Better Sleep Better Health

As 2010 gets put to bed, it is time to look at the stories about sleep that were most talked about this year:

• More Children Are Medicated for Insomnia -  Illustrating a disturbing trend in medicine, many children are given prescription sleep aids for Insomnia.

• US Military Finds Bright Light Can Improve Alertness, Reduce Post Traumatic Stress - Another link between exposure to light and our circadian rhythms.

• Tired Teenagers At Risk For Depression – Teens’ schedules are causing increased rates of depression in today’s youth.

• Shift Work Hurts Productivity – Important news for businesses with employees on late shifts.

• Sudden Infant Death Syndrome Linked to Low Levels of Serotonin – New research sheds light on the possible causes of SIDS, a scourge that continues to puzzle scientists.

• Sleep Suffers During Wartime Deployment – The stress of war is affecting our troop’s sleep and peace of mind, making it harder to adjust upon their return home.

• Insomnia And Sleep Duration Linked to Early Death – Startling news on the connection between lack of sleep and mortality.

• Percy Harvin’s Trouble With Sleep Apnea – The Viking’s receiver’s continued woes with his sleep disorder.

• Biggest Loser Contestant on CPAP – Contestant Sherry Johnston talks about sleep apnea and continuous positive airway pressure.

• Obstructive Sleep Apnea Linked to Heart Disease – A recent study finds that the common sleep disorder is even more serious than previously thought.

A good diet and a regular exercise regimen have been heralded for years as the best way to lose weight and stay healthy. Regular moderate exercise may also help people to combat the most common sleep disorder: Insomnia.

Many people suffer from Insomnia, the inability to fall or stay asleep. There can be multiple causes for the condition including stress, bad sleep hygiene, hormone imbalance, and Obstructive Sleep Apnea. When faced with repeated instances of insomnia, one should contact a sleep specialist for evaluation. Appropriate testing may rule out a physical cause of the problem. If there is no evidence of an underlying sleep disorder, doctors may recommend several countermeasures to help alleviate the condition. One that has great value is the introduction of a moderate exercise program.

Researchers recently investigated different exercises and determined that a light to moderate intensity daily workout worked best to eliminate insomnia. Examples of the low to moderate exercises found to be beneficial to sleep include 50 minutes light jogging on a treadmill, yoga, and resistance band training. They found that higher intensity workouts close to bedtime, while beneficial physically, often actually disrupt people’s sleep patterns. Instead, it is recommended that exercise should occur 4-8 hours before bedtime to avoid sleep disruption.

If you have chronic primary insomnia, regular exercise may help to get you into a normal sleep cycle. As with any change in physical activity, you should consult with your physician before beginning a new exercise regimen. For more information or to seek help for your insomnia problems, contact Oregon Sleep Associates.

Cell phones have become ubiquitous in modern life. Once a rare luxury only available to the rich, now they are so commonplace that even children have them in elementary school. They’re found in our pockets, purses, cars, and workplaces. Unfortunately they’re also found one place they shouldn’t be: the bedroom.

A Pew Research survey recently reported that over two-thirds of Americans now sleep with their cell phones within reach. This may not be a serious problem if people only used them for emergency calls or as alarm clocks, but with the advent of smartphones the usage of cell phones has changed. They are now more commonly used to check email, watch videos, text, and surf the web. These practices, while useful during the daytime, disrupt and delay sleep for many people. In addition to the bad habits cell phones encourage in the bedroom, their screens can actually alter your brain chemistry to disrupt your sleep cycle and cause insomnia. Many phones have bright screens that emit blue and green light. These wavelengths can alter the natural human light reactive circadian process by preventing the body from secreting melatonin, a sleep inducing neurotransmitter. Many sleep specialists who have encouraged people not to watch TV before bedtime for the same reason now extend the warning to avoid cell phones and computer screens around bedtime. If you’re an avid texter, internet surfer, or compulsive email checker try turning of your phone an hour before bed. Don’t worry, it will still be there the next morning and you may just get a better night’s sleep.

Anyone who has worked an overnight shift knows how difficult it is to adjust back to a normal schedule. You feel like a sleep deprived zombie, never able to fully fit in during the waking hours. New evidence suggests that the toll taken may also be passed along to businesses in the form of lost productivity.

The research, as reported by the American Academy of Sleep Medicine, found that the key for maximum productivity is to schedule shift start times that allow the worker to sleep right before reporting for duty.  The study used a mathematical formula to see the effects of 24 start times, each varying by one-hour increments. The hypothetical work schedule lasted six days. Each shift was nine hours and started at the same time each day. The findings suggest that the best shift start times begin in the late morning or early afternoon, whereas shifts that begin between 8 PM and 12 AM were found to be the most limiting to both sleep and work performance.

The lead investigator on the study, Angela Bowen, suggests that government labor regulations may need be changed to take into account different shift start times. “Shifts of equal duration differ in how fatiguing they are depending on the time of day when they are scheduled,” said Bowen. “The same limitation on the number of duty hours may be either overly restrictive if during the day or too liberal if during the night.”

If you currently are an overnight shift worker, the AASM suggests taking steps to maximize your sleep time. Wear sunglasses on the way home and minimize light and sound exposure in your bedroom. Try to sleep immediately after your shift in the late morning until the early evening. On days off, do not switch back completely to a normal schedule. Instead, try a compromise by going to sleep about 3 AM.

If you would like more information on sleep and shift work, check out sleepeducation.com or contact the sleep specialists at  Oregon Sleep Associates.

Many people around the world suffer from insomnia. There are treatments such as pharmaceuticals, but often concerns over cost and side effects turn people off of using them. But now individuals who cannot sleep have a safe and effective alternative: Cognitive Behavioral Therapy.
Cognitive Behavioral Therapy (CBT) is a novel approach to dealing with insomnia without the need for medications. Instead of masking the problem, CBT focuses on addressing the factors that cause chronic insomnia. These factors can be personal, physiological, cognitive, and behavioral. According to the AASM, the therapy is based on two premises. First, that some of the underlying personal and physiological factors can be directly altered. Second, that maladaptive thoughts and behaviors are learned and that they serve to perpetuate insomnia. If they are learned, then they can be “unlearned” by the CBT process.  The process of the therapy typically consists of individual meetings with an insomnia specialist over several weeks. The specialist may use multiple techniques to help the patient. These techniques can include alternative medications, relaxation methods such as meditation and biofeedback, adjustment of sleep schedules, and bright light therapy. When performed correctly, CBT can be as effective in treating insomnia as medications.
Many doctors are still not aware of the existence and efficacy of CBT for insomnia. It’s best to find a sleep specialist that is specifically trained in administering CBT. Oregon Sleep Associates currently offers Cognitive Behavioral Therapy for insomnia. For more information call 503-288-5201 or visit us online at www.oregonsleepassociates.com.

Each day we willingly let a dangerous intruder into our homes. This thief distracts us from our families, influences our children, and steals something precious every night. The outlaw is television and a new report details just how much of our lives we give away to the glowing box.

The Nielsen Company, which tallies ratings and television viewership across the country, recently revealed that American households spent on average 8 hours and 18 minutes per day watching television during the 2007-08 television season. This is a record high since the company began measuring TV watching in the 1950s.

This is significant because, according to the National Sleep Foundation’s Sleep In America Poll, Americans average only 6 hours and 40 minutes sleeping per day. Watching TV does not have positive effects on a person’s health. Though some people treat it as one, it is not a necessity for humans. Sleep is a necessity and is being disregarded in favor of electronic distraction. For the sake of your health and well being, turn the TV off and go to bed.

For more information on proper sleep hygiene and sleep in general, visit Oregon Sleep Associates.

You come home from work, enjoy dinner with the family, relax for a while, and settle into bed to fall asleep. But then something happens. You can’t stop thinking about your job, your grocery list, your home repairs, etc. Your mind is still racing and you just can’t relax enough to fall asleep. Pretty soon you realize it’s 3 am and you have to be up in a few hours. Just another sleepless night…

This scenario is all too familiar for many people. Insomnia, the inability to fall asleep or maintain sleep, is one of the most common sleep disorders. As outlined in Volume 2, Issue 1 of OSA’s Better Sleep, Better Health newsletter, there are many causes of Insomnia including situational stresses, shift work, and Obstructive Sleep Apnea. But what if you have seen a sleep doctor and determined you have none of these? You just feel you cannot turn off your brain.

It turns out there may actually be a previously unknown physical reason for this problem. Research published in the November 2008 issue of SLEEP suggests people may suffer from Primary Insomnia because of a lack of chemical transmitter in their brains. Gamma-aminobutyric acid, or GABA, is a common inhibitory transmitter which decreases or stops transmission of nerve impulses. The study found people with Primary Insomnia have on average 30% less GABA in their brains than those without Insomnia.

“GABA is reduced in the brains of individuals with insomnia, suggesting over-activity is present,” explains principal investigator Dr. John Winkelman in an interview on sleepeducation.com. Low GABA levels create an imbalance of brain activity. This “may lead to an inability to shut down waking signals in the brain,” he said.

Insomnia can seriously affect a person’s life and should be dealt with early on. Treatments can include short term use of hypnotic medications and cognitive behavioral therapy. For more information on sleep and Insomnia, check out our sleep center’s website.

Since Starbucks Coffee® opened its first location in 1971, the company has ballooned to have more than 15,000 stores in 44 countries.  In recent years sales of energy drinks such as Rockstar® and Redbull® have reached well over 3.5 billion dollars annually. While slick advertising and aggressive business tactics can help explain the successes of these products, there is one underlying reason for it all:  Caffeine addiction.

Caffeine has been called the most popular drug in the world and is used by over 80% of the population. It is found naturally in over 60 plants including the coffee bean, tea leaf, and cacao pod. All over the world people consume caffeine on a daily basis in coffee, tea, chocolate, soft drinks, and some drugs. Because caffeine is a stimulant, most people use it after waking up in the morning or to remain alert during the day. While it is important to note that caffeine cannot replace sleep, it can temporarily make us feel more alert by blocking sleep-inducing chemicals in the brain and increasing adrenaline production. Once in the body, caffeine will persist for several hours: it takes about 6 hours for one half of the caffeine to be eliminated.

Though there are numerous studies to support the idea that caffeine causes physical dependence, traditionally it has been thought of as having fairly benign health effects. However, in recent years more evidence has surfaced on the damaging prospects of caffeine use. In one 2007 study by Kaiser Permanente, researchers reported that the risk of miscarriage by pregnant women doubles with just moderate caffeine use. They advised that pregnant women reduce or eliminate their caffeine intake. Also, the substance has been found to increase blood sugar levels in people with Type II Diabetes, making it harder to control that disease.

Doctors recommend limiting caffeine use to less than 200 mg per day, or about the equivalent of 3 cups of coffee. Try not to consume any caffeinated items within 8 hours of your bedtime.

Just in time for St. Patrick’s Day and green beer:

Benjamin Franklin famously said, “Beer is living proof God loves us and wants us to be happy.” Maybe so, but he also said “Early to bed, early to rise makes a man healthy, wealthy, and wise.” Now new research shows that alcohol and sleep make lousy bedfellows.

In fact, scientists now say that too much alcohol affects the body’s circadian rhythm. The Circadian rhythm is the 24 hour cycle that synchronizes sleep and wake times depending on exposure to light. Researchers at Kent State University recently conducted a study on the effects of alcohol on sleep. They found that even low levels of alcohol intake can affect your sleep cycle.

The researchers used hamsters as test subjects because their sleep cycles are set by exposure to light, just like humans. The hamsters were given different levels of alcohol and then were exposed to bright and dim lights. The hamsters that were inebriated had the hardest time shifting their sleep/wake rhythms after the exposure to dim light. The more they drank, the harder it was to adjust.

Professor David Glass, who worked on the study, says: “Hamsters’ circadian rhythms are very clear and predictable and they’re easy to maintain in the lab. They also love to drink alcohol.” The rodents reactions act as a model for how humans’ body clocks are affected by excessive drinking.

“Part of the reason for problems in an alcoholic’s life is the impact alcohol has on the circadian clock. We think alcohol prevents light information necessary for proper clock activity from reaching the brain. This information is critical for daily activity.” Alcohol blocks sensory information from stimulating the brain’s control centers.  “Because the body has trouble determining what time of day it is, it can’t function properly”, explains Professor Glass.

To help avoid alcohol’s negative effects on sleep, abstain from drinking within 3-4 hours of bedtime and always use moderation.

In 2006, sales of the sleep aid Ambien® topped almost two billion dollars and placed that medication at number 13 on the list of the top 200 drugs prescribed in the US. The popularity of Ambien® and other sleeping aids suggests a growing trend of addressing sleep problems with medications. Unfortunately, with so many competing drugs and opinions based upon advertising, it is hard for a patient to distinguish what sort of treatment they need.

If you are having trouble sleeping, the first thing a doctor should do is determine what type of Insomnia you are experiencing. Insomnia can be “Transient”, occurring infrequently and in relation to temporary difficult or stressful times, or “Chronic”, occurring on a regular basis. The symptoms of insomnia can also arise as “Sleep-onset Insomnia” or they can manifest themselves after the patient has fallen asleep as “Sleep Maintenance Insomnia”. Depending on what type of Insomnia you have, sleeping pills might be an effective treatment. For example, a person has Transient Insomnia triggered by stress at work; they can’t seem to shut off their mind and fall asleep. In this situation, a short term prescription of a sleep aid might help them. On the other hand, someone else has been waking up several times a night and has difficulty getting back to sleep. In their situation it would be prudent to be screened for an underlying sleep disorder such as Sleep Apnea. Their sleep may be disrupted by the disorder, resulting in Insomnia symptoms and sleeping pills would further mask the problem.

It’s important to remember that sleeping pills should not be prescribed nor used lightly as they can have serious side effects and consequences. One recent study concluded that patients with Sleep Apnea who did not have their condition treated and were instead given sleeping aids had a substantially higher risk of car accidents. Also, some people may experience effects similar to sleep walking and may become a danger to themselves and others. Long term effects of sleeping aids have not been well documented and the FDA generally recommends short term use of most hypnotic medications.