Surgical Menopause Linked To More Insomnia and Sleep Difficulties

MedicalResearch.com Interview with:

Sooyeon Suh, PhD Department of Psychology Sungshin University Seoul, Republic of Korea

Dr. Suh

Sooyeon Suh, PhD
Department of Psychology
Sungshin University
Seoul, Republic of Korea

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

Response: Women who are going through menopause frequently complain of sleep complaints and depressive symptoms in addition to other typical symptoms such as hot flashes and night sweats. Two of the most common ways of becoming menopausal are through natural menopause and surgical menopause. While natural menopause is usually experienced in the course of aging, surgical menopause is usually induced by OBGYN surgery such as bilateral oopherectomy, often as a result of illnesses such as ovarian cancer.

Many studies have found that women who experience surgical menopause often experience more psychological and physical difficulties compared to women who transition through menopause naturally due to a more acute drop in estrogen following surgery. Unfortunately, in clinical settings, women who undergo surgical menopause are not provided with additional psychoeducation or customized treatment to address these issues.

The main findings of these studies support these issues. In 526 postmenopausal women, women who went through surgical menopause reported significantly worse sleep quality an shorter sleep duration. Additionally, they had a 2.13 times higher likelihood of having insomnia that warranted treatment.

Finally, even though women who went through surgical menopause engaged in the same sleep-interfering behaviors (e.g., drinking caffeine, drinking alcohol before bed, watching TV in bed, etc) as women who went through menopause naturally, their sleep was impacted more negatively.  Continue reading

Bisexual Adults Have Highest Prevalence of Sleep Problems in NYC Survey

MedicalResearch.com Interview with:

Dustin T. Duncan, ScD Associate Professor Director, NYU Spatial Epidemiology Lab Department of Population Health NYU School of Medicine NYU Langone Health

Dr. Duncan

Dustin T. DuncanScD
Associate Professor
Director, NYU Spatial Epidemiology Lab
Department of Population Health
NYU School of Medicine
NYU Langone Health

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

Response: Sleep and sleep hygiene have emerged as one of the major determinants of health and wellbeing (alongside good diet, regular exercise, and not smoking). However, a small number of studies have used population-representative samples to examine sexual orientation disparities in sleep. Our study aimed to fill this gap in knowledge.
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Decreased Sleep Associated With Lower Testosterone Levels

MedicalResearch.com Interview with:
Kristen L. Knutson, PhD Associate Professor Center for Circadian and Sleep Medicine Department of Neurology Northwestern University Feinberg School of Medicine Chicago, IL  60611​Premal Patel, MD, PGY-5
Urology
University of Manitoba

MedicalResearch.com: What is the background for this study? What are the main findings? What should readers take away from your report?

Response: Within the literature there has only been small experimental studies which looked at impaired sleep and testosterone. To our knowledge, there has been no study that has evaluated sleep and testosterone using a population dataset. We utilized the National Health and Nutrition Examination Survey to assess the association of sleep with serum testosterone. NHANES examines a nationally representative sample of about ~5000 persons each year.

After performing a multivariate linear regression of numerous variables within the NHANES database (age, marital status, prior co-morbidities, number of hours of sleep, etc…) we found that a reduction in the number of hours slept, increasing body mass index and increasing age were associated with lower testosterone levels.

Given that this is a cross-sectional analysis, we are unable to provide causality of this relationship but we do feel it is important to counsel patients with low testosterone about the importance of living a healthy lifestyle which includes a well-balanced diet, exercise and sufficient sleep.

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Sleep Deprivation Leads to Build Up of Junk Amyloid in Brain

MedicalResearch.com Interview with:

Nora D. Volkow MD Senior Investigator Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism National Institutes of Health, Bethesda, MD 20892

Dr. Nora Volkow

Nora D. Volkow MD
Senior Investigator
Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health, Bethesda, MD 20892

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

Response: Findings from animal studies had shown that sleep deprivation increased the content of beta-amyloid in brain, which is a risk factor for Alzheimer’s disease.  We wanted to test whether this also happened in the human brain after one night of sleep deprivation. We found that indeed one night of sleep deprivation led to an accumulation of beta amyloid in the human brain, which suggest that one of the reasons why we sleep is to help clean our brain of degradation products that if not removed are toxic to brain cells.  Continue reading

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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Insomniacs May Benefit From Internet Delivered Program

MedicalResearch.com Interview with:

Lee M. Ritterband, Ph.D. Professor, Department of Psychiatry and Neurobehavioral Sciences Director, Center for Behavioral Health and Technology University of Virginia School of Medicine Ivy Foundational Translational Research Building Charlottesville, VA 22903

Dr. Lee M. Ritterband

Lee M. Ritterband, Ph.D.
Professor, Department of Psychiatry and Neurobehavioral Sciences
Director, Center for Behavioral Health and Technology
University of Virginia School of Medicine
Ivy Foundational Translational Research Building
Charlottesville, VA 22903 

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

Response: Cognitive behavioral therapy for insomnia, a non-pharmacological intervention, is the first line recommendation for adults with chronic insomnia (see recommendations made earlier this year from the American College of Physicians). Access to CBT-I, however, is limited by numerous barriers, including a limited supply of behavioral medicine providers. One way to help improve access to this effective treatment is to develop and evaluate additional delivery methods of CBT-I, including Internet-delivered CBT-I.

This study was designed to evaluate the efficacy of an Internet-delivered CBT-I program (SHUTi: Sleep Healthy Using The Internet) over the short-term (9-weeks) and long-term (1-year).

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Cognitive Behavioral Therapy May Help Many Patients With Insomnia

Jason Ong, Ph.D., CBSM Associate Professor, Department of Behavioral Sciences Director, Behavioral Sleep Medicine Training Program Rush University Medical CenterMedicalResearch.com Interview with:
Jason Ong, Ph.D., CBSM
Associate Professor, Department of Behavioral Sciences
Director, Behavioral Sleep Medicine Training Program
Rush University Medical Center

Medical Research: What is the background for this study? What are the main findings?

Response: Insomnia is a very common sleep problem that was previously thought to be related to another medical or psychiatric condition.  Evidence now supports the notion that insomnia can emerge as a disorder distinct from the comorbid condition.  In this study, we evaluated the effectiveness of cognitive behavioral therapy for insomnia (CBT-I), the most widely used nonpharmacologic treatment for insomnia, in the context of medical and psychiatric comorbidities.

We conducted a systematic review and meta-analysis of 37 studies and found that 36% of patients who received cognitive behavioral therapy for insomnia were in remission at post-treatment compared to 17% who received a control or comparison condition.  CBT-I had medium to large effects for improving sleep quality and reducing the amount of time awake in bed.  Positive findings were also found on the comorbid condition, with greater improvements in psychiatric conditions compared to medical conditions.

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Cognitive Therapy May Be Safe and Effective For Chronic Insomnia

MedicalResearch.com Interview with:
Dr David Cunnington
Sleep Physician & Director
Melbourne Sleep Disorders Centre
East Melbourne Australia

Medical Research: What is the background for this study? What are the main findings?

Response: Insomnia is a very common problem with 15-20% of adults having chronic insomnia, that is, trouble getting to sleep or staying asleep most days for  3 months or more. The most commonly used treatment is sleeping pills or hypnotics, however, they don’t address the underlying disorder, and come with potential side effects. Also, sleeping tablets just mask the symptoms, and as soon as tablets are stopped, symptoms recur. People with chronic insomnia think and behave differently around sleep, which perpetuates their symptoms. The key to improving symptoms in the long run is addressing thoughts and behaviours around sleep, which is what cognitive behaviour therapy does.

Our study showed that cognitive behaviour therapy reduced the time taken to get to sleep by 20 minutes and reduced the amount of time spent awake after falling asleep by nearly 30 minutes. These effects were maintained out to 12 months after treatment. These reductions in time taken to get to sleep and time spent awake are similar to those reported in clinical trials of hypnotics.  Continue reading

Insomnia Major Contributor To Fatal Falls and Motor Vehicle Accidents

Lars Laugsand, MD, PhD, Postdoctoral fellow Department of Public Health Norwegian University of Science in Technology Trondheim, Norway.MedicalResearch.com Interview with:
Lars Laugsand, MD, PhD, Postdoctoral fellow

Department of Public Health
Norwegian University of Science in Technology
Trondheim, Norway.

Medical Research: What is the background for this study?

Dr. Laugsand: Very few prospective studies have assessed the association of insomnia symptoms and risk for injuries.

Medical Research: What are the main findings?

Dr. Laugsand: We found that increasing number of insomnia symptoms was strongly associated with higher risk for both overall unintentional fatal injuries and fatal motor-vehicle injuries in a dose-dependent manner. Those who reported to suffer from all major insomnia symptoms were at considerably higher risk than those who had no symptoms or only a few symptoms. Among the different insomnia symptoms, difficulties falling asleep appeared to have the strongest and most robust association with fatal injuries.
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Sleep Difficulties Linked To Shrinking Brain

Dr. Claire Sexton Ph.D. University of OxfordMedicalResearch.com Interview with:
Dr. Claire Sexton Ph.D.
University of Oxford

Medical Research: What are the main findings of the study?

Dr. Sexton: We found that sleep difficulties (which can include trouble falling asleep, waking up during the night, or waking up too early) were associated with an increased rate of decline in brain volumes over 3-5 years.

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Poor Sleep Linked To Missed Work Days

Tea Lallukka, PhD Finnish Institute of Occupational Health & University of Helsinki, Hjelt Institute, Department of Public Health University of Helsinki, FinlandMedicalResearch.com Interview with:
Tea Lallukka, PhD
Finnish Institute of Occupational Health &
University of Helsinki, Hjelt Institute, Department of Public Health
University of Helsinki, Finland


Medical Research: What are the main findings of the study?

Dr. Lallukka: Our study used nationally representative survey data linked with
register data on medically certified sickness absence among working
-aged Finnish women and men. We showed consistent associations between
insomnia symptoms, sleep duration, and being tired and sickness
absence. The follow-up lasted around 7 years.
Sickness absence days were derived from comprehensive registers from
the Social Insurance Institution of Finland. The associations were
broadly similar among women and men. Furthermore, they remained even
after considering key correlates of sleep and sickness absence
including socioeconomic position, working conditions, health
behaviors, obesity, and mental and physical health. Health data were
derived from physical examination conducted by field physicians. These
data are more objective, and help provide more robust evidence. We
further covered all key sleep disturbances and sleep duration for more
comprehensive understanding about the contribution of sleep to
sickness absence. Finally, a novel method developed by the authors
(Härkänen & Kaikkonen) allowed us to estimate the difference in
sickness absence days per working year among those reporting and not
reporting different sleep disturbances. Using the difference in days
absent from work, we were further able to estimate the hypothetical
direct costs of sickness absence highlighting notable societal
significance of sleep. Thus, a large part of all costs of sickness
absence are attributable to poor sleep. For example, those sleeping 5
hours or less or 10 hours or more, were absent from work ca 5-9 days
more, as compared to those with optimal sleep length. The optimal
sleep length with the lowest risk of sickness absence was 7 hours 46
minutes for men and 7 hours 38 minutes for women.
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Adolescent Insomnia Linked to Depression, Anxiety and Chronotype

MedicalResearch.com Interview with:
Pasquale K Alvaro
School of Psychology
University of Adelaide
South Australia, Australia

Medical Research: What are the main findings of the study?

Answer: In adolescents, insomnia is related to depression beyond chronotype (a classification system for circadian rhythms or body clock), anxiety and age. Insomnia is also related to Generalised Anxiety Disorder (GAD) beyond chronotype, depression and age. Depression accounts for the relationship between insomnia and Obsessive Compulsive Disorder (OCD), Separation Anxiety Disorder (SAD) and Social Phobia (SP). Furthermore, an evening chronotype  (delayed sleep phase, that is, preferring to go to bed in the early morning) predicts insomnia beyond depression, anxiety and age. Moreover, an evening chronotype predicts depression beyond insomnia, anxiety and age. Finally, insomnia and depression account for the relationships between an evening chronotype and panic disorder, OCD, SAD and SP.

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Insomnia and Health Services Utilization in Middle-Aged, Older Adults

Hemodialysis.com Interview with: Christopher Kaufmann, MHS
Department of Mental Health,
Johns Hopkins Bloomberg School of Public Health
Hampton House, Room 800
624 North Broadway
Baltimore, MD 21205
email: ckaufman@jhsph.edu

MedicalResearch.com: What are the main findings of the study?

Mr. Kaufmann:  The purpose of our study was to examine the association between insomnia and the use of a number of costly health services.  We used data from the Health and Retirement Study, a large nationally representative longitudinal population-based study of US middle-aged and older adults.  We found that individuals who reported a greater number of insomnia symptoms were more likely to report being hospitalized, using home healthcare services, and using nursing homes two years later.  After we accounted for a number of demographic and clinical characteristics, the association between number of reported insomnia symptoms and hospitalization remained statistically significant.

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The subjective–objective mismatch in sleep perception among those with insomnia and sleep apnea

 MedicalResearch.com Interview with
Matt T. Bianchi MD PhD MMSc  Assistant Professor Department of Neurology Director, Sleep Division Massachusetts General HospitalMatt T. Bianchi MD PhD MMSc
Assistant Professor
Department of Neurology
Director, Sleep Division
Massachusetts General Hospital

MedicalResearch.com: What are the main findings of the study?

Dr. Bianchi: We showed that patients reporting symptoms of insomnia tend to under-estimate the amount of time they slept during overnight sleep testing in our clinical sleep laboratory.
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Genetic factors in evolution of sleep length – a longitudinal twin study in Finnish adults

 MedicalResearch.com Interview with: Christer Hublin

Apulaisylilääkäri, neurologian dosentti (Helsingin yliopisto) – Assistant Chief Medical Officer, Docent (Adjunct Professor) in Neurology (Helsinki University)
Unilääketieteen erityispätevyys (Suomen lääkäriliitto)
Sleep medicine specialist (NOSMAC/ESRS)
Työterveyslaitos – Finnish Institute of Occupational Health
FIN-00250 Helsinki Finland

MedicalResearch.com What are the main findings of the study?

Answer: We found in an adult twin cohort (the Finnish Twin Cohort) that the proportion of variance in sleep length accounted for by genetic effects was relatively low (about one third) but stable (correlation 0.76 over a period of 15 years.). In contrast, the proportion of variance accounted for by environmental effects was high (about 0.7) and these effects were less stable (correlation over the time period 0.18). The proportion of short sleepers was more than doubled in both genders, whereas in the proportion of long sleepers no major change was seen during the follow-up. To our knowledge, this is the first longitudinal study providing data on the contribution of genetic factors to stability and change of sleep length over time.
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Study finds Insomnia affects 40% of Adult Canadians

Sleep disorders affect 40 percent of Canadians

Quebec City, September 8, 2011—Sleep disorders affect 40% of adult Canadians according to a study conducted by Université Laval researchers under the supervision of Dr. Charles M. Morin. The work of Dr. Morin and his colleagues will be presented at the 4th World Congress on Sleep Medicine which runs September 10-14 in Quebec City, Canada.

Dr. Morin’s team surveyed a sample of 2,000 people across the country to draw a portrait of Canadians’ sleep quality.

Their data revealed that 40% of respondents had experienced one or more symptoms of insomnia at least three times a week in the preceding month, i.e., taking more than 30 minutes to fall asleep, being awake for periods longer than 30 minutes during the night, or waking up at least 30 minutes before they had planned. Moreover, 20% of the participants said they were unsatisfied with the quality of their sleep, and 13.4% of respondents displayed all the symptoms required to diagnose insomnia.

Although many respondents experienced at least one symptom of insomnia, only 13% said they had consulted a healthcare professional about it. The survey data revealed that Canadians use prescription medicine (10%), natural products (9%), over-the-counter drugs (7%), or alcohol (5%) to treat their sleep problems.

Surprisingly, the researchers observed that 9.5% of French speakers suffered from insomnia compared to 14.3% of English speakers. However, French speakers take more prescribed sedatives (13% vs. 9%) and natural products (16% vs. 7%) than English-speaking Canadians.

“Many people who suffer from insomnia try to treat the problem themselves rather than consulting a healthcare professional,” said Dr. Morin, a professor and researcher at Université Laval’s School of Psychology. “This is not a good idea because we don’t know the risks and benefits of products that have not been approved by government health agencies,” he explained.

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Apart from Charles M. Morin, the co-authors of the study are Mélanie LeBlanc, Lynda Bélanger, Hans Ivers, and Chantal Mérette.