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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.

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Thursday, April 19, 2007

Neck Pain Due to Fragmented Sleep
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A recent study at John's Hopkins University, published in the Journal Sleep, discovered what many of us have known for years: lack of sleep hurts, literally.

What researchers called "fragmented sleep" (waking their patients up every hour for 7-8 hours) caused lower pain tolerance and more spontaneous pain in normal healthy women than keeping them awake for 36 hours straight.

This is a great case of science finally listening to MOMS, who say that waking up all night with their kids "just hurts!"

What does this mean in the long term? It's hard to say -- but these researchers are asking if poor sleep can be an early signal of chronic pain.

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Posted by: Dr. Breus at 4:37 PM

Tuesday, April 17, 2007

Proof that Parents are Sleep-Deprived
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Here is a study out of Brown Medical School that again seems obvious to me; but at least we now have some science to back it up.

When kids don't sleep, neither do their parents -- specifically their mothers.

Julie Boergers, PhD, studied 107 families seeking treatment for their children aged 2 to 12 at a pediatric sleep disorders clinic, and found a link between children's and parents' sleep problems.

For both parents, having a child with more than one sleep disorder was associated with greater parental daytime sleepiness. Also, mothers of children with sleep disorders had significantly greater daytime sleepiness than fathers, even though they reported about the same number of hours of sleep per night.

Why, you ask, could this be true? Well, for one, mothers may be the ones who get up in the middle of the night with the little ones, at least more so on average.

According to a poll by by the National Sleep Foundation, 53% of parents say they are awakened by their child at least once a week.

I say HAH, I wish I was only up once per week by my kids -- that would actually be heaven! My 5 year old, no problem, but my 3.5 year old is now finally getting to the point of sleeping significantly better.

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Posted by: Dr. Breus at 3:49 PM

Thursday, April 12, 2007

Cheaper Sleep Medications?
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Guess what? The time has actually come for the patent of one of the most widely used sleep medications in the world -- Ambien -- to come to an end. According to a recent article in The Sleep Report:


This year alone, 10 brand-name medications with revenue exceeding $8.1 billion are expected to lose patent exclusivity, including the widely prescribed sleep medication Ambien (zolpidem tartrate).
  • Ambien's US sales exceeded $2 billion last year.

  • Medications to treat sleep disorders are one of the fastest growing categories of drug spending, rising 31.5% in 2005 alone according to Medco Health Solutions Inc, a pharmacy benefit manager.

  • While seniors use the most hypnotics, younger adults showed the greatest increase in use of these drugs.

  • According to Medco's analysis, the number of adults aged 20 to 44 years using sleeping medications increased by 128% between 2000 and 2005.

  • According to pharmacy market analyst IMS Health, a one percent increase in generic utilization nationwide yields almost $4 billion in savings.

So what does this mean for those of you who are taking these valuable medications?

First, you should know that the makers of Ambien have done a great job of reducing the price of their newest medication, Ambien CR, so that it will match or come very close to the price of generic.

Next, I hope to see insurance companies recognizing that the use of these medications can in fact LOWER our healthcare premiums, but I doubt it.



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Posted by: Dr. Breus at 4:14 PM

Tuesday, April 10, 2007

Sleep Spas: The Wave of the Future?
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Move over Canyon Ranch (which actually has had a sleep lab for several years now), and welcome the newest hot trend in sleep diagnostics -- sleep spas.

True, we have seen sleep labs in hotels (an idea that seemed to be a bit before its time). Who could resist the idea of a free USA Today and a continental breakfast after a grueling night hooked up to a computer via 27 electrodes?

The big problem happened when the labs could not stay full, or doctors said to themselves "I just do not like sending my patients to a hotel for a medical service."

But a sleep spa may be a different story. What if the spa was not trying to treat a sleep disorder, but rather, my passion -- disordered sleep?

Here you could have a non-clinical situation, where people with crummy sleep, but not so bad as to qualify for a sleep study, could come, learn about sleep, learn relaxation strategies, and take these ideas home with them after a night of real rest.

I agree there is a market for the sleep spa service. I am not the only one saying this: Millennium Research Group (MRG) found that increased awareness of sleep disorders in the US has sparked one of the hottest spa trends in 2007. These data are discussed in the group's US Market Opportunities for Respiratory and Sleep Management Devices 2007.

So what are we in for, in the future? I think you already know. Not only will we be able to go someplace to be pampered and to relax, but we will also go to learn how to sleep better.

Sweet dreams.

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Posted by: Dr. Breus at 3:07 PM

Friday, April 06, 2007

Men, Sleep, and Libido
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Photo Credit: Gisela Giardino

In a recent issue of the Journal Sleep, there was a fascinating new study, once again showing the importance of sleep in all areas of health. This time it was referring to men's health --specifically testosterone levels.

We have known for a while that men's levels of testosterone vary with age and usually decline. Some men seem to have higher levels of testosterone well into their 80s. High levels of testosterone have been thought to be linked to hair loss, while low levels have been linked to lack of energy and libido. There is now evidence to suggest that these testosterone variations may be linked to sleep.

Researchers found that the amount of sleep that older men in their study got was significantly related to the amount of testosterone in their a.m. blood samples. More sleep lead to higher levels of testosterone.

What does this mean? It is really hard to say.

First, the results may need to be re-confirmed. Next, we would want to look not just at the total minutes of sleep, but also at the actual quality of the sleep these men are getting.

But what is quality sleep? Is it more delta sleep or slow wave sleep (that "wake up and feel great" sleep!)?

Another good question, but I would say that since we know that the elderly have lower wave amplitude (meaning that their brainwaves do not have as much power to the punch as they may have had when younger... but again we do not yet know what this may mean), we would want to see if those with higher testosterone at 80 have not only more minutes, but also higher amplitude.

How can this study have any effect on our real world thinking?

Here is how I see it: the more sleep you get at 80, the less hair you may have, but the more sexual drive is likely to stay with you.

So ask yourself: do you want to be bald and hot to trot, or do you want to have a head full of hair but not be that interested?

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Posted by: Dr. Breus at 2:50 PM

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