Sleep Duration & Obesity in Children

A new study examined the relationship between sleep duration and obesity in children.

The study involved 5,159 children from 13 schools in Hong Kong; they had a mean age of 9 years. Sleep times and other data were collected using questionnaires.

Results show that children with shorter sleep durations had higher body mass index scores. Children slept for more than 10 hours at night on weekends and holidays; but they slept for only a little more than nine hours on school nights.

Children who slept less than eight hours during weekdays were more than two times more likely to be overweight or obese. The risk was highest in children who did not compensate for weekday sleep loss by sleeping longer on weekends and holidays.

The Sleep Education Blog has reported on a variety of factors that contribute to sleep loss in children. These include family status, prenatal influences, inactivity and watching TV.

Other studies also have linked sleep duration to the risk of obesity. So what is a parent to do?

Don’t wait for your child to “catch up” on sleep over the weekend; help him or her get more sleep during the week to avoid building up a sleep debt.

In July the Sleep Education Blog reported that children who go to bed after 9 p.m. take longer to fall asleep; they also have a shorter total sleep time.

So make sure your child has time to wind down and get in bed before 9 p.m. each night. One way to help is to turn off the TV and the computer earlier in the evening.

What helps your children get to bed early on school nights?

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Sleep Apnea & Surgery: Caught on Camera

Surgery is one treatment option for people who have obstructive sleep apnea. Procedures tend to be “site-specific;” they will seek to eliminate the cause of the obstruction.

The challenge is finding the right site for surgery. Problem areas related to OSA include the tonsils, tongue, soft palate, throat, jaw and nose.

As a result, surgery isn’t a “one size fits all” treatment. In fact, the AASM’s clinical guidelines list more than 20 common surgical procedures for OSA.

Yesterday the Baylor College of Medicine reported that one way to address this challenge is to use an “endoscope;” this is a small flexible device with a camera on the end.

Doctors at the BCM are using it to help identify the cause of obstructions that happen during sleep apnea. They insert the endoscope into the back of the nose to view the throat while the patient is sedated and sleeps.

The camera gives them a front-row seat when an episode of OSA occurs. By finding the cause of the problem, they can develop a more precise treatment plan. This helps prevent unnecessary surgery.

The AASM reports that CPAP therapy is the treatment of choice for all severity levels of OSA. An oral appliance and surgery are alternative treatment options that may help some people with sleep apnea.

The AASM clinical guidelines report that “maxil­lary and mandibular advancement” is one surgical procedure that is often effective. Cuts are made into the bones of the upper and lower jaws. The jaws are pulled forward to enlarge the entire upper airway.

Most other sleep apnea surgeries will rarely cure OSA; you may need to continue with another treatment such as CPAP. But surgery may help reduce symptoms and improve quality of life.

Positive results also may not be permanent; symptoms may reappear at a later time after surgery.

Get help for sleep apnea at an AASM-accredited sleep center near you.

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Sleep Apnea May Trigger Abnormal Heart Rhythms

A new study suggests that episodes of obstructive sleep apnea may trigger two types of “cardiac arrhythmias,” which are abnormal heart rhythms.

The study involved 2,816 people. Their sleep was evaluated during an overnight sleep study.

The sleep study results were examined for two types of abnormal heart rhythms: ventricular tachycardia and atrial fibrillation – or AF.

Results show that the overall rate of arrhythmias was low; 62 abnormal heart rhythms occurred in 57 people.

But the relative risk of an abnormal heart rhythm was much higher after a breathing disturbance; people were nearly 18 times more likely to have an arrhythmia after a breathing pause than after normal breathing.

“Do these events act as a trigger for cardiac abnormalities?" study co-author Dr. Susan Redline said to HealthDay News. “We established that there is a close temporal relationship.”

The study also found that abnormal heart rhythms occurred even when OSA was less severe.

“Most of the arrhythmias occurred in people with mild-to-moderate sleep apnea," said Redline.

AF is the most common type of serious arrhythmia; long-term AF can lead to stroke and heart failure. AF is a very fast and irregular contraction of the atria.

The atria are the two upper chambers of the heart. They collect blood as it comes into the heart.

Ventricular tachycardia is a fast, regular beating of the ventricles. These are the two lower heart chambers. They pump blood out of the heart to the lungs and other parts of the body. Ventricular arrhythmias can be very dangerous.

In June the Sleep Education Blog reported on the link between sleep apnea and abnormal heart rhythms in older men.

Find out more about cardiac arrhythmias on the NHLBI Web site. Get help for sleep apnea at an AASM-accredited sleep center near you.

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Infant Sleep Apnea

Obstructive sleep apnea is common in adults; OSA also occurs in children, especially in preschoolers. Central sleep apnea is most common in middle-aged and older adults. But did you know that infants can have sleep apnea too?

Primary sleep apnea of infancy is most common in small, preterm infants; it is rare in full-term newborns.

During the first month after birth it may occur in about 84 percent of infants who weigh less than 2.2 pounds. The risk decreases to about 25 percent for infants who weigh less than 5.5 pounds.

Apneas that occur in larger premature infants and full-term infants tend to be “central” apneas. These apneas occur when the body decreases or stops its effort to breathe.

The majority of apneas that occur in small, premature infants are “mixed” apneas. These breathing pauses involve an obstructive apnea that directly follows a central apnea.

An obstructive apnea involves a halt in airflow despite an ongoing effort to breathe. It occurs when soft tissue in the back of the throat collapses and blocks the upper airway.

Primary sleep apnea of infancy may be a developmental problem; it may be related to the immaturity of the brain.

It also may be caused or made worse by a variety of medical problems. These include anemia, an infection, acid reflux and chronic lung disease.

In most cases short-term treatment is required. The good news is that primary sleep apnea of infancy tends to go away as the child grows and matures. Long-term complications are rare for most children with primary sleep apnea of infancy.

Learn more about primary sleep apnea of infancy on SleepEducation.com.

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To Sleep, Perchance to Dream: Or Stroll or Snack...

Former "American Idol" judge Paula Abdul told Fox News that while they were living together, her former co-star Kara DioGuardi suffered from sleep eating and sleepwalking.

Sleepwalking is typically seen as a childhood problem. While it is more common in children (as many as 17 percent of children sleepwalk), up to four percent of adults sleepwalk as well.

Sleepwalking, also known as somnambulism, tends to occur during slow-wave sleep, or when you aren’t dreaming. It is difficult to wake a sleepwalker. Sometimes they wake themselves. Other times they go back to bed, not knowing they ever got up.

Most people naturally outgrow sleepwalking. Those who wake up and find themselves in dangerous or embarrassing situations, however, may need treatment.

Sometimes sleepwalking is harmless. You may wake up somewhere other than your bed and wonder how you got there. It can also be dangerous. Children can fall down stairs and adults might even try to drive!

DioGuardi’s problem, sleep related eating disorder, is unusual. But like other eating disorders, it is much more common in women than in men.

People with SRED often prepare and eat food with no recollection of doing so. They may gain weight. Eventually they can even develop type 2 diabetes.

Sleep eating tends to occur in people with histories of alcoholism, drug abuse and other sleep disorders. People with high levels of stress and anxiety may also find themselves snacking in their sleep.

DioGuardi admits that in the past she had an eating disorder and has received professional help to overcome it.

Visit an AASM-accredited sleep disorders center if you suffer from sleepwalking or have an ongoing sleep problem.

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Celtics Getting Sleep for the NBA Season

Boston Celtics head coach Doc Rivers is looking for any advantage that will help his team return to the NBA Finals this year. After winning the 2008 NBA Title, the Celtics were ousted from the 2009 playoffs by the Orlando Magic.

This season the Celtics get All-Star forward Kevin Garnett back from a knee injury. They’re also getting more sleep.

The team is being advised by Harvard sleep researcher Dr. Charles Czeisler. As a result they’re practicing at noon instead of early in the morning. And they’re no longer holding morning shootarounds on game days.

“I think they’re fresh,” Rivers told the Boston Globe. “I think we’ve had better practices.”

The goal is to help the players avoid the sleep deprivation that is rampant in the NBA. The 82-game regular season can be a brutal grind.

Play a late game; fly deep into the night to the next city on the schedule; fight off jet lag for a morning practice. Do it all over again.

As teams criss-cross the country sleep can get lost like checked luggage. That may be one reason why only seven of the 30 NBA teams had a winning record on the road last season.

“What we are trying to do is leverage the power of sleep,’’ said Czeisler. “As pro athletes, they spend so much time trying to practice and master the skills of the game - and sleep turns out to be a very critical part of the process…Teams that take advantage of this can really enhance their play.”

In January the Sleep Education Blog reported that the Portland Trail Blazers were getting help from Czeisler. They had finished the previous season with a mediocre 41-41 record.

The Blazers surged to a tie for first place in their division with a 54-28 record. The turnaround was fueled in part by a seven-game improvement in their road record.

The Celtics hope sleep will be a successful part of their gameplan this year. They’ll get their first test when they open the season against LeBron James and the Cavaliers in Cleveland on Tuesday night.

As for Czeisler, he hopes that we would all get more sleep.

“We are such a sleep-deprived society,’’ Czeisler said. “But the message is beginning to get through, that sleep is important for performance…It’s all about making sleep a priority.”

Learn more about how sleep improves sports performance.

Image by Daniel Go

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Biofeedback to Treat Insomnia

A recent article from Health magazine describes the use of “biofeedback” to treat insomnia.

What’s biofeedback? It’s a form of therapy that gives you visual or auditory feedback for certain body signals.

Cues may give you details about your heart rate, blood pressure, breathing or body temperature. Then you learn to control the body in a way that promotes sleep.

Author Leslie Goldman describes how for eight years she struggled with sleep. Then she gave biofeedback a try.

“The change has been dramatic,” she writes. “After nearly a decade of sleeping for no longer than two hours at a time, I can sleep for four hours straight and doze off again after I wake up.”

The AASM recommends biofeedback as an effective treatment for chronic insomnia.

Often biofeedback will be combined with other treatment methods. This is called cognitive behavioral therapy, or CBT.

CBT is a safe and effective treatment option for people who are struggling with ongoing insomnia. It uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep.

Learn more about how CBT for insomnia is safe and effective. Get help for insomnia at an AASM-accredited sleep disorders center near you.

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