Suicidal Thoughts and Behaviors Affected by Sleep

sleep deprived

New research out of the University of Manchester and published in the journal, BMJ Open, has identified the link between suicidal ideation (thoughts and behaviors) and sleep problems.

The study was conducted by scientists out of the School of Health Sciences at the University of Manchester, alongside some researchers from the University of Oxford.  There were 18 participants interviewed about how sleep has played a role in their mood problems and suicidal tendencies.

Overall, there were three pathways to inter-related suicidal thoughts identified as developing from sleep deprivation or other sleep disorder.  The first pathway was identified as being awake late at night, which heightened the risk of having suicidal thoughts and attempts.  This is thought to be due in part to lack of sleep, as well as the lack of available resources to help at night.

The second pathway was noted to be a prolonged failure to achieve quality sleep through the night, which made life much more difficult for interviewees.  This added to depressive symptoms, increased negative thinking processes, made focus and paying attention during the day difficult, and led to malaise or inactivity.

Lastly, the third pathway was the respondents reported that sleep served as the alternative to suicide because it allowed them to escape from their daily problems that were causing so much strife and discomfort while awake.  Unfortunately, however, this desire to use sleep as an escape or avoidance tactic led to more sleeping during the day, which further exacerbated sleeping problems at night.  This then reinforced the first two pathways noted above.

Lead author of the study, Donna Littlewood, noted that this research implies that there is a desperate need for service providers like healthcare specialists and social service agents that can help during the nighttime hours.

This new research underscores the importance of maintaining healthy sleep patterns, especially in relation to coping with mental health disorders, suicidal tendencies, and behavioral difficulties.

Furthermore, services at night should be a primary consideration within suicide action plans or prevention strategies used in the medical community.  This is because these findings show that those who are awake late at night are at higher risk of suicide.




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.

Sleeping Between Study Sessions Improves Memory Recall

sleep and memory

New findings published in the journal Psychological Science from the Association for Psychological Science notes that sleeping in between study sessions may make recalling what you have studied easier, even up to six months later.

Stephanie Mazza, psychological scientist at the University of Lyon, notes that these results show sleeping in between study sessions has a twofold advantage, with the reduction of extra time that would need to be spent relearning the information while also ensuring better long-term retention.  This is more effective than repetitive practice alone.  Further, she notes that studies in the past have shown sleeping after studying is a good strategy, but these new findings suggest that sleeping in between two sessions improves the strategy.

There are separate studies that show both regular sleep schedules and practice repetition improves memory; however, very little in the way of combining the two has been reviewed.  Ms. Mazza and the other scientists in the study hypothesized that between-session sleeping may make relearning the information easier, which would reduce the effort and time needed to commit that information to long-term memory.

In this study, a total of 40 French adults participated.  Each person was randomly assigned to either the “wake” group or the “sleep” group.  The first study session included all participants, each of whom were shown 16 French-Swahili random word pairs.  They were allowed to study the words for 7 seconds, after which the words disappeared and only the Swahili word was shown to them.  They then had to recall which French word matched the Swahili term.  The correct word pair was shown for 4 more seconds, and any words that were not translated correctly were shown again until all word pairs were given back correctly by participants.

The participants repeated the recall task 12 hours later by practicing the entire list of words until all pairs were translated correctly.

Some of the people in the study completed both sessions within the same day, with the first session happening in the morning and the second session in the evening.  This was the wake group.  The others in the study, the sleep group, completed the first session in the evening, went to sleep, and then did the second session the next morning.

In the first session, both groups showed little difference in their ability to recall the words or the number of times they needed to see the words to retain the pairs in memory.  However, 12 hours later, the data showed something very different.  Those in the sleep group were able to recall an average of 10 of the 16 word pairs.  Those in the wake group recalled an average of 7.5 words.  Relearning data was different as well.  The sleep group participants only needed three trials to remember all 16 word pairs, while the wake group needed 6 trials.

In the end, all participants were able to recall all the word pairs; however, it is notable that the sleep group was able to do this in less time with less effort than those in the wake group.

Ms. Mazza notes that the sleep group participants seemed to have some sort of memory transformation.  This transformation made it possible for participants to re-encode the information more quickly during the relearning session, which saved them a good amount of time.

The sleep group’s retention and ability to recall words lasted over time.  A followup interview showed that those in this group were able to recall more words than those in the wake group a week later.  The sleep group participants did not have too much trouble with forgetfulness and were able to recall an average of 15 word pairs.  The wake group, on the other hand, could only recall about 11 word pairs.  This was still noticeable six months later.

It is notable that sleep benefits in this study could not be ascribed to quality or level of fatigue, or to their long- and short-term memory capacity.  Both groups showed equal measures in these components.

The importance of these findings is profound, especially for teens and college students.  Alternating study sessions and sleeping in between may be an effective way to better retain the information over a longer period and with less effort.



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.

Back To School Sleep Tips

child sleeping

As the days slowly get shorter and the weather begins to change, we are made aware of the fact that summer is coming to an end.  As beach days turn into school days, many families are hit with the realization that summer sleep schedules are not conducive to a well rested family during the school year.  To avoid the shock of the early wake up alarm, as well as a school year experienced through a haze of sleep deprivation, here are some back to school sleep tips to make the transition from summer to fall a little bit easier on your family.

1) Decide on an age appropriate bedtime for your child for the school year.  Each day move your child’s summer bedtime 15 earlier until you reach the newly prescribed bedtime.  For example, if your child’s school year bedtime will be 7:00pm, but you have been putting him or her to bed over the summer at 8:00pm, 4 days before school starts begin to move the bedtime earlier in 15 minute increments until you reach the new earlier bedtime.

2) Your household should start winding down after dinnertime and bath time.  Lights in the household should be dimmed.  All rough and tumble play should cease.  Older children should terminate the use of electronic devices at least one hour before bedtime.

3) Every household should have a digital clock in the main living area and all children aged 2 and above should have a digital clock in their bedrooms.  Children should be made aware of their bedtime and their appropriate wake up time.  Having a digital clock allows for a child to have a concrete visual for bedtime and wake up time.  This gives children a sense of control over their sleep rules.  For young children who don’t know their numbers, place a sticky note over the last two numbers after the colon.  On that sticky note draw a copy of the number that signals bedtime.  For example, if your child’s bedtime is 7:00, draw an identical number 7 on a sticky note and place it over the :00.  That way, all a young child has to do is recognize that the numbers match.

4) Reestablish a brief and consistent bedtime routine.  For younger children, this routine should be no longer than 15 minutes and should be the same for naps and bedtime.  Bedtime routines lower the anxiety levels for both children and adults, as everyone knows what is going to come next and it creates a feeling of a sense of control over the environment.  It also assures that children will not manipulate bedtime to last too long, leading the child to become overtired before they have the opportunity to fall asleep.

5) All caregivers should together develop a plan of action for dealing with any sleep issues that may potentially arise in the new school year.  Consistency, both within methods and between caregivers, is key in fixing sleep problems.  Everyone who takes care of a child in relation to sleep needs to agree to the same plan of action.

6) Create a Sleep Rule Reward Chart.  Choose the most important sleep rule for your child and write it on a chart.  Only include one sleep rule at a time.  Your child can help decorate his or her sleep rule chart.  Take your child to a 99 cent type store and have him/her pick out a treasure chest and fill it with little rewards such as bouncy balls and erasers.  Your child can help decorate the treasure chest as well.  At wake up time, if your child has followed the sleep rule, s/he gets to put a sticker on the chart and choose a reward from the treasure chest.  Reward charts have proven to be very effective in working with behavioral sleep problems.

7)Stay consistent, firm, confident and committed to healthy sleep for your child.  With parents’ help, children can be taught good sleep habits and families can be well rested!

Wishing all children returning to school a very successful school year and wishing all families many long and peaceful nights of sleep!


Author: Whitney Roban, Ph.D.

Dr. Whitney Roban  obtained a Ph.D. in Clinical and School psychology from Hofstra University, Whitney began her career creating psychoeducational books and games for Childswork/Childsplay. Whitney formed SLEEP-EEZ KIDZ and SLEEP WELL/WORK WELL and has helped hundreds of children and their parents sleep soundly every night.

For more information about Dr. Whitney Roban, SLEEP-EEZ KIDZ and SLEEP WELL/WORK WELL, please visit  You can also visit and

Blocking Hypertension in Patients with Sleep Apnea

health monitor and sleep

Obstructive sleep apnea (OSA) is a prevalent condition that affects one out of four Americans between the ages of 30 and 70 years.  Unfortunately, it is frequently the cause of high blood pressure, or hypertension.

In the August 2016 issue of the journal, Science Signaling, new findings were published from researchers out of the University of Chicago that showed the cascade of signals that happens in this type of hypertension caused by OSA.  They make suggestions about ways to disrupt the signals and prevent hypertensive episodes.

Leader of the study, Dr. Nanduri Prabhakar, and director of the Institute for Integrative Physiology and Center for Systems Biology of Oxygen Sensing at the University, notes that these results provide the mechanistic cause of OSA-related hypertension.  The findings also offer a way to block hypertensive episodes and restoring normal blood pressures.

The link between hypertension and OSA starts in the carotid body, which is a cluster of cells inside the carotid arteries located on either side of the neck.  The chemosensory cells in the carotid bodies measure blood oxygen levels and use it to regulate breathing.  People with apnea have frequent starts and stops in breathing during sleep, so their oxygen levels decline significantly.  The carotid bodies then release the messages to increase breathing rate to bring the oxygen back to normal in the bloodstream.  Unfortunately, however, the signals also increase the blood pressure, which sometimes leads to having a stroke during sleep.

In both types of apnea (central and obstructive), the authors note, there are acute elevations in blood pressure that are linked to the apnea episodes.  This further makes patients susceptible to hemorrhagic stroke, chronic hypertension, and heart failure.  Therefore, it is vital to control hypertension in patients with sleep apnea, as it has become a major clinical concern.

Since this is such a concern, scientists mapped out the signaling cascades that start with sleep apnea and lead to the development of hypertension.

Apneic episodes lead to low oxygen levels in the blood, at which time the carotid bodies generate reactive oxygen species (the natural byproduct of oxygen metabolism).  Heme oxygenase-2 is then deactivated, which is an enzyme that makes carbon monoxide, and this leads to higher hydrogen sulfide, a product that stimulates the carotid bodies and allows them to send signals throughout the body to make more oxygen.

Those signals also cause constriction of the blood vessels, which raises blood pressure.  Standard hypertension therapies, Dr. Prabhakar notes, do not work for apnea-related hypertension.

Carotid bodies were first researched in the 1960s, in patients with asthma.  Doctors found that removing the carotid bodies would treat the disease but cause sleep apnea.  Even though removal of the carotid bodies prevented hypertension, the side effects were severe.  Patients were unable to exercise much because they could not breathe more during exertion activities.  Some of those patients died in their sleep after extended apneic episodes.  Therefore, while the information was useful, it is not an option for treatment.

Instead, the scientists have suggested using medications to inhibit the cystathionine-y-lyase enzyme, which is needed to make hydrogen sulfide and signal the intake of oxygen.  These drugs may be able to disrupt the network of signals that lead to sleep apnea-related hypertension.

Results suggest that the inhibition of that enzyme in order to reduce hydrogen sulfide signals in the carotid bodies may be the next approach to helping patients with apnea-related hypertension.


 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 Loss and Circadian Clock Have Different Effects on Brain Regions

circadian rhythm

New research has emerged that maps the effects the circadian clock has on different regions of the brain.  The new study shows:

  • How the brain can keep up performance throughout the day
  • Why there is so much waxing and waning of symptoms in psychiatric and neurodegenerative diseases
  • Why it is necessary that we avoid negotiations that lead long into the night
  • Peak activity assessed on brain imaging varies by region in the brain, and those regions are affected differently depending on sleep loss and time of day (circadian rhythm)
  • Implications for understanding how our internal time of day and circadian rhythms affect the brain


Results help scientists understand why shift work and people who work long hours have a hard time concentrating and paying attention on the job, especially in the early morning hours.

What happens inside the brain when you are awake for 36-48 hours before you can get some shut-eye?  A new study, which was published in Science, looked at the scans of 33 brains over a 2-day period of sleep deprivation, which was then followed by recovery sleep.  This research was done out of the University of Liege and University of Surrey.  Several brain regions were identified with activity on the scans, especially in the subcortical areas.  All of these regions followed a 24-hour pattern of rhythm with a timing that varied across each of the regions.

Other areas of the brain, such as the frontal brain region, had less activity with awake time after a return to pre-deprivation levels following the sleep recovery.  Some of the regions showed a combination between a decline linked to wakefulness and a rhythmic pattern.

Additionally, researchers found that the sleep-loss associated brain activity effects were more widespread and broad when participants performed simple tasks like reaction time, instead of harder memory-reliant tasks.

There were 13 brain scans obtained in each participant.  Twelve scans were taken during sleep deprived periods and one was taken during sleep recovery.  The data were compared to the melatonin rhythm, which is the human brain’s circadian pacer.

These findings, including the prominent circadian rhythm component of the brain responses, gives scientists greater understanding of the complex mechanisms of the brain’s function and activity as a result of sleep loss.  Researchers also note that they have found that the time of day the scans were taken made a big difference in the pictures they get as well.

It has long been suggested that wakefulness duration and internal time of day (circadian rhythm) affects the brain’s function.  Performance does not linearly deteriorate during periods of sleep deprived states when compared to functioning while awake.  Performance is a constant throughout the day, rapidly deteriorating during the internal nighttime, but improving slightly upon waking.

These two processes can be seen on functional MRI, which is an imaging study that can measure brain activity.  Furthermore, these findings indicate that the contribution of sleep deprivation and effects of internal time vary in different brain regions.

Researchers note that it is interesting to see that the circadian rhythm and sleep deprivation have such a profound impact on the brain’s function, which can be seen and monitored on imaging studies.  This may help researchers in understanding how brain performance is maintained throughout the day, why psychiatric and neurodegenerative symptoms seem to wax and wane, and why it is so hard to stay focused in the morning after a night without sleep.

These findings will highlight the complicated communication and link between the awake time and our biological clocks on a more widespread regional brain level.


 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.

New Protein Found that Helps Repress Inflammation During Sleep

sleep research

A new study published in the online source, The FASEB Journal, has found that the body’s biological clock or circadian rhythm creates a protein that can actively repress pro-inflammatory markers and pathways within the extremities or parts of the body during sleep.  The protein is called CRYPTOCHROM and is proven to have anti-inflammatory effects on the body’s cultured cells.

This finding offers scientists new ways and opportunities to develop improved forms of treatments with medications that could be used in the care plans of chronic inflammatory conditions like arthritis and asthma.

Dr. Julie Gibbs, Ph.D., one of the lead researchers of this study, as well as a fellow at the University of Manchester, United Kingdom Centre for Endocrinology and Diabetes at the Institute of Human Development, has much to say on the study findings.  She tells us that if we could understand inflammation by focusing on how the biological clock affects it, then there is a possibility and opportunity to make new and better treatments that would exploit the knowledge.  Dr. Gibbs’ focus is on arthritis research in the UK.

Additionally, Gibbs notes, this knowledge could help physicians adapt medication therapies to the time of day that the drugs are administered to achieve maximum benefit and make them more effective for the patient.

This discovery was made through a diligent harvesting process.  Dr. Gibbs and the rest of the research team obtained and harvested the joint tissue cells from either humans and/or mice.  The cells were called fibroblast-like synoviocytes.  These are vital in the pathological role they play in inflammatory arthritis.

These cells keep a 24-hour rhythm to them, and a disruption in this rhythm showed an increased inflammatory response.  The rhythm disruption came from taking out the cryptochrome gene.  This is indicative that the gene product, or the CRYPTOCHROME protein, has excellent anti-inflammatory components.  Researchers tested this hypothesis.  They gave medications to human subjects, which were designed to activate the CRYPTOCHROME protein, to see if there was protection against an inflammatory response.  The results showed that there was.

This research is a reminder that inflammation, especially those conditions that are considered brittle and chronic, can actually be nuanced, Dr. Thoru Pederson, Ph.D. and Editor-in-Chief of The FASEB Journal stated.  In this study, it is clear that the changes and effects happened under the influence of the brain’s SCN, or suprachiasmatic nucleus, which is responsible for the physiology and functioning of the body’s circadian rhythm or the biological clock that controls our sleep.

While further studies will likely be done in this field with the CRYPTOCHROME protein, these current findings are far-reaching and likely to be helpful in the development of new treatment regimens for chronic inflammatory 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.

New Study: Increased Risk of Heart Disease in Patients with Obstructive Sleep Apnea

sleep health and heart

Recent research has shown that patients with obstructive sleep apnea (OSA) are at higher risk of developing cardiovascular (CV) disease.  The AHI, or apnea-hypopnea index, is used to measure OSA.  The AHI is technically the number of times the person’s breathing pauses or slows down significantly per hour during sleep.  However, there are other measures taken during a sleep study when looking for OSA as well.  It is unknown whether these other measures are associated with or can predict heart disease as good as AHI can, or better.

At the University of Toronto, a group of researchers led by Tetyana Kendzerska did a cohort study of over 10,000 people who were referred for suspected obstructive sleep apnea and underwent sleep study (polysomnography) at St. Michael’s Hospital sleep lab between the years 1994 and 2010.  The provincial health administrative data in Ontario was used to follow up the patients up to 05/2011.  They were evaluated for any form of cardiovascular disease including myocardial infarction, congestive heart failure, revascularization procedures, and stroke.  Death from any other causes was analyzed as a composite outcome.

Of the 10,149 patients followed, about 11.5% (1172 people) had the composite outcome.  Researchers did adjust for some factors including sleep time, awakenings, leg movements, time spent with low oxygen saturation (under 90%), daytime sleepiness, and heart rate, and it was found that the strongest association to the composite outcome was the total sleep time spent with oxygen saturations below 90%.

Increased relative risk ranged between 5% and 50% after adjusting and controlling for the other well-known heart disease risk factors.  Additionally, it was noted that OSA risk factors were linked to more hospitalizations for heart failure, stroke, and an increased risk for mortality when outcomes were examined individually.  It is notable that there was no increased risk for acute myocardial infarction (heart attack).

When looked at by itself, AHI was linked to the composite outcome noted above.  After OSA risk factors were added to the whole model, the apnea-hypopnea index was no longer a predictor.

A nomogram was used to help predict the risk of cardiovascular disease in people based on their sleep study; however, this nomogram needs to be further validated by using it in a separate sample of patients before they can use it clinically in this study.

The one limitation to the study was that there was no way to tell how compliant patients were with OSA treatments using a CPAP machine.  When patients with an insurance claim for a CPAP device were excluded, all except one of the associations were found.

The researchers reported that there might need to be a revision of the definition of OSA, which would reflect not only the frequency of hypopneas or apneas, but the other health consequences as well that result from OSA such as sleep deprivation, fragmented sleep, sympathetic activation, and decreased oxygen saturation levels.  The most predictive measure of cardiovascular risk is the “downstream” phenomena, authors note.  The predictors of OSA identified in this study could be identified using much simpler studies, like home sleep studies, rather than polysomnography.



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.

Insomnia Related to Menopause May be Accelerating the Aging Process

aging and sleep

New research out of the University of California Los Angeles has revealed that menopause and its accompanying symptom insomnia are accelerating the aging process.

This was a dual study, with findings published in the Proceedings of the National Academy of Sciences and Biological Psychiatry this month.  These factors may be increasing the risk of age-related diseases and earlier death in women.

Senior author of the study and professor of Human Genetics and Biostatistics at UCLA’s David Geffen School of Medicine, Steve Horvath, notes that for decades scientists have disagreed on whether menopause is caused by aging or aging is caused by menopause.  It is a constant debate similar to the chicken and the egg theory: which one came first?  This study is the first to show evidence that it is menopause and its related sleeping disorder that is causing aging.

Judith Carroll, one of the researchers of the study and associate professor of Psychiatry at UCLA Semel Institute for Neuroscience and Human Behavior, reminds readers that restorative sleep is essential to overall well-being.  Sleep deprivation may be affecting our biological clocks in addition to our mental functioning during the day.

The women who were studied reported restless sleep, frequent awakenings, waking too early in the morning, and trouble falling asleep at night.  These women tended to be biologically older than women of the same chronological age without similar symptoms.

Both studies used a biological clock, which was developed by Dr. Horvath and has been widely used for tracking the epigenetic shift in the genome associated with the clock.  Of note, epigenetics is the study of DNA changes in packaging, which influences the expression of the genes but not the sequence itself.

Connecting Menopause to Aging

One of the studies in this research was focused on linking menopause to aging.  The scientists tracked methylation, which is a biomarker that is associated with aging.  They analyzed DNA samples from over 3100 women in four large studies.  One of the studies is the large 15-year research program from the Women’s Health Initiative (WHI), which looked at the most common causes of disability, death, and poor quality of life in postmenopausal women.

The biological age of cells in the saliva, blood, and inside of the cheek were measured and recorded.  This was done to determine the difference between chronological age and biological age.

Dr. Horvath noted that cellular aging is increased by an average of 6% due to menopause.  That may seem like a low number, but it does add up over the lifespan.  For example, a woman who goes into early menopause at 42 will be a year older in eight years than a woman who entered menopause at age 50.

The younger the woman is at the start of menopause, the faster her body’s biological cells and blood will age.  This is an important finding since the blood can determine what is happening in the rest of the body, which has implications for disease risk and early death.

The Link and Importance of Quality Sleep

This study looked closely at sleep patterns of more than 2000 women in the WHI study.  The biological clock noted that women who were postmenopausal and had at least five symptoms of insomnia were biologically an average of two years older than women of the same chronological age but with no symptoms.

 While scientists cannot confirm that insomnia leads to increased biological age, the findings are still significant and can be a foundation for further research into the effects of insomnia in postmenopausal women.  The same women in this study will need to be followed in the future to determine the cause-and-effect relationship between sleep disorders and biological age.

These findings may seem daunting for many women, but Dr. Horvath notes that the biological epigenetic clock can help physicians in the future determine proper hormone replacement therapies and treatment interventions for sleep disorders.  The real question is which treatment plan will help offset the aging process the most without risking overall health and well-being.



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.

New Study: Improved Sleep with Weight Loss and High-Protein Diet

sleep and diet

A new study out of Purdue University has found that adults who are achieving weight loss with a high-protein diet are sleeping better.

Wayne Campbell, Professor of Nutrition Science, notes that most of the research in this field focuses on how sleep plays a role in weight, but this current research switches the question around and looks at how weight loss with regard to the amount of protein intake affects sleep.  Taking in a higher protein and lower calorie diet led to improved sleep quality in middle-aged adults compared to adults who lost the same amount of weight but did not increase their protein intake.

Affiliated with the American Society for Nutrition and funded by organizations like the National Pork Board, National Dairy Council, Beef Checkoff, National Institute of Health, and Purdue Ingestive Behavior Research, these findings were published in the American Journal of Clinical Nutrition.

The first part of the study was a pilot, analyzing the diet and sleep patterns of 14 participants.  After four weeks of a high-protein diet, these participants showed significant improvement in their sleep.  In the main study, 44 people who were obese or overweight were analyzed.  Some had a normal-protein diet and others had a high-protein weight loss diet.  They were given three weeks to adapt to the diet, with one group taking in 0.8 kg and the other 1.5 kg for each kilogram of weight.  This was done for 16 weeks.

A survey was given to each participant to rate their quality of sleep each month of the study.  Those with more protein in their diet reported drastically improved sleep quality over three and four months of the high-protein weight loss diet.

Diets were designed by a registered dietitian in order to meet individual energy needs of each participant, including cutting out 750 calories of fats and carbs while maintaining the proper amount of protein according to the study guidelines.  Protein sources included pork, soy, beef, milk protein, and legumes.

Poor sleep quality and duration is frequently associated with cardiovascular and metabolic diseases, including early death; therefore, researchers of this study believe it is vital to understand the prevalence of sleep disorders and their relationship to diet and lifestyle.  Understanding this, researchers state, will help develop intervention programs that will improve sleep quality.

Additionally, the lead researchers of this study are looking at how protein sources, quantity, and patterns affect body composition, weight, and appetite.

A higher protein diet while losing weight is already at the top of the list of healthy eating habits, and improved sleep quality is another benefit added to the list of advantages to this kind of diet, which also includes things like fat loss, regulation of blood pressure, and leaner body mass.  We know that sleep is important for overall good health, but improving quality with diet is an important modifier to currently known information about the topic.  It emphasizes the need for further research into the relationship between diet and sleep, using objective measurements of sleep to confirm the results.


Author: 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.


Bedwetting Solutions


Try Not to Cry When Your Child’s Not Dry

Finding Solutions to Bedwetting

What is Primary Nocturnal Enuresis (PNE)?

Primary nocturnal enuresis is the medical term for bedwetting. Bedwetting is a very common problem, and parents are often wondering how best to approach it for their child.  While many parents report that their child wets the bed because he or she is a very deep sleeper, the validity of this has been debated.  There is an association between children who wet the bed and those who spend more time in deeper stages of sleep but nonetheless, bedwetting can occur at any time during the night.

You’re not alone…

While the prevalence of PNE is approximately 13-16% in 5 and 6-year-olds, it decreases with age.  By age 7-8, only 7-10% are bedwetters, and by age 10, only 5%.  In teenagers, PNE is reported as low as 1-3%.  It is more common in boys and is also highly genetic. You have approximately a 40-45% chance of having PNE if one parent had it and a 75% chance if both parents had it.

What are common misconceptions about PNE?

Although it is easy to want to blame your child, bedwetting is not your child’s fault and is not under his or her full control.  It should never be punished.  Bedwetting will often resolve without intervention, usually around the age a family member outgrew their bedwetting.

Treatment options for younger children

Most experts agree that children can start to be part of the treatment process at the age of 5. Parents can limit fluid intake after dinner, remind children to void (use the bathroom) before bed, and incentivize using the bathroom in the middle of the night by developing a reward system. Involving children in the cleanup process can help motivate them to use the toilet instead of wetting the bed by demonstrating that it requires more effort to clean up after themselves than to use the bathroom when they need to go.

Treatment options for older children

As children get closer to 7 or 8 years of age, a more definitive treatment approach can be added.  While medications are sometimes used, we suggest they be used sparingly.  Due to potential side effects and limited long term benefits, medications should be reserved for special occasions such as an overnight camp or a sleepover at a friend’s house. The enuresis (bedwetting) alarm is the most effective treatment for this condition when a child is motivated.

How does the alarm work?

The bedwetting sensor is attached to the child’s underwear, while the alarm is fastened to the child’s pajama top. When the sensor gets wet, the alarm goes off.  Once this occurs, the child is encouraged to hold his or her urine in an attempt to finish voiding in the toilet.  Over time, the brain learns to associate the contraction of the bladder sphincter with the alarm and ultimately the brain will contract the sphincter before wetting ever occurs.

Because you can start to see improvement within 2 weeks, children are often motivated to continue its use. Best outcomes are seen in children who have used the alarm for 3 successive months and achieved 21 consecutive dry nights. While older children and teenagers can be completely independent with the alarm, younger children might require the help of a parent at first.  Ultimately, the bedwetting alarm has a 75-80% cure rate with regular use.

When should you call your doctor?

Consult your doctor if your child’s bedwetting is accompanied by any neurological signs such as weakness, numbness, bowel incontinence, or signs of infection such as fever or burning with urination. You should also contact your doctor if your child has a period of dryness of 6 months or more but then reverts back to bedwetting.  If the bedwetting alarm goes off more than once a night, medication in conjunction with the alarm may be helpful.  Always consult your doctor If there are any other signs and symptoms that seem concerning.


Authors: Cheryl Tierney, MD, MPH, Taylor Aves, Eugenia Gisin, Alexandra Lazzara, Megan Veglia

Cheryl Tierney, MD, MPH is a Board-Certified behavior and developmental pediatrician who has been in practice since 2002. She is a native of Brooklyn, New York and completed medical school at Tufts University in Boston. Her pediatric residency was at Carolinas Medical Center in Charlotte, North Carolina. She completed Fellowships in Health Services Research, where she received her MPH at Harvard School of Public Health as well as Behavior and Developmental Pediatrics in 2002.  She is an active member of The Society for Developmental and Behavioral Pediatrics (SDBP) as well as the Academic Pediatric Association (APA). She enjoys participating in outdoor activities with her family.

Associate Professor of Pediatrics
Section Chief, Developmental Pediatrics, Penn State Hershey Children’s Hospital