Sleep Archive

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Sleep breathing problems may hasten decline in thinking skills

As we reported in March, sleep apnea and other sleep breathing problems are associated with the development of dementia. Now a study published online April 15, 2015, by Neurology finds that sleep breathing problems are associated with an earlier onset of the decline in thinking skills.

Researchers analyzed the medical histories of about 2,500 people ages 55 to 90 and found that people with sleep breathing problems were diagnosed with mild cognitive impairment (a decline in thinking skills) an average of 10 years earlier than people who didn't have those problems. The encouraging news: people who treated their sleep breathing problems with a continuous positive airway pressure (CPAP) machine were diagnosed with mild cognitive impairment about 10 years later than people whose problems were not treated. The study doesn't prove a cause-and-effect relationship, but it does offer hope. "CPAP improves the quality of sleep in people with sleep-disordered breathing. Healthy sleep is an important time for our brains to accomplish critical 'housekeeping' tasks. One of these tasks is clearing beta-amyloid, one of the main proteins associated with Alzheimer's disease," says Dr. Scott McGinnis, an instructor in neurology at Harvard Medical School.

Cognitive behavioral therapy offers a drug-free method for managing insomnia

Many people with insomnia turn to sleeping pills, which often have unwanted side effects. Few of them know about an equally effective therapy that targets the root cause of insomnia without medications. Called cognitive behavioral therapy for insomnia, or CBT-i, this short-term talk therapy teaches people to change the unproductive thinking patterns and habits that get in the way of a good night’s sleep. While this therapy can’t “cure” insomnia, it does provide tools to better manage it. In a review article in this week’s Annals of Internal Medicine, researchers found that people treated with CBT-i fell asleep almost 20 minutes faster and spent 30 fewer minutes awake during the night compared with people who didn’t undergo CBT-i. These improvements are as good as, or better than, those seen in people who take prescription sleep medications such as zolpidem (Ambien) and eszopiclone (Lunesta). And unlike medications, the effects of CBT-i last even after the therapy ends.

Trouble falling asleep linked to high blood pressure

High blood pressure is one of the many health risks associated with not getting enough sleep, which is often caused by insomnia, or difficulty falling or staying asleep. Although often considered a nighttime problem, some people with insomnia may be in a state of "hyperarousal" that also makes it hard for them to nod off during the day. Now, new research suggests that people with chronic insomnia who also have trouble napping face a higher risk of high blood pressure.

The study, in the March 2015 issue of Hypertension, included more than 200 people with chronic insomnia (defined as insomnia that lasts more than six months) and almost 100 normal sleepers. All underwent daytime nap tests, which measures how quickly a person falls asleep in a quiet environment during the day. People with chronic insomnia who took longer than 14 minutes to fall asleep during the nap studies had three times the risk of high blood pressure compared with normal sleepers, the researchers found. Treatments such as medications and biofeedback to help dampen hyperarousal may be best for people with this type of insomnia, they suggest, although more research is needed.

When sleeplessness starts in the legs

Uncomfortable nighttime leg sensations can spoil your sleep, but you can take steps to relieve it.

Is restless legs syndrome (RLS) the cause of your restless sleep? This exasperating condition triggers abnormal sensations in the legs and an irresistible urge to move them. It can wreak havoc with sleep, leading to daytime fatigue.

Full bladder wakes women more often than thought

Two in three women over age 40 wake up at least once each night because of a full bladder, and nearly half make two or more nighttime trips to the bathroom. But only a quarter of women who get up to urinate during the night say they are bothered by having to do so.

That's the finding from a survey of more than 2,000 northern California women ages 40 and older. Factors that increased the likelihood that a woman woke at night to urinate included older age, past hysterectomy, hot flashes, and use of vaginal estrogen. However, the late-night bathroom breaks weren't caused by an overactive bladder or stress incontinence. The results were published in the January 2015 issue of the journal Obstetrics and Gynecology.

iPad can disrupt sleep, study suggests

Image: Thinkstock

Using an iPad or other backlit electronic tablet in the hours before bedtime not only prevents you from falling asleep, it may also affect your alertness the next day, according to a report published in the Proceedings of the National Academy of Sciences, Dec. 22, 2014. Researchers at Harvard-affiliated Brigham and Women's Hospital found that the light emitted by the devices reset the body's circadian clock, which synchronizes the daily rhythm of sleep to daylight. As a result, people reading e-books took longer to fall asleep and were less alert the next morning than when they read print books instead.

During the two-week study, 12 men and women read digital books on an iPad for four hours before bedtime each night for five consecutive nights. They also followed the same routine using printed books. When they read the iPad, participants were less sleepy before bedtime but were less alert the following morning, even after eight hours of sleep.

Poor sleep linked to dementia and ministrokes

Images: Thinkstock

Poor sleep is linked to high blood pressure, diabetes, obesity, and heart disease. Now a study published in Neurology Dec. 10, 2014, suggests that people with conditions that rob them of oxygen and deep sleep are more likely to have changes in the brain that may lead to dementia. Researchers say conditions such as emphysema and sleep apnea reduce the amount of oxygen in the blood during sleep, which can lead to silent, undetectable "ministrokes." Researchers also found that people who spend less time in deep sleep, called slow-wave sleep, are more likely to have loss of brain cells than people who spend more time in slow-wave sleep. Slow-wave sleep is important in processing new memories and remembering facts. The researchers noted that past evidence has shown that using a continuous positive airway pressure (CPAP) machine for obstructive sleep apnea may improve cognition, even after dementia has developed. "Sleep quantity and quality are important to maintain optimal health and prevent disease," says sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School. "By getting enough sleep, you ensure that you are getting all the types of sleep, which is necessary to maintain proper functioning." 

Gentler exercise for mind and body is best for sleep

Image: Thinkstock

Just as regular exercise has a host of health benefits for the body, staying mentally active appears to preserve memory and general sharpness. But for getting a good night's sleep, light workouts for both body and brain may be best, according to a study in the Journal of the American Geriatrics Society.

The study focused on 72 people, ages 67 to 79, who reported poor sleep as well as declining mental sharpness. They were assigned at random to do either strenuous aerobic exercise or a gentler stretching routine, paired with either watching educational DVDs (followed by short quizzes) or engaging in more demanding computer-based brain training.

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