Sleep

Past research suggests that poor sleep during adolescence can have “lasting consequences” on the brain. Now a new study offers additional insights into the negative health effects of sleep deprivation on teens’ health.

In the study, researchers analyzed data collected from more than 10,000 adolescents as part of the National Comorbidity Survey Adolescent Supplement. As MedPage Today reports, their findings show that prolonged fatigue is associated with mood and anxiety disorders among teens:

In a nationally representative sample of adolescents ages 13 to 18, 3% reported having extreme fatigue lasting at least 3 months and about half of those who did also had mood or anxiety disorders, according to Kathleen Merikangas, PhD, of the National Institute of Mental Health in Bethesda, Md., and colleagues.

Having both prolonged fatigue and a mood or anxiety disorder was associated with poorer physical and mental health and greater use of healthcare services compared with having only one of the disorders, the researchers reported online in the American Journal of Psychiatry.

“This suggests that the presence of fatigue may be used in clinical practice as an indicator of a more severe depressive or anxiety disorder,” Merikangas and colleagues wrote.

Stanford physician Michelle Primeau, MD, recently explored the topic of how teen sleep habits affect mood in a recent Stanford Center for Sleep Sciences and Medicine blog entry on the Huffington Post. In her post, she explains why teens in particular are at risk of chronic partial sleep deprivation:

Teenagers need to sleep about nine hours, and as they get older, they tend to sleep less. This is not because they need less, but because they are busier with school, jobs, extracurricular activities, and friends. Their biology also will often shift so that they tend to fall asleep later and want to sleep in later, an occurrence that may represent delayed sleep phase syndrome. This may explains why your teenager is so hard to wake up on Saturdays. But this shift to a later bedtime, both of social and biologic causes, in combination with fixed early school times, means that many teenagers are walking around sleep deprived.

Previously: Can sleep help prevent sports injuries in teens?, Study shows link between lack of sleep and obesity in teen boys, Study shows lack of sleep during adolescence may have “lasting consequences” on the brain, Teens and sleep: A Q&A, Sleep deprivation may increase young adults’ risk of mental distress, obesity, Districts pushing back bells for the sake of teens’ sleep and Lack of sleep may be harmful to a teen’s well-being
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Chronic sleep problems affect an estimated 70 million Americans, according to the latest data from the Centers for Disease Control and Prevention. Among those who have trouble sleeping soundly is KQED reporter Scott Shafer, so he recently spent the night at the Stanford Sleep Medicine Center to better understand what was keeping him from resting easy.

Shafer describes his experience staying overnight at the clinic and analyzing his sleep results with Stanford’s Rafael Pelayo, MD, in a new segment on the California Report. In describing what it’s like to snooze at a sleep clinic, he says:

It was time to get ready for bed, no small thing at the Sleep Medicine Center. I went to my room — called simply Sleep 18. Technician Robert Tognoli hooked me up with 28 wires in all — attached to my legs, my head, my abdomen - all of it designed to sense and measure my breathing, eye motions, blood oxygen, snoring, leg and chest movements.

Tognoli told me the wires would monitor the phases of my sleep, when I dreamed and if there were any “interruptions to my sleep architecture,” as shown by my brain waves. Then he stuck all the wires into a box that he hung around my neck. Next, he turned on a machine that blew air to dry the glue holding the wires attached to my head. Finally, I was ready to hit the sack. How did I sleep, and what story did all those wires tell?

Listen to the full segment to find out what Shafer learned from spending a night at the clinic and why it can be tricky to accurately evaluate one’s quality of sleep without having a lot of data.

Previously: Stanford center launches Huffington Post blog on the “very mysterious process” of sleep, Study: Parents may not be as sleep-deprived as they think, Exploring the effect of sleep loss on health and How lack of sleep affects the brain and may increase appetite, weight gain
Photo in featured entry box by Juan Antonio Flores Segal

Yesterday, Emmanuel Mignot, MD, PhD, director of the Stanford Center for Sleep Sciences and Medicine, introduced the Stanford Sleep Blog, which is being published by the Huffington Post. In the inaugural post, Mignot describes the importance of better understanding sleep and the goal for launching this blog:

Sleep is a window to our general health and a very mysterious process that still mystifies scientists today. Almost a quarter of the population has sleep issues, and these can affect many organs in our body: the brain, of course, but also the heart and many others. It is truly a trans-disciplinary field. Sleep issues can be trivial (why do we jerk when we fall asleep?), cause enormous suffering (insomnia), or have lethal consequences (falling asleep at the wheel). Finally, too much of what is written on sleep and sleep problems in the press is either not accurate or sensationalized. Sleep problems affect real people, and the information available often washes out the complexities of sleep problems at the individual level.

In the weeks and months to come, various sleep experts from Stanford University will attempt to bridge these gaps here, alternating between the presentations of real sleep medicine cases, with favorable or unfavorable resolution, and scientific discussions on sleep and sleep disorders that will cover general background or news. Our goal will not be simply to inform but also to teach not only what we know but also what we don’t know. We come to this subject with an educated and critical eye.

Mignot goes on to explain Stanford’s rich history of sleep research and describe how the Stanford Center for Sleep Sciences was established to address recent changes in the field. We invite readers to check in on the blog regularly for a deeper understanding of sleep issues.

Previously: Study: Parents may not be as sleep-deprived as they think, Exploring the effect of sleep loss on health, How lack of sleep affects the brain and may increase appetite, weight gain, CDC report highlights the dangers of sleep deprivation and Sleep deprivation may increase young adults’ risk of mental distress, obesity
Photo by Chris March

As an enemy of daylight saving time I am a fan of writer /chronobiologist Bora Zivkovic’s lucid denunciation of this outmoded practice. In a new article crossposted by Scientific American and Zócalo Public Square, he spells out the madness of shifting clocks forward an hour at the start of spring (and shifting back an hour in the fall). The piece points out that daylight saving time no longer serves its original purpose - to save energy used for lights. And more concerning, it explains that the clock shift leads to increased incidence of injuries and illness. He explains:

Chronobiologists who study circadian rhythms know that for several days after the spring-forward clock resetting – and especially that first Monday – traffic accidents increase, workplace injuries go up and, perhaps most telling, incidences of heart attacks rise sharply. Cases of depression also go up.

For more details on why the rest of the world should join Russia and Belarus, both of which stopped switching the clock forward and back in 2011, give it a read. You’ll also pick up some interesting facts: Cells in our eyes adjust to the shift in about a day, while cells in our digestive systems can take weeks.

Photo by Slideshow Bruce

The cause of some of my sleep-deprived nights.

New research out of the University of Madison-Wisconsin may fall on deaf ears – specifically parents’ ears. The study, published in American Journal of Epidemiology, has found that the amount of sleep deprivation that parents experience is actually quite minimal.

Say what?! Have the researchers seen the dark circles under my eyes or scanned the Facebook updates of my mom friends, who constantly complain about how tired and sleep-deprived they are? I guess not. But, as described on Today.com:

Researchers relied on data collected between 1989 and 2008 by the Wisconsin Sleep Cohort Study, where participants tracked how much they slept, how sleepy the were during the day and the amount they dozed. Then, to arrive at their findings, they factored in which participants had kids and how many they had.

Here’s what they found: Each child under age 2 years was associated with 13 fewer minutes of parental sleep per 24-hour period. For kids ages 2 to 5, parents had nine fewer minutes of sleep. And each child ages 6 to 18 years was associated with four fewer minutes of sleep.

“In general, parents with younger children reported shorter average sleep durations, and for parents with multiple children, each child contributed to reductions in sleep duration,” said study author Paul Peppard, assistant professor in the University of Wisconsin’s Department of Population Health Sciences.

As a mom to two little girls, the finding that more kids means more sleep loss is something I can relate to. But only 21 fewer minutes of sleep (9 minutes because of my 2.5 year old and 13 minutes because of my 11-month-old)?? I respectfully beg to differ.

Previously: Exploring the effect of sleep loss on health
Photo by Margarita Gallardo

Past data from the Centers for Disease Control and Prevention shows that 30 percent of American workers don’t get enough sleep, increasing their risk of stoke, obesity and other chronic diseases. Recognizing that there are times when it’s not possible to get the recommended seven to nine hours of shut-eye each night, such as those experienced by soldiers in combat or parents with a newborn, a group of researchers are developing new technology that could allow us to pack a good night’s sleep into a few hours.

As a recent New Scientist story (registration required) explains, this next generation of sleep devices could aid the sleep deprived, help in treating mental-health conditions and even potenially extend our lifespan. Writer Jessa Gamble describes one prototype funded by the U.S. Defense Advanced Research Projects Agency and being developed at Carlsbad, Calif.-based Advanced Brain Monitoring:

[Researchers] designed a device they call the Somneo mask, a thick, padded band that covers the cheeks, ears and much of the head. It carries a heating element around the eyes, piggybacking on research that shows facial warming sends people to sleep. In so doing, the mask fast-tracks the wearer through the stage 1 on-ramp, which seemingly has few inherent benefits, to enter stage 2 more quickly - albeit by only 2 minutes. “This might not sound like much, but it’s the same reduction we see with hypnotic drugs,” says [Chris Berka, CEO of Advanced Brain Monitoring] such as zolpidem, which is used to treat insomnia.

More importantly, the mask’s built-in EEG monitors any changes in sleep stage. Program it to allow you exactly 20 minutes of sleep, and it will start counting only when it detects actual sleep. Don’t want to wake up groggy? If you are approaching stage 3 but don’t have time for a full sleep cycle, the mask will trip an alarm. Not just any alarm: the mask contains a blue light that gradually brightens, suppressing the sleep hormone melatonin to help you hit the ground running.

…

Researchers are just beginning to find evidence of complicated connections between sleep and, for example, mental health and ageing. “People with depression have sleep patterns that look nothing like the cycles of healthy sleepers,” says Berka. They spend more time in REM and stage 1 sleep during an average night. Use [transcranial direct current stimulation] to nudge them into a healthy pattern, she says, and it might be possible to ameliorate the symptoms.

The device won’t be in bedrooms anytime soon, but we can still dream of a day when technology give us a fast track to a blissful rest.

Previously: Study estimates Americans’ insomnia costs nation $63 billion annually, Stanford sleep expert offers evaluation of science behind one sleep device, CDC report highlights the dangers of sleep deprivation and Sleep deprivation more common in the U.S. than Europe
Photo by Francisco de Souza junior

Every two weeks, I call my 99-year-old grandmother in Taiwan on Skype. And every time she repeats the same message before we sign off: “Eat well, sleep well, don’t work too hard.” This is exactly what she used to say to me when I was a child growing up in Taipei. Now, fifty years later and halfway around the world, she repeats the same advice to me as if I were still a little girl.

As much as I respected her, for most of my adult life I considered my grandma’s words a well-intentioned old wives’ tale. I am a woman of science, after all - a molecular epidemiologist who has devoted her life to cutting-edge cancer research. I believe in data, not proverbs.

Of course, it turns out that Grandma was right. I am now aware of abundant data suggesting that eating and sleeping well boost our immune function, minimize harmful inflammatory conditions and regulate hormonal metabolism, thereby lowering our risk for cancer.

Epidemiological studies suggest that consuming whole grains (containing fiber and vitamins), fruits and vegetables (antioxidants, fiber, and specific compounds such as sulforaphane in cruciferous vegetables), tomatoes (lycopene), allium vegetables such as garlic and chives, tofu (isoflavones) and fish (the omega-3-containing varieties) reduces the risk of cancer. Research also suggests that eating foods high in certain chemicals, such as heterocyclic amines found in some grilled foods, increases the risk of cancer.

Although we are still learning about the specific biological mechanisms underlying these epidemiologic findings, ongoing studies, including those at the Stanford Cancer Institute and the affiliated Cancer Prevention Institute of California (CPIC), are revealing the molecular relationships between dietary components and cancer risk.

The value of getting to sleep early (before 11 p.m.) and sleeping well long escaped the attention of scientists. I first became interested in sleep as a risk factor for cancer when epidemiologic studies began to show that rotating-shift workers have a higher risk of endocrine-related malignancies, including breast and prostate cancers.

Over the last seven years, my research group has investigated the association of circadian rhythms, including sleep duration, serum melatonin, and 9 circadian core genes, with prostate cancer risk. During the same period, laboratory studies have shown a link between circadian rhythms and inflammation. The numbers of different immune cells (e.g., “T-cells” or natural killer cells) have been shown to peak during different parts of the sleep/wake cycle. We have found evidence that several risk factors that appear to be related to inflammation - including gallstones, obesity, and diet - are risk factors for cancers of the prostate, gallbladder and liver.

While I and other researchers continue our quest to understand the molecular steps involved in carcinogenesis and design the most effective interventions and medicines for cancer prevention, it is clear that we can behave better to reduce our cancer risk - even without knowing the detailed biological pathways - through a sensible lifestyle. My 99-year-old grandmother, who loves broccoli but doesn’t know anything about DNA methylation, is living proof. And her habits reveal a lot: She rises each day at 5 a.m. and is asleep at 11 p.m.; she eats three small meals daily, at exactly the same time; and she has a cup of coffee (containing phenols) every day at 3 p.m. My grandma believes that having healthy habits improves life, and I now have the data suggesting that they decrease cancer risk and improve life expectancy, as well.

Before I ever studied the role of circadian rhythms in cancer, my grandmother knew that sleeping well was good for her health. So I’m looking forward to my next conversation with my grandma. Perhaps if I listen well, I’ll find another pearl of wisdom that leads to my next research project.

Ann Hsing, PhD, MPH, is director of research for the Cancer Prevention Institute of California (CPIC). Part of the Stanford Cancer Institute, the CPIC conducts population-based research to prevent cancer and reduce its burden where it cannot yet be prevented.

Researchers here have shown that sleep may have a positive effect on athletic performance. And new findings presented at the American Academy of Pediatrics’ national conference hint that sleep might provide another sports-related benefit: In a study of young athletes, those who slept at least eight hours a night had a 68 percent lower risk of sports injury.

MedicalNews Today reports on the study:

The researchers asked school athletes - 160 students, 54 males and 58 females, mean age 15 years - from middle and high school, grades 7 to 12, who were part of the Harvard-Westlake School in Studio City, California, to complete a questionnaire which requested details of their sports, how much time they spent in each sport both at school and outside, did they have private coaching, were they involved in any strength training, what their sleeping patterns were, and how much they enjoyed their sport.

The questionnaires were completed by 112 of them. The researchers then analyzed them, specifically looking at sleeping patterns, and checked the school records for sports injuries.

They found that the more sleep the pupils got, the lower their risk of injury seemed to be.

The work relies on self-reports, which yield data that may be less accurate than if the scientists had gathered the information themselves. However, the finding are intriguing and worth exploring further. As author Matthew Milewski, MD, commented, “nobody has really looked at [lack of sleep] in terms of the adolescent athletic population” before.

Previously: A slam dunk for sleep: Study shows benefits of slumber on athletic performance, Could game time affect a baseball player’s at-bat success?, Want to be like Mike? Take a nap on game day, Sleep deprivation may increase young adults’ risk of mental distress, obesity and Lack of sleep may be harmful to a teen’s well-being
Photo by K.M. Klemencic

Due to yesterday’s Nobel win, my colleagues and I woke up, and began working, at 3 AM - and I was reminded of how difficult it is to function after getting such a small amount (four hours, in this case) of sleep. My sleep deprivation, thankfully, was a temporary thing – but chronic sleep loss is something that millions of Americans deal with on a regular basis. And, as Stephanie Lee highlights in a recent San Francisco Chronicle story, its effect on health is something that researchers are busy studying:

Over the past five or so years, scientists have begun to make inroads into understanding the way poor or little sleep wreaks havoc on the immune system.

“We’re at the beginning stage,” said Clete Kushida, medical director of Stanford University’s Sleep Disorders Clinic. “There are a number of studies that indicate that sleep can affect immune functions in terms of the amount of sleep, as well as the degree of sleep deprivation.”

Their research shines a light on an exhausting and common lifestyle. Nearly one-third of U.S. workers - 41 million people - get less sleep than the recommended seven to nine hours of sleep a day, the Centers for Disease Control and Prevention reported this spring.

The health consequences can be significant. Sleeping fewer than six hours a night can weaken the effectiveness of vaccinations, an August study found, while other studies have shown that sleep loss changes the body’s bacteria-fighting mechanisms, sometimes in ways that can actually do harm. These discoveries are opening up avenues of study that scientists hope will lead them to someday understand the precise ways sleep loss causes sickness.

During sleep, even anesthesia–induced sleep, part of the brain appears to continue working to process information and cement memories. That’s according to a study (subscription required) published yesterday in Nature Neuroscience, and the findings, say researchers, could offer new insights into better understanding Alzheimer’s disease.

Health Day reports on the UC Los Angeles research:

For the study, which was performed on mice, the researchers measured the activity of single neurons from three parts of the brain involved in memory formation in order to identify which brain region was activating other areas of the brain and how this activation was spreading.

The investigators discovered that the entorhinal cortex has what is called persistent activity, which is believed to be involved in working memory when people are awake, such as remembering a phone number or following directions.

…

Persistent activity in the entorhinal cortex during sleep may be a way to unclutter memories and delete information that was processed during the day but not needed, which results in important memories becoming prominent and readily accessible, [senior author, Mayank R. Mehta, PhD,] suggested.

The findings are important because people spend one-third of their lives sleeping, and a lack of sleep causes various health problems, including learning and memory problems, Mehta said. The researcher also noted that Alzheimer’s disease starts in the entorhinal cortex and these patients are known to have sleep problems.

Related to this, a previous mouse study done at Stanford showed that fragmented sleep can cause memory impairment.

Previously: Is quietly resting as helpful to your brain as sleeping?, Experts discuss possible link between sleep disorder and dementia and In mice, at least, uninterrupted sleep is critical for memory
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