When a Virtue Becomes a Vice: Football Stars Turned Sleepless Stars

Football season is fast approaching, but all the spotlights will be on the young, active players making headlines. Most of those achy, old players trying to survive retirement with bad knees, backs, shoulders and hips won't get much attention. But they did get a nod this month when the NFL announced it was going to do a better job at taking care of these outdated sports stars.

As a sleep doctor, you could see how the article I read mentioning this news immediately caught me eye: "Aid on the Way for Retired NFL Players with OSA." "OSA" is short for "obstructive sleep apnea," which is a common sleep disorder whereby a person temporarily stops breathing during sleep. Chances of having OSA increase tremendously with weight and even thick necks (picture those meaty linebackers).

The original article detailed how NFL players with physical and mental ailments would soon receive financial help from the league in addressing their issues, which, as you can imagine, will have a lot do with assisting those battered and beat-up players pay for surgeries. Funds will also be set up to help cover heart and cardiovascular screening. I hear there has been a lot of noise lately from former football stars unhappy about how the NFL Players Association has been treating them. In fact, the legendary Mike Ditka of the Chicago Bears allegedly boycotted the recent Hall of Fame ceremony until "they fix the system."

What truly surprised me, though, was reading that screening for sleep apnea would be among the top health concerns addressed. In addition to heart disease and cardiovascular-related problems, sleep apnea has been identified as one of the three major medical issues NFL players face once their careers end.

Of course, this comes as no surprise to me because sleep apnea is much more common in those carrying a wide girth. I don't know many slender, lanky football players. And let's be honest: most retired football stars have a tendency to either gain more weight or experience a "conversion" of muscle mass to fat mass.

I feel bad for all those great former football stars who, by virtue of their size, made for great (and entertaining) players. But now that "big" virtue is an even bigger vice. Now they contend with poor sleep, ailing bodies, and did I mention poor sleep? It's all a vicious cycle.

My hope is that with this announcement, more players - including those in other sports - will take heed the warning: size does matter. What's more, OSA can be serious. In 2006, sleep apnea was established as a contributing cause in the death of Reggie White, a Hall of Fame defensive end for the Philadelphia Eagles and Green Bay Packers. He was only 43 years old.

I wonder how many sumo wrestlers, for example, who have notoriously short lives and even more notoriously large bodies, suffer from OSA

Hike!

Related Topics:

• WebMD Video: Diagnosing Sleep Apnea
• Comfortable Way to Treat Sleep Apnea

Technorati Tags: sleep apnea, OSA, NFL, football, health and wellness

The Buzz on Energy Drinks

It was only a matter of time. In the past week I've read two different articles about "energy drinks." One was posted online at WebMD.com and the other was published in the Wall Street Journal on August 22nd, titled "Energy Drinks Under Fire."

I remember when "energy drinks" were all about sugar. But now they are more about sugar, caffeine, and sometimes alcohol (I still don't get how they can market the word "energy" with "alcohol", but your guess is as good as mine). Now there's a call to action from attorneys general who want federal regulators to crack down on the how these drinks are marketed - pointing to misleading advertising on a product that can pose serious health and safety risks.

I'd rather sip a cup of strong Joe to get my buzz (sans the alcohol, thanks), but according to a new review in Consumer Reports, the caffeine and calorie content in many of these drinks are off the charts - especially when you consider that people easily guzzle an entire can or bottle meant for two or three people. One serving can get you 200 mg of caffeine (almost twice the amount found in a regular cup of coffee and nearly 7 times the amount found in a can of Coke). A serving can pack up to 260 calories, much of that in the form of unhealthy sugars that won't satisfy hunger. Which is why we call those kinds of calories "empty." (Low-cal and sugar-free versions are available, but you'll have to endure the artificial-sweetener flavor, and who really knows what those will do to you over time?)

According to Information Resources, a market-research firm, as consumers we spent $744 million on those caffeinated beverages in the past year, a 34 percent increase over the previous year. With names like Rockstar, Full Throttle, Red Bull, Cocaine, and No Fear, it's no wonder they appeal especially to young adults and those who may want to feel like a younger, more "energetic" person.

But how much is too much? On the one hand, drinks with caffeine can offer some benefits. Among them:

• Test subjects dosed with the amount found in a cup of coffee come out ahead on problem-solving tasks.


• By triggering the release of adrenaline to help muscles work harder and longer, caffeine so clearly enhances athletic performance that until 2004 it was considered a controlled substance by the International Olympic Committee.


• Caffeine may reduce the risk of Parkinson's disease by blocking receptors for adenosine, a neurotransmitter that plays a role in motor function. Caffeine also heads off migraines by contracting blood vessels in the brain.


• Coffee, like blueberries and broccoli, contains potent antioxidants. It appears to reduce the risk of colon cancer, gallstones, and liver cancer, among other illnesses.

(For an array of more facts on caffeine, I invite you to go here.)

But with every virtue there is a vice. And with caffeine, the one that sits atop my personal list is its impact on achieving quality sleep. It can take up to two days for the body to get rid of all traces of caffeine, and if you're sensitive to caffeine you may not realize that your poor sleep can be blamed on all the sources of caffeine you encounter during the day - from energy drinks to medication and even chocolate.

Sleep, after all, factors into these same benefits, helping us look and feel younger, organize our memories, and prepare us for problem-solving quickly during the day. Let's not forget that sleep has no calories and rejuvenates our bodies on a cellular level, which can't be said for the energy drink (even though it may come brilliantly packaged to look like a battery).

In fact, sleep burns calories whereas the drink adds calories. So I think the benefits of high-quality sleep outweigh the benefits of caffeine, don't you? Especially when taken in large doses.

Don't get me wrong. I love my coffee but I take caffeine in moderation. I bet that pretty soon those attorneys general will get what they want and we'll be seeing "Warning" signs on some of these concoctions. I wonder what they will say: "May cause dizziness, weight gain, and the jitters?"

Bottom line: an occasional energy drink is fine for most people, but do the math and avoid overindulging. If you want a great alternative to these over-the-top sugary beverages, try a cup of hot or iced tea. The health secrets of tea have long been reported. Cheers.

Related Topics:

• What's the Buzz About Energy Drinks?
• WebMD Video: The Truth About Tea

Technorati Tags: energy drinks, caffeine, sleep, coffee, tea, health and wellness

Having Trouble Sleeping? Are You a Clean Freak, Lyricist, or Just an Old-Fashioned Insomniac?

Anecdotal evidence aside, I'd venture to guess that the number one cause of insomnia is having racing thoughts at bedtime. You know how it goes: You climb into bed exhausted and looking forward to a good night's sleep. Then bam! Some little annoying thought or a minor worry about a To-Do tomorrow rushes into your head and steals the moment. Okay, it steals many moments that add up to a lot of time - hours you should be banking in the pleasures of sound sleep.

I was recently amused by two stories I read online about celebs with serious bedroom issues. One related Kelly Clarkson's experience with lyrics coming to her as she's trying to get to sleep. The first winner of the hit show American Idol, Kelly feels the need to write them down or record them on the spot. So guess what: she doesn't sleep all that much.

The other article revealed Hillary Duff's clean-freakish behaviors that sacrifice more than a few Zs. She needs to have a spotless room before going to bed, and admits she cannot sleep past 7 a.m. Ms. Duff routinely finds herself cleaning up hotel rooms before checking out, because she just can't handle a mess of any kind. And she attributes her addiction to cleaning and getting up early to OCD - obsessive compulsive disorder

What are your issues that translate to poor sleep? You don't have to have OCD to be an insomniac. You can just be an active participant in modern life to have trouble sleeping as you suffer through the daily stresses of running a business and household or juggling work and personal time in a world that likes to keep you up 24/7.

Insomnia is the most common sleep complaint among Americans, affecting about 10 to 15 percent of adults chronically. More than half of adults encounter this demon a few nights a week or more. (So the next time you're tossing and turning, think how many others are doing the same.)

According to an article by The National Academies, insomnia may be cheaper to treat than to ignore. The proof is in the statistics: "Untreated insomnia creates a 'significant economic burden' through missed work and medical expenditures..."

I'm not surprised in the least by this finding. Who doesn't want to slack off at work when you're tired and sleepy? (No wonder sleep is the new sex.) We've seen a plethora of "next generation sleeping pills" emerge on the market lately. No doubt you've seen the ads on television. But get this: Studies have shown that cognitive behavior therapy (CBT), a form of talk therapy that helps you think differently about your sleep, in fact, beats sleeping pills. This proves just how powerful thoughts can be, and that getting restful sleep is more about how you teach your mind to think than using any external trick such as a drug or other sleep aid.

I cover this topic at length in my latest book Good Night. Many people distort their worries at bedtime, over-exaggerating the magnitude of their woes and the urgency with which they need to remedy them. They also have a tendency to think irrationally as their anxieties rush over them in bed and provoke catastrophic thinking. If this describes you, you might find it helpful to create a Worry Journal and write down your thoughts prior to sleep. Write out your 'To-Do' list and be done with it so they won't gnaw on your sleepy time.

Count backwards from 300 by 3's (I know this sounds crazy but it really works!). The reason this is helpful is quite simple: What else do you have to think about but your worries right before bed? During the day other activities will likely distract the majority of your worries, so you don't concentrate on them, which is a good thing! Just don't plan on being a neat freak or Grammy-winning singer right before bed.

Maybe you can find a lullaby in your bed partner's snoring, which is what actress Evan Rachel Wood experiences when she's trying to fall asleep beside rocker Marilyn Manson. She recently told GQ magazine that his nighttime noises have a hypnotic effect on her. Go figure.

Related Topics:

• WebMD Video: Tired and Sleepless
• What's Keeping You Up?

Technorati Tags: insomnia, sleep, Kellly Clarkson, Hillary Duff, health and wellness

Magnetic Slow-Wave Sleep

In a recent article, the work of Dr. Giulio Tononi, a professor of psychiatry at the University of Wisconsin-Madison School of Medicine and Public Health, was discussed, and I found it quite fascinating. Tononi claims to have discovered "how to stimulate brain waves that characterize the deepest stage of sleep."

While we still are not 100% sure what the purpose of slow wave sleep (Stages 3 and 4) is, we do have a few hints: restoration and mood elevation.

Slow wave sleep occupies about 25% of the sleep of a normal healthy volunteer (aged 20-40). However, we know that as we age (40+), the power or amplitude of these waves change. They change so much that it is thought that the elderly have less than 25% slow wave sleep, and in many cases none at all. There is tremendous controversy in this area because no one knows if a smaller slow wave is any different than a larger one.

In their paper published in the scientific journal PNAS, Tononi and colleagues described the use of transcranial magnetic stimulation (TMS) to initiate slow waves in sleeping volunteers. The researchers recorded brain electrical activity with an electroencephalograph (EEG).

According to the researchers a "TMS instrument sends a harmless magnetic signal through the scalp and skull and into the brain, where it activates electrical impulses. In response to each burst of magnetism, the subjects' brains immediately produced slow waves typical of deep sleep" (Tononi says).

In theory, creating slow waves on demand could someday lead to treatments for insomnia, where a magnetically stimulated "power nap" might give the benefit of eight hours sleep in just a few hours.

Before that happens, however, Tononi must go further and prove that artificial slow waves have restorative benefits to the brain. Such an experiment would ask whether sleep with TMS leads to greater brain restoration than an equal amount of sleep without TMS.

Again, I found this quite fascinating, since we are getting closer to basically getting "Sleep on Demand," much like cable TV.

The question however still remains: is it good for you?

Related Topics:

• WebMD Video: Napping on the Job
• WebMD Video: Sleep Cycle Struggles

Technorati Tags: sleep, slow wave sleep, nap, health and wellness

Link Found Between Elderly, Sleep Disturbances and Risk of Suicide

Some alarming research has emerged showing a link between those who don't sleep well and an increased risk of suicide in the older population. The study was done over a ten-year period, showing that people who complain of sleep problems are more likely to die by suicide. And this finding came independent of depression.

While anyone at any age can have trouble sleeping, older adults tend to get less sleep than they need because falling asleep is a challenge. Insomnia affects almost half of adults 60 and older.

High-quality, restful sleep may also be but a dream. There are numerous reasons for this, such as the fact many older people contend with health issues like arthritis and chronic pain, or take medications that disrupt sound sleep.

Unfortunately, it's a vicious cycle. Poor sleep can exacerbate one's health problems while adding a few more to the list.

Sleep-deprived older adults 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. None of these bodes well for one's quality of life.

An older person does not have to accept poor sleep as a result of age. In fact, no one should think that bad sleep and age go hand in hand.There are many options and treatments available that can help get everyone the sleep they need. If you are having problems sleeping, seek advice from your primary care doctor and if the answers are not quite there, ask for a referral to a sleep specialist.

Related Topics:

• WebMD Video: Growing Old Gracefully
• Sleep Disorders: Behavioral Treatments

Technorati Tags: sleep, aging, insomnia, suicide, health and wellness

RLS: More Than a Feeling

I was thrilled to find an article in USA Today summing up studies showing a genetic link to Restless Legs Syndrome (RLS). Remember, RLS is that condition where people get a creepy, crawly sensation in their legs, usually around bedtime when they lie down. When they get up it goes away.

People suffering from this sleep disorder get horrible sleep because the sensation creates an irresistible urge to move the legs. I know that on the surface this may sound like an allergic reaction (i.e., itching) or some type of spasm, but it is very real. You may have noticed ads on TV promoting the drugs that have recently come out to treat RLS. While there are times when I wonder about the pharmaceutical industry in regards to treating a disorder, this is not one of those times.

RLS has been a mystery for quite some time, and the jury is still out on its exact cause. Now that scientists have linked certain genes to RLS, we may be moving toward a better idea about what RLS is and what causes it. Better yet, we now have more reason to call it a true health problem than an imagined one.

But the debate has just begun. As with most studies, results do lead to various interpretations. No one can agree on how prevalent RLS is in the population, and there's a lot more research that needs to be done.

I have to admit, "restless leg syndrome" may not have been my pick for a legitimate label; it's more fit for a sitcom - and ironically the USA Today article mentions how RLS was featured once in a Seinfeld episode. (If you recall, Kramer expresses how disturbed he feels that his girlfriend has "the jimmy legs" and kicks in bed.)

As more and more disorders and conditions become identified in medicine in general, it's good to see the science emerging to help shed light on these often weird and obscure medical conditions. Sleep medicine in particular should benefit enormously with new science. Who knows, maybe RLS will be due a new name when we truly understand it. After all, "syndromes" don't get much appreciation these days.

Related Topics:

• WebMD Video: Restless Legs Syndrome
• Tips for Restless Legs Syndrome Relief

Technorati Tags: restless legs syndrome, RLS, sleep, health and wellness