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.

Adolescents, Poor Sleep and the Toll on Their Health

Most people consider sleep disorders such as sleep apnea, snoring and poor quality sleep an adult health issue, but research is mounting that young people may suffer from sleep disorders as much as adults do.

Earlier this year, Penn State researchers published the results of a study which showed that children who have learning, attention and/or behavior problems may be suffering from a condition known as excessive daytime sleepiness (EDS)—even if tests indicate that they are getting enough sleep at night.

And The New York Times article from April 16, 2012 entitled “Attention Problems May Be Sleep Related”  also examined the relationship between children’s sleep quality and the ability to pay attention at school.

The article was on another recent study called “Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years,” published in the Official Journal of the American Academy of Pediatrics.

One researcher in the article noted that cases of attention deficit hyperactivity disorder (A.D.H.D.) in children may have been misdiagnosed—that the cause of behavior such as moodiness and hyperactivity might have been due to obstructive sleep apnea (OSA) or other sleep disorder, which caused sleep deprivation in the child. Worse, the drugs prescribed for the misdiagnosed A.D.H.D. might actually be making the child’s symptoms worse.

Now, new research from The Hospital for Sick Children (SickKids) in Toronto found a link between poor sleep quality in adolescents and a host of negative health issues, including higher cholesterol levels, higher body mass index BMI, larger waist size, higher blood pressure, increased risk of hypertension and cardiovascular disease later in life.

The hospital is one of Canada’s most research-intensive hospitals, and is recognized as one of the world’s foremost pediatric health-care institutions. For the study, lead researcher Dr. Indra Narang, Director of Sleep Medicine and Staff Respirologist at SickKids, and her colleagues studied 4,104 adolescents in the Healthy Heart Schools' Program that screens and identifies teens at risk of coronary vascular disease.

The young participants slept an average of 7.9 hours during the week, and 9.4 hours on weekends. Their sleep patterns, length and quality of sleep were recorded, and data was collected on their BMIs, cholesterol levels and blood pressures. They also found out if any participants had a family history of premature cardiovascular disease.

The results of the study were published in the October 1 edition of the CMAJ — Canadian Medical Association Journal. Almost 20 percent of the adolescents reported poor sleep quality during the week, and 10 percent reported poor sleep quality on weekends. Of the participants, almost 6 percent reported using medications to help them sleep.

From the data collected, the researchers found a link between poor sleep quality—also known as sleep disturbance—and cardiovascular risk in adolescents, based on high cholesterol levels, increased BMI and hypertension. In addition, researchers found a higher sleep disturbance score in adolescents with higher cholesterol level, higher BMI, larger waist size, higher blood pressure and increased risk of hypertension.

Higher sleep disturbance scores were also found in the adolescents who consumed more fried foods, soft drinks, sweets and caffeinated drinks, exercised less and spent more time in front of computer screens. Shorter sleep duration was also associated with higher BMI and waist size. While more research is needed, the findings of the study add to compelling evidence that poor sleep quality in young people is a problem that should be addressed.
Parents, caretakers, teachers and doctors should take a young person’s “sleepy” complaints seriously, and look for clues in their behavior that may indicate sleep deprivation, including excessive daytime sleepiness and symptoms such as inattentive behavior, trouble learning and paying attention, and weight gain/obesity.

I agree with Dr. Brian McCrindle, senior author and cardiologist at SickKids, who recommends that parents do what they can now to help improve the sleep habits of children early in life, such as monitor their caffeine intake and bedtimes, and make sure their bedrooms do not have too much media, especially late at night. Doing so can help ensure that a child’s neurobehavioral challenges are properly diagnosed and treated, leading to better behavior, greater ability to learn and a happier child.

Read the full report, “Poor sleep in adolescents may increase risk of heart disease.”

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.”

“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.

Is Excessive Daytime Sleepiness the Cause of Learning and Behavior Problems in Children?

For months now, I have been writing about the studies that are being published—seemingly by the month—linking obstructive sleep apnea (OSA) to more and more medical conditions, including hypertension,heart disease, mood and memory problems.

The latest research didn’t surprise me, but it did upset me more than usual — because it concerns our children, and the negative effects that poor sleep can have on their ability to pay attention, learn and control their behavior.

On May 1, the results of a study by Penn State researchers was published showing that children who have learning, attention and/or behavior problems may be suffering from a condition known as excessive daytime sleepiness (EDS)—even if tests indicate that they are getting enough sleep at night. 

For the study, the researchers conducted sleep testing on 508 children, and asked their parents to report if their child seemed excessively sleeping during the day. Then, the children were divided into two groups: children with excessive daytime sleepiness, and those without EDS. The results, published in the May 2012 issue of SLEEP,  showed that the children in the parent-reported EDS group were more likely to have "neurobehavioral” problems, including behavior/conduct problems, attention/hyperactivity and poorer performance in learning speed and working memory than children without indications of EDS.

What surprised the researchers was that, even if a child was in the EDS group, few also showed signs of short (not enough) sleep when tested. As a result, the researchers did not associate short sleep with any of the learning, attention and behavior problems.

So, what is causing these children’s extensive daytime sleepiness if they are getting enough sleep (at least on paper)? Like in adults, perhaps it is not just the length of sleep time, but the quality of sleep that determines restorative rest, or not.

A New York Times article from April 16, 2012 entitled “Attention Problems May Be SleepRelated”  also examined the relationship between children’s sleep quality and the ability to pay attention at school. The article was on another recent study called “Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years,” published in the Official Journal ofthe American Academy of Pediatrics. 

What I found disturbing about this article was that it pointed out that many cases of attention deficit hyperactivity disorder (A.D.H.D.) in children may have been misdiagnosed—that the cause of behavior such as moodiness and hyperactivity might in fact be due to obstructive sleep apnea (OSA) or other sleep disorder, which is causing sleep deprivation in the child. Worse, the drugs diagnosed for the A.D.H.D. are probably making the child’s symptoms worse!

This should be a call to arms for parents, caretakers, teachers and the medical community. If you know of a child suffering from sleep deprivation and/or extensive daytime sleepiness, and the symptoms that result, such as behavioral and learning problems … speak up and suggest they get tested for a sleep disorder first.

 Impairment due to EDS in daytime cognitive and behavioral functioning can have a significant impact on children's development. This is not to say that A.D.H.D. cannot be a true cause, but misdiagnosis of anyone—especially a child prescribed drugs—should not be tolerated.

Stay aware of the child’s behavior; look for clues, such as inattentive behavior and obesity, take a child’s “sleepy” complaints seriously … and then say something. You could be the reason a child’s neurobehavioral challenges are properly diagnosed and treated, leading to better behavior, greater ability to learn and a happier child.

Read the abstract of the report, “Learning, Attention/Hyperactivity, and Conduct Problems as Sequelae of Excessive Daytime Sleepiness in a General Population Study of Young Children.”

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.

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.

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.

The Importance of Sleep

The medical community and healthy lifestyle advocates see the evidence mounting. Our spouses and children recognize the symptoms even when they don’t know the cause. They all agree: We need a good night’s sleep!

When we don’t get a full night of restful sleep, it can dramatically affect our health and impair our mental function and job performance. It can ruin our relationships with our loved ones. Research also points to a myriad of physical health issues caused by a lack of sleep including obesity, diabetes and heart disease.

How much is a “Good Night’s” Sleep?

A good night’s sleep isn’t just determined by the length of time one sleeps, but how restful, deep and uninterrupted that sleep is throughout the night. Even still, the average minimum amount of sleep required to be considered “a good night’s” sleep is between 7 and 8 hours for adults, with teenagers, children and infants needing more sleep, according to the American Sleep Association.

Lack of sleep can be caused by just not getting to bed when one should because of poor habits like watching TV until the wee hours of the night. Certain medicines, food, smoking and alcohol can all affect the ability to fall asleep, stay asleep, or the restfulness of sleep. Stress is also a big contributor. Usually a person can change their routines, and those with insomnia or stress-related causes can usually be treated by over the counter or prescription medicines. When a lack of sleep is caused by snoring, the issue becomes even more complicated, and the health consequences are much more serious.

Snoring – a Major Cause of Sleep Deprivation

Unlike a sleep disorder, snoring is a physical condition. It is caused when the throat relaxes and the tongue falls into the airway in the back of the throat causing a vibration in the soft tissue during sleep. This vibration is an interruption of airflow through the nose and throat.

It is estimated that more than 40 million Americans snore. Snoring interrupts sleep throughout the night, leaving the snorer with the same mental and physical conditions as someone who is sleep deprived.  There are numerous causes of snoring such as deviated nasal septum, nasal polyps or turbinates. Sinusitis and allergies can cause snoring as can anatomical factors such as abnormally relaxed neck muscles, a large tongue or tonsils and obesity because excessive weight can narrow the windpipe. Smoking, alcohol, sedatives or certain sedating antihistamines can lower muscle tone in the upper airways, and also cause snoring.

Sleep apnea is the most common cause of snoring and also the most dangerous. People who suffer from sleep apnea stop breathing dozens of times during sleep and it is particularly severe and life threatening when there are more than twenty or thirty events per hour. There are three types of sleep apnea, obstructive (OSA), central and mixed, with OSA being the most serious type because it effects blood pressure, the heart and lungs.

The Consequences

Without enough sleep we loose our ability to concentrate and our physical performance suffers. Sleep is necessary for the nervous system to function properly. For example the ability to do math and operate a car are compromised.  Other symptoms include daytime sleepiness, morning headaches, irritability, and poor memory. A person with sleep deprivation can burn-out easily, and it can lead to feelings of depression, mood swings and even hallucinations.

Unfortunately if lack of sleep is caused by snoring, often a person doesn’t even know they snore unless they’re told by a partner. Even when a person knows they snore, they often go untreated because they are embarrassed and hide it, or they don’t know it is a serious problem so they ignore it.

In the case of sleep apnea, there is even more of a toll on the body. Considering an apnea patient is unable to breathe many times throughout the night, their sleep is especially interrupted by episodes of waking up gasping for air. This oxygen deprivation combined with an inability to get a good night’s sleep, causes severe sleep deprivation and other health issues. Apnea can lead to high blood pressure because during apnea events, blood oxygen drops abnormally low, resulting in an increase in blood pressure which can bring about stroke. It can cause lung dysfunction because of low levels of oxygen in the blood and high concentrations of carbon dioxide in lung tissue. Since the heart is sensitive to oxygen levels in the blood, apnea is most dangerous in people who are already prone to heart disease. Arrhythmia is very common as is enlargement of the heart. An estimated 80-85% of sleep apnea patients go untreated, which is a serious health problem in the U.S. today.

Luckily, just as we have learned more about the consequences of sleep deprivation and snoring, today there is also a wide variety of surgical and non-surgical treatment available for snoring sufferers. If you suspect that you snore at night, or have been told by a loved one that you do, it is important to speak to your doctor. He or she can recommend you to an Ear, Nose and Throat Doctor or Otolaryngologist who will provide you with the correct diagnosis and start you on the path of treatment for a lifetime of healthy sleep.


For more information, contact the Manhattan Snoring and Sleep Center: (866) 835-2361 or visit www.drvolpi.com.

Snoring: It’s in the Air that You Breathe

Using EPA air pollution data from a number of different American cities, researchers have established the first link between air pollution and both hypopnea (under breathing) and apnea (pauses in breathing) during sleep. Also studied was the affect that increases of temperature play on these sleeping disorders. Known as sleep disordered breathing (SDB), hypopnea and apnea can cause temporary elevations in blood pressure, lower blood oxygen levels, and can lead to high blood pressure and cardiovascular diseases.

In a study that will be published in the upcoming issue of the American Journal of Respiratory and Critical Care Medicine, researchers from Brigham and Women’s Hospital and the Harvard School of Public Health have explored the effects of air pollution and temperature increases on sleep apnea and hypopnea episodes. Using data from the EPA monitoring air pollution levels in 7 U.S. cities (Framingham, Minneapolis, New York City, Phoenix, Pittsburgh, Sacramento and Tucson), they studied it against data from the Sleep Heart Health Study of 6,000 people from 1995 to 1998.

The doctors were looking to find a correlation between “the elevation in ambient air pollution with an increased risk of SDB, nocturnal hypoxia and with reduced sleep quality,” as well as how “seasonal variations in temperature would exert an independent effect on SDB and sleep efficiency.” Using the data, and taking into account certain seasonal variables, they looked at known SDB factors including a patient’s age, gender and whether or not they smoke.

The results were that this is the first study to link air pollution and sleep disordered breathing. Antonella Zanobetti, Ph.D, a researcher on the project stated, ’We found novel evidence for pollution and temperature effects on sleep-disordered breathing.” They also found that increases in sleep apnea or hypopnea “were associated with increases in short-term temperature over all seasons, and with increases in particle pollution levels in the summer months." The short-term rises in temperature were associated with changes in respiratory disturbances, blood oxygen levels and decreases in sleep efficiency.

Sleep disordered breathing affects nearly 17 percent of the adults in the U.S., and many more aren’t aware they have a problem, since the episodes happen at night. If you feel you might suffer from a sleep apnea or hypopnea, because you’re experiencing some of the daytime symptoms, it is important to get treatment.

To get more information on how to treat sleep apnea or snoring disorder, contact The Manhattan Snoring and Sleep Apnea Center.