Children with issues in classroom may have sleep disorder

Children who show ADD or ADHD symptoms in the classroom may be experiencing a sleep disorder.

More parents are waking up to the fact that sleep disorders are more common than most of us think. Now the American Academy of Pediatrics and doctors continue to warn parents that sleep disorders can trick you into thinking you’re dealing with something else all together.

Dr. Akinyemi Ajayi, the Medical Director of Children’s Sleep Lab, says that when a child is tired and can’t focus in the classroom or they’re fidgeting to stay awake, a teacher sees that and may presume the child has ADD and ADHD.

Parents Garrett and Joey Myers had the same problem with their twin daughters Monica and Megan. The girls were never diagnosed with a learning disorder, and it was a journey of many doctor visits to figure out why there girls where having behavioral problems.

“It’s a never ending battle of what looks like eating disorder or anxiety or OCD,” said Garret Myers, the girls’ father.

As the parents visited one medical expert after the next, mom Joey Myers, tried to ask doctors if the twins could possibly have narcolepsy, like she was diagnosed with in adulthood. So finally, the Myers met Dr. Ajayi, who after a series of test, determined the twins did have narcolepsy.

The girls are now being treated at separate therapeutic boarding schools out of state. “They basically have to finish growing up,” said Garrett Myers. “They stopped and at 10-years old, they regressed.”

Now the parents are trying to educate others moms and dad to be vigilant if they feel their child might be experiencing problems because of a sleep disorder.

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

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

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

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

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

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

Reciprocal relationship

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

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

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

Thorough interviews and diagnoses

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

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

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

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

What comes first?

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

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

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

Vicious cycle

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

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

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

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

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

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

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

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Study: Link between depression and sleep disorders in men

A study found a link between depression and sleep disorders in men.

Sleep problems are often caused by various mental illnesses, such as depression or post-traumatic stress disorder, but a new research shows interchangeability between sleep disorders and depression. Apparently, having trouble sleeping can also be a trigger.

Researchers from the University of Adelaide and the Adelaide Institute for Sleep Health examined levels of sleepiness throughout the day in almost 2,000 Australian men aged between 35 and 83.

It turned out that those exhibiting severe daytime sleepiness had 10 percent more chances of becoming depressed than those who felt rested during waking hours. Even after various risk factors were taken into account, the link between the two held up.

At the beginning of the assessment, none of the men entering the study were diagnosed with severe obstructive sleep apnea, but after joining, 856 of them were examined in the light of symptoms related to the condition.

Those receiving this diagnose turned out to be 2.1 times more prone to become depressed than participants who didn’t have the sleep condition.

According to the results, men who struggled with both extreme daytime sleepiness and severe sleep apnea had even more increased chances of depression – 4.2 times more than men with no sleep disorders. Suffering from both conditions also meant 3.5 times more chances of depression when compared with men with only one of them.

Two follow-up tests were involved in the evaluation of depression levels, taken at a five years difference from one another. This period allowed researchers to observe whether it is possible that sleep disorders are linked to a recent diagnosis of depression.

During those five years, men suffering from severe sleep apnea diagnosed during the study turned out to have 2.9 times increased risk of becoming depressed.

However, the study’s design could not help researchers determine whether sleep problems can be considered boosters of depression risk in men. They believe it is possible that depression is a cause of sleep disorders, but the reverse was more difficult to assess.

The team also considered the possibility that a third factor included in the equation could cause both depression and sleep troubles.

Authors of the study are still unsure about the exact relation between a sound sleep and risk of depression, but the results offer enough information doctors can use in their practices. For example, after a patient receives a depression diagnosis, physicians should order a screening for obstructive sleep apnea, even if the patient doesn’t show signs of sleepiness.

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When is the right time to get a sleep study done? When you feel...

This article explains when might be the appropriate time to get a sleep study done.

The long term effects of sleep deprivation can leave you physically and emotionally drained, and can have a serious effect on your overall health. Often times, people don’t necessarily realize that certain symptoms they are experiencing could actually be signs of an underlying sleep disorder. Common symptoms of a sleep disorder include:

• Waking up with a sore or dry throat
• Loud snoring
• Occasionally waking up with a choking or gasping sensation
• Sleepiness or lack of energy during the day
• Sleepiness while driving
• Morning headaches
• Restless sleep
• Forgetfulness and mood changes
• Recurrent awakenings or difficulty going to sleep

If you are experiencing any of these symptoms, there are things you can do to improve your sleep hygiene and hopefully alleviate sleep disturbances.  For instance, avoid caffeine consumption or eating a heavy meal in the evenings. Establish a pre-sleep routine to help you wind-down and prepare for sleep. Do something that is relaxing for you, such as turning off electronic devices, dimming the lights, taking a warm bath, listening to soft, calming music or reading a book.

If you have tried methods to improve your sleep hygiene, yet are still experiencing symptoms of a sleep disorder, it is time to talk to your doctor about getting a sleep study. Many people are apprehensive about sleep studies because they are uncomfortable with the thought of sleeping in an unfamiliar place while being monitored. However, Cone Health Sleep Disorders Centers (at Annie Penn Hospital and in Greensboro) have designed their facilities to feel like you are staying the night in a hotel room. Patients are also invited to bring pillows, blankets or other items from home to increase their comfort level. And remember, the benefits of having a sleep study administered and a treatment plan tailored to your condition well out-weighs the detrimental effect long term sleep deprivation can have on your overall health.

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Village in Kazakhstan hit with mystery sleep disorder

A small village in Kazakhstan is being hit with a mysterious sleep disorder where people fall asleep for days at a time.

Residents of a Kazakhstan town are being affected by a sleep disorder in which some fall asleep suddenly and don't wake up for days.

Over 150 cases since March 2013 have hit the town of Kalachi in northern Kazakhstan. The cause of the incidents, which come in waves, are unknown. The ninth wave of the mysterious illness was reported this week.

"The disease is characterized by the fact that the sickness immerses himself in unusually long sleep, while to bring them into full consciousness is practically impossible on the first day," said Leonid Rikhvanov of Russia's Tomsk Polytechnic University, who has studied the area for four years.

"During hospitalization, people exposed to the disease were marked by identical complaints: dizziness, weakness, loss of coordination, unconsciousness or semiconscious state for up to three days. After passing the first symptoms, they get headaches, become confused, and suffer emotional instability and memory disorders, which can last up to several weeks. In some cases, hallucinations occur, particularly in children. Some repeatedly fall asleep."

Rikhvanov suspects a nearby abandoned uranium mine is emitting radon, a colorless gas which could be working as an anesthetic or providing a narcotic effect. Other theories involve possible carbon monoxide poisoning and mass hysteria.

About 100 of Kalachi's 680 residents have been relocated to other parts of Kazakhstan, local government leader Amanbek Kalzhanov said.

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Tips to beat insomnia

This article gives 10 tips to help you beat insomnia.

Insomnia is the inability to get enough sleep needed to wake up feeling refreshed and well-rested.  Millions of people are suffering from this sleeping disorder.   You can cure insomnia without the additional cost of medication with just little changes in your lifestyle.

1. What you drink and eat before bedtime are also factors that can induce insomnia.  Cut down on alcohol, and do not eat heavy meals before bedtime.  Stick to light snacks and chamomile tea.Cut the caffeine – caffeine is a stimulant.  Cut down on other drinks and foods that have caffeine also, like sodas, teas, and tiramisus.  Coffee should be drank in the morning or at least eight hours before sleep.
2. Keep a quite, dark, and cool bedroom – an uncomfortable sleeping area will not induce sleep. Noise, light, and heat interfere with sleep.
3. The bed is for sleeping and sex – train your brain and body that the bed is for sleeping and sex. Doing office work and reading in bed is a no-no.  The goal is to associate the bed with relaxation and sleep.  Avoid watching TV while lying down in bed, watching TV stimulates your brain to think.  It may make your eyes tired, but the brain is busy converting images to thoughts.  Better yet, transfer the TV to the living room.
4. Avoid naps – try hard not to get that super nap in the afternoon. Naps disrupts sleep at night.  If you really can’t avoid it, limit it to 30 minutes before 3 pm.
5. Quit Smoking – nicotine, like caffeine, is a stimulant. The more you smoke, the more awake you’ll be.  Aside from the hazards of smoking, quitting will do wonders on your sleeping habits.
6. Change the way you think about insomnia – self-defeating thoughts help fuel insomnia. Think positive.  Instead of thoughts like “It’s the same every night,  another night of misery’, think this way instead “This does not every nught, some nights I get enough rest.”  Don’t worry too much, quit this mental habit.
7. Do away with stressful situations before bedtime – avoid heated discussions, heavy mental activities, even strenious activities before bedtime. Try some relaxing activities instead, listening to soft music with keeping the lights low will help in relaxing the brain.
8. Ban Blue Light in the bedroom – Short waves from blue light interferes with sleep. Use devices that have blue light an hour before going to sleep.  This includes TV, cellphones, and digital clocks.
9. Fat or Flat – not the body types, this refers to pillows. The discomfort you give your necks affects the quality of sleep, aside from having a sore neck upon waking up.  Pillows should be just the right size.  Side sleepers should have their nose align with the center of the body while sleeping.  Stomach sleeping should be avoided as this cranes the neck.
10. Control your body clock – go to sleep and wake up around the same time daily, irregardless if its a holiday or a weekend the next day. Our bodies have biological clocks and it is light regulated.  Try getting a ray of sunshine the minute you wake up, for 5 to 30 minutes.

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How to get good sleep if you do shift work

This article explains why shift work can hurt your sleep and gives tips on what to do if you do shift work.

If you work a non-traditional shift like the night shift or rotating shifts, you may be missing out on more than daylight and watching your kids’ soccer games. You could be missing out on sleep and better health.

Night shift workers who have trouble sleeping may have a condition known as shift work sleep disorder.

“Working non-traditional shifts interferes with the body’s circadian rhythms,” says sleep expert Tina Waters, MD. “Most of us are awake during the day because our body’s internal clock is keeping us awake. So no matter how tired you are after working all night, your awakening signals will conflict with your desire tosleep.”

Fortunately, there are some lifestyle changes that can help. But first, let’s look at the problems this disorder can cause.

Why shift work sleep disorder can be hazardous to your health

Studies have shown that lack of sleep can lead to other health issues. Some people develop gastrointestinal distress or metabolic disorders, such as diabetes. Others may develop heart disease.

“There was also a large study done on nurses who worked the night shift in which they were found to have a higher prevalence of infertility and even cancer,” Dr. Waters says.

From a non-health perspective, working alternate shifts can make it difficult to lead a balanced life. “If you’re a spouse or a parent, there are things going on during the time you need to be sleeping,” Dr. Waters says.

Do you have shift work sleep disorder?

Not all shift workers will develop shift work sleep disorder.

If you’re having trouble sleeping and you think this disorder could be the culprit, expect your doctor to first run some tests to rule out other underlying sleep disorders, such as sleep apnea or narcolepsy.

“It’s also a good idea to keep a sleep diary of which shifts you worked and what hours you slept,” says Dr. Waters. A sleep diary can help your doctor identify the problem and monitor its progression over time.

What you can do to get a good ‘night’s’ sleep

Practice good sleep hygiene. If you’re diagnosed with shift work sleep disorder, one of the most important things you can do to make sure you are getting enough sleep is to practice ‘good sleep hygiene.’ which includes:

• Establishing a regular bedtime routine and sticking to it
• Making your environment conducive to sleep (e.g., keeping your bedroom dark, cool and quiet)

Go straight to bed after work. Dr. Waters also recommends going home and sleeping as soon as your shift is over. “One of the triggers that keeps people awake is light, so it helps to decrease your light exposure at least 30 minutes before trying to sleep,” she says. “One way you can do that is to wear sunglasses on your way home, even on a cloudy day.”

Cut back on caffeine. Another thing you can do to help you get a better ‘night’s’ sleep is to reduce yourcaffeine intake. “If you’re drinking caffeine to stay awake, try not to drink any within four hours of the end of your shift to give your body time to metabolize it,” Dr. Waters says.

Set boundaries. It’s also a good idea to let people know what hours you’re working and when you will be sleeping, so they know when to leave you alone.

Get help from your doctor if you need it. If behavioral techniques aren’t helping you sleep, your doctor may prescribe melatonin to induce sleep, medications to promote wakefulness, or prescription sleep aids.

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Study shows many fire fighters have sleep disorders

A recent study reveals that many fire fighters suffer from sleep disorders.

Sleep disorders are independent risk factors for heart attacks and motor vehicle crashes, which are the two leading causes of death for firefighters in the United States. In a national sample of almost 7,000 firefighters, researchers at Brigham and Women's Hospital (BWH) examined the prevalence of common sleep disorders and their association with adverse health and safety outcomes and found that sleep disorders are highly prevalent, and associated with substantially increased risk of motor vehicle crashes and cardio-metabolic diseases among firefighters.

Findings of the study, led by Laura K. Barger, PhD, associate physiologist in BWH's Division of Sleep and Circadian Disorders, are published in the Journal of Clinical Sleep Medicine on November 13, 2014.

"Our findings demonstrate the impact of common sleep disorders on firefighter health and safety, and their connection to the two leading causes of death among firefighters," said Barger. "Unfortunately, more than 80 percent of firefighters who screened positive for a common sleep disorder were undiagnosed and untreated."

Based on specific criteria, 66 US fire departments were selected to participate in a workplace based sleep disorders screening and educational program. Approximately 7,000 firefighter participants were assessed for common sleep disorders. Firefighters were also surveyed about health and safety, and documentation collected for reportedmotor vehicle crashes.

Participants reported current health status, previous diagnoses of sleep and other medical disorders, the likelihood of falling asleep while driving, motor vehicle crashes, near crashes, and injuries.

Researchers found that a total of 37.2 percent of firefighters screened positive for sleep disorders including obstructive sleep apnea, insomnia, shift work disorder and restless leg syndrome. Firefighters with a sleep disorder were more likely to report a motor vehicle crash and were more likely to report falling asleep while driving than those who did not screen positive. Additionally, firefighters with sleep disorders were more likely to report having cardiovascular disease, diabetes, depression and anxiety, and to report poorer health status, compared with those who did not screen positive.

"Occupational sleep disorder screening programs can identify individuals who are vulnerable to adverse safety and health consequences, including those that are leading causes of death in firefighters," stated Charles Czeisler, PhD, MD, FRCP, chief, BWH Division of Sleep and Circadian Disorders. "This study provides the rationale for further research evaluating the effectiveness of occupational sleep disorders management programs on disease risk, mental health and safety outcomes."

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Women, in addition to men, suffer from sleep apnea

This article explains that not only men are affected by sleep apnea.

Decades ago, heart disease was thought of as a "man's disease" before well-targeted public education campaigns increased cardiac illness recognition among women and its profound impact on their health. Similarly, one of the most common sleep disorders, obstructive sleep apnea (OSA), has received a masculine label.

Granted, OSA affects half as many women as men, but it is far from rare -- about 6 percent of women suffer from this condition [1]. The lack of awareness in the medical community about the impact of OSA on women is partly rooted in gender bias and partly due to sex differences of the symptoms.

OSA is characterized by repeated episodes of the throat closing or narrowing enough to restrict airflow, which results in fluctuations in the amount of oxygen in the blood. This leads to numerous brief disruptions of sleep as well as poor sleep quality.

Untreated OSA is a risk factor for high blood pressure, heart disease and stroke, and is associated with overall decreased quality of life and wellbeing. The "textbook" symptoms primarily include loud snoring, episodes of gasping for air often witnessed by bed partners, excessive daytime sleepiness, and waking up unrefreshed.

Between 1979 and 1988, many reports on the overwhelming predominance of men among OSA sufferers were published in prestigious journals [2, 3, 4]. This led to health care providers primarily screening male patients for OSA symptoms thereby under-recognizing and thus under-diagnosing OSA in women.

On standardized questionnaires, women with OSA tend to be as sleepy as men, but are more likely to complain of insomnia, depression and fatigue rather than the textbook symptoms of the disorder [5]. Women more often lack a bed partner's account of observed snoring and pauses in breathing and more of them come to the clinic without a spouse or a life partner who can serve as a witness [6].

Another difference among men and women is the change in the OSA risk throughout the lifespan. While a man's risk increases linearly as he ages, a woman's risk is relatively low until menopause and then sharply increases to reach that of similarly aged men [7].

Two exceptions are pregnant women, especially those who are obese before conception, and women with polycystic ovarian syndrome (PCOS). PCOS is a reproductive hormonal disorder characterized by higher than normal testosterone levels and problems with fertility [8]. Among pregnant women, untreated OSA increases the risk of gestational diabetes and pregnancy-induced hypertension [9].

It is essential to educate both health care providers and the population at large on both the prevalence of OSA in women and its unique clinical presentation in order to recognize and appropriately treat women with OSA. Early diagnosis and treatment can help prevent the complications mentioned above, improve overall wellbeing, and indirectly reduce the costs of managing multiple, preventable chronic illnesses.

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Cutting calories can help sleep apnea

Obese adults eating fewer calories can have positive effects on sleep apnea and blood pressure.

A recent study conducted by Brazilian researchers reported that consuming fewer calories could improve sleep apnea and lower blood pressure in obese adults.

Sleep apnea is a potentially serious sleep disorder in which breathing stops and starts during sleep. Additionally, the disorder is associated with high blood pressure, heart problems, and stroke.

The Brazilian study involved 21 obese adults, between 20 and 55 years old, with sleep apnea. Some of the 21 adults reduced their caloric intake by 800 calories over a 16-week period, while the remaining made no changes to their diet.

At the study’s end, investigators found that those who reduced calories had lower blood pressure, had lost more weight, had fewer breathing issues during sleep, and had higher amounts of oxygen in their blood.

Findings of the study were announced at the American Heart Association high blood pressure meeting in San Francisco last week. Data and research presented at medical seminars is deemed inconclusive unit it is published in a peer-reviewed journal.

Dr. Marcia Klein, study co-author and adjunct professor at the University of Rio de Janero State University in Brazil, said the study’s findings reveal that moderate energy restriction in obese adults can improve sleep apnea, as well as blood pressure and heart rate.

Even a slight energy restriction, said Klein, can improve an obese adult’s entire cardiovascular system.

Klein also said that losing weight through dieting and exercise should remain the number one combative against sleep apnea. As a result, systolic blood pressure is often lowered by weight reduction.

Systolic blood pressure is the top number in a blood pressure reading that reflects the force of blood in the arteries when the heart beats. The bottom number in a reading, diastolic blood pressure, measures pressures in the arteries between heart beats. A good blood pressure reading is considered to be below 120/80 mm Hg.

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Caffeine therapy, preemies, and sleep trouble

A study found that preemies are at risk for having sleep issues and sleep disorders later in life, regardless of any caffeine therapy they may have had in the NICU.

Using caffeine to treat premature newborns for apnea - dangerous pauses in breathing during sleep - does not have long-term harmful effects on their sleep or breathing patterns, according to research led by Children's Hospital of Philadelphia. 

But the new study also found that prematurity itself is a risk factor for sleep disorders years later. Children born preterm had high rates of obstructive sleep apnea and periodic limb movement during sleep, whether or not they had caffeine therapy in the neonatal intensive care unit.

The very idea of caffeinating fragile preemies may sound misguided. But eight years ago, an international study that compared the stimulant to a placebo found it had benefits, including relieving sleep apnea.

Still, there were lingering concerns. Caffeine works in the brain, blocking a molecule that promotes sleep. Animal studies suggest that such early biochemical tinkering can lead to permanent sleep and breathing abnormalities.

"I think we all know from daily life the effect that caffeine has on us," said lead author Carole L. Marcus, a pediatric pulmonologist and director of the sleep center at Children's Hospital. "We give the equivalent of six cups of coffee a day for a week or more - and these are little babies whose brains are still developing."

The new study, published Friday in the American Journal of Respiratory and Critical Care Medicine, tracked down 201 of the original 2006 premature babies, now ages 5 to 12. Half had gotten caffeine therapy, the other half a placebo.

For two weeks, the children wore a noninvasive sensor at night to monitor their sleep. The parents also filled out questionnaires.

There were no differences in the children's sleep patterns, including how long they took to fall asleep and how soundly they slept.

But both caffeine and placebo groups had high rates of sleep disorders. Overall, about 10 percent had periodic limb movement disorder (episodes of involuntary movement, usually of the legs), and 14 percent had obstructive sleep apnea. In general, less than 4 percent of school-age children have apnea, and 5 percent to 8 percent have the limb movement disorder.

Obstructive sleep apnea is different from the apnea of prematurity. In the obstructive form, the throat airway collapses or becomes blocked. In preemies, breathing stops because their immature nervous systems cannot yet enable continuous respiration.

Obstructive apnea can lead to daytime sleepiness, learning problems, high blood pressure, and heart disease. Limb movement disorder is less understood but has been linked to attention deficit hyperactivity disorder and a serious sleep problem called restless leg syndrome.

If caffeine isn't a culprit, why are sleep disorders common in former premature babies?

One possibility, the researchers noted, is enlarged tonsils. About a quarter of the children had already undergone tonsillectomies, the primary treatment for childhood obstructive sleep apnea.

"We're thinking the rate of apnea would have been even higher if not for the tonsillectomies," Marcus said.

The limb movement may be related, at least partly, to iron deficiency. Low blood iron levels were found in the children with the movement disorder who underwent testing.

All the children with apnea or limb movement disorder were referred for more testing and treatment, but most former preemies are not even checked for such problems. The study suggests that should change.

"We should be screening these children," Marcus said. "Then we could prevent problems, or treat them earlier."

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Suicide risk increased by sleep disorder presence

This article discusses the association seen between presence of a sleep disorder in older adults and increased suicide risk.

Sleep quality influences suicide risks for older adults, according to a research undertaken by scientists from Stanford University School of Medicine. Rebecca Bernert, the study’s author, says this is a highly treatable condition. Bernert, PhD, is the director of the Suicide Prevention Research Laboratory at Stanford. The fact that sleep disorder increases suicide risks for older adults comes after a complex research.

Another research carried earlier this year involvedblood analysis to determine suicide risks.

“Suicide is the outcome of multiple, often interacting biological, psychological and social risk factors,” Bernert said. “Disturbed sleep stands apart as a risk factor and warning sign in that it may be undone, which highlights its importance as a screening tool and potential treatment target in suicide prevention.

To reach the conclusion, the team of scientists from Stanford looked at data from 14.456 adults over 65 years old. Out of this group, they chose 400 individuals who had similar sleeping patterns to 20 people who committed suicide. Scientists followed the sleeping behavior over a 10 years period. In the end, researchers concluded that older people with sleeping disorders have a suicide risk 1.4 times higher than their counterparts with high sleep quality.

The comparison between the two groups was done by looking at a series of data obtained through interviews. The questions addressed topics such as depression signs, and mental and physical functioning. Even after taking out the depression variable, the lack of quality sleep remained an important factor determining an increased risk of committing suicide.

Suicide is associated with stigma, so people suffering suicidal thoughts or attempts have troubles talking about the issue. However, if a disturbed sleeping pattern accounts for such a high influence in determining suicide, there is a ray of hope. If trouble sleeping is not a stigmatized disorder, focusing on improving the older adults’ sleep quality might reduce the suicide rates.

The subjects involved in the study were mostly white males. A group of twenty suicide victims is surely not enough to draw the definitive conclusion that sleep disorder increases suicide risks, but is a start. Further research involving data from cases involving women and minority groups may shed additional light on the issue.

People who are at risk of committing suicide should ask for help by calling the National Suicide Prevention Lifeline (1-800-273-TALK).

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All about sleep apnea

This article provides much information on sleep apnea, including signs you may have it, and what you should do to get checked if you think you might have sleep apnea.

Think you might have sleep apnea? Not sure what the symptoms are? It's a growing sleep disorder that people are more and more being affected by.

Sleep apnea affects some 18 million Americans and around 850,000 Canadians. The etymology of the word apnea translates into the suspension of breathing or the absence of respiration. Pauses can last anywhere from a few seconds to a few minutes, this can occur up to 30 times per hour in some cases.

Obstructive sleep apnea can be mild, moderate or severe. The severe form of this ailment can progressively degenerate, leading in some cases to death in patients. Sleep apnea often goes undiagnosed as extreme snoring. Both sexes experience sleep apnea but it is more common in males than females. Certain racial groups are also more prone to this condition, Hispanics have higher rates of sleep apnea than Caucasians.

Common Sleep Apnea Statistics

The Sleep Disorders Guide has provided the following research information.

- 1 in every 15 Americans has sleep apnea

- University of California’s San Diego campus discovered 17 percent of the 54 African Americans had obstructive sleep apnea. The 346 Caucasians tested only had an 8 percent indicator

- 1 in 50 Americans are undiagnosed

- obstructive sleep apnea patients are at an increased rate for traffic incidents

- People driving drowsy is responsible for 100,000 car accidents, 40,000 injuries and up to 1,550 deaths per year if your bed partner has this condition you are unlikely to get any sleep

- stroke, hypertension and heart disease are all linked to sufferers of sleep apnea

A lack of proper sleep has been linked to cognitive problems in the workforce and decreases in educational achievement. Memory and complex decision making skills are also affected at an increased rate leading to occupational accidents and fatalities.

Fatalities Caused By Sleep Disorders

The impact of getting a lack of sleep can not be underestimated. Medical resident students work longer hours than most hospital staff. During the first year residency med students usually work a 24 hour shift every third night they can work up to 96 hours in some cases. Columbia University’s College of Physicians and Surgeons states that medical student hours can not exceed 80 hours per week with at least 24 consecutive hours free from duty in a week. These guidelines are often not adhered to with priority shifts and hours going to senior staff. The Accreditation Council for Graduate Medical Education found that residents who worked more than 80 hours per week were at risk for making significant medical errors that led to negatively impacting patients. Sleep related fatigue is a leading cause of medical errors facing hospitals and patients.

The Three Mile Island incident of 1979 resulted in a cooling malfunction in reactor #2, radioactive gas was released, fortunately there were no fatalities. Cooling to the reactor was eventually restored, this incident was thought to have been caused by lack of sleep of the plant employees. The occupational damage from lack of sleep ended up costing $975 million back in March 28th of 1979.

The Exxon Valdez Oil Spill was one of the worst environmental disasters in U.S. history. The 987 foot long oil tanker ran aground a reef in Prince William Sound, Alaska releasing 10.8 million gallons of crude oil into the Pacific ocean. The oil spill ended costing $3.8 billion to clean up. This incident again was related to the ships crew suffering from lack of sleep.

Who Is At Risk For Sleep Apnea?

The Centers for Disease Control and Prevention (CDC) states that one-third of U.S. adults or 34.9 percent are obese. The medical costs for treating obese people amounted to $147 billion in 2008 U.S. dollars. The male gender and certain racial groups are more at risk for sleep apnea than other demographics. Blacks are at a 47.8% increased risk of obesity compared to 42.5% for Hispanics. Whites have a 32.6% obesity rate compared to 10.8% for Asians.

Obesity and socioeconomic status go hand in hand when it comes to obesity. Blacks and Mexican Americans are prime candidates for the battle of the bulge. Among women obesity levels rise with education levels. Women with a college degree had a 23.4% obesity rate compared to 42.1% of women without a high school diploma. Men and women with college degrees have significantly lower rates of obesity. The common denominator is the more education people have the more income they earn and the healthier food they can purchase.

Simply put people with higher incomes are able to afford organic or natural foods. GM staple crops like GM corn are modified to produce higher yields. A Norway research study fed rats GM corn for 90 days, the end result was the rats feeding on the GM corn grew obese, in contrast to the rats fed on the non-GM diet. The physiology of rats is similar to humans, if rats grow obese from a GM diet than humans eating the same type of food will also become obese. Nutrient levels in today’s crops have decreased significantly since WWII, modern day food simply does not have the nutritional density it once did. A lack of nutrient dense crops results in people eating large quantities of food, the more food a person consumes to make up for the lack of nutrients the more weight they put on. Mexican Americans and Blacks from lower economic levels live in areas with an abundance of fast food outlets and grocery stores that do not have access to the organic food market because of the higher prices, this makes this demographic prime candidates for sleep apnea.

Diagnosing Sleep Apnea

The most direct method to diagnose sleep apnea is at a sleep clinic managed by qualified sleep technicians. The clinical name for the study of sleep is called polysomnography, this test measures brain wave activity, heart rate, breathing and eye and leg movements. Patients undergoing this study check in during the evening into a private room that has a video camera, the sleep room is adjacent to the monitoring room where the sleep technician monitors the patient. Sensors are placed on the legs of the individual to monitor restlessness at night. A sensor belt is placed around the abdomen and waist to monitor breathing, additional sensors are placed near the mouth and nose to measure the respiratory rate.

The final step in polysomnography is the attachment of a Continuous positive airway pressure (CPAP) device that attaches to the mouth of the patient. The CPAP machine supplies light air pressure through the mouth or nose, this pressure is enough to keep the airway open so the patient can breathe properly while sleeping. If the presence of obstructive sleep apnea is documented during the night the sleep technician will re-enter the room and apply a CPAP mask that is attached to a CPAP machine. The sleep technician will wait for the patient to enter a deep sleep before gradually determining the minimum airflow to keep the airway open. The technician will also monitor the patients other vitals for symptoms of sleep apnea. A definitive diagnosis can be made later by a physician sleep specialist that is dedicated to the study of sleep medicine.

CPAP is the most widely accepted and effective machine to treat sleep apnea today. If you think you may be a sufferer of sleep apnea consult your physician regarding making an appointment at a sleep clinic.

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Usefulness of sleep tracking devices

This article discusses how useful sleep tracking devices are to those who may have issues sleeping.

The average adult needs at least seven hours of sleep each night, though unfortunately many get a lot less. Approximately 70 million Americans have a sleep disorder, which may be why there's tremendous interest in popular fitness trackers that allow you to quantify and evaluate the quality of your sleep -- without the expense of a sleep specialist.

Personal sleep trackers seem like a great investment for anyone suffering from insomnia or sleep deprivation. But are they accurate?

"The reason why these devices are so good is it puts greater emphasis on sleep," Michelle Primeau, clinical instructor at the Stanford Center for Sleep Sciences & Medicine told CNET reporter Sumi Das. "Most adults in the U.S. are somewhat sleep deprived."

Fitness trackers with sleep tracking capabilities, such as Fitbit, work by keeping track of how much you toss and turn in your bed to provide data on your sleep quality. This is done with accelerometers.

"They are measuring an indirect approximation of sleep through movement," said Primeau. "In order to make these estimations of deep or light sleep they are probably using an algorithm that takes into account the relative amount of movement that a person is having in the course of a night."

On the other hand, sleep specialists base their treatments and diagnoses on polysomnography, a special multifaceted test that typically involves sleeping in a controlled environment -- a sleep lab -- hooked up to plenty of wires. This gold-standard for sleep specialists measures everything from your brain activity, heart rate and breathing to your eye and muscle movements. Polysomnography generates far more information than currently any personal sleep tracker can, and is used to diagnose problems such as sleep apnea, circadian rhythm disorders, nighttime movement disorders and other health issues.

"Polysomnography is a collection of different physiological measurements that we use to define and characterize sleep," explained Primeau. "We start with EEG which are little electrical wires that measure your brainwaves. It also includes measures like a snore mic. Belts around you chest and abdomen will also record your breathing."

But some experts argue that sleeping in a controlled setting, such as a sleep lab, messes up the evaluation before it even has the chance to begin, since the person won't sleep the same as in their own bed. In general, a personal sleep tracker could be a good starting point for a better night of sleep, but these devices may not be enough to diagnose and solve your shuteye challenges.

If you're desperately tired but still skeptical, a sleep app for a smartphone may be a good place to start, since it will only set you back a few dollars compared with a hundred or more for a tracker device. Sleep Cycle, Sleep as Android and Sleepbot operate on the accelerometers built into a phone.

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Signs it's time for a sleep study

This article discusses different types of sleep disorders, and tells signs that may indicate it's time for a sleep study.

There are a number of sleep disorders that keep us from getting the rest we need. While poor sleep can be devastating to our quality of life, some sleep disorders — such as sleep apnea — can actually be life-threatening. The most common sleep disorders are:

• Sleep apnea — interrupted breathing while sleeping
• Insomnia — inability to get to sleep or stay asleep
• Daytime sleepiness disorder (hypersomnia) — feeling sleepy all day, unable to stay awake, difficulty focusing
• Restless leg syndrome — uncomfortable urge to move legs while at rest
• Narcolepsy — sudden sleep attacks

A sleep study is typically the quickest and best way to find out whether you have a sleep disorder. It's time for a sleep study if:

• Your bed partner complains of loud snoring and has witnessed you not breathing.
• You wake up with a dry mouth or sore throat, coughing, choking or unable to catch your breath.
• You have excessive daytime sleepiness and decreased energy during the day.
• You are unable to remain awake while driving.

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How to treat sleep problems following a concussion

New clinical guidelines have been released regarding how to treat sleep problems in people following a concussion.

The Defense and Veterans Brain Injury Center has released new clinical recommendations and support tools to assist in the identification and treatment of a sleep disturbance occurring in patients after a concussion (mild traumatic brain injury or mTBI). The suite of products assists health care providers in the identification of a sleep problem and provides recommendations for its treatment.
"Sleep disorders are common after a person sustains a concussion," said Col. Sidney Hinds, II, M.D., Defense and Veterans Brain Injury Center's, or DVBIC's, national director. "The prompt identification and treatment of sleep disorders are an important part of the recovery process for concussion. Sleep is critical to the brain's healing and recovery processes. Research shows that if sleep is regular and adequate, restorative processes are promoted." 

Since 2000, more than 300,000 U.S. service members have sustained a traumatic brain injury.

Common sleep disorders associated with traumatic brain injury, referred to as TBI, include insomnia, circadian rhythm sleep wake disorder and obstructive sleep apnea. Insomnia is the most common sleep disturbance after concussion.

The new Management of Sleep Disturbances following Acute Concussion/Mild TBI Clinical Recommendations suite is composed of clinical recommendations, a clinical support tool, a provider education slide deck and a patient education fact sheet.

"These clinical recommendations advise that all patients with concussion symptoms should be screened for the presence of a sleep disorder," said U.S. Public Health Service Capt. Cynthia Spells, DVBIC's clinical affairs officer. "Patients should be asked if they are experiencing frequent difficulty in falling or staying asleep, excessive daytime sleepiness or unusual events during sleep. The initial step in the diagnosis of a sleep disorder includes a focused sleep assessment."

Non-pharmacological measures to treat insomnia that focus on stimulus control and good sleep hygiene are the preferred methods of treatment. Short-term use of sleep medication may be necessary in addition to these measures if they are not effective by themselves.

Spells said stimulus control means controlling your environment to help promote sleep. Examples of stimulus control measures include relaxing before bedtime, going to bed only when sleepy, getting out of bed when unable to sleep, removing electronics (TV, smart phone, computer) from the bedroom and using the bedroom only for sleep and intimacy.

Sleep hygiene habits include avoiding caffeine and other stimulants close to bedtime, daily physical activity but not exercising close to bedtime, arising at the same time every morning, getting natural light exposure every day, and avoiding alcohol, nicotine and large meals close to bedtime.

Spells said the new sleep disturbance clinical recommendations and support tool product suite was developed by the Department of Defense in collaboration with the Department of Veterans Affairs and civilian medical professionals.

"Although tailored for the military and VA health care systems, these recommendations may be used by civilian health care providers treating concussion associated sleep disorders," Spells said. "Many service members and veterans, especially those serving in the National Guard and Reserve, receive care from civilian health care specialists." 

DVBIC serves as the Department of Defense subject matter expert on TBI and manager of the TBI pathway of care.
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