Kids' Sleep Patterns Affected by Electronic Media Time and Media Presence in the Bedroom

July 25, 2013 — Children's sleep disruption is worse with increased time spent watching TV or playing on the computer, finds research in Biomed Central's open access journal BMC Public Health. The greater the e-media use was at the start of the study, the shorter the sleep duration and the later the bedtime was eighteen months later. The academics suggest that where children are struggling to sleep, or are tired, their media habits should be taken into consideration.

The amount of sleep children get has a direct bearing on their performance in school and their mental and physical health. Snap shot studies suggest that the more kids use electronic media the less sleep they get, and that their sleep is more likely to be disturbed. But how much does watching TV or playing on the computer affect sleep patterns as children grow up?

To answer this question researchers from Folkhälsan Research Center, Finland, compared computer use and TV viewing with sleep patterns in 10-11 year olds and then reassessed them eighteen months later. Children with a TV or computer in their bedroom, compared with the frequency of usage, demonstrated a greater delay when going to bed on school days and the weekend which resulted in less sleep. However girls may be catching up at the weekends as they tended to sleep in more as they got older.

When the researchers looked at boys and girls separately they found that there were other gender differences -- boys with a computer or TV in their bedroom went to bed later than the girls and had a larger increase in bed time.

Teija Nuutinen, who led this study commented, "Children need extra sleep as they go through puberty but our study finds that TV and computer use affect the sleep of children. This is especially true during the week and may be impacting their school work as well as their development. Media viewing habits should be considered for kids who are tired and struggling to concentrate, or who have behaviour problems caused by lack of sleep."

Story Source:

The above story is based on materials provided by BioMed Central Limited, via AlphaGalileo.

http://www.sciencedaily.com/releases/2013/07/130725202325.htm?goback=.gmr_3289633.gde_3289633_member_260969519.gmr_3289633.gde_3289633_member_261241554

Snoring Is No Laughing Matter

Millions of Americans have obstructive sleep apnea and don't know it. But the disorder can have serious health consequences.

By Dr. Sanjay Gupta

If you snore at night and feel drowsy all day, then you may be one of 18 million Americans who have obstructive sleep apnea (OSA). Most people with the sleep disorder don’t know they have it, but left untreated OSA can lead to serious complications. 

“People with sleep apnea have been shown to be at a higher risk for cardiovascular diseases, particularly hypertension, stroke and diabetes,” said Thomas Roth, MD, director of the Center for Sleep Disorders and Research at Henry Ford Hospital in Detroit.

OSA, the most common form of sleep apnea, occurs when muscles in the back of the throat relax, disrupting a person’s breathing while they’re asleep. Central sleep apnea, a rarer form in which the brain doesn’t send signals to the muscles that control breathing, affects less than 5 percent of people and is usually the result of another condition such as Parkinson’s disease or stroke.

Anyone can have OSA, but there are several risk factors. Being overweight can lead to fat deposits around the upper airway that obstruct breathing. A recent study found that the obesity epidemic may be responsible for a 55 percent jump in sleep apnea cases over the past 20 years.

“Weight loss can be helpful in reducing the severity of sleep apnea or even curing it with mild forms of the condition,” said Ashish Adlakha, MD, director of the Middlesex Hospital Comprehensive Sleep Disorders Center in Middletown, Conn.

Age and gender are factors: Most sleep apnea patients are over age 60, and men are twice as likely to have it as women. People with naturally narrow throats, or who develop enlarged tonsils or adenoids have a greater risk; as do people who smoke or drink alcohol.

Sleep apnea is more than a mere annoyance, and it can lead to potentially life-threatening health conditions. “When a person has chronic sleep deprivation and they’re waking up a lot during the night, there are frequent drops in blood oxygen levels, which trigger the response of the systemic nervous system,” said Dr. Adlakha.

These “stresses to the nervous system and low oxygen levels have a big impact on blood pressure and a person’s cardiovascular system and metabolism,” said Tucker Woodson, MD, director of the Froedtert Hospital/Medical College of Wisconsin Sleep Disorders Program in Milwaukee.

Recent studies suggest sleep apnea may be responsible for up to 60 percent of hypertension cases that don’t respond to medication. The condition has also been linked to increased risk of sudden cardiac death.

Research has shown that sleep apnea patients have a greater likelihood of suffering from other diseases, including type 2 diabetes, chronic kidney failure, and asthma.

“A big challenge for sleep medicine doctors is knowing what’s associated or related to the sleep apnea versus what’s causing the sleep apnea itself,” said Dr. Woodson. “That’s often the case with obesity, and sometimes hypertension.”

Lifestyle changes such as weight loss, exercise, and quitting smoking and drinking are recommended for anyone with OSA. More serious cases can be treated with a device known as a Continuous Positive Airway Pressure (CPAP) machine that delivers air pressure to keep airway passages open. The patient has to wear a mask while sleeping, which can be an annoyance; and the air pressure can cause dry mouth and nose.

“It’s a big problem in trying to treat the disease because people don’t use it correctly or as much as they’re supposed to,” said Dr. Roth.

Another treatment option is wearing a mouthpiece, similar to a dental mouth guard, to correct jaw or tongue problems and keep the throat open. In severe OSA cases where no other treatment proves effective, there are surgical options to relieve airway blockages.

“The biggest reason we treat sleep apnea is to improve a person’s quality of life, as it can make almost any other condition a person has worse,” said Woodson. “If you’re not sleeping well, good health is hard to come by.”

Originally Published At:  http://www.everydayhealth.com/sanjay-gupta/snoring-is-no-laughing-matter.aspx

Sleep Apnea And Strokes

Check Out This Video Which Discusses the Obstructive Sleep Apnea Connection with Strokes.

http://www.kutv.com/health/features/check-health/stories/vid_423.shtml

By Carla Roberts (KUTV) A few weeks ago, 78-year-old Malan Jackson suffered a stroke. “I suddenly felt confused in my head.” Jackson went to the emergency room and is now on the mend. Aside from therapy, doctors recommended that Malan undergo a sleep study to see if he had sleep apnea. 
Experts at Utah Valley Regional Medical Center are conducting a study to further understand a possible link between sleep apnea and strokes. Sleep apnea is a type of sleep disorder where a person stops breathing during sleep. The person may no breath for a few seconds, but doctors say over time, sleep apnea may cause serious health problems like strokes. “The biggest problem that we have is that 80-85% of everyone with sleep apnea still remains undiagnosed.” Wayne Woodward is assisting with the study at Utah Valley Regional Medical Center. He says numbers show that many people who suffered a stroke, had sleep apnea. He says there are treatments available for patients who have sleep apnea. “The data strongly supports that if we treat sleep apnea in stroke patients, we have much better outcomes.”
Risk factors for sleep apnea include: age, weight, blood pressure and snoring. Experts say if you suspect you have sleep apnea, you should see your doctor. A sleep study will help determine if you have sleep apnea or not. 
For more information, visit:http://intermountainhealthcare.org/hospitals/uvrmc/services/sleepcenter/Pages/home.aspx

Snoring, sleep apnea can kill

By Philip Chua
Cebu Daily News

12:15 pm | Monday, July 15th, 2013

Read more: http://newsinfo.inquirer.net/445233/snoring-sleep-apnea-can-kill#ixzz2ZEv4KtRB

FOR years physicians have suspected that snoring is generally associated with sleep apnea, and sleep apnea was linked to sudden cardiac death. Unlike heart attack not related to sleep apnea, which could occur anytime of the day, cardiac death from sleep apnea happens while the patient is asleep.

In an article in June 11, 2013 in the Journal of American College of Cardiology, Dr. Apoor Gami, a cardiac electrophysiologist at the Midwest Heart Specialists-Advocate Medical Group in Elmhurst, Ilinois, and leader of the study, confirmed that link.

What is sleep apnea?

Usually associated with snoring, sleep apnea means the involuntary cessation of breathing during sleep, which deprives the individual of valuable oxygen during the episodes. This breath-holding initially lasts for 10 seconds and progresses to 20 to 30 seconds, and each episode is immediately followed by gasping for air. This cycle could repeat itself several times (20 to 100 times per hour) the whole night long. The snorer is totally oblivious of all this and only the roommate is aware of this bothersome snoring and scary sleep apnea.

How common is sleep apnea?

The incidence is about 2% among middle-aged women and 4% among men of that age group, which is similar to the incidence of diabetes and asthma. Sleep apnea is a primary risk factor for hypertension (high blood pressure). Breath-holding during sleep affects about 12 million American adults, but many more are not reported or are not diagnosed. Some studies say the incidence is rising because of the epidemic of obesity.

How does obesity contribute to sleep apnea?

In some people, especially after middle age and those who are obese, the muscles of the upper airways in the back of the throat, like the soft palate (the back end of the roof of the mouth), the uvula (tiny appendage that hangs down), tonsils, adenoids, become flabby and vibrate with the airflow, causing the various classical noises of snoring. These structures could also cave in and out (like a floppy valve) with respiration, blocking the upper airway and causing sleep apnea and oxygen deprivation. Besides the anatomical component, there could also be central (neuro-hormonal) factors, especially among obese persons. Weight reduction could help some individuals.

How is the diagnosis made?

To confirm the diagnosis is sleep apnea, a Sleep Test is performed, where the patient sleeps in a Sleep Laboratory, attached to brain, heart and blood oxygen monitor, with a video cam showing his/her sleep activity, body movements, etc. All these data are then analyzed the following day. If the patient stops breathing for 10 seconds or more at least five times every hour while asleep, the diagnosis is confirmed.

What are the complications of sleep apnea?

The person wakes up with a dry mouth and throat, perhaps with a headache, and a lousy feeling akin to a hangover. There may also be fatigue and sleepiness throughout the day, together with some memory deficiency, poor attention and concentration, and bad mood–all signs of lack of sleep, due to sleep apnea. The psychological stress of all this impacts negatively on the individual. The recurrent transient hypoxemia (low blood oxygen level) and daily impairment of sleep are added risk factors for the development of hypertension and coronary heart disease. Some develop sudden death due to cardiac arrhythmia (heart irregularity) from lack of oxygen, as the new study shows.

What is the incidence of sudden cardiac death?

In general sudden death kills 450,000 people annually in the United States, from various causes which lead to cessation of breathing, triggering serious abnormality in the heart’s electrical system, ending as fatal irregularity of the heartbeats, if resuscitation is not performed immediately.

Does singing lessen snoring?

Singing helps tone the flabby muscles of our upper airways, the soft palate, in particular. Singing exercises for 20 minutes a day appear to do the trick for some. Belting out a few songs, even off key, everyday in the family room or in the shower might annoy your house mate, but it will at least please her in bed every night when you snore less.

Are “snore stoppers” effective?

“Snore aids” advertised in the various media, such as nostril clips, nasal or throat sprays, magnetic wrist bands do not work to stop snoring, much less cure sleep disorders. One contraption, the jaw sling, which prevents the jaw from dropping while the person is asleep, appears to show promise for some snorers, but uncomfortable to wear.

What is the non-specific therapy?

Weight loss for those who are overweight can minimize the episodes of sleep apnea. Avoidance of sleeping pills, sedatives and alcohol, all of which increase the frequency and duration of sleep apnea, is most essential. Lying flat on the back induces sleep apnea for a lot of people. This could be avoided by placing a pillow at the back and lying on the side.

What are the various treatment regimens?

Sleep apnea must be treated because the risk of sudden death is real and scary. The three modalities are: (1) Physical or Mechanical, (2) Surgery, and (3) Non-specific therapy. The specific prescription depends on the medical examination and laboratory findings. The physical or mechanical treatment works only when used as the patient sleeps and apnea returns when the regimen is not utilized. There are two forms: Continuous Positive Airway Pressure (CPAP) and Dental/Oral Appliances. CPAP, the most commonly prescribed, uses a snugly fitted face mask where continuous positive pressure air is blown into the nose, forcing the airway to stay open for proper breathing. Dental/oral appliance, which is fitted by an ortho dentist, uses a device that moves the lower jaw forward to cause an under bite, which opens the airway.

What is the surgical treatment?

Surgery removes tissues, like nasal polyps, adenoids, tonsils, and any oro-pharyngeal deformities that causes obstruction to airflow. One of them is called uvulopalatopharyngoplasty, which excises tissues at the back of the throat. The success rate is low, between 30-60% and it is hard to know which patients will benefit from it, its side effects and eventual outcome. The others are tracheostomy (creating a hole in the windpipe for those with severe obstruction, which is not too common), surgical reconstruction for those with deformities, and surgery to treat diet-and-exercise-resistant obesity, which contributes to sleep apnea.

Indeed, sleep apnea is a warning and nothing to snore about.

Read more: http://newsinfo.inquirer.net/445233/snoring-sleep-apnea-can-kill#ixzz2ZEvF6gfr

When is snoring sleep apnea?

Please read about the symptoms of sleep apnea. An overnight sleep study (polysomnogram) done either at a sleep lab or at home will give you the diagnosis.

http://www.philly.com/philly/health/20130714_When_is_snoring_sleep_apnea_.html

POSTED: July 14, 2013

Q:I snore like a freight train every night, or so says my wife of 50 years. She's concerned I have sleep apnea. Should I see a doctor about it?

A: Snoring occurs on a spectrum. While some people have occasional, quiet snoring, others experience loud, habitual snoring nearly every night or on most nights. In the frequent-snoring group, snoring may be an indication of an underlying sleep disorder called obstructive sleep apnea.

Other symptoms of sleep apnea include:

Choking or gasping during sleep.

Breathing stops during sleep, observed by others.

Waking up sleepy despite having slept a sufficient number of hours.

Feeling tired or sleepy during the day.

Falling asleep while sedentary (such as while watching television, reading, driving and stopped in traffic, or during conversations).

More than 80 percent of patients with sleep apnea do not know they have it. If it is not diagnosed, sleep apnea may contribute to other health problems, including hypertension, heart disease, stroke, and crashes from falling asleep at the wheel.

So if you are experiencing loud, habitual snoring, please talk with your doctor to see whether an evaluation for sleep apnea should be done.

- Dr. Indira Gurubhagavatula with staff writer Leila Haghighat

---

Indira Gurubhagavatula is a professor in the division of sleep medicine at the University of Pennsylvania Perelman School of Medicine.

Sleep Apnea Patients More Likely To Fail Simulated Driving Test, Study Says

Here's another reason to make sure your snoring isn't sleep apnea.

According to a new study, people with sleep apnea -- a condition where a person stops breathing for periods of time throughout the night, leading to disrupted sleep -- were more likely to fail a driving simulator test and also reported falling asleep while driving more than people without the sleep condition.

The study, conducted by researchers from the the University Hospital in Leeds and presented at the Sleep And Breathing Conference in Berlin, included two parts. The first part tested the driving ability of 133 people with untreated sleep apnoea, as well as 89 people without the condition. Each participant underwent a 90-kilometer (approximately 56-mile) driving simulation, where they were tested for things like time it takes ti compete the course, time spent driving in the middle lane, and unprovoked car crashes.

Researchers found the participants with untreated sleep apnea were more likely to fail the test. Twice as many people with sleep apnea failed the test than people without the condition -- 24 percent versus 12 percent. Furthermore, several of the patients with sleep apnea couldn’t finish the test, had more unprovoked crashes and had more difficulty adhering to the clear driving instruction given at the beginning of the exam.

The second study also involved comparing the driving of people with sleep apnea with those without sleep apnea. The study participants -- 118 of whom had untreated sleep apnea and 69 of whom did not have the condition -- completed a questionnaire about driving behavior, and then did a 90-kilometer driving test in the simulator.

Thirty-five percent of people withe sleep apnea said they fell asleep while doing the driving test, and 38 percent of them failed the test. No one in the group without sleep apnea failed the test, but 11 percent of the these people admitted to nodding off while driving.

The findings have yet to be published in a peer-reviewed journal, so they should be considered preliminary. But considering more than 18 million Americans have sleep apnea, this information could prove useful in reducing the amount of accidents on the road that may be caused, at least in part, by the sleep condition.

The findings are also important considering rates of sleep apnea may be high in truck drivers, according to a recent study from Australia. And according to the Federal Motor Carrier Safety Administration, as many as 28 percent of truck drivers have the sleep condition. Two government panels also recently recommended that U.S. truckers who have a body mass index indicative of obesity be screened for sleep apnea.

Source:  http://www.huffingtonpost.com/2013/04/14/sleep-apnea-driving-risk-drowsy_n_3061126.html

Dental sleep medicine classes reach across the border

Tufts inclusion of dental sleep medicine was almost two decades after the inaugural 1991 meeting of the American Academy of Dental Sleep medicine.

May 29, Sleep apnea

The field of dental sleep medicine was barely out of its infancy when Tufts faculty realized the importance of training students to screen, diagnose and treat sleep disorders. In 2009, the school became the first in the U.S. to incorporate dental sleep medicine into its curriculum.

But Americans aren't the only ones whose nights are upended by conditions such as obstructive sleep apnea, which not only deprive their sufferers of much-needed rest but pose significant health risks. So when the Tufts-trained dean of a Mexican dental school realized his country could benefit from dentists with sleep medicine expertise, he reached out to Boston. The result is a collaboration between Tufts School of Dental Medicine and the University of Monterrey (UDEM) that allows students in Mexico to take the Tufts class in dental sleep medicine using distance-learning technology.

"I knew that I had to bring something that would have an impact for our community," says Hector Martinez, DG08, dean of the UDEM dental school. "So I turned right back to Tufts and asked for help to develop this program." The UDEM dental sleep medicine program, now in its second year, is the first of its kind in Latin America.

The course is taught by Leopoldo Correa, DG11, an associate professor of diagnosis and health promotion and head of the dental sleep medicine section at Tufts' Craniofacial Pain, Headache and Sleep Center. UDEM associate professor Hector Cuellar provides hands-on instruction on his end in Mexico. With a generation of students accustomed to using Skype and Facetime, the virtual attendance of the Mexican students is fairly easy to handle, Correa says.

The 24 UDEM students are in their final year of a five-year dental program, all specializing in a track known as growth and development. UDEM is a bilingual university, and the students are tested to assure their fluency in English.

The prevalence of sleep disorders in Latin America has not been measured extensively, but a 2008 study in the Journal of Clinical Sleep Medicine that examined sleep issues in four Latin American cities, including Mexico City, found a "high prevalence of sleep-related symptoms and undiagnosed obstructive sleep apnea," ranging from 2.9 percent to 23.5 percent of the study subjects.

In the U.S., it's estimated at least 40 million people have some sort of sleep disorder, and up to 5 percent of the population may have obstructive sleep apnea, in which the airways consistently become blocked during sleep. The result, in addition to loud snoring or gasping, can be sleep that is disrupted anywhere from a few times to several hundred times a night. Along with daytime sleepiness, the periodic lack of oxygen can create a risk for cardiovascular conditions, such as high blood pressure or stroke, as well as diabetes and depression.

The first-line treatment is usually a nighttime device known as a Continuous Positive Airway Pressure (CPAP), which uses mild air pressure to keep the airways open during sleep. For many patients, an oral appliance is used to help prevent the collapse of the tongue and soft tissues in the back of the throat along with, or instead of, the CPAP.

Martinez's wife, Gabriela Garza, DG09, works at UDEM's orofacial pain clinic, where patients thought to have sleep disorders are evaluated and diagnosed.

"Most of the time patients don't know what the problem is," Martinez says. "In Mexico, patients don't visit the dentist to try and take care of sleep problems. All they know is they are not having good sleep." If nighttime restlessness or daytime sleepiness prompts anyone to take action, the choice is usually a trip to a physician. So the task for Martinez and his colleagues was not only to train dentists in sleep medicine, but to enlighten physicians and dentists outside UDEM about the relatively new field.

"Word started to spread about what we are doing for sleep disorders, and after that we started growing. We try to give physicians and dentists guidance on how to manage their cases," Martinez says.

"The University of Monterrey is trying to take the lead in public awareness of the medical consequences of untreated sleep apnea and sleep disorders," Correa says.

Mexico's public health plans do not cover treatment for sleep disorders, nor do most private Mexican dental insurance plans, Martinez says. At UDEM, a private university where there is an emphasis on community service, "we can give service to the low-income community, those who cannot pay for dental insurance and those who are not being treated by a government program, and give them very high-quality dental treatment, and a type of treatment that is very rare in Mexico," he says. "People are now coming from outside Monterrey, from distant parts of Mexico, to have diagnoses here on sleep medicine. So we're having an impact on the whole country."

Provided by Tufts University

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