May 4, 2023: Difficulty initiating and maintaining sleep is a common problem for many patients. Over-the-counter sleeping aids are used by many and we commonly get asked for prescription medications to help with their sleep.
Unfortunately, the ideal sleeping medication doesn’t exist and many have potentially worrisome adverse effects, some produce daytime somnolence and others may have the potential to produce dependence.
Cognitive behavioral therapy is an alternative treatment option to pharmacologic therapy and is safe, can be easily taught, and offers an alternative to the many with chronic insomnia. In this podcast, we’ll discuss this innovative treatment option with sleep expert, Michael H. Silber, M.B.Ch.B., a neurologist at the Mayo Clinic.
This Friday, March 17, is World Sleep Day, an annual event that aims to raise awareness of the importance of getting a good night’s sleep. This year’s campaign tagline is “Sleep is essential for health.” According to a study by the American College of Cardiology, up to 8 percent of deaths from any cause could be attributed to “poor sleep patterns”, while those with healthier sleep habits are less likely to die prematurely.
Data from Statista Consumer Insights shows that in the United States, 39 percent of respondents said they had suffered from a sleep disorder (problems falling asleep or staying asleep, insomnia, etc.) in the 12 months prior to the survey. Italians were among the worst sleepers in the survey at 48 percent reporting a sleep disorder, while India registered a higher share of good sleepers, with only 26 percent suffering from poor sleep.
Yale Medicine (March 12, 2023) – As we age, are melatonin starts rising at an earlier hour in the night, thus we may tend to go to sleep earlier than when we were younger. We still require the same number of hours of sleep (7-9 hours on average), so we may also rise earlier. Our sleep is more likely to be disturbed by medical conditions, medications, or substance use.
Research on sleep disorders and the importance of regular shut-eye has deepened our understanding of the link between sleep and brain health.
February 2023
Overall, there are more than 80 sleep disorders, ranging from the mildly annoying to the potentially deadly. The best known is probably insomnia; about 10 percent of the general population has chronic insomnia, an inability to fall asleep for multiple nights over a period of months.
Addressing sleep disorders “is paramount to not only protecting the brain down the road but also on a day-to-day basis,” says Daniel Barone, MD, associate medical director of the Weill Cornell Center for Sleep Medicine in New York City and co-author of The Story of Sleep: From A to Zzz (Rowman & Littlefied, 2023). “One of the best ways to take care of our brains is by getting quality sleep.”
Intriguing Clues
Research on sleep disorders has led to improvements in treatment for a variety of sleep and neurologic conditions. Case in point: Studies in the late 1990s on the causes of narcolepsy with cataplexy—the condition Connor was initially diagnosed with—led to the development of dual orexin receptor agonists, drugs now commonly prescribed to treat insomnia. The researchers discovered that people with narcolepsy with cataplexy often had low levels of hypocretins (orexins), brain chemicals that sustain alertness and prevent REM from happening at the wrong time.
“Once they found out, ‘If I take away your hypocretin, it makes you sleepy,’ there was a new idea of how to make a sleeping pill,” says Rafael Pelayo, MD, clinical professor of psychiatry and behavioral sciences at Stanford University School of Medicine in California and a sleep specialist at the university’s Sleep Medicine Center.
“Melatonin is a hormone that is naturally made by your brain in response to darkness,” says sleep specialist Marri Horvat, MD. “When someone takes melatonin, they are either trying to increase the amount of this hormone overall or increase the amount they have in their body at a certain time to help them fall asleep.”
While there are some possible setbacks to taking melatonin (depending on how your body reacts), it isn’t addictive. Turns out, even if you depend on melatonin to make you fall asleep, it won’t cause your body to become dependent on it.
“As we age, we have a natural decrease in the amount of melatonin we produce, so supplementation can often be helpful,” Dr. Horvat explains.
For many older adults, a good night’s rest is elusive. The implications of chronically poor sleep can be far-reaching and include a decline in cognitive functioning and detrimental effects on health and general well-being. Fortunately, relief may be in sight.
A new study led by investigators at the Stanford University School of Medicine shows that neurons in the lateral hypothalamus, a brain region, play a pivotal role in sleep loss in old mice. More specifically, the arousal-promoting hypocretin neurons become hyperexcitable, driving sleep interruptions.
Luis de Lecea, PhD, is a professor of psychiatry and behavioral sciences at Stanford Medicine. He is the study’s senior author and hopes the finding could pave the way to new drug treatments for age-related sleep problems in humans.
Shi-Bin Li, PhD, is an instructor in the Psychiatry and Behavioral Sciences department at Stanford Medicine. He is also a basic life research scientist in the de Lecea lab, and is the lead author of the study. Lisa Kim is Senior Manager of Media Relations for Stanford Medicine and Stanford Health Care. Lisa has a deep background in journalism, as she is an Emmy Award-winning journalist who has covered stories on both the national and local levels.
Back-sleepers beware. “I know many people find it to be comfortable, because they’re not putting weight on their joints,” says Dr. Lois Krahn, a Mayo Clinic sleep specialist. But Mayo Clinic experts say sleeping on your back is actually the worst sleeping position, especially if you have sleep apnea. “Sleeping on the back means that your tongue and jaw can fall down and crowd your airway. And many people snore more on their back,” says Dr. Krahn. Sleeping on your stomach helps keep the airway open, but it can put a strain on your spine and neck. “There’s a host of evidence overall suggesting that probably sleeping on the side is better,” says Dr. Virend Somers, a cardiologist and director of the sleep facility within Mayo Clinic’s Center for Clinical and Translational Science.
Did you know that not getting enough zzz’s can actually make you hungrier? According to sleep scientist Matt Walker, the relationship between what you eat and your sleep is a two-way street. Here’s why understanding it can help you improve your overall health.
Sleep — we spend one-third of our lives doing it, but what exactly do we get out of it? And how can we do it better? In this TED series, sleep scientist Matt Walker uncovers the facts and secrets behind our nightly slumber. (Made possible with the support of Oura) Check out more episodes on TED.com: https://go.ted.com/sleepingwithscience
Doctors Without Waiting Rooms 