|Sleep is related to everything in your life....sleep affects everyday health, relationships and decision-making.......|
Posted by Vishva News Reporter on June 26, 2009
.......Income and employment status,
relationship satisfaction and hobbies
AND SLEEP AFFECTS ALL OF THE ABOVE
DAILY HEALTH AND DECISION MAKING
according to scientific research presented recently in Seattle at the
annual meeting of the Associated Professional Sleep Societies.
.......HIGHLITES OF THE SLEEP
OF TODAY'S NEWS SHARING BY PVAF....
.......TO MAKE YOUR TOMORROW HAPPIER THAN TODAY....
WITH KNOWING MORE THE STILL EVOLVING SCIENCE OF SLEEP.........
- Across racial and ethnical groups, one in five people
reported problems with sleep on seven of the 14 nights before the
survey...especially women in lower socioeconomic levels, divorced and
separated men and men and women ages 18 to 24....
- Gently cooling the frontal cortex of brain during sleep
reduces metabolic activity thus increasing slow-wave sleep of the
deepest sleep and creates better sleep reducing insomnia in five out of
|- On a
day-to-day basis, inadequate and/or bad night's sleep leads to
depression, unhappy co-sleeping couples with many next-day problems....
- When parents mandate early bedtimes as against
bedtimes of midnight or later for teenagers, it helped to reduce the
teens’ risk for depression and suicidal thoughts; math, history and
English scores correlated with sleep quality; and decline in grade-point
average at the university.....
....after reading the latest sleep research report plus the basics of
sleep including the following topics:
Sleep: A Dynamic Activity
How Much Sleep Do We Need?
What Does Sleep Do For Us?
Dreaming and REM Sleep
Sleep and Circadian Rhythms
Sleep and Disease
Tips for a Good Night's Sleep.....
.......by clicking on the next line.....
Better sleep, better living....r />
How you fare during your waking hours has a
lot to do with a good night’s rest....
18 Jun 2009: Shari Roan; Los Angeles Times
Sleep isn’t just a chunk of time carved out to recharge for the
following day. Increasingly, scientific evidence shows that life and
sleep are woven together like 800-threadcount sheets.
How people fare
during their waking hours has a lot to do with how they sleep — and vice
Income, employment status, relationship satisfaction and hobbies all
affect sleep, according to research presented recently in Seattle at the
annual meeting of the Associated Professional Sleep Societies.
And sleep affects health, relationships and decision-making.
“““Sleep is related to everything,” said Michael Grandner, a fellow at the
Center for Sleep and Respiratory Neurobiology at the University of
Some news from the meeting:
Who can’t sleep?
presentation, Grandner reviewed responses from 159,856 people who
participated in a government survey — one of the largest to gather data
on sleep difficulties. Overall, one in five people reported problems
with sleep on seven of the 14 nights before the survey.
Grandner found little difference among racial and ethnic groups, except
for people of Asian ethnicity, who had far fewer problems.
But people in lower socioeconomic levels, especially women, reported
more problems. So did divorced and separated people, especially divorced
and separated men. />
And men who described themselves as homemakers reported sleep problems
on par with people who were unemployed (who had high rates of problems).
Perhaps most surprising, the worst sleep seems to occur in men and women
ages 18 to 24.
“The story with age is fascinating,” Grandner said. “Usually, the common
knowledge is that as you get older you have more sleep problems. We
found pretty much the opposite.”
IIt could be that older people are accustomed to sleep disturbances and
don’t complain about them, he said. But it remains to be seen why so
many young, ostensibly healthy people are missing out on sweet dreams.
Cooling the brain:
Treatments for insomnia include medications and
lifestyle changes, neither of which appeal to some people. But research
on a non-drug treatment is underway.
Insomnia seems to be caused by excessive metabolic activity in the
brain’s frontal cortex. For deep, refreshing sleep to occur, the frontal
cortex has to rest, said Dr. Eric ofzinger, a professor of psychiatry
at the University of Pittsburgh.
Research on brain injuries has shown that cooling the brain reduces
metabolic activity. Nofzinger and his colleagues decided to try the same
concept on insomnia by designing a device that gently cools the frontal
cortex during sleep.
In a pilot study of eight patients, five showed activity reductions in
that brain area. Six of the eight reported they slept better.
“They had increased slow-wave sleep, which is the deepest sleep,”
|The device is a cap worn over the forehead containing tubes that
circulate cool water. Nofzinger has started a company to advance the
research beyond these preliminary stages. (The study was small, and
reports of better sleep could be a placebo effect.) |
““Insomnia is widely prevalent,” Nofzinger said. “And when you look at
patient preferences, the majority would prefer a nonpharmaceutical
Bedtime and depression:
When parents mandate early bedtimes for
teenagers, they might help reduce the teens’ risk for depression and
suicidal thoughts, researchers from Columbia University found.
A study of 15,000 teenagers included 1,143 who had depression and 2,038
who had experienced suicidal thoughts.
Those whose parents allowed
bedtimes of midnight or later were 25 per cent more likely to suffer
from depression and 20 per cent more likely to have suicidal thoughts.
The study supports the idea that inadequate sleep could lead to
depression, said the lead author, James Gangwisch.
Happy, rested couples: The quality of a couple’s sleep and relationship
tend to follow the same trajectory, researchers said. On a day-to-day
basis, a couple’s relationship affects how well they sleep. And how well
they sleep affects how the relationship functions the following day.
RResearchers at the University of Arizona studied 29 heterosexual,
co-sleeping couples who did not have children. Each person completed a
sleep diary for seven days and was asked to record, six times a day, the
quality of interactions with his or her partner.
The study found that, for men, better sleep was linked to more positive
ratings of relationship quality the next day. Negative interactions with
a partner during the day led to poorer sleep that night for both woman
and man. The study’s take-home message, lead investigator Brant Hasler
says, is to settle conflicts before going to bed and avoid
confrontational discussions on a day when one partner, or both, has had
a bad night’s sleep.
The importance of sleep to academic performance is one
of the most robust findings in sleep research in recent years. One
study, from the University of Pittsburgh, found that math, history and
English scores all correlated with sleep quality.
Different types of sleep problems, however, affected different types of
function. Higher math scores were related to greater sleep quality and
fewer nighttime awakenings, whereas good English and history scores were
linked to less difficulty awakening. br />
OOverall, teens in the study who had regular and predictable sleep
schedules coped better with short term sleep deficits than those with a
more varying and chaotic sleep schedule.
Another study, from Hendrix College in Conway, Ark., found that poor
sleep patterns were linked to poorer academic performance and a decline
in grade-point average during the transition from high school to
college. Students who were “evening types” had an average GPA of 2.84 in
the first year of college, whereas “morning or intermediate types” had
an average GPA of 3.18. /td>
QUICK PRIMER ON SLEEP
FOR YOUR EDUCATION
A BETTER SLEEP TOMORROW THAN TODAY
|Do you ever feel sleepy or "zone out" during the day? Do you find it
hard to wake up on Monday mornings? If so, you are familiar with the
powerful need for sleep. However, you may not realize that sleep is as
essential for your well-being as food and water. The following topics
will give you a quick primer on sleep:
Sleep: A Dynamic Activity
How Much Sleep Do We Need?
What Does Sleep Do For Us?
Dreaming and REM Sleep
Sleep and Circadian Rhythms
Sleep and Disease
Tips for a Good Night's Sleep
Until the 1950s, most people thought of sleep as a passive, dormant part
of our daily lives. We now know that our brains are very active during
sleep. Moreover, sleep affects our daily functioning and our physical
and mental health in many ways that we are just beginning to understand.
NNerve-signaling chemicals called neurotransmitters control whether we
are asleep or awake by acting on different groups of nerve cells, or
neurons, in the brain. Neurons in the brainstem, which connects the
brain with the spinal cord, produce neurotransmitters such as serotonin
and norepinephrine that keep some parts of the brain active while we are
awake. Other neurons at the base of the brain begin signaling when we
fall asleep. These neurons appear to "switch off" the signals that keep
us awake. Research also suggests that a chemical called adenosine builds
up in our blood while we are awake and causes drowsiness. This chemical
gradually breaks down while we sleep.
During sleep, we usually pass through five phases of sleep: stages 1, 2,
3, 4, and REM (rapid eye movement) sleep. These stages progress in a
cycle from stage 1 to REM sleep, then the cycle starts over again with
stage 1 (see figure 1 ). We spend almost 50 percent of our total sleep
time in stage 2 sleep, about 20 percent in REM sleep, and the remaining
30 percent in the other stages. Infants, by contrast, spend about half
of their sleep time in REM sleep.
During stage 1, which is light sleep, we drift in and out of sleep and
can be awakened easily. Our eyes move very slowly and muscle activity
slows. People awakened from stage 1 sleep often remember fragmented
visual images. Many also experience sudden muscle contractions called
hypnic myoclonia, often preceded by a sensation of starting to fall.
These sudden movements are similar to the "jump" we make when startled.
When we enter stage 2 sleep, our eye movements stop and our brain waves
(fluctuations of electrical activity that can be measured by electrodes)
become slower, with occasional bursts of rapid waves called sleep
spindles. In stage 3, extremely slow brain waves called delta waves
begin to appear, interspersed with smaller, faster waves. By stage 4,
the brain produces delta waves almost exclusively. It is very difficult
to wake someone during stages 3 and 4, which together are called deep
sleep. There is no eye movement or muscle activity. People awakened
during deep sleep do not adjust immediately and often feel groggy and
disoriented for several minutes after they wake up. Some children
experience bedwetting, night terrors, or sleepwalking during deep sleep.
When we switch into REM sleep, our breathing becomes more rapid,
irregular, and shallow, our eyes jerk rapidly in various directions, and
our limb muscles become temporarily paralyzed. Our heart rate increases,
our blood pressure rises, and males develop penile erections. When
people awaken during REM sleep, they often describe bizarre and
illogical tales – dreams.
The first REM sleep period usually occurs about 70 to 90 minutes after
we fall asleep. A complete sleep cycle takes 90 to 110 minutes on
average. The first sleep cycles each night contain relatively short REM
periods and long periods of deep sleep. As the night progresses, REM
sleep periods increase in length while deep sleep decreases. By morning,
people spend nearly all their sleep time in stages 1, 2, and REM.
People awakened after sleeping more than a few minutes are usually
unable to recall the last few minutes before they fell asleep. This
sleep-related form of amnesia is the reason people often forget
telephone calls or conversations they've had in the middle of the night.
It also explains why we often do not remember our alarms ringing in the
morning if we go right back to sleep after turning them off.
Since sleep and wakefulness are influenced by different neurotransmitter
signals in the brain, foods and medicines that change the balance of
these signals affect whether we feel alert or drowsy and how well we
sleep. Caffeinated drinks such as coffee and drugs such as diet pills
and decongestants stimulate some parts of the brain and can cause
insomnia, or an inability to sleep. Many antidepressants suppress REM
sleep. Heavy smokers often sleep very lightly and have reduced amounts
of REM sleep. They also tend to wake up after 3 or 4 hours of sleep due
to nicotine withdrawal. Many people who suffer from insomnia try to
solve the problem with alcohol – the so-called night cap. While alcohol
does help people fall into light sleep, it also robs them of REM and the
deeper, more restorative stages of sleep. Instead, it keeps them in the
lighter stages of sleep, from which they can be awakened easily.
People lose some of the ability to regulate their body temperature
during REM, so abnormally hot or cold temperatures in the environment
can disrupt this stage of sleep. If our REM sleep is disrupted one
night, our bodies don't follow the normal sleep cycle progression the
next time we doze off. Instead, we often slip directly into REM sleep
and go through extended periods of REM until we "catch up" on this stage
People who are under anesthesia or in a coma are often said to be
asleep. However, people in these conditions cannot be awakened and do
not produce the complex, active brain wave patterns seen in normal
sleep. Instead, their brain waves are very slow and weak, sometimes all
Sleep Do We Need?
The amount of sleep each person needs depends on many factors, including
age. Infants generally require about 16 hours a day, while teenagers
need about 9 hours on average. For most adults, 7 to 8 hours a night
appears to be the best amount of sleep, although some people may need as
few as 5 hours or as many as 10 hours of sleep each day. Women in the
first 3 months of pregnancy often need several more hours of sleep than
usual. The amount of sleep a person needs also increases if he or she
has been deprived of sleep in previous days. Getting too little sleep
creates a "sleep debt," which is much like being overdrawn at a bank.
Eventually, your body will demand that the debt be repaid. We don't seem
to adapt to getting less sleep than we need; while we may get used to a
sleep-depriving schedule, our judgment, reaction time, and other
functions are still impaired.
People tend to sleep more lightly and for shorter time spans as they get
older, although they generally need about the same amount of sleep as
they needed in early adulthood. About half of all people over 65 have
frequent sleeping problems, such as insomnia, and deep sleep stages in
many elderly people often become very short or stop completely. This
change may be a normal part of aging, or it may result from medical
problems that are common in elderly people and from the medications and
other treatments for those problems.
Experts say that if you feel drowsy during the day, even during boring
activities, you haven't had enough sleep. If you routinely fall asleep
within 5 minutes of lying down, you probably have severe sleep
deprivation, possibly even a sleep disorder. Microsleeps, or very brief
episodes of sleep in an otherwise awake person, are another mark of
sleep deprivation. In many cases, people are not aware that they are
experiencing microsleeps. The widespread practice of "burning the candle
at both ends" in western industrialized societies has created so much
sleep deprivation that what is really abnormal sleepiness is now almost
Many studies make it clear that sleep deprivation is dangerous.
Sleep-deprived people who are tested by using a driving simulator or by
performing a hand-eye coordination task perform as badly as or worse
than those who are intoxicated. Sleep deprivation also magnifies
alcohol's effects on the body, so a fatigued person who drinks will
become much more impaired than someone who is well-rested. Driver
fatigue is responsible for an estimated 100,000 motor vehicle accidents
and 1500 deaths each year, according to the National Highway Traffic
Safety Administration. Since drowsiness is the brain's last step before
falling asleep, driving while drowsy can – and often does – lead to
disaster. Caffeine and other stimulants cannot overcome the effects of
severe sleep deprivation. The National Sleep Foundation says that if you
have trouble keeping your eyes focused, if you can't stop yawning, or if
you can't remember driving the last few miles, you are probably too
drowsy to drive safely.
Return to Index
Does Sleep Do For Us?
Although scientists are still trying to learn exactly why people need
sleep, animal studies show that sleep is necessary for survival. For
example, while rats normally live for two to three years, those deprived
of REM sleep survive only about 5 weeks on average, and rats deprived of
all sleep stages live only about 3 weeks. Sleep-deprived rats also
develop abnormally low body temperatures and sores on their tail and
paws. The sores may develop because the rats' immune systems become
impaired. Some studies suggest that sleep deprivation affects the immune
system in detrimental ways.
Sleep appears necessary for our nervous systems to work properly. Too
little sleep leaves us drowsy and unable to concentrate the next day. It
also leads to impaired memory and physical performance and reduced
ability to carry out math calculations. If sleep deprivation continues,
hallucinations and mood swings may develop. Some experts believe sleep
gives neurons used while we are awake a chance to shut down and repair
themselves. Without sleep, neurons may become so depleted in energy or
so polluted with byproducts of normal cellular activities that they
begin to malfunction. Sleep also may give the brain a chance to exercise
important neuronal connections that might otherwise deteriorate from
lack of activity.
Deep sleep coincides with the release of growth hormone in children and
young adults. Many of the body's cells also show increased production
and reduced breakdown of proteins during deep sleep. Since proteins are
the building blocks needed for cell growth and for repair of damage from
factors like stress and ultraviolet rays, deep sleep may truly be
"beauty sleep." Activity in parts of the brain that control emotions,
decision-making processes, and social interactions is drastically
reduced during deep sleep, suggesting that this type of sleep may help
people maintain optimal emotional and social functioning while they are
awake. A study in rats also showed that certain nerve-signaling patterns
which the rats generated during the day were repeated during deep sleep.
This pattern repetition may help encode memories and improve learning.
and REM Sleep
We typically spend more than 2 hours each night dreaming. Scientists do
not know much about how or why we dream. Sigmund Freud, who greatly
influenced the field of psychology, believed dreaming was a "safety
valve" for unconscious desires. Only after 1953, when researchers first
described REM in sleeping infants, did scientists begin to carefully
study sleep and dreaming. They soon realized that the strange, illogical
experiences we call dreams almost always occur during REM sleep. While
most mammals and birds show signs of REM sleep, reptiles and other
cold-blooded animals do not.
REM sleep begins with signals from an area at the base of the brain
called the pons (see figure 2 ). These signals travel to a brain region
called the thalamus, which relays them to the cerebral cortex – the
outer layer of the brain that is responsible for learning, thinking, and
organizing information. The pons also sends signals that shut off
neurons in the spinal cord, causing temporary paralysis of the limb
muscles. If something interferes with this paralysis, people will begin
to physically "act out" their dreams – a rare, dangerous problem called
REM sleep behavior disorder. A person dreaming about a ball game, for
example, may run headlong into furniture or blindly strike someone
sleeping nearby while trying to catch a ball in the dream.
REM sleep stimulates the brain regions used in learning. This may be
important for normal brain development during infancy, which would
explain why infants spend much more time in REM sleep than adults (see
Sleep: A Dynamic Activity ). Like deep sleep, REM sleep is associated
with increased production of proteins. One study found that REM sleep
affects learning of certain mental skills. People taught a skill and
then deprived of non-REM sleep could recall what they had learned after
sleeping, while people deprived of REM sleep could not.
Some scientists believe dreams are the cortex's attempt to find meaning
in the random signals that it receives during REM sleep. The cortex is
the part of the brain that interprets and organizes information from the
environment during consciousness. It may be that, given random signals
from the pons during REM sleep, the cortex tries to interpret these
signals as well, creating a "story" out of fragmented brain activity.
and Circadian Rhythms
Circadian rhythms are regular changes in mental and physical
characteristics that occur in the course of a day (circadian is Latin
for "around a day"). Most circadian rhythms are controlled by the body's
biological "clock." This clock, called the suprachiasmatic nucleus or
SCN (see figure 2 ), is actually a pair of pinhead-sized brain
structures that together contain about 20,000 neurons. The SCN rests in
a part of the brain called the hypothalamus, just above the point where
the optic nerves cross. Light that reaches photoreceptors in the retina
(a tissue at the back of the eye) creates signals that travel along the
optic nerve to the SCN.
Signals from the SCN travel to several brain regions, including the
pineal gland, which responds to light-induced signals by switching off
production of the hormone melatonin. The body's level of melatonin
normally increases after darkness falls, making people feel drowsy. The
SCN also governs functions that are synchronized with the sleep/wake
cycle, including body temperature, hormone secretion, urine production,
and changes in blood pressure.
By depriving people of light and other external time cues, scientists
have learned that most people's biological clocks work on a 25-hour
cycle rather than a 24-hour one. But because sunlight or other bright
lights can reset the SCN, our biological cycles normally follow the
24-hour cycle of the sun, rather than our innate cycle. Circadian
rhythms can be affected to some degree by almost any kind of external
time cue, such as the beeping of your alarm clock, the clatter of a
garbage truck, or the timing of your meals. Scientists call external
time cues zeitgebers (German for "time givers").
When travelers pass from one time zone to another, they suffer from
disrupted circadian rhythms, an uncomfortable feeling known as jet lag.
For instance, if you travel from California to New York, you "lose" 3
hours according to your body's clock. You will feel tired when the alarm
rings at 8 a.m. the next morning because, according to your body's
clock, it is still 5 a.m. It usually takes several days for your body's
cycles to adjust to the new time.
To reduce the effects of jet lag, some doctors try to manipulate the
biological clock with a technique called light therapy. They expose
people to special lights, many times brighter than ordinary household
light, for several hours near the time the subjects want to wake up.
This helps them reset their biological clocks and adjust to a new time
Symptoms much like jet lag are common in people who work nights or who
perform shift work. Because these people's work schedules are at odds
with powerful sleep-regulating cues like sunlight, they often become
uncontrollably drowsy during work, and they may suffer insomnia or other
problems when they try to sleep. Shift workers have an increased risk of
heart problems, digestive disturbances, and emotional and mental
problems, all of which may be related to their sleeping problems. The
number and severity of workplace accidents also tend to increase during
the night shift. Major industrial accidents attributed partly to errors
made by fatigued night-shift workers include the Exxon Valdez oil spill
and the Three Mile Island and Chernobyl nuclear power plant accidents.
One study also found that medical interns working on the night shift are
twice as likely as others to misinterpret hospital test records, which
could endanger their patients. It may be possible to reduce
shift-related fatigue by using bright lights in the workplace,
minimizing shift changes, and taking scheduled naps.
Many people with total blindness experience life-long sleeping problems
because their retinas are unable to detect light. These people have a
kind of permanent jet lag and periodic insomnia because their circadian
rhythms follow their innate cycle rather than a 24-hour one. Daily
supplements of melatonin may improve night-time sleep for such patients.
However, since the high doses of melatonin found in most supplements can
build up in the body, long-term use of this substance may create new
problems. Because the potential side effects of melatonin supplements
are still largely unknown, most experts discourage melatonin use by the
Sleep and sleep-related problems play a role in a large number of human
disorders and affect almost every field of medicine. For example,
problems like stroke and asthma attacks tend to occur more frequently
during the night and early morning, perhaps due to changes in hormones,
heart rate, and other characteristics associated with sleep. Sleep also
affects some kinds of epilepsy in complex ways. REM sleep seems to help
prevent seizures that begin in one part of the brain from spreading to
other brain regions, while deep sleep may promote the spread of these
seizures. Sleep deprivation also triggers seizures in people with some
types of epilepsy.
Neurons that control sleep interact closely with the immune system. As
anyone who has had the flu knows, infectious diseases tend to make us
feel sleepy. This probably happens because cytokines, chemicals our
immune systems produce while fighting an infection, are powerful
sleep-inducing chemicals. Sleep may help the body conserve energy and
other resources that the immune system needs to mount an attack.
Sleeping problems occur in almost all people with mental disorders,
including those with depression and schizophrenia. People with
depression, for example, often awaken in the early hours of the morning
and find themselves unable to get back to sleep. The amount of sleep a
person gets also strongly influences the symptoms of mental disorders.
Sleep deprivation is an effective therapy for people with certain types
of depression, while it can actually cause depression in other people.
Extreme sleep deprivation can lead to a seemingly psychotic state of
paranoia and hallucinations in otherwise healthy people, and disrupted
sleep can trigger episodes of mania (agitation and hyperactivity) in
people with manic depression.
Sleeping problems are common in many other disorders as well, including
Alzheimer's disease, stroke, cancer, and head injury. These sleeping
problems may arise from changes in the brain regions and
neurotransmitters that control sleep, or from the drugs used to control
symptoms of other disorders. In patients who are hospitalized or who
receive round-the-clock care, treatment schedules or hospital routines
also may disrupt sleep. The old joke about a patient being awakened by a
nurse so he could take a sleeping pill contains a grain of truth. Once
sleeping problems develop, they can add to a person's impairment and
cause confusion, frustration, or depression. Patients who are unable to
sleep also notice pain more and may increase their requests for pain
medication. Better management of sleeping problems in people who have
other disorders could improve these patients' health and quality of
At least 40 million Americans each year suffer from chronic, long-term
sleep disorders each year, and an additional 20 million experience
occasional sleeping problems. These disorders and the resulting sleep
deprivation interfere with work, driving, and social activities. They
also account for an estimated $16 billion in medical costs each year,
while the indirect costs due to lost productivity and other factors are
probably much greater. Doctors have described more than 70 sleep
disorders, most of which can be managed effectively once they are
correctly diagnosed. The most common sleep disorders include insomnia,
sleep apnea, restless legs syndrome, and narcolepsy.
Restless Legs Syndrome
Almost everyone occasionally suffers from short-term insomnia. This
problem can result from stress, jet lag, diet, or many other factors.
Insomnia almost always affects job performance and well-being the next
day. About 60 million Americans a year have insomnia frequently or for
extended periods of time, which leads to even more serious sleep
deficits. Insomnia tends to increase with age and affects about 40
percent of women and 30 percent of men. It is often the major disabling
symptom of an underlying medical disorder.
For short-term insomnia, doctors may prescribe sleeping pills. Most
sleeping pills stop working after several weeks of nightly use, however,
and long-term use can actually interfere with good sleep. Mild insomnia
often can be prevented or cured by practicing good sleep habits (see
"Tips for a Good Night's Sleep"). For more serious cases of insomnia,
researchers are experimenting with light therapy and other ways to alter
Sleep apnea is a disorder of interrupted breathing during sleep. It
usually occurs in association with fat buildup or loss of muscle tone
with aging. These changes allow the windpipe to collapse during
breathing when muscles relax during sleep (see figure 3 ). This problem,
called obstructive sleep apnea, is usually associated with loud snoring
(though not everyone who snores has this disorder). Sleep apnea also can
occur if the neurons that control breathing malfunction during sleep.
During an episode of obstructive apnea, the person's effort to inhale
air creates suction that collapses the windpipe. This blocks the air
flow for 10 seconds to a minute while the sleeping person struggles to
breathe. When the person's blood oxygen level falls, the brain responds
by awakening the person enough to tighten the upper airway muscles and
open the windpipe. The person may snort or gasp, then resume snoring.
This cycle may be repeated hundreds of times a night. The frequent
awakenings that sleep apnea patients experience leave them continually
sleepy and may lead to personality changes such as irritability or
depression. Sleep apnea also deprives the person of oxygen, which can
lead to morning headaches, a loss of interest in sex, or a decline in
mental functioning. It also is linked to high blood pressure, irregular
heartbeats, and an increased risk of heart attacks and stroke. Patients
with severe, untreated sleep apnea are two to three times more likely to
have automobile accidents than the general population. In some high-risk
individuals, sleep apnea may even lead to sudden death from respiratory
arrest during sleep.
AAn estimated 18 million Americans have sleep apnea. However, few of them
have had the problem diagnosed. Patients with the typical features of
sleep apnea, such as loud snoring, obesity, and excessive daytime
sleepiness, should be referred to a specialized sleep center that can
perform a test called polysomnography. This test records the patient's
brain waves, heartbeat, and breathing during an entire night. If sleep
apnea is diagnosed, several treatments are available. Mild sleep apnea
frequently can be overcome through weight loss or by preventing the
person from sleeping on his or her back. Other people may need special
devices or surgery to correct the obstruction. People with sleep apnea
should never take sedatives or sleeping pills, which can prevent them
from awakening enough to breathe.
Restless Legs Syndrome
Restless legs syndrome (RLS), a familial disorder causing unpleasant
crawling, prickling, or tingling sensations in the legs and feet and an
urge to move them for relief, is emerging as one of the most common
sleep disorders, especially among older people. This disorder, which
affects as many as 12 million Americans, leads to constant leg movement
during the day and insomnia at night. Severe RLS is most common in
elderly people, though symptoms may develop at any age. In some cases,
it may be linked to other conditions such as anemia, pregnancy, or
diabetes. br />
Many RLS patients also have a disorder known as periodic limb movement
disorder or PLMD, which causes repetitive jerking movements of the
limbs, especially the legs. These movements occur every 20 to 40 seconds
and cause repeated awakening and severely fragmented sleep. In one
study, RLS and PLMD accounted for a third of the insomnia seen in
patients older than age 60.
RRLS and PLMD often can be relieved by drugs that affect the
neurotransmitter dopamine, suggesting that dopamine abnormalities
underlie these disorders' symptoms. Learning how these disorders occur
may lead to better therapies in the future.
Narcolepsy affects an estimated 250,000 Americans. People with
narcolepsy have frequent "sleep attacks" at various times of the day,
even if they have had a normal amount of night-time sleep. These attacks
last from several seconds to more than 30 minutes. People with
narcolepsy also may experience cataplexy (loss of muscle control during
emotional situations), hallucinations, temporary paralysis when they
awaken, and disrupted night-time sleep. These symptoms seem to be
features of REM sleep that appear during waking, which suggests that
narcolepsy is a disorder of sleep regulation. The symptoms of narcolepsy
typically appear during adolescence, though it often takes years to
obtain a correct diagnosis. The disorder (or at least a predisposition
to it) is usually hereditary, but it occasionally is linked to brain
damage from a head injury or neurological disease. br />
Once narcolepsy is diagnosed, stimulants, antidepressants, or other
drugs can help control the symptoms and prevent the embarrassing and
dangerous effects of falling asleep at improper times. Naps at certain
times of the day also may reduce the excessive daytime sleepiness.
IIn 1999, a research team working with canine models identified a gene
that causes narcolepsy–a breakthrough that brings a cure for this
disabling condition within reach. The gene, hypocretin receptor 2, codes
for a protein that allows brain cells to receive instructions from other
cells. The defective versions of the gene encode proteins that cannot
recognize these messages, perhaps cutting the cells off from messages
that promote wakefulness. The researchers know that the same gene exists
in humans, and they are currently searching for defective versions in
people with narcolepsy.
Sleep research is expanding and attracting more and more attention from
scientists. Researchers now know that sleep is an active and dynamic
state that greatly influences our waking hours, and they realize that we
must understand sleep to fully understand the brain. Innovative
techniques, such as brain imaging, can now help researchers understand
how different brain regions function during sleep and how different
activities and disorders affect sleep. Understanding the factors that
affect sleep in health and disease also may lead to revolutionary new
therapies for sleep disorders and to ways of overcoming jet lag and the
problems associated with shift work. We can expect these and many other
benefits from research that will allow us to truly understand sleep's
impact on our lives.
a Good Night's Sleep:
Adapted from "When You Can't Sleep: The ABCs of ZZZs," by the National
Set a schedule:
Go to bed at a set time each night and get up at the same time each
morning. Disrupting this schedule may lead to insomnia. "Sleeping in" on
weekends also makes it harder to wake up early on Monday morning because
it re-sets your sleep cycles for a later awakening.
Try to exercise 20 to 30 minutes a day. Daily exercise often helps
people sleep, although a workout soon before bedtime may interfere with
sleep. For maximum benefit, try to get your exercise about 5 to 6 hours
before going to bed.
Avoid caffeine, nicotine, and
Avoid drinks that contain caffeine, which acts as a stimulant and keeps
people awake. Sources of caffeine include coffee, chocolate, soft
drinks, non-herbal teas, diet drugs, and some pain relievers. Smokers
tend to sleep very lightly and often wake up in the early morning due to
nicotine withdrawal. Alcohol robs people of deep sleep and REM sleep and
keeps them in the lighter stages of sleep.
Relax before bed:
A warm bath, reading, or another relaxing routine can make it easier to
fall sleep. You can train yourself to associate certain restful
activities with sleep and make them part of your bedtime ritual.
Sleep until sunlight:
If possible, wake up with the sun, or use very bright lights in the
morning. Sunlight helps the body's internal biological clock reset
itself each day. Sleep experts recommend exposure to an hour of morning
sunlight for people having problems falling asleep.
Don't lie in bed awake:
If you can't get to sleep, don't just lie in bed. Do something else,
like reading, watching television, or listening to music, until you feel
tired. The anxiety of being unable to fall asleep can actually
contribute to insomnia.
Control your room temperature:
Maintain a comfortable temperature in the bedroom. Extreme temperatures
may disrupt sleep or prevent you from falling asleep.
See a doctor if your sleeping
If you have trouble falling asleep night after night, or if you always
feel tired the next day, then you may have a sleep disorder and should
see a physician. Your primary care physician may be able to help you; if
not, you can probably find a sleep specialist at a major hospital near
you. Most sleep disorders can be treated effectively, so you can finally
get that good night's sleep you need. br />
For information on other neurological disorders or research programs
funded by the National Institute of Neurological Disorders and Stroke,
contact the Institute's Brain Resources and Information Network (BRAIN)
P.O. Box 5801
Bethesda, MD 20824
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
BBethesda, MD 20892
NINDS health-related material is provided for information
purposes only and does not necessarily represent endorsement by or an
official position of the National Institute of Neurological Disorders
and Stroke or any other Federal agency. Advice on the treatment or care
of an individual patient should be obtained through consultation with a
physician who has examined that patient or is familiar with that
patient's medical history. /strong>
All NINDS-prepared information is in the public domain and may be freely
copied. Credit to the NINDS or the NIH is appreciated.br />
NIH Publication No.06-3440-c
Last updated May 21, 2007
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