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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Helpful Tips for Sleeping Better This Summer

June 27, 2013 

By Dr. Mercola

If you’re like most Americans, you’re likely not getting enough sleep. Nearly 41 million US adults are sleeping just six hours or less each night, which recent research has linked to an increased risk of chronic inflammation and heart disease in women.1

Over the course of the five-year long study,2 women who slept poorly—quantified as sleeping less than six hours per night—had 2.5 times higher increases in inflammation levels compared to men who slept poorly. As reported by the featured article:3

“Researchers speculated that the gender difference may be due to lower estrogen levels in the study's post-menopausal female subjects, whereas men were protected by higher levels of testosterone.”

But regardless of gender-based hormonal differences, summertime can be a time of year when sleep becomes harder to come by, courtesy of rising temperatures. This is just one of a whole host of factors that can have an adverse effect on your sleep. Restless legs syndrome is another ailment that can prevent you from getting sufficient amounts of shut-eye.

Interestingly, a recent observational study4 found that men with restless legs syndrome have a whopping 40 percent higher risk of total mortality. This finding was independent of other known risk factors, including a variety of chronic diseases. As reported by MedPage Today:5

“The relationship between restless legs syndrome and all-cause mortality was stronger for men who had symptoms 15 or more times per month compared with those who had symptoms five to 14 times per month.”

According to the researchers, one (of several) potential mechanisms that might account for this increased mortality risk is disturbed sleep. Previous research has also found that people with chronic insomnia have a three times greater risk of dying from any cause.

Sleep Deprivation Takes a Serious Toll on Your Health...

You can have the healthiest diet on the planet, doing vegetable juicing and using fermented veggies, be as fit as an Olympic athlete, be emotionally balanced, but if you aren’t sleeping well it is just a matter of time before it will adversely, potentially seriously affect your health.

Sleep deprivation is such a chronic condition these days that you might not even realize you suffer from it. Science has now established that a sleep deficit can have serious, far reaching effects on your health. For example, interrupted or impaired sleep can:

• Dramatically weaken your immune system
• Accelerate tumor growth—tumors grow two to three times faster in laboratory animals with severe sleep dysfunctions, primarily due to disrupted melatonin production. Melatonin inhibits the proliferation of a wide range of cancer cell types, as well as triggering cancer cell apoptosis (self destruction). The hormone also interferes with the new blood supply tumors require for their rapid growth (angiogenesis)
• Cause a pre-diabetic state, making you feel hungry even if you've already eaten, which can wreak havoc on your weight
• Seriously impair your memory; even a single night of poor sleep—meaning sleeping only 4 to 6 hours—can impact your ability to think clearly the next day. It’s also known to decrease your problem solving ability

What You Need to Know About Sleeping Pills

While it may be tempting to look for a pill to quickly help you sleep, these willnot address any of the underlying causes of insomnia. In fact, researchers have repeatedly shown that sleeping pills don’t work, but your brain is being trickedinto thinking they do...

In one meta-analytic study, they found that, on average, sleeping pills help people fall asleep approximately 10 minutes sooner. From a biomedical perspective, this is an insignificant improvement. On average, sleeping pills increase total sleep time by about 15-20 minutes. But here is the catch: This study also discovered that while most sleeping pills created poor, fragmented sleep, they also created amnesia, so upon waking, the participants could not recall how poorly they’d actually slept!

Worse yet, sleeping pills have also been linked to a wide variety of health hazards, including a nearly four-fold increase in the risk of death, along with a 35 percent increased risk of cancer.

Additionally, most people do not realize that over-the-counter (OTC) sleeping pills -- those containing Benadryl -- can have a half life of about 18 hours. So, if you take them every night, you're basically sedated much of the time. Not surprisingly, they're associated with cognitive deficits in the morning. Trust me, there are far better, safer and more effective ways to get a good night's sleep...

Tips for High-Quality Shut-Eye from a Sleep Wellness Consultant

As previously discussed by Dr. Rubin Naiman, a leader in integrative medicine approaches to sleep and dreams, sleep is the outcome of an interaction between two variables, namely sleepiness and what he refers to as "noise.” This is any kind of stimulation that inhibits or disrupts sleep. In order to get a good night's sleep, you want your sleepiness level to be high, and the “noise” level to be low. Under normal conditions, your sleepiness should gradually increase throughout the day and evening, peaking just before you go to bed at night. However, if noise is conceptually greater than your level of sleepiness, you will not be able to fall asleep.

Total video Length: 1:02:37

Download Interview Transcript

In a recent CNN article, 6 sleep wellness consultant Nancy Rothstein offered up six tips to improve your sleep, wisely starting off by addressing environmental “noise” in your bedroom (for the rest of her suggestions, please see the original article):7

• Create a sleep sanctuary. This means removing items associated with entertainment, recreation, work and hobbies, and turning your bedroom into a single-purpose space—one for sleeping. Of utmost importance: Make sure your bedroom is cool, dark and quiet. These three factors can have a major impact on your sleep.
With regards to temperature, studies show that the optimal room temperature for sleep is quite cool, between 60 to 68 degrees Fahrenheit, so keep the temperature in your bedroom no higher than 70 degrees.
As for light, even the tiniest bit of light in the room can disrupt your internal clock and your pineal gland's production of melatonin and serotonin, hormones involved in your body’s circadian rhythm of sleep and wakefulness. So close your bedroom door, get rid of night-lights, and most importantly, cover your windows. I recommend using blackout shades or heavy, opaque drapes. Also cover up your clock if it has a lit display. Alternatively, you could wear an eye mask to block out any stray light.
• Turn off your gadgets well before bedtime. Again, the artificial glow from your TV, iPad, computer or smartphone can serve as a stimulus for keeping you awake well past your bedtime by disrupting melatonin production. I recommend turning off all electronic gadgets at least one hour before bed. As Rothstein suggests, that time is far better spent reading a good old fashioned book, practicing relaxation techniques or meditating.
Some people find the sound of white noise or nature sounds, such as the ocean or forest, to be soothing and sleep-promoting. An excellent relaxation/meditation option to listen to before bed is the Insight audio CD. Another favorite is the Sleep Harmony CD, which uses a combination of advanced vibrational technology and guided meditation to help you effortlessly fall into deep delta sleep within minutes. The CD works on the principle of "sleep wave entrainment" to assist your brain in gearing down for sleep.
• Exercise to sleep better, but do it early! Exercising for at least 30 minutes per day can improve your sleep, but if you exercise too close to bedtime (generally within the three hours before), it may keep you awake instead.
• Party-goers beware: alcohol tends to prevent good sleep... Summertime tends to spark party invitations, but as Rothstein warns, it would be wise to consider how a few drinks will affect your sleep pattern. Although alcohol will make you drowsy, the effect is short lived and you will often wake up several hours later, unable to fall back asleep. Alcohol can also keep you from entering the deeper stages of sleep, where your body does most of its healing.
The same applies to eating. Ideally, you’ll want to avoid eating or snacking at least three hours before bed. Especially troublesome are grains and sugars, as these will raise your blood sugar and delay sleep. Later, when your blood sugar drops, you may wake up and be unable to fall back asleep.

Two More Aces Up Your Sleeve When Sleep Becomes Elusive...

My personal favorite fix for insomnia is the Emotional Freedom Techniques (EFT). Most people can learn the basics of this gentle tapping technique in a few minutes. EFT can help balance your body's bioenergy system and resolve some of the emotional stresses that are contributing to your insomnia at a very deep level. The results are typically long lasting and improvement is remarkably rapid.

Another strategy that can help is to increase your melatonin. Ideally it is best to increase your levels naturally, by exposing yourself to bright sunlight during daytime hours (along with full spectrum fluorescent bulbs in the winter) followed by absolute complete darkness at night. If that isn't possible, you may want to consider a melatonin supplement. In scientific studies, melatonin has been shown to increase sleepiness, help you fall asleep more quickly and stay asleep, decrease restlessness, and reverse daytime fatigue. Melatonin is a completely natural substance, made by your body, and has many health benefits in addition to sleep.

If you decide to give melatonin supplements a try, start with a very small dose, about an hour before bed—as little as 0.25 mg can be sufficient for some.8 Many end up taking too much right off the bat, which could end up having the reverse effect you’re looking for. Taking too much could also result in side effects9 such as drowsiness, confusion, headache, nightmares, and more. So, start with a tiny dose, and if after three nights you notice no improvement, take a little more. The tips discussed so far are among the most important for a restful night's sleep, but they are only the beginning. For more, please read my comprehensive sleep guide: 33 Secret's to a Good Night's Sleep.

Improving Your Sleep Hygiene Pays Off in Health Dividends

There's convincing evidence showing that if you do not sleep enough, you're really jeopardizing your health. Everybody loses sleep here and there, and your body can adjust for temporary shortcomings. But if you develop a chronic pattern of sleeping less than five or six hours a night, then you're increasing your risk of a number of health conditions, including heart disease.

To make your bedroom into a suitable sleep sanctuary, begin by making sure it’s pitch-black, cool, and quiet. Remember, even the tiniest bit of light can disrupt your pineal gland's production of melatonin and serotonin. For this reason, I highly recommend adding room-darkening blinds or drapes to your bedroom, or if this is not possible wearing an eye mask to block out any stray light.

For even more helpful guidance on how to improve your sleep, please review my 33 Secrets to a Good Night's Sleep. If you're even slightly sleep deprived, I encourage you to implement some of these tips tonight, as high-quality sleep is one of the most important factors in your health and quality of life.

[-] Sources and References

• 1 Daily News June 7, 2013
• 2 Journal of Psychiatric Research May 28, 2013 [Epub ahead of print]
• 3 See ref 1
• 4 Neurology June 12, 2013 [Epub ahead of print]
• 5 MedPage Today June 15, 2013
• 6 CNN.com June 6, 2013
• 7 See ref 6
• 8 Sleepingwithasleepingdisorder.com, Is There Such a Thing as Too Much Melatonin?
• 9 See ref 8

Children’s Sleep in Their Genes?

How long kids sleep may be genetic, study finds

By Children's Health Team | 6/5/13 11:17 a.m.

Your toddler’s sleep habits may be affected by both genetics and environment.

Genes play an important role in how long your child sleeps at night, and environmental factors influence daytime naps, says a new study. But this doesn’t mean your child’s sleep habits are out of your control, researchers add.

Jyoti Krishna, MD, did not take part in the study but treats pediatric sleep disorders at Cleveland Clinic. He says some children just don’t need as much sleep as others.

“If the child isn’t sleeping during the day with naps, if he’s happy and growing normally, then you have to think he may be genetically programmed to sleep a little bit less than his peers,” says Dr. Krishna.

What the study found

Laval University (Quebec) researchers followed nearly 1,000 twins whose mothers reported on their sleep habits from age 6 months to 4 years. About 400 were identical twins, which mean they share genes. The rest were fraternal who were no more genetically similar than other non-twin siblings.

The study found that genes seemed to explain differences among children in how long they sleep at night. However, napping was most linked to the environmental setting, especially for toddlers and preschoolers.

Dr. Krishna agrees that the environment can be key while putting your child down for sleep beyond the 6-month age.

“Where you put your child to bed is important, for example. Is the baby being put to sleep on the couch while Mom and Dad are watching TV? These things can go a long way in making for a poor bedtime routine as the child grows.”

What parents can do to improve sleep habits

Researchers say more studies will be needed to pinpoint the genes contributing to short or persistent nighttime sleep, or what environmental factors are most critical for daytime sleep.

In the meantime, Dr. Krishna says these guidelines can help parents navigate the tricky business of putting their toddlers down for bedtime:

• Maintain a regular and consistent sleep schedule - Your child’s bedtime and wake-up time should be about the same every day, whether it’s a school day or not. The consistency of wake-up time sets the stage for the rest of the day and allows your child to get adequately tired by bedtime.
• Don’t let your child go to bed hungry – Give your child a light snack before bedtime — a glass of milk, piece of fruit or bowl of cereal. A heavy meal within one or two hours of bedtime can interfere with sleep, however.
• Plan for up to an hour of quiet time before bed – Every night before bed, set aside calm activities your child enjoys like reading or listening to quiet music. Brushing teeth and going to the bathroom can be part of this quiet time, too, in preparation for bed. No TV, homework or video games. The quiet time doesn’t need to take place in the bedroom, but should end there for the last 10-15 minutes before it’s time to go to sleep.
• Keep the bedroom environment sleep-friendly – Keep the bedroom quiet, comfortable (70 to 75 degrees F) and dark (a nightlight is OK). Don’t have a TV in the bedroom so your child will not develop the habit of needing a TV on to fall asleep.
• Develop a warm, secure and consistent bedtime routine – It’s fine to encourage the use of a security object like a blanket or stuffed animal so the child feels safer in bed. Always give a hug and a kiss, say goodnight and turn off the light before leaving the bedroom; the predictability of these acts are warm and reassuring.

Remember to keep the bedroom as a place associated with positive feelings. Don’t use it for time outs or as a room for punishment; keep it as a comforting place for quiet time and sleeping.

Is Snoring Affecting Your Relationship With Your Significant Other?

Posted: Jun 11, 2013 5:47 PM CDTUpdated: Jun 11, 2013 5:47 PM CDT

By Randy Key, WJBF Web Content Producer - email

By ABC News

New York City -

A quarter of married couples say they sleep in separate beds just to get a good night sleep.

"I can't deal with this anymore! I can't sleep!" says Nancy, from Michigan.

"It usually turns out someone stomping out to the couch!" says Gina, from New Jersey.

Dr. Jennifer Ashton, reporting: I'm embarrassed to admit. I often move to a different room."

"She says I disrupt her sleep. I snore," says my husband, Rob.

It causes me to wake up from my sleep three or four times a night.

Even though we're both doctors, we have long laughed and debated what's really going on, so we called in professional help, sleep researcher Dr. Wendy Troxel.

"What's your goal here?" asks Dr. Troxel. I would like to sleep next to my husband every single night.

She put us to the test, measuring our brain activity while we slept.

Dr. Ashton: "The sleep study will confirm scientifically that rob's snoring disrupts my sleep."

The first night, side-by-side...snoring woke me up.

With Rob, I had 173 awakenings, which is sleep science lingo for coming out of deep sleep. The next night couldn't come soon enough.

Dr. Ashton: "I get to sleep by myself."

But, to my great suprise: alone, I had 135 awakeningsnearly as many as when I slept with Rob.

"There was a link between Rob's snoring and you having these little awakenings from sleep, but it wasn't all Rob's fault. You continued to have awakenings throughout the night, even when Rob had stopped snoring."

That's because science confirms women are lighter sleepers than men. Biologically, our brains are conditioned to just wake up, but the good news is women are better sleepers than men and quickly fall back to sleep again.

But, Dr. Troxel says the bad news for women is we often think we sleep worse than we really do. I was proof, the study actually showed my overall sleep quality was actually excellent both nights.

"Your sleep when you were sleeping with Rob, compared to the night you were sleeping alone, was virtually identical," Dr. Troxel says.

But for Rob...a bigger impact...he got an extra twenty minutes of deep sleep with me by his side.

"So, I am telling you there is actually health benefits, at least for Rob, to sleeping with you," says Dr. Troxel. "Now, I feel really guilty," I said.

Because research shows that men sleep better with a partner than alone...and protecting sleep, for both of us, means protecting our marriage.

Doctors say it's important to rule out medical causes for snoring and insomnia, like sleep apnea. But, they say making sleep a priority is important for good health and your marriage.

For the health of the pregnant mom and unborn, it's essential that obstructive sleep apnea is ruled out.

Why Pregnancy Snoring Matters

By Stacey Whitman

About as glamorous as stretch marks and swollen ankles, pregnancy snoring is surprisingly common and may be far more serious than simply disturbing a bedmate.

That’s because expectant moms who acquire a pregnancy snoring habit are twice as likely to develop high blood pressure or preeclampsia, according to a recent study in the American Journal of Obstetrics and Gynecology. Preeclampsia is a very dangerous condition that—if left untreated—could be fatal to mother and baby.

Lead researcher Louise O’Brien says pregnant women (particularly those with high blood pressure) who experience loud snoring three nights a week or more should be screened for obstructive sleep apnea or gestational diabetes, two more serious causes of pregnancy snoring. If pregnancy snoring has become a problem for you, talk to your OB/GYN. In the meantime, there are a few ways that might help you find sweet sleep relief:

Pregnancy snoring remedies

• Apply a nasal strip before bed. It opens your nasal passageways, making pregnancy snoring less likely.
• Run a warm-mist humidifier in your bedroom. It helps keep your throat and mouth from getting dry, which is a common cause of pregnancy snoring.
• Use an extra pillow. It’ll keep your head elevated, which can stop your throat and tongue from sagging.
• Keep pregnancy weight gain in check. Too many extra pounds can increase the likelihood of pregnancy snoring.