Cognitive behavioral therapy showed to help with insomnia, even with other health conditions

A study shows that talk therapy, specifically cognitive behavioral therapy, helps people with insomnia, even if they have other health conditions.

Talk therapy may help treat insomnia in people with physical or mental health problems, a new study suggests.

With cognitive behavioral therapy, people talk with a therapist to identify the negative thoughts and feelings that cause them problems, and to learn ways to solve their problems, according to the U.S. National Institute of Mental Health.

Past studies have found cognitive behavioral therapy for insomnia can improve sleep. But, many of those studies didn't include people with psychiatric and medical conditions.

For the new study, researchers from Rush University Medical Center in Chicago looked at 37 previous studies. The research included nearly 2,200 people and looked at cognitive behavioral therapy for insomnia in people who had depression, alcoholism and post-traumatic stress disorder and/or with medical conditions such as cancer, chronic pain and fibromyalgia.

The new analysis showed that cognitive behavioral therapy for insomnia reduced insomnia symptoms and sleep disturbances. Twice as many people who received the therapy no longer had insomnia, compared to people who didn't have the therapy, the researchers said.

Cognitive behavioral therapy was also associated with positive effects on co-existing psychiatric and medical conditions, but it showed the strongest benefit with psychiatric disorders.

This may be due to a stronger link between psychiatric disorders and insomnia, the researchers said.

The findings provide support for using talk therapy as a treatment for insomnia in people who have other psychiatric conditions, study author Jason Ong, a behavioral sleep medicine specialist at Rush University Medical Center, and colleagues concluded in a university news release.

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The link between sleep and children's mental health is...complicated...

A study indicates that a link exists between children with sleep disorders and their mental health.

Toddlers who take a long time to fall asleep or wake up many times during the night have put many a desperate mom and dad to the test. Tired parents are often told that night waking is part of toddlerhood, and that it will soon pass on its own, but this is not the case for everyone.

Researchers at NTNU's Department of Psychology have conducted a comprehensive survey of nearly 1,000 toddlers that shows that serious sleep disorders in young children can have long-term consequences.

The study shows that four-year-olds with sleep disorders have a higher risk of developing symptoms of psychiatric problems as six-year-olds, compared with children who sleep soundly.

At the same time, four-year-olds with psychiatric symptoms have a greater risk of developing a sleep disorder as six-year-olds, compared with children who do not have these kind of symptoms.

Reciprocal relationship

"It is common for children to have periods when they sleep poorly, but for some children, the problems are so extensive that they constitute a sleep disorder. Our research shows that it is important to identify children with sleep disorders, so that remedial measures can be taken. Sleeping badly or too little affects a child's day-to-day functioning, but we are seeing that there are also long term repercussions," says Silje Steinsbekk, an Associate Professor and Psychologist in NTNU's Department of Psychology.

Her previous research on the relationship between sleep disorders and psychological problems in children has shown that four-year-olds with sleep disorders often also show symptoms of psychiatric problems.

The new study, which was recently published in the Journal of Developmental & Behavioral Pediatrics, shows that the correlation between sleep disorders and psychiatric disorders is also found over time and that the relationship is reciprocal.

Thorough interviews and diagnoses

We know that 20-40 per cent of young children struggle with sleep in one way or another, but we lack data on how many of them are suffering from a diagnosable sleep disorder.

NTNU researchers conducted diagnostic interviews with the parents of the children participating in the study. The interview was based on the DSM-IV diagnostic manual, which contains the official diagnostic criteria for mental disorders.

One thousand four-year-olds participated in the study. Parents of around 800 of these children were interviewed again two years later. The comprehensive study is part of a longitudinal study in Trondheim that examines the incidence, progression and risk factors for the development of mental health problems in children. The project conducts follow-up visits with the children and their parents every other year.

"Previous studies of sleep problems in children have mainly used a questionnaire format, with questions like, "Does your child have trouble sleeping?" But what parents define as sleep problems will vary. In the diagnostic interview we ask parents questions until we are confident that we have enough information to assess whether a symptom is present or not. The information we've collected is more reliable than information obtained from the questionnaire," says Steinsbekk.

What comes first?

Can we say that poor sleep causes psychiatric problems -- or do psychiatric problems cause poor sleep? The findings from the study suggest that the relationship goes both ways.

One possible explanation for this reciprocity may be that both conditions are biologically determined, by common underlying genetics, for example.

Another explanation may be that insufficient sleep creates general functional impairment, and that the risk of other problems therefore increases -- in the same way that psychiatric symptoms often result in poorer everyday functioning, which in turn may negatively affect sleep.

Vicious cycle

Perhaps sleep disorders and mental health issues share the same risk factors. A child who shows signs of anxiety or a behavioural disorder may easily end up in a vicious cycle, where conflict with adults triggers anxiety and in turn leads to trouble falling asleep.

It may also be that difficult and negative thoughts steal both energy and sleep and make us restless and depressed if we fail to gain control over them.

"Given that so many children suffer from insomnia, and only just over half 'outgrow it,' it is critical for us to be able to provide thorough identification and good treatment. Perhaps early treatment of mental health problems can also prevent the development of sleep disorders, since psychiatric symptoms increase the risk of developing insomnia," says Steinsbekk, stressing that this is something that must be examined in further research.

Insomnia is most prevalent The study shows that insomnia is the most prevalent sleep disorder. Children who suffer from insomnia struggle with falling asleep and frequent waking. Insomnia was diagnosed in 16.6 per cent of the four-year-olds surveyed, and 43 per cent of these still had insomnia as six- year olds.

Insomnia in four-year olds increases the risk for symptoms of anxiety, depression, ADHD and behavioural problems as six-year-olds. After the researchers had taken into account the children's psychiatric symptoms at age four, the relationship between insomnia and ADHD disappeared.

Similarly, children who show symptoms of anxiety, depression, ADHD and behavioural disturbances as four-year-olds have a greater risk of developing insomnia as six-year-olds. When symptoms of insomnia at age four were adjusted for, the relationship between insomnia and anxiety disappeared.

Examples of other types of sleep disorders are hypersomnia, i.e. an extreme urge to sleep, and various cases of parasomnia, such as nightmares, night terrors and sleepwalking. These conditions are uncommon, and the study also shows that, with the exception of sleepwalking, they are shorter-lived.

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Poor sleep affects you over a lifetime

New research indicates that poor sleep not only affects you the next day, but over a lifetime.

A poor night's sleep can affect performance at work the next day, but over time, could disrupted sleep affect brain function in a permanent way? New evidence suggests it could.

A new study found that patients with issues like sleep apnea or heavy snoring developed problems with cognition around 10 years earlier than those without sleep-breathing troubles.

"Abnormal breathing patterns during sleep such as heavy snoring and sleep apnea are common in the elderly, affecting about 52 percent of men and 26 percent of women," explained the study's lead author, Ricardo S. Osorio, M.D., of the NYU School of Medicine in New York, in a press release.

In sleep apnea, breathing starts and stops repeatedly over the course of the night. Osorio and team wanted to see whether sleep apnea and other abnormal breathing patterns (called sleep-disordered breathing) were tied to cognitive issues.

To do so, these researchers looked at data from the Alzheimer’s Disease Neuroimaging Initiative, which involved over 2,000 adults between the ages of 55 and 90. Some patients had no cognitive problems, while some developed Alzheimer's disease or mild cognitive impairment (MCI). In MCI, cognitive issues have developed beyond what is expected in normal aging but not far enough to be considered dementia.

Osorio and team found that patients who had sleep-disordered breathing started showing signs of cognitive problems an average of 10 years earlier than those who did not have issues with abnormal breathing patterns during sleep.

When looking only at patients with cognitive issues, those with sleep-disordered breathing started showing signs of MCI at an average age of 77. The same was true for those without the breathing troubles at an average age of 90.

In this group of patients, Alzheimer's disease was also seen earlier -- at an average age of 83 among those with sleep-disordered breathing, compared to an average age of 88 among those without breathing issues.

Osorio and team also looked at the effects of treating abnormal breathing patterns with continuous positive airway pressure (CPAP). CPAP delivers air pressure through a mask during sleep, helping to keep the airways open.

Treatment with CPAP seemed to reduce the risk of developing cognitive issues earlier, Osorio and colleagues found. Patients who used CPAP developed MCI at an average age of 82, compared to an average age of 72 among those who did not receive treatment for their sleep-disordered breathing.

"These findings were made in an observational study and as such, do not indicate a cause-and-effect relationship,” Osorio noted. “However, we are now focusing our research on CPAP treatment and memory and thinking decline over decades, as well as looking specifically at markers of brain cell death and deterioration.”

This study was published online April 15 in the journal Neurology.

Several study authors received industry support within the past two years and held patents involving procedures related to the study. A number of groups funded this research, such as the Foundation for Research in Sleep Disorders and the Alzheimer’s Disease Neuroimaging Initiative.

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Link between mental illness and sleep aid use

A possible link exists between mental illness and using sleep aids.

In today's "always on," high-stress world, it has become commonplace to turn to over-the-counter sleep aids for a little help with drifting off into dreamland at night. However, that habit, if made a consistent one, could lead to potentially serious damage when it comes to ones mental health.

A new study zeroing in on anticholinergic drugs -- a category that includes common non-prescription sleeping aids and antihistamines like Benadryl -- found that the long-term use of such medications in higher doses can lead to an increased risk of developing dementia, including Alzheimer's disease, in the future. It's the first study of its kind to prove this dose-response effect, meaning that the higher, cumulative consumption of the drug, the higher the likelihood of a person developing dementia later in life. It's also the first to suggest that this dementia risk may persist -- and be irreversible -- even years after people have stopped taking these drugs. The study was published in JAMA Internal Medicine in late January.

Dr. Shelly Gray, a professor at the University of Washington's School of Pharmacy and lead author of this study, originally intended to disprove this association that had been researched previously and published last year with her more rigorous study design, she told The Huffington Post. Dr. Gray and her colleagues tracked approximately 3,5000 men and women aged 65 and older who exhibited no dementia symptoms at the beginning of the study. Each participant was part of the joint Group Health–University of Washington study funded by the National Institute on Aging, which made it more efficient for them to track exposure to anticholinergic drugs via each person's pharmacy computer records.

Anticholinergics, which block the neurotransmitter acetylcholine in the brain and body, are typically taken to address gastrointestinal problems, urinary issues, respiratory disorders and insomnia, with side effects ranging from drowsiness to constipation urine retention to dry mouth.

Using more rigorous methods, a follow-up period extending beyond seven years, a more thorough assessment of pharmacy records regarding the medication use (both prescription and over-the-counter options), Dr. Gray's team was better able toconfirm this link between anticholinergic medication use and mental illness.

The pharmacy data allowed Dr. Gray and her team to calculate the standard daily medication doses of each study participant as well as their cumulative exposure to anticholinergics over a 10-year period. Over the course of the study, almost 800 participants developed a degree of dementia. The pharmacy data also revealed themost common medications (and daily doses) used by the group of participants: antidepressants (10 mg per day of doxepin), first-generation antihistamines (4mg per day of chlorpheniramine) and antimuscarinics for bladder control (5 mg per day of oxybutynin). They estimated that the use of such amounts for more than three years could result in a greater risk of developing dementia.

According to Dr. Gray, substitutes are available for the first two medications in this list. A selective serotonin re-uptake inhibitor like citalopram or fluoxitene can aide depression symptoms, while a second-generation antihistamine like loratadine can address allergies without the harmful, anticholinergic exposure. However, it can be more difficult to find an effective alternative for for urinary incontinence.

Dr. Gray hopes that this study will help inform older adults that many common medications have strong anticholinergic effects and come with a degree of risk when it comes to their mental health. However, for adults who are already taking drugs found to be problematic in this study, it's important to talk to your physician before terminating any medicinal regimen, as well as inform them of the over-the-counter drugs you take -- no matter how mainstream and benign they may seem.

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Military members and sleep problems

This article discusses the importance of sleep for members of the military, especially post-deployment.

Improving the quality and quantity of U.S. military members' sleep following deployment could help reduce other health problems, including depression and post-traumatic stress disorder, according to a new RAND Corporation study.

However, a lack of consistent and transparent sleep-related policies may impede efforts to promote sleep health among service members, researchers say.

"The U.S. military has shifted from combat operations in Iraq and Afghanistan toward helping service members and veterans reintegrate into noncombat roles," said Wendy Troxel, co-leader of the study and a behavioral scientist at RAND, a nonprofit research organization. "One issue that is often overlooked once military men and women return home is that of persistent sleep problems, because in many ways such problems are viewed as endemic to military culture."

Sleep disturbances are a common reaction to stress and are linked to a host of physical and mental health problems. Sleep problems often follow a chronic course, persisting long after service members return home from combat, with consequences for their reintegration and the readiness and resiliency of the force, researchers say.

The RAND report is the first comprehensive review of sleep-related policies and programs across the U.S. Department of Defense, examining the frequency of sleep disorders and factors that contribute to the problem. A survey of nearly 2,000 service members from all branches of the U.S. military found sleep problems had negative effects on mental health, daytime functioning and perceived operational readiness.

"Military policies on prevention of sleep problems are lacking, and medical policies focus on treating mental disorders that are often linked with sleep problems, instead of sleep itself," said Regina Shih, project co-leader and a senior social scientist at RAND. "We know that sleep problems may precede the onset of mental disorders."

While there may be stigma about seeking sleep treatment, it may be lower than the stigma associated with seeking help for mental health problems. Researchers say this suggests sleep could be a gateway to improving psychological health and readiness in service members.

Researchers say that historically, military cultural attitudes have tended to discount the importance of sleep. For example, service members noted that depriving oneself of sleep is often seen as a badge of honor and acknowledging the need for sleep can be seen as a sign of weakness.

The study recommends widespread education and awareness programs within the Defense Department as one means of shifting these cultural attitudes. In operational contexts, the military emphasizes mission first and the need for sleep may be sacrificed for operational demands. Policies are needed to educate service members and leaders about the importance of sleep, including awareness on the importance of sleep for resilience.

Leaders are not always sure how to develop and execute sleep plans that can balance circadian rhythms with the realities of operational environments, or how to allow for adequate recovery periods after extended sleep deprivation in order to optimize force readiness.

The RAND study presents 16 policy recommendations to help the military improve the prevention, identification and treatment of sleep problems in service members. Those policies fall under four broad categories: prevention of sleep problems; increasing identification and diagnosis of sleep problems; ways to clinically manage sleep disorders and promote sleep health; and ways to improve sleep in training and operational contexts.

The report can be found online at:http://www.rand.org/pubs/research_reports/RR739.html

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Getting to bed early helps mental health

Going to sleep early can help a person's mental health.

There are many benefits of going to bed early- and now, a team of researchers have found how this teeny tiny habit could have a positive impact on not just your physical health, but mental health as well.

Researchers from Binghamton University have found a possible connection between sleeping disorders and anxiety. It has been found that depression, anxiety, stress and obsessive compulsive disorders may cause heavy psychological traffic that could have an individual clinging too much to the past.

This new study, which took into consideration one hundred young adults, asked them to fill out questionnaires and carry out certain computerized tasks while the researchers assessed the extent of their obsessive behavior and thinking and worrying with respect to it. The study subject included individuals having different sleeping habits- some of them were night owls, while others had regular sleeping hours.

They found that individuals who slept less or went to bed late had signs of negative thinking as compared to those who slept early. While repetitive negative thinking isn’t a disorder as such, it does increase the risk of several anxiety disorders including depression and stress.

While the reason behind this phenomenon is unclear, scientists are making assumptions to decode it all. They have noted that sleeping late at night tends to disrupt the biological clock of the body, which also plays a negative impact on the levels of certain chemicals in our body.

These kinds of irregular sleeping patterns tend to upset the chemical production in the brain as well as other organs, even if you manage to get your much needed 8 hours of sleep a day.

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Sleep issues in children with mental health diagnoses

Sleep issues are common among children with mental health diagnoses, and may go undiagnosed due to the co-existing conditions.

Sleep difficulties, particularly problems falling asleep, are common among toddlers and preschoolers with mental health issues, according to a new study.

"Sleep problems in young children frequently co-occur with other behavioral problems, with evidence that inadequate sleep is associated with daytime sleepiness, less optimal preschool adjustment, and problems of irritability, hyperactivity and attention," said the study's leader, John Boekamp, clinical director of the pediatric partial hospital program at Bradley Hospital in Providence, R.I.

However, he said, sleep disorders may be unrecognized and underdiagnosed in young children, particularly when behavioral or emotional problems are present.

The study, published online in Child Psychiatry & Human Development, involved 183 children aged 6 years or younger receiving outpatient treatment for psychiatric problems. The researchers examined the prevalence of sleep disorders among these children and the nature of the sleep problems.

"The most common sleep difficulties reported nationally for toddlers and preschoolers are problems of going to bed, falling asleep and frequent night awakenings. Collectively, these problems are referred to as behavioral insomnias of childhood," said Boekamp in a hospital news release.

Recognized sleep disorders, particularly sleep onset insomnia, were more common than expected, the researchers found. Overall, 41 percent of children in the study met the criteria to diagnose a sleep disorder.

Sleep problems were most common in kids with disruptive behavior, and attention, anxiety and mood problems, the researchers found.

Early sleep problems could not only be the result of behavioral and emotional problems, but could also contribute to them, the researchers noted.

"Essentially, these young children might be caught in a cycle, with sleep disruption affecting their psychiatric symptoms, and psychiatric symptoms affecting their sleep-wake organization," said Boekamp. "It is important for families to be aware of how important sleep is to the behavioral adjustment and well-being of young children."

Sleep problems can complicate treatment for challenging behaviors, such as aggression and attention and mood problems. Daytime sleepiness and fatigue can make these problems even worse, the study's authors noted.

"This study is a great reminder that it's critical for mental health providers working with young children and their families to ask about children's sleep," said Boekamp.

"Simple questions about children's sleep patterns, including how long it takes a child to fall asleep at night and how frequently a child awakens after falling asleep, may yield important information that is relevant to clinical care, even when sleep problems are not the primary focus of treatment," he explained.

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Sleep necessary for mental health and well-being

This article discusses how crucial good sleep is for a person's mental health and well-being, and the consequences of not having good quality sleep.

Having a good quality and restorative sleep is essential for one to be able to function well throughout the day. Failure to do so will lead to numerous impacts to health, both long- and short-term.

According to the Sleep Disorder Society Malaysia (SDSM) president Dr Muhammad Muhsin Ahmad Zahari, some of the short-term negative impacts include short attention span, memory recall and learning; while its long-term effects have long been associated with hypertension, ischaemic heart disease, stroke, obesity, diabetes, weakened immune system, and cancer.

Dr Muhammad Muhsin added that sleep disorder can also increase the risk of accidents.

"People who suffer from insomnia are seven times more likely to become involved in an accident which then resulted in death or serious injury," he said at the launch of the `World Sleep Day Celebration and Sleep 2014 Conference' at Cititel Hotel, here, today.

He revealed that sleep disorder actually constitute a global epidemic that threatens health and quality of life for up to 45% of the world's population, thus it is essential for everyone to have a better understanding of sleep conditions.

"Sleep is a basic human need and it is crucial not only to our health and well-being, it also plays an important role in the metabolic regulation in children," said Dr Muhammad adding that SDSM is working closely with the relevant authorities, associations and organisations in improving the quality of service of sleep medicine.

"With regards to the quality service in sleep medicine, facilities such as sleep laboratory are vital. As our population grows, there is definitely a need to increase the number of sleep laboratory in public hospitals to cater to the need of the people." he added.

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Autism not related to mother's antidepressant use

A large study has shown that a mother's antidepressant use while pregnant is not linked to her child having autism.

Despite some concerns to the contrary, children whose moms used antidepressants during pregnancy do not appear to be at increased risk of autism, a large new Danish study suggests.

The results, published Dec. 19 in the New England Journal of Medicine, offer some reassurance, experts said.

There have been some hints that antidepressants called selective serotonin reuptake inhibitors (SSRIs) could be linked to autism. SSRIs are the "first-line" drug against depression, and include medications such as fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa) and paroxetine (Paxil).

In one recent U.S. study, mothers' SSRI use during pregnancy was tied to a twofold increase in the odds that her child would have autism. A Swedish study saw a similar pattern, though the risk linked to the drugs was smaller.

But both studies included only small numbers of children who had autism and were exposed to antidepressants in the womb.

The new study is "the largest to date" to look at the issue, using records for more than 600,000 children born in Denmark, said lead researcher Anders Hviid, of the Statens Serum Institute in Copenhagen.

And overall, his team found, there was no clear link between SSRI use during pregnancy and children's autism risk.

Hviid cautioned that the finding is still based on a small number of children who had autism and prenatal exposure to an SSRI -- 52, to be exact. The researchers noted that it's not possible to rule out a small increase in autism risk.

But, Hviid said, "at this point, I do not think this potential association should feature prominently when evaluating the risks and benefits of SSRI use in pregnancy."

Commenting on the findings, Christina Chambers, director of the Center for the Promotion of Maternal Health and Infant Development at the University of California, San Diego, stated, "I think this study is reassuring."

One "important" point, Chambers added, is that the researchers factored in mothers' mental health diagnoses -- which ranged from depression to eating disorders to schizophrenia.

"How much of the risk is related to the medication, and how much is related to the underlying condition?" Chambers said. "It's hard to tease out."

In theory, she noted, depression or other mental health disorders could contribute to autism risk because those moms may be more likely to make unhealthy lifestyle choices, such as smoking or drinking.

In this study, Hviid's team did initially see a slightly increased risk of autism among children whose mothers used SSRIs during pregnancy. But once the researchers factored in the psychiatric disorders themselves, that statistical link fell away.

On top of that, there was a slight increase in autism risk among children whose mothers had used an SSRI in the two years before pregnancy, but not during pregnancy.

Hviid said that all suggests it's the underlying conditions, rather than the drugs, that are associated with a small autism risk -- though the reasons, he added, are unknown.

The study, which was funded by the Danish government, is based on records from Denmark's national system of health databases. Of nearly 627,000 children born between 1996 and 2005, just under 3,900 were later diagnosed with autism.

Among those children, 52 were born to mothers who filled an SSRI prescription during pregnancy. There were just over 6,000 other children whose mothers used the antidepressants during pregnancy but did not develop autism.

Both Hviid and Chambers said the findings do not prove that SSRIs carry no autism risk. And a connection is biologically plausible, Hviid said.

No one knows what causes autism, which affects an estimated one in 88 children. But it involves a disruption in fetal brain development. It's thought that serotonin -- the chemical that SSRIs target -- contributes to early brain development, and in animals, altered serotonin levels can affect brain function and behavior.

"It's still worthwhile to continue to study this," Chambers said.

But, she added, based on the human studies so far, "if there is any increased risk of autism, it appears small."

And for any one woman, Chambers said, that possible risk would have to be balanced against the risks of leaving major depression untreated.

"For some women, the optimal situation may be to take an SSRI, even if there is an association [with autism]," Chambers said.

Hviid agreed, saying that's a decision that has to be left up to women and their health care provider.

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Social status can change brain activity

A person's social status can alter their brain activity as well as their physical and mental health.

 New studies released today reveal links between social status and specific brain structures and activity, particularly in the context of social stress. The findings were presented at Neuroscience 2013, the annual meeting of the Society for Neuroscience and the world's largest source of emerging news about brain science and health.

Using human and animal models, these studies may help explain why position in social hierarchies strongly influences decision-making, motivation, and altruism, as well as physical and mental health. Understanding social decision-making and social ladders may also aid strategies to enhance cooperation and could be applied to everyday situations from the classroom to the boardroom.

Today's new findings show that:

• Adult rats living in disrupted environments produce fewer new brain cells than rats in stable societies, supporting theories that unstable conditions impair mental health and cognition
• People who have many friends have certain brain regions that are bigger and better connected than those with fewer friends. It's unknown whether their brains were predisposed to social engagement or whether larger social networks prompted brain development
• In situations where monkeys can potentially cooperate to improve their mutual reward, certain groups of brain cells work to accurately predict the responses of other monkeys
• Following extreme social stress, enhancing brain changes associated with depression can have an anti-depressant effect in mice

Other recent findings discussed show that:

• Defeats heighten sensitivity to social hierarchies and may exacerbate brain activity related to social anxiety

"Social subordination and social instability have been associated with an increased incidence of mental illness in humans," said press conference moderator Larry Young, PhD, of Emory University, an expert in brain functions involved with social behavior. "We now have a better picture of how these situations impact the brain. While this information could lead to new treatments, it also calls on us to evaluate how we construct social hierarchies -- whether in the workplace or school -- and their impacts on human well-being."

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Study: Moderate exercise prevents depression

Research shows that exercise can both prevent and treat depression. 

Physical activity is being increasingly recognized as an effective tool to treat depression. PhD candidate George Mammen's review published in the October issue of theAmerican Journal of Preventive Medicine has taken the connection one step further, finding that moderate exercise can actually prevent episodes of depression in the long term.

This is the first longitudinal review to focus exclusively on the role that exercise plays in maintaining good mental health and preventing the onset of depression later in life.

Mammen -- who is supervised by Professor Guy Faulkner, a co-author of the review -- analyzed over 26 years' worth of research findings to discover that even low levels of physical activity (walking and gardening for 20-30 minutes a day) can ward off depression in people of all age groups.

Mammen's findings come at a time when mental health experts want to expand their approach beyond treating depression with costly prescription medication. "We need a prevention strategy now more than ever," he says. "Our health system is taxed. We need to shift focus and look for ways to fend off depression from the start."

Mammen acknowledges that other factors influence a person's likelihood of experiencing depression, including their genetic makeup. But he says that the scope of research he assessed demonstrates that regardless of individual predispositions, there's a clear take-away for everyone. "It's definitely worth taking note that if you're currently active, you should sustain it. If you're not physically active, you should initiate the habit. This review shows promising evidence that the impact of being active goes far beyond the physical."

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Link between sleep apnea and mental illness

This article discusses the interesting link that exists between sleep apnea and mental illnesses such as depression and bipolar disorder.

With bipolar disorder cropping up from celebrities to politicians, you may be wondering what truly affects these individuals. Yes, a mental illness is typically a misfire of chemical and electrical  waves within the brain. Nevertheless, is there another, underlying cause? One cause can point to a varying disorder called sleep anpea, a condition that can create a mental abnormality. Does the lack of oxygen to the brain due to lack of sleep cause a mental illness?

If you snore, the two greater factors of blame are pointed to either, obstructive sleep apnea or obesity. The lack of oxygen to the brain can cause one to be tired during the day, inciting drastic mood swings. In most cases, individuals suffer from depression and inconsistent sleep schedules, resulting in lying awake at night. Sleep is imperative to the overall general health of an individual. Finding the serenity of slumber should be natural, without one becoming dependent on sleep aids.

If you are prescribed a muscle relaxant, your lack of sleep can actually become worse; especially, sufferers of obstructive sleep apnea. It’s not advised to have certain muscle relaxants including medications, such as: Valium, Ativan and Klonopin. These prescriptions can cause the surrounding airway muscles to collapse- causing sleep depravity, resulting in mood changes and chemical imbalances.

Medication for many, is imperative to live a functionally, normal life, but many contemplate what can be done to lesson the side-effects they feel? The first suggestion is moderate exercise and changing your diet. For some, it is not that simple and many should look into acquiring a prescribed CPAP. This machine produces the air that individuals need when the body is having complications during sleeping. This machine has been used on individuals who have undergone a sleep study and suffer from conditions that require its use. Speak to your doctor who will determine the machine type, they will also determine the air pressure that you need to stay consistently asleep. Once sleep is obtained normally, the mental balance can once again become stabilized.

Sleep deprivation is a condition millions of Americans suffer from. Psych Central advises individuals can suffer from memory loss, a disorientation of rationalization, resulting in severe mood swings. When your body is tired, it becomes dehydrated and this combination can be a deadly mix to your mental stability. Some individuals with a deeper severity of sleep loss had reported hallucinations and slurred speech. Dr. Yasinski of Yasinski Psychiatry states,

“Without adequate oxygen to your brain, the ability of psychiatric medications, exercise and healthy living to improve depression or bipolar disorder is decreased and thus many patients present as ‘treatment resistant’ when in reality they are resistant only due to a co-morbid sleep apnea disorder that has gone unrecognized.”

A sleep study is highly recommended for individuals who suffer from sleep disruption and mental disorders like bipolar. This painless test can gauge the level of severity from children to adults. If sleep apnea is the cause of the mental illness, treatment can be recommended and prescribed by a doctor, leading to stability of sleep, mind and life.

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Keeping the brain healthy with exercise

New research shows that an active lifestyle can help keep the brain healthy in addition to the body.

An active lifestyle has long been promoted as a way to keep the heart pumping strong. Now new research shows that physical activity may help to keep the brain robust as well, preserving areas critical for thinking and memory and possibly even helping to ward off Alzheimer’s disease in old age.

Earlier studies have linked activities like walking and ballroom dancing to a lower risk for dementia. Exercise is known to boost cardiovascular health, and what’s good for the heart is good for the brain, the thinking goes.

Now scientists at the University of California, Los Angeles, have examined the effects of remaining active directly on the brain. For the report, they looked at detailed records of 876 older adults, average age 78, over decades. Some had Alzheimer’s disease or serious memory problems, while others were cognitively alert. Along with medical reports, the records included information on how often each participant engaged in activities like gardening and yard work, bicycling or riding an exercise bike, dancing, and recreational activities like golfing, walking or tennis.

"We had 20 years of clinical data on this group, including body mass index and lifestyle habits," said Dr. Cyrus Raji, a radiology resident at U.C.L.A, one of the study leaders. "We drew our patients from four sites across the country, and we were able to assess energy output in the form of kilocalories per week." The findings were reported at the annual meeting of the Radiological Society of North America.

Using specialized brain scans, the researchers created 3-D maps of the brain, including areas of gray matter critical for thinking and memory. "Gray matter volume is a key marker of brain health. Larger gray matter volume means a healthier brain. Shrinking volume is seen in Alzheimer's disease," Dr. Raji said.

The researchers found that those men and women who were most active had more gray matter in parts of the brain critical for memory and thinking. They took into account such factors as age, head size, body mass index, and education, which can influence Alzheimer’s risk.

"The areas of the brain that benefited from an active lifestyle are the ones that consume the most energy and are very sensitive to damage," Dr. Raji said. "What struck me most about the study results is that it is not one but a combination of lifestyle choices and activities that benefit the brain."

Dr. Raji said the benefits of an active lifestyle on the brain were likely due to improved blood vessel health. "Virtually all of the physical activities examined in this study are some variation of aerobic physical activity, which we know from other work can improve cerebral blood flow and strengthen neuronal connections," he said. Although more research is needed in this area, “our initial results show that brain aging can be alleviated through an active lifestyle," he said.

In a separate study also presented at the Radiological Society of North America’s annual meeting, scientists at the Medical University of South Carolina in Charleston reported that men and women with Alzheimer’s disease had different patterns of gray matter loss, or atrophy.

"We found that the extent and distribution of regional gray matter volume loss in the brain was strongly influenced by gender," said lead researcher Dr. Maria Vittoria Spampinato. "The female patients in our study initially had more gray matter atrophy than the male patients, but over time, the men caught up. In the men, the disease developed more aggressively in a shorter period of time."

The findings could have implications for monitoring the effects of new Alzheimer’s drugs on the brain. "Knowing the difference between the male and female patterns of atrophy will help researchers better decipher a patient's response to drug therapy," Dr. Spampinato said.

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Children with temporal lobe epilepsy and depression

Psychiatric evaluation is shown to be important for children with temporal lobe epilepsy.

Depressive symptoms, behavioural problems and psychiatric illnesses are common among children and adolescents with temporal lobe epilepsy, a new study has shown.

Researchers at the Children's National Medical Centre in Washington DC, US, say their findings underline the importance of carrying out full psychiatric evaluations on children with epilepsy, particularly if they are not responding to anti-seizure medications and may be eligible for epilepsy surgery.

The research team looked at case records for 40 children, aged six to 17 years, who were not benefiting from anti-seizure medications.

Patients received psychiatric evaluations prior to undergoing epilepsy surgery, while their parents completed questionnaires aimed at assessing their children's behaviour.

Previous research suggests that up to 40 per cent of children with chronic epilepsy have mental illnesses, with depression, anxiety, attention issues and learning difficulties being most common.

However, the latest study found the rate of psychiatric and behavioural problems to be far higher.

Overall, nearly 80 per cent of the children had significant psychiatric symptoms.

The researchers also observed that children with temporal lobe epilepsy were more likely to have depressive symptoms and significant behavioural issues than those whose seizures originated in other parts of the brain.

Their study, which is published in the journal Epilepsia, is not the first to suggest a link between temporal lobe epilepsy and depression, as previous research in a 2009 issue of the same journal found an association in adult patients.

However, the latest study indicates that this link extends to children with epilepsy as well.

"Understanding the paediatric patient's mental health status is important, as the severity of psychiatric illness may impact the overall risk-benefit of epilepsy surgery," explained Dr Jay Salpekar, the study's lead author.

"Given that psychiatric illness, particularly depression, is so prominent in those with temporal lobe seizures, routine psychiatric evaluation appears to be important not only for adults, but also for children and adolescents prior to epilepsy surgery.

"In fact, it may be beneficial for most patients with medically refractory epilepsy to have a psychiatric assessment, regardless of seizure localisation, to improve quality of life."

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The Importance of Slumber from the NIH

This article from the National Institutes of Health discusses the importance and benefits from getting a good night's sleep.

We have so many demands on our time—jobs, family, errands—not to mention finding some time to relax. To fit everything in, we often sacrifice sleep. But sleep affects both mental and physical health. It’s vital to your well-being.

Of course, sleep helps you feel rested each day. But while you’re sleeping, your brain and body don’t just shut down. Internal organs and processes are hard at work throughout the night. 

“Sleep services all aspects of our body in one way or another: molecular, energy balance, as well as intellectual function, alertness and mood,” says Dr. Merrill Mitler, a sleep expert and neuroscientist at NIH.

When you’re tired, you can’t function at your best. Sleep helps you think more clearly, have quicker reflexes and focus better. “The fact is, when we look at well-rested people, they’re operating at a different level than people trying to get by on 1 or 2 hours less nightly sleep,” says Mitler.          

“Loss of sleep impairs your higher levels of reasoning, problem-solving and attention to detail,” Mitler explains. Tired people tend to be less productive at work. They’re at a much higher risk for traffic accidents. Lack of sleep also influences your mood, which can affect how you interact with others. A sleep deficit over time can even put you at greater risk for developing depression.

But sleep isn’t just essential for the brain. “Sleep affects almost every tissue in our bodies,” says Dr. Michael Twery, a sleep expert at NIH. “It affects growth and stress hormones, our immune system, appetite, breathing, blood pressure and cardiovascular health.”

Research shows that lack of sleep increases the risk for obesity, heart disease and infections. Throughout the night, your heart rate, breathing rate and blood pressure rise and fall, a process that may be important for cardiovascular health. Your body releases hormones during sleep that help repair cells and control the body’s use of energy. These hormone changes can affect your body weight. 

“Ongoing research shows a lack of sleep can produce diabetic-like conditions in otherwise healthy people,” says Mitler. 

Recent studies also reveal that sleep can affect the efficiency of vaccinations. Twery described research showing that well-rested people who received the flu vaccine developed stronger protection against the illness. 

A good night’s sleep consists of 4 to 5 sleep cycles. Each cycle includes periods of deep sleep and rapid eye movement (REM) sleep, when we dream. “As the night goes on, the portion of that cycle that is in REM sleep increases. It turns out that this pattern of cycling and progression is critical to the biology of sleep,” Twery says.

Although personal needs vary, on average, adults need 7 to 8 hours of sleep per night. Babies typically sleep about 16 hours a day. Young children need at least 10 hours of sleep, while teenagers need at least 9 hours. To attain the maximum restorative benefits of sleep, getting a full night of quality sleep is important, says Twery.  

Sleep can be disrupted by many things. Stimulants such as caffeine or certain medications can keep you up. Distractions such as electronics—especially the light from TVs, cell phones, tablets and e-readers—can prevent you from falling asleep.

As people get older, they may not get enough sleep because of illness, medications or sleep disorders. By some estimates, about 70 million Americans of all ages suffer from chronic sleep problems. The 2 most common sleep disorders are insomnia and sleep apnea.

People with insomnia have trouble falling or staying asleep. Anxiety about falling asleep often makes the condition worse. Most of us have occasional insomnia. But chronic insomnia—lasting at least 3 nights per week for more than a month—can trigger serious daytime problems such as exhaustion, irritability and difficulty concentrating.

Common therapies include relaxation and deep-breathing techniques. Sometimes medicine is prescribed. But consult a doctor before trying even over-the-counter sleep pills, as they may leave you feeling unrefreshed in the morning. 

People with sleep apnea have a loud, uneven snore (although not everyone who snores has apnea). Breathing repeatedly stops or becomes shallow. If you have apnea, you’re not getting enough oxygen, and your brain disturbs your sleep to open your windpipe. 

Apnea is dangerous. “There’s little air exchange for 10 seconds or more at a time,” explains Dr. Phyllis Zee, a sleep apnea expert at Northwestern University. “The oxygen goes down and the body’s fight or flight response is activated. Blood pressure spikes, your heart rate fluctuates and the brain wakes you up partially to start your breathing again. This creates stress.” 

Apnea can leave you feeling tired and moody. You may have trouble thinking clearly. “Also, apnea affects the vessels that lead to the brain so there is a higher risk of stroke associated with it,” Zee adds.

If you have mild sleep apnea, you might try sleeping on your side, exercising or losing weight to reduce symptoms. A CPAP machine, which pumps air into your throat to keep your airway open, can also help. Another treatment is a bite plate that moves the lower jaw forward. In some cases, however, people with sleep apnea need surgery. 

“If you snore chronically and wake up choking or gasping for air, and feel that you’re sleepy during the day, tell your doctor and get evaluated,” Zee advises.

NIH is currently funding several studies to gain deeper insights into sleep apnea and other aspects of sleep. One 5-year study of 10,000 pregnant women is designed to gauge the effects of apnea on the mother’s and baby’s health. Zee says this study will shed more light on apnea and the importance of treatment.

Good sleep is critical to your health. To make each day a safe, productive one, take steps to make sure you regularly get a good night’s sleep. 

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