Caffeine vs Napping

If a 20-minute nap, a cup of joe, and more shuteye at night were in a cage match, who would win for reducing that classic afternoon "dip"? The answer is: (in order of effectiveness)

1. Nap,
2. Caffeine,
3. Then more nighttime sleep.

A new study just released proves the power of a nap over a jolt of caffeine and even more sleep at night. It's actually the first such study to look at all three methods for combating the afternoon lull that's commonly experienced – and which is a very normal physiological response to the body cycling through its natural rhythms during the day.

Just because you feel sleepy at some point in the afternoon doesn't actually mean you're sleep deprived. About eight hours after you wake up, the body's temperature dips a little, triggering that oh-so-annoying drowsiness after lunch and smack dab in the middle of your attempts to focus and get more done in the late afternoon.

Why am I not surprised the nap wins out? For many reasons:

• Naps refresh you at a cellular level that – sorry, Mr. Joe and Soda – caffeine just can't do.
• It's easier to over-sleep than you think. Biologically, the body doesn't necessarily need that extra sleep if you force yourself to sleep more at night. And getting sufficient sleep doesn't mean your body won't go through the dip regardless; it's a natural, physiological phenomenon tied more to your circadian rhythm than to your previous night's sleep and potential sleep debt.
• Caffeine can wear off (especially if you're so used to it) whereas the benefits of a nap may charge your battery for a longer period of time. No one gets a "high tolerance" to napping.

I've long been an advocate for napping. The best kind? A 20-minute snooze within a 30 minute time period (10 extra minutes to get comfortable and into sleep mode). Or try the Nap-a-latte™, which is the dynamic duo.

But here's a big caveat: most people would probably choose caffeine over a nap, and ditch the nap entirely. Downing caffeine can be easier, quicker, and socially more acceptable in many ways. Finding a place to nap in the middle of the workday can be a challenge. And studies have also shown that when deciding between a nap and an "attractive wakeful activity," they choose the activity.

Let's face it, coffeehouses have multiple buzzes going on. People. Internet. Connectivity. Social interaction. Exchanges of ideas. And tasty treats beyond the joes and javas. Naps tend to be solitary and, dare I say, not as sexy.

But for what it's worth, hail to the nap.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor™

This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

Mattress Money Stasher Throws Out a Million!

The story reads like something out of a sitcom or a joke that doesn't have a punchline. Woman stashes life savings to the tune of $1 million in her mattress. Woman throws out the mattress by mistake. After a day goes by, she remembers her major gaffe and frantically searches for her fortune in three different landfills. Finds nothing. One of the managers at a rubbish site suggests a homeless person picked up the mattress and probably has no idea he could give up the park bench and check into the Ritz.

Some of you may have heard of this crazy, true story last week in the news. To my knowledge, the Israeli woman is still fishing for her hidden treasure. (And no one really knows how she amassed such an amount, but she did say she had "traumatic experiences with banks" in the past, which might explain her homemade bank account.)

She may be the first person to stockpile a million bucks in a mattress and manage to mistakenly throw it away, but she won't be the first – or last – person to resort to this old-fashioned way of saving and storing money.

Especially in times like these, as people lose their faith in traditional banks, I bet more and more people are using their mattresses... and home safe boxes, cellars, closets, secret spots, etc. to keep a healthy sum of money should something go terribly wrong with the banking system (despite the government-backed FDIC guarantee up to $250,000 per person.)

And then there is this idea: how about a mattress wallet? You heard that right. A real mattress can be hard to carry around, let alone save in a house fire in the middle of the night with your dollars and cents. I don't think your homeowners insurance company will appreciate you claiming a lot of funds deposited into your now fried mattress. So what about a wallet-sized device that offers these "shrewd features":

• Holds four traditional-sized credit cards.
• Holds dollars, euros, yens, pounds, and I.O.U.s
• Made from high-quality stitching and authentic mattress material (yes, it even looks like a mini-mattress!)
• Doubles as a generous napping aid (up to 5mm of comfortable padding on each side).
• Folds down to just about the same size as a traditional wallet.
• And best of all, it's endorsed by Washington Mutual's CFO (ahem, one of the banks seized by the government and sold off to Chase).

Don't believe me? Then check it out yourself and have a good laugh. You might be able to rest more comfortably on your mattress if you don't have stacks of bills beneath you.

Sweet Dreams,
Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

Sleep on the Government's Agenda

Has someone been falling asleep in Congress?

I was delighted to hear that Florida Congressman Gus Bilirakis has just introduced a sleep apnea awareness resolution to the House of Representatives. The goal is to raise public awareness of this serious condition and encourage all Americans to educate themselves – and others – about the consequences and potential treatments of sleep apnea. Perfect timing given the fact the President is about to focus on health care.

I've been talking about obstructive sleep apnea (OSA) for years trying to raise awareness and help people successfully treat it. Some basic facts about OSA:

• OSA afflicts more than 12 million Americans.
• OSA is characterized by repeated stops and starts of breathing during sleep when throat muscles relax and block the airway.
• Snoring is often a sign of OSA.
• When left untreated OSA can trigger a variety of health problems, from cardiovascular challenges to mood and memory problems.

Don't have OSA? Don't think it affects you? Well, consider the fact that people with OSA experience fragmented sleep, which makes for chronic daytime drowsiness. So imagine all those drowsy drivers sharing the same roads as you. Think about all the long-term health care costs that can be saved by treating OSA patients successfully.

Currently, the CPAP machine is the gold standard for treating OSA. But there's also an association between OSA and weight, as studies have shown that OSA decreases with more physical activity and less weight – a message that the health care industry would do well to support.

Kudos to Congress for not falling asleep at the wheel, so to speak, on this issue. I just wonder, though, how many of our Congressional leaders suffer from OSA? Those long sessions probably can be tiring and tedious, certainly not the place were you want to be caught nodding off. And luckily, this is one issue immune to the politics of partisanship. All of us can benefit, from the floors of Congress to the streets of America.

Sweet Dreams,
Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• Understanding Obstructive Sleep Apnea
• Video: Sleep Apnea – Adam's Story
• Find in-depth information on sleep apnea

The Sounds and Sleeplessness in the ICU (Part II)

Earlier this week I covered a new study that points to the disturbing effects (literally) of noise pollution in intensive care units. The second half of the article discussed several methods to reduce noise and their effectiveness.

Some of the methods examined in the study to reduce such noise included the following:

• Earplugs/earmuffs on patients (self-explanatory)


• Behavioral modifications: Enforcing stricter rules among hospital staff so they are more aware of how much noise they are making. This is the "Tone it down!" strategy, which entails establishing set quiet times during which the ambient light is lowered, alarms are cut down in intensity, and phones, televisions, and radios are turned off.


• Sound masking: The use of white noise machines to neutralize certain noises.


• Acoustic absorption:The use of certain materials like foam to dampen noise levels.

Not surprisingly, all four strategies to lower the noise proved effective. But surprisingly, sound masking beat out the sound-absorbing treatment. That's good news for people who want to take a study like this and apply it to their bedroom setting at home. Far from an ICU, yes, but the two places share much in common.

It helps to think of your own bedroom as sanctuary for recovery much like an ICU. Applying these techniques at home can be equally as effective, if not more so since you're not simultaneously battling serious health challenges (hopefully!). While I don't expect you to install sound absorbers in your walls, the top three ideas are quite practical:

• Earplugs: these are inexpensive and available at most drug stores. I like the foam ones that expand in your ear canal.


• Behavioral modifications: evict the gadgets and machines from you room; if a television is a must, set boundaries so you're not letting it encroach on your bedtime turf. Have a "lights-off" time set (and don't fall asleep with the TV still on! – there are TV timers on most TVs today.)


• Sound masking: white noise machines can be incredibly powerful in axing out any background noise. Many clock-radios have built-in white noise makers, or you can try an oscillating fan. Some find the rhythmic beat of a fan to be very calming and "white-noise"-like.

My hope is that hospitals heed the lessons from studies like this one, and learn how to minimize unnecessary noise to maximize the very purpose those facilities serve – to spur the healing process and foster recuperation. Which is exactly what your bedroom is supposed to do. The ICU is a special place. And so is your bedroom.

Sweet Dreams,
Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• Video: Dr Breus on Insomnia and TV in the Bedroom
• Get the Sleep Well newsletter in your inbox
• Do You Need a Sleep Makeover?

The Sounds and Sleeplessness in the ICU (Part I)

Noise. Whether it's the blare of traffic and the hustling sounds of a city, or just your neighbor's barking dog and lawn mower cutting into your Sunday snooze, noise pollution is something we all have to deal with to some degree. But what about indoor disturbances--in a hospital when you're lying in the Intensive Care Unit?

I know, it's not something we think about much, which is partly why there hasn't been extensive investigations into this arena. But a fresh study out of the U.K. sheds some fascinating light on this subject.

As we all can attest from experience, noises can disturb sleep and make for rude awakenings when your body is trying to cycle through its motions to refresh and rejuvenate itself. But for people under compromised health conditions and enduring recoveries in ICUs, noises and their resulting sleep interruptions can be especially problematic. And most aren't in a position to complain or tell people in the room to tone it down.

Most case studies show that the noise levels in hospitals are much higher than established guidelines, and the very nature of ICUs in particular make for off-the-charts excessive noise levels. How does this all affect a sleeping patient? Significantly. Here are just a few consequences highlighted by the recent study:

• Deeper delirium: – the state of mind typical of those suffering through a trauma or fever and who experience restlessness, illusions, and incoherent thoughts and speech. No doubt any drugs a patient will be on can make this state worse, but so can poor sleep brought on by something as simple as too much ambient noise. Delirium not only increases a person's length of stay in a hospital, but also the severity of their condition.


• Irregular circadian rhythms: ICU patients don't usually keep their normal sleep-wake patterns. Their physical condition can have them sleeping on and off during the day and night. Add to that intermittent loud noise and you've got a recipe for more erratic sleep patterns.


• Post-traumatic stress disorder: Not all patients experience post-traumatic stress disorder after a stay in the ICU, but for those who don't get the sleep they need to recover quickly and stave off episodes of delusional memories, the risk for post-traumatic stress disorder rises considerably.


• Lowered immune function: Just two days of sleep deprivation has been shown to impair the immune system. So imagine what this means for patients in need of their immune system the most at times like these.


• Cardiovascular and respiratory effects: Studies have shown how noises can lower the function of these critical systems, causing a speed-up of the heart and negatively dampening respiratory performance.

Being in the ICU is hard enough to endure. Throw in sleeplessness caused by noise pollution and just about everything worsens. Sleep is essential in the recovery from illness or injury. Of all the places that should shelter sleep, the ICU has to be close to the top of the list.

So what can we do about all this? I'll get to that in my next post, when I cover the study's examination of noise-reduction techniques in Part II. Do they work? And can you try them in your home?

Sweet Dreams,
Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• Video: Family-Friendly ICUs
• Get the Sleep Well newsletter in your inbox
• Sleep Disorders: Member Discussion

Do You Recognize Me?

The Power of Sleep in Identifying a Face

We've all experienced it. You see a face and think, "Where do I now that person from? He looks so familiar!" Sometimes, a few more minutes of pondering or resorting to some awkward inquiry can result in an answer. Other times, you're not so lucky and you never figure it out. Can your sleep be at all related to this scenario?

A new study just released suggests that yes, our ability to remember faces is linked to how long we are awake.

Specifically, when you are awake for lengthy periods of time - 12 hours or more - your capacity to retain the new information of a fresh face is impaired. The study didn't find that sleep helps long-term consolidation of that memory, but I would venture to guess that future studies may confirm that sleep indeed helps us keep our new found friends and neighbors at our mental fingertips. It's well-documented that sleep has a profound role in helping us to:

• remember things


• learn new information


• process data efficiently


• consolidate memories (In fact, it's believed that dreams may play a special role in that consolidation, though we don't know exactly how that all works yet.)

I love a good study, and this one is especially unique because it examines an aspect of life so central to human behavior: being able to recognize others. This skill has been the basis for human interactions for millennia, key to not just social interactions but also survival. (Remembering where you put your keys or what time you're supposed to pick up the kids may also be on your survival radar, but those circumstances call for another study. And I bet sleep also would be a factor.)

So the next time you can't conjure a name quickly to match that oh-if-I-can-just-put-my-finger-on-it face, you may want to look no further than your last sleeping session. How long ago was it?

Keep that memory sharp. Keep up the good nights.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article on sleep and memory, and other sleep articles, is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• WebMD Video: How Sleep Affects My Memory
• Sinus, Snoring, Sleep Apnea: Jordan S. Josephson, MD
• Sleep Disorders: Member Discussion
• Get the Sleep Well newsletter in your inbox weekly

Fido or Tabby Got Your Sleep?

If you're still scratching your head wondering why you're not feeling as refreshed as you should in the morning, you may have overlooked a little furry sleep thief: your pet.

I get asked about pets in the bedroom pretty frequently, and it can be a hard to hear that pets in the bedroom can be problematic for sleep. Pets are like family members, and we don't like to exclude them from snuggling with us when they show so much affection and beg to be with us at night. But they can be a major cause of poor and disrupted sleep.

Studies have demonstrated that a reasonable percentage of pet owners who allow their pets in bed have sleep problems. And if you think a cat is harmless, then look no further than a home video of what goes on in night when you think your furry friend acts like a stuffed animal. If only...

For starters, cats are nocturnal by nature. They typically won't snooze with you for 7 or 8 hours straight. They may look harmless when you’re about to drift off, but a cat usually will get up, move around, play, and try to rouse you.

Dogs aren't quite so nocturnal, but because of their size, every time they move or begin to scratch and groom themselves they can wake the soundest sleeper. They can also snore as badly as a human -- ever listen to an Old English Bulldog?

How about a cat or dog bed? If you've already introduced your pet to your own bed, then it's going to be pretty hard to get it to use its own special bed--no matter what the person at the pet store said or how fancy, fluffy, and "pet-friendly" the bed is. Fido and Tabby may turn their noses up at that and be in your bed faster than you can snap your fingers. To this end, let me offer some tips:

• Everyone has a different tolerance level for pets in the bedroom, so both bed partners must agree on who gets to sleep where. If pets don't disturb anyone's sleep, then there's usually no harm.


• Understand that once you allow pets to share your bed, it becomes difficult to curb or stop the habit. To stop the habit, you'll have to endure some heart-wrenching complaints from Fido or Fluffy until they learn that your bedroom is off limits.


• Make sure that your intimacy needs do not suffer from sharing your bed with pets. Remember the bed is for both sleep and sex; do not trade one for the other.


• Have your allergies checked. Over time it's quite easy to develop allergies to pets and not realize it. If you wake with a stuffy nose every day, it could be time to find Fido or Fluffy its own space.


• Review the habits of your beloved pet to make sure they're compatible with yours: a snoring bulldog can be a bigger problem than you might think.

The good news is pets can't hold grudges the way humans can. So even though you may have to practice some tough love for a while, you won't risk losing your best friend.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article about sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• WebMD Video: Pets in the Bed: Is It Bad?
• Sinus, Snoring, Sleep Apnea: Jordan S. Josephson, MD
• Sleep Disorders: Member Discussion
• Get the Sleep Well newsletter in your inbox weekly

Trouble Keeping Up with Your CPAP?

It's widely known in sleep medicine circles that the most common - and helpful - treatment we have these days for patients with Obstructive Sleep Apnea (OSA) is the CPAP machine, short for Continuous Positive Airway Pressure. If you've been diagnosed with OSA, then you know exactly what I mean.

The problem with CPAP therapy is that not a lot of people are good about using it on a routine basis. Or, like trying to start a ambitious exercise program, they are compliant at the start and then slowly drop off. Within a few months, they are rarely found using their CPAP. And sleeping poorly as a result.

But there's hope: new research that just surfaced and was presented last week at a conference in San Diego has revealed that when patients are prescribed just a two-week course of a certain sleep aid (the one marketed as Lunesta), they are more apt to be using their CPAP in six months.

Lunesta is one of the more popular prescribed sleep aids, which can help you to fall asleep and stay asleep by enhancing the activity of a sleep-friendly chemical called gamma-aminobutyric acid (GABA). My guess and experience is that many of the sleep aids in this category would work as well.

So I ask you:

• Do you have OSA?


• Do you have a CPAP collecting dust in your closet or beside table?


• Are you tired of being tired?


• Have you ever heard about apnea and how it can affect your health and relationship?

If you answered yes (and I know there are a lot of you out there) then you may want to take up this conversation with your doctor. Using a sleep aid for a short period of time in conjunction with a CPAP appears to be able to help you set an important pattern in your nightly routine. You'll get used to using the CPAP, and feel the difference a good night's sleep brings.

I know, the CPAP isn't the sexiest of devices, especially for a bedroom. But it can transform an OSA-sufferer's sleep. OSA is associated with some pretty unwanted health consequences - from heart problems to mood and memory problems, and even weight issues. Yet there's no consequence to using a CPAP machine other than better sleep, better health...and a happier bed partner who doesn't have to listen to your episodic breathing (and probably snoring) all night.

It's time to put OSA to bed.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article about Obstructive Sleep Apnea is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• Sleep Apnea Health Center
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• Sleep Disorders: Member Discussion
• Get the Sleep Well newsletter in your inbox weekly