10 Health Condition That Steal Sleep

Depression and menopause are just two medical conditions that can rob you of sleep. Discover other culprits that can motive insomnia. Having problems going to sleep or staying asleep? A health fit out could be to blame. Research suggests that sleep disturbances such as insomnia are imbedded in certain medical conditions.
“We’re finding that both the quantity and grade of sleep a person gets can be linked to a number of health issues and diseases,” says James Wellman, MD, medical the man of the Sleep Disorders Center of Georgia in Augusta. Sleep problems may be caused by natural, emotional, or hormonal conditions everything from asthma to depression to menopause. Here are the most standard culprits.
Depression: Sleep problems and depression are common bedfellows. Some research shows that 90 percent of people with depression experience troubled sleep. “In low-grade depression, insomnia is often the most prominent symptom,” says Dr. Wellman. Waking up too early in the morning is a hallmark of serious depression. Other depression-related sleep problems include difficulty falling asleep and sleeping excessively. Anxiety (persistent worrying and uneasiness) can also leave you wide awake due to the inability to relax. Appropriate medications can help ease depression and anxiety, as well as the resulting sleep problems.
Menopause: As a woman’s periods start to end, insomnia may begin. According to the National Sleep Foundation, 61 percent of menopausal women have sleep problems. One possible reason: Progesterone levels drop off during menopause. “Progesterone is a sleep-promoting hormone,” says Wellman. Changing levels of estrogen during menopause can also cause sleep disruptions by bringing on hot flashes, sudden waves of intense body heat, and sweating.
Diabetes: Diabetics often find restful sleep elusive due to blood sugar fluctuations, night sweats, and the need to urinate frequently during the night. Insomnia can also increase the risk of developing diabetes. In a recent study involving 1,741 adults, people who slept less than six hours were more likely to develop type 2 diabetes than those who got more sleep.
Musculoskeletal disorders: The intense pain of arthritis can make drifting off to dreamland difficult. Plus, arthritis patients who must shift positions during the night often find it hard to fall asleep again. A pain reliever before bed can help ease sleep-stealing arthritis pain. Fibromyalgia, a condition characterized by painful ligaments and tendons, has also been linked with sleep disturbances, as well as next-day fatigue.
Cardiovascular disease: Two common cardiovascular conditions, coronary artery disease and congestive heart failure, have been linked to sleep problems. In coronary artery disease, fluctuations in circadian rhythms can cause chest pain, an irregular heartbeat, or even a heart attack while sleeping. Congestive heart failure prevents the heart from pumping enough blood to reach all parts of the body. As a result, extra fluid accumulates around the lungs while you are lying down, causing you to wake up during the night. Using pillows to elevate the upper body can help.
Asthma: People with asthma often have sleep disturbances because of breathing difficulties, wheezing, and coughing, says Wellman. Asthma symptoms are usually worse at night due to night time changes in functioning that constrict the airway, increasing the risk of asthma attacks during the night. Some of the medications used to treat asthma can also cause insomnia and fragmented sleep.
Heartburn or GERD: In heartburn or gastroesophageal reflux disease (GERD), acidic juices in the stomach flow back into the esophagus, causing irritation and painful burning sensations. This can make it difficult to fall asleep and stay asleep. Lying down often worsens the condition. Avoiding big meals, coffee, and alcohol in the evening may help relieve heartburn and bring on a restful night’s sleep.
Eating disorders: “Anorexia has been found to interrupt normal sleep patterns, possibly due to malnutrition and excessive weight loss,” says Wellman. Research suggests that anorexics get more non-REM sleep and less REM sleep than people of normal weight, resulting in next-day tiredness. Bulimia is often characterized by eating binges and purges during the night, interfering with a good night’s sleep.
Kidney disease: Kidney disease prevents the kidneys from filtering wastes from the blood, which can lead to insomnia or restless legs syndrome. Dialysis or even a kidney transplant doesn’t always result in normal sleep, says Wellman. Researchers aren’t sure why.
Thyroid disease: An overactive thyroid gland (hyperthyroidism) can cause sleep-busting night sweats, while an underactive thyroid gland (hypothyroidism) brings on excessive daytime sleepiness. Both of these thyroid conditions can be diagnosed with a simple blood test and easily treated with medications.
When sleep problems are due to a medical problem or physical condition, treating the condition will often resolve the insomnia and ease sleep disturbances, says Wellman. See your doctor for an evaluation, and you may find that your insomnia does a disappearing act, in the buy Ambien online. If not, the next step is to make an appointment with a sleep specialist.

Insomniacs should get out of bed for better sleep

Getting out of bed may be the key to helping insomnia, a new study published in the Archives of Internal Medicine suggests.

The study, done by a team of researchers at the University of Pittsburgh school of Medicine and led by Daniel Buysse, followed 79 adults with chronic insomnia who averaged 72 years of age.
Buysee wanted to find out if cognitive behavioral therapy for insomnia, which is just as effective as a pill according to previous research, could be shortened and simplified at lower costs. In the past, these pill-free therapies have been very involved and too pricey for the general population.
One conclusion from the behavioral study stated by Buysee, “When you are sleeping poorly, the most important thing you can do is spend less time in bed.”
Insomnia is defined as the difficulty in initiating, or maintaining, sleep and an estimated 30%-50% of the general population are affected by this sleep disorder. Statistically insomnia seems to affect more women than men and it’s incidence tends to increase with age.
Insomnia can affect a person’s ability to function during the day which can lead to accidents, and a wide range of various physical symptoms, including hypertension and inflammation.
The study focused on using cognitive behavioral therapy for the participants that were unable to get to sleep. The participants were given either printed educational materials about sleep, or 2 brief behavioral in-person treatment sessions followed by 2 phone call sessions.
The mental health nurse practitioner conducting the sessions focused the sleep instruction on restricting time in bed and setting regular sleep and wake-up schedules. The practitioner also gave instructions on the biological reasons for the particular sleep strategies utilized in the behavioral therapy study.
Thomas Neylan of the University of California, San Francisco, gave comment to this research stating, “A lot of insomniacs spend a lot of time lying in bed worrying about their sleep, among other things. They expect to have insomnia.”
Neylan gave further recommendations for insomniacs by suggesting, “If you’re not ready to fall asleep, don’t lie down in bed and try to force yourself to sleep. And if you wake up in the middle of the night and don’t fall back asleep easily, get out of bed. You don’t want to have any linkage between the experience of lying in bed and being awake. “

Insomnia in women with breast cancer linked to heart rate

This study is the first to analyze both hormonal and autonomic responses in metastatic breast cancer patients suffering from insomnia.
Westchester, Ill. –A study in the October 15 issue of the Journal of Clinical Sleep Medicine shows that respiratory sinus arrhythmia (RSA) is a significant predictor of insomnia in women with breast cancer and confirmed that longer nocturnal wake episodes were associated with a flatter diurnal cortisol slope.
Results of this study confirmed a relationship between frequent awakenings and abnormal cortisol (a steroid hormone that regulates blood pressure), rhythms in metastatic breast cancer, thus concluding that a disrupted cortisol rhythm may have serious medical implications in women with breast cancer.
With the addition of demographics, disease severity and psychological variables, findings suggest that Vagal regulation, assessed via RSA, an important marker of parasympathetic tone, is the most consistent and significant predictor of sleep continuity disturbance. Diminished RSA has been associated with both worse medical and psychiatric health. Previous studies suggest that RSA is associated and may even be predictive for insomnia in healthy subjects.
"It was surprising to see that the strongest association was between a parasympathetic nervous system dysregulation and sleep problems even after we considered patients' age, their disease severity, type of treatment and psychological variables such as pain and stress," said the study's lead author, Oxana Palesh, PhD, Research Assistant Professor at the University of Rochester Cancer Center.
Insomnia symptoms were associated with a lower baseline of RSA. Lower RSA is associated with decreased parasympathetic functioning in insomniacs, and weakened parasympathetic functioning is associated with increased stress and decreased emotional regulation.
The study included 99 women who had metastatic breast cancer or recurrent breast cancer and who were over the age of 45. Thirty-nine patients took antidepressant medications in this study, and 19 took medications specifically prescribed for treating disrupted sleep during study baseline. Participants collected saliva for cortisol measurement for two days, completed questionnaires, wore actigraphs to monitor their sleep-wake cycles for three days, and participated in the Trier Social Stress Task (TSST) approximately one-to-two weeks after the cortisol baseline collections. The TSST is a standardized social and cognitive stress test. Demographic and cancer diagnosis history was collected from the women through self-report.
Heart rate dysregulation (diminished or low respiratory sinus arryhthmia) during a stress task was associated with four objective measures of sleep disruption: sleep efficiency, wake after sleep onset, average number of awakenings and average length of waking episode.
Estimates from two nights of actigraphy indicate that participants spent about eight hours in bed and had wakefulness after sleep onset (WASO) of more than 71 minutes. They also had an average of 15 wake episodes each night with an average duration of 4.81 minutes.
While demographics explained some portion of the development of sleep disruption, four of the six sleep parameters examined (Sleep efficiency, wakefulness after sleep onset, mean number of waking episodes and average length of waking episodes) were best explained by low RSA.
In healthy people, cortisol levels peak early in the morning and level-out by the end of the day. However, in one-third to two-thirds of women with metastatic breast cancer, circadian rhythms are disrupted and diurnal cortisol slopes are either flattened, have multiple peaks, or are elevated at the end of the day. In the non-cancer population, evidence shows that people with insomnia have an elevated response to stress in general. Psychiatric disorders, including major depression, are linked with hypothalamic-pituitary-adrenal axis (HPA) dysregulation. Past research has linked insomnia to activation of the stress-response system, which results in an increased level of cortisol.
Sleep disruption is two to three times more common in cancer patients than in the general population; these disturbances may exacerbate concurrent cancer and/or treatment related symptoms such as fatigue, mood disturbance, and gastrointestinal distress, psychiatric illness and may lead to reduce quality of life and overall health.
According to Palesh, one of the best interventions for regulation of autonomic functioning is diaphragmatic breathing. Any number of stress management techniques would be effective, including biofeedback treatment, hypnosis, visualization exercises, meditation, progressive muscle relaxation and yoga.

Arousal frequency in heart failure found to be a unique sleep problem

Findings show that factors other than central sleep apnea may contribute to poor sleep quality in heart-failure patients. A study in the Jan. 1 issue of the journal Sleep demonstrates that the frequent arousals from sleep that occur in heart failure patients with central sleep apnea (CSA) may reflect the presence of another underlying arousal disorder rather than being a defensive mechanism to terminate apneas.
Principal investigator, Douglas Bradley, professor of medicine at the University of Toronto said that researchers involved in the study were surprised that using CPAP to alleviate CSA had no effect on arousals and no effect on sleep structure.
Bradley said, "These results indicate that unlike OSA, arousals from sleep in CSA are not protective, but probably have the opposite effect: they appear to be causative. This finding suggests that future studies should explore preventing arousals from sleep in order to treat CSA."
Results indicate that after three months of treatment with continuous positive airway pressure (CPAP) therapy, heart failure patients with CSA show no significant improvement in the frequency of their arousals or in their sleep structure even though breathing pauses are significantly reduced by 55 percent from 35.4 central apneas and hypopneas per hour to 16.1 events per hour. Arousals remain high (24.3 arousals per hour on CPAP compared to 28.8 at baseline), total sleep time stays the same at 318 minutes, and sleep efficiency remains low at 70 percent.
Data were analyzed from 205 heart failure patients with CSA who were enrolled in the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure trial, a prospective, randomized, multicenter clinical trial. Participants were between 18 and 79 years of age, and they were randomly assigned to a CPAP treatment group (97 members) or a control group (108 members). CSA was defined as an apnea-hypopnea index (AHI) of 15 or more with more than 50 percent of apneas and hypopneas central in nature. Members of both groups were assessed by overnight polysomnography at baseline and again after three months. Participants in the treatment group were instructed to use CPAP nightly for six or more hours, and their actual usage time was 4.6 hours per day.
According to the authors, arousals in patients with obstructive sleep apnea (OSA) are considered to be an important defense mechanism to terminate apneas, and treating OSA with CPAP immediately reduces the frequency of arousals. In contrast, arousals in heart failure patients with CSA often occur several breaths after apnea termination.
The authors suggest that hear failure patients with CSA may have a "predisposition to hyperarousability," and in some there may be an underlying arousal disorder accompanied by sleep disruption that is neither a consequence of CSA nor of impaired cardiac function. In heart failure patients with CSA, arousal from sleep may be incidental to, or play a causative role in, the development of CSA by rendering the respiratory control system unstable. Thus factors other than sleep apnea such as pulmonary congestion during the night, other comorbidities, or medications, may explain the frequent arousals that heart failure patients experience.

Measuring Heart Rate Easier for Diagnosing Sleep Disorders

Researchers may have found an easier way for diagnosing sleep disorders. Standard sleep studies are involved, necessitating an overnight stay at a sleep center or hospital, while wearing electrodes on the chest and head. During a sleep study, monitors record a variety of bodily functions to help diagnose sleep disorders.
Scientists from Israel and Germany have discovered that simply measuring and recording heart rate -then analyzing the data as it relates to breathing and sleep patterns- might be an easier way to diagnose sleep disorders
Synchronization between heart rate and breathing occurs during certain stages of sleep. Measuring heart rate and breathing can yield important information about sleep duration and quality. During inhalation, the heart beat speeds up. Heart rate slows with exhalation. During REM (rapid eye movement) sleep, heart rate and breathing become more variable, as opposed to deep, steady sleep with regular breathing.
The study included data from 295 people from the European project SIESTA, spanning seven countries. Nearly half have sleep disorders. Study participants underwent normal sleep studies, including electrodes that monitor heart rate, brain waves, eye movement, and muscle activity. Next, the researchers analyzed heart rate only in 150 subjects, known to have sleep disorders. Using their own mathematical model, measuring heart rate and breathing synchronicity, yielded the same results found in the traditional sleep studies. They found that heart rate and breathing are not synchronous during REM sleep, but that heart rate and breathing synchronizes during light and deep sleep.
The researchers plan to continue their studies. They hope that easier diagnosis of sleep disorders will help in the diagnosis of cardiac disease, and treatment of heart failure. Monitoring heart rate and respirations to determine the presence of sleep disorders might also help athletes with optimal training.
Sleep disorders can lead to serious health complications. Making sleep disorders easier to diagnose could reduce traffic fatalities that occur from lack of sleep, heart attacks, obesity, depression and stroke.

What A Sleep Study Can Reveal About Fibromyalgia

Research engineers and sleep medicine specialists from two Michigan universities have joined technical and clinical hands to put innovative quantitative analysis, signal-processing technology and computer algorithms to work in the sleep lab. One of their recent findings is that a new approach to analyzing sleep fragmentation appears to distinguish fibromyalgia patients from healthy controls.
Joseph W. Burns, a research scientist and engineer at the Michigan Tech Research Institute (MTRI); Ronald D. Chervin, director of the University of Michigan’s Michael S. Aldrich Sleep Disorders Laboratory; and Leslie Crofford, director of the Center for the Advancement of Women’s Health at the University of Kentucky, report the results of their study in the current issue of the journal Sleep Medicine
MTRI, a freestanding research institute acquired by Michigan Tech in 2006 and based in Ann Arbor, specializes in remote sensors that collect data, and in signal processing, using algorithms or computer programs to analyze and correlate the information the sensors gather. MTRI has developed an ongoing collaboration with the University of Michigan’s sleep laboratory, one of the nation’s leading clinical and research centers specializing in sleep medicine.
This several-year collaboration provided MTRI’s first opportunities to apply quantitative analysis, remote sensing technology and computer algorithms to clinical challenges, said Burns. “In this case, our analyses of sleep stage dynamics suggest potential clinical relevance,” he noted. Newly explored measures of sleep fragmentation seem to correlate—at least in this study—with levels of pain reported by fibromyalgia patients.
Burns, who has a PhD in electrical engineering, finds that more and more of his research is taking a biomedical turn. He and his team are working with Chervin to use signal-processing technology to record and analyze the brain waves and biophysical responses of children and adults with a variety of sleep disorders. They hope it will help them better understand conventional sleep patterns, as well as diagnose and treat sleep disorders.
They presented the results of research related to assessment of sleep-disordered breathing and sleep fragmentation at Sleep 2008, an international sleep research conference, in Baltimore in June.
Patients who may have sleep disorders often undergo complicated and expensive tests in sleep laboratories, Chervin explained. These studies collect an assortment of biophysical data that reflect brain, cardiovascular and muscle activity throughout the night. Up to now, these data had to be analyzed manually by highly trained technicians.
“We are collaborating to find new ways to analyze routinely collected data in a way that will be meaningful to the patient’s health and will help us understand how sleep disorders affect brain functions,” he said.
Automated analysis of data potentially can provide improved assessments and reduce the cost of sleep studies, Burns noted. For example, MTRI and UM have developed an automated technique for assessing the severity of sleep-disordered breathing, using just two signals—brain waves and respiration—instead of the dozen or more signals typically needed for standard visual scoring of a sleep study.
“It may even become possible for people to take sleep tests—simpler and more effective than some of those currently available—at home where they can sleep in their own familiar bedrooms,” he suggested.
Both partners are reaping the benefits of the collaboration, Burns said. Not only can automated technology improve clinical research; what the MTRI scientists have learned about biomedical techniques such as brain mapping is informing their more traditional work on radar and optical sensing technology.

Women Who Sleep Less Than 8 Hours Live Longer

How much sleep is too much or too little? For women, researchers at the University of California, San Diego say that to live longer, the optimal number is less than 8 hours, and that 5.0 to 6.5 hours is ideal.

Eight hours is too much sleep for women

In the new study, a team of investigators evaluated data originally collected between 1995 and 1999 from 459 women ranging in age from 50 to 81. That study had indicated women who slept 6.5 to 7.5 hours per night had the best survival rates.
Now, 14 years later, the researchers took another look at the original group of women, of whom 444 could be identified for evaluation purposes. Eight-six women had died.
According to the study’s lead scientists, Daniel F. Kripke, MD, professor emeritus of psychiatry at UC San Diego School of Medicine, “when sleep was measured objectively, the best survival was observed among women who slept 5 to 6.5 hours. Women who slept less than five hours a night or more than 6.5 hours were less likely to be alive at the 14-year follow-up.”
The researchers also found that obstructive sleep apnea among older women did not predict an increased risk of death. Kripke noted that while sleep apnea may be associated with a greater risk of death among younger women, “it does not seem to carry a risk in the older age group, particularly for women.”
Countless studies have explored the optimal amount of sleep needed for various populations, from infants to the elderly. According to the National Sleep Foundation, there is no “magic number.” Visitors to the Foundation’s website will find that “not only do different age groups need different amounts of sleep, but sleep needs are also individual.”
That said, research shows that getting too little sleep is associated with many health concerns, including inhibited productivity, difficulty remembering and consolidating information, increased risk for motor vehicle accidents, increase in obesity, increased risk of diabetes and heart problems, and increased risk for psychiatric conditions. Some research also shows that too much sleep (generally considered more than 9 hours or more) is associated with an increased risk of illness and morbidity.
Are people losing sleep over worrying whether they are getting enough or too much sleep? According to Kripke, the results of this new study should provide some answers, at least for women who may worry about sleeping less than 8 hours. “This means that women who sleep as little as five to six-and-a-half hours have nothing to worry about since that amount of sleep is evidently consistent with excellent survival.”