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Don’t Forget to Make Sleep a Priority This Holiday Season

Dec 20th, 2010
by Dr. Lisa Shives.
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Amsterdam-based Philips Center for Health and Well-Being, reported that Americans are primarily losing sleep because of worry. According to results, 57 percent of Americans reported that their sleep loss affected their physical health, 48 percent believed their sleep loss affected their mental health and 46 percent believed sleep loss affected their home life.

Research shows that sleep loss is associated with decreased job and school performance, slower reaction times, poor memory and concentration as well as impaired cognitive performance. Long-term sleep deprivation is also associated with serious mental and physical health problems such as increased risk for depression, obesity, diabetes, high blood pressure,  stroke and heart disease.

The AASM recommends that in order to make your holidays healthier and safer, you:

  • Pace yourself to avoid late nights filled with last-minute preparations.
  • Avoid eating large meals near bedtime.
  • Avoid wrapping gifts or writing cards in bed; reserve your bed for sleep.
  • Be able to relax at bedtime by setting aside time during the day to deal with holiday stress.
  • Wake up at the same time every day, even on weekends and days off from work.
  • If you need a boost, take a short 20-minute nap in the early afternoon.
  • Avoid driving when you are sleepy.
  • Days before a long flight, gradually adjust your sleep schedule to prepare for the new time zone.
  • Drink alcohol in moderation and avoid alcohol 2 hours before bed
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Posted in: Good Sleep as Preventive Medicine, Sleep.
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Your Genes May Determine How Long and How Well You Sleep

Dec 13th, 2010
by Dr. Lisa Shives.
1 comment

A new study published in the journal Neurology found that individual differences in the way people fall asleep, stay asleep, and deal with insomnia can be predicted by looking for an allele called DBQ1*0602, according to CBS News.

Results of the study led authors to believe that up to 25 percent of people in the world are positive for this gene, which is also an indicator of Narcolepsy. The gene causes insomnia like symptoms, including daytime sleepiness and difficulty falling asleep and staying asleep at night.

Those who do not have the gene typically fall asleep quickly and are able to obtain high quality sleep.

The American Academy of Sleep Medicine (AASM) posted on their “Sleep Better Blog” that another study, published in the Journal Sleep reported the discovery of the first gene involved in the regulation of human sleep. The gene, which is a rare mutation in the “DEC2” gene, allows some people to function well after only six hours of sleep per night.

People with this mutation are able to function without impairment on what is typically considered to be an inadequate amount of sleep.

USA Today reported that this gene was found in less than three percent of people.

The Center for Disease Control (CDC) estimates from  data collected from 2004 to 2006 that  about 21 percent of U.S. adults usually sleep for only six hours in a 24-hour period; about eight percent reported sleeping less than six hours.

In 2009, the National Sleep Foundation’s Sleep in America poll found that one-third of Americans are losing sleep over the state of the U.S. economy and other personal financial concerns.

According to Sleep experts, most adults need seven to eight hours of sleep per night in order to function at their highest level.

The AASM claims that even one night of sleep deprivation is associated with consequences such as daytime sleepiness, increases in errors and decreases in attention span and reaction time. Chronic sleep deprivation can lead to serious health problems, including increased risk for weight gain, diabetes, stroke and heart attack.

Lifestyle changes, such as keeping a regular schedule, sleeping in a cool, dark room and refraining from drinking alcohol at night may improve quality of sleep. You should contact a sleep expert if sleep problems continue for more than a month.

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Posted in: Insomnia, Sleep, Sleep Disorders.
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Short Sleep Duration Associated with Increased Risk for Heart Disease in Men

Dec 6th, 2010
by Dr. Lisa Shives.
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A new study, which was presented at the American Heart Association’s annual meeting in Chicago, shows that shorter sleep duration is associated with increased risk of cardiovascular disease in men, according to Business Week.

Findings indicate that shorter sleep duration is associated with a thickening of men’s carotid arteries which are located in the neck.  This thickening is considered to be a major marker for future heart attack and stroke.  This association of short sleep duration and thickening of the carotid artery wall was found only in men.  More research needs to be done to follow up on this association between short sleep and cardiovascular disease.

More than 600 middle-aged black and white individuals from across the country were chosen to participate in the study. Subjects underwent ultrasound analysis of their carotid arteries.  Participants ranged in age between 37 and 52 years. Almost 60 percent were women.

Results show that men slept 5.7 hours per night, while women slept 6.3 hours per night. On average, male participants also had thicker carotid artery walls (0.74 mm) compared to females (0.68 mm).

Sleep experts recommend that adults sleep between seven and eight hours each night in order to maintain both mental and physical well being.

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Posted in: Good Sleep as Preventive Medicine, Sleep, Sleep Medicine News, Sleep and Heart Health Facts, Your Health and Sleep.
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Using Sleeping Pills and Anti-Anxiety Medication May Increase Your Risk of Death

Nov 29th, 2010
by Dr. Lisa Shives.
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According to Science Daily, a new study published in the Canadian Journal of Psychiatry shows that the use of medications for treatment of insomnia and anxiety may result in increased risk of death.

The study analyzed 12 years worth of data on over 14,000 Canadians that were obtained through Canada’s National Population Health Survey between the years of 1994 and 2007. Subjects ranged in age between 18 and 102 years. .

After accounting for social demographics, health status and lifestyle factors that increase the risk of mortality, researchers involved in the study determined that the consumption of sleeping pills for the treatment of insomnia or anti-anxiety medications was associated with a 36 percent increase in the risk of death.

Scientists believe that the association between consumption of sleeping and anti-anxiety medication could be caused by several factors, including delayed reaction time and decreased coordination, which could result in more falls and accidents.

People experiencing ongoing insomnia symptoms (difficulty falling asleep, staying asleep or waking up early) should speak with their doctor or a sleep specialist for a proper diagnosis and to determine the best method of treatment.

Sleep experts typically recommend cognitive behavioral therapy (CBT) to ease symptoms before prescribing medication. Cognitive behavioral therapy is a non-pharmacological way to obtain long- lasting relief for insomnia. Because of potential side effects and addictive properties, sleep medications are typically only used to relieve symptoms for a short period of time.  Patients often resist CBT because they think it won’t work but many research studies and my own clinical experience show that it is the best long term treatment for insomnia.

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Posted in: Insomnia, Natural Sleep Remedies, Sleep, Sleep Disorders, Sleep Medicine News.
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Have your Turkey…and your Sleep Too!

Nov 23rd, 2010
by Dr. Lisa Shives.
1 comment

Thursday, November 25th, is Thanksgiving. Although it is largely a myth that the Tryptophan in turkey causes sleepiness, eating a traditional Thanksgiving feast can cause you to feel tired.  It may be because we overload on carbs which makes our glucose rise which stimulates insulin release which in turn lowers the glucose in the blood and can result in a relative hypoglycemia which can make you sluggish and sleepy.

Although you may feel tempted to sleep the afternoon away, you may regret the decision when you try to go to sleep at night. If you do decide to take a nap, it should be no later than 2:00 or 3:00 p.m. and for no longer than 30 minutes.

You can also avoid disrupting your nightly sleep by serving your Thanksgiving meal in the early afternoon.

The American Academy of Sleep Medicine states that a great deal of your post-Thanksgiving sleepiness could be caused by sleep debt or chronic sleep deprivation that accumulates during the work or school week.  You might have an undiagnosed sleep problem such as sleep apnea. restless legs syndrome, insomnia or a circadian rhythm disorder, or maybe you are so busy that you just don’t get the sleep you require.

Although you should enjoy the holiday, you should refrain from deviating too far from your daily routine, in order to ensure your sleep pattern remains intact.

In order to get a good night’s sleep on a regular basis, the American Academy of Sleep Medicine recommends that you:

  • Try a hot bath/shower an hour or so before bed
  • Don’t go to bed hungry, but don’t eat a big meal before bedtime either.  Try a small snack that combines protein and carbs, for example cheese and crackers.
  • Avoid alcohol, foods or drinks that contain caffeine, and any medicine that has a stimulant, prior to bedtime.
  • Follow a consistent bedtime routine.
  • Avoid any rigorous exercise within two-to-three hours of your bedtime.
  • Make your bedroom quiet, dark and a little bit cool.
  • Get up at the same time every morning.
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Posted in: Diet, Sleep, Your Health and Sleep.
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My New CNN Health Sleep Blog

Nov 21st, 2010
by Dr. Lisa Shives.
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I am excited to report that as of this Monday, November 15th, I will be writing weekly blog posts on Tuesdays  for CNN Health’s “The Chart.”

My goal for this blog is to explain some of the biggest problems and issues concerning sleep, and offer advice to help readers get better rest.  I will also keep readers up to date on the latest research and the newest treatments.

Although I will cover a variety of subjects, insomnia will be a topic I discuss frequently, as it is a difficult condition to manage and there are so many useful tips that I can’t discuss them all in one blog.

My first post focused on the importance of understanding how light affects the brain and helps control the sleep/wake cycle.

Many people don’t understand the importance of limiting their exposure to light before bedtime.  Light is the strongest cue that will alert you; unfortunately, when people can’t sleep they tend to watch TV, use a computer or read a book, all of these activities can stimulate your brain and keep you awake.

Many people experience occasional sleepless nights. Insomnia symptoms (difficulty falling asleep, staying asleep or waking up too early) can be caused by stress, illness or anxiety. Symptoms of insomnia can often be eliminated naturally. Simple lifestyle changes such as going to bed and waking up at the same time each night, keeping your bedroom cool and dark and abstaining from drinking alcohol before bed may help you obtain better sleep.

If your troubles persist for longer than a month, however, it is best to consult a sleep physician to determine the best type of treatment.  Many people wait for for years before seeking professional help and, by that time, they will often have developed bad habits that exacerbate the insomnia problem.

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Posted in: Dr. Shives in the News, Insomnia, Sleep, Sleep Disorders.
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Undiagnosed Obstructive Sleep Apnea may Interfere with Asthma Treatment

Nov 17th, 2010
by Dr. Lisa Shives.
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According to a new study published in the journal CHEST, asthma patients with high risk for obstructive sleep apnea (OSA) have more difficulty controlling their condition than patients who are low risk for the sleep disorder.

The study involved 472 people between the ages of 18 and 75 years with clinically diagnosed asthma. Participants had received treatment for their asthma condition at the University of Wisconsin tertiary-care clinic between the years 2007 and 2009.  All subjects completed the Sleep Apnea Scale of the Sleep Disorder Questionnaire to assess the severity of OSA symptoms and the Asthma Control Questionnaire to assess the quality of asthma control.

Previous studies have found that patients with undiagnosed OSA may continue to have difficulty controlling their asthma symptoms, even if they are receiving optimal care.

Results of the study show that 80 (17 percent) of patients had asthma symptoms that were not well controlled, and 109 (23 percent) were at high risk for OSA. Researchers found that after controlling for factors that are known to affect asthma control (such as obesity), patients at high risk for OSA were 2.87 times more likely to have poorly-controlled asthma compared to patients who were at low risk for the sleep disorder.

These findings suggest that treatment of OSA in asthma patients may lead to improvement in the treatment of asthma symptoms.

Patients who are at high risk for OSA should undergo a polysomnogram with a sleep specialist in order to determine the severity of their condition and determine the best course of treatment. The most common treatment for OSA is continuous positive airway pressure (CPAP) therapy, which uses a device to push a steady stream of air through a mask in order to open a patient’s airway while they sleep.

My Asthma patients often fear that CPAP will worsen or exacerbate their Asthma, and so I like to share research such as this to reassure them that most likely treating their sleep apnea with CPAP or with other methods will help them have fewer Asthma attacks.

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Posted in: CPAP, Sleep, Sleep Apnea, Sleep Disorders, Your Health and Sleep.
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Lack of Sleep May Increase ADHD Symptoms

Nov 15th, 2010
by Dr. Lisa Shives.
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According to MSNBC Health News, a new study published in the journal Sleep shows that children with attention-deficit hyperactivity disorder (ADHD) sleep less, have more difficulty falling asleep and spend less time in the rapid eye movement (REM) stage of sleep.

Sleep experts believe that enforcing a strict bedtime routine to ensure children get the sleep they need may reduce ADHD symptoms, but it will not eliminate them. Research shows that sleep problems are not a cause of ADHD, though sleep deprivation or inefficient amounts of sleep does increase symptoms.  Undiagnosed pediatric obstructive sleep apnea can cause such sleep disruption, usually with the parents’ awareness, that children can have daytime symptoms that mimic ADHD or other learning problems or even psychiatric disorders.

The study analyzed the sleep of 15 children between the ages of 7 and 11 years of age who were diagnosed with ADHD, and 23 children who did not have the disorder. Researchers tracked the amount of time taken to fall asleep, the amount of time the children slept and how much time the children slept in each stage of sleep. Parents also completed questionnaires concerning their children’s sleep habits. None of the children was taking ADHD medication at the time of the study and children were monitored at home in their own beds.

Results showed that children with ADHD slept about a half-hour less, on average than their peers without the condition and spent 15 fewer minutes in REM sleep. The children with ADHD also took longer to fall asleep, were more anxious about sleep, and less likely to get enough sleep.

Although the purpose of REM stage sleep is not completely understood, previous research indicates that it is necessary for the brain to process and sort information.

It is important to create healthy bedtime habits and a steady bedtime routine.  However, a child may need additional help to get the sleep he or she needs. Adjusting ADHD medication may be one solution. If your child continues to have difficulty falling asleep or staying asleep, he or she may be suffering from a sleep disorder. Visit our pediatric website to learn more about sleep disorders in children and to review our pediatric sleep questionnaire to see if your child might have the signs or symptoms of a sleep disorder.

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Posted in: Child Sleep Problems, Sleep.
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Sleep and Weight Loss Presentation on Nov. 13th at the American Society of Bariatric Physicians’ 60th Anniversary Celebration in New Orleans

Nov 10th, 2010
by Dr. Lisa Shives.
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On Saturday, November 13, I will be speaking about the relationship between sleep disorders and weight gain at the American Society of Bariatric Physicians’ 60th Anniversary Celebration in New Orleans.

During my lecture I will discuss the association of sleep disorders with impaired glucose tolerance, changes in appetite hormones, diabetes and weight gain/obesity.  There is a growing body of literature that shows a strong  association between short sleep durations and weight gain/obesity.

Research shows that sleep deprivation increases your risk for weight gain and obesity. The Huffington Posts reportsthat sleep restriction has been shown to increase levels of the hormone ghrelin, which makes you feel hungry while also slowing your metabolism. A new area of research focuses on how specific sleep disorders such as Obstructive Sleep Apnea, Insomnia, Restless Leg syndrome may lead to weight gain, either through the short sleep mechanism or other physiologic pathways.

The American Academy of Sleep Medicine claims that at least 40 million Americans have chronic sleep problems, and an additional 20 million experience occasional sleep disturbances. As many as 47 million Americans have metabolic syndrome, which is a group of conditions that are shown to increase the risk of heart disease and stroke and is usually associated with overweight/obesity.

According to the National Sleep Foundation, a study published in the International Journal Obesity found that middle-aged women who suffer from sleep disorders are more likely to have problems with their weight than their peers who get eight hours of sleep per night. Results were unique, in that they demonstrated that sleep problems precede weight gain.

A study published in the May 2010 edition of the journal Sleep found that people who fail to get an adequate amount of sleep (less than six hours per night) tended to weigh more and exercise less. This group was also more likely to prefer fatty foods, snack frequently and eat out more often.

It is important to recognize the relationship between sleep and weight gain, in order to address the epidemic of obesity. Many people do not realize that sleep is as important to good health as exercise and diet. By obtaining seven to eight hours of sleep per night, you are helping your body stay strong, both mentally and physically.

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Posted in: Diet, Exercise: The Three Pillars of Health, Insomnia, Sleep, Sleep Apnea, Sleep Disorders, Sleep and Heart Health Facts, Sleep and Obesity, Sleep and Weight Gain, Your Health and Sleep.
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National Drowsy Driving Prevention Week (November 8-14th)

Nov 9th, 2010
by Dr. Lisa Shives.
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Today is the start of National Drowsy Driving Prevention Week, a National Sleep Foundation public awareness campaign that was created to raise awareness of the dangers of driving while fatigued as well as ti reduce the number of car crashes and to improve road safety.

According to a study released by the AAA Foundation, the contribution of drowsy driving to motor vehicle accidents that result in injuries and deaths are not fully appreciated. Results of the study found that about one in eight deadly crashes was related to drowsiness or fatigue; one in ten crashes resulting in occupant hospitalization, and one in twenty crashes in which a vehicle was towed.

A study that was published in the June 2010 edition of the journal Sleep found that extreme sleepiness increases the likelihood of an auto accident causing serious injury. Overall, crash rates were about 12 percent higher in tired drivers.

The American Academy of Sleep Medicine reports that drowsy driving is related to at least 100,000 motor-vehicle accidents and more than 1,500 deaths per year in the United States.

Tired drivers often experience slower reaction times, vision impairment, lapses in judgment and delays in processing information. Research shows that being awake for more than 20 hours results in an impairment equal to a blood alcohol concentration of 0.08 percent, the legal limit in all states.

Sleep experts recommend that adults sleep seven to eight hours a night in order  to function at their highest level; however, due to work and family obligations many people fail to get the sleep they need on a regular basis.

Sleepy drivers often do not recognize the extent of their fatigue, and can inadvertently put themselves, their passengers and their fellow drivers at risk.

If you experience any of these symptoms, you are most likely incapable of driving safely:

  • Difficulty focusing, frequent blinking and/or heavy eyelids
  • Difficulty keeping reveries or daydreams at bay
  • Trouble keeping your head up
  • Drifting from your lane, swerving, tailgating and/or hitting rumble strips
  • Inability to clearly remember the last few miles driven
  • Missing exits or traffic signs

As the holidays approach, it is likely that there will be more tired drivers on the road more frequently. In order to keep yourself safe while driving, there are a few tactics you may consider to maintain a high level of alertness while driving.

  • Find a safe place to take a 15-20 minute nap if you think you might fall asleep.
  • Avoid alcohol and medications that cause drowsiness as a side-effect.
  • Avoid driving at times when you would normally be asleep.
  • Consume caffeine. The equivalent of two cups of coffee can increase alertness for several hours.

Keep in mind that if you suffer from an undiagnosed sleep disorder, your chances of drowsy driving are greatly increased.  Consult with a physician if you have excessive daytime sleepines, sleep difficulties at night, memory or mood impairments or loud snoring.

For more information about drowsy driving, visit the National Sleep Foundation’s drowsy driving website at www.DrowsyDriving.org.

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Posted in: Sleep, Sleep Disorders, Sleep Medicine News, Your Health and Sleep.
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