Sleep Better — Get Smart about Your Smartphone

By Dr. David O. Volpi, M.D.

Smartphones, iPads, and other personal electronic devices are great ways to communicate and entertain ourselves, but they may also be negatively impacting the quality and quantity of our sleep.

As personal electronic devices have become more ubiquitous, the bright-light emitting screens that allow the use of mobile devices in dimly lit rooms have become a more common reason for sleep disruption, whether users realize it or not.

Why is that? Melatonin is a hormone produced by the pineal gland at night and when it is dark. It is a “timer” that tells the body that it is nighttime, and time to go to sleep. Exposure to light at night, such as that in the brightly-lit screens of many personal mobile devices, can interfere with melatonin, the hormone that helps control our sleep and wake cycles.

But rest easier: New research from the Mayo Clinic in Scottsdale, AZ explains a way to reduce the impact of electronic devises on sleep cycles.

Lois Krahn, M.D., a psychiatrist and sleep expert at the Mayo Clinic and co-author of the study said, “In the old days, people would go to bed and read a book. More commonly, people go to bed and they have their tablet on which they read a book or newspaper or look at material. The problem is it's a lit device, and how problematic is the light source from the mobile device?"

That question prompted Dr. Krahn to wonder, is the light from screens always a negative factor for sleep?" To find out, Krahn and his colleagues experimented with two tablets and a smartphone in a dark room, using a meter on its most sensitive setting to measure the light the devices emitted at various settings when held various distances from a person's face.

They discovered that when the brightness settings were lowered and the devices were held just over a foot from a user's face, it reduced the risk that the light would be bright enough to suppress melatonin secretion and disrupt sleep.

Explains Krahn, “We found that only at the highest setting was the light over a conservative threshold that might affect melatonin levels. If it's at the mid setting or at a low setting, it's bright enough to use."

The new Mayo Clinic research, which was presented in June at SLEEP 2013, the 27th annual meeting of the Associated Professional Sleep Societies LLC, in Baltimore, Md., also suggests things you can do to help prevent screen light from interfering with melatonin and affecting sleep.

These tips include dimming the smartphone or tablet brightness settings and holding the device at least 14 inches from your face while using it.

Other general tips include moving the TV and computer out of the bedroom, or at the very least, do not watch TV or work on the computer to bedtime.

With so many electronic distractions in our lives, it's important to re-claim the bedroom for its intended purpose: rest, relaxation, and sleep.

Sleep apnea causes systemic inflammation: CPAP can help

By Dr. David O. Volpi

If you, or someone you know, have been diagnosed with obstructive sleep apnea (OSA), you’re probably familiar with a treatment called CPAP, or Continuous Positive Airway Pressure.

While some people find the mask worn for CPAP treatment uncomfortable—more on that later—it has been proven to be a highly effective way to keep the airways open that become obstructed in sleep apnea patients, and reduce or prevent snoring and paused breathing.

There’s a new study that found that CPAP treatment also reduces the systemic inflammation caused by sleep apnea, usually in the bronchial and nasal passages.

Systemic inflammation is the chronic biological response, or inflammation, of blood vessel tissues due to dangerous or foreign elements, such as pathogens or damaged cells. It is increasingly being recognized that systemic inflammation is a risk factor for a number of health complications, including atherosclerosis, and is a well-established factor in the development of cardiovascular disease.

The new study published March 22 in the Journal of Inflammation found that treating OSA with a CPAP machine helps to lower systemic inflammation, which might prevent some of the other problems associated with OSA. The source of the research was the PubMed, Embase and Cochrane library.

Here’s a refresher on how CPAP machines help OSA patients: When you fall asleep, your muscles relax, and the soft palate at the back of the throat may sag. When this happens, the upper airway can become obstructed, causing the soft palate and uvula to vibrate, causing snoring.

When the airway is completely obstructed, breathing stops for a period of time, until the body is jerked awake in reaction. This is known as obstructive sleep apnea. OSA can cause interrupted breathing hundreds of times a night, usually around 20 seconds per pause. This paused breathing causes waking through the night, preventing deep, restorative sleep. This often leads to a host of problems, from daytime sleepiness and reduced job performance to hypertension, heart disease, mood, and memory problems.

A CPAP machine helps this condition by pumping a continuous flow of air into the nasal passages—via a mask worn at night—keeping the airway open—and preventing or greatly reducing snoring and paused breathing.

To find out if CPAP treatment reduces inflammatory symptoms or “markers” in OSA patients, the researchers pooled data from 24 trials involving more than 1,000 patients. The resulting data suggested that treating OSA with CPAP significantly reduces levels of two proteins associated with systemic inflammation: tumor necrosis factor and C-reactive protein (CRP).

While more study is needed, the researchers believe that reducing systemic inflammation in OSA patients with CPAP treatment may be one way to reverse some of the long-term health disorders associated with OSA.

If you or someone you know is considering Continuous Positive Airway Pressure (CPAP) treatment, you'll need a sleep study to diagnosis whether or not you have sleep apnea, and a sleep specialist will recommend the correct CPAP machine, or treatment, for you.

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!

Why Home Sleep Testing is Revolutionizing Sleep Apnea Treatment

Although home sleep apnea testing equipment has be utilized for a few years, it wasn’t until recent findings presented at the American Thoracic Society 2010 International Conference confirmed that patients that used the home sleep test showed similar improvements in their obstructive sleep apnea (OSA) treatment as did patients who had their sleep testing performed in an overnight lab.

Prior to the findings of this study, it was commonly thought that patients would have the most successful treatment if they stayed overnight in a lab, because they would be spending more time with a technician who provides education of OSA and the importance of its treatment, which would improve the patient’s compliance using the standard CPAP (continuous positive airway pressure) device of their treatment once at home. Since many patients complain about the discomfort of the CPAP, compliance is difficult for many.

However, as this study found, of 300 patients who randomly either underwent their sleep testing in the lab or at home, 185 of them completed three months of follow-up treatment. The results of their OSA improvements using CPAP treatment where similar regardless of whether they had their sleep testing done in the lab or in the home.

The Manhattan Snoring and Sleep Center now offers home sleep testing equipment to qualified patients, and has found similar results as this study with its own patients who either under go sleep testing at the center’s overnight lab or at home.

A home sleep test is used only to diagnose sleep apnea, and obstructive sleep apnea is the most common type, as well as the most serious. It is caused by an obstructed upper airway in which soft tissue of the palate, throat or tongue blocks the flow of air as a person struggles to breathe. Since OSA symptoms can lead to severe health conditions, it is very serious and important that patients receive expert medical care and guidance. There are other physical causes of snoring and apnea, and since home sleep tests only diagnose apnea, a patient should have a thorough physical exam first to see if the test is right for them or if a different line of treatment is necessary. Even if sleep apnea is suspected, there are other factors that may make a test in an overnight sleep lab necessary.

Visit the Manhattan Snoring and Sleep Center website for more information about the home sleep test. If you suspect that you have sleep apnea or if snoring is keeping you from getting a good night’s sleep, contact us today to schedule an appointment.