Exercise helps you sleep and keeps away sleep apnea

A national poll from the National Sleep Foundation showed that getting exercise is a very important contributor to getting good sleep. Also, those who did not exercise were at the highest risk for sleep apnea.

Exercise can affect your sleep. The results of the National Sleep Foundation's 2013Sleep in America® poll show a compelling association between exercise and better sleep.

"Exercise is great for sleep. For the millions of people who want better sleep, exercise may help," says David Cloud, CEO of the National Sleep Foundation (NSF).

Exercisers say they sleep better

Self-described exercisers report better sleep than self-described non-exercisers even though they say they sleep the same amount each night (6 hours and 51 minutes, average on weeknights). Vigorous, moderate and light*exercisers are significantly more likely to say "I had a good night's sleep" every night or almost every night on work nights than non-exercisers (67%-56% vs. 39%). Also, more than three-fourths of exercisers (76%-83%) say their sleep quality was very good or fairly good in the past two weeks, compared to slightly more than one-half of non-exercisers (56%).

"If you are inactive, adding a 10 minute walk every day could improve your likelihood of a good night's sleep," says Max Hirshkowitz, PhD, poll task force chair. "Making this small change and gradually working your way up to more intense activities like running or swimming could help you sleep better."

"Our poll data certainly find strong relationships between good sleep and exercise," adds Hirshkowitz. "While cause and effect can be tricky, I don't think having good sleep necessarily compels us to exercise. I think it is much more likely that exercising improves sleep. And good sleep is fundamental for good health, productivity, and happiness."

Vigorous exercisers report the best sleep

Vigorous exercisers are almost twice as likely as non-exercisers to report "I had a good night's sleep" every night or almost every night during the week. They also are the least likely to report sleep problems. More than two-thirds of vigorous exercisers say they rarely or never (in the past 2 weeks) had symptoms commonly associated with insomnia, including waking up too early and not being able to get back to sleep (72%) and difficulty falling asleep (69%). In contrast, one-half (50%) of non-exercisers say they woke up during the night and nearly one-fourth (24%) had difficulty falling asleep every night or almost every night.

"Poor sleep might lead to negative health partly because it makes people less inclined to exercise," says Shawn Youngstedt, PhD, poll task force member. "More than one half (57%) of the total sample reported that their activity level will be less than usual after a night of poor sleep. Not exercising and not sleeping becomes a vicious cycle."

Non-exercisers are the sleepiest and have the highest risk for sleep apnea

Non-exercisers tend toward being more excessively sleepy than exercisers. Nearly one-fourth of non-exercisers (24%) qualify as "sleepy" using a standard excessive sleepiness clinical screening measure. This sleepiness level occurs about twice as often than for exercisers (12-15%). Also, about six in ten of non-exercisers (61%) say they rarely or never have a good night's sleep on work nights.

Sleepiness clearly interferes with many non-exercisers' safety and quality of life. One in seven non-exercisers (14%) report having trouble staying awake while driving, eating or engaging in social activity at least once a week in the past two weeks, almost three times the rate of those who exercise (4-6%).

"Sometimes we might feel tired, and that's normal," says Matthew Buman, PhD, poll task force member, "but if excessive sleepiness is your normal state, it warrants a conversation with your doctor. It could be a red flag that something is wrong with your health."

Indeed, non-exercisers have more symptoms of sleep apnea. Sleep apnea is a serious medical condition in which a person stops breathing during sleep. Its symptoms often include tiredness, snoring, and high blood pressure. It also increases the risk for heart disease and stroke. More than four in ten non-exercisers (44%) exhibit a moderate risk of sleep apnea, compared to between one in four and one in five of light exercisers (26%), moderate exercisers (22%) and vigorous exercisers (19%).

"The poll data suggest that the risk of sleep apnea in exercisers is half that of non-exercisers," says Christopher Kline, PhD, poll task force member. "People with sleep apnea are often overweight. Exercise can be part of the treatment."

Less time sitting is associated with better sleep and health

Separate from exercise, spending less time sitting may improve sleep quality and health. Those who sit for less than eight hours per day sitting are significantly more likely to say they have "very good" sleep quality than those who sit for eight hours or more (22%-25% compared to 12%-15%). Furthermore, significantly more of those who spend less than 10 hours per day sitting mention excellent health, compared to those who spend 10 hours or more sitting (25-30% compared to 16%).

"This poll is the first to show that simply spending too much time sitting might negatively affect our sleep quality," says Prof. Marco Tulio de Mello, poll task force member. "In addition to exercise, standing at your desk, getting up for short breaks, and moving around as much as possible are important healthy behaviors to include in our lives."

Exercise at any time of day appears to be good for sleep

Those who report exercising close to bedtime and earlier in the day do not demonstrate a difference in self-reported sleep quality. In fact, for most people exercise at any time seems to be better for sleep than no exercise at all.

This finding contradicts long-standing "sleep hygiene" tips that advise everyone not to exercise close to bedtime. The National Sleep Foundation has amended its sleep recommendations for "normal" sleepers to encourage exercise without any caveat to time of day as long as it's not at the expense of sleep. (However, people with chronic insomnia should continue to restrict late evening and night exercise, if this is part of their treatment regimen.)

"Exercise is beneficial to sleep. It's time to revise global recommendations for improving sleep and put exercise -- any time -- at the top of our list for healthy sleep habits," says Dr. Barbara Phillips, poll task force member.

Healthy Sleep Advice

To improve your sleep, try the following sleep tips:

• Exercise regularly. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.
• Create an environment that is conducive to sleep that is quiet, dark and cool with a comfortable mattress and pillows.
• Practice a relaxing bedtime ritual, like a warm bath or listening to calming music.
• Go to sleep and wake at the same time every day, and avoid spending more time in bed than needed.
• Use bright light to help manage your "body clock." Avoid bright light in the evening and expose yourself to sunlight in the morning.
• Use your bedroom only for sleep to strengthen the association between your bed and sleep. It may help to remove work materials, computers and televisions from your bedroom.
• Save your worries for the daytime. If concerns come to mind, write them in a "worry book" so you can address those issues the next day.
• If you can't sleep, go into another room and do something relaxing until you feel tired.
• If you are experiencing excessive daytime sleepiness, snoring, or "stop breathing" episodes in your sleep, contact your health care professional for a sleep apnea screening.

Poll Methodology and Definitions

The 2013 Sleep in America® annual poll was conducted for the National Sleep Foundation by WB&A Market Research, using a sample of 1,000 adults between the ages of 23 and 60. The number of completes needed for both age groups and regions was determined using the most current U.S. Census data from 2010.

The maximum sampling error of the data for the total sample is +/- 3.1 percentage points at the 95% confidence level. The sampling error will vary depending on the sample size and the percentages being examined in the sample.

* Using a self-reported measure of physical activity, for which respondents considered physical activity they did for at least 10 minutes in the past 7 days, participants were classified into four different activity levels: vigorous, moderate, light and no activity. In this self-report measure, vigorous was defined as activities which require hard physical effort such as: running, cycling, swimming or competitive sports. The next level, moderate, was defined as activities which require more effort than normal such as: yoga, tai chi and weight lifting. Light activity was defined as walking, while those who do not do any activity classified themselves into the no activity level. Segments are often referred to as vigorous exercisers, moderate exercisers, light exercisers and non-exercisers based on this measure of self-categorization.

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Tonight honey, I have a headache: Migraine Headaches Relieved by Sex

This article discusses a study that found that sex works as well as medication at relieving migraine headaches. 

I'm certainly not ready to make this recommendation in the office....awkward....

As an aside, I am not sure how they would do more research on this topic.JR

Maybe Marvin Gaye was right.

Researchers say sexual healing — as the crooner suggested, in his so-titled hit — is not all in the head. In fact, having sex can actually cure what ails the head.

More than half of migraine sufferers said their pain subsided when they had sex, researchers found. And one in five who took part in the study said their pain disappeared completely, The Daily Mail reported.

“Our results show that sexual activity during a migraine attack might relieve or even stop an attack in some cases, and that sexual activity in the presence of headache is not an unusual behavior,” researchers found, The Daily Mail reported. “Sex can abort migraine and cluster headache attacks.”

The studies were conducted at the University of Munster in Germany. They involved 400 patients suffering from two different types of headaches, cluster and migraines. One neurologist emphasized that the findings were preliminary. But they’re significant enough to moot at least one age-old excuse.

“We can now say, however, that the excuse of ‘not tonight, I have a headache,’ may not be taken seriously by all sexual partners,” said Nick Silver, a consultant neurologist at the NHS Walton Centre for Neuroscience and Neurosurgery in Liverpool, in The Daily Mail report.

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How to spot sleep problems in special needs children

Special needs children have a higher rate of sleep disorders. This article discusses how to spot their sleep issues and what can be done to help them.

About 30 percent of children have a sleep disorder, but the rate is even higher in children with special needs, an expert says.

This increased risk in children with special needs is likely related to physical and behavioral differences, as well as side effects from medication, said Dr. Jennifer Accardo, director of the Sleep Disorders Clinic and Lab at the Kennedy Krieger Institute in Baltimore, Md.

Not all children with special needs who have sleep disturbances will be diagnosed with a sleep disorder, but early detection of common signs is the key to improving sleep. Parents know their child's sleep patterns best and can spot sleep issues if they know what to look for.

Signs of sleep problems in school-age children with special needs include: snoring; difficulty falling or staying asleep; sleepwalking, night terrors and other nighttime activities; sleeping too much; and needing parents to be in the room to fall asleep.

"While a good night's sleep is important for all children, it is especially critical for children with special needs," Accardo said in an institute news release. "Parents can make small changes at home to help their child get a better night's sleep and improve their performance in daytime activities, therapies and social interactions."

Accardo offered tips to improve sleep for children with special needs:

• Make sleep a priority and develop a bedtime routine.
• Keep schedules consistent every day on both weekdays and weekends.
• Make the bedroom a restful place and have your child sleep in the same place every night.
• Avoid caffeine.
• Put your child to bed when he or she is sleepy, but not yet fully asleep.
• Address anxiety, which is common in children with special needs.
• Take note of signs of sleep problems.

"If parents are concerned about their child's sleep patterns and behaviors, they should consult with their pediatrician or a sleep expert," Accardo said. "Sleep evaluations can be extremely beneficial in identifying causes and ultimately improving sleep for the entire family."

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Identifying conditions contributing to concussions and brain damage

A new computer model claims to help reduce concussions and brain injury in athletes and soldiers.

Concussions can occur in sports and in combat, but health experts do not know precisely which jolts, collisions and awkward head movements during these activities pose the greatest risks to the brain. To find out, Johns Hopkins engineers have developed a powerful new computer-based process that helps identify the dangerous conditions that lead to concussion-related brain injuries. This approach could lead to new medical treatment options and some sports rule changes to reduce brain trauma among players.

The research comes at a time when greater attention is being paid to assessing and preventing the head injuries sustained by both soldiers and athletes. Some kinds of head injuries are difficult to see with standard diagnostic imaging but can have serious long-term consequences. Concussions, once dismissed as a short-term nuisance, have more recently been linked to serious brain disorders.

"Concussion-related injuries can develop even when nothing has physically touched the head, and no damage is apparent on the skin," said K. T. Ramesh, the Alonzo G. Decker Jr. Professor of Science and Engineering who led the research at Johns Hopkins. "Think about a soldier who is knocked down by the blast wave of an explosion, or a football player reeling after a major collision. The person may show some loss of cognitive function, but you may not immediately see anything in a CT-scan or MRI that tells you exactly where and how much damage has been done to the brain. You don't know what happened to the brain, so how do you figure out how to treat the patient?"

To help doctors answer this question, Ramesh led a team that used a powerful technique called diffusion tensor imaging, together with a computer model of the head, to identify injured axons, which are tiny but important fibers that carry information from one brain cell to another. These axons are concentrated in a kind of brain tissue known as "white matter," and they appear to be injured during the so-called mild traumatic brain injury associated with concussions. Ramesh's team has shown that the axons are injured most easily by strong rotations of the head, and the researchers' process can calculate which parts of the brain are most likely to be injured during a specific event.

The team described its new technique in the Jan. 8 edition of the Journal of Neurotrauma. The lead author, Rika M. Wright, played a major role in the research while completing her doctoral studies in Johns Hopkins' Whiting School of Engineering, supervised by Ramesh. Wright is now a postdoctoral research fellow at Carnegie Mellon University. Ramesh is continuing to conduct research using the technique at Johns Hopkins with support from the National Institutes of Health.

Beyond its use in evaluating combat and sports-related injuries, the work could have wider applications, such as detecting axonal damage among patients who have received head injuries in vehicle accidents or serious falls. "This is the kind of injury that may take weeks to manifest," Ramesh said. "By the time you assess the symptoms, it may be too late for some kinds of treatment to be helpful. But if you can tell right away what happened to the brain and where the injury is likely to have occurred, you may be able to get a crucial head-start on the treatment."

Armed with this knowledge, Ramesh and his colleagues want to use their new technology to examine athletes, particularly football and hockey players, who are tackled or struck during games in ways that inflict that violent side-to-side motion on the head. In the recent journal article, the authors point out that many professional sports games are recorded in high-definition video from multiple angles. This, they write, could allow researchers to reconstruct the motions involved in sport collisions that lead to the most serious head injuries.

The authors also noted that some sports teams equip their players' helmets or mouth guards with instruments that can measure the acceleration of the head during an impact. Such data, entered into the researchers' computer model, could help determine the likely location of brain damage. These results, combined with neuropsychological tests, could be used to guide the athlete's treatment and rehabilitation, the authors said, and to help a sports team decide when an athlete should be allowed to resume playing. This strategy also may help reduce the risk to athletes arising from a degenerative disease linked to repeated concussions.

More research, testing and validation must be conducted before the computer model can become useful in a clinical setting. This will include animal experiments and the correlation of data from event reconstruction to make sure the model accurately identifies brain injuries.

Ideally, Ramesh would like to collect digital brain images from soldiers and athletes before they enter combat or join highly physical sports activities. "We would then be able to track a high-risk population and keep records detailing what types of head injuries they experience," he said. "Then, we could look at how their brains may have changed since the original images were collected. This will also help guide the physicians and health professionals who provide treatment after critical events."

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Link found between insomnia and heart failure

A new study shows a link between insomnia and heart failure.

People who suffer from insomnia appear to have an increased risk of developing heart failure, according to the largest study to investigate the link.

The study, which is published online today in the European Heart Journal, followed 54,279 people between the ages of 20-89 for an average of more than 11 years, and found that those who suffered from three symptoms of insomnia had a more than three-fold increased risk of developing heart failure compared to those with no insomnia symptoms.

Dr Lars Laugsand, a post-doctoral fellow in the Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway, said: "We related heart failure risk to three major insomnia symptoms including trouble falling asleep, problems staying asleep, and not waking up feeling refreshed in the morning. In our study, we found that persons suffering from insomnia have increased risk of having heart failure. Those reporting suffering from all three insomnia symptoms simultaneously were at considerably higher risk than those who had no symptoms or only one or two symptoms."

However, he stressed that although the study shows that insomnia is linked to an increased risk of heart failure, it does not show that it causes it. "We do not know whether heart failure is really caused by insomnia, but if it is, insomnia is a potentially treatable condition using strategies such as following simple recommendations concerning sleeping habits (often referred to as sleep hygiene), and several psychological and pharmacological therapies. Evaluation of sleep problems might provide additional information that could be used in prevention of heart failure."

He said further research would be required to establish whether or not insomnia caused the condition. "It is still unclear why insomnia is linked to higher heart failure risk. We have some indications that there might be a biological cause, and one possible explanation could be that insomnia activates stress responses in the body that might negatively affect heart function. However, further research is also needed to find the possible mechanisms for this association."

Dr Laugsand and his colleagues collected data from men and women enrolled in the Nord-Trondelag Health study (HUNT) between 1995 and 1997 and who were free from heart failure when they joined. Heart failure is a condition in which the heart is unable to pump enough blood around the body at the right pressure. It usually occurs because the heart muscle has become too weak or stiff to work properly. The researchers followed the study participants until 2008, by which time there had been a total of 1412 cases of heart failure.

When participants joined the study they were asked whether they had difficulty going to sleep and staying asleep, with the possible answers being "never," "occasionally," "often" and "almost every night." They were also asked how often they woke up in the morning not feeling refreshed (non-restorative sleep): "never, few times a year," "one to two times per month," "once a week," "more than once a week."

After adjusting for factors that could affect the results, such as age, sex, marital status, education, shift work, blood pressure, cholesterol, diabetes, body mass index, physical activity, smoking, alcohol, any previous heart attack, depression and anxiety, the researchers found that having difficulties going to sleep and staying asleep almost every night, and having non-restorative sleep more than once a week were associated with an increased risk of heart failure when compared with people who never or rarely suffered from these symptoms. There was a trend showing a link between the frequency of the symptoms and the increased risk, although most of these findings did not reach statistical significance.

When they looked at the number of symptoms, the researchers found a statistically significant three-fold (353%) increased risk of heart failure for people who had all three insomnia symptoms, compared to those with none, after adjusting for most confounding factors apart from depression and anxiety. When they adjusted their findings to include depression and anxiety, the risk was still significant, with a slightly more than four-fold risk (425%) of heart failure.

The authors write in their paper: "We found a moderate risk increase related to the individual insomnia symptoms. However, the risk among those with all the three insomnia symptoms simultaneously was particularly high even after adjustment for established cardiovascular risk factors and psychological distress. This finding may be interpreted as suggesting that compromising some aspects of sleep may be somehow compensated for, and the net effect on cardiovascular disease may be limited. For example, having difficulty falling asleep might be compensated for by a satisfactory depth and a good continuity of sleep. However, if the initiation of sleep is poor and combined with repeated awakenings and superficial sleep, there may not be any compensatory mechanisms."

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Childhood ADHD Lasts Into Adulthood

A study that followed children with ADHD into adulthood shows their ADHD symptoms lasted in adulthood and are associated with other psychiatric issues.

The first large, population-based study to follow children with attention-deficit hyperactivity disorder into adulthood shows that ADHD often doesn't go away and that children with ADHD are more likely to have other psychiatric disorders as adults. They also appear more likely to commit suicide and to be incarcerated as adults. The findings appear in the March 4 online issue ofPediatrics.

"Only 37.5 percent of the children we contacted as adults were free of these really worrisome outcomes," says lead investigator William Barbaresi, M.D., of Boston Children's Hospital, who started the study when he was at Mayo. "That's a sobering statistic that speaks to the need to greatly improve the long-term treatment of children with ADHD and provide a mechanism for treating them as adults."

The study is unique because it followed a large group of ADHD patients from childhood to adulthood, says Slavica Katusic, M.D., an epidemiologist and Mayo Clinic's lead researcher on the study.

ADHD is the most common neuro-developmental disorder of childhood, affecting about 7 percent of all children and three times as many boys as girls. Most prior follow-up studies of ADHD have been small and focused on the severe end of the spectrum -- such as boys referred to pediatric psychiatric treatment facilities -- rather than a cross-section of the ADHD population.

The study followed all children in Rochester who were born between 1976 and 1982, were still in Rochester at age 5 and whose families allowed access to their medical records. That amounted to 5,718 children, including 367 diagnosed with ADHD. Of this group, 232 participated in the follow-up study. About three-quarters received ADHD treatment as children.

At follow-up, the researchers found:

*29 percent of children with ADHD still had ADHD as adults.

*57 percent of children with ADHD had at least one other psychiatric disorder as adults, as compared with 35 percent of those studied who didn't have childhood ADHD. The most common were substance abuse/dependence, antisocial personality disorder, hypomanic episodes, generalized anxiety and major depression.

*Of the children who still had ADHD as adults, 81 percent had at least one other psychiatric disorder, as compared with 47 percent of those who no longer had ADHD and 35 percent of those without childhood ADHD.

*Seven of the 367 children with ADHD (1.9 percent) had died by the time the study began, three of them from suicide. Of the 4,946 children without ADHD whose outcomes could be ascertained, 37 children had died, five by suicide.

*Ten adults who had childhood ADHD (2.7 percent) were incarcerated when the study started.

"We suffer from the misconception that ADHD is just an annoying childhood disorder that's overtreated," Dr. Barbaresi says. "This couldn't be further from the truth. We need to have a chronic disease approach to ADHD as we do for diabetes. The system of care has to be designed for the long haul."

Dr. Barbaresi thinks the study findings may underestimate the bad outcomes of childhood ADHD. Most of those studied were white and middle class, with good educations and access to health care.

"One can argue that this is potentially a best-case scenario," Dr. Barbaresi says. "Outcomes could be worse in socioeconomically challenged populations."

He advises parents of children with ADHD to ensure that their children are in high-quality treatment -- and remain in treatment as they enter adolescence. Children also should be assessed for learning disabilities and monitored for conditions associated with ADHD, including substance use, depression and anxiety.

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Overcoming Sleep Disturbances in Children

Helping children get over their sleep issues requires finding the source of the issue according to the following article.

Annie was having a tough time. While her five-year-old son Paul would sleep through the night, her two-year-old daughter Nina would wake every few hours, meaning Annie was exhausted. “My little girl had extremely interrupted sleep patterns and would rarely sleep for more than three hours at a time,’’ says Annie, a Dubai HR officer. “She’d wake up crying as if she’d had a nightmare and it would take a lot of comforting before she’d go back to sleep.’’

Her husband Mathew helped her to soothe Nina and put her back to bed, and the lack of sleep was taking its toll on both parents. “I was finding it difficult to concentrate at work and my husband said that he once even dozed off at the wheel,’’ says Annie. “I realised then I needed to do something before a disaster happened. The lack of sleep was becoming dangerous.”

She took the toddler to her doctor for a check-up, but there was nothing physically wrong with her. “We tried all kinds of things like rubbing her back, cuddling her and putting her to bed at fixed times,” says Annie. “It took nearly a year before she fell into a regular sleep pattern.’’ Annie’s not sure what caused the problems, but suspects it was a stage her daughter eventually grew out of.

Nothing that can’t be tackled

Battling through months of disturbed sleep is to be expected when you’ve got a new baby. But when your child is older and still not sleeping through the night, it can be a huge family problem. However, there are very few issues that can’t be tackled, promises Dr Richard Ferber, director of the Centre for Pediatric Sleep Disorders at Boston Children’s Hospital.

He stresses that while children’s sleep problems vary widely (common issues include being unable to fall asleep without help, getting up repeatedly during the night, waking early, being hard to wake up, bed-wetting and sleep apnoea) they are rarely the result of poor parenting.

A revised version of Dr Ferber’s book, Solve Your Child’s Sleep Problems, was published recently, and he hopes parents of children of any age will read it to help them understand sleep so they can prevent problems occurring. “Pretty much all children have the ability to sleep fairly normally,” he says. “But there are many ways sleep patterns can be disrupted and that’s when it’s worth trying to sort it out.”

Stop it at the source

Dr Ferber says that one of the most common problems is children not being able to go to sleep easily or stay asleep. This is often due to schedules (the timing of sleep and how it’s controlled) and habits related to sleep (what they’re used to doing before sleep) such as feeding. As a child gets older, there may be issues around limit setting (sticking to strict rules on sleep-delaying tactics), and night-time fears may also cause problems.

He explains that solutions will differ depending on the child, and says that while trying something such as controlled crying – where babies older than six months are left to cry but checked regularly and reassured without being picked up – may help in particular situations, it’s often not appropriate.

It shouldn’t be used if children are in pain or discomfort, if their sleep schedule isn’t correct (if parents think the child should be sleeping for longer than he or she is capable) or if they’re frightened. If a child has night-time fears, it’s important to identify the source of the fears and deal with it so the problem can be resolved. “The first question is ‘why is a child crying?’” stresses Dr Ferber.

He says that it’s to do with some sort of association, for example if they have to have their back rubbed to fall asleep, then if they wake up in the middle of the night, which is a normal part of the sleep cycle, someone can’t be there to rub their back all night. “If they learn how to go to sleep without back rubbing, there’s no problem, so withdrawing it is appropriate,” says Dr Ferber. “If the child is upset, you may want to check them at increasing intervals to show you haven’t disappeared, but without reinstating the back rubbing or the habit related to them getting to sleep.”

According to Dubai-based Dr Onita Nakra, educational psychologist and counsellor, American School of Dubai, poor sleep can impact a child negatively. “The child’s health, safety, development, learning and behaviour can be affected,” she has said. “A common complaint is difficulty concentrating or poor retention at school. A tired child also has difficulties focusing in the classroom.”

Dr Ferber points out that children often have a combination of more than one sleep problem, and parents need to be aware that if they deal with one problem such as a sleep association and the child still has sleep difficulties, it may be because there’s an another issue. This may be an incorrect sleep schedule. “Parents may come to the conclusion that their child is just a bad sleeper, but if they fix the schedule as well, they may find the child’s actually a great sleeper,” he says.

Another sleep problem is a child not getting enough sleep. While Ferber stresses there’s no way of telling from numbers alone, a general guide for how much children should be getting is around 14-18 hours for a baby, around 12-14 hours for a toddler and around 11-13 hours for primary school-aged children.

A bedtime routine is very important. A child put to bed straight after watching TV without any transition period can cause problems. “Establishing a routine the child looks forward to, such as a song or a story, makes the process more pleasurable,” says Dr Ferber. “It’s also a chance for parents to get away from other distractions and interact with their child. It can be as special a time for parents as it is for children. We’re not talking about much time, but it’s time well spent.”

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Females may have advantage to not developing autism

This study suggests that females may have an advantage in resisting genetic pressures to develop autism symptoms.

A protective effect in females may help explain one of the biggest mysteries of autism: Why boys are five times more likely to develop the developmental brain disorder than girls.

A new, preliminary study suggests that developing females are much better able than males to fight off genetic pressure to develop symptoms of autism.

The findings aren't definitive and don't point to a treatment or cure. Still, "first steps like this are important" and could lead to greater understanding of autism, said study lead author Elise Robinson, an instructor in the department of medicine at Harvard Medical School in Boston.

An estimated 1 in 88 children in the United States has an "autism spectrum disorder." The condition, which can range from mild to severe, is characterized by impaired communication and social interaction. Prevalence of autism is increasing in the United States, although it's not clear if that's largely because there's more awareness of the disorder.

According to the U.S. Centers for Disease Control and Prevention, boys are almost five times more likely than girls to have a form of the disorder -- 1 in 54 boys compared to 1 in 252 girls.

There are many theories about why this autism "gender gap" exists. One idea is that males are threatened in the womb by exposure to testosterone, the male hormone. Another theory holds that females might be somehow inherently better protected against the threat of the condition.

This may fit in with the idea that males are weaker in the womb than females. Boys are generally more prone to develop neurological disorders than girls, noted Dr. Andrew Zimmerman, director of clinical trials at the Lurie Center for Autism at Massachusetts General Hospital.

"We poor males are vulnerable," he said. "Girls have two X chromosomes, so if there's a problem on one, they have a spare." On the other hand, males have one X chromosome and "a Y chromosome that has very few genes," added Zimmerman, who was not involved in the study.

In the new study, published online Feb. 18 in Proceedings of the National Academy of Sciences, researchers aimed to figure out how females fared who were born into families that appeared to have a higher genetic risk of autism symptoms. The study authors looked at more than 3,800 pairs of non-identical twins from Great Britain and more than 6,000 pairs of non-identical twins from Sweden. They then tried to figure out how a family risk of autism symptoms (not diagnosed autism itself) affected the twins.

They found evidence that it takes greater family risk -- meaning a higher genetic load -- for a girl to develop autism symptoms. In other words, girls appeared to be more resilient against the threat of autism symptoms compared to boys.

"There's more pressure on them to get it, and once they get it, it's more obvious than in their relatives," said Zimmerman.

Genetics researchers should spend more time studying families with autistic girls in order to better understand the disorder, the research team concluded. This gender-specific research might also help identify ways to prevent autism, they said.

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Link Between Lack of Sleep and Junk Food Binging

Lack of sleep can result in a person eating greater quantities of high-calorie junk food resulting in weight gain over time

Lack of sleep can lead you to eat larger portions of high-calorie foods and increase your long-term risk of weight gain, according to a small new study.

Swedish researchers asked 16 normal-weight males to choose their ideal portions of high-calorie meals and snacks. They did this when they had a normal night of about eight hours sleep and again when they went a night without sleep.

The participants chose larger portion sizes after the night with no sleep. They did this both before and after a breakfast, which suggests that sleep deprivation increases food intake regardless of whether a person feels full, said study author Pleunie Hogenkamp, of Uppsala University.

"Bearing in mind that insufficient sleep is a growing problem in modern society, our results may explain why poor sleep habits can affect people's risk to gain weight in the long run," Hogenkamp said in a university news release.

The study was published online Feb. 18 in the journal Psychoneuroendocrinology.

In a previous study, the same team of researchers found that young, normal-weight men who went a single night without sleep had increased activation of a brain region involved in the desire to eat.

Although the study found an association between lack of sleep and increased appetite for high-calorie foods, it did not prove a cause-and-effect relationship.

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10 Important Things to Know About Epilepsy

This article discusses 10 important aspects of epilepsy that are important to know.

As a neurologist with specialty training in this field, I have been devoted to helping the plight of individuals with epilepsy find better treatments, advocate for better management and to illuminate some of the terrible misinformation that is spread about this condition.  In March 2012, the Institute of Medicine took up the topic of epilepsy and how it is handled in the United States (U.S.).  As a member of that panel, I was able to hear important testimony from public, private and government institutions about how epilepsy is managed in the U.S. and some of the major problems that affect its care and the people who have it.  The following are several important items that may help to clarify one’s knowledge about epilepsy and show that this is truly a common condition.

1. Epilepsy is the condition of having repeated, unprovoked seizures, whereas a seizure is anabnormal electrical discharge of the brain which then results in an individual losing consciousness or having a change in their neurological function. There are several types of seizures and not all are dramatic in their presentation, though they are often depicted in movies and television as a convulsion.  Some seizures manifest by one simply losing focus, but to a bystander, it may seem as daydreaming, wandering or a tremor.  Therefore, not all seizures are very dramatic in their presentations.

2. Epilepsy is very common.  According to the CDC, one in 26 people in the U.S. will develop epilepsy at some point in their lifetime.  If you think about it, that means two persons on every bus or two people in every subway car will have epilepsy.  There are 150,000 new cases of epilepsy diagnosed in the United States annually; 2.2 million people in the U.S. and more than65 million people worldwide have the condition.

3. Children and older adults are the fastest-growing segments of the population with new cases of epilepsy; however, the reason that they have epilepsy varies dramatically.  In children, we see an overabundance of genetic and infectious causes of seizures. For older adults, stroke and Alzheimer’s disease seem to be the common cause of epilepsy and seizures in this population.

4. There are numerous causes of seizures and epilepsy.  Stroke, head trauma and tumors are common causes of seizures in the U.S., yet the number one cause of seizures outside of the U.S. is an infection which is completely preventable by simply washing one’s hands. Neurocysticercosis– caused by the Taenia solium tapeworm– is one of the most common causes of epilepsy in the world and an increasing cause of seizures in the U.S.   Other preventable causes of epilepsy are head trauma from car accidents, violence or the consequences of military intervention.

5. Epilepsy is not a benign condition and can result in death. The number of people with epilepsy who die of sudden unexpected death in epilepsy (SUDEP) varies from one of every10,000 newly diagnosed to nine of every 1,000 candidates for epilepsy surgery.

6. For many people with epilepsy, seizures can be effectively reduced or eliminated by medication, surgery, devices and dietary or other therapies; however, referral to epilepsy centers for surgery can take 15 years or more.  In the Latino population, there is a considerable misinformation and lack of information; oftentimes that lack of access does not translate into meaningful care. There are 26 different drugs approved for treatment in the U.S. for epilepsy.  Moreover there is a pacemaker like device known as the vagus nerve stimulator, a diet- ketogenic or modified Atkins, and numerous surgeries.  These effective treatments are available for many types of epilepsies; however, access and referrals to these treatments fall short.

7. There is considerable stigma associated with epilepsy that sometimes overwhelms the condition itself. The word” epilepsy” is considered stigmatizing in its own right.  The long history of epilepsy is full of examples of discrimination and secrecy due to misinformation and lack of understanding by the general public.  This stigma can have a detrimental effect on people with epilepsy and continued and sustained efforts are needed to raise public awareness and convey what epilepsy is and what it is not, as well as the basic message that this is an exceedingly common condition.

8. There are significant quality of life issues associated with epilepsy and one of the most significant is driving.  Every state in the U.S. has a law that dictates whether someone with epilepsy can or cannot drive and the length of time they need to be seizure free for them to drive.  In six of these states, the law has mandatory reporting by the physician of all patients with epilepsy to a medical board.  Individuals need to be aware of these laws as there are, in some cases, criminal consequences for both physician and patients for their lack of awareness associated with it.

9. Epilepsy is more than just seizures as it often has other accompanying conditions associated with it.  Oftentimes, poor memory, mood issues, depression and anxiety walk hand in hand with issues associated with epilepsy and need to be managed and thought of when caring for the individual with epilepsy.

10. Sadly, many health professionals need to be better informed about epilepsy.  Only 20 percent of U.S. medical schools require training in neurology…and epilepsy and how to treat it.  Improvements in epilepsy care can only be made if the quality and quantity of education about epilepsy for health care professionals are improved dramatically at undergraduate and graduate levels of lifelong learning processes.  In addition, more educational efforts for patients with epilepsy and their families is needed.

It is only with a concerted effort to illuminate epilepsy and talk about the condition that one will hopefully empower individuals with knowledge so as to improve quality of life.

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Increased Risk of Narcolepsy in Children Who Received Vaccination for Swine Flu

A study from England shows there is an increased risk of children developing narcolepsy if they received the H1N1 swine flu vaccine.

A study finds an increased risk of narcolepsy in children and adolescents who received the A/H1N1 2009 influenza vaccine (Pandemrix) during the pandemic in England.

The results are consistent with previous studies from Finland and Sweden and indicate that the association is not confined to Scandinavian populations. However, the authors stress that the risk may still be overestimated, and they call for longer term monitoring of the cohort of children and adolescents exposed to Pandemrix to evaluate the exact level of risk.

In 2009, pandemic influenza A (H1N1) virus spread rapidly, resulting in millions of cases and over 18,000 deaths in over 200 countries. In England the vaccine Pandemrix was introduced in October 2009. By March 2010, around one in four (24%) of healthy children aged under 5 and just over a third (37%) aged 2-15 in a risk group had been vaccinated.

In August 2010 concerns were raised in Finland and Sweden about a possible association between narcolepsy and Pandemrix. And in 2012 a study from Finland reported a 13-fold increased risk in children and young people aged 4-19.

But a lack of reported cases in other countries led to speculation that any possible association might be restricted to these Scandinavian populations.

Narcolepsy is a chronic disorder of excessive daytime sleepiness, often accompanied by sudden muscle weakness triggered by strong emotion (known as cataplexy). To evaluate the risk after vaccination in England, a team of researchers reviewed case notes for 245 children and young people aged 4-18 from sleep centres and child neurology centres across England.

Of these, 75 had narcolepsy (56 with cataplexy) with onset after 1 January 2008. Eleven had been vaccinated before onset of symptoms; seven within six months.

After adjusting for clinical conditions, vaccination at any time was associated with a 14-fold increased risk of narcolepsy, whereas vaccination within six months before onset was associated with a 16-fold increased risk.

In absolute numbers, this means that one in 52,000 to 57,500 doses are associated with narcolepsy, say the authors.

They write: "The increased risk of narcolepsy after vaccination with ASO3 adjuvanted pandemic A/H1N1 2009 vaccine indicates a causal association, consistent with findings from Finland. Because of variable delay in diagnosis, however, the risk might be overestimated by more rapid referral of vaccinated children."

While further use of this vaccine for prevention of seasonal flu seems unlikely, they say their findings "have implications for the future licensure and use of AS03 adjuvanted pandemic vaccines containing different subtypes such H5 or H9."

And they conclude: "Further studies to assess the risk, if any, associated with the other A/H1N1 2009 vaccines used in the pandemic, including those with and without adjuvants, are also needed to inform the use of such vaccines in the event of a future pandemic."

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How Cognitive Performance is Affected by Heading a Soccer Ball

This article discusses the results of a study on the changed in cognitive tasks after high school female soccer players headed a soccer ball.

Sports-related head injuries are a growing concern, and new research suggests that even less forceful actions like 'heading' a soccer ball may cause changes in performance on certain cognitive tasks, according to a paper published February 27 in the open access journal PLOS ONEby Anne Sereno and colleagues from the University of Texas Health Science Center at Houston.

The researchers tested the effects of non-injurious head-to-ball impacts on cognitive function using a tablet-based app. They found that high school female soccer players were significantly slower than non-players on a task that required pointing away from a target on the screen, but showed no difference in performance when pointing to the on-screen visual target.

According to the study, tasks that involve pointing away from a target require specific voluntary responses, whereas moving toward a target is a more reflexive response. Based on their observations, the authors conclude that sub-concussive blows to the head may cause changes specifically linked to certain cognitive functions.

The authors say that the app used in their research may be a quick and effective way to screen for and track cognitive changes in athletes. They add that a tablet-based application for such quick screens may also have broader applications in the clinic or the field.

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15 Tips for Better Sleep

This article discusses 15 simple tips to help you get a better night's sleep.

The worst part is that physically all the tossing and turning is guaranteed to turn you into a crabby and worn out person during the next day. If getting good night's sleep is a struggle for you, then it's time to adopt a healthier lifestyle or tweak your current one. Today, we have compiled a list 20 best tips which will help get the most out of your sleeping hours.

Tip for better sleep # 1: Follow a sleep timetable
Follow a sleeping and waking up routine. Our sleep cycles work together with the 'circadian clock' of our brains. If you follow a same sleeping pattern, your brain will discipline your body to strictly maintain the same sleeping schedule. Hence, maintain a regular bedtime and wake-up time even during weekends to strengthen your circadian function which will help you to achieve a consistent and sound sleep.

Tip for better sleep # 2: Create a bedtime habit and follow it
You can teach your body any form of bedtime activity like going for a shower or listening to a soothing music or reading a book before going to sleep.

These types of activities will promote better sleep by easing the evolution period from wakefulness to sleepiness. All your pre-sleeping activities should preferably be done in dimmed lights. Never include electronic gadgets like TV or computer in your bedtime ritual as it will interfere with your sleeping pattern.

Tip for better sleep # 3: Take a small nap if you missed your sleeping pattern
If you failed to catch up on your regular sleeping timetable then opt for a nap during the day time instead of sleeping a little extra in the morning. Its best to pay off your sleep debts without disturbing your routine.

If you break your timetable regularly, then the lack of sleep will put you at several sleep disorders risk like insomnia. Hence, pay your sleep loans by taking small naps or by practicing relaxation techniques during day time.

Tip for better sleep # 4: Create a sleeping environment
Deep sleep can be achieved only in a sleep-conducive environment. Choose a dark, quiet, comfortable and cool place to sleep. Your sleeping area should be without interruptions and noise - including your partner's snoring, too much light and heat. Use dark curtains, fans and ear plugs to create a sleeping atmosphere.

Tip for better sleep # 5: Avoid harmful drinks before sleep
Avoid drinking liquids like coffee, tea and cola at least four to six hours before bedtime. Coffee includes caffeine - a product which can keep you awake for hours. Wondering if you should refrain from drinking alcohol as well? Then the answer is yes.

Though alcohol can help you to sleep, but if you keep drinking regularly it can act as a stimulant and can keep you awake for longer. Hence, limit the consumption of alcohol to not more than one drink per day and avoid drinking before three hours of bedtime.

Tip for better sleep # 6: Restrict your area just for sleep and sex
Your bedroom should be the place for relaxation and rest. Practice only sex and sleep in your bedroom and never use it for talking on the phone, watching TV or eating.

Tip for better sleep # 7: Learn your sleeping position
Sleep position is the position you move onto before falling asleep. If you are not feeling sleepy, you will keep on taking twist and turns and will probably lie on your back or stomach until sleep hits.

Learn your best sleep position so that you can go in your dreamland as soon as you get into your bed.

Tip: Take a few deep breaths, relax and your body will assume that it's time to sleep and you'll be fast asleep in no time.

Tip for better sleep # 8: Good mattress is important
Invest in a nice, comfortable and supportive mattress and pillow. If your mattress is comfortable and supportive then you will be able to fall asleep sooner.

Tip for better sleep # 9: Limit daytime naps
Your long daytime naps can also be the reason for your sleepless nights. If you are struggling with sleepless nights than limit your snooze time to about 10 to 30 minutes and it should be ideally mid afternoon. But you are a night worker, and then you are an exception to this rule.

Tip for better sleep # 10: Refrain from using TV or computer at night
Many people relax by watching television or using the computer at the end of the day. People, this is a big mistake and should be avoided as far as possible. TV lights can stimulate your mind rather than relaxing it. Hence, if you prefer watching your favorite show before going to bed, then it's best to tweak that habit.

Tip for better sleep # 11: Exercise regularly
Exercising regularly will help you to fall asleep easily and will also contribute to a quality sleep. However, finish your exercise at least 3 hours before bedtime so that your body temperature is associated with sleep onset.

Tip for better sleep # 12: Go to sleep when you are tired
If you simply hit the bed after a restful day, then we are pretty sure that you will actual struggle to sleep and this struggle to fall asleep can actually lead to frustration. If you're not asleep after 20 minutes, get out of bed, go to another room, and do something relaxing like deep breathing, meditation or listening to music.

Tip for better sleep # 13: Quit smoking
Cigarette is filled with nicotine and it is substance similar to caffeine. It acts as a stimulant and can keep you away from getting a good night's sleep. Hence, quit smoking if you want to sleep better or smoke fewer cigarettes at least four hours before bed.

Tip for better sleep # 14: Manage your stress level
One of the biggest enemies of good sleep is your stress level. If you constantly worry then you are consciously hampering your sleep pattern. If you want to sleep well, then mange your stress level efficiently. Give yourself a break or share a laugh with your friends. Before bedtime, jot down what's on your mind and then set it aside for tomorrow.

Tip for better sleep # 15: Visit a doctor
In spite of trying all the possible tips if you are still experiencing trouble while falling asleep, then consult a doctor as soon as possible. A doctor will actually help you to find out the core reason which is disturbing your sleep pattern. If you are experiencing trouble falling asleep for more than 20 days, then it's high time that you should take medical help.

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Study: Ultrasound shows risk of autism at birth

This study claims that an ultrasound within the first few days of life can show brain abnormalities that can indicate a risk of developing autism later in life.

Low-birth-weight babies with a particular brain abnormality are at greater risk for autism, according to a new study that could provide doctors a signpost for early detection of the still poorly understood disorder.

Led by Michigan State University, the study found that low-birth-weight newborns were seven times more likely to be diagnosed with autism later in life if an ultrasound taken just after birth showed they had enlarged ventricles, cavities in the brain that store spinal fluid. The results appear in the Journal of Pediatrics.

"For many years there's been a lot of controversy about whether vaccinations or environmental factors influence the development of autism, and there's always the question of at what age a child begins to develop the disorder," said lead author Tammy Movsas, clinical assistant professor of pediatrics at MSU and medical director of the Midland County Department of Public Health.

"What this study shows us is that an ultrasound scan within the first few days of life may already be able to detect brain abnormalities that indicate a higher risk of developing autism."

Movsas and colleagues reached that conclusion by analyzing data from a cohort of 1,105 low-birth-weight infants born in the mid-1980s. The babies had cranial ultrasounds just after birth so the researchers could look for relationships between brain abnormalities in infancy and health disorders that showed up later. Participants also were screened for autism when they were 16 years old, and a subset of them had a more rigorous test at 21, which turned up 14 positive diagnoses.

Ventricular enlargement is found more often in premature babies and may indicate loss of a type of brain tissue called white matter.

"This study suggests further research is needed to better understand what it is about loss of white matter that interferes with the neurological processes that determine autism," said co-author Nigel Paneth, an MSU epidemiologist who helped organize the cohort. "This is an important clue to the underlying brain issues in autism."

Prior studies have shown an increased rate of autism in low-birth-weight and premature babies, and earlier research by Movsas and Paneth found a modest increase in symptoms among autistic children born early or late.

The study was supported by a grant from the National Institutes of Health.

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