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Sleep Disorders

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

Friday, November 20, 2009

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

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

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

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

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

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

Now go sleep. And go play.

Sweet Dreams,

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

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Posted by: Dr. Breus at 6:00 AM

Thursday, November 05, 2009

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

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

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

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

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

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

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


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

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

Sweet Dreams,

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

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Posted by: Dr. Breus at 7:06 AM

Monday, October 19, 2009

Tick-Tock: News about Your Clock
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I love a study that debunks an old theory long believed true. Last week scientists at the University of Michigan came out with a bold statement: everything we know about the human biological clock is wrong.

According to these researchers, who hail from mathematics, the cells responsible for maintaining the clock in the part of the brain called the suprachiasmatic nuclei, or SCN, don't fire all day and night like previously thought. The cells that control the clock are silent during the day. Though these cells sustain an electrically excited state, they don't actually fire until a brief period around dusk, and then remain quiet throughout the night before releasing another burst of activity around dawn. Think of a clock that only chimes twice a day - because the time only needs to be announced at two particular times. The clock keeps ticking during the silent periods, to make sure the time is accurate when it is time for the chimes to sound.

This may not sound like big news for you (or even mean all that much), but it means a lot to people in sleep medicine and in general medicine for that matter. I've written often about biological clocks in the past. It's a fascinating area of research that has so many applications to everyday life. Consider how much your internal clock determines the quality of your life. And if you don't know what I mean by that, then here's a quick summary. All of the following relate to your internal clock:

  • Your sleep/wake cycles.

  • How refreshed you feel in the morning.

  • How easy it is for you to fall asleep at night.

  • Whether you can recover quickly from jet lag.

  • The fate of a shift worker who has to be productive at odd hours.

  • Whether you're a lark or an owl.

  • Your mood and energy level.

  • The strength of your immune system.

  • Your ability to ward off diseases, including cancer and Alzheimer's.


It may seem unfathomable that your body's clock can influence diseases like cancer, but it's true. Think of your clock as your body's central pacemaker - a means by which the body can remain balanced and, in medical speak, in a state of homeostasis.

I expect future studies to validate some of this new information. It's been suggested that there's more than one clock in the body. Perhaps these math gurus should apply their mathematical model to these other clock ideas and see what emerges. Time will tell...tick-tock...

Sweet Dreams,

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

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Posted by: Dr. Breus at 8:15 AM

Tuesday, October 06, 2009

Buying A Mattress: And The Survey Says...
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October's Consumer Reports features a review on something most people find frustrating, and almost everyone asks me about: buying a mattress.

I've written about this chore numerous times, and offered lots of tips to making it as painless and inexpensive as possible (though my jaw still drops at the fact some retailers can sell a mattress for tens of thousands of dollars; as you're about to find out, price doesn't always matter). Unfortunately, many people put off replacing their old, dirty, dust-mite-laden mattress for as long as they can because, well, the thought of shopping for a mattress just doesn't sound like fun. There are other ways we'd rather spend a weekend. And though our backs would disagree, mattresses often don't break beyond use.

Which is why I love to read research and reports like the one Consumer Reports just put together based on more than 17,000 online subscribers who bought a mattress in the past few years and dished about their experience. Here are the highlights:

  • Which brands won out? Tempur-Pedic, Original Mattress Factory brand, and Select Comfort (then Denver Mattress, Simmons, Kingsdown, Serta, and Sealy).

  • Which brands got a so-so response from owners? Spring Air and Stearns & Foster, coming in at 9 and 10 respectively on the list.

  • Does price matter? Not really: 78% of those who spent more than $4,000 said they were highly satisfied with their purchase. But 66%of those who spent less than $1,000 were also highly satisfied. Go figure.

  • Which brands are best for problem sleepers? Tempur-Pedic and Select Comfort.

  • Are test-runs necessary? It appears so, as 72% of those who invested at least 10 minutes (for instance, lying down on each side, back, and stomach) were highly satisfied with their mattress purchase compared with 62%who didn't.

  • Which retailers got high fives? The Original Mattress Factory was noted as the top-ranked seller for both service and selection. Costco was also highly rated, but it got a few dings (with its competitor Sam's Club) for less-than-perfect service and selection.

  • Would they buy the same brand again? Maybe. Less than 50% said they would definitely buy the same brand again. And that number was still less than 60% when reported by buyers of the highest scoring brands.


How's that for an idea of what to look for during your next mattress-buying adventure? The one caveat that even Consumer Reports can't remedy, though, is price. You'll always find a sale somewhere on mattresses, and trying to make sense of the "suggested retail price" among different manufacturers can make your head spin.

So shop with your wallet and your back in mind. Oh, and one more myth to bust that Consumer Reports highlights: The best bed is the one that's most comfortable to you. Older backs don't necessary need firmer beds. There have been no well-controlled studies to indicate the best firmness overall.

A few of my own tips to add to the mix:

  • Take your own pillow with you. Use it when you test drive a mattress

  • Remember to lay on each of the mattresses you try for at least 10 minutes on you back, your side and even your stomach, if you are a stomach sleeper.

  • While you've got that pillow with you, check it out as well. Might be time for an upgrade there, too.


If you fall into heaven when you test out a new mattress that's just shy of $1,000, grab it. On the other hand, if your back seems to only like expensive tastes, well then. Consider it a worthy investment.

Sweet Dreams,

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

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Posted by: Dr. Breus at 3:11 PM

Tuesday, September 22, 2009

The Secret to a Happy Marriage (and Healthy Self): Separate Beds? I Doubt it!
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This topic is always popular: sleeping in separate beds for the sake of getting restful sleep and enjoying your partner even more as a result.

  • Have you ever been awakened by your bed partner? (snoring, thrashing, moving around)
  • Have you ever been the unintentional recipient of a battle by your bed partner in the middle of the night? (hit or punched as your bed partner physically plays out his dream without even knowing it)
  • Have you ever gotten better sleep in your partner's absence?
  • Have you ever slept on a couch because you couldn't get the sleep you needed in the same bed as your partner?
  • Have you ever thought about sleeping in separate beds on a routine basis?

If you answered yes to any of the above, you're not alone (well, maybe you are alone now sleeping soundly in your own bed).

In 2005, the National Sleep Foundation began reporting on this trend in separate sleeping beds. A survey then showed that 23 percent of married Americans sleep alone, an increase from 12 percent in 2001. Glamour magazine also reported on a survey of builders and architects who predict that double master bedrooms will soon be the norm.

Then there's the report by British sleep specialist Dr. Neil Stanley at a recent conference that has lots of people talking on the Internet: married people suffer 50 percent more harmful sleep disturbances if they share a bed. And this does not bode well for the sufferer of poor sleep, as it can cause depression, heart disease, stroke, lung disorders and accidents.

No doubt about that. He could have just summed it all up by saying bed partners are hazardous to your health!

But I think this is a bit one-sided. I am not questioning the validity of his results, but there are some serious advantages to sleeping with a bed partner.

  • In many cases this is the time for intimacy, from cuddling to sex, and it usually occurs in bed. Sure you can have "dates" for this, but how do you say "Honey I love you, thanks and Bye!"
  • Sometimes this is one of the best times for communication. If you have been running around all day, and not had time to "catch up" with your partner, this is usually the best time to do it. Of course large emotional discussions are best out of the bedroom, but just everyday catching up is fine.
  • While I can't put my finger on it, the mere fact that you are physically close to someone, feels like (no pun intended) it has a positive effect on any relationship. Think about what you are saying to someone when you refuse to sleep next to them.
  • There is also one research study from Australia that shows men sleep better when they are sleeping next to someone.

Okay, so the separate bed thing may not be for everyone. But if you have a bad bed partner, and the last time you got a good night's sleep was when you were alone in your bed, then it may be time to look at this situation. Here is what I suggest:

If you are concerned that your bed partner may have a sleep disorder, a visit to a primary care physician and/or sleep specialist is the place to start to rule out potentially serious disorders like sleep apnea, periodic limb movement, or restless leg syndrome, or any other health issue that could be interfering with their (or your) sleep.

  • If it is snoring that bothers your sleep, consider ear plugs, a sound machine, or some type of anti-snoring device.
  • If it is their movement that bothers your sleep, consider a new mattress that reduces motion transfer.
  • If they get up in the middle of the night and disturb you, consider two beds in the same room, or a mattress that reduces motion transfer.
  • If they have a different schedule, consider scheduling changes, eye masks, book lights, etc.

Or, in the very least, opt for a bigger bed. You may be surprised by how well today's mattresses can accommodate two very different sleepers.

Here is what I know to be true above all else:

I have saved more marriages as a sleep specialist than I probably would have as a marital therapist, just by getting people back in bed, sleeping together!

Sweet Dreams.

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

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Posted by: Dr. Breus at 7:11 AM

Friday, September 18, 2009

Beware of Late-Night Eating
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Don't eat after 7 pm.
It's okay to eat late at night so long as you didn't pig out during the day.
Scratch that. It's not about timing, it's about calories.
No, it's about timing and calories!

Confused? I know, the messages tend to get mixed and muddled. So let me set the record straight (for now) based on a recent finding that will have you thinking twice about that late-night snack.

Northwestern University has just come out with a study that shows what a lot of people don't want to hear: eating when the body prefers to be sleeping (ahem, when it's dark outside and most of your neighbors are in bed) can have an impact on weight gain - regardless of your calorie load for the day. Timing your meals, it turns out, plays a much bigger role in your weight equation than previously thought.

This doesn't surprise me in the least. We've known for quite some time how influential the body's internal clock, or circadian rhythm, can be on its physiology. Recent studies have also confirmed that this clock regulates energy use, suggesting the timing of meals may matter in the balance between caloric intake and expenditure. In other words, time a meal badly in relation to your body's clock, and you'll gain weight. Time it perfectly, and your body will use those incoming calories to burn for energy rather than store them as fat.

Without even getting into the scientific details of how this is so, it's easy to imagine how the body would prefer to not have to work so hard when it wants to sleep. The moment you put something in your mouth when the body is trying to slow down and get some rest, it's screaming back at you: What are ya doing? It's time for bed! I don't want to burn these calories now. Let's save them for tomorrow...and put them on the shelf for now (as fat).

So, based on these findings, let me offer some advice short of writing the new diet book:
  • Set a time after which you try not to eat anything prior to bed. Ideally, this time should be at least an hour before hitting the pillow.

  • Choose bedtime snacks intelligently. If you eat dinner on the early side, and need a snack before bedtime, go for something that entails complex carbs and a little protein, such as a piece of toast with a small smearing of a nut butter on top.

  • Avoid fatty foods before bedtime. This is not the time to be chowing down on hot fudge sundaes, triple-cheese pizzas, and the classic burger and fries.


I've always said that getting good sleep is one of the easiest (and cheapest) ways to lose weight. Now there's one more reason hit the hay on a empty stomach.

Sweet Dreams.

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

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Posted by: Dr. Breus at 10:10 AM

Wednesday, September 09, 2009

Moms: A New School Year Can Spell Sleep Relief (or Not)
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"A woman's work is never done" - a phrase that will never go out of style, and its partner - a woman's often low-quality sleep life. At least that's what some are reporting as study after study indicate that all the multitasking in the world can't create more time to rest and enjoy leisure time.

In fact, a study that came out earlier this year in The Economist revealed that, across 18 countries, men had between 4 to 80 minutes more leisure time per day than women.

Now, 4 more minutes isn't all that much. But 80? That's plenty of time for a good long nap, more time in bed, or simply some downtime sitting on the couch.

Many moms are rejoicing at the thought of the kids going back to school. This means:

  • Keeping regular routines and a consistent schedule.
  • Having set bed times and wake times.
  • Not having to provide entertainment or activities for kids as much during long, summer days.
  • No more sleepovers, pool parties, and events way past the kids' bedtime.
  • Knowing you've got teachers and a school helping to care for the best interests of your children.

All of these things bode well for the mom trying to avoid major sleep deprivation. With the start of school, however, also come the occasional late-night homework and school projects. Calls from the nurse to come pick up sick little Suzie and take her home. And keeping up with the school-year's list of household chores like laundry, meal planning, and lunch-making.

Men and women do share more household responsibilities now more than ever, but it's still the women who carry the heaviest load of caretaking, basically acting as CEO of a family. Another recent study out of the University of Cincinnati suggests that the uneven distribution of domestic responsibilities result in stresses that may be driving a trend of lower quality sleep among working women.

Solution? Either the men have to pick up more slack, or the women have to give themselves permission to do less. Which is more realistic? I'll leave that answer to you.

But if I can give these over-tasked and over-tasking women a few tips to consider as this school year kicks off, here's a few with an eye toward better sleep:

  • Knock one item off your "To Do" list a day and aim to be in bed 15 minutes earlier than the previous night.
  • Give yourself a set bed time and wake time, just as you do your kids. You wouldn't let your seven year old stay up past midnight, so why should you?
  • Likewise, you watch what your kids eat before bedtime. What are you eating within an hour of your bed time? If you're in the kitchen plowing through a box of sugary cookies or leftover meatloaf, reconsider.
  • If you read to your kids at bedtime, you're teaching them great habits for sleep hygiene. Reading can help a person to unwind, relax, and prepare for sleep. When's the last time you did something like that before putting yourself to bed?

Welcome to the new school year. May it be filled with fresh wisdom, challenging activities, and lots of sound sleep.

Sweet Dreams,

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

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

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Posted by: Dr. Breus at 11:51 AM

Thursday, September 03, 2009

Off to College - Probably Not Off to Sleep: Part 2
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Ah, there's nothing quite like dorm room living:
  • Tight quarters.
  • Old, rickety furniture and carpeting.
  • A small, hard bed.
  • Thin walls and rowdy neighbors.
  • Late-night hallway parties.
  • Perhaps a humming mini-refrigerator and an annoying roommate with whom you share absolutely nothing in common.

Now, that might not sound so pleasant if you're over the age of, say 30, but for many college students, it's acceptable - a kind of hazing period during the transition from high school to the big school.

But none of this bodes well for sleep hygiene. I don't know any college student who isn't sleep deprived and living on caffeine.

Last week, I dispensed some secrets to settling into college life without losing too much sleep over it. The dorm room deserves special attention. It's where college students will spend a great deal of time mixing attempts to get some shut-eye and a host of other activities-socializing, writing papers, studying, talking on the phone, hanging out, listening to music, and so on. Whether it's your first-born making the move to college or you yourself are about to move on up, heed these dorm room makeover tips:

  • If possible, strategically arrange the bedroom furniture around any incoming light and noise.
    • Face the bed west if possible so that you don't get direct sunlight in the morning.
    • Avoid placing the bed directly across from a window that faces east
      (or you will be rising with the sun).
    • If you can get away from the noise but that puts you in the light, move away from the noise and buy some blackout shades.

  • Consider the use of a room divider or screen. This will give you more privacy and help dampen light (and some noise) coming from your roommate.

  • Decorate the area around the bed differently than the rest of the room. Keep it clutter-free, and try not to snuggle up with your cell phone. Teddy bears are better sleep mates.

  • Splurge on good bedding materials that are comfortable for you:
    • soften up a hard mattress with a featherbed (which is like a big body pillow you rest on top of the mattress),
    • lots of pillows
    • consider a mattress topper, and
    • a plush comforter.

  • Keep high-wattage lights away from the bed. Most dorm rooms are equipped with desks. Keep the high-wattage lights there and install low-wattage lights (45 watts or less) anywhere near the bed.

  • Position your entertainment, television and/or computer area so it's not directly aligned with your line of vision when you're in bed. Again consider the use of covers for the monitor and turning off the CPU itself at night.

  • Bedside sleep savers:
    • Eye shades.
    • Ear plugs.
    • Sound machine to wash out background noise.
    • Reading lamp or book light.
    • Drape clip. If the room is equipped with draperies, try clipping the drapes together at night using a chip clip so there's no light leaking through the crack.
    • Aromatherapy.
    • Watch out for alarm clocks that light up the whole room.

But all that aside, I'll admit that the most challenging task of all awaits: Having that straightforward conversation with your roommate(s) about the rules. What if one of you needs to stay up late finishing a lab report, tapping on a laptop with the lights on? What if your roommate wants to invite the entire floor to party in your room until the wee hours of the morning on the night you've promised yourself to go to bed early? How will you manage living with someone who likes to keep to a totally different sleep schedule than you?

Conversation.

You must have it.

Early and often.

Good luck, my aspiring graduates. Cheers to the new academic year.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™

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

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Posted by: Dr. Breus at 3:55 PM

Friday, August 28, 2009

Off to College - Probably Not Off to Sleep: Part I
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The dog days of summer are fast coming to a close. In the coming weeks, millions of college-bound students will be hitting the books again and adjusting back into university life. For first timers, this is an exciting time period. For veteran upper classmen, it's also a thrilling time to know that you're close to being fully independent and out in the "real" world on your own.

But for both newbies and soon-to-be graduates alike, the one thing that seems to get the best of them every single year is sleep. It's not hard to get that "A" in not enough sleep. Translation: serious deprivation.

Okay, so I'll admit, it comes with the territory. College life is, well, college! A rite of passage, and we all have our top secret stories from then. The two biggest culprits of a sleepless college student:
  • Academics and late-night studying.

  • "Social" studies and late-night partying.

You can't necessarily forgo either of the above on a consistent basis. But your body wants sleep on a consistent basis, which can conflict with the trappings of a successful and fun college life. And, without mom or dad around to nag about bedtime (and, might I add, wake time in order to be in class on time), the transition back to school life with all its demands and nocturnal distractions can be difficult.

So let me offer some realistic solutions that can ease any college student back into the swing of things quickly and restfully:
  • Time management: this is a no-brainer, albeit hard to do well. When homework, the social calendar, and sleep all call for attention, which goes first? How can you maximize all three?

  • Set clear boundaries. Tell yourself you won't party past a certain time; keep to a regular sleep-wake schedule as best you can, even on the weekend. Don't use the 24-hour library. Keep a routine study session daily, say from 4 to 7 at night, and don't let social distractions get in the way that will later have you back in the books past midnight.

  • Turn off your cell phone after a certain hour, say 10 pm.

  • Establish coping skills and stress-reduction practices. College comes with an enormous set of stresses and challenges. Strategies to help balance your stress will have a huge impact in your ability to get things done, and yes, get a good night's sleep.

  • Don't forget to exercise. The freshmen 15 isn't just related to a higher intake of (usually buffet-style) food; most college students forgo regular exercise and sleep - the double whammy for packing on the pounds.

  • Enlist a support buddy to keep you on track. Having someone who can watch out for you and let you know when it's time to re-think your habits can be a lifesaver. And doing the same for them reaps benefits for you.

  • Become a pro napper. Napping can be difficult to pull off out in the corporate world. But there's ample time to nod off in the afternoon library (just don't be caught doing it in class). It's exercise for the brain, after all.

College students get free passes for keeping their computers in their dorm rooms, but watch out for those bright screen savers. Before you put yourself to bed, put your computer to sleep.

In part II, I'll share my ideas for the ultimate dorm room makeover. It's a little different than reconfiguring your bedroom back home. Even in an itty-bitty room the size of a closet or bathroom, you can create a sanctuary for sleep. And yes, even study.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™

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

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Posted by: Dr. Breus at 9:01 AM

Monday, August 24, 2009

Something New in Melatonin?
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You don't have to be a shift worker or jet setter to have awkward or non-existent sleeping habits, but both groups suffer quite a bit. Melatonin, one of the more popular over-the-counter supplements, may be headed toward a new delivery system, a patch placed on the body with small pulses of the hormone administered throughout the evening (or day), through your skin!

I've written about this sleep aid frequently because I get so many questions on it. Many supplement companies and health food stores will claim that melatonin is a natural sleeping aid or nightcap because it "naturally" helps regulate sleep-wake cycles. Given its wide spread availability today, you'd presume it's safe and effective.

Is it?

Well, that depends. Melatonin has been shown to help regulate sleep cycles in certain populations and really help out quite a few people, but like anything there are pros and cons:

  • The precise mechanism of melatonin secretion in the body is not well understood. We do know, however, that melatonin isn't just about sleep-wake cycles. It's been shown to help regulate the female reproductive cycle and may also affect the onset of puberty. Children who take melatonin can suffer a delay in sexual development. (So never ever give a child a melatonin supplement.)

  • This new patch study showed that men and women had different levels of melatonin in their system with the same dosage patch! So a gender difference may apply.

  • Studies have pointed to melatonin's role in regulating blood flow, specifically in constricting coronary arteries.

  • And it's been suggested that melatonin can increase depression in people prone to the illness.

For the record, melatonin is a hormone, and it's not a regulated drug under the FDA. No other hormone is available in the United States without a prescription. In some parts of Europe, melatonin is available by prescription only.

If this experimental patch version of melatonin reaches the market, it could have a much bigger effect on the body than just popping a pill. The half-life of a melatonin pill is short and it doesn't last long; a patch, on the other hand, can deliver small doses throughout its use to keep the levels in the body consistent for a longer, stronger effect. This might be great for shift workers who sleep during the day, when the body does not like to produce melatonin.

The patch has been tested on people who sleep during daylight hours and work at night.. For this reason, I can see why a melatonin patch could be helpful to those who maintain schedules opposite to the usual solar day (where the body prefers to be functional). And I have great respect for those who manage to live this life for the sake of their careers and my safety (e.g., emergency care, pilots, etc.). But, even though the patch would be sold as a prescription, it wouldn't surprise me to see people getting their hands on it without trying other sleep hygiene tactics first, which can be far more effective and healthier overall for the body, particularly for those of us that can really get our shut-eye at night.

Sweet Dreams,

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

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

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Posted by: Dr. Breus at 8:48 AM

Thursday, June 04, 2009

Do You Recognize Me?
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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.

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Posted by: Dr. Breus at 2:26 PM

Wednesday, June 03, 2009

Fido or Tabby Got Your Sleep?
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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.

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Posted by: Dr. Breus at 7:44 AM

Tuesday, May 12, 2009

Short Sleeper: Are You Fooling Yourself?
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There are plenty of stories about famous short sleepers to go around. Among those who claim (or claimed, as some are no longer with us) that they do perfectly well on four hours of sleep are Jay Leno, Madonna, Michelangelo, Napoleon Bonaparte, Florence Nightingale, and Thomas Edison (whose invention - the light bulb - forever changed our sleep habits). Winston Churchill got by on six hours, and Leonardo DaVinci kept one of the most outrageously crazy sleep schedules, sleeping 15 minutes every four hours day and night.

If you're a short sleeper, which is technically defined as someone who gets fewer than 6 hours a night, are you living well off that brief sleep? Are you catching more Zs during the day in the form of a nap? (Which, by the way, is how some of the aforementioned geniuses got by. Churchill took a complete 1.5- to 2-hour nap in the afternoon-and he undressed and got into bed.)

Well, if you think you could use more sleep time, you're probably right. And science continues to reveal what sleep deprivation can do to us (other than make us tired and cranky). The National Sleep Foundation recently released an alert pointing to new evidence: people who average fewer than six hours a night could develop prediabetes. And you know what that leads to: full-fledged diabetes.

Granted, some people actually can do well with fewer than four hours of sleep, and those people are probably genetic anomalies - people programmed to avoid all the risks related to insufficient sleep. For them, four to six hours is sufficient.

But that, unfortunately, is not the case for the vast majority of the rest of us. Just as you don't hear about people who drink, smoke, and eat poorly living to the ripe old age of 100 very often, you don't hear about too many people who live like vampires and escape the ravages of that lifestyle. Those who claim they "get by" on little sleep are likely fooling themselves, but their bodies won't fool them.

So I ask you:
  • How many hours of sleep are you getting on a regular basis?

  • Do you feel refreshed when you wake up?

  • Do you reach for caffeine, an energy drink, or a sugary snack in the afternoon?

  • Are you having trouble losing weight or maintaining your ideal weight?

  • Have you been diagnosed as prediabetic or diabetic but haven't changed your sleep habits?


May those answers inspire a lunch pad for making change. I'll give you wiggle room if you're about to change the world with an incredible invention you've been working on like mad, or if you're ruling the world as a great leader. But if you are... then it's highly unlikely - I'll make that impossible - that you're reading this blog.

Got ya. Now go get some more sleep!

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

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

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Posted by: Dr. Breus at 8:28 AM

Tuesday, April 28, 2009

Take a Caffeinated Shower
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Looking for an extra boost in the shower to wake you up? How about a caffeinated shower?

You read that right. I had to do a double-take myself when I read about this in an airplane magazine. It's called Shower Shock (aptly titled) and the product claims to contain approximately 12 servings (yes, that'd be 12 showers) per 4-ounce bar.

The hilarious part of the sales pitch: 200 milligrams of caffeine per serving, which is the equivalent of two mugs of coffee. According to the product label, caffeine can be absorbed through the skin and for maximum effect, "build up a good Shower Shock lather across your entire body before rinsing!"

Is this a joke? No, I don't think so, at $6.99 per bar. But how true is it? Can you really get a jolt from caffeinated soap?

Not so fast. We've watched caffeine turn up in all kinds of products lately, from water to lip balm, cosmetics and beauty products. I don't blame manufacturers for trying to sell caffeine in whatever they can put it in - after all, it's arguably the world's most popular drug. It will never go out of style. But don't be fooled by gimmicks like this. Some facts to consider:

  • The effectiveness of such products has not been proven, and they are likely to have little stimulatory effect on the central nervous system.


  • Caffeine is not readily absorbed through the skin and even if it could be, soap is probably not the best delivery device.


  • The soap itself is likely to keep much of the caffeine from coming in direct contact with the skin by holding the chemical in suspension.


  • The water and soap will dilute the caffeine, and generally soap is washed off the skin after less than a few minutes, or even seconds.


  • As a comparison, most drugs delivered through the skin (called "transdermal drug delivery") is done with substances with active doses under 1-2 milligrams. Far from the case here with caffeinated soap.


So are there any benefits to this soap?

Well I bet the peppermint oil in the soap will give you a nice little wake up call when it hits your nose and eyes. Perhaps the peppermint oil is adding to the placebo effect of the caffeine.

And let's not forget that caffeine is a strong antioxidant, so assuming you get some of that caffeine into the upper layers of your skin, it can help you ward off those free radicals that contribute to aging. A beauty bar, just as soap should be.

Not, I'm sorry to report, a substitute for your morning cup of Joe.

What will they think of next...

Oh, I guess they already have. How about a caffeine necklace (a necklace with a caffeine molecule pendant)? Or sunflower seeds imbued with the powers of caffeine, taurine, lysine, and ginseng (just like an energy drink)? And just how do they get those ingredients into the seeds? A topic for another day. Let me sleep on that.

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.

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Posted by: Dr. Breus at 6:24 PM

Monday, April 27, 2009

Snoring: A Health Hazard or a Harmless Habit?
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When I tell people that snoring can be a sign of a serious health problem, they typically act surprised because snoring is so common. In other words, how can it be so serious if it's so universal?

Approximately 90 million American adults snore, and of those 37 million snore on a regular basis. It's a problem among all ages and both genders, but it seems to affect men more than women, and it can worsen with age.

Snoring is a turbulence problem. Air rushes down a tube that causes a vibration in the tissue, which causes a cadence and then a snore. This can cause frequent disruptions in a person's sleep (not to mention the other person trying to sleep in the same bed). Snorers generally don't wake up feeling as refreshed as they should.

So, what makes this so dangerous?

It can be a sign of obstructive sleep apnea (OSA), a common sleep disorder I've blogged about several times. People with OSA briefly stop breathing multiple times during the night when the muscles in the back of the throat fail to keep their airway open. This results in fragmented, poor sleep, as well as low blood oxygen levels. OSA has been associated with an increased risk for myriad health problems, including hypertension, heart disease, mood and memory problems.

Not everyone who snores has OSA, but the link between the two is well documented, and research showing the strong association between snoring and cardiovascular problems continues to come out. The good news is treating OSA is pretty simple these days thanks to the Continuous Positive Airway Pressure machine, or CPAP.

This nifty device, which forces the airway to stay open so breathing is possible, is the best we have right now for treating sleep apnea. Sleep becomes much more restful and solid; it also shuts up the snoring that frequently accompanies that apnea. People who sleep with a snorer often rejoice, as data shows that sleeping with a snorer can steal about 1 hour of sleep. CPAP has others ways of saving lives; check out my previous post here.

Is there a way to nix the OSA and the snoring altogether? Yes, but the cure isn't necessarily the easiest to achieve. Of all the risk factors for OSA, weight and physical activity factor heavily in that risk. People who have thick necks are more likely to experience OSA due to the extra fat they have at the back of their throats, which can be an underlying cause to the blocked airway. Studies also have shown that OSA wanes among people who begin exercise programs, regardless of weight loss. Losing weight and boosting exercise both require lifestyle shifts that aren't always easy. The benefits are huge, though, and extend beyond the issue of OSA and snoring. Many people do not know it, but being sleep deprived, like having undiagnosed apnea, can prevent you from losing weight; it's a vicious cycle, as described in my previous blog post on weight loss and sleep loss.

The bottom line is clear: preventing OSA is largely about maintaining a healthier, more active lifestyle. If you do suffer from OSA, treating it with a CPAP will help support sound sleep, which can then foster a healthier, more efficient body. And a more efficient body will shed those extra pounds more easily, as well as energize you in ways you never thought possible before.

I've always said that the bedroom should be saved for sleep and sex only. The time has come to put snoring in its place. It's not a harmless habit. It's a health hazard, and a wake up call to action.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

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


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Posted by: Dr. Breus at 7:00 AM

Thursday, April 23, 2009

Secrets of Sound Sleepers
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Just because I'm a sleep doc doesn't mean I only encounter insomniacs and narcoleptics. Much to the contrary, I meet sound sleepers all the time and love engaging them in conversation. Have they always been good sleepers? What's their "secret"?

Well, sorry, but there isn't just one secret. But a pattern emerges when you begin to collect such words of wisdom:
  • I set clear boundaries, like never working past 7 pm and I don't bring work to bed with me.
  • I read to my kids and it helps me wind down.
  • I don't have a television or computer in my room.
  • I drink a warm cup of tea about an hour before bedtime.
  • I practice some deep breathing once I tuck myself in.
  • I have the coziest bed in the world!
  • I don't see midnight anymore. I'm pretty good about bedtimes.
  • I avoid coffee in the afternoons and switch to tea if I need a boost.
  • If we eat late, I make my husband do the dishes and clean the kitchen so I can relax.
  • Sex. We do it just before bed and I drift off quite easily.
  • As long as I exercise, I sleep great.

And my personal favorites:
  • I love sleep! I don't fear it like some people. It's my micro-vacation every day.
  • What do you mean? I work so hard all day long that there's nothing left in me BUT sleep by the time I crawl into bed!

Do you see the pattern?

They all practice good sleep hygiene (maybe not the person in the last comment, thought there's something to be said for physically tiring yourself out during the day and having no problem transitioning at bedtime).

Every one of these secrets is based on preparing for bed throughout the day, and having a positive mindset toward sleep. The person with the coziest bed probably invested in a great mattress and doesn't take her bedroom's setting for granted.

Okay, so you want just one thing to do differently this week and see if it has an impact on your sleep?

How about this: Avoid the Internet within 30 minutes of bedtime.

It should come as no surprise that staring at a computer screen and enthusiastically typing or surfing not only can steal precious time you should be banking in deep sleep, but the actual light emanating from the screen can also disrupt your body's ability to prepare for sleep and literally wind down.

Your taxes should already be done. Finito. So you don't need to be scrambling for last-minute tips. Quit hopping online just to check one more thing, news brief, e-mail, or blog (ahem, okay, except maybe this one).

See how many of the above statements you can make in the coming weeks. It's more about choosing restful sleep than expecting it.

Got some secrets of your own? Send them to me.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

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

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Posted by: Dr. Breus at 1:31 PM

Monday, April 20, 2009

Melatonin: Miracle or Mistake?
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In this day and age, when sleep rhythms can go haywire at the drop of bad news, questions about sleep aids are a hot topic. They are no longer confined to those who are presumed to have oddball sleep cycles, such as jet setters and shift workers.

I get a lot of questions about melatonin in particular, since many supplement companies and health food stores will tout that melatonin is a "natural" sleeping aid. Given the availability of this supplement today, you'd presume it's safe and effective. But is it really?

What's better, taking a melatonin supplement to help you go to sleep on a crazed Monday night or going for a "PM" version of a pain reliever? Melatonin is a hormone your body produces to help it regulate your sleep-wake cycles, but taking additional melatonin in the form of a supplement isn't as good of an idea as you might think.
  • And it's not a regulated drug under the FDA.

  • No other hormone is available in the United States without a prescription.

  • In Europe, melatonin is only available by prescription.


So here's the 411 on how natural melatonin-the kind produced by your body-works. When the sun sets and darkness sweeps over, a pea-sized structure located deep between the hemispheres of your brain called the pineal gland begins to secrete this hormone-preparing you for bed.

Pineal-gland


As melatonin levels in the blood rise, you begin to feel less alert and sleep becomes more inviting. Melatonin levels stay elevated for about 12 hours, falling back to low daytime levels by about 9 a.m. Daytime levels of melatonin are barely detectable.

The precise mechanism of melatonin secretion is not well-known. We do know, however, that melatonin isn't just about sleep-wake cycles. It's been shown to:
  • Help regulate the female reproductive cycle and may also control the onset of puberty.

  • Children who take melatonin can suffer a delay in sexual development. (So never ever give a child a melatonin supplement.)

  • Studies have pointed to melatonin's role in regulating blood flow, specifically in constricting coronary arteries.

  • It's been suggested that it can increase depression in people prone to the illness.

A hormone with all of these possible effects - even though it's "natural" - isn't something you should be taking without the specific recommendation of your doctor.

Most commercial products are offered at dosages that cause melatonin levels in the blood to rise to much higher levels than are naturally produced in the body. So taking a typical dose (1 to 3 mg) may elevate your blood melatonin levels to 1 to 20 times its normal state. If you take it at the wrong time of day, you may reset your biological clock in an undesirable direction.

How much to take, when to take it, and melatonin's effectiveness, if any, for particular sleep disorders is only beginning to be understood. Remember melatonin is a sleep regulator not a sleep inducer, so it really should not be used as a sleeping pill. In the future, we may find several useful applications of melatonin.

You're better off regulating your own sleep-wake cycles in a genuinely natural way by:
  • exposing yourself to light during the day (preferably sunlight),

  • engaging in physical activity regularly,

  • practicing good sleep hygiene.

Remember: Your body will reset its own internal clock with the proper exposure to light at the right time. (And you shouldn't need a PM formula, either, unless you truly do need an occasional fix for quelling muscle aches or other pains that can prevent you from going to sleep easily. Just don't make this a habit every night.)

Bottom line: better sleep hygiene, better time going to sleep. And better moods the next day. Melatonin, on its own, is not a sleeping pill.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

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

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Posted by: Dr. Breus at 10:00 PM

Tuesday, April 14, 2009

Foods for Sweet Dreams
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Pop Quiz: Which is the better bedtime snack - an oatmeal raisin cookie with milk or another serving of the pasta with meat sauce you ate at dinner?

Answer: Go for the cookie and milk.

It's common knowledge that caffeine and alcohol can ruin a good night's sleep if consumed too close to bedtime. But what about foods? Which ones will keep you up and which ones will work in sync with your dreams of sleep?

Everything you put into your mouth within the hours of bedtime can have an impact, a fact I've talked about numerous times. Even water that you drink can disrupt your sleep, which is why I advocate avoiding all liquids within 90 minutes of bedtime (with the exception of herbal tea during your prep time to calm you down and get you ready for sleep). Ninety minutes is about how long it takes for your body to process liquids.



Dinner needs to incorporate some protein but be on the complex carbohydrate track. Studies have shown that meals high on the glycemic index are ideal since carbohydrate intake may help induce sleep. This is when the timing of the meal is most important. It's best to schedule your dinner about four hours prior to your self-prescribed bedtime.

Why? This gives you plenty of time to metabolize whatever you've eaten that day. Meals that are high in carbohydrates and low-to-medium in protein will help you relax in the evening and set you up for a good night's sleep. Here are some of my favorite sleep-friendly meals:
  • pasta with Parmesan cheese (you may want to avoid red, tomato-based sauces since the high acidity can increase the likelihood for reflux)

  • scrambled eggs and cheese

  • tofu stir-fry with brown rice

  • hummus with whole wheat pita bread (as a side to any lean protein dish)

  • seafood, pasta, and cottage cheese

  • meats and poultry with veggies (especially broccoli, spinach, and artichokes)

  • tuna salad sandwich

  • chili with beans, not spicy, and with a sweet potato

  • sesame seeds (rich in tryptophan - for regulating sleep) sprinkled on salad with tuna chunks, and whole wheat crackers

You may need to sneak in a snack closer to bedtime (about an hour prior), however, if you experience hunger pangs at night. That snack should be from the complex carbohydrate category, like a piece of whole grain toast with a thin spread of natural peanut butter or slice of cheese on top.

The best bedtime snack is one that has both complex carbohydrates and a little protein, plus some calcium. Calcium helps the brain use the tryptophan to manufacture melatonin. This explains why dairy products, which contain both tryptophan and calcium, are one of the top sleep-inducing foods. And by combining carbohydrate together with a small amount of protein, your brain produces serotonin, which is known as the "calming hormone."

The oatmeal raisin cookie and milk beats the pasta for this reason. The pasta can be too heavy and, if spicy or garlicky, can present further problems once you lie down and suddenly feel bloated and acid reflux coming on. Similarly, eating too much protein without accompanying carbohydrates may keep you awake, since protein-rich foods contain the amino acid tyrosine, which perks up the brain.

The trick to eating the ideal bedtime snack is to stick with foods that are high in carbohydrates and calcium, and medium-to-low in protein... BUT avoid heavy carbs that you're bound to overdo, like pastas and rices. Watch your portions before bedtime. Some examples:
  • small slice of apple pie and 1 scoop of ice cream (my favorite)

  • whole-grain cereal with skim milk (steer clear of the high-sugar cereals)

  • hazelnuts and tofu

  • oatmeal raisin cookie and a glass of milk

  • peanut butter sandwich, ground sesame seeds

  • fruit and sour cream or cottage cheese

  • whole grain toast topped with 1 small slice of low-fat cheese

  • whole wheat crackers topped with mild cheese

  • a banana with 1 teaspoon of peanut butter

Bedtime snacks should be consumed about an hour before your actual bedtime, and should be within 200 calories - not more. It takes about an hour for the tryptophan in the foods to reach your brain, so don't wait until right before you hop into bed to have your snack.

Warning: If you are lactose intolerant you should use lactose-free products.

Sweet Dreams,

Michael Breus, PhD
The Sleep Doctor

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


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Posted by: Dr. Breus at 2:04 PM

Monday, April 06, 2009

Why Little Kids Need Big Sleep
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Photo Credit: Gareth Saunders
If sleep weren't such a necessity during those tender years, then you wouldn't see babies snoozing most of the day, and you wouldn't have your toddler take afternoon naps so there's a semblance of sanity in the home. We all need sleep as much as we need water and food, but how much is enough? What's the difference between the needs of a baby and that of a toddler or nine-year-old? What are the rules of disengagement from the world when it comes to children under 10?

Shifts in Rhythms, Changes in Bedtimes
One of the most profound changes that occurs in a developing human is the shift in biological rhythms. Everyone's body clock or circadian "pacemaker" ticks at a different rate, but as you age your pacemaker will speed up or slow down, thus altering how your body responds to that 24-hour cycle. Babies don't get a rhythm going until about 6 months of age, at which point they establish a rhythm that matches closely with the 24-hour day. This is explains why newborns maintain irregular sleep schedules. But even once they establish a rhythm and have a regular sleep-wake cycle, sleep remains the dominant theme here as they develop and grow. Sleeping a total of 10.5 to 18 hours around the clock with periods of one to three hours of wakefulness, a newborn's cycle is primarily based on the need to be fed, changed, and nurtured. A lot is going on developmentally and at the cellular level, for which sleep is the ideal environment.

By six months of age, many infants don't need to be fed during the night; 70 to 80 percent will sleep through the night by nine months of age. Infants typically sleep 9 to 12 hours a night and take 30 minute to two-hour naps, one to four times daily. Naps become fewer as they reach their first birthday.

By the age of two, most children have spent more time asleep than awake. A child will spend about 40 percent of his or her childhood asleep. Why? Because it's critical for their development both mentally and physically.

Trouble Beings During Toddler and Preschool Years
Virtually everyone has witnessed the tantrums of toddlerhood. It is during this stage in life when trouble can set in to the achievement of high-quality sleep, which is why napping should be carefully planned so it doesn't occur too close to bedtime. In general, toddlers need about 12 to 14 hours of sleep in a 24-hour period. By the time they are 18 months old, toddlers nap only once a day for about one to three hours.

As many parents can attest, toddlers' rapidly growing sense of independence coupled with their expanding motor, cognitive, and social skills can make for difficult bedtimes. They may not want to go to bed when they are supposed to, and can also show signs of separation anxiety from mom and dad. Nightmares can also become a common experience, intruding on a toddler's sleep. It helps to remember that a child's imagination is also springing into action at this age, which can further complicate restful sleep. Toddlers who are unusually sleepy and cranky during the day may not be getting enough sleep.

Photo Credit: katrinket
Those between the ages of 3 and 5 typically sleep 11 to 13 hours nightly, and most don't nap after five years of age. As with toddlers, difficulty falling asleep and waking up during the night are common. With further development of their imagination, preschoolers commonly experience nightmares and a general fear of the night. Sleepwalking and sleep terrors peak during these years.

There's nothing more frustrating for a parent than a sleep-deprived child-at any age. Bedtimes are important, and not just for kids. As parents, we need to set examples and be open with our kids about the value of sleep. To that end, here are a few pointers:
  • Make sufficient sleep a family priority. It's important for the health of all family members.

  • As parents, you need to determine the amount of sleep each family member needs, especially if you have a household with mixed ages, and take steps to ensure individual needs are met.

  • Establish regular bedtime routines, creating a quiet and comfortable bedroom. Help your toddlers prepare for bed by making sure they disengage from stimulating activities at least 30 minutes prior to bedtime. Reading, for example, is much more relaxing and sleep-inducing than watching TV.

  • Learn to recognize sleep problems. The most common sleep problems in children include difficulty falling asleep, nighttime awakenings, snoring, stalling and resisting going to bed, having trouble breathing, and loud or heavy breathing while sleeping. These sleep problems can be evident in daytime behavior such as being overtired, sleepy or cranky.

  • Talk to your child's doctor about sleep - even if your doctor doesn't breach the topic.

Remember: little kids need big sleep. It's during these critical years that they are rapidly developing physically, socially, and psychologically. Sleep plays a huge role in this development and will continue to do so as they get older and learn new things. If they can enter their preteen and teenager years "well-rested," they will be all the more prepared and ready for whatever life brings. Which is sure to get more challenging.

Sweet Dreams,

Michael Breus, PhD
The Sleep Doctor

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Posted by: Dr. Breus at 6:00 AM

Monday, March 16, 2009

What's in a Dream?
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Apparently, a lot. An intriguing article posted online summarizes studies exploring how much people value - and heed - their dreams. In short, most of us put a lot of significance on our dreams and believe they speak the truth to us.

What do you think? Ask yourself...

Let's say you're about to embark on a plane trip and the night before you take off, you have a vivid dream that has you in a terrible plane crash. You wake up the next morning to learn that security has been "heightened" at airports. Which bothers you more: the heightened terror alert or the dream (ahem, nightmare) of you crashing to earth from thousands of feet in the sky?

If you're like most people who answered a similar question, the dream bothered you mightily and now you don't want to walk onto that plane. The anxiety you feel is chiefly from the dream, as if it were a warning.

Dreams are indeed wondrous events (minus the occasional nightmare), and we don't have a full understanding of them yet. Most of us remember our dreams on a regular basis, especially during times of acute stress or psychological mayhem. There's been a surge in the study of dreams lately, fueled by an increased interest in understanding them as meaningful representations of our deepest concerns and emotions.

So when do dreams happen, and why do they seem to be tied to our feelings?

I get these questions a lot, and I start by explaining that the most memorable and emotionally powerful dreams happen during the REM (rapid-eye movement) phase of sleep, which is the stage of sleep when our brains are most similar to a wakeful state.

It is during REM that the hippocampus and amygdala, two organs in our heads responsible for memory and emotions respectively, and areas in the frontal and prefrontal lobes near the forehead responsible for attention and coordination, work together in dream production.

If, for example, you have a fear of flying and it's literally on your mind, you're more likely to produce an associated image of that fear, which then emerges during REM as those emotionally-charged areas of the brain become activated.

Exceptionally vivid and memorable dreams occur just before we wake up, but it's possible that we've been dreaming similar themes all night long during the four or five phases of REM that we go through. So even though we recall just what we dreamed about in the last cycle, it could be reflective of the night's cumulative dream content. Like a single television show with one theme interrupted by unrelated commercials, which are the other phases of sleep where we don't dream.

I've heard all kinds of stories from people who claim they work out their emotions in their sleep, or how they've come to rely on dreams as an important "survival strategy." Indeed, I think dreams do serve a role in our survival - otherwise, what would be the point?

This doesn't mean that I believe dreams are to help us avoid plane crashes or catastrophic events. But, I think there's something to be said for taking dreams seriously once in a while when they do touch us in a deeply mysterious way. They are, after all, part of what make us human.



What I'd like to know is whether other animals dream, too. Or is this just a human experience? Ever asked a rat or reptile what he dreamed about last night? Science has yet to find a way to capture the dreams of animals. Maybe that's best left to Mother Nature.

Same goes for future events, however good or bad.

Sweet Dreams,

Michael Breus, PhD
The Sleep Doctor

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

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Posted by: Dr. Breus at 3:04 PM

Friday, March 06, 2009

Headaches and Insomnia Going Hand in Hand
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Headaches come with the territory these days. Any look at the news can give you one of the most common types around: the tension-type. But if you suffer from chronic tension headaches and resort to sleeping them off, you may want to listen up: a new study out of Rush University just emerged showing a behavioral link between these kinds of headaches and insomnia.

In other words, you could be worsening your headaches-and the quality of your sleep - by snoozing them off.

It's no surprise that one of the ways to treat a headache is to lie down and take a nap (assuming, of course, you have the luxury of napping in the middle of your day). But napping can also conflict with your nighttime sleep if it's not planned carefully. It also appears to incite a vicious cycle: 59 percent of those in the study with tension-type headaches complained of sleep problems as a trigger of those headaches.

It's the classic catch-22. Sleep to dull headache. Sleep to trigger headache.

Not fair? Well, there are some solutions to consider.

The first is treating the headache with other means, such as drugs like aspirin or ibuprofen. A little bit of caffeine can help, too (which can be found in headache meds like Excedrin). But the secret is to be mindful of your nighttime sleep schedule and avoid things that can disrupt your normal bedtime.

I've always advocated avoiding naps after 3:00 pm, and the same goes for caffeine, including those caffeine-rich headache medicines.

So what do you do if your head begins to pound in the late afternoon?

The late-day headache can be a monster. Sometimes they are simply the result of:
  • staring too long at the computer

  • losing all sense of good posture and straining your neck, upper back, and shoulders

  • forgetting to have a snack when your blood-sugar dives

  • not realizing you haven't had anything to drink in hours

  • letting the tensions of the day pile up in your head-literally.
For late-day headaches, why don't you try:
  1. Take a 15 minute break from whatever you were doing. Go outside, breathe in some fresh air, and get your circulation going at a faster clip. You'd be amazed by what a little circulation can do.

  2. Have a light snack and drink plenty of water.

  3. Consider a brisk walk.

If you can work the headache out without resorting to pills, naps, or caffeine late in the day, you'll be able to sleep better at night and welcome a better-headache-free-day the next.

Nothing is more frustrating than a headache that won't go away... or chronic insomnia that has you perpetually on edge. The good news is acknowledging the link between the two can kill these two annoying beasts with one stone.

Sweet Dreams,

The Sleep Doctor
Michael Breus, PhD

This article by The Sleep Doctor is also available at Dr. Breus's official blog, The Insomnia Blog.

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Posted by: Dr. Breus at 4:24 PM

Tuesday, March 03, 2009

Make Money in Your Sleep
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Now this is pretty funny. Depending on how you look at it.

Earlier this month Steve Martin appeared on David Letterman talking about his experience with a sleep aid (you can go here to view the actual clip). An avid online poker fan, Mr. Martin found himself playing late one night, going to sleep after taking a sleep aid, and then waking the next morning to find new winnings in his online poker account. He'd gone to bed with $500 in his account and discovered that the same account was worth $1,500 the next day.

He thought there had been a glitch in the system. He thought there had been a mistake. But no, there wasn't a glitch or a mistake. When Mr. Martin called to check with the people behind the online poker game, he was told that he'd in fact won that extra $1,000 while playing between 4 am and 5 am.

Needless to say, Mr. Martin had no recollection of getting up, getting online, and playing poker in the middle of his sleep. The experienced freaked him out enough that he stopped using the sleep aid.

Is this the norm?

Far from it. Sleep aids are some of the most widely prescribed medications in America, and it's rare to have such a bizarre reaction to these drugs. Reports have emerged about strange side-effects like sleepwalking, sleep talking, driving, eating, and performing tasks while supposedly in your sleep. But again, these side-effects are extremely rare.

It's not known whether Steve Martin's mid-sleep poker playing (and win) was related to his taking a sleep aid. But his experience marks the first time someone has come out and blamed a sleep aid on winning money from playing poker during sleep.

This gives new meaning to "making money in your sleep," doesn't it? Good thing he posted winnings that night. What if he'd gone online and unknowingly blown away thousands of dollars? He'd probably call his lawyer.

Sweet Dreams,

The Sleep Doctor
Michael J. Breus, PhD

This article by The Sleep Doctor is also available at Dr. Breus's official blog, The Insomnia Blog.

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Posted by: Dr. Breus at 12:52 PM

Thursday, February 26, 2009

Good News for Coffee Drinkers
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Photo Credit: Colin and Sarah
I frequently get asked if I think drinking coffee is like sleeping with the devil. People are surprised when I tell them no, and that coffee can be a healthy part of life - it doesn't have to mess with your sleep. There are a multitude of benefits that accompany coffee drinking, and now we have one more reason to add to the list: it can cut the risk of stroke in women.

The new study just published shows that four or more cups of coffee a day reduced the risk of stroke by 20 percent in women. (Sorry, but men were not analyzed; this study came from a 24-year examination of nurses with no history of stroke, heart disease, diabetes, or cancer, starting in 1980. My guess is they'd find similar results in men. The risk of stroke is higher in women, however.)

The best news came for those who don't smoke. Among those who either quit or never smoked at all, the risk was reduced by 43 percent. That's incredibly telling. Another blow to smoking. Another reason to kick that habit. But keep drinking your coffee.

So, how do you get your coffee fill without losing sleep over it? Four cups might seem like a lot, but not if you're drinking a regular brew. Some coffees contain more caffeine than others (a cup from Starbucks is like high-octane gas versus the regular stuff you make at home).

The secret is to avoid drinking coffee after 2 PM. It's a challenge if you're used to getting a pick-me-up when those late-afternoon slumps kick in. This is when switching to a less caffeinated beverage like green tea is ideal. Or sneak a 20-minute nap before 3 PM, then have a cup of tea. Just be sure to avoid all sources of caffeine after 3.

Interestingly, the benefits of drinking coffee seem to be limited to coffee. It's not the caffeine that's lowering the risk for stroke. There's something in the components of coffee itself.

That means don't start doubling up on your soda intake. No free passes on that, no matter how much you love a cold can of Coke or Pepsi. I know plenty of people who are addicted to soda and wonder why they don't sleep well at night when they drank it too close to bedtime. Caffeine and sugar make for a powerful "insomnia" punch. If you need the fizz, try sparkling water. You'll probably lose weight, too, as you gain better sleep and nix excess calories. A sure-fire way to reduce your risk for all sorts of health problems.

Sweet Dreams,

The Sleep Doctor
Michael J. Breus, PhD

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

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Posted by: Dr. Breus at 9:00 AM

Wednesday, February 11, 2009

Getting Paid to Sleep... in Public
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Now this is downright bizarre. Imagine being on display in a museum. Correction: Imagine getting paid to sleep for an exhibit...and be on display.

That's what the New Museum of Contemporary Art (hey, you knew it'd have to be contemporary) in Manhattan is offering. This past week the museum sought women ages 18 to 40 to participate in a new exhibit that would have them taking sleeping pills so they can be in bed between noon and 6 p.m. daily for the artist Chu Yun. (Yes, the sleeping pills are doctor-prescribed.)

I wouldn't bother trying to be one of these women at this point. I hear the museum has been inundated with volunteers. Talk about the perfect job for someone who recently got laid off or is so depressed about the state of affairs in the world that she only enjoys the blissfulness of sleep.

I'll admit, I'm not quite sure what the real meaning of seeing a woman sleeping soundly in real life is all about. The exhibit is called "The Generational: Younger Than Jesus" and will feature an installation by the artist, who "creates a human sculpture by inducing sleep."

What happens when these women move during sleep or worse, have weird dreams that have them talking or moaning in their sleep? Can they ruin the exhibit? According to the details I read, the title of the work changes according to the participant's name, from "This is Kate" to "This is Jenny", and so forth. This isn't a first for this exhibit; it was first seen at Frieze Art Fair in London, where the piece featured a different participant each day. Chu Yun's work has been exhibited throughout China and Europe.

I always wished I could camp out in a museum. I think all of us have dreams of sleeping in a forbidden place like that. Nap next to creations of great artists. But to be on display? I guess there's that other dream of pretending to be a mannequin in a store-front window display. But seriously. Sleep in front of the public like that?

Assuming you're truly sound asleep, you wouldn't be able to see what's going on, or hear what people are saying. And what if you start drooling...or an old flame shows up to see the exhibit... or a piece of your clothing comes loose (which brings up another question: what are these women wearing to bed?)

Okay, so that's being a little pessimistic. It's a fun bit of news this week, and it probably is a fascinating exhibit. Oh, and did I mention how much they pay? $10 an hour. That's more than what you get working a hard, laborious shift at a fast food joint.

Please, if any of you go see this exhibit, write to me and tell me what you think.

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

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Posted by: Dr. Breus at 1:19 PM

Thursday, January 22, 2009

More Boost to Immunity
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Cold and flu season is upon us, and the news last week which showed the impact of sleep on immunity was downright fascinating.

Pop quiz: Does it matter whether you get an infection during the night versus during the day?

It appears so. Stanford researchers showed just how much stronger our immune system is at night by infecting flies with two strains of bacteria - but some of those flies were infected during the day. Those that got sick during the night were more likely to survive than those getting sick during the day.

Okay, so we're not fruit flies. But researchers routinely use flies to help make observations and conclusions that can be related to humans. I have no doubt that if we were to test this theory on humans, we'd find similar results. It's long been known that quality sleep boosts immunity (ahem, I wrote about this in my last post). I love another study emerging to confirm this fact. When most of our bodily functions are at rest, our immune systems can amplify.

The Stanford scientists also noticed that circadian rhythms come into play. Flies in the study that had abnormal sleep-wake patterns-even when infected with the bacteria during the night-had a hard time beating the infection. In humans it's the same: if your body clock is off, which can happen when you travel, work odd hours, or have difficulty sleeping to keep your internal clock and natural sleep patterns "on time," you run the risk of lowering your immunity.

I know plenty of people who've suffered from a common cold recently. Hey, it's a part of the winter experience. But it'd be nice to avoid as many as possible, and if we do pick one up, seeing it go away as soon as possible is...well, the goal. Unfortunately, we're not likely to become infected at night (unless our infectious bed partner sneezes on us). We pick up bugs during the day as we come into contact with others and their germs. Knowing we can do something as simple as get restful sleep to help fortify our immune system is pretty cool. No vitamins or Echinacea required. Just pure and simple sleep.

Sweet Dreams,

The Sleep Doctor™
Michael Breus

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

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Posted by: Dr. Breus at 12:00 PM

Wednesday, January 21, 2009

The Scent of Sleep
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If the thought of another holiday cocktail makes your stomach rumble, then seeing this article posted last month won't be appealing. But it offers some intriguing ideas on how to pump up your drinks with immunity-boosting additives like ginger, cloves, juniper and chili powder. (And you probably would have done well with one of these New Year's Eve.)

One cocktail in particular listed is an Absolut Vanilla infused with lavender. Why lavender? Because its scent - yes, its scent, not the ingredients it imparts in your body - has been shown to improve sleep. This in turn helps boost your immunity because your defense system loves restful sleep. Interesting that no one mentioned that the alcohol will have some pretty dramatic effects on your sleep as well (some not so positive!).

We all know that we're more susceptible to getting a cold when we haven't been sleeping well, and there's a scientific reasoning for this. Certain immune cells that modulate the immune system increase during sleep, so missing out on sleep means your resistance to infection drops. Some studies even suggest that those who get six hours or less of sleep have 50 percent less immunity protection than those who get eight hours per night.

Lavender is usually studied as lavender oil (rather than an additive in a cocktail!), and it allegedly has depressant effects on the central nervous system. It's been used for centuries to calm the mind and relax muscles. Subjects in one study a few years ago who were given 3 minutes of aromatherapy with lavender oil reported relaxation, less depression, and increased cognitive skills.

I routinely tell people that if you like the smell of lavender, it can be a great addition to the bedroom as a calming aroma (hence, so many lavender "aromatherapy" products). But I don't recommend using candles because I don't want to be blamed for starting fires. Use sprays, powders, or even fresh flowers (if no one is allergic).

You don't need to mix a cocktail to deliver a sleep-enhancing supplement. Besides, the alcohol opens another can of worms. The lavender's effect, if any, in that drink will be doused by the alcohol for sure... especially if you have another and another and another.

For more information about herbal remedies and sleep strategies, check out my book GOOD NIGHT. It's chock full of insights and a 28-day program to achieve restful sleep once and for all. If your New Year's resolution is about feeling and looking better, this program is for you.

Sweet Dreams,

The Sleep Doctor™
Michael Breus

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

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Posted by: Dr. Breus at 5:00 PM

Tuesday, January 20, 2009

Sleep In, Save Your Heart
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If you're looking for a great cocktail hour topic, try this: an extra hour of sleep can be good for your heart. A new study just reported indicates that an extra hour can lower your risk of developing calcium deposits in your arteries. Yes, calcium is good for you, but not in your arteries. If you get technical with your cocktail friends, remind them that calcium deposits are a precursor of heart disease. Also not a good thing.

This isn't surprising to me. Too little sleep has been linked to several health troubles, from obesity and diabetes, to an increased risk for stroke and high blood pressure. This recent study looked at nearly 500 people between 35 and 47 years old, each one equipped with a special wrist gadget that kept their sleep patterns recorded. The researchers then used computed tomography (CT) scans to evaluate the buildup of calcium inside their heart arteries. They performed one scan at the start of the study and one five years later.

Even after accounting for factors like age, gender, race, education, smoking, and risk for sleep apnea, the scientists discovered that how long a person sleeps may play a significant role in the development of calcium buildup in the arteries. About 12 percent of the people studied developed artery calcification, and among those who slept fewer than five hours a night, 27 percent had developed artery calcification. That percentage dropped to 11 among those who slept five to seven hours, and then to 6 percent among those who slept more than seven hours a night.

Why? We don't know exactly. It could be a combination of reasons or one we haven't identified yet. We do know that people who sleep longer tend to have lower blood pressure, which falls during sleep. Sleep also protects us from too much exposure to the stress hormone cortisol, which also dips during sleep. Chronic exposure to cortisol can trigger lots of unhealthy consequences, one of which is a higher risk for cardiovascular problems.

With all the stress people feel theses days, sleep can be a remedy to cope, and to do good for your heart, which bears so much of that stress. How many of us have felt our hearts beat faster upon hearing bad news lately? Recently I wrote about sleep being one of the best gifts of all this holiday season. I think this new study offers more credence to that suggestion.

And it can be the best gift you give yourself.

Cheers.
Michael Breus, PhD
The Sleep Doctor™

This article on sleep is also available at Dr. Breus' official blog, The Insomnia Blog
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Posted by: Dr. Breus at 10:00 AM

Thursday, January 15, 2009

Oh Canada, Get Some Sleep!
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A recent study I read showed some interesting aspects about the sleep of our friends to the north, and they seem to be as bad as ours here in the US! The study recently published in the journal Sleep explained the economic cost associated with sleep disorders in Canada. Here are the bullets (all in Canadian $):

  • total annual cost of insomnia (direct and indirect) in the province of Quebec was estimated at $6.6 billion

  • prescription medications ($16.5 million)

  • over the-counter products ($1.8 million)

  • alcohol used as a sleep aid ($339.8 million)

  • The total estimated annual cost of alcohol used for promoting sleep was $51.1 million spent by people with insomnia syndrome, $211.2 million by those with symptoms of insomnia and $77.5 million by good sleepers.

What everyone seems to be making a big deal about is the alcohol consumption number. My question is WHY?

Sleep researchers for YEARS have known that the #1 sleep aid in the world is alcohol. If you go back to the 1998 Sleep In America Poll, you find that 10% of all Americans had used alcohol in the past year to "help" with sleep. Another study collected in the Detroit area showed that 13% of those polled used alcohol as a sleep aid.

Let's do some math here. There are approximately 7.5 M people in the Province of Quebec. If we took the percentage of people we know in the US who use alcohol as a sedative (say 10%) and said those 750,000 account for the $340 million spent on alcohol as a sleep aid, that equals 453 dollars per person. If you have symptoms of sleep problems 4 nights a week and 50 weeks a year that is about $2.27 per night, or a beer or two.

What is important here is that the number was 20 times more than prescription medication, and 188 times more than OTC products for sleep. And we wonder why pharmaceutical companies keep introducing new insomnia medications?

Don't get me wrong, I am a very large proponent of natural, non-pharmaceutical methods for helping with sleep (cognitive behavior therapy, sleep hygiene, sleep supplements, etc.). But it looks like people are looking for better answers to a better night's sleep, and let me tell you alcohol is not the answer.

Alcohol, in large quantities, while making you sleepy, keeps you out of the deep stages of sleep, makes you dehydrated, and wakes you in the middle of the evening (usually to go to the bathroom). So the moral of the story is a glass of wine with dinner may be fine, but a six pack is not a good bedtime story.

Sweet Dreams,

The Sleep Doctor

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

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Posted by: Dr. Breus at 9:00 AM

Monday, January 12, 2009

Hope for Jet Setters and Shift Workers
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Nothing is more frustrating than needing to be and feel awake and alert, but you just can't for whatever reason. Although life is usually very busy for those who have regular 9 to 5 jobs and families to run, it's quite different for people whose jobs have them covering odd shifts or traversing the country through different time zones and long journeys (ahem, business travelers).

I admire the people who can continue to live "like that" - working when most of the world is sleeping or working mostly from the road or an airport. It's very difficult not only to sleep well (and regularly), but also to eat well and find a routine that jibes with your family life, too.

And there are more people who fall under this category than you might think: According to U.S. labor statistics, about 20 percent of the workforce or about 19.7 million U.S. workers are early risers who begin work between 2:30 a.m. and 7 a.m.m.

That kind of timing can throw any body rhythm out of whack--a rhythm that's essential to feeling sleepy or awake at the right time. Let's not forget about others like traveling athletic teams, tourists, and experts in their field who are called to speak, consult, and interview across the country. Back when I was rigorously promoting my book, my schedule fit the bill! I'm thankful I don't have to do that 365 days a year, so I'm sympathetic to those who do.

Which is why I was happy to read about a new study that offers hope for the lagging jet-setters and people dedicated to irregular job hours. Turns out that an insomnia drug that helps the body produce more melatonin, the sleep hormone that starts pumping when night falls to signal your body that it's time to go to sleep, may improve Zs for jet-lagged travelers and shift workers. The drug is called tasimelteon, or VEC-162, and it's just been shown to help people sleep longer and more deeply than a placebo.

So why not just take melatonin as a supplement instead? Given the availability of this supplement today, you'd presume it's safe and effective.

It's true that melatonin is a hormone your body produces to help it regulate your sleep-wake cycles, but taking additional melatonin in the form of a supplement can be difficult. It's not a regulated drug under the FDA, so without knowing your source, it could be trouble.

Having to take a drug at all to maximize sleep quality isn't ideal, but in many cases it's better than the alternative. If only the entire world could keep operating if everyone slept at night and work and played during the day. Maybe the cavemen - who didn't live in a global 24/7 society - really did have it better.

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

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Posted by: Dr. Breus at 8:30 AM

Thursday, January 08, 2009

The (Un)Lucky Snorers Burn More Calories
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If you knew that snoring allows you to burn hundreds of more calories a night than a non-snorer, would you like to find a way to pick up the habit?

I thought so. Well, my guess is some of you who feel desperate to lose weight (especially this time of year) would do just about anything.

The news just came out about a new study where researchers found that those who had the most fitful sleep characterized by snoring burned around 2,000 calories a day while resting as opposed to the 1,600 burned by sound sleepers. How is this possible? One of the reasons given is that the snoring and/or snoring-related problems may cause changes in the nervous system, thus requiring the body to use up more energy. I'll add that these numbers should be taken lightly. Everyone's metabolism and energy needs are different; the more important conclusion here is the fact snoring seems to up caloric expenditure.

Not that all this is a good thing. (And who really wants to snore or sleep with a snorer?)

Snoring can be a sign of a more serious problem, such as sleep apnea. This disorder can cause a person to temporarily stop breathing while at rest, and has been linked to cardiovascular problems and high blood pressure. I've long been an advocate for sleep as a method of weight loss and weight maintenance (of course in combination with other healthy lifestyle factors), but not because you're likely to burn more calories in episodic snoring sessions throughout the night. Sound sleep allows the body to regulate its appetite, hunger, and general metabolic hormones better. The only silver lining I can find in this study is the fact many snorers are, in fact, overweight or obese, so burning a few extra calories might help them take the weight off...and kick the habit for good.

But no one is going to get fit and trim from snoring alone, so don't let the headlines fool you.

That said, there was another headline this week that caught my attention and that I think is more appropriate. Kevin Braun wrote an article for The Atlanta Journal-Constitution about the perfect gift: sleep. Mr. Braun had a sleep study performed on him a year and a half ago at the urging of his (sleep-deprived) wife. He learned he had sleep apnea, and treated his problem with a CPAP (Continuous Positive Airway Pressure) machine, which pushes air through his airway passage at a pressure set to prevent apnea. He calls it the gift that keeps on giving...good night sleeps.

Bottom line: if you're a snorer or know someone who is, don't rejoice. Ask for or give the perfect gift by seeking help in understanding the root cause of your snoring. Then you'll really have reason to rejoice.

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

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Posted by: Dr. Breus at 12:00 PM

Monday, December 22, 2008

Get Moving, Get Sleeping
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I love hearing news that confirms lessons I've already given in my presentations, conversations with patients, and published works. Just recently, another study came out that points to the value exercise has in upping the quality of sleep.

I'm not the first person to tell you that exercise is good for you. But if there's one magic bullet for enhancing the quality of your life - from increasing your overall health to fighting the onset of age-related disease and elevating your mood and sense of well-being - it's exercise. And it can also have a positive impact on your sleep.

When you think about it, most people who complain of sleep problems lead sedentary lives and don't practice a regular exercise routine. Aerobic exercise has shown to aid in sleep primarily by doing two things:
  1. helping you fall asleep quicker; and

  2. plunging you into deep (or delta) sleep for a longer period of time, which is where you need to be to feel refreshed and restored the next day.

Studies on people who participate in aerobic activities show that they have a tendency to secrete more growth hormone at night, which aids in repairing and rejuvenating the body.

The recent study out of Stanford lends more credence to the exercise-sleep connection. Participants in a 12-month study who engaged in a "moderate-intensity exercise program" reported improvements in their sleep. They were able to fall into Stage 2 sleep more quickly and stay there longer, experience fewer awakenings in the night, and feel more rested the next day.

The control group, which didn't have to exercise but instead just got a dose of (likely bland) "health education," didn't report such benefits.

I know personally and from anecdotal evidence from thousands of patients I've treated that exercise boosts sleep. And don't even ask me when the ideal time of day to schedule exercise for a good night's sleep is, because the best answer to that is whenever you can. We have enough to do in a day and too often exercise gets thrown out the window. Following are some tips from my recent book, How the Get the Most Out of Exercise's Benefits:
  • Get a physical and discuss your goals to get fit with your doctor, ruling out any medical issues you need to address in pursuit of establishing an exercise program.

  • Experiment with exercise at different times of the day: first find a convenient time and then worry about whether it disrupts your sleep or not.

  • Include cardio training, strength training, and stretching for flexibility.

  • Be sure to get your heart rate up for at least 20 to 30 minutes most days of the week.

  • Build your fitness level slowly; don't jump into a strenuous fitness routine too quickly.

  • Exercise in bright outdoor light if possible.
If you haven't thought about New Year's Resolutions yet, consider this: if you vow to get more exercise into your life, you'll probably simultaneously sleep better, too. Now that's killing two Resolution birds with one stone.

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

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Posted by: Dr. Breus at 7:00 AM

Monday, December 15, 2008

Gobble Up Your Zs this Holiday Season
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The food comas that will descend on many of us over the holidays may not actually come from the turkey, ham or other holiday meal. You'd have to eat about 40 pounds of the big bird on an empty stomach to get enough of that tryptophan enzyme to make you drowsy, and it does not work well in the presence of protein, so even if you did, that is not what is making you tired.

What will make you want to nod off, though, is the over-filling of fat-laden and sugary foods, the lackadaisical nature of endless TV watching - football, parades, movie marathons, you name it - and staying up late to hang with friends and family. Really late. Maybe with booze and board games. Or maybe just over coffee and another slice of pie a la mode with a sibling at the kitchen counter.

Least on everyone's list is exercise, which of course will help counter all those calories and the stress that holidays can sometimes bring.

I give you all permission to sleep as much as you like. If you've been working like a mad dog and feel like you haven't had a good night's sleep in a long while, then I hope you do put time on a bed or cozy couch at the top of your list. Just be careful not to let all the brouhahas of the holidays (like family dramas and late-nights) steal your Zs.

And here's something else to keep in mind that intrigued me this morning: I just read about a new study pointing to the duality of exercise and sleep on reducing our risk for cancer. Even though the study looked only at women and the risk for colon and breast cancer specifically, I think it's good advice for anyone to consider.

With more studies, we may find out that exercise alone isn't enough to lower cancer risks. Much of the cancer-preventive benefit that may follow doing more physical activity could be undermined by lack of sufficient sleep. So we need to sleep well, too. Repeatedly (not just on holidays and vacations).

Cheers to good nights and active days long before those New Year's resolutions roll around.

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

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Posted by: Dr. Breus at 4:00 PM

Monday, November 24, 2008

Good News for People with Insomnia
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It's one o'clock in the morning and you're exhausted. The alarm will herald a new day in fewer than five hours and you're staring into the dark room (maybe listening to your spouse sleeping soundly). You can't fall sleep. You've done everything you're supposed to do in order to enter dreamland easily, such as relax before bedtime, cast away negative thoughts, and avoid work, caffeine, and stimulating activities like being on the computer. But now you're at your wit's end trying to figure out the problem. Why can't you fall asleep?

Well, insomnia just had a brighter light shined on it.

A new study in the journal Sleep reports that some people have abnormal brain activities that keep them hyperalert. The specific culprit is a neurochemical called GABA (for you science geeks, that's short for gamma-aminobutyric acid), which is reduced by nearly 30 percent in people who have been suffering from insomnia for more than six months.

Mind you, we're talking about primary insomnia, which, as opposed to secondary, means that you're having sleep problems that are not directly associated with any other health condition or problem such as asthma, depression, arthritis, pain, alcohol use, etc. Of the 10 percent of adults who suffer from insomnia, 25 percent of those are considered to have the "primary" variety.

Because this kind of insomnia is also a risk factor for mood and anxiety disorders, the study also raises the possibility that sleep habits could be a factor in people with these health issues and who have GABA deficiencies. It doesn't take a genius to link sleep habits to problems with chronic blue moods and feelings of intense anxiety. The current craziness going on between Wall Street and Main Street has me wondering how many more people are walking around with low GABA activity, and low quality sleep.

So where's the good news in all this? Insomnia may have real physiological reasons behind it, and because many of the hypnotic medications that are most effective in treating insomnia do, in fact, increase activity in the brain at the GABA neurons, there's hope for people who fall into this category.

If you're one of them, it still helps to follow the usual recommendations for getting a good night's rest. But when you have tried everything, this gives you one more thing to consider. It could be all in your head - literally.

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

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Posted by: Dr. Breus at 8:01 PM

Tuesday, November 18, 2008

Cutting Risk of SIDS Could Be as Easy as Using a Fan
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I was fascinated to read about the report that came in the October issue of the Archives of Pediatrics and Adolescent Medicine. New research offers another tool parents can use to reduce their chances of SIDS: a fan.

Unfortunately, we don't know what causes SIDS. What we do know is that it seems to happen more frequently in premature and low-birth-weight babies; in babies whose mothers didn't get medical care during their pregnancy; and in babies whose mothers smoke. There also is a pattern of SIDS among babies who shared the womb with siblings (as in twins or triplets) and whose mothers are younger than 20.

SIDS, while rare, is one of the most common causes of death in babies between 1 and 12 months of age. Most babies who die of SIDS are between the ages of 2 and 4 months. Oddly, more boys than girls die of SIDS, and most cases of SIDS occur in the winter.

Conventional wisdom on avoiding SIDS has alerted parents to place babies on their backs rather than their bellies, where they may not breathe well. Side sleeping has also been deemed a no-no, as babies can roll over onto their bellies and have trouble breathing.

You'd think that if a baby were being suffocated by its position, the body would sense the danger and do something to move. But this doesn't happen in our very young, leading researchers to study the possibility that SIDS may be caused by problems with how well the brain controls breathing and/or temperature during the first few months of life.

So, how can something as simple as a fan help? The theory works like this: babies who re-breathe carbon dioxide (presumably from their own exhalations) are at a higher risk for SIDS. If the pooling of carbon dioxide around an infant's nose and mouth during sleep increases the risk, anything to move that gas away cuts that risk. Hence the benefits of having a fan nearby to circulate air. This can be especially helpful in warm rooms with no windows.

SIDS, like so many other illnesses, may never have a "cure." The best we can do is learn how to reduce its risk and take those precautions every single day. Adding a fan to your baby's room is an inexpensive and easy thing to do.

This sleep article is cross-posted at Dr. Breus' official blog, The Insomnia Blog.

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Posted by: Dr. Breus at 3:07 PM

Tuesday, November 04, 2008

Don't Take the Election TOO Seriously
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Highly emotional moments can be stressful... and deadly. I think we all know someone who has been taking the election so seriously that thoughts of their party losing has them contemplating a move to another country.

But too much can be, well, too much. Take Terence Tolbert as an example. Working tirelessly for Obama as his campaign director in Nevada, he died of a massive heart attack Sunday night while driving alone near the offices in North Las Vegas. He was a young 44.

While I cannot speculate that the campaign had anything to do with his death--for all we know he could have had a congenital defect in his heart or some such and would have died even under the least stressful situations--I think it's fair to point out that when someone young dies suddenly under a very stressful job situation or environment, you have to wonder.

Within days before E-Day (the actual election), McCain and Obama crisscrossed the country with very little sleep to capture last-minute votes. McCain even held a rally in his home state long after midnight. What does that do to a septuagenarian? Obama was caught yesterday giving a talk in Florida thinking he was in Ohio. The sleep deprivation is definitely taking its toll and spotting his memory.

We were all blessed (except for the candidates, no doubt) with an extra hour of sleep the other night, and it could have meant more than you think it did. The end of daylight savings could not have come at a better time this year, as a new study shows the impact that one extra hour can actually have on you.

And you can thank the Swedes for finding this: the extra hour of sleep we gain from turning back the clock may protect us from a heart attack. We've long known that Mondays tend to be "heart attack days." Because they are usually considered the worst day of the week for many, there's a pattern of higher heart attacks on Monday morning as people dread the new work week, stressful thoughts rush in, and there's an uptick in activity following the restful weekend.

After poring over 20 years of records, Swedish researchers discovered something else is actually going on. Time shifts negatively affect our biological rhythms, but when those shifts offer more sleep, there's a 5 percent drop in Monday Blues heart attacks. Pretty amazing, don't you think? Yet another example of how sleep really has an impact on our stress level and ability to cope. In the spring, when we "spring forward," there's an increase in heart attacks after that one-hour loss of sleep.

So what's my point here? Well, today is a very stressful, exciting, and activity-filled day for millions of Americans. If there is no clear winner by suppertime, how many will stay up late watching the coverage on television? How many hearts will sink--or race like a rabbit--when their candidate loses or wins?

Take heart: this is an historic election. Experience it in stride. Whatever the outcome, great reform and change is likely on the way. Just don't take is so seriously that it ruins your health. Or you may not be around to watch this next president in action. (And if you've been emotionally involved in this election for the past 18 months, then think about all that accumulated stress. You, more than anyone, need a good night's sleep.)

Vote early. And get to bed early!



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This article about sleep is cross-posted at The Insomnia Blog.

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Posted by: Dr. Breus at 1:50 PM

Thursday, October 30, 2008

Warning: Energy Drinks Steal Sleep and Sanity
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They are no longer targeted to athletes and people looking for a mid-morning or mid-afternoon pick-me-up between meals. Energy drinks reflect a gi-normous market today, as they find their way into everyday life for many Americans, especially young adults and teens. Funny how they first emerged on the scene as "dietary supplements." Now they seem like a revved up version of soda pop, or Coke on crack (to put it lightly).

There's a growing movement to put warning labels on the ones that contain exorbitant amounts of caffeine (yes, more caffeine than coffee in some cases) as researchers publish a new paper on these high-octane beverages. The industry, of course, begs to differ and doesn't want to reveal such information on its products, much less agree to warning labels.

Energy Drinks: No Limits on Caffeine
In the article online that summarized this recent brouhaha, I was surprised to learn that although the FDA limits the caffeine contents of cola-type soft drinks to 71 milligrams per 12 fluid ounces, no such limit is required on energy drinks. And between the lack of information on the label and the lack of regulation, it can be hard to know what's in an "energy" can.

That said, at least the names of some of these drink should be a big hint: Monster, Rockstar, Tab Energy, and the ubiquitous Red Bull. My favorite, though (at least in name) has got to be either Fixx (as in Get Your Fixx) or Wired X505, which contains 505 milligrams of caffeine. That's about twice the amount of a strong Starbucks drip. Are you shaking yet?

How Energy Drinks Affect Your Sleep
It's certainly fair to say that energy drinks can and sometimes do serve a positive purpose in our lives when used appropriately. But they have become so mainstream that I'm afraid people drink them without knowing exactly what's in them and whether those ingredients should be regulated in one's diet. And I'm not just talking about the caffeine. Many of these drinks impart so much sugar that you'd be looking for another fix soon after the first one. What does that mean for a good night's sleep? A lot.

Many people are used to watching their coffee consumption in the later parts of the day if they know it can impinge on their sleep at night. But what about energy drinks? These energy bombs do more than work against sleep; they can cause you to feel anxious, jittery, and wired and tired at the same time. If you're addicted to them, now may be the time to take inventory and cut back.

Some suggestions for cutting back on energy drinks:
  • Instead of waking up to an sugar-laden energy drink, try a cup of plain black tea or a simple cup of Joe.

  • Instead of having another energy drink at lunch, try a glass of unsweetened iced tea or other tea of your choice.

  • Kill the late-afternoon lull with a protein-rich snack that has a little carbs, such as slices of turkey on whole wheat crackers or a scoop of nut butter and celery sticks. If you need a little caffeine buzz, try green tea.

  • Avoid all sources of caffeine after 4 p.m.

All natural energy abounds if you get a good night's sleep. Try it sometime, and see how many fewer cans of soda and energy drinks you need. I bet you won't only gain more restful sleep, but you'll lose weight, too. And who doesn't want that?

This article on sleep is cross-posted at Dr. Breus's official blog, The Insomnia Blog.

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Posted by: Dr. Breus at 3:04 PM

Wednesday, October 15, 2008

Do Your Kids Have High Blood Pressure? Check Their Sleep.
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By now we are all aware that heart disease is the number one killer among men and women in the US. But here's a new twist: how well your children sleep in their teenage years could have an impact on their ability to stave off cardiovascular problems in their adult lives.

A fresh study that I just read about online reveals that sleep-deprived teens, which includes teens who don't get high-quality sleep, could be setting themselves up for heart disease later on. I was surprised to learn that this reflects the first study to look at the links between high blood pressure and sleep quality in healthy adolescents. That's right: healthy adolescents.

So we're not talking about special cases of teens out on the fringes of the bell curve who suffer from things like sleep apnea or other health problems. The researchers were also careful to rule out links explained by socioeconomic status.

Bottom line: if your healthy kid is getting poor sleep, he or she is at risk for elevated blood pressure.


The culprit to teenage sleeplessness? As noted in the study, music players, computers, and phones could be partly to blame, and I agree with that statement. Our kids are bombarded by digital electronics today that keep them up, alert, and online. Gone are the days you'd say goodbye to your classmates at the end of the last class and go home to a quiet, wire-free room to do your homework (if only!). Kids these days write more text messages and e-mail than they do research papers and book reports.

How many hours of sleep is your teen getting? Do you know? On average, they need about 9 hours of sleep, which his very difficult to get these days. Policing your teens sleep habits can be challenging, if not seemingly impossible. May I suggest...
  • Speaking openly with your teen about setting boundaries for using the computer and cell phone late at night for purposes other than homework.

  • Reminding them about the value of sleep. They can avoid the routine frustration of having a hard time getting out of bed in the morning to go to school, much less stay awake in class.

  • Scheduling a check-up for your child early in the school year. Bring up any concerns you have with your kid's doctor - sometimes hearing advice from someone other than you will get your kid to change habits.

  • Practicing what you try to preach. If your sleep habits are terrible, guess what - so will your kids' habits. Establish a healthy sleep hygiene and your kids will notice. Your whole family will benefit.

We often associate high blood pressure with adulthood, but it helps to remind ourselves that our health status throughout our lives can be predicated on the habits we establish as youths. You could be doing your teen more good than you can appreciate now by bearing this in mind. High blood pressure does not discriminate. And neither does getting a restful night's sleep. It's for all of us.

This article is cross-posted at Dr. Breus's official blog, The Insomnia Blog.

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Posted by: Dr. Breus at 12:38 PM

Monday, October 13, 2008

Get Sleep, Get Smart, Get Sane
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It's hard not to comment on the financial doom surrounding us this week like a darkening tunnel, but I want to point something out that's very positive and that can potentially help you to navigate these uncertain times. It's the value sleep can have on your smarts. Yes, you read that right: sleep can make you smarter. And saner.

Unlike a stock that you buy and declines in value (with your sanity), if you buy yourself more sleep you could add value to just about everything that makes you, well, you. And perhaps one of the best payoffs to more sleep is getting smarter. Simple as that. A sharper, wittier mind can make better decisions, manage stress more easily, put things into perspective, and generally make sense of a world that oftentimes seems so crazy and out of balance.

An article I read online yesterday reminds us just how critical sleep is in our ability to maintain our wits. It's no joke that sleep increases our judgment, creativity, and memory. Our bodies may be resting up and repairing before the next day at battle, but our minds are hard at work in the night - performing all the actions that need to get done behind the scenes for us to be able to learn new things, complete difficult tasks, solve challenging problems, and capture profound memories the next day so they don't just dissipate. In fact, memories can have emotions attached to them, which help us keep track of what's safe or not, what brings us joy or pain. Those memories could be critical to our survival, and sleep is what allows us to keep them.

I say all this knowing, though, that sleep is so hard to come by, especially given our current economic climate. You may be watching the news like a hawk and having nightmares about your retirement fund. You could be worried about your job and ability to pay the bills next month. None of this bodes well for a good night's sleep.

This week, I have a 3-piece recipe for you to try; get our your daily agenda or calendar out and mark these down as reminders:
  1. Within EIGHT HOURS of bed (between 2:00 and 3:00 PM for most people): quiet the caffeine and sugar. Stop consuming highly-caffeinated and sugared beverages. What I'm really getting at here is halting coffees and sodas. We tend to drink them mindlessly, then wonder why we're wired and tired, and having a hard time sleeping later on. All that sugar and caffeine will feed your worries and distort your perspective.

  2. Within THREE HOURS of bed: quiet your mind by eliminating all sources of stress and anxiety. This means avoiding certain conversations, work, media (including the Internet), and anything that will bring stressful topics to your eyes and conscious.

  3. Within ONE HOUR of bed: quiet your body by engaging in an activity that is soothing, relaxing, and pleasurable. It could be a warm bath, light reading, light stretching, or even sex. Have a cup of herbal tea if you like.

Keeping the mind nourished and nurtured is much easier that you think. The mind is a terrible thing to waste in sleep deprivation. Remember, get sleep to get smart! It also helps to remember this: stocks are NOT necessary for survival, but sleep is. The more refreshing sleep you get, the saner life seems to become.

This sleep article is cross-posted on Dr. Breus's official blog, The Insomnia Blog.

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Posted by: Dr. Breus at 12:41 PM

Wednesday, October 08, 2008

The News Got You Down? Turn It Off
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The Olympics are over and we are deluged with the old, depressing news again, wrapped around the incessant coverage of the upcoming election. Between the energy and housing crises, between the bickering about global terrorism and war, and between woes about the stock market and the future of health care, it's no wonder most Americans are gloomy. But should we be this gloomy?

There was a fascinating op-ed piece in the Los Angeles Times written by Dan Ariely, a Duke University professor of behavioral economics who commented on the doldrums of consumer confidence today, which is at a 40-year low. The problem we have, according to Ariely, is that we're experiencing "learned helplessness."

This phenomenon happens as a result of chronic exposure to an alarming sequence of market disasters. First we had the tech bubble burst, then came the housing tumble, and now oil prices and the mortgage meltdown keeps people up at night. Add to that all the depressing news circling daily about new and old wars, and threats to our health like tainted food and toxic products. All these events have occurred in quick succession and in some regards, unexpectedly. No one, for example, could have predicted the housing fallout during the boom just a few years ago.

Of all the remarks Ariely makes, I particularly enjoy his pointing out the fact we consume news much differently today than in previous decades. Not only do we seek sensational news rather than that which can help us make sense of the world, but we eat it up 24-7 on our televisions, radios, computers, and even cell phones. He writes, "Even stories about the economy take the shape of gossip about people who are struggling, who have lost their jobs and can't pay for gasoline." How true that is.

Now you're probably wondering what all this has to do with sleep. Well, my friends, how many of us sit up late at night watching re-runs of news we've already seen on TV earlier in the day? Watching television can be relaxing for some, but I'm not sure there's anything sedative about today's news (unless, of course politics really puts you to sleep - then you're in luck!).

I think we would all do well if we were more mindful of when and how we get our news. Unlike the recent Olympics, which were stimulating, warm and friendly, today's news is mostly rousing and disheartening. A bad mix for restful sleep and insightful days.

I challenge anyone who feels down to try this: like caffeine, avoid all news within four hours of bedtime. This includes newsy journals and magazines, too. See if you sleep better. Watch how you feel better.

Top 5 Things to Avoid before Bedtime (within 4 hours)

  • Caffeine (including medications that include caffeine like headache medicine)
  • Arguments and heated conversations (ahem, this includes your kids)
  • Too much alcohol or rich foods that can cause digestive issues
  • Electronic overload, such as computer usage, texting, e-mail, and Internet surfing
  • Stimulating, depressing news or TV shows
This article is cross-posted on Dr. Breus's official blog, The Insomnia Blog.

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Posted by: Dr. Breus at 2:36 PM

Tuesday, May 01, 2007

Sleep, Odor, & Memory
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Jayson Emery
In an article in Forbes.com (3/11/07; you may need an account to read it.), there was a recap of a study published in one of the most prestigious journals known, Science. In the study:

German scientists used medical students as their guinea pigs, having them play a computer version of a common memory game: They turned over pairs of cards to find each one's match. Some played in a rose-scented room. Later that night, while they were in a deep stage of sleep known as slow-wave sleep, researchers gave them another whiff of roses. The next day, the rose-scented sleepers remembered the locations of those cards better than people who didn't get a whiff - they answered correctly 97 percent of the time compared with 86 percent.
In no other sleep stage was there a difference in memory performance.

Interestingly, when asked to do a different type of memory task (numeric and finger-tapping), the subjects' performance was unchanged with any odor in any stage of sleep. The scientists theorized that since there are different types of memory, the numeric memory task must be stored in an area of the brain that is unaffected by smell.

What interests me about this study was that I had learned that we cannot smell in our sleep; at least not consciously, which is why smoke alarms have a loud noise associated with them. However, this study would indicate that there may be an unconscious stimuli for smell in sleep.

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Posted by: Dr. Breus at 9:00 AM

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

Monday, March 19, 2007

Daylight Savings Time
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I just finished a 15-city radio media tour talking about Daylight Savings Time and what we all need to watch out for in terms of how it affects our sleep.

As you all know, we have all "sprung" forward, or lost 1 hour of sleep (Unless you live in one of those states that does not participate in daylight savings, which I do :-)). There can be several consequences of this sleep loss:

  1. Slower thinking and slower reaction time. There are more car accidents in the 2-3 days following Daylight Savings than on any other day of the year.

  2. Moodiness and exhaustion. One hour of sleep loss can cause increased fatigue and irritability.

  3. Tired children. If you are a parent, you should realize that not only are you losing an hour, but so are your children -- and this can have a big effect on their little circadian systems. When my wife and I took our 6 month old to Alaska, it took him about 4 days to get on the right time schedule -- and since he usually woke at 7 a.m., he was waking up at 3-4 a.m., and we were both asleep in our tiny cruise ship cabin -- what a mess!)

So what can you do about this lost hour of sleep?

  1. Go to bed 1/2 hour earlier and sleep 1/2 an hour later. This will help your body begin to adjust.

  2. Go in late to work for a few days. Tell the office your sleep doctor told you to do so.

  3. Watch out for late evening caffeine consumption. Try to move to decaf by 2 pm.

  4. Make your bedroom more sound for sleep. Use aromatherapy to help set the mood for sleep. I like lavender and vanilla -- check out the cool stuff at Bath and Body Works.

  5. Relax. Consider my yoga and meditation recommendations in my book.

  6. Dim the lights. Make sure to have a dimly lit room. Change the bulbs to 45 watts and use a book light when reading -- I like the LightWedge.

  7. Keep out the sun and street lamps. Consider eye shades or blackout curtains that really block out the light.

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Posted by: Dr. Breus at 5:30 PM

Monday, March 12, 2007

Buying Prescription Medication on the Internet
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In my most recent issue of the Sleep Review Newsletter I learned that what I had suspected could happen, has indeed occurred:

"The Food and Drug Administration (FDA) has become aware that a number of Americans who placed orders for specific drug products over the Internet, including Ambien, Xanax, Lexapro, and Ativan, instead received a product that, according to preliminary analysis, contains haloperidol, a powerful anti-psychotic drug.

Several people ended up in the ER with several problems including:
  • difficulty in breathing

  • muscle spasms

  • muscle stiffness
Obviously this is a tremendous problem. The packages were postmarked in Greece and the FDA has posted photographs of the tablets and shipping packages in question.

This is not to say that errors like this occur in all instances. But when buying prescription medications over the internet, it is best to know what they look like, if possible, and to buy them through a site that your health insurance carrier recommends.

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Posted by: Dr. Breus at 11:45 AM

The opinions expressed in the WebMD Blogs are of the author and the author alone. They do not reflect the opinions of WebMD and they have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance or objectivity. WebMD Blogs are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified health provider because of something you have read on WebMD. WebMD does not endorse any specific product, service or treatment. If you think you have a medical emergency, call your doctor or dial 911 immediately.