Lack of sleep associated with injuries and illnesses

It is estimated that 50-70 million adults in the Agreed States have chronic sleep difficulties. Scant quality sleep can lead to many form concerns, including chronic disease, limitations in everyday functioning and injury. During National Slumber Awareness Week, March 7th through the 13th, the National Sleep Foundation encourages all Americans to bring steps toward getting adequate be in the arms of sleep each night.

Sleepiness Contributes to Traffic Accidents and Difficulty Performing Everyday Tasks 

The Centers for Ailment Control and Prevention has released two large constitution studies linking sleep impairment to poor as a church-mouse health in the March 4th issue of the Morbidity and Mortality Weekly Narrative (MMWR). In the first analysis, researchers old data from the Behavioral Risk Circumstance Surveillance System (BRFSS) conducted in 2009. During the course of 74,000 adults from 12 states responded to the measurement, with 35.3% stating that they had had less than 7 hours of saw wood on average per night.
The National Sleep Rationale suggests that healthy adults stress at least 7 to 9 hours each night. Approximately 38% of responded reported unintentionally falling asleep during the day at least second during the preceding month. Nearly 5% said they had nodded off or fallen asleep while driving. “Dozy Driving” is responsible for an estimated 1,550 fatalities and 40,000 nonfatal injuries annually in the US, per the CDC.
Compared with employed adults, those unqualified to work were significantly more right to report fewer hours of saw wood. Other groups less right to sleep well were adults with at least some college cultivation; divorced, widowed, or separated adults, buy Ambien without prescription, and persons superannuated less than 65 years. Scant sleep also impacts the capacity of adults to carry out commonplace activities.
A second division, with data from the 2005-2008 Native Health and Nutrition Check-up Survey (NHANES), finds that cut sleep duration and inveterate sleep loss leads to plight concentrating and worsened tribute. Difficulty in performing employed or volunteer sweat and inability to take tribulation of financial affairs was reported by scarcely 10% of all respondents who slept less than 7 hours per Cimmerian dark.

Actually, inadequate sleep is not limited to Americans. Another recent study by the Economic and Social Research Council found that one in eight Brits also suffer from sleep deprivation, getting less than six hours of sleep per night.
Promoting sleep health is a goal of “Healthy People 2020”. The CDC offers the following tips to improve sleep quantity and quality:
• Keep a regular sleep schedule.
• Avoid stimulating activities within 2 hours of bedtime.
• Avoid caffeine, nicotine, and alcohol in the evening.
• Avoid going to bed on a full or empty stomach.
• Sleep in a dark, quite, well-ventilated space with a comfortable temperature.
• See your healthcare provider about health conditions that lead to inadequate sleep such as snoring and restless legs syndrome.

Wake Up America 1 in 5 People Are Sleepy

About 30 percent of U.S. adults reported moderate to excessive sleepiness, with 11 percent of them reporting severe sleepiness, said Maurice Ohayon, a psychiatry professor at Stanford University and director of the Stanford Sleep Epidemiology Research Center.
“The prevalence of excessive daytime sleepiness is very high in the American population, much higher than what we observed in the European population. Insufficient sleep is plaguing the American population and is one of the leading factors for excessive daytime sleepiness,” Ohayon stated.
“The number of individuals sleepy or drowsy during situations where they should be alert is disturbing,” Ohayon said. “Sleepiness is underestimated in its daily life consequences for the general population, for the shift workers and for the people reducing their amount of sleep for any kind of good reasons. It is always a mistake to curtail your sleep.”
Those most likely to suffer excessive sleepiness were people with sleep apnea, a breathing disorder in which the sleeper's soft tissue blocks the upper airway, decreasing or halting airflow multiple times per night.
People with an insomnia diagnosis also suffered from daytime sleepiness as did, those who sleep six hours or less, night workers and those with a major depressive disorder. Women between the ages of 25 and 34 had the highest rate of daytime sleepiness. Ohayon believes that motherhood might play a role in demanding their attention at all hours.
The study consisted of asking 8,937 people aged 18 or over living in Texas, New York and California about sleeping habits, health, sleep problems and mental disorders. The researchers were then able to gather the data for this study, which was funded by a grant from Cephalon, a pharmaceutical company and maker of Nuvugi, a medication that helps people stay awake and alert. The research was supported by the Arrillaga Foundation, the National Institute of Neurological Disorders and Stroke of the National Institutes of Health.

Sleep loss linked to psychiatric disorders

Sleep deprivation and mental health

It has long been assumed that sleep deprivation can play havoc with our emotions.
This is notably apparent in soldiers in combat zones, medical residents and even new parents. Now there's a neurological basis for this theory, according to new research from the University of California, Berkeley, and Harvard Medical School.
In the first neural investigation into what happens to the emotional brain without sleep, results from a brain imaging study suggest that while a good night's rest can regulate your mood and help you cope with the next day's emotional challenges, sleep deprivation does the opposite by excessively boosting the part of the brain most closely connected to depression, anxiety and other psychiatric disorders.
"It's almost as though, without sleep, the brain had reverted back to more primitive patterns of activity, in that it was unable to put emotional experiences into context and produce controlled, appropriate responses," said Matthew Walker, director of UC Berkeley's Sleep and Neuroimaging Laboratory and senior author of the study, which will be published today (Monday, Oct. 22) in the journal Current Biology.
"Emotionally, you're not on a level playing field, "Walker added.
That's because the amygdala, the region of the brain that alerts the body to protect itself in times of danger, goes into overdrive on no sleep, according to the study. This consequently shuts down the prefrontal cortex, which commands logical reasoning, and thus prevents the release of chemicals needed to calm down the fight-or-flight reflex.
If, for example, the amygdala reacts strongly to a violent movie, the prefrontal cortex lets the brain know that the scene is make-believe and to settle down. But instead of connecting to the prefrontal cortex, the brain on no sleep connects to the locus coeruleus, the oldest part of the brain which releases noradrenalin to ward off imminent threats to survival, posing a volatile mix, according to the study.
The study's findings lay the groundwork for further investigation into the relationship between sleep and psychiatric illnesses. Clinical evidence has shown that some form of sleep disruption is present in almost all psychiatric disorders.
"This is the first set of experiments that demonstrate that even healthy people's brains mimic certain pathological psychiatric patterns when deprived of sleep, "Walker said."Before, it was difficult to separate out the effect of sleep versus the disease itself. Now we're closer to being able to look into whether the person has a psychiatric disease or a sleep disorder."
Using functioning Magnetic Resonance Imaging (fMRI), Walker and his team found that the amygdala, which is also a key to processing emotions, became hyperactive in response to negative visual stimuli - mutilated bodies, children with tumors and other gory images - in study participants who stayed awake for 35 hours straight. Conversely, brain scans of those who got a full night's sleep in their own beds showed normal activity in the amygdala.
"The emotional centers of the brain were over 60 percent more reactive under conditions of sleep deprivation than in subjects who had obtained a normal night of sleep," Walker said.
The team studied 26 healthy participants aged 18 to 30, breaking them into two groups of equal numbers of males and females. The sleep-deprived group stayed awake during day 1, night 1 and day 2, while the sleep-control group stayed awake both days and slept normally during the night. During the fMRI brain scanning, which was performed at the end of day 2, each was shown 100 images that ranged from neutral to very negative. Using this emotional gradient, the researchers were able to compare the increase in brain response to the increasingly negative pictures.
Since 1998, Walker, an assistant professor of psychology at UC Berkeley and a former sleep researcher at Harvard Medical School, has been studying sleep's impact on memory, learning and brain plasticity.
During his research, he was struck with the consistency of how graduate students in his studies would turn from affable, rational beings into what he called "emotional JELL-O" after a night without sleep. He and his assistants searched for research that would explain the effect of sleep deprivation on the emotional brain and found none, although there is countless anecdotal evidence that lack of sleep causes emotional swings.
"You can see it in the reaction of a military combatant soldier dealing with a civilian, a tired mother to a meddlesome toddler, the medical resident to a pushy patient. It's these everyday scenarios that tell us people don't get enough sleep." Walker said.
The body alternates between two different phases of sleep during the night: Rapid Eye Movement (REM), when body and brain activity promote dreams, and Non-Rapid Eye Movement (NREM), when the muscles and brain rest.
"All signs point to sleep doing something for emotional regulation and emotional processing," Walker said. "My job now is to figure out what kind of sleep."

AASM On Sleep Medications And Insomnia Treatment

Insomnia and Sleep Medications
Insomnia occurs when people have trouble falling asleep or staying asleep, and it is a common sleep compliant. While a brief case of insomnia can arise due to temporary stress, excitement or other emotion, more than 20 million Americans report having a chronic form of insomnia that keeps them from sleeping well nearly every night. As a result, the insomnia, which is a serious and often debilitating condition, can lead to severe daytime fatigue, poor performance at school and work, physical symptoms such as headaches, and in some cases depression.
People suffering from insomnia need to know that there are effective insomnia treatments and their sleep can improve. The American Academy of Sleep Medicine recommends that people who experience insomnia see a sleep medicine specialist or primary care physician for proper diagnosis and to discuss treatment options before treatment with medications is undertaken. This evaluation should also look for specific causes of insomnia such as restless legs syndrome or depression.
Sleep medications are often used for the short-term treatment of insomnia and, on occasion, for more chronic insomnia. Medications that currently are available by prescription are known to improve sleep by reducing the amount of time it takes to fall asleep, increasing sleep duration and/or reducing the number of awakenings during sleep. While modern hypnotics are considered safe, individuals should be aware that, like all medications, side effects may occur in a minority of patients. These side effects can include sleep walking, sleep eating and other complex sleep behaviors as well as difficulty with memory.
RECOMMENDATIONS FOR PATIENTS
Behavioral therapies and medications have been shown to be effective therapies for insomnia. Behavioral therapies use nonpharmacologic methods to improve sleep and are effective and long lasting. Sleep medications are effective and safe treatments for insomnia when used properly and judiciously by a patient who is under the supervision of a sleep medicine or primary care physician.

Deep Sleep Plays Role In Visual Learning

A relationship has been observed between deep sleep and the ability of the brain to learn specific tasks. Researchers at Brigham and Women's Hospital (BWH) have now shown that the processes that regulate deep sleep may affect visual learning.
"These findings show that deep sleep is important for visual learning and possibly the ability of the brain to learn new tasks," said Daniel Aeschbach, researcher in the Division of Sleep Medicine at BWH and lead author of the study.
Deep sleep, also called slow wave sleep, is a period of non-rapid-eye-movement sleep when very large brain waves, called slow waves, can be observed in the EEG, which is a recording of the brain waves. Slow waves are thought to reflect the need for sleep, but their exact function is unknown. Researchers sought to determine the function of these waves in visual learning.
Aeschbach and colleagues trained healthy subjects on a visual learning task in which they were required to determine on a computer screen the orientation of a few dashes that were embedded in a field of horizontal dashes. Subjects were tested on their accuracy of performing this task before and after they had slept for a period of four hours. One group of subjects slept normally, with no interruptions, and their visual skill in performing the task improved after sleep. In another group, researchers suppressed the occurrence of slow waves by playing targeted acoustic tones while subjects were asleep. The tones did not wake the subjects, but prevented them from slipping into deep sleep as monitored on the EEG. This group was also tested in the visual task after sleep and their skill did not improve.
Researchers suggest that these findings could have clinical implications for conditions like depression and insomnia, as well as aging, which are associated with learning deficits and also a reduction of deep sleep.
This research was funded by awards from the National Alliance for Research on Schizophrenia and Depression, the Milton Fund of Harvard University, and the National Institutes of Health.

Obstructive sleep apnea taking disease pattern

A study in the Dec. 15 issue of the Journal of Clinical Sleep Medicine is the first to show the full clinical picture of comorbid conditions associated with obstructive sleep apnea (OSA), quantify their frequency of occurrence and reveal their possible interrelationships.
Results show that the number of cases of Obstructive sleep apnea peaks between the ages of 0-4 years, is low during adolescence, and then rises from 25-29 years to a peak at 55-59 years. The rates are slightly higher for girls than boys in the 0-4 age group (9.4% and 6.7%) and the 5-9 age group (6.0% and 3.9%), and the occurrence rate in males is higher than in females after 20-24 years of age.
According to the study's co-author,Chin Moi Chow , PhD, Senior of health sciences, at the University of Sydney, this study will have a significant impact on the understanding of the disease pattern of Obstructive sleep apnea and conditions associated with it.
"This research provides a clinical picture of Obstructive sleep apnea from over six million hospital admissions of all medical conditions and those associated with OSA, and describes its occurrences according to age and gender groups," Chow said.
Findings indicate that Obstructive sleep apnea patients are high users of health-care services, with comorbid conditions most often involving cardiovascular diseases, endocrine/metabolic diseases (mainly diabetes) and respiratory diseases. Comorbid conditions most frequently appearing with OSA in adults are essential hypertension, obesity, hypercholesterolemia, type 2 diabetes, past or current tobacco use, and ischemic heart conditions.
Data plotting shows that the onset and peak occurrences of obesity and OSA are identical. From obesity onset there is a latent period of five years for the development of hypertension and type 2 diabetes and 15 years for chronic ischemic heart conditions.
A random dataset from the years 1999 through 2004 was extracted using a Health Outcomes and Information Statistical Toolkit. The data set was a representative collection of hospital records in the Inpatient Data Collection System of New South Wales, the most populated Australian state. The data included patient records from 278 public hospitals and 180 private hospitals.
The extracted dataset contained a total of 1.51 million hospital records. Four percent of all records – representing 60,197 patients - had a principal or secondary diagnosis of Obstructive sleep apnea, with a male to female ratio of 2.6:1. The authors report that previous knowledge of disease associations with OSA was fragmented and did not explain possible interrelationships between comorbid diseases. The data mining technique was used to provide the full clinical picture of comorbid conditions associated with Obstructive sleep apnea.

MRI May Help Reduce Effects Of Sleep Apnea

Using cardiac magnetic resonance imaging, Ohio State University Medical Center researchers are able to assess the effects of a common treatment for sleep apnea on heart structure and function in otherwise healthy individuals.
“Little data exists on continuous positive airway pressure’s therapeutic effects on the heart’s right side, so we are leveraging the advantages of imaging to see if the treatment helps these patients,” says Dr. Ulysses Magalang, medical director of Ohio State’s Sleep Disorders Center and first author of the study that appears in the Journal of Clinical Sleep Medicine.
Researchers found that continuous positive airway pressure therapy improves heart structure with improvements in the volume of the right ventricle.
“By getting clear pictures of the heart in these patients, we were able to better understand the cardiovascular consequences of obstructive sleep apnea. These results can be used to guide treatments to reduce death and disability due to heart disease,” says Dr. Subha Raman, medical director of the cardiac magnetic resonance and computerized tomography program at Ohio State’s Richard M. Ross Heart Hospital, and also senior author of the study.
Drs. Magalang and Raman recently collaborated on a study published in the journal Experimental and Clinical Endocrinology & Diabetes showing a possible link between sleep apnea and heart disease, which is the leading cause of death responsible for 29 percent of people worldwide. The researchers identified a substance that may prevent atherosclerosis.
Affecting approximately 12 million Americans, obstructive sleep apnea is a condition in which breathing is interrupted for brief periods during sleep. These repetitive disruptions, known as intermittent hypoxia, occur when oxygen levels drop below normal levels.
Continuous positive airway pressure therapy is administered by a device that delivers continuous positive airway pressure during sleep. The device encompasses a mask worn over the nose, tubing and a fan that delivers enough air pressure to keep the throat open, preventing obstruction of the airway, and reversing the negative consequences of sleep apnea on the heart.