Posts tagged sleep deprivation effects
While surgery is necessary to prevent a condition, illness, or injury from getting worse, it still doesn’t make it any easier dealing with the pain that comes afterward. Postoperative pain can sometimes feel unbearable. Medications are able to reduce the pain but you’ll need all the help you can get to make the recovery process less stressful.
You’re probably wondering what other options are available. Well, if the University of Michigan’s Department of Anesthesiology is to be believed, a good night’s sleep and caffeine can make the pain go away. Sleep is always a major factor when it comes to how your body recovers. Let’s find out what how postoperative pain is affected by your sleep quality.
Looking Into Postoperative Pain
“Postoperative pain control is challenging,” says Giancarlo Vanini, M.D., a research assistant professor in the Department of Anesthesiology at Michigan Medicine. “There is a general long-standing interest in the relationship between sleep and pain, and we know that both are reciprocally related.”
“Several studies demonstrate that pre- and postoperative sleep disturbances worsen pain and, more importantly, predict the onset of long-term postoperative pain. However, while the relationship between sleep and pain is well-known, its underlying mechanisms remain unclear.”
“Based on previous studies published by our group and others, we predicted that a brief sleep disturbance prior to surgery would worsen postoperative pain,” Vanini says. “But, we wanted to examine if there were any treatments or interventions that could aid to minimize the effect of sleep loss by reducing the severity of pain experienced after surgery.”
The Impact of Sleep Loss
To understand the dangers of sleep loss, let’s look at the impact it can have on your body. A lack of sleep, over a long period of time, can lead to a series of health problems. Sleep deprivation has long been associated with heart conditions like heart disease, heart attack, stroke, heart failure and more. Many sleep disorders are also known to put you at risk for stroke and diabetes.
Another part of the body that sleep loss can target is the mind. Sleep conditions like insomnia can put a tremendous amount of stress on the brain. Depression, anxiety, and stress are not uncommon among patients dealing with this condition. Sleep is also critical to your brain’s ability to process information. When people sleep normally, the mind is able to process our experiences into memories. The less sleep one receives, the harder it is for them to think, learn, and recall crucial information.
Using Caffeine as a Substitute for Sleep
While drinking caffeinated beverages is not the same as going to sleep, it can mimic its effects on our body. When we receive proper sleep, the body feels energize and no longer crave more sleep. The same effect happens with caffeine. A sleep inducer known as adenosine has no effect when the body has caffeine in its system. The body feels awake and focused, which is why many people choose to drink coffee in the morning.
Dr. Vanini and his team wanted to know how effective caffeine is at mimicking the effects of sleep. More specifically, they wanted to know if drinking caffeine could reduce postoperative pain like sleep does. “Insufficient sleep enhances pain perception, so we reasoned that caffeine might also be useful for reversing the increase in pain caused by sleep loss,” says Dr. Vanini. “We liked the potential of this intervention because it is simple and virtually everyone is familiar with caffeine.”
Results of the Study
Using test rats, the team sought to see the effects of sleep deprivation before surgery on postoperative pain, and how caffeine affects postoperative pain. Their hypothesis was right. The rats who didn’t receive enough sleep experienced more pain after surgery. Even worse, their recovery times took longer than it should have. However, the results were completely different for the rats that had caffeine in their system after surgery.
“The effect of sleep deprivation on pain sensitivity in operated and intact rats was virtually eliminated by pharmacologically blocking the action of adenosine in a brain region in the anterior hypothalamus known to regulate sleep, which is connected to major pain-related areas,” Dr. Vanini says.
“Caffeine blocked the increase in surgical pain caused by previous sleep loss,” Vanini says. “Surprisingly, the data showed that this is not due to caffeine’s analgesic properties.
“Furthermore, it looks like caffeine was effective only in those rats that underwent sleep deprivation before surgery. We think that caffeine might prevent the increase in pain sensitivity by blocking part of the neurochemical changes induced by sleep deprivation in specific brain areas that control sleep and wakefulness, and project to pain-related sites.”
It’s not just New York City that never sleeps anymore. With the rise of smartphones and digital devices, it seems the whole world is up 24/7. As a society, we seem to be addicted to the always connected nature of digital technology. But what effect does this behavior have on our sleep? It turns out that using technology right before we go to bed is contributing to the high prevalence of reported sleep dysfunction and poor sleep quality.
A Story All Too Familiar
What’s the last thing you remember doing before you went to bed? There’s a good chance you were up all night, lying in bed, scrolling through your social media feed with the lights off. Sometimes we are a slave to our phones and tablet. Analytics firm Flurry confirms that we spend almost 5 hours a day on our mobile devices. This is a significant increase from the amount of time we spent on our devices a couple of years ago.
Sleep-Wake Cycles and Sleep Quality
The evolution of how we consume media is beginning to show drastic consequences. Researchers at the University of Houston looked into the effect of artificial light generated from smartphones, tablets, and televisions. What they found is that this ‘blue light’ contributes to poor sleep quality and the development of sleep dysfunctions.
Over a period of two weeks, researchers had several participants, ages 17-42, wear short wavelength-blocking glasses for three hours before bedtime. During that time, the subjects were allowed to continue their daily routine as they normally would. Researchers found a 58 percent increase in their night time melatonin levels.
Melatonin is a hormone that is produced by the brain. It helps control when we go to sleep and when we wake. Melatonin is heavily influenced by the amount of light we are exposed to. When the sun goes down, melatonin goes up. As the sun rises, the level of melatonin produced our brain decreases. This process controls our natural sleep-wake cycle.
“By using blue blocking glasses, we are decreasing input to the photoreceptors, so we can improve sleep and still continue to use our devices. That’s nice because we can still be productive at night,” Ostrin said.
Too Much Artificial Light Works Against Us
The blue light generated by our phones and devices is similar to the light from the sun. So, as we are using our phones or watching television before we sleep, our melatonin levels decrease. Our sleep-wake cycle is completely thrown off.
Exposure to sunlight, or blue light, activates intrinsically photosensitive retinal ganglion cells (ipRGCs). This neuron is found in the retina and suppresses melatonin. Instead of preparing to rest, our body is alert and awake.
“The most important takeaway is that blue light at night time really does decrease sleep quality. Sleep is very important for the regeneration of many functions in our body,” says Dr. Ostrin.
What You Can Do at Home
While some of us feel like we can’t live without our phones, it’s important to spend some time away from them. You’ll find that your ability to fall asleep faster, sleep better, and sleep longer increases dramatically. There are some other methods you can apply if still want to use your phone at night.
Most phones have a neat little feature call night time mode. This decreases the amount of blue light your device produces. You can also apply screen filters that block blue light or use glasses with anti-reflective lenses.
Either way, you should find a way sleep better. Sleep deprivation can lead to a series of fatal diseases. Disorders like sleep apnea can lead to obesity, diabetes, heart disease and more. Take control of your sleep health early in order to stay happy and healthy.
The average life expectancy is 78.8 years, according to the CDC. The advancement of modern medicine and technology has made living this long possible. However, bad habits and diseases continue to fight against the progress we have made. That’s why it’s important to know what diseases and conditions lower your life expectancy.
Even conditions that prove to be a minor inconvenience can have a long-term impact on your health. Sleep apnea, for instance, is a troublesome condition that is often overlooked. Now, scientists are concerned that disorder’s influence on your quality of life can also affect how long you live. (more…)
You’ve probably heard of restless leg syndrome (RLS) before. It’s a condition where you feel an uncontrollable need to move your leg. This can be due to unpleasantness or even a feeling of being uncomfortable. While this disorder can seem like a minor inconvenience, it can have impactful consequences. The Centers for Disease Control (CDC) even classifies restless leg syndrome as an essential sleeping disorder.
Why Is Restless Leg Syndrome Classified as a Key Sleeping Disorder?
The symptoms of RLS can infer with sleep. The uncontrollable urge to move your legs can manifest from feelings of itchiness, pain, or discomfort. According to the CDC:
“This [RLS] often causes difficulty initiating sleep and is relieved by movement of the leg, such as walking or kicking. Abnormalities in the neurotransmitter dopamine have often been associated with RLS. Healthcare providers often combine a medication to help correct the underlying dopamine abnormality along with a medicine to promote sleep continuity in the treatment of RLS.”
There are several factors that lead to RLS, including:
- Iron Deficiency
- Parkinson’s Disease
- Kidney Failure
- Peripheral Neuropathy
Recently, a study even looked into the link between RLS and pregnant women to find out the effect it has on one’s quality of sleep. The researchers discovered that the disorder is strongly associated with poor sleep quality, excessive daytime sleepiness, and poor daytime function in pregnant women.
RLS and Pregnant Women
It’s common for women in their third trimester to have restless sleep syndrome with moderate to severe symptoms. In fact, the American Academy of Sleep Medicine found this to be the case with 36 percent of pregnant women. These women were also twice as likely to experience symptoms of sleep-wake disturbances and daytime sleepiness.
“While we expected that RLS would be relatively common in pregnant women, we were surprised to observe just how many had a severe form,” said lead author Galit Levi Dunietz, Ph.D., a T32 post-doctoral research fellow at the University of Michigan Sleep Disorders Center in Ann Arbor. “These women experienced RLS symptoms at least four times per week.”
The study looked at 1,563 pregnant women with an average age of 30 years, all in their third trimester. The researchers monitored their symptoms and gave them a sleep questionnaire to determine their status. Thankfully, they also determined that RLS had no adverse effect on the delivery process. However, researchers are afraid that doctors and other health care providers will dismiss sleep symptoms simply because women are pregnant.
“These sleep-wake disturbances are considered common symptoms in pregnancy and are frequently attributed to physiological changes that occur in normal pregnancy, but our data suggest that RLS is an additional contributor to these symptoms,” said Dunietz.
RLS usually goes away once pregnancy is over. The problem is dealing with the disorder during pregnancy. Some suggest that lifestyle changes, decreasing the use of caffeine, and regular exercise might help. Other methods for treating restless leg syndrome include leg massages, good sleeping habits, and hot baths. If you feel you have restless leg syndrome, talk to an otolaryngologist today.
There are a number of things that your child goes through as they grow up. Many of these situations involve their health, requiring that they undergo pediatric surgery to remedy whatever ills them. However, what are the after effects of surgery on a child? One study published in The Journal of Pain hopes to find the answer. Researchers discovered that 20 percent of children experience persistent pain after surgery. What is more revealing is that poor sleep health may be the cause.
How Rest Helps the Body
Sleep is important for many reasons as it plays a crucial role in rejuvenating the body’s basic functions and your overall health. The more rest your body receives, the healthier your brain, emotional well-being, physical health, and quality of life will be. For example, sleep maintains a good balance of hormones, especially the ones that control hunger and your blood pressure. Poor sleep health can cause your body to suffer, leaving it at risk for issues like obesity, heart disease, or high blood pressure.
The CDC recommends that children, ages 3-5 years old, receive at least 10-13 hours a day. Meanwhile, older kids, ages 6-12 years old, should sleep for 9-12 hours a day. The CDC states that “Signs of poor sleep quality include not feeling rested even after getting enough sleep, repeatedly waking up during the night, and experiencing symptoms of sleep disorders (such as snoring or gasping for air). Improving sleep quality may be helped by better sleep habits or being diagnosed and treated for any sleep disorder you may have.” For more recommendations by the CDC, click here.
Evaluating Poor Sleep Health in Kids
Researchers from the University of Washington and Seattle Children’s Hospital studied 66 children who underwent major surgery. Over a four-month period, the researchers monitored the sleep patterns of the subjects. They wanted to access the relationship between sleep and pain, and see if poor sleep health is associated with greater pain after surgery. To some extents they were correct.
“Poor sleep quality predicted greater subsequent pain intensity the next day and our findings suggest that poor sleep quality may continue to influence the experience of post-surgical pain in children even four months after surgery,” said lead author Jennifer Rabbits, MB, ChB, Department of Anesthesiology at Seattle Children’s Hospital.
On average, most of the children returned to an adequate quality of sleep four months after surgery. However, looking at the children individually revealed the connect to sleep and pain. Rabbits and the rest of the study’s authors hope that this will show how important sleep quality is. If improve their sleeping habits after major surgery, it could aid in reducing post-surgical pain and recovery.
Aside to post-surgical recovery, good quality sleep has proven necessary in improving many other aspects of your health. Other studies have shown that sleep can stimulate your brain’s ability to learn and reduce stress. If you want your child to remain healthy, make sure their sleep schedule is consistent and they aren’t distracted by electronic devices during the night. This will help them stick to better sleeping habits and maintain their overall quality of life.
The pressures of college life can take a toll on our habits. Some students suffer through late nights in order to cram for tomorrow’s big test. Others are beholden to their class schedule, waking up and going to sleep at different times of the day. This kind of lifestyle leads to irregular sleep patterns, which some researchers are saying holds negative effects.
To understand the importance of our sleep patterns, we have to look at circadian rhythms. Our circadian rhythms are physical, mental, and behavioral changes that react to your body’s natural internal clock. Effectively, these rhythms dictate several aspects of our body. Mainly, they change when we are ready to go to sleep and when we are most alert.
Normally, circadian rhythms regulate what time we wake up and go to sleep. This is based on the amount of light in our given environment. When the sun rises we wake up, and when it’s dark, our body is ready to go to sleep. However, after a thorough analysis of sleep patterns, researchers at Brigham and Women’s Hospital found that a disruption of these rhythms affects the academic performance of students.
Factoring in Irregular Sleep
For this study, the Brigham and Women’s Hospital gathered 61 full-time undergraduates from Harvard College. The participants used sleep diaries to record their activities. The main factors the team was looking for include the following:
- Sleep Regularity
- Sleep Duration
- Quality of Sleep
- Sleep-Wake Times
- Academic Performance
“Our results indicate that going to sleep and waking up at approximately the same time is as important as the number of hours one sleeps,” stated Andrew J. K. Phillips, Ph.D., biophysicist at the Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and lead author on the paper. “Sleep regularity is a potentially important and modifiable factor independent from sleep duration,” Phillips said.
“We found that the body clock was shifted nearly three hours later in students with irregular schedules as compared to those who slept at more consistent times each night, stated Charles A. Czeisler, Ph.D., MD, Director of the Sleep Health Institute at Brigham and Women’s Hospital, and senior author on the paper.
“For the students whose sleep and wake times were inconsistent, classes and exams that were scheduled for 9 a.m. were, therefore, occurring at 6 am according to their body clock, at a time when performance is impaired. Ironically, they didn’t save any time because, in the end, they slept just as much as those on a more regular schedule,” continued Czeisler.
Too many changes to the circadian clock can disrupt the body. The process takes some time to adjust to the new schedule of students. As a reaction, the melatonin that your body needs to wake releases much later.
“Regular sleepers got significantly higher light levels during the daytime, and significantly lower light levels at night than irregular sleepers who slept more during daytime hours and less during nighttime hours.”
Researchers suggest that fixing irregular sleep requires that students are exposed to more natural light and avoid using electronic devices at night. They should also stick to a better schedule for when to go to bed and wake up.
One of the most difficult aspects of the sleep apnea condition is identifying it. This disorder often goes undiagnosed, as no blood test exist to indicate if an individual has sleep apnea. Even worse, apparent symptoms, like snoring or pauses in your breath, only occur during sleep. Unless a person with sleep apnea is being monitored after they go to bed, they are otherwise unaware of their symptoms.
While sleep apnea may seem like a harmless condition but over time it significantly effects the body. Left untreated, sleep apnea leads to an increased risk of high blood pressure, heart attack, stroke, obesity, and diabetes. The disorder can also lead to an increased chance of having work-related or driving accidents. With an early diagnosis, patients can avoid these comorbidities from developing. A new disposable diagnostic patch hopes to make identifying the condition a reality.
Detecting One’s Sleep Apnea Condition
The skin-adhesive diagnostic patch (known as the SomnaPatch) monitors several factors to determine if a patient has a sleep apnea condition. By measuring nasal pressure, blood oxygen saturation, pulse rate, respiratory effort, sleep time and body position, doctors have several variables to work with.
“Our study provided clinical validation of a new wearable device for diagnosing sleep apnea,” said principal investigator Maria Merchant, Ph.D., CEO of Somnarus Inc. “It was most surprising to us how well this inexpensive miniature device performed in comparison with in-lab sleep studies.”
Another impressive aspect of the patch is how accessible it is for patients.174 who subjects participated in the American Academy of Sleep Medicine’s analysis. Using simultaneous polysomnography and patch recorders, they were able to discover signs of the disorder. Afterward, subjects took a home usability study, which determined that 38 of the 39 users successfully used the patch without any issues. Following the instructions, they were able to activate and collect a little more than 4 hours of sleep data.
“Most home sleep diagnostic devices are difficult for patients to use and are disruptive to patient’s sleep,” said Merchant. “Our study showed that this wearable home sleep monitor is very comfortable, easy to use and does not negatively affect sleep.”
Dr. Merchant explains that her team wants to put these positive results to good use. The researchers hope to present the patch and gain approval from the U.S. Food and Drug Administration.
Detecting Sleep Apnea
This technology is still in the process of approval. If you live with a family member or life partner, have them monitor your sleep. They should tell if you are snoring loudly, restless, or wake up unexpectedly during sleep. You should also pay attention to how your body feels during the day. A lack of energy, sleepiness, morning headaches, and other symptoms are telltale signs of the condition.
You should see a doctor immediately if you have any of these symptoms. See an otolaryngologist, who treats conditions that affect the ears, nose, and throat. They can perform certain procedures, like Functional Endoscopic Sinus Surgery and Balloon Sinuplasty, to improve your breathing and help you sleep better at night.
As children, our parents always told to go to sleep early and that getting enough rest is good for the body. We know that sleep is good for the body, but have you ever wondered how? Does better sleep mean better benefits for the body? Well, deep sleep can help with heart health, your immune system, and so much more. One aspect of deep sleep, in particular, helps our learning efficiency. It is possible for this process to be interrupted. In a recent study by researchers at the University of Zurich and the Swiss Federal Institute of Technology, they developed a non-invasive method for affecting deep sleep in humans.
Receiving Better Sleep Is Important
A lack of sleep does more than just make you sluggish and tired throughout the day. The nerve cells in our body, called synapses, remain active as we receive information from the environment around us. Once we go to sleep, those active synapses return to normal. However, if we do not receive proper rest, those nerve cells stay active and new information becomes harder to process. Sleep deprivation and other disorders impede your ability to retain new information. This malfunction in your ability to learn can affect how your mind operates.
How Researchers Manipulated the Brain
“We have developed a method that lets us reduce the sleep depth in a certain part of the brain and therefore prove the causal connection between deep sleep and learning efficiency,” says Reto Huber professor at the University Children’s Hospital Zurich and of Child and Adolescent Psychiatry at UZH.
The study tested several subjects, six women, and seven men. Each of the subjects performed tasks that required them to master three different motoric tasks through finger movements. Once each day ended, the subjects went to sleep. During the first night, they were allowed to sleep uninterrupted. However, after the second night, the experiment truly began. Unbeknownst to the patients, the researchers manipulated the motor cortex using acoustic stimulation.
The effect of the manipulation was not apparent at first. During the morning, the subject performed the motoric tasks and finger movements as usual. As the day went on, however, the subjects made more and more mistakes. This is a contrast compared to the first day of testing, where the patients performed positively. After receiving better sleep again, the subjects exhibited the same results as the first day.
Nicole Wenderoth, professor in the Department of Health Sciences and Technology at the ETH Zurich, explains that “In the strongly excited region of the brain, learning efficiency was saturated and could no longer be changed, which inhibited the learning of motor skills.”
What We Can Learn From This Study
This study is another example of why sleep health and deep sleep is necessary. Brain disorders could affect sleep the same way the researchers did. Huber explains that “Many diseases manifest in sleep as well, such as epilepsy. Using the new method, we hope to be able to manipulate those specific brain regions that are directly connected with the disease.”
Growing older is always an adjustment as the human body’s needs tend to change. Also, the elderly is more susceptible to debilitating conditions, like wakefulness and the inability to sleep. It doesn’t matter what age you are. Sleep is always necessary. In fact, a recent study at the University of California – Berkeley found that deep sleep can fight off mental and physical ailments, keeping the body effectively younger.
Do Older Adults Need Sleep?
Teenagers and children require more sleep than adults. The CDC even recommends that adolescents should receive 8-10 hours and school-aged children should be getting 9 to 12 hours a night. For adults, 18 and older only, the CDC suggest 7 or more hours of sleep per night. However, that doesn’t mean they don’t need it at all. Sleep is critical for anyone. When you put your sleep health in jeopardy, your body reacts accordingly.
What Happens When You Don’t Receive Enough Deep Sleep?
According to the researchers at UC Berkeley, quality sleep is important for the elderly. The scientists linked Alzheimer’s disease, heart disease, obesity, diabetes and stroke in the elderly to a lack of sleep.
“Nearly every disease killing us in later life has a causal link to lack of sleep,” said the article’s senior author, Matthew Walker, a UC Berkeley professor of psychology and neuroscience. “We’ve done a good job of extending life span, but a poor job of extending our health span. We now see sleep, and improving sleep, as a new pathway for helping remedy that.”
Other studies show that poor sleep can cause older adults cognitive functions to weaken. Furthermore, adults start to experience inadequate sleep around their 30s. By the time these people age, their lack of sleep will affect their health more and more.
Why Natural Sleep Is Important
Modern medicine has come far, but it cannot replace natural sleep. The researchers at UC Berkeley state that pills used to aid sleep do not provide the same benefits as regular deep sleep. The brain needs deep sleep to replenish most of its functions.
It is hard for older adults to sleep naturally because of a change in their brain chemistry. The brain doesn’t produce the necessary waves that promote deep curative sleep. Also, the elderly receives less of the neurochemicals that grant us the ability to switch from sleep to wakefulness effectively.
“The parts of the brain deteriorating earliest are the same regions that give us deep sleep,” said article lead author Mander, a postdoctoral researcher in Walker’s Sleep and Neuroimaging Laboratory at UC Berkeley.
“The American College of Physicians has acknowledged that sleeping pills should not be the first-line kneejerk response to sleep problems,” Walker said. “Sleeping pills sedate the brain, rather than help it sleep naturally. We must find better treatments for restoring healthy sleep in older adults, and that is now one of our dedicated research missions.”
Hopefully, the researchers and doctors looking into sleep can find a way to improve the quality sleep health in older adults. This research will help prevent cognitive issues and prevent developing diseases in the future.
There are several key signs of sleep apnea that you should look for in your child. For example, snoring may seem like a common occurrence, but it is usually a sign of something obstructing the airways. You may also want to look out for recurring daytime sleepiness. Untreated sleep apnea can cause your child’s health to deteriorate over time. In fact, scientists have found that the disorder has the potential to harm a child’s brain cells if left unchecked.
Untreated Sleep Apnea and Developing Conditions
Conditions that affect your breathing often seem like a minor inconvenience rather than a pressing matter. However, the truth is that sleep disorders affect you over an extended period of time. The longer you wait to treat the problem, the worse your symptoms become. The disorder can even develop into chronic diseases. Some researchers have even associated untreated sleep apnea with diseases like diabetes, cardiovascular disease, obesity, and depression.
Brain Cells Affecting Mood and Cognition
At the University of Chicago Medical Center, scientists performed a study examining the sleep and brain patterns of children with and without severe sleep apnea, both ages 7 to 11 years old. The children stayed overnight at the university’s pediatric sleep laboratory while undergoing neuro-cognitive testing and MRI scans.
What they found was a significant difference between the two groups of kids. Those with moderate to severe sleep apnea had reductions in grey matter, a major part of the central nervous system. The children who slept with trouble showed no signs of reduced brain activity.
“The images of gray matter changes are striking,” said one of the study’s senior authors, Leila Kheirandish-Gozal, MD, director of pediatric clinical sleep research at the University of Chicago. “We do not yet have a precise guide to correlate loss of gray matter with specific cognitive deficits, but there is clear evidence of widespread neuronal damage or loss compared to the general population.”
Grey matter is brain cells that aid in a variety of essential functions. These functions include the brain’s ability to control movement, memory, emotions, speech, perception, decision-making and self-control. Grey matter is found in several regions of the brain including the frontal, prefrontal, and parietal cortices, as well as the temporal lobe and the brain stem.
Are Their Consequences to Lost Grey Matter
“MRI scans give us a bird’s eye view of the apnea-related difference in volume of various parts of the brain, but they don’t tell us, at the cellular level, what happened to the affected neurons or when,” said co-author David Gozal, MD, professor of pediatrics, University of Chicago. “The scans don’t have the resolution to determine whether brain cells have shrunk or been lost completely,” he added. “We can’t tell exactly when the damage occurred. But previous studies from our group showed that we can connect the severity of the disease with the extent of the cognitive deficits when such deficits are detectable.”
This study brings up a lot of questions. The scientists hope that more advanced brain scanning methods can help them measure if the lost grey matter has any effect on children. Future will determine definitive answers.