Sleep

Daniel Pendick

Sleep drug dosage change aims to avoid daytime drowsiness

The FDA is urging doctors to lower the starting dose of zolpidem, a popular prescription sleep aid, due to concerns that the drug can linger too long in the body. This causes daytime drowsiness that has led to car accidents. Sleep aids affected by the FDA’s announcement includes generic zolpidem and brand names Ambien, Ambien CR, Edluar, and Zolpimist. The FDA lowered the starting dose for women from 10 milligrams (mg) to 5 mg; for men it is now 5 to 10 mg. The drug should be taken right before going to bed. Taking too much of a sleep drug can give you a “hangover” of daytime drowsiness the next morning that could raise the risk of accidents or falls. Because people respond to medications in their own ways, it’s safest to start taking a sleep drug on a weekend, and start with a dose lower than the maximum recommended starting dose. If you feel drowsy the next day, the dose can be reduced; if it didn’t work, the dose can be increased.

Dennis Rosen, M.D.

Why “sleeping in” on weekends isn’t good for teens

After getting too little sleep Monday through Friday, many teens try to catch up on weekends, sometimes straggling out of bed after noon. While they may feel like they are doing their bodies a favor, they actually aren’t. Sleeping late on Saturday and Sunday may fill a teen’s sleep deficit, but it creates a bigger problem. It allows his or her inner clock to further drift away from the external clock, worsening the shift begun by delaying bedtime on school nights. The result: the circadian sleep is thrown out of whack, which makes it much more difficult to get up at the usual wake time. In effect, by sleeping late on Saturday and Sunday, your teen is suffering from the equivalent of a five-hour jet lag when it’s time to get up on Monday morning. The alarm clock may be saying 6:00 am, but his or her inner clock is reading 1:00 am. This will make it much harder for your teen to concentrate and take in anything at school.

Heidi Godman

Losing weight and belly fat improves sleep

Do you have trouble sleeping? If you’re carrying extra pounds, especially around your belly, losing weight and some of that muffin top may help you get better ZZZs. So say researchers from Johns Hopkins University School of Medicine, who presented their findings at this year’s annual meeting of the American Heart Association. In a six-month trial that included 77 overweight volunteers, weight loss through diet plus exercise or diet alone improved sleep. A reduction in belly fat was the best predictor of improved sleep. Among people who are overweight, weight loss can reduce sleep apnea, a nighttime breathing problem that leads to frequent awakenings. Exercise has also been shown to improve sleep quality. Despite what thousands of websites want you to believe, there are no exercises or potions that “melt away” belly fat. Instead, the solution is old-fashioned exercise and a healthy diet.

Daniel Pendick

Restless legs linked to broken hearts

The sleep-robbing condition known as restless legs syndrome (RLS) raises the risk of heart disease in older women about as much as smoking and obesity, according to a new Harvard-based study published online in the journal Circulation. The key sign of RLS is an irresistible urge to move the legs, often accompanied by an uncomfortable “creepy-crawly” sensation. It affects about 2% of adults and is twice as common in women as in men. Symptoms typically flare as people settle into bed, but may also arise when simply resting in a chair or sitting at a desk. Most people with RLS also experience periodic jerking leg motions during sleep. Uncovering this link could help people with RLS pay better attention to their cardiovascular health and potentially ward off a heart attack, stroke, or other cardiovascular condition.

Howard LeWine, M.D.

Late to bed, early to rise: a recipe for diabetes

Sleeping poorly night after night—because you are trying to burn the candle at both ends or you work night or rotating shifts—has long-term health consequences. People who don’t average at least six hours of sleep a night are more likely to be overweight or develop various medical problems. New research from Harvard-affiliated Brigham and Women’s Hospital shows that lack of sleep plays a complex and powerful role in the development of type 2 diabetes. Among volunteers who lived in a sleep lab for several weeks, their bodies made less insulin after meals when they got under 5.5 hours of sleep a night for three weeks. As a result, their blood sugar levels went haywire. Some of the people had blood sugar levels high enough to have been diagnosed as prediabetic.

Patrick J. Skerrett
Patrick J. Skerrett

Snoring in kids linked to behavioral problems

Children who snore, or sometimes stop breathing during sleep for a few seconds then recover with a gasp (a pattern known as sleep apnea), are more likely to become hyperactive, overly aggressive, anxious, or depressed, according to a new new study in the journal Pediatrics. How could snoring or apnea contribute to behavioral or emotional problems? It is possible that nighttime breathing problems during the brain’s formative years decrease the supply of oxygen to the brain. That could interfere with the development of pathways that control behavior and mood. It is also possible that breathing problems disturb sleep, and it’s the interrupted or poor sleep by itself that may cause trouble in the developing brain.

Harvey B. Simon, M.D.

Sleep helps learning, memory

Sleep may be time off for the body, but it’s part of a day’s work for the brain. During sleep, the brain is hard at work processing the events of the day, sorting and filing, making connections, and even solving problems. New research suggests that dreaming can improve memory, boost performance, and even improve creativity. Naps have been shown to improve recall. Napping won’t make you smart or assure success, but it can help improve your memory and solve problems. Sleeping well at night, and long enough, is associated with good health. The combination is a two-step approach that should give everyone something to sleep on.

Patrick J. Skerrett

Overnight treatment for chronic insomnia

For some people, trouble falling asleep or staying asleep is just a now-and-then hitch. For others, insomnia is a chronic problem that affects mood, daytime alertness and performance, and emotional and physical health. Some people turn to medications, others to behavioral approaches that often take weeks to get results. A new approach using a 25-hour program called intensive sleep retraining may be enough to break the cycle in a day. Australian researchers showed that it worked better than standard behavioral therapy. As the researchers themselves point out, intensive sleep retraining is expensive. Let’s hope that the Australian study stimulates the creation of similar boot-camp approaches that can be done at home.

Kay Cahill Allison

Fight fatigue by finding the cause

Feeling tired? If so, it’s not surprising. Fatigue is one of the most common problems people report to their doctors. But fatigue is a symptom, not a disease. Different people experience it in different ways. The tiredness you feel at the end of a long day or after a time zone change might feel similar to that resulting from an illness. Fatigue from stress or lack of sleep usually subsides after a good night’s rest, while disease-related lethargy is more persistent and may be debilitating even after restful sleep. Either way, you don’t have to live with it. You can find out what is causing you to feel tired and discover what you can do to renew your energy levels.