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

sleep and diet
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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.

Reference:  http://www.eurekalert.org/pub_releases/2016-07/uoc–hnf072216.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.

 

Bedwetting Solutions

bedwetting

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.

President, ABA in PA INITIATIVE
Associate Professor of Pediatrics
Section Chief, Developmental Pediatrics, Penn State Hershey Children’s Hospital

What is Obstructive Sleep Apnea?

Picture of obstructive sleep apnea

Obstructive sleep apnea is the most common form of sleep apnea.  It is characterized by frequent starts and stops in breathing while asleep.  This type of apnea occurs when the muscles in the back of the throat relax and block the airway.  These muscles help to support oral and pharyngeal structures like the tongue, uvula, soft palate, and tonsils.

When the airway is either completely or partially blocked, there is usually 10 to 20 seconds of breathing cessation, which can lower blood oxygen levels.  The brain panics when this happens and rouses the body to restart breathing.  Generally, this is a very brief awakening that most people do not even notice or remember.  It can happen over 30 times an hour all throughout the night, which significantly disrupts restful sleep cycles.

Symptoms of Obstructive Sleep Apnea

The most obvious and common sign of this type of apnea is loud snoring.

Other signs and symptoms that may occur during the night or in the daytime include:

  • Excessive sleepiness during the day, leading to difficulty with focus and concentration
  • Waking up in the middle of the night short of breath
  • Breathing cessation throughout the night, which is usually observed by someone else
  • Dry mouth and sore throat in the morning
  • Chest pain upon waking up
  • Morning headaches
  • Mood instability like frequent bouts of depression, anxiety, or excessive irritability
  • Insomnia, problems staying asleep, and/or restless sleep
  • Hypertension

Not everyone who snores has obstructive sleep apnea.  This type of snoring is extremely loud and identifiable through the long periods of deafening silence when breathing stops.

Typically, adults and children will differ in symptoms.  For example, the hallmark of OSA in adults is excessive daytime sleepiness, to the point where they may fall asleep for short periods throughout regular daily activities.

Children with OSA may suffer from hyperactivity, malnutrition, and failure to thrive, which is where their growth rates are significantly reduced.  

 The poorer growth can happen for one of two reasons:

  1. The work of breathing is burning off a lot more calories.
  2. There is so much nasal and airway obstruction that it is difficult to swallow food and drink.

Symptoms can be present for years without the person knowing they have the disorder.  Many will have issues for only a short period, with symptoms disappearing after weight loss, surgery, or other lifestyle changes.  Symptoms may also be the result of a respiratory infection, congestion, throat swelling, etc.

Causes of Obstructive Sleep Apnea

In children, enlarged tonsils or adenoids most often cause OSA.  Surgical removal often leads to resolution of OSA symptoms.  For adults, causes may vary and include:

  • Age
  • Obesity, which may cause increased soft tissue around the airway
  • Structural deformities that obstruct the airways
  • Decrease in muscle tone, which can be caused by alcohol, substance abuse, neurological disorders, or some other underlying health conditions.

tongue and sleep apnea

Some scientific evidence suggests that snoring for years at a time can lead to the development of lesions in the throat, just as the vibrations from snoring can lead to nerve or neuron lesions all around the body.

Snoring Mouth Picture
Snoring Mouth Picture

Women are typically less likely to suffer from OSA than men, as men in middle years are more likely to have changing anatomy in their neck and soft tissues.  Women could also be at decreased risk because of the higher levels of progesterone, but they are more likely to suffer symptoms during pregnancy and after menopause.

Furthermore, there seems to be a genetic component to OSA.  Studies have shown that sufferers often have a positive family history.  Lifestyle factors like drinking, smoking, and overeating increase the chances of developing the condition.

Diagnosing Obstructive Sleep Apnea

OSA is diagnosed through a series of exams and tests.  A thorough history and physical is taken by the primary care physician, which includes questioning how the patient is performing in daily activities and family history.  The physical exam includes examining the back of the throat for any abnormalities, checking blood pressure, and measuring neck and waistlines.

Tests used to diagnose obstructive sleep apnea are polysomnography and home sleep study sleep apnea test……

……….Read the complete article on obstructive sleep apnea.

Emotional Disorders linked to Sleep Deficiency in Children

child sleeping

The most common responses to how lack of sleep affects emotions are fogginess, irritability, and grumpiness.  There are hundreds of jokes that are rooted in how sleep deprivation can turn a nice kid into something from a bad horror flick, but lack of sleep can actually lead to a great deal of serious health consequences for them in later years.

A clinical psychologist and associate professor of psychology at the University of Houston, Candice Alfano, reminds us that children who are not getting quality sleep are more likely to suffer from anxiety and depression disorders in later years.  A new study funded by a grant from the National Institute of Mental Health, a subsidiary of NIH, was looking to see the different ways lack of sleep in children leads to increased risk of developing emotional disorders as they grow up.

Ms. Alfano is the principal investigator of the study, which was done at the Sleep and Anxiety Center of Houston (SACH).  She states that the main priority of this study is to understand how children who have had adequate and inadequate amounts of sleep evaluate, regulate, and later recall emotional experiences.  Childhood ages were focused on for this study because sleep patterns, along with emotional problems like anxiety and depression, develop in early years.

Alfano and colleagues are looking to identify emotional processes that make the children more vulnerable to anxiety and depression when there is a lack of good quality sleep.  To gauge this accurately, they temporarily restricted the sleep in 50 children between 7 and 11 years.  This will help them pinpoint behavioral, physiological, and cognitive patterns of emotional risk.

Findings were clear:  Lack of sleep or disruption in sleep negatively impacts emotional health in children by creating negative emotions, as well as altering positive experiences and recalls.  For instance, children experienced less pleasure from positive things after only two nights of poor sleep.  Additionally, they were less likely to recall positive details about the experiences later in the study and were less reactive to them.  These emotional disconnections are less apparent when sleep habits are more normalized and adequate in duration.

We know that healthy sleep patterns are critical for the overall well-being of children; however, this study shows us that lack of sleep not only creates negative behaviors, but impacts their ability to experience pleasurable activities.  Getting inadequate sleep on a continual basis does lead to anxiety, depression, and many other types of emotional imbalances.  Therefore, it is vital that parents think about developing a healthy sleep routine and consider it an essential component of keeping their children healthy, just as they do with dental hygiene, exercise, and nutrition.

Bottom line is that if your child is having difficulty waking up in the morning or feeling excessively sleepy during the day, then their bedtime routine should be adjusted.  This can be caused by several factors like later bedtimes, unrestful sleep throughout the night, or an inconsistent schedule or sleep environment.

Childhood is when emotional regulation and sleep patterns are developing, so Alfano and her colleagues have made it a point to study the link between sleep problems and impaired emotional processing more closely.  Understanding the association between need for good quality sleep and better brain plasticity could be a critical window of opportunity for early psychological intervention.  The combined cost of depressive and anxiety disorders on society and the economy is an estimated $120 billion yearly, which is a clear indication that there needs to be more diligent attention to identifying and treating risk factors and developing more effective intervention methods.

Another article by Alfano and colleagues, published in Sleep Medicine Reviews, pays particular attention to the medical and scientific nomenclature of emotion and sleep regulation.  This article provides evidence that inadequate sleep leads to poor responses to positive or rewarding experiences, especially if they require effort.  They say that over time, these changes in behavior lead to increased risk for depression and poor quality of life.

It seems that there are several processes that are affected by poor sleep, including the ability to pick up on nonverbal cues, self-monitor, and experience empathy, Alfano noted.  Combined with decreased impulse control, one of the more notable highlights of adolescence, and inadequate sleep creates a perfect storm for negative emotional responses.

Reference:  http://www.eurekalert.org/pub_releases/2016-07/aaos-pod071516.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.

Veterans Continue to Suffer with Sleep Disorders

soldier

New research has indicated a six-fold increase in the prevalence of a sleep disorder in U.S. veterans over an 11-year period.  Researchers noted that the highest increases in sleep disorder diagnoses were happening in patients with combat experience, posttraumatic stress disorder (PTSD), or other mental health condition.  Further, PTSD occurrences and prevalence tripled throughout the duration of the study.

A sample of more than 9.7 million U.S. military veterans was used in this study, with the age-adjusted prevalence of sleep disorders increasing to almost 6% in 2010 from 1% in 2000.  The most common diagnosed sleep disorder among the veterans was sleep apnea, including about 47% of individuals.  The second most common condition was insomnia, affecting about 26% of participants.  Those with previous or current diagnoses of chronic diseases such as cancer and cardiovascular disease were at higher risk of developing a sleep disorder when compared to those without comorbid conditions.

These results have been reviewed and published in the journal, Sleep.

The study was led by Principal Investigator and senior author, Dr. James Burch, PhD, who is an associate professor in Epidemiology and Biostatistics in the Arnold School of Public Health at the University of South Carolina.  Dr. Burch also stands as a Health Science Specialist in Columbia, South Carolina at the WJB Dorn Department of Veterans Affairs Medical Center.  He notes that PTSD-diagnosed veterans are at much higher risk of developing sleep disorders compared to others with various health conditions or other population characteristics that were examined.

This does not mean that PTSD causes sleep disorders, Burch notes, as the study was not designed to look that far into PTSD related to sleep disorders.  However, while this does not prove PTSD leads to the diagnoses, researchers did perform a follow-up study that is nearly ready for publication, which examines the issue in further detail.  This follow-up study identifies a pre-existing history of PTSD linked to increased risk of developing sleep disorder onset.

Sleep apnea is a form of sleep disordered breathing, which is characterized by symptoms of abnormal respirations during sleep, as defined by the American Academy of Sleep Medicine. Obstructive sleep apnea is what we hear most about in sleep medicine, which is a syndrome that features symptoms that obstruct the airway during sleep, including frequent starts and stops in breathing.  It is a repetitive partial or complete closure of the upper airways.

The American Academy of Sleep Medicine characterizes insomnia as regular and persistent problems falling and staying asleep throughout the night, which frequently leads to poor sleep quality, fatigue, daytime impairment, and irritability.

This above study was focused solely on U.S. veterans who sought treatment at the Veterans Health Administration between the years 2000 and 2010, with a sample total of 9,786,778, most of which consisted of men (93%), and over 751,000 had at least one sleep disorder diagnosed.

Researchers note that the trajectory of diagnoses observed here shows that the trend is likely to continue, and the results emphasize the importance of further research and the need for management of sleep disorders among veterans.

 Reference:  http://www.eurekalert.org/pub_releases/2016-07/aaos-pod071516.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.

 

Earlier Bedtimes in Children may Reduce Obesity Risk

obesity and sleep

New research has determined that preschool aged children who regularly go to bed by 8 p.m. are less likely to become obese in teenage years than children with later bedtimes.  According to the study out of the Ohio State University College of Public Health, children who went to bed after 9 p.m. were at twice the risk of obesity later in life.

 

Dr. Sarah Anderson, lead author of the study and Associate Professor of Epidemiology reminds parents that this reinforces the importance of establishing a healthy bedtime routine.  Further, it helps pediatricians provide evidence-based advice to parents in the clinical setting.

 

This can significantly lower children’s risk of developing diabetes, with a variety of positive benefits on social, emotional, cognitive, and behavioral development, Dr. Anderson states.

 

Childhood obesity is a big problem in the United States.  According to the latest figures from the Centers for Disease Control and Prevention (CDC), about 17% (over 12 million) children and teens are affected.  Obesity is a dangerous problem that can set children up for health and social struggles, including problems like heart disease, diabetes, and depression.

 

Published in The Journal of Pediatrics, this research focused on data from 977 children in the Study of Early Child Care and Youth Development.  The research closely followed babies born in 10 U.S. cities in 1991.

 

The preschool children were divided into three categories:  Those who went to bed at 8 p.m. or earlier, those between 8 p.m. and 9 p.m., and those who were put to bed after 9 p.m.  The average age was 4-1/2 years when mothers began reporting their weekday bedtime activities.

 

The children were followed to an average age of 15, with bedtimes reviewed very closely to determine which teens were more prone to obesity.  There was a striking difference.  Only 1 out of 10 children in the earlier bedtime (8 p.m. or earlier) were obese in their teen years.  Comparatively 16% of the children with bedtimes between 8 and 9 p.m. and 23% of children with bedtimes after 9 p.m. were reported to be obese as a teenager.  About half the kids who were part of the study fell into the middle category of bedtimes.  One quarter had earlier and one quarter had the later bedtime.

 

Videoed interactions between mothers and children were also reviewed, because emotional climate at home can have an influence on bedtime routines.  This measurement was referred to as “maternal sensitivity,” which looks at the mother’s respect for the child’s autonomy, hostility levels, and maternal support.

 

The maternal-child relationship did not strongly impact the findings.  There was still a strong association between obesity and bedtimes.  However, it is notable that the children who went to bed later and whose mother had the lowest sensitivity ratings were at highest risk for obesity.

 

Further, it was noted that children who went to bed later were of non-white ethnicity, lived in low-income households, and their mothers received less education.

 

Research in the past has positively linked a relationship between obesity and short sleep durations.  One study associated later bedtimes with a five-year risk of obesity.  This new study is the first to use information collected 10 years after preschool.

 

This team has performed a number of sleep-related studies, with prior research illustrating the importance of routines for young children, which was used to help build this current study.  Dr. Anderson and her colleagues focused on bedtimes for this study because they have more influence on sleep duration than wake times, over which parents have very little control.

 

It is no guarantee that putting a child to bed earlier will mean they will fall into deep sleep right away; however, a consistent bedtime routine makes it more likely that the children will get plenty of sleep to perform to their highest potential during the day.

 

Pediatricians are now in a position to talk to parents about earlier bedtimes for their young children in order to help prevent obesity risk.  This evidence-based research will also help pediatricians assist parents in overcoming obstacles they may be facing with their children, which may be related to their sleep duration and quality.

 

Earlier bedtimes may be more challenging for some families than others, especially when parents work later.  There are competing demands and compromises that are constantly made in the home setting, which need to be considered when the pediatricians go to discuss the earlier bedtimes.  Most children, however, are biologically programed to be ready for sleep before 9 p.m., so it may not be as difficult as some parents may feel in the beginning.

 

The researchers noted in their published findings that while this study helps identify a link to bedtimes and obesity, it does not answer the questions about how bedtime can influence other factors of weight gain like nutrition, physical activity, and social environment, all of which remain active areas of research.

 

Reference: http://www.eurekalert.org/pub_releases/2016-07/osu-epb071116.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.

 

Mirroring Neurotechnology to Help Athletes with Concussion

exercise and sleep

After using HIRREM® neurotechnology, Brain State Technologies has reported that young athletes who suffered from symptoms of concussion are showing a number of long-term improvements.  After three months of therapy, the small group of athletes reported continued symptom reduction, with all of them returning to full activities and exercise.  These findings were presented in Chicago at the American Academy of Neurology Sports Concussion Conference this month.

 

Symptoms of sports- or recreation-related concussions include sleep disturbance, nausea, cognitive impairments, headaches, depression, and other health concerns.  Most athletes who get a concussion will recover within a few days; however, about 10% will go on to develop long-term symptoms, which can last for weeks, months, or even years.  In this study using neurotechnology, 19 people participated in the study, and each had symptoms for an average of five and a half months before using HIRREM®.

 

High-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM®) is a noninvasive procedure using computer technology developed by the CEO of Brain State Technologies, Lee Gerdes, whose background also includes software engineering in Silicon Valley.  Using algorithms built into the software, brain wave frequencies are translated into audible tones, which are then returned to the person in real-time.  The intention is to support self-optimization of electrical activity patterns within the brain.

 

Most of the athletes who were part of the study went right back to participating in their chosen sport.  There were changes noted in the variability of their heart rate, which suggests that their heart could make more rapid adjustments and adapt better to pumping functions.  A portion of the participants underwent reaction testing both before and after HIRREM®, which showed even greater improvements, with better reaction times.

 

Co-investigator in the study and Director of Research at Brain State Technologies, Dr. Sung Lee, reminded the group at the presentation that concussion presents unique challenges not only to the brain, but to the rest of the body as well, because the brain is the central command station.  It was exciting to the researchers that the athletes were not only self-reporting improvements, but that there were objective measures to show better reaction times and heart rate variability, leading them to be able to participate in sports again.

 

Estimates show that about 190,000 people in the United States develop persistent sports- or recreation-related concussion symptoms every year.  The guidelines in the sports medicine industry state that athletes’ return to competitive play cannot be based on the use of drugs that will mask underlying symptoms that would otherwise prevent the individual from participating.  Not only would that put them at risk of developing further symptoms and ending their career, but the symptoms may actually be severe enough to prevent them from participating in non-athletic activities.

 

There has been a recent increase in concerns about the potential long-term effects of concussion symptoms in athletes, which is partially due to the recognition of CTE, or chronic traumatic encephalopathy, which has been reported in National Football League (NFL) players that were exposed to repeated head injuries and hard impact.

 

HIRREM® has created a “closed loop” of information exchange in clinical studies, which has been linked to improved sleep quality, reduced posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) symptoms, and better symmetry in electrical brain activity, along with other objective health benefits.

 

Reference: http://www.eurekalert.org/pub_releases/2016-07/bstl-awc071316.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.

Psychological Disorders Related to Sexual Behavior in Sleep

bed in bedroom 001 (3)

New research out of Edinburgh has found that sexual behavior in sleep (SBS) may be linked to underlying psychological and psychiatric conditions that are rooted all the way back to childhood.

The findings were presented in Edinburgh this month at the Federation of European Neuroscience Societies (FENS) Forum.  Researchers presented the likely case that SBS actually originates from childhood sleep disturbances and may be linked to more serious underlying mental health disorders.

While some people may find SBS comical in nature, others find it disconcerting and too intimate to discuss.  In any case, most sufferers and their partners find it embarrassing and exceedingly difficult to live with.  The case for SBS has been used as part of a defense in some sexual assault cases as well.

Sexual behavior in sleep, or sexsomnia as it is sometimes called, is considered a parasomnia, which describes abnormal behaviors in the autonomic nervous system during sleep.  This includes things like sleep talking, night terrors, and sleep walking.

SBS is a parasomnia characterized by the act of engaging in sexual activity during sleep, but not remembering the act upon waking.  These types behaviors can be inappropriate and out of character for that individual such as fondling, vocalizations, intercourse, and masturbation.  These actions by the sufferer are uncontrollable and can sometimes be violent.

In the past, studies and research have been focused primarily on individual case studies, forensic psychology, and expert opinions.  The research team at the University of Edinburgh have tried to take a broader view.  They examined three women and 20 men who were referred to one of the most widely known and prestigious sleep centers in the United Kingdom.

Led by Drs. Renata Riha and Ian Morrison out of the University of Edinburgh, the research panel consisted of scientists in the fields of psychiatry, psychology, sleep medicine, neurology, and law from various universities throughout Scotland. The study is part of a larger program that is investigating psychological and psychiatric causes of sleep behaviors that have been otherwise unexplained.

One of the authors of the study, Ms. Emmalee Maschauer, told delegates at the forum that this study stands out because some of the features of SBS that have not been identified previously have been targeted in this analysis.  These components include childhood onset, possible links to underlying psychiatric disorders like anxiety and post-traumatic stress disorder (PTSD), and the variable ability to recall the behaviors.  Researchers believe these are some of the more important components of the condition, especially in forensic cases, because it may influence not only treatment options for sufferers, but even the outcome of some criminal trials.

Reference:  https://www.bna.org.uk/news/view.php?permalink=AXC0YOCU5V

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.

4 Ways to Teach Your Mind to Sleep

sleep better

There can be a large mental component that prevents people from sleeping well. This may manifest as a racing mind that prevents you from falling asleep at night. It might mean you wake up multiple times per night with no real cause.

There are ways you can teach your mind to sleep deeper and to fall asleep faster. Some of these techniques are solid and have been proven with countless scientific studies, while others are on the cutting edge and more research needs to be done to reach a definitive conclusion. This article should give you a good basis on how to begin teaching your mind to sleep better.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral techniques have their roots in stoic philosophy. You can think of CBT as using your mind to critically think about how you are thinking, and then to actively begin thinking differently. Your brain is built to recognize and create patterns which is why CBT can be so powerful. Sleep itself is just another pattern that can be affected by the mind.

In this randomized, placebo-controlled clinical trial, at a single academic medical center, CBT was tested along with traditional pharmacological approaches for insomnia. 78 older adults participated to see how best to treat their insomnia, both short and long term.

They found that CBT alone could reduce the time spent awake by as much as 55%. When combined with some pharmaceuticals the effectiveness was boosted to 63%.

Here is the kicker: Those that underwent cognitive behavioral training continued to sleep better into the future. The group that only took sleep inducing drugs lost the sleep benefits as soon as they stopped taking the medication.

“Subjects treated with behavior therapy sustained their clinical gains at follow-up, whereas those treated with drug therapy alone did not.” – Charles M. Morin, PhD; et al.

Autogenic Training

Dr. Shultz was a german psychiatrist that developed autogenic training (AT) in the 1930’s. It is a mind-body technique that allows you to relax much more deeply than you typically are able to throughout the day.

Autogenic training has many things in common with self-hypnosis. It can produce physical phenomenon, it can become self-guided, and can put the mind in a meditative state.

In this cohort analysis study made by the Royal London Hospital for Integrated Medicine and University College London Hospitals, autogenic training was shown to positively impact insomnia.

There were 153 participants, of whom 73% were identified as having a sleep-related problem. The study showed improvements in sleep onset latency (how fast you fall asleep), falling asleep more quickly after waking up, feeling more refreshed, and feeling more energized after waking up. There were positive emotional benefits too, as well being, anxiety, and depression scores all significantly improved after a course in autogenic training.

This quote from the article sums it up nicely:

“This study suggests that [autogenic training] may improve sleep patterns for patients with various health conditions and reduce anxiety and depression, both of which may result from and cause insomnia. Improvements in sleep patterns occurred despite, or possibly due to, not focusing on sleep during training. [Autogenic training] may provide an approach to insomnia that could be incorporated into primary care.” – Bowden A, Royal London Hospital for Integrated Medicine

Hypnosis and Hypnotherapy

Although the root word of hypnosis is “hypnos” the greek word for sleep, modern hypnotherapy does not involve a person becoming unconscious. Hypnosis works by bringing about a self-directed altered state, often called a hypnotic trance, which leaves a person more susceptible to beneficial instructions.

Rather than being magic, hypnosis could more properly be described as an enhanced state of learning. You can learn new habits and new beliefs much faster in a hypnotic state. The current field of hypnosis is intertwined with the latest in practical neuroscience and it is evolving as we learn more about how the brain works.

Hypnotic relaxation techniques have been shown to improve sleep. In this multifaceted program for treatment of insomnia in adolescents, hypnosis was used in conjunction with progressive muscle relaxation and CBT to improve sleep in the study participants. More than that, progressive muscle relaxation is also a very common procedure used to induce hypnotic trance.

This describes the process of the study:

“Each treatment session starts with a short warm-up game and ends with the rehearsal of an imaginative or hypnotherapeutic procedure (trance). Participants are asked to practice these trances between the sessions.”

“The adolescents showed a significantly shorter sleep onset latency after the treatment. Furthermore, total sleep time as well as sleep efficiency were significantly higher after the treatment although going to bed earlier is unpopular with adolescents…. The adolescents not only gained more knowledge about sleep and sleep hygiene but also more skills to resolve their sleep problems by applying behavioral as well as hypnotherapeutic strategies.” – Angelika A Schlarb, Department of Psychology, University of Tuebingen.

Another study that researched the efficacy of hypnosis in the treatment of insomnia had this to say:

“Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions.” – Ng BY, Department of Psychiatry, Singapore General Hospital

Although it was quick to add why there is not much data on this powerful technique:

“It is hard to perform a randomised, double-blind, controlled trial to evaluate hypnotherapy given that cooperation and rapport between patient and therapist is needed to achieve a receptive trance state.”

Hypnosis has been shown time and again to be effective for things like reducing anxiety, pain, and even the side effects of chemotherapy. It’s no wonder that it is starting to show how powerful a tool it can be for sleep.

Mindfulness Meditation

Meditation is another useful tool that can help improve the quality of your sleep. As a psychological technique, mindfulness meditation allows a person to reflect on their true thoughts and to begin to slow their racing mind.

Mindfulness Based Stress Reduction (MBSR) techniques have become in vogue recently as more studies have come out demonstrating how effective they can be for increasing emotional well being. Recent research has shown that a regular practice of meditation can actually change the structure of the brain itself, increasing areas associated with emotional control, and shrinking areas linked to stress and worry.

This quote from a meta analysis of 38 articles studying mindfulness helps to identify MBSR as a useful tool for insomnia:
“There is some evidence to suggest that increased practice of mindfulness techniques is associated with improved sleep and that MBSR participants experience a decrease in sleep-interfering cognitive processes (eg, worry). More research is needed using standardized sleep scales and methods, with particular attention to the importance of MBSR home practice.” – Winbush NY

Conclusion

People sometimes think that if you can’t sleep easily, the best thing to do is to reach for the medication. While medication can be helpful, it’s more apparent that psychological approaches are an effective front line tactic to help a person sleep.

It’s often time not one thing that helps a person rebuild their sleep pattern. It can be a combination of meditation, relaxation techniques, hypnosis, sleep hygiene, and CBT that finally allows a person to sleep better. If you have trouble sleeping you should find what works best for you by trying many different approaches.

ABOUT THE AUTHOR:

Benjamin Schoeffler, Ch,t. is a board certified medical hypnotist with the IMDHA. He has a private practice in Boise, ID at Thrive Hypnotherapy and an online sleep hypnosis program.

 

Night Terrors? Sleep Walking? Don’t Lose Sleep When Your Child Has These Common Sleep Complaints!

sleep night terror nightmare

What are parasomnias?

Parasomnias are common sleep disruptions that can occur when a child is falling asleep or waking up.   Parasomnias occur at the transition of deep sleep and consciousness where a child’s brain can be caught in between the two states, and explains why a child can appear awake but actually be sleeping.  This article will discuss examples of parasomnias including sleep talking (somniloquy), sleep walking (somnambulism), night terrors (pavor nocturnus), and confusional arousals.

Common features to all Parasomnias

Parasomnias are common in childhood and share many features.  They are generally harmless and most children outgrow them. A child may appear awake, but their brain is asleep and unaware of the event.  Unlike nightmares, a child will awaken unaffected and have no recollection of it the next day.  Other than sleep talking, most other parasomnias happen around the same time, usually within 4 hours of falling asleep. While parents may worry their child might have multiple events throughout the night, this isn’t the norm.

Categories of Parasomnias

To ease our understanding of how to approach these different conditions, we classify them into two distinct categories. The first category includes sleep talking (somniloquy) and confusional arousals, which are found to be innocent and generally do not require intervention. Sleep talking is a condition in which a child vocalizes during sleep.  Confusional arousals are characterized by a child waking up briefly.  He or she may have a slow reaction time, have trouble understanding questions, and act confused before returning to bed with no recollection of the event the next day.

Do you ever wonder if your child will wake up if you try moving them? Sleep talking is an easy way to determine how deeply your child is sleeping.  If your child is speaking clearly, they are in a lighter stage of sleep and more likely to wake up if disturbed.  Mumbling and incoherent speech indicate deeper sleep, during which your child is less likely to awaken.

The second category of parasomnia classification includes night terrors (pavor nocturnus) and sleepwalking (somnambulism), which are generally innocent, but in certain circumstances may require intervention. Night terrors are episodes that are named for their appearance rather than what a child is actually perceiving. If your child is having a night terror, he or she will appear panicked and exhibit behaviors such as screaming, sweating, breathing rapidly, and crying, when in fact he or she is actually asleep.  A common misunderstanding is that your child is having a nightmare, yet not experiencing anything that is actually frightening them and will have no recollection of the event once awakened in the morning.  Lastly, sleepwalking is commonly seen in school-aged children and is characterized by walking in a state of partial wakefulness.

Treatment options for Parasomnias

When observation is the only intervention:

Sleep talking and confusional arousals are harmless and require no intervention.

When observation is the preferred intervention:

When night terrors are infrequent (less than a few times a week) and brief (less than 20 minutes in duration), observation and reassurance are generally all that is needed.  Talking to or touching your child during a night terror can prolong the episode, but by letting it run its course, you can significantly shorten the event.

When sleepwalking is infrequent, we recommend gently guiding your child back to bed without waking him or her. While it is not dangerous to wake a sleepwalker, it is not necessary. If there are concerns the child may leave the house or use sharp objects, take simple safety precautions such as securing knives and installing wireless door chimes on exit doors.

When behavioral strategies are the preferred intervention:

When night terrors and sleepwalking are frequent, particularly for a sleepwalker who has already engaged in a dangerous behavior (e.g. leaving the home, engaging in aggressive acts during sleep) ,“planned night awakenings” can prevent parasomnias.  This involves waking a child briefly for 7 consecutive nights 30 minutes before the earliest possible event is likely to occur.  Other strategies include avoiding sleep deprivation, setting a regular bedtime routine, and following healthy sleep habits.

When to consult your physician:

In severe cases where behavioral interventions fail, short term treatment with medications may be available to help. If your child’s condition does not seem to respond to typical suggestions, or you are worried there might be another cause for your child’s sleep problems, consult your pediatrician.  In some cases, parasomnias have been linked to sleep apnea and your child’s doctor is the best source of information to determine if your child is at risk for this condition.


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.

President, ABA in PA INITIATIVE
Associate Professor of Pediatrics
Section Chief, Developmental Pediatrics, Penn State Hershey Children’s Hospital