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Improving Sleep: A guide to a good night's rest

Do you have trouble falling asleep? Trouble staying asleep?

Remember when you could fall asleep as soon as your head hit the pillow and not wake up until the alarm went off?

As we get older, it becomes a little harder to fall asleep and stay asleep. But although our sleep patterns change, our need for sleep doesn’t. Just like diet and exercise, a good night’s sleep is essential for your good health, for keeping you alert and energetic, and for building your body’s defenses against infection, chronic illness, and even heart disease.

Improving Sleep is an instructive and fact-filled report from Harvard Medical School that explains why sleep often eludes us as adults. You’ll read about those habits and conditions that rob us of peaceful slumber. And most importantly, you’ll learn what you can do to again enjoy the satisfaction of a restful night’s sleep.

You learn not only what triggers insomnia but also how new techniques and therapies are helping men and women get to sleep more quickly — without the use of medications. You’ll read about the benefits of “strategic naps.” You’ll discover how to make your sleep surroundings more conducive to rest. And you’ll be told about seven things you should do — and not do — before going to bed.

Do you or your spouse snore? There are hundreds of devices marketed as aids to stop snoring. But do any work? The report will sort them out and will brief you on new procedures that are restoring quiet to the bedroom. Have you ever been screened for sleep apnea? The report gives you a six-question test that will help you determine if you need to be tested for this life-threatening condition.

Plus, you may want to speak to your physician after you read about those medications that can cause insomnia, drowsiness or even nightmares. And the report will share news about advances in controlling such sleep-troublers as heartburn, arthritis, nocturia, and restless legs syndrome.

Prepared by the editors of Harvard Health Publications in consultation with Lawrence Epstein, M.D., Instructor in Medicine, Harvard Medical School; Division of Sleep Medicine, Brigham and Women’s Hospital; and Medical Director, Sleep Health Centers, Brighton, MA. 52 pages. (2013)

  • Sleep mechanics
    • Quiet sleep
    • Dreaming (REM) sleep
    • Sleep architecture
    • Your internal clock
  • Sleep throughout life
  • SPECIAL SECTION
    Dangers of sleep deprivation
  • General ways to improve sleep
    • First-line strategies
  • Medical conditions and sleep problems
    • Illnesses that affect sleep
  • Insomnia
    • Types of insomnia
    • First-line treatment: Behavioral changes
    • Prescription medications for insomnia
    • Over-the-counter sleep aids
  • Breathing disorders in sleep
    • Snoring
    • Sleep apnea
  • Movement disorders and parasomnias
    • Movement disorders
    • Parasomnias
  • Narcolepsy
    • Symptoms of narcolepsy
    • Treatments for narcolepsy
  • Disturbances of sleep timing
    • Delayed sleep phase syndrome
    • Advanced sleep phase syndrome
    • Jet lag
    • Sunday insomnia
    • Shift work
    • Seasonal affective disorder
  • Evaluation of sleep disturbances
    • When to seek help
    • Sleep laboratory evaluation
    • Home-based tests
  • The benefits of good sleep
  • Resources
  • Glossary

How sleep loss harms your health

A growing number of studies have linked long-term sleep deficits with significant health problems.

Viral infections

Anecdotal evidence supports the notion that when you’re tired and run-down, you’re more likely to get sick. A study in Archives of Internal Medicine offers some proof. Researchers tracked the sleep habits of 153 men and women for two weeks, then quarantined them for five days and exposed them to cold viruses. People who slept an average of less than seven hours per night were three times as likely to get sick as those who averaged at least eight hours.

Weight gain

Not getting enough sleep makes you more likely to gain weight, according to a review article in the journal Obesity that analyzed findings from 36 different studies of sleep duration and body weight. The link appears to be especially strong among children. Lack of sufficient sleep tends to disrupt hormones that control hunger and appetite, and the resulting daytime fatigue often discourages you from exercising. Excess weight, in turn, increases the risk of a number of health problems—including some of those listed in the following paragraphs.

Diabetes

A report in Diabetes Care found a sharp increase in the risk of type 2 diabetes in people with persistent insomnia. People who had insomnia for a year or longer and who slept less than five hours per night had a threefold higher risk of type 2 diabetes compared with those who had no sleep complaints and who slept six or more hours nightly. As with overweight and obesity (which are also closely linked to type 2 diabetes), the underlying cause is thought to involve a disruption of the body’s normal hormonal regulation resulting from insufficient sleep.

High blood pressure

Researchers involved in the diabetes study also evaluated risk of high blood pressure among the same group of people, which included more than 1,700 randomly chosen men and women from rural Pennsylvania. As described in the journal Sleep, the researchers found the risk of high blood pressure was three-and-a-half times greater among insomniacs who routinely slept less than six hours per night compared with normal sleepers who slept six or more hours nightly.

Heart disease

A number of studies have linked short-term sleep deprivation with several well-known risk factors for heart disease, including higher cholesterol levels, higher triglyceride levels, and higher blood pressure. One such report, published in Sleep, included more than 98,000 Japanese men and women ages 40 to 79 who were followed for just over 14 years. Compared with women who snoozed for seven hours, women who got no more than four hours of shut-eye were twice as likely to die from heart disease, the researchers found.

One common cause of poor sleep, sleep apnea, also raises heart disease risk. In the Wisconsin Sleep Cohort study, people with severe sleep apnea were three times more likely to die of heart disease during 18 years of follow-up than those without apnea. When researchers excluded those who used a breathing machine (a common apnea treatment), the risk jumped to more than five times higher. Apnea spells can trigger arrhythmias (irregular heartbeats), and the condition also increases the risk of stroke and heart failure.

Mental illness

A study of about 1,000 adults ages 21 to 30 found that, compared with normal sleepers, those who reported a history of insomnia during an interview were four times as likely to develop major depression by the time of a second interview three years later. And two studies in young people—one involving 300 pairs of young twins, and another including about 1,000 teenagers—found that sleep problems developed before a diagnosis of major depression and (to a lesser extent) anxiety. Sleep problems in the teenagers preceded depression 69% of the time and anxiety disorders 27% of the time.

Mortality

In the Japanese heart disease study described above, short sleepers of both genders had a 1.3-fold increase in mortality compared with those who got sufficient sleep. Severe sleep apnea raises the risk of dying early by 46%, according to a study of 6,400 men and women whom researchers followed for an average of eight years. Although only about 8% of the men in the study had severe apnea, those who did and who were between 40 and 70 years of age were twice as likely to die from any cause as healthy men in the same age group.

The following reviews have been left for this report. Log in and leave a review of your own.

Improving Sleep May I add an important tip? In most cases of insomnia you have an uncontrolled wandering of mind with negative or positive thoughts. Or you have the habit to revisit the incidents of the day or even plan your future actions. These habits impede the start of a restful slumber causing partial or persistent insomnia. Just wanting to interrupt the persisting thoughts is not an easy enterprise. However there is an easy but powerful way to keep your disobedient mind under control, i.e. by the regular practice of MEDITATION which among the most important conditions for your quality of life also allows you to enjoy a restful slumber, waking up in the morning refreshed and ready to deal with the most difficult problems with inspiration and confidence. Pablo L.Mainzer
It's clear and written in distinct sections that allow the reader to focus on their problem, and not on the entire sleep industry. I would like to have a software version for my e-reader. The PDF does not format well on e-readers.
Very happy with the report. Covered what I have already learned, and added more. And...I agree with the reviewer who thinks that these reports, in general, are overpriced.
I ordered this because I had been very happy with the report on elevated cholesterol. This report, however, was very thin in content--nothing beyond what I knew from casual reading. I think, in general, that these reports are mispriced. They are pamphlets sold for the price of a book.

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