Number of sleep-disorder facilities growing as Kentuckians admit they're tired

The number of sleep-disorder facilities in Kentucky doubled from 25 to 52 in the past 10 years, part of a nationwide trend to help the 70 million Americans who have trouble getting some shuteye.

"Demand growth is a result of more physicians being better educated to recognize sleep deprivation symptoms as well as the public having more and better access to information and advertising that focuses on it," reports Anne Charles Doolin in an in-depth piece for The Lane Report. "Changes in insurance reimbursement also is playing a major part in the accredited facility surge."

Estimates show Americans suffer from more than 80 kinds of sleep disorders, though 85 percent of people are undiagnosed. "When we look at the most common sleep disorder, sleep apnea, we have evidence that demonstrates 25 percent of men are at risk and 9 percent of women are at risk," said Kathryn Hansen, executive director of the Kentucky Sleep Society.

In general, people don't think sleep problems can be fixed. "A typical patient is a male, in his 50s, slightly overweight," said Dr. Pam Combs, a cardiologist who has been studying sleep issues since the 1990s. "They don't think about sleep problems as the problem. They just think they're getting old and tired."

But not getting a good night's rest "is associated with a myriad of health conditions, and mental health conditions, and it undoubtedly affects productivity," said Dr. Ryan Wetzler, a clinical psychologist at Louisville's Sleep Medicine Specialists. "When you get a patient who has taken two hours to go to sleep for years or even decades, getting maybe four hours of sleep a night, and then with treatment they fall asleep quickly and get seven hours a night, it's a huge difference."

"Addressing the problem means less illness, less missed work and more productivity," said neurologist James M. Thompson. It's also less costly. Sleep disorders, sleep deprivation and sleepiness add up to about $15.9 billion to the national health care bill, the National Center on Sleep Disorders Research has found. "Other costs to society for related health problems, lost worker productivity and accidents can't be calculated, but educated guesses begin at 10 times NCSDR's health care cost tally," Doolin reports.

The assessment of sleep disorders has become more widely accepted as a field of study, with a recognized board exam, formal training programs and journals, said Dr. Barbara Phillips, director of the Sleep Center at the University of Kentucky Good Samaritan Hospital. But not all changes have been positive, with some fly-by-night "apnea mills" popping up "where the focus is on lucrative testing, and actual patient care and follow-up get shortchanged," Phillips said. (Read more)

Read More

Lack of sleep can lead to heart attack or stroke

Night's sleep, which lasts less than 7.5 hours, is the fault of 33 percent of cardiovascular disease and attacks, such as strokes and heart attacks

Results of the analysis of scientists published in the Journal of the American Medical Association Archives of Internal Medicine. "

Japanese researchers for over 50 months were watching a dream in 1255 people suffering from high blood pressure, according to newsme.com.ua. They have daytime and nighttime blood pressure checked, sleep duration and the presence of heart attacks, such as stroke, myocardial infarction and irreversible cardiac arrest.

As a result, doctors have registered 99 cases of cardiovascular disease, and found that among those who slept less than 7.5 hours of knocking, your risk of stroke was 2.4 per 100 man-years. For those who slept more - 1.8 per 100 man-years.

In addition, it was found that cardiovascular disease are more prone to those with night on the rise in blood pressure.

"Shorter sleep duration is a predictor of cardiovascular disease in older persons with hypertension," - writes in a research article, the author Kazuo Eguchi.

Read More

The Big Sleep

This blog usually focuses on diet, because that's my specialty. But if you want Whole Health, you need the whole package: a diet and lifestyle that is broadly consistent with our evolutionary heritage. I think we all know that on some level, but a recent paper has reminded me of it.

I somehow managed to get on the press list of the Annals of Internal Medicine. That means they send me embargoed papers before they're released to the general public. That journal publishes a lot of high-impact diet studies, so it's a great privilege for me. I get to write about the studies, and publish my analysis at the time of general release, which is the same time the news outlets publish their stories.

One of the papers they sent me recently is a fat loss trial with an interesting twist (1; see below). All participants were told to eat 10% fewer calories that usual for two weeks, however half of them were instructed to sleep for 8 and a half hours per night, and the other half were instructed to sleep for 5 and a half hours*. The actual recorded sleep times were 7:25 and 5:14, respectively.

Weight loss by calorie restriction causes a reduction of both fat and lean mass, which is what the investigators observed. Both groups lost the same amount of weight. However, 80% of the weight was lost as fat in the high-sleep group (2.4/3.0 kg lost as fat), while only 48% of it was lost as fat in the low-sleep group (1.4/2.9 kg lost as fat). Basically, the sleep-deprived group lost as much lean mass as they did fat mass, which is not good!

There are many observational studies showing associations between insufficient sleep, obesity and diabetes. However, I think studies like that are particularly vulnerable to confounding variables, so I've never known quite what to make of them. Furthermore, they often show that long sleep duration associates with poor health as well, which I find highly unlikely to reflect cause and effect. I discussed one of those studies in a post a couple of years ago (2). That's why I appreciate this controlled trial so much.

Another sleep restriction trial published in the Lancet in 1999 showed that restricting healthy young men to four hours of sleep per night caused them to temporarily develop glucose intolerance, or pre-diabetes (3).

Furthermore, their daily rhythm of the hormone cortisol became abnormal. Rather than the normal pattern of a peak in the morning and a dip in the evening, sleep deprivation blunted their morning cortisol level and enhanced it in the evening. Cortisol is a stress hormone, among other things, and its fluctuations may contribute to our ability to feel awake in the morning and ready for bed at night.

The term "adrenal fatigue", which refers to the aforementioned disturbance in cortisol rhythm, is characterized by general fatigue, difficulty waking up in the morning, and difficulty going to sleep at night. It's a term that's commonly used by alternative medical practitioners but not generally accepted by mainstream medicine, possibly because it's difficult to demonstrate and the symptoms are fairly general. Robb Wolf talks about it in his book The Paleo Solution.

The investigators concluded:

Sleep debt has a harmful impact on carbohydrate metabolism and endocrine function. The effects are similar to those seen in normal ageing and, therefore, sleep debt may increase the severity of age-related chronic disorders.

So there you have it. Besides making us miserable, lack of sleep appears to predispose to obesity and diabetes, and probably sets us up for the Big Sleep down the line. I can't say I'm surprised, given how awful I feel after even one night of six hour sleep. I feel best after 9 hours, and I probably average about 8.5. Does it cut into my free time? Sure. But it's worth it to me, because it allows me to enjoy my day much more.

Keep your room as dark as possible during sleep. It also helps to avoid bright light, particularly in the blue spectrum, before bed (4). "Soft white" bulbs are preferable to full spectrum in the evening. If you need to use your computer, dim the monitor and adjust it to favor warm over cool colors. For people who sleep poorly due to anxiety, meditation before bed can be highly effective. I posted a tutorial here.

1. Nedeltcheva, AV et al. "Insufficient Sleep Undermines Dietary Efforts to Reduce Adiposity." Annals of Internal Medicine. 2010. Advanced publication.


* The study was a randomized crossover design with a 3 month washout period, which I consider a rigorous design. I think the study overall was very clever. The investigators used calorie restriction to cause rapid changes in body composition so that they could see differences on a reasonable timescale, rather than trying to deprive people of sleep for months and look for more gradual body fat changes without dietary changes. The latter experiment would have been more interesting, but potentially impractical and unethical.

Read More

TRAVEL TIPS

* Travel Pharmacy
* Vaccination schedule

Important when traveling in tropical areas

* After a long flight schedule with the time difference as a rest day.
It makes sense to the daily rhythm of the local population to adapt or leave the country, eg keep in warm countries, a long lunch and rest before the evening again become active.

* Eat only peeled or cooked or fried or grilled foods (no fruits or vegetables that are not peeled, can any salad - Cook it, peel it or forget it!).

* Drink only bottled drinks ready (not tap water, not even to brush your teeth, no ice, no ice cream).

* Regularly and drink plenty of fluids is especially important in the tropics. Quiet on the normal thirst also drink (bottled water is best, because of the salts). The bright yellow urine should not be dark. Ice cold drinks do not drink too fast (risk of diarrhea)

* Wear light and airy clothing from sweat-absorbent cotton again.

* Do not walk barefoot (insect stings, the risk of hookworm infection or bites by poisonous animals).

* Evening, long-sleeved clothes and long trousers (risk of insect bites, for example by the malaria mosquito).

* Avoid swimming and bathing in rivers or lakes (freshwater) in Africa and South America. Here is threatening infection by flukes (schistosomiasis).

* Mosquito nets should be well fixed under the mattress. sleep so that the body does not affect the network.

* After a tropical stay of more than three months after the return you should necessarily a medical examination of blood, urine and stool can perform, even if there are no complaints.

Important:

Who suffers after returning from inexplicable complaints such as fever, nausea, diarrhea, nausea, rash, cough, should definitely consult a doctor and inform him about the trip (risk of malaria and other infectious diseases).

Read More

EAR PLUGS may addictive.

In many tourists take their luggage next to the bathing suit and ear plugs. In unfamiliar surroundings, perhaps even disturbed by some nightclub, many cannot sleep as good as at home in bed. Earplugs should put things right.

Mostly it works well, but the thing has a catch: those who too often fall asleep in such a claim, which may have problems falling asleep without it. Was on holiday when it is not so important to get up at a certain time, you should really use it so only when necessary, recommend ENT doctors.

Read More