31 August 2014

Guest Post || CPAP Care and Maintenance with Rui de Sousa, RPSGT, RST, B.Sc

CPAP therapy typically includes a unit with
a humidity chamber, tubing, a CPAP mask
and its headgear, all which need regular
cleaning and maintenance in order to
preserve function, hygiene and value
So you have been diagnosed with sleep apnea. And now you have this monstrosity at your bedside that is supposed to help you sleep. You know you have to use it every night, it is essential to keeping you healthy. But did you know you have to clean it every morning too? 

Cleaning and maintaining your CPAP and accessories properly not only makes it work better, but it helps it lasts longer, and also keeps you healthier.

Morning maintenance

MASK

After using the CPAP all night, you have to clean the mask every morning. The mask is made with very delicate silicon material that must be cleaned every morning to prevent decay and breakdown of the material. Masks typically last six months to a year with proper maintenance. Cleaning the mask removes the oils that your skin released as well as germs and dirt and dead skin cells that were picked up during the night. This is especially important if you are fighting a cold or otherwise sick. If you fail to properly wash your mask in the morning, the cold may last much longer than it would have normally.

In the morning, fill the sink with warm water. Add some mild dish washing soap (like a Palmolive for example) or a mild antibacterial hand washing soap. Let the mask soak in this solution for a few minutes. You can also gently rub the delicate membrane to help clean it. After 5-10 minutes, rinse it with clean water and let it air dry.

There are also one-time-use disposable wipes specifically made for CPAP masks. You just clean the mask with these wipes and let it air dry. Dispose of the wipe in the garbage.

I will also add that, before you put on the mask at night, wash your face well--remove dirt, sweat, oil from your face. If you moisturize, avoid the areas of the mask. This will limit the accumulation of dirt and oil throughout the night. 

Also, check your mask for tears in the silicon or broken plastic parts. If the mask is defective, replace it immediately. A tear can result in excessive air leakage, reducing the pressure required to keep your airway open throughout the night.

HEADGEAR

Depending on how dirty the headgear gets, it can be washed weekly, in the same manner as the mask, using a mild soap and letting it soak. You can wash it more often if needed.

Weekly maintenance

TUBING

Some people will suggest washing the tubing every morning or once a week. I would say that once a week is enough, unless you are feeling under the weather. Then you might want to wash it out every morning until you feel better.

Fill the tubing about a quarter full of soapy water, then pick it up from both ends, blocking both ends with your thumbs, and rock the tubing up and down, swishing the water inside. Then just immerse the tubing in the soapy water for the same 5-10 minutes. Drape the tubing over the top of the door or on the towel rack to drain and dry throughout the day.

Check your tubing for slight tears and leaks. It will sometimes tear at the neck, near the ends. If you find a tear, replace it immediately, since the loss of air pressure can affect the minimal effective pressure needed to keep your airway open.

CPAP UNIT 

Wipe down the actual CPAP unit weekly. Avoid using any hard cleaning chemicals on the CPAP unit itself. You can easily wipe it down with a moist cloth to remove dust and dirt.

CPAP units also often have filters that need cleaning. Some filters are disposable (usually white), which you can replace. Depending on how much dirt and dust is in the air, these filters can last anywhere from a month to several months. If you live in the country, you can expect a dirtier filter and you may need to replace it more often. Please note that not all CPAPs have a disposable filter. Check the owner's manual or call the CPAP representative to double check if your unit has such a filter.

Some filters are re-usable (usually look like a sponge). These should be rinsed with cool water once a week or so. Just rinse the filter until the water runs clear. You can gently squeeze the filter to help eliminate the water. Let air dry and replace in the CPAP unit once it is completely dry.

Caution: There is no reason to open the CPAP unit. There is nothing inside the CPAP that needs to be maintained on a regular basis. If the CPAP seems to be malfunctioning, please have a professional look at it. Not only can tinkering with it void the warranty, but you can do more damage to the unit; or worse, you can get hurt.

HUMIDIFIER CHAMBER

The humidifier can be cleaned weekly with warm soapy water. Swish the solution in the chamber, then rinse it with clean water. You can also disinfect it with a vinegar/water solution (1 part vinegar to 4 parts water) and let soak for about 30 minutes. Then rinse and let air dry.  

Some chambers can be disassembled. If you have one that can, you can open it and place it on the top rack of your dishwasher. Most humidifiers are dishwasher safe, just check the owner's manual.

Annual Maintenance

It is a good idea to have the CPAP unit looked at once a year by qualified personnel. Take the CPAP unit in to be checked annually to the same people you purchased it from. The will have specialized equipment to make sure the CPAP unit is working optimally.

A short comment on traveling with CPAP

Never travel with water in the humidifier chamber. Depending on the model, water from the humidifier chamber can splash back into the actual CPAP unit, either rendering it useless, or shortening its lifespan. 
If this happens, it is important to immediately dry the unit as quickly as possible. Turn the unit over until the last drops have dripped out, then run the CPAP for 10-15 minutes without the tubing, just blowing off excess moisture that may have entered inside.

_____________________________________


Rui de Sousa,
RPSGT, RST, B.Sc

Rui de Sousa is a Canadian sleep technologist with over 20 years experience helping patients sleep better in and around the greater Toronto area. Rui is also heavily involved in educating new sleep technologists and the population at large. He has presented education forums for the interested public. He has published several chapters in a medical textbook and articles in local newspapers, and has been interviewed on TV and on the radio. He also keeps abreast of the latest knowledge, techniques and technologies attending local and international conferences.








30 August 2014

New technologies: Blue light blocking shields for electronics

Perhaps you know, intellectually, that you need to turn off your laptop or your phone or tablet right before bed because you know that blue spectrum light emission may be part of the problem behind your insomnia. And yet... let's be perfectly honest here: the habit of checking email one more time, playing one more game of Words with Friends before going to bed, or even reading a book on your tablet at bedtime can be very hard to kick.

Finally there's a solution to help with this dilemma. SleepShield has developed a line of screen shields which are designed to block blue light emissions on everything from phones to tablets to game consoles to laptops.

These shields, which you apply directly to the screen, are composed of high-grade PET anti-blue light film which reduces the amount of blue spectrum light emitted from your personal electronics. These films have a 93 percent transparency rate and the manufacturer promises they won't alter the color of the screen being shielded.

SleepShield screen films are recommended by Dr. Michael J. Breus PhD, known on the Internet as "The Sleep Doctor." Breus is a clinical psychologist who works with the American Board of Sleep Medicine and the American Academy of Sleep Medicine to educate the public about sleep health.

If you have trouble with insomnia, and you regularly work on a backlit electronic screen up until bedtime, you may wish to try out this nonpharmaceutical solution to your sleep problems if you are unable to kick your electronics habit.

28 August 2014

Lifespan || Back to School: Have You Reset Your Kids' Bedtimes?

Kids are usually not ready to go back to school in the fall, and to confuse matters, they sleep following a summer schedule which generally puts them in bed later than is recommended for school-aged kids needing to get up early for school the next day. This can mean a tough transition from summer to school days for many families, with many elements to blame for this challenge.

Daylight hours are still long and late enough to make it hard for kids to go to bed at a normal time. The sky doesn't darken early enough in August, even in early September, and that means parents may have to double their efforts to get their kids to bed at a healthy time.

On top of that, many schools still have earlier start times than are recommended by most sleep health organizations. This is a particularly significant problem for teenagers as their sleep phases tend to delay at this time in their lives, as they are literally unable to fall asleep until later as a result of major developments in the brain combined with considerable changes in hormone levels. Many school districts have become aware of the need for teens to sleep in and start school later and have adjusted their start times so elementary aged children start off the day earlier (between 7 and 8 AM), allowing junior high and high schoolers the later (around 9 AM) slots. But there are still many school districts across the country which have not made these changes, perhaps at the peril of the kids in those communities. Some research shows that test scores for teens with early start times are considerably lower than those who get to sleep in, and other studies indicate that teens with early start times are also more likely to get into motor vehicle accidents as a result of sleep deprivation which may partly be blamed on this lack of allowance for sleep imposed on them by their school district.

Warmer temperatures in late summer and early fall can also make it harder to fall asleep, as the human body must be able to "cool off" at night in order to achieve sleep onset; warm days, especially in humid areas east and south, can interfere with sleep hygiene in this regard.

What can parents do?

  • Know what your child's sleep needs are first, then factor in bedtime rituals, morning rituals and transportation to school, then subtract these from your child's school start time to find the right bedtime to which your child acclimates.
    • Preschoolers (up to age 6) need 10 to 12 hours
    • Pre-adolescent school-aged kids (ages 7-12) need 10 to 11 hours
    • Teens (13 to 18) need 8 to 9 hours

      Picking a bedtime (example): If your child is 10 years old, and they need about half an hour to get to bed, half and hour to get ready in the morning and half an hour to get to school, and their school start time is 8am, then they need to start going to bed at about 830 at night. This allows them to get ready between 830 and 9pm, to sleep until 7am, then they can get ready from 7 to 730am and head off to school promptly to meet the 8am start time. 
  • Gradually put your kids to bed earlier over the course of the late summer, if they are pre-adolescent. 
  • In the case of older kids in late summer, ask them to try to be home earlier or go to bed earlier so they can adjust to the more structured sleep schedule they'll have to deal with in the fall. If you have teens in sports or other activities that meet before school, discuss with them the importance of getting enough sleep so they can better manage the demands these early schedules can place on their energy and alertness while in class.
  • Go cold turkey: the night before school starts, put the kids to bed at the time you want them to go to bed. Prepare for them to be tired or unruly or otherwise less functioning for the first couple of days. Many school districts start in mid-week to prepare for this reality anyway.
  • If you have to choose one time to be consistent about, make it the morning wake-up time. All human beings do better if they rise at exactly the same time every morning and allow the day's activities and their own natural circadian rhythms to determine their bedtimes later. 
  • Don't give your teens too hard a time about the fact they can't get to sleep at an earlier time. This is something they physiologically have no say over and is, in fact, a normal part of their development.
  • Institute "screen rules" at bedtime. Kids in 2014 are essentially "plugged in" through their phones, laptops, and video game consoles. The problems with screens are two-fold: first, these devices emit blue spectrum light, which is scientifically proven to shut off melatonin production in the brain (melatonin is a hormone that is secreted in order to prepare the body for sleep); in addition, the content of movies, television shows, Skype phone calls, video games, Facebook and other electronic communications can be tantalizing enough to make it difficult for kids to shut their minds down at bedtime. If your kids can't learn to police these activities now, the odds of their ever getting a good night's rest even beyond college life are likely to be next to nothing. Old habits die hard. Don't let them form these poor sleeping habits in the first place and they'll be healthier adults in the long run.
  • Make sure your kids are not eating late or having snacks right before bedtime. Especially be vigilant about stopping their consumption of caffeine-laced products like chocolate, soda, coffee, cocoa and energy drinks after 5pm at night. 
  • Put room-darkening window treatments in your kids' rooms if they have many windows which bring in a lot of light. An eastern or northern exposure window will always be darker at night than a western or southern one, but don't forget to factor in streetlights outside their rooms, house lights or any lights from passing traffic, which can continually illuminate their bedrooms just as they are trying to fall asleep.
  • Make sure your kids are not physically exerting themselves until bedtime. The adrenaline rush that commands the bloodstream following a period of exercise takes a couple of hours to wear off, and that could mean your kids might end up being too hyper to sleep right afterward.
  • Remove distractions from your kids' sleeping environment. That means having them pick up the clutter of their day, if possible, so that they don't have in their sight lines the reminders of interesting activities to thwart their attempts to sleep.
  • Stick to a relaxing bedtime ritual. For younger kids, this could be a bath, teeth brushing and bedtime stories or prayers. For older kids, it could also be a shower or bath and other self care and reading a book, if they can't fall asleep right away. 
  • Teach your children meditation. Meditation is a great way to practice mindful living, as it helps with the practice of shutting down the active mind. Meditation also involves healthy breathing practices which can be the basis for a good night's sleep if practiced at bedtime. Meditation can also be especially useful for kids dealing with the stresses of daily living: family problems, bullies, challenging subjects at school, budding romances, pressures derived from competitive activities. If kids can manage their stress levels, they will be better equipped to deal more successfully with all the very real challenges that childhood and adolescence can bring.


25 August 2014

Sleep in the Media || Book Review || Wide Awake and Dreaming


Wide Awake and Dreaming: A Memoir of Narcolepsy
Julie Flygare

Who should read this book?
Anyone with an interest in compelling memoirs would find this book completely fascinating and--ironically perhaps--eye opening. Julie Flygare tells the curious tale of her entree into the quasi-real world of narcolepsy: the strange markers of its onset, how it progressed while she was up to her eyeballs in law school studies, its impact on her social and work life, and where her experience with this rare disorder has taken her since she graduated with a law degree in 2009.

Flygare is now a leading spokesperson for the Narcolepsy Network and helped to establish the first Sleep Walk in Washington DC in 2011. Perhaps one of her most important jobs as spokesperson for sleep disorders has been her collaboration with Harvard Medical School researchers over the last four years in the form of a 5-hour educational workshop based on her narcolepsy experience, now a required educational component for all Harvard Medical School students. It's no small feat to train medical practitioners to recognize the value of sleep: currently, many if not most primary care physicians and specialists in all branches of medicine overlook the critical role sleep plays in endocrinological, neurological, psychological, respiratory, immunological and cardiopulmonary function. Sleep is a whole body process that cannot be ignored or replaced with medication.

Why should you read this book?
I would personally give this book to every person I know who has ever made a wisecrack or insensitive comment about sleep disorders (narcolepsy, in particular, with its unfortunate and insensitive "Mr. Magoo" representation in our sleep-deprived culture) so that they can understand how real, how challenging and how mystifying this illness is. My own experiences are extremely mild compared to Flygare's, for which I am ever so thankful. At the same time, living with this invisible and incurable condition has its own challenges, not least of which is the balance one must strike between the needs of the body and mind while living in a culture which doesn't value sleep and which tends to judge those who take sleep seriously as somehow being lazy, stupid or unstable. Flygare's book is an important entry in the chronicles of contemporary sleep medicine.

Sleep Hygiene Tip of the Week || Think carefully before napping

"Rosie and Jennie Took a Cat-Nap."
Harry Whittier Frees, 1915. Public domain.
There's lots of contradictory advice out there about napping. Who should nap? Who shouldn't nap? When is a nap a good idea? A bad idea? What's a good nap length? Let's take these one at a time.

1. Who should nap?
  • Naps are good for children as their developing bodies often need the added rest.
  • The elderly often nap, and it's not a bad idea. They may have multiple health conditions that lead to daytime sleepiness, and they may also be taking numerous medications that cause them to feel drowsy. 
  • Anyone who is sick with a virus or infection can benefit from napping. The body is working hard at the cellular level to manage healing; sleeping gives the body an added opportunity to repair itself.
  • Anyone with a chronic health condition or a serious disease like cancer can benefit from a nap. 
  • Postoperative patients can benefit from naps while they are in recovery and/or rehabilitation mode.
2. Who shouldn't nap?

  • Don't get into the habit of napping if you are suffering from insomnia. It seems counterintuitive ("don't sleep if you can't sleep?"), but regular napping may actually lead to chronic insomnia. Try to get most of your sleep at night and only nap if you really can't avoid it. 
  • If you suffer from depression, taking a nap may not help matters as it may continue to alter already disrupted sleep patterns that arise from the condition or via the pharmaceuticals used to treat depression.

3. When is a nap a good idea?

  • If you are unexpectedly drowsy, a quick nap can give you the recharge you need. Often we feel drowsy in the early to mid-afternoon. As long as you don't oversleep, you can benefit from a nap at this time.
  • If you work night or overnight shifts, a nap prior to working can add some sleep to your "bank" so your recovery time afterward can be easier.
  • If you have been diagnosed with idiopathic hypersomnia or narcolepsy, planned naps can help offset these conditions. (Please don't diagnose yourself: get a confirmed diagnosis from a sleep health professional. Excessive daytime sleepiness can be caused by any number of health conditions, many of them not related to sleep.)

4. When is a nap a bad idea?

  • If you tend to wake up groggy from naps, then you might not benefit from taking them right before you need to perform tasks that require alertness. 
  • If you have insomnia, you might consider how often you nap, and for how long. Naps, if not absolutely necessary for function or healing, can actually reduce your sleep drive at night and make it harder to fall asleep or to get most of your sleep at night.
  • It's after 3pm. Any naps after this time may very well disrupt your nighttime sleeping patterns.

5. What's a good nap length?

  • Quick naps are best. Ten to 30 minutes should do the trick.

Other things to consider:

  • If you use a device for your nighttime sleeping, such as supplemental O2 through a cannula, a PAP mask, nasal strips or an oral device, make sure and enlist these tools for naps, as well. They are yours to use to improve all sleep, not just the sleep you get at night.
  • Eating a meal right before a nap could aggravate any heartburn or gastroesophageal reflux disease you may suffer from. You may wish to take a medication for this condition prior to napping.
  • Always opt for a nap if you are driving a motor vehicle or operating heavy machinery and find you are extremely drowsy. Do not think you can "power through" extreme fatigue. Your sleep drive is a physiological process which can't be denied. 
  • A warm room might be conducive to sleep onset, but you may not have a very long nap if you are overheated. If your sleeping environment is overwarm, try using a fan and blankets to moderate ambient temperature.
  • Make sure you nap in an environment conducive to sleep (make sure it is dark and quiet, for example) or you might be frustrated by your failure to sleep.
  • If you are regularly fatigued and need to nap daily, this could be a sign of an underlying health condition. Contact your doctor to discuss your options.

24 August 2014

MAILBOX || What's your sleep problem? Ask SleepyHead Central for help!

Many people think trouble with sleeping is normal, and just as many people think it's normal to be sleepy during the day. Not true in either case. In fact, some people have had a lifetime of bad sleeping patterns, and that means they aren't functional at 100 percent on a daily basis.

The thing is... almost every kind of sleep problem out there is treatable and those who seek help discover renewed energy, better health and potentially a prolonged life just by improving their sleep hygiene. The first step is to ask yourself what your sleep is like and whether your habits might be cheating you out of the energy and vitality you need as a human being to get through your busy life.

When it comes to sleep, just asking the question "do I sleep well?" may very well be the key to pursuing a healthier, more energetic future.

If you're not sure if you have a real sleep problem, then ask SleepyHead Central! One of the goals of this clearinghouse is to help readers determine if they should pursue medical advice with relation to their sleep habits. Your best advice, of course, comes directly from your MD, but if you're still on the fence about your sleep issues and aren't ready to see your doctor, you can ask SleepyHead Central for help in the form of up-to-date information and tips for getting through or better understanding your sleep challenges.

It's easy! Click the CONTACT link above and send an email with your question; you can request a private or a public response to your question. It could be a problem or a question you have about your own habits, or it could be about someone in your life you're concerned about. SleepyHead Central is  happy to help and promises to give you the best information found on the subject.

19 August 2014

AASM News Headlines, Summer 2014 Edition: New insomnia pill; Pledge to "stop the snore;" Relaxis Pad for RLS; CDC shows striking rise in sleep related clinic visits

Here are some links to AASM news posted between June and mid-August 2014. For more news, visit the AASM here.

FDA approves new sleeping pill Belsomra (suvorexant) for insomnia
Suvorexant (Belsomra) tablets were approved by the FDA on August 13, 2014 for the treatment of insomnia. Suvorexant is a receptor antagonist for the neurotransmitter orexin; it functions by altering the brain's chemical signals responsible for regulating the sleep-wake cycle. Studies show that patients taking suvorexant tend to fall asleep faster and spend less time awake after sleep onset when compared to those taking placebo. Next-day drowsiness is the medication's most common side effect. More information

Stop the snore: AASM urges sleep apnea action for those at risk
Obstructive sleep apnea (OSA) is a potentially life-threatening disease that afflicts at least 25 million American adults. Untreated OSA can increase your risk for serious health problems like heart disease, stroke, diabetes and depression. Did you know that snoring is its most common warning sign? If you snore, or you know someone who snores, it's worth checking out, as OSA is fairly simple to treat. Interested in "stopping the snore?" Take the Pledge.

FDA clears the Relaxis Pad for treatment of restless legs syndrome
A new nonpharmaceutical treatment for Restless Legs Syndrome (RLS), a health condition that can significantly disrupt sleep patterns, is now available through Sensory Medical. The Relaxis Pad is a noninvasive device which emits vibratory counterstimulation to relieve pain and tension in the legs at bedtime. As many as 12 million Americans suffer from RLS, which can rob the body of deep, restorative sleep. Many sufferers go undiagnosed as the symptoms of RLS often resemble stress, arthritis, muscle cramps, or are often attributed to the “normal effects” of aging. Its nonpharmaceutical value makes the Relaxis Pad a breakthrough medical device for many. More information

CDC study examines national trends in office visits for sleep problems
The number and percentage of office visits for sleep related problems, and the number and percentage of office visits accompanied by a prescription for a sleep medication, have increased significantly since 1999. Most striking were increases in the number of office visits resulting in the acquisition of prescription sleep aids. Read the abstract here.

The American Academy of Sleep Medicine (AASM) is the only regulatory, professional organization dedicated exclusively to sleep health. It sets standards and promotes excellence in sleep-related healthcare, education and research and is comprised of nearly 12,000 accredited sleep labs and sleep professionals across the US. 

18 August 2014

Sleep Hygiene Tip of the Week || Just say No to phones and beds

It's a common habit (we see it in the sleep lab all the time): people take their phones to bed with them, often tucking them under their pillows or next to them on the bedding.

People, don't do this. Four good reasons:

1. You could catch your linens on fire. Cell phones have been known to melt or otherwise catch on fire because of a faulty battery. They can also overheat if left in a functional mode. This is advice from the category of Good Common Sense: if you need to have your cell phone nearby, then at least put it on a firm surface. Read more: "What's causing your cellphone to get so hot?"

2. It might be even Better Common Sense to not have your phone in the same room with you at all while you sleep. Why? Every time you get a text or a call, even if the sound is turned off, the screen flashes on, and in doing so, it emits blue spectrum light. Your body can still perceive blue spectrum light even if your eyes are shut, due to photoreceptor cells that are contained in your skin. Blue spectrum light has been shown to delay or block the production of the sleep-promoting hormone, melatonin, in the pineal gland. If your body is not getting adequate melatonin, it cannot effectively achieve sleep onset. So... perhaps turning the phone off entirely would make more sense, or at least turning it face down with the sound off would be the alternative if you just couldn't stand to not have your phone with you. Learn more: The melanocyte photosensory system in the human skin.

3. Though the jury is still out on this point, you might consider the fact that cellphones to emit a small amount of electromagnetic radiation (EMR). Sleeping with a constant stream of EMR emissions next to your head or even next to your bed may be yet one more reason to not have your phone in the same room with you at all while you sleep. Check out this detailed discussion at the David Suzuki Foundation, which does not take a position on the debate surrounding EMR and cell phone use.

4. Finally, having a cell phone in bed with your, or even next to you, means you are more likely to answer it, no? You are woken up by a text or a call... how much self control do you have? If you receive important calls at night because you are on call or in management or for some other legitimate reason, that's one thing. Using your cell phone as an alarm is common and, probably, harmless if you keep your phone plugged in away from your head. But we have seen patients in the sleep lab who are just having conversations with people in different time zones at that time. Patients who are taking calls from people who have no business calling at that time of night (meaning: people who are practicing very poor sleep hygiene and have no respect for other people's lifestyles). Patients who reach for their phones to check the time in the middle of the night, though there is no healthy reason to check the time in the middle of the night (it will not make you go back to sleep more easily, that's a guarantee!) Or patients who, because they can't sleep (see number 2), turn on their phones to find something to pass the time, which further interrupts melatonin production and more grossly enhances their sleeplessness. Are you worried you might have a cell phone addiction? Check out these various entries on cell phone overuse at Huffington Post.

Bedtime is supposed to be about sleep. If you are struggling to get sufficient sleep and keep your phone at your bed because you can't resist checking out the latest Pinterest link your friend has just texted you or playing your round of a smartphone game app as soon as your opponent's notification arrives--even if it's at 2am--then you need to be thinking about what your priorities are. You cannot live well with insufficient sleep. Insufficient sleep causes car accidents, loss of sex drive, impaired judgment, reduced performance on the job, increased risk for disease (especially cardiovascular, but stroke and diabetes, as well), accelerated aging of the skin, weight gain, memory loss, cognitive deficits, and depression. It's up to you to decide if that Pinterest link arriving at 2am is worth breaking a healthy cycle of sleep for, but we suspect that you will ultimately decide it's not.

17 August 2014

Insomnia Central || The "walrus"* in space

You'd think it's plenty quiet and dark in space... so how does it happen that astronauts struggle with insomnia?

All living things (including humans, plants and animals) have photoreceptors which recognize the difference between light and dark cycles. These light cues (known in the sleep world as zeitgebers), help us to stay awake during the day and to fall asleep at night. Melatonin production in the brain increases as the sky darkens in the afternoon, then drops off dramatically with the first peek of daylight in the morning.

Astronauts, however, have a different relationship with sunrises and sunsets while working on the International Space Station, where the sun rises and sets every 90 minutes. This rapidly shifting rhythm of light to dark can seriously impose itself on the human circadian system, which is entrained to 24-hour days. Over time, this can lead to hormonal confusion in the brain and, ultimately, insomnia for these space walkers.

Insomniac astronauts are not a good idea. What this could mean is that, during their waking hours, these sleep-deprived astronauts may share a common risk-taking behavior with long-haul truckers, bus drivers and airline pilots: drowsy driving. Lack of quality sleep can result in poor judgment, inability to achieve an appropriate level of alertness in emergency situations, even the opportunity to "sleep drive" (like sleepwalking, but while driving).

Most astronauts end up taking Ambien (aka zolpidem as a generic) to regulate their sleep cycles and comply with their daily requirement of 8.5 hours of sleep, but Ambien can leave them with a foggy morning-after hangover that can impair their performance nearly as much as sleep deprivation. It can also be to blame for some unusual behaviors that can occur while asleep which are typically hallucinatory in nature and may resemble sleep walking.

So which is better... sleep deprived astronauts or hallucinating ones?

Dr Charles Czeisler, a Harvard Medical School sleep expert who co-authored a recent article for Lancet about the problem of sleep for astronauts, said: "Future exploration spaceflight missions to the moon, Mars, or beyond will require more effective countermeasures to optimize human performance by promoting sleep during spaceflight... These may include modifications to schedules, strategically timed exposure to specific wavelengths of light, and behavioral strategies to ensure adequate sleep, which is essential for maintaining health, performance and safety."

So really, the answer is neither. Humans need sleep, even and, perhaps, especially, those who don't have their feet solidly planted on the terra firma.

Read more:


*Ambien is popularly referred to as "the walrus" after a comic strip artist began to write about Ambien experiences in which a "walrus" told him things while he was under its influence. 

16 August 2014

Welcome!


Thank you for visiting! SleepyHead Central launches quietly today with posts coming regularly starting tomorrow! Future discussions include many common sleep topics:

Insomnia - Sleep Apnea - Sleep Disorders 101 - Sleep Hygiene Tip of the Week - New Technologies - Sleep in the News - Quotes from Experts - The ABCs of Sleep - Sleep in the Lifespan - Sleep Awareness Events - Sleep Health Organizations - Testimonials from Patients - Sleep-Related Legislation - Sleep and Health Literacy

Also, SHC is set up to field your questions about sleep health and hopes to post a regular Mailbag feature, so if you have a question about sleep health--yours or someone else's--feel free to contact SHC here.

Please help spread the news about SleepyHead Central! Here are links you can send to your friends, coworkers and family so that they can find us!

Home base: HTTP://www.sleepyheadcentral.com

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Google+:  https://plus.google.com/u/0/b/100937696911716686369/100937696911716686369

Email: sleepyheadcentral@gmail.com




13 August 2014

Be a Sleep Activist! Support H.R.5294 - Health Equity and Accountability Act of 2014

From my sleep health cohort Edward Grandi, this post in Facebook:

"For those working in the sleep field... ask your member of Congress if they support H.R.5294, the Health Equity and Accountability Act of 2014. There are important provisions to further sleep research."


Thank you, Ed. In essence, HR 5294 exists "to improve the health of minority individuals, and for other purposes..." which specifically includes The Sleep and Circadian Rhythm Disorders Health Disparities Act as illustrated in the bill's text under Subtitle I, sections 791-793, supporting research activities at the NIH and the CDC.


Folks, important advancements in sleep health have always needed the support of the government in order to get the funding necessary to research such important topics as sleep deprivation, SIDS, drowsy driving and other sleep health challenges. Please help to inspire our politicians to make this as important a discussion at the federal level as cancer, AIDS and other health crises in this country.

11 August 2014

Sleep Hygiene Tip of the Week || Stay Cool!

"Kawasaki Electric Fan," 2004. Credit: CC BY-SA 3.0
It may seem obvious that warm weather makes it hard for many to be comfortable enough to sleep during the summer, especially if they don't have air conditioning or good air circulation in their homes. But keeping a proper temperature in your sleeping space at every time of year is important for more than just comfort.

Part of your body's circadian system relies on your body's careful regulation of its temperature. A general reduction in core temperature helps to facilitate sleep. You achieve your lowest core temperature about four hours into your sleep period and this low point helps reset your rhythms for the day.

By no means does this suggest you make your efforts at body temperature reduction extreme, as being too cold can also keep you from sleeping. But generally speaking, the human body has a thermal pattern that includes a cooling off period at night which helps make you sleepy.

So there's a heat wave on where you live. What then? If the ambient room temperature in your sleeping space is uncomfortably high, you will end up sweating, tossing and turning because your body isn't going to achieve the lower core temperature required to become drowsy.

While there isn't a perfect room temperature conducive to sleeping for all human beings, being in a sleeping space that's 54-75 degrees Fahrenheit is one's best bet. Therefore, if you don't have air conditioning or even a fan to help move air and make you feel cooler, and it's very warm in your sleeping area, you may need to cool your core temperature with cold fluids at bedtime or even take a sponge bath using cool (not icy) water to help cool yourself off before going to bed.

Research has shown that insomniacs generally have a higher core body temperature, no matter what time of year, which could be part of their sleeping challenge. One way to help drive that drop in core temperature for them might be to take a hot bath right before bed. I know, it seems counterintuitive! But once out of the hot bath, the body naturally cools in a cooler space and this could lead to the drowsiness that can elude some insomniacs.

Also, if you wear too many blankets at any time of year and sweat a lot during the night because of it, this could hamper your efforts to more quickly fall asleep, so you might think about turning down your room temperature if you can't get rid of the blankets, or try for lighter blankets so you can better facilitate your own good sleep.

04 August 2014

Sleep Hygiene Tip of the Week || Give Fido his own bed

Do you take a menagerie to bed with you every night?

Just how still and quiet are they? Hmmmmm?

You might laugh about the fact that pets are a major contributor to poor sleep for their human caretakers, but the truth is that people who take a lot of pets to bed with them may be making their sleeping life much more difficult than it needs to be.

Pets get up and moved around. They make sounds in their sleep. They act out their dreams sometimes. Is it any wonder that sleeping with pets might be one reason why you aren't getting a full night's sleep?

SLEEP HYGIENE TIP OF THE WEEK: It may be difficult to retrain pets to NOT sleep with you, and it may be difficult for you to fall asleep without your beloved pets at your side. However, I see patients all the time who normally sleep with pets; in the lab during a sleep study, they have to sleep without their pets. Guess what? At least half of them sleep better WITHOUT their pets. It can be done if you are resolved to make the change.

If you are introducing a new pet to your household, make it a priority to train them to sleep in their own bed, even in a separate room. And don't forget, not only might you be suffering from poor sleep due to your pets' sleeping behaviors, but you may also be very active or noisy in sleep, keeping them awake as well!