Impaired Ability to Recognize Facial Expressions is Linked to Sleep Deprivation

sleepy face

A study out of the University of Arizona Psychology Department found that a rough night’s sleep may impair your ability to read the room when it comes to facial expressions.

Published in Neurobiology of Sleep and Circadian Rhythms, the research reported that participants who were sleep deprived had a harder time recognizing happy and sad facial expressions than those who were well rested.

However, it is notable that sleep-deprived participants did not show any impairment in recognizing other emotional facial expressions like anger, surprise, fear, and disgust.  That may be because those expressions and emotions are more primitive, and they are wired differently in our brains to help us survive dangers.

Research was led by the UA professor of psychology, psychiatry, and medical imaging, Dr. William D.S. Killgore.

Social emotions like sadness and happiness do not indicate threat like anger and fear do, so they are emotions that are not as necessary for immediate survival.  When we are sleep deprived, we are more likely to dedicate all resources to recognizing only things that put us in immediate danger.

Dr. Killgore notes that even when you are sleep deprived, you should still be able to identify when someone is trying to harm you.  In that kind of situation, being able to read whether someone is happy or sad is not that important, so social emotions are put on the backburner when your body is trying to fight the effects of exhaustion.

Dr. Killgore collected data from previous research that focused on how sleep deprivation affects emotional, social, and moral judgements.

Fifty-four people were analyzed in this study.  They each were shown a photograph of the same man’s face expressing different degrees of emotions like sadness, anger, fear, happiness, disgust, and surprise.  The participants then had to determine which of those emotions was being expressed on the man’s face.

The images were intentionally somewhat ambiguous, using commonly confused expressions that were morphed and modified by a computer program.  For example, one expression may have shown 30% surprise and 70% sadness.  This was done to analyze the participants’ ability to recognize more subtle expressions.  A total of 180 images of blended facial expressions were shown in each session.

The baseline response to the photographs when well-rested were compared to their responses after one night of sleep deprivation.

The more obvious facial expressions, like a frown or grin, could be identified without any problem, regardless of how much sleep that person got the night before; however, tired participants had a tough time recognizing subtle expressions of sadness and happiness, even though their ability to identify other emotions was not impaired.

After a good night’s sleep, the participants had no problems recognizing those sad and happy expressions, immediately returning to baseline level after recovery sleep.

The difference between the two was not as significant as some might hope; however, it is enough evidence to suggest that long-term sleep deprivation could have a significant effect on social interactions.

Dr. Killgore notes that in this society, most people are not able to get the recommended seven to eight hours of sleep each night, with the average being less than six hours of sleep.  This could impair the ability to read common emotions and, therefore, interfere with daily interactions.  For instance, you may respond inappropriately to a person who is sad because you thought they were angry.  Social emotions are uniquely human, so not being able to identify those in other people could lead to some serious complications in everyday life.  You would be unable to read what your spouse or partner needs from you as well.

This research was built onto the existing work focused on how sleep deprivation affects the brain’s prefrontal cortex, which is responsible for making decisions, judgements, and using emotions.

An earlier study from Harvard found that sleep deprivation causes a disconnect between the prefrontal cortex and the amygdala, which is the part of the brain that helps you respond to emotions.

Essentially, these two parts of the brain control emotions and help us recognize those expressions on others, and sleep deprivation causes them to lose their communication.  The point of this study was to test that theory from the Harvard study, and Dr. Killgore is confident that it does.


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

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Sound Waves Help Older Adults Achieve Deep Sleep

sound waves deep sleep

Deep sleep is important for memory consolidation, yet, as human beings enter into middle age, the quantity of deep (or slow wave) sleep they achieve is known to decrease significantly. Researchers believe that this reduction in slow wave sleep is one of the causes of memory loss when we age, and neuroscientists are constantly researching new methods to enable people to achieve better quality sleep in their older years.

 A recent study, published by scientists at Northwestern University (March, 2017) has shown that a promising new way to achieve deep sleep in older adults, is gentle sound stimulation (such as the sound of waves or water flowing), synchronized to the rhythm of brain waves. The study showed that elderly adults who relied on this technology, not only achieved more deep sleep but were also able to recall more words. Previous research had shown that acoustic stimulation methods worked well with young adults in terms of increasing the quantity of deep sleep but the new study is the first of its kind to be carried out on older adults.

In the study, 13 participants between the ages of 60 and 84 received acoustic stimulation on one night, and placebo stimulation on another night. On both occasions, participants took a memory test before sleeping, and again in the morning. Those who received the placebo stimulation showed better results in the morning than they had at night time, but those who received ‘pink-noise stimulation’ using a specific algorithm, saw three times as much improvement in their test results. Memory improved in accordance with the degree of slow wave sleep stimulation provided, indicating that deep sleep is indeed important for memory retention, even for older people.

The secret of pink noise stimulation lies in the algorithm developed by one of the study authors, Giovanni Santostasi, a specialist in Neuroscience, Biotechnology and Biostatistics. This algorithm is both automated and adaptive, capable of monitoring slow wave activity in the EEG, and phase-locking the timing of the pink noise stimulation to one particular phase of the slow wave. The algorithm adapts to each individual, given that each person achieves deep sleep at a different time.

Achieving deep sleep is as vital as keeping our circadian rhythms in sync. Failing to respect the natural sleep-wake cycle can lead to everything from problems with learning to sleep disturbance and mood changes, while deep sleep is crucial for hormone regulation and physical renewal. The lead authors of the study noted that although larger studies would be necessary to confirm the efficiency of pink noise stimulation in older adults, the technology could eventually be offered to people for home use. They are currently conducting research into whether or not acoustic stimulation can improve cognitive functioning in adults with mild cognitive impairment. Previous studies carried out in these individuals showed that there is a possible relationship between quality of sleep and memory impairment.

The study authors also stated that more research would be required to elicit the effects of repeated nights of pink noise stimulation on the brain physiology and memory. The positive results achieved thus far, they noted, could indicate that the elderly population (particularly those with a high risk for cognitive decline, such as the elderly and those with cardiovascular disease) could benefit greatly form this relatively simple intervention. Future studies would therefore need to focus on repeated use at home, potentially over various weeks, as a means of improving memory in high-risk groups.

Some of the areas most affected by cognitive decline in the elderly include memory, processing speed and executive function. Elderly adults often complain that they cannot recall specific facts or episodes; this type of decline is related to age-related dementia. The researchers noted that cognitive decline is often attributed to failures in encoding and/or retrieval of information, yet consolidation also plays a vital role in optimal cognitive functioning.

Further Reading, What Role does Your Biological Clock Play in Recovery?, accessed March, 2017.

Acoustic Enhancement of Sleep Slow Oscillations and Concomitant Memory Improvement in Older Adults, accessed March, 2017.

 How the Brain Consolidates Memory During Deep Sleep, accessed March, 2017., Longitudinal invariance of adult psychometric ability factor structures across 7 years, accessed March, 2017., Mild Cognitive Impairment, accessed March, 2017.

Guest Author: Anne James is a freelance writer. She previously held a management role in healthcare.

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Sleep Apnea in Children Could Lead to Changes in Mood and Cognition

A new study from the University of Chicago compared children between 7 and 11 years old with sleep apnea to children who slept normally.  Findings showed that there were significant decreases in gray matter in various regions in the brains of the sleep apnea children.  Gray matter is responsible for memory, emotions, perception, speech, movement, self-control, and decision-making.

Sleep apnea affects approximately 5% of children in the world, so these findings point to a connection between delayed growth of the developing brain and sleep disturbances.  The noticeable and proven gray matter reduction in children with sleep apnea – a treatable disorder – adds another reason for parents to consider getting early treatments for their child if there are symptoms of sleep apnea.

Director of pediatric clinical sleep research out of UC, Dr. Leila Kheirandish-Gozal, notes that these findings are astonishing.  There is no precise guide to link cognitive deficits with gray matter loss; however, evidence shows a widespread problem of neuronal damage and loss when compared to children of the same age without any conditions.

These findings were published in Scientific Reports on March 17.  Researchers analyzed 16 children with a diagnosis of obstructive sleep apnea (OSA).  The children stayed overnight in UC’s pediatric sleep laboratory to have their sleep patterns analyzed throughout the night.  Additionally, all children underwent brain scans, MRI, and neuro-cognitive testing.  Scientists from the University of California in Los Angeles analyzed the images.

Those analyses were compared to the MRI and neuro-cognitive tests from nine healthy children from the general population that matched the gender, age, weight, and ethnicity of the children with sleep apnea.  The results for the 16 OSA children were also compared to 191 MRI’s of children who were already part of an MRI database in the National Institutes of Health.

The gray matter in brains of the OSA children was significantly reduced in several regions.  These regions included the prefrontal cortices (responsible for planning, personality, and complex behavior), the frontal cortices (movement, memory, judgement, language, problem solving, and impulse control), the parietal cortices (integration of sensory input), the temporal lobes (selective listening and hearing), and the brainstem (control of respiratory and heart functions).

The consequences of reduced gray matter may be obvious on the scans and comparisons, but the true effects are difficult to measure.

Co-author of the study, Dr. David Gozal from UC, notes that while the MRI scans provide a good amount of information regarding the difference in volume levels within the brain of apnea patients, it is still unclear how and when the neurons are affected at a cellular level.  MRI scans are not designed to determine the size, movement, and presence of brain cells.  From the MRI, there is no way for scientists to determine when the damage and loss occurred.  However, prior studies from this same group connected the cognitive deficits with disease severity, when the deficits can be detected.

Future collaborative studies with UCLA are underway, which will use state-of-the-art technology and imaging techniques to attempt to answer the questions raised in this study.  Without further research and cognitive function tests before the onset of OSA, there is no way to measure how neuron loss affects functioning.

As an example, someone who is born with an IQ of 180 may lose 8 to 10 points on that scale because of sleep apnea; however, that may never be apparent.  If the child’s IQ is average (between 90 and 100) and they sustain that drop in IQ because of sleep apnea, that could place them below the national normal average.

It may be too soon to measure to effects in children of this age group.  Studies that connected higher intelligence with increased gray matter are well-documented, but only in adolescents that are an average age of 15.4 years.

The potential to reverse the effects of gray matter reductions are essentially undiscovered; however, it is likely that decreased gray matter in so many areas of the brain interferes with brain functioning and will put the child at risk of developmental delays.  This should prompt detailed research to determine the best ways to prevent severe cognitive delays in children.


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

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Bright Light Therapy for Patients with Parkinson’s and Sleep Disorders

light bulb

Bright Light Therapy for Patients with Parkinson’s and Sleep Disorders

 Bright light therapy is a treatment that has been used in patients with disruptions in their circadian rhythms.  This is the internal biological clock that tells the brain and body when it should be awake and when it should sleep.  There are several factors that could disrupt this rhythm, including chronic disease, travel, stress, and light pollution.

Recent studies published in Psychogeriatrics and JAMA Neurology have found that bright light therapy (BLT) may be helpful in some debilitating chronic diseases like dementia, Alzheimer’s, and Parkinson’s disease, which are notorious for negatively affecting sleep patterns in sufferers.

For the most part, hypnotic drugs are used to help with sleep, but side effects can be extremely troublesome for patients who are already cognitively and neurologically compromised.  Dementia and Parkinson’s patients react badly to sleep drugs because of the daytime sleepiness, amnesia, and additional fall risks.

Therefore, bright light therapy was trialed first in Alzheimer’s and dementia patients, and then in Parkinson’s patients.

Daytime administration of BLT was helpful for dementia patients because it retrained the circadian rhythm to override the disturbances; however, as with all studies, researchers noted some limitations and issues.

They did not adjust findings to types or grades of dementia, and there is no set protocol for BLT administration yet.  In the study of dementia and Alzheimer’s patients, 17 participants were given BLT for one hour a day in the morning for a total of two weeks.  Four of the 17 patients showed marked improvement in their sleep quality, all of whom had Alzheimer’s type dementia.  These patients were still in earlier stages of the disease.  This indicates that BLT could be an effective preventive measure for Alzheimer’s patients, depending on type and grade.

Parkinson’s disease patients have limited options to treat their sleep problems as well.  As noted in the study published in JAMA Neurology from Northwestern and Rush Universities, bright light therapy showed significant improvement in daytime sleepiness for these patients, per results on the Epworth Sleepiness Scale; however, dim-red light therapy also showed some improvements in sleep quality.

A total of 31 patients participated in this Parkinson’s study, which was randomized and placebo-controlled. Patients were split into two groups: one group received bright light therapy and the other received dim-red light therapy for one hour a day over the course of two weeks.

Patients who received BLT reported improvement in sleep metrics like reduced number of nighttime awakenings and the ability to fall asleep faster.  Both forms of light therapy showed increases in physical activity.

Light therapy is a non-invasive or pharmaceutical intervention that is well-tolerated.  It may prove to be a good intervention for chronic disease patients with disrupted sleep-wake cycles.  As with all scientific findings, further research with larger and more diverse patient populations would be beneficial in determining the efficacy of bright light therapy for sleep disturbance.


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

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Sleep-Deprived Teens More Likely to Commit Crimes than Adults

sleep deprived

New research out of the University of York in the United Kingdom and the University of Pennsylvania reported that teens who report midday sleepiness tend to show more anti-social behaviors like fighting, cheating, stealing, and lying.  In fact, more than a decade later, those same overtired teens were 4-1/2 times more likely to commit violent crimes.

One of the lead authors of the study is Adrian Raine, who is a Professor at Richard Perry University and a member of the Criminology and Psychology Department in the School of Arts & Sciences, as well as Penn’s Perelman School of Medicine Department of Psychiatry.  This is one of the first studies to link daytime sleepiness in teens to criminal activity more than a decade later.

These findings were published in the Journal of Child Psychology and Psychiatry. 

As part of his Ph.D. research, Dr. Raine collected data 39 years ago, under the guidance of Peter Venables from the University of York.  He never truly analyzed this data, however.  There has been a recent influx in cross-sectional studies analyzing behaviors at specific points in time in order to link behavioral problems and sleep deprivation in children.  In response to these studies, Dr. Raine reviewed his dissertation and research to find a link between criminal behaviors in adulthood and sleep loss in childhood and adolescence.

The previous research focused heavily on sleep problems, but in the recent study, researchers measured daytime drowsiness in the children instead.

Drs. Raine and Venables used a sample size of 101 teenage boys (15 years of age) from three different schools in northern England.  Each lab session ran from 1 to 3 p.m.  At the end of these sessions, Dr. Raine would ask the participants to rate their sleepiness on a scale of 1 to 7, with 1 being ‘unusually alert’ and 7 being ‘sleepy.’  He captured information on sweat-rate responses and brain-wave activity to stimuli.  These measured attention levels to a musical tone played through headphones, representing attentional function.

Dr. Raine collected information about anti-social behavior, both from teachers who had worked with the teen for a minimum of four years, as well as those behaviors self-reported by the boys.

Both measurements were helpful because some of the boys did not want to discuss their behaviors, which is where the information from the teachers became useful.  Surprisingly, the teacher and participant reports correlated well.  This is atypical, because you generally get a different story from the kid tham you would get from the teacher.

Dr. Raine followed these same participants by searching London’s Central Criminal Records Office for any criminal activity between the ages of 15 and 29.  He excluded minor violations and focused on property damage offenses and violent crimes.  Also, he only looked at crimes for which the participate was formally convicted.  It was noted that 17% of the boys had some sort of violent criminal behavior by the age of 29.

Dr. Raine incorporated socioeconomic status into his conclusions, noting a definite connection.  The link was found between low social class and early social diversity leading to daytime sleepiness, which in turn led to brain dysfunction and inattention, resulting in criminal behavior 14 years later.  Dr. Raine describes this finding as a flow diagram moving cleanly from one point to the next.

In other words, poor attention is connected to daytime sleepiness.  That lack of focus then serves as the proxy for a dysfunctional brain, which, in Dr. Raine’s analysis, can lead to criminal behavior.

Scientists do emphasize, however, that drowsiness does not predispose a teen to anti-social behavior and criminal activity.  Thousands of children suffer from sleep problems and do not grow up to break the law.  However, it is notable that researchers did find a greater prevalence of anti-social behavior in teens who reported midday sleepiness, which lead to a higher occurrence of crime later in life.

This provides an opportunity to help identify and treat children with behavioral disorders.  A simple trial of getting more quality sleep at night may help solve the behavioral problems.


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

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A Placebo May be Effective in Treating Insomnia

The journal, Brain, published new research suggesting that insomnia treatment may not need to include neurofeedback, or training of the brain functions.  Instead, researchers found that patients experienced the same benefits if they just believed they were receiving neurofeedback training.

Approximately 10% to 35% of the world’s population suffers from insomnia.  Very few studies have addressed insomnia treatments using non-pharmaceutical measures, despite the condition being a major health concern in our culture.  For this study, scientists recruited 30 patients with a diagnosis of primary insomnia.  All patients underwent neurofeedback training and then a placebo training over the course of several weeks.

The goal of this research was to investigate findings from an earlier study that showed positive effects on sleep quality and memory using neurofeedback.  Researchers wanted to determine if these effects could be replicated in a double-blind placebo study.  All participants underwent 12 sessions of neurofeedback and placebo feedback training in a laboratory.

The focus of the study was on mapping the EEG response to neurofeedback, while also looking at quality of life and sleep habits in insomnia patients.  Because of this, patients underwent EEG before and after both the real and the placebo feedback trainings.  In between the first and second, as well as the third and fourth visits, patients went through 12 sessions each of neurofeedback and placebo feedback training, all with real EEG feedback on different frequency bands.  The order of trainings was counterbalanced, so all 12 sessions were finished within four weeks for each intervention.  Sleep-wake cycles were monitored and analyzed using data from eight nights in a sleep lab, as well as actigraphy and diaries over the entire study period.

Both forms of feedback training were shown to cause equally effective results, which were reflected in patient measures of any sleep complaints.  This suggests that the improvements were more likely due to immeasurable factors such as trusting the experimenter, as well as receiving empathy and care from them.  The improvements, however, were not seen on EEG measures of sleep quality.

For primary insomnia, scientists note that neurofeedback treatment is not more or less efficacious than the placebo.  There was no noticeable advantage of neurofeedback over that of the placebo intervention.

Ultimately, these results indicate that patients would have subjective improvements in sleep and life quality from any form of treatment if they believed it would help.  Scientifically speaking, however, there is no verifiable evidence on EEG brain activity that would suggest real improvement.

Lead author of the study, Manuel Schabus, noted that these results bring up the question of how much of the published data on neurofeedback results are due to patient expectations or unspecified placebo effects.

The symptom improvement reported by patients was not specific to the neurofeedback training.  Instead, the improvement seems to be brought on by immeasurable factors, such as feeling cared for.  Therefore, it must raise the question of whether or not neurofeedback should be promoted as an alternative treatment method for primary insomnia.  This research will stimulate discussions surrounding the usefulness and efficacy of neurofeedback on a broader level.  It may be difficult to achieve positive neurofeedback effects on an objective level due to the patient population having various complaints surrounding insomnia, including learning difficulties.


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


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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.


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

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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.


 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.


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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.


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.



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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.


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

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