Sleep apnea may hold hidden dangers for women

Monday 28 October 2013 - 3am PSTFeatured ArticleAcademic Journal Current ratings for:
Sleep apnea may hold hidden dangers for women
A new study on sleep apnea reveals there could be some hidden dangers - particularly for women who have the condition - where breathing is interrupted during sleep. Women with sleep apnea may appear healthy, but they have subtle symptoms so their sleep problem is often misdiagnosed.
Now, new research, led by the University of California Los Angeles (UCLA) School of Nursing, shows that the body's autonomic responses, which normally control blood pressure, heart rate, sweating and other basic functions, are not as strong in people with obstructive sleep apnea, and even less so in women.
Obstructive sleep apnea is a serious condition that happens when the person is asleep, sometimes hundreds of times a night. When it occurs, blood oxygen drops and eventually damages many cells of the body.
There are over 20 million adult Americans living with the condition, note the researchers, who explain that it is linked with several serious health problems and also early death.
Women are much less likely to be diagnosed with obstructive sleep apnea than men.
Lead researcher Dr. Paul Macey says:

"We now know that sleep apnea is a precursor to bigger health issues. And for women in particular, the results could be deadly."

Dr. Macey and his colleagues describe their work in a recent online issue of PLOS ONE
.
For their study, the team recruited 94 adult men and women, comprising 37 newly diagnosed, untreated obstructive sleep (OSA) patients and 57 healthy volunteers to act as controls.
The three groups had their heart rates measured as they went through three different physical challenges:
The Valsalva maneuver - where they had to breathe out hard while keeping the mouth closedA hand-grip challenge - where they had to just squeeze hard with one handA cold pressor challenge - where the right foot is inserted into near-freezing water for a minute.
The team notes the main results:

"Heart rate responses showed lower amplitude, delayed onset and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in females."

Dr. Macey adds:

"This may mean that women are more likely to develop symptoms of heart disease, as well as other consequences of poor adaptation to daily physical tasks. Early detection and treatment may be needed to protect against damage to the brain and other organs."

The team now intends to investigate if the usual treatments for OSA, such as continuous positive airway pressure (CPAP), help to improve the autonomic responses.
CPAP is where a machine helps the OSA patient breathe more easily while asleep.
Funds from the National Institutes of Health and the National Institute of Nursing Research helped finance the study.
In another study published recently, researchers from Brigham and Women's Hospital in Boston, MA, found that sleep apnea is linked to early sign of heart failure.
Written by Catharine Paddock PhD

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I’ll see your animal rescue bikers and raise you…

These tough bikers have a soft spot: aiding child-abuse victims. Anytime, anywhere, for as long as it takes the child to feel safe, these leather-clad guardians will stand tall and strong against the dark, and the fear, and those who seek to harm.The girl chewing on her lip was abused by a relative, according to police reports – someone she should have been able to trust. He’s not in the state any longer, but the criminal case is progressing slowly, so he’s not in jail, either. He still terrorizes her at night, even though he’s nowhere near. She wakes, heart pounding. The nightmare feels real again. She never feels safe, even with her parents just downstairs. The unruly-looking mob in her driveway is there to help her feel safe again. They are members of the Arizona chapter of Bikers Against Child Abuse International, and they wear their motto on their black leather vests and T-shirts: “No child deserves to live in fear.”

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My take on Buzzfeed’s DIY projects.

I’ve always wanted a lumpy, flimsy body pillow!People are going to start leaving their garbage on your porch.

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Segment sleeping arrangements to control malaria

Wednesday 20 November 2013 - 1am PSTCurrent ratings for:
Segment sleeping arrangements to control malaria

Better malaria control might come from segregating household sleeping arrangements, according to a new study co-authored by a University of Guelph professor.

The researchers found malaria eradication related more to household size than to a country's wealth or temperature. Guelph economics professor Ross McKitrick and two Finnish professors, Larry and Lena Huldén, found that when average household size drops below four persons, malaria extermination is much more likely.

Malaria is transmitted by infected mosquitoes. The research team examined data on malaria insect vectors, as well as demographic, sociological and environmental factors for 232 countries. Malaria is still prevalent in 106 countries.

"When we controlled for all the variables, the factor that had the most explanatory power on malaria control was household size," said McKitrick.

"Malaria-bearing mosquitoes mainly feed at night, and tend to return to the same location for blood meals. The more people who sleep in one area, the greater the likelihood of an infected mosquito spreading the parasite to a new, uninfected victim."

Malaria infects red blood cells and can cause anemia, nausea, fever and, in some cases, death. Each year, 225 million people are infected and 800,000 die, mostly children.

"It is a common misconception that malaria is a tropical disease, and with 90 per cent of malaria deaths taking place in Africa, it is easy to see why people believe this," said McKitrick.

"But historically, malaria has occurred in all climate zones including the Arctic, and was endemic in North America and Europe a hundred years ago. In many cases, the disease disappeared even in countries that made no efforts to fight it, while others that tried to eradicate it failed. We found declining average household size key to explaining this pattern. "

The researchers looked at factors such as gross domestic product per capita, urbanization and slums, latitude, mean temperature, forest coverage, national DDT use, household size and even religion.

Countries with a significant Muslim population generally had large households but did a better job of eradicating malaria, with the researchers speculating it may be because of their segregated sleeping arrangements. Males and females generally sleep in separate areas.

As household size continues to decline, McKitrick said malaria should gradually disappear. But countries need not wait for that to happen.

In Vanuatu - with an average 5.6 people per household - providing bed nets and effective drug distribution and surveillance since 1996 has effectively wiped out malaria.

"The key factor is segmenting sleeping quarters and greater use of bed nets in those countries where malaria is still prevalent," he said.

"Individual bed nets can emulate a household with several bedrooms, making it difficult for the mosquitoes to transmit the parasite to other household members."

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SIDS: Brainstem abnormalities found in infants, in both safe and unsafe sleep environments

Wednesday 13 November 2013 - 12am PST Current ratings for:
SIDS: Brainstem abnormalities found in infants, in both safe and unsafe sleep environments

Investigators at Boston Children's Hospital report that infants dying suddenly and unexpectedly, in both safe and unsafe sleep environments, have underlying brainstem abnormalities and are not all normal prior to death.

The researchers also point to the need to detect and treat this underlying vulnerability early, the focus of their current work. They report their findings in the December issue of Pediatrics.

The investigators, led by Hannah Kinney, MD, a neuropathologist at Boston Children's, have shown over the past two decades that infants who die suddenly, unexpectedly and without explanation - whose deaths are generally attributed to sudden infant death syndrome (SIDS) - have differences in brainstem chemistry that set them apart from infants dying of other causes.

These abnormalities impair brainstem circuits that help control breathing, heart rate, blood pressure and temperature control during sleep, and, the researchers believe, prevent sleeping babies from rousing when they rebreathe too much carbon dioxide (due to inadequate ventilation) or become overheated (from overbundling).

At the same time, epidemiologic studies have shown that infants dying suddenly and unexpectedly are often found in unsafe sleep environments, such as sleeping face down with their face in the pillow, or sleeping with another person in the bed.

In the new study, Kinney and colleagues asked if these infants are truly normal. They reexamined their data, reviewing the cases of 71 infants who died suddenly and unexpectedly, were autopsied at the San Diego County Medical Examiner's office from 1997 to 2008, and had brainstem samples available for analysis. The researchers grouped the infants according to sleep circumstances - those considered safe (asphyxia not likely) or unsafe (asphyxia likely) based upon death-scene investigation reports.

In the end, they compared 15 infants with SIDS whose deaths were deemed not to involve asphyxia (group A), 35 SIDS infants whose deaths were possibly asphyxia-related (group B) and 9 infants who clearly died from other causes (controls). They excluded the other infants, who either had insufficient data or had evidence of other clear risk factors for death, such as exposure to drugs or extremes of temperature.

Brainstem neurochemical abnormalities - involving serotonin, serotonin receptors, GABA receptors and 14-3-3 (a protein that regulates serotonin) - were found in both group A and group B. Neurochemical measures didn't differ significantly between the two groups, but each group differed significantly from the controls.

"Even the infants dying in unsafe sleep environments had an underlying brainstem abnormality that likely made them vulnerable to sudden death if there was any degree of asphyxia," Kinney says. "The abnormality prevents the brainstem from responding to the asphyxial challenge and waking."

The investigators believe these findings confirm that sudden unexplained death in infants is associated with underlying vulnerabilities, and that not all infants who die in compromised sleep environments are normal.

"Certainly, there are unsafe sleeping environments that can cause any baby to die, such as entrapment in the crib, but if it's just sleeping face down, the baby who dies may have an underlying brainstem vulnerability," says Kinney. "We have to find ways to test for this underlying vulnerability in living babies and then to treat it. Our team is focused now upon developing such a test and treatment.

"Safe sleep practices absolutely remain important, so these infants are not put in a potentially asphyxiating situation that they cannot respond to," she adds.

Funders of the study included the National Institutes of Health, the National Institute of Child Health and Development (# R01-HD20991), First Candle, the CJ Foundation for SIDS, the Jacob Neil Boger Foundation for SIDS, the Marley Jaye Cerella Foundation for SIDS, River's Gift and the Intellectual and Developmental Disabilities Research Center at Boston Children's Hospital (# P30-HD18655).

Bradley Randall, MD, of the University of South Dakota Sanford School of Medicine, was the study's first author. Co-authors were David Paterson, PhD, Kevin Broadbelt, PhD, Jhodie Duncan, PhD, and Othon Mena, MD, Boston Children's Hospital; Elisabeth Haas, MPH and Henry Krous, MD, University of California, San Diego; and Felicia Trachtenberg, PhD, New England Research Institutes (Watertown, MA).

Boston Children's Hospital

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Consistent sleep patterns tied to healthier weight

Tuesday 19 November 2013 - 8am PSTFeatured ArticleAcademic Journal Current ratings for:
Consistent sleep patterns tied to healthier weight

A new study published online recently in the American Journal of Health Promotion suggests that keeping to a consistent sleep routine may help people maintain a healthier weight.

Bruce Bailey, a professor in exercise science at Brigham Young University in Provo, UT, and colleagues found that women who woke at the same time and went to sleep at the same every day had lower body fat.

Prof. Bailey suggests going to bed late and sleeping in may do more harm than good:

"We have these internal clocks and throwing them off and not allowing them to get into a pattern does have an impact on our physiology."

Researchers found that women whose sleep routines are more consistent have the least amount of body fat.

While previous studies have looked at sleep patterns and weight, this is the first study to look at the link between consistency of bed and wake time and body fat.

For their study, the researchers examined data on more than 300 young women aged between 17 and 26 attending two major Western US universities.

At the start of the study period, the women were assessed for body composition and were then given activity trackers to record their movements during the day and their sleep patterns at night for 7 consecutive days and nights.

The results showed that:

A consistent bed time, but particularly a consistent wake time, were linked to lower body fat.Sleeping less than 6.5 or more than 8.5 hours a night was tied to higher body fat.Sleeping between 8 and 8.5 hours a night was tied to the lowest levels of body fat.Quality of sleep also appears to make a difference to body composition.Participants whose wake and sleep time varied by more than 90 minutes had more body fat than those whose variations were limited to 60 minutes.

The researchers said they found wake time was particularly tied to body fat. The participants who consistently woke at the same time every day had the least body fat.

Prof. Bailey suggests consistent sleep patterns are probably closely tied to good sleep hygiene.

Altering sleep hygiene likely changes patterns of physical activity, which in turn alters hormones involved with digestion, with a knock-on effect on body fat.

Prof. Bailey's recipe for improving sleep quality is to exercise, keep your bedroom cool, dark and quiet, and only use your bed for sleeping in. He adds that:

"Sleep is often a casualty of trying to do more and be better and it is often sacrificed, especially by college students, who kind of wear it as a badge of honor."

In 2010, researchers reported in the Annals of Internal Medicine that insufficient sleep can make dieters lose muscle instead of fat.

They found participants on a low-calorie diet lost the same amount of weight whether they slept an average of 8.5 hours or 5.5 hours each night. However, while they lost the same amount of weight, the composition was different.

Written by Catharine Paddock PhD

Copyright: Medical News Today
Not to be reproduced without the permission of Medical News Today.

Objectively Measured Sleep Patterns in Young Adult Women and the Relationship to Adiposity; Bruce W. Bailey, Matthew D. Allen, James D. LeCheminant, Larry A. Tucker, William K. Errico, William F. Christensen, and Marshall D. Hill; American Journal of Health Promotion, In Press, published online 7 November 2013; DOI: 10.4278/ajhp.121012-QUAN-500; Abstract.

Additional source: Brigham Young University news release 13 November 2013.

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More sleep for children may decrease calorie intake

Wednesday 6 November 2013 - 1am PSTCurrent ratings for:
More sleep for children may decrease calorie intake

It seems everyone is looking for a culprit when it comes to childhood obesity: fast food, sugary drinks, super-sized everything. But it turns out part of the blame may lie with the simple matter of turning out the lights and rolling into bed.

That's according to the results of a study conducted by Chantelle Hart, associate professor of public health at Temple's Center for Obesity Research and Education (CORE), published in Pediatrics. The study, entitled "Changes in Children's Sleep Duration on Food Intake, Weight, and Leptin," is the first known study to examine the impact of sleep on children's eating behaviors by manipulating the amount of sleep that study participants were able to get.

The study, which was conducted while Dr. Hart was at the Miriam Hospital and Alpert Medical School of Brown University, involved 37 children, ages 8 to 11; 27 percent of whom were overweight or obese.

For the first week of the study, children were asked to sleep their typical amount. Next, during the second week, the group was randomized to either reduce or lengthen their sleep time; participants completed the opposite sleep schedule during the third and final week of the study.

The results were conclusive: During the week that the children increased their sleep, they reported consuming an average of 134 fewer calories per day, weighed a half pound less, and had lower fasting levels of leptin, a hunger-regulating hormone that is also highly correlated with the amount of adipose tissue, when compared to the week of decreased sleep.

"Findings from this study suggest that enhancing school-age children's sleep at night could have important implications for prevention and treatment of obesity," said Hart. "The potential role of sleep should be further explored."

So what's next? Hart is working on a study funded by the National Heart Lung and Blood Institute of the NIH using a brief behavioral intervention to get kids to increase their sleep to determine if there are significant changes in eating, activity behaviors and weight status.

While it is still early in the testing, Hart hints that the intervention looks promising:

"Given all of its documented benefits, in many ways, you can't lose in promoting a good night's sleep."

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