Sunday, 28 May 2017

Different ways to tackle sleep deprivation and remain healthy

From thenational.ae

Doctor Irshaad Ebrahim of the Dubai-based London Sleep Centre describes the number of current sleep disorders as "an epidemic".
"It’s so much more important than what’s being reported in the press: lifestyle, pace of work, demands of technology, screen use – they are harming our sleep/wake cycle."
The number of sleep clinics in the UAE are on the rise, as are do-it-yourself responses such as sleep treatments at luxury hotels and online apps for managing one’s sleep cycle. "It is a response to demand," says Ebrahim, "just the number of people seeking help".


    According to Elizabeth Graf, a clinical psychologist at a private clinic in New York, "research continues to show the emotional and physical benefits of sleep".
    Studies have linked lack of sleep to poor performance at work, depression and overall health, including links to cancer. It is not uncommon for studies to speak about the "public health crisis" of lack of sleep, in which billions of dirhams are spent tackling the secondary effects of poor slumber. Others point to its effect on the economy, and even its role in disasters such as the nuclear meltdowns at Three Mile Island and Chernobyl.


      New technologies for imaging the brain’s activity during sleep have made it easier to understand REM sleep, or "rapid eye movement" sleep, in which most of its benefits accrue. Though it has often been associated with the formation of memories, one new sleep study looked at the shrinking of synapses in the brain during sleep to suggest that a good night’s rest is an aid to forgetfulness.
      Sleep is also a wider cultural topic: last year, author Arianna Huffington released The Sleep Revolution: Transforming Your Life, One Night at a Time, in which she said that taking control of one’s sleep is the key to unlocking a happier, more fulfilling and productive life.

      The New York-based artist Shana Moulton has dealt with sleep disorders in her work. In the video Restless Legs Saga (2012), her alter ego "Cynthia" is afflicted with Restless Leg Syndrome, or the desire to move one’s legs while falling asleep.
      Cynthia is plagued by her restless legs, while the pharmaceutical industry is on a relentless advertising blitz to treat it. "Sleep causes enough disruption that people feel motivated to do something about it, as opposed to their typical responses to other psychological disorders," says Aamnah Husain, a psychologist and sleep specialist at the German Neuroscience Center in Dubai.


        "There can be a genetic component to insomnia, but that’s rare. The leading causes are lifestyle, stress, obesity and depression."
        Depression is both a cause of insomnia and a symptom – meaning depression and insomnia can lock you in a cycle of poor sleep habits and worsening symptoms.
        Ebrahim mentions that "many medical disorders get worse at night – either from sleep per se such as asthma, or from lying down such as gastro-oesophageal reflux". These make it harder to stay asleep, while also aggravating the medical condition.


          According to the London Sleep Centre, about 30 to 40 per cent of adults experience insomnia annually, with insomnia being chronic or acute for about 10 to 15 per cent among them. Insomnia increases with age and is more common in women. Ebrahim’s clinic treats sleep disruptions associated with pregnancy, post-pregnancy and menopause.
          Jet lag, a frequent characteristic of life for many in the UAE, can exacerbate insomnia, but will not itself cause it. However, there is evidence that it affects children more profoundly than adults.

          One woman in the UAE, who grew up between her boarding school in the United Kingdom and her parents’ home, says the frequent bouts of eight-hour jet lag had a long-lasting effect on her sleep cycle. Treatment options for insomnia vary, with CBT, or cognitive behavioural therapy, being the best known. CBT focuses on changing the thought processes around situations that provoke anxiety to curb negative patterns. For sleep therapy, for example, a CBT approach might entail the therapist asking an insomniac to confront his worst fear – a night without sleep – and then to show how such an eventuality is actually manageable.


            "CBT is one of the many treatment options," says Graf. "It is important to identify the source of insomnia, if possible. Causes can range from too much caffeine, or overstimulation before bed from screens, to psychiatric disorders such as depression or bipolar disorder. Working on sleep hygiene and ruling out underlying medical/psychiatric causes can help to treat the problem."
            Sufferers of insomnia in the UAE have often complained that there are few treatment options in the region beyond medication, but the rise in sleep disorder clinics has made more types of treatment available.


              Husain says she uses a combination of CBT and mindfulness therapy, which means "being in touch with one’s own senses and one’s body. We abuse our bodies a lot". "We only pay attention to our body when we need something from it or want it to look a certain way," she says.
              For acute insomnia, medication is often needed before therapy can be effective. Ebrahim says he transitions from a medical approach – once the acute phase is over – to more integrated CBT one.


                There are also online CBT therapies such as Sleepio (52 weeks of unlimited access costs around Dh1,100) or Sleep Healthy Using the Internet (with a joining offer of Dh475 for the first eight weeks). These help users track their sleep patterns, and also give feedback to establish proper sleep habits.
                Studies show that such online counselling programmes can be effective. "People do not have a clear understanding of their own sleeping," says Husain. "They tend to over-report or under-report."

                Any tracking mechanisms will help people understand what is really going on in their bodies, though these programmes will be of limited efficacy to those with acute sleep disorders or psychological conditions.
                Sleep benefits are also a new watchword in the relaxation business, and a number of luxury hotels now provide sleep treatments to help harried guests. Just recently, Park Hyatt in Abu Dhabi launched a sleep treatment. It includes meditation, reflexology massage, head massage and candles for an hour to an hour-and-a-half – the property says it has already become popular. Other hotels are increasingly offering similar treatments and wellness programmes.


                  "Everyone likes a nice massage," admits Husain. But he warns "that’s not going to treat the underlying problem".
                  Are you at risk?
                  Recent reports have focused on screen time as the culprit for poor sleeping. Smartphone and tablet screens emit blue light, a high-intensity energy source that stimulates people when they should be going to sleep.
                  Patients are advised to avoid screen use in bed, or at least 30 minutes before bedtime, and to wear sunglasses if you really need to check your phone.


                    But experts say screen time is not the only factor. "The problem is much, much larger," says Ebrahim, adding that people need to slow down more generally.
                    There are a number of tests available online to determine whether your sleep disruption warrants attention. Insomnia denotes the inability to fall or stay asleep through the night – or sleep of poor quality – where you’ve slept through the night, but do not wake feeling refreshed. Other sleep disorders include sleep apnoea, Restless Legs Syndrome and narcolepsy, or uncontrollable daytime sleepiness.

                    For general insomnia, proper sleep hygiene is the first place to start: limiting screen use before bedtime, making sure that the bed is only used for sleep – not work – and most importantly, sticking to a bedtime routine. This means that even after a night of terrible sleep, you shouldn’t sleep in for more than half-an-hour to catch up.
                    For jet lag, research suggests that rather than reorienting yourself immediately to a new time zone, you should let your body feel like it’s had its full night’s sleep – expose yourself only to the sunlight and your breakfast routine (both Sun and food are cues by which the body sets its circadian rhythm) at your normal wake-up time. You are better placed to combat sleep changes when you are fully rested.

                    http://www.thenational.ae/arts-life/well-being/different-ways-to-tackle-sleep-deprivation-and-remain-healthy

                    Friday, 19 May 2017

                    These Are The Troops Most Affected By The Military’s Worsening Sleep Problem

                    From taskandpurpose.com

                    The U.S. military’s sleep problem is getting worse, and it’s hurting certain troops more than others.
                    Instances of insomnia among military personnel have nearly quadrupled in the last decade, rising from 16 reported cases in every 1,000 troops in 2005 to 75 in every 1,000 in 2014, a 372% increase, according to a new study published in the Journal of Sleep Research.
                    Cases of obstructive sleep apnea — blockages in the upper airway that affect breathing — have seen a five-fold increase, rising from 44 cases in every 1,000 troops in 2005 to 273 in every 1,000 in 2014, a 517% jump.
                    Overall, the incidence of the two disorders among service members is nearly double that of the U.S. civilian population.
                    “Sleep disorders are a serious problem that interferes with the ability of soldiers to do their jobs effectively,” study author Harris Lieberman of the U.S. Army Research Institute of Environmental Medicine told Reuters. “When you’re sleep deprived, you can’t use your brain in the way soldiers need to do … You’re unable to think at the level you can perform at when well-rested.”
                    If this research is correct, the results suggest that out of the total U.S. military population of 1.4 million personnel, some 105,000 were dealing with insomnia and 382,200 with sleep apnea — which would mean that, as of 2014, nearly a third of America’s fighting force isn’t getting adequate sleep.
                    The impact of sleep issues isn’t spread equally across the armed forces. The study reveals that while men tend to experience higher rates of sleep apnea, it’s women who have to deal with insomnia most. Generally, African-Americans, senior enlisted personnel, Army personnel, and all individuals over the age of 40 disproportionately report falling victim to both disorders.
                    The findings support the results of a 2015 RAND Corporation study on sleep problems in the U.S. military, in which nearly half the service members surveyed reported “clinically significant” poor sleep quality. Only 37% of service members reported getting the recommended eight hours of sack time each night.
                    This is a big problem for the Department of Defense. Pentagon research has shown for years that poor sleep patterns negatively impact operational readiness and future health and well-being. The 2015 RAND study found that 33% of service members reported feeling fatigued more than 3 times a week due to lack of sleep, while 51% reported some sort of sleep-related impact on their daily responsibilities.
                    The RAND study also suggests that clinical fatigue creates a vicious cycle of chemical dependence among service members, in which troops use energy drinks and other stimulants to make up for their sleep debt and turn to sleep aids to help them finally conk out at night:
                    A prior study by Joint Mental Health Advisory Team 7, established to assess the behavioral health and treatment of deployed forces, found that almost 50 percent of deployed service members used energy drinks on a daily basis. 
                    Less is known, however, about how frequently service members use these products after returning home. In the RAND sample, only 8–10 percent reported daily use of energy drinks, but service members in the sample tended to be older, all were married, and most were not currently deployed, which could help to explain the differences between the RAND and Joint Mental Health Advisory Team studies.
                    The use of sleep medications was more common: More than 18 percent of service members surveyed reported using sleep medications in the past month, which is consistent with use among the general population.
                    While RAND noted at the time that the “efficacy and safety” of medical supplements in military settings hasn’t been fully explored, chronic use is likely to contribute to long-term health problems, which could pose a big problem down the line for a VA already facing increasing health-care costs.
                    But the pressing problem isn’t future health-care costs: It’s operational readiness downrange. And with sleep disorders on the rise, American combat troops aren’t nearly as sharp and efficient as they should be — a condition that could come with deadly consequences.

                    http://taskandpurpose.com/military-sleep-problems-research/

                    Friday, 12 May 2017

                    Study reveals that laughter improves cognition, insomnia and depression

                    From emaxhealth.com

                    We have all heard that laughing is good for our health. But now there are studies proving that laughter improves cognition, insomnia and depression. So, here is what researchers found when they put 48 elderly through laughter therapy.
                    In this study, researchers wanted to investigate the effects of laughter therapy on depression, cognitive function, quality of life, and sleep of the elderly in a community. So, for a period of one month, 48 subjects underwent laughter therapy with a licensed nurse, and 61 subjects were used as a control group and then compared. Researchers observed that cognition, insomnia and depression improved in the laughter therapy group, while they worsened or showed no significant change in the control group.
                    These results demonstrating that laughter improves cognition, insomnia and depression are further confirmations of earlier research that have shown that humour is correlated with increased self-esteem and decreased depressive features.
                    In a recent clinical trial, the same results were observed in children, as researchers evaluated the impact of a humour therapy program on stress levels in pediatric inpatients. In the first phase, an intervention and a control group were studied over 2 consecutive 3-month periods. Salivary cortisol levels were measured, and also tests were done to measure stress levels. Test results revealed, that the children in the intervention group presented lower cortisol levels and lower stress levels.
                    The demonstration that laughter improves cognition, insomnia and depression are encouraging news, since laughing costs no money, it is not invasive and it does not require you to use prescription drugs. But, as important, is the now observed fact that humour is able to regulate cortisol levels, which when elevated, affect brain serotonin function leading to a manifestation of a depressive state.

                    What areas of the body does laughter affect?
                    The effects of laughter therapy were observed to affect the Autonomic Nervous System, which in people suffering from depression has been found to be dysfunctional.
                    It is important to note that continual stress, not only causes a dysfunction in cortisol levels, which affect serotonin and leads to depression. But, stress has also been proven to affect immunity.
                    If there is a continual assault to a person immune system, there are immediate effects seen in the brain, resulting in a decrease in neurotrophins, leading to reduced neuronal repair, a decrease in neurogenesis, and an increased activation of the glutamatergic pathway that contributes to neuronal apoptosis (death), oxidative stress and the induction of apoptosis (death) in astrocytes and oligodendrocyte. All these processes, have been examined and may lead to the development of various neuropsychiatric disorders such as depression.
                    However, laughter has been shown to elevate the natural killer cell activity, meaning it can boost people's immunity. Given that laughter can affect the brain and immunity, its no wonder that it can improve cognition, insomnia and depression.

                    http://www.emaxhealth.com/13644/study-reveals-laughter-improves-cognition-insomnia-and-depression