Today's #Sleeptember FACT --- The Sun and Moon may not be our circadian systems' only dynamic duo

#SLEEPTEMBER

We've long understood that the rhythms we live by (sleep, wake, hunger, even our digestive system rhythms) are finely tuned to the circadian cycles of the planet which revolve around the daily light-dark cycle and, in the longer view, the seasons.

Now scientists have found a couple of neurological companions in the brain which may also be responsible for turning these cycles off and on via biochemical activity noticed in membranes referred to as ion channels.

Image courtesy www.columbia.edu

As reported in MD, sodium and potassium channels worked in opposition to shift the circadian cycles in both fruit flies and mice. This potentially suggests that circadian rhythms are not only influenced by external forces like light and darkness, but internal processes built into our systems which are entrained to those external forces.

Up to 16 percent of the population struggles with some form of circadian rhythm disorder, according to statistics published by the American Academy of Sleep Medicine. 

That's a lot of people who might have faulty biochemistry when it comes to switching from sleep to wakefulness or mitigating other processes that are information by circadian rhythms.

Ultimately, "[a] better understanding of this mechanism could lead to new drug targets to address disturbances of the sleep-wake cycle, such as jet lag, shift work, and circadian disorders," writes Melissa Glim for MD. "It may become possible to reset a person’s internal clock to match his or her situation." Read more here

SLEEP STUFF: Light therapy

It may not occur to some people with sleep problems that light might be both their problem and their solution. Controlling light exposure at key times during the day is important for keeping fixed to normal circadian rhythms.

The people who often struggle most with finding quality sleep are also the ones working night shift or who stay up too late while on their computers. Their exposures to artificial light at these hours makes sleep harder to achieve due to the way that the eyes and skin absorb light; this absorption can literally turn off your brain's melatonin production. It's melatonin that helps the body transition from wakefulness to sleep.

On the flip side, people who are sleepy during the day often live in climates where the fall and winter bring longer periods of darkness during the day. Less exposure to quality light (natural or artificial) first thing in the morning can lead to daytime sleepiness as well as mood changes.

There are a few different products on the market geared to help people gain some better control over their light exposure. As always, discuss these options with your physician. In some cases, they might even be able to prescribe light therapy, if it's warranted, and insurance may then cover some or all of the expense.

Neuro:On Mask with Circadian Lighting
This is a wearable sleep mask that uses a "smart wakeup" technology to help you fall asleep and to wake you up at the optimal time in the morning, usually after you have completed your last REM cycle and have moved into a lighter stage of sleep. It measures several biological signals like brain waves, muscle tension, eye movements, pulse, core temperature and more via Bluetooth 4.0 LE-compliant digital analysis. For those who struggle with an irregular sleep schedule, general restlessness and jet lag, the NeuroOn might be a useful solution. It runs about $300. Learn more

FeelBrightLight Visor
You might have seen these before: visors that have lights built underneath their brims. These lights shine specific kinds of colored light indirectly above the eyes to help improve energy and mood. They offer a device you can clip to any visor you already have for around $110 and a deluxe version that includes a carrying case and a visor for $150. This could be a good option for people who need to move about and desire a hands-free solution to daytime sleepiness. Learn more

Philips Wake-Up Light
This attractive round light props up on a table, desk or nightstand nearby and can be used to help you fall asleep or wake up more gently depending upon how you program it. Its chief job is to stimulate sunrise and sunset lighting. Dimmer light at night is better for achieving sleep onset, while gradual illumination to morning sunlight aids in waking. This device also includes an option so you can awaken to pleasing natural sounds. Priced between $70 and $170, depending upon features. Learn more

Re-Timer 
Here's another wearable light therapy device, worn like a pair of lightweight and nonrestrictive goggles, that uses green spectrum light. It is designed to fit the majority of the population ("one size fits most") and its manufacturers claim it can bring relief to users in as little as three days following specific therapy protocols. It is used by people with delayed sleep phase syndrome (night owls who need to shift their sleep phases earlier), people with advanced sleep phase syndrome (morning larks who need to shift their sleep phases later), shiftworkers and those suffering from chronic jet lag. Prices run around $300. Learn more

Sleep Hygiene Tip of the Week || Rise time versus Bed time... which is better?

We're a culture in perpetual motion, so it's hard to always have the same sleep schedule, day in and day out. Either it's travel that messes up our schedule, or the variations in morning and evening schedules that come from parenthood, or we might work jobs that don't support a regular sleep schedule.

So if forced to choose, which is better? Going to bed at the same time at night or getting up at the same time every morning?

Circadian resetting occurs at the time you awaken. What this means is that the morning light sends a signal through both your eyes and--believe it or not--your skin, which stimulates your wakefulness drive. If you get up at the same time of day, even as seasons shift, your body resets to the circadian rhythms of the planet, which more or less guide the processes of all living things. It's easier to stay on track if you get up at the same time every day. It's even better to GO OUTSIDE for even 10 minutes, as that short dose of sunlight (even if it's dim or overcast) is still brighter than the lights in your house, and this will help you fight sleepiness during the day.

At night, it's a good idea to try to stick to a bedtime schedule (especially for children or for people with challenging schedules where they have to work hard to make sure they get enough sleep between shifts). But sometimes you just aren't as sleepy at that time. No worries. Remember that wakefulness drive I mentioned earlier? It works in tandem with your sleep drive. We all have a built in drive to sleep (just like we have a hunger drive, or a sex drive, or a thirst drive). That drive is informed by how much we slept previously (that includes naps during the day). So if you normally go to bed at 9pm and get up at 5am, and you take a 2-hour nap at 1pm, you might not feel as sleepy later, at 9pm, because you actually banked a couple of hours of sleep, thus delaying your sleep drive. So what do you do? You just go to bed when you begin to feel drowsy and don't worry so much about what time the clock says. Your body has its own built-in clocks, it will let you know when it's time to hit the hay.

One thing to keep in mind... some people tend to have more "morningness" (aka "larks") while some people tend to have more "eveningness" (aka "owls). Neither is better than the other, they are simply tendencies ingrained into our biological clocks at a fairly early age. The time when you go to bed or rise should suit your lifestyle and your natural tendencies rather than follow a prescription set by somebody else (except in the case of children, who are still developing their sleep habits).

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.