EIC Social Media Team
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Chronic kidney disease (CKD) is commonly associated with type 2 diabetes. Both these diseases are more commonly found in overweight and obese individuals, and another disorder that is common to them is obstructive sleep apnea (OSA). OSA is a blockage of the air passageways during sleep, which causes the individual to stop breathing periodically during their time asleep, causing their body to slightly wake up each time as it pushes the passageway open again. For individuals who are overweight or obese, their extra weight sometimes pushes against their air passageways and can block the lungs from properly breathing while they sleep. Because of this condition among those with CKD, type 2 diabetes and obstructive sleep apnea, researchers wonder if the statistical connection is more than just a coincidence. Scientists from the American Society of Nephrology (ASN) have looked at the possible connections between obstructive sleep apnea and kidney disease in their correlation to type 2 diabetes, looking at sleep apnea as a factor of accelerated renal function decline. Renal function is the most common indication of the state of the kidneys, because it shows how well they function in separating the toxins out from the body and pushing the waste to the proper areas of the body for elimination.
What is currently known is that type 2 diabetes can contribute to the development of chronic kidney disease. Researchers started with this information, along with knowing that CKD patients usually also suffer from obstructive sleep apnea. They analyzed information from over 50 patients with type 2 diabetes and CKD who had performed a specific questionnaire to determine whether or not they also had obstructive sleep apnea. The results showed that over 60% of these patients did have sleep apnea, and those who did have OSA had a significantly lower level of kidney function than those whom it was determined did not have sleep apnea. From the research team’s study, it seems that sleep apnea and kidney disease do have potential links, because obstructive sleep apnea does indeed accelerate kidney function decline in diabetic patients who also have non-dialysis CKD. Not enough evidence was present to determine if this is also the case for those with CKD who do need dialysis. What this study shows, however, is that OSA may lead to accelerated loss of renal function in the kidneys, which leads to chronic kidney disorder progression faster than those without sleep apnea.
Researchers out of the University of Calgary, Canada, released a study that shows it may be possible to treat depression and Obstructive Sleep Apnea (OSA) with the same treatment. Certain devices that are normally used for treating OSA have been found to also alleviate symptoms of depression, according to the study. These machines, the continuous positive airway pressure (CPAP) and the mandibular advancement devices (MADs), help patients during sleep by keeping them breathing properly and avoiding those moment where OSA blocks the airways and stops the person from breathing for a moment; this moment can last a few seconds before the body “awakes” just enough to push through the blockage to start the breathing process again.
The researchers studied 22 randomized clinical volunteers, each diagnosed with sleep apnea and showing signs of depressive symptoms. Of those who were using the CPAP and MAD devices to help with their sleep apnea, each person showed signs of improving their depressive symptoms, according to the questionnaires filled out before, throughout, and after the trial period. Those who did not treat their sleep apnea, or who were treating it with methods besides the CPAP or MAD device, did not show many signs of improvement in their depressive symptoms. This data was cross-referenced with the known literature on sleep apnea treatment and depression, as there seems to be a connection between people with OSA and the depression a majority of them report to experience. One thing the researchers knowingly could not take into consideration with this kind of study was how much non-OSA treatments help with depressive symptoms, like depression medications and therapy, when used in conjunction with the OSA treatments. More studies are needed to learn the connections of these different types of treatments.
The results of this study further affirms that there are benefits to the CPAP and MAD devices that are greater than only helping the person breathe normally throughout the night. The depressive symptoms which seem to be strongly connected to sleep apnea, and the inability to sleep properly throughout the night, are alleviated due to a person being able to both breathe all throughout the night and being able to achieve uninterrupted sleep for several hours at a time. And, the study further revealed, the worse a person’s depression is before the treatment, the more improvement the treatment is on their depressive symptoms. As the main author of this Canadian study says, “This systematic review summarizes the available literature on OSA treatment,” further adding that this could be a novel way to treat depression and Obstructive Sleep Apnea together. “Our results,” he said, “illustrate that the greatest benefit of CPAP treatment on depressive symptoms may occur in populations with worse depression scores at baseline.”
Lack of sleep has detrimental effects upon people of all ages, with the age range of each individual creating different problems from the lack of sleep. In children, sleep deprivation can lead to behavioral problems, a difficulty focusing and learning in school, and negative effects on the immune system. For children, says the experts who conducted this study, “Chronic tiredness makes it harder to cope and process what’s going on around you.” This study was conducted by Ohio State University’s Wexner Medical Center, and shows how not sleeping affects all ages in various ways. The data goes on to say that a lack of sleep affects teenagers worse than children, on average. Only about 15 percent of the teenage population in the United States gets the recommended amount of sleep needed for proper daily activities and good health. Sleep is when the body restores itself, when muscles and other tissues repair, hormones that control growth are released, and when energy rejuvenates and memories solidify. Without the proper amount of sleep each night, each of these areas is heavily affected in teenagers and young adults.
Though it is clear that not getting enough sleep affects all ages, for adults, sleep loss is a more serious problem. This sleeplessness accumulates over the years, and can contribute to several chronic diseases, including heart disease, diabetes, high blood pressure, depression, and obesity. Sleep-related disorders – insomnia or sleep apnea – are more prevalent in adults. Medications that many adults take are also known to affect sleep patterns. With all of this information, the National Sleep Foundation released the following guidelines for hours of sleep we should get throughout our lives:
- Infants: up to 16 hours total, including naps
- Toddlers (1-3 yrs): 12-14 hours, including naps
- Preschool (3-5 yrs): 11-13 hours, most do not nap after age 5
- School-age (5-12 yrs): 10-11 hours
- Teens: 8.5-9.5 hours
- Adults: 7-9 hours
There are countless reasons why a person might not be able to properly sleep at night. Anxiety, stress, difficulty breathing, and physical pain are only a few of the many obstacles that can prevent the brain from shutting down alpha activity and preparing for REM sleep, and for some it can feel impossible to go to sleep. Although there are varied treatments that scientists and doctors have developed – from physical exercises throughout the day to sleep aids and other medications – many are unwilling, or simply unable, to receive these treatments for one reason or another. Many of them turn to home remedies, with alcohol among the most used. Using alcohol as a sleep aid has been given as prevalent advice from many societies for hundreds – or even thousands – of years. Alcohol is seen by many as having a positive effect on helping the restless go to sleep faster, and though this seems to initially be the case for those who consume alcohol before sleep, new research has confirmed that alcohol also causes disturbances while the person is asleep.
“People likely tend to focus on the commonly reported sedative properties of alcohol, which is reflected in shorter times to fall asleep, particularly in adults, rather than the sleep disruption that occurs later in the night,” said Christian L. Nicholas, of the University of Melbourne, who was one of the researchers who looked at the effects of alcohol on the brain before and during sleep. Those using alcohol as a sleep aid may think it is helping counter-act their restlessness, but in fact it may be adding to it. The team’s study included 24 healthy people, 12 men and 12 women, from the ages of 18 to 21 years old and who socially drank (with less than seven standard drinks consumed per week in the month leading up to the study). They engaged in pre-sleep alcohol activities as well as placebos, and their brains were measured for delta frequency electroencephalogram (EEG) activity of Slow Wave Sleep (SWS), which helps promote restful sleep, as well as frontal alpha power, which is associated with wakeful states of the brain. The results from all participants were an increase in both EEG activity as well as frontal alpha power. This explains why alcohol initially seems to promote restful sleep, with the increase of the EEG activity, and also explains why so many report either sleep disturbances throughout the night or a lack of restful rejuvenation from the hours they do sleep. “Similar increases in alpha-delta activity, which are associated with poor or unrefreshing sleep and daytime function, have been observed in individuals with chronic pain conditions,” Nicholas said, adding that this study confirms that alcohol is not a sleep aid. The additional sleep that someone may get from pre-sleep alcohol consumption is disturbed and altered because of the alcohol, negating any positive effects. The best way to fight restlessness is to consult a sleep specialist, or at the very least a physician, who can recommend cheap-to-free alternatives to alcohol consumption to get your needed rest at night.
Last week I shared the research that sleep affects each age range differently. Teens sometimes have it the worst, as only 15 percent of the teenage population in the United States gets an adequate amount of sleep each night. One of the contributing factors to this, aside from hormones and activities keeping the teens up later than others, is the time their respective high school starts each morning. Teens with earlier school start times are more likely to get into vehicle motor accidents than those with an hour, or an hour and a half, later school start time.
Researchers have studied this effect on teenage drivers while on their way to, or even leaving from, their high school. One of these researchers, American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, concluded, “When high school classes begin early in the morning, we ask teens to shine when their biological clock tells them to sleep.” Results of this research show the crash rate for teen drivers during the 2009-2010 and 2010-2011 school years was an average of 28 percent higher in Chesterfield County, Va., with a school start time of 7:20 am, than in adjacent Henrico County, Va., with a school start time of 8:45 am. No variations were detected among vehicle crashes of adult drivers from the same counties.
Not only is the crash rate higher for teens with earlier school start times, but the performance levels and overall health of the teenagers seem to also be affected. Another researcher looking at teens and the sleep they need to fully function each day, Dr. Robert Vorona, informed us that, “Insufficient sleep appears to have deleterious consequences such as decrements in mood and increased risk taking, impaired academics and increased crash rates.” It’s worth it to make sure your teenager gets the rest they require, not only for their production throughout the school year, but for their safety as well.
Orexin, a protein developed in the brain by the hypothalamus, is responsible for helping to wake the brain from a sleep state. It stimulates wakefulness, acting like a switch to wake the sleeping brain up. Researchers looking at this protein have learned that its presence in mice is a contributing factor to the development of brain plaques, mostly consisting of amyloid beta, which have been linked to memory loss, disorientation, personality changes, and dementia, all symptoms of Alzheimer’s disease. Brain plaques are always present before the onset of these conditions, and they increase in accumulation on the brain throughout their duration. Because of these known correlations, researchers are now looking at brain plaques, and at the orexin protein, for possible methods of preventing Alzheimer’s. By preventing the buildup of these plaques, researchers hope to slow, and possibly avoid, the onset of Alzheimer’s and other brain-related diseases.
Researchers out of Washington University School of Medicine looked at lab rats that were genetically manipulated to develop brain plaques more rapidly than normal. These rats developed symptoms of memory loss and dementia. They were then bred with rats that had a deficiency in the orexin protein. The result was as the researchers had hoped: the rats with less orexin slept an average of an entire hour more – over a 12 hour cycle – than rats with normal levels of the protein. The other result that researchers were hoping for also occurred; the rats that slept more (with deficient levels of the orexin protein) developed brain plaques at half the rate of those who had more orexin protein and slept less each day. Now that researchers are beginning to understand the link between sleep disorders and the development of Alzheimer’s, they are hopeful that the orexin protein could be a major factor in future Alzheimer’s prevention. One possible setback they learned from the study, though, is that decreasing the levels of orexin without changing the amount of sleep the rats got each night did not change the rate of brain plaque development. This means that in order for the elimination of the orexin protein to make any difference in slowing or stopping the onset of Alzheimer’s, there has to be a change in sleep patterns as well, which could be difficult to control on a large scale. Regardless, researchers are hopeful that this new understanding will help us get closer to eliminating Alzheimer’s disease in the future.
Scientists from the University of Wisconsin’s School of Medicine and Public Health, in Madison, Wisconsin have released the results of a long-term study looking at possible connections between the symptoms of asthma and the development of Obstructive Sleep Apnea (OSA) in adults. The study began in 1988, and the results were released in January of this year. From the beginning of the study, the team of researchers looked at over 500 randomly selected adults, ages 30 to 60 years old at the onset of the study, and followed them every four years until shortly before releasing their results. These results, they found, show that asthma is linked to sleep apnea risks being higher, especially as adults further age.
Of those chosen randomly for the study, 466 of them did not have adult asthma symptoms and 81 of them did. Each participant attended an in-laboratory overnight stay to study their sleep patterns, concluding with a questionnaire about their sleeping habits, daytime sleepiness, etc. roughly every four years. The rate of OSA in each grouping remained essentially constant within each four-year interval, as twenty-two of the eighty-one participants who suffered from asthma experienced incidents of Obstructive Sleep Apnea, which is twenty-seven percent of this group, while only seventy-five of the four hundred and sixty-six participants who did not suffer from asthma experienced incidents of Obstructive Sleep Apnea, which is roughly sixteen percent of the group. In the last four-year interval that the participants were studies, the rate of Obstructive Sleep Apnea incidents remained at twenty-seven percent for those with asthma, and only increased to seventeen percent for the group without asthma. The authors of this study wrote, “This study prospectively examined the relationship of asthma with OSA assessed with laboratory-based polysomnography and found that preexistent asthma was a risk factor for the development of clinically relevant OSA in adulthood over a 4-year period. Furthermore, the asthma-OSA association was significantly dose-dependent on duration of asthma.” These results showed the scientists that, indeed, asthma is linked to sleep apnea risks being higher than they normally would without asthma. They concluded, “Studies investigating the mechanisms underlying this association and the value of periodic OSA evaluation in patients with asthma are warranted,” adding that they would conduct further studies to find a direct causal relationship between asthma and the risks of Obstructive Sleep Apnea.
Video Games and Sleep Research: Video Games Used to Help Measure Memory Loss
Conventional wisdom holds that video games contribute to a lack of sleep, especially in younger people. Young men tend to play more video games, so it is not surprising that they are the primary sufferers of this form of sleep deprivation, simply from staying up to play video games. There is even evidence that late-night video gamers suffer from sleep disturbances caused by their addiction to the flashing lights of the games; they may actually be waking in the middle of the night to ‘get their fix.’ Studies have, in fact, confirmed these effects on some people. Thus, the common belief is video games are responsible for many more negative effects on a person’s sleep patterns than any positive effects that they could produce. This is probably generally true. However, the connection between video games and sleep research is not uniformly bad, as video games were recently enlisted for use in a sleep study involving memory loss and sleep deprivation.
The study, conducted by NYU’s Langone Medical Center in New York City, was led by Andrew Varga, clinical instructor of Medicine in the Division of Pulmonary, Critical Care and Sleep Medicine. This study demonstrated that the deprivation of REM sleep has a detrimental effect on a person’s memory of everyday events. They tested several subjects who played video games both at the beginning and the end of each trial, introducing a period of sleep deprivation in between the game playing. The mistakes and confusions which resulted when the subjects played the video games after sleep deprivation underscored the need for proper, unbroken REM sleep throughout the night.
Sleep apnea, the most common sleep disorder in the United States, has two main negative effects. It creates numerous repetitive dips in the blood’s oxygen levels, and it creates numerous small arousals that interrupt sleep continuity. The disruption of spatial memory caused by sleep apnea was easily measured in the playing of repetitive video games. Moreover, the study utilizing video games and sleep research showed that the loss of memory can have further implications. Clearly, our bodies need more than just rest, as unbroken sleep seems to be the key to gaining all of the positive effects of sleeping each night.
Your Skin and Sleep: Deep Relationship Discovered Between Skin and Sleep Patterns
Researchers have long known that there is a distinct connection between a person’s skin and the sleep that they receive each night. Skin can absorb vitamin D through sunlight, which is a key factor in the production of melatonin. The more sunlight we receive, the less melatonin we create. The more melatonin we create, the more prone we are to sleep restfully throughout the night. So, darkness promotes sleep and proper rest. This connection between your skin and sleep is key to regulating your sleep cycle and helping to keep your sleeping patterns normal and healthy. The more constant your sleep cycle is, the better your overall health can be. But there are more connections being discovered every year, and new studies have revealed a deeper relationship between skin and sleep patterns.
A new connection that has been discovered has to do with the risk and prevalence of fracture and bone or joint injury. Researchers have found an unlikely link between adult eczema – or the inflammation, discomfort, and discoloration of skin – and sleep disturbances that cause a higher prevalence of fracture and bone or joint injury (FBJI). The newly found connections between your skin and sleep show that those with adult eczema and sleep disturbances suffer from more of these FBJI incidents than those who have sleep disturbances but no adult eczema. Sleep disturbances, a common risk factor in FBJI incidents, seems to have added risks for those with eczema. The study – conducted by Northwestern University, Chicago – examined the link between eczema and sleep disturbances in those who suffer FBJI. They concluded that adult eczema is a previously unrecognized risk factor for fracture and other injury. This has led to the idea that eczema and sleep disturbances should be treated in conjunction with one another.
Symptoms of Insomnia Increase Risk of Fatal Accidents: Motor Vehicle Deaths and Sleep Disorders
Everyone knows that the less you sleep the worse you feel. Your thoughts are slower and sluggish, as is your body strength and reflexes. In-depth research has concluded that symptoms of insomnia increase risk of fatal accidents, including vehicle motor deaths. This research was conducted by the Norwegian University of Science in Technology in Trondheim, Norway, and supported by the ‘Sleep Well, Be Well’ campaign of the National Healthy Sleep Awareness Program. The researchers compiled data from around the world in which insomnia symptoms were or were not identified in those who had died in a motor vehicle accident. The results indicated that those who had difficulty falling asleep were over two times more likely to die from motor vehicle injury, and more than one-and-a-half times more likely to die from any fatal injury. The results went further to say that self-reported difficulties in falling asleep contributed to over 34 percent of motor vehicle deaths and 8 percent of all unintentional fatal injuries and, in the absence of insomnia, that most of these deaths could have been prevented.
According to the CDC (Centers for Disease Control and Prevention), there are more than 125,000 unintentional injury deaths in the United States every year. Thus, unintentional injury deaths are the fifth leading cause of death nationwide. Of these deaths, over 33,000 were motor vehicle deaths and 27,000 were from unintentional falls. Research shows that the symptoms of insomnia increase the risk of fatal accidents in every circumstance. Difficulty falling asleep, sluggish behavior during the day, and overall grogginess are the biggest contributing factor to these accidents. Obviously, it is important to get a good night’s sleep every night. If you are finding it difficult to sleep nightly, consult your physician or a sleep specialist.