Sleep Archive

It always takes me a few days to get used to Daylight Saving Time. While I love the extra hour of light at the end of the day, I’m not so wild about the extra hour of darkness in the morning or waking up an hour earlier than I need to. And I sure miss the hour of sleep I lost yesterday. That lost hour seems to be a big deal. A report in this month’s American Journal of Cardiology details the jump in heart attacks seen in a large Michigan hospital the first week after the start of Daylight Saving Time, and the small decline after it ends in the fall. A few years back, researchers showed a similar pattern in Sweden. The number of traffic accidents are similarly affected. In a Canadian study, there were more accidents on the Monday after the start of Daylight Saving Time than there were on the Monday the week before the change. If ever there was a perfect day for a nap, today would be it. A single nap won’t fully reset your body clock or make up for a lost hour of sleep, but it can help. It’s also a good way to stay sharp, especially in the afternoon.

If you're overweight, particularly around the middle, you may sleep better if you drop a few pounds. A recent study presented at an American Heart Association meeting found that losing weight, especially in your belly, improves the quality of sleep for overweight and obese people.

Weight-sleep connection

Researchers found that people who spent six months following either a combined diet and exercise program or a diet program alone lost an average of 15 pounds, with 15% of it in their bellies. Both groups also experienced improved sleep quality.

Memory slips are aggravating, frustrating, and sometimes worrisome. When they happen more than they should, they can trigger fears of looming dementia or Alzheimer’s disease. But there are some treatable causes of forgetfulness.

Protect your brain with a sleep apnea diagnosis.

Controlling heart disease, cholesterol, and hypertension are all good ways to help prevent a stroke. Now doctors are also urging you to get obstructive sleep apnea (OSA) diagnosed and under control. The idea has been gaining favor for the past few years, and the latest to join the chorus are the participants of the Canadian Stroke Congress, who recently added OSA diagnosis to their stroke care guidelines. Harvard sleep expert Dr. Lawrence Epstein agrees. "A person with untreated OSA has an increased risk of having a stroke, a fatal stroke, and a second stroke compared to those without sleep apnea," says Dr. Epstein, who's also an instructor in medicine at Harvard Medical School.

The connection

A stroke occurs when an artery that supplies blood to the brain becomes blocked or bursts. Without blood, brain cells go without oxygen and begin to die.

Are you at increased risk for this often-symptomless disease?

The aorta is the body's largest artery—and its lifeline. The aorta carries freshly oxygenated blood from the heart down through the chest and abdomen, before dividing into the arteries that serve the legs. All organs and arteries in the body owe their survival to blood delivered through a healthy aorta.

Poor-quality sleep and heart disease are connected.

We've all heard stories about super snorers, whose snorts and snores rattle windows and awaken the neighbors. Many of these people suffer from sleep apnea. In this condition, the airway becomes blocked, or the muscles that control breathing stop moving. Either way, breathing stops... and then resumes with a gasp. In the worst cases, this can happen hundreds of times every night.

Because sleep apnea sufferers are constantly awakened, they have poor-quality sleep and feel exhausted all day. They may also suffer from poor cardiovascular health. The sleep disorder is found in 47% to 83% of people with cardiovascular disease, 35% of people with high blood pressure, and 12% to 53% of people with heart failure, atrial fibrillation (a heart rhythm abnormality), and stroke. Researchers estimate that untreated sleep apnea may raise the risk of dying from heart disease by up to five times.

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.

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.

Q. I have always had a snoring problem and recently underwent a sleep test at the insistence of my wife. I was diagnosed as having sleep apnea We have read about the connection between sleep apnea and heart disease, and now we are both concerned. Will treating my sleep apnea reduce my heart risk?

A. Sleep apnea is a nighttime breathing pattern of held breaths and explosive snores. There's little question that it's associated with both high blood pressure (hypertension) and coronary disease. But does sleep apnea cause cardiovascular disease? Or is the association due to common risk factors, such as obesity, which contribute to the development of both sleep apnea and cardiovascular conditions? In other words, we don't know whether sleep apnea is a cause of heart disease, or an innocent bystander. Maybe it is both. Obstructive sleep apnea, the most common form of this condition in which the tongue or throat tissue blocks the airway, causes surges of adrenaline during the periods when breathing is obstructed. It is highly likely that those surges contribute to hypertension and strain the cardiovascular system. People with obstructive sleep apnea also have an elevated risk for stroke and heart failure.

… but are sleep aids and prescription drugs hurting or helping?

Sleep is essential to good health, and a lack of it can lead to heart disease, high blood pressure, stroke, weight gain, and diabetes. Yet 22% of Americans struggle with insomnia every night, according to the National Sleep Foundation, and people ages 65 and older are one-and-a-half times more likely to battle the condition.