Category: Health

Published on Friday, 31 May 2013 13:57

Written by Aaliya Imtiaz

A new report shows that the number of emergency department visits involving adverse reactions to the sleep medication zolpidem rose nearly 220% from 6,111 visits in 2005 to 19,487 visits in 2010. The Substance Abuse and Mental Health Services Administration (SAMHSA)report also finds that 2,010 patients aged 45 or older represented about three-quarters of all emergency department visits involving adverse reactions to zolpidem.

In 2010, there were a total of 4,916,328 drug-related visits to emergency departments throughout the nation.

From 2005 to 2010, there was a 274% increase in the number of female visits to the emergency department involving zolpidem (from 3,527 visits in 2005 to 13,130 in 2010) in comparison to a 144% increase among males during the same period (2,584 visits in 2005 to 6,306 in 2010). In 2010, females accounted for more than two-thirds (68%) of all emergency department visits related to zolpidem.

Zolpidem is an FDA-approved medication used for the short-term treatment of insomnia and is the active ingredient in drugs such as Ambien, Ambien CR, Edluar, and Zolpimist. These drugs have been used safely and effectively by millions of Americans; however, in January 2013, FDA responded to increasing numbers of reports of adverse reactions by requiring manufacturers of drugs containing Zolpidem to halve the recommended dose for females. FDA also suggested that manufacturers reduce the recommended dose for men.

Adverse reactions associated with the medication include daytime drowsiness, dizziness, hallucinations, agitation, sleep-walking, and drowsiness while driving. When zolpidem is combined with other substances, the sedative effects of the drug can be dangerously enhanced. This is especially true when zolpidem is combined with certain anti-anxiety medications and narcotic pain relievers that depress the central nervous system. The report finds that in 2010 half of all emergency department visits related to zolpidem involved its use with other drugs. In 37% of all emergency department visits involving zolpidem, it was used in combination with drugs that depress the central nervous system.

A new study conducted by monitoring the brain waves of sleeping adolescents has found that changes occur in the brain as it prunes away neuronal connections and makes the major transition from childhood to adulthood.

“We’ve provided the first long-term, longitudinal description of developmental changes that take place in the brains of youngsters as they sleep,” said Irwin Feinberg, professor emeritus of psychiatry and behavioral sciences and director of the UC Davis Sleep Laboratory. “Our outcome confirms that the brain goes through a remarkable amount of reorganization during puberty that is necessary for complex thinking.”

The research, published in the February 15 issue of the American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, also confirms that electroencephalography, or EEG, is a powerful tool for tracking brain changes during different phases of life, and that it could potentially be used to help diagnose age-related mental illnesses.

For the current study, Feinberg and his research team monitored 28 healthy, sleeping children between the ages of 6 and 10 for two nights every six months. The new findings show that synaptic density in the cerebral cortex reaches its peak at age 8 and then begins a slow decline. The recent findings also confirm that the period of greatest and most accelerated decline occurs between the ages of 12 and 16-1/2 years, at which point the drop markedly slows.

“Discovering that such extensive neuronal remodeling occurs within this 4-1/2 year timeframe during late [childhood] and the early teen years confirms our view that the sleep EEG indexes a crucial aspect of the timing of brain development,” said Feinberg.

Alcohol’s Effect on Nighttime Breathing

In general, alcohol is a substance that may have significant impacts on your health. You may not have realized that it may also affect your sleep, especially if you have sleep-disordered breathing, such as sleep apnea.

Alcohol can decrease your drive to breathe, slowing your breathing and making your breaths shallow. In addition, it may relax the muscles of your throat, which may make it more likely for your upper airway to collapse.

The Consequences of Alcohol in Sleep Apnea

As the result of alcohol use, apnea events occur more frequently in someone who is predisposed to them. In addition, the drops in the oxygen levels of the blood (called desaturations) become more severe. This may lead to increased carbon dioxide levels in the body, a condition called hypercapnia. Therefore, the consequences of sleep apnea may become more pronounced with alcohol use.

If You Have Sleep Apnea, Should You Avoid Alcohol?

If you have sleep apnea, the best advice would be to abstain from all alcohol use. At the very least, alcohol should not be used in the several hours prior to bedtime to minimize the effects overnight.

You should also keep in mind that it is important to set up your continuous positive airway pressure (CPAP) under typical sleeping conditions. Therefore, if you drink alcohol daily but abstain prior to your titration study, the pressure may not be adequate to maintain your airway when you drink. If you wish to maximize your therapy, consider the role that alcohol use plays in treating your sleep apnea.

Eat to Dream: Study Shows Dietary Nutrients Associated with Certain Sleep Patterns

First Nationally-Representative Analysis Reveals People Who Eat a Varied Diet Have Healthier Sleep Duration

Newswise — PHILADELPHIA — “You are what you eat,” the saying goes, but is what you eat playing a role in how much you sleep? Sleep, like nutrition and physical activity, is a critical determinant of health and well-being. With the increasing prevalence of obesity and its consequences, sleep researchers have begun to explore the factors that predispose individuals to weight gain and ultimately obesity. Now, a new study from the Perelman School of Medicine at the University of Pennsylvania shows for the first time that certain nutrients may play an underlying role in short and long sleep duration and that people who report eating a large variety of foods – an indicator of an overall healthy diet – had the healthiest sleep patterns. The new research is published online, ahead-of-print in the journal Appetite.

“Although many of us inherently recognize that there is a relationship between what we eat and how we sleep, there have been very few scientific studies that have explored this connection, especially in a real-world situation,” saidMichael A. Grandner, PhD, instructor in Psychiatry and member of the Center for Sleep and Circadian Neurobiology at Penn. “ In general, we know that those who report between 7 – 8 hours of sleep each night are most likely to experience better overall health and well being, so we simply asked the question “Are there differences in the diet of those who report shorter sleep, longer sleep, or standard sleep patterns?”

To answer this question, the research team analyzed data from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) sponsored by the Centers for Disease Control and Prevention. NHANES includes demographic, socioeconomic, dietary, and health-related questions. The sample for the survey is selected to represent the U.S. population of all ages and demographics. For the current study, researchers used the survey question regarding how much sleep each participant reported getting each night to separate the sample into groups of different sleep patterns. Sleep patterns were broken out as “Very Short’’ (<5 h per night), ‘‘Short’’ (5–6 h per night), ‘‘Standard’ (7–8h per night), and ‘‘Long’’ (9 h or more per night). NHANES participants also sat down with specially trained staff who went over, in great detail, a full day’s dietary intake. This included everything from the occasional glass of water to complete, detailed records of every part of each meal. With this data, the Penn research team analyzed whether each group differed from the 7-8 hour “standard” group on any nutrients and total caloric intake. They also looked at these associations after controlling for overall diet, demographics, socioeconomics, physical activity, obesity, and other factors that could have explained this relationship.

The authors found that total caloric intake varied across groups. Short sleepers consumed the most calories, followed by normal sleepers, followed by very short sleepers, followed by long sleepers. Food variety was highest in normal sleepers, and lowest in very short sleepers. Differences across groups were found for many types of nutrients, including proteins, carbohydrates, vitamins and minerals.

In a statistical analysis, the research team found that there were a number of dietary differences, but these were largely driven by a few key nutrients. They found that very short sleep was associated with less intake of tap water, lycopene (found in red- and orange-colored foods), and total carbohydrates, short sleep was associated with less vitamin C, tap water, selenium (found in nuts, meat and shellfish), and more lutein/zeaxanthin (found in green, leafy vegetables), and long sleep was associated with less intake of theobromine (found in chocolate and tea), dodecanoic acid (a saturated fat) choline (found in eggs and fatty meats), total carbohydrates, and more alcohol.

“Overall, people who sleep 7 – 8 hours each night differ in terms of their diet, compared to people who sleep less or more. We also found that short and long sleep are associated with lower food variety,” said Dr. Grandner. “What we still don’t know is if people altered their diets, would they be able to change their overall sleep pattern? This will be an important area to explore going forward as we know that short sleep duration is associated with weight gain and obesity, diabetes, and cardiovascular disease. Likewise, we know that people who sleep too long also experience negative health consequences. If we can pinpoint the ideal mix of nutrients and calories to promote healthy sleep, the healthcare community has the potential to make a major dent in obesity and other cardiometabolic risk factors.”

Other authors for Penn include Nicholas J. Jackson and Jason R. Gerstner, PhD.
This research was supported grants from National Institutes of Health (T32HL007713, 12SDG9180007 and P30HL101859)

By Elizabeth Foster

Losing a few hours of sleep a night can lead to weight gain, a new study has shown, and effects can be seen after just a week

Sleep is disrupted in people who likely have early Alzheimer’s disease but do not yet have the memory loss or other cognitive problems characteristic of full-blown disease, researchers at Washington University School of Medicine in St. Louis report March 11 in JAMA Neurology.

The finding confirms earlier observations by some of the same researchers. Those studies showed a link in mice between sleep loss and brain plaques, a hallmark of Alzheimer’s disease. Early evidence tentatively suggests the connection may work in both directions: Alzheimer’s plaques disrupt sleep, and lack of sleep promotes Alzheimer’s plaques.

“This link may provide us with an easily detectable sign of Alzheimer’s pathology,” says senior author David M. Holtzman, MD, the Andrew B. and Gretchen P. Jones Professor and head of Washington University’s Department of Neurology. “As we start to treat people who have markers of early Alzheimer’s, changes in sleep in response to treatments may serve as an indicator of whether the new treatments are succeeding.”

Sleep problems are common in people who have symptomatic Alzheimer’s disease, but scientists recently have begun to suspect that they also may be an indicator of early disease. The new paper is among the first to connect early Alzheimer’s disease and sleep disruption in humans.

For the new study, researchers recruited 145 volunteers from the University’s Charles F. and Joanne Knight Alzheimer’s Disease Research Center. All of the volunteers were 45 to 75 years old and cognitively normal when they enrolled.

As a part of other research at the center, scientists already had analyzed samples of the volunteers’ spinal fluids for markers of Alzheimer’s disease. The samples showed that 32 participants had preclinical Alzheimer’s disease, meaning they were likely to have amyloid plaques present in their brains but were not yet cognitively impaired.

Participants kept daily sleep diaries for two weeks, noting the time they went to bed and got up, the number of naps taken on the previous day, and other sleep-related information.

The researchers tracked the participants’ activity levels using sensors worn on the wrist that detected the wearer’s movements.

“Most people don’t move when they’re asleep, and we developed a way to use the data we collected as a marker for whether a person was asleep or awake,” says first author Yo-El Ju, MD, assistant professor of neurology. “This let us assess sleep efficiency, which is a measure of how much time in bed is spent asleep.”

Participants who had preclinical Alzheimer’s disease had poorer sleep efficiency (80.4 percent) than people without markers of Alzheimer’s (83.7 percent). On average, those with preclinical disease were in bed as long as other participants, but they spent less time asleep. They also napped more often.

“When we looked specifically at the worst sleepers, those with a sleep efficiency lower than 75 percent, they were more than five times more likely to have preclinical Alzheimer’s disease than good sleepers,” Ju says.

Ju and her colleagues are following up with studies in younger participants who have sleep disorders.

“We think this may help us get a better feel for the way this connection flows — does sleep loss drive Alzheimer’s, does Alzheimer’s lead to sleep loss, or is it a combination?” Ju says. “That will help us determine whether we can change the course of disease with pharmaceuticals or other treatments.”

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This study was funded by an Ellison Medical Foundation Senior Scholar award and NIH grant P01NS074969 from the National Institute of Neurological Disorders and Stroke.

Ju Y-E S, McLeland JS, Toedebusch CD, Xiong C, Fagan AM, Duntley SP, Morris JC, Holtzman DM. Sleep quality and preclinical Alzheimer disease. JAMA Neurology, online March 11.  National Sleep Foundation

Now we dream! In “rapid-eye movement” sleep, the eyes are active and the brain is more so.  Faster brain waves return as if we’re awake.  Our limbs become temporarily paralyzed so we don’t act out our dreams.  Newborns spend half their sleep time in REM sleep, elderly adults only spend 15 percent in this stage of sleep.

Hormones are released, triggering functions such as restoring energy, repairing tissues, regulating appetite and strengthening the immune system.  If you walk or talk in your sleep, you’ll probably do it during Stage 3.