TV Watching Interferes With Sleep
Preparing the body for sleep is one of our most important daily rituals, although few people realize the importance it plays in maintaining good health. Our bodies need from seven to eight hours of sleep per night to adequately recharge. Many Americans chronically receive less sleep than they need, unwittingly increasing their health risk. Getting less than the optimum amount of sleep not only decreases our level of alertness the next day, it has been shown to contribute to obesity and diabetes, decrease our ability to fight off disease and infection, exacerbate anxiety and depression, and increase mortality.
The critical importance sleep plays in maintaining good health makes the rituals we practice to prepare our bodies for sleep vitally important. In a survey of 21,475 Americans aged 15 and older, more than 50% listed “watching television” as their most prevalent pre-sleep activity. Conducted by University of Pennsylvania School of Medicine researchers Mathias Basner and David Dinges between 2003 and 2006, the American Time Use Survey provided insights into how Americans prepare for sleep. The results of their study are being presented today at SLEEP 2009, the annual meeting of the Associated Professional Sleep Societies.
“Given the relationship of short sleep duration to health risks, there is concern than many Americans are chronically under-sleeping due to lifestyle choices,” said Dinges in an American Academy of Sleep Medicine press release. More than 50% of Americans surveyed watched late night television in the two hours preceding sleep to cue their bodies to begin the sleep cycle. Because television engages the brain and is built around half hour and one hour schedules, it actually encourages wakefulness.
Staying up to watch TV past the point of being tired, then using alarm clocks to wake up before the body has had enough sleep is creating a serious sleep deficit among Americans, study researchers warn. “While the timing of work may not be flexible,” said Dr. Basner, “giving up some TV viewing in the evening should be possible to promote adequate sleep.”
Up to 40% of Americans get less than the recommended amount of sleep per night. If you are among those who suffer from a sleep disorder, Atlanta psychiatrist Dr. Tracey Marks can help.
Talk Yourself to Sleep
Using talk therapy to help insomniacs fall asleep produced better results than commonly used sleep medications, according to a new study released this week. In a Canadian study of 160 chronic adult insomniacs, researchers at Laval University in Quebec, Canada compared talk therapy to the popular sleep aid zolpidem, which is sold both generically and under the brand name Ambien. Because long-term use of sleep medication carries the risk of dependency, researchers are searching for drug-free alternatives to help chronic insomniacs fall asleep and sleep longer.
Insomnia is a common sleep problem that can lead to depression and high blood pressure. Medications like Ambien are frequently prescribed to help people sleep, although they are generally recommended only for short-term use. Common side effects of zolpidem and Ambien can include morning drowsiness, hallucinations, sleepwalking, sleep driving, binge eating, talking during sleep, and drug dependence.
During the initial six weeks of the trial, weekly group therapy sessions and nightly medication achieved similar results, improving both the ability t0 sleep and the length of sleep periods for about 60% of study participants. However, during the six-month follow-up period, study participants who attended refresher talk therapy sessions slept better and longer than those who took drugs. Participants were instructed to only sleep in bed and to avoid reading, watching TV or worrying when they went to bed. They were also encouraged to get up at the same time every morning and to go to bed at the same time every night. If they were unable to fall asleep within 20 minutes, they were instructed to get up and return to bed only when they became sleepy again.
“The best long-term outcome was obtained with patients treated with combined therapy initially, followed by [talk therapy] alone,” wrote study researcher Charles Morin. “Although the present findings are promising, there is currently no treatment that works for every patient with insomnia.”
The study found that bimonthly individual therapy sessions provided the most effective talk therapy. Study participants who were able to discuss with a therapist the personal issues that were causing them to lose sleep were able to break the cycle of chronic insomnia and achieve the most productive and longest sleep.
Stress, Depression Plague Collegiates
College students are feeling the pressure, and they’re not just worrying about grades. Money and relationships are creating as much stress and depression on college campuses as schoolwork, according to a recent Associated Press-mtvU poll of college students on 40 campuses. Of the collegiates polled, 85% reported daily feelings of stress, the Associated Press reported. In addition, 42% said they had felt depressed or hopeless within the past two weeks, 13% showed signs of mild depression, and 11% said they’d had suicidal thoughts.
While 74% of the students were stressed about grades, concern over financial matters ran a close second, worrying 67% of the survey group. Half of the students (52%) were stressed about the economy, many saying that financial problems brought about by the recession could impact their ability to register for fall classes. Fifty-four percent of the students surveyed were stressed about family issues, and nearly half (47%) were worried about finding a job after graduation. Across the board, collegiates felt they were under more stress this year than last year. In all categories, collegiates surveyed in 2009 expressed a 3% to 6% increase in stress levels over their 2008 peers.
Students experiencing high levels of stress said they lacked energy, were having trouble sleeping and/or felt hopeless; but few said they had sought professional help. At the University of Maryland in College Park, two student suicides within two weeks shocked students last semester, but didn’t seem to change students’ views about seeking help.
“It was pretty scary,” admitted UM junior Aimee Mayer, a psychology major. While she said the university provides students with plenty of information and help with mental disorders, Mayer told the Associated Press, “there’s still a stigma associated with mental health issues and so a lot of people don’t want to go to those services. They feel like they’re less cool or something like that it they go. It’s like a sign of vulnerability.”
That’s an unfortunate attitude because depression can be successfully treated using a combination of cognitive-behavioral therapy, psychodynamic therapy and sometimes medications. When given the opportunity to intervene, psychiatrists can also identify potential suicide victims and help them before they act. Many mental health disorders begin early in life, so it is not unusual for symptoms to emerge under the stress of college life. Parents should talk to their children regularly to gauge their mental health.
Women’s Sleep Habits Linked to Mood
When mom doesn’t get enough sleep, the whole family suffers. In women, there’s a definite connection between sleep and mood. Worry, stress and anxiety can interfere with sleep, and sleep problems can increase depression and anxiety symptoms. According to a 2007 National Sleep Foundation study on women’s sleep habits, the relationship between sleep and mood is bi-directional. More than half of the women surveyed in the NSF poll said they had felt unhappy, sad or depressed in the past month, and one-third (36%) had felt hopeless about the future. Most reported problems sleeping, and 40% had been diagnosed with a sleep disorder.
Biology affects a woman’s sleep habits. The NSF study analyzed sleep patterns at each stage of a woman’s life:
- Menstruation. Menstruating women slept longest, averaging 7 hours, 32 minutes of shut-eye; however, 67% reported insomnia several nights a week. One-third experienced sleep problems during their cycle.
- Pregnancy. Women got more sleep during pregnancy than at any other time — approximately 8 hours, 14 minutes per night — although 84% complained of insomnia several nights a week and 30% said they never got a good night’s sleep.
- Post Partum. Women slept least — an average 7 hours, 46 minutes — after childbirth. Nearly half (47%) reported never getting a good night’s sleep, and 84% experienced chronic insomnia, 90% related to child care. Two in every 10 women experienced post partum blues or depression.
- Perimenopausal. During menopausal transition, women got the least amount of sleep (7 hours, 12 minutes). More than half (59%) reported insomnia a few nights each week; and 43% experienced a sleep disorder, hot flashes or night sweats that interfered with sleep.
- Postmenopausal. Postmenopausal women slept an average 7 hours, 19 minutes but had the highest incidence of sleep disorders (50%) and insomnia (61%). Forty-one percent used a sleep aid several nights a week.
Because of the link between sleep and mood, psychiatric treatment that addresses both issues through cognitive-behavioral therapy and psychodynamic therapy can be most effective. A board-certified psychiatrist like Dr. Tracey Marks with considerable experience treating sleep disorders can help you find workable and lasting solutions to sleep better and enjoy life more.
Why Women Have Trouble Sleeping
Less than half of American women get a good night’s sleep on a regular basis with stay-at-home moms least likely to enjoy adequate pillow time. According to a 2007 National Sleep Foundation (NSF) poll quizzing women about their sleep habits, 67% of American women experience frequent trouble sleeping and 43% report that daytime tiredness interferes with their normal daily activities. More likely to experience sleep problems than men, women said lack of sleep permeated every aspect of their lives, blaming inadequate sleep for everything from high stress levels to being late for work to being too tired for sex.
Women of all ages reported experiencing sleep problems which the poll found changed and increased in severity as women moved through the various biological stages of life. Lifestyle also played a role in sleep experience and daytime alertness. Stay-at-home moms, 74% of whom reported experiencing insomnia at least a few nights each week, exhibited the highest level of overall sleep problems. Fifty-nine percent of stay-at-home moms said they regularly woke up feeling unrefreshed. Working mothers (72%) and single working women (68%) also experienced periodic insomnia that affected job performance.
The majority of women polled seemed to accept chronic tiredness as a normal state for women. Eighty percent of women said they just kept going if they became sleepy during the day, 65% using caffeinated beverages to boost their alertness. Despite chronic tiredness, the NSF poll found that women didn’t head for bed sooner when they could. In the hour before they went to bed, instead of turning in early, 87% watched television, 60% finished household chores, 37% interacted with their children or family, 36% were on the Internet, and 21% were engaged in job-related activities.
“Women of all ages are burning the candle at both ends and as a result they are sleepless and stressed out,” said Richard Gelula, NSF chief executive officer in a NSF press release announcing poll results. “Poor sleep impacts every aspect of a woman’s life, as well as her health.”
“Women who spend less than seven hours in bed at night are more likely to doze off during the day, report symptoms of depression, drive drowsy and use coping mechanisms just to make it through their day,” said NSF task force member Dr. Kathryn Lee, professor of family health care nursing at the University of California, San Francisco.
Friday: How women’s sleep patterns change with age
More Sleep Can Improve ADHD Symptoms
A common behavior disorder that affects 8% to 10% of U.S. school-aged children, ADHD – attention deficit hyperactivity disorder — has been linked to children’s failure to get enough sleep. In a new study (see our April 29 post), researchers at the University of Helsinki in Finland found that children who typically received less than 7.7 hours of sleep per night were significantly more likely to develop ADHD than children who slept longer. The study is the first to pinpoint length of sleep alone as a source of behavioral symptoms.
Interestingly, the study found that parents regularly over-reported the amount of sleep their children received compared to objectively measured results, suggesting both that most parents are unaware of their children’s actual wake-sleep cycles or that a “social desirability bias” promotes over-reporting. Despite such discrepancies, study results clearly found a direct, measurable, causal link between short sleep cycles and increased symptoms of ADHD.
“Even though we hypothesized that sleep duration would affect behavioral symptoms, we were somewhat surprised that the effect was so very, very clear,” principal researcher Dr. E. Juulia Paavonen told Medscape Psychiatry in an April 28, 2009, online article about the study.
The study found the lowest risk of developing ADHD symptoms among children who regularly received an average night’s sleep characterized by at least 7.7 to 9.4 hours of uninterrupted sleep per night. Parents who are able to help their children establish and maintain adequate sleep cycles of 8 to 10 hours of uninterrupted sleep per night may be able to significantly reduce their children’s risk of developing ADHD. In children who already exhibit symptoms of the disorder, maintaining adequate sleep patterns may help to control and/or alleviate symptoms, researchers believe. In an independent European study, lengthening children’s sleep cycles by just 30 minutes per night was found to significantly improve cognitive and attention behavior with observable improvement exhibited in less than one week.
Here are some things parents can do to help their children get the sleep they need:
- Establish a regular bedtime.
- Decrease activity about 30 minutes before bedtime.
- Ban TVs, video games and other over-stimulating activities from the bedroom.
- The bedroom should be comfortable — well ventilated and slightly cool with a nightlight.
- Establish a soothing bedtime routine — bath, brushing teeth, toileting, story time, prayers.
ADHD Linked to Lack of Sleep in Kids
Lack of sleep in children increases their risk of developing attention deficit hyperactivity disorder (ADHD), according to new research published in the April 27, 2009 online edition of Pediatrics. In a study of 7- and 8-year-olds conducted by researchers at the University of Helsinki in Finland, children who received less than 7.7 hours of sleep per night were at significantly increased risk of developing hyperactive/inattentive disorders compared to children who slept longer. The Finish study is the first to identify length of sleep alone as a source of behavioral difficulties.
“There is a large amount of literature linking sleeping difficulties to behavioral symptoms,” principal researcher E. Juulia Paavonen, M.D., Ph.D. told Medscape Psychiatry in an April 28, 2009, online article about the study. “However, this study shows short sleep duration itself is related to behavioral symptoms, independent of sleeping difficulties.”
The study provides a potential key for the treatment of rising attention and cognitive performance issues among U.S. children. As many as one-third of American children do not receive an adequate amount of sleep. While previous studies have indicated a probable link between sleep disorders, such as sleep apnea, and the behavioral symptoms associated with ADHD, none of those studies included behavioral assessments. The Finish study is the first to specifically assess the effects of sleep length on behavioral issues in children and show a definite causal effect between lack of sleep and decreased attention span and cognitive performance.
The study evaluated the sleep habits and duration of 280 boys and girls with a mean age of 8.1 years. Assisted by the children’s parents, sleep journals logged when children went to bed, woke up and were allowed to leave their beds over seven-day intervals. Problems such as illness that could affect sleep quality were also recorded. Hyperactivity, impulsivity and inattention symptoms were evaluated using the maternal ratings from the ADHD Rating Scale. Socioeconomic status, parental education and other demographic data were also considered. The majority of the test group (80.7%) were categorized as average sleepers, getting 7.7 to 9.4 hours of sleep per night. Short sleepers (9.3%) received less than 7.7 hours of sleep, while long sleepers (10%) got more than 9.4 hours of sleep.
Next time: Study recommendations: What parents can do.
Night Owls Stay More Alert Longer
Each person has an internal biological clock that determines his own personal sleep/wake cycle. Called circadian rhythm, your individual 24-hour clock determines whether you’re an early riser or a night owl (see our April 24 post). Interestingly, new research conducted by researchers in Brussels, Belgium indicates that people who wake later in the morning, 9 a.m. as opposed to 5 or 6 a.m., remain more alert for longer periods during the day, even if they turn in early.
In tests comparing the sleep cycles of early birds and night owls, MRI brain scans were taken to measure brain activity at different times throughout the day and night. Night owls were slower than early risers to exhibit sleep pressure (the urge to sleep) as the day progressed, remaining alert for one to two hours longer per day than early risers. Eventually though, the study found that night owls paid a price for their late hours. Out of synch with society’s daily schedule (children, school, job schedules, etc.), night owls tended to rack up a sleep deficit as the week progressed, requiring additional sleep on the weekends to recover.
Similar studies in the U.S. have shown that teenagers who typically prefer staying up late and sleeping in might do better in school if the school day started later and went longer. Some school districts are considering switching high school schedules to accommodate teenage circadian rhythms. In recent trials, starting high school classes at 9 a.m. and ending at 5 p.m. to 6 p.m. resulted in more alert students and improved academic performance.
While the exact role of sleep is still under debate, director of the Belgium study, Philippe Peigneux, professor of clinical neuropsychology at the Free University of Brussels explained in an article posted to The Why? Files website that researchers are convinced that an activity at which you spend fully one-third to one-quarter of your life — sleep — must have multiple functions critical to the health of mind and body. “When you fall asleep, you are not conscious of the external world, but sleep helps restore your ability to be alert the next day. Sleep is believed to be important for thermal regulation and memory consolidation, and many other functions,” he said. Continuing research will determine what other roles sleep plays in good health.
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