It’s Not Just Pre-Bed Screen Time that Causes Sleep Loss

Electronics and Sleep

The ideal 7-9 hours of nightly sleep is a recent discovery.  Historical data suggests humans have been struggling to get a good amount of sleep long before the invention of electronic devices.  Broken sleep was normal in industrial times, according to research from Virginia Tech’s sleep historian, Roger Ekirch.

Several studies have shown that screen time before bed can interrupt sleep patterns; however, recent research shows that even without television, laptops, or other electronic gadgets, people are getting less sleep than recommended by sleep experts.

A study out of Duke University looked at the sleep patterns of a Madagascar farming village without electricity or artificial lights.  Researchers found that these farmers actually get poorer, shorter sleep than those in Europe or the U.S.; however, of important note is that these villagers make up for lost sleep by having a regular sleep routine.

Findings were published in the American Journal of Human Biology. 

The addition of electronics and artificial light use before bed has greatly contributed to the decline of American sleep quality.  These bright lights and active screens make it near impossible for us to stay on course with a 24-hour synched biological clock.  Specifically, our brains are sensitive to the “blue” light that comes from a TV, computer, LED bulb, smartphone, or a number of other devices.  This light signals the brain to slow down its melatonin production, which is the hormone necessary for sleep.

Charles Nunn, a Duke professor, and his colleagues went to a small Madagascar village to try to gain a better understanding of human sleep patterns, especially since these people live without electricity.  This area is one of the few slivers of Earth that has little to no light pollution.

More than a billion people around the world live without electricity.  Rather than flipping a switch to turn on a light at night, villagers and those without electricity spend their time in relative darkness, with the use of oil lamps, the soft glow of cooking fires, or the light of the moon.

Scientists analyzed the nighttime and day naptime sleep patterns of 21 villagers aged 19 to 59 years.

Data was collected using watch devices on the participants, which had built-in motion and light sensors that track any form of movement and light exposure in real-time.  This was done for 292 nights.  Nine of the participants had a polysomnogram performed to see how restful and deep their sleep was.

Findings showed that these villagers got less sleep than those in Europe or America, even without the distraction of gadgets and artificial light.

However, notably, villagers had a more patterned sleep routine.  They generally went to bed around two hours after sunset, approximately 7:30 p.m.  They awoke about an hour before sunrise, around 5:30 a.m.; however, data showed that only 6.5 of those hours were spent sleeping.

Sleep was noted to be light and fragmented.  Houses were made of bamboo walls and thatched or tin roofs that did not keep out noise, and there were nightly parties, roosters, crying children, and barking dogs, making for a hectic sleep environment.

There were frequent nighttime awakenings, often to use the bathroom, which caused them to stay up for another hour or two before falling back to sleep.  Participants spent less time in deeper stages of sleep, especially the dream state called REM.  There was no complaining, however.  About 60% of participants reported being satisfied with their sleep.

The loss of sleep is compensated with daytime naps, usually up to an hour, which is twice as long as catnaps taken by many Westerners, Samson reported.  Researchers noted that the villagers’ sleep habits and bedtime routines were much more consistent than those in Western cultures were.  Even with the use of an LED lantern in the village for one week, participants still had virtually the same sleep and wake times.

This indicates that a regular bedtime routine and sleep schedule is important for a good night’s sleep.

Duke researchers will continue studying sleep patterns in urban populations around the world, with the goal being to build a better understanding of traditional sleep on a global level.

Reference:  https://www.sciencedaily.com/releases/2017/02/170217012515.htm

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include reading, traveling, and cooking.

Some Insomnia Drugs May Be Prescribed Out of Habit

Insomnia medication can be over-prescribed

Multiple factors are responsible for driving the complex clinical decision-making process.  Things like peer pressure, psychological and social dynamics, as well as exposure to pharmaceutical advertising play a role in a physician’s choice of medication to use on patients suffering from insomnia.

Harvard Medical School conducted new research, which shows a physician’s choice of insomnia drug is based heavily on habit.

These results indicate that physicians and other prescribing practitioners use these specific insomnia drugs almost like a reflex, done mostly out of routine rather than taking into account a patient’s medical history, symptoms, or sensitivities.  They may even ignore patient preferences in favor of their preferred insomnia medication.  It was the clinician’s prescribing pattern, not patient characteristics, that was the primary predictor of which drug would be used with insomnia patients.

This research was based on the review of 1,105 patient medical records, including clinical notes.  Results were published in February’s issue of Scientific Reports. 

These results show that, like the rest of the human race, physicians are ultimately creatures of habit, notes Andrew Beam, lead author of the study and research fellow at Harvard’s Department of Biomedical Informatics.  Dr. Beam reminds readers that doctors may not always be as rational as many people believe.

Approximately $60 billion is spent on insomnia every year in the United States.  That number does not even take into account the physical toll the condition takes on sufferers.  It is estimated that insomnia actually affects up to 40% of Americans.  Still, insomnia is one of the most underdiagnosed and poorly treated conditions that blight the American people.

Dr. Beam added in the report of their findings that choosing the right medication should be based on individual patient needs and characteristics.  This is critical to the successful resolution of symptoms, as well as the avoidance of social and psychological consequences related to insomnia.

The two most frequently prescribed insomnia medications, zolpidem and trazodone, were analyzed in this research.  Zolpidem is a newer drug with proven recorded efficacy; however, it is associated with several side effects including dizziness and drowsiness the next day.  Trazodone is older and often used for depression, but it does not have the efficacy of zolpidem; however, its safety profile is well established.

It is still unclear as to why doctors will choose one drug over another, which was the original driving factor for this research at Harvard.  Scientists set out to unravel the driving factors of clinical decision-making.

Researchers analyzed the narrative clinical notes, patient records, and physician prescribing records.  They found that a physician who prescribed one drug in the past was three times as likely to prescribe that medication again to other patients.

It was notable that patients who had depression symptoms along with insomnia were more likely to get a prescription for trazodone than insomnia patients who had no symptoms of depression.  Researchers note that this particular finding suggests that there are some considerations to patient characteristics in the provider’s medical decision-making.

Furthermore, these findings emphasize the importance of the data contained within electronic medical records, which can yield exceptionally interesting insights into the relationship between patient characteristics and provider medical decision-making with regard to treatment options.

Dr. Zak Kohane, department chair at HMS’s Biomedical Informatics, notes that electronic medical records have played a pivotal role in providing a richness to the information that is immediately available for research.  It allows scientists to deconstruct physician behaviors and decision-making habits and put them in context of the patient-provider encounter.  This is a good way to approach treatment decisions for more complex conditions.

 Reference: https://www.eurekalert.org/pub_releases/2017-01/nsf-wig011917.php

 Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.

 

Sleep Quality May be Affected by Air Conditioners

A joint research team from Toyohashi University of Technology, National Institute of Advanced Industrial Science and Technology, and the Department of Architecture and Civil Engineering published findings that showed air conditioning (AC) airflow stimulates the body during sleep, even when the velocity of the air is lower than an insensible level.  The AC may be affecting sleep conditions.  This indicates that some AC settings may have an unintentional negative affect on sleep quality, even if the person feels comfortable through the night.

Warming in urban areas blocks the temperature from cooling down at night.  This leads to sweltering heat at night, which severely deteriorates sleep quality; however, the general belief is that better sleep quality can be achieved if the temperature in the room is controlled with an AC.  Most people will leave the AC on all night, but there is a general scientific theory that this is bad for health.  Additionally, many people will experience chills during sleep, which will cause them to wake up periodically.

The AC system can be set up to configure the airflow velocity in a room; however, no published data has looked at airflow velocity measurement or the influence of airflow to human health and sleep quality.

Professor Kazuyo Tsuzuki led the research team.  Subjects were placed in one of two types of bedrooms, each with the same temperature but different airflow velocities.  Scientists then compared the body temperature control and depth of sleep using an electroencephalogram (EEG) and subjective reporting by the participants.

Insensible airflow is defined as air velocity that is 0.2 m/s or lower.  This means that the person in the room is unaware of the airflow level.  For this research, a comparison was made between the two types of airflow: customized AC mean velocity of 0.04 m/s and standard AC mean velocity of 0.14 m/s.  All rooms were set at room temperature.

Subjects reported they felt cooler with the higher airflow velocity during sleep and wakefulness.  There was no observable difference between length of sleep, skin temperature, rectal temperature, comfort, or sense of coolness or warmth.  Standard AC settings automatically lower the airflow velocity when the temperature reaches the setting.  It starts to increase again when the temperature rises.  The timing of airflow velocity and body movements were compared, along with waking stages, sleep depth, and heart rate.

The results of the study indicated that participants had more body movements, faster heart rates, and more nighttime awakenings in the standard AC room with a mean velocity of 0.14 m/s.  This indicates that standard AC settings may influence sleep, as researchers found that subjects have varying sleep depth changes or will roll over once cool air starts to blow into the room.

Only healthy adult male subjects participated in this study.  The findings and sample population imply that colder airflow may affect elderly, females, people with lower physical strength, and people with higher sensitivity to cold differently with regard to sleep quality.  These findings are expected to help figure out a healthy airflow velocity that would create the best sleeping environment.

Research findings were published in the online journal, Energy and Buildings.

 Reference:  https://www.eurekalert.org/pub_releases/2017-02/tuot-uaa021617.php

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.

 

 

Benefits of Low-Cost Treatments like Massage and Guided Imagery for Insomnia

massage and sleep

Many patients in a progressive care unit suffer from difficulty sleeping, as well as pain and anxiety.  In a recent study, researchers found that clinical massage and guided imagery might be a low-cost benefit to treating insomnia, anxiety, and pain in these patients.

The progressive care units in hospitals are for patients who are more stable than patients in the intensive care unit (ICU); however, they still need to be closely monitored with nursing care than those on regular hospital wards.  Patients on these wards have varying degrees of illnesses and morbidities.  It is well known that patients on the progressive care unit suffer high levels of anxiety, pain, and difficulty sleeping, so researchers are looking for non-pharmacological ways to treat these comorbidities.

While this was a small-scale study, using a sample size of 288 inpatients on two different progressive care units, scientists are hopeful in their discovery.  Findings were published in the journal, Critical Care Nurse.

The patients on the first progressive care unit were given a free 15-minute clinical massage every day by a trained massage therapist in the integrative medicine department at Beaumont’s Troy, Mich campus.  The therapist used Swedish massage techniques, typically targeting the hands and feet or neck and scalp, according to the patient’s comfort level.

Those on the second progressive care unit were offered 30 minutes of guided imagery meditation via an audio recording.  This recording focused on pain and anxiety reduction, as well as promoting sleep.  On discharge, these patients were asked if they had listened to the recording and, if they did, how many times.  Patients also gave their reason for listening to the recording – whether it was pain, anxiety, and/or insomnia – and reported whether or not it was helpful.

Results found that massage had an immediate benefit with reduction in self-reported anxiety and pain.  Additionally, guided-imagery patients reported improvement in their insomnia, as well as in their pain and anxiety.  Using an 11-point scale for the massage intervention, more than 80% of these patients reported at least a 1-point decrease in pain and anxiety after treatment.

More than 85% of guided-imagery patients reported some form of improvement in their insomnia, pain, and anxiety.

These reported improvements, while subjective, are dramatic when looking at pain, anxiety, and insomnia scores.  It shows that the treatment interventions had a positive impact on the patients’ well-being.

 Lead author of the study, Gail Elliott Patricolo from Integrative Medicine at Beaumont Health System notes that the results of these interventions are positive and can be used in practical measures to improve patient care, but that there needs to be additional education to staff and patients on these methods.

Further studies will need to be done on a larger scale, to include a more diverse population sample.  Additionally, it would be beneficial to add treatment options to the study that would include patients with visual or hearing impairments.

 Reference:  http://ccn.aacnjournals.org/content/37/1/62.full

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her

Research Shows Camping Good for Sleep

camping good for sleep

Research Shows Camping will Recover Sleep Patterns

Many people stay up late into the night, usually watching some type of screen like a television, phone, or tablet.  Reading is even a major culprit to sleep loss.  Waking up in the morning is rarely easy for most people.  Now, however, scientists have discovered evidence that points toward additional sunlight exposure recovering sleep patterns.  Findings were published in February’s issue of Current Biology.

No matter what time of year we are in, a few days outdoors in nature, without electricity for distraction, will reset the biological clock and lead to earlier bedtimes.

Most people now understand that sleep deprivation, including disrupted sleep and shorter duration, in our modern culture is negatively associated with health problems and decreased performance, including excessive daytime sleepiness, lower productivity and focus, mood disorders, diabetes, obesity, and substance abuse.  Kenneth Wright from the University of Colorado Boulder noted that these findings show that modern environments lead to interrupted sleep and disrupted circadian rhythms, no matter the season; however, a weekend camping trip can restore these rhythms.

Past studies have shown that exposure to electrical lights and loud environments lead to a delay of about two hours in the biological clock, which is shown through a shift in normal levels of melatonin, the primary hormone responsible for regulating sleep.  Just a week of outdoors time under a summer sun could shift those biological clocks to factory settings, allowing one to get to bed earlier.

Additional questions surfaced at these findings:

  1. What about winter, with its frigid air and shorter days?
  2. How fast do our clocks really change?

In this most recent research, scientists addressed these questions by sending a group of five people out into the cold Colorado winter weather for some camping.  This was done around the time of the winter solstice, which is the shortest day, or longest night, of the year.  Cell phones and flashlights were not allowed.  Scientists monitored their response to sleep and hormonal rhythms.

Modern lifestyles, with our electricity requirements, reduce sunlight exposure in winter by 13 times.  However, increased time outside during winter months led to earlier bedtimes by about an hour.  Biological clocks changed to a rhythm that showed 2.5 hours earlier than before the camping trip.  Biological clock rhythms were measured by determining when melatonin levels increased in the body.  Sleeping patterns in the Colorado participants followed those expected melatonin changes.

Mr. Wright and his team reported that one of their questions was whether camping just once in the summer was enough to reset the clocks, and it was.  For this part of the study, they sent nine participants into the wilderness, keeping another five participants at home.  That weekend of camping prevented the typical pattern of weekend late nights and sleeping in, which prevented the disruption in the circadian rhythm.

While people are certainly responsive to seasonal changes to sunlight, our modern chaotic culture of light and noise bump our clocks out of sync even further; however, this can be fixed with just a few days of nature and sunlight.

If an individual is looking to restore their sleeping patterns and start getting to bed at an earlier time, a camping weekend may be just the answer; however, it is important to remember that consistence is the key to success.  Keeping a regular schedule and a bedtime routine will be essential.  Mr. Wright notes that increasing sunlight exposure during the day and reducing screen time and light exposure at night will go a long way to helping you restore your rhythm.

These findings indicate that it may be worthwhile for companies to create a working environment that allows for more sunlight exposure, and it may lead to lighting companies incorporating tunable lighting options, which would change by the hour and depend on where the sun is located in the sky.  There is the possibility that doing this will improve health, performance, and productivity.

It is the hope of Mr. Wright and his colleagues that they will discover how much sunlight is really needed to recover sleeping rhythms, as well as figure out the connection between health, circadian rhythms, and natural light exposure.

 Reference:  https://www.eurekalert.org/pub_releases/2017-02/cp-tgt012617.php

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include reading, traveling, and cooking.

 

Discovery of Breathing Molecule May Help Treat Sleep Apnea

sleep research

Targeted treatment for respiratory conditions, especially sleep apnea, are possible with the discovery of a breathing molecule found in new research out of the University of Warwick.

The name of the molecule is Connexin26 (Cx26).  It identifies CO2 levels in the blood and then activates the breathing mechanisms that release it, which means it has evolved specifically for this purpose.

This new research could lead to better treatment options for respiratory conditions and even deafness because physicians will be able to target the problem more accurately.

A professor at the School of Life Sciences by the name of Nicholas Dale is the person who made the discovery of Connexin26 (Cx26).  He identified it as the key molecule that reacts to CO2 levels, which then causes the body to activate the muscles necessary for breathing.

The discovered molecules are responsible for alerting the body when CO2 levels reach a certain point in the bloodstream and need to be excreted through exhalation, as well as take in oxygen for replenishment with inhalation.  This is the vital process of preserving life, and we now have an identified molecule that activates that involuntary process of breathing, allowing blood to flow to the brain.

If this molecule were to malfunction or stop working, our bodies would fill with CO2 and breathing would become exceedingly difficult or near to impossible.  Furthermore, high CO2 levels can be toxic to the human body.

The Cx26 molecule can mutate, and there are a number of serious medical conditions that are associated with this mutation, including congenital deafness and respiratory diseases.  Cx26 mutations are associated with vision impairment and skin syndromes as well.  Those who have these mutations are at increased risk of sleep apnea because properly Cx26 molecular function is directly associated with comfortable breathing.

Professor Dale notes that identification of these molecular mutations will allow scientists to work with them and discover ways to restore the molecule to normal function, which could also include targeted treatment options more personalized in nature, thereby improving patient experience and quality of life.

Each being on earth has a different tolerance level to CO2 in their bloodstream.  This group looked further at this theory to see if the Cx26 properties would match in different animals.  They analyzed birds because of their high-altitude flying and their ability to tolerate higher levels of CO2.  Furthermore, humans were similar to rats in CO2 tolerance, and mole rates (who live underground) had extremely high tolerance to CO2.

This team of researchers discovered that the binding properties of CO2 correlated with the sensitivity levels in each animal examined.  Natural selection in our evolutionary scale has modified the CO2 binding properties in the Cx26 molecule, leading researchers to believe that the molecule is universally important to warm-blooded animals when it comes to detecting CO2 levels.  This finding could certainly add weight to research in sleep apnea treatments.

Regarding the findings, Professor Dale notes that these important molecules show universal function in the physiological sense, which evolution has continually shaped over time.  This fact was shown in these findings, he notes, because CO2 binding characteristics in the Cx26 molecule are necessary for us to breathe and survive.  This will likely help scientists discover better treatment options for people with respiratory illnesses, especially sleep apnea.

Professor Dale published ‘Evolutionary Adaptation of the Sensitivity of Connexin26 Hemichannels to CO2’ in Proceedings of the Royal Society B.

 Reference:  https://www.eurekalert.org/pub_releases/2017-02/uow-bmd020117.php

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include reading, traveling, and cooking.

 

Sleep Deprivation Leads to Decreased Immunity

sleep deprived

More consequences of sleep deprivation – decreased immunity

Subjective complaints of illness creep up after a prolonged period of sleep loss, and new research points to an explanation of why.

Researchers for this study analyzed blood samples of 11 pairs of identical twins.  The different sleep patterns were measured and reviewed, noting that the twin who had more sleep deprivation also had a weaker immune system than his or her sibling.  Findings were published in January’s issue of the journal, SLEEP.

Dr. Nathaniel Watson, co-director at Harborview Medical Center’s UW Medicine Sleep Center notes that this research shows that the immune system is stronger when the individual gets plenty of quality sleep.  He reminds readers that current data shows seven to eight hours to be recommended for optimal health.

The unique attribute of this research was the employment of identical twins, rather than fraternal twins or individual adults, so scientists could control for the genetic disposition in the sleep duration of humans.  Scientists note that genetics is responsible for about 31% to 55% of sleep behavior and duration, while environment and setting account for the rest.

Senior author of the research and director of Computations Medicine Core at the Center for Lung Biology at UW Medicine, Dr. Sina Gharib, explains that current published research shows us that sleep deprivation, even when done for a short time in a laboratory setting, activates immune cells and increases the presence of inflammatory markers around the body.  It is notable, however, that scientists do not completely understand the true effects of sleep deprivation in natural conditions in the long term.  While the study used real world conditions and simulations, Dr. Gharib notes that this research shows us, for the first time, that chronic sleep deprivation negatively affects the immune response seen in white blood cells.

Dr. Watson notes that these findings correlate with the current published studies, which show that sleep deprived individuals who are exposed to rhinovirus are more likely to be sick from the virus than those who get enough sleep.  Furthermore, these findings show that those with sleep deprivation who are given a vaccination have a lower antibody response in the body.  This research adds data to these findings with evidence that sleep affects overall health and well-being, especially with regard to immunity.

Scientists cited data found at the Centers for Disease Control, which stated that people in the U.S. have been getting about 1.5 to 2 hours less than the recommended amount of sleep over the last century.  The CDC reports that about 1/3 of workers in the country sleep fewer than six hours every night.

What is the cause? Researchers believe that modern society’s control over technology, light, and countless competitors for your time are what to blame for sleep loss and decreasing health.  This, coupled with the trending belief that sleep is not an important factor in our health, has led to a widespread practice of de-prioritizing sleep.

Reference:  https://www.eurekalert.org/pub_releases/2017-01/uowh-csd012617.php

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include reading, traveling, and cooking.

 

Study Shows Midlife Women have no Sleep Benefits from Yoga and Exercise

exercise and sleep

New research shows that aerobic exercise and yoga do not significantly impact the sleep disturbances objectively reported by midlife women who experience hot flashes.

A randomized control trial was used for secondary analysis of this finding.  Researchers found that neither 12 weeks of cardiac exercise nor 12 weeks of yoga showed any statistically significant differences in the objective measures of quality and duration recorded by participants.  There were no reports of difficulty falling asleep; however, sleep disturbance was a common occurrence at baseline measurements and then remained that way after the interventions.  The women reported waking up in the middle of the night for at least 50 minutes, and sometimes longer.

Authors of this study note that prior analyses published in various journals used the same trial to state that aerobic exercise and yoga interventions did show statistically significant improvements in self-reported insomnia severity and sleep quality, albeit small improvements.

Lead author of the analysis, Diana Taibi Buchanan, associate professor at the University of Washington in Seattle’s Bio-Behavioral Nursing and Health Informatics department, noted that these primary findings showed that the two interventions of aerobics and yoga did not significantly improve objective sleep outcomes in women in their middle years who suffer from hot flashes.  These findings imply there are other behavioral treatments that have the potential to improve sleep quality and duration in this population, and that this should be further studied.

These results were published in January’s issue of the Journal of Clinical Sleep Medicine, which can be found online.

The MsFLASH network, which stands for Menopause Strategies: Finding Lasting Answers for Symptoms and Health, was used in this study analysis by researchers.  There were 186 postmenopausal and late transition women experiencing hot flashes.  All women were aged between 40 and 62 years.  Each woman experienced an average of 7.3 to 8 hot flashes every day.  For this study analysis, researchers randomized participants into one of three groups: usual activity, 12 weeks of aerobic exercise, or 12 weeks of yoga.

Wrist actigraphy was used to measure sleep.  The sleep and wake times were determined specifically from each participant’s sleep diary.  Average sleep duration at the beginning of the study and after the intervention was less than the recommended seven hours each night, as given by the American Academy of Sleep Medicine for best health benefits in adults.

Scientists from this study note that additional research should be performed to explore approaches that would improve sleep quality in this patient population, which likely will include cognitive behavioral therapy for insomnia (CBT-I).

Reference:  https://www.eurekalert.org/pub_releases/2017-01/aaos-sst012317.php

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.

 

Patients with Muscular Dystrophy Benefit from Sleep Disorder Therapy

Most patients with myotonic dystrophy type 1 (DM1) also suffer from respiratory and sleep disorders.  DM1 is the most common form of muscular dystrophy found in adults.  Recent research published in the Journal of Neuromuscular Diseases notes that due to the variety of sleep difficulties in DM1 patients, the treatments often do not work on a one-size-fits-all model.

Sophie D. West, MD, lead investigator of the study from Newcastle Regional Sleep Service, Newcastle upon Tyne Hospitals in the UK, notes that patients with myotonic dystrophy type 1 frequently suffer from severe daytime sleepiness, with anywhere between 33% and 80% of patients reporting problems.  She notes that there may be other contributing problems leading to the sleepiness like obstructive sleep apnea (OSA), periodic limb movements in sleep, poor sleep patterns, respiratory failure, or narcolepsy.

Overnight sleep studies were given to all DM1 patients who showed signs of severe daytime sleepiness in their annual follow-up visits between May 2011 and May 2015 at John Walton Muscular Dystrophy Research Center in Newcastle upon Tyne.  In 120 DM1 patients, scientists found that 30% showed intrinsic sleepiness on the Epworth Sleepiness Score (ESS), 27% experienced respiratory failure, and 18% suffered from OSA.

Patients were put into one of four groups:

  1. Those with intrinsic sleepiness on ESS
  2. Those with respiratory failure during the day
  3. Those with OSA symptoms
  4. A control group for those who had no sleep-related problems

Treatments were administered for the individual symptoms, including use of the drug modafinil for daytime sleepiness, non-invasive ventilation for respiratory failure, and continuous positive airway pressure (CPAP) for OSA patients.

The study showed that only 29% of patients continued the therapies and reported benefits.  This was an unexpectedly lower result than what would be seen in other patient populations, suggesting that additional research is needed to identify if DM1 patients are more likely to benefit from targeted therapy.  Additional research is also needed to find the most effective way to deliver targeted therapies to these patients.

To improve target therapies for DM1 patients, researchers recommend classifying these patients in three types of sleep disturbances, as listed above.  Those with high ESS scores, light use of sedatives, and no restless leg syndrome, modafinil showed good results for daytime sleepiness.  For those with OSA without respiratory failure, the standard CPAP treatment would be beneficial.  For patients with daytime respiratory failure and abnormalities on sleep studies, providers should try noninvasive ventilation techniques.

There are varying levels of muscular and respiratory impairment, as well as sleepiness in all muscular dystrophy patients.  The disease is heterogeneous in nature.  Dr. Sophia West notes that this data is extremely valuable for those who are working toward better treatment methods for DM1 patients with excessive daytime sleepiness.  These findings support their efforts with detailed sleep tests and targeted therapies that will, hopefully, improve symptoms in the long-run.

Reference:  https://www.eurekalert.org/pub_releases/2017-01/ip-ttf011317.php

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.

 

Sleep Education Reduces Risk of Injury and Disability in Firefighters

firefighter sleep

Long workweeks and extended shifts have contributed to a high number of firefighters suffering from acute and chronic sleep deprivation, as well as disrupted circadian rhythms, or sleep-wake cycles.  Previous studies have shown a link between long shifts and risk of burnout, sleepiness, errors, and injuries, especially when compared to shorter shifts in first responders, ER physicians, and EMTs.  Furthermore, sleep disorders in firefighters often go undiagnosed, increasing their risk of injury and deteriorating health.

Researchers at Brigham and Women’s Hospital theorized that a workplace-based Sleep Health Program (SHP) would benefit firefighters by increasing their knowledge about health and safety compared to standard practices.  The SHP was created to incorporate education and a sleep disorder screening.  In the mid-sized fire departments that were tested, half of the employees participated in the SHP, while the other half continued as they had been.  Injuries, disability days, and other measures were watched and recorded over the next 12 months.  This study is the first randomized trial to demonstrate the reduction in injury and disability risk with an SHP in place.

The research found an almost 50% reduction in disability days among those who had the SHP.  Additionally, the firefighters who attended the sleep health education sessions were less likely to be injured over the 12-month period.  These findings are published in the online journal, SLEEP.

Dr. Steven W. Lockley, senior author of the study and neuroscientist at the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital, notes that this indicates a wellness and sleep health education program held in workplace setting for firefighters, along with free screenings and information about sleep disorders, resulted in fewer injuries and disability days.  Sleep disorders are prevalent in firefighters and are comparable to those found in a large nationwide cohort study.  When this is coupled with 24-hour shifts and chronic sleep loss, risks for on-the-job sleepiness and injury become a real problem.  This SHP program showed that to reduce injury and disability, implementation of a thorough and well-maintained educational program would be beneficial in all fire departments.

The scientists emphasize that there is a definite and well-defined connection between higher risk of health problems like heart disease and metabolic syndromes and untreated sleep conditions.  It is also well established that sleep deprivation leads to higher rates of automobile accidents, so a Sleep Health Program could help identify and treat these disorders and reduce that risk, which would benefit firefighters’ long-term health and short-term safety.  Many occupational health programs that offer sleep health education and sleep disorder diagnosis and treatment can be promoted as well.

Reference:  https://www.eurekalert.org/pub_releases/2017-01/bawh-shp011217.php

Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.