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brain-damage

Studies show that obstructive sleep apnea (OSA) affects much more than just your sleep. It can even damage your brain.

A recent brain imaging study from France involved 16 adults. Each of them had just been diagnosed with sleep apnea.

In numerous brain regions the study found a loss of “gray matter.” This is brain tissue that contains fibers and nerve cell  bodies. There also was a decrease in brain metabolism.

The authors suggest that these changes may explain some of the impairments that often occur in people with sleep apnea. Examples include attention lapses and memory loss. The study was published in March 2009 issue of the Journal of Sleep Research.

The results are similar to those found by a research team from UCLA. Their study was published in Neuroscience Letters in June 2008. They reported that people with sleep apnea have tissue loss in the “mammillary bodies.” These are brain regions that help store memory.

In July 2008 the UCLA team published another brain imaging study in the journal Sleep.It involved 41 people with moderate to severe sleep apnea. It also included 69 control subjects matched by age.

Results show that people with sleep apnea have extensive alterations in “white matter.” This is nerve tissue in the brain. It contains fibers that are insulated with myelin -a white, fatty sheath. The structural changes appear in brain regions that help control mood and memory. These regions also play a role in adjusting your blood pressure. Damage also was found in fiber pathways that connect these brain regions.

What causes the brain damage? The authors suggest that oxygen, blood flow and blood pressure may be involved. Sleep apnea involves breathing pauses that can occur hundreds of times a night of sleep. These pauses can produce drastic changes in oxygen levels.

These breathing pauses also reduce blood flow in the brain. People with sleep apnea also are at risk for high blood pressure. Both of these conditions create a potential for brain tissue damage.

Dr. Ronald Harper of UCLA said that the studies show how important it is for sleep apnea to be treated. CPAP is the most common treatment for sleep apnea. The findings make it all the more imperative that OSA be treated as soon as possible to prevent further injury. The long-term effects of OSA are terribly damaging to memory and thinking processes.

Can treatment reverse the brain damage caused by sleep apnea? The authors are uncertain if the changes are permanent.

But studies show that CPAP does help your heart, it may even save your life.

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mind-racing

Insomnia can make you feel like your mind is racing out of control. A revealing new study explains why your brain may be unable to put the brakes on your thoughts. It links the problem to low levels of a brain chemical.

A new study shows that GABA levels are reduced by 30 percent in adults with chronic primary insomnia. The study was published in the Nov. 1 issue of the journal Sleep.

GABA is reduced in the brain of individuals with insomnia, suggesting over activity is present. It was explained that low GABA levels create an imbalance of brain activity. This may lead to an inability to shut down waking signals in the brain.

If your GABA levels are low, then your mind can’t slow down. It may race forward at full speed even when it is time to sleep. An over active mind is a key feature of psychophsicological insomnia. At bedtime you are unable to stop thinking and worrying. Your body may be ready for sleep, but your mind remains alert. This state of “hyperarousal” can make it hard for you to fall asleep.

Most with insomnia have “secondary” insomnia. It occurs along with another medical problem, mental illness or sleep disorder. It also may result from the use of a medication or substance. In contrast primary insomnia is unrelated to another health problem. Estimates that about 25 percent of people with insomnia have primary insomnia. The study only links low GABA levels to long lasting, primary insomnia.

All participants in the study had been suffering from primary insomnia for mor than six months. The average duration of their symptoms was about 10 years. The GABA connection affirms that primary insomnia is a legitimate disorder.

Recognition that insomnia has manifestations in the brain may increase the legitimacy of those who have insomnia and report substantial daytime  consequences. It was also explained that insomnia can affect your energy, concentration and mood. It also increases your risk of depression.

One solution for the problem of primary insomnia is the use of hypnotic medication. The short-term use of a sleeping pill can help break the cycle of sleepless nights. The study notes that many of the most effective sleeping pills increase activity at the GABA neurons.

Another treatment option is cognitive behavioral therapy. CBT helps you learn how to correct attitudes and habits that hinder your sleep. Many of these bad habits develop as people try to cope with chronic insomnia.

 
manheadacheWhen you’re feeling stressed on the job, it can be hard to leave work at the office. Your job may preoccupy your mind as you drive, as you eat, and as you interact with family or friends. But the battle to control your mind can intensify when you try to go to sleep.

Sleep and stress are competitors. When stress continually activating a part of the brain that is otherwised used for sleep, then stress wins the tug-of-war.

According the AASM, job stress can be a cause of adjustment insomnia. This involves disturbed sleep or sleeplessness that may last for a few days or a few weeks. Other symptoms may include anxiety, worry and tension.

A common feature of adjustment insomnia is “ruminative thoughts.”  This is when you dwell on the same thoughts, chewing them over and over in your mind. You may lie in bed staring at the ceiling, unable to stop thinking about work. Even when you finally fall asleep, your work may invade your dreams. The Staples National Small-Business Survey polled 302 owners and executives of small businesses, and more than half said they dream about work -or “sleepwork.”

Scientific research confirms that job stress can affect your sleep. In 2005 a study in the journal Sleep involved 8,770 Japanese workers. In both men and women, a high level of stress at work was liked to insomnia.

A 2007 study in the International Journal of Behavioral Medicine linked insomnia to these three types of job stressors:

  • High work demand
  • Low influence over decisions
  • High professional compromise

The type of job stress you experience may affect your sleep in different ways. Another study linked work overload to poor sleep quality.  Having role conflicts at work was related to non-restorative sleep and trouble falling asleeo or staying asleep.

According to the National Institute for Occupational Safety and Health, sleep disturbances are one early warning sign of job stress. Others may include:

  • Headaches
  • Difficulty concentrating
  • Short temper
  • Upset stomach
  • Job dissatisfaction
  • Low morale

Job stress may be unavoidable. But sleep specialists say you can take steps to improve your sleep even when you are stressed.  Establishing a pattern of relaxing behaviors close to bedtime and limiting work to the early evening may help to reduce stress.

Here are jus a few more tips to help you be less restless with work worries:

  • Remain active
    Try to get some exervise every day. Both your mind and body will be more relaxed when its bedtime.
  • Express yourself
    Take some time to slow down before going to bed. Get away from the computer, turn off the TV and the cell phone, and relax quietly for 15 to 30 minutes. Take a warm bath, enjoy a light snack or listen to some soft music.
  • Avoid “bedwork”
    Never bring any work to bed with  you; your bed should be refuge from your job. Also avoid doing other activities in bed such as reading, watching TV or talking on the phone. Only use your bed for sleep.
  • Get out of bed
    If you have trouble falling asleep, get out of bed and do something relaxing until you feel sleep agian. Tossing and turning will only increase your frustrations.
  • See a specialist
    Some doctors are specialists in behavioral sleep medicine. They can teach you how to relax at bedtime so you can fall asleep more easily.

The wise words of Wilse Webb, a prominent sleep researcher recently said.

  So, question of pose: How long can humans stay awake?

The experiemental answer to this question is 264 hours (about 11 days).  In 1965, Randy Garder, a 17 year-old high school student, set this apparent world-record for a science fair. Several other normal research subjects have remained awake for eight to 10 days in carefully monitored experiments. None of these individuals experienced serious medical, neurological, physoiological or psychiatric problems.

  On the other hand, all of them showed progressive and significant deficits in concentration, motivation, perception and other higher mental processes as the duration of sleep deprivation increased. Nevertheless, all experimental subjects recovered to relative normality within one or two nights of recovery sleep.  Other anecdotal reports describe soldiers staying awake for four days in battle, or un-medicated patients with mania going without sleep for three to four days.

  The more difficult answer to this question revolves around the definition of “awake.” As mentioned above, prolonged sleep deprivation in normal subjects induces altered stated of consciousness ( often described as “microsleep”), numerous brief episodes of overwhelming sleep, and loss of cognitive and motor functions. We all know the dangerous, drowsy driver, and have heard about drowsy flyers crashing planes because they fell asleep while flying. RandyGardner was “awake” but basically cognitively dysfunctional at the end of his ordeal.

 In certain rare human medical disorders, the question of how long people can remain awake raises other surprising answers, and more questions. Morvan’s fibrillary chorea or Morvan’s Syndrome is characterized by muscle twitchings, pain, excessive sweating, weight loss, periodic hallucinations, and severe loss of sleep ( agrypnia ). Michel Jouvet and his colleagues in Lyon, France, studies a 27 year-old man with this disorder and found he had virtually no sleep over a period of several months. During that time he did not feel sleepy or tried and did not show any disorders of mood, memory, or anxiety. Nevertheless, nearly everynight between 9:00 and 11:00 p.m., he experienced a 20 to 60-minute period of auditory, visual, olfactory and somesthetic (sense of touch ) hallucinations, as well as pain and vasoconstriction in his fingers and toes. In recent investigations, Morvan’s Syndrome has been attributed to serum antibodies directed again by specific potassium (K+) channels in cell and nerve membranes.

  So, to return to the orginal question, “How long can humans stay awake?” the ultimate remains unclear. Despite studies, there are no reports that sleep deprivation per se has killed any humab ( excluding accidents and so forth ). Indeed, the U.S. Departmend of Defense has offered research funding for the goal of sustaining a fully awake, fully functional “24/7” soldier, sailor, or airman. Future warriors will face intese, around the clock fighting for weeks at a time. Will bioengineering eventually produce genetically cloned soldiers and citizens with a variant of Morvan’s Syndrome who need no sleep but remain effective and happy? I hope not. A good nights sleep is one of life’s blessings.

As Coleridge wrote years ago, “Oh sleep! It is a  gentle thing, beloved from pole to pole.”

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HomeSleepQuiz

1. The record for the longest period without sleep is 18 days, 21 hours, 40 minutes during a rocking chair marathon.  The record  holder reported hallucinations, paranoia, blurred vision, slurred speech and memory and concentration lapses.

2. Anything less than five minutes to fall asleep at night means you’re sleep deprived. The ideal is between 10 and 15 minutes, meaning you’re still tired enough to sleep deeply, but no so exhausted you feel sleepy by day.

3. It’s impossible to tell if someone is really awake without close medical supervison. People can take cat naps with their eyes open without even being aware of it, microsleep.

4. A new baby typically results in 400-750 hours lost sleep for parents in the first year.

5. One of the best predicors of insomnia later in life is the development of bad habits from having been sleep deprived by young children.

6. The continuous brain recordings that led to the discovery of REM (rapid eye movement) sleep were not done until 1953, partly because the scientists involved were concerned about wasting paper.

7. REM sleep occurs in bursts totaling about 2 hours a night, usually beginning about 90 minutes after falling asleep.

8. Dreams, once thought to occure only during REM sleep, also occure (but to a lesser extent) in non-REM sleep phases. It’s possible there may not be a single moment of our sleep when we are actually dreamless.

9. REM dreams are characterized by bizarre plots, but non-REM dreams are repetirive and thought-like, with little imagery obesessively returning to a suspicion that you left your mobile phone somewhere, for example.

10. Certain types of eye movements during REM sleep correspond to specific movements in dreams, suggesting at least part of the dreaming process is analogous to watching a film.

11. No-one knows for sure if other species dream, but some do have similar sleep cycles to humans.

12. Elephants sleep standing up during non-REM sleep, but lie down for REM sleep.

13. Some scientists believe we dream to fix experiences in long-term memory, that is, we dream about things worth remembering. Others reckon we dream about things worth forgetting to eliminate overlapping memories that would otherwise clog up our brains.

14. Dreams may not serve any purpose at all but be merely a meaningless byproduct of two evolutionary adaptations: sleep and consciousness.

15. REM sleep may help developing brains mature. Premature babies have 75 percent REM sleep, 20 percent more than full-term babies. Similerly, a newborn kitten, puppy, rat or hamster experiences only REM sleep, while a  newborn guinea pig (which is much more developed at birth) has almost no REM sleep at all.

16. Scientists have not been able to explain a 1998 study showing a bright light shone on the backs of human knees can reset the brain’s sleep-wake clock.

17. British Ministy of Defense researchers has been able to reset soldiers’ body clocks so they can go without sleep for up to 36 hours. Tiny optical fibers embedded in special spectacles project a ring of bright white light ( with a spectrum identical to a sunrise) around the edge of soldiers’ retinas, fooling them into thinking they have just woken up. The system was first used on US pilots during the bombing in Kosovo.

18. Seventeen hours of sustained wakefulness leads to a decrease in performance equivalent to a blood alcohol-level of 0.05%.

19. The 1989 Exxon Valdex oil spill off Alaska, the Challenger space shuttle disaster and the Chernobyl nuclear accident have all been attributed to human errors in which sleep-deprivation played a role.

20. The NRMA insurance estimated fatigue is involved in one in 6 fatal road accidents.

21. Exposure to noise at night can suppress immune function even if the sleeper doesn’t wake. Unfamiliar noise, and noise during the first and last two hours of sleep, has the greatest disruptive effect on the sleep cycle.

22. The “natural alarm clock” which enables some people to wake up more or less when they want to is caused by a burst of the stress hormone adrenocorticotropin. Researchers say this reflects an unconscious anticipation of the stress of waking up.

23. Some sleeping tablets, such as barbiturates supress REM sleep, which can be harmful over a long period.

24. In insomnia following bereavement, sleeping pills can disrupt grieving.

25. Tiny luminous rays froma digital alarm clock can be enough to disrupt the sleep cycle even if you are not fully awake. The light turns off a “neutral switch” in the brain, causing levels of a key sleep chemical to decline within minutes.

26. To doze off, we must cool off; body temperature and the brain’s sleep-wake cycle are closely linked. That’s why hot summer nights can cause a restless sleep. The blood flow mechanism that transfer core body heat to the skin works best between 18-30 degress. But later in life, the comfort zone shrinks to between 23-25 degress, one reason why older people have more sleep disorders.

27. A night on the grog (alochol) will help you get to sleep but it will be a light slumber and you won’t dream much.

28. After five nights of partial sleep deprivation, three drinks will have the same effect on your body as six would when you’ve slept enough.

29. Humans sleep on average around three hours less than other primates like chimps, rhesus monkeys, squirrel monkeys and baboons, all of whome sleep for 10 hours.

30. Dolphins at risk of attack by predators are able to balance the need for sleep and survival, keeping one half of the brain awake while the other slips into sleep mode.

31. Ten percent of snorers have sleep apnea, a disorder which causes sufferers to stop breathing up to 300 times a night and significantly increases the risk of sufferig a heart attack or stroke.

32. Snoring occurs only in noo-REM sleep.

33. Teenagers need as much sleep as small children ( about 10 hrs.) while those over 65 need the least of all ( about six hours). For the average adult aged 25-55, eight hours is considered optimal.

34. Some studies suggest women need up to an hour’s extra sleep a night compared to men, and not getting it may be one reason women are much more susceptible to depression than men.

35. Feeling tired can feel normal after a short time. Those deliberately deprived of sleep for research initially noticed greatly the effects on their alterness, mood and physical performance, but the awareness dropped off after the first few days.

36. Diaries from the pre-electric-light-globe Victorian era show adults slept nine to ten hours a night with periods of rest changing with the seasons in line with sunrise and sunsets.

37. Most of what we know about sleep we’ve learned in the past 25 years.

38. As a group, 18-24 year-olds deprived of sleep suffer more from impaired performance than older adults.

39. Experts say one of the most alluring sleep distractions is the 24-hour accessibility of the internet.

40. The extra-hour of sleep received when clock are put back at the start of daylight savings has been found to coincide with a fall in the number of road accidents.

          *While there are many physical aspects of sleep apnea, there are also psychological ones, and they may be more subtle to identify and accurately diagnose. The first aspect we see in this condition is that the person does not receive a restful night’s sleep. The reason we need sufficient sleep is because the body needs a certain amount of sleep to restore, repair and recharge the body’s major organs right down to the cellular level. If this doesn’t happen, the person will feel fatigue in the morning. Daytime drowsiness occurs, and this overwhelming desire to sleep will stay with the person throughout the day.

Lack of sleep due to sleep apnea will cause frustration and irritability, as the person needs to stay awake to operate their daily tasks. Problems with concentration and memory loss are also common pshchological aspects of sleep apnea. All of these emotions will add up and provoke a growing sense of depression. The person may even feel like they are losing their mind, as their ability to think clearly is reduced.  The only desire may be to stay in bed and get the rest they think they need, when in reality, they should be getting treatment for their sleep apnea.

In extreme cases, the psychological effects of sleep apnea may include thoughts of suicide. If the brain is continually not getting enough oxygen night after night, the quality and purpose of a person’s life steadily drops. Antidepressant drugs are not efficient in this case, ither, because the medical condition of sleep apnea needs to be diagnosed and effectively treated first.

Depression and Snoring

        * Recent research suggest a link between some cases of clinical depression and obstructive sleep apnea (OSA). While steadily becomes more widely known and understood in developed countries, obstructive sleep apnea remains on of the least-diagnosed health issues affecting millions of people.
In OSA sufferers, changes in structures and tissues in the throat cause the throat to collapse or close off during sleep, blocking breathing completely and leading to the signature deep and loud snore as the person finally overcomes the obstruction and gasps for a breath of air. Respiratory interference during sleep often results in alarmingly low blood oxygen levels-which in turn lead to changes in metabolism and blood chemistry, raising the risks of cardiovascular disease among other health issues, and sometimes even causing sudden death by asphyxiation. Now it appears that the chemical changes brought on by this disease may also lead to deep mental depression in some patients.
 If you sometimes wake to hear yourself snoring-or if your spouse complains of your loud snoring- it might be awfully smart for your mental as well as physical health to contact on otolaryngologist or sleep clinic to see if an attended or unattended sleep study is appropriate and indicated. However preformed, the object of such a study is to record your breathing and your blood oxygen levels throughout a night of sleep, to determine if your own throat is collapsing and stopping your breathing. If so, then a various of surgical and non-surgical treatments are available to save your life and breath-and apparently even your sanity!
    

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