You may be looking in the wrong place for a cure. It could be that your digestive system is sabotaging your sleep.

Increasingly, scientists are linking digestive disorders with a host of nocturnal problems ranging from insomnia to restless nights that lead to exhaustion during the day.

For example, a small pilot study published in November in Alimentary Pharmacology & Therapeutics showed that heartburn treatments may lead to a more restful night’s sleep in people suffering from gastroesophageal reflux syndrome (GERD). And a study published in Mayo Clinic Proceedings in December found that irritable bowel syndrome may be linked with insomnia.

Reflux redux

The connection between damaged sleep and heartburn is “the real deal,” says Dr. David Metz, a professor of medicine in the division of gastroenterology, director of the acid peptic disorders program and co-director of the GI physiology laboratory, all at the University of Pennsylvania in Philadelphia.

And many people don’t even know that reflux is the source of their daytime fatigue. “They don’t know why they feel tired all the time and their quality of work suffers,” Metz says. “They think they’re sleeping through the night and they’re not.”

In desperation, some patients turn to sleeping pills. That’s a bad idea for people with GERD, Metz says, because the stomach acid that has leaked into the throat stays there longer and does more damage to the esophagus. If you wake up—even briefly—you will swallow and clear the acid from your esophagus, he says.

The heartburn study followed for 8 weeks 18 patients who had been diagnosed with GERD. Researchers asked the patients to fill out two questionnaires—one designed to determine the severity of GERD symptoms and the other designed to uncover sleep problems.

At the beginning of the study, only 11 percent of patients had normal sleep, says Dr. David A. Johnson, a professor of medicine and chief of gastroenterology at Eastern Virginia Medical School. After four weeks of taking a proton pump inhibitor for heartburn, half the patients were getting a restful night’s sleep.

“What we think happens is that the GERD bumps you out of the pattern of progression to restful sleep,” Johnson says. “People get up in morning and don’t feel good and they don’t know why.”

The study does have limitations, Johnson allows. In particular, the study was small, and researchers didn’t have a control group to compare to the patients who received GERD therapy.

The next step is a large placebo-controlled study, Johnson says.

IBS and sleep

The association between irritable bowel syndrome and insomnia turned up in a survey of 2,269 people chosen at random from Olmsted County, Minn. The Olmstead residents were asked both about digestive symptoms and sleep problems.

The most common digestive problem linked with insomnia was IBS, but patients with sensitive stomachs also had problems getting to sleep.

What isn’t clear is whether the digestive ills cause insomnia or poor sleep leads to stomach and bowel problems, says study co-author Dr. Nick Talley, a professor of medicine and gastroenterology at the Mayo Clinic College of Medicine in Rochester, Minn. It’s also possible that some other problem is causing both the digestive ills and the sleep disturbance, Talley says.

“There could be an abnormality in the brain centers that regulate sleep and bowel function,” he adds. “We do know from imaging studies that blood flow in the brain is altered in IBS. Sleep disturbance could be a reflection of this.”

The study may help researchers figure out causes for both problems, says co-author Dr. G. Richard Locke, an associate professor of medicine at Mayo.

It could be as simple as a single neurotransmitter out of whack, Locke and Talley say. “For instance, we know that serotonin, a chemical released in the bowel, is very important for proper functioning,” Talley says. Serotonin is also involved in sleep, he adds.

Locke says the researchers originally got the idea for the study because so many IBS patients coming to their clinic mentioned they have problems sleeping.

A study in the Oct.1 issue of the journal Sleep shows that long-term alcoholism affects sleep even after long periods of abstinence, and the pattern of this effect is similar in both men and women.
Results indicate that in long-term alcoholics who had not had a drink for up to 719 days, the percentage of slow wave sleep was significantly lower (6.6% in men, 11.1% in women) than in controls (12.0% in men, 12.1% in women). Alcoholics also had significantly more stage 1 non-rapid eye movement (NREM) sleep (8.5% in men, 6.3% in women) than controls (6.2% in men, 5.6% in women). According to the authors, having less deep, slow wave sleep and more light, stage 1 sleep is reflective of poorer sleep quality, which could act as an exacerbating factor in alcoholics’ cognitive decline.

Although women had better sleep efficiency and fewer wake periods than men, no significant interactions between sex and alcoholism diagnosis were found for any measures. This suggests that women show the same general pattern of alcoholism-related sleep changes as men.

Principal investigator Ian Colrain, PhD, director of the SRI International Human Sleep Research Program and a professional fellow in psychology at the University of Melbourne in Australia, also was surprised to find that a significant increase in the percentage of REM sleep persisted in alcoholics who had abstained from drinking for an extended period.

“Previously the REM changes in the acute detox period were assumed to be related to a rebound of the REM suppression effects of alcohol,” said Colrain. “The persistence indicates that there is some possibly permanent structural/functional change in REM regulation mechanisms produced by long-term alcohol abuse.”

The study involved 42 alcoholics (mean age 49 years, 27 men) who were recruited from an inpatient treatment program and 42 controls (mean age 51 years, 19 men). Estimated lifetime alcohol consumption was significantly higher in male alcoholics (1,607.2 kg) than female alcoholics (843.7 kg). All participants were screened for medical, psychiatric and sleep problems, and their sleep was measured by a full night of polysomnography following an adaptation night. Data were collected from multiple scalp sights and subjected to power spectral analysis. Sleep architecture and electroencephalogram (EEG) spectral power measures were evaluated for the effects of alcoholism diagnosis and sex using age as a covariate.

Results also show that perceived sleep as measured by the Pittsburgh Sleep Quality Index (PSQI) was significantly worse in alcoholics than in controls. Estimated lifetime alcohol consumption was significantly related to the scores on the PSQI in men and women, with higher lifetime consumption predicting less sleep satisfaction. Spectral analysis revealed that alcoholics had significantly reduced levels of slow wave activity during NREM sleep but not during REM sleep, showing that the reduction in slow wave activity in alcoholism is sleep-state specific.

Colrain said that there is a substantial body of literature describing the functional correlates of the structural damage produced by long-term alcohol abuse. Many aspects of psychological functioning are affected by damage to the frontal cortex, including those that relate to judgment and risk taking. He added that there is a growing appreciation for the role of slow wave sleep in supporting memory and other mental functions.

This study was funded by the National Institute on Alcohol Abuse and Alcoholism.
The study: “Impact of Alcoholism on Sleep Architecture and EEG Power Spectra in Men and Women.”

Source:
Kelly Wagner
American Academy of Sleep Medicine

We could all take a cue from these practical felines. While humans don’t need to sleep as much as cats do, the average person probably needs more rest than he or she gets. And if going to bed earlier or getting up later just isn’t an option, the obvious solution is to sneak in a rejuvenating catnap during the day.

Perhaps you think of naps as a luxury reserved for babies, sick people, or the elderly. You, as a vibrant adult, should be able to power through your day without closing your eyes. But there are definite biological rhythms that govern our alertness over a 24-hour period, and it’s been widely acknowledged that mid-afternoon is prime time for napping. Our bodies seem wired to doze after lunch. In fact, many countries, recognizing this universal need for rest, close offices and shops for several hours so workers can go home and relax.

Ever wonder how a dolphin can sleep without drowning or why a bat sleeps upside down? Well, you won’t have to wonder any more. Check out how our favorite animals sleep below.

Dolphins
Can you sleep and swim at the same time? For dolphins, this is an easy task. They can turn off half their brain and close one eye, allowing them to be partly asleep and awake at the same time. Dolphins sleep this way so they can be ready to protect themselves from predators and swim to the surface for air. Mothers and their baby calves often don’t sleep at all for the first few months after birth.

Walruses
Walruses can sleep and swim at the same time, too. While in the water, walruses can choose between sleeping underwater or above. A walrus can hold its breath for five minutes, just enough time for a nap. For a deeper sleep, walruses inflate spaces inside their body, called pharyngeal pouches, with up to 13 gallons of air. These pouches act like a life-jacket, allowing them to remain in the water by bobbing up and down while keeping their head above for air. For the deepest sleep, walruses will either hook their tusks onto a stable piece of ice or move to land. Walruses can sleep up to 19 hours at one time. Unlike most animals, walruses do not need to sleep every day, and they can swim without stopping to sleep for more than three days.

Giraffes
Giraffes need less sleep than any other mammal. According to the Smithsonian publication, Zoogoer, giraffes sleep for five minutes at a time, adding up to an average of 30 minutes per day. Why don’t they sleep all night like other mammals? Because giraffes are considered to be a prey animal, which means that they are often hunted by other animals for food. Lying down to sleep for a long time would make it easier to get caught. Giraffes sleep standing up with one eye open and both ears moving.

Brown Bats
While a giraffe may only sleep for minutes at a time, the little brown bat typically sleeps 12 to 19 hours without stopping. They are nocturnal creatures, which means they sleep during the day and are awake at night. Bats spend most of the day hanging upside down in small, dark crevices or with claws hooked into ceilings. Have you ever wondered why they sleep upside down? It is because their wings are not strong enough to fly into the air from the ground. It is more efficient for bats to use gravity by dropping into flight from their perch.

Squirrels
Have you ever seen a sleeping squirrel? Most likely not because the most common squirrels, such as the grey squirrel, are tree dwelling. This means that they make their homes high up in trees or attics. Squirrels sleep in nests called dreys that look a lot like birds’ nests. They use twigs, leaves, moss, bark, grass, paper and even dog hair to build their homes. In the winter, several squirrels will cuddle together in the drey for warmth.

Royal Philips Electronics today announced the introduction of the FullLife full-face mask for the treatment of obstructive sleep apnea (OSA). This revolutionary mask covers both the nose and mouth, while being compact and offering a clear line of sight for patients. The mask is being launched first in the U.S., followed by Canada; a global launch is planned for September 2009.

Representing a new generation of full-face masks, the FullLife is smaller and lighter, yet made of durable materials. The conventional forehead pad was eliminated to provide a clear line of sight. A newly designed, dual-textured cushion reduces leaks and creates a solid seal even with patient movement. The step-by-step numbered headgear system makes assembly and fitting easy.

“The FullLife mask is built on the same platform as our successful OptiLife mask, which was introduced in 2007,” said Gretchen Jezerc, director, U.S. Marketing, Sleep Disordered Breathing, Philips Home Healthcare Solutions. “With a minimalist design and lightweight, durable materials, FullLife provides comfort and convenience for patients. Among its features, a clear line of sight benefits patients who feel claustrophobic, and an integrated exhalation port makes it exceptionally quiet for patients and their bed partners.”

With one faceplate for all three sizes (small, medium, and large)—as well as FitPack and DuoPack fitting and supply replacement options—FullLife also is a good choice for clinicians and homecare providers.

Reviewed by QualityHealth’s Medical Advisory Board
Drinking alcohol makes you drowsy. Counting sheep makes you doze off. You can catch up on lost sleep over the weekend. When it comes to getting your Z’s, it can be difficult separating fact from fiction. But according to experts, knowing the facts can help improve your sleep, reduce your disease risk, and boost your health. Read on to uncover the most common sleep myths so you can get a more restful slumber.
Myth 1: If you can’t fall asleep, you need to try harder.
Fact: Contrary to popular belief, you can’t force yourself to sleep by spending more time in bed. If you can’t fall asleep, you should get out of bed, move to another room, and wait until you’re truly tired to return. And don’t even think about counting sheep: An Oxford University study found that insomniacs who counted sheep were less likely to doze off than those who didn’t. It may be more helpful to establish a relaxing bedtime routine. This may include taking a warm bath or shower, reading a book, or listening to soothing music. Relaxing activities done in low lighting can help ease the transition between wakefulness and sleepiness.
Myth 2: Alcohol promotes good sleep.
Fact: Although a few drinks may make you feel drowsy, alcohol can disrupt your sleep patterns, causing you to wake up after only three or four hours. It can also make chronic insomnia worse and increase symptoms of sleep deprivation. What’s more, alcohol dependence has been linked to insomnia that can persist for months into abstinence and recovery, according to the National Institutes of Health. For a better bedtime beverage, try green tea.

Myth 3: You can catch up on lost sleep over the weekend.
Fact: While you may be able to get back on schedule, the sleep you lose on any given night is lost forever—it can’t be made up. In addition, sleeping for longer than recommended on the next night may be more harmful than helpful. According to experts, the best policy is to avoid skimping on sleep in the first place.
Myth 4: You need less sleep as you get older.
Fact: Because sleep rhythms tend to change with age, it’s often assumed that older people require less sleep. But studies suggest otherwise. According to the National Sleep Foundation, older people may wake up more frequently through the night and get less quality sleep, but they require seven to eight hours’ sleep, the same amount as younger people.
Myth 5: Insomnia is simply the inability to fall asleep.
Fact: In reality, insomnia refers to several sleep-related problems, including waking up too early and not being able to fall back asleep, getting up frequently during the night, or waking up without feeling refreshed. Be sure to chart your patterns in a sleep journal, and talk to your doctor about your symptoms so he or she can she can suggest suitable treatment options.
Myth 6: A lack of sleep may be inconvenient, but it’s not a serious health problem.
Fact: This is perhaps the most dangerous sleep myth of all. The fact is, insufficient sleep has been linked to dozens of serious health conditions, including obesity, hypertension, diabetes, depression, and even cancer. What’s more, according to the Journal of Occupational and Environmental Medicine, sleep deprivation accounts for two out of three U.S. road accidents. Again, be sure to talk to your doctor about your symptoms and treatment options.

October 5, 2009
You might be getting more sleep than you think. Elderly women who reported shorter and poorer quality of sleep actually had longer and less-fragmented sleep than elderly men, according to a recent study in the journal SLEEP. The study, conducted by researchers in the Netherlands, examined 956 participants ages 59 to 97 years old. Participants were asked to wear an actigraph — an accelerometer that measures sleep activity — and keep a sleep diary for six consecutive nights. According to the study, women reported a shorter sleep time, an increase in the time it takes to fall asleep, and poorer sleep efficiency and quality compared to the men. However, after examining data from the actigraphs, researchers discovered the women slept longer than the men and with less disturbances. The study found that men actually overestimated the amount of sleep they got and their quality of sleep, with participants claiming they got seven hours of sleep when in reality they only got six and a half.

A recent video on YouTube showing a sleepwalking dog that runs into a wall may be comical but it also highlights potentially serious sleep disorders that can affect pets, according to a press release by Texas A&M University’s College of Veterinary Medicine and Biomedical Sciences. The video, titled “Sleepwalking Fail,” shows a sleeping dog that starts to “run” in his sleep, only to suddenly jump up and run head first into a wall. According to the press release, the dog is most likely displaying signs of a sleep disorder and it could be a dangerous condition. The press release notes that the two sleep disorders most dangerous to an animal’s health are narcolepsy and cataplexy. “These two sleep disorders are usually a congenital and inherited condition that can be brought on by excitement such as playing, eating, drinking or greeting owners and can last seconds to minutes, many times a day, or infrequently,” said Dr. M.A. Crist, clinical assistant professor at Texas A&M College of Veterinary Medicine. Narcolepsy is a neurological disorder caused by the brain’s inability to regulate sleep-wake cycles normally. It’s often associated with sudden sleep attacks, insomnia, dream-like hallucinations and a condition called sleep paralysis. According to the press release, if your pet suffers from narcolepsy or cataplexy and is left alone or unattended near water, it could possibly drown.

You should also inquire about the coverage for CPAP (continuous positive airway pressure), because this is the treatment your doctor is likely to recommend if you test positive. (see About OSA for more information). Because HST is so new, some companies may have changed their testing policy to pay for HST, but failed to modify the treatment policy. You don’t want to run into a situation where you can be diagnosed but not treated because of an oversight. If you do find a CPAP policy is still outdated, point this out to the insurer. Ask for a written confirmation from someone at the company confirming they will pay for CPAP, if you are diagnosed by a Home Sleep Test.

A few companies such as Cigna, United and Anthem Blue Cross will cover home sleep testing in certain circumstances and require a specific test device, which basically records one more channel than the device IDS currently uses. IDS expects to have compatible testing devices by late spring or summer of 2009.

Who should have a Home Sleep Test?
HST is intended for patients who have a moderate to high suspicion of sleep apnea based on an assessment by their treating physician. It will not tell if you have insomnia or other sleep disorders, and is not intended to be used as a screener (used on patients without symptoms). Typical HST patients should have at least two of the following symptoms:

Loud snoring
Pauses in breathing during sleep as noted by others
Excessive daytime sleepiness (falling asleep easily & sometimes inappropriately)
Morning headaches
High blood pressure
Diabetes (which may contribute to or be a consequence of sleep apnea)
Memory problems or poor judgment
Feelings of depression
Gastro esophageal reflux (heartburn)
Impotence
Frequent nighttime urination
Difficulty concentrating
Irritability
Personality changes
When will my doctor get the report?
Once IDS gets the device back from you by priority mail, we process it and make it available to our panel of sleep physicians for review. In most cases, it is interpreted the same day. Our automated system immediately faxes the report to your physician as soon as it is read. You can call your doctor to see if the results have been received after 4 or 5 days. Please do not call IDS for your results. Only your physician can discuss the findings with you.

How much will the IDS Sleep test cost?
That depends on your insurance. As an example, the cost for a patient with Medicare and no supplement insurance is $28. Some private insurances may be a little higher, perhaps $35-60. The cost will never be more than $300, even for those without insurance.

What exactly will the test show?
The ApneaLink device will tell if there are pauses in your breathing during sleep called sleep apnea (see About OSA for more information). It does not distinguish between central and obstructive apneas. It also records your pulse rate and the level of oxygen in your blood. Changes in pulse and blood oxygen levels, to some degree, are a measure of how much stress each of these abnormal breathing events cause your body.

Should I change my routine?
Since it is assumed that you are sleeping when the device is on, it’s important that you try to get a good night sleep by not napping and limiting caffeine and alcohol the day of the test. If you are a caregiver for someone else (such as an infant or someone who is bedridden), you should make arrangements for alternate coverage the night of the test. Otherwise, go to bed at your normal bedtime and try your best to stay in bed all night.

Don’t linger in bed too long in the morning. Get up and turn the device off as soon as possible after the alarm goes off or you wake up naturally.

What if I can’t sleep? What if a sensor falls off?
Call IDS in the morning and discuss it with the technician. They will make a determination as to whether you should repeat the test the following night. Most importantly, don’t worry about these things. Worrying is more likely to keep you awake.

Will I be able to follow the instructions?
The device is extremely simple and the instructions very clear. Instructions are written, drawn and presented in a video which you can watch. If you still have questions, you will be provided with a toll-free support line staffed by IDS Sleep Technicians 24 hours a day, 7 days a week.

NEXT: Get Tested!