Study finds association between genetics and sleep behavior

A recent study found an association between genetics and sleep behavior.

The Coriell Personalized Medicine Collaborative (CPMC), a research initiative exploring the utility of genetic information in the clinical setting, has published a study and identified six noteworthy genes that affect human sleep duration.

Available in Volume 168, Issue 8 of the American Journal of Medical Genetics: Neuropsychiatric Genetics, the paper, titled, "Using the Coriell Personalized Medicine Collaborative Data to Conduct a Genome-Wide Association Study of Sleep Duration," draws on data collected from Coriell study participants to establish its findings.

"The fundamental biological purpose of sleep is still not understood," says Dr. Michael Christman, President and CEO of Coriell Institute. "But by engaging a diverse participant population and accumulating rich datasets, the CPMC research study is pursuing the type of insights that will help us learn more about sleep duration and, ultimately, improve human health."

The focus of the CPMC paper was to identify the genes associated with sleep duration and validate the connection between sleep and several demographic and lifestyle factors, including age, gender, weight, ethnicity, exercise, smoking and alcohol. Analysis implicated genes involved in ATP metabolism, circadian rhythms, narcolepsy, sleep cycles in mice, and bear hibernation.

"Researchers widely acknowledge that receiving inadequate sleep is a serious problem and can potentially contribute to a variety of health complications, such as a weakened immune system or an increased risk for obesity and diabetes," says Dr. Laura Scheinfeldt, lead author on the paper and a research scientist at Coriell.

"Individuals who average six hours or less are more susceptible to adverse health issues, and we found that participants enrolled in the CPMC study vary greatly in the amount of sleep they receive," says Dr. Scheinfeldt. "Effectively, by learning more about an individual's sleep patterns and considering environmental and genetic risk factors, physicians may one day be able to identify risks before they occur and target health solutions."

Founded in 2007, the CPMC research study involves a network of physicians, scientists, genetic counselors, and upwards of 8,500 volunteer participants. The study has produced more than 20 publications examining a range of complex human conditions, including cardiovascular disease, breast and lung cancer, and type I and II diabetes.

The Coriell study is committed to advancing the precision medicine discussion by aligning with progressive institutions, including the United States Air Force Medical Service, and sharing noteworthy data.

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Treating sleep apnea helps children behave

According to this article, treating sleep apnea helps children behave.

Obstructive sleep apnea makes it nearly impossible to get a good night's sleep. Imagine air stopping in your throat, prompting you to choke anobesity, AHDH, and heart disease. If that weren't reason enough to seek treatment, maybe this will: A recent study conducted by the University of Michigan Health System found remedying a child’s sleep apnea improves their behavior, no matter if they have a low or high IQ.

"When a clinician sees a pediatric patient who has a problem in school, they ask about sleep," said Dr. Ronald Chervin, neurologist and director of the University of Michigan Sleep Disorders Center, in a statement. "We wondered, in high-performing children, do we still need to worry about snoring or sleep issues?"

Chervin and his colleagues recruited 147 children between the ages of 3 and 12 who were scheduled to undergo an adenotonsillectomy — a procedure that removes the patient’s tonsils and adenoids. Adenotonsillectomy is usually performed when children are suspected of having obstructive sleep apnea, which is characterized by enlarged tonsils and adenoids that stop children from breathing up to ten seconds throughout the night.

Researchers conducted sleep tests that monitored brain wave patterns, eye movements, heart rhythm, muscle activity, airflow out the nose and mouth, chest movements, and snoring. They then asked parents to grade their child's behavior with regard to inattention, hyperactivity, social problems, and perfectionism. The results showed children from both low and high IQ groups experienced similar behavioral improvements when they were reevaluated six months after the adenotonsillectomy.

"Regardless of intellectual level, we can expect to see some behavioral improvement along with better sleep," said Dr. Bruno Giordani, a professor of neurology, psychiatry, psychology, and nursing. "Once behavior improves, attention in school improves, and emotional ability and behavioral and impulsivity control improve."

Although children with high IQs were included in the study, identifying children with high IQs and obstructive sleep apnea is difficult in practice because they don't typically show problems with school performance. Spotting a child who is struggling from a lack of good sleep is a lot tougher than an adult who almost certainly will appear to be tired the next day, if not outright complain about it. Children, on the other hand, often react to a lack of sleep by being hyperactive the next day.

"Children with obstructive sleep apnea are fidgeting and not able to stay on task, because they're doing anything they can to stay awake," said Dr. Seockhoon Chung. "Even when those behavioral problems are minimal, improvement is still possible."

Studies have shown improved behavioral problems related to sleep apnea is imperative to ensuring these behaviors don't carry over into teenage years. A study presented at SLEEP 2012 found children with untreated obstructive sleep apnea suffered more from long-term behavioral problems, including aggression, hyperactivity, difficulty in controlling their behavior, and many other social and behavioral problems.

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Study: Frequent social media use linked to sleep disturbance

A recent study links frequent social media use is linked to sleep disturbances.

Young adults who spend a lot of time on social media during the day or check it frequently throughout the week are more likely to suffer sleep disturbances than their peers who use social media less, according to new research from the University of Pittsburgh School of Medicine.

Published online and scheduled for the April issue of the journal Preventive Medicine, the study indicates that physicians should consider asking young adult patients about social media habits when assessing sleep issues. The research was supported by the National Institutes of Health (NIH).

"This is one of the first pieces of evidence that social media use really can impact your sleep," said lead author Jessica C. Levenson, Ph.D., a postdoctoral researcher in Pitt's Department of Psychiatry. "And it uniquely examines the association between social media use and sleep among young adults who are, arguably, the first generation to grow up with social media."

In 2014, Dr. Levenson and her colleagues sampled 1,788 U.S. adults ages 19 through 32, using questionnaires to determine social media use and an established measurement system to assess sleep disturbances.

The questionnaires asked about the 11 most popular social media platforms at the time: Facebook, YouTube, Twitter, Google Plus, Instagram, Snapchat, Reddit, Tumblr, Pinterest, Vine and LinkedIn.

On average, the participants used social media a total of 61 minutes per day and visited various social media accounts 30 times per week. The assessment showed that nearly 30 percent of the participants had high levels of sleep disturbance.

The participants who reported most frequently checking social media throughout the week had three times the likelihood of sleep disturbances, compared with those who checked least frequently. And participants who spent the most total time on social media throughout the day had twice the risk of sleep disturbance, compared to peers who spent less time on social media.

"This may indicate that frequency of social media visits is a better predictor of sleep difficulty than overall time spent on social media," Dr. Levenson explained. "If this is the case, then interventions that counter obsessive 'checking' behavior may be most effective."

Senior author Brian A. Primack, M.D., Ph.D., assistant vice chancellor for health and society in Pitt's Schools of the Health Sciences, emphasized that more study is needed, particularly to determine whether social media use contributes to sleep disturbance, whether sleep disturbance contributes to social media use -- or both.

For example, social media may disturb sleep if it is:

• Displacing sleep, such as when a user stays up late posting photos on Instagram.
• Promoting emotional, cognitive or physiological arousal, such as when engaging in a contentious discussion on Facebook.
• Disrupting circadian rhythms through the bright light emitted by the devices used to access social media accounts.

Alternatively, young adults who have difficulty sleeping may subsequently use social media as a pleasurable way to pass the time when they can't fall asleep or return to sleep.

"It also may be that both of these hypotheses are true," said Dr. Primack, also director of Pitt's Center for Research on Media, Technology and Health. "Difficulty sleeping may lead to increased use of social media, which may in turn lead to more problems sleeping. This cycle may be particularly problematic with social media because many forms involve interactive screen time that is stimulating and rewarding and, therefore, potentially detrimental to sleep."

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Sleeping in on weekends can lessen risk of diabetes

Sleeping in on weekends and playing "catch up" on lost sleep can lessen the risk of diabetes due to sleep deprivation.

Two consecutive nights of extended sleep, a typical weekend occurrence, appears to counteract the increased risk of diabetes associated with short-term sleep restriction during the work week, at least in lean, healthy, young men eating a controlled diet.

The finding, based on a study performed at the University of Chicago sleep laboratory published early online by the journal Diabetes Care, could affect large numbers of people who work long hours.

The pattern of cutting back on sleep during the work week followed by catching up on sleep over the weekend is common. Even short-term sleep restriction, with four or five hours of sleep per night, can increase the risk of developing diabetes by about 16 percent--comparable to the increase in risk caused by obesity.

"In this short-term study, we found that two long nights spent catching up on lost sleep can reverse the negative metabolic effects of four consecutive nights of restricted sleep," said study author Josiane Broussard, PhD, now an assistant research professor in the Department of Integrative Physiology at the University of Colorado, Boulder.

The researchers recruited 19 volunteers, all healthy young men. On one occasion, they were allowed to sleep normally, spending 8.5 hours in bed for four nights. On another occasion, the same volunteers were first sleep deprived, allowed only 4.5 hours in bed for four consecutive nights. They spent an average of 4.3 of those hours asleep each night. Subsequently, they were allowed 2 nights of extended sleep, during which they averaged 9.7 hours of sleep.

Investigators then determined the subjects' insulin sensitivity--the ability of insulin to regulate blood sugars--and the disposition index, a predictor of diabetes risk. After four nights of sleep restriction, the volunteers' insulin sensitivity decreased by 23 percent and their diabetes risk increased by 16 percent.

After two nights of extended sleep, however, insulin sensitivity and the risk of diabetes returned to normal sleep levels.

"The metabolic response to this extra sleep was very interesting and encouraging," said senior author Esra Tasali, MD, associate professor of medicine at the University of Chicago. "It shows that young, healthy people who sporadically fail to get sufficient sleep during the work week can reduce their diabetes risk if they catch up on sleep during the weekend."

"Though this is evidence that weekend catch-up sleep may help someone recover from a sleep-deprived week," Broussard said, "this was not a long-term study and our subjects went through this process only once. Going forward we intend to study the effects of extended weekend sleep schedules in people who repeatedly curtail their weekday sleep."

Increased risk of developing diabetes is not the only drawback associated with inadequate sleep, the authors point out. The volunteers in this study were given a calorie-controlled diet, but sleep-deprived adults outside the laboratory setting tend to eat more, with a strong preference for sweets and high-fat foods. Chronically sleep deprived people are more likely to develop other health problems such as increased inflammation and high blood pressure. They also show cognitive problems, tend to be less alert and have difficulty concentrating, reasoning and solving problems. They are prone to traffic accidents. The impact of extra weekend sleep on other adverse health and safety outcomes remains to be determined.

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Poor sleep could mean strokes for seniors

Poor sleep could raise stroke risk in seniors.

Poor sleep may raise seniors' risk of hardening of the brain arteries, and possibly contribute to the chances of a stroke, a new study suggests.

Researchers examined the autopsied brains of 315 people, average age 90, who had undergone at least one full week of sleep quality assessment before their death. Twenty-nine percent of them had suffered a stroke, and 61 percent had moderate-to-severe damage to blood vessels in the brain.

Those with the highest levels of sleep fragmentation -- repeated awakenings or arousals -- were 27 percent more likely to have hardening of the brain arteries. Among study participants, sleep was disrupted an average of nearly seven times an hour.

For each additional two arousals during one hour of sleep, there was a 30 percent greater likelihood of having visible signs of oxygen deprivation in the brain, the study authors said.

However, the study was not designed to prove a cause-and-effect link between poor sleep and stroke risk.

The findings were independent of other stroke and heart disease risk factors, such as weight, diabetes, smoking and high blood pressure, as well as other health conditions such as Alzheimer's disease, depression, heart failure and pain, according to the study published Jan. 14 in the journal Stroke.

"The forms of brain injury that we observed are important because they may not only contribute to the risk of stroke but also to chronic progressive cognitive and motor impairment," lead investigator Dr. Andrew Lim, an assistant professor of neurology at the University of Toronto, said in a journal news release.

"However, there are several ways to view these findings: sleep fragmentation may impair the circulation of blood to the brain, poor circulation of blood to the brain may cause sleep fragmentation, or both may be caused by another underlying risk factor," said Lim, who is also a neurologist and scientist at Sunnybrook Health Sciences Center in Toronto.

While the findings suggest that sleep monitoring could help identify seniors at risk for stroke, further research is needed to clarify a number of areas.

One expert praised the research, but added that it wasn't the last word on the topic.

"This is an excellent study, highly provocative, but not definitive because of the design, as mentioned by the authors themselves," said Dr. Richard Libman, vice chairman of neurology at Long Island Jewish Medical Center in New Hyde Park, N.Y.

"There appears to be a clear association between poor sleep [sleep fragmentation] and hardening of the arteries and risk of stroke," Libman said. "As noted, the direction of this association is uncertain.

"Sleep, to some degree, is within our control and we should all make attempts to improve the quality of our sleep," he added.

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Sleep apnea and heart problems

This article explains heart problems that can be caused by obstructive sleep apnea.

A common sleep problem is bad for your heart, and the number of people that have it has increased by double digits over the past decade.  Studies suggest as many as 26 percent of all Americans may have mild to severe sleep apnea, and only about 10 percent are aware that they have it.
So, as many as 75 million people have a condition that many of know little about.  Sleep apnea is a condition that intrudes into daily living by causing snoring, daytime sleepiness, headache, and poor concentration, but it also can lead to potentially deadly cardiac issues.
Let’s take a look at some of the heart problems that studies have shown sleep apnea can cause:

1. Atrial fibrillation.  Traditional treatment for the irregular heart rhythm called atrial fibrillation consists of blood thinners, medications, and an invasive, expensive procedure called ablation.  There may be a more natural approach.  Atrial fibrillation has been cured in people who are overweight and have sleep apnea.  The treatment consists of weight loss, and sometimes using a device called CPAP to improve oxygen levels during sleep.  According to the Sleep Heart Health Study, the likelihood of developing afib if you have untreated sleep apnea increases fivefold, and treatment improves the likelihood that your rhythm will stay regular into the future.   
2. Hypertension.  There is no doubt that undiagnosed and untreated obstructive sleep apnea can result in high blood pressure.  In addition, apnea can make hypertension very difficult to treat with medication, and one-third of people with a condition called resistant hypertension have undiagnosed sleep apnea. Again, weight loss and using a CPAP mask as prescribed by a sleep specialist can make a huge difference
3. Stroke.  Obstructive sleep apnea (called OSA), has been shown to increase the risk of both stroke and premature dementia.  An analysis published just this month in the journal PLOS One demonstrated that treating the condition with CPAP was associated with a lower incidence of stroke and cardiac events.       
4. Coronary artery disease.  Not only does untreated OSA worsen atherosclerotic coronary disease  (the blockages that cause heart attacks), it also messes with metabolism, worsening cholesterol and sugar levels. This can lead to fatal heart attacks.   Reggie White, the Philadelphia Eagle great, died at age 43, most likely from OSA.
5. Pulmonary hypertension. This condition, in which blood pressure in the lungs can be markedly elevated, is another cardiovascular disease with a well-established relationship to OSA.  Sleep apnea is also associated with congestive heart failure, and inflammation that may have an impact on other non-cardiac problems such as Parkinson’s disease.

Obstructive sleep apnea is often associated with being overweight, and losing weight can be a cure.   If you are a guy with a neck size over 18 inches, or a woman with a neck measuring more than 17 inches, there is an increased chance that you may have OSA.  It is more common in men than women, with up to 34% of men and 17% of women having undiagnosed OSA.

Central sleep apnea, the less common type, and is not related to weight. 

The only way to diagnose sleep apnea is to have a sleep study.  For years, this had to be done in a clinic, but now more people are being screened at home.

Treatment with a CPAP machine requires wearing a mask over your nose or mouth while sleeping, a deal breaker for many.  Newer technologies including smaller masks and mouth appliances have improved treatment, so if this fear has prevented you from getting checked out, it may be a good time to reconsider.

Seeing a sleep specialist now may avert the need to see a cardiologist in the future. 

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How what you eat affects how you sleep

A study looked into how what you eat affects your sleep and found diet quality and influence sleep quality.

A recent study held by researchers from the Institute of Human Nutrition at Columbia University Medical Center in New York has found that a person's diet greatly affects the quality of sleep that they get.

"Our main finding was that diet quality influenced sleep quality," study leader Marie-Pierre St-Onge, PhD, assistant professor in the department of medicine and Institute of Human Nutrition at Columbia University Medical Center, said in a press release.

The study, published in the Journal of Clinical Sleep Medicine, found that a diet containing more saturated fat and more sugar and less fiber is linked to less restorative, disrupted sleep.

"It was most surprising that a single day of greater fat intake and lower fiber could influence sleep parameters," St-Ongeadded.

The study looked into the sleep quality of 26 adult participants (13 men and 13 women). These participants weighed normally and had an average age of 35. They were given controlled diets for four days and were given freedom to choose the food they want on the fifth day of the study.

The participants spent five nights in a “sleep lab,” spending 9 hours in bed from 10 p.m. to 7 a.m. They slept an average of 7 hours and 35 minutes every night. Participant sleep data were gathered every night using polysomnography. Moreover, the data were analyzed after three days of feeding on controlled diets and after the fifth night where the participants chose their own food.

The researchers found that, when a participant consumes more fiber and less sugars and less saturated fat,he/she will be spending more time in the stage of deep, “slow wave” sleep, which is more restorative. On the other hand, greater sugar intake was linked to a heightened number of arousals during sleep.

The researchers also found that the participants were able to sleep quicker when they ate the fixed meals, which had low amounts of saturated fat and higher amounts of protein compared to the meals the participants themselves selected. These fixed meals were provided by a nutritionist.

The participants, after eating the meals they selected on their own, were able to sleep an average of 29 minutes after consuming their food and drink. On the other hand, it took them only an average of 17 minutes to sleep after eating the meals provided by the nutritionist.

"The finding that diet can influence sleep has tremendous health implications, given the increasing recognition of the role of sleep in the development of chronic disorders such as hypertension, diabetes and cardiovascular disease," St-Onge said.

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Study: Texting negatively affects teen's sleep and academic performance

A study shows that teenagers who text at night hurts their sleep and academic performance.

Can't stop texting? If you're a teenager, it may be to blame for falling grades and increased yawning in school, according to a new Rutgers study.

The study, published in the Journal of Child Neurology, is the first of its kind to link nighttime instant messaging habits of American teenagers to sleep health and school performance.

"We need to be aware that teenagers are using electronic devices excessively and have a unique physiology," says study author Xue Ming, professor of neuroscience and neurology at Rutgers New Jersey Medical School. "They tend to go to sleep late and get up late. When we go against that natural rhythm, students become less efficient."

The American Academy of Pediatrics reports that media use among children of all ages is increasing exponentially; studies have found that children ages 8 to 18 use electronic devices approximately seven-and-a-half hours daily.

Ming's research is part of a small but growing body of evidence on the negative effects of electronics on sleep and school performance. But few studies, Ming says, have focused specifically on instant messaging.

"During the last few years I have noticed an increased use of smartphones by my patients with sleep problems," Ming says. "I wanted to isolate how messaging alone - especially after the lights are out - contributes to sleep-related problems and academic performance."

To conduct her study, Ming distributed surveys to three New Jersey high schools - a suburban and an urban public school and a private school - and evaluated the 1,537 responses contrasting grades, sexes, messaging duration and whether the texting occurred before or after lights out.

She found that students who turned off their devices or who messaged for less than 30 minutes after lights out performed significantly better in school than those who messaged for more than 30 minutes after lights out.

Students who texted longer in the dark also slept fewer hours and were sleepier during the day than those who stopped messaging when they went to bed. Texting before lights out did not affect academic performance, the study found.

Although females reported more messaging overall and more daytime sleepiness, they had better academic performance than males. "I attribute this to the fact that the girls texted primarily before turning off the light," Ming says.

The effects of "blue light" emitted from smartphones and tablets are intensified when viewed in a dark room, Ming says. This short wavelength light can have a strong impact on daytime sleepiness symptoms since it can delay melatonin release, making it more difficult to fall asleep - even when seen through closed eyelids.

"When we turn the lights off, it should be to make a gradual transition from wakefulness to sleep," Ming says. "If a person keeps getting text messages with alerts and light emission, that also can disrupt his circadian rhythm. Rapid Eye Movement sleep is the period during sleep most important to learning, memory consolidation and social adjustment in adolescents. When falling asleep is delayed but rising time is not, REM sleep will be cut short, which can affect learning and memory."

Ming notes some benefits to early-evening media use, such as facilitating collaboration for school projects, providing resources for tutoring, increasing school readiness and possibly offering emotional support systems.

She suggests that educators recognize the sleep needs of teenagers and incorporate sleep education in their curriculum. "Sleep is not a luxury; it's a biological necessity. Adolescents are not receiving the optimal amount of sleep; they should be getting 8-and-a-half hours a night," says Ming. "Sleep deprivation is a strong argument in favor of later start times for high schools - like 9 a.m."

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Health consequences of texting in bed

A study indicates that texting in bed can lead to losing sleep in addition to poor school performance in teens.

Many American teens text in bed, leading to lost sleep, daytime drowsiness and poorer school performance, a new study says.

Researchers from New Jersey looked at nearly 3,200 middle and high school students in the state. They found that nearly 62 percent of the kids used their smartphones in some capacity after bedtime; nearly 57 percent texted, tweeted or messaged in bed; and nearly 21 percent awoke to texts.

"Our study confirms that many teenagers are texting late at night when they should be sleeping. This behavior is more common among older teenagers, especially those in high school, and among girls," said study co-author Vincent DeBari. He is director of research at the Seton Hall University School of Health and Medical Sciences, in South Orange.

"One of the most worrisome aspects of our findings is that in addition to affecting the quality and amount of sleep teenagers are getting, bedtime smartphone use seems to be having a negative impact on their level of alertness during the day and on their grades in school," DeBari said in a university news release.

His study co-author, Dr. Peter Polos, added that teens whose sleep is disrupted by incoming texts may feel compelled to respond to those texts immediately. These exchanges can go on for hours.

"This leads to excessive stimulation at night. Light from electronic devices can suppress the secretion of melatonin, a hormone that promotes sleep. All of these factors combine to make sleep difficult in the face of excessive smartphone use at night," said Polos, a member of the sleep medicine division of the JFK Neuroscience Institute in Edison, N.J.

The researchers also found that smartphone use just before or after bedtime may worsen teens' tendency to go to bed much later and sleep until late morning. This behavior has been linked with depression, anxiety and attention-deficit hyperactivity disorder, the study authors said.

"Repeatedly, studies have shown that today's adolescent students are seriously sleep-deprived, and that it affects their health, their mood and their safety behind the wheel. Our study shows that the unrestricted use of smartphones at night may be a major contributing factor," Dr. Sushanth Bhat, an assistant professor of neuroscience at Seton Hall, said in the news release.

"Since getting the proper amount of sleep is very important for brain development and learning in the teenage years, our study should prompt parents and guardians to consider placing reasonable limitations on adolescent smartphone usage at night," Bhat concluded.

The study findings appear in the October issue of the Journal of Adolescence.

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Night owl sleep habits can make you put on weight

A study shows that night owl sleep habits can cause a person to put on weight.

A new study done at the UC Berkeley’s Golden Bear Sleep and Mood Research Clinic, says going to bed late at night can lead to weight gain, according to an article onnews.berkeley.edu.

The study found a link between sleep and Body mass index (BMI), and the results are showing that teens and also adults that get to bed late during the week are probably going to put on more weight than those who have an earlier bedtime each night.

The researchers looked at the numbers from over 3,300 participants, youth and adult, and they discovered a gain of 2.1 pounds on the BMI for each hour of sleep lost over a five -year period.

Surprisingly, they found that the gain in BMI held true despite the participants regimen of exercise, TV or computer screen time or even the number of hours they slept overall.

BMI is calculated using the body’s height and weight and is a useful metric for measuring weight gain and obesity.  A healthy BMI is said to be between 18.5 and 24.9.  A BMI of 25.0 to 29.9 is considered overweight and 30.0 or greater is classified as obese.

The data the researchers used came from the National Longitudinal Study of Adolescent Health.  That study has been recording the behaviors of teens from the United States since 1994.  In the new study, they compared the BMI and the bedtimes for teens at the onset of puberty, during their college-age years and as young adults.

Lauren Asarnow, lead author of the study and a doctoral student in UC Berkeley’s Golden Bear Sleep and Mood Research Clinic said “These results highlight adolescent bedtimes, not just total sleep time, as a potential target for weight management during the transition to adulthood.”

She also added that young people that go to sleep earlier each night “set their weight on a healthier course as they emerge into adulthood.”

Earlier surveys and studies have revealed that teens do not get the recommended amount of sleep each night, and many teens report having difficulty staying alert and awake in school.

Later in life, the natural circadian rhythm shifts toward a later sleep cycle.  The circadian rhythm is the natural body clock that regulates your metabolic and physiological functions.

Other studies have suggested a link between late night owls and mental health.  It appears that people that are going to bed later have an increased risk of developing depression and other mental health related issues.

The hope is that the findings of the study will encourage young adults to be more conscious of the effect of late-night bedtimes, despite the pressure they will feel to be a part of their social group, particularly in a college-type setting.

Even if they are aware of the benefits of earlier sleep times, it will be difficult to maintain that type schedule while being a student.

Habits are hard to break as well.  If teens are used to going to bed a 10 to 11 PM during high school years, they will have a hard time changing their cycle once they are out on their own.  Parents who see the results of the study may want to monitor their children more closely and develop an earlier bedtime ritual at an early age to make it easier later on in life.

No teen wants to gain weight, especially around their peers in a university setting, and it is hoped that these findings will encourage teens and young adults to take their sleeping habits more seroiously.

The co-authors of the study include Allison Harvey at UC-Berkeley and Elanor McGlinchey at Columbia University, along with Ms. Asarnow, who is a researcher on UC-Berkeley’s Teen Sleep Study.

The Teen Sleep Study seeks to assist teens to reset the circadian rhythms of young people that are having trouble sleeping and waking up on time.

The results of the study were published in the October edition of the journal Sleep.

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Melatonin use in children

This article discusses melatonin use in children.

What we do know: Supplemental melatonin can help children with sleep dysfunction (those who lie awake for hours at bedtime) fall asleep. However, melatonin only helps with sleep initiation (falling asleep) not staying asleep. So if you are dealing with wake ups during the night... melatonin is not the solution. Normal awakenings shift and change due to all sorts of developmental milestones and changes as children grow. Overnight awakenings will always be normal although how our children get back to sleep on their own changes our night of sleep dramatically!

What Is Melatonin?
Melatonin is a naturally-occurring hormone that our brains produce to help regulate sleep and wake cycles. People call it the "sleep hormone" because unlike the parts of body that drive wakefulness, melatonin drives sleepiness. Normally, melatonin levels begin to rise in the late evening (around 8 p.m. for kids, around 10 p.m. for teens), remain high for most of the night, and then drop in the early morning a couple hours before we wake up. Light inhibits melatonin and affects how much melatonin your body produces. Hence why being outside in the light during the day with a newborn (especially the ones who want to party all night) or when switching time zones makes a lot of sense! Light from screens (Kindles, iPads, tablets, computers, TVs) inhibits melatonin from being released. Getting outside during the day helps teach your brain day vs. night -- an important strategy for anyone struggling with sleep.

The Melatonin Supplement
The melatonin supplement you find at your local drug store is synthetically produced in factories. Because it's a supplement and not a medicine it's not regulated by the FDA like medicines. Therefore inconsistency in dosing is possible (no one can say that one brand's 1-mg tablet is the same dose as another's). Potency varies by brand and even between different batches from the same manufacturer. Always avoid "natural" melatonin (derived from cow or pig brains) and purchase only the man-made synthetic supplement that is far more readily available.

Melatonin Dosing Recommendations
"There are no clear-cut dosage guidelines because neither melatonin nor any other medication or supplement is approved by the FDA for the purpose of treating insomnia in children," said sleep expert Dr. Maida Chen of Seattle Children's Hospital.

Typically you always want to use the lowest dose: 0.5mg or 1mg -- then consider increasing by 0.5mg every few days if your child isn't falling asleep within an hour of bedtime. While increasing dose, make sure you're also working on consistent bedtimes, policing screens in the bedroom, and working to get good exercise OUTSIDE during the day. Many children will respond to a dose 0.5mg or 1mg an hour or two prior to bedtime. Some children and teens with significant challenges falling asleep are often given doses as high as 3mg to 6mg with severe insomnia at bedtime but in my experience many children get the hypnotic effect at smaller doses. Talk with your child's physician about how to determine a dose if or when melatonin is being used and if it's not working, GET OFF OF IT. Not all children respond to the hypnotic effect of supplemental melatonin.

Timing: You want to give melatonin prior to bedtime to help with increasing sleepiness. Most physicians recommend giving about 1-2 hours prior to ideal bedtime when helping little children fall asleep. However, it does depend why and how you plan to use melatonin. Here's a GREAT on how melatonin works and when to administer from Dr. Craig Canapari -- a pediatric sleep expert at Yale.

Children With ADHD and/or Autism Spectrum Disorders (ASD)
Children with ADHD and/or autism spectrum disorder are known to have challenges falling asleep. Studies with melatonin have been done in these populations of children. Dr. Chen explains:
"More trials of melatonin for sleep difficulties have been done in children with ADHD or ASD than studies for typically developing children. Evidence from these trials suggests that melatonin is safe and does shorten the length of time it takes to fall asleep. However, the effects are not generally overwhelming and not every child who takes melatonin shows sleep improvement. The studies mostly evaluate short-term use only." Most worries about long-term use and safety are speculative (based on studies in animals or adults) but without clarity from research it's always best to get kids off melatonin when you can.

Sleep matters. Good sleep is essential. But it's rare for a child to need meds.

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Health effects of sleep apnea

This article discusses the effects of sleep apnea beyond snoring.

According to the American Sleep Apnea Association, about 22 million Americans have sleep apnea and about 80 percent of those cases are undiagnosed. Sleep apnea is an involuntary sleep disorder in which breathing repeatedly stops and starts.

Sleep apnea can occur when tissue in the back of the throat blocks the airway. If the airway is blocked, the amount of oxygen delivered to the body’s organs is reduced. When blood-oxygen levels drop low enough, the body wakes itself up. Sometimes it happens so fast that it goes unnoticed to the sleeper. People with sleep apnea can stop breathing hundreds of times during the night and often for a minute or longer.

Sleep apnea can have serious and life-shortening consequences if it is not treated. These include high blood pressure, heart disease, stroke, memory problems, diabetes and depression.

Symptoms of sleep apnea:

• loud snoring
• fatigue
• insomnia
• persistent daytime sleepiness
• awakening out of breath during the night
• frequently waking in the morning with a dry mouth or a headache

The most widely used treatment for sleep apnea is a Continuous Positive Airway Pressure (CPAP) machine. The CPAP has a mask that goes over the nose, or sometimes nose and mouth, during sleep and supplies pressurized air that flows into the person’s throat. The increased air pressure keeps the airway open. Sometimes people still struggle with sleep apnea even after they use a CPAP. In those cases, surgery may be needed.

Sleep apnea is sometimes caused by the back of the tongue or tonsils blocking the airway. In these cases, an uvulopalatopharyngoplasty (UVPPP) is required. UVPPP involves shortening the soft palate and removing the tonsils, and it has been the most common sleep apnea surgical procedure performed in the past 25 years. In addition, robotic-assisted resection of the base of tongue is a minimally invasive approach to remove obstructive tongue tissue blocking the airway. After this surgery, sleep apnea is often corrected. At Long Beach Memorial, the da Vinci Si Robotic Surgical System is used to remove redundant tongue tissue and is performed in conjunction with the UVPPP to help our patients get a good night’s rest.

In order to properly diagnose sleep apnea, a physician must conduct a sleep study in a sleep lab, usually overnight. A sleep study monitors activity during sleep such as measuring brain waves, heart rate and rhythm, breathing patterns and oxygen levels.

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Study: CPAP use may reverse negative changes in brain stem activity

A study shows that treating sleep apnea with a CPAP may reverse brain stem activity. -JR

Sleep apnea treatment may reverse changes in brain stem activity associated with increased risk of heart disease, a new study suggests.

The findings "highlight the effectiveness of CPAP treatment in reducing one of the most significant health issues [heart disease] associated with obstructive sleep apnea," the researchers concluded. CPAP stands for continuous positive airway pressure.

Previous research suggests that people with obstructive sleep apnea have greater activity in nerves associated with stress response, which can lead to high blood pressure and heart problems. This increased nerve activity is due to altered brain stem function caused by sleep apnea, earlier studies have shown.

In this small study, published recently in the Journal of Neurophysiology, Australian researchers found that CPAP treatment reduced that nerve activity by restoring normal brain stem function.

The study included 13 sleep apnea patients who were assessed before and after six months of CPAP treatment.

"These data strongly suggest that functional and anatomical changes within the brain stem, which we believe underlie the elevated sympathetic activity in individuals with untreated obstructive sleep apnea, can be restored to healthy levels by CPAP treatment," the University of Sydney researchers wrote.

In obstructive sleep apnea, muscles in the airway collapse during sleep and block breathing. A CPAP device keeps airways open by delivering a steady flow of air while patients sleep.

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CPAP can help adults with sleep apnea and depressive symptoms

Depressive symptoms in adults with sleep apnea are improved when the person uses a CPAP.

A new study shows that depressive symptoms are extremely common in people who have obstructive sleep apnea, and these symptoms improve significantly when sleep apnea is treated with continuous positive airway pressure therapy.

Results show that nearly 73 percent of sleep apnea patients (213 of 293 patients) had clinically significant depressive symptoms at baseline, with a similar symptom prevalence between men and women. These symptoms increased progressively and independently with sleep apnea severity.

However, clinically significant depressive symptoms remained in only 4 percent of the sleep apnea patients who adhered to CPAP therapy for 3 months (9 of 228 patients). Of the 41 treatment adherent patients who reported baseline feelings of self-harm or that they would be "better dead," none reported persisting suicidal thoughts at the 3-month follow-up.

"Effective treatment of obstructive sleep apnea resulted in substantial improvement in depressive symptoms, including suicidal ideation," said senior author David R. Hillman, MD, clinical professor at the University of Western Australia and sleep physician at the Sir Charles Gairdner Hospital in Perth. "The findings highlight the potential for sleep apnea, a notoriously underdiagnosed condition, to be misdiagnosed as depression."

Study results are published in the September issue of the Journal of Clinical Sleep Medicine.

The American Academy of Sleep Medicine reports that obstructive sleep apnea (OSA) is a common sleep disease afflicting at least 25 million adults in the U.S. Untreated sleep apnea increases the risk of other chronic health problems including heart disease, high blood pressure, Type 2 diabetes, stroke and depression.

The study group comprised 426 new patients referred to a hospital sleep center for evaluation of suspected sleep apnea, including 243 males and 183 females. Participants had a mean age of 52 years. Depressive symptoms were assessed using the validated Patient Health Questionnaire (PHQ-9), and the presence of obstructive sleep apnea was determined objectively using overnight, in-lab polysomnography. Of the 293 patients who were diagnosed with sleep apnea and prescribed CPAP therapy, 228 were treatment adherent, which was defined as using CPAP therapy for an average of 5 hours or more per night for 3 months.

According to the authors, the results emphasize the importance of screening people with depressive symptoms for obstructive sleep apnea. These patients should be asked about common sleep apnea symptoms including habitual snoring, witnessed breathing pauses, disrupted sleep, and excessive daytime sleepiness.

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Being in nature can help your sleep

A study suggests that being in nature can help your sleep quality.

Getting close to nature might improve the quality of your sleep, new research suggests.

Seniors and men sleep more soundly if they have access to natural surroundings, such as beaches or parks, according to a study published in the September issue of the journal Preventive Medicine.

"It's hard to overestimate the importance of high-quality sleep," study author Diana Grigsby-Toussaint, a professor of kinesiology and community health at the University of Illinois.

"Studies show that inadequate sleep is associated with declines in mental and physical health, reduced cognitive function and increased obesity," she said in a university news release. "This new study shows that exposure to a natural environment may help people get the sleep they need."

More than 255,000 adults from across the United States were surveyed about their quality of sleep in the previous month. Most said they slept poorly fewer than seven nights during the month.

But those who said they slept poorly on 21 to 29 nights were less likely to have access to green spaces or other natural areas than those who said they slept poorly on fewer than seven nights.

The link between good sleep and exposure to natural areas was much stronger for men than for women, the researchers found.

Living near parks and other natural areas can boost seniors' physical activity levels, which can help them sleep better, Grigsby-Toussaint explained.

She said the stronger link between green spaces and sleep among men could reflect women's reluctance to take advantage of such areas out of concern for their safety. More research is needed to understand this difference, she said.

"If there is a way for persons over 65 to spend time in nature, it would improve the quality of their sleep -- and their quality of life -- if they did so," Grigsby-Toussaint said.

The results provide an incentive for nursing homes and retirement communities to design buildings with nature trails and dedicated garden spaces, and to provide safe, inviting outdoor areas, she added.

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Study: Caffeine before bedtime offsets your internal clock

A study shows that drinking caffeine three hours before bedtime can delay your internal clock significantly.

A double espresso three hours before bedtime can induce a 40-minute time delay in your body's internal clock, making it harder to go to sleep on time and more challenging to wake up in the morning, scientists have shown for the first time.

The study led by the University of Colorado Boulder and the Medical Research Council's Laboratory of Molecular Biology in Cambridge, shows for the first time that evening caffeine delays the internal circadian clock that tells us when to get ready for sleep and when to prepare to wake up.

The research team showed the amount of caffeine in a double espresso or its equivalent three hours before bedtime induced a 40-minute phase delay in the roughly 24-hour human biological clock.

The study also showed for the first time how caffeine affects "cellular timekeeping" in the human body, said CU-Boulder Professor Kenneth Wright, who co-led the study.

"This is the first study to show that caffeine, the mostly widely used psychoactive drug in the world, has an influence on the human circadian clock," said Wright.

"It also provides new and exciting insights into the effects of caffeine on human physiology," he said.

For the study the team recruited five human subjects, three females and two males, who went though a double-blind, placebo-controlled 49-day protocol.

The subjects were tested under four conditions: low light and a placebo pill; low light and the equivalent of a 200-milligramme caffeine pill dependent on the subject's weight; bright light and a placebo pill; and bright light and the caffeine pill.

Saliva samples of each participant were tested periodically during the study for levels of the hormone melatonin, which is produced naturally by the pineal gland when directed to do so by the brain's "master clock."

The master clock is re-set by exposure to light and coordinates cellular clocks throughout the human body.

Melatonin levels in the blood increase to signal the onset of biological nighttime during each 24-hour period and decrease at the start of biological daytime, said Wright.

Those who took the caffeine pill under low-light conditions were found to have a roughly 40-minute delay in their nightly circadian rhythm compared to those who took the placebo pill under low light conditions, said Wright.

The magnitude of delay from the caffeine dose was about half that of the delay induced in test subjects by a three-hour exposure to bright, overhead light that began at each person's normal bedtime.

The study also showed that bright light alone and bright light combined with caffeine induced circadian phase delays in the test subjects of about 85 minutes and 105 minutes respectively.

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