recuperated, and the women were observed at the same phase of their menstrual cycle. The amount of time spent in each sleep phase—stage 1, stage 2, slow wave sleep (SWS), and REM sleep—was recorded.

For the first four days in both sleep phases, the participants ate meals to meet their energy requirements for weight maintenance. On day four, they rated their hunger and level of desire for different foods. On day five, their resting metabolic rate (RMR) was measured, and for the final two days of the sleep phase studies, the participants were allowed to select their own foods.

The researchers then compared the participants' sleep architectures in both the short sleep and habitual sleep conditions. They also analyzed the relationships between sleep architecture, resting metabolic rate, food intake and food desire ratings.

Shechter and his colleagues found that sleep duration is important, but sleep composition—the time and percentage of overall sleep spent in each stage—also plays an important role in the link between sleep and obesity.

Head researcher Shechter explained, “Any number of various factors like obstructive sleep apnea, certain drugs/medications, chronic exposure to short sleep duration, shift work, jet lag, and changes in the scheduling of the sleep episode, can affect sleep stage quantity and distribution. Our data may provide an explanation for the greater obesity prevalence observed within some of these conditions."

Read the full article, “Changes in Sleep Architecture Increase Hunger, Eating.”
The results of this study remind me of another study I blogged about not long ago on “social jetlag,” another reason for all of us to get more sleep.

Social jetlag is a modern syndrome caused by the discrepancy between our internal body clock and our social clock. And according to Professor Till Roenneberg, Ph.D. at the University of Munich’s Institute of Medical Psychology in Germany, that gap between how much sleep we need and how much we’re actually getting is contributing to our global weight gain and the growing worldwide obesity epidemic.

Each of us has a physiological clock, and that internal clock — also known as our circadian rhythm — is regulated by daylight and darkness to prompt us to go to sleep or wake up. We also have a social clock of things that make up our daily lives, such as our work schedules and social calendars.

The problem is, in our modern society of too-late work hours and too much time in front of computer screens, we are listening to our social clocks more than our physiological clocks, causing a greater sleep gap known as social jetlag. As a person’s circadian rhythm gets more out of whack, their physiological clock gets set later and later, keeping them awake into the night, and feeling chronically tired during the day.

In their study, Professor Roenneberg and his fellow researchers in Munich discovered that people with different weekday and weekend sleep schedules—i.e., those with more social jetlag — were three times more likely to be overweight. That is a significant increase worth repeating: Three times more likely to be overweight!

Furthermore, the body mass index (BMI) of the overweight participants tended to increase as the gap between their weekday and weekend sleep clocks widened.
I applaud the efforts of Roenneberg and his team for their work in particular, because they are bringing a public awareness of a growing syndrome that is affecting many people worldwide — not just shift workers or those with irregular work schedules.

So, why does social jetlag cause weight gain? One of the theories is that late hours encourage irregular meal times and late-night eating, when the body has more difficulty digesting and metabolizing food. That translates into body fat. Another is that chronically tired people are less likely to exercise and more likely to smoke and drink, further contributing to weight gain.

Whatever the causes, it is in all our personal best interests to become more aware of our own physiological clocks and get more restful sleep. Doing so can help us all maintain a healthy body weight, avoid many health problems, feel better and live happier, more productive lives.

So, now that you have this new knowledge about sleep, weight gain, I suggest you give yourself a wonderful personal gift: get more sleep, especially during the holiday season, when many people are overeating and busier than usual. Also spend more time outdoors and exercise. More and better sleep is one of the best gifts you can give yourself for the holidays.

Read Professor Roenneberg and his team’s full report entitled, “Social Jetlag and Obesity,” published in the May 10 issue of Current Biology.

Women, Wake Up: Sleep Apnea is Not Just a Male Disorder

Earlier this year, a particularly alarming statistic came out of Valme University Hospital in Seville, Spain, where researchers found that women with untreated severe OSA are three and a half times more likely to die from cardiovascular disease than women without OSA. (Read a summary of the study here.)

Since then, more research has been published showing high rates of sleep apnea in women,  as well as increasing links between OSA and age, obesity and hypertension.

In one new study published in August, researchers from Uppsala and Umeå University in Sweden analyzed 400 women between the ages of 20 and 70 years. They found that OSA was present in 50 percent of ALL the women participants aged 20 to 70 years.

They also found that 80 percent of women with hypertension and 84 percent of obese women suffered from sleep apnea. Of the obese women, 31 percent between age 55 and 70 had severe sleep apnea.

The alarming high percentages show that this should be a wake-up call to women.  Sleep apnea is not just a male disorder. Women—especially those with hypertension and/or obesity—need to wake up to the dangers of OSA and seek treatment if diagnosed with it.

Even Dr. Karl Franklin, lead author of the Swedish study, was surprised by the findings. He said, “We were very surprised to find such a high occurrence of sleep apnea in women, as it is traditionally thought of as a male disorder. These findings suggest that clinicians should be particularly aware of the association between sleep apnea and obesity and hypertension, in order to identify patients who could also be suffering from the sleeping disorder.

I agree wholeheartedly with Dr. Franklin, and add to his point that individuals, not just doctors, also need to be aware and speak up if they suspect they may have sleep apnea and related conditions. Read a summary of the study.

A few more recent studies showing OSA’s link to women’s health issues:

A study published in the September issue of the journal Obstetrics & Gynecology out of the University of South Florida found that babies born to obese women with OSA were more likely to be admitted to the neonatal intensive care unit than babies born to women without OSA. In addition, the women with OSA were more likely to develop a high blood pressure condition during pregnancy known as preeclampsia, and to deliver their babies by cesarean section.

Read the study, entitled, “Sleep apnea in obese pregnancy women linked to poor maternal and neonatal outcomes.”

In another study also published in September, sleep apnea in women has been linked to overactive bladder syndrome.

Researchers from the Hospital del Mar in Barcelona, Spain gave 72 women a questionnaire regarding their bladder control and four specific symptoms. According to the results, 62 of the women polled were diagnosed with obstructive sleep apnea (OSA). Further, the women with OSA scored higher on the questionnaire for the prevalence of bladder control symptoms, and the discomfort related with these symptoms.

More research is needed, but clearly, evidence is mounting showing the link between women and sleep apnea, and related disease and disorders. With one in four women over age 65 suffering from sleep apnea, according to the National Sleep Foundation, every woman who believes she is suffering from a sleep disorder-related condition should learn more and get checked out by a qualified sleep doctor. Many women are selfless caretakers, and will put their own worries or needs aside to take care of the needs of others. But don’t wait: Your health is the most important thing, and the healthier you are, the more productive you’ll be and the better you can care for your loved ones.

How do you know you may have obstructive sleep apnea? Some common symptoms include snoring, paused breathing during sleep and excessive sleepiness during the day. If you or someone you know is waking during the night gasping for air, that is a signal to seek diagnosis. Increased blood pressure is another sign you may have sleep apnea. For further study, read “Women and Sleep”  on the National Sleep Foundation website.

When you go for an exam, be specific with your doctor about the symptoms you are experiencing. While sleep apnea is more common in men, OSA increases in women after age 50. Many times, obstructive sleep apnea can be misdiagnosed in women as chronic fatigue, insomnia, depression, or some other non-specific condition. Also, some doctors still associate sleep apnea more with men than women, and are too quick to prescribe a medication, rather than do a full sleep disorder work up. Be  as clear and detailed as you can about your symptoms and what you are experiencing, and don’t wait —it could save your life.

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.”

Lack of Sleep is Stressing Us Out, New Study Says

Stress in our life is not only caused by what we do and our busy schedules—stress is also caused by what we don’t do, namely, not get enough sleep. A new study by researchers in England and the Netherlands have discovered that a severe lack of sleep creates a response in the immune system that is similar to the body’s immediate response when it experiences a stressful situation. Yes, even lack of sleep is stressing us out.

The study was a joint effort by the Department of Forensic Molecular Biology at the Erasmus MC University Medical Center in Rotterdam and the Centre for Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, and the University of Surrey Clinical Research Centre in England.

So how did the researchers determine this? They compared the white blood cell counts of 15 healthy young men under both normal and severely sleep-deprived conditions.

In the first phase of the study, the men followed a strict schedule of eight hours of sleep per night every day for one week. They were also exposed to at least 15 minutes of outdoor light within the first 90 minutes of waking, and prohibited from using caffeine, alcohol or medication during the final three days of the first week.

The researchers required this in order to stabilize the participant’s circadian clocks and minimize sleep deprivation before the second phase of the study. The researchers then categorized and measured each participant’s white blood cells.

In the second phase of the study, the men stayed awake for 29 continual hours, and their white blood cells were again recorded and compared to the white blood cell numbers collected in the first phase of the study.

According to the researchers, the effect of sleep loss on the white blood cells was immediate. The white blood cells known as granulocytes showed a loss of day-night rhythmicity—the circadian rhythm of the granulocytes slowed—and their numbers also increased, particularly at night. This reaction directly mirrors the body’s white blood cell response to stress.

Read the full study entitled, “Diurnal Rhythms in Blood Cell Populations and the Effect of Acute Sleep Deprivation in Healthy Young Men,” published in the July 2012 issue of the journal, Sleep. 

The results of the study are in line with other previous research that shows a link between lack of sleep and a negative immune system response. In March of this year, the University of Rochester Medical Center published results that showed that the immune system of older adults who do not get enough sleep responds to stress with inflammation, increasing the risk for mental and physical health problems.

These studies and others like them reinforce the fact that more quality, restful sleep not only helps us feel better – it may also help us avoid myriad poor mental and physical health conditions. So, get some sleep out there — you’ll feel less stressed out!

“Social Jetlag” Contributing to Global Weight Gain

Here’s another reason to get more sleep — and another new term to describe one of our modern maladies: “social jetlag.” What exactly is social jetlag? It is a syndrome caused by the discrepancy between our internal body clock and our social clock. And according to Professor Till Roenneberg, Ph.D. at the University of Munich's Institute of Medical Psychology in Germany, that gap between how much sleep we need and how much we’re actually getting is contributing to our global weight gain and the growing worldwide obesity epidemic.

Each of us has a physiological clock, and that internal clock — also known as our circadian rhythm — is regulated by daylight and darkness to prompt us to go to sleep or wake up. We also have a social clock of things that make up our daily lives, such as our work schedules and social calendars. The problem is, in our modern society of too-late work hours and too much time in front of computer screens, we are listening to our social clocks more than our physiological clocks, causing a greater sleep gap known as social jetlag. As a person’s circadian rhythm gets more out of whack, their physiological clock gets set later and later, keeping them awake into the night, and feeling chronically tired during the day.

Professor Roenneberg and his fellow researchers in Munich discovered the negative effects of social jetlag after compiling and studying the sleep habits of more than 65,000 adults over the past 10 years. Roenneberg and his team recorded sleep times and other data of the participants, such as height and weight, and started to draw conclusions.

The results of the study — which you can read in the May 10 issue of Current Biology — showed that people with different weekday and weekend sleep schedules—i.e., those with more social jetlag — were three times more likely to be overweight. That is a significant increase worth repeating: Three times more likely to be overweight!  Furthermore, the body mass index (BMI) of the overweight participants tended to increase as the gap between their weekday and weekend sleep clocks widened.

Two-thirds of participants reported at least one hour's difference in their average weekday and weekend sleep schedules, and more than 10 percent reported three-plus hours difference between their weekday and weekend sleep schedules. Roenneberg and his colleagues also found that people who are chronically sleep-deprived are also more likely to smoke and drink more alcohol and caffeine.

The results of the study are similar to those of previous studies linking a higher body mass index and even diabetes to the irregular sleep schedules and sleep deprivation of shift workers. But I applaud the efforts of Roenneberg and his team for their work in particular, because they are bringing a public awareness of a growing syndrome that is affecting many people worldwide — not just shift workers or those with irregular work schedules.

So, why does social jetlag cause weight gain? One of the theories is that late hours encourage irregular meal times and late-night eating, when the body has more difficulty digesting and metabolizing food. That translates into body fat. Another is that chronically tired people are less likely to exercise and more likely to smoke and drink, further contributing to weight gain.

Whatever the causes, it is in all our personal best interests to become more aware of our own physiological clocks and get more restful sleep. Doing so can help us all maintain a healthy body weight, avoid many health problems, feel better and live happier, more productive lives. In the words of Professor Roenneberg, “Good sleep and enough sleep is not a waste of time but a guarantee for better work performance and more fun with friends and family during off-work times.” Knowledge of the study and an increased awareness of the effects of social jetlag can also have positive effects on the economy and education: Companies can make more informed decisions about employees’ work schedules and schools can make more educated decisions about school hours.

So, now that you have this new knowledge about social jetlag, your physiological and social clocks and how a gap between your weekday and weekend sleep schedules can contribute to your weight gain, what are you going to do about it? I present you with a personal challenge that will only help you feel better. I challenge you to get more sleep. Turn off the TV and computer and go to bed earlier. Forego that invitation for a late-night dinner. Spend more time outdoors, and if you’re stuck in an office all day, try to sit near a window. I promise you, you’ll feel less social jetlag.

To read Professor Roenneberg and his team’s full report entitled, “Social Jetlag and Obesity,” published in the May 10 issue of Current Biology.

Another Reason: Oxygen Depletion from OSA Linked to Higher Rate of Cancer

Every month, I take time to write these blogs to help educate people about the negative health effects associated with obstructive sleep apnea (OSA), and the importance of getting it properly diagnosed and treated. I hope my point is getting across out there.

If you or someone you love regularly experiences OSA symptoms, such as snoring and disordered (interrupted) breathing, here’s another reason to get it checked out: Two new studies claim that OSA sufferers are more likely to die from cancer.

Their findings are significant because it marks the first time that cancer growth has been associated with sleep apnea in people. In a previous study about a year ago, Spanish researchers had already linked the intermittent lack of oxygen caused by OSA—known as hypoxia—with increased tumor growth in mice. That study also found that the mice had more dead cells, which indicates a more aggressive type of cancer.

In one of the new studies, researchers at the University of Wisconsin School of Medicine and Public Health studied data on about 1,500 state workers who have been taking part in overnight sleep studies every four years since 1989.

The researchers found that people with severe sleep apnea who had the most intermittent disordered breathing problems were almost five times more likely to die from cancer than those without OSA. They also found that people considered to have moderate cases of OSA died of cancer at double the rate than those without OSA at all.

This is consistent with the hypoxemia theory—that an increase of interrupted/disordered breathing is actually contributing to cancer cell growth … because the body is being depleted of oxygen.

What the researchers also discovered—and what I found particularly notable—was that when OSA patients who were being treated with continuous positive airway pressure (CPAP) therapy were removed from the Wisconsin study, the OSA/cancer association increased.  In other words, OSA patients who undergo CPAP treatment—who lower their interrupted/disordered breathing episodes—may likely reduce their risk of dying from cancer due to OSA-related oxygen depletion.

In the second related study, researchers at the Spanish Sleep Network used the hypoxemia index, which measures the amount of time the level of oxygen in a person’s blood drops below 90 percent at night.

The researchers followed more than 5,000 OSA patients for seven years. None of them had any cancer diagnosis when the study began, but they found that those with the most severe forms of sleep apnea had a 65 percent greater risk of developing cancer of any kind. In other words, the greater the extent of oxygen depletion during sleep, the more likely a person was to be diagnosed with cancer during the study.

It should be noted that, in both the Wisconsin and Spanish studies, the researchers only looked at cancer diagnoses and deaths in general, not the specific type of cancer.

The takeaway for all of is that this is one more study … one more reason … for you or someone you love with OSA-related paused/intermittent breathing issues to take sleep apnea seriously and get diagnosed asap.

New Study: Health Effects of Sleep Apnea Evident After One Month

It’s an interesting time in the world of sleep apnea research, a disorder in which a person has periods of slow or paused breathing during sleep. It seems that every month there is a new study showing yet another link between sleep apnea and sleep-disordered breathing (snoring, paused breathing, etc.), and its negative effects on health.

Recent studies have linked obstructive sleep apnea (OSA) to depression, silent strokes and small brain lesions, abnormalities in the blood vessels, high blood pressure, heart disease and strokes, even sudden hearing loss. And women take note: Sleep apnea has been linked to dementia in older women, and another study found that women with untreated severe OSA are three and a half times more likely to die from cardiovascular disease than women without OSA!

Clearly, the link between OSA and an increased risk of stroke has been medically established. But what effect does OSA have on the brain vessels and cerebral circulation? Researchers at the   Baylor College of Medicine in Houston, Texas developed a way to find out.

In late April, a study entitled, “Cerebrovascular Consequences of Obstructive Sleep Apnea” was presented and discussed at the Experimental Biology 2012 meeting at the San Diego Convention Center. The researchers described how they developed a new way to induce the effects of obstructive sleep apnea in mice—specifically, the closure of the airway that results in paused breathing and the physiological side effects of OSA. The new testing model enabled the researchers to mimic the symptoms and effects of OSA in humans, and thus study the results in a controlled environment.

For the study, the researchers induced sleep apnea in the mice while they slept. Surprisingly, they found that—after just one month of induced repeated apneas—the mice’s “cerebral vessel dilatory function” was reduced by as much as 22 percent, and the mice’s cerebrovascular function did not function as normal, or before the apneas.

In other words, after just one month of repeated apneas, after a month of repeated apneas, the blood vessels in the mice’s brains did not work as well as they did.

What are the implications of this study? According to the researchers, one is that the new method of testing provides researchers with a more accurate and complete way to study the effects of sleep apnea on people. The other, which I find compelling, is that only one month of moderate, repeated sleep apnea caused a change in cerebrovascular function which could result in a stroke. It is important to note that the results of the study correlates with other studies that show similar cell dysfunction in arteries, which has caused an increased risk of stroke in OSA patients.

This just reinforces the speed in which sleep apnea can damage the body, and the importance of getting diagnosed and treated as quickly as possible.  The results are also a wake-up call to both sleep and medical doctors that damage to the vascular wall in brain arteries could be a factor predisposing an individual with OSA to stroke. Sleep and medical doctors should be working more in tandem to treat patients.

Again, it is in interesting time for sleep apnea research. And I hope and encourage researchers to continue studying and publishing their results so we can all better understand the symptoms and treatments of this disorder. I believe the need for treatment will only increase with time. As obesity, hypertension and other related conditions continues to plague this country, and as the general population ages, we will see an increase in OSA cases. It is no longer a male condition—women, non-obese people and even children can have OSA.

An estimated 18 million Americans have sleep apnea, including one in four women over 65, according to the National Sleep Foundation. While apnea is more common in men, it increases in women after age 50. And some researchers estimate that up to 85 percent of people with clinically significant sleep apnea have not even been diagnosed yet.

Sleep apnea and other sleep-related disorders are prevalent in our society, and people need to wake up to the symptoms and risks associated with them. (I am on a personal mission to educate people about this, and my blog is one of the ways in which I do so.)

So how do you know if you have sleep apnea? The first step is to become aware of some common symptoms, including trouble falling asleep at night, waking throughout the night, chronic snoring, morning headaches, poor memory, daytime sleepiness/falling asleep during the day, bad moods and irritability, increased depression and trouble concentrating/driving/making decisions.

If you have any of the symptoms mentioned above, and suspect that you may have sleep apnea, please get checked out by a doctor who specializes in sleep disorders. Be specific about the symptoms you are experiencing. Many times, sleep apnea can be misdiagnosed as chronic fatigue, insomnia, depression, or some other non-specific condition. Also, some doctors are too quick to prescribe a medication, rather than do a full sleep disorder work up. Again, to try and avoid misdiagnosis, go to a qualified sleep specialist and be specific about your symptoms. Don’t wait—it could save your life, not to mention help your bedmate keep his or her sanity.

Sleepy on the Job? Tips for a Better Night’s Sleep

There’s no denying that sleep deprivation, and the health issues that result, are becoming more prevalent in our go-go, techno society. But a recent sleep study by the National Sleep Foundation (NSF) grabbed my attention as particular cause for concern.

Every year, the NSF releases a Sleep in America® poll.  For its 2012 survey, the NSF examined the specific sleep habits and work performances of transportation workers—pilots, train operators, truck, bus, taxi and limousine drivers. The transportation workers were asked about the duration and quality of their sleep, specifically on work nights, and how it affects their work performance.

Some of the results of the survey are:

• About one-fourth of the train operators and pilots polled said that sleepiness has affected their job performance at least once a week.
• One in five pilots polled—about 20 percent—said they have made a “serious error” as a result of on-the-job sleepiness.
•  One in five pilots and one in six train operators admit to a “near miss” due to on-the-job sleepiness.
• Pilots and train operators are more likely than non-transportation workers to have been involved in a sleep-related car accident while commuting.
• Among all workers surveyed, train operators and pilots report the most work day sleep dissatisfaction.
• Almost two-thirds of train operators and one-half of pilots say they rarely or never get a good night’s sleep on work nights.
• About one-third of bus, taxi, and limo drivers said they rarely or never get a good night’s sleep on work nights.

The results of the poll are some cause for alarm, and reinforce the growing problem of sleep disorders and the potential risks they pose, such as commuter car accidents and errors by public transportation drivers responsible for many people.

Persistent sleep problems left untreated can also lead to myriad health problems, including memory and concentration problems, increased risk of high blood pressure, hypertension, stroke and heart attacks, depression, diabetes and sexual dysfunction. Severe cases of sleep apnea can even be fatal.

Besides these sobering health risks, an untreated sleep disorder can also be the root cause of poor performance at work or school, car accidents and other activities that require focus and concentration.

Common Symptoms of Sleep Disorders

Many people experience some occasional difficulty sleeping and/or daytime fatigue. But how does a person know if he or she has a temporary sleep problem that can be remedied with some simple behavioral changes, or if it is a legitimate disorder such as snoring, sleep apnea, sinusitis or nasal obstruction that should be diagnosed and treated properly?

The first step is to be aware of some common symptoms of sleep disorders. Keep in mind that symptoms vary between disorders, such as snoring, sleep apnea, insomnia, restless leg syndrome, nasal obstruction, narcolepsy, so it pays to do some research based on what you are personally experiencing.

Some common symptoms of sleep disorders include:

• Trouble falling asleep at night
• Waking throughout the night
• Chronic snoring
• Morning headaches
• Poor memory
• Daytime sleepiness/falling asleep during the day/low energy
• Bad moods/ irritability
• Increased depression
• Trouble concentrating/driving/making decisions

The Link Between Lifestyle and Sleep Problems

If you or someone you know is experiencing some of the above common symptoms of sleep disorders, the next step is to examine if lifestyle habits are contributing to the difficulty sleeping, fatigue and irritability during the day and other symptoms.
Some behavioral/lifestyle questions to ask include:

• Am I watching TV or using the computer late at night and too close to bedtime?
• Am I consuming too much caffeine during the day?
• Am I taking a medication that may be affecting my sleep quality and duration?
• Is there something particularly stressful going on in my life that is causing me worry and anxiety?
• Am I exercising enough to help alleviate some of that stress and tension?

See a Specialist—And Be Specific

Many sleep problems can be remedied by making some common sense behavioral changes. However, if you or someone you know is experiencing one or more of the above symptoms on a regular basis, see a qualified ear, nose and throat doctor or otolaryngologist to get diagnosed and treated properly. There are multiple options and minimally invasive techniques available today to treat your sleep disorder.

When you see a specialist, be specific about the symptoms you are experiencing. Many times, sleep apnea and other sleep disorders can be misdiagnosed as chronic fatigue, insomnia, depression, or some other non-specific condition. Some doctors, for example, still associate sleep apnea more with men than women, and are too quick to prescribe a medication, rather than do a full sleep disorder work up.

It may help to keep a sleep log (or, more accurately, lack of sleep log) next to your bed to write down what you are experiencing, when you wake and some symptoms you experience. Again, to try and avoid misdiagnosis, go to a qualified sleep specialist and be specific about your symptoms. Don’t wait — it could save your life.

To read the full report, see “Sleepy Pilots, Train Operators and Drivers”  on the National Sleep Foundation website.

How Do You Know if You Have a Sleep Disorder

Many people experience some occasional difficulty sleeping and/or daytime fatigue. But how do you know if your sleep problem is temporary and can be fixed with some simple behavioral changes, or if it is a legitimate disorder such as snoring, sleep apnea, sinusitis or nasal obstruction that should be diagnosed and treated properly?

That is one of the most common questions we get here at Eos Sleep.

The first thing you can do is take an honest look at your lifestyle habits. Are you watching TV or on the computer too close to bedtime? Consuming too much caffeine during the day? Taking a medication with sleep-related side effects? Is there something particularly stressful going on in your life that needs to be addressed?  Are you exercising enough to help relieve tension and anxiety? The good news is that many sleep “issues” can be remedied by making some common sense behavioral changes.

However—and I would be remiss if I didn’t mention it at this point—persistent sleep problems left untreated can lead to myriad health problem, including memory and concentration problems, increased risk of high blood pressure, hypertension, stroke and heart attacks, depression, diabetes and sexual dysfunction. Severe cases of sleep apnea can even be fatal.

Besides these sobering health risks, an untreated sleep disorder can also be the root cause of poor performance at work or school, car accidents and other activities that require focus and concentration.

New research is exposing the societal risk that can result from untreated sleep apnea and other sleep disorders. The National Sleep Foundation’s 2012 “Sleep in America” poll, which focused in on the sleep habits and performance of transportation workers, states that about one in 10 Americans are likely to fall asleep at an inappropriate time and place, such as during a meeting or while driving.

Other results of the study: About one-fourth of polled train operators (26%) and pilots (23%) admit that sleepiness has affected their job performance at least once a week, compared to about one in six non-transportation workers (17%).

Even more concerning: One in five pilots (20%) admit that they have made a serious error and one in six train operators (18%) and truck drivers (14%) say that they have had a “near miss” due to sleepiness.

The numbers are in: Sleep problems are prevalent in our society, and people need to wake up (no pun intended) to the symptoms and risks associated with them. Some common symptoms of sleep disorders include:

•    Trouble falling asleep at night
•    Waking throughout the night
•    Chronic snoring
•    Morning headaches
•    Poor memory
•    Daytime sleepiness/falling asleep during the day/low energy
•    Bad moods/irritability
•    Increased depression
•    Trouble concentrating/driving/making decisions

Keep in mind that symptoms vary between disorders, whether it’s snoring, sleep apnea, insomnia, restless leg syndrome, nasal obstruction, narcolepsy or some other sleep disorder,  so it pays to do some research based on what you are personally experiencing. If you experiencing one or more of the above symptoms on a regular basis—meaning, more than once in a blue moon—it is imperative that you see a qualified sleep doctor, and get diagnosed and treated properly. The good news is there are multiple options and minimally invasive techniques available today to treat your sleep disorder.

Women and Sleep Apnea: At Greater Risk Than We Thought

A few months ago, my blog entitled, “Who’s Suffering More from Lack of Sleep — Men or Women?”  discussed “the sleep battle of the sexes,” specifically, who suffers more from sleep disorders — men or women? In that blog, I made the point that, while men are generally more likely to suffer from obstructive sleep apnea (OSA) than women, men are also more likely to get tested and treated for the disorder.

That’s not good, because we are learning that many more women than previously thought suffer from OSA, and leaving it unchecked can have dire consequences on a woman’s cardiovascular health.

I read a recent women and sleep apnea study out of Spain that said that women with untreated severe OSA are three and a half times more likely to die from cardiovascular disease than women without OSA. Three and a half times!

Thankfully, the study also showed that women who treat their severe sleep apnea at night with a technique called continuous positive airway pressure (CPAP) significantly reduce their risk of heart attack-related deaths to about the same risk level as women without OSA.

The study was conducted by Dr. Francisco Campos-Rodriguez, director of the sleep-disordered breathing unit at Valme University Hospital in Seville, Spain. To read a summary of the study, go to the Annals of Internal Medicine.

The research is a wake-up call to both patients and doctors because it is the first published results that link OSA to cardiovascular death in women, and that CPAP treatment can reduce OSA-related mortality risk.

It also shines a light on the need for more research regarding sleep apnea and women, as well as the need for women to take their symptoms seriously, and not just consider OSA “a man’s disease.”

What Women Should Know About Sleep Apnea

So how do you know you may have obstructive sleep apnea? Some common symptoms include snoring, paused breathing during sleep and excessive sleepiness during the day. Increased blood pressure is another sign you may have sleep apnea.

While sleep apnea is more common in men, OSA increases in women after age 50. According to the National Sleep Foundation, one in four women over age 65 have sleep apnea.

Being overweight also increases a woman’s risk of having sleep apnea. Menopausal women are three and a half times more likely to get OSA, possible due to reduced amounts of progesterone.

If you have any of the symptoms mentioned above, and suspect that you may have sleep apnea, please get checked out by a doctor who specializes in sleep disorders. Be specific about the symptoms you are experiencing. Many times, sleep apnea can be misdiagnosed in women as chronic fatigue, insomnia, depression, or some other non-specific condition.

Also, some doctors still associate sleep apnea more with men than women, and are too quick to prescribe a medication, rather than do a full sleep disorder work up. Again, to try and avoid misdiagnosis, go to a qualified sleep specialist and be specific about your symptoms. Don’t wait — it could save your life.

New Study Uncovers the Beliefs Behind Behavior of Poor Sleepers

Difficulty Sleeping

I do my best to stay up (no pun intended) on the latest research and findings regarding sleep-related disorders and their treatments. New results out of Ryerson University in Toronto don’t surprise me — that taking sleeping pills or drinking alcohol is not a long-term solution for dealing with insomnia.

The study was conducted by Heather Hood, a PhD student in clinical psychology and lead author of the study, along with Dr. Colleen Carney, director of Ryerson's Sleep and Depression Laboratory, and graduate psychology student, Andrea Harris.

Hood is an insomnia therapy specialist and had previously researched the link between anxiety disorders and “safety behaviors” — things people do to self-treat a disorder. With the new research, Hood and her associates wanted to examine the relationship between insomnia and safety behaviors, such as taking sleep medication or drinking alcohol before bed. Specifically, they wanted to uncover the belief systems of poor sleepers: how much a person with insomnia believes that their behaviors are helping them sleep, even if those behaviors are not helping them sleep at all.

According to the National Sleep Foundation, 48 percent of Americans report occasional insomnia. And a recent Harvard Medical School study determined that insomnia costs U.S. companies about $63 billion a year due to missed days and poor work performance. Clearly, lack of sleep and insomnia are an American pandemic, and the efforts of Hood, Carney and Harris to help uncover the beliefs behind the behavior of poor sleepers was resulted in some very important information.

For the insomnia/safety behavior study, the researchers asked 397 Ryerson University undergraduate students to complete an online survey that asked about their safety behaviors. The questionnaire also asked how often they performed their nightly rituals, and how much they felt they needed to fall sleep. They were also asked how they defined insufficient sleep, and to what extent they went to in order to avoid feeling tired.

The results of the study, published in the December 2011 issue of Behavior Therapy, found that 40 percent of the students polled were poor sleepers who were likely to use safety behaviors, such as taking sleep medication or drinking alcohol, which in fact, not helping them fall sleep. They also observed that the poor sleepers felt dependent on these behaviors and believed they helped them sleep, even though the behaviors were actually compounding their sleeping problems. The students who did not experience sleep problems often didn't think of anything — they simply fell asleep.

Based on the research, Dr. Colleen Carney, director of Ryerson's Sleep and Depression Laboratory, believes that poor sleepers who engage in safety behaviors are actually disrupting their sleep in the long term. These safety behaviors are driven by unhelpful beliefs about sleep, but people suffering from insomnia or poor sleep feel they need to do these things to help them fall asleep.

Dr. Carney’s conclusion: That cognitive behavior therapy — not taking a pill or a drink of alcohol—is the best long-term treatment for insomnia and other sleep disorders.With cognitive behavior therapy, patients are taught to work with their physiology to help develop good sleeping habits and learn how to fall asleep naturally, rather than relying on chemicals. In our pharmaceutical society, that seems like a rogue idea … but I believe it’s the right one.

Mending Your Relationship When Snoring Rips You Apart

Snoring is a major cause of couple's unhappiness.

Although in this blog I generally discuss the health consequences of snoring, I’d like to bring to light another serious side effect, which is the devastation snoring can wreak on marriage. Often I meet with married couples in my practice who are at their wits end. Both partners are exhausted…the snorer because of the toll snoring takes on their body, and the spouse whose health is impacted dramatically from their partner’s snoring because of the daytime fatigue brought on by their inability to get a healthy full night’s sleep.

According to a new study by the British Lung Foundation (BLF)¹, loud snoring forces more than a third of couples to sleep in separate beds at night. The foundation polled more than 2,500 adults through an online survey in the United Kingdom this past Spring. Even more drastic for these couples is the fact of the 39% who admit they sleep apart, a full third (33%) claim it has become a permanent sleeping arrangement. Certainly sleeping apart from your significant other all the time can’t be healthy for the relationship. In addition to the noise of snoring creating distance between couples, snoring can also be a factor that leads to sexual dysfunction in men, according to a study² that was reported in The Journal of Sexual Medicine.

When couples feel that snoring is ripping their marriages apart, it is often because they are both tired, irritable and tense. If they have been sleeping separately, most likely their relationship has eroded, and their communication has faltered. Certainly the lack of intimacy—not just physically, but the relaxing interactions between companions such as pillow talk—has worn them down.

How intrusive is snoring in a marriage? In 2006, a study from the Rush University Medical Center in Illinois3 determined that couples have a high divorce rate when the husband snores due to sleep apnea. Sleep apnea is the most serious of the many causes of snoring because it causes the snorer to stop breathing multiple times throughout the night, which can lead to heart and lung issues, high blood pressure and stroke. For years many snorers were reluctant to seek treatment because some of the most common treatments involved cumbersome sleep masks or surgery. Thankfully, today there are a number non-invasive in-office techniques that successfully treat the varied types of snoring such as the Pillar® Procedure, Balloon Sinuplasty™, and more based on the individual cause of your snoring.

Although I’m not a marriage counselor or sex therapist, patients who come to the Manhattan Snoring and Sleep Center are taking a positive step to mend their relationship and hopefully will not become one of the statistics of divorce due to snoring. They are not only mending their relationship, but they are taking control of their health, leading to a more fulfilling life.

My marital advice to snorers? Seek treatment and enjoy getting close to your partner again.

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1. The British Lung Foundation, 14 June 2011, Survey of over UK 2,500 adults aged 16 and over through TNS between 28 April – 3 May 2011, completed online through an OnlineBus.
2. Hanak, V., Jacobson, D. J., McGree, M. E., Sauver, J. S., Lieber, M. M., Olson, E. J., Somers, V. K., Gades, N. M. and Jacobsen, S. J. (2008), ORIGINAL RESEARCH—MEN’S SEXUAL HEALTH: Snoring as a Risk Factor for Sexual Dysfunction in Community Men. The Journal of Sexual Medicine, 5: 898–908. doi: 10.1111/j.1743-6109.2007.00706.x
3. The Sleep Disorders Center at Rush University Medical Center, Illinois: The Married Couples Sleep Study, January 2006

Sleep Deprivation – Your Spouse’s Snoring Takes a Toll on Your Health

On our blog here we often discuss the health consequences for a person who snores. We’ve talked in detail about the dangers of snoring, especially sleep apnea which can lead to heart disease, high blood pressure, lung dysfunction and stroke. However what also needs to be brought to light are the health implications on the spouse whose sleep is interrupted by their snoring sleep partner.

A new study from the University of Wisconsin-Madison has found that even five consecutive nights of four hours or less of sleep per night has the same negative affects on the brain and body than total sleep deprivation.

Unfortunately for those who share a bed – or even the next room with a chronic snorer, a simple change in lifestyle like making sure you go to bed early enough to get 7-8 hours of sleep need to totally restore the body’s brain and muscle function isn’t an option.

After 5 days with only 4 hours of sleep your body will show signs of exhaustion. Symptoms include:

• Lethargy, which make even the simplest tasks seem difficult
• Impaired coordination—very dangerous if you need to be behind the wheel or operating equipment
• Blurred of vision
• Wearing down of the immune system which will cause you to pick up colds and other illnesses that you would be able to fend off if you had a strong immune system
• Irritability
• Headaches
• Impairment of cognitive function, making it more difficult to make a decision, especially if quick-thinking is needed
• It can even increase the resistance of insulin in the body, which leads to a risk of diabetes

If you are sleep deprived because of your spouse’s snoring, then it is in both of your best interest to seek help from a snoring specialist. Many snorers are hesitant to seek treatment because they are concerned that the only treatment options are surgery or the CPAP mask which they are afraid may be uncomfortable. However many minimally invasive techniques are available today to help treat snoring and sleep apnea on an out-patient basis.

If you’re in the New York Tri-State area, schedule an appointment at the Manhattan Snoring & Sleep Center, New York City’s top medical practice for snoring and sleep apnea diagnosis and treatment. The center’s medical/surgical snoring specialists offer the latest techniques to treat snoring and sleep apnea including the Pillar Procedure, Balloonplasty™ and even provide the Home Sleep Test for patients for whom an overnight sleep lab is not an option.

Disclaimer:
This article is intended for general information only is in no way intended to be a substitute for receiving direct medical advice from a medical professional, their diagnosis or treatment. Use and access to this website or any of the links contained within the site do not create a doctor-client relationship. If you have any questions regarding a medical condition, or if you suspect you may have a snoring disorder.