An exploration of sleep and insomnia, with a single destination in mind:
a good night's sleep.

Saturday, February 27, 2016

Morning Haze: Why It's Time to Stop Hitting the Snooze button

By Gemma Paech

It’s 6.30am and after a long holiday break, your alarm clock is insistently telling you it’s time to get out of bed. For many people – me included – the automatic reaction is to hit the snooze button, often more than once.

But while it might feel like those extra minutes leave you more rested, morning snoozes can leave you feeling groggier and less alert. And late.

Sleep regulation

Photo by John Christian Fjellestad. Licensed under
Creative Commons. 
Sleep is regulated by two mechanisms: a homeostatic process based on prior sleep and wake, and a circadian process commonly referred to as our 24-hour body clock. These processes work together to influence when we go to sleep and get up, and sleep structure during the night.

Throughout the night, sleep cycles between deep sleep and light sleep, with each cycle lasting approximately 90 to 100 minutes. Deep sleep – which is difficult to wake from – dominates in the early parts of sleep, while light sleep – which is easier to be woken from – is more common closer to natural waking.

Each time we fall asleep, sleep starts at the beginning of the cycle.

You snooze, you lose

Shortly before waking, our sleep becomes lighter, our core body temperature rises and levels of hormones such as cortisol increase. If we were to sleep naturally without that pesky alarm clock, these factors would allow our bodies to gradually prepare for waking.

When we use an alarm clock, we may be woken during the middle of a sleep cycle when our bodies have not had time to fully prepare us for waking. This may lead to an increase in sleep inertia, the groggy feeling you have immediately upon waking, and often the inevitable snoozing cycle.

So when you hit snooze and fall back asleep, your sleep cycle starts from the beginning. Except this time when your alarm goes off, if you’re in a deeper stage of sleep, it’s a lot harder to wake up. The end result is that the last proportion of your sleep becomes highly fragmented. This means you miss out on the recovery benefits of consolidated sleep, and your ability to function effectively during the rest of the day may be impaired.

Why do some people love to snooze?

While the ability to resist hitting the snooze button may just come down to self-control, there are two biological reasons why some of us are more inclined to do so.

The first relates to diurnal preferences. People who are morning birds generally find it easier to wake up unaided while us night owls find it a lot harder.

The circadian rhythm of early birds allows them to fall asleep earlier and therefore they’re more likely to complete their natural sleep cycle by the time the alarm goes off in the morning.
Night owls prefer to stay awake for longer at night and sleep later into the morning, making it difficult to get up in the morning and often resulting in a truncated sleep.

The desire to hit snooze may also relate to whether you’re suffering from sleep loss. When you’re sleep-deprived, you require longer, deeper sleep periods. There is a greater chance of being woken during a deeper stage of sleep, and therefore want to snooze, when you’re sleep-deprived.

How to resist the urge

The best way to keep your hand off the snooze button is to have a regular sleep schedule every day of the week. Set a bedtime and wake time and keep to it, even on weekends. After a while your body will naturally adapt to this schedule and it will be easier to wake up in the morning.

If your boss or job allows it, flexible working hours can allow you to sleep according to your natural circadian preference. For many people this is not possible, and so you may need to shift your body clock. The easiest way to do this is to get natural sunlight during the daytime and to reduce light exposure at night.

Other lifestyle factors can also help you sleep better and wake more refreshed. Regular exercise and a healthy diet along with natural morning light exposure can improve sleep.

Minimising your alcohol and caffeine intake can also help consolidate your sleep period and make waking easier. So if your New Year’s resolution is to adopt a healthier lifestyle, you might see your sleep patterns improve too.

The Conversation
Gemma Paech, Postdoctoral research fellow, Sleep and Performance Research Center, Washington State University
This article was originally published on The Conversation. Read the original article.

Saturday, January 30, 2016

How a Week of Camping Resets the Body Clock

By Hannah Valmadre

One week of camping outdoors and eschewing all man-made light is enough to reset a person’s body clock to its natural sleep rhythms, a new study has found.

Our increased use of electrical light, and reduced exposure to natural light, caused modern humans to stray from our natural circadian rhythms or sleep patterns, and may be a contributor to poor quality sleep.

The findings, published in Current Biology, show that humans' internal biological clocks will synchronise to a natural, midsummer light-dark cycle if the opportunity arises. A midsummer light-dark cycle in Colorado, in the US where the study took place, is 14 hours and 40 minutes of light, 9 hours and 20 minutes of darkness in a 24 hour period.

Relying on electrical light after sunset contributes to late sleep schedules, which disturbs natural circadian rhythms and can leave us feeling not well rested.

The new study, conducted by Dr. Kenneth Wright and colleagues from the University of Colorado in the US, found that increased exposure to sunlight, as opposed to largely relying on electric light, shifted the internal clock earlier, which could help reduce the “physiological, cognitive and health consequences of circadian disruption.”

The study ran for two weeks, and included eight participants (six men, two women) who had a mean age of 30.3 years. For the first week, participants were encouraged to perform their daily routines of work, school, social activities and self-selected sleep schedules. For the second week, participants camped in tents outdoors with only natural light and campfires. Torches or personal electronic devices were banned. The participants' internal circadian timing was recorded and compared for both weeks of the experiment. The study was conducted in the Rocky Mountains, Colorado, in July.

Easier to wake

After a week of exposure to only natural light, our internal circadian clocks align with solar time, the study found. In other words, our internal biological night begins at sunset, and ends when we wake just after sunrise.

“After exposure to natural light, we found the timing of the circadian clock to be approximately two hours earlier and [sleep-promoting hormone] melatonin offset to occur more than 50 minutes prior to wake time, suggesting that if human circadian and sleep timing was in synchrony with the natural light-dark cycle, the circadian low point in brain arousal would move to before the end of the sleep episode, making it easier to awaken in the morning,” the researchers found.

Researchers also found that the participants' average light exposure increased more than four times during the week of only natural light.

Dr Nicole Lovato, a sleep expert and Postdoctoral Research Fellow at Flinders University, described the research as “a novel approach to research aimed understanding the basic physiological processes which govern our daily lives.”

“It confirms existing knowledge regarding the effect of light exposure on the circadian rhythm, or body clock, and its timing in humans,” said Dr Lovato, who was not involved in the study.

Restful camping

Dr Leon Lack, another sleep expert from Flinders University said the new study “confirms many anecdotal reports from patients who suffer from delayed sleep periods that the only time when they could get to sleep early and wake up early was while camping during the summer.”

The study “suggests that controlling light exposure (decreasing evening light levels, or filtering out the shorter wavelengths such as blue and green) and increasing morning light exposure would be sufficient to treat delayed sleep problems. This is a fairly common problem in adolescents and young adults,” said Dr Lack, who was also not involved in the study.

An outdoor lighting regime could temporarily correct the problems of delayed sleep phase, but it is likely these changes would be gradually lost, he said.

“This is likely to be due to those with delayed sleep phase disorder having longer period lengths of their circadian rhythms (24.8 hours instead of 24.3 hours). These people have a stronger tendency to delay with respect to our 24 hour world because their body clock ticks over more slowly.”

The Conversation
Hannah Valmadre, Editor, The Conversation
This article was originally published on The Conversation. Read the original article.

Thursday, January 14, 2016

Are You a Midnight Clock Watcher?

by Bill Adler

Is it better to look at the clock when you wake up in the middle of the night or not know what time it is?

Photo by Rob and Stephanie Levy.
 Licensed under Creative Commons.
There are two diametrically opposed views on this subject. One group of sleepers must know what time it is. When these people wake up before their alarm signals morning, they have to look at their clock. Not knowing the time causes anxiety, which breeds more insomnia: Is it 6:25 AM? Do I have only 25 more minutes to slumber? Or is it 3:35 AM and I have nearly 3-1/2 hour of blissful coma remaining? There's a world of difference between waking up just a little before your alarm versus in the dead of night. Have I slept through my alarm? Some people have to know, because without that information the stress center of their brain goes into overdrive.

For others, ignorance is indeed bliss. Even a quick glance at the clock destroys the illusion of sleep. "It's 5 AM in the real world" summons the real world, which kills sleep. For people who don't want to look at the clock, it's important to maintain the illusion of sleep when they wake up. If you realize that you have 4 hours left, you might be happy. But if you see only one hour remaining, despair becomes your sleeping partner.

Which is better? To look at the clock or not? There's no scientific evidence that either is better. (There is a some anecdotal evidence that not looking at a clock helps you fall back asleep, but anecdotes are not science.) One blogger who changed from a clock watcher to a non-watcher writes, "It didn’t matter what time I woke up, I could tell myself that by not 'really' knowing the time, I had all the time in the world to sleep. There was no pressure of an impending wake up deadline. I became a happy sleeper."

Looking or not looking is a personal preference, with two but's. First, if you are a middle of the night clock looker, use a clock that doesn't use a blue-LED light, which can reduce your body's ability to produce melatonin, and make it harder to sleep. Second, if you're a midnight clock watcher because you're worried that you might have slept --or will sleep-- through your alarm, set two alarms, or use a wake up service. Worry --any kind of worry-- is a drag on sleep.

As with many sleep solutions, choose what works best for you.

Thursday, January 7, 2016

Talking Turkey About Tryptophan

by Bill Adler

According to the online magazine Life Extension, "The two main biomolecules that are involved in the production of normal sleep—the neurotransmitter serotonin and the hormone melatonin—are both naturally made from tryptophan in the body. That makes tryptophan a tremendously valuable supplement for those whose sleep is lacking in either quantity or quality."

Life Extension isn't alone in extolling the benefits of tryptophan for sleep. The University of Maryland Medical Center reports, "Medical research indicates that taking 1 g L-tryptophan before bedtime can induce sleepiness and delay wake times. Researchers think L-tryptophan brings on sleep by raising levels of serotonin, a body chemical that promotes relaxation."

(There's a very important asterisk for anyone thinking about taking tryptophan supplements, the University of Maryland Medical Center also points out: "Consumers should take this supplement with caution as it may adversely interact with certain antidepressants, including selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and others, and cause serious negative side effects. Serotonin Syndrome, for example, can be fatal.")

Photo by Allen. Licensed under Creative Commons.
Now, to turkey. As everyone knows, a full turkey dinner makes you sleepy. It's the tryptophan in the turkey! But it's not. Somehow America's national gastro-economic rumor mill got filled with this idea, like a turkey stuffed on Thanksgiving. But in fact, turkey has no more tryptophan in it that any other poultry or meat product. Consuming tryptophan, an amino acid, along with other amino acids, of which there are plenty in turkey, diminishes tryptophan's effectiveness.

Turkey also has less tryptophan per serving that many nuts do.

For tryptophan to help you sleep, you need to take it alone, as a supplement, and not around the same time that you're ingesting protein-rich foods. The supplement, L-tryptophan was banned in the United States in 1991 after some 37 people consumed contaminated L-tryptophan and died from eosinophilia myalgia syndrome. The US Food and Drug Administration allowed the sale of L-tryptophan again in 2002.

So why do you get sleepy after Thanksgiving dinner? Maybe it's all that wine. Or because your Uncle Wally keeps telling the same story about how when he was a kid and baseball games were different.

Enjoy your turkey. Just don't count on it to put you to sleep.

Monday, January 4, 2016

Sleep Apnea is an Inherited Disease; Get Your Kids Checked

By Ken Mallows

Most sufferers don't know it, but sleep apnea is an hereditary disorder. If you have sleep apnea, there's a one-in-four chance that some of your children will have it, according to Michael Decker, PhD, Registered Nurse, Registered Respiratory Therapist and Diplomate of the American Board of Sleep Medicine.

"This is what a lot of people don’t understand. Sleep apnea is an inherited disorder," says Decker, who is Associate Professor in the School of Nursing at The Frances Payne Bolton School of Nursing at Case Western Reserve University. He told Fleet Owner magazine: "Kids with sleep apnea have reduced academic performance. They don’t do well in school. They can become hyperactive. I often encourage a person who may have sleep apnea to get tested. Even if you may not want treatment yourself, your children may have this disorder, and they need treatment because it’s going to impact the rest of their life."

He adds that the latest research concludes that sleep apnea is a neuromuscular disease of the upper airway. Says Decker: "The part of the brain that controls the upper airway fails to work properly in people who have sleep apnea. They simply have less strength in their upper airway muscles. Many people have sleep apnea but the disease may not show itself unless there’s a trigger. That trigger, for instance, can be a change in weight or alcohol use."

Decker notes that while many doctors suspect sleep apnea based with an office visit and a questionnaire, it can only be properly diagnosed with monitors that check vital signs during sleep like blood oxygen levels, heart rate, blood pressure, etc. Until these tests are performed, however, many doctors give their at-risk patients – like truck drivers – a CPAP machine which can work immediately. "Is it worth putting that person and others around them at risk for six weeks on the road while a sleep study is scheduled, or do you go ahead and treat them right away and say you know this isn’t going to be perfect but it’s going to make you feel a lot better and keep you alert and possibly alive until we get you into the laboratory? The  answer often is 'yes.'"

While CPAP usage is common, it can be uncomfortable for many patients. "It’s very difficult for people to adapt to CPAP because it's blowing air into your face; it’s like having a vacuum cleaner running in reverse connected to a mask attached to your face. It’s very difficult to breathe against that. So many people are just unable to tolerate CPAP. They make an honest effort but they’re just not able to adapt to that high pressure in their face."

Fortunately, there are other remedies including oral appliances and implanted neurostimulators that 'ping' the upper airway muscles during sleep much as a heart pacemaker works. "You turn it on when you go to sleep, perhaps by passing a little magnet over your chest and that turns it on. They’re very effective. The secret is picking the right patient, because there are certain people it won’t work in and other for whom it works exceptionally well."

Thursday, December 31, 2015

Nod by Adrian Barnes (a Book Review for Insomniacs)

Sure, it sucks when you can’t sleep. You're tossing and turning in bed all night long. Your eyes look like they're held open with toothpicks; your mind replays the day in a neverending loop; you feel worn down like a car tire that’s never been changed. But no matter how tired you are, you're unable to sleep. We’ve all had nights like that.

As awful as a night without sleep makes you feel the next morning, imagine what life would be like if you could never sleep again. If the night before was the last time you ever slipped into unconsciousness. If your mind and body never again got its eight—or even four or three or any—hours of necessary rejuvenation. Imagine that it’s not that you don’t need sleep—you do need sleep, you desperately do—and you long for sleep more than you’ve ever wanted anything in your life. The problem is that you can’t ever sleep again.

Nod by Adrian Barnes
Now imagine that the entire world is afflicted with the same sickness, incurable, and endless—or for as long as you can live without sleep. Which isn’t long. It’s about thirty days before you brain and body shut down. And before your thirty day expiration date arrives,madness is your certain fate.

That’s the premise of Adrian Barnes’ debut novel Nod: A world in which suddenly nobody sleeps anymore. Or almost nobody: One out of about every 10,000 people still sleep.

Nod takes place in Vancouver, Canada and follows the lives of Tanya and her husband Paul, an etymologist and writer, who is one of the rare Sleepers. Paul is the novel’s narrator. Early on in Nod, Tanya, an Awaker, desperate for sleep as anyone would be after several days of watching the moon make its slow crawl across the sky, demands sex from Paul, because she hopes that will get her to sleep. Tanya and Paul’s touching is coarse, brutal, and primitive, setting the stage for the rest of the novel.

In Barnes’ world, some children can sleep. As the Awakers’ psychosis grows, the Awakers come to believe that drinking the blood of these children will cure their terminal insomnia. The Awakers, banded together in savage, hierarchical packs, hunt the children.

Can the Sleepers protect these children? How can the Sleepers even protect themselves from desperate Awakers while they sleep? Will the Sleepers be able to ride out these terrifying four weeks until the Awakers, rapidly devolving into their Neanderthal progenitors, finally die?

Violent, frightening, textured, and dystopian are words that aptly describe the short-lived world that Barnes has created. Barnes’ writing is beautiful, but sometimes a little too good; the descriptions, both compelling and creepy, occasionally subtract from the story he’s trying to tell:
What else do I see? Packs of dogs, heads hovering low, roam the periphery of things. The long-standing human-canine alliance has been irretrievably severed, I’m sincerely sorry to report—the gnawed bones and matted chunks of hair scattered along the shores of Lost Lagoon testify to this. It’s sad, but then again those plump collies and German shepherds don’t seem too weighed down by nostalgia for bone-shaped vegan treats and belly rubs from the opposably-thumbed as they wander about, licking their chops.
Nod is a must for every insomniac because it shows you that no matter how bad your night of no sleep is, things could be a lot worse. The usual warnings about not reading a scary novel in bed when you want to sleep don’t apply here. Nod is best enjoyed in the place that you want to sleep because you will eventually fall asleep—unlike the doomed souls in Adrian Barnes' novel.

Monday, December 28, 2015

Belsomra Report Card: Meh

By Ken Mallows

            Readers of this blog know that we're not particular fans of sleep drugs. We're not against the occasional use of prescription medicine for sleeplessness, but the science shows that continual use of sleeping pills may do more harm than good. Plus, they really don't solve your sleep issues; they mask them.
            We think that natural remedies and techniques are best in the long run.
            We're always willing to have our minds changed – we believe in modern medicine – but such is not the case with a relatively new drug known as Belsomra from drug maker Merck. Belsomra is a new type of sleep medicine called an orexin receptor. The chemical name is suvorexant. Most sleeping pills increase GABA a neurotransmitter that slow brain activity so you can nod off.  Belsomra decreases the neurotransmitter Orexin which keeps you up.
            Merck's TV commercials have been a big hit, using an odd (and to me, scary looking) plush creature that is supposed to show the drug gently purring you to sleep. Belsomra has been around a little over the year and doctors wrote 4,000 prescriptions when it first hit pharmacy shelves. It may turn out to be the best selling insomnia medication ever which is saying something because the FDA estimates that docs handed out more than 42 million sleep aids scripts in the U.S. in 2014.
            So what's the problem?
            Clinical tests show that Belsomra may really not work any better than Lunesta and Ambien, which both have their own problems. According to  Dr. Gregg Jacobs, an insomnia specialist at the Sleep Disorders Center at the UMass Memorial Medical Center: "At the 20 mg dose [the highest] that was approved by the FDA, people ... only obtained an extra 16 minutes of sleep. This is meaningless clinically." Participants also only fell asleep an average of six minutes faster than those who took a placebo.
            Consumer Reports also weighed in and commissioned two drug safety experts—Steven Woloshin, M.D., and Lisa M. Schwartz, M.D., both at the Geisel School of Medicine at Dartmouth—to review the research about Belsomra. Schwartz served on an FDA advisory committee of experts that looked at Belsomra in 2013. According to their analysis "people who took a 15 mg or 20 mg dose of Belsomra every night for 3 months fell asleep just 6 minutes faster on average than those who got a placebo pill. And the Belsomra group slept only 16 minutes longer—6 hours and 12 minutes total vs. 5 hours and 56 minutes for the placebo group, Consumer Reports reported.
            Like other pills such as Ambien and Lunesta, users also reported being drowsy the next day not to mention a drop in memory and other cognitive functions. Other tests of the Belsomra showed that it worked about the same as a placebo and that cognitive behavior therapy worked better than all drugs. In fact, CBT works on about 80 percent of those with insomnia. Studies also show other tricks like relaxation, cutting back on blue light before bedtime, exercise and cutting back on caffeine all help to give you a good night's sleep.

            Belsomra's success in the marketplace cannot be denied, however, but it speaks more to advertising and patient pleas to their doctors just to get the good night's sleep that they so dearly want and need – and will do most anything to achieve. 

Saturday, December 26, 2015

Explainer: What Is Jet Lag and How Can You Overcome It?

By Leon Lack

Long flights across many time zones often leave us feeling fatigued, sleepy, irritable and generally out of sorts. And it’s not just because of poor sleep on the plane and dehydration from the altitude – the feelings persist for several days.

Jet lag is caused by our 24-hour body clock lagging behind the rapid change of clock time over the flight. Our body clock has a strong effect on the times across the day we feel alert and when we feel sleepy. The body clock consists of our circadian rhythms.

For a person who regularly sleeps from 11pm to 7am, all of our circadian rhythms will become aligned to ensure best sleep during those times. In the middle of the sleep period, around 4am, the body drops to its lowest body temperature (known as Tmin). This is also the time when melatonin hormone secretion is highest.

The alignment of these rhythms is not caused directly by the timing of our sleep period, but indirectly by the timing of darkness during sleep and visual light stimulation when we are awake.

Once the body clock becomes stabilised, it is resistant to change. So, after less than a day in the air, our body clock is still on home time when we arrive at our destination. This is where the problem arises.

Flying westward

Take the example of flying from the Sydney to London. At this time of year, there is a nine hour time zone difference between the two cities. If you arrive in London at 7am in the morning, your body clock will be telling you it’s 4pm.

By 1pm London time, you’re likely to want to take a nap. But try not to fall into a deep sleep; your body will be telling you it’s 10pm so you’ll have to resist the urge to sleep through until 7am your body clock time. This, of course, would mean waking up at 10pm London time ready to start your “day”.

If you manage to stay awake until early evening, you will still be woken up early the next morning by your early timed body clock and early “wake-up zone”, making you feel tired the next day. Until you can shift the timing of your body clock later by about eight to nine hours, your jet lag will continue to cause extreme tiredness in the late afternoon and disturbed sleep at night.

Lowest body temperature shifts from 4am Australian time to 7pm UK time
 (orange arrow pointed to the left). She must now delay her body clock by nine hours
(bottom orange arrow pointed to right). Leon Lack/The Conversation

Resetting your body clock

The good news is you can re-time the body clock. The strongest effect is from appropriately timed visual light stimulation.

But take care to get the timing right so you move your body clock in the right direction. Light stimulation before your body reaches its lowest body temperature (Tmin), usually about 2 hours before your typical wake-up time, will delay your body clock to a later time. However, light after Tmin will shift your body clock earlier.

For a Sydney to London trip, you would need to delay your body clock by about nine hours to most quickly align your body clock to London time. Fortunately, normal daylight can be used as it occurs before Tmin up to about the Tmin time. So spend the day outdoors if possible. Even a cloudy day is better than staying indoors.

However, after your body clock has been delayed by a few hours from outdoor light, your Tmin will now have moved “out of reach” of the delaying effect of daylight, since only light administered close to Tmin has a strong re-timing effect. Your body clock re-timing may stop well short of the eight to nine hour delay needed for full re-alignment.

In that case, it would be useful to use artificial indoor light stimulation in the later evening to complete the jet lag cure.

Flying eastward

Flying across many time zones in the opposite direction (eastward) can present a more challenging re-adjustment. Flying across seven time zones to the US West coast, for instance, requires an advance of the body clock (re-timed earlier).

This is the same type of change needed when we go onto daylight savings time in the spring. That causes some disruption of sleep and daytime alertness for a few days in many people. Now multiply that change by seven times and it will give you some perspective on this jet lag disruption.

If your trip is short, it may be
less disruptive to not go
through any re-adjustment
olaerik/FlickrCC BY-NC-SA

Upon arriving at your US West Coast destination, your body clock timing will be seven hours too late. The time of your Tmin may be as late as 11am instead of 4am. Your body won’t be ready for sleep until the wee hours of the morning and it will want to sleep most of the day away (an extreme example of the delayed sleep pattern of many adolescents).

Again, light can be used to re-time your internal clock. To maximise the re-timing effect you should avoid very early bright light up until about 10am because being before your Tmin it might shift your clock in the wrong delay direction. Instead you should get bright light preferably for several hours starting around 10am.

Then, as your body clock becomes timed earlier the beginning of the light stimulation can start earlier (8-9am) to complete the re-alignment job.

Overcoming jet lag

One way to reduce the time taken to overcome jet lag in your destination is to do some re-adjustment of your sleep period and light exposure before leaving on your trip. Jet lag calculators can work out the specific times for your light exposure before and after the trip.

Taking melatonin can also assist this re-timing process: a low-dose (0.5-1mg) short-acting preparation (available over-the-counter in the US or by doctor’s prescription in Australia) taken at the desired bedtime in your destination. In conjunction with appropriately timed bright light, melatonin can greatly reduce the duration of your jet lag.

But should you even attempt to re-time your body clock? That depends on how long you’re staying in the new time zone. If your stay is short (one to three days), it may be less disruptive to not go through any re-adjustment but simply keep your body clock on “home” time. That way you also avoid re-adjusting again when flying home. Most airline flight crew follow this rule.

But if your stay overseas is going to be at least a week and if you want it to be more pleasurable, you can minimise jet lag by appropriately timed light stimulation and melatonin.

The Conversation
Leon Lack, Professor of Psychology, Flinders University
This article was originally published on The Conversation. Read the original article.

Thursday, December 24, 2015

How Late in the Day Can You Drink Coffee?

Attention coffee addicts. How late in the day is it safe to have a cup of regular coffee? Will that 7 PM cup of Joe keep you from falling asleep? What about coffee at 4 PM?

Scientists have studied this question in considerable detail and have found that for regular mortals, drinking coffee within six hours of when you want to sleep is a bad idea. Caffeine "6 hours prior to bedtime each [has] significant effects on sleep disturbance relative to placebo." This study, reported in the Journal of Clinical Sleep Medicine concluded, "The magnitude of reduction in total sleep time suggests that caffeine taken 6 hours before bedtime has important disruptive effects on sleep and provides empirical support for sleep hygiene recommendations to refrain from substantial caffeine use for a minimum of 6 hours prior to bedtime."

Summarizing this study, Michael J. Breus, Ph.D, a Clinical Psychologist and both a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine wrote, "Even if you don’t feel that late-afternoon cup of coffee has a negative impact on your sleep, this study suggests that it is likely to be interfering nonetheless. This is one reason that I have long recommended a 2 PM cutoff time for caffeine consumption."

The study's author, Christopher Drake, PhD, emphasises the point that late afternoon coffee is harmful to sleep: "'Drinking a big cup of coffee on the way home from work can lead to negative effects on sleep just as if someone were to consume caffeine closer to bedtime. People tend to be less likely to detect the disruptive effects of caffeine on sleep when taken in the afternoon."

Another study in the journal Science Translational Medicine found that caffeine can alter your body's circadian rhythm and disrupt the production of melatonin, a hormone that helps us fall asleep.

An Israeli study showed that late night coffee can reduce the amount of sleep you get by an hour and a half

So there you have it. Six hours before you want to sleep, definitely stop drinking coffee (and other caffeinated beverages.) Make 2 PM your cutoff time, if you want to doubly ensure a good night's sleep.

Monday, December 21, 2015

Lose Weight - Any Amount - and Sleep Better

By Ken Mallows

The act of losing weight – not necessarily trimming down to your ideal weight  – may help you sleep better, according to researchers from the Perelman School of Medicine at the University of Pennsylvania.

Doctors know that obesity can lead to sleep-robbing factors such as snoring and sleep apnea, but they are not clear on how much weight a person needs to shed in order to see an improvement in sleep. This research shows that mice who lost weight slept fewer hours and showed increased alertness than mice who didn't lose weight despite how much they lost or at what weight they started and ended.

In this research, half of the mice received their normal diet while the other half received a high fat diet. In fact, they ate three times more fat for eight weeks. At the end of that period, some of the mice were switched to the alternative diet for one week causing the high fat content mice to gain weight and the newly fed normal diet to lose weight. The rest of the mice consumed their current diet.

A week later, nine weeks total, mice who ate the high fat diet weight 30 percent more, slept more than one hour longer per day, and showed signs of drowsiness during the day compared to the regular diet mice. The “diet switch” groups, however, had similar body weight at week nine, but completely different sleep/wake profiles when compared to each other.

“Our findings suggest body weight is a less important factor than changes in weight for regulating sleepiness,” said the study’s lead author, Isaac Perron, a PhD student in Neuroscience at the University of Pennsylvania. “Diet-induced obese mice that ate a regular chow diet for only one week showed the same sleep/wake profile as mice that ate a regular chow diet for nine weeks.”

The implications for humans is that losing some weight, no matter how much, can improve sleep quality.

 “The diet consumed during the final week was key to driving the sleep effects, independent of the starting body weight,” said Perron. “If you’re overweight and often feel tired, you may not need to lose all the weight to improve sleep, but rather just beginning to lose that excess weight may improve your sleep abnormalities and wake impairments.”

The research was published in the current issue of the journal Sleep

Thursday, December 17, 2015

Should You Sleep Naked?

What yields a better night's sleep? Wearing pajamas or sleeping naked?

Photo by Vidibio. Licensed under Creative Commons.
The answer, if you haven't tried it, is that for many people sleeping naked does a better job of letting them fall asleep and stay asleep. Less than 10 percent of Americans sleep naked. But maybe they know something that you don't know. There are several reasons why sleeping in the buff is healthy, and one important reason why sleeping naked may not work. Let's start with the reasons why sleeping au natural can help fix your insomnia.

First, if you and your partner sleep naked, you have a slightly --or perhaps considerably-- greater prospect for sex. Sex is often a great soporific. Or, let's put it this way, sex is better at relaxing you than editing that office report in bed. According to Sheenie Ambardar, MD “After orgasm, the hormone prolactin is released, which is responsible for the feelings of relaxation and sleepiness"

Second, sleeping naked reduces the feeling of weight on your body. Pajamas, nightgowns and other bed clothes can twist and that can cause mini-wakings. You know how that works: You turn one way, but your pajama pants turn the other way. The less pressure, even from something as relatively light as a flannel nightgown, the more at ease your muscles will be. The less often you'll wake up at night.

Cooler temperatures are better for sleep: Between 60 and 67 degrees is optimal. Having a blanket on top of you makes you warmer, but it's easy to slip your leg out from under that blanket, or to pull it down or entirely off of you, if you become too hot. But it's harder to achieve the best sleeping temperature if you're wearing pajamas and you have a blanket on top. Lose the pajamas for a cooler environment and a better sleep.

Some people report that when they sleep naked, they wake up more refreshed because they've sweat less during their sleep. Waking up more easily, more refreshed, is a sure sign that you're sleeping better. Waking up refreshed is sleep's mission.

Not sweating also reduces the need for a nighttime glass of water: Sweat, drink. Drink, have to go to the bathroom. Sleeping naked can help break this thirst, drink, bathroom cycle.

Give this experiment a week, or a month if you can. As with many sleep tips, there's no way to know if it's going to work for you or not. The only reason not to sleep naked is that doesn't help you sleep faster or longer. But the only way to know is to try.