This page presents research related to sleep disorders, daytime wakefulness, work productivity, and innovative treatment interventions for common sleep disorders, such as, sleep apnea, insomnia, narcolepsy, nightmares, and restless legs syndrome.
In a study published in a 2009 issue of Journal of Clinical Sleep Medicine, the authors underscore the prevalence of sleep complaints in Latin American countries, particularly Brazil. The sample studied consisted of 2,110 people 16 years of age and older from 150 different cities in Brazil. Data from face-to-face interviews revealed 63% reported at least one sleep complaint with increasing prevalence with age. Prevalence rates were not dependent on region or size of city. Insomnia and nightmares were more prevalent among women and snoring among men. Sixty-one percent snored, 35% complained of insomnia, 17% reported nightmares, 53% reported leg kicking, and 37% reported pauses in breathing. Clearly, the results showed a high prevalence of sleep disorders in Brazil. Insomnia was the most common complaint and was in line with other studies that show rates between 10% and 48%. Women reported insomnia symptoms 2:1 to men and attributed it to hormonal and genetic factors. Snoring was the second common complaint. The study reinforces what we know about sleep disorders and work productivity, well being, and absenteesim and supports the belief that sleep complaints are a common international experience.
In another study published in the April, 2010 issue of the Journal of Clinical Sleep Medicine, the multicomponent model of Cognitive Behavior Therapy (CBT) for insomnia was investigated. A major component of CBT is sleep restriction therapy (SRT). Since time factors limit what a clinician can do for patients with insomnia in a primary care setting, this study compared the combination of SRT + hypnotic medication withdrawl to sleep hygiene education alone on total sleep time, sleep efficiency, sleep latency onset, and wake time after sleep onset. The clinician was a nurse in a primary care setting, where most cases of insomnia are discovered. As expected SRT + hypnotic withdrawl fared better in terms of symptom relief than sleep hygiene education, which had minimal, if any, effect. The results were maintained at 6 and 12 month follow-ups and showed that simply providing information about correcting sleep habits to patients was insufficient. It also showed that SRT is a critical component in the CBT model of treatment.
Young people are sleeping less these days. There also appears to be an increase in the prevalence of psychological distress in younger people over the past few years as well. Sleep disturbance can be a factor that contributes to psychological distress. Whether younger people are voluntarily staying up late or experiencing a sleeping disorder, the overall total sleep time for adolescents is decreasing and now averages 7 - 8 hours per night. Short sleep duration and psychological distress was studied and reported in a recent issue of Sleep, the official journal of the American Academy of Sleep Medicine. After analyzing the survey data from 20,822 young Australians, the authors reported that shorter sleep duration was associated with psychological distress. What is not known is whether short sleep duraction actually causes psychological distress or is only correlated with it. What is know, however, is that distress usually has as one of its symptoms, insomnia. The study is correlational only and does not lead to any causal relationships. What is important is that young people's sleep quality is jeopardized more so now than ever before. Online activity with it's cognitive arousal characteristics can certainly contribute to short sleep duration. More research is needed in this interesting area.
In yet another study published in Sleep (May, 2010), researchers, when studying Canadian workers, determined that trouble sleeping was associated with increased work injury. Interestingly, women were more affected than men. These results were very unique to the workplace and did not apply to motor vehicle accidents where men more than women had more accidents due to sleep problems.
In the same issue, a commentary was written expanding on the bidirectional relationship between obesity and sleep. Some research has shown that poor sleep can lead to obesity as well as other health problems, such as, diabetes. On the other hand, many people who suffere from these medical disorders also report poor sleep. Chicken or the egg? More research is needed.
The November, 2010 issue of Sleep published a study looking at the relationship between cancer symptoms, hot flashes, pain, dysfunctional sleep thoughts and behaviors and their affect on insomnia in 41 breast cancer survivors. The results found the following:
1) poor sleep was related to nighttime pain and hot flashes, 2) dysfunctional sleep-related thoughts had a strong effect on sleep efficiency and quality, 3) poor sleep predicted high levels of pain, fatigue, and hot flashes. Of great significance in this study is that it further supports the applicability of Cognitive-Behavior Therapy for insomnia, not only with "normal" insomniacs, but also with middle-aged breast cancer survivors.
In a significant study published in Sleep, 2009, Cincotta and others explored factors that perpetuated chronic insomnia. Mindfulness-based stress reduction, a well-established intervention that addresses stress, was used to treat both cognitive and somatic arousal, factors commonly elevated with insomniacs. Study participants went through an 8 week program meeting once weekly learning the techniques associated with MBSR. Unsurprisingly, MBSR led to improvements not only in sleep but also pre-sleep arousal.
In a similar study, Gourineni and his buddies explored the influence of daytime meditation on sleep with individuals who have been suffering from ongoing insomnia. Though a pilot study with a small sample size, they found that subjective sleep quality was improved with meditation but there may have been a strong placebo effect. On other measures of sleep, there was no difference between the meditation and control group. Like I mentioned, it was a pilot study and further research is needed.
Did you know that SSRIs can contribute to or cause restless legs syndrome? It's always to inquire about medications when evaluating restless legs syndrome.
Coming up.......A program to treat veterans who experience chronic and frequent nightmares.
More to come......
The November, 2010 issue of Sleep published a study looking at the relationship between cancer symptoms, hot flashes, pain, dysfunctional sleep thoughts and behaviors and their affect on insomnia in 41 breast cancer survivors. The results found the following:
1) poor sleep was related to nighttime pain and hot flashes, 2) dysfunctional sleep-related thoughts had a strong effect on sleep efficiency and quality, 3) poor sleep predicted high levels of pain, fatigue, and hot flashes. Of great significance in this study is that it further supports the applicability of Cognitive-Behavior Therapy for insomnia, not only with "normal" insomniacs, but also with middle-aged breast cancer survivors.
In a significant study published in Sleep, 2009, Cincotta and others explored factors that perpetuated chronic insomnia. Mindfulness-based stress reduction, a well-established intervention that addresses stress, was used to treat both cognitive and somatic arousal, factors commonly elevated with insomniacs. Study participants went through an 8 week program meeting once weekly learning the techniques associated with MBSR. Unsurprisingly, MBSR led to improvements not only in sleep but also pre-sleep arousal.
In a similar study, Gourineni and his buddies explored the influence of daytime meditation on sleep with individuals who have been suffering from ongoing insomnia. Though a pilot study with a small sample size, they found that subjective sleep quality was improved with meditation but there may have been a strong placebo effect. On other measures of sleep, there was no difference between the meditation and control group. Like I mentioned, it was a pilot study and further research is needed.
Did you know that SSRIs can contribute to or cause restless legs syndrome? It's always to inquire about medications when evaluating restless legs syndrome.
Coming up.......A program to treat veterans who experience chronic and frequent nightmares.
More to come......
