Showing posts with label visions of sugarplums. Show all posts
Showing posts with label visions of sugarplums. Show all posts

24 December 2015

20 September 2015

ANNIVERSARY SPECIAL: SleepyHeadCENTRAL's top 25 most popular posts


As determined by Google Analytics, including posts timestamped between September 19, 2014 and September 19, 2015
  1. APR 15. 2015 || JUST BREATHE: Upper airway resistance. It's a thing. And it matters.
  2. NOV 29, 2014 || SHED SOME LIGHT: Misconceptions about Circadian Rhythm Disorders
  3. NOV 21, 2014 || SHED SOME LIGHT: Terra Ziporyn Snider, PhD, on later school start times
  4. JUN 12, 2015 || GUEST POST: Insights into the recent ASV device recall
  5. FEB 13, 2015 || ALTERNATIVES: Therapies for Sleep Apnea that don't involve a mask
  6. APR 30, 2015 || JUST BREATHE: "Heard About Sleep?" APNEA... If not, listen in here.
  7. APR 30, 2015 || JUST BREATHE: What happens if I don't treat my sleep apnea?
  8. NOV 7, 2014 || SHED SOME LIGHT: ...on circadian disorders
  9. OCT 24, 2014 || MONSTERS OF SLEEP: Ken Scholes on sleeping and PTSD
  10. NOV 17, 2014 || SLEEP HYGIENE TIP OF THE WEEK: Melatonin is tricky
  11. NOV 11, 2014 || SHED SOME LIGHT: ...on non-24 disorder
  12. OCT 18, 2014 || CPAP CENTRAL: A Season for Masks: Smaller Might Be Better
  13. JAN 2, 2015 || DEFINITIONS: What is normal sleep?
  14. NOV 4, 2014 || SHED SOME LIGHT: Are insomnia and winter depression linked?
  15. MAR 24, 2015 || INSOMNIA: Why is it linked to depression?
  16. JUL 24, 2015 || SLEEP STUFF: Smartphone apps for sleep
  17. SEP 20, 2014 || GUEST POST:  Edward Grandi on Sleep Apnea: What is it and what can I do about it?
  18. JAN 17, 2015 || ALTERNATIVES: Sleep better when you have the flu with these tips
  19. DEC 18 , 2014 || VISIONS OF SUGARPLUMS: Alcohol is NOT the sweet dream fairy
  20. FEB 17, 2015 || ALTERNATIVES: Valerian, aka "Nature's Valium" -- safe to use, effective? You be the judge
  21. MAR 11, 2015 || INSOMNIA: On Sleep State Misperception, with Dr. Robert Rosenberg, DO
  22. DEC 17 , 2014 || VISIONS OF SUGARPLUMS: Sleep Disorders 101: NS-RED and NES, Sleep Eating Disorders
  23. FEB 17, 2015 || ALTERNATIVES: Aromatherapy
  24. MAR 17, 2015 || INSOMNIA: The problem with insomnia forums
  25. APR 23, 2015 || JUST BREATHE: Hope2Sleep's "Dangers of Untreated Sleep Apnoea" infographic 

31 December 2014

LAST CALL! December's SleepyHeadCENTRAL Poll: Midnight Snacks



QUESTION... How often do you partake in midnight snacks? Take our poll now!
Click on the answer/answers that best fit your experience in the green box in the upper left corner of this page. Poll results are collected through the end of the month and announced in the following month's newsletter.

23 December 2014

December's SleepyHeadCENTRAL Poll: Midnight Snacks



QUESTION... How often do you partake in midnight snacks? Take our poll now!
Click on the answer/answers that best fit your experience in the green box in the upper left corner of this page. Poll results are collected through the end of the month and announced in the following month's newsletter.

18 December 2014

VISIONS OF SUGARPLUMS || Drugs and Sleep: Alcohol is NOT the sweet dream fairy

The idea of nightcaps as a way to induce relaxation for sleep is nothing new. Insomniacs, in particular, often believe it is the only way they can achieve sleep at all. However, the reality is this: drinking right before bed is not a healthy way to achieve quality sleep. Alcohol may help you to relax so that you can fall asleep, but that's about all the good it will do you. So many studies on alcohol's impact on sleep have been done that there's really no controversy: Alcohol degrades sleep quality. 

This probably isn't what you want to hear, going in to the holiday season, where late parties at homes and offices mean plenty of champagne, eggnog, wine and toddies will be flowing. But remember, alcohol is a drug, and one that can become habituated to. Even if one is not alcoholic, alcohol in the bloodstream will still generate a withdrawal response once it has been metabolized by the body.
At that moment, your body will go into withdrawal mode, generally at the time you should be experiencing REM sleep. Instead, hormones and body chemistry shift to stages of arousal and divert the brain from REM sleep.

Why is this a problem? When REM sleep is disrupted, many brain functions like concentration, memory and wakefulness are impaired as soon as the next day. The "fog" you feel during a hangover is an extreme version of this, but even light or moderate alcohol use will shortchange you the important stage of REM sleep and lead to cognitive shortcomings. If drinking alcohol before bedtime is a regular practice, you should expect it to eventually lead to problems with family, work and regular daytime function related to executive function.

Losing REM sleep isn't the only problem with sleep that alcohol contributes to.

The chemical relaxation that alcohol brings can lead to extremely loud snoring, as the tissues and muscles of the upper airway are extremely relaxed, creating resistance (which generates the noises of snoring). You may not think snoring is a big deal, but your sleep partner may very well disagree. Even if you don't have a sleep partner, snoring can rob you of deep sleep and lead to morning headaches and morning sore throats. It can always mark your potential for developing apnea.

If you have issues with obstructive sleep apnea--the partial or complete obstruction of the upper airway during sleep--alcohol will only worsen these episodes, leading to more gasping, choking and coughing as well as poor blood oxygen levels. Hours of low blood oxygen can lead to all kinds of other health problems over time. Apneas also generate arousals, just like the withdrawal affects of alcohol on the bloodstream, leading to more disruptive episodes of wakefulness during the night.

How bad can alcohol be for your sleeping process, then? It depends mostly on how much you consume. One or two drinks consumed within 2 hours of sleep might not show an impact, but more than that, over a shorter period of time, will absolutely rob your body of the sleep it needs.

In addition, alcohol before bed may increase the odds that you will suffer from sleepwalking, sleep talking and episodes of sleep "drunkenness." And for some, the continued use of alcohol can actually contribute to chronic maintenance insomnia, a condition in which one falls asleep, but cannot maintain sleep, leading to strings of sleep deprivation over weeks and months. Older people who drink before bedtime do not metabolize alcohol in the same way as their younger counterparts and may actually have a higher blood alcohol level in their system than a younger person after consuming the same amount--the problem here being that they may become at higher risk for accidental falls, and the problems of frequent nocturnal urination can also be exacerbated.

Even worse, scientific studies now suggest that there's a link between this kind of sleep disruption and cancer.

This is not to say that you shouldn't participate in the consumption of a little holiday "cheer" at your office or neighborhood shindig. Just be aware of the potential for lost sleep and expect to drag the next day. If you have sleep apnea, however, and you aren't treating it, be wary of drinking a lot of alcohol right before bed; those who already have moderate to severe apnea can suffer dangerous worsening of this condition following drinks before bedtime.

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Here's a good overall discussion describing the biological metabolism of alcohol to show you what will happen if you decide to enjoy several holiday nightcaps

For something more detailed and scientific check out this research study funded by the National Institutes of Health.

Finally, the Cleveland Clinic offers this report on Drug and Alcohol Related Sleep Disorders.

17 December 2014

VISIONS OF SUGARPLUMS || Sleep Disorders 101: NS-RED and NES, Sleep Eating Disorders

"Sleep eating" image courtesy Dr Austin Ejaife.
Believe it or not, some people eat while they are asleep. They literally get up to prepare and consume food in the middle of measurable sleep stages during the night.

There are also people who wake up and have to eat something or else they will not be able to fall asleep again.

Our media tends to address these legitimate health problems either as amusing or freakish, but the fact is that they are serious, life-altering, even threatening, conditions that require diagnosis and treatment. They are not the result of "poor willpower" or some other judgmental explanation. Sleep eating disorders are uncommon, but they do exist. These abnormal eating patterns during the night can definitely make life hard for those suffering. Uncontrolled weight gain in either case can lead to anxiety and depression from the feelings of shame and powerlessness brought on by these unusual disorders.

There is some difference of opinion regarding whether either or both of these are categorized as parasomnias and/or eating disorders. However, both can wreak havoc not only on a person's metabolic function but also on their sleep habits.

Nocturnal sleep-related eating disorder, also known as NS-RED or somnambulistic sleep eating, may take place during a spell of sleepwalking, which generally occurs as a kind of arousal between sleep stages. Those who eat while asleep are not generally conscious of their behavior. Regular episodes of NS-RED can heighten the risk for developing diabetes, as the body is not designed to manage caloric intake during sleep. The rise and fall of blood sugar during sleep can lead to problems with insulin resistance and other disorders of metabolism.

The other form of sleep-eating disorder is NES, or night eating syndrome. People who suffer from this have symptoms that can persistent for eight weeks or longer. They wake up lacking an appetite and tend to eat more of their total daily intake of calories AFTER dinner. While some of those who suffer from NES may be practicing unhealthy dieting patterns during the day (low-calorie daytime dieting which leads to binge eating at night), some of their issues may also be related to addiction issues, in which the brain lacks the necessary controls to stop unhealthy behavior.

Treatment of these disorders combines therapy for weight loss and addiction management with some environmental adjustments, such as placing locks on cabinets and refrigerators for those who are unaware of their nocturnal sleep eating challenges. Current pharmaceutical treatment with topimarole shows some promise for some nighttime sleep eaters. It's also critical that doctors review a patient's medications if they suffer from either of these problems so as to rule out drug-induced behaviors.

Note also that binge eating may also be associated with a separate sleep disorder, a form of hypersomnia called Kleine-Levin Syndrome, more popularly known as "Sleeping Beauty" disorder, in which sufferers extended periods of irresistible sleepiness and participate in overeating and hypersexual behaviors.


Resources

"Classification of Sleep Disorders." Michael J. Thorpy. Neurotherapeutics. 2012 October; 9(4): 687–701. Published online 2012 September 14. doi: 10.1007/s13311-012-0145-6

"Sleep and Parasomnias." Dr. Carlos Schenck. National Sleep Foundation. 2014.

"Sleep-related Eating Disorder." Mayo Clinic. 2014

"Sleep-Related Eating Disorders." Cleveland Clinic. 2013


14 December 2014

December's SleepyHeadCENTRAL Poll: Midnight Snacks



QUESTION... How often do you partake in midnight snacks? Take our poll now!
Click on the answer/answers that best fit your experience in the green box in the upper left corner of this page. Poll results are collected through the end of the month and announced in the following month's newsletter.

10 December 2014

VISIONS OF SUGARPLUMS || Why insomnia and sleep deprivation cause cravings

The science has been out for a while on this topic, but it's always good to raise the issue of sleep loss as it relates to weight gain. There is definitely a yin-yang element balancing our metabolism with our ability to achieve quality sleep, night after night.

First, some clarifications of terms:

Insomnia is the inability to fall asleep or to maintain sleep over many nights. It can have many causes: behavioral, physiological, pharmaceutical, environmental.

Sleep deprivation is the result of not getting adequate sleep night after night, either due to insomnia or other health condition, or to some self-imposed behavior (going to bed late then getting up early, perhaps, or working the overnight shift and not getting good recovery sleep).

If you suffer from one or both of these situations, you are setting yourself up for the possibility of slower metabolism and unwanted weight gain over time. Here's a few reasons why.

"Voodoo Doughnut Documentary Project" (2005)
by Anna Maj Michelson. CCA:2.0-Generic.
Studies show that sleep deprivation influences the primal region in the brain which controls decisions, especially when they involve rewards. In addition, our usually logical, more sensible executive functions are blunted by inadequate sleep and fail to override bad decisions about things like eating. It's a lose-lose situation, if we are sleep deprived, we are more inclined to crave unhealthy food and have little willpower to make good choices. If offered apples, carrots or strawberries, we will still likely abandon these healthier choices for pizza, doughnuts and hamburgers if given the opportunity.

Other studies have shown that chemical processes that take place in those with inadequate sleep generally create a hormonal imbalance that "informs" your cravings in the less healthy direction. Fat cells release the hormone leptin into the bloodstream to signal the appetite has been satiated. When the body is hungry, the same fat cells release the hormone ghrelin into the bloodstream to signal that is time to eat. When one is sleep deprived, there's often less leptin in the bloodstream and too much ghrelin in the bloodstream, and this is what leads to cravings: the brain is convinced you are starving because of this hormonal imbalance in the bloodstream.

Put these two elements of sleep physiology together and you can see where you might be headed if you don't keep up a decent sleep schedule. If you have just one night of insomnia or you have to shave off a couple of hours of sleep every once in a while due to work or travel, it's not going to turn into a downward obesity spiral, but if you have chronic problems with poor or inadequate sleep, you may find yourself packing on the weight and finding it difficult to stave off cravings. And then the vicious cycle begins: overweight bodies are overtired, while often underexercised and deprived of sleep, simultaneously.

National Geographic recently ran some eye-opening surveys about sleep in America, confirming what scientific evidence has been saying for a while now: the less that you sleep, the more weight you are likely to gain, as much as almost 8 times more than those who sleep close to 8 hours every night. This, even after accounting for exercise habits and family history.

The takeaway is this: Want to be healthy? Want to avoid obesity? Get your ZZZs.

Resources

Insomnia Increases Junk Food Cravings: Sleep deprivation blunts brain function linked to eating healthy foods || Psychology Today--The Athlete's Way

Body Weight and Sleep || Sleepdex

The State of Sleep Deprivation in America || National Geographic Channel

08 December 2014

Sleep Hygiene Tip of the Week || What about those sugarplums anyway? Will eating sugar hurt my sleep?

"Sugarplums," artist unknown.
Sugarplums are actually not fairies, as commonly assumed by fans of the ballet. They are a kind of confection made either of dried fruit (plum) and sugar, or a sugary gelatin confection shaped like a plum and colored purple.

They are an old-fashioned treat that probably isn't consumed as much anymore as was done in the old days. But sugarplums are also a more generalized reference to all things sugary and sweet and enjoyed at the holidays. This can include candy canes, butterscotches, ribbon candies, Turkish delight, pralines, penuche, divinity fudge, white almond bark... ANY candy, really, that is not made of chocolate.

Okay, so it's the holidays, and that means these foods enter into our diets more frequently for a temporary (let's hope!) time in our lives as part of the festivities. And that's okay. But consuming lots of sugary treats will have an impact on your ability to sleep well, so it's a good idea to know what to expect before you launch into a bowl of eggnog taffy or those leftover gumdrops from last night's gingerbread house party right before you go to bed.

What goes up must come down 
Sugary foods eaten right before bedtime can drastically increase, then decrease your blood glucose levels, as your body is forced to release hormones to establish balances between blood sugar and insulin. This swing in hormone release can impair sleep, which is a body process that relies upon, among other things, a balance in your blood chemistry. You may find you have early-night insomnia, for instance, or you wake up an hour or so after falling asleep; this can be due to glucose regulation and even the "crash" (or withdrawal) that comes after consuming a lot of sugar. (This also holds for alcohol "nightcaps.")

This is not the same thing as being "hyperactive." Remember the old days when people said kids who were hyperactive at bedtime probably just ate a bunch of sugar? Not really true. Sugary foods will spike your energy levels briefly but what follows is a downward spiral of energy leading to sleepiness. Here's a great article at Slumberwise which illustrates the sugar-sleep paradox.

Carbo loading
Sugary foods, by the way, are carbohydrate in nature. Other carbohydrates that aren't sugary include foods like rice, bananas, bread, pasta and warm milk, which could actually make you feel more sleepy afterward than straight-up sugary foods might. The body processes these kinds of carbs more slowly than pure sugar (and its cousins, honey, corn syrup, and the like), so you may only feel the hypoglycemic (blood sugar crash) after-effect and not the initial rise in energy (hyperglycemia, or blood sugar high) like you might after eating a candy cane. These carbs inspire your brain to send messages to your digestive system to slow down for the purpose of starting the sleeping process. If you want to sleep, this is not really a problem; however, if you're working the night shift, then you might want to avoid these foods in order to stay alert on the job.

Nighttime bathroom breaks
One of the things that happens when your blood sugar is out of whack is that your body will try to eliminate the excess sugar. Dr. Lynn Maarouf, RD and diabetes education director at the Stark Diabetes Center in Galveston points out that “any time your blood sugar is really high, your kidneys try to get rid of it by urinating, so you are probably getting up and going to bathroom all night long -- and not sleeping well.” This isn't true only for diabetics, but for prediabetics and healthy individuals who have consumed a large amount of sugar in one sitting. That is what the body's filtration system does: it kicks out the excess waste products through urination and/or bowel movement, both which should be more active processes during the day, but not so much at night.

If you are needing to use the restroom all night, you should probably mention this to your primary care physician so they can look for reasons as to why this is happening. It could just be a temporary imbalance in processes brought on by increased sugar intake, but it could also be a sign of metabolic dysfunction or something else entirely, like sleep apnea, which causes the body to frequently arouse due to lack of oxygen, which sends signals to the bladder to be emptied upon awakening.

Here's a great article on sugar intake and sleep quality worth checking out if you are concerned about the possibility of developing or aggravating a diabetic condition.

How to achieve sweet dream
So what does one do with all these wonderful sugarplums winking at us at our neighborhood party, the office kitchen or the family gathering by candlelight? If you already have a known metabolic condition, you know the answer is to stick to the healthy stuff. But if you don't, and you need to get a good night's sleep after the party is over, try to limit yourself to a few sugary treats and break up the sugar infusion with some crudite or a small protein bite in between to keep your blood sugar on an even keel. Drinking water in between also helps you to avoid the sugar-insulin rollercoaster ride by helping you to avoid dehydration, which concentrates your blood sugar and makes you hyperglycemic.

Whatever you do, be prepared. If all else fails, you might not get all your winks that night, and remember, if you're a believer in the fat man... Santa does see you when you're sleeping, and he knows when you're awake...

02 December 2014

December's SleepyHeadCENTRAL Poll: Midnight Snacks

Yes, that's right! This is our
100th published post at SHC!
Thank you for visiting and
supporting our efforts to
curate sleep health information!
QUESTION... How often do you partake in midnight snacks? Take our poll now!
Click on the answer/answers that best fit your experience in the green box in the upper left corner of this page. Poll results are collected through the end of the month and announced in the following month's newsletter.

01 December 2014

VISIONS OF SUGARPLUMS || Sleep Hygiene Tip of the Week: How overeating at bedtime affects sleep

You might think that eating a big meal right before bedtime would help make you more sleepy. Initially, it might. Studies do suggest that eating large meals in general can have a hypnotic or tranquilizing effect on the body, and a high carbohydrate meal will have an impact on sugar-insulin balances which can result in sleepiness.

But the relationship between sleep and digestion is far more intricate, and going to bed sleepy after a big meal does not mean you are going to sleep well. Here's some basic biology about digestion as it relates to sleep.

Your digestive system tends to also "go to sleep" when your body and brain begin to send out sleep signals. This means the muscular work that the bowel does slows down, you generate less saliva and swallow less, and stomach acid remains in the system longer, peaking in quantity at around midnight. This is due to a "digestive" clock in the brainstem which syncs with other clock signals in the brain related to sleep stages.

Photo courtesy Health.com
This is the reason why you are not up all night having bowel movements after large meals. Your brain communicates to the digestive system organs to take a few hours off and finish up digestion when the body reawakens.

However, if you have a very large meal late in the evening, just as your body and brain are closing down shop for the night, the digestive system gets confused or doesn't function properly.

With less swallowing and less saliva comes less opportunity for the body to clear away the stomach acid after it has done its job. Acid secretions that remain in the stomach after digestion can potentially travel out of the stomach, back up into the esophagus while you sleep, leading to the common problem of gastroesophageal reflux disease or GERD, which is marked by heartburn and indigestion. You wake up with a nasty acid taste in your mouth and a burning sensation in your throat and it can make it very hard to return to sleep. If you've ever had heartburn, you may have also noticed how the salivary glands can suddenly produce a lot of saliva that you swallow; this is the body's way to move the process along and clear out that acid.

But you aren't consciously thinking about swallowing while you are asleep, right?

When your body goes into REM sleep, all muscles below the chin paralyze, making it impossible to swallow against a rising flow of reflux (stomach acid that is still digesting your meal). What's more, you run the risk of actually inhaling some of this flow if it rises high enough in the throat to access your airway.

So what happens to your sleep quality on a night when you've eaten a large meal late? Either your body wakes from much-needed REM sleep to participate in some emergency swallowing, or you sleep through acid erosion in your throat, unaware that over time, this can create a lot of damage to the mucous membranes and the muscles that are meant to keep the stomach acid from reentering the esophagus, meaning the damage can be permanent.

It gets even worse for people who have asthma. They may actually inhale this acidic matter into their lungs, which is dangerous to their already compromised pulmonary system.

And what about the bowel? It's suddenly full of matter that needs to be moved out of the body precisely when the body's muscular system isn't primed to do the work. The unprocessed food waste waits there, as if in a traffic jam, and this can lead to trapped gas, constipation and pain.

There may be a link between Irritable Bowel Syndrome and late-night eating habits because the usual mechanisms for digestion simply aren't "awake" to do their job in regulating waste. People who awaken in the early morning hours with gastrointestinal pain may also be more likely to develop ulcers.

Going back to that original blood sugar-insulin imbalance described earlier, it's important to note that the body generally is meant to "fast" overnight rather than spend its time digesting things. (This is where the term "breakfast" comes from... in the morning, you "break" your "fast.") If you eat a large meal, then go to bed, this interrupts the normal fasting process and leads to dysregulation of glucose, insulin and other appetite-related hormones. If one falls into the habit of eating large meals late most of the time, they may find themselves battling with any number of metabolic disorders, including obesity and diabetes, as the body no longer can effectively process "energy" (calories) the way it is meant to process them.

'Tis the season to celebrate, often late into the evening and inside a food-laden landscape. Going to a feast after midnight mass on Christmas Eve won't automatically lead to all of these problems, so don't worry so much about a rare late meal. But if you find yourself turning to over-the-counter digestive aids like Tums or Gas-X or Pepto Bismol frequently during the holidays, you may want to reconsider your eating habits and how they might interact with your sleep, because if they have a negative impact on your sleeping life, they can eventually lead to systemic health problems down the line.

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Sources: 

"Gastrointestinal Physiology in Relation to Sleep." Orr, W. and "Gastrointestinal Disorders." Orr, W. from Principles and Practice of Sleep Medicine, 5th Edition, eds. Kryger, Roth and Dement.

VISIONS OF SUGARPLUMS || How do we sleep with all this holiday cheer upon us???

This month at SHC, you're going to find lots of discussion about the whats, whens and hows of all that we eat. After all, food and drink can impact our sleep in ways both good and bad. Sleep problems can also be linked to disorders of metabolism and digestion. And let's not forget that there are some sleep disorders which actually involve eating while asleep. 
You'll note these posts regarding the shared intersection between food and sleep by the icon posted above, VISIONS OF SUGARPLUMS. It's an idea borrowed from the classic poem, "'Twas the Night Before Christmas," in which children "were nestled all snug in their beds // while visions of sugarplums danced in their heads."

Regardless what traditions you celebrate this holiday season, you're bound to be actively participating in lots of festivity that includes eating, drinking and late-night merriment, as well as the stress of managing holiday deadlines, enduring the challenges that come with hosting family gatherings, and keeping tabs on the budget. Yes, these things, too, can and do wreak havoc on our ability to get a good night's sleep at precisely the time when we need it the most. 

Personally, I admire those who can go to bed and fall asleep to visions of sugarplums (whatever those might be...). We don't live in a society that easily shuts off the day switch for the night switch. But at the same time...

It might be a good thing that I really don't know what a sugarplum is, or what it tastes like. Being the gourmand that I am, if I knew a sugarplum was absolutely, irresistibly delicious, I would probably find a way to stock them in the pantry, and then I might not be able to fall asleep knowing they were in the house, waiting to be devoured!

Stay tuned as we take on VISIONS OF SUGARPLUMS in December, and keep warm and safe!

--The Curator