TAG: "Sleep"

Treating insomnia in elderly reduces inflammation


Study finds a common form of psychotherapy is most effective at alleviating sleeplessness.

Michael Irwin, UCLA

Lack of sleep can make you sick. And while everybody has the occasional restless night, for those who suffer from chronic insomnia — some 15 percent of older adults in the United States — that sleep loss can increase the risk for cardiovascular disease, hypertension, weight gain, type 2 diabetes and even lead to an earlier death.

The reason for the increased risk of health problems is thought to be an association between insomnia and an increase in inflammation throughout the body that becomes chronic. Though inflammation can be a good thing — part of a robust immune response that heals injury and fights infection, chronic inflammation can damage and kill healthy cells, leading to disease.

What hasn’t been known is whether treating insomnia could reduce inflammation, thereby lowering the risk for chronic disease in older adults. Nor has it been known what the most effective therapy is to treat insomnia.

Now UCLA researchers have answered both these questions. In a new study, they demonstrate that reducing insomnia can indeed lead to decreases in inflammation, and second, that a form of psychotherapy called cognitive behavioral therapy proved superior to other forms of treatment.

The study appears in the September issue of the journal Sleep.

The results were obtained from a randomized clinical trial of 123 adults older than 55, and showed that treating insomnia led to decreases in a known marker of inflammation called C-reactive protein (CRP). The protein is found in blood plasma, and its levels rise in response to an acute inflammatory stimulus. The CRP levels were measured at the beginning of the study, again after treatment, and again in a follow-up 16 months later.

“What we found particularly intriguing was that the levels of the CRP inflammatory marker remained low even 16 months after treating the insomnia,” said Michael Irwin, first author, and a professor of psychiatry and director of the Cousins Center for Psychoneuroimmunology at the UCLA Semel Institute for Neuroscience and Human Behavior.

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Study finds sleep disorders widely undiagnosed in individuals with MS


More than 70 percent of study participants screened positive for at least one sleep disorder.

Steven Brass, UC Davis

In what may be the largest study of sleep problems among individuals with multiple sclerosis (MS), researchers at UC Davis have found that widely undiagnosed sleep disorders may be at the root of the most common and disabling symptom of the disease: fatigue.

Conducted in over 2,300 individuals in Northern California with multiple sclerosis, the large, population-based study found that, overall, more than 70 percent of participants screened positive for one or more sleep disorders.

The research highlights the importance of diagnosing the root causes of fatigue among individuals with MS, as sleep disorders may affect the course of the disease as well as the overall health and well-being of sufferers, the authors said.

The study “The Underdiagnosis of Sleep Disorders in Patients with Multiple Sclerosis,” is published online today (Sept. 12) in the Journal of Clinical Sleep Medicine.

“A large percentage of MS subjects in our study are sleep deprived and screened positive for one or more sleep disorders,” said Steven Brass, associate clinical professor and director of the Neurology Sleep Clinical Program and co-medical director of the UC Davis Sleep Medicine Laboratory.

“The vast majority of these sleep disorders are potentially undiagnosed and untreated,” he said. “This work suggests that patients with MS may have sleep disorders requiring independent diagnosis and management.”

Fatigue is the hallmark of multiple sclerosis, an inflammatory disease affecting the white matter and spinal cord of sufferers. MS symptoms include loss of vision, vertigo, weakness and numbness. Patients also may experience psychiatric symptoms. Disease onset generally is between the ages of 20 and 50 years. The cause of MS is not known, although it is believed to be an autoimmune condition.

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Study shows evidence that sleep apnea hurts brain


UCLA researchers find that people suffering from sleep apnea have weaker brain blood flow.

This brain scan shows that the brain blood flow in a subject with obstructive sleep apnea (left) is markedly lower compared to a subject without the sleep disorder.

Employing a measure rarely used in sleep apnea studies, researchers at the UCLA School of Nursing have uncovered evidence of what may be damaging the brain in people with the sleep disorder — weaker brain blood flow.

In the study, published Aug. 28 in the peer-reviewed journal PLOS ONE, researchers measured blood flow in the brain using a non-invasive MRI procedure: the global blood volume and oxygen dependent (BOLD) signal. This method is usually used to observe brain activity.  Because previous research showed that poor regulation of blood in the brain might be a problem for people with sleep apnea, the researchers used the whole-brain BOLD signal to look at blood flow in individuals with and without obstructive sleep apnea (OSA).

“We know there is injury to the brain from sleep apnea, and we also know that the heart has problems pumping blood to the body, and potentially also to the brain,” said Paul Macey, associate dean for Information Technology and Innovations at the UCLA School of Nursing and lead researcher for the study. “By using this method, we were able to show changes in the amount of oxygenated blood across the whole brain, which could be one cause of the damage we see in people with sleep apnea.”

Obstructive sleep apnea is a serious disorder that occurs when a person’s breathing is repeatedly interrupted during sleep, hundreds of times a night. Each time breathing stops, the oxygen level in the blood drops, which damages many cells in the body. If left untreated, it can lead to high blood pressure, stroke, heart failure, diabetes, depression and other serious health problems. Approximately 10 percent of adults struggle with obstructive sleep apnea, which is accompanied by symptoms of brain dysfunction, including extreme daytime sleepiness, depression and anxiety, and memory problems.

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How sleep impacts PTSD


Fragmented REM sleep may hinder effective treatment of post-traumatic stress disorder.

The effectiveness of post-traumatic stress disorder (PTSD) treatment may hinge significantly upon sleep quality, report researchers at the UC San Diego School of Medicine and Veterans Affairs San Diego Healthcare System in a paper published today (Aug. 26) in the Journal of Neuroscience.

“I think these findings help us understand why sleep disturbances and nightmares are such important symptoms in PTSD,” said Sean P.A. Drummond, Ph.D., professor of psychiatry and director of the Behavioral Sleep Medicine Program at the VA San Diego Healthcare System. “Our study suggests the physiological mechanism whereby sleep difficulties can help maintain PTSD. It also strongly implies a mechanism by which poor sleep may impair the ability of an individual to fully benefit from exposure-based PTSD treatments, which are the gold standard of interventions.

“The implication is that we should try treating sleep before treating the daytime symptoms of PTSD and see if those who are sleeping better when they start exposure therapy derive more benefit.”

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Teen night owls likely to perform worse academically, emotionally


Results present compelling argument for later middle and high school start times.

Lauren Asarnow, UC Berkeley

Lauren Asarnow, UC Berkeley

Teenagers who go to bed late during the school year are more prone to academic and emotional difficulties in the long run, compared to their earlier-to-bed counterparts, according to a new study from UC Berkeley.

Berkeley researchers analyzed longitudinal data from a nationally representative cohort of 2,700 U.S. adolescents of whom 30 percent reported bedtimes later than 11:30 p.m. on school days and 1:30 a.m. in the summer in their middle and high school years.

By the time they graduated from high school, the school-year night owls had lower GPA scores, and were more vulnerable to emotional problems than teens with earlier bedtimes, according to the study published online today (Nov.10) in the Journal of Adolescent Health.

The results present a compelling argument in favor of later middle and high school start times in the face of intense academic, social and technological pressures, researchers said.

“Academic pressures, busy after-school schedules, and the desire to finally have free time at the end of the day to connect with friends on the phone or online make this problem even more challenging,” said Lauren Asarnow, lead author of the study and a graduate student in UC Berkeley’s Golden Bear Sleep and Mood Research Clinic.

On a positive note, she said the findings underscore how a healthy sleep cycle promotes the academic and emotional success of adolescents.

“The good news is that sleep behavior is highly modifiable with the right support,” said Asarnow, citing  UC Berkeley’s Teen Sleep Study, a treatment program designed to reset the biological clocks of adolescents who have trouble going to sleep and waking up.

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Sleep apnea study uncovers more hidden dangers for women


UCLA researcher: “We now know that sleep apnea is a precursor to bigger health issues.”

Paul Macey, UCLA

Paul Macey, UCLA

There’s more bad news for women with sleep apnea. A new study from the UCLA School of Nursing shows that the body’s autonomic responses — the controls that impact such functions as blood pressure, heart rate and sweating — are weaker in people with obstructive sleep apnea but are even more diminished in women.

Women with obstructive sleep apnea may appear to be healthy — having, for instance, normal resting blood pressure — and their symptoms also tend to be subtler, which often means their sleep problem is missed and they get diagnosed with other conditions.

“We now know that sleep apnea is a precursor to bigger health issues,” said Paul Macey, lead researcher on the study, which appears today (Oct. 23) in the peer-reviewed journal PLOS ONE. “And for women in particular, the results could be deadly.”

Obstructive sleep apnea is a serious disorder that occurs when a person’s breathing is repeatedly interrupted during sleep, sometimes hundreds of times. Each time, the oxygen level in the blood drops, eventually resulting in damage to many cells in the body. The condition affects more that 20 million adults in the U.S. and is associated with a number of serious health consequences and early death. Women are much less likely to be diagnosed than men.

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Study aims to get teen night owls to bed earlier


Dim lights may be ticket to a better night’s sleep.

Dim lights, board games and no bedside electronics: An old-fashioned sleepover? Not exactly. This overnight takes place at UC Berkeley and involves dozens of undergraduate research assistants, some in white lab coats and goggles, who collect saliva samples to gauge the hormone levels of teenage night owls.

The campus’ Teen Sleep Study is a unique four-year experiment to reset the biological clocks of adolescents who have trouble going to sleep and waking up. It’s specifically aimed at 10-to-18-year-olds whose bedtimes range between 10:40 p.m. and midnight. Most participants are between ages 14 and 16 and some have reported bedtimes later than 2 a.m. To qualify, sleep-deprived teens must also suffer from one or more emotional, social, behavioral or academic problem.

“Huge numbers of kids want to come here to get this treatment,” said Allison Harvey, a psychology professor and principle investigator of the Teen Sleep Study, which is conducted at the Golden Bear Sleep and Mood Research Clinic. “They’re using electronics or doing homework until late at night, and so we’re looking at ways to help them wind down earlier. Some of them are stuck in vicious cycles and they need help.”

With easy access to Facebook, Twitter, tablets and smartphones, not to mention later curfews and bedtimes, the need for sustained quality slumber among youth is reaching a critical mass. Earlier this month, U.S. Education Secretary Arne Duncan put in a plug for later school start times, arguing that the teenage brain has trouble rallying in the early mornings.

“One of the common things we hear from the teenagers is that they try to get to bed earlier, but can’t get to sleep, or they have trouble getting their day started. It’s stressful for everyone in the family,” said Kerrie Hein, director of the Golden Bear Sleep and Mood Research Clinic and the study’s chief logistics czar.

Friday, Sept. 20, marked the semester’s first overnighter for 27 new recruits. After eating dinner, they arrived at the campus’s Tolman Hall with pajamas, toothbrush, books and homework in hand. There to get them settled in for the night were their “sleep buddies,” undergraduate research assistants whose job it is to support study participants and keep them engaged and on task.

“You have to keep them entertained – else they might get bored – while still maintaining professionalism in that we’re here to run a study and collect data,” said Ben Greenberg, a junior majoring in psychology and the sleep buddies team leader.

The Teen Sleep Study piloted in fall 2012 with a half-dozen teenagers and began in earnest this spring with eight participants. At least two dozen teens are expected to complete the study this fall, and at least 170 by the time the study ends in 2016, at which time the results will be reported. Advertised on fliers and in school newsletters and online communities such as the Berkeley Parents Network, among other venues, it’s generating a lot of interest among sleep-deprived San Francisco Bay Area families.

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Sleep deprivation linked to junk food cravings


UC Berkeley study sheds new light on the link between poor sleep and obesity.

Stack of cheeseburgersA sleepless night makes us more likely to reach for doughnuts or pizza than for whole grains and leafy green vegetables, suggests a new study from UC Berkeley that examines the brain regions that control food choices. The findings shed new light on the link between poor sleep and obesity.

Using functional magnetic resonance imaging (fMRI), UC Berkeley researchers scanned the brains of 23 healthy young adults, first after a normal night’s sleep and next, after a sleepless night. They found impaired activity in the sleep-deprived brain’s frontal lobe, which governs complex decision-making, but increased activity in deeper brain centers that respond to rewards. Moreover, the participants favored unhealthy snack and junk foods when they were sleep deprived.

“What we have discovered is that high-level brain regions required for complex judgments and decisions become blunted by a lack of sleep, while more primal brain structures that control motivation and desire are amplified,” said Matthew Walker, a UC Berkeley professor of psychology and neuroscience and senior author of the study published today (Aug. 6) in the journal Nature Communications.

Moreover, he added, “high-calorie foods also became significantly more desirable when participants were sleep-deprived. This combination of altered brain activity and decision-making may help explain why people who sleep less also tend to be overweight or obese.”

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Sleepless nights can turn lovers into fighters


UC Berkeley study finds bad sleep compromises couples’ ability to avoid, manage conflict.

Couple fightingRelationship problems can keep us awake at night. But new research from UC Berkeley suggests that sleepless nights also can worsen lovers’ fights.

UC Berkeley psychologists Amie Gordon and Serena Chen have found that people are much more likely to lash out at their romantic partners over relationship conflicts after a bad night’s sleep.

“Couples who fight more are less happy and less healthy,” said Gordon, a doctoral student in psychology and lead author of the study published online in the journal, Social Psychological and Personality Science.

“Our research helps illuminate one factor that leads couples to engage in unnecessary and harmful conflict by showing that couples experience more frequent and severe conflicts after sleepless nights,” she added.

While previous studies indicate that poor sleep has a negative impact on romantic relationships, these new findings shed more light on how bad sleep compromises couples’ ability to avoid and manage conflict, researchers said.

“For the first time, to our knowledge, we can see the process of how the nature, degree, and resolution of conflict are negatively impacted by poor sleep,” said Chen, a professor of psychology at UC Berkeley.

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UCLA researchers find new clue to cause of narcolepsy


Excess of histamine cells may be cause of loss of hypocretin cells in human narcoleptics.

Hypothalamus of narcoleptic has many more histamine cells (1,604)

Hypothalamus of narcoleptic has many more histamine cells (1,604)

In 2000, researchers at the UCLA Center for Sleep Research published findings showing that people suffering from narcolepsy, a disorder characterized by uncontrollable periods of deep sleep, had 90 percent fewer neurons containing the neuropeptide hypocretin in their brains than healthy people. The study was the first to show a possible biological cause of the disorder.

Subsequent work by this group and others demonstrated that hypocretin is an arousing chemical that keeps us awake and elevates both mood and alertness; the death of hypocretin cells, the researchers said, helps explain the sleepiness of narcolepsy. But it has remained unclear what kills these cells.

Now the same UCLA team reports that an excess of another brain cell type — this one containing histamine — may be the cause of the loss of hypocretin cells in human narcoleptics.

UCLA professor of psychiatry Jerome Siegel and colleagues report in the current online edition of the journal Annals of Neurology that people with the disorder have nearly 65 percent more brain cells containing the chemical histamine. Their research suggests that this excess of histamine cells causes the loss of hypocretin cells in human narcoleptics.

Narcolepsy is a chronic disorder of the central nervous system characterized by the brain’s inability to control sleep–wake cycles. It causes sudden bouts of sleep and is often accompanied by cataplexy, an abrupt loss of voluntary muscle tone that can cause person to collapse. According to the National Institutes of Health, narcolepsy is thought to affect roughly one in every 3,000 Americans. Currently, there is no cure.

Histamine is a body chemical that works as part of the immune system to kill invading cells. When the immune system goes awry, histamine can act on a person’s eyes, nose, throat, lungs, skin or gastrointestinal tract, causing the symptoms of allergy that many people are familiar with. But histamine is also present in a type of brain cell.

For the study, researchers examined five narcoleptic brains and seven control brains from human cadavers. Prior to death, all the narcoleptics had been diagnosed by a sleep disorder center as having narcolepsy with cataplexy. These brains were also compared with the brains of three narcoleptic mouse models and to the brains of narcoleptic dogs.

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Prader-Willi syndrome associated with interference in circadian, metabolic genes


Finding could point way to new therapies for disease that can lead to morbid obesity.

Janine LaSalle, UC Davis

Researchers with the UC Davis MIND Institute and Agilent Laboratories have found that Prader-Willi syndrome — a genetic disorder best known for causing an insatiable appetite that can lead to morbid obesity — is associated with the loss of non-coding RNAs, resulting in the dysregulation of circadian and metabolic genes, accelerated energy expenditure and metabolic differences during sleep.

The research was led by Janine LaSalle, a professor in the UC Davis Department of Medical Microbiology and Immunology who is affiliated with the MIND Institute. It is published online in Human Molecular Genetics.

“Prader-Willi syndrome children do not sleep as well at night and have daytime sleepiness,” LaSalle said. “Parents have to lock up their pantries because the kids are rummaging for food in the middle of the night, even breaking into their neighbors’ houses to eat.”

The study found that these behaviors are rooted in the loss of a long non-coding RNA that functions to balance energy expenditure in the brain during sleep. The finding could have a profound effect on how clinicians treat children with Prader-Willi, as well as point the way to new, innovative therapies, LaSalle said.

The leading cause of morbid obesity among children in the United States, Prader-Willi involves a complex, and sometimes contradictory, array of symptoms. Shortly after birth children with Prader-Willi experience failure to thrive. Yet after they begin to feed themselves, they have difficulty sleeping and insatiable appetites that lead to obesity if their diets are not carefully monitored.

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Lack of sleep may contribute to excessive worrying


UC Berkeley neuroscientists find that sleep deprivation amplifies anticipatory anxiety.

Matthew Walker, UC Berkeley

UC Berkeley researchers have found that a lack of sleep, which is common in anxiety disorders, may play a key role in ramping up the brain regions that contribute to excessive worrying.

Neuroscientists have found that sleep deprivation amplifies anticipatory anxiety by firing up the brain’s amygdala and insular cortex, regions associated with emotional processing. The resulting pattern mimics the abnormal neural activity seen in anxiety disorders. Furthermore, their research suggests that innate worriers – those who are naturally more anxious and therefore more likely to develop a full-blown anxiety disorder – are acutely vulnerable to the impact of insufficient sleep.

“These findings help us realize that those people who are anxious by nature are the same people who will suffer the greatest harm from sleep deprivation,” said Matthew Walker, a professor of psychology and neuroscience at UC Berkeley and senior author of the paper, to be published June 26 in the Journal of Neuroscience.

The results suggest that people suffering from such maladies as generalized anxiety disorder, panic attacks and post-traumatic stress disorder, may benefit substantially from sleep therapy. At UC Berkeley, psychologists such as Allison Harvey, a co-author on the Journal of Neuroscience paper, have been garnering encouraging results in studies that use sleep therapy on patients with depression, bipolar disorder and other mental illnesses.

“If sleep disruption is a key factor in anxiety disorders, as this study suggests, then it’s a potentially treatable target,” Walker said. “By restoring good quality sleep in people suffering from anxiety, we may be able to help ameliorate their excessive worry and disabling fearful expectations.”

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