Study: Children with ADHD benefit from treating sleep problems

A study shows that children with ADHD benefit from treating underlying sleep problems.

Addressing sleep problems often improves psychiatric symptoms in children and teens, including those with attention-deficit/hyperactivity disorder and chronic pain.

Sleep-focused treatment improves mood and quality of life in children with attention-deficit/hyperactivity disorder (ADHD), asthma, chronic pain, and cancer, according to speakers at symposium on sleep in children with chronic health conditions at the annual meeting of the American Academy of Sleep Medicine and Sleep Research Society in Minneapolis in June.

Children with ADHD are two to three times more likely to have trouble sleeping than children without the disorder, said Penny Corkum, Ph.D., a professor of psychology and neuroscience at Dalhousie University in Halifax, Nova Scotia. Their sleep problems may undermine daytime performance, said Corkum, who directs research and training at Colchester Regional Hospital’s ADHD Clinic.

In research reported at the meeting, she and colleagues assessed sleep in 30 children newly diagnosed with ADHD and 30 age- and sex-matched typically developing controls. The children’s mean age was about 8.5. At baseline, children with ADHD took 47 minutes to fall asleep in the sleep laboratory, while controls took 24 minutes. Children with ADHD slept about 30 minutes less than controls.

In a four-week medication trial, the researchers gave the 30 children with ADHD either a standard single daily morning dose of methylphenidate or a placebo, in random order for two weeks. While children took longer to fall asleep and slept less when taking the stimulant than when taking the placebo, parents and teachers said their behavior improved.

Children being evaluated for problems with attention, Corkum said, should also be screened for sleep disorders. Consequences of sleep disorders such as obstructive sleep apnea, insomnia, and periodic limb movement disorder/restless leg syndrome may mimic symptoms of ADHD.

Children with and without ADHD, she added, benefit from having a consistent bedtime, learning to fall asleep on their own, sleeping in a dark room, and avoiding television, computers, telephones, and other electronic devices near bedtime.

Children and adolescents with persistent pain commonly report difficulty falling or staying asleep or complain of poor quality sleep, said symposium speaker Tonya Palermo, Ph.D., a professor of anesthesiology and pain medicine at the University of Washington, Seattle.

About 5 percent to 8 percent of children and adolescents in community samples experience moderate to severe disability from persistent pain, most often in the head, abdomen, or limbs, she noted. Common causes include headache disorders, juvenile arthritis, and sickle-cell disease.

Some have depression. Their pain medications may be sedating. These youngsters often say, “I’m always tired,” Palermo noted. Many take frequent and often long naps that may interfere with school or social activities. Concerned parents may allow children to stay in bed late in the morning.

Engaging children and adolescents in self-assessment, Palermo said, may foster improved sleep habits. She asks them to abstain from watching television in their bedroom for a week, for example, to see how that affects their sleep. She also encourages them to use an alarm clock and get up on their own and to maintain a consistent weekday/weekend schedule.

Palermo and colleagues also found that poor sleep diminishes the effectiveness of cognitive-behavioral therapy for chronic pain. She said sleep-specific intervention may need to be delivered before pain-focused behavioral therapy starts.

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What price new parents pay for interrupted sleep

This article discusses what happens to parents of newborns after one night of interrupted sleep, such as being in a bad mood and other consequences of interrupted sleep.

The familiar cry in the night, followed by a blind shuffle to the crib, a feeding, a diaper change, and a final retreat back into oblivion—every hour on the hour. Such is the sleep pattern of most new parents, who report feeling more exhausted in the morning than when they went to bed the night before.

Now, in the first study of its kind, Prof. Avi Sadeh and a team of researchers from Tel Aviv University's School of Psychological Sciences explain why interrupted sleep can be as physically detrimental as no sleep at all. In the study, published in the journal Sleep Medicine, Prof. Sadeh and his colleagues Michal Kahn, Shimrit Fridenson, Reut Lerer and Yair Ben-Haim establish a causal link between interrupted sleep patterns and compromised cognitive abilities, shortened attention spans, and negative moods. The researchers discovered that interrupted sleep is equivalent to no more than four consecutive hours of sleep.

"The sleep of many parents is often disrupted by external sources such as a crying baby demanding care during the night. Doctors on call, who may receive several phone calls a night, also experience disruptions," said Prof. Sadeh. "These night wakings could be relatively short – only five to ten minutes – but they disrupt the natural sleep rhythm. The impact of such night wakings on an individual's daytime alertness, mood, and cognitive abilities had never been studied. Our study is the first to demonstrate seriously deleterious cognitive and emotional effects."

Putting Mom and Dad in a bad mood

"In the process of advising these parents, it struck me that the role of multiple night wakings had never been systematically assessed," said Prof. Sadeh, who directs asleep clinic at TAU, where he advises exhausted and desperate parents on how to cope with their children's persistent night wakings. "Many previous studies had shown an association, but none had established a causal link. Our study demonstrates that induced night wakings, in otherwise normal individuals, clearly lead to compromised attention and negative mood."

The study was conducted on student volunteers at TAU's School of Psychological Sciences. Their sleep patterns were monitored at home using wristwatch-like devices that detected when they were asleep and when they were awake. The students slept a normal eight-hour night, then experienced a night in which they were awakened four times by phone calls and told to complete a short computer task before going back to sleep after 10-15 minutes of wakefulness. The students were asked each following morning to complete certain computer tasks to assess alertness and attention, as well as to fill out questionnaires to determine their mood. The experiment showed a direct link between compromised attention, negative mood, and disrupted sleep—after only one night of frequent interruptions.

Paying a high price

"Our study shows the impact of only one disrupted night," said Prof. Sadeh. "But we know that these effects accumulate and therefore the functional price new parents—who awaken three to ten times a night for months on end—pay for common infant sleep disturbance is enormous. Besides the physical effects of interrupted sleep, parents often develop feelings of anger toward their infants and then feel guilty about these negative feelings.

"Sleep research has focused in the last 50 years on sleep deprivation, and practically ignored the impact of night-wakings, which is a pervasive phenomenon for people from many walks of life. I hope that our study will bring this to the attention of scientists and clinicians, who should recognize the price paid by individuals who have to endure frequent night-wakings."

Prof. Sadeh is currently researching interventions for infant sleep disturbances to reduce the detrimental effects of disrupted sleep on parents.

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Sleep improved after weight loss

A study looks into mood and sleep after substantial weight loss and found that both improved in those studied.

Obese adults who lose at least 5 percent of their body weight report that they sleep better and longer after six months of weight loss, according to a new study. The results were presented Tuesday at the joint meeting of the International Society of Endocrinology and the Endocrine Society: ICE/ENDO 2014 in Chicago.

"This study confirms several studies reporting that weight loss is associated with increased sleep duration," said the study's lead investigator, Nasreen Alfaris, MD, MPH, a fellow in the Department of Medicine at the Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

In addition, the study found that weight loss at 6 months improved sleep quality, as well as mood, regardless of how the individuals lost the weight.

The 390 study subjects participated in the Practice-Based Opportunities for Weight Reduction at the University of Pennsylvania (POWER-UP) trial. This 2-year study, funded by the National Institutes of Health, compared three behavioral interventions for weight loss in obese adults treated in primary care practices.

Subjects (311 women and 79 men) were randomly assigned to one of three programs that provided varying amounts of support to achieve the same diet and exercise goals. The groups were: (1) usual care, in which subjects received printed educational materials during quarterly visits with their primary care provider; (2) brief lifestyle counseling, which included quarterly visits with their primary care provider, combined with brief meetings with lifestyle coaches; or (3) enhanced brief lifestyle counseling, with meal replacements or weight loss medications added to the second intervention.

The researchers evaluated changes in weight, sleep duration and quality, and mood after 6 and 24 months of treatment. They compared subjects who lost 5 percent or more of their original body weight with those who lost less than 5 percent, regardless of their group assignment. The analyses controlled for several subject variables, including sex and age.

At month 6, subjects in both lifestyle counseling groups lost more weight on average (brief counseling: 7.8 lb; enhanced counseling: 14.7 lb) than those in the usual care group (4.4 lb), Alfaris reported.

Examining all three groups together, subjects who lost at least 5 percent of their weight at month 6 reported that they gained an average of 21.6 minutes of sleep a night, compared with only 1.2 minutes for those who lost less than 5 percent. Likewise, subjects who lost >5% of initial weight reported greater improvements on measures of sleep quality and mood (i.e., symptoms of depression), compared with subjects who lost <5%.

Only improvements in mood remained statistically significant at 24 months, according to Alfaris.

"Further studies are needed to examine the potential effects of weight regain in diminishing the short-term improvements of weight loss on sleep duration and sleep quality," she said.

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Nightmares and insomnia can make depression worse

This article discusses the link between nightmares and insomnia, and how they can make depression worse.

Nightmares can cause difficulty both to sleep and to our waking lives. Intense and distressing dreams often lead to waking at night and can create anxiety about returning to sleep. Nightmares also can have an impact on our moods the next morning, bringing anxiety and difficult emotions into the waking day. New research suggests that nightmares also have an aggravating effect on symptoms of depression, and in combination with insomnia may significantly exacerbate the severity of the mood disorder.

Researchers at Japan's Tokyo Medical University investigated the influence of nightmares on depression, both independently and in conjunction with insomnia. They found the presence of nightmares associated with aggravating effects on depression. They also learned that the joint presence of insomnia with nightmares had a significant effect on the severity of depression.

The study included 2,822 adults, all of whom were residents of a rural community in Japan. The average age of participants was 57. All participants responded to questionnaires regarding their sleep habits and sleep quality, as well as the presence of nightmares and their frequency. Participants also answered questions to evaluate the presence and severity of depression. Researchers' findings indicate that while both insomnia and nightmares influence depression, when they exist together their influence is particularly strong:

• Among the 2,822 adults in the study, 25.5 percent had insomnia. 
• Of the total participants, 4.6 percent experienced nightmares one or more times per week. 
• Nightmares were present much more often in people with insomnia than without. Among participants with insomnia, 70.7 percent also had nightmares, compared to 29.3 percent of participants without insomnia. 
• Both insomnia and nightmares were linked individually to higher scores for depression, indicating more severe versions of the disorder. 
• When insomnia and nightmares were both present, depression severity was rated even higher, indicating a compounding effect of the two sleep problems.

Interestingly, researchers found that the severity of depression was no worse among people who experienced nightmares three or more times in a week, compared to people who reported having nightmares one or two times weekly. This suggests that it is the presence of nightmares at an even modest degree, as opposed to the frequency of the nightmares, which may exacerbate depression.

Nightmares remain a relatively little understood phenomenon of sleep. But we have seen recent research that explores the neurological activity that takes place during disturbed dreaming, as well as investigations of the possible neurocognitive functions behind nightmares and bad dreams.

A recent study explored the often provocative and frightening content of disturbed dreams, as a way to further understand the purpose and the impact that these dreams have on our sleep and our waking lives. There is also a body of research that links the presence of nightmares to more severe depression and anxiety as well as to increased risk of suicide among people with depression:

• Among patients with major depression, nightmares may increase the likelihood of suicide attempts, according to research. In a group of people diagnosed with major depression, those who had attempted suicide one or more times had significantly higher rates of both nightmares and insomnia.

• Another study examining the link between major depression and nightmares found that patients with major depression who reported frequent nightmares were more likely to be identified as suicidal than people who suffered major depression not accompanied by nightmares. Women with major depression and nightmares were found to be at particular risk for suicidal tendencies.

• Other research also indicates women may be especially vulnerable to the influence of nightmares on depression. Scientists in Estonia studied anxiety and depression in relation to sleep problems among a group of medical students. They found among female students an association between the presence of nightmares and both anxiety and depression. No similar link between nightmares, anxiety, and depression was found in male students.

We have a great deal more to learn about nightmares and other forms of disturbed dreaming, and how they may complicate and heighten the risk of mood disorders such as depression. We've seen some important recent breakthroughs in treatment for depression that highlight how important a role sleep play in the course of depressive illness, and in its treatment:

• Recent research indicates that a drug used to treat the sleep disorder narcolepsy may have benefits for depression when used in combination with other medication. Modafinil, a drug used to treat narcolepsy, has shown promise in easing the severity of depression when used in conjunction with anti-depressant medication. This treatment combination also raised rates of remission from depression.

• A federal study on sleep and depression -- the first of several to be released on the topic -- found that treating insomnia in people with depression may as much as double the likelihood of recovery from the mood disorder.

Achieving a deeper understanding of sleep and its impact on mental health may soon be changing the way we treat depression and other mood disorders. Just as sleep is now recognized not only as a symptom of depression but also a contributor to the illness, we may also find that nightmares exist as both a consequence of depression and a factor in its development.

Recognizing the specific risks that the presence of nightmares may pose -- on their own and in combination with other symptoms of disrupted sleep -- can help better identify people who are at higher risk for more aggravated and more dangerous forms of depression. And that could bring us one important step closer to getting people the help they need.

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Link between migraines and bipolar disorder

A study shows that there may be a link between migraine headaches and bipolar disorder.

Doctors who work with patients with bipolar disorder should keep in mind that those people are also at high risk for migraine headaches, a Pennsylvania State University researcher says.

A new study led by Erika Saunders, executive vice-chair of psychiatry at the Penn State Milton S. Hershey Medical Center, found that people with bipolar disorder were far likelier than the general population to get migraines and that those who got the awful headaches were at risk for worse psychosocial functioning, more severe depression, and earlier onset of bipolar symptoms.

"All of those are markers for more severity of bipolar disorder," Saunders said.

Bipolar disorder, which affects 2.6 percent of the U.S. population, is characterized by extreme mood shifts. Symptoms can include hallucinations and delusions.

Six percent of Saunders' healthy control group had migraines, compared with 31 percent of the 412 bipolar patients. In both groups, migraines were more common in women than in men.

Men with bipolar disease who got migraines tended to have bipolar II, a variant with more severe depression and less severe mania or "high" periods.

Migraine was more common in patients who had suffered emotional or sexual abuse or emotional neglect.

The study, done with researchers from the University of Michigan, was published in the Journal of Clinical Psychiatry.

Saunders suspects that many psychiatrists do not know their patients also have migraines. The doctors may be distracted by the many other medical problems such patients tend to have. Patients may consider headaches a problem for a primary care doctor, not a psychiatrist.

She now wants to explore the possibility of a shared biological link between bipolar disorder and migraine. Valproic acid, an antiseizure medicine, is used to treat mania and prevent migraines. Abnormal inflammatory mechanisms have been found in both, and both are episodic conditions. "There is something going on in the brain that's happening only at certain times for some reason," she said.

Saunders plans to study a dietary program she hopes will affect the inflammatory response, improve mood stability, and reduce migraines. She said it would involve changing the intake of fatty acids, but wouldn't talk about the details.

Some patients, she said, have more stable moods when their migraines are well-controlled.

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Study: Later school start times are beneficial for adolescents

A study shows that later school start times result in improved sleep quality and a better overall mood in adolescents.

Julie Boergers, Ph.D., a psychologist and sleep expert from the Bradley Hasbro Children's Research Center, recently led a study linking later school start times to improved sleep and mood in teens. The article, titled "Later School Start Time is Associated with Improved Sleep and Daytime Functioning in Adolescents," appears in the current issue of the Journal of Developmental & Behavioral Pediatrics.

"Sleep deprivation is epidemic amongadolescents, with potentially serious impacts on mental and physical health, safety and learning. Early high school start times contribute to this problem," said Boergers. "Most teenagers undergo a biological shift to a later sleep-wake cycle, which can make early school start times particularly challenging. In this study, we looked at whether a relatively modest, temporary delay in school start time would change students' sleep patterns, sleepiness, mood and caffeine use."

Boergers' team administered the School Sleep Habits Survey to boarding students attending an independent high school both before and after their school start time was experimentally delayed from 8 to 8:25 a.m. during the winter term.

The delay in school start time was associated with a significant (29 minute) increase in sleep duration on school nights, with the percentage of students receiving eight or more hours of sleep on a school night jumping from 18 to 44 percent. The research found that younger students and those sleeping less at the start of the study were most likely to benefit from the schedule change. And once the earlier start time was reinstituted during the spring term, teens reverted back to their original sleep levels.

Daytime sleepiness, depressed mood and caffeine use were all significantly reduced after the delay in school start time. The later school start time had no effect on the number of hours students spent doing homework, playing sports or engaging in extracurricular activities.

Boergers, who is also co-director of the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital, said that these findings have important implications for public policy. "The results of this study add to a growing body of research demonstrating important health benefits of later school start times for adolescents," she said. "If we more closely align school schedules with adolescents' circadian rhythms and sleepneeds, we will have students who are more alert, happier, better prepared to learn, and aren't dependent on caffeine and energy drinks just to stay awake in class."

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Quitting smoking can help you with a good night's sleep

A recent study shows that quitting smoking has many health benefits, such as increasing her sleep quality.

As if cancer, heart disease and other diseases were not enough motivation to make quitting smoking your New Year's resolution, here's another wake-up call: New research published in the January 2014 issue of The FASEB Journal suggests that smoking disrupts the circadian clock function in both the lungs and the brain. Translation: Smoking ruins productive sleep, leading to cognitive dysfunction, mood disorders, depression and anxiety.

"This study has found a common pathway whereby cigarette smoke impacts both pulmonary and neurophysiological function. Further, the results suggest the possible therapeutic value of targeting this pathway with compounds that could improve both lung and brain functions in smokers," said Irfan Rahman, Ph.D., a researcher involved in the work from the Department of Environmental Medicine at the University of Rochester Medical Center in Rochester, N.Y. "We envisage that our findings will be the basis for future developments in the treatment of those patients who are suffering with tobacco smoke-mediated injuries and diseases.

Rahman and colleagues found that tobacco smoke affects clock gene expression rhythms in the lung by producing parallel inflammation and depressed levels of brain locomotor activity. Short- and long- term smoking decreased a molecule known as SIRTUIN1 (SIRT1, an anti-aging molecule) and this reduction altered the level of the clock protein (BMAL1) in both lung and brain tissues in mice. A similar reduction was seen in lung tissue from human smokers and patients with chronic obstructive pulmonary disease (COPD). They made this discovery using two groups of mice which were placed in smoking chambers for short-term and long-term tobacco inhalation. One of the groups was exposed to clean air only and the other was exposed to different numbers of cigarettes during the day. Researchers monitored their daily activity patterns and found that these mice were considerably less active following smoke exposure.

Scientists then used mice deficient in SIRT1 and found that tobacco smoke caused a dramatic decline in activity but this effect was attenuated in mice that over expressed this protein or were treated with a small pharmacological activator of the anti-aging protein. Further results suggest that the clock protein, BMAL1, was regulated by SIRT1, and the decrease in SIRT1 damaged BMAL1, resulting in a disturbance in the sleep cycle/molecular clock in mice and human smokers. However, this defect was restored by a small molecule activator of SIRT1.

"If you only stick to one New Year's resolution this year, make it quitting smoking," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "Only Santa Claus has a list longer than that of the ailments caused or worsened by smoking. If you like having a good night's sleep, then that's just another reason to never smoke."

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Epilepsy surgery can improve children's behavior and mood

Children who undergo specific types of epilepsy surgery have shown to have their mood and behavior to be substantially improved post-surgery.

Certain types of epilepsy surgery led to significant improvements in children's mood and behavioral problems, a researcher said.

Children undergoing left-side resections were more likely to show neuropsychiatric symptom improvements if the target was in the frontal rather than the temporal lobe, while those having right-side surgeries had improvements irrespective of site, said Elizabeth Andresen, PhD, of theCleveland Clinic's Neurological Institute.

Relatively little improvement was seen in mood or behavioral symptoms in children with left-side temporal lobe seizure foci, but the baseline symptom burden was relatively lower to begin with, she said at a press briefing prior to her platform talk at the annual meeting of the American Epilepsy Society.

Andresen noted that neuropsychiatric complaints are extremely common in children with epilepsy. Previous studies have found a nearly five-fold increase in risk of such disorders in such children compared with the general population, and a 2.5-fold risk increase relative to children with other chronic diseases.

Some other studies have found improvements in such symptoms following epilepsy surgery, she said, but they had not examined whether the benefit varied with the surgical site, either by hemisphere or by lobe.

The study was based on a combination of child self-reports and parental assessments using standard instruments, administered before and after 100 surgeries in pediatric epilepsy patients. Of 54 left hemisphere resections, 38 were in the temporal lobe and 16 in the frontal lobe; of 46 right-sided surgeries, 26 were in the temporal lobe and 20 in the frontal.

At patients' neuropsychological evaluation after surgery, 83% were seizure-free. At last follow-up an average of 5 years after surgery, 57% of the cohort still had not had a recurrence of seizures. Patients were from 5 to 16 years of age (mean 11) at surgery, with mean duration of epilepsy symptoms of 5.3 years (SD 3.6).

In children with left-side resections, normalized T-scores for anhedonia, social anxiety, and withdrawn/depressed symptoms declined significantly for those with frontal lobe targets compared with temporal lobe patients.

• Anhedonia: 59 pre, 50 post in frontal lobe; 50 pre, 50 post in temporal lobe (P=0.009)
• Social anxiety: 59 pre, 42 post in frontal lobe; 49 pre, 48 post in temporal lobe (P=0.001)
• Withdrawn/depressed: 59 pre, 55 post in frontal lobe; 58 pre, 50 post in temporal lobe (P=0.039)

For right-sided surgeries, targets in both lobes were associated with declines in a "social problems" composite. Normalized T-scores for this measure declined from 69 to 64 with frontal lobe procedures and from 59 to 56 with temporal lobe resections (P=0.001 with respect to time and P=0.005 between groups).

Depression was significantly relieved after surgery when Andresen and colleagues analyzed the entire 100-patient cohort. Among the 25 patients rated as depressed prior to surgery, 64% were no longer depressed at follow-up.

Similarly, anxiety resolved in 60% of children with presurgical symptoms, Andresen reported.

She noted that 6% of children who had no symptoms of depression before surgery developed symptoms by the time of follow-up, and 11% of the cohort showed new postsurgical anxiety. But she said rates of emergent depression and anxiety symptoms were similar in a group of epileptic children not undergoing surgery who underwent the same neuropsychological testing.

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Study: The color of a night light can alter your mood

According to a recent study, mood at night can be affected by the color of a night light.

When it comes to some of the health hazards of light at night, a new study suggests that the color of the light can make a big difference.

In a study involving hamsters, researchers found that blue light had the worst effects on mood-related measures, followed closely by white light.

But hamsters exposed to red light at night had significantly less evidence of depressive-like symptoms and changes in the brain linked to depression, compared to those that experienced blue or white light.

The only hamsters that fared better than those exposed to red light were those that had total darkness at night.

The findings may have important implications for humans, particularly those whose work on night shifts makes them susceptible to mood disorders, said Randy Nelson, co-author of the study and professor of neuroscience and psychology at The Ohio State University.

"Our findings suggest that if we could use red light when appropriate for night-shift workers, it may not have some of the negative effects on their health that white light does," Nelson said.

The study appears in the Aug. 7, 2013, issue of The Journal of Neuroscience.

The research examined the role of specialized photosensitive cells in the retina -- called ipRGCs -- that don't have a major role in vision, but detect light and send messages to a part of the brain that helps regulate the body's circadian clock. This is the body's master clock that helps determine when people feel sleepy and awake.

Other research suggests these light-sensitive cells also send messages to parts of the brain that play a role in mood and emotion.

"Light at night may result in parts of the brain regulating mood receiving signals during times of the day when they shouldn't," said co-author Tracy Bedrosian, a former graduate student at Ohio State who is now a postdoctoral researcher at the Salk Institute. "This may be why light at night seems to be linked to depression in some people."

What people experience as different colors of light are actually lights of different wavelengths. The ipRGCs don't appear to react to light of different wavelengths in the same way.

"These cells are most sensitive to blue wavelengths and least sensitive to red wavelengths," Nelson said. "We wanted to see how exposure to these different color wavelengths affected the hamsters."

In one experiment, the researchers exposed adult female Siberian hamsters to four weeks each of nighttime conditions with no light, dim red light, dim white light (similar to that found in normal light bulbs) or dim blue light.

They then did several tests with the hamsters that are used to check for depressive-like symptoms. For example, if the hamsters drink less-than-normal amounts of sugar water -- a treat they normally enjoy -- that is seen as evidence of a mood problem.

Results showed that hamsters that were kept in the dark at night drank the most sugar water, followed closely by those exposed to red light. Those that lived with dim white or blue light at night drank significantly less of the sugar water than the others.

After the testing, the researchers then examined the hippocampus regions of the brains of the hamsters.

Hamsters that spent the night in dim blue or white light had a significantly reduced density of dendritic spines compared to those that lived in total darkness or that were exposed to only red light. Dendritic spines are hairlike growths on brain cells that are used to send chemical messages from one cell to another.

A lowered density of these dendritic spines has been linked to depression, Nelson said.

"The behavior tests and changes in brain structure in hamsters both suggest that the color of lights may play a key role in mood," he said.

"In nearly every measure we had, hamsters exposed to blue light were the worst off, followed by those exposed to white light," he said. "While total darkness was best, red light was not nearly as bad as the other wavelengths we studied."

Nelson and Bedrosian said they believe these results may be applicable to humans.

In addition to shift workers, others may benefit from limiting their light at night from computers, televisions and other electronic devices, they said. And, if light is needed, the color may matter.

"If you need a night light in the bathroom or bedroom, it may be better to have one that gives off red light rather than white light," Bedrosian said.

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Sleep Disorders and Night Terrors in Children

Children with parasomnias such as night terrors often have other sleep disorders as well.

Sleep disordered breathing, periodic limb movement, and mood disturbances are common comorbidities in pediatric patients with parasomnias, researchers reported here.

Among children with parasomnia, roughly half surveyed reported snoring, mood disturbances, or demonstrated signs of obstructive sleep apnea on a pediatric sleep questionnaire, according to Arveity Setty, MD, of Cincinnati Children's Hospital in Ohio, and colleagues.

Other common co-conditions with pediatric parasomnia included breathing pauses, frequent leg movements, insomnia, and adverse effects that occurred during waking hours, Setty noted at a poster presentation at the Associated Professional Sleep Societies meeting.

Prior research has shown that sleep disordered breathing can trigger parasomnias and that treating sleep apnea can also resolve parasomnias. Parasomnias, such as night terrors, are common in pediatric populations.

Other research has also shown associations between epilepsy and parasomnias, night waking, sleep duration, and daytime sleepiness in pediatric populations.

The authors studied sleep complaints and coexisting sleep disorders through a survey of 145 pediatric patients, ages 1 to 20, with parasomnia through survey and overnight sleep study at a single center. Participants had a mean age of 11.3.

Patient's sleep complaints and daytime symptoms were recorded, as were data from the overnight sleep study, to compile frequency of various co-occurring symptoms with patients' parasomnias. Coexisting disorders were validated through polysomnography.

Nearly half of the patients in the study had symptoms of snoring (48.3%), insomnia (41.4%), mood disturbances (41.4%), and had Michigan Pediatric Sleep Questionnaire scores indicating obstructive sleep apnea (40.7%).

Roughly one-third of study participants reported breathing pauses while sleeping (35.2%) and received a diagnosis of obstructive sleep apnea following the overnight sleep study (31%).

Frequent leg movements were reported by 22.1% of participants and confirmed periodic limb movement disorder in 17.9% of patients following the sleep study.

In addition to mood disturbance, other daytime adverse events included daytime headache in 7.6% of patients, daytime sleepiness in 22.1% of patients, and, following scoring though the Epworth sleepiness scale, significant excessive daytime sleepiness in 15.9% of patients.

Participants who participated in long-term follow-up and received treatment for obstructive sleep apnea and periodic limb movement disorder showed improvement in parasomnia.

"Parasomnia in children is associated with significant daytime consequences, including daytime headaches, excessive daytime sleepiness, and mood disturbances," as well as coexisting disorders such as sleep apnea and periodic limb movement disorder, Setty concluded.

Setty added that follow-up studies should determine whether the daytime symptoms are the result of the parasomnia or the associated and coexisting sleep disorders.

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Poor sleep may worsen schizophrenia symptoms

Neuroscientists found that some symptoms of schizophrenia can worsen with irregular sleep cycles or poor sleep quality.

The possible link between poor sleep and schizophrenia prompted the research team, led by scientists from the University of Bristol, the Lilly Centre for Cognitive Neuroscience and funded by the Medical Research Council (MRC), to explore the impact of irregular sleep patterns on the brain by recording electrical brain activity in multiple brain regions during sleep.

For many people, sleep deprivation can affect mood, concentration and stress levels. In extreme cases, prolonged sleep deprivation can induce hallucinations, memory loss and confusion all of which are also symptoms associated with schizophrenia.

Dr Ullrich Bartsch, one of the study’s researchers, said: “Sleep disturbances are well-documented in the disease, though often regarded as side effects and poorly understood in terms of their potential to actually trigger its symptoms.”

Using a rat model of the disease, the team’s recordings showed desynchronisation of the waves of activity which normally travel from the front to the back of the brain during deep sleep. In particular the information flow between the hippocampus — involved in memory formation, and the frontal cortex — involved in decision-making, appeared to be disrupted. The team’s findings reported distinct irregular sleep patterns very similar to those observed in schizophrenia patients.

Dr Matt Jones, the lead researcher from the University’s School of Physiology and Pharmacology, added: “Decoupling of brain regions involved in memory formation and decision-making during wakefulness are already implicated in schizophrenia, but decoupling during sleep provides a new mechanistic explanation for the cognitive deficits observed in both the animal model and patients: sleep disturbances might be a cause, not just a consequence of schizophrenia. In fact, abnormal sleep patterns may trigger abnormal brain activity in a range of conditions.”

Cognitive deficits — reduced short term memory and attention span, are typically resistant to medication in patients. The findings from this study provide new angles for neurocognitive therapy in schizophrenia and related psychiatric diseases.

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