What causes poor sleep, and how do I get better sleep?

This article discusses health conditions that cause a person to get poor sleep, and discusses things everyone can do to get better sleep.

With any illness, injury or sniffle, you'll hear one common suggestion: Get plenty of rest. Whether we're nursing a broken bone or trying to recover from the flu, we are led to believe that adequate sleep will put us right on the path to recovery. But just how important is sleep, and what about those of us who can't seem to get quality sleep?

Lack of sleep is linked to several health concerns:

Colds, flu, viruses and infections. One of the first systems to be adversely affected by lack of quality sleep is immune function. When you're tired, you feel worn down -– and that's not just a feeling. Your body is using all energy reserves to fight off the viruses and exposure to germs that might not affect a person with a thriving immune system. Also, if you receive vaccines, the sleep-deprived are slow to respond to the immunity the vaccines are designed to build.

Heart disease. According to Donna Arand, clinical director of the Kettering Sleep Disorder Centers in Dayton, Ohio, lack of sleep causes an inflammatory response to the cardiovascular system. Rises in C-reactive protein due to impaired sleep are warning signs that the body is responding to a perceived injury, infection or disease. In this case, lack of sleep is that perceived threat that results in inflammation. Poor sleep also causes the body to produce more stress hormones, which may contribute to cardiovascular disease. Chronic stress coupled with lack of quality sleep causes double trouble for the heart, arteries and ventricles.

Diabetes. In the past decade, there has been growing evidence that too little sleep can affect hormones and metabolism in ways that promote diabetes. According to a study published in the Lancet in 1999, healthy men with a week of impaired sleep –- only four hours a night –- showed dramatic changes in glucose tolerance. They also had higher-than-normal glucose levels after just one week. This study involved healthy people with no previous record of insulin resistance or history of diabetes.

For those already diagnosed with diabetes, sleep deprivation leads to extremely poor blood sugar control. These studies do not include control factors of the snowball effect that often starts with losing a night's sleep. Sleepy people don't usually reach for healthy foods as snacks and meals. They don't usually choose to walk during their lunch break -– or head to the weight room after work. Tight glucose control involves nutrition and exercise parameters, and both of those are adversely affected by just one night of impaired sleep.

How Can We Improve Our Sleeping Patterns? 
1. Keep the bedroom for sleep and sex. Don't let the bedroom become the home office. Keep the clutter and distraction of that quickly approaching timeline out of the bedroom. Keep a cool temperature, and design the room for its purpose. Walking into your bedroom should be a clear change from the rest of the house.

2. Put down the screens. An hour or more before bedtime, put down the computer, smartphone and TV. Dim the lights throughout the house, and start getting your mind ready to wind down. Some people use blackout shades in the bedroom during the summer months. Before electricity, people stayed awake two or three hours past dusk with candlelight, and their natural circadian rhythms prompted them to sleep. There's a lot of research that links artificial light –- including blue-light from screens -– with interrupted sleep patterns. If we're staying up six or more hours past dusk with fluorescent light glowing, our bodies don't know when it’s time to sleep.

3. Pay attention to what you eat and drink before bedtime. Try not to go to bed ravenous or stuffed. Be aware that a glass of wine might help calm the nerves, but metabolizing alcohol keeps the body in an alert mode while the mind is trying to snooze. Have that glass of wine earlier in the evening. And yes, eating bad pizza right before bed can cause nightmares. So can stuffing yourself with any food minutes before trying to sleep. Your body is trying to do two things: metabolize food and sleep. The food is going to win, and that's a cause for dreams and other disruptions to quality sleep.

4. Move your body. There is substantial evidence that exercise helps you sleep. Even moderate exercise like a daily walk promotes better sleep -– in terms of quality and quantity. Be careful with your exercise timing, so you're not too energized with endorphins to sleep. There's also a direct link between exercise and stress, and stress is a big factor in sleep-deprived people. Move your body. Manage your stress. Get quality sleep.

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Sleep disorders in children may be caused by winter viruses

Sleep disorders in children related to breathing during sleep may be due to winter viruses.

A good night's sleep is important to our children's development. But with the first day of school just passed, many children are at increased risk for sleep breathing disorders that can impair their mental and physical development and hurt their academic performance.

A study conducted in North America in 2011 showed that the frequency of sleep-disordered breathing increases in the winter and spring. Until now, researchers believed asthma, allergies and viral respiratory infections like the flu contributed to disorders that affect children's breathing during sleep.

Now, in a new study conducted at the Pediatric Sleep Center at the Tel Aviv Sourasky Medical Center and published in the journal Sleep Medicine, Riva Tauman and her fellow researchers of the Sackler Faculty of Medicine at Tel Aviv Univ. have shown that asthma and allergies do not contribute to pediatric sleep-disordered breathing. Viruses alone, they say, may be responsible for the seasonal variation seen in children.

The researchers say the study has broad implications for the treatment of sleep-breathing disorders in children, bolstering the idea that the time of year is relevant when treating children for sleep-disordered breathing in borderline cases.

Blowing hot and cold

"We knew from research and clinical practice that sleep-disordered breathing in children gets worse during the colder months," Tauman says. "What we didn't expect is that the trend has nothing to do with asthma or allergies."

"Sleep-disordered breathing" is a blanket term for a group of disorders. One of the common disorders is obstructive sleep apnea, in which the upper airway becomes blocked, usually by enlarged tonsils or adenoids, causing snoring and, in more severe cases, breathing pauses that lead to poor-quality and fragmented sleep and decreased oxygen and elevated carbon dioxide levels in the bloodstream.

In the long term, sleep-disordered breathing in children can cause stunted growth, heart disease and neurocognitive problems associated with diminished school performance, impaired language development and behavioral issues.

In their study, Tauman and her Sackler Faculty of Medicine colleagues Michal Greenfeld and Yakov Sivan statistically analyzed the cases of more than 2,000 children and adolescents who were referred to the sleep center to be tested for suspected sleep-disordered breathing between 2008 and 2010. Confirming earlier results of a 2011 study of five- to nine-year-olds, the researchers found that pediatric sleep-disordered breathing is worse in the winter — which in Israel they defined as from November to March — than in the summer. The seasonal variability is most apparent in children less than five years old, they found.

The researchers also found that wheezing and asthma do not contribute to the trend.

Based on their findings, the researchers speculate that viral respiratory infections — which are more prevalent in younger children and during colder months — are the major contributor to the seasonal variability seen in pediatric sleep-disordered breathing.

Taking the long view

If the sleep clinic tests had all been conducted in the winter, the researchers estimate that seven percent more children would have been diagnosed with sleep-disordered breathing. Seven percent fewer would have been diagnosed if all the tests had been done in the summer, they estimate.

"Our study suggests that if a child comes into the sleep laboratory in the winter with a mild case, I may consider not treating him. I can assume he will be better in the summer," says Tauman. "But if he has only mild symptoms in the summer, I can assume they are more severe in the winter."

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Top reasons for school absences, and how to handle them

With cold and flu season right around the corner, keeping children healthy is on the top of every parent's mind.

According to 2010 figures from the National Center for Health Statistics, 43% of children ages 5-17 years missed three or more school days in the past year because of illness or injury; 6% missed 11 days or more. An estimated 22 million school days are lost annually because of colds alone.

"There is a correlation between academic success and being in school," says Martha Dewey Bergren, director of research for the National Association of School Nurses. "Seat time affects learning."

Here's a look at some of the ailments that most often keep students out of school, and advice for parents:

Asthma

The chronic lung disease affects an estimated 7 million kids under 18 and accounts for more than 14 million absences annually. Parents should give the school office (plus teachers and coaches) a plan that specifies symptoms, medications and what to do if an asthma episode does not improve with prescribed medicine, says Norman Edelman, the American Lung Association's chief medical officer. Early in the school year, parents should "do an environmental check of the allergens and other irritants that can trigger an attack," he adds.

It's important that "families work together with their schools and health care provider to manage conditions," says Linda Caldart-Olson of the American School Health Association.

Respiratory infections

A group of viruses that cause various upper and lower respiratory infections are quite common in autumn, says Cynthia DiLaura Devore, chair of the American Academy of Pediatrics Council on School Health. These infections, which also can trigger asthma attacks, cause flu-like symptoms (coughs, fever, lack of appetite, vomiting, diarrhea) that can put a child out of commission for five to 10 days, and are contagious, says Devore. She says parents should keep children home until they're fever-free and off symptom-reducing medicines for 24 hours.

Influenza

January to March is the height of flu season, but now is the time for everyone 6 months and older to get the flu vaccine, says pediatric infectious-disease specialist Mary Anne Jackson of the University of Missouri-Kansas City School of Medicine. This year's vaccine is formulated to protect against the same three strains as last year's.

Stomach viruses

A number of viruses can infect the gastrointestinal tract, resulting in gastroenteritis or "stomach flu." Marked by vomiting and diarrhea, it usually lasts only 24 to 72 hours, says Devore. Because the viruses are spread through close contact by sharing food or eating utensils, hand-washing and the use of hand sanitizers are critical.

Head lice

In school districts with "no nit" policies, kids with lice must stay home until any sign of eggs has passed. The American Academy of Pediatrics and the National Association of School Nurses oppose the policies because they have not been shown to effectively reduce the spread, no disease is linked to lice, and in-school transmission is rare, says Devore.

Preventable diseases

Outbreaks in the USA last year of potentially fatal, vaccine-preventable diseases, including pertussis (whooping cough) and measles, highlight the importance of "being vigilant about all immunizations," says Jackson. CDC offers immunization schedulers at cdc.gov/vaccines.

School refusal

Repeated episodes of what Devore calls "Sunday Night Stomach" or chronic absences without a medical excuse should be taken seriously, she says. When kids express anxieties, fears and resistance to school, they may simply need a little extra "reassurance, understanding and limit-setting" or there may be serious mental health concerns. Either way, it shouldn't be lightly dismissed, says Devore.

Read more: http://yourlife.usatoday.com/parenting-family/story/2011-09-21/Top-reasons-for-school-absences-and-how-to-handle-them/50501620/1