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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Study: No Link Between Flu Vaccine and Epileptic Seizures

This article discusses how no link was found between the H1N1 Influenza vaccine and the development of epilepsy or seizures.

Epileptics are often encouraged to receive flu vaccines because the risk of seizure increases when a patient has the flu. With more focus recently on vaccine safety and side effects, many are wondering if this preventative measure could actually make conditions worse.

A recent study looked at the risk of epileptic seizures after receiving the vaccine for the H1N1 flu. The study found no evidence of patients having more seizures after vaccination.

Lisen Arnheim-Dahlstrom, PhD, and colleagues from the Karolinska Institute in Stockholm, Sweden examined 373,398 people who received a version of the H1N1 vaccine, Pandemrix, in three counties in Sweden.

Pandemrix was developed by GlaxoSmithKline and began being distributed for the H1N1 flu in October 2009. It was one of four authorized vaccines used during the 2009 flu pandemic known as the swine flu.

The safety of Pandemrix drew attention when cases of narcolepsy occurred in children and teenagers after receiving the vaccine. In addition, the European Medicines Agency (EMA) received reports of epileptic seizures occurring after vaccination.

These reports made further investigation of the drug necessary.

The researchers were able to access records for the 373,398 through the Swedish vaccination register, a database of all vaccinations in Sweden. The patient’s unique personal identification number was then used to look up histories of epilepsy andantiepileptic drugs in other registries.

Within the study population, 7,787 people were considered epileptic during the year before the study and 356,611 were not.

Dr. Arnheim-Dahlstrom and team determined how many of the total study population experienced at least one epileptic seizure during the time period of 90 days before vaccination to 90 days after vaccination. During this 180 day period surrounding the vaccination, 859 people experienced epileptic seizures.

For those previously diagnosed with epilepsy, there was no increase in risk of seizures during the first week after vaccination. During this week, there was an insignificant decrease in risk of seizure for people without epilepsy.

From day 8 to day 30 after the vaccination, there was no increase in risk of seizure for those diagnosed with epilepsy. There was an insignificant increased risk of seizures in people without epilepsy during this time period.

These results dismiss safety concerns with Pandemrix for those with epilepsy.

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Study: Link found between flu during pregnancy and infant autism

A study from Denmark examines a link between having the flu or prolonged fever during pregnancy and the chance of the infant having autism.

An epidemiologic study from Denmark has raised the possibility that influenza and fever during pregnancy increase the risk of autism in infants, but the findings are far from conclusive.

The researchers studied the records of more than 96,000 children and interviewed their mothers about infections during pregnancy. About 1% of those children had autism spectrum disorder (ASD) or infantile autism. The researchers found signs that flu during pregnancy doubled the risk of infantile autism and that prolonged fever during pregnancy tripled it.

But because they assessed so many pregnancy-related variables, they said those findings could have shown up merely by chance, and much more research is needed. Their report was published online yesterday by Pediatrics.

Clue from animal studies
Evidence from animal studies suggests that activation of the immune system during pregnancy can cause problems with brain development in fetuses, the report says. Hence the research team set out to assess whether common infections, febrile episodes, or use of antibiotics during pregnancy were associated with a risk of ASD or autism in babies.

Using the Danish national birth cohort and the Danish Psychiatric Central Register, the team examined data on 96,736 children born from 1997 to 2003. In telephone interviews they questioned the children's mothers about infections, febrile episodes, and antibiotic use during pregnancy and the early postpartum period. The questions covered 11 types of infections and symptoms and five classes of antibiotics.

The team found that 976 (1%) of the children had ASD, including 342 (0.4%) with infantile autism.

The researchers found no significant associations between overall ASD and specific types of infections. But when they looked at infantile autism only, they found that flu during pregnancy was associated with a 2.3-fold increase in risk (adjusted hazard ratio, 2.3; 95% confidence interval [CI], 1.0 to 5.3).

Similarly, febrile episodes in general were not associated with any increase in risk of ASD or autism. But febrile episodes longer than 7 days were associated with a 1.6-fold increase in the risk of ASD (95% CI, 1.0 to 2.5) and a 3.2-fold jump in the risk of infantile autism (95% CI, 1.8 to 5.6).

The analysis also linked the use of various antibiotics during pregnancy with a small increase in risk of ASD or infantile autism. The use of sulfonamides or penicillin raised the risk by about 50%, and the use of macrolides increased the risk of infantile autism 2.2-fold (95% CI, 1.1 to 4.4).

A major qualifier
But the researchers take pains to explain that these hints of associations could be pure chance findings rather than evidence of a real connection.

"A great limitation of this study is that we made 106 adjusted comparisons; thus, the few statistically significant associations observed could be chance findings," they state. "The study is explorative, and we thus made no adjustments for multiple testing."

In fact, they add, "None of the statistically significant findings would have survived any correction for multiple comparisons."

Their overall conclusion is that there was little evidence that self-reported common infections during pregnancy are risk factors for ASD in children. On the other hand, the findings alone do not rule out a possible association. "We emphasize the need for further research on this important topic," the report concludes.

Andrew T. Pavia, MD, chief of the Division of Pediatric Infectious Diseases at the University of Utah, agreed with the authors' caveats about their findings.

"This is an interesting study, but at best exploratory," Pavia commented by e-mail. "In addition to being exploratory, the major limitation is statistical. As the authors point out, the associations they found were just marginally statistically significant in the way they approached the analysis, meaning there would be about a 5% chance of finding an association by chance alone when there was in fact no association."

Pavia said the problem of multiple comparisons makes the findings "relatively unreliable," although the topic deserves more research.

"In essence the problem of multiple comparisons is that if you look at 20 random variables (cystitis, penicillin, herpes outbreaks, etc) then on average you will find one association by chance alone with a 'statistically significant' P value of 0.05," he said. "The authors looked at 106 variables, which suggested that on average they would find 5 significant associations that were due to chance alone. They found about that [many]."

He added that the relatively wide confidence intervals noted in the findings, with lower limits as low as 1.0, support the possibility that they could have occurred by chance.

Pavia also commented, "This type of epidemiological study may eventually point us in the right direction, but no single study can be taken alone. This is analogous to some of the studies of heart disease and diet, where depending on the study and the methods, a given food may or may not appear to be associated with disease. Epidemiologists understand this, but when the public hears about each study with a weak effect, it becomes pretty chaotic."

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Neurological conditions increase flu risk

Doctors should be alert to the possibility of influenza among children and young adults with neurological and neurodevelopmental conditions, U.S. officials say.

A study published in the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report

describes the findings of a joint investigation between the CDC and the Ohio Department of Health into an outbreak of influenza in a residential facility for children and young adults with neurological and neurodevelopmental conditions.

"Among 130 residents of the facility, 58 percent developed respiratory illness in February 2011; 13 became severely ill and seven of those patients died," the report said. "All 13 severely ill residents had multiple neurological and neurodevelopmental conditions, and their underlying medical conditions might have hindered early diagnosis and treatment and contributed to the severity of illness."

Because those with neurological and neurodevelopmental disorders are at high risk for complications from influenza, vaccination should be part of a larger program of influenza prevention that includes antiviral drugs that are given early in the course of illness -- ideally within 48 hours of symptom onset, the report said.

Read more: http://www.upi.com/Health_News/2012/01/06/Neurological-conditions-increase-flu-risk/UPI-51281325829521/#ixzz1jJNbmkYT

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