American Sleep Association Launches Sleep Apnea Awareness Week On October 1, 2007

The American Sleep Association is preparing for Sleep Apnea Awareness Week, a national event focused on increasing public awareness about this potentially deadly sleep disorder. The event will occur during the first seven days of October.

Local and national members and affiliates of the American Sleep Association (ASA) will be participating in the event. ASA affiliated sleep disorder laboratories will be prepared to answer questions from the public about sleep apnea. The website, http://www.SleepApneaAwarenessWeek.com, sponsored by the ASA, will feature a unique lecture on sleep apnea each day during the week.

Obstructive Sleep Apnea (OSA) is a disorder characterized by repetitive pauses in breathing during sleep caused by a temporary blockage in the throat. Over 5% of adults suffer from obstructive sleep apnea. Most individuals affected by the disorder are unaware of its presence. Dr. Neil Kline, of the ASA, states, "Sleep apnea is associated with an increased risk of motor vehicle accidents as well as an increase risk of heart attack, stroke, and deadly heart rhythms. Yet, it is easily treated once it is diagnosed."

There are a few options available for the treatment of obstructive sleep apnea. Continuous Positive Airway Pressure (CPAP) is the most popular and successful treatment option. A mask placed over the nose delivers air pressure into the throat, preventing the airway from closing during the night. Other treatment options include a custom-made mouth piece, weight loss, and surgery.

Once treated, individuals diagnosed with sleep apnea often feel significantly more alert, and also decrease their risk of heart attacks, strokes, and accidents related to excessive daytime sleepiness.

The American Sleep Association (ASA) is a national organization focused on improving public awareness about sleep disorders, promoting sleep medicine research, and providing a portal for communication between patients, physicians/healthcare professionals and scientists. The ASA is a member-driven public service project. For further information about Sleep Apnea Awareness Week, visit http://www.sleepassociation.org or http://www.SleepApneaAwarenessWeek.com.

Too Little or Too Much Sleep Increases Risk of Death

Researchers from the University of Warwick, and University College London, have found that lack of sleep can more than double the risk of death from cardiovascular disease. However they have also found that a point comes when too much sleep can also more than double the risk of death.

In research presented to the British Sleep Society, Professor Francesco Cappuccio from the University of Warwick's Warwick Medical School showed the results of a study of how sleep patterns affected the mortality of 10,308 civil servants in the "Whitehall II study". Amongst other things the data they used provided information on the mortality rates and sleep patterns on the same group of civil servants at two points in their life (1985-8 and those still alive in 1992-3).

The researchers took into account other possible factors such age, sex, marital status, employment grade, smoking status, physical activity, alcohol consumption, self-rated health, body mass index, blood pressure, cholesterol, other physical illness etc. Once they had adjusted for those factors they were able to isolate the effect that changes in sleep patterns over 5 years had on mortality rates 11-17 years later.

Taking those who had not made any change in their sleeping habits between 1985-8 and 1992-3 as their baseline (7 hours per night being the figure normally recommended as an appropriate period of sleep for an adult) they were able to see what difference having reduced the amount of sleep over time made to mortality rates by 2004.

Those who had cut their sleeping from 7h to 5 hours or less faced a 1.7 fold increased risk in mortality from all causes, and twice the increased risk of death from a cardiovascular problem in particular.

Professor Francesco Cappuccio from the University of Warwick's Warwick Medical School said to the British Sleep Society:

"Fewer hours sleep and greater levels of sleep disturbance have become widespread in industrialised societies. This change, largely the result of sleep curtailment to create more time for leisure and shift-work, has meant that reports of fatigue, tiredness and excessive daytime sleepiness are more common than a few decades ago. Sleep represents the daily process of physiological restitution and recovery, and lack of sleep has far-reaching effects."

Curiously the researchers also found that too much sleep also increased mortality. They found that those individuals who showed an increase in sleep duration to 8 hours or more a night were more than twice as likely to die as those who had not changed their habit, however, predominantly from non-cardiovascular diseases.

Professor Francesco Cappuccio says:

"Short sleep has been shown to be a risk factor for weight gain, hypertension and Type 2 diabetes sometimes leading to mortality but in contrast to the short sleep-mortality association it appears that no potential mechanisms by which long sleep could be associated with increased mortality have yet been investigated. Some candidate causes for this include depression, low socioeconomic status and cancer-related fatigue."

"In terms of prevention, our findings indicate that consistently sleeping around 7 hours per night is optimal for health and a sustained reduction may predispose to ill-health."

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Article adapted by Medical News Today from original press release.
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The research paper entitled: "A prospective study of change in sleep duration; associations with mortality in the Whitehall II cohort" will be published in the Journal SLEEP and the full list of the authors is: Jane E. Ferrie, Martin J. Shipley, Francesco P. Cappuccio, Eric Brunner, Michelle A. Miller, Meena Kumari, and Michael G. Marmot

Source: Peter Dunn
University of Warwick

No Link Found Between Working The Night Shift And An Increased Risk Of Cancer, Study Finds

Working the night shift doesn't appear to increase the risk of developing cancer, suggests the findings of a new study of Swedish workers.

Recent studies --and corresponding news headlines -- have found that regularly working the night shift may increase the risk of developing breast, prostate and colon cancers. Some researchers say that the connection could be due to a decrease in the production of the hormone melatonin, as some animal experiments suggest that the hormone may have anti-cancer properties.

Our bodies produce their highest levels of melatonin at night, during sleep, but exposure to light at night suppresses melatonin production, said Judith Schwartzbaum, the study's lead author and an associate professor of epidemiology at Ohio State University.

"However, the effects of melatonin on cancer development in humans are not well understood," she said.

Schwartzbaum and her colleagues found no link between working the night shift and the risk of developing any kind of cancer. They came to this conclusion after analyzing nearly 20 years' worth of data that compared people who reported jobs that required working during the day to people who said they had jobs that required night shift work.

The findings appear in a forthcoming issue of the Scandinavian Journal of Work, Environment and Health. Schwartzbaum conducted the study with researchers from the Institute for Environmental Medicine, located at the Karolinska Institutet in Stockholm, Sweden.

The study included all Swedish citizens who worked at least 20 hours a week in 1970, and who were included in both the 1960 and 1970 population censuses -- a total of about 3.2 million people. The researchers gathered job information from each census.

They categorized the occupations according to the percentage of people who reported shift work: more than 70 percent, more than 40 percent, less than 30 percent, and no employees reporting shift work.

The researchers collected information on the people from 1971 through 1989 or until a worker was diagnosed with cancer or died.

Information about the cause of death came from the Swedish Cause of Death Registry. All cases of cancer that occurred within the study's time frame were identified from the national Swedish Cancer Registry. Schwartzbaum said that all Swedish physicians who care for cancer patients must notify the national cancer registry when a patient is diagnosed with the disease.

To determine the percentage of night-shift workers in each job category included in the census, the researchers used additional occupational information from the Swedish Survey of Living Conditions conducted from 1977 through 1981. During this five-year stretch more than 46,000 workers were personally interviewed about their jobs and work schedules, including what hours during the day they worked. Schwartzbaum and her colleagues applied this information to the overall study group.

About 200,000 men and 100,000 women in the study developed cancer. There were roughly 2.1 million working men included in the census data, and about 1.1 million working women.

In the researchers' main analysis, participants were categorized as either exposed or not exposed to shift work according to their occupation in 1970. The researchers followed both groups for 19 years.

In separate analyses, the researchers took the duration of night-shift exposure into account. They defined "exposure" as working in a job that met the criteria for night-shift work in both the 1960 and 1970 censuses.

"We identified occupations where many employees worked during hours that could affect the production of melatonin," Schwartzbaum said.

Schwartzbaum and her colleagues defined shift work as work that had a rotating schedule with three or more possible shifts per day, or where the schedule included working between 1 and 4 a.m., which the researchers defined as working at night.

A very small percentage of the working population included in this study reported having jobs that met the definition of shift work (just 4 percent of men and 0.4 percent of women.)

For men, the main night-shift occupations included work in the paper manufacturing industry, working as a furnace operator and working as firefighters, policemen or train operators. The occupations of women who worked at night primarily included work as crane or hoist operators, delivery agents in the paper and publishing industries, or working as midwives.

The final results showed no relationship between shift work and an increased risk of developing prostate, colon or breast cancers or nearly any other kind of cancer, regardless of how much the occupation depended upon shift work.

Schwartzbaum points out that the current results don't agree with a number of recently published studies, two of which found an increased risk of prostate cancer among rotating shift workers, and another half-dozen studies that suggested an increase in breast cancer risk among female shift workers.

"Many of these studies included very specific worker populations," she said. "For example, studies of female flight attendants have found an increased risk of breast cancer and also a higher-than-expected risk for developing malignant melanoma.

"But airline workers differ from other shift workers due to their increased exposure to cosmic and solar radiation," Schwartzbaum continued. "So it's tough to tease out what exactly may contribute to their elevated risk of cancer."

What's needed, Schwartzbaum said, are large-scale international studies to help tease out the relationship between shift work and the risk of developing cancer.

"It seems like 3 million workers ought to be enough to get a firm idea of the risk, but it isn't, especially considering the relatively low percentage of jobs that require shift work," Schwartzbaum said. "We need studies that include data from multiple countries."

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Article adapted by Medical News Today from original press release.
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Written by Holly Wagner

Source: Judith Schwartzbaum Ohio State University

Rozerem

ROZEREM(TM) (ramelteon) Now Available in U.S. Pharmacies
First and Only Non-Scheduled Prescription Sleep Medication

Takeda Pharmaceuticals North America, Inc. today announced that ROZEREM™ (ramelteon) 8-mg tablets are now available by prescription in pharmacies across the U.S. for the treatment of insomnia characterized by difficulty with sleep onset. ROZEREM is the first prescription insomnia medication with a new therapeutic mechanism of action in 35 years, and can be prescribed for long-term use in adults.

ROZEREM is the first and only prescription sleep medication that has shown no evidence of abuse and dependence in clinical studies. As a result, ROZEREM is not designated as a controlled substance by the U.S. Drug Enforcement Administration (DEA). With the exception of ROZEREM, all other prescription medications indicated for insomnia are classified as controlled substances by the DEA, most as Schedule IV drugs.

"The availability of ROZEREM represents the second Takeda-discovered-and-developed product to reach physicians and patients in our brief history," said Mark Booth, president of Takeda Pharmaceuticals North America. "We are excited to be able to offer an important new option for people living with insomnia that has not shown the potential for abuse or dependence."

ROZEREM has a unique therapeutic mechanism of action that selectively targets two receptors located in the brain's suprachiasmatic nucleus (SCN). The SCN is known as the body's "master clock" because it regulates 24-hour, or circadian, rhythms including the sleep-wake cycle.

About Insomnia

Approximately 60 million people in the United States suffer from insomnia, yet the vast majority remains undiagnosed and untreated. Insomnia is characterized by difficulty falling asleep, difficulty staying asleep, or poor quality sleep, leading to impairment of next-day functioning.

Insomnia has been linked to a variety of health problems, including obesity, diabetes, hypertension, heart disease and depression. According to the U.S. Surgeon General, nearly $15 billion annually is spent on healthcare related to insomnia, while $50 billion is lost in productivity.

About ROZEREM™ (ramelteon)

ROZEREM™ (ramelteon) is indicated for the treatment of insomnia characterized by difficulty with sleep onset. ROZEREM can be prescribed for long-term use. ROZEREM should not be used in patients with hypersensitivity to any components of the formulation, severe hepatic impairment, or in combination with fluvoxamine. Failure of insomnia to remit after a reasonable period of time should be medically evaluated, as this may be the result of an unrecognized underlying medical disorder. Hypnotics should be administered with caution to patients exhibiting signs and symptoms of depression.

ROZEREM has not been studied in patients with severe sleep apnea, severe COPD, or in children or adolescents. The effects in these populations are unknown. Exercise caution if consuming alcohol in combination with ROZEREM.

ROZEREM has been associated with decreased testosterone levels and increased prolactin levels. Health professionals should be mindful of any unexplained symptoms possibly associated with such changes in these hormone levels. ROZEREM should not be taken with or immediately after a high-fat meal. ROZEREM should be taken within 30 minutes before going to bed and activities confined to preparing for bed.

The most common adverse events seen with ROZEREM that had greater than 2% incidence difference from placebo were somnolence, dizziness, and fatigue. For complete prescribing information, please visit www.rozerem.com.

Takeda Pharmaceuticals North America, Inc.

Based in Lincolnshire, Ill., Takeda Pharmaceuticals North America, Inc. is a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, the largest pharmaceutical company in Japan. In the United States, Takeda currently markets oral diabetes, insomnia, and cholesterol-lowering treatments, and through the Takeda Global Research & Development Center, Inc., the company has a robust pipeline with compounds in development for diabetes, cardiovascular disease, sepsis, and other conditions. Takeda is committed to striving toward better health for individuals and progress in medicine by developing superior pharmaceutical products. To learn more about the company and its products, visit www.tpna.com.

Contacts:
Jocelyn M. Gerst
Takeda Pharmaceuticals North America
847-383-3696 (office)
847-769-6889 (cell)

Adam Pawluk
Ketchum
646-935-4135 (office)

Pillows

Changing your Pillow

Maybe the reason you're not sleeping well is because your current pillow is too old. Our advice? Get rid of it.

Still, if you have a sleep disorder, where to start? A good rule of thumb when it comes to deciding whether your old pillow is indeed too old is to fold it in half. If it springs back, the pillow should be fine; it has some life left to it. But it it remains in place or folds open too slowly, a good idea is to toss the pillow and select another.

Choosing a Pillow

Choosing the correct pillow to help ease your sleep disorder can be a crucial decision in how well you sleep. Various brands on the market include the popular Temper-Pedic pillow, which we at SleepDisorderOnline find to be among the best on the market. It offers fine support.

Another alternative to the foam pillow are buckwheat pillows, which also offer good support without storing unnecessary heat. For many with a sleep disorder, they prove the right choice. For those with sleep disorders who prefer feather pillows, make certain that you are not allergic to goose down and that the pillows are of of high quality; otherwise, you either will be sneezing through the night and/or your pillow will soon go flat, with uncomfortable sleeping results sure to follow.

Do you sleep on your side? If so, perhaps you'd be more comfortable with a thicker, firmer pillow, one that will support your neck. Do you sleep on your stomach? If so, maybe a flatter pillow would be best for you, or at least one that is softer than a foam or memory foam pillow. Finally, if you sleep on your back, a medium-density pillow is likely the best choice and will offer the best support.

Pillow Pricing

Choosing a pillow solely on its price is considered a mistake by the editors of Sleep Disorder Online. In our experience, the highest price doesn't necessarily mean the best quality. Keep in mind your needs when you shop for a new pillow. Also, it's always good to look out for the Good Housekeeping seal of approval.

Rules of Thumb

Remember, the purchase of any pillow must come down to two important facts--support and comfort. Since finding just the right fit can take time, do business with local bedding outfitters that offer a pillow loan program. Ask to see if you can try a pillow for a few nights to see if it fits your needs. Otherwise, you might find yourself with a closet filled with pillows that never allowed you what you deserve--to ease your sleep disorder and help you sleep properly through the night.

--SleepDisorderOnline

Memory Foam Mattresses

Developed by NASA, the revolutionary technology behind today's popular memory foam mattresses, also known as visco-elastic foam, can lead to a great improvements in sleep and in easing sleep disorders.

We at Sleep Disorder Online have tried a number of memory foam mattresses and prefer them to the latex foam mattress, which tends to be less responsive and not as willing to mold to one's body, thus lessoning the amount of body support.

For us with sleep disorders, the noted benefits of the memory foam mattress were:

• Reduced pressure points;
• Reduced appearance of back pain;
• The mattress molds to one's body, thus supporting the spine and joints;
• The mattress seemed to encourage and improve circulation;
• The mattress seemed to help in reducing restless leg syndrome;

The brands we tried--Sensur-Pedic, Isotonic, Tempur-Pedic and Visco Lux--didn't absorb heat as some memory foam mattresses do, thus allowing for a more comfortable sleeping experience.

The potential cons of a memory foam mattress will be apparent for those used to a firm mattress; getting acclomated might take time. Still, the benefits for those with sleep disorders can be rewarding, particularly for those who suffer from back pain. As with any mattress, buying a memory foam mattress is a personal decision, so we at SleepDisorderOnline encourage you to try them out at your local mattress retailer and also to talk to your doctor before purchasing.

Of additional interest, check out our information on Foam Pillows, Memory Foam Pillows and Buckwheat Pillows.

More Sleeping Tips

Adapted from "When You Can't Sleep: The ABCs of ZZZs," by the National Sleep Foundation.

• 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.

• Exercise
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 alcohol
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 problem continues
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.

--National Institute of Neurological Disorders and Stroke

Ambien-CR

First and Only Extended-Release Prescription Sleep Medication Indicated for Sleep Induction and Maintenance Covers Broad Insomnia Population

BRIDGEWATER, N.J., Sept. 6 /PRNewswire-FirstCall/ -- Sanofi-aventis (NYSE: SNY; EURONEXT: SAN) announced today that the U.S. Food and Drug Administration (FDA) has approved AMBIEN CR(TM) (zolpidem tartrate extended-release tablets) CIV, a new extended-release formulation of the number one prescription sleep aid, AMBIEN(R) (zolpidem tartrate) CIV, for the treatment of insomnia. AMBIEN CR is non-narcotic and a non-benzodiazepine, formulated to offer a similar safety profile to AMBIEN with a new indication for sleep maintenance, in addition to sleep induction.

AMBIEN CR is the first and only extended-release prescription sleep medication to help people with insomnia fall asleep fast and maintain sleep with no significant decrease in next day performance. AMBIEN CR, a bi-layered tablet, is delivered in two stages. The first layer dissolves quickly to induce sleep. The second layer is released more gradually into the body to help provide more continuous sleep.

"Insomnia is a significant public health problem, affecting millions of Americans. Insomnia impacts daily activities and is associated with increased health care costs," said James K. Walsh, PhD, Executive Director and Senior Scientist, Sleep Medicine and Research Center at St. Luke's Hospital in St. Louis, Missouri.

According to a recent National Sleep Foundation poll, more than one half (54%) of Americans said they experience at least one symptom of insomnia at least a few nights a week. Additionally, one in five adults experienced difficulty falling asleep and one in three reported wakingoften during the night at least a few nights a week.

"Helping patients stay asleep is recognized as being as important as helping them fall asleep," said Walsh. "AMBIEN CR has shown evidence of promoting sleep onset and more continuous sleep."

The safety and efficacy of zolpidem, the active ingredient in AMBIEN CR, has been reinforced by 17 years of real-world use and 12 billion nights of patient therapy worldwide, since the first launch. AMBIEN CR will be available in a 12.5 mg dose recommended for adults and a 6.25 mg dose recommended for the elderly.

About AMBIEN CR
AMBIEN CR is indicated for the treatment of insomnia. Until you know how AMBIEN CR will affect you, you shouldn't drive or operate machinery. Side effects may include drowsiness, dizziness and headache. You shouldn't take it with alcohol. All sleep medicines carry some risk of dependency. Do not use sleep medicines for extended periods without first talking to your doctor. Be sure you are able to devote 7-8 hours of sleep before you need to be active again.

For full prescribing information, please visit
http://products.sanofi-aventis.us/ambien_cr/ambien_cr.pdf

About AMBIEN
AMBIEN is indicated for the short-term treatment of insomnia. There is a low occurrence of side effects associated with the short-term use of AMBIEN. The most commonly observed side effects in controlled clinical trials were drowsiness, dizziness, and diarrhea. When you first start taking AMBIEN, use caution in the morning when engaging in activities requiring complete alertness until you know how you will react to this medication. In most instances, memory problems can be avoided if you take AMBIEN only when you are able to get a full night's sleep (7 to 8 hours) before you need to be active again. As with any sleep medication, do not use alcohol while you are taking AMBIEN. Prescription sleep aids are often taken for 7 to 10 days -- or longer as advised by your doctor. All people taking sleep medicines have some risk of becoming dependent on the medicine.

For full prescribing information, please visit http://www.ambien.com.

About sanofi-aventis
The sanofi-aventis Group is the world's third largest pharmaceutical company, ranking number one in Europe. Backed by a world-class R&D organization, sanofi-aventis is developing leading positions in seven major therapeutic areas: cardiovascular, thrombosis, oncology, metabolic diseases, central nervous system, internal medicine, and vaccines. The sanofi-aventis Group is listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY) Sanofi-aventis Group subsidiaries in the United States include Sanofi-Synthelabo Inc., and Aventis Pharmacuticals Inc. and Sanofi Pasteur Inc.

U.S. Contact: Melissa Feltmann, +1 908-243-7080,
melissa.feltmann@sanofi-aventis.com

SOURCE sanofi-aventis
Web Site: http://www.sanofi-aventis.com

Sleep Disorders and Prescription Sleep Aids

Currently, a number of prescription sleep aids are available to those with short-term or even severe sleep disorders. They include Ambien, Sonata and Lunesta.

Ambien and Sonata are both approved for short-term use of sleep disorders while Lunesta, a new form of therapy, has been approved for long-term use for sleep disorders. None should be used without the guidance of your doctor.

Most sleeping pills fall under the class of hypnotics. They can stop working after several weeks of nightly use, and long-term use can actually interfere with good sleep. Some side-effects can occur, such as morning drowsiness, forgetfulness and nausea. Mild insomnia often can be prevented or cured by practicing good sleep habits.

For more serious sleep disorders, researchers are experimenting with light therapy and other ways to alter circadian rhythms.

--SleepDisorderOnline

How Much Sleep Do We Need?

Sleep Disorders and Sleep:
How Much 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 the norm.

Many studies make it clear that sleep deprivation is dangerous. People with sleep disorders 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.

--National Institute of Neurological Disorders and Stroke

Sleep Disorder and Disease

Sleep disorder 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 life.

Sleep Disorders and Sleep Apnea

Sleep apnea is a sleep 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.

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.

An 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.

Sleep Disorders and 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.

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.

RLS 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.

Sleep Disorder and Narcolepsy

• What is Narcolepsy?
Narcolepsy is a chronic neurological disorder caused by the brain's inability to regulate sleep-wake cycles normally. At various times throughout the day, people with narcolepsy experience fleeting urges to sleep. If the urge becomes overwhelming, individuals will fall asleep for periods lasting from a few seconds to several minutes. In rare cases, some people may remain asleep for an hour or longer. In addition to excessive daytime sleepiness (EDS), three other major symptoms frequently characterize narcolepsy: cataplexy, or the sudden loss of voluntary muscle tone; vivid hallucinations during sleep onset or upon awakening; and brief episodes of total paralysis at the beginning or end of sleep. Narcolepsy is not definitively diagnosed in most patients until 10 to 15 years after the first symptoms appear. The cause of narcolepsy remains unknown. It is likely that narcolepsy involves multiple factors interacting to cause neurological dysfunction and sleep disturbances.

• Is there any treatment?
There is no cure for narcolepsy. In 1999, after successful clinical trial results, the FDA approved a drug called modafinil for the treatment of EDS. Two classes of antidepressant drugs have proved effective in controlling cataplexy in many patients: tricyclics (including imipramine, desipramine, clomipramine, and protriptyline) and selective serotonin reuptake inhibitors (including fluoxetine and sertraline). Drug therapy should be supplemented by behavioral strategies. For example, many people with narcolepsy take short, regularly scheduled naps at times when they tend to feel sleepiest. Improving the quality of nighttime sleep can combat EDS and help relieve persistent feelings of fatigue. Among the most important common-sense measures people with narcolepsy can take to enhance sleep quality are actions such as maintaining a regular sleep schedule, and avoiding alcohol and caffeine-containing beverages before bedtime.

• What is the prognosis?
None of the currently available medications enables people with narcolepsy to consistently maintain a fully normal state of alertness. But EDS and cataplexy, the most disabling symptoms of the disorder, can be controlled in most patients with drug treatment. Often the treatment regimen is modified as symptoms change. Whatever the age of onset, patients find that the symptoms tend to get worse over the two to three decades after the first symptoms appear. Many older patients find that some daytime symptoms decrease in severity after age 60.

• What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research into narcolepsy and other sleep disorders in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. The NINDS continues to support investigations into the basic biology of sleep, including the brain mechanisms involved in generating and regulating sleep. Within the National Heart, Lung, and Blood Institute, also a component of the NIH, the National Center on Sleep Disorders Research (NCSDR) coordinates Federal government sleep research activities and shares information with private and nonprofit groups.

Sleep Disorders and Insomnia

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.

For more serious cases of insomnia, researchers are experimenting with light therapy and other ways to alter circadian cycles.

Currently, there are a number of sleep aids that can help with insomnia. With a doctor's prescription, available sleep aids include Ambien, Sonata and Lunesta. Ambien and Sonata are approved for short-term use, no more than 7-10 days, while Lunesta has been approved for long-term use. Every sleeping pill comes with its share of side effects and drawbacks; make sure to consult with your physician to see if one is right for you.

Herbal remedies such as melatonin also are popular today, as are over-the-counter sleep aids such as Tylenol PM. Again, as with any remedy to a sleep disorder, check with your physician first.

--NINDS/SleepDisorderOnline.com

Sleep Disorders and Insomnia
Insomnia: Break the Cycle and Get Some Sleep!

Insomnia is a common sleep sickness that affects many people around the world. For some, it is a chronic situation that may require medical attention; for others, an occasional nuisance. Whichever applies to you, a few tested methods can help.

You know the frustration of looking repeatedly at your clock while tossing and in your bed. It's mental and emotional stress to say the least. Just when you think you might drift off due to pure exhaustion, your alarm rings and you dread trying to get through the day with no energy.

Well, it’s time to break that cycle. Here are some tips to help you fall asleep faster and sleep better through the night.

1) Go to bed at the same time and wake up at the same time, EVERYDAY, even on the weekends. Some insomniacs try to catch up on lost sleep by napping on Saturday or Sunday or “sleeping in”. This is the biggest mistake you can make. You will disturb your body clock and make your insomnia worse. If you can't sleep one night, get up the usual time the next morning. If you’ll stick with a schedule, you’ll set your body clock and start sleeping like a baby. You might even find you can do without an alarm altogether.

2) Don't eat within 4 hours of your bedtime. If you’re really hungry have a very light snack or a glass of milk. But don't indulge in an "eat-all-you-can" feast right before bedtime. Your body has to work hard to digest that food and this could result in discomfort while you’re trying to sleep.

3) Don't drink caffeine or alcohol. Both can increase your heart rate and keep you from relaxing enough to fall asleep. Alcohol can make you feel drowsy, but once that drowsiness wears off, the restlessness will begin.

4) Manage your stress and develop outlets to work out problems during the day. Find ways to relax and stay fit. Exercise daily to release tension. Other ways to find harmony are meditating, practicing yoga, use the power of prayer or use breathing exercises to relax. Try not to take your worries to bed with you; remember that you can’t do everything at once. A good night’s rest will better prepare you to face your problems.

5) Never force yourself to sleep. Don’t concentrate on falling asleep, just try to empty your mind. Sleep comes best if you are in a relaxed and comfortable state. Just lie down, relax, and let the sleeping fairy cast its spell upon you.

6) Fueling your body with nutritional foods and making sure you are getting all the vitamins and minerals you need to have a strong body during the day will also help you sleep at night. Choose a healthy eating plan that provides the appropriate mix of protein, carbohydrates and fats.

**Kris Haisten provides health and nutrition advice and promotes good health through Fruta Vida International. For a complete nutritional supplement with a great taste, visit http://www.Frutavidarightnow.com. Contact her at Kris@haisten.net

Sleep Disorders and Hypersomnia

Hypersomnia is characterized by recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep.

Different from feeling tired due to lack of or interrupted sleep at night, persons with hypersomnia are compelled to nap repeatedly during the day, often at inappropriate times such as at work, during a meal, or in conversation.

These daytime naps usually provide no relief from symptoms. Patients often have difficulty waking from a long sleep, and may feel disoriented. Other symptoms may include anxiety, increased irritation, decreased energy, restlessness, slow thinking, slow speech, loss of appetite, hallucinations, and memory difficulty. Some patients lose the ability to function in family, social, occupational, or other settings.

Hypersomnia may be caused by another sleep disorder (such as narcolepsy or sleep apnea), dysfunction of the autonomic nervous system, or drug or alcohol abuse.

In some cases it results from a physical problem, such as a tumor, head trauma, or injury to the central nervous system. Certain medications, or medicine withdrawal, may also cause hypersomnia. Medical conditions including multiple sclerosis, depression, encephalitis, epilepsy, or obesity may contribute to the disorder.

Some people appear to have a genetic predisposition to hypersomnia; in others, there is no known cause.

Hypersomnia typically affects adolescents and young adults.

• Is there any treatment?
Treatment is symptomatic in nature. Stimulants, such as amphetamine, methylphenidate, and modafinil, may be prescribed. Other drugs used to treat hypersomnia include clonidine, levodopa, bromocriptine, antidepressants, and monoamine oxidase inhibitors. Changes in behavior (for example avoiding night work and social activities that delay bed time) and diet may offer some relief. Patients should avoid alcohol and caffeine.

• What is the prognosis?
The prognosis for persons with hypersomnia depends on the cause of the disorder. While the disorder itself is not life threatening, it can have serious consequences, such as automobile accidents caused by falling asleep while driving. The attacks usually continue indefinitely.

--National Institute of Neurological Disorders and Stroke

Sleep Disorders and Depression

A depressive disorder is an illness that involves the body, mood, and thoughts. It can affect the way you sleep.

A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away.

People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms such as sleeplessness can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

Depression often accompanies anxiety disorders and, when it does, it needs to be treated as well.

Symptoms of Depression and Mania

Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.

Depression

• Persistent sad, anxious, or "empty" mood

• Feelings of hopelessness, pessimism

• Feelings of guilt, worthlessness, helplessness

• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex

• Decreased energy, fatigue, being "slowed down"

• Difficulty concentrating, remembering, making decisions

• Insomnia, early-morning awakening, or oversleeping

• Appetite and/or weight loss or overeating and weight gain

• Thoughts of death or suicide; suicide attempts

• Restlessness, irritability

• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Mania

• Abnormal or excessive elation

• Unusual irritability

• Decreased need for sleep

• Grandiose notions

• Increased talking

• Racing thoughts

• Increased sexual desire

• Markedly increased energy

• Poor judgment

• Inappropriate social behavior

If you are experiencing any of these symptoms, they might be the root of your sleep disorder. As always, check with your doctor for information and a diagnosis.

Obesity Surgery Can Improve Sleep And Reduce Snoring, US And Spanish Studies Conclude

Two studies presented at the annual Congress of the European Respiratory Society (ERS) in Stockholm have revealed that obesity surgery (known to specialists as bariatric surgery) may have important advantages beyond its primary objective of major weight loss. It can significantly reduce, or even eliminate, interruptions to breathing (apnoea) during sleep. Sleep apnoea can cause snoring and is a recognised risk factor for cardiovascular disease.

It is common knowledge that obesity now represents a major public health problem throughout the world and is widely forecast to grow steadily worse over time. Aesthetics are by no means the only issue here, since extra weight impacts negatively on health as a whole and on various specific processes within the body. In respiratory medicine, it has for example significant repercussions: it has long been known to be associated with severe sleep disturbances, particularly with obstructive sleep apnoea, whose best-known consequence is snoring.

In obese subjects, the airway is narrowed by fatty tissue around the neck. When the throat muscles relax during sleep, this narrows this sector of the airway even further and in some cases can temporarily obstruct it completely when the muscles are entirely relaxed.
This change in calibre leads to a reduction in respiratory flow (known by the technical term of hypopnoea), or by a complete interruption to breathing (apnoea). The obstruction clears only when the drop in blood oxygen and the corresponding rise in carbon dioxide reach the warning levels and set off the breathing reflex.

The resumption in breathing following an apnoeic pause is generally very noisy, and this is the commonest type of snoring. Given other deleterious consequences of apnoea, it is important for snorers to try and lose weight, generally through a healthier lifestyle, with regular physical activity and a lower-calorie diet.

More snorers than expected

Yet these measures, it is acknowledged, are not enough for morbidly obese subjects to attain a healthy body weight. Hence a number of surgical techniques, known collectively as "bariatric surgery", have been used on such patients, often providing excellent results in terms of weight reduction. The two studies presented in Stockholm now show that weight loss is not by any means the only benefit of this type of surgery, and that bariatric surgery patients also benefit from improved sleep quality.

This can be seen clearly from the results presented to the Congress by Ana Maria Fortuna, of the Department of Respiratory Medicine, Santa Creu y Sant Pau Hospital, Barcelona. "We determined the frequency of obstructive sleep apnoea syndrome (OSAS) in 31 obese patients prior to bariatric surgery and then measured the benefits in terms of reduced sleep apnoea resulting from the weight loss linked to the surgery", Fortuna told the Congress. The subjects' initial body mass index (BMI) averaged 47, which, for a person 170 cm in height would correspond to a weight of approximately 135 kg, instead of the 72 kg that would be normal for this height.

The first thing that the Barcelona researchers pointed out was that a very large proportion of the subjects - more than expected - suffered from apnoea. In fact, 19 of the 31 patients (a prevalence of 61%) were found to suffer from OSAS, although only four of them had been diagnosed prior to the study. As is typically the case, proportionally more men than women had OSAS (nine of the ten men participating in the study).

Breathing interrupted for twenty to forty minutes each night

The Catalan team was also struck by the severity of the OSAS among the morbidly obese patients.

"Of the nineteen patients diagnosed, fourteen had an apnoea/hypopnoea index (AHI) of more than 15, which mean that they stopped breathing for over ten seconds at least fifteen times per hour. That index was as high as thirty for eleven of the patients", Fortuna explained.
A simple calculation shows that, in an eight-hour night, these subjects stop breathing for at least ten seconds between 120 and 140 times, which is the equivalent of spending a total of twenty to forty minutes without breathing each night!

Focusing on the fourteen patients with the most severe OSAS, the Barcelona team tried to identify how their apnoea had evolved following the obesity surgery, once their weight had stabilised at the eighteen-month or two-year mark. At that stage, their BMI had fallen to between 25 and 30, which meant that most of the subjects were no longer obese, but merely overweight. The operation had helped them to lose between 35 and 65 kg.

As Fortuna and her team told the Congress, the weight loss had significantly improved the apnoea symptoms and the severity of OSAS: "Following surgery, the apnoea/hypopnoea index (AHI) fell from 59 to nine on average, with only three patients presenting an AHI above 15".

So the Barcelona study's conclusion is very clear. Not only have the patients undergoing bariatric surgery a high prevalence of OSAS, but obesity surgery reduces apnoea symptoms, and can indirectly put an end to snoring. It also improves OSAS, which means that these patients no longer require treatment for sleep disturbances. "These factors point to a need for routine screening of OSAS in such obese patients", concludes Fortuna's team.

Three to four times less apnoea two years later

The other study presented to the ERS Congress on the subject of apnoea was carried out by a team in Salt Lake City (USA), led by James Walker, of the Intermountain Sleep Disorders Centre at LDS Hospital. The subjects, 22 men and 131 women, were also morbidly obese (with an average Body Mass Index of 47-48) and almost all of them presented obstructive sleep apnoea syndrome (95% of the men and 83% of the women).

Like the Barcelona team, Walker and his colleagues initially registered substantial weight loss among their subjects following bariatric surgery. "On average, 26 months after surgery, the weight loss was of the order of 55 kg for men, taking them to an average weight of 112 kg, and 43 kg for women, who attained an average weight of 84 kg", Walker stated. "Importantly, this weight loss reduced the number of apnoeas/hypopnoeas for both men and women, respectively from 40 to 10/hour and from 20 to 7/hour", he continued.

So the bariatric surgery made it possible to normalise breathing and blood oxygen levels during sleep.

Better still, as the Salt Lake City investigators told the Congress, post-surgery the patients had a reduced level of insulin resistance, an element of metabolic syndrome that is known to be linked to cardiovascular risks and diabetes.

--Medical News Today

Sleep Disorders 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, 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 zone.

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 general public.


A worthwhile site for additional information

Society for Research on Biological Rhythms

Sleep Disorders and Chronic Fatigue Syndrome

Could improving your sleep lessen the symptoms of Chronic Fatigue Syndrome (CFS)?

Our aim here is to understand the connection between the two as it may be possible to confuse the symptoms of CFS and sleep deprivation. There are however definite differences.

Chronic Fatigue Syndrome Symptoms

The main symptom of CFS and probably the hardest to live with, is constant and persistent fatigue lasting 6 months or more. Others include:

* Feeling feverish
* Sore throat
* Muscle aches and pains
* Tender or swollen lymph nodes
* Joint pain
* More headaches than usual
* Abnormal lethargy after exercise
* Poor concentration
* Depression
* Poor quality sleep

Although not everyone who suffers with CFS will display all of the above, two or more of these symptoms would definitely bear further investigation. By contrast, sleep deprived people would not usually experience swollen lymph nodes, joint pain, feverishness or sore throat.

CFS often follows a bout of flu or other respiratory disease. It's onset can be quite sudden following recovery of the initial disease. It occurs more frequently in middle age and elderly people, and twice as often in women as men. Sleep deprivation is not so choosey! It can affect male, female and all ages alike.

CFS is a debilitating illness which is hard to diagnose due to the symptoms being non specific. Also the symptoms described by the sufferers often cannot be verified. For instance, patients often describe feeling feverish although their temperature is normal.

Recent studies indicate CFS may in fact be an immune disorder due to inflammation of the immune system, but there are medical practitioners who still believe it to be a disease of "malingerers". In fact some of those suffering with CFS often wonder sometimes if they are imagining their symptoms. But CFS is very real and can lead to broken marriages and wrecked careers.

It is very important for those who suspect they have CFS to seek medical attention straight away. If you feel your doctor is not taking you seriously, get a second and even a third opinion. It helps if you have been seeing the same doctor for some time, as they know you and can recognize that you are not a "hypochondriac" or a time waster looking for sympathy.

CFS is certainly not new, although the association of symptoms under the name Chronic Fatigue Syndrome only took place in the 1990s. Previously it was largely overlooked or thought to be something else, for example low blood sugar, Lyme disease, allergies, fybromyalgia, yeast infections etc.

Chronic Fatigue Syndrome Treatment

These vary from antidepressants, steroids, immune system medications and anti-histamines to the more holistic treatments like evening primrose oil, diet therapy, cognitive behavioural therapy, removal of dental fillings (mercury poisoning) and gentle exercise programs.

Although lack of a definite treatment for CFS leaves a lot to be desired, the above treatments, whether all or a combination, can prove fairly effective. The broad answer seems to be to treat the symptoms as they occur and make the effort to improve quality of sleep.

The quality of sleep of patients must have a direct effect on the severity of the disease. If depression is the main problem, treatment of that can significantly improve the quality of sleep, thus relieving somewhat the persistent fatigue.

In conclusion. a combination of better quality sleep with gentle exercise, optimal diet and cognitive behavioural therapy would go a long way to improving the lives of patients with CFS.

This article is for informational purposes only and should not be taken as medical advice. Please see your health care provider.

Copyright 2005 Wendy Owen

**About The Author

Want to know how to have better sleep? Find out how! Sign up for our monthly ezine and score our free book “How to Cure Insomnia and Achieve Healthy Sleep” at: http://www.insomnia-connection.com, your resource for detailed information on better sleep and curing stress. The author, Wendy Owen, has had a lifetime interest in general and alternative health as well as being an ex insomniac.

For Pregnant Women, Good Sleep Promotes a Healthy Baby

The American Academy of Sleep Medicine (AASM) says that one of the ways for expectant mothers to help give their baby a better chance of a healthy and full-term birth is to practice good sleep hygiene.

October is National Campaign for Healthier Babies Month, an initiative devoted to promoting prenatal care for and awareness of healthy lifestyle choices among pregnant women.

New research presented at SLEEP 2007 sheds light on pregnant women and sleep: -- Pregnancy is associated with a larger predominance of restless legs syndrome with the general population. -- Women starting a family later in life are more likely to have established careers and more restricted sleep schedules. Older women are more likely to be working late in pregnancy, spend less time in bed and obtain less sleep, although their sleep is more consolidated than that of a younger woman. Older women's subjective experience of insufficient and disrupted sleep has implications for the growing group of older childbearing women.

Jodi A. Mindell, PhD, a professor of psychology at St. Joseph's University in Philadelphia, and associate director of the Sleep Center at the Children's Hospital of Philadelphia, says that most pregnant women struggle with sleep problems, and that these problems don't just start in the third trimester.

"Thanks to surging hormones, sleep disturbances may begin right at the start of pregnancy," says Dr. Mindell. "That means that many women may experience nine long months of problems sleeping. Pregnant women are frequently told that it is just part of pregnancy and they must deal with it. Usually the most sympathy they receive is a comment from friends and family, 'just wait until you have the baby, then you'll know what lack of sleep means'."

Not getting enough sleep can affect every aspect of a woman's life, notes Dr. Mindell, adding that studies have shown that it affects mood, performance, parenting ability and health. In addition, Dr. Mindell points out, being sleep deprived can have dangerous, consequences, including drowsy driving and accidental injuries.According to Dr. Mindell, sleep problems change as pregnancy progresses. "

During the first trimester, women often experience frequent waking at night, often related to frequent trips to the bathroom during the night and nighttime nausea," says Dr. Mindell. "Other issues that some pregnant women face in the early days of pregnancy include overwhelming daytime and evening fatigue and an increased need for nighttime sleep. During the second and third trimester, a growing belly can make for a hard time finding a comfortable sleeping position, and heartburn, back pain and leg cramps can all disrupt sleep."

Dr. Mindell warns that a sleep disorder may develop or worsen during pregnancy, including insomnia, restless legs syndrome, and obstructive sleep apnea (OSA). OSA, the most serious of these sleep disorders, can increase the risk of preeclampsia and hypertension, notes Dr. Mindell.

Children with prenatal cocaine exposure are more likely to have a sleep problem, and may also experience behavior and cognitive effects. Dr. Mindell says that keeping good sleep habits is especially essential when a woman is pregnant. On behalf of the AASM, Dr. Mindell offers the following sleep hygiene tips for all moms-to-be:

1. Maintain a consistent sleep schedule.

2. Make your bedroom dark, cool and comfortable.

3. Sleep on the left side, which is best for the developing baby.

4. Don't clock-watch.

5. Don't stay in bed and try to sleep. If, in 10-15 minutes, you are struggling to fall asleep, get up and move to another room and do something distracting, but not stimulating. Read or perhaps listen to soft music.

6. Avoid alcohol and caffeine.

7. Allow yourself time to unwind before bed.

Risk for a sleep-related breathing disorder among infants and toddlers born prematurely may be higher than among those born full-term. Consistent with the poor growth found in children with a sleep-related breathing disorder, prematurely born infants and toddlers at risk for snoring and a sleep-related breathing disorder also have a lower current body weight independent of age.

Not sleeping well can lead to a number of problems. Expectant mothers who have poor nighttime sleep are more likely to have a depressed mood, attention and memory problems, excessive daytime sleepiness, more nighttime falls, and use more over-the-counter or prescription sleep aids, all of which may adversely affect the healthy development of her baby.

Source: MedicalNews Today

Sleep Aids Forum

Another important forum I'd like to start is a Sleep Aids forum.

Let's talk about what's working for us, and what isn't working. What are your experiences, for example, with Ambien? How about Lunesta or any number of the other sleep aids on the market? How do they work for you?

Beginning a conversation about our efforts to work through our insomnia is an important step in the right direction.

I'll begin.

I started taking Ambien about 9 years ago after a traumatic event in my life. I always have had difficulty sleeping, but as I got older (I'm 41 now), it became nearly impossible for me to sleep, particularly after this event. So, after exhausting every natural sleep tip I could glean from the Internet, I decided to do something about it. I went to see a psychiatrist, who gave me Ambien.

The first few weeks on the drug were curious, to say the least. I had never taken a sleeping pill before, so I didn't know what to expect. I certainly didn't expect to hallucinate, which was the case during those first several night on Ambien. Once, I remember standing in front of my bedroom mirror, just after taking the pill, and watching my face start to melt. Another time, I was sitting in my living room and actually watched a little girl run by me to the kitchen. Since there are no children in my house, this was, to say the least, somewhat alarming.

Concerned, I phoned my doctor, who asked whether I was taking Ambien and then going directly to sleep. Naturally, I wasn't. I didn't have much faith in the drug, and so I sat up as usual, waiting to feel tired. This is when the episodes would happen. My doctor said I needed to go to sleep right away after taking it--and it worked.

It still works. Though I'm certain I'm now dependant on Ambien, I nevertheless do sleep at night. I wake feeling reasonably refreshed (some mornings I don't, such as this morning, but we'll talk about that later), and I can get on with my day.

What are your experiences?

Insomnia Forum

Good morning!

To build a helpful sleep community, please considering using this space to ask questions and start a conversation about your experiences with insomnia. If you have ideas for other forums, please email me at sleepdisorderon@aol.com, and I will be happy to put that forum up for you.

In this new Insomnia forum, let's talk about how insomnia affects you. What are the meathods you're using to treat it? Do you have any questions for the community? Though the advice mentioned here comes with the disclaimer that you should always act on the advice of your doctor, talking about our difficulties with sleep nevertheless can go some way to give understanding and hope.

Let's not be shy. What's on your mind?

Thanks,
Mike

Top 10 Sleeping Tips for the Insomniac

With sleep so elusive for so many of us, I thought I'd compile a list of the top 10 sleeping tips that have worked for me throughout the years. All of these might be attempted if you'd first like to think beyond using prescription sleep aids.

While for many of us sleep aids appear to be the easy answer (in my case, using Ambien turned out to be the only answer), making an effort to consider what else we can do to ease the onset of sleep is an important tactic to assume.

For many, these tips will seem like common sense, but it's amazing how, if you're not focusing on exactly what you need to do to improve your sleep, that you might be making the following mistakes without giving them a second thought. So, I offer them below, just as a gentle reminder that I hope will work for you.
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