Sleep Review: The Journal for Sleep Specialists is dedicated to helping its 20,000 readers stay on top of changes in the rapidly growing field of diagnosing and treating sleep disorders. Each issue covers case reports, innovative research findings, business news, and product and service introductions, as well as offering inspiring stories of leading sleep centers and useful ideas for improving..
A new study shows poor sleep can slow down parts of your brain and make you a bit sluggish, reports Medical Xpress.
We have all been there. We stay up late and skip a few hours of sleep or go out on an all-nighter and forget sleeping altogether. But missing out on your sleep, even a few hours, can have some long-lasting consequences in your body. Lack of sleep could increase your chances of developing hypertension, diabetes, obesity and even depression.
Skipping a few ZzZzz can even affect the function of genes involved in a myriad of processes. For example, a 2013 study identified more than 700 genes that had their function altered by lack of sleep. A 2016 study found that sleep deprivation also affects genes involved in cholesterol metabolism and our response to injury.
According to Herald.ie, not getting enough sleep can contribute to anxiety and other serious health issues like heart disease and obesity in schoolchildren, a leading sleep expert has warned.
Irish sleep consultant Lucy Wolfe, of Cork’s Sleep Matters Clinic and author of The Baby Sleep Solution, claims sleep is more than a behavioural technique. “It is not always the case that children outgrow their sleeping problems,” she said.
“Continued broken sleep and not enough sleep could be a contributory factor to a compromised immune system, lack of concentration and anxiety. As many as 70% of parents reporting struggles with their children’s sleep have symptoms that go way beyond the typical duration.”
“Most research has concentrated on the brain consequences of sleep loss – based on the belief that sleep is for the brain alone. There is now growing evidence that short-duration sleep results in metabolic changes that may contribute to the development of obesity, insulin resistance, diabetes and cardiovascular disease.
“According to a recent study, for each additional hour of sleep, the risk of a child becoming overweight or obese is lowered by an average 9%.”
It’s a little surprising that so few of us go to bed in the nude considering the benefits that come with sleeping naked—including reduced stress and improved sleep, reports Vogue Australia.
Your body has an inner clock, or circadian rhythm, which tells you when it is time to go to sleep and when it is time to wake up. The darkness of the night sends a signal that it is time to unwind whereas daylight sends a signal that it’s time to be alert. When these signals are disrupted, we find it hard to relax and fall sleep and also hard to wake up refreshed. Aside from light and dark, our circadian rhythm is also governed by our body temperature. When you go to bed fully clothed (especially in nylon or flannel) you warm up.
When your body temperature is on the rise it tells your brain that you’re supposed to stay awake so you feel more alert. (Ever wondered why it’s so hard to sleep on those hot sticky nights?) At night, our body temperature usually cools down to a degree which leaves you comfortably drowsy. Sleeping naked means you let your body temperature and internal clock adjust naturally.
We all know we need to get enough sleep to stay healthy, but you may not know that insomnia takes a toll on your wallet, according to News 8 WTNH.
You go to work, make money and pay your bills on time to keep your finances in check. But experts say another important step to managing money is sleep! “Not getting the right amount of sleep or the right kind of sleep can actually interfere with your ability to earn a living,” said Meir Kryger.
Meir Kryger is a Yale professor and physician at the Sleep Disorder Center in North Haven where people try to improve their sleep habits. It’s recommended you get between 7 and 9 hours a night but there are large groups of people who don’t. People suffering from chronic sleep disorders, shift workers and of course new moms.
Marc Yeoman complained he was getting less than one hour’s sleep a night, reports Manchester Evening News.
A former night worker took his own life after moving to an early shift left him with ‘terrible’ insomnia. Marc Yeoman, who worked in the builders’ yard at B&Q, took a fatal combination of painkillers and whisky days after telling his doctor he couldn’t sleep. A coroners’ inquest heard the 45-year-old from Fallowfield sent a final text to his girlfriend Kate Tyler saying ‘xxx’. He was found dead at his home in Fallowfield by his landlord and friend of 20 years, Marc Connor, after Miss Tyler couldn’t get hold of him.
Miss Tyler told the inquest: “We were in a relationship for a year. We spent a lot of time together. He was a live wire, always loving life. He was kind, funny and a genuinely lovely person. “He had no significant mental health issues, and the only health problem he had was with his knee. We would go hill walking and climbing together. He would always complain about pain in his knees after a long day in the mountains.
People and other animals sicken and die if they are deprived of sleep, but why is sleep so essential?
Psychiatrists Chiara Cirelli, MD, PhD, and Giulio Tononi, MD, PhD, of the Wisconsin Center for Sleep and Consciousness proposed the “synaptic homeostasis hypothesis” (SHY) in 2003. This hypothesis holds that sleep is the price we pay for brains that are plastic and able to keep learning new things.
A few years ago, they went all in on a 4-year research effort that could show direct evidence for their theory.
The result, published in February 2017 in Science, offered direct visual proof of SHY. Cirelli a professor in the University of Wisconsin’s School of Medicine and Public Health, expanded on the research on Feb 17, 2018, at the annual meeting of the American Association for the Advancement of Science.
Striking electron-microscope pictures from inside the brains of mice suggest what happens in our own brain every day: Our synapses—the junctions between nerve cells—grow strong and large during the stimulation of daytime, then shrink by nearly 20% while we sleep, creating room for more growth and learning the next day.
A large team of researchers sectioned the brains of mice and then used a scanning electron microscope to photograph, reconstruct, and analyze two areas of cerebral cortex. They were able to reconstruct 6,920 synapses and measure their size.
The team deliberately did not know whether they were analyzing the brain cells of a well-rested mouse or one that had been awake. When they finally “broke the code” and correlated the measurements with the amount of sleep the mice had during the 6 to 8 hours before the image was taken, they found that a few hours of sleep led on average to an 18% decrease in the size of the synapses. These changes occurred in both areas of the cerebral cortex and were proportional to the size of the synapses.
The study was big news, picked up by outlets including The New York Times and National Public Radio. It was bolstered by a companion Johns Hopkins University study that analyzed brain proteins to also confirm SHY’s prediction that the purpose of sleep is to scale back synapses.
For Cirelli, the study was a big gamble that paid off. But she’s not resting on her laurels. Her lab is now looking at new brain areas, and at the brains of young mice to understand the role sleep plays in brain development.
Salk Institute and University of California San Diego School of Medicine researchers have been awarded a $1.5 million grant by the Department of Homeland Security for a 3-year study to see whether restricting food intake to a 10-hour window can improve firefighters’ well-being.
“Firefighters seem invincible to us, but they are actually at high risk for many chronic diseases because of how shift work disrupts the body’s natural rhythms,” says Satchidananda Panda, PhD, a professor in Salk’s Regulatory Biology Laboratory and co-principal investigator of the new study, in a release. “We want to understand if we can counter some of the disruption with simple changes not only to what firefighters eat but also when they eat.”
For most of human evolutionary history, daylight and access to food were limited. So almost every cell in our body has a biological clock that tells it when to be active—using the nutrients from food to grow and conduct normal business—and when to rest. These 24-hour clocks produce circadian rhythms in almost every aspect of physiology and behavior. Increasing evidence is showing that disruptions to this natural cycle caused by the modern lifestyle, with its artificial light and round-the-clock access to food, can impact our health, resulting in everything from poor-quality sleep to obesity, heart disease, diabetes, and cancer.
Panda, whose laboratory studies the molecular bases of circadian timekeeping in mammals, previously found that restricting the access of lab mice to food for 8-10 hours a day resulted in slimmer, healthier animals compared to mice that ate the same number of calories around the clock. Preliminary studies in humans suggest similar health benefits of such “time-restricted eating,” which does not change the quality or quantity of food, just the time period in which it is consumed.
Because firefighters are at higher risk of developing cardiovascular diseases than the general public, Panda and collaborating co-principal investigator Pam Taub, MD, associate professor of medicine at UC San Diego School of Medicine, plan to use the grant to test the effectiveness of a circadian-rhythm-based diet intervention compared to standard nutritional behavioral counseling on firefighters’ cardiovascular health.
“Shift workers, like firefighters, are a critical part of our community’s well-being and we need to identify strategies to improve their overall cardiovascular health. We believe that a simple lifestyle intervention, such as time-restricted eating, can prevent or help reverse cardiovascular diseases, such as high blood pressure, diabetes and coronary artery disease,” says Taub, cardiologist and director of the Step Family Cardiovascular and Rehabilitation Center at UC San Diego Health. “The goal of our study is to better understand how giving the body a ‘metabolic rest’ by limiting the amount of time food is consumed can improve important parameters for health such as weight, blood glucose levels and cholesterol.”
The circadian intervention will incorporate an app developed by the Panda lab and already tested by thousands of people to conveniently track food intake, sleep, and exercise habits. The study will enroll 150 firefighters who will be randomly assigned to either the circadian group, whose food intake will be limited to a 10-hour period, or the behavioral counseling group, which will serve as the control. In addition to regular clinic visits to measure blood glucose and lipid levels, all subjects will undergo continuous health monitoring via wearable sensors.
The study will be a close collaboration between Salk, UC San Diego, and the San Diego Fire-Rescue Department, which has a robust wellness program.
“The wellness of our employees is our top priority,” says San Diego Fire-Rescue chief Brian Fennessy. “We are hopeful this study will give our members information they can apply to their lives, which will reduce the incidence of chronic disease that firefighters are prone to.”
The study will be closely watched by the National Fire Protection Association, which is interested in extending any beneficial results to other fire departments. And because nearly 20% of Americans are shift workers with nonstandard hours of activity and rest, the study results may also prove applicable to these individuals and their family members, who can likewise be substantially impacted by a shift worker’s schedule.
“We are very excited about this study, which embodies a collaborative model for biomedical research in which landmark discoveries from a premier basic science institute are tested in a real-world situation through a world-class medical research entity,” says Panda. “It’s a win-win-win.”
Photo: From left, members of the Salk-UCSD-SDFD firefighter wellness study: Kevin Ester, John Cerruto, Pam Taub, Adena Zadourian, Brian Fennessy, Satchidananda Panda, David Picone, Emily Manoogian, Chris Webber, and Kurtis Bennett. Courtesy San Diego Fire-Rescue Department
Inspired by a stylish sister with amyotrophic lateral sclerosis (ALS) who carried around her BiPAP device in a Lord & Taylor shopping bag, inventor Hindy Ginsberg wanted to create designer bags for medical equipment.
So “Spoonful of Sugar” was born. “We know that it’s difficult to get patients to use the CPAPs that they have been prescribed and we hope that using a Spoonful of Sugar bag that is both stylish and convenient will make the experience just a little easier,” Ginsberg says.
The Spoonful of Sugar CPAP bags are $169 each and include the following features:
padded lining in the machine compartment
individual compartments for each part of the machine
adjustable compartments for machines of every size
Traditionally, scientists thought that star-shaped brain cells called astrocytes were steady, quiet supporters of their talkative, wire-like neighbors, called neurons. Now, an National Institutes of Health (NIH) study suggests that astrocytes may also have their say. It showed that silencing astrocytes in the brain’s breathing center caused rats to breathe at a lower rate and tire out on a treadmill earlier than normal. These were just two examples of changes in breathing caused by manipulating the way astrocytes communicate with neighboring cells.
“For decades we thought that breathing was exclusively controlled by neurons in the brain. Our results suggest that astrocytes actively help control the rhythm of breathing,” says Jeffrey C. Smith, PhD, senior investigator at the NIH’s National Institute of Neurological Disorders and Stroke (NINDS) and a senior author of the study published in Nature Communications, in a release. “These results add to the growing body of evidence that is changing the way we think about astrocytes and how the brain works.”
Smith’s lab investigates how breathing is controlled by the rhythmic firing of neurons in the preBötzinger complex, the brain’s breathing center that his lab helped discover. For this study, his team worked with Alexander Gourine, PhD, professor at University College London (UCL), whose lab found that astrocytes in neighboring parts of the brain may regulate breathing by sensing changes in blood carbon dioxide levels.
At least half of the brain is comprised of cells called glia and most of them are astrocytes. Recently scientists have shown that astrocytes may communicate like neurons by shooting off, or releasing, chemical messages, called transmitters, to neighboring cells.
In this study, the scientists tested the role of astrocytes in breathing by genetically modifying the ability of astrocytes in the preBötzinger complex to release transmitters. When they hushed the astrocytes in rats by reducing transmitter release, the rats breathed and sighed at a lower rate than normal. In contrast, if they made the astrocytes chattier by increasing transmission, the rats breathed at higher resting rates and sighed more often.
The team also tested how silencing astrocytes affected the rats’ responses to changes in oxygen and carbon dioxide levels. Although the rats’ breathing rate increased when oxygen levels were lower or carbon dioxide levels higher, it was still lower than normal. Silencing astrocytes also decreased the rate at which the rats sighed under lower oxygen levels. Moreover, the rats became exhausted much earlier than normal. They could only run half the distance that normal rats could run on a treadmill before tiring out.
“The primary goal of breathing is the exchange of carbon dioxide and oxygen that is critical for life. Our results support the idea that astrocytes help the brain translate changes in these gases into breathing,” says Shahriar Sheikhbahaei, PhD, formerly a doctoral student at UCL and participant in the NIH Graduate Partnership Program, and the lead author of the study.
Finally, the team showed that these astrocytes used adenosine triphosphate (ATP) to communicate with other cells in the brain. Inactivating released ATP reduced resting breathing rates and the frequency of sighs under normal and low oxygen levels.
“Our results expand our understanding of how the brain controls breathing under normal and disease conditions,” says Smith. “We plan to follow this path to understand how astrocytes help control other aspects of breathing.”
Image: NIH study in rats shows that star-shaped brain cells, called astrocytes (red) may play an active role in breathing. Courtesy of Jeffrey C. Smith lab, NIH/NINDS
An analysis of trends in sudden unexpected infant death (SUID) over the past two decades finds that the drop in such deaths that took place following release of the 1992 American Academy of Pediatrics (AAP) “back to sleep” recommendations, did not occur in infants in the first month of life. The report from investigators from MassGeneral Hospital for Children (MGHfC) and Newton-Wellesley Hospital (NWH), which has been published online in the Journal of Pediatrics, identifies several potentially modifiable factors that may contribute to the persistent risk of sudden, unexplained death during the first days and weeks of life.
“The frequency of SUID in the first month of life is higher than generally recognized, at an average of 444 cases per year in the US, of which 66 per year occur on the first day and 130 occur in the first week of life,” says lead and corresponding author Joel Bass, MD, chair of the NWH Department of Pediatrics, in a release. “There actually has been a dramatic and unexpected increase in deaths attributed to suffocation and asphyxiation in both newborns and infants up to 1 year old, and these deaths are potentially preventable.”
SUID is defined as the sudden, unexpected death of an apparently healthy, full-term infant under 1 year of age, the cause of which is not immediately apparent. It encompasses a range of situations, including sudden infant death syndrome (SIDS), which refers to deaths that remain unexplained after a thorough investigation, and deaths found to result from accidental strangulation or suffocation caused by factors such as unsafe bedding, becoming trapped between a mattress and a wall, or sleeping with a parent or another adult who inadvertently blocks the infant’s airway.
Using Centers for Disease Control and Prevention records of births and infant deaths from 1995 through 2014, the researchers analyzed deaths occurring in the neonatal (first 27 days of life) and postneonatal (28 days to 1 year) periods. While the rates of postneonatal SUID declined nearly 23% from 1995 to 2002, after which they remained stable, SUID rates during the neonatal period remained unchanged. During that 20-year period the percentage of SUID cases attributed to suffocation or strangulation increased in both age groups—from around 2% to nearly 23% in the neonatal period and from 3.4% to almost 25% in the postneonatal period.
Almost 30% of neonatal deaths occurred during the first 6 days of life. Bass notes that many of these deaths may be the result of sudden unexpected postnatal collapse (SUPC), a collapse—sometimes with full respiratory and cardiac arrest—of an apparently healthy newborn born at more than 35 weeks gestation. SUPC leads to death in around half the cases and serious neurological consequences in half of survivors. There currently is no standard diagnostic code for SUPC, and Bass and his co-authors—including senior author Ronald Kleinman, MD, MGHfC physician-in-chief—have called for standardizing the definition of the condition and establishment of an SUPC registry to better identify such events and facilitate further study.
The investigators note that several recommended practices designed to promote breastfeeding, the importance of which they fully support, may inadvertently contribute to SUPC risks. The practice of skin-to-skin care, in which an infant is placed in a prone position on the mother’s chest has been noted in other reports to have a strong association with SUPC. If the mother is also exhausted or sedated, she may even fall asleep with the infant on her chest resulting in co-bedding, an established risk factor for SIDS.
Another recommendation that may have unintended consequences is avoiding the use of pacifiers, which some breastfeeding advocates suggest eliminating and the AAP suggests should not be used until breastfeeding is well established. As pacifier use is strongly associated with a reduced risk of SIDS, the authors feel that recommendation should be reconsidered. Since breastfeeding is also associated with a reduced risk of SIDS, the authors recommend that safe-sleep education be integrated with lactation advice.
Kleinman says,”Overall, we think it is possible that certain neonatal practices resulting in unsafe sleep circumstances both during and after the birth hospitalization, along with pacifier avoidance, may have inadvertently interfered with the implementation of safe-sleep messages and prevented a decrease in the death rate. Future research is needed to more fully explore the best messaging during the birth hospitalization that will enhance safe-sleep practices recommended by both the National Institutes of Health and the AAP and help to prevent SUID.”
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