As We Age, Our Circadian Clock Becomes Less Sensitive To Light, Leading To Sleep Problems

MedicalResearch.com Interview with:
“Woman sleeping” by Timothy Krause is licensed under CC BY 2.0Dr Gurprit S. Lall BSc, MSc, PhD, PGCHE, FHEA

Medway School of Pharmacy
Interim Deputy Head of School
Senior Lecturer in Pharmacology
Director of Graduate Studies (Research),
University of Kent at Medway
Chatham Maritime, Chatham, Kent

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Medical advancement in prevention and diagnosis of disease has increased life expectancy significantly, thus generating an ageing population far greater than previously seen.  Because of this, it is essential that we begin to understand the ageing process, together with the health implications associated with senescence.  Recent research has found that changes in the circadian clock, located in the brain, play a contributing role in the decline of many physiological and behavioural traits observed through the ageing process.  One example of this, which is commonly seen in the elderly is a decline in sleep-wake cycle regulation; typically presenting as disrupted sleeping patterns.

The circadian clock, in mammals, possesses the ability to integrate our social lifestyle choices with the environmental day-night cycle to generate a 24-hour rhythm to which our physiological functions are synchronised.  It is this synchronisation that plays a vital role in regulating many of our behavioural outputs, such as sleeping-wake patterns.  This clock takes its strongest timing cue from the natural day night cycle governed by the duration of daily sunlight.

Our study investigated the changes in the interpretation of this light signal by the circadian clock as we age and its impact on function.  We found that the clock became less responsive to light stimuli at both the level of clock cells and at driving behavioural activity.  We were able to narrow this down to changes in the proteins within cells that relay light information to the molecular time setting machinery.  In detail, light signals are relayed to the clock through an excitatory neurotransmitter called glutamate and this signal is predominantly relayed through NMDA receptors located on the surface of clock cells.  It is the configuration of the NMDA receptor that alters as we age and this leads to the clock becoming less responsive to light.

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Does Caffeine Really Affect Your Sleep?

MedicalResearch.com Interview with:
Coffee being poured Coffee pot pouring cup of coffee. copyright American Heart AssociationJulia F. van den Berg, PhD

Leiden University, Department of Clinical Psychology
Leiden, The Netherlands 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Caffeine is the most used psychoactive substance worldwide, mostly consumed via coffee, energy drinks, tea and chocolate. Experimental studies have shown that caffeine can negatively affect sleep quality. The timing of caffeine consumption may play a role; the closer to bedtime, the more caffeine consumption is  likely to have a negative effect on sleep. We also wondered if chronotype, being a morning or evening person, would make a difference in the effect of caffeine on sleep.

We sent out questionnaires on sleep quality, chronotype, and a detailed questionnaire on type and timing of caffeine use to 880 secondary education students (mean age 21.3 years). We found that for the entire group, the amount of caffeine per week was not associated with sleep quality, regardless of chronotype. However, when we divided the group into subgroups of students who did, and students who did not usually consume caffeine in the evening (after 6PM), we found something interesting. Only for students who did not consume caffeine in the evening (20% of the total sample), a higher total caffeine consumption per week was associated with poorer sleep, in spite of the fact that these students consumed a lot less  caffeine per week than the group who did consume caffeine in the evening.

This suggests a self-regulatory mechanism: students who know they are sensitive to caffeine do not drink it in the evening, nevertheless, the caffeinated beverages they drink during the day do affect their sleep.

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Majority of Middle and High School Students Do Not Get Enough Sleep on School Nights

MedicalResearch.com Interview with:
“He isn't sleeping, he is mad. When we don't get our way pouting always works (okay.. It's worth a try at least!) #kids #dad #father #family #funny #like #parenting #photooftheday #instaphoto #instacute” by dadblunders is licensed under CC BY 2.0Anne G. Wheaton, Ph.D.
Epidemiologist
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Population Health
Epidemiology and Surveillance Branch
Atlanta, GA  30341-3717

MedicalResearch.com: What is the background for this study?

Response: Insufficient sleep among children and adolescents is associated with an increased risk for obesity, diabetes, injuries, poor mental health, and attention and behavior problems.

In previous reports, CDC had found that, nationwide, approximately two thirds of U.S. high school students report sleeping <8 hours per night on school nights. CDC conducted this study to provide state-level estimates of short sleep duration on school nights among middle school and high school students using age-specific recommendations from the American Academy of Sleep Medicine (AASM). AASM has recommended that children aged 6–12 years should regularly sleep 9–12 hours per 24 hours and teenagers aged 13–18 years should sleep 8–10 hours per 24 hours for optimal health.

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Only An Hour Of Daily Social Media Linked To Decreased Sleep in Adolescents

MedicalResearch.com Interview with:
“social media” by Jessie James is licensed under CC BY 2.0Jean-Philippe Chaput, Ph.D.

Associate Professor of Pediatrics, University of Ottawa
Research Scientist, Healthy Active Living and Obesity Research Group
Children’s Hospital of Eastern Ontario Research Institute
Ontario, Canada

 

 MedicalResearch.com: What is the background for this study? What are the main findings?

Response: No studies to date have examined the association between social media use (e.g., Facebook, Twitter, Instagram) and sleep duration in a representative sample of middle and high school students, who are a vulnerable age group that has reported high levels of social media use and insufficient sleep.

Our findings suggest an important association between the use of social media and short sleep duration among student aged 11-20 years. Using social media for at least one hour per day was associated with short sleep duration in a dose-response manner.    Continue reading

Bright Light Exposure Improved Sleep In Cancer Patients

MedicalResearch.com Interview with:

Lisa M. Wu, Ph.D. Assistant Professor Northwestern University Feinberg School of Medicine Department of Medical Social Sciences Chicago, Illinois 60611

Dr. Lisa Wu

Lisa M. Wu, Ph.D.
Assistant Professor
Northwestern University
Feinberg School of Medicine
Department of Medical Social Sciences
Chicago, Illinois 60611

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sleep disturbances are reported by cancer patients at a significantly higher rate than in the general population. Among post‐treatment cancer survivors, 23% to 44% experience insomnia symptoms even years after treatment. Sleep disturbances are most commonly treated with medications which many cancer patients are reluctant to add to the large group of medications already prescribed. Furthermore, systematic light exposure intervention is less burdensome than other non‐pharmacologic interventions for sleep disturbance.

In a pilot study, systematic light exposure intervention (i.e., bright white light from a small light source for 30 minutes each morning for 4 weeks) with a mixed group of fatigued cancer survivors was significantly more effective than comparison dim light exposure in improving sleep efficiency (i.e., clinically large effects). Medium to large effect sizes were also seen in self‐reported sleep quality, total sleep time, and wake time. Results support the conclusion that systematic light exposure intervention has considerable promise for reducing negative side effects among cancer survivors.

MedicalResearch.com: What should readers take away from your report?

Response: Resulting improvement in sleep efficiency was sustained to 3 weeks post‐intervention. Moreover, sleep efficiency in thebright light group improved to clinically normal levels on average (>85%) by the end of the intervention; this improvement was observed even 3 weeks afterward. The comparison dim light group remained at low sleep efficiency levels on average for the entire study.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response:Systematic light exposure using bright white light is a low cost and easily disseminable intervention that offers a feasible and potentially effective alternative to improve sleep in cancer survivors, particularly for those who are fatigued. Future large-scale studies are warranted.

MedicalResearch.com: Is there anything else you would like to add?

Response: Lisa M. Wu, Ph.D. was lead author on the manuscript. William H. Redd, Ph.D. at the Icahn School of Medicine of Mount Sinai was the principal investigator of the study itself. This study was conducted at Mount Sinai.
Lisa Wu’s Primary Job Title: Assistant Professor

Lisa Wu’s Primary Affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Member of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University

Lisa Wu’s Secondary Affiliation: Adjunct Assistant Professor, Department of Population Health Science and Policy, Icahn School of Medicine at
Mount Sinai (where the study was conducted).
William Redd’s Affiliation: Professor, Department of Population Health Science and Policy, Icahn School of Medicine at
Mount Sinai.

Citations:

Lisa M. Wu, Ali Amidi, Heiddis Valdimarsdottir, Sonia Ancoli-Israel, Lianqi Liu, Gary Winkel, Emily E. Byrne, Ana Vallejo Sefair, Alejandro Vega, Katrin Bovbjerg, William H. Redd. The Effect of Systematic Light Exposure on Sleep in a Mixed Group of Fatigued Cancer Survivors. Journal of Clinical Sleep Medicine, 2018; 14 (01): 31 DOI: 10.5664/jcsm.6874

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Program Improves Sleep For Mothers Hospitalized For Delivery

MedicalResearch.com Interview with:
“Now I’m having contractions.” by Remus Pereni is licensed under CC BY 2.0Kathryn A. Lee, RN, CBSM, PhD
Department of Family Health Care Nursing
University of California at San Francisco
San Francisco, California 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sleep deprivation can adversely affect health and wellbeing in any patient population.

In pregnancy, adverse outcomes may include preterm birth, longer labor, cesarean birth, and depression.

We found that women with high-risk pregnancies were sleep deprived even prior to hospitalization. Our sample averaged 29 weeks gestation, and half reported getting only between 5 and 6.5 hours of sleep at home before hospital admission. Our sleep hygiene intervention strategies gave them more control over the environment in their hospital room, and they self-reported significantly better sleep than controls. Interestingly, both groups increased their sleep time to almost 7 hours at night, on average, in the hospital before they were discharged home.

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Parents Encouraged To Keep Screen Devices Out Of Kids’ Bedrooms At Night

MedicalResearch.com Interview with:
“Video Game Addicts” by Michael Bentley is licensed under CC BY 2.0Dr. Marsha Novick, MD

Associate professor of pediatrics and family and community medicine,
Penn State College of Medicine 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The results of this study solidify some well-established data concerning childhood obesity – namely that children who watch more television and have a more sedentary lifestyle are more likely to have an overweight or obese BMI compared with those who are more active. The survey results highlight some associations between increased technology use and difficulty with sleep quantity in children and adolescents.

The data suggest:

  • ​​Increased technology use at bedtime, namely television, cell phones, video games and computers, is associated with a decrease in the amount of sleep children are getting. These children were more likely to be tired in the morning and less likely to eat breakfast.
  • Specifically, children who reported watching TV or playing video games before bed got an average of 30 minutes less sleep than those who did not, while kids who used their phone or a computer before bed averaged an hour less of sleep than those who did not.
  • The data also suggests that children with overweight or obesity were more likely to have trouble falling asleep and trouble staying asleep than their normal BMI counterparts
  • When children were reported by their parents to use one form of technology at bedtime, they were more likely to use another form of technology as well.

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Sleep Apnea Increases Amyloid Load In Brain, A Hallmark of Alzheimer’s Disease

MedicalResearch.com Interview with:

Ricardo S Osorio MD Center for Brain Health Department of Psychiatry Center of Excellence on Brain Aging NYU Langone Medical Center New York, NY 10016, USA

Dr. Osorio

Ricardo S Osorio MD
Center for Brain Health
Department of Psychiatry
Center of Excellence on Brain Aging
NYU Langone Medical Center
New York, NY 10016, USA 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This was a study that was performed in a group of healthy normal elderly from the community that volunteered for studies on memory and aging.

The main findings were that sleep apnea was very common, in almost all cases undiagnosed, and that it was associated with a longitudinal increase in amyloid burden which is considered one of the hallmark lesions of Alzheimer’s disease

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Women With Severe Hot Flashes At Higher Risk of Obstructive Sleep Apnea

MedicalResearch.com Interview with:
Stephanie S. Faubion, MD, FACP, NCMP, IF
Director, Executive and International Medicine
Director, Office of Women’s Health
Associate Professor of Medicine
Division of General Internal Medicine 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS) was used for this study investigating the association between vasomotor symptoms (hot flashes and night sweats) and risk for obstructive sleep apnea, a common and underdiagnosed sleep disorder in women which is associated with increased cardiovascular risk.

We found that Women who had severe or very severe hot flashes or night sweats were more likely to be at increased risk for obstructive sleep apnea.  This association held even after adjusting for age, body mass index, smoking and hypertension, such that the odds of women having intermediate /high risk for obstructive sleep apnea were 1.87 times higher for those with severe/very severe hot flashes/night sweats compared to those with less severe symptoms.  We decided to analyze the group of women with normal body mass index, and indeed, this finding was still significant in the lean group of women.

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Chronic Insomnia Associated With Higher Risk of End Stage Kidney Disease and Mortality

MedicalResearch.com Interview with:
Dr. Jun Ling (Lucy) Lu, MD, CCRP
Senior Clinical Research Coordinator in the Department of Medicine

Csaba P Kovesdy MD FASN
Fred Hatch Professor of Medicine
Director, Clinical Outcomes and Clinical Trials Program

Division of Nephrology, University of Tennessee Health Science Center
Nephrology Section Chief, Memphis VA Medical Center
Memphis TN, 38163 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Around one third of the world’s population suffers from insomnia. Previous studies showed that sleep disorders affect the hypothalamic–pituitary–adrenal axis and the sympatho-adrenal system, which may cause abnormalities in several organ systems and pathways causing metabolic or cardiovascular abnormalities. However, there is inadequate evidence of an association between chronic insomnia and adverse renal outcomes.

After examining 938,473 US veterans (4.4% of them had chronic insomnia) with baseline estimated eGFR >60 ml/min/1.73m2, we found that chronic insomnia is associated with a 43% higher risk of all-cause mortality, a 2.5-fold higher incidence of eGFR ≤45ml/min/1.73m2, a 2.3-fold higher ESRD risk, and with rapid loss of kidney function.

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Starting School Before 8:30 AM Associated With More Anxiety and Depression in Adolescents

MedicalResearch.com Interview with:
Jack Peltz, Ph.D.

Clinical assistant professor in Psychiatry
Rochester Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Approximately 90% of high-school aged adolescents get either
insufficient sleep during school nights or barely meet the required
amount of sleep (ie, 8–10 hours) expected for healthy functioning.(1)

In fact, sleep problems and insufficient sleep are so pervasive for
adolescents that they could be considered an epidemic due to their
adverse impact on adolescent mental and physical health.(2–5)

As a result,addressing insufficient adolescent sleep represents a critical
point of study and intervention. The growing body of evidence suggests
that later school start times (SST), 8:30 AM or later as recommended
by the American Academy of Pediatricians,6 convey
multiple benefits on adolescents, including improved sleep, better
mental and physical health, and improved academic outcomes.(7–10)

This research, however, has focused on the direct effects of delaying
school start times, or specifically how moving SST back directly predicts changes
in an outcome (eg, mental health, academic achievement). This
type of analysis precludes examining the important role that SST
might play as a condition or context under which other sleeprelated
processes take place. For instance, earlier school start times might exacerbate
the impact of sleep-related processes on adolescent behavioral
health outcomes. Thus, incorporating school start times as a larger contextual variable
that might moderate models of sleep and adolescent functioning
represents a gap in the literature and a unique opportunity to advance
conceptual models. Accordingly, the current study examines
the moderating role of school start times on the associations between sleep hygiene,
sleep quality, and mental health.

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Half of Menopausal Women Report Getting Insufficient Quality Sleep

MedicalResearch.com Interview with:
Dr. Anjel Vahratian PhD MPH Maternal and Child Health Epidemiologist Branch Chief at the National Center For Health Statistics   Centers for Disease Control and PreventionDr. Anjel Vahratian PhD MPH

Maternal and Child Health Epidemiologist
Branch Chief at the National Center For Health Statistics
Centers for Disease Control and Prevention

MedicalResearch.com: Why did you conduct this study?

Response: Our research focuses on the health of women as they age and transition from the childbearing period. During this time, women may be at increased risk for chronic health conditions such as diabetes and cardiovascular disease.

As insufficient sleep is a modifiable behavior that is associated with these chronic health conditions, we wanted to examine how sleep duration and quality varies by menopausal status.

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Sleep-Disordered Breathing Associated With Increased Risk of Cognitive Impairment

MedicalResearch.com Interview with:
Yue Leng, M.Phil, MD, PhD

Postdoctoral Research Fellow
Department of Psychiatry,
University of California, San Francisco
SFVAMC 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sleep-disordered breathing (SDB) is a very common but treatable condition in older adults. Recent evidence has suggested a link between SDB and cognitive decline in the elderly, but previous studies have been conflicting and have used different methods to examine SDB or cognition. Therefore, it is difficult to draw conclusion on the consistency of this association based on each individual study. Moreover, because each study has reported on specific domains using different scales, it is unclear if Sleep-disordered breathing has differential effects on cognitive domains.

The current study is the first to quantitively synthesize all published population-based studies, which covers a total of over 4 million adults, and concluded that people with Sleep-disordered breathing were 26% more likely to develop cognitive impairment than those without SDB. They also had slightly worse performance in executive function but not in global cognition or memory.  Continue reading

Despite Sleep Benefits To Teens, Only Half of Parents Support Later School Start Times

MedicalResearch.com Interview with:

Galit Dunietz, Ph.D., MPH Doctor of Philosophy Department of Neurology University of Michigan  Ann Arbor MI

Dr. Dunietz

Galit Dunietz, Ph.D., MPH
Epidemiologist, Sleep Disorders Center
Department of Neurology
University of Michigan
Ann Arbor MI

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Insufficient sleep has a negative impact on health, cognition and mood and is linked to motor vehicle accidents. However, sleep loss in adolescents has become an epidemic and arises in part from biological processes that delay sleep and wake timing at the onset of puberty. This biology does not fit well with early school start times (before 8:30 a.m.). Despite recommendations from the American Academy of Pediatrics and the American Academy of Sleep Medicine to delay school start times, most schools in the U.S. have current start times before 8:30 a.m.

In this nationally representative study of US parents of teens, we examined whether parents supported or opposed later school start times (after 8:30 a.m.). We also examined what may have influenced their opinions.

We found that only about half of surveyed parents of teens with early school start times supported later school start times. Opinions appeared to depend in part on what challenges and benefits were expected to result from the change.

For example, parents who expected an improvement in their teen’s academic performance or sleep quantity tended to support the change, whereas parents that expected negative impact on afterschool activities or transportation opposed delays in school start times.  We also found that parents had misconception about sleep needs of their adolescents, as the majority perceived 7-7.5 hours of sleep as sufficient, or possibly sufficient even at this young age when 8-10 hours are typically recommended.

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Chronic Fatigue Syndrome Symptoms Blocked By IM Lidocaine

MedicalResearch.com Interview with:

Roland Staud, M.D. Professor of Medicine University of Florida Gainesville, FL 

Dr. Staud

Roland Staud, M.D.
Professor of Medicine
University of Florida
Gainesville, FL

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Fatigue after exertion or sleep loss is normal. However, fatigue at rest is not. Resting fatigue is reported by cancer, heart disease, RA, SLE patients and patients with chronic fatigue syndrome (CFS). CFS has been mostly associated with chronic infections but findings are inconsistent. We hypothesized that chronic fatigue is signaled by sensitized tissue receptors to the CNS where minute amounts of muscle metabolites can activate these receptors (metabo-receptors). Why the receptors are sensitized is unclear. To test our hypothesis we injected CFS patients with lidocaine or normal saline into muscles once. We saw a statistical improvement of overall fatigue (27%) with lidocaine compared to saline.

Conclusion: Chronic fatigue syndrome patients are using metabo-receptors for inappropriately signaling fatigue to the CNS.

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Mobile Message Delivery Can Help Parents Learn Safe Infant Sleep Practices

MedicalResearch.com Interview with:

Rachel Y. Moon, M.D. Division Head, General Pediatrics Professor of Pediatrics University of Virginia School of Medicine Charlottesville, VA 22908

Dr. Moon

Rachel Y. Moon, M.D.
Division Head, General Pediatrics
Professor of Pediatrics
University of Virginia School of Medicine
Charlottesville, VA 22908

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Approximately 3500 babies die suddenly and unexpectedly during sleep in the US every year. Even though there are safe sleep recommendations, many parents do not follow them because of misinformation or misconceptions.

Therefore we tested 2 complementary interventions to promote infant safe sleep practices. The first was a nursing quality improvement intervention aimed at ensuring that mothers would hear key messages and that there was appropriate role modeling of safe sleep practices by hospital personnel.

The second was a mobile health intervention, in which mothers received videos and text messages or emails with safe sleep information during the baby’s first two months of life. We randomized mothers to receive either the safe sleep interventions or breast-feeding interventions (the control interventions). Mothers who received the mobile health intervention reported statistically significantly higher rates of placing their babies on their back, room sharing without bed sharing, no soft bedding use, and pacifier use, compared with mothers who received a control intervention. Although the nursing quality improvement intervention did not influence infant safe sleep practices, there was an interaction such that mothers who received both the safe sleep nursing quality improvement intervention and the safe sleep mobile health intervention had the highest rates of placing their babies on the back.

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Obstructive Sleep Apnea May Accelerate Alzheimer’s Disease

MedicalResearch.com Interview with:

O. Michael Bubu, M.D., M.P.H., C.P.H Wheaton College

Dr. Bubu

O. Michael Bubu, M.D., M.P.H., C.P.H
Wheaton College

MedicalResearch.com: What is the background for this study?

  • Obstructive Sleep Apnea (OSA) and Alzheimer’s disease (AD) are both chronic disease conditions that are highly prevalent, cause significant morbidity and mortality to those afflicted, and have an enormous socio-economic impact. Recent human and animal studies describe associations between Sleep Disordered Breathing (SDB) and Alzheimer’s Disease (AD). However, whether OSA accelerates longitudinal increases in amyloid (Aβ) burden in MCI patients is presently unclear.
  • In this study, we examined the effect of Obstructive Sleep Apnea (OSA) on longitudinal changes in brain amyloid deposition, and Alzheimer’s disease (AD) Cerebrospinal fluid (CSF) biomarkers including CSF beta-amyloid 42 peptide (Aβ-42), CSF TAU protein, CSF phosphorylated TAU protein (PTAU) in Cognitive Normal (CN), Mild Cognitive Impairment (MCI) and AD elderly. Brain amyloid (Aβ) burden, CSF Abeta42 and tau proteins are biomarkers (measurable substances whose presence are indicative) of AD-associated pathologic changes in the brain.
  • Data from 1639 subjects (516 CN, 798 MCI and 325 AD, mean ages = 74.4 ± 5.8; 73.4 ± 7.4 and 75.1 ± 7.8 respectively), in the Alzheimer’s disease Neuroimaging Initiative (ADNI) database was used. OSA was self-reported and participants were labeled OSA positive, or OSA negative (mean ages = 72.3 ± 7.1; and 73.9 ± 7.3 respectively). Statistical analyses were conductedto examine whether OSA positive compared to OSA negative participants experienced significant differences in the rate of change of AD biomarkers over time (mean = 2.52 ± 0.51 years) in each group (CN, MCI and AD). Both OSA positives and negatives were similar in age, APOE e4 status, and history of cardiovascular disease. The final models controlled for sex, body mass index (BMI), and Continuous Pulmonary Airway Pressure (CPAP) use.

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Decreased DNA Repair Links Shift Work and Increased Cancer Risk

MedicalResearch.com Interview with:
Parveen Bhatti, PhD
Associate Member
Fred Hutchinson Cancer Research Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Evidence in humans for an association between shift work and cancer has been mixed. This may be due to difficulties in accurately assessing long-term exposures to shift work in studies of cancer risk. We took a different approach that circumvented these difficulties. Rather than look at cancer risk directly, we measured, among actively employed shift workers, a marker of DNA damage that has been linked to cancer.

When repaired by cellular machinery, this particular marker is excreted in urine where it can be measured. We found that, compared to sleeping at night during their night off, shift workers had lower urinary levels of the DNA damage marker during their night work. This effect appears to be driven by reductions in circulating melatonin levels among shift workers during night work relative to night sleep. Given that melatonin has been shown to enhance repair of DNA damage, our results suggest that, during night work, shift workers have reduced ability to repair DNA damage resulting in lower levels being excreted in their urine. Because of this, shift workers likely have higher levels of DNA damage remaining in their cells, which can lead to mutations and cause cancer.

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If High School Students Are Naturally Owls, Shouldn’t School Start Later?

MedicalResearch.com Interview with:
Dr. Dorothee Fischer
Department of Environmental Health
Harvard T.H. Chan School of Public Health, Boston, Massachusetts
Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety
Hopkinton, Massachusetts,

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Chronotypes are a result of how the circadian clock embeds itself into the 24h light-dark cycle, producing earlier and later individuals (“larks and owls”) with regards to rhythms in physiology, cognition and behavior, including sleep.

It can be beneficial for health and safety to sync forced wake times (work, school) with individual chronotypes, thereby reducing the misalignment between sleep, circadian rhythms and external demands.

To better inform potential interventions such as tailored work schedules, more information is needed about the prevalence of different chronotypes and how chronotype differs by age and sex.

To the best of our knowledge, this is the first large-scale and nationally representative study of chronotypes in the US.
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SIMPONI ARIA (golimumab) Improved Sleep and Pain in Ankylosing Spondylitis Trial

MedicalResearch.com Interview with:

Atul A. Deodhar, MD, MRCP, FACP, FACR Professor of Medicine Medical Director, Rheumatology Clinics Medical Director, Immunology Infusion Center Oregon Health & Science University 

Dr. Deodhar

Atul A. Deodhar, MD, MRCP, FACP, FACR
Professor of Medicine
Medical Director, Rheumatology Clinics
Medical Director, Immunology Infusion Center
Oregon Health & Science University 

MedicalResearch.com: What is the background for this study?

Response: The GO-ALIVE study (CNTO148AKS3001) is a multicenter, randomized, double-blind, placebo-controlled study of golimumab, an anti-TNFα monoclonal antibody, administered intravenously (IV), in adult patients with active ankylosing spondylitis (AS). The primary objective is to evaluate the efficacy of golimumab 2 mg/kg in patients with active AS by assessing the reduction in signs and symptoms of AS. The secondary objectives include assessing efficacy related to improving physical function, range of motion, health-related quality of life, and other health outcomes.

A total of 208 patients who had a diagnosis of definite  ankylosing spondylitis (per modified New York criteria) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥4, total back pain visual analogue scale (VAS) ≥4, and CRP ≥0.3 mg/dL were randomized.  Patients were treated with IV golimumab (n=105) at Weeks 0, 4, and every 8 weeks through Week 52 or placebo (n=103) at Weeks 0, 4, and 12, with crossover to IV golimumab at Week 16 and through Week 52.

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Continuous Release REMfresh® Mimics Natural Melatonin Release

MedicalResearch.com Interview with:

David C. Brodner, M.D</strong>. Founder and Principle Physician, The Center for Sinus, Allergy, and Sleep Wellness Double Board-Certified in Otolaryngology (Head and Neck Surgery) and Sleep Medicine Assistant Clinical Professor, Florida Atlantic University College of Medicine Medical Director, Good Samaritan Hospital Sleep Laboratory Senior Medical Advisor, Physician’s Seal, LLC®

Dr. Brodner

David C. Brodner, M.D.
Founder and Principle Physician, The Center for Sinus, Allergy, and Sleep Wellness
Double Board-Certified in Otolaryngology (Head and Neck Surgery) and Sleep Medicine
Assistant Clinical Professor
Florida Atlantic University College of Medicine
Medical Director, Good Samaritan Hospital Sleep Laboratory
Senior Medical Advisor, Physician’s Seal, LLC®

MedicalResearch.com: What is the background for this study?

Response: Chronic sleep and wakefulness disorders affect an estimated 50 to 70 million Americans, and long-term sleep deprivation has been associated with negative health consequences, including an increased risk of diabetes, hypertension, heart attack, stroke, obesity and depression.

Sleep/wake cycles are regulated by melatonin, levels of which normally begin to rise in the mid- to late evening and remain high for the majority of the night. Levels begin to decline towards early morning, as the body’s wake cycle in triggered. Melatonin levels typically decline with age, with a significant decrease after age 40.

And as people age, their bodies may no longer produce enough melatonin to ensure adequate sleep. In addition to difficulties falling asleep, sleep in older populations can include fragmented and sustained sleep problems. Melatonin supplementation has been shown to promote and maintain sleep in older populations.

In this study, we compared the pharmacokinetics (PK) profile of REMfresh®, a continuous release and absorption melatonin (CRA-melatonin), with that of a leading immediate-release melatonin (IR-melatonin) formulation.

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Blood Pressure Variability May Trigger Stroke, Especially During Sleep

MedicalResearch.com Interview with:

Shyam Prabhakaran, MD, MS</strong> Department of Neurology Feinberg School of Medicine Northwestern University Chicago, IL

Dr. Prabhakaran

Shyam Prabhakaran, MD, MS
Department of Neurology
Feinberg School of Medicine
Northwestern University
Chicago, IL

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Wake-up stroke, or stroke onset during sleep, accounts for one-quarter of stroke presentations. Yet, there are few studies exploring mechanisms or triggers of onset during sleep. We explored whether blood pressure variability which is known to have circadian patterns could trigger wake-up stroke. We found that in the first 24 hours after stroke, those with wake-up stroke had greater blood pressure variability than non-wake up stroke patients.

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Cycles of Poor Sleep Then Crashing Leads To Loss of Creativity

MedicalResearch.com Interview with:

Michael K. Scullin, Ph.D. Assistant Professor of Psychology and Neuroscience Director, Sleep Neuroscience and Cognition Laboratory Baylor University Waco, TX 76798

Dr. Scullin

Michael K. Scullin, Ph.D.
Assistant Professor of Psychology and Neuroscience
Director, Sleep Neuroscience and Cognition Laboratory
Baylor University
Waco, TX 76798

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In studio-based courses (e.g., design, architecture, art), students have a large project due at the end of the semester that requires creativity and attention to detail. Anecdotally, they will work long hours without sleep to finish the project.

The problem is that cutting back on sleep may actually be impeding their ability to execute the project successfully.

We used wristband actigraphy (a device that detects movement and light) to monitor sleep for one week in 28 interior design students—many of whom had a final project due. At the beginning and end of the week, the participants completed tests of attention and creativity.

We found that students slept less than contemporary recommendations (7 to 9 hours; Associated Professional Sleep Societies) on approximately half of the nights, and shorter sleep was associated with declining attention and creativity scores across the week. The more thought provoking result was that many individuals showed inter-night variability in how long they slept (e.g., going from 4 hours to 11 hours to 5 hours to 8 hours, etc.). Inter-night variability in sleep duration was an even stronger predictor than total sleep time in how creativity scores changed across the week.

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Sleep Difficulties Linked to Survival Among Women With Breast Cancer

MedicalResearch.com Interview with:

Claudia Trudel-Fitzgerald Ph.D. FRQS Postdoctoral research fellow & Clinical psychologist (OPQ) Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health Boston, MA 02115

Dr. Trudel-Fitzgerald

Claudia Trudel-Fitzgerald Ph.D. 
FRQS Postdoctoral research fellow & Clinical psychologist (OPQ)
Department of Social and Behavioral Sciences
Harvard T.H. Chan School of Public Health
Boston, MA 02115

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is very limited research on the association between sleep characteristics and survival among individuals with cancer. However, this is an important question, especially among breast cancer patients because sleep disturbances are frequently reported by these women. Preliminary studies have suggested that sleep duration is related to mortality. The novel findings of our research indicate that not only sleep duration, but also changes in sleep duration before versus after diagnosis, as well as regular difficulties to fall or stay asleep, may also be associated with mortality among women with breast cancer over a period of up to 30 years.

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Insomnia Linked to Increased Risk of Stroke and Heart Attack

MedicalResearch.com Interview with:
Qiao He

Master’s degree student
China Medical University
Shenyang, China

MedicalResearch.com: What is the background for this study?

Response: Sleep is an important factor for biological recovery functions, but in modern society, more and more people have complained having sleep problems like insomnia, one of the main sleep disorders. It is reported that approximately one-third of the German general population has been suffering from insomnia symptoms. In decades, many researchers have found associations between insomnia and bad health outcomes. Insomnia seems to be a big health issue. However, the results from previous studies regarding the association of insomnia and cardiovascular or cerebrovascular events were inconsistent. Therefore, we conducted this study.
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