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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New sleep duration recommendations

New sleep duration recommendations are being recommended by the National Sleep Foundation.

The National Sleep Foundation (NSF), along with a multi-disciplinary expert panel, issued its new recommendations for appropriate sleep durations. The report recommends wider appropriate sleep ranges for most age groups. The results are published in Sleep Health: The Official Journal of the National Sleep Foundation.

The National Sleep Foundation convened experts from sleep, anatomy and physiology, as well as pediatrics, neurology, gerontology and gynecology to reach a consensus from the broadest range of scientific disciplines. The panel revised the recommended sleep ranges for all six children and teen age groups. A summary of the new recommendations includes:

• Newborns (0-3 months): Sleep range narrowed to 14-17 hours each day (previously it was 12-18)
• Infants (4-11 months): Sleep range widened two hours to 12-15 hours (previously it was 14-15)
• Toddlers (1-2 years): Sleep range widened by one hour to 11-14 hours (previously it was 12-14)
• Preschoolers (3-5): Sleep range widened by one hour to 10-13 hours (previously it was 11-13)
• School age children (6-13): Sleep range widened by one hour to 9-11 hours (previously it was 10-11)
• Teenagers (14-17): Sleep range widened by one hour to 8-10 hours (previously it was 8.5-9.5)
• Younger adults (18-25): Sleep range is 7-9 hours (new age category)
• Adults (26-64): Sleep range did not change and remains 7-9 hours
• Older adults (65+): Sleep range is 7-8 hours (new age category)

"This is the first time that any professional organization has developed age-specific recommended sleep durations based on a rigorous, systematic review of the world scientific literature relating sleep duration to health, performance and safety," said Charles A. Czeisler, PhD, MD, chairman of the board of the National Sleep Foundation, chief of sleep and circadian disorders at Brigham and Women's Hospital, and Baldino Professor of Sleep Medicine at the Harvard Medical School. "The National Sleep Foundation is providing these scientifically grounded guidelines on the amount of sleep we need each night to improve the sleep health of the millions of individuals and parents who rely on us for this information."

A new range, "may be appropriate," has been added to acknowledge the individual variability in appropriate sleep durations. The recommendations now define times as either (a) recommended; (b) may be appropriate for some individuals; or (c) not recommended.

"The National Sleep Foundation Sleep Duration Recommendations will help individuals make sleep schedules that are within a healthy range. They also serve as a useful starting point for individuals to discuss their sleep with their health care providers," said David Cloud, CEO of the National Sleep Foundation.

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Short sleep and breathing issues increases obesity risk in children

A child's risk of obesity is increased by sleeping for short amounts of time and breathing issues while sleeping.

Too little sleep has officially been linked to an increased risk of obesity, particularly among young children. Recent findings published in The Journal of Pediatrics reveals a high connection between sleep-related breathing problems and obesity.

For the study, researchers analyzed data from 1,900 children in England and followed the participants for about 15 years. Study results showed that those who got the least amount of sleep between the ages 5 and 6 had between a 60 percent and 100 percent increased risk of obesity by age 15.

"In recent years, lack of sleep has become a well-recognized risk for childhood obesity," said lead study author Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women's health at Einstein, in a news release. "Sleep-disordered breathing, or SDB, which includes snoring and sleep apnea, is also a risk factor for obesity but receives less attention. These two risk factors had not been tracked together in children over time to determine their potential for independently influencing weight gain. Our study aimed to fill in that gap."

Furthermore, researchers found that children with the most severe sleep-disorder breathing (SDB) had the highest obesity risk. Children whose SDB levels peaked at around 5 to 6 years old still had a 60 to 80 percent increased risk of obesity, but fared better overall.

"If impaired sleep in childhood is conclusively shown to cause future obesity, it may be vital for parents and physicians to identify sleep problems early, so that corrective action can be taken and obesity prevented. With childhood obesity hovering at 17 percent in the United States, we're hopeful that efforts to address both of these risk factors could have a tremendous public health impact," Bonuck concluded.

A common cause of sleep-related breathing problems in children is oftentimes due to enlarged tonsils or adenoids, which can be removed with surgery if a problem occurs. Misalignment of jaws or teeth can also cause issues.

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Insomnia in older adults affects sleep quality

A study showed that older adults who have insomnia have their sleep quality affected, but not their sleep duration.

Reports of insomnia are common among the elderly, but a new study finds that sleep problems may stem from the quality of rest and other health concerns more than the overall amount of sleep that patients get.

An estimated 30 percent of adults report having some symptoms of insomnia, which includes difficulty falling asleep, staying asleep or waking up too early and then not feeling well rested during the daytime. Prior studies suggest that nearly half of older adults report at least one insomnia symptom and that lack of restorative sleep might be linked to heart disease, falls, and declines in cognitive and daytime functioning.

The new study found discrepancies between self-reported insomnia and outcomes recorded on a sleep-monitoring device. Older adults' perception of sleep does not always match what's actually happening when a more objective assessment is used to monitor sleep patterns and behaviors.

A study, published online by Journals of Gerontology: Medical Sciences, used data from 727 participants in the National Social Life, Health and Aging Project who were randomly invited to participate in an "Activity and Sleep Study." The activity and sleep study had two components: a self-administered sleep booklet, which included questions about the person's sleep experience, (e.g., "how often do you feel really rested when you wake up in the morning?") and 72-hours of wrist actigraphy, which is a wristwatch-like sensor that monitors sleep patterns and movements.

An author on the study, Linda Waite, the University of Chicago Lucy Flower Professor in Urban Sociology and the director of the Center on Aging at NORC at UChicago, said the researchers wanted to objectively evaluate several aspects of older adults' sleep characteristics, which is why they used the actigraphs in addition to the survey questions.

"Older adults may complain of waking up too early and not feeling rested despite accumulating substantial hours of sleep," Waite said.

The actigraph measurements showed that most of the older adults got sufficient amounts of sleep.

Even though reported sleep problems are common among older individuals, according to the survey only about 13 percent of older adults in the study said that they rarely or never feel rested when waking up in the morning. About 12 percent reported often having trouble falling asleep, 30 percent indicated they regularly had problems with waking up during the night and 13 percent reported problems with waking up too early and not being able to fall asleep again most of the time.

The actigraph provided data that showed the average duration of sleep period among the study participants was 7.9 hours and the average total sleep time was 7.25 hours. Waite said this indicates that the majority of older adults are getting the recommended amount of sleep and usually not having common sleep problems.

One other unexpected finding for the researchers was that respondents who reported waking up more frequently during the night had more total sleep time. "This suggests that a question about feeling rested may tap into other aspects of older adults' everyday health or psychological experience," said Waite.

"Our findings suggest that reports of what seem like specific sleep problems from survey questions may be more accurately viewed as indicators of general problems or dissatisfaction with sleep that may be due to other issues in their lives affecting their overall well-being. These survey questions and actigraphy may measure different aspects of sleep experience."

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Technology in a child's bedroom is associated with less sleep each night

A child sleeping with technology in his or her bedroom has been shown to be associated with up to one hour less of sleep per night.

Sleep, or lack thereof, and technology often go hand in hand when it comes to school-aged kids. Nearly three out of four children (72%) between the ages of 6 and 17 have at least one electronic device in their bedrooms while sleeping, according to a National Sleep Foundation survey. Children who leave those electronic devices on at night sleep less -- up to one hour less on average per night, according to a poll released by the foundation earlier this year.

Dr. Jill Creighton, Assistant Professor of Pediatrics, Stony Brook Children's Hospital says the key to a successful school year starts with Z's. So parents, how can you power down your kids at night and make bedtime easier? Dr. Creighton shares her tips. "First -- develop a nighttime routine," says Dr. Creighton. Whether it's a bath, reading a book or listening to soothing music, these actives will have a better impact on your child to help them relax before going to sleep.

Second -- Power off! "The hour before bed should be a no-electronics zone," says Dr. Creighton. Studies show that the light from backlit electronics (like tablets, smartphones and video games) can disrupt our ability to fall -- and stay -- asleep. Dr. Creighton says designate a spot in your home for electronics to be plugged in, then have your kids start their bedtime routine by plugging in one hour before lights out. Ban hand-held devices from the bedroom. "The burst of light from a phone (even if it's just to check the time) can break a sleep cycle," says Dr. Creighton. "A regular alarm clock is best."

If your child has a slight addiction to technology and is resistant about turning off their device, try dialing down the screen time. "Reduce screen time by 30 minutes or more each week until you reach your goal," says Dr. Creighton. "A good rule of thumb is try to limit recreational screen time to 60 minutes every day. And for every 30 minutes of screen time, make sure your kids get 30 minutes of physical activity."

Try to replace screen time with an activity. "It's sometimes hard to get kids off the couch and get them moving, especially if they think of physical activity as "exercise'' or "boring," says Dr. Creighton. "Parents, get creative and make moving fun for kids." Some of Dr. Creighton's ideas: a 20-minute family walk, 20 minutes of shooting hoops outside, walking the dog, going bike riding and doing chores (with the promise of an allowance) such as vacuuming, putting away laundry, raking leaves, shoveling snow and helping with the garbage/recycling, which are big favorites in her household.

Lastly, establish good habits. Being distracted by phones, hand-held devices and TV shows during mealtime cannot only lead to overeating, but additional unneeded screen time. And be a good role model. Parents, set a good example when it comes to screen time.

So how much sleep do your children need? General sleep guidelines from the National Heart, Lung and Blood Institute show that sleep time change as we age, but experts say there is no magic number for sleep, with individual needs varying.

• Newborns: 16-18 hours a day.

• Preschool-age children: 11-12 hours a day.

• School-age children: at least 10 hours a day.

• Teens: 9-10 hours a day.

• Adults (including the elderly): 7-8 hours a day.

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Study: Enough sleep means less sick days

A study shows that getting enough sleep can mean less sick days from school or work.

New research suggests that sleeping 7 to 8 hours per night is associated with the lowest risk of absence from work due to sickness. The results underscore the importance of the "Sleep Well, Be Well" campaign of the National Healthy Sleep Awareness Project, a collaboration between the Centers for Disease Control and Prevention, American Academy of Sleep Medicine, Sleep Research Society and other partners.

Results show that the risk of an extended absence from work due to sickness rose sharply among those who reported sleeping less than 6 hours or more than 9 hours per night. Further analysis found that the optimal sleep duration with the lowest risk of sickness absence from work was between 7 and 8 hours per night: 7 hours, 38 minutes for women and 7 hours, 46 minutes for men. Insomnia-related symptoms, early morning awakenings, feeling more tired than others, and using sleeping pills also were consistently associated with a significant increase in workdays lost due to sickness.

"Optimal sleep duration should be promoted, as very long and very short sleep indicate health problems and subsequent sickness absence," said principal investigator Tea Lallukka, PhD, specialized researcher at the Finnish Institute of Occupational Health. "Those sleeping five hours or less, or 10 hours or more, were absent from work every year for 4.6 to 8.9 days more, as compared to those with the optimal sleep length."

The study results are published in the September issue of the journal Sleep.

"Insufficient sleep -- due to inadequate or mistimed sleep -- contributes to the risk for several of today's public health epidemics, including cardiovascular disease, diabetes and obesity. Getting at least seven hours of nightly sleep is a key to overall health, which translates to less sick time away from work," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. The "Sleep Well, Be Well" campaign was launched earlier this year to increase awareness of the importance of sleep as one of the three pillars of a healthy lifestyle.

The study involved a nationally representative survey of 3,760 men and women in Finland who had been working at any time in the prior year. Participants were 30-64 years old at baseline. Sleep characteristics were determined by questionnaire, and health measures were derived from physical examination conducted by field physicians. Data for work absences due to sickness were gathered from the Social Insurance Institution of Finland, which tracks all sickness absences lasting more than 10 days. The average follow-up period was seven years.

A novel statistical method developed by study co-authors Tommi Härkänen, PhD, and Risto Kaikkonen, MSc, was used to predict adjusted average sickness absence days per working year. Additional statistical estimates found that the direct costs of sickness absence to the Finnish government and employers could decrease by up to 28 percent if sleep disturbances could be fully addressed.

"Insomnia symptoms should be detected early to help prevent sickness absence and deterioration in health, well-being and functioning," said Lallukka. "Successful prevention of insomnia not only promotes health and work ability among employees, but it can also lead to notable savings in reduced sickness absence costs."

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Study: Weighted blankets do not help children with autism sleep...even though patients like them!

A study shows that weighted blankets do not help autistic children sleep.

But, it appears that parents and children like them and they are seem harmless.

This intervention goes into the category of "may be helpful" and "probably benign".

JR


Weighted blankets did not improve sleep duration, falling asleep faster or waking less often among children with autism spectrum disorder, according to recent study findings published in Pediatrics.

Paul Gringras, MBChB, MRCP, MsC, of Evelina London Children’s Hospital, and colleagues evaluated 67 children aged 5 to 16 years with a confirmed diagnosis and severe sleep problems for 10 months to determine the effect of weighted blankets on sleep duration, time to fall asleep and times waking throughout the night. Participants used a weighted blanket or usual weight blanket (control) for 2 weeks each.

At baseline, no differences were found between the groups for total sleep time, average sleep onset latency, average sleep efficiency, duration of wake after sleep onset and average number of night wakening.

The control blanket caused statistically significant better sleep (P=.01), although small, compared with the weighted blanket on the Composite Sleep Disturbance Index.

However, on the questionnaire, the weighted blanket yielded better results for the “really liked” category (48%) vs. the control (31%). Similarly, parents reported more improved sleep and their children being calmer with the weighted blanket compared with the control blanket.

“Weighted blankets are widely available commercially, and anecdotal reports promote their use in children with ASD,” the researchers wrote. “The blankets will cost families in excess of [$150] and cannot be returned to manufacturers if they are not effective. Our findings provide valuable evidence that although weighted blankets in children with ASD are safe and well perceived by child and parent alike, there is no measurable evidence they are beneficial for children’s sleep.”

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Sleep deprivation and obesity in children

This article explains that sleep deprived children are more likely to be obese than children who get enough sleep.

Tired and hungry. There is a reason why these two conditions seem to go together so easily.

A “well established” link in medical research suggests young children and infants who do not get enough sleep are likely to develop obesity —and a host of devastating related health conditions — before they enter their teen years.

And by then, reversing the obesity is almost impossible, health experts say.

A study published in May in the journal “Pediatrics” hypothesizes that children sleeping less in early childhood developed obesity by age 7.

But the findings — from researchers at Massachusetts General Hospital for Children — are hardly shocking, say local physicians.

While studies such as this are likely to be confirmed by additional research in the years ahead, the other non-controversial conclusion is that obese children who suffer from obstructive sleep apnea also experience a variety of health issues, according to Dr. Ignacio Tapia, a pediatric pulmonologist and sleep medicine specialist at the Sleep Center in The Children’s Hospital of Philadelphia.

Tapia notes that youngsters of normal weight who experience deep sleep and REM or rapid eye movement sleep find sleep restorative, resulting in benefit for everything from brain activity to hormone secretions.

But the obese often cannot attain deep sleep because of the apnea, a condition characterized by brief, numerous involuntary breathing pauses that prevent people from reaching restorative levels of slumber.

When children do not get the sleep they need, they are at risk for health, performance and difficulties in school; researchers find that sleep deficiencies in children can be misdiagnosed as attention-deficit or behavior disorders.

Young patients with sleep apnea can be treated effectively with surgery to remove their tonsils and adnoids but for obese children, such a procedure may not resolve the issue. Further treatment can involve wearing cumbersome masks that help regulate breathing.

“Remember when your grandparents told you you need to go to sleep to grow?” Tapia asked. “Well, that turned out to be true. Growth is associated with longer sleep. The people who sleep less (for example) may have less insulin secretion which can be related to diabetes and pre-diabetes.”

Since the 1800s, each generation has lived longer than the one that preceded it, said Tapia, also assistant professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Such longevity can be linked to the development of antibiotics and advances in cardiac care.

Now, this generation may be the one that loses ground, because of the epidemic of obesity, which is a complex issue relating to social and cultural issues as well and having income components, physicians say. Those who earn less may not have ready access to healthy foods while eating at fast-food chains has been made increasingly affordable, Tapia said. Portion size also is an issue in this country.

“We are seeing patients who are not a little big but really really big,” he said. “It is not rare to see patients who have doubled their ideal weight. They do not weigh 20 or 30 percent more but 100 percent more’’ than growth charts indicate.

The “Pediatrics” study measured the effect of sleep deficiencies over time, using data from Project Viva, a longitudinal research study of women and children that examines the effects of mothers’ diets and other factors during pregnancy and after birth.

Obesity “definitely spans all ages,” said Dr. Tina Rakitt, a pediatric gastroenterologist at the Unterberg Children’s Hospital at Monmouth Medical Center. But the study published in May “is unique enough to say the obesity and sleep link even exists in young children,” she added. “There are many reasons for that link. People who don’t sleep well tend to eat more and they tend to eat more of the wrong things.”

The battle is lost once children are old enough to select their own snacks or meals, unless they are taught correctly. Physicians say healthy eating must be established when children are infants and must be carried on by the family. Obesity does not exist in a vacuum, the experts said.

“The obesity epidemic is not only an adult problem; it is a adult-pediatric problem,” Rakitt said. “We are seeing more sleep apnea…That is a terrible one. Children are developing fatty liver disease. We are starting to see some kids with serious complications either in their childhood or young adult years.”

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Neighborhood's Socioeconomic Level Linked to Sleep Duration

A study found that a neighborhood's amount of socioeconomic deprivation was linked to both longer and shorter sleep duration than is recommended for adults.

A new study of adult twins suggests that the level of socioeconomic deprivation in a neighborhood is associated with the sleep duration of residents.

Results show that increased socioeconomic deprivation was significantly associated with decreased sleep duration across all twins. Further analysis within twin pairs found that this association remained significant after accounting for genetics and shared family environment, indicating a robust relationship.

"These results are a starting point for discussing the impact that neighborhood-level factors have on sleep duration," said principal investigator Dr. Nathaniel Watson, president-elect of the American Academy of Sleep Medicine and professor of neurology at the University of Washington in Seattle, where he is co-director of the University of Washington Medicine Sleep Center and director of the Harborview Medical Center Sleep Clinic. "If we improve upon social deprivation, we may have an opportunity to improve upon habits that influence how long people sleep."

The research abstract was published recently in an online supplement of the journal Sleep and was presented in Minneapolis, Minnesota, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies LLC.

The study group comprised 2,202 twin pairs -- 1,268 monozygotic pairs and 934 dizygotic pairs -- from the University of Washington Twin Registry. The mean age of study subjects was 37 years, and 62.1 percent were female. Mean self-reported nightly sleep duration was 7.4 hours.

Community socioeconomic deprivation was measured using the Singh Index (SI), a composite, area-level measure. The index combines 17 indicators measuring factors such as poverty, income, education and housing.

Watson's research team also found an intriguing gene by environment interaction. As socioeconomic deprivation increased, the total genetic and non-shared environmental variability of sleep duration also went up.

"The more socioeconomically deprived the neighborhood, the more erratic the sleep duration, both shorter and longer than the healthy seven to nine hours per night that we recommend," he said.

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Less sleep may mean faster brain aging for older adults

When older adults get less sleep, it may mean their brains age faster according to a recent study.

Researchers at Duke-NUS Graduate Medical School Singapore (Duke-NUS) have found evidence that the less older adults sleep, the faster their brains age. These findings, relevant in the context of Singapore's rapidly ageing society, pave the way for future work on sleep loss and its contribution to cognitive decline, including dementia.

Past research has examined the impact of sleep duration on cognitive functions in older adults. Though faster brain ventricle enlargement is a marker for cognitive decline and the development of neurodegenerative diseases such as Alzheimer's, the effects of sleep on this marker have never been measured.

The Duke-NUS study examined the data of 66 older Chinese adults, from the Singapore-Longitudinal Aging Brain Study(1). Participants underwent structural MRI brain scans measuring brain volume and neuropsychological assessments testing cognitive function every two years. Additionally, their sleep duration was recorded through a questionnaire. Those who slept fewer hours showed evidence of faster ventricle enlargement and decline in cognitive performance.

"Our findings relate short sleep to a marker of brain aging," said Dr June Lo, the lead author and a Duke-NUS Research Fellow. "Work done elsewhere suggests that seven hours a day(2) for adults seems to be the sweet spot for optimal performance on computer based cognitive tests. In coming years we hope to determine what's good for cardio-metabolic and long term brain health too," added Professor Michael Chee, senior author and Director of the Centre for Cognitive Neuroscience at Duke-NUS.

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Sleep education for preschoolers helped them get more sleep

A study based on a sleep education program for preschoolers caused the children to get 30 minutes more sleep per night.

Taking part in an educational sleep program resulted in a 30-minute average increase in sleep duration at a one-month follow-up for preschoolers, according to a new study from the University of Michigan.

In the study, published in the journal SLEEP, families in two Head Start programs participated in the Sweet Dreamzzz Early Childhood Sleep Education Program™. The Detroit-area nonprofit organization, Sweet Dreamzzz, Inc. developed the program and offers it for free when funding allows. Head Start programs aim to give preschool opportunities to low-income families, in part to improve readiness for elementary school.

Researchers found that among 152 preschool children and their families, the sleep education program produced a 30-minute increase in sleep duration among the kids, says lead author Katherine (Wilson) DeRue, M.D., M.S., who conducted the study while a postgraduate fellow at the University of Michigan Sleep Disorders Center and Departments of Neurology and Pediatrics.

"We know that an increase in sleep duration of that magnitude is associated with better function for kids during the day" says DeRue, who is now a pediatrician and sleep physician at IHA Pulmonary, Critical Care and Sleep Consultants in Ann Arbor, Mich.

"Parents often underestimate how much sleep their kids require, so an educational program like this, directed at parents when they have more control over their kids' sleep schedules, can have great impact."

The study also found that parents' awareness and knowledge of good sleep behaviors also improved after program participation, but this effect was not sustained when parents were retested one month later.

The educational program included a one-time, 45-minute sleep education program for parents, and two weeks of classroom sleep education for the preschoolers. Parents were asked to keep diaries for assessment of their children's sleep habits.

"So we found that a two-week program of daily exposure to sleep education in the preschool classroom, along with an initial presentation for parents, can be an effective strategy," says Ronald D. Chervin, M.D., M.S., the study's senior author, director of the U-M Sleep Disorders Center, and a volunteer on Sweet Dreamzzz's Advisory Board.

"But repeated exposure or reminders about the sleep information may be necessary to maintain the effects for kids and especially parents over time." This is believed to be the first study to examine the effect of a sleep education program on the sleep of preschool age children.

The Head Start programs were located in greater Lansing, Mich. and Detroit, Mich.

The lessons taught in school seemed to stick with the children. Among the lessons were recognizing 8 p.m. as the desirable bedtime; learning that an apple is a better snack before bedtime than a candy bar; and identifying reading rather than watching TV as a relaxing activity before bedtime.

"We are pleased to see that the University of Michigan researchers have been able to measure the impact of our sleep program. We know a proper sleep environment, regular bedtime routine, and the right amount of sleep hours each night can impact the future of our children," says Nancy Maxwell, executive director of the non-profit Sweet Dreamzzz, Inc.

Sweet Dreamzzz provides educational programs on sleep, along with free sleep essentials- such as sleeping bags, toothbrushes, and books about sleep -- to schoolchildren in low-income areas. Sweet Dreamzzz's main aims are to encourage better sleep -- and thereby better health and learning -- at the earliest ages.

Most evidence indicates that children commonly obtain insufficient sleep, says DeRue, and this study provides a critical demonstration that minimal, relatively inexpensive interventions can make a difference.

"Family sleep education during early childhood years, when the sleep habits are being established, could prove to be a cost-effective but impactful strategy to improve children's overall health," says DeRue.

"Nutrition and exercise are commonly the focus of educational efforts to improve children's health," adds Chervin. "Good sleep -- in quality and quantity -- is no less vital to our kids' future, yet it's rarely if ever discussed. Our new findings suggest that a small amount of effort to promote better sleep could have substantial benefit now, and conceivably for years to come as these youngsters grow older."

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Study: People who sleep less eat more

A new study in children show that those who sleep less are more likely to be overeaters.

Young children who sleep less eat more, which can lead to obesity and related health problems later in life, reports a new study by UCL researchers.

The study found that 16 month-old children who slept for less than 10 hours each day consumed on average 105kcal more per day than children who slept for more than 13 hours. This is an increase of around 10% from 982kcal to 1087kcal.

Associations between eating, weight and sleep have been reported previously in older children and adults, but the study, published in the International Journal of Obesity, is the first to directly link sleep to energy intake in children under the age of 3 years. The association was observed before differences in weight emerged, strongly suggesting that energy intake is a key pathway through which sleep contributes to weight gain in early childhood. While the exact causes remain unclear, the regulation of appetite hormones may become disrupted by shorter sleeping patterns.

The study, funded by Cancer Research UK, involved 1303 UK families in the Gemini birth cohort, monitoring sleep when children were 16 months old and diet at 21 months old.

"We know that shorter sleep in early life increases the risk of obesity, so we wanted to understand whether shorter sleeping children consume more calories" explains Dr Abi Fisher of the Health Behaviour Research Centre at UCL. "Previous studies in adults and older children have shown that sleep loss causes people to eat more, but in early life parents make most of the decisions about when and how much their children eat, so young children cannot be assumed to show the same patterns.

"The key message here is that shorter sleeping children may prone to consume too many calories," says Dr Fisher. "Although more research is needed to understand why this might be, it is something parents should be made aware of."

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How long you sleep can influence depression and anxiety development

Research shows that a person's sleep duration can influence the development and symptom severity for anxiety and depression.

Short and long sleep duration, but not insomnia, predict a chronic course of depressive and anxiety disorders independent of symptom severity, research indicates.

Patients with persistent depression or anxiety were more likely to have insomnia than those without persistent disorders. However, insomnia was not independently associated with persistence after accounting for symptom severity.

“Our results also show that it is important to differentiate between insomnia and sleep duration, since there was no interaction effect between insomnia and sleep duration,” the researchers note in the Journal of Clinical Psychiatry.

They studied 1069 individuals aged an average of 42.7 years with DSM-IV-diagnosed depression or anxiety, 59% of whom had insomnia, diagnosed as a Women’s Health Initiative Insomnia Rating Scale score of 9 or above. At 2-year follow-up, persistent depressive and/or anxiety disorder, according to the Composite International Diagnostic Interview, was seen in 61.1% of patients.

Patients who reported sleeping an average of 10 hours or more per night were a significant 2.52 times more likely to have persistent (6-month diagnosis) depression and/or anxiety over 2 years of follow-up than patients who reported sleeping for a normal 7 to 9 hours per night. This was after adjusting for sociodemographic characteristics, chronic medical disorders, psychotropic medication, and symptom severity.

Those who reported short sleep durations of 6 hours or less per night were a significant 1.64 times more likely to have persistent depression and/or anxiety, but, as with insomnia, significance was lost after adjustment for symptom severity.

Both long and short sleep duration were also independently associated with a chronic course (no remission, and at least mild symptoms for 2 years of follow-up) of depression and/or anxiety, increasing the risk a significant 2.91-fold and 1.50-fold, respectively.

When the researchers looked at the effects of sleep duration on the course of depression and anxiety separately, they found that both long and short sleep duration predicted a chronic course of anxiety symptoms, with significant odds ratios of 7.73 and 1.62, respectively. The same was true for chronic depressive symptoms, with corresponding odds of 4.34 and 2.03.

Long and short sleep duration also predicted persistent depressive disorder, at significant odds ratios of 2.52 and 1.49, respectively, but neither predicted persistent anxiety disorder.

“[O]ur study adds significant information on the impact of sleep disturbances on the course of psychopathology,” say lead researcher Josine van Mill (EMGO Institute for Health and Care Research, Amsterdam, the Netherlands)and colleagues.

They add: “In clinical practice, routinely asking for sleep duration might identify subjects at risk for a chronic course.”

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Study: Sleep can make children smarter and calmer

A study claims that changing how long a child sleeps can make the child both smarter and calmer.

For a long time we have thought that sleep affects children’s emotional and cognitive functioning.  However, few studies have been done in youths to verify this.  Just such a study was performed in the November issue of the Journal of Pediatric Psychology, called Manipulating Sleep Duration Alters Emotional Functioning and Cognitive Performance in Children.

In the study, 32 children (8-12 years old) wore devices that can detect sleep, called actigraphs.  These are worn on the wrist, similar to a watch.  They detect motion or its absence and can differentiate sleep from wake.  The children were initially studied under their usual sleep habits for one week.  Then during week two, half were deprived of one hour of sleep (short sleep) and the other half had their sleep lengthened by one hour (long sleep).  During week three, each group was exposed to the opposite condition.

The sleep manipulation ended on a Friday.  The next morning the children were put through a number of tests of cognitive function such as short term and working memory. They were also tested for emotional responses to positive and negative images.  The parents filled out detailed questionnaires about their children’s cognitive ability and emotional responses during the test period.

The results were quite impressive.  Parents reported that their children had more difficulty regulating their emotions when they were in the short sleep compared to the long sleep duration group.  In addition, the children, when tested, expressed far fewer positive responses to various stimuli when they were in the short sleep group.

Additionally, short term and working memory, as well as math fluency, were found to be negatively affected in the short sleep group.  Both parental observations and testing demonstrated significant problems with attention as well.

This is a very important study.  It demonstrates that reducing normal sleep by only one hour per day can have far-reaching consequences on children’s cognitive abilities and emotions.  We know that children in this age group should be sleeping 10 to 11 hours a night.  However, in reality, according to some studies 30 percent or more are getting far less than that.

The conclusions to be drawn are that in many instances problems with memory, attention, and emotional control may be linked to lack of sleep.  The take home message is that teachers, parents, and the children themselves need to be aware of the importance of sleep.  Apparently, there is no substitute for it.

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Coffee six hours before bedtime can reduce sleep by an hour

A study shows that coffee consumed six hours before bed can reduce sleep time by an hour or more.

A new study has revealed that caffeine consumption even six hours before bedtime can have significant, disruptive effects on sleep.

The study led by Christopher Drake, PhD, investigator at the HenryFord Sleep Disorders and Research Center, showed that about 2-3 cups of coffee taken at bedtime, three and even six hours prior to bedtime significantly disrupts sleep.

Even when caffeine was consumed six hours before going to bed, objectively measured total sleep time was dramatically reduced (more than one hour).

Drake said that drinking a big cup of coffee on the way home from work can lead to negative effects on sleep just as if someone were to consume caffeine closer to bedtime. People tend to be less likely to detect the disruptive effects of caffeine on sleep when taken in the afternoon.

Drake and his research team studied 12 healthy normal sleepers, as determined by a physical examination and clinical interview. Participants were instructed to maintain their normal sleep schedules.

They were given three pills a day for four days, taking one pill at six, three and zero hours prior to scheduled bedtime. One of the pills contained 400 mg of caffeine, and the other two were a placebo. On one of the four days, all three pills were a placebo. Sleep disturbance was measured subjectively with a standard sleep diary and objectively using an in-home sleep monitor.

The results suggest that caffeine generally should be avoided after 5 p.m. in order to allow healthy sleep.

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Children eat more when they lose sleep

A new study from Pediatrics looks specifically at what effects adding and losing hours of sleep have on children, specifically regarding their caloric intake. In short, they found that the less sleep a child gets, the more they eat.

Many studies have shown that kids and adults who sleep less are more likely to be overweight or obese. This correlation doesn't prove that sleeplessness causes obesity: Obesity can lead to sleep problems, and lack of sleep might be associated with socioeconomic factors, less organized homes and other factors that affect weight gain.

But a new experimental sleep study, reported in Pediatrics, actually looked at what adding and subtracting sleep does to weight and caloric intake in kids, and its findings suggest that just changing sleep duration may impact kids' waistlines.

The less you sleep, the more you eat

The researchers asked 37 kids, aged 8-11 years, 27 percent of them overweight or obese, to sleep as usual for the first week of the study. During the second and third weeks the kids alternated between sleeping 1.5 hour more and 1.5 hour less per night for an entire week. Sleep duration was verified by an actigraph -- a device that is placed on the wrist and monitors activity level. On average, the actual sleep difference between the week with increased and decreased sleep was about 2.5 hours.

So what can 2.5 hours do? During the week the kids slept more they reported eating 134 fewer calories per day compared to their intake during the reduced sleep condition, and their measured weight was about half a pound less.

While you may frown upon the 134-calorie decrease, if such a reduction is maintained over a long period of time -- something further studies that last longer than three weeks will need to prove -- this would be enormous. Weight is usually gained slowly, by eating just a little more than necessary over long periods of time. The energy gap is the daily discrepancy between energy intake and energy expenditure, and for American kids, the average energy gap estimate is just 64 calories a day. Eliminating calories in just the double digits daily could prevent further weight gain and doing that in your sleep could be sweet!

The exact mechanism in which sleep affects weight is unclear. After a good night's sleep we might be more active and burn more calories, we might have reduced appetites, and craving for high-calorie foods might be curbed.

Getting a good night's sleep

Getting enough sleep helps kids grow, concentrate in school, feel good, and -- as this study further suggests -- keep a healthy weight.

And while getting enough sleep isn't always easy, one of the factors that affect sleep is in our hands. TV before bed has been shown time and time again to result in kids sleeping later, and having a screen in the bedroom not only reduces sleep -- it is correlates independently with overweight.

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Autistic children's sleep patterns

A study shows that autistic children sleep for shorter periods of time and wake more easily than non-autistic children.

Sleep problems are common in children with Autism. Studies have revealed that 50 to 80% of children with autism experience sleep difficulties at some time. Past research has focused on disrupted sleep patterns linked to Autism however; the quality of the evidence accumulated to date has often been compromised by small sample size, lack of agreed definitions, and poor comparability of study participants.

In this new study researchers examined longitudinal sleep patterns in children with autistic spectrum disorders (ASDs) by using long term data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a cohort study of children born in Avon, England during 1991 and 1992. The study tracked the health and development of more than 14,000 children.

Parents were asked about their children's sleeping patterns when their kids were 6, 18, 30, 42, 69, 81, 115 and 140 months old, including when their children routinely went to bed and woke up on week days, and how much time they spent sleeping during the daytime.

Researchers also took into account other key information that included the results of the validated The Social Communications Disorders Check List (SCDC) a questionnaire completed by parents which measures social reciprocity and verbal/non-verbal characteristics similar to those found in Autism. The Wechsler Intelligence Scale for Children (WISC-III) was administered at age seven years. TheWISC-III considers a variety of constructs in determining the Full Scale Intelligence Quotient.

Eighty six of the children had been diagnosed with autistic spectrum disorders by the time they were 11 years old. Thirty had classic autism; 15 had atypical autism; and 23 had Asperger's syndrome.

The final analysis was based on 39 children with autistic spectrum disorders and 7043 typical children for who complete data across all time points were available.

Before the age of 30 months (2.6 yrs.) there was no major difference in sleep patterns between the two groups. However, from 30 months onwards, children with autistic spectrum disorders tended to sleep less in total, with the greatest discrepancy (43 minutes) persisting up to 140 months of age, a difference that remained significant after adjusting for sex, ethnicity, high parity and epilepsy.

The reduction in total sleep was wholly due to changes in night rather than daytimesleep duration. Night-time sleep duration was shortened by later bedtimes and earlierwaking times. Frequent waking (3 or more times a night) was also evident among the children with ASD from 30 months of age.

When it comes to disturbed sleep patterns the authors suggested that an increasing body of data suggests that production of the sleep hormone melatonin may be impaired in some children with autistic spectrum disorders.

The authors acknowledge it is unclear just what impact this shortened sleep pattern may have, however they point out that other researchers have suggested that sleep loss may have impact on neuronal development.

"If this hypothesis of cumulative sleep reduction resulting in neuronal loss is confirmed, then clinically [children with autism] might gain from even a small consistent increase in total sleep time," write the team.

In their conclusion the researchers write “Sleep duration in children with ASD is reduced from 30 months of age and persists until adolescence.”

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