Sleep Archive

Obstructive sleep apnea (OSA) is marked by a repetitive pattern of held breaths and explosive snores throughout the night. It happens when the tongue or throat tissue blocks the airway (sometimes hundreds of times a night) and is known to raise risk for high blood pressure, heart attack, and stroke. It's more common in people who are overweight and who have heart disease.

Now, a new study finds that a common treatment for OSA—called continuous positive airway pressure, or CPAP—can lower blood pressure in people with OSA who have or are prone to heart disease. Delivered through a bedside machine, CPAP provides a constant stream of air through a face mask, which prevents the back of the throat from collapsing and blocking airflow.

When people who use risky sleeping pills receive the right information, they are more likely to work with their doctors to taper off the medications and adopt safer methods to combat insomnia, according to a study in JAMA Internal Medicine.

Doctors have long cautioned people about using drugs called benzodiazepines as long-term sleep aids. Such drugs include alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan). The drugs' sedating effects can linger, leading to falls and accidents. Many find it hard to get off these drugs because of withdrawal symptoms and sleeplessness that often follow.

Q. Is it true that snoring raises your blood pressure? I'm a snorer, and I worry that it puts me at risk for other conditions.

A. Severe snoring can be a sign of obstructive sleep apnea (OSA). If you have OSA, then your breathing is blocked temporarily many times per night. That causes oxygen levels in your lungs and blood to start falling. Your brain sees this happening and sends adrenaline into your bloodstream. This stimulates the breathing center in your brain. It also makes your heart beat faster and raises your blood pressure. Fortunately, treatment for OSA can lower blood pressure.

Most people can drink a few cups a day. A higher intake may have negative side effects.

A daily caffeine jolt isn't usually harmful. It may have some health benefits. Caffeine can decrease fatigue and improve alertness, concentration, and motor performance. When added to painkillers, caffeine makes the drugs work faster and more efficiently.

Some men still take them for sleep problems or anxiety, but they can be risky. Use them cautiously and only for short periods.

The Rolling Stones famously sang of "mother's little helper," a sly reference to the tranquilizers, especially diazepam (Valium), that were all the rage in the 1970s. The medications in this class, benzodiazepines, are among the most widely prescribed drugs in the world.

Make 9 p.m. your cutoff time, and keep screens off if you wake in the night.

Maybe you've heard that turning off a computer, smartphone, or TV screen can help you fall asleep, but is there really any truth to it? "Absolutely," says sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School. "Light by itself is an alerting stimulus. It also suppresses the secretion of melatonin, a substance that helps regulate the body's internal clock, which controls the timing of the sleep-wake cycle." That means bright light in the late evening can delay the sleep period, making it harder to fall asleep at night and harder to get up early in the morning. "The later you look at bright screens, the more you can shift your internal clock," says Dr. Epstein.

With the introduction of benzodiazepines such as chlordiazepoxide (Librium) and diazepam (Valium) in the early 1960s, a new era in the treatment of insomnia and anxiety began. The benzodiazepines were more effective and far safer than the older drugs — barbiturates, meprobamate, and glutethimide — that had been prescribed for these purposes. For many years, benzodiazepines continued to be the most popular prescription tranquilizers and sedatives. Since the mid-1980s, new alternatives have been assuming some of these roles, but benzodiazepines are not about to leave the stage.

More than a dozen benzodiazepines are available by prescription. Benzodiazepines have a common basic chemical structure, and they all increase activity at receptors for the neurotransmitter gamma-aminobutyric acid (GABA). This transmitter inhibits the activity of neurons, slowing down the brain and nervous system. Benzodiazepines differ mainly in how quickly they are absorbed, how long their effects last, and how long they take to leave the body.

Q. Can my sleep position keep me from snoring? If so, how can I stay in the right position overnight?

A. Snoring has to do with how your upper respiratory tract is built and whether you have medical conditions that make it prone to narrowing—which may be more likely to occur in certain sleep positions. If anything narrows your throat, mouth, or nose, it's harder to breathe. Blood oxygen levels start dropping, and blood levels of waste material—carbon dioxide—start rising. That's not good. It strains the heart and many other organs.

Proper sleep, balanced diet, and strengthening exercises can boost endurance and ensure independence.

Muscle building isn't just for those who are into fitness as a hobby. Muscle strength is crucial for good health, especially as we age. "Muscle strength is important to help reduce injuries, most notably falls," says Ashley Wiater, a physical therapist at Harvard-affiliated Massachusetts General Hospital.