A team of researchers has suggested a set of breathing techniques to help athletes overcome vocal cord dysfunction and improve performance during high-intensity exercise.
The findings indicated that vocal cord dysfunction, also referred to as exercise-induced laryngeal obstruction (EILO), have been shown to improve for athletes after being trained to use the new techniques.
The use of real-time video data from a continuous laryngoscopy allowed the researchers to design a series of three breathing techniques that help athletes open their obstructed airways during high-intensity exercise.
The three breathing techniques are:
Tongue Variant- The "tongue variant" involves breathing evenly between the nose and mouth.
Tooth Variant- The "tooth variant" requires patients to generate high inhaling resistance by forcibly taking air in through their teeth, then quickly opening their mouth allowing air to flow freely.
Lip Variant-The third variant is the "lip variant" in which air is initially inhaled through pursed lips and then the mouth is abruptly opened, dropping resistance and allowing air to rush through the mouth.
Each of the breathing techniques described in the research focus on precisely and intentionally changing airflow during the inhalation part of breathing.
"These new breathing techniques could represent a breakthrough for athletes seeking help with breathing during training and competition," said senior author J. Tod Olin from National Jewish Health in Denver in the U.S.
EILO is characterised by involuntary and inappropriate closure of the upper airway during high-intensity exercise.
EILO causes shortness-of-breath during exercise and reduces exercise performance and can negatively affect an athlete's ability to exercise and perform.
An episode of EILO can be noisy and terrifying to patients and observers of episodes.
It is diagnosed by observing the upper airway with a flexible camera inserted in the airway during an episode.
The new breathing techniques, now named the Olin Exercise-Induced Laryngeal Obstruction Biphasic Inspiration Techniques (EILOBI), were developed and introduced by Dr. Olin, and are the subject of the research.
Nearly all of the subjects had received some form of respiratory retraining before learning one or more of the Olin EILOBI techniques.
The findings indicated that two-thirds of the participants reported the techniques were effective in treating symptoms, while 79 per cent confirmed they can be implemented during a variety of sporting activities.
Updated October 18th 2017
Snoring may be more than a common bedtime nuisance, say researchers. According to their new study, snoring, even without sleep apnea, causes thickening and abnormalities the carotid artery - a potential precursor to atherosclerosis.
Here's a wake-up call for snorers: Snoring may put you at a greater risk than those who are overweight, smoke or have high cholesterol to have thickening or abnormalities in the carotid artery, according to researchers at Henry Ford Hospital in Detroit.
The increased thickening in the lining of the two large blood vessels that supply the brain with oxygenated blood is a precursor to atherosclerosis, a hardening of the arteries responsible for many vascular diseases.
"Snoring is more than a bedtime annoyance and it shouldn't be ignored. Patients need to seek treatment in the same way they would if they had sleep apnea, high blood pressure or other risk factors for cardiovascular disease," says lead study author Robert Deeb, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.
"Our study adds to the growing body of evidence suggesting that isolated snoring may not be as benign as first suspected. So instead of kicking your snoring bed partner out of the room or spending sleepless nights elbowing him or her, seek out medical treatment for the snorer."
The study reveals changes in the carotid artery with snorers -- even for those without sleep apnea -- likely due to the trauma and subsequent inflammation caused by the vibrations of snoring. Study results will be presented January 25 at the 2013 Combined Sections Meeting of the Triological Society in Scottsdale, Ariz. It has been submitted to The Laryngoscope journal for publication.
Obstructive sleep apnea (OSA) -- a sleep disorder that occurs due to the collapse of the airway in the throat during sleep and causes loud snoring and periodic pauses in breathing -- has long been linked to cardiovascular disease, along with a host of other serious health issues. But the risk for cardiovascular disease may actually begin with snoring, long before it becomes OSA. Until now, there was little evidence in humans to show a similar connection between snoring and cardiovascular risk.
For the Henry Ford study, Dr. Deeb and senior study author Kathleen Yaremchuk, M.D., reviewed data for 913 patients who had been evaluated by the institution's sleep centre. Patients, ages 18-50, who had participated in a diagnostic sleep study between December 2006 and January 2012 were included in the study. None of the participants had sleep apnea.
In all, 54 patients completed the snore outcomes survey regarding their snoring habits, as well as underwent a carotid artery duplex ultrasound to measure the intima-media thickness of the carotid arteries. Carotid intima-media thickness, a measurement of the thickness of the innermost two layers of the arterial wall, may be used to detect the presence and to track the progression of atherosclerotic disease. Intima-media thickness is the first sign of carotid artery disease.
Compared to non-snorers, snorers were found to have a significantly greater intima-media thickness of the carotid arteries, the study finds.
The study also revealed no statistically significant differences in intima-media thickness for patients with or without some of the traditional risk factors for cardiovascular disease -- smoking, diabetes, hypertension or hypercholesterolemia.
"Snoring is generally regarded as a cosmetic issue by health insurance, requiring significant out-of-pocket expenses by patients. We're hoping to change that thinking so patients can get the early treatment they need, before more serious health issues arise."
The Henry Ford research team plans to conduct another long-term study on this topic, particularly to determine if there's an increased incidence of cardiovascular events in patients who snore.
Along with Drs. Deeb and Yaremchuk, Henry Ford study co-authors are Paul Judge, M.D.; Ed Peterson, Ph.D.; and Judith C. Lin, M.D.
Updated October 17th 2017
Sleeping well can seem impossible if you’re dealing with an ear, nose, or throat problem — you need a healthy nasal airway to breathe soundly through the night.
"Sinus infection, allergies, and other causes of nasal obstruction can make breathing difficult at night,” says Samer Fakhri, MD, associate professor of otolaryngology at the University of Texas Medical School in Houston.
“Anything that causes you to breathe through your mouth prevents your nose from warming, filtering, and moistening the air you breathe and can result in a high level of sleep disturbance."
In addition, breathing through your mouth (instead of your nose) can result in more problems. "Breathing through your nose is less work because there is more resistance breathing through your mouth,” says Kathleen L. Yaremchuk, MD, chairman of the ENT department at the Henry Ford Hospital in Detroit.
“When you breathe through your mouth at night, your jaw and tongue can fall back and block your airway, causing increased likelihood of sleep apnea and snoring."
Sleep apnea interferes with sleep and causes daytime sleepiness. In extreme cases, it can also cause high blood pressure and heart problems. "Sleep apnea is caused by collapse of the airway at night,” says Dr. Fakhri. “This results in a low oxygen level that triggers arousal from sleep.”
Symptoms of sleep apnea include loud snoring and periods of “apnea,” or the absence of breathing. Obstructive sleep apnea, a serious medical condition that affects about 12 million Americans, is more common if you are overweight and over age 65. Many people with obstructive sleep apnea are not aware of its dangers.
Nasal allergies, sinus infections, and the common cold can all cause the linings of your nose and sinuses to swell and make breathing at night difficult. Your nose and sinuses also will react to irritation or infection by producing more mucus, which can cause sinus pain, pressure, and postnasal drip — all making for an uncomfortable night.
Adults who are overweight may have trouble breathing at night because they have broad necks. Children may have trouble due to enlarged tonsils and adenoids.
Some people may have an overly long soft palate or uvula that can contribute to snoring and sleep apnea. Deformities of the bony structure of the nose, such as a deviated nasal septum, and nasal polyps are other examples of airway obstructions that can interfere with sleep.
"The average adult needs seven hours of sleep a night. Less than six hours leads to a lower metabolic rate and an increased likelihood of weight gain," warns Dr. Yaremchuk.
If you are having ENT-related sleep disturbances, the first place to start is with an ENT exam — one that checks out your nose, mouth, palate, and throat.
Says Fakhri, "The most important thing you need to do is to address the underlying cause of sleep issues. “ In addition to doing a thorough ENT exam, your doctor may order allergy testing and a sleep study.
It’s important to distinguish between sleep issues that are affecting your quality of life and those that are medically dangerous. “Obstructive sleep apnea, for instance, can interrupt sleep more than 40 times per hour and can be a very serious health issue," says Fakhri.
Once you have addressed the medical issues — allergies, a sinus infection, sleep apnea, or an anatomic abnormality — there are certain things you can do to get a better night's sleep on your own:
Updated October 15th 2017
There are many options to prevent snoring — some doctor recommended, others highly questionable. If you’re curious about alternative treatments, we investigated some of the most unusual remedies that get passed around and tested nightly in bedrooms, and asked experts which ones work — and which ones definitely don’t.
It’s important to note that while in many cases snoring may be the result of allergies, a cold, excessive alcohol consumption or weight, it can also be a symptom of a more serious condition known as obstructive sleep apnea. This is characterized by sudden stops in breathing during sleep that can be very dangerous.
So if you’re snoring consistently, you should get checked out. A proper diagnosis and personalized treatment will help to ensure you get a full, restful night’s sleep.
What the experts say: Doctor-approved
Research has consistently confirmed that sleeping on your back is likely to increase snoring, since it allows your tongue to relax and slide into the back of your throat, obstructing air flow. By sewing or duct taping a tennis ball to the back of a T-shirt and wearing it to bed, you force yourself to sleep on your side, since rolling onto your back would be extremely uncomfortable.
Dr. Robert Oexman, director of the Sleep to Live Institute, recommends trying the tennis ball trick for at least two weeks — enough time to retrain yourself to sleep on your side.
What the experts say: Proceed with caution
When placed next to your bed, this egg-shaped smart device will detect the sounds of snoring and gently move your head during sleep using an inflatable, wirelessly connected pillow insert, allowing you to breathe easily without waking you entirely.
Sounds great, but does it work? Experts are mixed on this product, with Dr. James MacFarlane, a sleep specialist and assistant professor at the University of Toronto, recommending it as a non-invasive snoring solution.
While New York-based dentist Dr. Edward Alvarez suggests that the repeated “microarousals” caused by moving the head around may reduce sleep quality and leave the user feeling tired the next morning.
What the experts say: Can’t hurt.
This form of yogic breathing requires “inhaling slowly and slightly constricting the muscles of the throat, and using that constriction to exhale through the nose, generating a hissing sound,” explains yoga instructor Parinaz Samimi.
This “helps strengthen the throat muscles,” she says, improving nighttime air flow much like the didgeridoo. It’s harmless, so even if it doesn’t stop your snoring, it may help you to relax more during the day.
What the experts say: Proceed with caution
You know the tight socks you sometimes wear on long flights to prevent blood clots? Research from the University of Toronto in 2015 found that a small group of sleep apnea patients who wore compression socks to bed noted a 27 percent decrease disruptions in breathing when they wore the socks to bed over a two-week period. The research did not note a reduction in daytime sleepiness, however.
Related post: Sleeping with a Pot Plant May Reduce Snoring
What the experts say: Can’t hurt.
Known more scientifically as a “tongue advancement device,” this gadget sticks to the tongue and pulls it toward the front of your mouth during sleep, bringing forward the muscles that may be obstructing your airway, according to Dr. Alvarez. “There is a possibility that this may work,” he says. “But it can be uncomfortable to use, and I don’t want to end up with a hickey on my tongue.”
What the experts say: Doctor-approved, but with a caveat.
The neti pot, a teapot-like device used to pour a saline solution through the nasal passageway is another alternative. One thing to note about the Neti pot: Though it’s effective and relatively easy to use, it must be cleaned thoroughly with sterile, distilled, or boiled water that has been cooled to room temperature after every use.
You can store previously boiled water in a sterile, closed container for up to 24 hours, according to the FDA. If not properly cleaned, a Neti pot can breed bacteria that can lead to infections, including the deadly “brain-eating amoeba.” With proper cleaning, though — never use unboiled tap water — nightly use is generally safe.
What the experts say: Skip it.
No, we’re not talking about old-school electric shock therapy. There are modern-day devices — like the Hivox Stop Snoring Device — that are designed to send a gentle electric shock to the user if snoring is detected, which either negatively reinforces the behavior or stimulates the neck muscles and forces you to maintain muscle tone. Sound far-fetched? You’re right on the money.
“I feel like these should be in the back of comic books,” says Dr. Alvarez. “Please save your money.”
What the experts say: Doctor-approved.
Playing the didgeridoo is one alternative, research-backed way to reduce or stop snoring, but learning to play other wind and brass instruments — such as the trumpet or trombone — has also been shown to reduce the likelihood of developing sleep apnea. Certain singing exercises have also been shown to strengthen the throat muscles and reduce nighttime snoring. Huffington Post
And the one that really works is sleepQ+.
Updated November 30th 2017
The 2017 US Major League Baseball season was a study in pure athletic prowess. Players broke the 2000 record for the number of home runs in a single season, and teams racked up enviable winning streaks. As players shift gears to the highly competitive postseason playoffs, maximizing performance, avoiding injuries, and maintaining endurance will be essential for bringing home the Commissioner’s Trophy.
Rajkumar Dasgupta, MD, specializes in pulmonology, critical care and sleep medicine at Keck Medicine of USC, says in a release, “Sleep, along with physical conditioning and conscious eating, plays a major role in athletic performance and competitive results.
A 2009 study in the journal Sleep confirms the role of sleep in performance: The study found that sleep deprivation negatively affected split-second, or ‘gut-feeling’ decision-making, while adequate sleep improved it.
“Sleep has gained a lot of attention in the sports world, and teams from all sports are finding ways to help players improve their athletic performance with sleep. Earlier this year, a soundproof ‘sleep room,’ featuring pillows that have been customized to each player, was installed in Fenway Park after the team consulted with a sleep specialist. Other teams are turning to wearable technology to monitor the sleep and health of their athletes.
By providing information the players can visualize, wearable technology has the potential to encourage better sleep habits. Professional teams are also emphasizing the use of strategic napping and the importance of sleeping well after a game, practice or other training event to enhance muscle recovery.
“The quality and amount of sleep athletes get is often the key to winning. A good sleep plan for professional athletes will maximize accuracy, improve reaction time and decision-making, increase speed and alertness, and prolong the amount of time it takes to reach exhaustion.
Updated October 12th 2017
Good hygiene habits — think brushing your teeth or washing your hands — are an essential part to your day. You already are most likely practicing good hygiene on a daily basis. You might not know how important hygiene habits are to getting a good night sleep.
Sleep hygiene is different than what you might think, although it is nice to go to bed with your teeth brushed and your body clean. Sleep hygiene instead refers to healthy sleep habits that can improve how you fall asleep and stay asleep.
Problems with sleeping are fairly common. One in four people report experiencing sleep difficulties, which include trouble falling asleep or staying asleep, early morning waking, sleeping too often, or restless and unsatisfying sleep.
The biggest culprits behind poor sleep are sleep disorders and poor sleep habits. If you are experiencing snoring or pauses in breathing while you sleep you need to make an appointment with your physician first to rule out dangerous sleep disorders such as sleep apnea. The good news is that poor sleep habits can be fixed so you can get back to getting quality and restorative sleep.
Getting enough sleep
Not being able to fall asleep, frequent sleep disturbances, and daytime sleepiness are all signs that you are practicing poor sleep hygiene. You should consider looking into your sleep nightly sleep routing if sleep disorders aren’t the cause of your nighttime sleep woes. Revising your bedtime routine and sleep habits could make the difference between a good night’s sleep and a night of misery. The first step in creating good sleep hygiene habits is to evaluate how much sleep you are getting. The average adult needs to be getting between seven to nine hours of sleep per night.
Not getting in enough sleep can lead to sleep debt. Sleep debt occurs much in the same way financial debt occurs. If you don’t have enough sleep each night, your body will “overdraw” from your energy reserves leading to mental and physical fatigue. Too many individuals make getting enough sleep a priority. Squeezing in more hours of work, socializing, or even managing the house become more important than hitting the pillow. Track the amount of hours you sleep over a two-week period. Consider cutting back on extra activities if you are consistently falling short of sleep each night. If you are still struggling, consider scheduling your sleep time just like you would any other important task. There are some barriers to getting enough sleep that can’t be avoided. Some of these barriers include parenting young children who still wake frequently through the night or complicated work schedules. In such cases, make sure you can squeeze in a nap to make up for the sleep lost during the night.
Avoiding stimulants
What you do during the day and before bed is an important part of your sleep hygiene habits. Simulants like coffee and energy drinks can give you the extra kick you need during the day to overcome the fact that you are sleeping well, but you may be creating a vicious cycle. Too much caffeine can interfere with your body’s signals that it’s time to fall asleep. You then fail to get enough sleep needing even more caffeine the next day to overcome the drowsiness from not sleeping. Part of your sleep hygiene routine should be limiting or eliminating caffeine from your daily routine. Nicotine can also affect your body’s ability to sleep so avoid smoking close to bedtime by causing you to be to jittery. Alcohol may help you fall asleep faster, drinking it to close to bedtime can disrupt your sleep during the night as your body begins to process the alcohol. Try to avoid smoking or drinking right before bed.
Other stimulants — bright alarm clocks, external lights, and blue lights from electronic — can mess up your natural sleep/wake cycle. There are ways to combat lights that mess up your body’s attempt to sleep. Cover up your bright alarm clock or invest in one with dim lighting. Dark curtains can block out the light coming from outside your bedroom. Avoiding the light from your electronic devices is as simple as not turning them on.
Watching television or being on an electronic device right before bedtime can stimulate your brain and block the signals that it’s time to sleep. It’s best to steer clear of stimulating media for at least 30 minutes before you plan to sleep.
Try and stay clear of eating any food right before bedtime that can be disruptive to your sleep. If you are prone to indigestion, try to avoid heavy or rich foods, fatty or fried foods, spicy dishes, citrus fruits, and carbonated drinks. Painful indigestion or heartburn can disrupt your sleep. If you are hungry before bed, try eating light cheese and crackers, sliced turkey, or bananas, or drink a warm glass of milk.
Daytime sleep hygiene
What you do during the day has a great effect on how you sleep at night. One of the best ways to get good sleep is to get moving during the day. Exercise gets your body ready for quality sleep. Even just ten minutes of aerobic exercise, such as walking or riding a bike, can improve your sleep. Shoot for at least 30 minutes of exercise three times a week. The best time to get moving is late afternoon or early evening. Strenuous exercise should be avoided right before you go to sleep as a lot of activity sends the signal that it isn’t time to sleep. Early morning exercise does wonders for your health but won’t help with your sleep.
Limit your daytime naps to 20-30 minute. A short nap can help improve your mood, alertness, and performance. Too much daytime napping can lead you to not feel sleepy when you need to be sleeping. Spending time outside can also help you with sleep. Exposure to natural light during the day as well as darkness at night helps your body maintain a natural circadian rhythm (sleep-wake cycle). Staying cooped up inside all day can send mixed signals to your body about when you should be sleeping and when you should be awake.
Bedtime Routine
A regular and relaxing bedtime routine should be part of your sleep hygiene habits. A regular nightly routine signals to your mind and your body that it is time to sleep. Chose to do something that is relaxing to you about 90 minutes before you plan to go to sleep. Make sure that you follow your routine every night so it becomes a habit.
Your routine could include taking a warm bath, meditation, listening to calm music, reading a book (not on a device), or going for a short walk. Make brushing your teeth, washing your face, and putting on your pajamas part of your routine. Try to go to bed at a similar time each night as well as waking up at the same time each morning. Regular sleep hours means that your body will learn to regulate your circadian rhythm better.
Go to bed when your body signals sleepiness. Trying to push past your body’s initial desire to sleep can actually make it harder for you to fall asleep. Also, sleep only when you feel sleepy. Don’t force yourself to sleep if you aren’t ready, as this will make you feel frustrated and delay sleep even more.
Get out of bed if you can’t fall asleep after 20 to 30 minutes of trying. Do something boring such as reading an appliance manual or try something relaxing such as drinking a cup of warm milk or listening to calming music. Go back to bed when you start to feel sleepy.
Another barrier to good sleep hygiene is worrying while you try to fall asleep. As odd as it sounds, try to schedule some worry time earlier in the evening. You can write down what’s worrying you and try to think of solutions before you try to sleep.
Julia Higginson
Updated October 10th 2017
THE PATH OF THE BREATH
The air we breathe is first processed through the nose. The nose is a miraculous filter lined with tiny hairs called cilia. The cilia have many functions: they filter, humidify and warm or cool the air (depending on the temperature) before it enters the lungs. It is estimated that cilia protect our bodies against about 20 billion particles of foreign matter every day!
Once it exits the nose, air passes through the mucus-lined windpipe. This is another avenue to trap unwanted particles before they enter the lungs. Next, air enters the lungs, where the oxygen is pumped into the bloodstream and circulated through the body. In exchange, the air leaving the body carries with it carbon dioxide from the cells, a waste material that is expelled through exhalation.
THE BENEFITS OF NASAL BREATHING
Breathing through the nose is the way our bodies were designed. In fact, it’s been said that breathing through your mouth is about as practical as trying to eat through your nose! According to experts, most people breathe at 10-20 percent of their full capacity. Restricted breathing greatly decreases respiratory function, which in turn decreases energy levels in the body. Since oxygen is our main source of life, and exhalation is the main way to expel toxins from our bodies, poor breathing can contribute to a multitude of health problems, from high blood pressure to insomnia. Poor breathing may even contribute to some forms of cancer: In 1931, Otto Warburg won a Nobel Prize for determining that only oxygen-starved cells will mutate and become cancerous. That is proof enough for me to learn to breathe properly!
Many of us feel stressed out, overworked, and overstimulated during our daily lives, which leaves us in a chronic state of fight or flight response. Breathing in and out through the nose helps us take fuller, deeper breaths, which stimulates the lower lung to distribute greater amounts of oxygen throughout the body. Also, the lower lung is rich with the parasympathetic nerve receptors associated with calming the body and mind, whereas the upper lungs — which are stimulated by chest and mouth breathing — prompt us to hyperventilate and trigger sympathetic nerve receptors, which result in the fight or flight reaction.
Another reason to embrace proper nasal breathing? It can enhance your workout! John Douillard, author of Body Mind Sport, says: “To experience the zone in training is our birthright, and it is within the design of our human nervous system to access it. To push ourselves to exhaustion when we have the capacity to allow effortless, perfect performance to flow naturally, from the inside out, seems somehow primitive and a waste of time. I have never heard of a peak experience that was described as painful, grueling or exhausting. Rather, the descriptions always fit the original definition of exercise: rejuvenating, stress-reliving and accessing full human potential.”
Here are a few more of the benefits of nasal breathing:
PERFECTING YOUR BREATH
Among all natural self-healing techniques, breath work is unique because breathing is the only conscious means of improving, maintaining, and repairing the other unconsciously run systems of the body. Heart rate, blood pressure, circulation, digestion, hormone secretion, and even our mental and emotional states all can be controlled, regulated, and healed through proper breathing practices. Ancient yogis knew this, and modern research and science agree. Once the body is healthy, nourished and calmed through proper breath work, the body can soar to its full potential. So how do we make sure we are breathing correctly? Here are some tips:
BELLY BREATHING
Belly breathing —in conjunction with nasal breathing — is the most efficient way to achieve optimal health. Many people who breath through the mouth too much are also shallow chest breathers. Poor posture and a sedentary lifestyle contribute to this lazy, ineffective and unhealthy way of breathing. Instead, focus on breathing through the nose and into the belly.
The breathing muscle is the diaphragm, which should rise and fall with each breath, producing a belly movement. This movement massages the stomach and vital organs of digestion, promoting good elimination, another way to remove toxins from the body. This type of breathing also stimulates the vagus nerve, a cranial nerve that starts in the brain stem and extends, down below the head to the neck, chest and abdomen, where it contributes to the innervation of the organs of the body. Besides output to the various organs in the body, the vagus nerve conveys sensory information about the state of the body’s organs to the central nervous system.
NASAL IRRIGATION
One reason people do not utilize the nose for optimal breathing is that they are chronically congested. The age-old practice of Jala Neti, nasal irrigation, is the answer. This practice is thousands of years old, adapted from Eastern medicine. It is as common in the yoga community as brushing your teeth!
Proper breathing oxygenates the body and helps eliminate free radicals by removing pollutants, toxins and allergens. Accumulation of toxins takes place all the time and it is necessary to find safe, natural, non-addictive ways to rid the body of them and restore cells to normal. Nasal irrigation tools, such as neti pots, are a great way to accomplish this. This non-pharmacological therapy involves rinsing the nasal passages with a saltwater solution, helping to rid the nose of allergens and mucus. Nasal saline irrigation has been shown to be a beneficial therapy in the treatment and prevention of sinus infection and allergic rhinitis, and may even reduce the need for antibiotics in those people prone to sinus infections. Using a neti pot will leave you feeling invigorated, will decrease drowsiness, and will balance and strengthen the nervous system.
Gwen Lawrence
Updated October 9th 2017
And it's affecting the way we live our lives.
Australia, it's time to face the facts. We have a sleep problem and it's affecting how we live our lives.
Research by the Sleep Health Foundation has found between 33 and 45 per cent of Aussies have poor sleep patterns that lead to fatigue and irritability that's putting them at risk of low productivity, damage to their mental health and unsafe behaviours.
Work published in the Foundation's international Sleep Health Journal on Wednesday shows that sleep deprivation is becoming a national epidemic and hasn't been made the priority health issue that it should be.
Director of the Sleep Health Foundation, Dr David Hillman, said: "Just like obesity, smoking, drinking too much and not exercising enough, sleep problems cause real harm in our community. It's high time we moved this issue off the backburner to the forefront of national thinking.
"There is a false belief shared by a lot of us that sleep is a waste of time and that we can get away with less than we really need, but the truth is people who cut corners with their sleep function below their best. They are not as mentally sharp, as vigilant, as attentive or as patient as they would otherwise be."
Led by Professor Robert Adams at the University of Adelaide, the study of 1011 Australians found problems related to sleep came in the form of individuals suffering difficulty sleeping at least a few times a week or more, and also sleep-related issues throughout the day such as fatigue, which affects more than a third of adults.
The research also found there are key issues that affect Australians based on their gender.
Women are more likely to experience difficulty falling to sleep while also waking up too early with a feeling of exhaustion and irritation -- even if they sleep the same amount as a man.
For Australian males, diagnosed sleep disorders such as the night time breathing condition obstructive sleep apnea were a more common issue than for women.
For Dr Hillman, night time computer use was a major factor that resulted in the issues around sleeping that everyday Australians have been facing.
"Overall, 44 per cent of adults are on the internet just before bed almost every night and 59 per cent of these late night workers, web surfers, movie watchers or online gamers have more than two sleep problems," he said.
"The result is a less productive, less safe and less pleasant work and family environment... Accident risk goes up, workplace performance goes down and your mood, your heart and your blood pressure can all be affected."
And the most alarming part? It's getting worse.
The study found that the numbers of sleep problems among Australians are 5 to 10 per cent higher than when the Sleep Health Foundation published its last survey on sleep health in 2010.
According to the Foundation, this is having a follow-on effect into the everyday lives of Aussies, particularly when it comes to tasks such as driving a car and attending work.
The research showed that 29 per cent of adults drive while drowsy at least once a month, 20 per cent have nodded off at the wheel at some time and five per cent admitted having an accident in the past year because they dozed off.
Additionally, 21 per cent of men and 13 per cent of women admitted to having fallen asleep while at work in the past month.
For Dr Hillman, the solution is a simple one -- Australia needs to change its attitude towards sleep and get it back into the national health discussion.
"We need a fundamental change in the way sleep is viewed by everyone from teenagers, parents and teachers through to bosses, doctors and our top politicians," he said.
"This habit is having a direct and very negative impact on sleep and without a cohesive national strategy to combat it, this won't change.
Sleep doesn’t come easily for nearly half of older Americans, and more than a third have resorted to some sort of medication to help them doze off at night, according to results from the National Poll on Healthy Aging.
But most poll respondents said they hadn’t talked to their doctor about their sleep, even though more than a third said their sleep posed a problem. Half believe—incorrectly—that sleep problems just come naturally with age.
The poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and is sponsored by AARP and Michigan Medicine, U-M’s academic medical center.
Those who turn to medications may not realize that prescription, over-the-counter, and even “natural” sleep aids carry health risks, especially for older adults, either alone or in combination with other substances. In fact, national guidelines strongly warn against prescription sleep medicine use by people over age 65.
Despite this, the nationally representative poll of people ages 65 to 80 finds that 8% of older people take prescription sleep medicine regularly or occasionally. Among those who report sleep troubles 3 or more nights a week, 23% use a prescription sleep aid. Most who use such drugs to help them sleep had been taking them for years. Manufacturers and the U.S. Food and Drug Administration say such drugs are only for short-term use.
Medication: Not the Only Option
“Although sleep problems can happen at any age and for many reasons, they can’t be cured by taking a pill, either prescription, over-the-counter, or herbal, no matter what the ads on TV say,” says poll director Preeti Malani, MD, a U-M physician trained in geriatric medicine, in a release. “Some of these medications can create big concerns for older adults, from falls and memory issues to confusion and constipation,” even if they’re sold without a prescription.
“The first step for anyone having trouble sleeping on a regular basis should be to talk to a doctor about it,” she continues. “Our poll shows that nearly two-thirds of those who did so got helpful advice—but a large percentage of those with sleep problems simply weren’t talking about it.”
She says non-medication-based sleep habits are the first choice for improving sleep in older people.
In all, 46% of those polled had trouble falling asleep one or more nights a week. Fifteen percent of the poll respondents said they had trouble falling asleep 3 or more nights a week.
Other health conditions can contribute to sleep difficulties. Twenty-three percent of poll respondents who had trouble sleeping said it was because of pain. And 40% of those with frequent sleep problems said their overall health was fair or poor. Other reasons for sleep troubles included having to get up to use the bathroom at night, and worry or stress.
Insomnia and other irregular sleep patterns can interfere with daytime functioning, and are associated with memory issues, depression, and an increased risk of falls and accidents. Even so, many said they didn’t see sleep issues as a health problem—in fact, this belief was the most common reason that poll respondents said they didn’t talk to their doctor about sleep.
This also highlights the need for doctors to ask their older patients about their sleep habits and what they’re doing to address any issues they may be having
“We know that sleep is a critical factor for overall health as we age, and this new research highlights sleep problems as both a significant health issue for older adults and an underacknowledged one both by patients and their providers,” says Alison Bryant, PhD, senior vice president of research for AARP. “We need to help people understand that lack of sleep is not just a natural part of aging.”
More About Medication Use
In all, 14% of the poll respondents said they regularly took a prescription sleep medication, prescription pain medication, OTC sleep aid or herbal supplement to help them sleep. Another 23% took one of these options occasionally; most of the occasional users said they chose OTC sleep aids.
The most recent Beers Criteria established by the American Geriatrics Society, which guides the use of medications among older people, gives a strong warning against use of prescription sleep drugs, which are sold under such names as Ambien, Lunesta, and Sonata.
Meanwhile, even though OTC sleep aids can be purchased without a doctor’s guidance or prescription, they still carry health risks for older people, Malani says. Most of them contain diphenhydramine, an antihistamine that can cause side effects such as confusion, urinary retention, and constipation.
Among poll respondents with frequent sleep problems who took something occasionally to help them sleep, OTC sleep remedies were the most common choice. But among those with frequent sleep issues who took something on a regular basis to try to sleep, prescription sleep medications were the most common option, with 17% reporting use.
Use of melatonin and other herbal remedies may be perceived as safer, but less is known about their potential side effects and they are not subject to the FDA’s approval process for medications, says Malani. But any issue that prompts someone to buy an OTC or herbal remedy on a regular basis is something they should discuss with their doctor, she adds.
Updated October 5th 2017
A study has given new insights into how sleep contributes to brain plasticity - the ability for our brain to change and reorganise itself - and could pave the way for new ways to help people with learning and memory disorders.
Researchers at the Humboldt and Charité Universities in Berlin, led by Dr Julie Seibt from the University of Surrey, used cutting-edge techniques to record activity in a particular region of brain cells that is responsible for holding new information - the dendrites.
The study, published in Nature Communications, found that activity in dendrites increases when we sleep, and that this increase is linked to specific brain waves that are seen to be key to how we form memories.
Dr Julie Seibt, Lecturer in Sleep and Plasticity at the University of Surrey and lead author of the study, said: "Our brains are amazing and fascinating organs - they have the ability to change and adapt based on our experiences. It is becoming increasingly clear that sleep plays an important role in these adaptive changes. Our study tells us that a large proportion of these changes may occur during very short and repetitive brain waves called spindles.
"Sleep spindles have been associated with memory formation in humans for quite some time but nobody knew what they were actually doing in the brain. Now we know that during spindles, specific pathways are activated in dendrites, maybe allowing our memories to be reinforced during sleep.
"In the near future, techniques that allow brain stimulation, such as transcranial magnetic stimulation (TMS), could be used to stimulate dendrites with the same frequency range as spindles. This could lead to enhance cognitive functions in patients with learning and memory disorders, such as dementia."
Updated October 4th 2017
If you have trouble sleeping, chances are you’ve tried a long list of potential remedies - from ditching coffee or taking a hot bath before bed to using apps or drinking sleep inducing teas. But what if the best way to tackle insomnia was to pretend it just didn’t matter? It’s an approach that sleep scientists are increasingly adopting with their patients.
The idea of ignoring insomnia is based on a simple principle: worrying about not sleeping keeps us awake. It’s a stress response and when we’re stressed our body goes into an alertness mode that makes it harder, biologically, to drop off. “The fact is, there’s no such thing as someone who can’t sleep,” Dr W Chris Winter, author of The Sleep Solution, says.
“The average patient with insomnia sleeps at least a few hours a night - they might not sleep well, but they do sleep,” he explains. “Using phrases like ‘I can’t sleep’ creates feelings of anxiety and helplessness - and once that happens it can become very difficult to penetrate the panic people build up about sleep.”
Learning to accept it.
The concept of insomnia acceptance aims to penetrate that panic. Instead of worrying that you’re awake, you just accept it’s happening. Yes, you’re awake now, but you can sleep and therefore, soon enough, you will.
“When you pull fear out of the process and adopt the idea of skipping a few hours’ sleep as not a huge problem, it changes your perspective,” Winter says. “If you can also embrace the idea that simply resting, even if you’re not sleeping, also makes you feel good in the morning, the fear that insomnia is somehow going to hurt you also fades away.” As it recedes, so does your stress response and, chances are, you’ll find yourself dropping off anyway.
Admittedly, getting into this placid state can be easier said than done, especially at 3am when the mind has an uncanny ability to ruminate. This is why British sleep expert Dr Guy Meadows, who’s a fellow proponent of the acceptance idea, suggests using mindfulness exercises to distract it. One idea he offers is to tune in to your sense of touch and focus, in minute detail, on how your body feels in the moment - the softness of the sheet or weight of the doona on your body, the warmth you feel or the cool underside of the pillow. Don’t judge any of these things but focus on every element of feeling them. A lot of the time you’ll end up falling asleep while you do it.
If no manner of mental trickery seems to send you to sleep, however, sleep specialist Leon Lack from Adelaide’s Flinders University suggests another radical idea to ponder as you stare at the ceiling: perhaps we don’t all sleep the same way. Maybe for some of us, waking up for a few hours a night is normal. “Sleep historians have determined that 300-400 years ago we didn’t sleep in long bursts.
We’d go to bed when it got dark, sleep for three-to-four hours, wake up for a few hours, then go back to sleep for three-to-four hours,” Lack says. “I, therefore, spend a lot of time in my clinic telling patients that what they consider insomnia might actually be a sleep pattern that years ago would have been the norm.” Accept that and you won’t stress during your few hours awake and will be more likely to fall asleep.
If none of these insomnia-tackling methods work for you, there’s another unusual one to consider: sleep restriction. The idea is based on the same premise that stressing about sleeplessness keeps us awake. However, while insomnia acceptance tries to tackle the problem mentally, sleep restriction does it physically, by actively cutting your sleep time to about six hours a night for a few weeks.
This technique has been used by sleep researchers for a while but hit headlines last year after a study by the University of Pennsylvania in the US found that people who slept well spent less time in bed than those who slept badly.
“Sleep restriction aims to create a state where the pressure to sleep is so great you can’t not drop off,” Dr Christopher Miller, from the Woolcock Institute of Medical Research in Sydney, says. “This resets your body clock but also reinforces your confidence in your ability to sleep.” To do it, set yourself a fixed time to get up in the morning and stick to it - even on weekends. Then, don’t go to bed until six hours before that wake-up time. So, if you have to get up at 7am, don’t go to bed until 1am.
How to Avoid Early-Morning Insomnia.
“I recommend six hours as we know that getting fewer than five hours in bed a night is associated with impairments in performance the next day,” Miller says.
Eventually, as the body starts to feel more and more sleep deprived, you’ll start to drop off quickly. In time, you might even find yourself feeling tired earlier than 1am. When that happens, move your bedtime 15-30 minutes earlier. If you fall asleep easily, stick with that timing for a week and reassess.
If you feel the need to fall asleep earlier, move the time forward again. Keep bringing it forward to the point where you can get into bed and sleep naturally.
That’s the amount of sleep you actually need. “It might not be the suggested eight hours,” Miller says. “In a way we’ve created more of a problem by setting this [as the] ideal for sleep - but if you’re not tired the next day it’s the right amount for you.” Admittedly, getting to this point isn’t going to be without a bit of suffering. Miller says you might feel as if you have jet lag during the process, while Winter goes a bit further and calls it “the Ice Bucket Challenge of Sleep”, but it can show results in as little as a week. However, a word of warning: If your job involves driving or operating heavy machinery, restricting sleep night after night might not be safe and shouldn’t be carried out without the advice of a sleep specialist.
HELEN FOSTER
UpdatedOctober 2nd 2017
Well-being in later life is largely dependent on psychosocial factors. Physical impairments tend to play a secondary role, as scientists at the Helmholtz Zentrum München and the Technical University of Munich (TUM) have discovered. The results of their study are published in BMC Geriatrics.
“Aging itself is not inevitably associated with a decline in mood and quality of life,” says Karl-Heinz Ladwig, summarizing the results in a release. “It is rather the case that psychosocial factors such as depression or anxiety impair subjective well-being.” Helmholtz Zentrum München, head of the Mental Health Research Group at the Institute of Epidemiology II, and professor of Psychosomatic Medicine at the TUM University Hospital adds, “And in the case of women, living alone also plays an important role.”
For the current study, Ladwig and his team relied on data derived from about 3,600 participants with an average age of 73 who had taken part in the population-based KORA-Age Study. “What made the study particularly interesting was the fact that the impact of stress on emotional well-being has barely been investigated in a broader, non-clinical context,” says Karoline Lukaschek, epidemiologist in the Mental Health Research Group and lead author of the paper. “Our study therefore explicitly included anxiety, depression and sleep disorders.”
To ascertain levels of subjective well-being, the scientists used a questionnaire devised by the World Health Organization (the WHO-5 Well-Being Index) with a score range of 0 to 100. For the purpose of analysis, they divided the respondents’ results into 2 categories: “high” (score > 50) and “low” (score ≤ 50). The subsequent evaluation revealed a high level of subjective well-being in the majority (79%) of the respondents. The average values were also above the threshold set by the WHO. In the “low” group, however, there was a conspicuously high number of women: about 24% compared to 18% for men.
Trying to uncover the most important causes for subjective well-being, the scientists mainly identified psychosocial factors: above all, depression and anxiety disorders had the strongest effect on well-being. Low income and sleep disorders also had a negative effect. However, poor physical health (for example, low physical activity or so-called multimorbidity) seemed to have little impact on perceived life satisfaction. Among women, living alone also significantly increased the probability of a low sense of well-being.
“The findings of the current study clearly demonstrate that appropriate services and interventions can play a major role for older people, especially for older women living on their own,” Ladwig says. “And this is all the more important, given that we know that high levels of subjective well-being are linked to a lower mortality risk.”
Updated September 28th 2017
