Category: Insomnia

Coaches, owners and fantasy-league traders take note: Sleep researcher W. Christopher Winter, MD, has uncovered a link between a pro athlete's longevity and the degree of sleepiness experienced in the daytime.

Winter is presenting two studies June 12 at SLEEP 2012 that associate the career spans of baseball and football players with their voluntary answers on a sleepiness questionnaire. The results show that less sleepy football players tended to remain with their drafting NFL teams after college. In addition, attrition rates for sleepier baseball players trended higher than MLB averages.

"A team's ability to accurately judge a prospect or a potential trade in terms of the value they will get for that player is what makes or breaks many professional sport teams," said Winter, principal investigator of the studies and the sleep advisor for Men's Health magazine. "These studies demonstrate that a simple evaluation of sleepiness may be a powerful tool to add to the list of tests athletes already undergo, such as the Wonderlic Cognitive Abilities Test and the 40-yard dash."

The football study looked at 55 randomly selected college players who landed in the NFL, finding that sleepier athletes only had a 38 percent chance of staying with the team that originally drafted them. In comparison, 56 percent of the less sleepy players were considered a "value pick" because they did stay with the original team. The baseball study analyzed the sleepiness scale of 40 randomly selected baseball players and found that players who reported higher levels of daytime sleepiness also had attrition rates of 57 percent to 86 percent, well above the 30 — 35 percent MLB average.

Winter said measuring sleepiness could do more for a team than help it decide who to draft. "Addressing sleepiness in players and correcting the underlying issues causing sleepiness may help to prolong a player's career," he said.

Winter and his colleagues at Martha Jefferson Hospital Sleep Medicine Center and CNSM Consulting in Charlottesville, Va., used the Epworth Sleepiness Scale (ESS), a short questionnaire that can be helpful in detecting excessive daytime sleepiness. EDS is a common symptom of many sleep disorders such as obstructive sleep apnea.

The abstracts "Sleepiness as a predictor of draft value in the National Football League" and "Sleepiness as a predictor of player longevity within Major League Baseball" are being presented today at SLEEP 2012, the 26^th annual meeting of the Associated Professional Sleep Societies (APSS) in Boston.

 A new Northwestern University study shows that the biological clock is not the only clock women trying to conceive should consider. The circadian clock needs attention, too.

Epidemiological studies have shown female shift workers, such as nurses, and female flight attendants who work on long-distance east-west routes (i.e., those with constant jet lag) have fertility and menstrual issues. They are habitually out of sync with the external light cycle. But the role circadian rhythm disruption may play in their reproductive problems is a poorly studied area.

Research led by Northwestern circadian rhythm expert Fred W. Turek now draws a clear line between disrupted circadian rhythms and reproductive physiology. Turek and his colleagues are the first to show that if you disrupt the circadian clock environmentally in mice, with repeated changes in their light-dark cycles, there are problems with pregnancy outcomes.

And the effect can be dramatic. The researchers found evidence suggesting the severity of circadian disruption may be linked to the severity of pregnancy disruption: mice subjected to advances of the light-dark cycle had greater circadian clock disruption and lower reproductive success. This group's pregnancy success rate was only 22 percent.

The study was recently published in the journal PLoS ONE.

"Our results have important implications for the reproductive health of female shift workers, women with circadian rhythm sleep disorders and/or women with disturbed circadian rhythms for other reasons," Turek said.

He is the Charles E. and Emma H. Morrison Professor of Biology in the Weinberg College of Arts and Sciences and director of Northwestern's Center for Sleep and Circadian Biology.

"If you disrupt your internal rhythms, there will be negative consequences — that is very clear," said Keith Summa, first author of the paper and an M.D./Ph.D. candidate working in Turek's lab. "Our results suggest people should consider their biological rhythms for optimal health."

The repeated shifting of the light-dark cycle shifts the biological clock throughout the body. This environmental disturbance is more relevant to shift workers and those frequently flying across time zones, the researchers note, than genetic disruption of the circadian clock, which also negatively influences reproductive function.

Turek, Summa and their colleague and co-author Martha H. Vitaterna studied three sets of normal laboratory female mice, all who had recently mated. The study was conducted over the course of 21 days, the duration of a typical pregnancy.

One set was a control group of 12 mice that experienced normal days of 12 hours of light, followed by 12 hours of darkness. The two other groups, of 18 mice each, also experienced days of 12 hours of light and 12 hours of darkness. But the phase-advanced group had its 12 hours of light start six hours earlier every five days. The phase-delayed group had its light start six hours later every five days. (There were a total of four phase shifts over the duration of the study.)

The researchers monitored the mice throughout the gestation period to count the number of full-term pregnancies. The results surprised them.

In the control mice, 90 percent of the matings led to full-term pregnancies. But in the phase-delay group, the pregnancy success rate was 50 percent, while in the phase-advanced group, it was only 22 percent.

"We were surprised at how dramatic the effect of manipulating the light-dark cycle was, especially in the phase-advanced group," Summa said. "We expected a negative effect from the circadian clock disruption, but not this much."

They next looked at a separate group of females in the phase-delay and phase-advance protocol to see how the animals responded to the repeated phase shifts. The researchers found the phase-advanced animals required one to two days longer, on average, to return to normal rhythms. This suggests the magnitude of circadian disruption is associated with the severity of pregnancy loss.

The next steps, the researchers say, are to identify specifically the stage at which pregnancy is affected and to understand exactly how circadian disruption results in the observed adverse effects.

"We've made an interesting observation, but what's causing the reduced fertility?" Summa said. "We would like to determine where exactly the phase shifts and internal rhythm disruptions are having an effect."

The March of Dimes Foundation and the Institute for Women's Health Research at Northwestern University supported the research.

Social jetlag — a syndrome related to the mismatch between the body's internal clock and the realities of our daily schedules — does more than make us sleepy. It is also contributing to the growing tide of obesity, according to a large-scale epidemiological study reported online on May 10 in Current Biology, a Cell Press publication.

"We have identified a syndrome in modern society that has not been recognized until recently," said Till Roenneberg of the University of Munich. "It concerns an increasing discrepancy between the daily timing of the physiological clock and the social clock. As a result of this social jetlag, people are chronically sleep-deprived. They are also more likely to smoke and drink more alcohol and caffeine. Now, we show that social jetlag also contributes to obesity; the plot that social jetlag is really bad for our health is thickening."

Each of us has a biological clock, he explained. We can't set those clocks according to our whims like watches. They are rather entrained by daylight and night-darkness to provide the optimal window for sleep and waking. In modern society, we listen to those clocks "less and less due to the increasing discrepancy between what the body clock tells us and what the boss tells us."

To find out how big this problem really is, Roenneberg's team is compiling a vast database on human sleeping and waking behavior, which they'll eventually use to produce a world sleep map. Now 10 years into the effort, they already have lots of information, including participants' height, weight, and sleep patterns.

Their analysis shows that people with more severe social jetlag are also more likely to be overweight. In other words, it appears that living "against the clock" may be a factor contributing to the epidemic of obesity, the researchers say.

The findings should weigh in on decisions about Daylight Saving Time, not to mention work and school times, they add. It would also help if people began spending more time outdoors in open daylight or at least sitting by a window. As people fail to do this for one reason or another, their body clocks get set later and later, leaving them awake into the night and tired by day.

"Waking up with an alarm clock is a relatively new facet of our lives," Roenneberg says. "It simply means that we haven't slept enough and this is the reason why we are chronically tired. Good sleep and enough sleep is not a waste of time but a guarantee for better work performance and more fun with friends and family during off-work times." And slimmer waistlines, too.

NewsPsychology (May 10, 2012) — Urgent appointments, tight work timetables and hectic social schedules structure modern life, and they very often clash with our intrinsic biological rhythms. The discrepancy results in so-called social jetlag, which can damage one’s health. Among other effects, it can contribute to the development of obesity, as a new LMU study shows.

Three temporal cycles shape our lives. Our biological clock ensures that fundamental physiological processes oscillate with a period of approximately 24 hours. This internal timekeeper used the daily succession of light and dark to synchronize to the 24-hour day on our planet. Our social clock, on the other hand, often takes little or no heed of our natural needs and biological rhythms. The beat of the social clock is determined by the demands of our work schedules and other extraneous timetables, and its timekeeper is the trill of the alarm clock.

“Our surveys suggest that in Western societies two thirds of the population are burdened with a significant discrepancy between their internal time and the demands imposed by school and work schedules and leisure stress,” says LMU chronobiologist Professor Till Roenneberg, who coined the term “social jetlag” to describe the phenomenon. If the rhythms dictated by our lifestyles are persistently out of phase with our biological clock, the risk of illness, such as high blood pressure and even cancer, rises.

Tired — around the clock A team of researchers led by Roenneberg has now shown that social jetlag also contributes to another growing health problem, particularly in countries with a Western lifestyle — obesity. Individuals who are overweight are at increased risk for serious metabolic diseases, such as diabetes. Many factors, in addition to excessive consumption of energy-rich foods, play a role in the development of obesity, and one of them is a lack of sleep. In persons who get too little sleep, the perception of hunger is perturbed, often leading to overeating.

And it is not just sleep duration that is important here. The LMU team has also found that social jetlag shows a significant association with increased body-mass index (BMI). The BMI, which is based on a quantitative relationship between weight and height, is used as a measure of body fat, and varies depending on age and sex. Individuals with BMIs above the normal range are regarded as being overweight or obese. The results of the new study strongly indicate that a lifestyle that conflicts with our internal physiological rhythms can promote the development of obesity.

Moreover, it appears that the incidence of social jetlag is itself increasing, perhaps as a consequence of a general reduction in sleep duration.”The ongoing debate on the usefulness of daylight-saving time (DST) should take note of our findings,” remarks Roenneberg. “Just like conventional school and work schedules, DST disrupts our biological clock and subjects us to more social jetlag with all its consequences.”

The data used in the new epidemiological study are based on responses to a standardized set of questions, known as the Munich ChronoType Questionnaire. This is freely available on the internet, and more than 130,000 people have already filled it out, providing detailed information on their sleeping patterns and other aspects of their normal lifestyles on working days and on weekends.(suwe)

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Story Source:

The above story is reprinted from materials provided by Ludwig-Maximilians-Universitaet Muenchen (LMU), via AlphaGalileo.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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Journal Reference:

1. Till Roenneberg, Karla V. Allebrandt, Martha Merrow, Céline Vetter. Social Jetlag and Obesity. Current Biology, 2012; DOI: 10.1016/j.cub.2012.03.038

Toss out another old wives' tale: Sleeping too much does not make you fat. Quite the opposite, according to a new study examining sleep and body mass index (BMI) in twins, which found that sleeping more than nine hours a night may actually suppress genetic influences on body weight.

The study looked at 1,088 pairs of twins and found that sleeping less than seven hours a night was associated with both increased BMI and greater genetic influences on BMI. Previous research has shown that genetic influences include things like glucose metabolism, energy use, fatty acid storage and satiety. In this study, the heritability of BMI was twice as high for the short sleepers than for twins who slept longer than nine hours a night.

"The results suggest that shorter sleep provides a more permissive environment for the expression of obesity related genes," said principal investigator Nathaniel Watson, MD, MSc, of the University of Washington. "Or it may be that extended sleep is protective by suppressing expression of obesity genes."

Watson and colleagues determined that for twins sleeping less than seven hours, genetic influences accounted for 70 percent of the differences in BMI, with common environment accounting for just 4 percent and unique environment 26 percent. For twins averaging more than nine hours of sleep, genetic factors were attributed to 32 percent of weight variations, with common environment accounting for 51 percent and unique environment 17 percent.

More research is needed, Watson said, but these preliminary results may suggest that behavioral weight loss measures would be most effective when genetic drivers of body weight are mitigated through sleep extension.

Night-time departures, early morning arrivals, and adjusting to several time zones in a matter of days can rattle circadian rhythms, compromise attention and challenge vigilance. And yet, these are the very conditions many pilots face as they contend with a technically challenging job in which potentially hundreds of lives are at stake.

In an article to be published in a forthcoming issue of Current Directions in Psychological Science, a journal of the Association for Psychological Science, John A Caldwell, a psychologist and senior scientist at Fatigue Science, a Honolulu business focusing on fatigue assessment, examines the problem of sleep deprived pilots by teasing out the complex interplay of inadequate sleep and circadian rhythms. He explains how airline industry solutions miss the point and then suggests other options.

Caldwell points out that "fatigue-related performance problems in aviation have been consistently underestimated and underappreciated, despite the fact that decades of research on pilots and other operational personnel has clearly established that fatigue from insufficient sleep significantly degrades basic cognitive performance, psychological mood, and fundamental piloting skills."

Evidence abounds. In 2004, a corporate airlines flight crashed as it approached Kirksville Regional Airport; in 2008, Honolulu based pilots of Go! Airlines overshot their destination by more than thirty miles because they fell asleep during a trip that was only fifty minutes long. A Northwest Airlines Flight overflew its destination by 150 miles because pilots had dozed off at the controls. In 2009, fifty people were killed when a Continental Connection flight en route from Newark to Buffalo crashed into a house. Pilots failed to respond properly to a stall warning and the flight went out of control.

After examining what went wrong, the NTSB concluded that, "the pilots' performance was likely impaired because of fatigue." Since 1990 the US National Transportation Safety Board has placed pilot fatigue on the Most Wanted List of safety related priorities.

Why? Because as fatigue increases, "accuracy and timing degrade, lower standards of performance are accepted, the ability to integrate information from individual flight instruments into a meaningful and overall pattern declines, and attention narrows. "

In one study, F-117 pilots were deprived of one night of sleep and then were tested on precision instruments. Not only did pilot errors on those instruments double after one night of sleep loss, pilots reported feeling depressed and confused.

Clearly fatigue is fundamentally the result of insufficient sleep, but for pilots the important issue is the consequences of that sleep loss when they are sitting at the control panel. The author suggests that "fatigue related risks increase substantially when (a) the waking period is longer than 16 hours, (b) the preduty sleep period is shorter than 6 hours, or (c) the work period occurs during the pilot's usual sleep hours."

"Regulators, and often the pilots themselves, have tried to address the fatigue problem by focusing on duty hours rather than focusing on the physiological factors that are truly responsible," Caldwell says. "The combination of insufficient sleep and circadian factors is at the heart of the fatigue problem in any operational context."

The two most important variables for alertness are recent sleep and the body's natural circadian rhythm, or "body clock." What that means is that when a pilot reports for duty, he or she should have had from seven to nine hours of good sleep within a reasonable period of time before work and that as often as possible, the work schedule is in some harmony with the pilot's natural daily rhythm.

The amount of time that a pilot is actually working is much less important. But that is the area airlines and regulators have focused on to address the problem. "Hours-of- service" regulations have been instituted to mitigate fatigue, but "that seems to be a function of convenience rather than science." Caldwell writes that in traditional regulatory approaches "one hour of daytime flight in one's home time zone after plenty of sleep is considered to generate the same amount of fatigue as an hour of nighttime flight" that was preceded by a transcontinental transition and sleep outside of a normal sleep cycle. Fortunately, new Federal Aviation Administration regulations better account for the true physiological nature of fatigue, but additional fatigue-management strategies are needed.

Caldwell acknowledges that the very nature of airline travel predisposes pilots to disrupted sleep schedules, but he points out several approaches that can both predict a truly impaired pilot and mitigate the consequences of a lack of sleep. There are some fatigue prediction models that can help determine the impact of work/rest schedules on aviator performance. Crew members should be educated on sleep hygiene so they can snag some restorative rest before duty or during layovers. Onboard cockpit napping should be authorized so that pilots will be able to compensate for a lack of sleep. And new wearable sleep-tracking technologies should be utilized to actually measure the pre-duty and layover sleep of flight crews so that they can better manage and optimize their own sleep.

"As a society, we must come to grips with the fact that the average adult needs 7-9 hours of sleep every single day," he says. "And there is no amount of willpower, professionalism, training, or money that will prevent the performance losses associated with the failure to routinely acquire sufficient sleep."

— A study by researchers at Brigham and Women's Hospital (BWH) reinforces the finding that too little sleep or sleep patterns that are inconsistent with our body's "internal biological clock" may lead to increased risk of diabetes and obesity. This finding has been seen in short-term lab studies and when observing human subjects via epidemiological studies. However, unlike epidemiological studies, this new study provides support by examining humans in a controlled lab environment over a prolonged period, and altering the timing of sleep, mimicking shift work or recurrent jet lag.

The study will be electronically published on April 11, 2012 in Science Translational Medicine.

Researchers hosted 21 healthy participants in a completely controlled environment for nearly six weeks. The researchers controlled how many hours of sleep participants got, as well as when they slept, and other factors such as activities and diet. Participants started with getting optimal sleep (approximately 10 hours per night). This was followed by three weeks of 5.6 hours of sleep per 24-hour period and with sleep occurring at all times of day and night, thereby simulating the schedule of rotating shift workers. Thus, during this period, there were many days when participants were trying to sleep at unusual times within their internal circadian cycle-the body's "internal biological clock" that regulates sleep-wake and many other processes within our bodies. The study closed with the participants having nine nights of recovery sleep at the usual time.

The researchers saw that prolonged sleep restriction with simultaneous circadian disruption decreased the participants' resting metabolic rate. Moreover, during this period, glucose concentrations in the blood increased after meals, because of poor insulin secretion by the pancreas.

According to the researchers, a decreased resting metabolic rate could translate into a yearly weight gain of over 10 pounds if diet and activity are unchanged. Increased glucose concentration and poor insulin secretion could lead to an increased risk for diabetes.

"We think these results support the findings from studies showing that, in people with a pre-diabetic condition, shift workers who stay awake at night are much more likely to progress to full-on diabetes than day workers," said Orfeu M. Buxton, PhD, BWH neuroscientist and lead study author. "Since night workers often have a hard time sleeping during the day, they can face both circadian disruption working at night and insufficient sleep during the day. The evidence is clear that getting enough sleep is important for health, and that sleep should be at night for best effect."

This research was supported by the National Institute on Aging; National Heart, Lung and Blood Institute; National Center for Research Resources; Center for Clinical Investigation of the Harvard Clinical and Translational Science Center; Joslin Diabetes and Endocrinology Research Center Service Specialized Assay Core; the National Space Biomedical Research Institute; and Natural Sciences and Engineering Research Council of Canada.

Is it possible to influence people as they sleep and give them their perfect dream? April 10 sees the launch of a new study that uses a specially designed iPhone app in an attempt to improve the dreams of millions of people around the world. If successful, the study will allow people to create their perfect dream and so wake up feeling especially happy and refreshed.

This study was launched at the Edinburgh International Science Festival by psychologist Professor Richard Wiseman from the University of Hertfordshire.

Wiseman has teamed-up with app developers YUZA to create 'Dream:ON' — an app that monitors a person as they sleep and plays a carefully crafted 'soundscape' when they dream. Each soundscape has been carefully designed to evoke a pleasant scenario, such a walk in the woods, or lying on a beach, and Wiseman hopes that these sounds will influence people's dreams. At the end of the dream the app sounds a gentle alarm and prompts the person to submit a description of their dream into a database known as 'The Dream Catcher'. Users of Dream:ON are also encouraged to share their dreams via Facebook and Twitter.

Each night Wiseman will collect thousands of dream reports and use the information to discover whether it is possible to give the world sweet dreams. "The app is free and we want as many people as possible to participate," noted Wiseman. "I have conducted many mass participation experiments in the past, but this is by far the most ambitious and exciting."

As part of the launch, Wiseman has carried out a national survey into dreaming. The results demonstrate the need for sweeter dreams, with 21% of respondents reporting that they have trouble sleeping and 15% suffering from unpleasant dreams (see the 'UK dream map'). "Getting a good night's sleep and having pleasant dreams boosts people's productivity, and is essential for their psychological and physical well-being. Despite this, we know very little about how to influence dreams — this experiment aims to change that" commented Wiseman.

The concept of the subliminal message is now familiar. A subconscious suggestion can help a person bring about positive change, such as smoking cessation, or otherwise influence one's actions. The science behind reaching this suggestive state and how to successfully present a message of change has its own journey.

The current issue of the journal Biofeedback presents the science and research that developed "Twilight Learning" technology in the 1970s. This article, by the late Thomas H. Budzynski, is part of a special section focusing on his pioneering contributions to this field.

Twilight Learning is a process that uses EEG neurofeedback to cultivate a hypersuggestible brain state in a subject. Auditory "change messages" are then given to the individual, allowing "enhanced learning" to take place. This cognitive therapy had many contributions along the way.

One study found that as the individual passed from wakefulness to sleep, brain rhythms changed from an alpha to a theta state, and a loss of volitional control occurred first, followed by a loss of awareness of one's surroundings and then of reality. Another study found that attitude change messages presented to subjects in waking, drowsy, and deep sleep conditions were effective only in the drowsy condition.

These and other contributions helped Budzynski develop a system that could reliably produce this brain state without hypnosis or waiting for someone to fall asleep. An EEG range of 4-7 Hertz was found to indicate the theta, hypersuggestible brain state. Subjects could then be presented with therapeutic messages designed to make changes in maladaptive habits, addictions, and poor self-image.

More than 20 years of case studies have shown how Twilight Learning can be applied. These include a graduate student who experienced so much anxiety over passing an exam necessary for graduation that he found it impossible to study. Twilight Learning sessions helped change his attitude and allowed him to relax, study, and pass the exam. Another patient found relief for psychogenic back pain. Other subjects found that repressed memories of childhood abuse and war were negatively influencing their adult lives and were able to make positive changes through Twilight Learning.

The Peniston Protocol, successfully used for alcoholism and posttraumatic stress disorder, and other new research studies have expanded on Twilight Learning. These projects are providing new evidence of what subliminal stimulation can do and are exploring new areas, such as influencing physical healing.

People with severe sleep apnea may have an increased risk of silent strokes and small lesions in the brain, according to a small study presented at the American Stroke Association's International Stroke Conference 2012.

"We found a surprisingly high frequency of sleep apnea in patients with stroke that underlines its clinical relevance as a stroke risk factor," said Jessica Kepplinger, M.D., the study's lead researcher and stroke fellow in the Dresden University Stroke Center's Department of Neurology at the University of Technology in Dresden, Germany.

"Sleep apnea is widely unrecognized and still neglected. Patients who had severe sleep apnea were more likely to have silent strokes and the severity of sleep apnea increased the risk of being disabled at hospital discharge."

The researchers found:

• Ninety-one percent (51 of 56) of the patients who had a stroke had sleep apnea and were more likely to have silent strokes and white matter lesions that increased risk of disability at hospital discharge.
• Having more than five sleep apnea episodes per night was associated with silent strokes.
• More than one-third of patients with white matter lesions had severe sleep apnea and more than 50 percent of silent stroke patients had sleep apnea.
• Even though men were more likely to have silent infarcts, correlations between sleep apnea and silent infarcts remained the same after adjustment for such gender differences.

The patients — average 67 years old, white and 54 percent women — underwent overnight in-hospital testing for sleep apnea.

Magnetic resonance imaging and computerized tomography determined silent strokes and white matter lesions. Neuroradiologists were blinded to the sleep study findings and outcome.

Researchers suggested that sleep apnea should be treated the same as other vascular risk factors such as high blood pressure.

"Demographic characteristics in our study are comparable to western European populations, but our findings may not be entirely generalizable to other populations with diverse ethnicities such as in the U.S.," Kepplinger said.

The researchers plan more studies on sleep apnea, particularly in high-risk patients with silent strokes and white matter lesions, to determine the impact of non-invasive ventilation and on short-term clinical outcome, researchers said.

Co-authors are: Kristian Barlinn, M.D.; Amelia Boehme, M.S.C.; Lars-Peder Pallesen, M.D.; Wiebke Schrempf, M.D.; Johannes Gerber, M.D.; Karen Albright, D.O., Ph.D.; Andrei Alexandrov, M.D.; and Ulf Bodechtel, M.D.