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Sleep Disorders

Sleep disorders include a range of problems -- from insomnia to narcolepsy -- and affect millions of Americans. Dr. Michael Breus shares information and advice on sleep disorder and insomnia treatments and causes.

Friday, November 20, 2009

Tee Off on This: Sleep Better, Golf Better
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I don't know any avid golfer who isn't looking for tips to improve his or her game. Some of my golfing friends are real fanatics, incessantly talking about ways to reduce the number of strokes it takes to get through eighteen holes. And now I finally have proof to make a case for my area of expertise: better sleep. Equipment, weather conditions, athleticism, and technique aside, if you can get your game on at night, you can get your game on over the greens. Seriously.

I'm not making this up. A study out of Morristown Memorial Hospital in New Jersey found a group of golfers that improved their golf game by up to three strokes. Granted, these golfers suffered from sleep apnea and were users of the C-PAP, a continuous positive airway pressure mask that helps them sleep better. But my guess is that if a study were done on the general golfing population, we'd see similar findings: those who sleep better, golf better.

Why? Easy. Consider the following benefits of a good night's sleep:

  • Better concentration and ability to focus.
  • Better hand-eye coordination.
  • Alertness.
  • Sharper memory (to recall the level of difficulty or technical secrets to a certain hole, the course terrain, etc.)

All of this bodes well for the golfer-or any sports player for that matter.

So, why were researchers looking at the effects of a C-PAP on golfers in particular? Sounds like an odd thing to report on. But not when you consider that savvy supporters of the C-PAP (myself included) are always looking for ways to motivate people who suffer from obstructive sleep apnea to wear these highly-effective devices. It also turns out that the better you are at golf, the more you have to gain (or lose, depending on how you look at it from a stroke perspective) from achieving restful sleep at night. The more adept golfers in the study lost the most strokes.

Now go sleep. And go play.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

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Posted by: Dr. Breus at 6:00 AM

Wednesday, November 18, 2009

Fact or Fiction: You Can Catch Up on Sleep Over the Weekend
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If we're watching our weight and "blow it" on any given day, we're told it's okay because we can make up for it the next day and get back on track. But what about when we lose sleep? Can we catch up over the weekend and, say, sleep in on Sunday morning to make up for those late, late nights during the work week?

I get this question a lot. I think it's because people expect to hear something different from the truth: NO, you can't just pay off a sleep debt by sleeping late on the weekend. Sorry. The proof? Check out the following studies of late, which have changed some of the conventional thinking of many of us in the world of sleep science:
  • In 2003, scientists at the Walter Reed Army Institute of Research examined the cognitive effects of a week of poor sleep, followed by three days of sleeping at least eight hours a night. The scientists found that the "recovery" sleep did not fully reverse declines in performance on a test of reaction times and other psychomotor tasks, especially for subjects who had been forced to sleep only three or five hours a night.

  • In a similar study in 2008, scientists at the Karolinska Institute in Stockholm found that when subjects slept four hours a night over five days, and then "recovered" with eight hours a night over the following week, they still showed slight residual cognitive impairments a week later, even though they reported no sleepiness.

  • Another study done this year at Walter Reed found that people recovered much more quickly from a week of poor sleep when it was preceded by a "banking" week that included nights with 10 hours of shuteye.

The good news in this latest study, and a change from prior thinking, is that it appears you can prepare for an upcoming sleep debt by banking some hours of sleep. In other words, if you know you have a week of little sleep ahead of you, try loading up on sleep beforehand, not simply afterward. However it should be noted that you are likely only paying off a bit of sleep debt, to bring your reserves back to normal, before depleting them again.

The bad news, of course, is that it's not so easy to pay off a sleep debt in a single night of solid sleep. And the effects of that sleep deprivation can last a lot longer than what you'd imagine. (We all just got an extra hour a few weeks ago when the time changed. How much better off are you today?)

The lesson: avoid chronic sleep deprivation entirely, and when life gets in the way of that goal, then plan for it. Use weekends to prepare for a long work week rather than trying to make up for them.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

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Posted by: Dr. Breus at 4:06 PM

Thursday, November 05, 2009

Housework After Sex, Not Sleep
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Hold on to your seat belt for this one.

Professor Elwyn Isaac from England's University of Leeds has just discovered an astonishing behavior among fruit flies: after mating, females ditch their usual afternoon siesta in favor of engaging in intense foraging (ahem, that would be akin to domestic-type duties or housework). The trigger? A "sex peptide" that is produced in the males' accessory gland, the equivalent of the human prostate, and attaches itself to the surface of the sperm's tail.

This sex peptides appears to have a chemical effect on the female, preventing her from taking her usual afternoon nap. This suggests the behavioral change has a purpose: to prepare females for the birth of offspring, and ensure successful paternity after mating.

Okay, so maybe you're not so impressed about new tidbit about how the fruit fly - that buggy nuisance you see on rotting fruit and vegetables - mates and changes behavior. But fruit flies, if you recall from high school biology days, have been the center of attention in research circles for decades. For starters, the fruit fly's genome has been fully mapped, so wide ranging genetic studies are possible. In terms of sleep studies:
  • They provide a good model for examining sleep behavior because they exhibit many of the hallmarks of mammalian sleep.

  • Like (most of) us, they sleep deeply at night from which they're difficult to rouse and they have a preferred sleeping posture. They also enjoy afternoon naps.

  • If they are sleep deprived, they show tiredness the next day.

  • If fed caffeine, they stay awake, and they become drowsy if given antihistamines.


Women can rest easy. I don't think human sperm contains a similar sex peptide that inhibits sleep and triggers them to spring into household action. (Though many women do feel energized after sex and can be known to get up and go as compared to their male, sleepy counterparts.) Human females have a long nine months during which they can prepare for birth.

But I wonder, are there ingredients in human sperm yet to be identified that can chemically alter a woman's body? Help her to conceive? Prepare the body for pregnancy? A lot of research in the past decade has focused on estrogen's role in sperm (yes, men do produce estrogen, and lots of it in sperm). So I don't doubt we'll learn more with closer inspection. Fruit flies and all (let's not forget about the mice, too).

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

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Posted by: Dr. Breus at 7:06 AM

Monday, November 02, 2009

When Power Snoring Exceeds a Power Saw
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Think you've got it bad putting up with a snoring bed partner? Well, think again. This month a British woman has been recorded as one of her country's loudest snorers. Her snore is so loud that from a decibel standpoint, it's louder than a jet plane!

Impossible? Not at all. Though snoring rarely exceeds 85 decibels, sixty-year-old Jenny Chapman comes in at 111.6 decibels, which could drown out a spinning washing machine, diesel truck, and speeding express train.

People confuse decibels all the time, because they aren't "units" per se. A decibel is literally one-tenth of a bel - the number of bels (named after Alexander Graham Bell) being the common logarithm of the ratio of two powers. In other words, they measure a ratio of powers. Decibels do measure loudness, but it's best to think of them in terms of percentages because they aren't quantities of anything. Here's a list of common sounds and their associated decibels:

Decibel Level

Sounds

0

The softest sound a person can hear with normal hearing

10

Normal breathing

30

soft whisper

50

rainfall, refrigerator, large office

60

normal conversation

70

Some research suggests that any sound above this range can stimulate the nervous system

70 - 95

garbage disposal

75 - 85

flush toilet

80

doorbell, ringing telephone

80 - 90

blender

85

heavy traffic, noisy restaurant

110

car horn, baby crying, shouting in ear, power saw, leaf blower

120

thunder

170

shotgun

180

rocket launching from pad



So what can Jenny do to tone down the volume (and invite her poor husband back into bed who sleeps in another room)? She's been working on living a healthier life - cutting back on alcohol and food intake at night, and exercising more. Though snoring is a multi-factorial problem, studies have long proven that excess weight, alcohol use, and being too sedentary can trigger or exacerbate the problem. When Jenny manages to gain better control of her snoring, she won't just make her husband happy. But she'll also make herself happier. Less ferocious snoring means more restful sleep.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

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Posted by: Dr. Breus at 11:06 AM

Friday, October 30, 2009

Andy Rooney on Sleep
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Yes, Andy, we do sleep about a third of our lives away.

And I agree, it would be nice to have a gauge on us to let us know when we need to get some shut eye or when we've had enough, much like a battery light that comes on to tell us it's time to charge a certain device for optimal use. Green means go. Red mean stop.

Earlier this month when Andy Rooney gave his classic spiel during the last segment of 60 Minutes, he talked about sleep. He doesn't quite understand why so many people have problems with sleep, especially since he "can sleep night or day, sitting, standing, or lying down" and he admits to falling asleep right at his desk or on a bus going across town. He can get along on 7 hours, and thinks that anyone who gets 9 hours or more is sleeping his or her life away.

Andy's quips were no doubt enjoyed by many. But a few big topics Andy failed to cover, though, are sleep's impact on:

  • overall health;

  • memory; and

  • the ability to get things done (ahem, like work into your nineties and have the energy to go on television on a weekly basis).

But what about that "device" to tell us when we've had the perfect amount of sleep? Might I suggest:

  • Signs of your battery is getting low: fatigue, sleepiness, low energy, need for caffeine, moodiness, inability to focus, difficult concentrating

  • Signs of your battery has been charged properly: feeling refreshed when you wake up, having the energy to get through your day, not needing caffeine to stay awake, alert, and productive

Put simply: the body tells us when we need sleep. It's the "y" effect. When we're hungry, we eat, when we're thirsty, we drink, and when we're sleepy, we sleep - or at least we should. And I sense that Mr. Rooney knows that, alongside the other secrets to sound sleep. How else can he be so vibrant, focused, and productive at ninety years old?

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

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Posted by: Dr. Breus at 3:05 PM

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