Sleep Newzzz

Fact or Fiction: You Can Catch Up on Sleep Over the Weekend

Michael J. Breus, Ph.D. — Tue, 17 Nov 2009 20:52:34 +0000

If we're watching our weight and "blow it" on any given day, we're told it's okay because we can make up for it the next day and get back on track. But what about when we lose sleep? Can we catch up over the weekend and, say, sleep in on Sunday morning to make up for those late, late nights during the work week?

I get this question a lot. I think it's because people expect to hear something different from the truth: NO, you can't just pay off a sleep debt by sleeping late on the weekend. Sorry. The proof? Check out the following studies of late, which have changed some of the conventional thinking of many of us in the world of sleep science:

• In 2003, scientists at the Walter Reed Army Institute of Research examined the cognitive effects of a week of poor sleep, followed by three days of sleeping at least eight hours a night. The scientists found that the "recovery" sleep did not fully reverse declines in performance on a test of reaction times and other psychomotor tasks, especially for subjects who had been forced to sleep only three or five hours a night.
• In a similar study in 2008, scientists at the Karolinska Institute in Stockholm found that when subjects slept four hours a night over five days, and then "recovered" with eight hours a night over the following week, they still showed slight residual cognitive impairments a week later, even though they reported no sleepiness.
• Another study done this year at Walter Reed found that people recovered much more quickly from a week of poor sleep when it was preceded by a "banking" week that included nights with 10 hours of shuteye.

The good news in this latest study, and a change from prior thinking, is that it appears you can prepare for an upcoming sleep debt by banking some hours of sleep. In other words, if you know you have a week of little sleep ahead of you, try loading up on sleep beforehand, not simply afterward. However it should be noted that you are likely only paying off a bit of sleep debt, to bring your reserves back to normal, before depleting them again.

The bad news, of course, is that it's not so easy to pay off a sleep debt in a single night of solid sleep. And the effects of that sleep deprivation can last a lot longer than what you'd imagine. (We all just got an extra hour last a few weeks ago when the time changed. How much better off are you today?)

The lesson: avoid choric sleep deprivation entirely, and when life gets in the way of that goal, then plan for it. Use weekends to prepare for a long work week rather than trying to make up for them.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™

www.thesleepdoctor.com

Andy Rooney on Sleep

Michael J. Breus, Ph.D. — Wed, 04 Nov 2009 21:36:59 +0000

Yes, Andy, we do sleep about a third of our lives away.

And I agree, it would be nice to have a gauge on us to let us know when we need to get some shut eye or when we've had enough, much like a battery light that comes on to tell us it's time to charge a certain device for optimal use. Green means go. Red mean stop.

Earlier this month when Andy Rooney gave his classic spiel during the last segment of 60 Minutes, he talked about sleep. He doesn't quite understand why so many people have problems with sleep, especially since he "can sleep night or day, sitting, standing, or lying down" and he admits to falling asleep right at his desk or on a bus going across town. He can get along on 7 hours, and thinks that anyone who gets 9 hours or more is sleeping his or her life away.

Andy's quips were no doubt enjoyed by many. But a few big topics Andy failed to cover, though, are sleep's impact on:
• Overall health
• Memory, and
• Ability to get things done (ahem, like work into nineties and have the energy to go on television on a weekly basis).

But what about that "device" to tell us when we've had the perfect amount of sleep? Might I suggest:

• Signs of your battery is getting low: fatigue, sleepiness, low energy, need for caffeine, moodiness, inability to focus, difficult concentrating
• Signs of your battery has been charged properly: feeling refreshed when you wake up, having the energy to get through your day, not needing caffeine to stay awake, alert, and productive

Put simply: the body tells us when we need sleep. It's the "y" effect. When we're hungry, we eat, when we're thirsty, we drink, and when we're sleepy we sleep. Or should at least. And I sense that Mr. Rooney knows that, alongside the other secrets to sound sleep. How else can he be so vibrant, focused, and productive at ninety years old?

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor^TM
www.thesleepdoctor.com

Pilot Fatigue to Blame?

Michael J. Breus, Ph.D. — Fri, 30 Oct 2009 11:54:48 +0000

If you learned upon landing that your plane's pilots had overshot the airport by 150 miles because they fell asleep at the controls, what would you feel?

Terrified?
Shocked?
Lucky?

I'd feel a mix of the above. In this week's latest hit to the airline industry, a Northwest flight to Minneapolis overshot its destination and pilot fatigue could be to blame. Of course, the pilots are saying they were in an argument at the time and that's the reason for the blunder (not that I'd like to see my pilots so distracted over a "debate" that they still overshoot the runway!).

Fatigue among pilots has been a recurring theme this year, punctuated earlier this year by the deadly crash near Buffalo that was partly blamed on fatigue (that crash was blamed on pilot error).

The Federal Aviation Administration is rewriting its rules that govern flight time for pilots and their required rest periods in order to reduce the chances of fatigue. It will be the first update to the rules in decades and will utilize research that wasn't available before.

Does that make me feel better the next time I fly?

A little, maybe. Trouble is, it can be hard to legislate such rules. And sometimes fatigue over a series of poorly slept nights can catch up to you days later. In other words, you could have a sleep-deprived weekend, feel okay on Monday but be a zombie on Tuesday when you're expected to perform-and the lives of countless others are in your hands.

I've written about shift workers a lot in the past. But those who have jobs that put the lives of many others at stake should be scrutinized to a much higher degree. If it's that easy to fall asleep at the controls of an airplane-without the airplane knowing (or its numerous flight attendants!), then I say, let's invent something that can keep check on that. With all the gadgets we have at our disposal today, can't we find one that can alert the crew on a flight when its captain has nodded off?

Just a thought. Now that would make me feel safer in the skies.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor^TM
www.thesleepdoctor.com

Tic-Toc: News about Your Clock

Michael J. Breus, Ph.D. — Sat, 24 Oct 2009 13:07:15 +0000

I love a study that debunks an old theory long believed true. Last week, scientists at the University of Michigan came out with a bold statement: everything we know about the human biological clock is wrong.

According to these researchers, who hail from mathematics, the cells responsible for maintaining the clock in the part of the brain called the suprachiasmatic nuclei, or SCN, don't fire all day and night like previously thought. The cells that control the clock are silent during the day. Though these cells sustain an electrically excited state, they don't actually fire until a brief period around dusk, and then remain quiet throughout the night before releasing another burst of activity around dawn. Think of a clock that only chimes twice a day - because the time only needs to be announced at two particular times. The clock keeps ticking during the silent periods, to make sure the time is accurate when it is time for the chimes to sound.

This may not sound like big news for you (or even mean all that much), but it means a lot to people in sleep medicine and in general medicine for that matter. I've written often about biological clocks in the past. It's a fascinating area of research that has so many applications to everyday life. Consider how much your internal clock determines the quality of your life. And if you don't know what I mean by that, then here's a quick summary. All of the following relate to your internal clock:

• Your sleep/wake cycles.
• How refreshed you feel in the morning.
• How easy it is for you to fall asleep at night.
• Whether you can recover quickly from jet lag.
• The fate of a shift worker who has to be productive at odd hours.
• Whether you're a lark or an owl.
• Your mood and energy level.
• The strength of your immune system.
• Your ability to ward off diseases, including cancer and Alzheimer's.

It may seem unfathomable that your body's clock can influence diseases like cancer, but it's true. Think of your clock as your body's central pacemaker-a means by which the body can remain balanced and, in medical speak, in a state of homeostasis.

I expect future studies to validate some of this new information. It's been suggested that there's more than one clock in the body. Perhaps these math gurus should apply their mathematical model to these other clock ideas and see what emerges. Time will tell...

Tic Tock.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor^TM
www.thesleepdoctor.com

Attention Parents with an Autistic Child: Is a Sleep Clinic in Order?

Michael J. Breus, Ph.D. — Mon, 19 Oct 2009 03:30:13 +0000

Nothing could be more challenging, exhausting and rewarding than raising an autistic child. Not only is the situation difficult for doctors and parents alike, but it's manifested in oh-so-many ways across a spectrum of symptoms and to varying degrees in different children. One of the most commonly experienced problems, however, is trouble sleeping.

So I applaud the sleep counselors at a special school in Manchester, England, who are helping autistic children and their parents deal with disturbed sleep patterns.

Typically, an autistic child can:
• Have erratic and prolonged settling down routines.
• Have the need to perform rituals prior to going to bed, such as going up and down stairs a certain number of times, or repeatedly check on other family members.
• Have trouble learning to sleep alone in a room.
• Wake frequently and require time to settle back down with the help of an overtired parent.
• Be very sensitive to light and sound.
• Be tactilely defensive to sheets, PJ's and covers.

All of this makes for overtired children and parents. Not a good thing for the health and wellness of either. This exacerbates an already difficult situation, affecting an autistic child's ability to perform and learn in school, as well as a child's ability to gain the upper hand on a sleep-deprived mood. Any parent who has had to endure endless nights of little sleep can attest to their own package of consequences: poor concentration levels, low tolerance for coping with the challenging behaviors of their children, and high stress. And I know those are just a few examples in the litany of negative effects to chronic sleep deprivation.

Establishing a firm routine appears to be the magic bullet to helping autistic children. This strategy actually works for helping anyone become a better, sounder sleeper. It lies at the core of sleep hygiene.

My hope is that the trend in addressing the sleep needs of autistic children expands and reaches the shores of us here in American. I'm not aware of any sleep clinics that focus chiefly on autistic children and their parents, but it wouldn't surprise me to see them pop up soon enough.

Ask your doctor in the meantime - and remember that the practice of good sleep hygiene can be helpful and rewarding to anyone -whether you're dealing with autism or not.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor^TM
www.thesleepdoctor.com

Something New in Melatonin?

Michael J. Breus, Ph.D. — Wed, 14 Oct 2009 20:50:47 +0000

You don't have to be a shift worker or jet setter to have awkward or non-existent sleeping habits, but both groups suffer quite a bit. Melatonin, one of the more popular over-the-counter supplements, may be headed toward a new delivery system, a patch placed on the body with small pulses of the hormone administered throughout the evening (or day), through your skin!

I've written about this sleep aid frequently because I get so many questions on it. Many supplement companies and health food stores will claim that melatonin is a natural sleeping aid or nightcap because it "naturally" helps regulate sleep-wake cycles. Given its wide spread availability today, you'd presume it's safe and effective.

Is it?

Well, that depends. Melatonin has been shown to help regulate sleep cycles in certain populations and really help out quite a few people, but like anything there are pros and cons :

• The precise mechanism of melatonin secretion in the body is not well understood. We do know, however, that melatonin isn't just about sleep-wake cycles. It's been shown to help regulate the female reproductive cycle and may also affect the onset of puberty. Children who take melatonin can suffer a delay in sexual development. (So never ever give a child a melatonin supplement.)
• This new patch study showed that men and women had different levels of melatonin in their system with the same dosage patch! So a gender difference may apply.
• Studies have pointed to melatonin's role in regulating blood flow, specifically in constricting coronary arteries.
• And it's been suggested that melatonin can increase depression in people prone to the illness.

For the record, melatonin is a hormone, and it's not a regulated drug under the FDA. No other hormone is available in the United States without a prescription. In some parts of Europe, melatonin is available by prescription only.

If this experimental patch version of melatonin reaches the market, it could have a much bigger effect on the body than just popping a pill. The half-life of a melatonin pill is short and it doesn't last long; a patch, on the other hand, can deliver small doses throughout its use to keep the levels in the body consistent for a longer, stronger effect. This might be great for shift workers who sleep during the day, when the body does not like to produce melatonin.

The patch has been tested on people who sleep during daylight hours and work at night.. For this reason, I can see why a melatonin patch could be helpful to those who maintain schedules opposite to the usual solar day (where the body prefers to be functional). And I have great respect for those who manage to live this life for the sake of their careers and my safety (e.g., emergency care, pilots, etc.). But, even though the patch would be sold as a prescription, it wouldn't surprise me to see people getting their hands on it without trying other sleep hygiene tactics first, which can be far more effective and healthier overall for the body, particularly for those of us that can really get our shut-eye at night.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor^TM

Big Decisions Decided After All-Nighters?

Michael J. Breus, Ph.D. — Tue, 13 Oct 2009 12:16:01 +0000

Imagine having to make a huge decision that may affect the lives of millions. Your constituents have voted with confidence in your ability represent them on issues like health care and education.

But after months of contentious debate, when the deadline nears, it comes time to make the critical decisions, there's nothing left to do but pull numerous all-nighters, eat poorly, and struggle to stay awake while you and your colleagues fight for a resolution.

Sound like a group project in college or business school? No wait - it is actually the State Senate!

This is what's been happening in states like California where budgets are running in the red and constitutional rules have forced legislators to lock themselves in the statehouse to get bills passed. California lawmakers have pulled at least six all-nighters so far this year.

On some of these nights, the atmosphere is more like a slumber party than a political arena, as some politicians sneak in a snore-laden snooze while others play solitaire, sing, or Twitter to the outside world. Activities that may help them stay awake during discussion or debate, but might not help them focus as much as they would like on the task at hand.

Crazy? I think so. No good decision can be made by anyone operating on so much sleep deprivation, especially when it's not just one or two people here. We're talking about an entire assembly of lawmakers trying to do their job and make an impact on the health and welfare of all of us - the folks that elected them - to keep us safe and make sound decisions about our future. That's right: we trust them to make decisions about the health and welfare of others even though when it comes to their own sleep, they don't always make the best health decisions. A real case of "do as I say, not as I do."

We know this about sleep deprivation: there are real physiological and psychological effects as we deprive our bodies of a basic physical need. Our judgment isn't always the best. We know that we start to make bad food choices - we crave things like doughnuts and cookies - choices we might not make when well rested and energized. We do things like "go all in" at 3 a.m., a choice we might not make earlier in the evening. Our reaction time slows, our memory decreases, our bodies and minds slow down in an effort to preserve the energy we have left.

Here's what I see going on as a result of all that sleepiness:

• Bad moods fueling endless, pointless debates among cantankerous colleagues.
• An inability to think clearly and rationally.
• Abuse of caffeine, Visine, and junk food.
• Sporadic snoozing, leaving many missing out on important conversations that are necessary for arriving at effective decisions.

How's that for inspiring confidence in effective lawmaking? I've always been a big fan of napping, but falling fast asleep on the carpet of your Capitol building's floor just doesn't cut it.

Rest up, lawmakers. We've all got a lot of expectations resting on the political agenda these days. One way to ensure you arrive at good decisions is to get a good night's sleep. Every day of the year. Both in and out of the political forums.

Put sleep at the top of your personal healthcare reform agenda. Stop growing your personal sleep debt - we're counting on you to be at the top of your game. You can't be there when you're falling asleep on the job.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor^TM
www.thesleepdoctor.com

Mom, A New School Year Can Spell Sleep Relief (Or Not)

Michael J. Breus, Ph.D. — Wed, 16 Sep 2009 20:32:10 +0000

"A woman's work is never done" - a phrase that will never go out of style, and its partner - a woman's often low-quality sleep life. At least that's what some are reporting as study after study indicate that all the multitasking in the world can't create more time to rest and enjoy leisure time. In fact, a study that came out earlier this year in the Economist revealed that, across 18 countries, men had between 4 to 80 minutes more leisure time per day than women.

Now, 4 more minutes isn't all that much. But 80? That's plenty of time for a good long nap, more time in bed, or simply some downtime sitting on the couch.

Many moms are rejoicing at the thought of the kids going back to school. This means:
• Keeping regular routines and a consistent schedule.
• Having set bed times and wake times.
• Not having to provide entertainment or activities for kids as much during long, summer days.
• No more sleepovers, pool parties, and events way past the kids' bedtime.
• Knowing you've got teachers and a school helping to care for the best interests of your children.

All of these things bode well for the mom trying to avoid major sleep deprivation. With the start of school, however, also come the occasional late-night homework and school projects. Calls from the nurse to come pick up sick little Suzie and take her home. And keeping up with the school-year's list of household chores like laundry, meal planning, and lunch-making. Men and women do share more household responsibilities now more than ever, but it's still the women who carry the heaviest load of caretaking, basically acting as CEO of a family. Another recent study out of the University of Cincinnati suggests that the uneven distribution of domestic responsibilities result in stresses that may be driving a trend of lower quality sleep among working women.

Solution? Either the men have to pick up more slack, or the women have to give themselves permission to do less. Which is more realistic? I'll leave that answer to you.

But if I can give these over-tasked and over-tasking women a few tips to consider as this school year kicks off, here's a few with an eye toward better sleep::
• Knock one item off your To Do list a day and aim to be in bed 15 minutes earlier than the previous night.
• Give yourself a set bed time and wake time, just as you do your kids. You wouldn't let your seven year old stay up past midnight, so why should you?
• Likewise, you watch what your kids eat before bedtime. What are you eating within an hour of your bed time? If you're in the kitchen plowing through a box of sugary cookies or leftover meatloaf, reconsider.
• If you read to your kids at bedtime, you're teaching them great habits for sleep hygiene. Reading can help a person to unwind, relax, and prepare for sleep. When's the last time you did something like that before putting yourself to bed?

Welcome to the new school year. May it be filled with fresh wisdom, challenging activities, and lots of sound sleep.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor^TM
www.thesleepdoctor.com

Off to College, Probably not off to Sleep--- Part 2

Michael J. Breus, Ph.D. — Mon, 14 Sep 2009 02:30:46 +0000

Ah, there's nothing quite like dorm room living:
• Tight quarters.
• Old, rickety furniture and carpeting.
• A small, hard bed.
• Thin walls and rowdy neighbors.
• Late-night hallway parties.
• Perhaps a humming mini-refrigerator and an annoying roommate with whom you share absolutely nothing in common.

Now, that might not sound so pleasant if you're over the age of, say 30, but for many college students, it's acceptable-a kind of hazing period during the transition from high school to the big school.

But none of this bodes well for sleep hygiene. I don't know any college student who isn't sleep deprived and living on caffeine.

Last week, I dispensed some secrets to settling into college life without losing too much sleep over it. The dorm room deserves special attention. It's where college students will spend a great deal of time mixing attempts to get some shut-eye and a host of other activities-socializing, writing papers, studying, talking on the phone, hanging out, listening to music, and so on. Whether it's your first-born making the move to college or you yourself are about to move on up, heed these dorm room makeover tips:

• If possible, strategically arrange the bedroom furniture around any incoming light and noise.
o Face the bed west if possible so that you don't get direct sunlight in the morning.
o Avoid placing the bed directly across from a window that faces east (or you will be rising with the sun).
o If you can get away from the noise but that puts you in the light, move away from the noise and buy some blackout shades.
• Consider the use of a room divider or screen. This will give you more privacy and help dampen light (and some noise) coming from your roommate.
• Decorate the area around the bed differently than the rest of the room. Keep it clutter-free, and try not to snuggle up with your cell phone. Teddy bears are better sleepmates.
• Splurge on good bedding materials that are comfortable for you:
o soften up a hard mattress with a featherbed (which is like a big body pillow you rest on top of the mattress),
o lots of pillows
o consider a mattress topper, and
o a plush comforter.
• Keep high-wattage lights away from the bed. Most dorm rooms are equipped with desks. Keep the high-wattage lights there and install low-wattage lights (45 watts or less) anywhere near the bed.
• Position your entertainment, television and/or computer area so it's not directly aligned with your line of vision when you're in bed. Again consider the use of covers for the monitor and turning off the CPU itself at night.
• Bedside sleepsavers:
o Eye shades.
o Ear plugs.
o Sound machine to wash out background noise.
o Reading lamp or book light.
o Drape clip. If the room is equipped with draperies, try clipping the drapes together at night using a chip clip so there's no light leaking through the crack.
o Aromatherapy.
o Watch out for alarm clocks that light up the whole room.

But all that aside, I'll admit that the most challenging task of all awaits: Having that straightforward conversation with your roommate(s) about the "rules." What if one of you needs to stay up late finishing a lab report, tapping on a laptop with the lights on? What if your roommate wants to invite the entire floor to party in your room until the wee hours of the morning on the night you've promised yourself to go to bed early? How will you manage living with someone who likes to keep to a totally different sleep schedule than you?

Conversation.
You must have it.
Early and often.

Good luck, my aspiring graduates. Cheers to the new academic year.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor
www.thesleepdoctor.com

Off to College, Probably not off to Sleep--- Part 1

Michael J. Breus, Ph.D. — Wed, 09 Sep 2009 12:24:42 +0000

The dog days of summer are fast coming to a close. In the coming weeks, millions of college-bound students will be hitting the books again and adjusting back into university life. For first timers, this is an exciting time period. For veteran upper classmen, it's also a thrilling time to know that you're close to being fully independent and out in the "real" world on your own.

But for both newbies and soon-to-be graduates alike, the one thing that seems to get the best of them every single year is sleep. It's not hard to get that "A" in not enough sleep. Translation: serious deprivation.

Okay, so I'll admit, it comes with the territory. College life is, well, college! A rite of passage, and we all have our top secret stories from then. The two biggest culprits of a sleepless college student:
• Academics and late-night studying.
• "Social" studies and late-night partying.

You can't necessarily forgo either of the above on a consistent basis. But your body wants sleep on a consistentbasis, which can conflict with the trappings of a successful and fun college life. And, without mom or dad around to nag about bedtime (and, might I add, wake time in order to be in class on time), the transition back to school life with all its demands and nocturnal distractions can be difficult.

Solet me offer some realistic solutions that canease any college student back into the swing of things quickly and restfully:

• Time management: this is a no brainer, albeit hard to do well. When homework, the social calendar, and sleep all call for attention, which goes first? How can you maximize all three?
• Set clear boundaries. Tell yourself you won't party past a certain time; keep to a regular sleep-wake schedule as best you can, even on the weekend. Don't use the 24-hour library. Keep a routine study session daily, say from 4 to 7 at night, and don't let social distractions get in the way that will later have you back in the books past midnight.
• Turn off your cell phone after a certain hour, say 10 pm.
• Establish coping skills and stress-reduction practices. College comes with an enormous set of stresses and challenges. Strategies to help balance your stress will have a huge impact in your ability to get things done, and yes, get a good night's sleep.
• Don't forget to exercise. The freshmen 15 isn't just related to a higher intake of (usually buffet-style) food; most college students forgo regular exercise and sleep-the double whammy for packing on the pounds.
• Enlist a support buddy to keep you on track. Having someone who can watch out for you and let you know when it's time to re-think your habits can be a lifesaver. And doing the same for them reaps benefits for you.
• Become a pro napper. Napping can be difficult to pull off out in the corporate world. But there's ample time to nod off in the afternoon library (just don't be caught doing it in class). It's exercise for the brain, after all.

College students get free passes for keeping their computers in their dorm rooms, but watch out for those bright screensavers. Before you put yourself to bed, put your computer to sleep.

In part II, I'll share my ideas for the ultimate dorm room makeover. It's a little different than refiguring your bedroom back home. Even in an itty bitty room the size of a closet or bathroom, you can create a sanctuary for sleep. And yes, even study.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor^TM
www.thesleepdoctor.com