Sleep Well

By Michael J. Breus, PhD

Here’s some truly fascinating sleep news, the kind that shows just how deeply sleep can affect every facet of our lives. Scientists at the University of California, Berkeley examined the relationship between sleep abnormalities and the brain areas related to emotions. They discovered that REM sleep processes emotional experiences, so that these experiences feel less painful, difficult, and emotionally charged after sleep.

Thirty-five adults participated in the study, all in good health. Researchers divided the participants into two groups. Both groups were shown the same series of 150 emotionally charged images, while researchers monitored brain activity with MRI. Each group was shown the entire series of images two times, with a 12-hour break between viewings. One group saw the images first thing in the morning and again in the afternoon, and they stayed awake during the 12-hour interim period. The other group saw the images for the first time in the evening, followed by a full night of sleep, during which their brain activity was monitored by electroencephalogram. Upon awakening, the second group was shown the images a second time. Researchers found that exposure to REM sleep had a dramatic effect on people’s reaction to the images:

• People who slept in between seeing the emotional images reported a decrease in the intensity of their emotional reaction the second time, compared to those who did not sleep
• Brain scans during sleep showed that during REM sleep the brain’s electrical activity slowed, essentially “soothing” the brain of stress.
• MRI showed a significant decrease in the region of the brain that processes emotions. This decrease corresponded with an increase in activity of the brain’s center for cognition, rational thought, and decision making.

Based on these results, it’s as though REM sleep allows the brain to have some control of an emotional memory.

This is a single study, and we need to see more research on this subject. But think for a moment about the implications of these results. Sleep problems and sleep disorders—from insomnia and sleep apnea to sleep deprivation and restless leg syndromes—can all increase risks for other health problems, from obesity to diabetes to heart disease. They also can affect mental health. One thing all sleep problems seem to have in common is in bringing about a feeling of being overwhelmed, or of having difficulty coping well with the demands of daily life. Anyone who has ever run short on sleep, or weathered a string of sleepless nights, will know what I’m talking about. Irritability, emotional fatigue, distractedness, short-temperedness—these feelings are common enough with disordered sleep as to be considered universal.

What if this possible function of REM sleep—to manage and soothe emotional experiences from our waking lives—is at play here? Is the absence of REM sleep a factor in the emotional and mental toll that sleeplessness takes on us? A greater understanding of this possible connection could have a profound effect on how we view, and treat, sleep problems and the secondary effects of sleeplessness.

So remember, as I always say, it is truly better to “Sleep on it” to feel better.

Sweet Dreams,

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

The Sleep Doctor’s Diet Plan: Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™
twitter: @thesleepdoctor
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By Michael J. Breus, PhD, ABSM

I wrote recently about the relationship between sleep and fibromyalgia, a chronic pain syndrome, and the about important—and complicated—relationship between sleep and pain. Now there’s news that one of the most effective remedies for sleep apnea—CPAP therapy—may also have the benefit of reducing sensitivity to pain. A recent study found consistent use of the CPAP could reduce pain sensitivity in patients with severe OSA. The study tested 12 patients—7 men and 5 women—with severe obstructive sleep apnea. They found that six to eight weeks of regular CPAP use led to significantly reduced pain sensitivity and also to improved continuity of sleep.

The relationship between sleep and pain is one we don’t yet fully understand. What we do know—and what anyone who suffers from chronic pain can attest to—is that each can have a significant effect on the other. The presence of pain can make it hard to fall asleep and stay asleep, and being sleep deprived can make a person feel more sensitive to aches and pains. Studies that have examined the relationship between sleep and pain found these links to be true—and also found that it doesn’t take a lot of lost or disrupted sleep to have an effect on how we experience pain:

• One study showed 12 women who were deprived of sleep for only three consecutive nights experienced increased sensitivity to pain. Pain sensitivity began to increase after a single night of disrupted sleep and grew worse each night.
• Another study tested healthy men for pain sensitivity after a short period of total sleep deprivation. Researchers found that total sleep deprivation dramatically decreased the men’s threshold for pain. A recovery sleep period after sleep deprivation restored the men’s pain threshold.
• Recent research into fibromyalgia showed that women who were sleep deprived had as much as five times higher risk of developing the chronic pain syndrome over a 10-year period as women who were not sleep deprived.
• A sleep-pain study performed on rats showed that when deprived of REM sleep, the rats experienced a significant increase in sensitivity to several types of pain stimuli.

The type of sleep we get—or don’t get—may be significant when it comes to pain. Researchers are increasingly focusing on stages of sleep that occur in the later stages of the sleep cycle—REM sleep and delta, or slow wave, sleep—as being critical in protecting pain thresholds. Throughout the night, your sleep unfolds in a recurring and progressive cycle. Over the course of a night, the cycle shifts so that you spend more time in REM sleep and in the later sleep stages that are considered slow wave sleep. If you are sleep deprived, or your sleep is constantly being interrupted, your body does not reach the REM and slow wave-rich sleep that occurs in these later periods.

Here’s where the CPAP may be playing its role in helping reduce pain sensitivity. CPAP works by pushing a constant stream of air through the sleeper’s airway, to keep it from closing. Sleep apnea occurs when muscles in the back of the throat collapse, closing off the airway. This causes a person to stop breathing. It also interrupts a person’s sleep cycle, since those who suffer from sleep apnea are awakened, however briefly, often many times throughout the night by their breathing problem.

It’s possible that the CPAP allows a person to sleep through their full sleep cycle, achieving those later stages of sleep that are so restorative, and also appear to help decrease our sensitivity to pain. This study is just a beginning—we don’t yet know why CPAP might be effective in reducing pain sensitivity. But these results are promising and intriguing, and this is a topic that deserves additional inquiry.

For millions of people who suffer from obstructive sleep apnea, and perhaps other independent conditions that bring about chronic or intermittent pain, the possibility that CPAP could help reduce sensitivity to pain is welcome and important news. It’s also another reason to make sure that patients who have been prescribed CPAP as a treatment actually follow through with the therapy. The CPAP can work very effectively, but only if it’s actually used! This latest research provides yet another very good reason for people with OSA to make sure that the CPAP is part of their nightly routine—every night. The benefits may be even broader than we previously thought.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

By Michael J. Breus, PhD

Listen up, partners and spouses of people with sleep apnea: Treating obstructive sleep apnea with CPAP works best when it’s a team effort. That’s the takeaway from a recent research review, which examined dozens of studies in an effort to identify the most effective ways to help patients comply with their CPAP regimen. What they found was that having a partner involved and engaged with CPAP treatment increases the likelihood that the patient will stick with their treatment plan.

More than 18 million Americans suffer from obstructive sleep apnea (OSA). It is among the most common sleep disorders. And CPAP—continuous positive airway pressure—is the most commonly prescribed treatment for OSA. Obstructive sleep apnea occurs when the muscles in the back of the throat collapse, blocking the airway. People with OSA stop breathing briefly, anywhere from a handful of times to hundreds of times in a night in severe cases. The health risks associated with sleep apnea are serious: in addition to disrupting sleep and lowering blood oxygen levels, OSA is associated with higher risks of high blood pressure, heart disease, and diabetes, in addition to mood and memory problems. CPAP works by pushing air constantly through the airway, keeping it open and allowing uninterrupted breathing through a night’s sleep. It’s a safe, effective, well-tested treatment for OSA that has proven results. The biggest challenge to CPAP success? Getting patients to use the device consistently.

The CPAP machine delivers the air pressure that keeps the airway open by a face mask that covers the nose, which must be worn by the patient during sleep. Sleeping with the CPAP mask can be a daunting prospect for newly diagnosed OSA sufferers. Some people may find it embarrassing to wear in front of a partner. Others may find wearing it feels uncomfortable or odd at first. As effective as CPAP can be if it’s used consistently and correctly, there are real risks of patients abandoning the treatment, especially in the very early stages, because they feel it’s too intrusive, disruptive or uncomfortable. Finding the best ways to encourage continued use of the device is a critical area of research.

A group of researchers at Penn State reviewed 80 CPAP-related studies, searching for evidence of the most important factors in successful CPAP therapy. They found that social support increases the likelihood that a CPAP user will continue to use the device. Spouses and partners who provide active support for the CPAP can help a patient feel more relaxed and comfortable with, and also more accountable to, following through with the treatment night after night. And it’s this follow through that makes all the difference in whether or not the CPAP treatment is allowed to work as successfully as it can.

This finding echoes other research that shows CPAP works best when couples work together in support of the treatment, and that—rather than drive partners away from sex and intimacy, CPAP can actually lead to improved intimacy between partners:

• One study indicated that men whose wives continue to sleep in the same bed with them when using the CPAP are 60% more likely to continue with the treatment than if they are sleeping alone.
• Another study examined sexual and intimate relationships in men with obstructive sleep apnea, and found then whereas OSA had a negative impact on men’s sex lives, regular use of CPAP for three months resulted in improvement in their sexual and intimate relationships. And the more serious the OSA was to begin with, the greater the improvement after using the CPAP.

It’s very common for the snoring that can accompany obstructive sleep apnea to drive partners to sleep in separate beds. So often, when the CPAP treatment begins, couples are already sleeping apart. The initial reluctance to return to the same bed is understandable—both partners may feel self-conscious. There’s no question that it takes work: trust, open communication, perhaps a decision to plan for sex and intimacy in different ways. But this is work that is worth doing—not only for the health of the person with OSA, but also for the health of your relationship.

There is no single right way to approach integrating the CPAP into your life. Researchers in the current review found that CPAP success is best promoted on a case-by-case basis, with individualized treatment regimens that take into account a patient’s life circumstances, the particulars of their disease, as well as their psychological and social circumstances. For example, for patients without partners, telecommunications strategies such as regular phone calls and wireless telemonitoring may be able to provide the social support and connection that appears to be so effective.

The bottom line? CPAP treatment not only can help alleviate OSA, and improve a patient’s health, it can also bring couples back into the same bed—if both patient and partner are willing to accept the device, and not let short-term, initial discomfort or awkwardness become entrenched. The discomfort is fleeting, but the benefits—including renewed intimacy in the bedroom—are long-term.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™
twitter: @thesleepdoctor
Facebook: www.facebook.com/thesleepdoctor

By Michael J. Breus, PhD, ABSM

Sleep was in the news throughout 2011, with breakthrough research and advances in our understanding of why we sleep, and how sleep—or a lack of it—can affect health and well being. Here are my picks for the most interesting and important sleep stories from the second half of 2011, with practical sleep suggestions you can start using today.

July 2011

Sleep suggestion: Your doctor’s sleep matters to your health

This year, changes went into effect that put new limits on the amount of time first-year residents can work without time off. Previously, these residents were able to work for as much as 30 hours straight! Now, first-year residents can work no more than 16 hours at a stretch without an 8-hour break. These changes are welcome and overdue, a start in what I hope will be a continued shift away from the sleep-deprived culture of medical training. The truth is that sleep-deprived doctors are less capable of retaining information, and long resident hours are associated with greater incidence of preventable medical errors.

August 2011

Sleep suggestion: To keep your kids at a healthy weight, make sure they get enough sleep

Researchers in New Zealand working with children ages 3-7 found that additional sleep reduced the children’s risk of becoming overweight and led to lower BMI. Helping kids develop strong sleeping habits from a young age is a long-term investment in their health and can help protect them from a host of health risks associated with obesity.

September 2011

Sleep suggestion: Don’t assume your sleep needs are the same as your mate’s

Gender differences in sleep were a hot topic this year. New research suggests that men and women do have basic, biological differences in their sleep. These differences offer up specific types of protection—women seem to weather mild sleep deprivation better than men, whereas men appear to be somewhat less vulnerable to sleep disorders. The differences in the way men and women sleep also make each more vulnerable to certain risks.

October 2011

Sleep suggestion: Want to protect your teen’s health? Start by protecting their sleep

A landmark study published in 2011 showed lack of sleep among teens is strongly associated with a long list of risky and unhealthful behaviors. The list includes smoking, drinking, drug use, overeating, avoiding exercise, depression and suicidal thoughts. Teens who slept fewer than 8 hours per night were at a greater risk for engaging in these behaviors than teens who slept for at least 8 hours or more. The message couldn’t be more clear: make sure your teens are getting sufficient sleep, at least 8-9 hours per night.

November 2011

Sleep suggestion: Want to avoid weight gain? Go to bed early

Sleep timing has an effect on diet and weight gain, according to this study published in 2011. Researchers at Northwestern University found that late bedtimes lead to late mealtimes, and that sleeping later and eating later make poor diets and weight gain more likely. In the study, sleeping less, going to sleep later in the night, and eating more heavily after 8 p.m. were all associated with higher BMI. If you’re looking to trim up in the New Year, shifting your bedtime back—and staying away from the refrigerator after 8 p.m.—can help.

December 2011

Sleep suggestion: A good night’s sleep may reduce your risk of fibromyalgia

The relationship between sleep and pain has become a hot topic in sleep studies—with good reason, since there seems to be a strong relationship between the two, one that we’re just beginning to understand. Studies such as this one, which suggests a link between sleep deprivation and the risk of fibromyalgia, are helping to increase our understanding of how sleep and pain interact in the body. This study demonstrated as much as a five times higher risk of fibromyalgia, a condition characterized by chronic pain, among women who reported frequent sleep problems.

Here’s to a New Year filled with good health and good sleep!

Sweet Dreams,

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

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™
twitter: @thesleepdoctor
Facebook: www.facebook.com/thesleepdoctor

By Michael J. Breus, PhD, ABSM

The year that just ended was a big one for sleep, with lots of important, news-making stories related to sleep and sleep disorders. Here are my picks for the biggest sleep stories of 2011, and the most important sleep advice to come from this year’s most compelling research.

January 2011

Sleep suggestion: Take your vitamins…for sleep

Vitamins don’t just do your waking body good, they also can help improve the quality of your sleep. Vitamin B helps the body’s production of serotonin, the “calming hormone” that lulls the body toward sleep. Calcium also helps relaxation, and taken in combination with magnesium, can help with chronic sleep problems. Vitamin D got a lot of attention this past year—for good reason, since many people (in northern climates, with darker skin tones, elderly, overweight, pregnant and post-natal women) are at risk for vitamin D deficiency. Vitamin D is showing promise in lowering fatigue and daytime sleepiness.

February 2011

Sleep suggestion:  To improve your sleep at night, make your bed in the morning

This is the kind of practical strategy that I love: creating a proper sleep environment helps us sleep better, according to a survey by the National Sleep Foundation.  People slept better when they kept a clean bedroom, kept clean sheets on the bed and changed them once a week, slept on comfortable mattress and pillows, and kept their rooms dark and cool. This is the essence of basic sleep hygiene. When your sleep starts to suffer, go back to basics and make sure your bedroom –especially your bed—is conducive to sleep.

March 2011

Sleep suggestion: Be mindful of your sleep

This fascinating news could have real implications for the treatment of obstructive sleep apnea, one of the most common sleep disorders. Researchers at the University of Toronto found that the interruption of breathing that occurs with OSA causes the brain to release a chemical called noradrenaline. Noradrenaline helps the body learn to breathe more deeply and fully. There’s a great deal more to investigate here, but research such as this could lead to simpler, more streamlined and effective treatments for OSA and sleep-disordered breathing. This is also a reminder of the power of the mind—and how we can put it to use in the service of sleep.

April 2011

Sleep suggestion: Don’t assume you are a super sleeper

I’m highlighting this news to point out what the vast majority of us are not. Super sleepers—these are people who can function at full capacity on fewer than six hours of sleep per night—made headlines in 2011. These folks exist, but they are in the distinct minority. Though many of us may try to convince ourselves we can sleep four or five hours of sleep per night and not pay the consequences, it’s just not true. Only 1-3% of the population is short sleepers. The rest of us—you know, the 99%—need seven to eight hours of sleep per night to function well.

May 2011

Sleep suggestion: Sleep more to weigh less

In 2011 we learned a lot about the connection between sleep and weight. Sleep helps regulate hormones that govern appetite and metabolism. It helps keep judgment sound and willpower strong. A full night of sleep allows you to wake feeling energized and ready to jump into your day, hopefully with calorie-blasting exercise. What’s more, during REM sleep, the body actually burns more calories than when you’re awake lying in bed.

June 2011

Sleep suggestion: Want to protect your memory? Get some sleep

This sleep news was some of the most intriguing of the year. Researchers at Washington University School of Medicine discovered a direct link between sleep and the establishment of long-term memories. Testing with fruit flies, scientists were able to manipulate cells in the fly brain to show that sleep had a direct effect on the creation of long-term memories. Flies that slept after being exposed to new information were able to convert that short-term knowledge into memory.

Stay tuned for more sleep tips and a roundup of the most promising and important sleep stories from the second half of 2011. Happy New Year!

Sweet Dreams,

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

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™
twitter: @thesleepdoctor
Facebook: www.facebook.com/thesleepdoctor

By Michael J. Breus, PhD, ABSM

There’s some important news for millions of people—most of them women—who suffer from the syndrome fibromyalgia: a new study suggests that sleep deprivation is associated with an increased risk of developing fibromyalgia.

The study was conducted at the Norwegian University of Science and Technology and included 12,350 women. At the outset of the study, all the women were free of physical impairment, musculoskeletal pain and fibromyalgia. A decade later, 327 of the women—2.6% of the study population—had developed fibromyalgia. Researchers asked all the women in the study to report on their sleep habits and their sleep problems. They found that women who reported sleep problems were significantly more likely to have developed fibromyalgia than women without sleep problems. The researchers also found that the risk of fibromyalgia increases with a woman’s age and with the severity of sleep problems:

• Women who reported having difficulty sleeping “always” or “often” had nearly 3½ times greater risk of fibromyalgia as women who did not have problems sleeping
• Women age 45 and older who “always” or “often” had sleep problems had more than five times the risk of developing fibromyalgia as women without sleep problems
• Younger women, ages 20-44, who “always” or “often” had difficulty sleeping were at three times greater risk of developing fibromyalgia than their counterparts who didn’t have trouble with sleep

It’s important to make clear that this study does not prove that sleep deficiencies cause fibromyalgia. What it does do—for the first time—is establish a strong connection between sleep problems and fibromyalgia by showing the increased risk of fibromyalgia that is associated with lack of sleep.

What is fibromyalgia? It’s a syndrome whose main characteristic is chronic pain. Pain is often felt throughout the body, in muscles, tendons and soft tissues. With fibromyalgia, the pain is often felt at certain trigger points, and radiates from those points outward. People with fibromyalgia often experience daytime fatigue, which can be severe, as well as depression, anxiety and memory problems. Women ages 20-50 are at the highest risk for fibromyalgia. Men do develop fibromyalgia, but women are more than 10 times as likely as men to develop the syndrome.

Fibromyalgia has a history that’s both contentious and mysterious. For a long time, there was no consensus in the medical community about whether it even existed, whether it was a “real” disorder or an “imagined” one. This has changed, and the medical establishment now overwhelmingly accepts that fibromyalgia exists as a very real disorder. But much about the syndrome—including and especially what causes it—remains unknown. For this reason, and because there is no single test that can positively identify fibromyalgia, it remains difficult to diagnose. Since it can’t be tested for, a diagnosis of fibromyalgia comes by way of eliminating other possible conditions.

There are signs of possible genetic and environmental links, since fibromyalgia seems to sometimes run in families. Researchers have explored links between fibromyalgia and other diseases and disorders, including arthritis, depression, anxiety, chronic fatigue and restless leg syndrome, but no conclusive evidence has been found to demonstrate a causal link between fibromyalgia and these conditions. That said, all of these disorders are found more often in people with fibromyalgia than in the general population.

Is sleeplessness a cause of fibromyalgia? Again, we just don’t know, and this current study doesn’t answer that question. The relationship between sleep and chronic pain is complicated, and there is a lot we do not understand about cause and effect. Here’s some of what we do know: The presence of chronic pain, such as with fibromyalgia, makes falling asleep and staying asleep more difficult. Sleep deprivation, in turn, can make people more sensitive to pain. Evidence that disrupted sleep can lead to a lower pain threshold can be found in this study. Researchers took a group of healthy, pain-free middle-aged women and disrupted their sleep cycle, depriving them of deep, slow-wave sleep for three consecutive nights. They then tested their threshold for musculoskeletal pain, tenderness and also mood. After only a few nights of disrupted sleep, the women experienced a significantly decreased pain threshold (meaning they felt pain more quickly and intensely), as well as increased fatigue and general discomfort.

We don’t need to know the root causes of fibromyalgia to know that improving sleep is at the core of a strong treatment plan for the condition. If you’re struggling with sleeping because of fibromyalgia or chronic pain, keep these strategies in mind to help improve and protect your sleep:

• Emphasize your rest. People with fibromyalgia simply cannot shirk their sleep routine. Make sure sleep stays a top priority by setting up a schedule that allows for plenty of rest and by creating a sleep environment that is relaxing, quiet, dark and conducive for sleep.
• Exercise. Regular exercise can help manage pain itself. It will also strengthen your sleep-wake cycle and help you sleep better. Schedule exercise earlier in the day, and outdoors in sunlight if you can.
• Use relaxation techniques. Meditation, massage and mind-body exercise are also powerful tools for pain management and for sleep as well. One study found that after three months of regular Tai Chi practice (two hour-long sessions per week), pain and depression among fibromyalgia patients had declined, and sleep had improved.
• Avoid alcohol, tobacco and caffeine. These chemicals may make you feel “better” in the very short term, but they disrupt sleep and increase stress, among other negative consequences. With fibromyalgia, your body is coping with enough stress without exposing it to taxing chemical stimulants and depressants.

There is so much that we still need to learn about fibromyalgia itself, as well as the relationship between chronic pain and sleep. One thing that’s not in question? Sleep is powerful healing tool. It costs nothing and doesn’t require a prescription. Make sure you’re using it to its greatest effect.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

Have you struggled with sleep problems or fibromyalgia? Join the discussion in our Sleep Disorders and Fibromyalgia communities or share your thoughts in the comments below.

By Michael J. Breus, PhD, ABSM

According to a couple of news reports from Britain, the ongoing financial crises—and the stress they cause to everyone from bank executives to everyday investors—are taking a toll on health, wellbeing and sleep.

A recent news story focused on the effects of the European debt crisis on workers in the banking industry. Depression, anxiety and insomnia are common and widespread among the UK’s financial workforce, according to the article, and these disorders are affecting those at all levels of the industry, from top executives on down. Reports that forecast increasing unemployment and particularly heavy layoffs in the financial sector are, understandably, exacerbating stress for workers in the financial industry.

As this article indicates, the culture of the financial workplace doesn’t always encourage employees to seek help for stress-related health problems such as insomnia, depression and anxiety. All too often, the underlying message is to “tough it out.” This leads to people denying symptoms even as they worsen, and often to compensating with drugs and alcohol, which only compound the problem.

On the heels of this news about financial workers comes a report on the state of sleep among Britons in general. In a poll of 3,000 adults, which was sponsored by the furniture company (and mattress purveyor) IKEA, Britons reported chronic and widespread sleep deprivation—and cited worries about work and finances at the top of the list of concerns that keep them awake at night. According to the poll:

• 70% of adults polled said they do not get enough sleep
• 57% say they are kept awake at night by worries about finances and work issues (This one just beats out being kept awake by a partner’s snoring, at 54%)

Stress from financial woes is nothing new. This is a perennial issue, but there’s no question that the last several years have been especially difficult and stressful for people in this regard. I’ve written before about the impact of a difficult and uncertain financial climate on sleep and health. Stress in whatever form is an enemy to sleep, and can also contribute to depression and anxiety. The relationship among these disorders themselves is complicated, with each being a possible trigger for the other. This dynamic is itself the subject of a recent study that shows insomnia is often accompanied by anxiety and depression.

Unfortunately, it doesn’t look like there are any quick fixes on the horizon for the economic problems in the UK, Europe or the United States. But here are some strategies for protecting your sleep if you find yourself coping with stress related to the difficult economy:

Don’t reach for sleeping pills FIRST. I do believe there may be circumstances that warrant prescription sleeping medication, and you should discuss your options with your primary care physician. But I always encourage my patients to explore natural remedies before turning to prescription sleep meds. Regular exercise, early-in-the-day exposure to sunlight, a regular bedtime, plus the tips that follow—these are the components of good sleep hygiene, and they should always be the first route toward a good night’s sleep.

Manage your exposure to news. Our 24-hour news cycle and the seemingly endless media outlets mean that there is no limit to the amount of information we can consume. All this information and media noise can lead to late-night worrying. Setting limits on media exposure can help you wind down peacefully toward sleep:

• Stop watching and reading the news two hours before bedtime. This includes all forms of news media: TV, online, radio, newspapers and magazines.
• Make dinnertime and evening a finance-free discussion zone. If you want to debate financial policy, or talk personal finances, plan to do this during the day, not at night.
• Give yourself a media holiday. From time to time, take a 24-hour break from ALL media. You’ll be amazed at how relaxing and refreshing this news break can be.

Create a soothing evening routine. Now that you’ve eliminated news media from your nightly routine, it’s time to replace it with activities that relax you. Try reading a novel for pleasure, treating yourself to a soothing bath, even taking a leisurely nighttime walk around the block. Quiet, romantic time with your partner is a great stress-reliever and great for your relationship as well!

Avoid alcohol. It can be tempting to decompress at the end of the day with a drink or two. But if you’re worried about your bank account, the ups and downs of the stock market, or the security of your job, then drinking to combat these stressful circumstances is a bad idea. This kind of drinking can lead to dependence. Moreover, alcohol, though it may make you feel temporarily relaxed and sleepy, will actually undermine your sleep. Use exercise, meditation, and time with friends and loved ones to provide yourself with relaxation and solace, not alcohol.

The effects of stress and financial uncertainty are not problems that are confined to the UK. We’ve got these issues on both sides of the pond. Wherever you are resting your head tonight, make sure you’re taking the right steps to leave your worries outside the bedroom door.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

The Sleep Doctor’s Diet Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™

twitter: @thesleepdoctor

Facebook: www.facebook.com/thesleepdoctor

By Michael J. Breus, PhD, ABSM

I love this story about how to combat “junior jet lag.” We’re in the thick of the holiday season, which is prime time for travel. School vacations and holiday visits to family make this a time of year when many people are packing up and heading across time zones. Travel can be disruptive to sleep for kids, especially travel that involves time zone changes. Long days in transit combined with time zone shifts can quickly throw kids’ schedules out of whack. Parents, you know what this means: tantrums in the airport, little ones wide awake at 3 a.m. in grandma’s spare bedroom, meltdowns at the dining room table and generally difficult behavior all around. Vacationing with the whole family should be fun—and it can be. Sleep can make a critical difference. It’s worth it to plan ahead to make sure that everyone in the family, especially kids, are prepared to handle jet lag and adjust their sleep schedules.

What’s behind jet lag? When we ask our bodies to adapt to a different time schedule, we disrupt our circadian rhythm, our body’s powerful internal regulator, which governs our sleep-wake cycle, our ability to fall asleep and to wake feeling rested and ready to get out of bed. Our circadian clocks have a powerful effect on our mood and energy levels, and even our immune systems. This internal regulatory mechanism is finely tuned—even very slight disruptions can have an effect on how we feel and our ability to sleep. Moving across time zones, with changes of an hour or more to the “normal” schedule, can have a significant effect.

Let’s face it, as adults we don’t always weather these changes particularly well (or happily), so it’s no surprise that our kids don’t handle jet lag with ease and good humor. The good news is there are a number of things you can do to prepare your kids for travel that involves changes to their schedules. Taking the time to plan ahead can make a huge difference in how well your children handle the travel itself and adapt to time zone changes when you arrive. Smart preparation begins before your bags are packed:

Book reasonably. That off-hours, overnight flight to your destination may save you a bit of money, but it may not be worth it if your family is too tired and irritable to enjoy your time once you arrive. A good rule to go by when factoring jetlag into your planning is that it takes the body one day to adjust for every 1-2 time zones you cross. Designing a travel schedule that minimizes delays and avoids overnight flights can help reduce the impact of jetlag, especially with kids in tow.

Bank sleep. The best strategy starts a few weeks ahead of your actual travel. Of course, making sure your child is getting plenty of sleep should always be a top priority. But in the weeks leading up to a trip, it’s even more important that your kids get ample rest. Go back to basics: stick closely to schedules for meals and homework in the evenings, make sure bedtime and wake times are consistent, turn off the TV and electronics (and especially for older kids, the smartphones and computers) in the hour immediately before bed. I call it the electronic curfew!

Adjust bedtimes in advance. Use the week before you plan to travel to begin to shift your child’s schedule toward the time zone where you’ll be going. Now, I’m not talking about keeping kids up late into the night, or waking them before dawn! But adjusting bedtimes 15 or 30 minutes (earlier or later, depending on where you are traveling) can give your kids a head start on the adjustment they’ll need to make during the trip.

When it’s time to travel, take a deep breath and keep these tips in mind:

Limit naps. As tempting as it might be to let your child sleep for hours on the plane, both of you may pay for that peace and quiet at your destination, when your child is up in the middle of the night, or refuses to go to bed at all. When deciding whether to allow your child to nap, keep in mind your destination time zone. Early in the day naps will pose fewer problems than naps closer to afternoon and evening times at your destination. Keeping naps brief, no longer than 30 minutes, will help prevent this extra sleep from disrupting your kids’ bedtime.

Avoid medication. I hear often that parents are using over the counter sleep and cold medication to help their kids sleep during travel. It’s never a good idea to employ medication for treatment beyond its intended uses. And medicating a child to sleep through travel will only further disrupt his or her sleep-wake cycle, leaving your child even less able to adapt to sleeping in the new time zone.

Get out in the light. Sunlight and exercise are two of the very best ways to help speed your child’s adjustment to a different time zone. Exposure to light and physical activity will help re-set their circadian clocks. If you’ve arrived early in the day, getting your kids outside to play will help boost their energy and fall asleep more easily at the right time. If you arrive in the late afternoon or evening, close to bedtime, keeping kids quiet and away from bright light will help prepare them to wind down for bed.

My last tip? Parents, take care of your own sleep! If you are rested, you’ll be that much better able to handle the ups and downs of travel—and your kids’ unpredictable moods—with patience and good humor.

Happy holidays and happy, well-rested travel!

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

By Michael J. Breus, PhD, ABSM

I was pleased to read this recent blog post, which addresses the link between obstructive sleep apnea (OSA) and sexual function in both men and women. In general, we don’t talk nearly enough about the detrimental effects of sleeplessness and sleep disorders on sexual relationships. As I wrote recently, science is increasingly focusing its attention on the hormone testosterone—which is affected by sleep and, in turn, affects sexual function—as an important factor in the sexual problems associated with sleeplessness.

A great deal more attention and study have been paid to the effects of sleep apnea on men’s sex lives, but the effects of sleep apnea on women’s’ sexual function has received comparatively little research attention. I’ve written before about how sleeplessness can inhibit a woman’s sex life, but we continue to rely on relatively little scientific knowledge of the impact of disorders such as sleep apnea on sex and intimacy for women. It’s welcome news, then, to see another recent study that examined the effects of obstructive sleep apnea on women’s sexual function.

This study included 80 women between the ages of 28-64. The women were all diagnosed with sleep apnea but had received no treatment for their condition. They responded to three questionnaires that addressed sexual function and sexual satisfaction, as well as overall life satisfaction. Their answers were compared to responses from 240 women who did not have sleep apnea. What did researchers find?

• Women with untreated sleep apnea were at significantly greater risk for sexual problems, related both to sexual function and sexual satisfaction
• Women with OSA also reported consistently lower scores on the overall life satisfaction questionnaire
• The negative effects of OSA on sexual function do appear to be affected by the severity of the sleep apnea—this means, among other things, that even mild OSA can have a disruptive effect on a woman’s sex life.

Obstructive sleep apnea is a serious disorder, which puts its sufferers at increased risk of a litany of health problems, including high blood pressure and heart disease. It’s also a sleep disorder that remains significantly under-diagnosed, perhaps especially for women. Among sleep disorders, OSA often is particularly—and incorrectly—thought of as a “men’s issue,” which likely accounts for the difference in the amount of attention that has been paid to its effects on men’s sexual function versus women’s. Numerous studies have shown that sleep apnea, untreated, can have serious consequences for men’s sexual function. One study showed that men with erectile dysfunction are more than twice as likely to have OSA than those without—and the more serious the erectile dysfunction, the more likely it is that the man also has sleep apnea.

But sleep apnea is not just a men’s disorder. There are a number of lifestyle choices that can help protect the quality of your sleep (and your health in general) and diminish your risk of developing OSA:

Keep your weight in a healthy range. Excess weight is a primary risk factor for sleep apnea in both men and women. Keeping your weight in check is perhaps the single most important thing you can do to protect yourself against developing sleep apnea as you age. And of course, maintaining a healthy weight confers a host of other protective health benefits. What’s one powerful tool in keeping your weight down—or losing weight, if you need to? You guessed it—a good night’s sleep.

Don’t smoke. This one should be beyond obvious. Smoking is a dangerous, potentially deadly habit. No one should smoke. Among its hazards, smoking increases the risk of OSA. There is also evidence that the combination of smoking and obstructive sleep apnea creates a particularly heightened risk of cardiovascular disease.

Get regular exercise. Exercise will help you keep your weight in check and also enhances the overall quality of your sleep. Exercise early in the day if you can, and outdoors when possible—the exposure to sunlight helps strengthen circadian rhythms that govern our sleep/wake cycle. For people who are treating sleep apnea with a CPAP device, there’s evidence that the combination of CPAP and exercise are particularly effective together in alleviating sleep apnea.

There is good news for women—and men—who are already suffering from sleep apnea. There are safe and effective treatments, particularly the CPAP—a device that’s worn while sleeping and keeps the airway from closing—that can diminish or alleviate sleep apnea, and don’t have to interfere with intimacy.

The relationship between sleep and sex needs more attention and more research—especially when it comes to issues particular to women. The basic truth, for everyone? Improving the quality of your sleep is likely to benefit your sex life.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

Has sleep apnea negatively affected your life? Share your stories in the comments below or in our Sleep Disorders Community.

By Michael J. Breus, PhD, ABSM

Moms and dads, here’s some important news: there are new guidelines you should know about that can help your baby sleep more safely. The American Academy of Pediatrics has issued new recommendations for sleep safety and protection against SIDS.

SIDS, sudden infant death syndrome, has yet to be fully explained. Its causes remain largely unknown, and though it is relatively rare, it remains the number one cause of death among infants. In 1992, the American Academy of Pediatrics first made the recommendation that infants and babies sleep on their backs at all times. Since then, the occurrence of SIDS-related deaths has decreased significantly. But other types of sleeping and crib-related deaths have increased, including suffocation, entrapment and asphyxia. The new sleep safety guidelines are a response to these increases, and an attempt to provide parents with a broader, more comprehensive picture of how to create a safe sleep environment for their babies.

So, what’s new in these recommendations? There are three major additions since the sleep safety guidelines were last updated:

• Breastfeeding is now recommended as a strategy for reducing SIDS risk. There are many benefits to breastfeeding, of course. Research has shown that one benefit of breastfeeding is a reduced risk of SIDS, perhaps by as much as 60 percent.
• It’s recommended that all infants be immunized. According to the American Academy of Pediatrics, research has shown that immunization reduces SIDS risk by 50 percent.
• The guidelines also suggest that cribs not contain bumper pads or other types of padding. Parents often think these types of crib padding make their babies safer, but they don’t. In fact, they can increase the risk of suffocation and strangulation.

These new guidelines join a series of recommendations that the Academy makes to parents about how to protect infants and babies from sleep-related injury and death, including SIDS. These include:

• Always place your baby on his or her back for every sleep time.
• Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
• The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).
• Keep soft objects or loose bedding out of the crib. This includes pillows, blankets, and bumper pads.
• Wedges and positioners should not be used.
• Pregnant woman should receive regular prenatal care.
• Don’t smoke during pregnancy or after birth.
• Offer a pacifier at nap time and bedtime.
• Avoid covering the infant’s head or overheating.
• Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.
• Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).

You’ll notice that these guidelines include recommendations for parents and moms-to-be, in terms of pre-natal care and healthy behaviors after baby is born. SIDS occurs more frequently in babies who were born prematurely, or whose mothers received less pre-natal care. The risk of SIDS also increases for babies with moms who smoked during pregnancy, or who live in smoking households. Part of guarding against the risk of SIDS and other sleeping risks begins before your baby is even born.

I’d like to add another one recommendation to the list. Using a fan in your baby’s room can help keep your child’s sleeping environment well ventilated and oxygen rich. This can diminish the amount of carbon dioxide your baby re-breathes during the night. Increased intake of carbon dioxide also poses a greater SIDS risk.

The Academy’s report emphasizes the importance of training in these new, expanded guidelines, for health-care and child-care providers—including hospital maternity staff, midwives, and child-care and social workers. These people are often the most direct link to new parents, and can provide a critical service in helping parents understand how to make smart choices when setting up their child’s sleeping environment.

I know this is a scary topic for parents. But information is power, and understanding the risks and also the ways to lower them is the best tool we have to keep all infants and babies sleeping not just soundly, but safely.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com

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