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Author Interviews, Sleep Disorders / 10.05.2015

Hans P.A. Van Dongen, Ph.D. Director, Sleep and Performance Research Center Research Professor, College of Medical Sciences Washington State University Spokane, Spokane, WA MedicalResearch.com Interview with: Hans P.A. Van Dongen, Ph.D. Director, Sleep and Performance Research Center Research Professor, College of Medical Sciences Washington State University Spokane, Spokane, WA On behalf of the authors: Paul Whitney PhD, John Hinson PhD, Melinda Jackson PhD, Hans Van Dongen PhD MedicalResearch: What is the background for this study? What are the main findings? Research: Our main interest is in better understanding why people sometimes are able to manage perfectly well with sleep loss, while at other times sleep loss can have profoundly negative effects. We found that sleep deprivation reduces the effectiveness of signals used to tell when you are right or wrong, an effect we labeled feedback blunting. Subjects in the study performed a decision making task that was simple but required feedback, i.e., a signal indicating the response was correct or incorrect, to perform correctly. We found that people who were sleep deprived were no longer able to use the feedback information to make correct responses. And when people had to adapt to unexpected changes in when to respond, sleep deprived people were completely unable to adapt to these changing circumstances. The finding of feedback blunting in this study indicates that people who are sleep deprived not only have trouble sustaining attention to details in the environment (a well established effect of sleep loss), they also have trouble changing the focus of attention to deal with changing circumstances. An interesting paradox in the research literature has been that people have been shown in many circumstances to perform complex tasks at a very high level while sleep deprived. Yet, we know from real-world experience that sleep deprived people can make catastrophic, life-threatening decisions that they would never have made if they were well rested. The current study is the first to shed light on this issue. It showed that sleep deprived people who get feedback, telling them that their actions are not effective, are less capable of changing their behavior. The study is part of a line of research in which we are trying to identify how sleep loss changes specific components of cognition, and how these changes may lead to serious problems in everyday life activities. Being able to study and understand these effects of sleep deprivation under controlled conditions is an important step toward preventing human error under real world conditions. (more…)
Author Interviews, Psychological Science, Sleep Disorders / 01.05.2015

Jaime L. Tartar PhD Behavioral Neuroscience Major Chair Division of Social and Behavioral Sciences Nova Southeastern University Fort Lauderdale, FloridaMedicalResearch.com Interview with: Jaime L. Tartar PhD Behavioral Neuroscience Major Chair Division of Social and Behavioral Sciences Nova Southeastern University Fort Lauderdale, Florida Medical Research: What is the background for this study? What are the main findings? Dr. Tartar: We set out to understand how poor sleep quality can influence emotion processing. Our rationale for this study was that although sleep perturbations are known to impair cognitive performance, it is not currently clear how poor sleep alters emotion processes. However, given that poor sleep quality is closely associated with the development of mood disorders, it is important to understand how sleep quality affects emotional functioning. We specifically examined the possibility that poor sleep quality creates a cognitive bias in memory and interpretation for emotionally negative stimuli. This would result in maladaptive emotional experiences- for example, through enhanced memory for emotionally negative events (which is also a common characteristic of depression). The idea that negative cognitive bias occurs with poor sleep quality is also consistent with the finding that sleep loss increases sensitivity to emotional stimuli as well as increases undesirable mood states like irritability, anger, and hostility.  It is particularly noteworthy that sleep perturbations result in increased emotionality since sleep perturbations are shown to result in a decrease in non-emotional cognitive processes (attention and memory).  In order to clarify the role of sleep quality on emotion processing, we tested the relationship between sleep quality and a negative cognitive bias through the use of an emotional memory task.  We also aimed to contrast these findings with performance on a non-emotional attention task since sleep impairments have previously been shown to cause impairments in (non-emotional) sustained attention. An interesting feature of the study was that we also accounted for potential confounding effects of stress sensitivity and chronotype (ones preferred time of day) since these are both factors known to be related to sleep quality. We found that, compared to those who reported good subjective sleep quality, participants who reported poor subjective sleep quality showed a negative cognitive bias towards emotionally negative stimuli. Also in agreement with previous work, we show that poor sleep quality has a negative effect on affective symptom measures- poor sleep quality relates to increased depressive symptoms, greater state and trait anxiety, and higher total mood disturbance (increased tension, fatigue, confusion and less vigor). Consistent with previous findings, we also found that subjective sleep quality was related to a decrease in performance on a sustained attention task. Although previous research suggests that stress sensitivity and chronotype would be important variables to consider in the impact of sleep perturbations on emotion processing, we did not find any stress, chronotype, or time of testing effects on these measures. (more…)
Author Interviews, Brigham & Women's - Harvard, CHEST, Sleep Disorders / 29.04.2015

dr-matthias-eikermann.jpgMedicalResearch.com Interview with: Matthias Eikermann, MD, PhD Associate Professor of Anaesthesia, Harvard Medical School Director of Research, Critical Care Division Massachusetts General Hospital Medical Research: What is the background for this study? What are the main findings? Dr. Eikermann: Obstructive sleep apnea occurs in about 5% of pregnant women, worsens as pregnancy progresses and is likely to persist into the early postpartum period. A main cause of anesthesia-related maternal death is postpartum airway obstruction. We observed among early postpartum women, that 45° upper body elevation increased upper airway diameter and mitigated sleep apnea, without adverse effects on quality of sleep after delivery. (more…)
Author Interviews, Cancer, Cancer Research / 15.04.2015

Josée Savard, Ph.D. School of Psychology, Laval University Cancer Research Center Quebec City, Quebec, CanadaMedicalResearch.com Interview with: Josée Savard, Ph.D. School of Psychology, Laval University Cancer Research Center Quebec City, Quebec, Canada MedicalResearch: What is the background for this study? What are the main findings? Dr. Savard: This paper reports on a secondary analysis of an 18-month longitudinal study initially conducted in 962 patients about to receive surgery for various types of cancer. The main results of this larger study indicated that insomnia is a significant problem in cancer patients. More precisely, it was found to affect up to 59% of patients at the peri-operative period. In addition, 32% of patients who were good sleepers developed insomnia symptoms at some point during the study (Savard et al., 2009; Savard et al., 2011). The goal of this particular analysis was to determine the role of cancer treatments and their side effects in triggering/aggravating insomnia symptoms during the 18-month follow-up. Study participants completed questionnaires assessing insomnia severity and somatic symptoms at baseline, as well as 2, 6, 10, 14 and 18 months later. This analysis was conducted separately in women treated for breast cancer (n=465) and men treated for prostate cancer (n=263). In breast cancer patients, chemotherapy and radiation therapy, but not hormone therapy, were found to be associated with increased insomnia severity. This deleterious effect appeared to be due to a number of side effects (e.g., nausea, night sweats, urinary symptoms). In prostate cancer patients, androgen-deprivation therapy was associated with aggravation of insomnia, an effect that was mainly due to the occurrence of night sweats. (more…)
Author Interviews, Circadian Rhythm, Ophthalmology, Sleep Disorders, UCSD / 09.04.2015

MedicalResearch.com Interview with: Carolina P B Gracitelli, M.D. Ophthalmology - PhD Candidate/ Research Fellow University of California San Diego - Hamilton Glaucoma Center  Medical Research: What is the background for this study? What are the main findings?  Dr. Gracitelli:  Of all the diseases that can lead to blindness, glaucoma is one of the most important diseases; it affects more than 70 million people worldwide, of whom approximately 10 % are bilaterally blind. Different studies have reported that the damage caused by glaucomatous disease lead to retinal ganglion cell (RGC) loss and consequently loss of intrinsically photosensitive retinal ganglion cells (ipRGCs), which is a subtype of RGC. This subpopulation of RGC is clearly related with non-image-forming visual function such as photic synchronization of circadian rhythms  and the pupillary light reflex. However, the true impact of glaucoma on sleep quality, sleep disturbance or circadian rhythm was until nowadays controversial. The main clinical finding of our study was that glaucoma leads to RGC death, including ipRGC death. These cells are connected to several non-image-forming functions, including circadian photoentrainment and pupillary reflexes. Therefore, the image-forming and non-image-forming visual systems are associated with glaucoma. Circadian function has not been well investigated in clinical daily practice, but it can interfere with the quality of life of these patients. Concerns about sleep disturbances in glaucoma patients should be incorporated into clinical evaluations.   Medical Research: What should clinicians and patients take away from your report? Dr. Gracitelli:  Our data support the concept that glaucoma is associated with a loss of ipRGCs that mediate the pupillary light response, particularly to the sustained component of the blue flash with a luminance of 250 cd/m2. Additionally, glaucoma patients had significant sleep disturbances that were inversely correlated with a measure of ipRGC function, the pupillary light reflex. These results suggest that the loss of ipRGCs in glaucoma may also lead to sleep disturbances. Both non-visual functions of ipRGCs are correlated, indicating that attention should be paid to the non-image forming visual functions in glaucoma patients.   Medical Research: What recommendations do you have for future research as a result of this study?  Dr. Gracitelli:  Sleep disorders is a complex system, therefore, some conclusions in this study should be carefully evaluated. Further studies with larger cohorts could also help to elucidate the association between the pupillary reflex and the polysomnography parameters. And longitudinal studies can better explain the associations between sleep disorders and glaucoma progression.  In addition, we know that there are several types of ipRGCs and they have specific functions (pupillary reflex or circadian rhythms), therefore, evaluations would also need to include a more thorough assessment to understand better the specific role of ipRGCs in sleep disturbances. However, it is true that these ipRGCs functions are impaired in glaucoma, affecting the quality of life of these patients.   Citation:   Intrinsically Photosensitive Retinal Ganglion Cell Activity Is Associated with Decreased Sleep Quality in Patients with Glaucoma  Gracitelli, Carolina P.B. et al. Ophthalmology Published Online: April 06, 2015 DOI: http://dx.doi.org/10.1016/j.ophtha.2015.02.030MedicalResearch.com Interview with: Carolina P B Gracitelli, M.D. Ophthalmology - PhD Candidate/ Research Fellow University of California San Diego - Hamilton Glaucoma Center Medical Research: What is the background for this study? What are the main findings? Dr. Gracitelli: Of all the diseases that can lead to blindness, glaucoma is one of the most important diseases; it affects more than 70 million people worldwide, of whom approximately 10 % are bilaterally blind. Different studies have reported that the damage caused by glaucomatous disease lead to retinal ganglion cell (RGC) loss and consequently loss of intrinsically photosensitive retinal ganglion cells (ipRGCs), which is a subtype of retinal ganglion cell. This subpopulation of RGC is clearly related with non-image-forming visual function such as photic synchronization of circadian rhythms and the pupillary light reflex. However, the true impact of glaucoma on sleep quality, sleep disturbance or circadian rhythm was until nowadays controversial. The main clinical finding of our study was that glaucoma leads to retinal ganglion cell death, including ipRGC death. These cells are connected to several non-image-forming functions, including circadian photoentrainment and pupillary reflexes. Therefore, the image-forming and non-image-forming visual systems are associated with glaucoma. Circadian function has not been well investigated in clinical daily practice, but it can interfere with the quality of life of these patients. Concerns about sleep disturbances in glaucoma patients should be incorporated into clinical evaluations. (more…)
Author Interviews, Endocrinology, JCEM, Metabolic Syndrome, Sleep Disorders / 03.04.2015

CDC- sleepMedicalResearch.com Interview with: Nan Hee Kim M.D., Ph.D., Professor Korea University Ansan Hospital, Gojan1-dong, Danwon-gu, Gyunggi-do, Korea MedicalResearch: What is the background for this study? Dr. Nan Hee Kim: Many individuals in modern society experience a discrepancy between social and biological time. Especially during the work or school week, we are often forced to be awake against our preferred time. In addition, the increase of light, TV, computer and internet make people stay up late at night. However, night owls (evening persons) have been reported to have more health and behavioral problems than morning persons. Evening persons experience eating disorders, negative mood and insufficient sleep compared to morning persons. They initiate sleep later in the night but need to wake up earlier than their biologic morning due to social demands. There is abundant evidence that short sleep duration and insomnia are significant risk factors for obesity and diabetes. Therefore, we feel the necessity to reveal whether evening persons are associated with metabolic abnormalities in the general population. MedicalResearch: What are the main findings? Dr. Nan Hee Kim: In middle-aged adults, people who stayed up late had a 1.7-fold increased risk for type 2 diabetes and metabolic syndrome, and a 3.2-fold increase in risk for sarcopenia as compared with morning persons, independent of sleep duration and lifestyle. Evening persons were associated with reduced muscle mass in men and increased fat mass including visceral fat in women. (more…)
Author Interviews, Sleep Disorders / 25.03.2015

MedicalResearch.com Interview with: Richard G. Stevens, Ph.D., Professor, Cancer Epidemiologist UConn Health Medical Research: What is the background for this study? What are the main findings? Dr. Stevens: Since first introducing the concept of a possible connection between exposure to light at night and breast cancer in the mid-80s, we’ve seen growing evidence of how artificial light can suppress the circadian hormone melatonin and bring about physiological changes. The extent of this “circadian disruption” varies by the type of light and the time of day. Humans evolved with a body clock that followed the solar clock. Nature intended us to be awake in daylight and at rest in the dark of night. Therefore, the intense, short-wavelength light of the sun in the morning triggers us to become awake and alert, just as the absence of sunlight in the evening allows our body to produce melatonin. Even with the use of fire to provide light in the evening, the circadian impact was relatively minimal because of firelight’s place on the red end of the visible spectrum. Humans survived under this simple formula for many thousands of years. Then electric light started to take an increasingly strong foothold in everyday life. Today we are typically surrounded at all hours of the day and night by artificial light – in many cases it’s not bright enough during the day to match the sun, and it’s too bright at night to be conducive to the natural sleep/wake cycle. Think computer screens, tablets, smart phones, e-readers, etc. These devices emit enough short-wavelength, or blue, light to disrupt our body clocks in the evening. So do fluorescent and LED lights. Our paper – I worked with Dr. Yong Zhu from Yale on this – represents a new analysis and synthesis of what we know up to now on the effect of lighting on our health. We don't know for certain, but there's growing evidence that the long-term implications of this may have ties to breast cancer, obesity, diabetes, and depression, and possibly other cancers. Exposure to electric light  started about 130 years ago,  which is a tiny period of time in evolutionary terms. In other words, not long enough to undo human evolution. (more…)
Author Interviews, Sexual Health, Sleep Disorders, University of Michigan / 24.03.2015

David A Kalmbach, PhD Sleep and Circadian Research Laboratory Department of Psychiatry University of Michigan Medical School MedicalResearch.com Interview with: David A Kalmbach, PhD Sleep and Circadian Research Laboratory Department of Psychiatry University of Michigan Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Kalmbach: As it happens, my research background is in sexual health, and my clinical work is in behavioral sleep medicine. Therefore, I've long been interested in the intersection between sleep and sexual response, though there has been little research in this area. With the growing recognition of a wide range of morbidities associated with poor sleep, coupled with the multifactorial etiology of sexual dysfunctions, I wanted to investigate whether sleep disturbance was associated with poorer sexual response. Using a 2-week daily diary approach in a sample of 171 young women, we found that longer reported sleep duration led to greater sexual desire the next day. This relationship was mirrored by finding that the likelihood of partnered sexual activity was increased following nights during which women slept longer. We also found an association between genital arousal and sleep length, though this relationship was more complex. Women reported greater vaginal arousal during sexual activity following nights of shorter sleep. However, women who slept longer on average reported better vaginal arousal than women who obtained less sleep on average. This dual relationship may reflect differential effects of a single night of sleep deprivations versus chronic sleep deprivation. However, I think more research is needed to delineate the underlying mechanisms of these relationships. Even so, I think it is notable that daytime sequelae of poor sleep (e.g., mood changes, fatigue) did not account for the relationships between sleep and sexual response. (more…)
Author Interviews, Endocrinology, Pediatrics, Sleep Disorders, Vanderbilt / 28.02.2015

Dave Kennaway, PhD Professor, Lloyd Cox Senior Research Fellow, Head Circadian Physiology Laboratory School of Paediatrics and Reproductive Health Robinson Research Institute, Faculty of Health Sciences, Medical School, University of Adelaide AustraliaMedicalResearch.com Interview with: Dave Kennaway, PhD Professor Lloyd Cox Senior Research Fellow, Head Circadian Physiology Laboratory School of Paediatrics and Reproductive Health Robinson Research Institute, Faculty of Health Sciences, Medical School, University of Adelaide Australia MedicalResearch: What is the background for this review? What are the main findings? Dr. Kennaway: There is evidence that melatonin is being prescribed to for sleep disorders in children and adolescents who are developing normally despite the fact that there have been no properly designed studies on the effects of prolonged administration to children. In countries where melatonin has been registered, it is for use as a monotherapy for the short term treatment of primary insomnia, characterised by poor quality of sleep in patients who are aged 55 years and over. Use in Paediatrics is always “off-label”. After more than 50 years of melatonin research in animals there is overwhelming evidence that melatonin administration affects many organ systems. These include important effects on the reproductive organs of rodents, cats, ruminants and primates and melatonin is in fact registered as a veterinary drug for this purpose. The effects of melatonin, however, go beyond the potential reproductive consequences, including effects on cardiovascular, immune and metabolic systems. It is clear that many paediatricians, practitioners and parents are unaware of this. MedicalResearch: What should clinicians and patients take away from your report? Dr. Kennaway: Clinicians and patients need to recognise that melatonin is a hormone and not a drug developed for a specific purpose or illness. There have been no appropriate trials in children addressing the effects of prolonged administration of melatonin in children. Given the extensive literature on the role of the hormone in normal physiology it is unlikely that such trials would ever be approved. Should endocrine or other abnormalities appear in the future in children previously treated with melatonin it will not be tenable to argue that we were surprised. (more…)
Anesthesiology, Author Interviews, JAMA, Sleep Disorders / 24.02.2015

Nick Franks FSB, FRCA, FMedSci, FRS Professor of Biophysics and Anaesthetics, Professor William Wisden, Chair in Molecular NeuroscienceMedicalResearch.com Interview Professor Nick Franks  Professor of Biophysics and Anaesthetics Professor William Wisden, Chair in Molecular Neuroscience Department of Life sciences Wolfson Laboratories, Imperial College, South Kensington London Medical Research: What is the background for this study? What are the main findings? Profs. Franks and Wisden: We were interested in finding out how a particular type of sedative drug, dexmedetomidine, works in the brain. This drug is increasingly used during intensive care for sedation of patients, but unlike other powerful sedatives, it induces a state whereby the patient can be temporarily woken up. This is a highly useful property because it means patients can be both sedated and responsive during procedures. The drugged sedative state induced by dexmedetomidine struck us as being highly similar to the deep sleep that we all need to have if we have been extensively sleep deprived. If people and animals are kept awake for extended periods of time, they have to sleep. Most people know this from common experience - catching up on lost sleep. But how and why we need to sleep after sleep deprivation is not known. We found that dexmedetomidine-induced sedation and this recovery sleep used the same brain circuits, in a tiny area at the base of the brain called the preoptic hypothalamus. To do this we used a new genetic technique in mice that allowed us to mark or "tag" which neurons in the mouse’s brain were active during sedation or recovery sleep after sleep deprivation. The beauty of this technique is that we could then specifically reactivate these same neurons several days later with a special molecule that only binds to the tagged neurons. This reactivation caused the mice to go into a deep sleep. We concluded that the sedative drug dexmedetomidine copies or hijacks the mechanism used by the brain to respond to sleep deprivation and trigger deep sleep. (more…)
Author Interviews, CHEST, Lifestyle & Health, Obstructive Sleep Apnea / 24.02.2015

Matthew Buman PhD Asst Professor SNHP Exercise & Wellness Arizona State UniversityMedicalResearch.com Interview with: Matthew Buman PhD Asst Professor SNHP Exercise & Wellness Arizona State University   Medical Research: What is the background for this study? What are the main findings? Dr. Buman: A lack of physical activity is a known risk factor for insomnia, poor sleep, and obstructive sleep apnea. In addition to physical activity, sedentary behavior has emerged as an important behavior. Sedentary behavior is not just the lack of physical activity, but actually refers to the time someone spend sitting. This behavior has been shown to, independent of physical activity, be related to many poor health outcomes including cardiovascular disease, diabetes, and even premature death. This is the first study to examine whether there is a relationship between excess sitting and insomnia, poor sleep, and risk for obstructive sleep apnea. We found, after adjusting for physical activity and body weight (among other confounding factors), that total daily sitting was associated with poor sleep quality but not other sleep metrics or OSA risk. However, we also examined sitting while watching television and found a significant relationship between this type of sitting and a host of sleep quality metrics as well as risk for OSA. In a subsequent analysis we found that despite the independent relationship between sitting while watching television with OSA risk, those that were physically active were protected from this negative impact. (more…)
Author Interviews, Pediatrics, Pediatrics / 20.02.2015

Katherine M. Keyes, Ph.D. Assistant Professor of Epidemiology Columbia University Mailman School of Public Health New York, NY 10032MedicalResearch.com Interview with: Katherine M. Keyes, Ph.D. Assistant Professor of Epidemiology Columbia University Mailman School of Public Health New York, NY 10032 Medical Research: What is the background for this study? What are the main findings? Dr. Keyes: The Monitoring the Future study is an annually conducted survey of 8th, 10th, and 12th grade high school students in the United States, covering a wide range of adolescent health behaviors. The same questions on adolescent sleep were queried every year since 1991, allowing us to examine historical trends in the amount of sleep adolescents report. We found that there have been substantial decreases in the proportion of adolescents who report 7 or more hours of sleep on a regular basis, across all age groups and across all demographic groups. In the most recent years, after age 15, less than half of adolescents report regularly getting 7 or more hours of sleep every night. Given the importance of sleep in both the short and the long term for adolescent health, these findings suggest substantial public health concern. (more…)
Author Interviews, BMJ, Sleep Disorders / 18.02.2015

Karen Thorpe PhD Professor, Developmental Psychology Program Leader, Early Education and Development Group Program leader, Sleep in Early Childhood Group School of Psychology and Counselling Queensland University of Technology Australia MedicalResearch.com Interview with: Karen Thorpe PhD Professor, Developmental Psychology Program Leader, Early Education and Development Group Program leader, Sleep in Early Childhood Group School of Psychology and Counseling Queensland University of Technology Australia MedicalResearch: What is the background for this study? Professor Thorpe: Sleep is undoubtedly important not only for how well we think, feel and behave in our daily lives but also for longer-term health. In childhood, the quantity and quality of night-time and 24 hour sleep have consistently been identified as predictor of health. For example, night sleep predicts weight status. These findings have led to the hypothesis that increasing quantity of sleep through promoting daytime sleep would benefit child health. We sought to look for evidence on the independent effects of daytime sleep on child health, learning and behavior to assess whether this hypothesis was supported. (more…)
Author Interviews, JAMA, Sleep Disorders / 16.02.2015

David S. Black, Ph.D., M.P.H. Associate Professor of Preventive Medicine Keck School of Medicine of USC.MedicalResearch.com Interview with: David S. Black, Ph.D., M.P.H. Associate Professor of Preventive Medicine Keck School of Medicine of USC. Medical Research: What is the background for this study? What are the main findings? Dr. Black: Sleep disturbances pose a significant medical and public health concern for our nation’s aging population. An estimated 50% of people aged 55 years and older suffer from some form of sleep problem, including initiating and maintaining sleep. Sleep can be affected by a number of things. There are obvious factors like disturbances, dealing with insomnia or any form of aches and pains. But there is also one that many people have probably not considered. Traffic noise. Just like the factors listed previously, there is always a solution to a problem. There isn't anything that cannot be fixed. If you are someone that is having trouble sleeping due to the high level of traffic noises around your area, it may be best to look into a site like soundproofpanda.com to find a solution that can help reduce this issue and eventually provide you with a good's night sleep. Older adults report the highest prevalence of sleep problems compared to younger age groups when quantified by both self-report and biological assessment. Moderate sleep complaints in older adults are often associated with deficits in daytime functioning, including elevated levels of fatigue, disturbed mood such as depressive symptoms and reduced quality of life, and lead to the onset of clinical insomnia. Addressing moderate sleep complaints and sleep-related daytime dysfunction using community-accessible programs is a promising public health approach. Our main findings indicate that the mindfulness training program, which is available to the general community, resulted in improvement in sleep quality at post-intervention relative to a highly active and standardized sleep hygiene education program. Effect size for improvement in sleep quality was large (0.89) and of clinical relevance considering that effect sizes obtained from all types of behavioral interventions on self-reported sleep quality outcomes averages 0.76 in older adults. Meta-analyses comparing treatment modalities indicate that the mean effect size for self-reported sleep improvements resulting from pharmacotherapy (0.87) (i.e., benzodiazepines, benzodiazepine receptor agonists) and behavioral therapy (0.96) are of medium-to-large magnitude in mixed-age adult samples with primary insomnia. Thus, our observed changes are consistent with previous studies and are at the level of a minimally important difference for insomnia severity. The mindfulness program also yielded relative improvements on sleep-related daytime impairments of depression and fatigue symptoms that were of medium-to-large effect size. (more…)
Author Interviews, Brigham & Women's - Harvard, PNAS, Sleep Disorders / 06.02.2015

Christa Van Dort PhD Department of Anesthesia, Critical Care, and Pain Medicine, Department of Brain and Cognitive Sciences, Picower Institute for Learning and Memory, Massachusetts General Hospital, Harvard Medical School Boston, MA, 02114MedicalResearch.com Interview with: Christa Van Dort PhD Department of Anesthesia, Critical Care, and Pain Medicine, Department of Brain and Cognitive Sciences, Picower Institute for Learning and Memory, Massachusetts General Hospital, Harvard Medical School Boston, MA, 02114 Medical Research: What is the background for this study? What are the main findings? Dr. Van Dort:  Sleep is crucial for survival and maintenance of health.  Inadequate sleep and sleep disorders impair many brain and body functions such as executive function, the immune system and memory consolidation. The benefits of sleep are dependent on normal sleep physiology and patterns. Natural sleep is composed of non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep alternating every 90 min in humans.  Each stage provides different benefits, for example deep NREM sleep is associated with feeling rested and REM sleep is important for learning. Current sleep aids do not effectively restore normal sleep physiology or timing and as a result do not fulfill the important functions of natural sleep.  To develop new strategies for reproducing natural sleep, we aimed to understand each component of sleep (NREM and REM sleep) individually and then in combination. Cholinergic neurons have been hypothesized to control REM sleep for many years but no one had been able to test this directly due to limited methodology. Optogenetics solved this problem by giving us the ability to activate selectively the cholinergic neurons in the pedunculopontine tegmentum (PPT) and laterodorsal tegmentum (LDT). The primary finding of this study was that cholinergic neurons in the PPT and LDT are sufficient to drive REM sleep from NREM sleep. These cholinergic neurons were important for initiation of REM sleep but not the duration of REM sleep. Understanding REM sleep control is an important first step in reproducing normal sleep patterns and by itself could enhance learning and memory. (more…)
Author Interviews, Baylor College of Medicine Houston, Cognitive Issues, Sleep Disorders / 26.01.2015

Michael K. Scullin, Ph.D. Principal Investigator of the Sleep Neuroscience & Cognition (SNaC) Laboratory and an Assistant Professor of Psychology & Neuroscience Director Sleep Neuroscience and Cognition Laboratory Baylor UniversityMedicalResearch.com Interview with: Michael K. Scullin, Ph.D. Principal Investigator of the Sleep Neuroscience & Cognition (SNaC) Laboratory and an Assistant Professor of Psychology & Neuroscience Director Sleep Neuroscience and Cognition Laboratory Baylor University Medical Research: What is the background for this study? What are the main findings? Dr. Scullin: One of the purposes of sleep in healthy adults is to optimize cognitive functioning. When we lose out on a few hours of sleep we tend not to be able to focus or think as well as when we get enough sleep (typically 8 hours). Even more interesting is that particular aspects of sleep physiology—our deepest levels of sleep known as slow wave sleep and rapid eye movement sleep—are essential to our brain’s ability to take the information that we learn during the day and stabilize those memories so that we can use them in the future. Sleep quantity and quality change markedly across the lifespan, though there are individual differences in how much one’s sleep changes. Our work was concerned with the possible long-term repercussions of cutting back on sleep and getting lower quality sleep (less slow wave sleep and rapid eye movement sleep).  We reviewed approximately 200 scientific articles on this topic and we found that the amount of total sleep and the quality of that sleep is important to cognitive and memory functioning in young adults and middle-aged adults and can even predict how well someone’s cognitive functioning will be decades later. Thus, if you’re sleeping well when you are 40 then you are investing in preserving your mental functioning at age 50. (more…)
Author Interviews, Mental Health Research, Sleep Disorders / 31.12.2014

Jacob Nota M.S. Binghamton Anxiety Clinic Department of Psychology Binghamton University Binghamton, NY 13902MedicalResearch.com Interview with: Jacob Nota M.S. Binghamton Anxiety Clinic Department of Psychology Binghamton University Binghamton, NY 13902 Medical Research: What is the background for this study? What are the main findings? Response: As psychologists we are interested in helping individuals improve their quality of life and reduce their symptoms. We know that many people, including those with anxiety and mood disorders, are bothered by repetitive negative thoughts that feel like they are out of control. We are always looking for new ways that we might be able to reduce these kinds of symptoms. We are specifically interested in learning more about how sleep relates to psychopathology because an extensive literature documents the cognitive and emotional impact of sleep disruption. Therefore, addressing sleep disruption may be another avenue for us to explore for helping out clients. However, there is relatively little research on the relation between sleep timing and psychopathology compared to that studying the relation between sleep duration and psychopathology, despite previous studies showing that individuals who go to bed later than they want to have more disorders characterized by worry, rumination, and obsessing. This study collected cross-sectional data (i.e., measuring sleep, worry, rumination, and obsessing all at the same point in time) from a group of 100 young adults at Binghamton University. We looked at measures of worry, rumination, and obsessing as well as a newer measure of the process thought to be shared across these psychological phenomena (repetitive negative thinking). We found that people who sleep for shorter amounts of time and go to bed later also have greater levels of worry, rumination, and obsessing. This is called repetitive negative thinking (RNT). We also found that individuals who are classified as "evening type" (i.e., tend to stay up later and shape their daily activities around this schedule), a trait that is linked to biological circadian rhythms, report significantly greater levels of repetitive negative thinking compared to individuals who are "morning" or neither type (i.e., not strongly morning or evening). This is one of the first studies to show that repetitive negative thinking is related to both how long you sleep and when you sleep. (more…)
Alcohol, Author Interviews, Insomnia / 23.12.2014

Michael Nadorff, PhD, Assistant professor Mississippi State University Starkville, Miss.MedicalResearch.com Interview with: Michael Nadorff, PhD, Assistant professor Mississippi State University Starkville, Miss. Medical Research: What is the background for this study? What are the main findings? Dr. Nadorff: A growing literature has found that insomnia symptoms are associated with suicidal behavior, and several studies suggest that this relation may be independent of several different forms of psychopathology.  However, little research has examined the role sleep disorders, such as insomnia, play in explaining why known risk factors, such as alcohol use, are associated with suicidal behavior.  In our study, we examined whether insomnia symptoms explained a significant portion of the relation between alcohol symptoms and suicide risk.  We found that for both men and women insomnia symptoms explained a significant amount of the variance in the relation between alcohol use and suicide risk. (more…)
Author Interviews, Dermatology, Nature, Sleep Disorders / 14.12.2014

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, IllinoisMedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois Medical Research: What is the background for this study? What are the main findings? Dr. Silverberg: Chronic itch related to childhood eczema has been shown to cause worsened sleep quality with shorter sleep duration, more frequent and prolonged awakening, and overall lower sleep efficiency. However, little is known about the sleep disturbances that occur in adults with eczema. (more…)
Memory, Sleep Disorders, University of Pennsylvania / 22.11.2014

MedicalResearch.com Interview with: Jennifer Choi Tudor, Ph.D. Postdoctoral Fellow Ted Abel Lab Department of Biology 10-17 Smilow Center for Translational Research Philadelphia, PA 19104 Medical Research: What is the background for this study? What are the main findings? Dr. Tudor: We (Dr. Tudor, Dr. Abel, and colleagues) are interested in better understanding the molecular changes that occur with sleep deprivation.  Previously, we found that the expression of over 500 genes changes with sleep deprivation and that many of the genes were involved with protein synthesis.  Upon further investigation, we found that 5 hours of sleep deprivation impairs protein synthesis in the hippocampus, a brain region critical for memory.  This impairment is due to changes in mammalian target of rapamycin (mTOR) signaling and eukaryotic initiation factor 4E binding protein 2 (4EBP2) is critical to this process.  When we boosted levels of 4EBP2 in the hippocampus, mice that were sleep deprived were resistant to the detrimental effects of sleep deprivation on memory. (more…)
Aging, Author Interviews, Insomnia / 13.10.2014

MedicalResearch.com Interview with: Jen-Hao Chen, Ph.D. Assistant Professor, Department of Health Sciences University of Missouri, Columbia, MO 65211 Medical Research: What are the main findings of the study? Dr. Chen: In this study, we mapped four commonly-reported insomnia symptoms (feeling rested when waking up, having trouble falling asleep, waking up during the night, waking up too early and not being able to fall asleep again) to direct assessment of sleep characteristics in the general population of U.S. older adults. While we know older adults frequently complain about their sleep, we know little about how these complain reflect older adults’ actual sleep outcomes. Using innovative actigraphy data of 727 older adults aged 62-91 from the National Social Life, Health and Aging Project, we found that two of these four common report of insomnia symptoms did not match specific objective sleep characteristics as these questions intends to index. The question of feeling rested was not related to any objective sleep characteristic. The question of difficulty falling asleep was not related to the objective measure of time to fall sleep but was related to other objective sleep characteristics. For waking up during the night question, high frequency was associated with more wake time after sleep onset and numbers of wake bout (but was also related to other objective sleep characteristics). For waking up too earlier question, answer of this question was related to earlier wake up time. But again, other objective sleep characteristics also predicted frequency of waking up earlier. In sum, many of the relationships and non-relationships found in this study were unexpected. Findings suggested that these widely used questions did not related to older adults’ sleep outcomes as exactly as the wording suggested. Thus, while older adults’ report of these questions are related to objective sleep characteristics in some ways, insomnia symptoms and objective sleep characteristics did not complete match each other as expected. (more…)
Author Interviews, Multiple Sclerosis, Sleep Disorders, UC Davis / 14.09.2014

Steven D. Brass, M.D., M.P.H., M.B.A. PI and Lead Author on the study Director of Neurology Sleep Clinical Program Co-Medical Director of Sleep Medicine Laboratory Associate Clinical Professor in the Department of Neurology UC Davis Health System 4860 Y Street — Suite 3700 Sacramento, CA 95817 MedicalResearch.com Interview with: Steven D. Brass, M.D., M.P.H., M.B.A. PI and Lead Author on the study Director of Neurology Sleep Clinical Program Co-Medical Director of Sleep Medicine Laboratory Associate Clinical Professor in the Department of Neurology UC Davis Health System 4860 Y Street — Suite 3700 Sacramento, CA 95817 Medical Research: What was the primary finding of your study? Dr. Brass : Among the 11,400 surveys mailed out to all members of the Northern California Chapter of the National Multiple Sclerosis Society, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome.  In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale.  There was also an increased risk between complaints of Fatigue based on screening positive for the Fatigue Severity Scale  and screening positive for Obstructive Sleep Apnea  (1.850, with a 95% p-value < 0.001). (more…)
Author Interviews, CMAJ / 12.09.2014

Annemarieke de Jonghe Academic Medical Center University of Amsterdam Departement of Internal Medicine Section of Geriatric Medicine F4-218 Amsterdam, The NetherlandsMedicalResearch.com Interview with: Annemarieke de Jonghe Academic Medical Center University of Amsterdam Departement of Internal Medicine Section of Geriatric Medicine F4-218 Amsterdam, The Netherlands Medical Research: What are the main findings of the study? Dr. de Jonghe: We investigated the preventive properties of melatonin versus placebo in a prospective cohort of elderly hip fracture patients (n=378). We found that 3mg melatonin vs placebo, given for 5 days from the day of admission, did not influence the incidence of delirium. However, in a posthoc analysis we found that more patients in the placebo group more often had a longer lasting delirium. (more…)
Author Interviews, Sleep Disorders / 10.09.2014

MedicalResearch.com Interview with Dr. Shona E. Fang Sc.D. New England Research Institutes, Inc Watertown, Massachusetts Medical Research: What are the main findings of the study? Dr. Fang: Sleep duration varied by neighborhood in Boston, a diverse urban setting. Individual factors, including socioeconomic status, explained some of this variation, while neighborhood socioeconomic status (SES) explained a much larger portion. (more…)
Author Interviews, Insomnia, Occupational Health / 04.09.2014

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. (more…)
Author Interviews, Insomnia, Mental Health Research / 31.07.2014

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. (more…)
Author Interviews, Sleep Disorders / 04.07.2014

Nathaniel F. Watson, MD, MSc Professor of Neurology, University of Washington Co-director, University of Washington Medicine Sleep Center Director, Harborview Medical Center Sleep Clinic Seattle, WashingtonMedicalResearch.com Interview with: Nathaniel F. Watson, MD, MSc Professor of Neurology, University of Washington Co-director, University of Washington Medicine Sleep Center Director, Harborview Medical Center Sleep Clinic Seattle, Washington MedicalResearch: What are the main findings of the study? Dr. Watson: The Singh Index is a composite measure of socioeconomically deprived neighborhoods. We found that as Singh Index increased, sleep duration reduced. This was true in the total sample of twins, and within twin pairs. The fact that we saw this within twin pairs means the association is present after controlling for genetics and shared environment, which substantially strengthens the association. (more…)
Aging, Author Interviews, Sleep Disorders / 03.07.2014

Dr. June Chi-Yan Lo Research Fellow Cognitive Neuroscience Laboratory Duke-NUS Graduate Medical School SingaporeMedicalResearch.com: Interview with: Dr. June Chi-Yan Lo Research Fellow Cognitive Neuroscience Laboratory Duke-NUS Graduate Medical School Singapore MedicalResearch: What are the main findings of the study? Dr. Lo: The Duke-NUS study examined the data of 66 older Chinese adults, from the Singapore-Longitudinal Aging Brain Study. Participants underwent structural MRI brain scans measuring brain volume and neuropsychological assessments testing cognitive function every two years. Additionally, their sleep duration was recorded through a questionnaire. Those who slept fewer hours showed evidence of faster brain aging and decline in cognitive performance. (more…)
Author Interviews, Case Western, Sleep Disorders / 18.06.2014

Ronnie Fass, M.D., FACG, Professor of Medicine Case Western Reserve University Director, Division of Gastroenterology and Hepatology, Head, Esophageal and Swallowing Center, Metro Health Medical Center Cleveland, OHMedicalResearch.com Interview with: Ronnie Fass, M.D., FACG, Professor of Medicine Case Western Reserve University Director, Division of Gastroenterology and Hepatology, Head, Esophageal and Swallowing Center, Metro Health Medical Center Cleveland, OH MedicalResearch: What are the main findings of the study? Dr. Fass: This is the first study to compare the extent of acid reflux between nighttime sleep and daytime naps in patients with Gastroesophageal reflux disease. The results of our study show that naps are associated with significantly greater esophageal acid exposure compared to sleep. Acid reflux events were more frequent and their total duration was longer during naps when compared with acid reflux events during nighttime sleep. Additionally, the fraction of time that the subjects were experiencing acid reflux with pH < 4 was significantly higher during naps than nighttime sleep and subjects experienced more symptoms due to acid reflux during their nap than their sleep. (more…)