Sleep disorders are more common in racial/ethic minorities

According to a recent study, sleep disturbances occur more frequently in middle-aged and older adults who are racial or ethnic minorities.

A new study suggests that sleep disturbances and undiagnosed sleep apnea are common among middle-aged and older adults in the U.S., and these sleep problems occur more frequently among racial/ethnic minorities.

Results show that 34 percent of participants had moderate or severe sleep-disordered breathing measured by polysomnography, and 31 percent had short sleep duration with less than 6 hours per night measured by actigraphy. Validated questionnaires also showed that 23 percent reported having insomnia, and 14 percent reported excessive daytime sleepiness. Only 9 percent of participants reported being told by a doctor that they had sleep apnea.

After adjustment for sex, age, and study site, blacks were most likely to have short sleep duration of less than six hours, and they were more likely than whites to have sleep apnea syndrome, poor sleep quality, and daytime sleepiness. Hispanics and Chinese were more likely than whites to have sleep-disordered breathing and short sleep duration, but Chinese were least likely to report having insomnia.

"Our findings underscore the very high prevalence of undiagnosed sleep disturbances in middle-aged and older adults, and identify racial/ethnic disparities that include differences in short sleep duration, sleep apnea and daytime sleepiness," said lead author Dr. Xiaoli Chen, research fellow in the Department of Epidemiology at Harvard T.H. Chan School of Public Health in Boston.

Study results are published in the June issue of the journalSleep.

The study population was recruited from six U.S. communities and comprised 2,230 racially/ethnically diverse men and women who were between the ages of 54 and 93 years. Data gathered by polysomnography, actigraphy and validated questionnaires were obtained between 2010 and 2013.

According to Dr. Chen and her colleagues, this is the first study that has comprehensively evaluated objective measures of sleep apnea, short sleep, and poor sleep, as well as subjective measures of habitual snoring, insomnia, and daytime sleepiness in a multi-ethnic U.S. population that includes Chinese Americans. Results suggest that sleep disturbances may contribute to health disparities among U.S. adults.

"As sleep apnea has been implicated as a risk factor for cardiovascular disease, stroke, diabetes, and mortality, our findings highlight the need to consider undiagnosed sleep apnea in middle-aged and older adults, with potential value in developing strategies to screen and improve recognition in groups such as in Chinese and Hispanic populations," said senior author Dr. Susan Redline, professor of medicine at Harvard Medical School and Division of Sleep Medicine at Brigham and Women's Hospital and Beth Israel Deaconess Medical Center in Boston. The study was supported by grants from the National Institutes of Health (NIH) and an award from the National Center for Advancing Translational Sciences (NCATS).

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More than 13% of boys in America have ADHD

This article claims that over 13% of American boys have ADHD.

A total of 9.5% of children aged 4-17 in the US have at some point been diagnosed with ADHD, according to statistics from the US Centers for Disease Control. While prevalence statistics often rely on the administration of mental health screening tests, the latest statistics reflect actual diagnoses given to the children by physicians or mental health care providers. The CDC also identified significant trends based on gender and income levels.

The latest statistics came from the National Health Interview Survey of the National Center for Health Statistics. Between 2011-13, information was collected for 29,968 children aged 4–17. Respondents were asked, “Has a doctor or health professional ever told you that [sample child] had attention deficit hyperactivity disorder (ADHD) or attention deficit disorder (ADD)?”

There were differences based on age, gender and income.

"For those aged 4–5, prevalence was 2.7%, 9.5% for those aged 6–11, and 11.8% for those aged 12–17," stated a CDC data brief. "13.3% of boys and 5.6% of girls aged 4–17 had ever been diagnosed with ADHD."

The ADHD rates were highest among children with public insurance at 11.7%, and lowest among uninsured children at 5.7%. Among children with private insurance, the rate was 8.6%.

Of families with incomes below 200% of the federal poverty threshold, 10.4% of children had been diagnosed with ADHD, compared with 8.8% of children in families with incomes at or above 200% of the poverty threshold.

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Study: Girls diagnosed with autism later than boys are

A study shows that girls are diagnosed with autism later than boys are.

Current statistics on autism spectrum disorder (ASD) show that boys are nearly five times more likely than girls to have autism. Now a new study proves that in addition to being diagnosed less, girls are also diagnosed at a later age than boys.

The study, conducted by the Kennedy Krieger Institute in in Baltimore, Maryland, analyzed data from the Institute’s Interactive Autism Network (IAN), an online information registry of nearly 50,000 people affected by autism and their families.  Researchers took into account the age that both boys and girls were diagnosed with autism for 9,932 children, and Social Responsiveness Scale data from 5,103 children, which identifies the presence and severity of social impairment.

Results showed that girls with a type of autism called pervasive developmental disorder (PDD)— which is characterized by delays in the development of socialization and communication skills— were diagnosed at an average age of 4 years old, compared to 3.8 years old in boys. In addition to PPD diagnosis, researchers found that Asperger’s syndrome diagnoses also happened later for girls – at 7.6 years old compared to 7.1 years of age for boys.

“The later diagnosis of girls appears to be tied to their areas of delay being less apparent, showing up more as shyness and quietness rather than the more unusual behaviors seen in boys, ” Dr. Paul Lipkin, study author and director of the Interactive Autism Network at Kennedy Krieger told FoxNews.com.

Lipkin said findings suggest that when it comes to social cognition, or the ability to interpret social cues, girls struggle more than boys, while boys have more difficulty with more obvious symptoms like severe mannerisms and repetitive behaviors.

“At the present time, autism screeners are not designed to look at boys and girls differently. This and other studies suggest that such may be needed, particularly around social skill development,” Lipkin said. “So parents, pediatric clinicians, therapists, educators now should give careful consideration to girls who are having difficulties in social situations and assist these girls early.”

Researchers noted an increase in the number of girls diagnosed with autism from 2010-2013 compared to the statistic measured four years earlier. Lipkin said he thinks the reason for the rise might be better public awareness and screening methods.

“We need to look at large groups of girls with autism and better understand their developmental pathways, in order to find the best means for their early identification and to find the best treatments for the challenges they experience,” he said. “One can no longer assume that boys and girls with autism are alike.”

Lipkin said he hopes the findings help change the way autism is diagnosed, and that further research will determine whether less recognizable symptoms in girls are not only leading to later diagnosis, but also under-identification of the condition.

“We need to find the best ways to identify those at both ends of the spectrum, those with severe problems and those with milder problems in social development,” he said. “The quiet girl with social difficulties may have an ASD and may benefit from special treatments aimed at these delays in social development.”

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Study: Seniors helped by sleep apnea treatment

A study claims that seniors are helped by sleep apnea treatments such as a CPAP.

A new study finds that continuous positive airway pressure (CPAP) is an effective treatment for seniors with sleep apnea.

CPAP is widely used to treat moderate to severe obstructive sleep apnea, a condition in which the airway relaxes and narrows during sleep, causing breathing problems and interrupted sleep that leads to daytime drowsiness.

CPAP keeps the airway open by pushing a stream of air through a patient's nose via a mask that is worn during sleep. Previous research has shown that CPAP benefits middle-aged adults with sleep apnea, but there had been no studies on whether it was useful and cost-effective in seniors.

This new study of 278 sleep apnea patients aged 65 and older in the United Kingdom found that CPAP reduced their levels of daytime sleepiness and their health care costs.

"Sleep apnea can be hugely damaging to patients' quality of life and increase their risk of road accidents, heart disease and other conditions. Lots of older people might benefit from this treatment," study co-lead author Mary Morrell, a professor at the National Heart and Lung Institute at Imperial College London, said in a college news release.

"Many patients feel rejuvenated after using CPAP because they're able to sleep much better, and it may even improve their brain function," Morrell added.

"We think low oxygen levels at night [because of interrupted breathing] might accelerate cognitive [mental] decline in old people, and studies have found that sleep apnea causes changes in the gray matter in the brain. We're currently researching whether treatment can prevent or reverse those changes," she noted.

CPAP should be offered to seniors with sleep apnea, and more needs to be done to raise awareness of the condition, the study authors said. The study is published in the Aug. 27 online edition of The Lancet Respiratory Medicine.

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Suicide risk increased by sleep disorder presence

This article discusses the association seen between presence of a sleep disorder in older adults and increased suicide risk.

Sleep quality influences suicide risks for older adults, according to a research undertaken by scientists from Stanford University School of Medicine. Rebecca Bernert, the study’s author, says this is a highly treatable condition. Bernert, PhD, is the director of the Suicide Prevention Research Laboratory at Stanford. The fact that sleep disorder increases suicide risks for older adults comes after a complex research.

Another research carried earlier this year involvedblood analysis to determine suicide risks.

“Suicide is the outcome of multiple, often interacting biological, psychological and social risk factors,” Bernert said. “Disturbed sleep stands apart as a risk factor and warning sign in that it may be undone, which highlights its importance as a screening tool and potential treatment target in suicide prevention.

To reach the conclusion, the team of scientists from Stanford looked at data from 14.456 adults over 65 years old. Out of this group, they chose 400 individuals who had similar sleeping patterns to 20 people who committed suicide. Scientists followed the sleeping behavior over a 10 years period. In the end, researchers concluded that older people with sleeping disorders have a suicide risk 1.4 times higher than their counterparts with high sleep quality.

The comparison between the two groups was done by looking at a series of data obtained through interviews. The questions addressed topics such as depression signs, and mental and physical functioning. Even after taking out the depression variable, the lack of quality sleep remained an important factor determining an increased risk of committing suicide.

Suicide is associated with stigma, so people suffering suicidal thoughts or attempts have troubles talking about the issue. However, if a disturbed sleeping pattern accounts for such a high influence in determining suicide, there is a ray of hope. If trouble sleeping is not a stigmatized disorder, focusing on improving the older adults’ sleep quality might reduce the suicide rates.

The subjects involved in the study were mostly white males. A group of twenty suicide victims is surely not enough to draw the definitive conclusion that sleep disorder increases suicide risks, but is a start. Further research involving data from cases involving women and minority groups may shed additional light on the issue.

People who are at risk of committing suicide should ask for help by calling the National Suicide Prevention Lifeline (1-800-273-TALK).

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Too much and too little sleep indicate memory problems

This article claims that both too much and too little sleep can lead to memory problems in older women.

Seniors who slept too little or too much during midlife or after are at increased risk for memory problems, as are those whose sleep habits changed over time, a new study suggests.

Researchers looked at more than 15,000 women, 70 and older, who took part in a large study of health professionals. The women were depression- and stroke-free when they underwent their initial assessment.

Participants who slept five hours or less, or nine hours or more a day -- either in midlife or later life -- had worse memory than those who slept seven hours a day. The difference in memory was equivalent to nearly two extra years of age, the researchers said.

Women whose amount of sleep changed by more than two hours a night over time had poorer memory than those who had no sleep changes, according to the study published May 1 in the Journal of the American Geriatrics Society.

"Given the importance of preserving memory into later life, it is critical to identify modifiable factors, such as sleeping habits, that may help achieve this goal," study leader Elizabeth Devore, of Brigham and Women's Hospital in Boston, said in a hospital news release.

"Our findings suggest that getting an 'average' amount of sleep, seven hours per day, may help maintain memory in later life and that clinical interventions based on sleep therapy should be examined for the prevention of [mental] impairment," she added.

The study adds "to our knowledge about how sleep impacts memory. More research is needed to confirm these findings and explore possible mechanisms underlying these associations," Devore concluded.

While the study found an association between sleep time during midlife and older age and memory function in older women, it did not prove a cause-and-effect relationship.

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Autism risk increases for children born to older mothers

A study looked into maternal age and autism and found that children born to older mothers have a higher risk for autism development.

Why autism strikes certain kids -- and not others -- has puzzled scientists for half a century. But one trend is clear: having older parents seems to increase the risk. Now, a study from Drexel University adds two more wrinkles to the story.

Brian Lee, a professor of epidemiology at Drexel University's School of Public Health, analyzed a Swedish database of more than 400,000 births to see how the ages of both parents related to a child's chances of autism.

"The mothers' risk seems to be, quantitatively speaking, more important than the father's," he said. "Having a mother who is 40 is going to have a bigger effect on the child's autism risk than having a father who is 40 years old."

The oldest mothers studied, ages 40 to 45, were 75 percent more likely than younger women to have kids with an autism spectrum disorder. Fathers of similar age had just a 14 percent added risk. How risk increased with age differed between parents, accelerating for moms but climbing in step for dads.

Lee also examined the interaction of both parents' age, finding older fathers increased risk only with younger mothers.

"The effect of the father seems to essentially be washed out when you have older mothers," he said.

Lee said the results aren't meant to discourage older couples from having children. Less than 1.9 percent of the oldest women in the study gave birth to children who would go on to develop autism.

"The reason we're interested in parental age in the first place is because it's a marker for some underlying mechanism that really we're interested in," he said.

According to Lee, knowing age seems to affect moms and dads differently opens up new avenues of investigation.

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Aging and impaired sleep

A study shows that the way that aging impairs a person's sleep may be reversible.

Sleep is essential for human health. But with increasing age, many people experience a decline in sleep quality, which in turn reduces their quality of life. In a new study publishing April 1 in the Open Access journal PLOS Biology, Scientists at the Max Planck Institute (MPI) for Biology of Ageing in Cologne have investigated the mechanisms by which ageing impairs sleep in the fruit fly. Their findings suggest that age-related sleep decline can be prevented and might even be reversible.

To uncover basic age-related sleep mechanisms, the Max Planck scientists studied the fruit flyDrosophila melanogaster, a classical model organism in ageing research. "Drosophila's sleep has many features in common with that of humans, including the decline in quality," says Luke Tain of the MPI for Biology of Ageing. "Like humans, flies sleep at night and are active during the day. We can observe when and how long flies sleep. We can also determine their sleep quality by measuring how often they wake. This allows us to study the effects of specific substances or other sleep-influencing factors such as age and genetic disposition."

Ageing researchers Athanasios Metaxakis, Luke Tain, and Sebastian Grönke, in the department of MPI Director Linda Partridge, discovered that a reduced activity in the IIS signalling pathway leads to improved sleep quality at night and higher activity levels at day. A signalling pathway is a biological method of transferring information, and via those pathways, the cell can respond to external conditions like the state of food supply. "In our study, we described the role of the IIS pathway in regulating sleep and activity through the neurotransmitters octopamine and dopamine," explains Tain. "What makes this pathway so interesting to us is the fact that it is evolutionarily conserved. This means that its components and functions are similar in diverse species from simple organisms like fruit flies to mice and even humans. Furthermore, we were able to improve sleep quality by administering therapeutic agents."

Moreover, the scientists found out that day activity and night sleep are regulated by two distinct signalling pathways, night sleep being mediated through TOR and dopaminergic signalling. Surprisingly, if TOR's activity is acutely inhibited by treatment with the therapeutic agent Rapamycin, sleep quality improves even in old flies, suggesting that age-related sleep decline is not only preventable, but also reversible.

The scientists will follow up on their findings. Luke Tain: "Given the high evolutionarily conservation of IIS and TOR function, our results implicate potential therapeutic targets to improve sleep quality in humans. This would be our longer-term goal. The next step however, is to find out whether these mechanisms also work in higher animals like mice."

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Study: Poor sleep is linked to cognitive decline in older men

A study found that poor sleep quality in old men is liked to their cognitive decline over a few years.

A new study of older men found a link between poor sleep quality and the development of cognitive decline over three to four years.

Results show that higher levels of fragmented sleep and lower sleep efficiency were associated with a 40 to 50 percent increase in the odds of clinically significant decline in executive function, which was similar in magnitude to the effect of a five-year increase in age. In contrast, sleep duration was not related to subsequent cognitive decline.

"It was the quality of sleep that predicted future cognitive decline in this study, not the quantity," said lead author Terri Blackwell, MA, senior statistician at the California Pacific Medical Center Research Institute (CPMCRI) in San Francisco, Calif. "With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly, it is important to determine prospective associations with sleep and cognitive decline."

The study involved 2,822 community-dwelling older men at six clinical centers in the U.S. Participants had a mean age of 76 years. The study is published in the April 1 issue of the journal Sleep.

"This study provides an important reminder that healthy sleep involves both the quantity and quality of sleep," said American Academy of Sleep Medicine President Dr. M. Safwan Badr. "As one of the pillars of a healthy lifestyle, sleep is essential for optimal cognitive functioning."

The population-based, longitudinal study was conducted by a research team led by Dr. Katie Stone, senior scientist at CPMCRI in San Francisco, Calif. Institutions represented by study collaborators include the University of California, San Francisco; University of California, San Diego; Harvard Medical School; University of Minnesota; and several Veterans Affairs medical centers.

An average of five nights of objective sleep data were collected from each participant using a wrist actigraph. Cognitive function assessment included evaluation of attention and executive function using the Trails B test. According to the authors, executive function is the ability for planning or decision making, error correction or trouble shooting, and abstract thinking. Results were adjusted for potential confounding factors such as depressive symptoms, comorbidities and medication use.

The underlying mechanisms relating disturbed sleep to cognitive decline remain unknown, the authors noted. They added that additional research is needed to determine if these associations hold after a longer follow-up period.

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Sleep apnea risk factors

This article discusses different risk factors for obstructive sleep apnea.

Obstructive sleep apnea is a deadly sleep disorder. Those with obstructive sleep apnea may feel lethargic after a good night's sleep or you may snore loudly. But, there are certain risk factors associated with obstructive sleep apnea. We explore these risk factors.

Risk factors of obstructive sleep apnea:

1) Age: Obstructive sleep apnea is mainly associated with age. Those above 60 are prone to obstructive sleep apnea, but there are other risk factors that bring down the age group for sleep apnea.

2) Males: Having the X and Y chromosomes can make you prone to obstructive sleep apnea.Yes, males have a higher chance of developing apnea.

3) Weight: Excessive weight can result in obstructive sleep apnea. Over weight individuals tend to have thicker necks which make it difficult to breath. But obstructive sleep disorder can also affect individuals who are thin.

4) Genes: Family history of obstructive sleep disorder and narrow airway that you may have inherited are risk factors for obstructive sleep apnea.

5) Menopause: Though obstructive sleep apnea is prone to men, it can affect women after their menopause, especially is they are overweight.

6) Difficulty is breathing: Individuals who have nasal congestion and allergies associated with the respiration system are likely to develop obstructive sleep apnea. But it also depends on the breathing with correlation to the above mentioned risk factors.

7) Smoking: Smoking tends to build up water in the upper airway and also results in inflammation of the air way. These are the risk factors of developing obstructive sleep apnea.

8) Relaxed muscles: Sedatives that relaxes the muscles is a risk factor for obstructive sleep apnea.

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Study: Migraine sufferers are twice as likely to also have depression

A study claims that depression is twice as likely in people who suffer from migraines in comparison to those who do not.

People who suffer from migraines are about twice as likely to be depressed and have suicidal thoughts, according to Canadian researchers, who say women and young people with migraines are particularly vulnerable to what Winston Churchill has called “the black dog” of depression.

Researchers at the University of Toronto surveyed more than 67,000 Canadians, over 6,000 of those reporting they had been diagnosed with migraine by a health care professional.

Both women and men with migraine were more than twice as likely to suffer from depression as those without the disease (women: 12.4% vs. 5.7%; men: 8.4% vs. 3.4%).

Serious thoughts of suicide – also known as suicide ideation – were also more common for migraine sufferers (women: 17.6% versus 9.1%; men: 15.6% versus 7.9%). Migraine sufferers under the age of 30 had four times the odds of suicidal ideation than those 65 and over.

Previous studies have also shown a link between migraines, suicide and depression, but this is one of the first to dig deeper and look at other factors associated with the comorbidities.  The study is published online in the journalDepression Research and Treatment.

Among both women and men with migraine, being younger, unmarried, poor, or disabled increased the odds of depression – in some cases dramatically. Single people with migraine were found to have 50% and 70% higher odds of depression and suicidal thoughts.

“The vulnerability of young people with migraine to depression and suicidal ideation is particularly worrying. For both genders, migraineurs under the age of 30 had at least six times the odds of current depression and four times the odds of lifetime suicidal ideation when compared to those aged 65 and above,” wrote lead author Esme Fuller-Thomson, a professor in the Department of Family & Community Medicine, University of Toronto.

“Older migraineurs, by contrast, have had a longer time to adjust to their condition, for example, by learning effective coping mechanisms or achieving adequate treatment, which may reduce the perceived burden of their illness.”

The first onset of migraine is typically experienced in late adolescence and early adulthood. The researchers believe diagnosis of migraine at a young age may interfere with normal developmental processes, such as obtaining an education, building a career, and starting a family.

“We are not sure why younger migraineurs have such a high likelihood of depression and suicidal ideation. It may be that younger people with migraines have not yet managed to find adequate treatment or develop coping mechanisms to minimize pain and the impact of this chronic illness on the rest of their lives,” said study co-author and former graduate student Meghan Schrumm.

The researchers say health care providers treating patients with migraine should be alert to signs of depression, particularly if the patient is younger and single.

“Informing a wider range of health professionals and migraine sufferers themselves about the patterns of depression and suicidal ideation surrounding age, marital status, and activity limitations may help to increase awareness of the comorbidities of migraine and empower migraineurs to come forward with their mental health concerns,” said Fuller-Thomson.

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Concussion symptoms the same for teens and adults

A study claims that concussions symptoms are at the same level of severity for teenagers and young adults.

Whether injured athletes are teens or young adults does not affect the severity of their concussion symptoms, according to a new study. However, differences may still exist in the concussion's aftermath, the researchers say.

Some previous research has raised concerns that high school-age athletes may suffer more severe symptoms after a concussion than college-age athletes, but this study found no evidence of that.

Related symptoms include headache, dizziness, nausea, fatigue, irritability, sleeping difficulties and problems with memory and concentration.

Vanderbilt University School of Medicine researchers compared concussion symptoms in 92 athletes aged 13 to 16 with those of 92 athletes aged 18 to 22. Both groups had 56 percent females and 44 percent males.

No significant differences occurred between the two groups in the number, duration or severity of concussion symptoms, according to the study published online Sept. 24 in the Journal of Neurosurgery: Pediatrics.

Some age-related differences may occur after sports-related concussion, the researchers said. They noted that previous research from the Vanderbilt Sports Concussion Center concluded that age-related differences exist in neurocognitive testing after sports-related concussion.

In evaluating sports-related concussion, it's important to separate different ways of assessing outcomes, study co-author Dr. Scott Zuckerman said in a journal news release. These methods include assessing symptoms, neurocognitive testing, balance problems, school performance and others.

"It appears that symptoms may not be a prominent driver when assessing outcomes of younger versus older athletes. We hope that our study can add insight into the evaluation of youth athletes after sports-related concussion," Zuckerman said in the news release.

The author of an accompanying editorial, Dr. Ann-Christine Duhaime, noted that definitions of concussion are not uniform, its diagnosis is not standardized and it's extremely difficult to match all variable factors in a study of sports-related concussion in different age groups.

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What increases risk for sleep apnea?

This article discusses 8 things and behaviors that can increase a person's risk for sleep apnea.

It used to be that if someone told you you snored, you shrugged it off as more of an annoyance to them than anything telling about your own health and wellbeing.

Today, we have a greater understanding of at least one potential risk of being a frequent snorer: You could have sleep apnea, a potentially harmful sleep disorder during which people stop breathing, sometimes hundreds of times a night.

Obstructive sleep apnea (OSA) is the most common type of sleep apnea, and occurs when the muscles in the back of the throat collapse, causing the opening through which air passes to disappear. (Watch this video for an in-depth explanation of what happens during OSA.)

But certain people are more likely to experience this interruption of breathing than others. We asked Dr. Matthew Mingrone, lead physician for EOS Sleep Centers in California specializing in sleep apnea and snoring issues, to help explain why.

Obesity
Likely the most indicative risk factor is carrying too much extra weight. Obese adults are seven times more likely to develop OSA than their normal-weight peers, according to WebMD. OSA is essentially a blockage of the upper airway, says Mingrone. Part of the tissue running from the nose to the voicebox collapses, cutting off the passage of oxygen. Excess weight adds to the pressure on tube, he says, making the diameter of the opening even smaller than it already is.

Neck Circumference

Obese people aren't the only demographic with larger-than-average necks. Consider the muscular build of professional athletes, for example, who aren't obese but thanks to muscle development are larger than us mere mortals.

Men with a neck circumference greater than 17 inches and women over 15 inches have a higher risk of OSA, WebMD reported.

Age
People of any age can develop sleep apnea, but the condition is more common the older you get, according to the National Heart Lung and Blood Institute. "As we get older, we lose tone and elasticity as part of the normal aging process," says Mingrone. With that natural softening of the tissue in the throat, there's higher likelihood of collapse, he says.

Family History
It's not that you have a genetic predisposition to developing sleep apnea, says Mingrone, like a specific type of cancer that may run in families. Instead, it's likely that you've inherited certain aspects of your physical makeup that increase sleep apnea risk, he says. If Mom's being treated for sleep apnea and you've inherited her narrow jaw, you may have a similar doctor's visit in your future.

Alcohol Use

Because it's a muscle relaxant, alcohol too close to bedtime can lead to episodes of apnea, says Mingrone, even in someone who doesn't have OSA. And in those with the disorder, alcohol can lengthen the duration of apnea episodes, according to the National Institute on Alcohol Abuse and Alcoholism.

Race
Studies show that both sleep apnea risk and sleep apnea severity vary by race. It may be due to anatomical differences in the airways of different ethnic groups, according to Mingrone.

Smoking

Current smokers are 2.5 times more likely to have OSA than smokers and nonsmokers combined, according to a 2001 study. "Smoking most airway tissue swell because it's an irritant," says Mingrone. Swelling in the nose and the throat further reduces the space for air to flow through.

Gender
Middle-aged men are twice as likely to have OSA than women of the same age, according to the American Lung Association. Mingrone says in his practice, about 15 to 20 percent of patients are female. The variance may be due again to anatomical differences, especially since men are simply bigger than women more often than not.

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Why sleep changes as we age

This article discusses why a person's sleep changes as he or she ages and what can be done about it.

As we age, sleep quality can decrease, partly because of normal changes and partly as a consequence of disease, poor habits, and medications.

That's not to say disrupted sleep or insomnia is OK; any problem sleeping should be discussed with your physician or a sleep specialist.

But there are differences between the natural changes we have in our sleep patterns as we age and changes caused by underlying issues that need to be addressed.

It is a normal part of aging, for example, to have an earlier bedtime and have difficulty staying asleep as long as we used to. It also may be normal to have less deep sleep and more awakenings toward the end of sleep. In addition, the diseases we accumulate as we age affect the quality of sleep. And pain from these illnesses and the medications we're taking for them can affect sleep significantly.

But it is not necessarily normal to snore, have pauses in your breathing (apnea), wake up with a headache, sleep fewer than six to seven hours, or have dream-related behaviors (movements that act out your dream). And excessive sleepiness during the daytime, increased irritability, worsened memory, and frequent awakenings or fragmented sleep may all be signs of a sleep disorder and should not be ignored.

In the case of obstructive sleep apnea, which occurs as frequently in the elderly as in the general population, signs may be different and snoring may be less pronounced. Snoring is rarely benign, and when coupled with increased sleepiness during the day or fragmented sleep, may indicate sleep disordered breathing.

In addition, the presence of dream enactment behaviors may increase with aging and can be associated with neurological disease and dementia, such as Parkinson's disease. The movements may seem small and infrequent but they can increase in frequency and may cause injury to you or your bed partner. The emergence of movement during dream sleep, and particularly mimicking the dream, should also be evaluated by your primary physician or a specialist.

Disordered sleeping of any kind, especially in the elderly, can lead to a worsened quality of life, impaired thinking, and exacerbate depression and anxiety.

Of all sleeping problems, insomnia is by far the most common complaint and it is typically not difficulty falling asleep but staying asleep. Changes in the body's natural clock and rhythm tend to cause this and include dampening of the signal and advancing phase, which helps keep us asleep. The result is typically an earlier bedtime with an earlier wake-up time and increasing difficulty staying asleep in the early morning hours.

As with all age groups, there are steps you can take to help make falling asleep and staying asleep easier:

Maintain a regular bedtime and wake time.

Remain active and get exercise every day.

Do not lie in bed trying to fall asleep; if you aren't asleep within 15 minutes, get out of bed and do something quiet and relaxing and try again when sleepy.

Avoid napping during the day.

Limit alcohol and caffeine late in the day.

Limit fluid intake before bedtime.

Keep the bedroom cool, dark, and quiet.

Know how your medications affect sleep.

Seek care if warning signs are present or sleep disturbance persists

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Evidence for generational accumulation of autism seen: Older grandfathers more likely to have grandchild with autism

Research shows that men who have children when they are older are more likely to have a grandchild with autism. This is strong evidence that autism might accumulate over generations.

Men who have children at older ages are more likely to have grandchildren with autism compared to younger grandfathers, according to new research. This is the first time that research has shown that risk factors for autism may accumulate over generations.

The study led by King's College London's Institute of Psychiatry, Karolinska Institutet in Sweden and the Queensland Brain Institute in Australia is published today inJAMA Psychiatry.

By using Swedish national registers, researchers identified 5,936 individuals with autism and 30,923 healthy controls born in Sweden since 1932. They had complete data on each individual's maternal and paternal grandfathers' age of reproduction and details of any psychiatric diagnosis.

The study found that the risk of autism in the grandchild increased the older the age of the grandfather at the time his son or daughter was born. Men who had a daughter when they were 50 or older were 1.79 times more likely to have a grandchild with autism. Men who had a son when they were 50 or older were 1.67 times more likely to have a grandchild with autism, compared to men who had children when they were 20-24.

Dr Avi Reichenberg, from King's Institute of Psychiatry and co-author of the paper says: "We tend to think in terms of the here and now when we talk about the effect of the environment on our genome. For the first time in psychiatry, we show that your father's and grandfather's lifestyle choices can affect you. This doesn't mean that you shouldn't have children if your father was old when he had you, because whilst the risk is increased, it is still small. However, the findings are important in understanding the complex way in which autism develops."

Emma Frans, lead author of the study from Karolinska Institutet says: "We know from previous studies that older paternal age is a risk factor for autism. This study goes beyond that and suggests that older grandpaternal age is also a risk factor for autism, suggesting that risk factors for autism can build up through generations."

In the UK, approximately 1 in 100 adults have an autism spectrum disorder (ASD), with the condition affecting more men than women. The condition affects people in very different ways: some are able to live relatively everyday lives, while others will require a lifetime of specialist support. People with ASD have difficulty communicating with and relating to other people, and making sense of the world around them.

Autism is known to be caused by a combination of genetic and environmental factors. Previous studies have shown that older paternal age is a risk factor for autism in children: fathers aged 50 or older have a more than doubled risk to have a child diagnosed with autism compared to younger fathers.

The mechanism behind this link is unknown, but may be explained by mutations occurring in the male sperm cells. Sperm cells divide over time, and on each division the genome is faced by the possibility of new mutations being introduced.

However, most genetic mutations do not result in the child developing autism. The new findings suggest that these 'silent' mutations are passed on to the otherwise healthy child, but may influence the risk of future generations developing autism. The authors suggest that genetic risk could accumulate over generations, or could interact with other risk factors, until it reaches a threshold resulting in the disorder manifesting itself.

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Youngest Kids in Class May Be More Likely to Get ADHD Diagnosis, Study Claims

A study claims that the youngest children in the class may be incorrectly diagnosed with ADHD and medicated due to a natural lack in maturity.

A new study from Iceland adds to existing evidence that kids are more likely to be diagnosed with attention deficit hyperactivity disorder if they're among the youngest in their grade at school.

The findings suggest -- but don't prove -- that some children are diagnosed with attention deficit hyperactivity disorder (ADHD) when they're just less mature than their peers.

"Educators and health-care providers should take children's ages in relation to their [classmates] into account when evaluating academic performance and other criteria for ADHD diagnosis," said study author Helga Zoega, a postdoctoral fellow at Mount Sinai School of Medicine in New York City. "Parents can use these findings to help inform their decisions about school readiness for children born close to cutoff dates for school entry."

Debate has erupted in recent years about whether ADHD is overdiagnosed in children who are naturally rambunctious and don't need to be medicated.

Earlier this year, a Canadian study found that more boys aged 6 to 12 were diagnosed with ADHD if they were the youngest in their grade levels: the percentages were 7.4 percent among the youngest boys and 5.7 percent among the oldest.

There also was a gap between older and younger girls, although they're much less likely than boys to be diagnosed with ADHD.

The new study tracked nearly 12,000 children born between 1994 and 1996 in Iceland, where there's also been a debate over the diagnosis of the condition and the use of stimulants to treat it, Zoega said. The researchers looked at the children's test scores at ages 9 and 12, and examined whether they were prescribed drugs for ADHD.

Overall, 740 children -- about 6 percent of the total -- were prescribed ADHD drugs at some point from 2003 to 2009.

Children in the youngest third of their classes were 50 percent more likely than those in the oldest third to be prescribed ADHD medications from ages 7 to 14.

The study also found that "being younger relative to one's classmates affects academic performance throughout childhood," Zoega said.

Richard Morrow, a health research analyst at the University of British Columbia who studies ADHD, said the findings are consistent with those from other countries.

"In the education system, it leads to the question, 'What strategies or resources do we need to help ensure the well-being of all children in the classroom, where children vary in age by up to a year?' " he asked. "Parents need to be aware that if behavioral issues arise for their child, this may be related to their child's relative age in the classroom.

"Similarly, doctors need to consider a child's relative age in school or other settings such as athletics before making a diagnosis or writing a prescription," Morrow added. "Lastly, we may need to revisit how the diagnosis is defined to lessen the risk of inappropriate diagnosis."

The findings appear online Nov. 19 and in the December print issue of the journal Pediatrics.

So what can be done?

"Children behave and perform according to their own maturity level within the classroom," Zoega said. "Being younger relative to one's classmates affects academic performance throughout childhood. When evaluating whether a child has ADHD, this should be taken into account to prevent unnecessary diagnoses and prescribing of stimulants."

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Study: High rates of sleep apnea in women

New research shows that sleep apnea has a high rate in women. This is surprising since sleep apnea is usually thought to be predominantly in males.

New research from Umeå and Uppsala universities has found high rates of sleep apnea in women, despite the condition usually being regarded as a disorder predominantly of males.

The study, published online ahead of print August 16 in the European Respiratory Journal, also suggested that women with hypertension and/or obesity were more likely to experience sleep apnea.

Obstructive sleep apnea is a condition in which there are frequent pauses in breathing during sleep. The incidence of the condition increases with age and it is considered more prevalent in men than in women. In this new study, researchers from Uppsala and Umeå University in Sweden aimed to investigate the frequency and risk factors of sleep apnea in women.

The study analysed 400 women from a random sample of 10,000 women aged 20-70 years. The participants answered a questionnaire and underwent a sleep examination.

The results found that obstructive sleep apnea was present in 50% of women aged 20-70 years. The researchers also found links between age, obesity and hypertension: 80% of women with hypertension and 84% of obese women suffered from sleep apnea.

Additionally, severe sleep apnea was present in 31% of obese women aged 55-70 years old.

Lead author Dr Karl Franklin said: "We were very surprised to find such a high occurrence of sleep apnea in women, as it is traditionally thought of as a male disorder. These findings suggest that clinicians should be particularly aware of the association between sleep apnea and obesity and hypertension, in order to identify patients who could also be suffering from the sleeping disorder."

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