Is my iPad disrupting my sleep?

This article explains how an iPad can disrupt a person's sleep.

Using an iPad or other backlit electronic tablet in the hours before bedtime not only prevents you from falling asleep, it may also affect your alertness the next day, according to a report published in the Proceedings of the National Academy of Sciences, Dec. 22, 2014. Researchers at Harvard-affiliated Brigham and Women’s Hospital found that the light emitted by the devices reset the body’s circadian clock, which synchronizes the daily rhythm of sleep to daylight. As a result, people reading e-books took longer to fall asleep and were less alert the next morning than when they read print books instead.

During the two-week study, 12 men and women read digital books on an iPad for four hours before bedtime each night for five consecutive nights. They also followed the same routine using printed books. When they read the iPad, participants were less sleepy before bedtime but were less alert the following morning, even after eight hours of sleep.

If you’re a bedtime reader who’s addicted to her iPad, don’t despair. The researchers used a 2010
iPad set at maximum brightness. Newer iPads and other e-readers have night-reading modes.

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Target enzyme for epilepsy drugs may also cause sleep loss

A study in fruit flies shows that an enzyme that is a target for epilepsy drugs also contributes for sleeplessness. This has many implications for treating both conditions.

A new study in a mutant fruitfly called sleepless (sss) confirmed that the enzyme GABA transaminase, which is the target of some epilepsy drugs, contributes to sleep loss. The findings, published online in Molecular Psychiatry, were led by Amita Sehgal, PhD, head of the Chronobiology Program at the University of Pennsylvania's Perelman School of Medicine. The findings shed light on mechanisms that may be shared between sleep disruption and some neurological disorders. A better understanding of this connection could enable treatments that target both types of symptoms and perhaps provide better therapeutic efficacy.

"Epilepsy is essentially an increase-in-firing disorder of the brain and maybe a decrease in activity of the neurotransmitter GABA, too," says Sehgal, who is also a professor of Neuroscience and an investigator with the Howard Hughes Medical Institute (HHMI). "This connects our work to drugs that inhibit GABA transaminase. Changes in GABA transaminase activity are implicated in epilepsy and some other psychiatric disorders, which may account for some of the associated sleep problems."

The team looked at the proteomics of the sss mutant brain -- a large-scale study of the structure and function of related proteins -- and found that GABA transaminase is increased in the sss brain compared to controls. This enzyme breaks down GABA, so GABA is decreased in the sss brain. Because GABA promotes sleep, there is a decrease in sleep in the sss mutant fly, as the name implies.

The relationship between the SSS protein and GABA is not fully understood. The SSS protein controls neural activity, and its absence results in increased neural firing, which likely uses up a lot of energy, says Sehgal. GABA transaminase works in the mitochondria, the energy-production organelle in the glial cells of the brain, which provide fuel for neurons. The large energy demand created by the increased neural firing in sss brains probably alters mitochondrial metabolism, including GABA transaminase function in glia.

In the sss mutant fly, there is a stream of connections that leads to its signature loss of sleep: The sss mutant has increased neuron firing caused by downregulation of a potassium channel protein called Shaker. Recently, the Sehgal lab showed that SSS also affects activity of acetylcholine receptors. Both of these actions may directly cause an inability to sleep. In addition, increased energy demands on glia, which increase GABA transaminase and decrease GABA, may further contribute to sleep loss. On the other hand, if GABA is increased, then sleep is increased, as in flies that lack GABA transaminase.

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Risks of sleep apnea - stroke, heart attack, pneumonia, dementia.

This article discusses the risks associated with untreated sleep apnea. My only comment for this article  is that "Sleep hygiene" does NOT treat sleep apnea. - JR

Sleep Apnea: The Real Risks Involved

Subscribe FreeBy Mike Tuttle · March 27, 2014 

"18 million Americans suffer from it. It can lead to both physical and psychological problems. Perhaps you, as many do, have it and aren’t even aware of it.

Sleep apnea is a sleep disorder that is characterized by snoring and pauses in breathing at night, waking the person momentarily before they fall back asleep. This disruption of sleep can occur several times a night, 5 to 30 times or more in just one hour. A person, both adults and children alike, can suffer from this disorder for years, even decades, before realizing it.

Studies have shown that sleep apnea can lead to problems like irritability, daytime fatigue, depression, hypertension, heart attack, and stroke, but recent studies have shown that the risks are actually more serious than, well, a heart attack. And while obesity can lead to this disorder, the disorder itself can lead to obesity.

The authors of a review posted in The Lancet Diabetes & Endocrinology journal wrote, “Metabolic health … is largely dependent on behavioral factors such as dietary habits and physical activity. In the past few years, sleep loss as a disorder characterizing the 24-hour lifestyle of modern societies has increasingly been shown to represent an additional behavioral factor adversely affecting metabolic health.”

...

“Our findings show that sleep apnea is an independent risk factor for incident pneumonia,” theysaid. “Our results also demonstrated an exposure-response relation in patients with more severe sleep apnea may have a higher risk of pneumonia than patients with sleep apnea of milder severity.”

Heart disease, dementia, diabetes … the negative effects continue to mount up. However, along with the worrisome research comes some hope.

Continuous positive airway pressure devices, or CPAP machines, are currently the most common treatment out there. They consist of a plastic facial mask, which the patient wears at night, connected by a flexible tube to a small bedside machine. Using air pressure, it keeps the patient’s airways open during sleep.

“We know that obstructive sleep apnea is a potential cause of high blood pressure, and we know that CPAP use is associated with reductions in blood pressure in people with hypertension,” sayssleep specialist Vishesh K. Kapur, MD. “And now there is reasonable evidence that this treatment can prevent high blood pressure in patients who don’t already have it.”

Modern CPAP machines also come with a built-in humidifier to help prevent dryness in the throat/nasal passages."

...

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Narcolepsy may be responsible for your daytime sleepiness

This article discusses narcolepsy and explains how it could be responsible for daytime sleepiness.

With busy schedules, it’s inevitable to feel sleepy once in a while. But habitually falling asleep during the day while watching TV, reading a book, or in the middle of having a conversation could be a sign of a serious sleep disorder known as narcolepsy.

An underdiagnosed medical condition

Narcolepsy is a sleep disorder that involves the brain’s inability to regulate sleep-wake cycles normally. It affects an estimated one in 2,000 people in the United States, with symptoms typically appearing in early adulthood. Yet it is estimated that 50 percent or more patients with narcolepsy have not been diagnosed. According to a recent survey conducted by Harris Interactive on behalf of Jazz Pharmaceuticals, awareness of narcolepsy is low. One thousand members of the general public and 400 practicing physicians were surveyed about their knowledge of narcolepsy and its symptoms. Only 7 percent of members of the general public who had heard of the condition reported being “very” or “extremely” knowledgeable about it relative to other chronic diseases. That number only increased to 24 percent among primary care physicians. The majority of people surveyed could not identify all five major symptoms of narcolepsy. In fact, studies have shown it may take 10 years or more for people with narcolepsy to receive a correct diagnosis.

“The symptoms of narcolepsy are not well-recognized, which can lead to misdiagnosis,” says Dr. Aatif M. Husain, professor of neurology at Duke University Medical Center.  “By becoming aware of the symptoms of narcolepsy, individuals can have more informed conversations with their doctors, which may help lead to quicker diagnosis.”

The symptoms of narcolepsy: more than daytime sleepiness

A recent study, in which researchers evaluated health care data of more than 9,000 narcolepsy patients compared to 46,000 controls, shows that people with narcolepsy are more likely to suffer from depression, anxiety and other conditions including sleep apnea, stroke and heart failure compared to the general population. There are five major symptoms of narcolepsy. Talk to a doctor if one or more sound familiar.

* Excessive daytime sleepiness (EDS) – EDS, the primary symptom of narcolepsy, is characterized by the inability to stay awake and alert during the day resulting in unplanned lapses into sleep or drowsiness; EDS is present in all people with narcolepsy.

* Cataplexy (muscle weakness with emotions) – A sudden, brief loss of muscle strength triggered by strong emotions like happiness, laughter, surprise, or anger.

* Sleep disruption – Frequent periods of waking up during sleep.

* Sleep paralysis – A brief inability to move or speak while falling asleep or waking up.

* Hypnogogic hallucinations – Vivid, dream-like events that occur when falling asleep or waking up.

These symptoms vary from person to person and not all five symptoms must be present for a narcolepsy diagnosis. It is also important that family and friends understand these symptoms, as they may observe them and encourage their loved ones to seek medical advice sooner.

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How caffeine disrupts your sleep

New research looks into the specifics of how late-in-the-day caffeine can disrupt your sleep at night.

You hear it all the time when it comes to sleep: Don't drink caffeine too late in the day. It's among the most common sleep tips -- and it's a good one. Caffeine, with its stimulant effects, is disruptive to good sleep. And these days, with the popularity of energy drinks and other caffeine-laden beverages and snacks, it's not difficult to wind up consuming caffeine throughout the day, even if you've set your coffee cup aside. The negative health consequences of too much caffeine also extend beyond sleep problems. Research shows that caffeine may contribute to cardiovascular problems. A recent large-scale study also suggeststhat heavy caffeine consumption -- more than four 8-ounce cups of coffee per day on a daily basis -- is linked to higher mortality rates in men and women.

But how late in the day is too late in the day to be consuming caffeine? Despite consensus about caffeine's sleep-disrupting effects, recommendations about the timing of caffeine consumption -- and when it's best to stop for the day -- can vary widely. Though an abundance of research has been conducted to establish caffeine's negative effects on sleep, very little attention has been paid to the specific timing of caffeine consumption relative to bedtime.

A new study attempts to fill in some of these important specifics about the effects of late-afternoon and early-evening caffeine consumption on nightly sleep. Researchers at Michigan's Henry Ford Hospital's Sleep Disorders & Research Center and Wayne State College of Medicine analyzed the sleep-disruptive effects of caffeine consumption at different lengths of time before bedtime. They found that caffeine consumed even six hours before bedtime resulted in significantly diminished sleep quality and sleep quantity. This is believed to be the first study to investigate directly the effects of caffeine at specific times before nightly sleep.

The study included 12 adult men and women, all of whom were healthy and were normal sleepers who in their regular lives were moderate consumers of caffeine. During the study period volunteers kept up their normal sleep routines, which included bedtimes between 9 p.m. and 1 a.m. and wake times between 6 a.m. and 9 a.m. Participants' total nightly sleep duration fell somewhere in the range of 6.5 to 9 hours per night, with no regular habit of napping during the day. Throughout the study researchers tracked sleep by having participants keep sleep diaries and by using at-home sleep monitors. Participants were given doses of caffeine in pill form as well as placebo pills, on a schedule that enabled researchers to measure the sleep-disruptive effects of caffeine taken at three different points: at bedtime, three hours before bedtime, and six hours before bed. They found significant disruptions to sleep as a result of caffeine taken at all three points:

• Caffeine consumed zero, three, and six hours before bedtime significantly reduced total sleep time. Even caffeine consumed six hours before bed reduced total nightly sleep amounts by more than one hour.
• Caffeine consumed at all three points diminished sleep quality. Caffeine taken three and six hours before bedtime, as well as caffeine consumed at bedtime, significantly increased the amount of time spent awake during the night.
• Disruptions to sleep as a result of caffeine were perceived by volunteers (as recorded in sleep diaries) for caffeine consumed at bedtime and three hours before bed, but were not reported for caffeine taken six hours before bed. However, sleep monitors measuring total sleep time, and sleep efficiency (time spent sleeping relative to total time spent in bed) showed that caffeine consumed six hours before bedtime had significant detrimental effects to both.

This last finding is especially important, because it suggests that people can't -- and shouldn't -- rely entirely on their own perceptions of how much or little caffeine affects their sleep, especially caffeine consumed in the afternoon. Even if you don't feel that late-afternoon cup of coffee has a negative impact on your sleep, this study suggests that it is likely to be interfering nonetheless. This is one reason that I have long recommended a 2 p.m. cut off time for caffeine consumption.

Remember, limiting caffeine doesn't mean removing it entirely from your daily routine. A moderate amount of caffeine, consumed at the right times, can be useful and evenhealthful, stimulating alertness and energy. These new findings provide us with some really important specifics about just how significantly late-in-the-day caffeine can undermine a good night's sleep. Want to enjoy your coffee without wrecking your sleep? Follow these basic suggestions for consuming caffeine in a sleep-friendly way:

Stick to a 2 o'clock cut off. As this current study shows, late-afternoon caffeine can cause problems for your sleep, even if you aren't aware of it. To avoid sleep disruption, restrict your caffeine consumption primarily to the morning hours. If you do have a midday cup of coffee, make sure to drink it before 2 p.m.

Taper caffeine as the day progresses. Start your day with your most highly caffeinated beverage and ease up on the caffeine as the morning goes on. First thing in the morning is likely when you'll crave caffeine the most, and when it can do you the most good in terms of boosting energy and shaking off the effects of a night's sleep. Switch over to tea or decaffeinated coffee as the morning continues, to keep overall daily caffeine amounts moderate and be comfortably caffeine-free by mid-afternoon.

Avoid jumbo drinks. These days, everything seems to be "super-sized" -- and caffeinated drinks are no exception. From a 20-plus-ounce latte or soda to a caffeine-packed energy drink, a lot of caffeine products deliver way more of the stimulant than is healthful. Stick to something much closer to the old-fashioned 8-ounce cup, and savor it.

Don't ignore your sleep problems. Being tired makes us more likely to feel the need for caffeine, and that extra consumption can in turn make sleep problems worse. Avoid this sleep-disruptive cycle by making sleep a daily priority. Practice good sleep hygiene and talk to your doctor about how you are sleeping, particularly about any problems that arise.

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Link between gestational diabetes and obstructive sleep apnea in pregnant women

A study claims shows that pregnant women with gestational diabetes may be at an increased risk for obstructive sleep apnea.

Pregnant women with gestational diabetes may have an increased risk of obstructive sleep apnea, a small new study suggests.

Gestational diabetes typically develops during the second trimester of pregnancy and occurs in roughly four to eight of every 100 pregnant women in the United States.

Sleep apnea causes brief interruptions in breathing during sleep. Left untreated, sleep apnea increases the risk for stroke, cardiovascular disease and heart attack, according to background information in the study to be published in the Journal of Clinical Endocrinology & Metabolism.

"It is common for pregnant women to experience sleep disruptions, but the risk of developing obstructive sleep apnea increases substantially in women who have gestational diabetes," study author Dr. Sirimon Reutrakul, who conducted the research at Rush University Medical Center in Chicago, said in a journal news release.

The study included 15 pregnant women with gestational diabetes, 15 pregnant women without the condition and 15 women who were not pregnant and did not have diabetes. Pregnant women without gestational diabetes got an additional hour of sleep per night and had less fragmented sleep than those with gestational diabetes.

"Nearly 75 percent of the participants in our study who had gestational diabetes also suffered from obstructive sleep apnea," Reutrakul said.

While the study found an increased risk of having sleep apnea among pregnant women with gestational diabetes, it did not prove a cause-and-effect relationship.

Previous research has shown that less sleep, fragmented sleep and shorter periods spent in deep sleep, which are all symptoms of sleep apnea, can increase a person's risk of developing diabetes.

"Based on these findings, women who have gestational diabetes should be considered for evaluation for obstructive sleep apnea, especially if other risk factors such as hypertension or obesity are present, and women already diagnosed with sleep apnea should be monitored for signs of gestational diabetes during pregnancy," Reutrakul said.

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Electronic media affects children's sleeping patterns

Research shows that children's sleeping patterns can be negatively affected due to the amount of time a child spends with electronic media.

Children's sleep disruption is worse with increased time spent watching TV or playing on the computer, finds research in Biomed Central's open access journal BMC Public Health. The greater the e-media use was at the start of the study, the shorter the sleep duration and the later the bedtime was eighteen months later. The academics suggest that where children are struggling to sleep, or are tired, their media habits should be taken into consideration.

The amount of sleep children get has a direct bearing on their performance in school and their mental and physical health. Snap shot studies suggest that the more kids use electronic media the less sleep they get, and that their sleep is more likely to be disturbed. But how much does watching TV or playing on the computer affect sleep patterns as children grow up?

To answer this question researchers from Folkhälsan Research Center, Finland, compared computer use and TV viewing with sleep patterns in 10-11 year olds and then reassessed them eighteen months later. Children with a TV or computer in their bedroom, compared with the frequency of usage, demonstrated a greater delay when going to bed on school days and the weekend which resulted in less sleep. However girls may be catching up at the weekends as they tended to sleep in more as they got older.

When the researchers looked at boys and girls separately they found that there were other gender differences -- boys with a computer or TV in their bedroom went to bed later than the girls and had a larger increase in bed time.

Teija Nuutinen, who led this study commented, "Children need extra sleep as they go through puberty but our study finds that TV and computer use affect the sleep of children. This is especially true during the week and may be impacting their school work as well as their development. Media viewing habits should be considered for kids who are tired and struggling to concentrate, or who have behaviour problems caused by lack of sleep."

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