Why am I always tired?

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“Why am I always tired?” is one of the most frequently asked questions on the internet. There are several potential causes for ‘being tired’. Here, we will discuss the causes of being tired. First, it is important to determine what is meant by ‘being tired’.

Let’s first discuss the word ‘Tired’.

The word “tired” can mean different things to different people. Clinicians usually try to differentiate if the person has fatigue or excessive daytime sleepiness.

Fatigue generally refers to the sensation of not having enough energy to complete certain tasks. The differential diagnosis (potential causes) of fatigue is very long. The list includes medications, anemia, depression, medical disorders, and many other causes.

Excessive Daytime Sleepiness, or EDS, has a much shorter list. However, the list is still long. Generally, the list includes causes that interfere with quality or quantity of sleep.

Causes of Excessive Daytime Sleepiness 

Many of the causes of Excessive Daytime Sleepiness include sleep disorders, such as sleep apnea, insomnia, circadian rhythm disorders, narcolepsy, and other sleep disorders.

Let’s return to determining the difference between fatigue and sleepiness. With fatigue, a person will usually complain that he or she does not have enough energy to get going, or to do certain things. But, when they close their eyes sitting or laying down, they do not fall asleep. This is an important point in differentiating the two symptoms.

With EDS, obviously when the person does sit or lay down for a rest opportunity, the person does fall asleep.

What can I do to be more alert and less sleepy?

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There are many things that you can do to be less sleepy. Once you know what the cause is, then you know where one of the fixes might be. A good start with improving daytime alertness is following good sleep hygiene. This includes getting adequate total sleep time. It also includes avoiding alcohol and caffeine before bedtime, not watching TV or reading in bed, and have a comfortable, quite, and dark bedroom.

Yes, people can have, and often do have, both complaints. It is also common for someone to have more than one problem. To start, it helps to know the difference between Excessive Daytime Sleepiness and fatigue. Instead of asking, “Why am I always tired?”, the question should be “Why I am always so sleepy?” or “Why I am I always so fatigued?”.  Once this has been determined, the next step is to figure out why.

In the following pages, we will explore some of the many sleep disorders that contribute to being sleepy. Part 2 – Sleep Disorders

ADHD Children Sleep Less and More Poorly

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Parents of ADHD children have claimed for years that their children have more trouble falling and staying asleep and have poorer quality sleep than other children.  A study out of Aarhus University has found that there is some truth behind this claim.

Recent studies have reported that approximately 70% of parents with ADHD children state that their child has a hard time falling and staying asleep and that their pre-bedtime routines take a long time.  Unfortunately, however, many science-based studies using electrodes to measure sleep quality have not been able to link ADHD and sleep quality.  This new Danish study gives some merit to these parental concerns and shows that children with ADHD do, in fact, sleep worse than other children their age.

Behind the study is lead researcher, Anne Virring Sorensen, a medical doctor at the Child and Adolescent Psychiatric Hospital in Risskov.  She reported that their study validates their experience, which is that their child with ADHD takes longer to get to bed and fall asleep.  With the measurements used in this study, researchers have seen also that these children have disruptive sleep, especially deep sleep.  Only looking at the length of sleep will tell you that children with ADHD sleep an average of 45 minutes less than other children; however, it is the quality of sleep that is most concerning, researchers state.

It is reported that two out of three children diagnosed with ADHD have at least one additional psychiatric condition, which in all likelihood increases the risks of poor sleep quality.  However, even when scientists look only at those with an ADHD diagnoses, they find that there is still a big difference in the patterns compared to children in the control group without a diagnosis.

In this Danish study, researchers also reviewed the daytime sleep patterns, and the findings were surprising.

They found that children with ADHD were able to fall asleep more quickly during the day than at night.  This is so surprising because one of the primary characteristics of ADHD is hyperactivity; however, researchers note that this hyperactivity may be compensatory for the inability to sleep during the day.

Researchers being unable to find a correlation between poor sleep quality and ADHD in the past may be due to the different methods of measurement.  In this study, electrodes were attached to the children for polysomnography readings during an afternoon at the hospital.  However, they still slept in familiar home surroundings.  Previously, children were admitted to sleep centers in a hospital overnight in order to get a sleep study performed.

Anne Virring Sorensen makes it clear in her findings that the children in this study received no medication to help them fall asleep.  This is a major concern because many ADHD children are given medication at night to help them sleep.

 This study will be important for both the short and long term, researchers believe.  So far, clinicians and parents are pleased that their concerns about their ADHD child getting poorer sleep have been confirmed.  Of course, the next step in this process is to identify the correlation that will help develop more efficient treatment regimens in the future.  This is an important foundation for further study, Sorensen states.

Findings of this study were published in the Journal of Sleep Research. 

 Study Facts

  • The study included a total of 76 children with ADHD, with an average age of 9.6 years.
  • Twenty-five healthy children made up the control group.
  • There were two types of studies:
    • Use of multiple sleep latency tests, which looked at the speed in which children were able to fall asleep
    • Outpatient examinations with electrodes, also called polysomnography
  • So far, this is the largest study that includes both of the above types of studies, as well as both children with and without ADHD

Reference:  http://www.eurekalert.org/pub_releases/2016-05/au-cwa050416.php

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.

The Mapping of Our Internal Clock

DNA sleep

The SCN (suprachiasmatic nucleus) makes the body run properly and on time.  It acts as the control center for our genetic clock and the circadian rhythm, which regulates multiple functions including insulin sensitivity, hunger, sleep, body temperature, hormonal levels, cell cycles, etc.  The suprachiasmatic nucleus has been extensively studied, but its neural network has remained a mystery to scientists.

In a new study from Harvard John A. Paulson School of Engineering and Applied Sciences, Washington University in St. Louis, and the University of California Santa Barbara, researchers have found that SCN neurons are linked to each other, which sheds immeasurable light on this area of the brain.  By understanding this brain structure and how it responds to disruption, scientists will be able to tackle more illnesses such as posttraumatic stress disorder and diabetes.  Additionally, researchers of this study report that disruption to the rhythms that come from the SCN, i.e., shiftwork and nighttime blue light exposure, negatively interferes with health.

The findings were published in the Proceedings of the National Academies of Science (PNAS).

The first author of the paper, John Abel from SEAS, stated that due to the noisiness of the cells within the SCN, it has been incredibly difficult to understand.  There are in excess of 20,000 neurons that reside within the SCN, and each of them have their own task of regulating the circadian rhythm; however, they also communicate with their fellow neurons in order to maintain relationships.  Now, scientists are able to cut through that noise of communication and determine which cells are sharing what with the others.

There are two hemispheres in the SCN, so it looks like a small brain.  It is located inside the hypothalamus.  It takes cues of light from the retina, which is what allows it to keep track of time and reset itself when needed.  When the SCN is functioning normally, all neurons in both hemispheres demonstrate a synchronized pattern in their oscillation.

Abel and the research team disrupted this synchronized pattern in order to better understand the network structure.  They did this by using a potent neurotoxin found in pufferfish, which turned the usually steady, rhythmic oscillating pulse into disconnected beats.  Then, they removed the toxin and used information theory to determine how the network re-established communication between cells.

John Abel likened this process to trying to determine if a group of people were friends without being able to look at their text messages or phone calls.  In large groups, you probably would not be able to tell who was a friend of whom, but if a group of people showed up to a party together, it is safe to assume that they communicate on a friendly basis.

At a single-cell resolution, the research team was able to identify groups of friendly neurons in the center of each hemisphere.  They shared a lot of information with each other during the resynchronization process.  Additionally, researchers found that there were dense connections between the hubs of each hemisphere.  The area called the shell outside the hub showed neurons that behaved like acquaintances rather than friends and shared very little information.

Researchers were surprised to find that the shell did not contain functionally connected collections of neurons.  Previously, it was assumed that the neurons in the shell played a bigger role in communication; however, this study shows that it is the core neurons that mediated the clustering.

It was also assumed in past research that the core SCN dominated the process because of its role in receiving light cues from the retina.  The use of the neurotoxin to disrupt circadian rhythm, however, allowed researchers to demonstrate the core to be the key player in resynchronization without light cues.

Co-author of the paper, Professor Frank Doyle, stated that in the 15 years of studying the complex control mechanisms involved in the circadian rhythms, this is the work that brings them closer to understanding the communication between neurons.  This would demonstrate the importance of seeing the link between genes, the cells, and the SCN tissue.

 Reference:  http://www.eurekalert.org/pub_releases/2016-05/au-cwa050416.php

 

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.

To Sleep Train or Not To Sleep Train, That is the (Ongoing) Question

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As a Pediatric Sleep Specialist, I am often confronted by parents with the question of whether they should sleep train their children. These parents express a strong desire and need for sleep for themselves and their children, but they are confused and overwhelmed as to how to proceed (if, at all). Sleep training, also referred to as “cry it out” (or CIO on the various message boards and chat groups), has been and continues to be one of the most controversial parenting topics. The good news is that there is so much information available to parents about sleep training, however, that is the bad news as well. With the advent of the internet, parents are bombarded with so much information about sleep training, and much of it is contradictory. After many sleepless nights, including 2am Google searches, on how to get their children to sleep, parents end up more confused and unsure about how to proceed with sleep training, and even if sleep training is right for their family. As a Clinical Psychologist, an expert in the field of Pediatric Sleep, and as a mother who successfully sleep trained her sons many years ago, I hope to shed some light on this topic and help parents in their quest for the elusive full night of sleep!

When sleep deprived parents call me to inquire about my services, one of the first things they tell me is how they “want” their kids to sleep and how much they themselves “want” to sleep as well. These statements are almost always tinged with parental guilt. In order to not only educate, but also to alleviate that self imposed guilt, I reassure these parents that their desire for sleep is not just a “want” but also a very important “need”. We are all human beings with the basic biological needs to breathe, eat, and SLEEP! Of course we all “want” to be well rested, but we also all physically “need” to sleep in order to function on a daily basis. Some parents have the misunderstanding that it is our job to be up all night with our children and we should resign ourselves to the fact that we will never sleep again. Of course, when our children are newborns this is to be true. However, as our children pass the infancy stage and beyond, it is imperative that everyone in the family get a good night’s slee.

There are two common misconceptions about sleep training that I believe are important to clarify. The first misconception is that “my child is just not a good sleeper”. It is true that some children are naturally better sleepers than others. However, all healthy children can develop good sleep habits. In order for this to happen, however, it is up to the parents to be consistent and to follow age appropriate sleep schedules and sleep routines for their children. The most common reasons for unsuccessful sleep training are inconsistency and developmentally inappropriate sleep schedules. It is not beneficial to label children “poor sleepers” and to just give up the hope of a well rested family. The short term sleep training journey to raising a great sleeper will result in a lifetime of longer lasting positive effects on the whole family.

The second misconception is that sleep training is all about the “cry-it-out”. It is not the crying (the quality nor the quantity) that teaches children to fall asleep and stay asleep. It is actually the learned behavior of self soothing (which is not innate in most children and must be cultivated by their parents) that allows a child to fall asleep unassisted and fall back to sleep unassisted. The crying (also known as protesting) is just the byproduct of learning the critical self soothing skill, which healthy children can learn to master rather quickly. Furthermore, there are several other central components to a sleep training program, such as consistent and age appropriate sleep schedules including naps, consistent bedtime and nap time routines, and safe and healthy sleep environments, that without, parents will not have the sleep training success they so desperately need, and deserve.

Another common issue that arises for parents during their decision to move forward with sleep training is the emotional component to the sleep training journey. Many parents question their emotional capacity to handle any protesting from their child, as well as question their sleep training decision by perusing the websites that try to convince parents that they are doing harm to their child if they choose to sleep train. Overall, the existing and quite limited negative research studies have actually looked at the overall daily crying response in children in neglectful environments and did not look at children’s cry response solely in sleep training settings in loving homes. Children that are allowed to learn how to become independent sleepers and experience the byproduct of a finite amount of protest crying cannot be compared to the infinite crying of children who are neglected throughout the day and night. Furthermore, the parents that I have worked with the past 11 years are, in fact, the exact opposite of neglectful parents. They understand the necessity of sleep for their children and themselves, and they desire a happy and healthy family. I have yet to have worked with a family who has regretted their choice to sleep train. In fact, most tell me they wish they didn’t wait so long! If parents want to focus on research, I strongly advise them to focus, instead, on the solid and non controversial research about the detrimental effects of sleep deprivation on both children and adults’ health, mood, temperment, behavior, cognitive development, and performance in the home, school and work settings. Healthy sleep has only been shown to have positive effects on the physical, cognitive, behavioral and psychological growth and development of all humans. I highly doubt I will ever come across a study that shows the positive effects of sleep deprivation!

Most parents, at one time or another, will question their parenting choices. For the parents who are undecided about embarking on the sleep training journey, I hope I have helped you make an informed decision about if and how to proceed in getting your family well rested. We all have the same end goal – a happy and healthy family. No matter what roads our parenting journey take us down, I hope we all reach our end goal!

Author: Whitney Roban, Ph.D.

PEDIATRIC SLEEP SPECIALIST

Dr. Whitney Roban considers sleep a necessity, not a luxury.  She lives and works by one philosophy: parenting is one of the hardest jobs, made even more difficult when a family doesn’t sleep. Her mission is to give the gift of sleep to families through her information dissemination and emotional support based sleep training system, as well as her parent and corporate wellness education workshops.

With 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 www.sleepeezkidz.com.  You can also visit facebook.com/sleepeezkidz and twitter.com/sleepeezkidz.

Time Zone Tips for Traveling with Children: Easy Ways to Help Reset Their Clocks

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Traveling with kids can be tiring for the whole family.  One major culprit is crossing time zones; it can wreak  havoc not only on sleep routines, but general behavior as well.    As I mentioned in  11 Sleep Tips for Traveling with Children,  you have two options: if you are only crossing one or two time zones for a couple of days,  consider remaining on your home time zone to make the transitions easier for everyone.  But if you are crossing multiple time zones for a longer period, the key to beating jet lag for children,  as well as adults,  is to shift to the new time zone as soon as possible–maybe even before you get there!

Here are my top tips to help your family get back on track fast and with as few meltdowns as possible!

Plan ahead

If you like to plan ahead, you can start the transition to the new time zone a few days before you leave.  These tips will ensure your child is at or close to the new time zone prior to leaving which can make travel and sleep easier.

Here’s how it works:  Start about 4-7 days before your departure (depending on how many times zones you are traveling), and shift nap times, mealtimes, and bedtime in 15 minute increments  either earlier or later depending on what direction you are going.

For example,  if you are traveling West crossing  two time zones, bedtime will be 2 hours later than usual.  To prepare in advance, begin to shift meal times, nap times, and bedtime later by 15 minutes per day for 7 days. When you arrive at your destination, you will already be at or close to the new time zone.

If you are traveling East by two time zones, bedtime will be two hours earlier than usual. That means that prior to  to departure, you will shift meal and sleep times earlier by 15 minutes per day for 7 days.

Advance planning isn’t for everyone, nor does everyone have the time to do it.  Don’t worry, your child will  adjust to the new time zone with the following  tips.

If you are Westward bound:

Light exposure:  Exposure to light at key times can help your child avoid jet lag and make a faster shift to the new time zone.  When traveling west, seek afternoon light and avoid bright light early morning in your new setting.  Make make sure your child’s room is as dark as possible so those early morning rays don’t wake him.  If black out curtains aren’t available,  black garbage bags can do the trick!  You can even find  an app that recommends light exposure at different times of day to help with the adjustment.

Bedtimes:  When crossing 2-3 time zones,  say a trip from one coast to another, attempt to keep your child awake until his normal bedtime hour occurs.   The more time zones  crossed, the harder this will be.  Aim  for 30-45 minutes later each night and expect your child will take a few nights to adjust.  If  you travel  from New York to California and your child usually falls asleep at 7:00 p.m, he will be tired at 4:00 p.m.  Try to keep him awake until at least 5:00 P.M.  on your first night, using late afternoon light exposure to help out;  the next night your goal should be closer  to 6:00 p.m..  By the third night or fourth night,  he should  fall asleep at close to his normal bedtime in the new time zone.

Morning wake times:  When traveling West, expect earlier wake times:  try to allow children to stay in their bed until a “reasonable” hour, but be flexible.  You will most likely be waking earlier too!  In a few days, wake times should resume to their normal time as long as you don’t respond to the  too early calls the first few days after you arrive.

Nap times:  Try to stick to a nap schedule as much as possible.  When going West, your child will probably be tuckered out earlier than usual during the day, but still try to keep her usual nap time.  If  you travel  from New York to California and she usually takes an afternoon nap at 1:00 p.m., then she will be tired as early as 10:00 a.m.  the first day or so.  Do everything possible to keep her going until as close to  1:00 p.m.as possible,  without allowing her to become  too overtired.  If you need to put her down around 10:30-11:30 a.m. the first day, go ahead, but then push her another 30-45 minutes later the next day.  Within three days she should be sleeping at her usual time.   Also, don’t allow her to nap too long, which is tempting  after a particularly long trip.  You may have to wake him from a nap no later than  3:30-4:00pm to ensure a reasonable bedtime.

If you are heading East: 

Light exposure:  When traveling east, seek morning light and avoid bright light in the afternoon, to help advance your child’s  biological  clock.

Bedtimes:  Eastward travel is always a bit more challenging for adults as well as children.  Your child may not be tired at her usual bedtime at first, though long days of travel often wear  them out!  Try to get her in bed close to her usual bedtime.  To get her to bed earlier than usual, rely on a soothing bedtime routine, a dark room, and some white noise to help you set the stage.   Again, it may take a few days of  preparation to shift the bedtime earlier in 30-45 minute increments to reach the “new” bedtime.  If you travel  from California to New York and your child usually falls asleep at 7:00 p.m., then she  may not be tired until close to 10:00 p.m.,  New York time, on the first night.  Use your bedtime cues (darkness, white noise, routines)  to help her fall asleep around 9:30p.m. the first night and then move it 30-45 minutes earlier the next night.  By the third or fourth night, she should fall asleep at  her usual bedtime.

Wake times:  When traveling East, avoid the temptation to allow your child to sleep in!  Wake your child at the usual wake time so her  body  can adjust to the new  time; also,  allow for lots of light and activity in the mornings to help reset her  biological clock.

Nap times:  Again, aim for naps at your child’s usual time.   Using the California to New York example, expect that your child won’t be tired at his usual 1:00 p.m.  nap time because it will only be 10:00 a.m. according to his internal clock.  But again, use a combination of a lot of morning light and activity, followed by a dark room,  and a consistent bedtime routine to get her to fall asleep close to that time.   If you want to put her down a bit later the first day, try to move the time as close to 1:00 pm as possible in 30-45 minute increments over a few days.

 

Author: Dr. Rebecca Kempton, M.D.

 After graduating with a B.A. in Psychology from Dartmouth and an M.D. from Cornell Medical School, Dr. Rebecca Kempton worked for several years as a medical director for healthcare technology and pharmaceutical companies before becoming certified as a pediatric sleep specialist and starting her own business, Baby Sleep Pro.  Using a variety of behavioral techniques, she customizes sleep solutions based on individual family goals and childrens temperaments and coaches families to a better nights sleep.  Dr. Kempton works with clients both nationally and globally by phone, Skype, and email and with home visits.   She lives in Chicago, with her husband and three children, ages 8 and under. For more information, email rhk@babysleeppro.com; visit www.babysleeppro.com and follow her on facebook.com/babysleeppro and twitter @babysleeppro

How Lack of Sleep Affects Cholesterol

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In previous studies, it has been found that sleep deprivation can negatively affect the immune system, metabolism, inflammatory process, and regulation of the hormone that controls appetite.  In a recent study out of the University of Helsinki, scientists have discovered that lack of sleep can also lead to problems with cholesterol metabolism.

The purpose of the study was to review the impact of sleep deprivation on cholesterol metabolism in both lipoprotein levels and gene expression.  With a tiny blood sample, scientists can find out about all gene activations and the different metabolites.  It is now possible to search for and find metabolic pathways and regulatory factors that partake in different bodily functions.

Vilma Aho, a researcher on the Sleep Team Helsinki group, states that they examined the changes lack of sleep caused on the body’s functions and what changes could lead to an increased risk for illness.

It was found that the genes responsible for cholesterol transportation are not as active in someone who has suffered with sleep deprivation as they would be in someone getting good, quality sleep.  This finding was noted on both a laboratory sleep loss experiment, as well as at the population level.

The different metabolites that were reviewed showed researchers that at the population level, people with sleep deprivation had lower HDL (high-density lipoproteins).  This is considered the good cholesterol level.  This finding was not present in those who got sufficient sleep.  Adding this to other risk factors of poor sleep, these findings add to the understanding of the higher cardiovascular disease risks that are seen in those with sleep deprivation.  The study has helped researchers further comprehend the mechanisms that cause the increased health risks in sleep-deprived persons.

It is of interesting note, Aho states, that the sleep deprivation components that are contributing to the development of atherosclerosis (changes to cholesterol metabolism) are found in both the laboratory experimental study and the epidemiological data.

Once again, we have a study that indicates the impact sleep has on our health.  The researchers of this study emphasize that education should focus heavily on the need for good sleep in order to prevent long-term health consequences.  This is in addition to a healthy diet and exercise regimen.  It is notable that even a small reduction in the number and severity of illnesses would result in extreme healthcare cost savings, which would impact the economic status of the society as a whole.

Just one week of poor sleep can lead to changes in the body’s immunity and metabolism.  The next goal of these researchers is to find out how small the sleep deficiency would need to be to cause such changes in the body.

 Background of the study:

This research out of the University of Helsinki is focused on studying the impact lack of sleep has on the body’s immunity and metabolism, especially with regards to cholesterol and lipid metabolism.  Hundreds of previous studies have shown the higher health risks in those who do not get sufficient sleep, but the Sleep Team Helisinki is looking to determine the mechanisms behind the risks on cholesterol metabolism in order to guide better education and understanding.

Heart diseases are linked to both the immune system and the body’s metabolism.  Lack of sleep has been found to cause an inflammatory reaction, and this may be contributing to the higher risk of developing a chronic illness.  Additionally, carbohydrate metabolism is thought to be affected by sleep deficiency in a way that resembles type 2 diabetes.

The impact that sleep has on cholesterol and lipid levels has been studied less frequently, which is why the researchers here are focusing their efforts on those mechanisms.

Reference:  http://www.eurekalert.org/pub_releases/2016-04/uoh-sld042116.php

 

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.

Men Who Eat a High-Fat Diet Have Poorer Sleep

junk food

A new study out of the University of Adelaide has found that men who take in high-fat diets are more likely to report having problems sleeping at night, feeling excessive daytime sleepiness, and are more likely to be diagnosed with sleep apnea.

This study, titled the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study, aimed to review the link between sleep and a high-fat diet, which was ultimately conducted by the Population Research and Outcome Studies unit at the University of Adelaide School of Medicine.  The Freemasons Foundation Centre for Men’s Health played a role in conducting the research as well.

More than 1800 Australian men between the ages of 35 and 80 were part of the study, which included an analysis of their dietary habits over a one-year period.  The results have been published in the journal, Nutrients.

One of the study’s authors from the University of Adelaide, Yingting Cao, said that even after adjusting for lifestyle factors, chronic diseases, and demographics, the results still showed that those who consumed a higher fat diet were more likely to have excessive daytime sleepiness.

Cao believes that these results have significant implications for concentration and alertness, which, of course, is of great concern to employers and employees.  In addition to these findings of excessive daytime sleepiness, Cao and her team found that men taking in high-fat diets were also more likely to have a diagnosis or suffer from sleep apnea.

Overall, the research showed that 41% of men who had dietary and sleep data available to review reported excessive daytime sleepiness, and 47% of men reported having poor sleep quality at night.  Mild to moderate sleep apnea was reported in 54% of participates, and 25% were found to have moderate to severe sleep apnea.  This was determined through a sleep study in those who had a previously reported diagnosis of sleep apnea.

The poor diet and sleep pattern is a vicious cycle, Cao and her colleagues say.  Feeling sleepy throughout the day because of poor sleep leads to one having less energy, which in turn is related to increased cravings of high-fat and sugary foods, which is further associated with poor sleep.

Quite simply, these results yield a common-sense message, and the researchers believe it is important for people to pay attention to it.  Frankly, they believe we need to have a healthier diet to have better sleep and more energy, which ultimately leads to higher concentration and daytime productivity.  Unfortunately, sleep quality is not often a consideration in the investigation of how the body is affected by various diets and weight loss.

Cao and the other researchers are hopeful that their work will help educate and guide interventional studies, which would enable people to lose weight in a healthy way, while also improving their sleep.

 Reference:  http://www.eurekalert.org/pub_releases/2016-04/uoa-fdl042016.php

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.

11 Sleep Tips for Traveling with Children

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When a friend told me she packs a suitcase full of her daughter’s favorite stuffed animals when they travel, I wasn’t surprised.   My family resembles a traveling caravan at airports as we transport all our gear.  Although trips with kids aren’t quite as blissful and relaxing as those pre-kid vacations,  advance planning helps.

With summer vacation season around the corner,  here are my  sleep tips for babies and toddlers  to alleviate some stress while on the road.

Start your trip well-rested.  Travel, whether by car, plane, or train,  can rob anyone of shut eye,  but it especially takes  its toll on young children and babies who accumulate sleep debts quickly.   Aim to have your child well-rested before leaving for your trip, taking restorative naps, and sleeping well at night for the days preceding your departure..  Babies and children whose sleep tanks are full  can adapt much easier to schedule changes and a little lost sleep here or there.

Plan travel time around sleep time.  Because children are naturally excited, or even stimulated, by travel plans, it’s often hard for them to sleep en route.  So, try to plan your departure and arrival times around naps as much as possible.  If your child still naps in the morning,  then plan to leave after the morning nap, not before.  Remember the first nap is usually the most restorative and helps curb over-tiredness for the rest of the day.  Also, transit naps are never as restful.   As much as possible, try  to arrive  at your destination in time for the usual  bedtime;  if the naps were shorter than usual, aim for an earlier bedtime.

Think ahead about sleeping conditions. Going from having their own bedrooms to crowding everyone into one bedroom can spell disaster for everyone’s sleep.   If you plan to stay in a hotel, splurge on a suite to give you some extra living space with a pull out or a crib.  This will allow you to enjoy the evening while your little ones sleep nearby; it may  even save you on food expenses if you also have a kitchenette  to store your own milk and snacks.   Finding a condo or private home has become easier than ever with sites like vrbo.com and airbnb.  Extra sleeping space makes for a more relaxed vacation  for everyone.

But if you are in a one room hotel room, all is not lost!  Get creative and think about where you can put a crib or small bed that is separate from you as possible. .  Sometimes it may mean the bathroom, a hallway, or even a large closet.  Rearranging the furniture can help as well as hanging a sheet from the ceiling to create a physical separator.  Hotel staff are usually more than willing to help you “redecorate” in the name of sleep.

All is not lost if your toddler ends up in your bed even though that is not your ideal  sleeping arrangement.  The key to a successful transition back home is communication ahead of time:  tell them this is a special sleeping arrangement just for the trip but when you return, you will be back in your own bed,  and he will be in his.  Frequent reminders  about sleep rules, even on the trip home,  are important to avoid the temptations to join you in bed upon return.

Buy, rent or reserve the beds you’ll need.   If you stay with family on a regular basis,  buy, or ask family members to borrow or rent,  a portable crib.    If you are staying in a hotel, call in advance, so the cribs or extra pull out beds will be ready when you check in. If you’re traveling by car, BYOB, or  bring your own bed;  a pack n play or  travel bed or sleeping bags  are great portable options which you’ll use many times.

Do practice runs.  Trips cause a lot of disruptions to familiar routines, whether it’s at a hotel or your  in law’s house. And you don’t want to arrive only to have your child  go into meltdown mode.   If you take your own travel bed or portable crib, allow your child to sleep in it a few nights before you leave to get used to it.  Also, prior to departure,  talk with toddlers about the plans, including new sleeping arrangements..

Take along helpful sleep accessories. Have you ever packed a suitcase full of toys only to never unzip the bag?  I have!  But these days I have  exchanged the extra toy bag for one with some helpful sleep accessories.

Here are some lightweight and useful options:

  •  A White noise app:  Download a white noise app, such as  “Relax Melodies” .  White noise is not only extremely soothing for both babies and toddlers,  but can help drown out ambient noise which may  be unavoidable away from home.
  • A favorite stuffed animal or lovey:  Bring one or two portable stuffed animals, lovies, or dolls  your child won’t sleep without.  But not a whole menagerie!
  • Sheets:  Even when traveling without the crib, consider taking your own sheets.  The  familiar patterns, the feel, and smell can help a child transition to a new sleeping environment..  Tip:  hotels (or even family) may not have appropriately-sized  sheets, so it’s better to take along your own.
  • Black plastic bags and some painter’s tape: They won’t  win any design awards, but garbage bags make great black out “curtains”  in a pinch and can help recreate the darkness that is essential for melatonin release and hence sleep.
  • Strollers: With travel more uncertain than ever, expect delays.  Even toddlers old enough to walk easily may benefit from rest on wheels, especially at an airport when there are flight delays..  Pushing a stroller is a whole lot easier than giving shoulder rides through the airport or amusement parks.

 Recreate bedtime routines.  Despite  changes of schedules and scenery, try to keep bedtime routines constant.   If bath, books, and song are parts of your normal routine, stick to them. If Grandma or Uncle Bob want to participate, let them join in  or take over!  It’s not so much about who does it, but that the routines are as consistent and predictable as they are at home.

Squeeze in naps as much as possible.   Whether walking  through Disney World or spending time with  your family,  it’s tempting to eliminate the nap while on vacation..  But  skipping routine naps spells trouble!   If your schedule necessitates a skipped nap one day, try to schedule a  lighter schedule the next to allow for crucial day time rest.   If you do miss a nap, compensate with an earlier bedtime.  The more the sleep deficit  accumulates, the more you head for dreaded meltdowns—even if you’re at the zoo!   Be flexible, but accommodate the daytime sleep needs as much as possible,  even if it is limited to napping  in the stroller or car or at the beach.  And when your child naps, take advantage of a midday siesta yourself!  It’s a great fix for the whole family.

Anticipate time differences.  If you are traveling across time zones,  the best advice is to move your schedules to the new time zone as soon as possible. And allow a few days to get sleep back on track both when arriving or returning home.   If you are only traveling for 2-4 days across one or two time zones, it is sometimes easiest to stay on your home time zone.  If you are traveling for a longer period to a different time zone, consider shifting to the new time zone during the week before your travel.  So modify your children’s sleeping and eating routines 15 minutes earlier, or later, each day prior to the trip.  This may  take 3-4 days, so plan ahead.

If you don’t make the adjustments prior to leaving, aim to  shift your child to the new time zone from day one.  So wake your child as close as possible to the new time zone or as the case may be, leave him if he wakes early and aim to do bedtimes at your usual time in the new time zone; the same goes for  naps.  Exposure to bright light early in the morning and dim light in the early evening if you are traveling East and doing the opposite  traveling West can help shift their circadian rhythms and make the transition easier.

 Break some rules and have fun!  Try not to stress out  about strict sleep habits on vacation.   Kids are surprisingly resilient:  if they  miss a few naps and go to bed too late a few nights,  they will survive and so will you!.  Let the kids have  fun doing something they don’t usually do.   And if you disturb a few people—fellow passengers or other hotel visitors– along the way, you won’t see them again, so don’t worry!

Get back on track as soon as you get home.  Sometimes the hardest part of a trip is to resume normal routines when you return.  Staying up late eating popcorn at grandma’s is so much more fun than hitting the hay at 7:00pm every night.  But don’t bring vacation habits home with you. Try to get back to nap and bedtime routines as soon as possible – knowing that it might take a few days and cause a few tears.

Author: Dr. Rebecca Kempton, MD

After graduating with a B.A. in Psychology from Dartmouth and an M.D. from Cornell Medical School, Rebecca Kempton worked for several years as a medical director for healthcare technology and pharmaceutical companies before becoming certified as an infant and toddler sleep consultant and starting her own business, Baby Sleep Pro.  With her three children, aged  seven and under, along with thousands of clients globally,  Rebecca has honed her sleep coaching skills.  Sleep training is never one size fits all!  Using a variety of behavioral techniques, she customizes sleep solutions  based on what she learns about you, your child, and your family’s goals. Rebecca  works with clients globally by phone, Skype, and email.  For more information, email rhk@babysleeppro.com; visit babysleeppro.com and follow her on facebook.com/babysleeppro and twitter @babysleeppro

Shifts in Sleep-Wake Cycles Affect Women More than Men

alarm clock  (3)

The Surrey Sleep Research Center at the University of Surrey has performed a new study that shows shifts in the sleep-wake cycles (circadian rhythm) has a greater impact on women than it does on men.  This study was published in the journal, Proceedings of the National Academy of Sciences (PNAS).

The study involved the assessment of the participants’ performance who were placed on 28-hour days with their circadian rhythm (sleep-wake cycle) shifted out of phase with the brain.  The cognitive performance, as mentioned, was more affected in women than in men.  This research indicates that there are significant implications for women who work nightshift hours, especially nurses, police officers, and security guards.

In this study, performed at the Surrey Clinical Research Centre, the researchers utilized a controlled environment without the natural light-dark cycles and placed 18 women and 16 men on a 28-hour day.  This was an effective way to desynchronize the brain’s 24-hour circadian clock, which is similar to a shiftwork scenario or jet lag.

During the awake period, participants were asked to perform a wide range of tests every three hours.  These included tests on mood and effort, self-reported assessments on sleepiness, as well as objective scales of cognitive performance.  This last included measurements of motor control, memory, and attention span.  Throughout this study, an EEG (electroencephalogram) to look at brain electrical activity, was monitored during the sleep states.  In both women and men self-reported assessments of sleepiness and cognitive function, the results showed that they were more sensitive to the circadian clock and the effects of awake time than the objective tests of performance.  Of critical note, however, is that women’s performance, more so than men’s, was strongly affected by the circadian clock shift.  It was such that women were more impaired cognitively during the early morning hours, which generally coincides with the end of a night shift in the real world.

Dr. Nayantara Santhi, co-author of the study out of the University of Surrey, reported that for the first time, this study shows that the challenges of a shifted circadian clock affects women and men’s performance very differently.  The findings suggest that there are significant cognitive impairments and changes in mood in those who do shiftwork.  Extrapolating these results shows that women are affected more negatively than men when it comes to this type of work.

Professor Derk-Jan Dijk, senior author of the study, reports that the results actually indicate circadian rhythmicity affects the brain’s function in both men and women, albeit differently in quantitative measures.  Professor Dijk also reports that, overall, these findings illustrate the importance of including both sexes in sleep studies, as well as the importance of using a wider range of objective and subjective indicators of brain function in order to get a better understanding of how circadian rhythm affects each group.

 Reference:  http://www.eurekalert.org/pub_releases/2016-04/uos-nsf041516.php

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.

Consolidating Memory During Sleep

sleeping

Sleep makes up about 1/3 of our lives.  Decades of research have concluded that sleep is vital for learning functions and making long-term memories.  However, knowing exactly how long-term memory is formed is not wholly understood.  It remains a primary question in neuroscience

New research from neuroscientists out of the University of California Riverside published in the Journal of Neuroscience reported that there may now be an answer to that question.  For the first time, this study will look at a mechanistic explanation for how deep sleep, or slow-wave sleep, is responsible for the consolidation of new memories.

Animal and human brains are disengaged from any sensory input during sleep.  Even so, the brain continues to be highly active, with electrical activity present in the form of hippocampal sharp-wave ripples, as well as high-amplitude slow oscillations in the cortex.  The hippocampus is a small brain region that is part of the limbic system.  The cortex is the outer part of the cerebrum.  This process reflects that there are alternating periods of silent and active neurons during deep sleep states.  During sleep, the episodic memories acquired during wakefulness are transferred from their initial spot in the hippocampus to the cortex and stored there as long-term memories.

The researchers at UC Riverside used a computational model to create the link between the neuronal synaptic connections and the brain’s electrical activity during deep sleep.  The model spontaneously generates patterns of slow oscillations in the cortex and shows that these patterns are directly influenced by the sharp-wave ripples in the hippocampus.  Additionally, the oscillations in the cortex determine synaptic changes in the neurons.  It is notable that synaptic strength is generally believed to play a role in memory storage and learning.  In this model, the synaptic changes affect the slow oscillation patterns and promote a sort of reinforcement and replay of specific memories.

Lead researcher and author of the study, Dr. Yina Wei, notes that the slow oscillations are undisturbed by input from the hippocampus.  This is interpreted as an explanation for the ability to consolidate specific memories during sleep because the traces of memory are formed within the cortex and then become completely independent of the hippocampus.

According to the computational model used, Dr. Wei explained that the hippocampal input goes to the cortex during deep sleep and then proceeds to influence how the slow oscillations are brought into the cortical network.

The influence of these slow oscillations and the input from the hippocampus activates memories during sleep, causing some memories to replay.  During this replay, synapses that correspond to these are strengthened for long-term storage within the cortex.  Dr. Wei reports that this suggests there is an important link between hippocampal sharp-wave ripples and the transfer of memories to the cortex.

As mentioned, brain activity stays high during sleep.  Normal sleep consists of rapid eye movement (REM) and non-rapid eye movement (NREM) sleep.  REM and NREM alternate several times throughout the sleep cycle, usually about four or five times in an eight-hour sleep period.  NREM occurs first, which is then followed by REM sleep, and one cycle lasts between 90 and 110 minutes.  There are three stages of NREM sleep, with the third stage being deep sleep.  Deep sleep makes up approximately 20% of the cycle and generally occurs in the first third part of the night.

It is of note that even spatially localized and weaker input from the hippocampus had an effect on the slow oscillation pattern, which then led to persistent changes of synaptic communication between neurons.  The model can make predictions, Wei believes, that can be experimentally tested, which include interventions that will either augment or suppress the process of memory consolidation.

Reference: http://www.eurekalert.org/pub_releases/2016-04/uoc–htb041416.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.