How what you eat affects how you sleep

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

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

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

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

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

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

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

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

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

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

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

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Being in nature can help your sleep

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

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

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

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

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

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

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

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

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

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

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

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

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Both too much and too little sleep can harm the heart

Too much and too little sleep can hurt the heart according to a recent study.

Otherwise healthy people who have poor sleep habits may be putting themselves at risk for early signs of heart disease, a new study suggests.

Folks who get too much or too little sleep -- or not enough quality rest -- are more likely to suffer from stiffened arteries and calcium deposits on the walls of their major arteries, said study lead author Dr. Chan-Won Kim.

"Coronary calcium develops way before heart attack symptoms occur, and a greater amount of calcium in the coronary arteries predicts future development of heart disease," said Kim, a clinical associate professor in the Center for Cohort Studies at Kangbuk Samsung Hospital in Seoul, South Korea.

The sweet spot appears to be about seven hours of sleep, the researchers reported. People who got more or less sleep tended to have increased signs of potential future heart problems.

Earlier studies have linked poor sleep to bad heart health, but this research goes a step further by looking for precursors of heart disease in people who appear healthy, said Dr. David Meyerson, a cardiologist at Johns Hopkins Bayview Medical Center in Baltimore and a national spokesman for the American Heart Association.

Because the study authors took this route, their implications more directly highlight sleep as a potential risk factor for heart disease, Meyerson said.

"Quality and duration of sleep is not always asked by every physician during a cardiovascular risk assessment session, and perhaps it should be," he said.

While the study uncovered a link between poor sleep and potential heart problems, it did not prove a cause-and-effect connection.

The study involved more than 47,000 young and middle-aged adults who completed a sleep questionnaire and had advanced tests to measure arterial stiffness and detect early artery lesions caused by calcium deposits.

The findings revealed that study participants who:

• got five or fewer hours of sleep a day had 50 percent more calcium in their arteries than those who slept seven hours a day.
• slept nine or more hours a day had at least 70 percent more calcium compared to those who slept seven hours.
• reported poor sleep quality had more than 20 percent more calcium than those who reported good sleep quality.

"Since we studied apparently healthy young and middle-age men and women without major diseases, it is unlikely that other health problems can explain the association between extreme sleep duration and early markers of heart disease," Kim said.

Doctors don't yet know exactly why the proper amount of sleep appears to protect heart health, said Meyerson and Dr. Mark Urman, a cardiologist with Cedars-Sinai Heart Institute in Los Angeles.

During sleep, a complex dance of metabolic changes, hormone releases, body repair and brain refreshment takes place. These processes affect blood pressure, blood sugar, inflammation, stress hormones and a host of other factors that can increase risk of heart disease, the cardiologists said.

"We know our bodies every day need this ability to recharge our batteries, to put everything at ease and calm everything down," Urman said, adding that poor sleep has been linked to heart risk factors like diabetes and obesity.

Sleep should be considered part of an overall heart-healthy lifestyle, Urman said.

"This adds to the importance of getting a good night's sleep on a regular basis, in addition to regular exercise and a heart-healthy diet, in reducing risk of heart disease," he said. "This is one more thing that's part of that package."

People who want to improve their sleep should dim the lights in their living room or bedroom as bedtime approaches, and they should go to bed at the same time every day, Kim said.

"It is also important to avoid exposure to electronic media at bedtime," Kim said. He added that "people who experience inadequate sleep need to avoid caffeine-containing beverages after lunch."

The study findings were published Sept. 10 in the American Heart Association journalArteriosclerosis, Thrombosis and Vascular Biology.

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Sleep and breast cancer diagnosis

Having poor sleep before diagnosis is linked to poorer diagnoses for women with breast cancer.

Breast cancer patients who had poor sleep and frequent snoring before their cancer diagnosis appear to have lower survival rates, a new study finds.

The study, which was not designed to prove cause-and-effect, included more than 18,000 cancer patients whose progress was tracked in the Women's Health Initiative study.

All of the women provided information about a number of aspects of their sleep prior to their cancer diagnosis, including the amount of sleep they got, whether or not they snored, and any history of insomnia.

Researchers led by Amanda Phipps, an assistant professor of epidemiology at the University of Washington in Seattle, found that women who slept 6 hours or less per night and were frequent snorers had more than twice the odds of a poor prognosis compared to women with neither of those factors.

A similar finding was seen for women with lung cancer, although the effect was not as large as was seen in women with breast cancer, the study authors said.

The study was published online in the journal Sleep and was also presented June 10 at the annual meeting of the Associated Professional Sleep Societies in Seattle.

"Our results suggest that sleep duration is important for breast cancer survival, particularly in women who snore," Phipps said in a journal news release.

Two breast cancer experts were cautious in interpreting the study results, however.

"At first glance it seems as though recommending more sleep could be of benefit [to breast cancer patients]," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. "However, one must remember that perhaps the factors that allow women to have more restful sleep -- such as healthier lifestyle or lower amounts of stress -- are the real reasons women who sleep well have better breast cancer outcomes."

Dr. Charles Shapiro co-directs the Dubin Breast Center at the Mount Sinai Hospital, also in New York City. "Sleep patterns often get disrupted, and insomnia is prevalent, in women who are diagnosed and treated for breast cancer and other cancers," he said.

"Precisely why insomnia is prevalent in cancer populations is unknown, but there are many potential causes including depression, anxiety, fatigue and [other issues] such as hot flashes," Shapiro added.

But he agreed with Bernik that "important factors like depression and obesity, known to be associated with increased breast cancer mortality, were not assessed [in the study]," and they could be the link between sleeplessness and breast cancer outcomes.

"Insomnia is a common but under-recognized and undertreated problem among breast cancer survivors," Shapiro said, "but whether it actually causes increased cancer deaths is unknown and we need a lot more information before we make that link."

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Sleep can be improved by some exercises but not others

A study claims that certain traditional exercises (e.g., walking, aerobics, yoga, etc.) can help you get better sleep at night while others (such as child care and household chores) may hurt your sleep.

Certain types of physical activity help you sleep better, while others might leave you tossing and turning, a new study finds.

Researchers looked at data from a survey of more than 429,000 American adults. They found that activities such as walking, bicycling, running, weight lifting, aerobics/calisthenics, gardening, yoga/Pilates and golfing were all linked to better odds of a good night's slumber.

But, people who got physical activity from household chores and child care had a greater risk of poor sleep, according to the study.

Results of the study were presented this week at the annual meeting of the Associated Professional Sleep Societies, in Seattle. Findings presented at meetings are generally viewed as preliminary until they've been published in a peer-reviewed journal.

The results of this study were surprising, according to study leader Michael Grandner, a psychiatry instructor at the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania in Philadelphia.

"Not only does this study show that those who get exercise simply by walking are more likely to have better sleep habits, but these effects are even stronger for more purposeful activities, such as running and yoga, and even gardening and golf," Grandner said in a university news release.

"It was also interesting that people who receive most of their activity from housework and child care were more likely to experience insufficient sleep -- we know that home and work demands are some of the main reasons people lose sleep," Grandner added.

"These results are consistent with the growing scientific literature on the role of sleep in human performance. Lab studies show that lack of sleep is associated with poor physical and mental performance, and this study shows us that this is consistent with real-world data as well," he explained.

But since the study design only allowed the researchers to find associations between activity and sleep, instead of proof of a cause-and-effect relationship, more studies are needed, according to Grandner.

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How sleep can affect your heart

This article describes the negative effects of getting a poor night's sleep, especially on your heart.

You might think that those nights when you don’t get a wink of sleep can’t do you any harm apart from the frustration you feel knowing that you have to work the next day and you might be asleep at the wheel.

However, sleep disorders have been associated with many conditions that you might develop later on in life. There are studies proving that insomnia or very few hours of sleep per night are linked to memory loss or to strokes as you become older.

Thus, it was proved that people who have the tendency to sleep less than seven hours every day are more likely to suffer a stroke.

A new research now shows that fewer hours of sleep every night might also be a cause for heart attacks later on in life.

The study conducted by researchers at World Health Organization revealed that sleeping disorders are as bad for your heart as smoking or leading a sedentary life.

“Sleep is not a trivial issue. Sleeping disorders were associated with greatly increased incidences of both heart attack and stroke. Poor sleep should be considered a modifiable risk factor for cardiovascular disease along with smoking, lack of exercise and poor diet,” said Professor Valery Gafarov.

He also added that a normal person should sleep between 7 and 8 hours every night and, if they don’t manage to do that, they should seek specialized help from a sleep doctor.

The study, which began in 1994, involved 657 men whose ages varied from 25 to 64 years old, from Russia. They had never suffered any heart attack or stroke and they did not have diabetes, which is a disease that can lead to these conditions.

Their sleep quality was rated according to the Jenkins Sleep Scale and it was regarded as either very bad, bad or poor for those who had a sleeping disorder.

They were monitored for heart attacks and strokes over the next 14 years and it was revealed that 63 percent of those who suffered a heart attack also suffered from a sleeping disorder.

Therefore, it was shown that people who had sleeping problems were more than 2 times more likely to have a heart attack and 1.5 to 4 times more at risk of having a stroke that those who had a  normal sleep every night.

These findings are extremely worrying, given the fact that the mortality rate associated with heart attacks is extremely high. It was estimated that it represents half of the causes of death all over the world, making it the leading cause in many countries, including the U.S.

This is why preventive measures are extremely important. We need to sleep well, exercise regularly, avoid smoking and drinking alcohol, eat healthy food and maintain a normal body weight.

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Study: Link between insomnia and stroke

A recent study indicates that those suffering from insomnia have a greater risk of stroke than those who do not have insomnia.

Insomniacs face a much higher risk of stroke than restful sleepers, according to a recent study.

The study, published in the peer-reviewed scientific journal Stroke, an American Heart Association (AHA) publication, sought to link cardiovascular health with sleep-related health.

Past research has shown that not getting enough sleep can lead to a significant number of health problems, including elevated stress levels, symptoms of Alzheimer's disease, and even widespread pain conditions such as fibromyalgia.

Now, researchers from Taiwan's Chia Nan University of Pharmacy and Science, and the Department of Medical Research at Chi-Mei Medical Center, have tied insomnia - a condition of chronic sleep deprivation - to an elevated risk of stroke.

To determine this, the researchers analyzed the medical records of more than 21,000 insomniacs in Taiwan, China. The medical data on these patients was observed for a four-year period, allowing the researchers to conclusively differentiate the intensity of each insomniacs' condition.

The participants were identified as having either chronic or persistent insomnia - disturbed sleep lasting for more than a month; relapse insomnia - return of insomnia symptoms after being free of the condition for more than 6 months; or remission insomnia - becoming non-insomniatic at any point during the study.

These groups were then compared to the medical histories of over 60,000 people who did not have insomnia.

Looking at hospital records, the researchers were able to determine that the patients with insomnia had a 54 percent increased risk of stroke than the non-insomniacs. Even more alarming, insomniacs who were diagnosed with the sleeping disorder when they were young-adults between 18 and 35 years old were a whopping eight times more likely to be hospitalized for stroke, compared to non-insomniacs.

Predictably, the risk of stroke was also found to be greatest in those who suffered from chronic or persistent insomnia or had diabetes.

According to the researchers, although they did not determine a cause-and-effect relationship with this study, past research has suggested that the stress disturbed sleep can have on your heart can cause inflammation, increased blood pressure, and even impaired glucose levels.

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Work programs can improve employees' children's sleep

A program aimed to reduce work-family conflicts for employees had a positive influence on the employees' children's sleep.

A workplace intervention designed to reduce employees' work-family conflict and increase schedule flexibility also has a positive influence on the sleep patterns of the employees' children.

The intervention, Support-Transform-Achieve-Results (STAR), includes training supervisors to be more supportive of their employees' personal and family lives, changing the structure of work so that employees have more control over their work time, and changing the culture in the workplace so that colleagues are more supportive of each other's efforts to integrate their work and personal lives.

The research team conducted several other tests of the effects of the intervention. In an earlier study, for example, they showed that STAR resulted in employed parents spending more time with their children without reducing their work time.

In this study, the researchers found that children whose parents participated in the STAR intervention showed an improved quality of sleep one year later compared to the children of employees who were randomly assigned to a control group. The researchers published their findings in the June issue of theJournal of Adolescent Health.

"These findings show the powerful effect that parents' workplace experiences can have on their children," said Susan McHale, distinguished professor of human development and family studies, Penn State. "The STAR intervention focused solely on workplace experiences, not on parenting practices. We can speculate that the STAR intervention helped parents to be more physically and emotionally available when their children needed them to be."

The youth in the study were ages 9 through 17, which is a crucial age group for developing healthy sleep habits, as youth become more independent and more involved in friends, school and social activities, McHale said.

McHale and her team measured sleep patterns by interviewing employees' children on the phone every evening for eight consecutive evenings both before and after the STAR intervention. Each night they asked the children about their sleep on the prior night, including what time they went to bed, what time they woke up that morning, how well they slept and how hard it was to fall asleep.

An important part of this method was collecting the data on consecutive nights.

"Precision of reports is enhanced by getting the data on a daily basis," McHale said.

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Naps may mean worse sleep in children

A study out of Australia shows that napping may be tied to children getting worse quality sleep.

New research has raised questions about something that's common practice in 80 per cent of Queensland childcare centers.

The Sleep in Early Childhood Research group found children exposed to more than an hour of forced napping at centers slept worse at night, even when they started school a year later.

Lead researcher Dr. Sally Staton, from the Queensland University of Technology, said childcare providers needed to question whether mandatory nap times were appropriate.

"Certainly we're not suggesting that sleep time is not an important component or providing for sleep is not an important component," she said.

"But certainly (they need to be) thinking about whether mandatory sleep times, in particular really long mandatory sleep times, are actually the most appropriate way of meeting sleep needs, particularly for these pre-school aged children where their needs are so diverse."

Dr. Staton said another recent study found children had grown out of napping by the time they were three or four years old.

Federal legislation calls for centers to cater to the individual sleep needs of all their students but there is limited guidance about what exactly that means.

In practice, Dr. Staton's previous research found about 80 per cent of centers enforced mandatory nap times, where children were forced to lie on their sleeping mat without access to any other activities.

Those sleep periods could be as long as two and a half hours but were about an hour on average.

But the study, to be published in the US-based Journal of Developmental and Behavioral Pediatrics next month, found even in long mandatory nap periods only half of the children actually slept.

The QUT research fellow's study of 168 children across 130 services, which were selected from a larger representative study, found children exposed to mandatory napping slept an average of 24 minutes less at night.

"I guess what's particularly concerning is when we got to the second year of the study, so once the children were in school, they were getting less sleep overall," Dr. Staton said.

"So their total sleep was less, probably because now they weren't napping and the amount of sleep they were getting was actually dropping below what we could consider the normal range for children of that age group."

Australian Childcare Alliance CEO Gwynn Bridge disputed the 80 per cent figure, saying most centers gave children options to cater for their individual needs.

"Most of them are encouraged to read a book or they can lay next to their friend and have a chat," she said.

"A lot in the older groups aren't even putting mats out now.

"[For] the children who want to sleep and the ones the educators know will sleep mats will be offered, but it's certainly not the case where every child must sleep for an hour and a half."

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Link between sleep and blood pressure

A study shows a link between getting enough good-quality sleep and lowering a person's blood pressure.

Looking to lower your blood pressure? Fix your poor sleep habits first, suggests a new study.

Mayo Clinic researchers recently set out to find how reduced sleep quantity and quality could affect a person's blood pressure. After monitoring their eight participants for 16 days, they found that when their subjects experienced prolonged periods of shorter sleep, they also registered substantially higher blood pressure numbers at night. While the size of the study was small, they presented their findings at the American College of Cardiology's 64th Annual Scientific Session in San Diego, California, on March 15.

The eight healthy, normal-weight participants with ages ranging from 19 to 36 experienced a 4-day acclimation period before being split into two groups: one set who slept only four hours each night for nine days, and the other who slept for nine hours each night for those same nine days. They all also completed three days of recovery. Throughout the 16-day period, the researchers monitored each subjects' blood pressure 24 times throughout a daily cycle.

Blood pressure levels naturally rise and fall in a circular pattern throughout the day. They tend to peak in the middle of the afternoon, and reach their lowest points in the middle of the night during one's deep sleep. Now in this study, the sleep-restricted participants registered an average of 115/64 mm Hg during the nighttime while their well-rested counterparts registered an average of 105/57 mm Hg. In addition to confirming that inadequate sleep limited the anticipated decrease in blood pressure with these figures, the experiment revealed a higher nighttime heart rate in sleep-deprived subjects than those who experienced normal sleep.

"We know high blood pressure, particularly during the night, is one of the major risk factors for heart disease, and Americans typically do not get enough sleep," lead author Naima Covassin, Ph.D., said in a statement.

This new study could also further demonstrate why sleep apnea is considered acommon contributor to high blood pressure. According to the National Sleep Foundation, this often-undiagnosed sleeping disorder creates pauses in a person's breathing that lead to snoring and restless nights. That resulting decrease in sleep quantity and quality can lead to hypertension and heart disease, as well as possible mood and memory problems.

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What should I know about sleep apnea?

This article gives information on the different types of sleep apnea and the available treatments.

Sleep apnea is a type of sleep disorder characterized by interruptions or pauses in breathing during sleep. These interruptions can be significant and can be potentially life threatening. Because of this, the disorder can have an important impact on quality of life as well as the health of a patient.

Kim LaJack, Director of the Sleep Disorders Center at Opelousas General Health System, says symptoms of sleep apnea might include loud snoring, excessive daytime sleepiness and feelings of exhaustion upon awakening, as if sleep had never taken place. Other symptoms include depression, irritability, morning headaches, loss of sex drive, lack of concentration and memory problems.

If untreated, sleep apnea can lead to accidents due to drowsy driving as well as health issues such as hypertension, heart attacks, diabetes and strokes, according to LaJack. 

The Three Types of Sleep Apnea 

1. Obstructive sleep apnea: OSA is essentially breathing that is interrupted by a physical block to airflow despite respiratory effort, causing complete or partial closure of the airway during sleep. The three causes for OSA are enlarged tonsils blocking the airway, an enlarged neck or a large tongue blocking the airway. 

2. Central sleep apnea: This type of sleep apnea occurs when the brain fails to send the appropriate signal to the muscles responsible for initiating breathing. “We see this with patients who have neuromuscular disorders or who are on a lot of pain medication,” LaJack explains. “Sometimes patients with heart failure also experience central sleep apnea.” 

3. Complex sleep apnea: This type of sleep apnea encompasses a combination of obstructive and central sleep apnea, with the airways closed off and breathing suspended. 

“While there are three different kinds of sleep apnea, the most frequently treated at Opelousas General is obstructive sleep apnea,” LaJack says. 

Diagnosis and Treatment

Giving the history of symptoms to a qualified physician is the only way to determine if a patient's experience requires a sleep study, says LaJack. Patients who have undergone initial evaluation spend an evening at the Sleep Disorders Center at Opelousas General Health System, where their sleep is closely monitored. 

“Monitoring involves obtaining information about sleep stages, including heart rate, respiratory effort and oxygen and carbon dioxide levels,” LaJack says. 

The treatment for sleep apnea varies depending on the cause. OSA in adults involves initiation of continuous positive airway pressure (CPAP) therapy. The CPAP machine delivers a pressure into the patient's airway by way of a mask and tubing, acting as a splint to hold the airway open. LaJack says OSA in children is generally treated with tonsillectomy. On occasion, children will need to be treated with CPAP, and with family support, it often is successful. In regards to central sleep apnea, PAP therapy involves an added element of delivering a breath during pauses in breathing. 

Dr. Joseph Y. Bordelon, Medical Director of the Sleep Disorders Center, emphasizes, “No matter the cause of the sleep apnea, the goal of therapy is to maintain an open airway so that the patient can have a more restful night of sleep, experience improved quality of life, and to prevent complications associated with untreated sleep disordered breathing. If we can delay someone's premature trip to the funeral home or nursing home, then we have been successful.”

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Alcohol doesn't help sleep

A study showed that drinking alcohol before bedtime does not help a person's sleep.

As many as one in five Americans turns to alcohol sometimes to help them fall asleep, but that can lead to sleep problems later in the night, a new study finds.

This is because alcohol hampers the brain's system for regulating a person's need for sleep, researchers found.

"The prevailing thought was that alcohol promotes sleep by changing a person's circadian rhythm -- the body's built-in 24-hour clock," study lead author Mahesh Thakkar, an associate professor and director of research in the neurology department at the University of Missouri School of Medicine, said in a university news release.

"However, we discovered that alcohol actually promotes sleep by affecting a person's sleep homeostasis -- the brain's built-in mechanism that regulates your sleepiness and wakefulness," Thakkar said.

Alcohol's effect on sleep homeostasis can lead to poorer quality sleep, according to the study published recently in the journal Alcohol.

Study co-author Dr. Pradeep Sahota said, "Based on our results, it's clear that alcohol should not be used as a sleep aid." Sahota is chair of the neurology department at the University of Missouri School of Medicine.

"Alcohol disrupts sleep and the quality of sleep is diminished. Additionally, alcohol is a diuretic, which increases your need to go to the bathroom and causes you to wake up earlier in the morning," Sahota explained in the news release.

Thakkar pointed out that sleep is an important area of study. "Approximately one-third of our life is spent sleeping. Coupled with statistics that show 20 percent of people drink alcohol to sleep, it's vital that we understand how the two interact," he said.

"If you are experiencing difficulty sleeping, don't use alcohol. Talk to your doctor or a sleep medicine physician to determine what factors are keeping you from sleeping. These factors can then be addressed with individualized treatments," Thakkar advised.

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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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PTSD and poor sleep

A study claims that poor sleep in people with PTSD could lead to a decrease in physical activity and an increase in obesity.

Poor sleep quality may lower physical activity in people with post-traumatic stress disorder, according to a recent study.

Researchers found that PTSD was independently associated with worse sleep quality at baseline, and participants with current PTSD at baseline had lower physical activity one year later.

Further analysis found that sleep quality completely mediated the relationship between baseline PTSD status and physical activity at the one-year follow-up, suggesting that the association of reduced sleep quality with reduced physical activity could comprise a behavioral link to negative health outcomes such as obesity.

"We found that sleep quality was more strongly associated with physical activity one year later than was having a diagnosis of PTSD," Lisa Talbot, lead author of the study and postdoctoral fellow at the San Francisco VA Medical Center and the University of California- San Francisco, said in a statement. "The longitudinal aspect of this study suggests that sleep may influence physical activity."

For the study, researchers collected and analyzed data from  the Mind Your Heart Study, a prospective cohort study of 736 outpatients recruited from two Department of Veterans Affairs (VA) medical centers. PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS).  At baseline participants rated their sleep quality overall during the last month, and at baseline and again one year later they reported how physically active they have been during the last month. Of the 736 military veteran participants, 258 had current or subsyndromal PTSD.

Researchers said the results suggest that behavioral interventions to increase physical activity should include an assessment for sleep disturbance.

"The findings also tentatively raise the possibility that sleep problems could affect individuals' willingness or ability to implement physical activity behavioral interventions," Talbout said. "Sleep improvements might encourage exercise participation."

The findings were recently published in the  Journal of Clinical Sleep Medicine, which is published by the American Academy of Sleep Medicine.

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Common issues that hurt your sleep

This article discusses common issues that hurt people's sleep, and tells you what to do about them.

You might remember a time when you could drift off to sleep in an instant and remain in a state of blissful slumber well past lunchtime the next day. Now your sleep is more likely to be lighter and more fitful, and when you wake up in the morning you don't always feel refreshed.

A lack of good-quality sleep could be a natural consequence of changing sleep-wake patterns after menopause. It's also likely that the issue is physical--and fixable. Many conditions can disrupt your rest, and they can be treated. It's important to address these issues. Lack of sleep does more than make you drowsy. Chronic insomnia has been linked to a variety of health problems, including obesity, high blood pressure, heart disease, diabetes and depression.

Go through this list to see whether you might have one of these sleep-stealing conditions. Also check your medicine cabinet. Some medications, including corticosteroids, beta blockers, cold and flu remedies, and certain antidepressants also can interfere with sleep.

1. Sleep apnea

The conventional image of sleep apnea is of the overweight man who snores, but women of any size can also develop these repeated pauses in breathing while they sleep.

"A woman who has a narrow jaw or a change in muscle tone can get apnea," says Dr. Julia Schlam Edelman, clinical instructor in obstetrics and reproductive biology at Harvard Medical School and author of "Successful Sleep Strategies for Women and Menopause Matters: Your Guide to a Long and Healthy Life." Either of these anatomical issues can block oxygen from reaching your lungs (and subsequently the rest of your body) while you sleep. Snoring might not be your main symptom if you do have sleep apnea, but you will notice that you're especially sleepy during the day.

Solution: See a specialist for a sleep study. You may be able to relieve apnea with a few lifestyle adjustments, such as sleeping on your side or losing weight. Your doctor might also suggest an oral appliance or a CPAP machine that blows air into your airways to keep them open at night.

2. Diet

What you eat can affect your sleep. Spicy foods can contribute to painful heartburn. Big meals leave you uncomfortably full, and over time can contribute to obesity--a well-known risk factor for sleep apnea. Too much caffeine could keep you wide awake, even if you finish your coffee in the morning.

"It takes six hours to clear half of the caffeine from your body. If you have enough caffeine, it's still in your body at 4 in the morning," says Dr. Edelman. And though a glass of wine or two with dinner will make you feel relaxed or even sleepy, it won't help you sleep. "You can fall asleep, but once you're asleep you can't sleep deeply," she says.

Solution: Eat dinner at least a couple of hours before bedtime, and keep the meal light. Avoid spicy, fatty foods, as well as alcohol and caffeine. Also, don't drink too many fluids before bed. Having to constantly get up to go to the bathroom can disrupt your sleep, too.

3. Lack of exercise

Sleep and exercise complement each other. Working out regularly can help you sleep better, and conversely, you're more likely to exercise if you get a good night's rest.

Solution: Exercise every day if you can, ideally in the morning. Doing a high-energy aerobic routine too close to bedtime can have the opposite of the intended effect, making you too energized to sleep. A gentle yoga stretch before bed probably won't hurt, though. It might even help you relax.

4. Pain

Arthritis aches or any other kinds of pain don't make for restful slumber. Conversely, a lack of sleep can increase your pain. Researchers believe that a lack of sleep may activate inflammatory pathways that exacerbate arthritis pain. Poor sleep can also make you more sensitive to the feeling of pain.

Solution: In addition to the pain remedies your doctor recommends, try using a heating pad or taking a warm bath before bed to soothe achy joints or muscles. Lying against a body pillow can put you in a more comfortable position while you sleep.

5. Restless legs syndrome

Women are twice as likely as men to have restless legs syndrome (RLS)--a condition that causes a creepy, crawly feeling and uncontrollable movements in the legs at night. It's often linked to hormonal changes early in life and during pregnancy, but RLS can continue as you get older. RLS isn't just miserably uncomfortable--researchers at Harvard have linked this condition to an increased risk for heart disease and depression in women.

Solution: Try simple interventions first. Exercise every day, take a hot bath before bed, massage your legs, and cut back on things that can make you jittery--like caffeine and tobacco. If these measures don't work, your doctor may recommend one of several medicines that reduce RLS symptoms--including ropinirole (Requip), pramipexole (Mirapex), rotigotine (Neupro), or gabapentin enacarbil (Horizant).

6. Depression

"Depression is a common compromiser of sleep, and it's much more common in women than in men," Dr. Edelman says. Women who are depressed may sleep more than usual, but their sleep isn't restful. Some of the antidepressants meant to counteract depression, particularly SSRIs, can also interfere with sleep.

Solution: See your primary care doctor, psychologist, psychiatrist, or therapist for help, which may include medications, talk therapy, or both. If your antidepressant seems to be keeping you awake, ask your doctor to switch you to another drug.

7. Stress

It's impossible to sleep when the weight of the day is pressing on you. Finding a sense of calm before bed isn't easy, especially when you can't unplug from the demands of your day.

Solution: Establish wind-down time. Do a quiet, relaxing activity before bed that doesn't involve a screen. Talk to a friend or family member, sew, or read a real book--not one on a backlit tablet device.

"Just allow yourself to have quiet time," Dr. Edelman adds. And don't sleep with your smartphone on your bedside table.

8. Poor sleep habits

Sometimes insomnia stems from long-ingrained behaviors, like staying up too late or engaging in stimulating activities before bed.

Solution: Follow a few basic sleep hygiene strategies. Go to bed and wake up at the same times each day. Keep your bedroom cool, dark, and comfortable. Use your bed for sleep and sex only. If you can't fall asleep within 15 minutes, get up and leave the bedroom. Read or do another quiet activity for 15 to 20 minutes until you get sleepy.

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