When using iPad at night, study suggests orange tinted glasses for better sleep

Sleep quality and health can be affected by exposure to different light-emitting devices. Exposure to short-wavelength-enriched (blue-enriched) light in the evening increases alertness and suppresses the production of melatonin, which is only produced during sleeping hours and helps regulate the sleep-wake cycle.

In this study, Gringras et al reveals the spectral profiles of the most popular devices in 2014: the iPad Air, the iPhone 5s, and the Kindle Paperwhite 1st generation. The difference in light signals emitted from a popular game (Angry Birds) and e-book text was also compared. The default brightness levels were used for the iPhone and iPad, and 50% brightness was used for the Kindle based on convenience sampling from users. Irradiance was measured as an exact spectral power distribution (SPD) using a spectrometer. The spectral profiles were similar across all devices, and between Angry Birds and e-book text. The intensity level was higher for the iPad.

Two strategies to reduce the impact of short-wavelength enriched light emissions were tested. First, the blue-blocking, orange-tinted Pyramex Ztek Safety Eyewear was very effective in decreasing the intensity of the short-wavelength/blue light emissions. Second, the Kids Sleep Dr app, which allowed for selection of a “sleep-aware” palate of colors on the device, was also successful in reducing short-wavelength light emissions, but also changed the spectral profile completely.

http://www.imedicalapps.com/2015/11/ipad-night-study-better-sleep/

Gringras P, Middleton B, Skene DJ, Revell VL. Bigger, Brighter, Bluer-Better? Current Light-Emitting Devices – Adverse Sleep Properties and Preventative Strategies. Frontiers in Public Health. 2015;3:233. doi:10.3389/fpubh.2015.00233.

Epilepsy in Adults With Mitochondrial Disease: A Cohort Study

The genetics of epilepsy is in a revolution.
Do you have an unknown cause?
 It turns our that adults have mitochondrial disease too. - JR


Epilepsy in Adults With Mitochondrial Disease: A Cohort Study

1. Roger G. Whittaker PhD^1,*, 
2. Helen E. Devine MRCP², 
3. Grainne S. Gorman MRCP²,
4. Andrew M. Schaefer MRCP², 
5. Rita Horvath PhD³, 
6. Yi Ng MRCP², 
7. Victoria Nesbitt MRCP², 
8. Nichola Z. Lax PhD², 
9. Robert McFarland PhD², 
10. Mark O. Cunningham PhD¹, 
11. Robert W. Taylor PhD, FRCPath²and
12. Douglass M. Turnbull PhD²

Article first published online: 17 NOV 2015

DOI: 10.1002/ana.24525

full abstract here

Objective

The aim of this work was to determine the prevalence and progression of epilepsy in adult patients with mitochondrial disease.

Methods

We prospectively recruited a cohort of 182 consecutive adult patients attending a specialized mitochondrial disease clinic in Newcastle upon Tyne between January 1, 2005 and January 1, 2008. We then followed this cohort over a 7-year period, recording primary outcome measures of occurrence of first seizure, status epilepticus, stroke-like episode, and death.

Results

Overall prevalence of epilepsy in the cohort was 23.1%. Mean age of epilepsy onset was 29.4 years. Prevalence varied widely between genotypes, with several genotypes having no cases of epilepsy, a prevalence of 34.9% in the most common genotype (m.3243A>G mutation), and 92.3% in the m.8344A>G mutation. Among the cohort as a whole, focal seizures, with or without progression to bilateral convulsive seizures, was the most common seizure type. Conversely, all of the patients with the m.8344A>G mutation and epilepsy experienced myoclonic seizures. Patients with the m.3243A>G mutation remain at high risk of developing stroke-like episodes (1.16% per year). However, although the standardized mortality ratio for the entire cohort was high (2.86), this ratio did not differ significantly between patients with epilepsy (2.96) and those without (2.83).

Interpretation

Epilepsy is a common manifestation of mitochondrial disease. It develops early in the disease and, in the case of the m.3243A>G mutation, often presents in the context of a stroke-like episode or status epilepticus. However, epilepsy does not itself appear to contribute to the increased mortality in mitochondrial disease. Ann Neurol 2015

Health consequences of texting in bed

A study indicates that texting in bed can lead to losing sleep in addition to poor school performance in teens.

Many American teens text in bed, leading to lost sleep, daytime drowsiness and poorer school performance, a new study says.

Researchers from New Jersey looked at nearly 3,200 middle and high school students in the state. They found that nearly 62 percent of the kids used their smartphones in some capacity after bedtime; nearly 57 percent texted, tweeted or messaged in bed; and nearly 21 percent awoke to texts.

"Our study confirms that many teenagers are texting late at night when they should be sleeping. This behavior is more common among older teenagers, especially those in high school, and among girls," said study co-author Vincent DeBari. He is director of research at the Seton Hall University School of Health and Medical Sciences, in South Orange.

"One of the most worrisome aspects of our findings is that in addition to affecting the quality and amount of sleep teenagers are getting, bedtime smartphone use seems to be having a negative impact on their level of alertness during the day and on their grades in school," DeBari said in a university news release.

His study co-author, Dr. Peter Polos, added that teens whose sleep is disrupted by incoming texts may feel compelled to respond to those texts immediately. These exchanges can go on for hours.

"This leads to excessive stimulation at night. Light from electronic devices can suppress the secretion of melatonin, a hormone that promotes sleep. All of these factors combine to make sleep difficult in the face of excessive smartphone use at night," said Polos, a member of the sleep medicine division of the JFK Neuroscience Institute in Edison, N.J.

The researchers also found that smartphone use just before or after bedtime may worsen teens' tendency to go to bed much later and sleep until late morning. This behavior has been linked with depression, anxiety and attention-deficit hyperactivity disorder, the study authors said.

"Repeatedly, studies have shown that today's adolescent students are seriously sleep-deprived, and that it affects their health, their mood and their safety behind the wheel. Our study shows that the unrestricted use of smartphones at night may be a major contributing factor," Dr. Sushanth Bhat, an assistant professor of neuroscience at Seton Hall, said in the news release.

"Since getting the proper amount of sleep is very important for brain development and learning in the teenage years, our study should prompt parents and guardians to consider placing reasonable limitations on adolescent smartphone usage at night," Bhat concluded.

The study findings appear in the October issue of the Journal of Adolescence.

Read more here

Similarities and differences between migraines and epilepsy

This article discusses similarities and differences between migraines and epilepsy.

Migraine and epilepsy have several things in common: they often co-occur and share similar symptoms, each is generally undertreated, one is often misdiagnosed as the other,1 and various medications are effective in treating both disorders.2 Recent research may help elucidate the relationship between the two and shed light on more appropriate diagnosis and treatment options.

“Patients with migraine are more likely to have epilepsy, and patients with epilepsy are more likely to experience migraine,” Pavel Klein, MD, director of the Mid-Atlantic Epilepsy and Sleep Center, told Neurology Advisor. In fact, people with seizure disorders are twice as likely to experience migraines which can often lead to misdiagnosis.3

There are commonalities between the two disorders “in clinical symptomatology, particularly with regard to visual and other sensory disturbances, pain, and alterations of consciousness.”3 For instance, if a patient has a migraine that causes focal neurological symptoms — numbness in the arm or face, for example — it can appear to be a seizure. It is also known that stress can trigger seizures, and in a less common scenario, “in someone with very severe migraine, it is possible that the stress of the pain could trigger a seizure,” Klein explained.

The potential reasons for the close relationship between the two disorders are just as varied. “There could be common substrates that cause both headaches and seizures,” said Klein. For example, a condition called benign epilepsy of childhood is commonly associated with migraine and is often misdiagnosed as such,3 while another possibility is that migraine could lead to mild forms of brain damage that increase the risk of epilepsy. Studies have found that MRI of some patients with migraine show small areas of abnormal lesions or scarring.4,5 Researchers are not yet sure of the cause, but it is possible that the scarring is a result of a stroke that is otherwise asymptomatic, and the “scarring leads to reorganization of the local network that could lead to seizures,” said Klein.

What Role Do Genetics Play?

Research published in Epilepsia in 2013 was the first to investigate the role of genetics in the co-occurrence of migraine and epilepsy.5 After testing 730 participants with epilepsy, researchers divided them into two non-overlapping groups — one with migraine with aura and one with migraine without aura — and interviewed participants about their family history of seizure disorders. The results showed that a history of migraine with aura was “significantly increased in enrolled participants with two or more additional affected first-degree relatives,” supporting the researchers' hypothesis of a shared genetic susceptibility to migraine and epilepsy.

“The hope of scientists, caregivers, and families with epilepsy is that genetics will offer a novel and wider understanding of the causes and the pathophysiology of epilepsy,” study co-author Melodie R. Winawer, MD, MS, an associate professor of neurology at Columbia University, told Neurology Advisor.

Approximately two thirds of epilepsy cases have no known cause, and genetic factors may play a critical role in that subset of cases. A ground-breaking aspect of these findings is in regards to reconceptualizing disease boundaries.

“A disorder does not stand alone but can be seen as part of a network of intersecting disorders — in fact, there have been intersecting bidirectional relationships identified for epilepsy, migraine, anxiety, depression, suicidality, and psychosis,” she said. “As we start to understand that some of these disorders are occurring in a network or a cluster rather than standing by themselves, I think it is going to completely transform treatment strategies” and potentially affect preventive efforts.

Ultimately, the knowledge of a shared pathophysiology could lead to the development of new treatment options, as well as recognition of accompanying disorders beyond seizures that can severely impact a patient's quality of life.

After all, failing to treat co-occuring disorders is a disservice to patients, said Winawer. Treatment of any condition — including migraine and epilepsy — should consider potential comorbidities that could worsen or improve depending on the chosen treatment. “We really need to understand epilepsy in its context,” said Winawer. “There is a huge move in the last few years to do that and I think this work is part of that larger question.” 

Read more here

Repetition may hurt knowledge application for children with autism

In children with autism, teaching through repetition may hinder that child's ability to apply that knowledge in a different context.

Individuals with autism spectrum disorder (ASD) sometimes acquire a new behavior or skill only in a specific context, but they have difficulty transferring that learned skill or information to a new context.

For example, children with autism can be taught what a dog is by showing them a picture of a dog and repeating the word "dog" over and over. But, when they are then taught what a cat is or even shown another type of dog, the previous knowledge does not transfer, and they have to learn this information from scratch.

A new study published in Nature Neuroscience shows that training individuals with ASD to acquire new information by repeating the information actually harms their ability to apply that learned knowledge to other situations. This finding, by an international research team, challenges the popular educational approaches designed for ASD individuals that focus on repetition and drills.

"There have been few systematic investigations into the fundamental mechanisms by which information is acquired by ASD individuals -- and into the potential reasons for their restricted, atypical learning," said Marlene Behrmann, the Cowan Professor of Cognitive Neuroscience at Carnegie Mellon University and a faculty member in the Center for the Neural Basis of Cognition (CNBC). "This study begins to scratch the surface of the phenomenon."

Using a computer screen, high-functioning ASD adults and control participants were trained to find the location of three diagonal bars surrounded by horizontal lines. Both groups were asked to identify the diagonal bars during eight daily practice sessions and their speed and accuracy were measured. The bars stayed in the same location for the first four days and were moved to a second location in the display for days five through eight.

"It was crucial to set up the experiment this way so that we could initially observe the learning in the ASD individuals in a simple, well-established task but then also document the difficulty in transferring the knowledge as the experiment progressed," said Dov Sagi of the Weizmann Institute of Science.

The results showed that for the first four days -- with the diagonal bars in the first location -- learning was equivalent for the ASD and control groups. However, once the location of the diagonal bars changed, there was a substantial difference. The control group smoothly transitioned to learning the new location and their performance continued to improve.

In contrast, the individuals with autism performed poorly when the target location was changed and they were not able to improve their performance, indicating that they received no benefit from initially learning the first location. Even more interesting, they were never able to learn the second location as well as the first, demonstrating an interference in learning that may reflect the consequences of extensive repetition.

"It's like they showed 'hyperspecificity' of learning -- their learning became fixed and inflexible -- since learning the first location adversely influenced their ability to learn the second instance," said Hila Harris, the study's lead author from the Weizmann Institute.

Next, the researchers looked for ways to circumvent the hyperspecificity. With a new group of ASD adults and controls, they ran the exact same experiment, but this time they occasionally inserted "dummy" screens that did not contain any diagonal bars.

This time, when the location of the bars changed on the fifth day, the ASD group efficiently learned the new location.

"Our conclusion is that breaks in repetition allow the visual system some time to rest and allow autistic individuals to learn efficiently and to then generalize," said New York University's David Heeger. "Repeated stimulation leads to sensory adaptation which interferes with learning and makes learning specific to the adapted conditions. Without adaptation, learning is more efficient and can be generalized."

The research team believes that the findings have important implications for educating individuals with autism.

"Individuals with autism need to be taught in ways that support or promote generalization rather than in ways that reinforce over specificity," said Nancy Minshew, professor of psychiatry and neurology at the University of Pittsburgh and in the joint CMU-Pitt CNBC. "For example, in the context of learning what a dog is, using a full range of examples of dogs -- and even of animals, more generally -- incorporates variability from the beginning and promotes learning a broad concept rather than a specific example."

Read more here

Study: Children with ADHD and congenital heart disease can take stimulants

According to a recent study, it is safe for children with both ADHD and congenital heart disease to take stimulant medication.

A new study finds that children with congenital heart disease and ADHD can take stimulant medications without fear of significant cardiovascular side effects.

In a study to be presented at a national meeting Oct. 4, researchers at Cincinnati Children's Hospital Medical Center have found no increased risk for death or changes in cardiac vital signs, such as blood pressure or heart rate, even for children with ADHD and severe heart conditions. They also found that when treated with stimulant medications, patients had significant improvements in ADHD symptoms as measured by standardized rating scales.

"Children with congenital heart disease are at high risk for ADHD, but fears about cardiovascular side effects, including sudden death, limit the use of stimulant medications," says Julia Anixt, MD, a developmental and behavioral pediatrician at Cincinnati Children's and senior author of the study. "This study indicates that stimulants are both effective and safe when prescribed with appropriate monitoring and in collaboration with the patient's cardiologist."

The study will be presented by Pon Trairatvorakul, MD, a fellow in the division of Developmental and Behavioral Pediatrics at Cincinnati Children's, at the annual meeting of the Society for Developmental and Behavioral Pediatrics in Las Vegas.

The researchers studied 44 children between the ages of 6 and 18 seen in the Cincinnati Children's Heart Institute Kindervelt Neurodevelopmental and Educational Clinic. They compared these patients to those with similar heart disease but who were not treated with stimulants. The researchers' next step is to study the effect of stimulant medications on electrocardiograms (EKGs), which measure electrical activity of the heart.

Since 2006, the U.S. Food and Drug Administration has required labeling of stimulant medications to include a warning that they generally should not be used in children and adolescents with serious structural cardiac abnormalities, cardiomyopathy or arrhythmias. However, stimulants are the most effective medication to treat ADHD symptoms, and patient families, cardiologists, and developmental pediatricians must together weigh the risks and benefits of medication treatment options for each individual patient, according to Dr. Anixt.

Read more here

Night owl sleep habits can make you put on weight

A study shows that night owl sleep habits can cause a person to put on weight.

A new study done at the UC Berkeley’s Golden Bear Sleep and Mood Research Clinic, says going to bed late at night can lead to weight gain, according to an article onnews.berkeley.edu.

The study found a link between sleep and Body mass index (BMI), and the results are showing that teens and also adults that get to bed late during the week are probably going to put on more weight than those who have an earlier bedtime each night.

The researchers looked at the numbers from over 3,300 participants, youth and adult, and they discovered a gain of 2.1 pounds on the BMI for each hour of sleep lost over a five -year period.

Surprisingly, they found that the gain in BMI held true despite the participants regimen of exercise, TV or computer screen time or even the number of hours they slept overall.

BMI is calculated using the body’s height and weight and is a useful metric for measuring weight gain and obesity.  A healthy BMI is said to be between 18.5 and 24.9.  A BMI of 25.0 to 29.9 is considered overweight and 30.0 or greater is classified as obese.

The data the researchers used came from the National Longitudinal Study of Adolescent Health.  That study has been recording the behaviors of teens from the United States since 1994.  In the new study, they compared the BMI and the bedtimes for teens at the onset of puberty, during their college-age years and as young adults.

Lauren Asarnow, lead author of the study and a doctoral student in UC Berkeley’s Golden Bear Sleep and Mood Research Clinic said “These results highlight adolescent bedtimes, not just total sleep time, as a potential target for weight management during the transition to adulthood.”

She also added that young people that go to sleep earlier each night “set their weight on a healthier course as they emerge into adulthood.”

Earlier surveys and studies have revealed that teens do not get the recommended amount of sleep each night, and many teens report having difficulty staying alert and awake in school.

Later in life, the natural circadian rhythm shifts toward a later sleep cycle.  The circadian rhythm is the natural body clock that regulates your metabolic and physiological functions.

Other studies have suggested a link between late night owls and mental health.  It appears that people that are going to bed later have an increased risk of developing depression and other mental health related issues.

The hope is that the findings of the study will encourage young adults to be more conscious of the effect of late-night bedtimes, despite the pressure they will feel to be a part of their social group, particularly in a college-type setting.

Even if they are aware of the benefits of earlier sleep times, it will be difficult to maintain that type schedule while being a student.

Habits are hard to break as well.  If teens are used to going to bed a 10 to 11 PM during high school years, they will have a hard time changing their cycle once they are out on their own.  Parents who see the results of the study may want to monitor their children more closely and develop an earlier bedtime ritual at an early age to make it easier later on in life.

No teen wants to gain weight, especially around their peers in a university setting, and it is hoped that these findings will encourage teens and young adults to take their sleeping habits more seroiously.

The co-authors of the study include Allison Harvey at UC-Berkeley and Elanor McGlinchey at Columbia University, along with Ms. Asarnow, who is a researcher on UC-Berkeley’s Teen Sleep Study.

The Teen Sleep Study seeks to assist teens to reset the circadian rhythms of young people that are having trouble sleeping and waking up on time.

The results of the study were published in the October edition of the journal Sleep.

Read more here