Secrets of Sleep

The Secrets of Sleep

There are lots of reasons why older folks struggle to get a good night’s sleep. Just don’t expect much consensus from the scientific community.

 

Sleep is a precious commodity here in Geezerville. At a certain age, in fact, we begin to pursue it with the sort of evolutionary fervor we once reserved primarily for procreative activities. And yet, for many elderly Americans, a good night’s sleep remains a maddeningly elusive goal. As Jane Brody notes in a recent New York Times column, a 1995 study found that 28 percent of people over 65 had difficulty falling asleep and 42 percent said they had trouble falling asleep and staying asleep. Given our current propensity to while away our evening hours staring at various electronic screens, Brody suggests those numbers are probably even higher now.

 

I am not one of these cranky insomniacs. Most evenings, I’m conked out within a few minutes of my 11 o’clock bedtime; most mornings, I rise reasonably refreshed, around 8. My Lovely Wife, on the other hand, is a night owl who will not entertain the notion of slumber until she is completely convinced she’s exhausted enough — physically and, more importantly, mentally — to hit the pillow and stay there.

 

She’s been this way since our first child was born, nearly 29 years ago. Hyperalert to any disturbances from the crib down the hall, and secure in the knowledge that I’ve been known to sleep through minor earthquakes, she took on the responsibility and maintains it now, long after our offspring have exited the nest.

 

I’d worry about MLW if she wasn’t able to snooze happily into the mid-morning hours when necessary. (She’s self-employed and has few time-sensitive obligations.) But for those aging insomniacs who never catch enough z’s, there can be serious consequences: cognitive disorders, psychomotor retardation, immune system dysfunction, and depression, among others.

 

Scientists, physicians, and psychiatrists have been trying to figure out the mysteries of sleep for as long as people have been tossing and turning. There are plenty of suggested cures — avoiding caffeine, alcohol, and computer screens before bedtime; ramping up your exercise; eschewing midday naps; and the like — but there’s little consensus on what might be happening in the body to make us more or less likely to snooze. Or why we need to sleep at all.

 

Researchers at Harvard Medical School recently weighed in on the debate with a study suggesting that it’s all connected to the body’s immune response, specifically certain type of brain-based immune proteins known as inflammasome NLRP3. When the brain detects an infection or inflammation in the body, it releases sleep-inducing immune molecules.

 

“We already know that sleep plays a protective role in resolving infections so our observation of inflammasome activation following infection suggests this immune mechanism may have a brain-protective role,” says lead study author Mark Zielinski, PhD.

 

I’m no sleep expert, but this would lead me to believe that my nightly snoozefest is the happy result of some stubborn infection, which seems to be something of a mixed blessing. Eradicate the infection, douse the inflammation, and the reward is an endless string of sleepless nights?

 

No one really questions that there is a restorative function to sleep, but University of Wisconsin–Madison scientists argue that its primary purpose is to help us forget. In a recent study published in the journal Science, biologists Giulio Tononi, MD, PhD, and Chiara Cirelli, MD, PhD, report that the brain’s synapses grow so exuberantly during the day that the circuits get too noisy. When we sleep, our brains surreptitiously delete unnecessary memories so we aren’t overloaded with useless information, rendering our useful memories fuzzy.

 

When I mentioned this the other day to MLW, she wondered how the brain could determine the difference between necessary and unnecessary memories. I said I didn’t know and I wasn’t going to lose any sleep over it. But now I’m sorry I mentioned it all, because she probably will.

 

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Treacher Collins Syndrome

What is Treacher Collins syndrome?

Treacher Collins is a condition that affects the development of bones and other tissues in the face.

 

 

What are the signs and symptoms of Treacher Collins syndrome?

The signs and symptoms of this disorder vary greatly, ranging from almost unnoticeable to severe. Most individuals have:

 

underdeveloped facial bones,

particularly the cheek bones, and

A very small jaw and chin (micrognathia).

 

Some people with this condition are also born with an opening in the roof of the mouth called a cleft palate. In severe cases, underdevelopment of the facial bones may restrict an affected infant’s airway, causing potentially life-threatening respiratory problems.

 

 

What are the characteristics of Treacher Collins syndrome?

 

People with TCS often have eyes that slant downward, sparse eyelashes, and a notch in the lower eyelids called an eyelid coloboma.

Some individuals have additional eye abnormalities that can lead to vision loss.

It also characterized by absent, small, or unusually formed ears.

Hearing loss occurs in about half of all individuals with the problem; hearing loss is caused by defects of the three small bones in the middle ear, which transmit sound, or by underdevelopment of the ear canal.

People with Treacher Collins usually have normal intelligence.

 

How common is this syndrome?

Treacher Collins affects an estimated 1 in 50,000 people.

 

How do you get Treacher Collins (Causes)?

When Treacher Collins results from mutations in the TCOF1 or POLR1D gene, it is considered an autosomal dominant condition, which means one copy of the altered gene in each cell is sufficient to cause the disorder. About 60 percent of these cases result from new mutations in the gene and occur in people with no history of the disorder in their family. In the remaining autosomal dominant cases, a person with TCS inherits the altered gene from an affected parent.

 

When TCS is caused by mutations in the POLR1C gene, the condition has an autosomal recessive pattern of inheritance. Autosomal recessive inheritance means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

 

 

What genes are related to this syndrome?

 

Mutations in the TCOF1, POLR1C, or POLR1D gene can cause Treacher Collins. TCOF1 gene mutations are the most common cause of the disorder, accounting for 81 to 93 percent of all cases. POLR1C and POLR1D gene mutations cause an additional 2 percent of cases. In individuals without an identified mutation in one of these genes, the genetic cause of the condition is unknown.

 

The proteins produced from the TCOF1, POLR1C, and POLR1D genes all appear to play important roles in the early development of bones and other tissues of the face. These proteins are involved in the production of a molecule called ribosomal RNA (rRNA), a chemical cousin of DNA. Ribosomal RNA helps assemble protein building blocks (amino acids) into new proteins, which is essential for the normal functioning and survival of cells. Mutations in the TCOF1, POLR1C, or POLR1D gene reduce the production of rRNA. Researchers speculate that a decrease in the amount of rRNA may trigger the self-destruction (apoptosis) of certain cells involved in the development of facial bones and tissues. The abnormal cell death could lead to the specific problems with facial development found in TCS. However, it is unclear why the effects of a reduction in rRNA are limited to facial development.

 

What are the treatment and management guidelines for this syndrome?

There is currently no cure for TCS. Treatment is tailored to the specific needs of each child or adult. Ideally, treatment is managed by a multidisciplinary team of craniofacial specialists.

 

Newborns may need special positioning or tracheostomy to manage the airway. Hearing loss may be treated with bone conduction amplification, speech therapy, and/or educational intervention.

 

In many cases, craniofacial reconstruction is needed. Surgery may be performed to repair cleft palate, to reconstruct the jaw, or to repair other bones in the skull. The specific surgical procedures used and the age when surgery is performed depends on the severity of the abnormalities, overall health and personal preference.

There are some possible treatments that are being investigated. Researchers are looking for ways to inhibit a protein called p53, which helps the body to kill off unwanted cells. In people with TCS, p53 is abnormally activated, leading to the loss of specific cells and ultimately causing features of TCS. It has been proposed that inhibiting the production of p53 (or blocking its activation) may help to treat affected people. However, more research is needed to determine if this type of treatment is effective and safe.

 

Researchers are also studying the use of stems cells found in fat tissue to be used alongside surgery in people with TCS and other craniofacial disorders. Early studies have shown that surgical outcomes may be improved using these stem cells to help stimulate the regrowth of affected areas. However, this therapy is still experimental and controversial.

 

 

What is the prognosis and life expectancy for a person with Treacher Collins syndrome?

Usually, people with TCS grow to become functioning adults with normal intelligence. With proper management, life expectancy is approximatelythe same as in the general population. In some cases, the prognosis depends on the specific symptoms and severity in the affected person. For example, very severe cases of TCS can cause perinatal death because of a compromised airway.

 

What other names do people use for Treacher Collins syndrome?

Other names for TCS include:

 

Franceschetti-Zwahlen-Klein syndrome

Mandibulofacial dysostosis (MFD1)

Treacher Collins-Franceschetti syndrome

zygoauromandibular dysplasia

 

 

If you have any questions or concerns regarding this article, please give us a call and we will help you with this and all your healthcare concerns.

 

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Sleep Apnea Linked to Cognitive Decline

Sleep Apnea Tied to Cognitive Decline

People who experience certain breathing problems at night may be more likely to develop cognitive impairment than individuals without any difficulties breathing while they sleep, a research review suggests.

Data obtained from 14 previously published studies with a total of more than 4.2 million men and women showed that people with sleep-disordered breathing had 26 percent higher odds of developing cognitive impairment, researchers report in JAMA Neurology.

“Identification of this sleep disorder in elderly persons might help predict future risk of cognitive impairment and thus is important for the early detection of dementia,” said lead study author Yue Leng of the University of California, San Francisco.

“Moreover, sleep-disordered breathing is a treatable disease,” Leng said by email. “If sleep-disordered breathing is a risk factor for dementia, then treatment of sleep-disordered breathing might benefit cognition and help reduce the risk of dementia in the long run.”

 

Many people with nighttime breathing problems had what’s known as apnea, a potentially serious sleep disorder that involves repeated stops and starts in breathing. Risk factors for sleep apnea include older age and obesity.

 

In the smaller studies included in the analysis, the increased risk of cognitive impairment associated with sleep-disordered breathing ranged from 23 percent to 86 percent.

 

When researchers analyzed the increased risk across all of the smaller studies with a similar design, excluding one that was done much differently, the overall increased risk of cognitive impairment associated with sleep-disordered breathing was 35 percent.

Sleep-disordered breathing was also associated with slightly worse “executive function” – that is, the mental processes involved in planning, paying attention, following instructions, and multi-tasking, for example – but it didn’t appear to influence memory, the study also found.

 

The researchers had only limited data on executive function, however, which made it difficult to determine whether any changes associated with sleep-disordered breathing might be clinically meaningful.

 

The analysis also didn’t account for obesity, which is independently a risk factor for both apnea and cognitive impairment, noted Marie-Pierre St-Onge, a researcher at Columbia University Medical Center in New York City who wasn’t involved in the study.

 

“It’s possible that the reduction in oxygen reaching the brain from apnea could, over time, lead to brain injuries that can lead to cognitive impairment,” St-Onge said by email. “There is also a link between obesity and mild cognitive impairment and between obesity and sleep-disordered breathing.”

 

Shedding excess weight might help, said Hui-Xin Wang of the Karolinska Institute in Stockholm.

 

“Weight-loss strategies, including physical exercise and diet, have been evaluated as a treatment strategy to improve sleep-disordered breathing and reduce the risk of cognitive decline,” Wang, who wasn’t involved in the study, said by email.

 

Beyond weight loss, treatments for apnea may include wearing a breathing mask or jaw support at night to keep airways open.

 

More research is needed, however, to determine whether and to what extent treating sleep apnea might lower the risk of cognitive decline, said Kristen Knutson of the Center for Circadian and Sleep Medicine at the Northwestern University Feinberg School of Medicine in Chicago.

 

“There are therapies available for apnea that would improve sleep and potentially improve health, including cognitive function,” Knutson, who wasn’t involved in the study, said by email. “People who have trouble sleeping or who snore loudly and frequently should raise this issue with their doctors and discuss potential treatments.”

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Lack of Sleep and Diabetes Link

Lack of Sleep and Diabetes Linked

 

New research links lack of sleep with heightened risk for type 2 diabetes in youth

 

A new review of scientific literature on the importance of sleep in youth suggests that a lack of sleep can lead to decreased appetite control and body weight regulation, all of which can raise risks for the development of type 2 diabetes.

 

The largest decline in sleep duration and poor sleep quality over the past decades has been seen in children and adolescents, a trend that earlier studies say may contribute to weight gain, increased risks for cardiovascular disease and poor mental health.

 

This new review of evidence, published in the journal Nutrition and Diabetes, has looked at 23 studies on the topic of risk factors for type 2 diabetes and sleep variables to try and elucidate the mechanisms that may explain the association between the two.

 

Researchers from Children’s Hospital of Eastern Ontario Research Institute, in Canada, reviewed studies that not only assessed risks from inadequate sleep, described as sleeping less than six hours per night – a two-hour or so sleep deficit compared to standard advice for children – but also sleep architecture.

 

A healthy sleep architecture refers to having the right number of restorative sleep cycles and rapid eye movement phases to feel sufficiently well-rested. An out of whack sleep architecture has been associated in past studies with insulin resistance.

 

In terms of sleep duration, researchers have found that the lowest risk for type 2 diabetes is observed, similar to the figure given for adults, at a minimum sleep duration of seven to eight hours per day.

 

Drawing from the findings of the different studies evaluated, they have identified a number of mechanisms by which the lack of sleep can elevate risks for type 2 diabetes among children.

 

One of them, perhaps the most prominent one, is the increased exposure to the stress hormone cortisol due to short sleep duration. This may contribute to the accumulation of visceral fat and subsequent increased insulin resistance.

 

The reason for this is that the authors also noted that the association between sleep quality and insulin resistance was not independent of the level of adiposity – the increase in the number of fat cells.

 

There may also be another phenomenon implicated that has to do with the nervous system which, in response to the stress of not sleeping, negatively influences the hormone leptin.

 

While we sleep, leptin usually rise to control appetite. However, when sleep is restricted, leptin gets inhibited. The inhibition of leptin leads to an increase in hunger and a decrease in satiety. These effects can translate into progressive weight gain.

 

Sleep is a modifiable lifestyle habit associated with the prevention of type 2 diabetes. One randomised trial that was part of the review conducted among children aged 8 to 11 years showed that increasing sleep duration by just 1.5 hour per night over a week resulted in lower food intake and lower body weight.

 

Although more studies are needed to shed light on the mechanisms linking insufficient sleep with type 2 diabetes risk, there’s no possible risk in children and teens improving their sleep and getting enough of it on a regular schedule each night.

 

If you need help, have concerns or just want a healthcare plan for YOU, then contact us and we will help you.

 

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Six Conditions Yoga Can Treat

Yogis, hippies, and holistic medicine specialists have been touting the health benefits of yoga for years: it can improve your fitness level, fight cancer, diabetes, obesity, heart disease, and a variety of other disorders, they’ve argued.

But when it comes to the science backing up these claims, a lot is still left unresolved. For example, research has shown that yoga doesn’t necessarily help at all in treating asthma compared to other breathing exercises. And while yoga and mindfulness can improve quality of life, and reduce chemotherapy side effects, it hasn’t been proved to treat cancer in any way, according to the American Cancer Society.

That being said, let’s take a look at all the conditions or disorders yoga does treat — according to the scientific evidence that’s out there, at least. Maybe this way, you can give yoga a try, and better understand how it may benefit you.

Back Pain

Some 80 percent of adults will experience back pain at some point in their lives, and it’s something that can cause a lot of distress and distraction. But research has shown that yoga or simply stretching can alleviate chronic back pain. A 2011 study found that both yoga and stretching helped people with chronic pain — they were considered “safe options” for a condition that is normally treated with a regimen of painkillers. As long as you focus on yoga’s therapeutic effects (and don’t push yourself too much trying to perfect the crazy poses), yoga may relieve your chronic back pain.

Arthritis

Doctors still aren’t certain whether yoga directly improves arthritis; several studies have yielded different and conflicting results. However, it’s generally agreed that yoga can and does assist in reducing the stress and frustration caused by arthritis — and that incorporating yoga into an arthritis treatment program can only enhance it.

“While there is a great deal of anecdotal evidence of the benefits of yoga (just visit any yoga studio), to date only a handful of scientific studies have been conducted on persons with [arthritis],” Johns Hopkins University states. “These early studies have shown promising results with some improvement in joint health, physical functioning, and mental/emotional well-being… People with arthritis may also enjoy yoga more than traditional forms of exercise, and exercise enjoyment is an important predictor of adherence.”

Heart Disease

A recent study out of Erasmus University Medical Center found that yoga was beneficial for cardiovascular health. While yoga mainly works on flexibility and muscular strength, it’s not considered an aerobic exercise like running — so it’s an interesting finding.

The researchers note they’re not sure exactly how yoga improves cardiovascular health. “Also unclear, are the dose-response relationship and the relative costs and benefits of yoga when compared to exercise or medication,” Myriam Hunink, lead author of the study, said. “However, these results indicate that yoga is potentially very useful and in my view worth pursuing as a risk improvement practice.”

Indeed, yoga is unlike other types of physical activity in that it focuses more on slower poses, meditative breathing, and a calm approach. This trifecta can assist in reducing stress and lowering blood pressure, which can all have a good effect on your heart health.

Anxiety Disorders, Depression

You may enter a yoga class, your body tensed and tight from weeks and even months’ worth of accumulated stress. Our body holds emotion in it — and yoga can help unravel that. Just an hour’s worth of yoga can force you to leave all your stresses and anxiety behind, and this “yoga high” effect can last for hours afterwards.

Though there aren’t too many studies on this yet, one study found that “several studies of exercise and yoga have demonstrated therapeutic effectiveness superior to no-activity controls and comparable with established depression and anxiety treatments” such as cognitive behavioral therapy, sertraline, and imipramine. “High-energy exercise and frequent aerobic exercise reduce symptoms of depression more than less frequent or low-energy exercise. For anxiety disorders, exercise and yoga have also shown positive effects.”

Chemotherapy Side Effects

While there is no evidence that yoga can fight cancer, or lower a person’s risk, it has been shown to reduce inflammation and alleviate chemotherapy side effects in cancer patients.

In one recent study, scientists gathered breast cancer patients who were suffering from debilitating chemotherapy effects, and placed them in 90-minute yoga classes twice a week. They found the cancer patients had more energy, less fatigue, and slept much better than the patients who didn’t do yoga.

Sleep Disorders

This brings us to yoga and sleep: like most exercise, yoga can improve your sleeping patterns and fight insomnia. Stress and the “buzz” of external anxieties — and yes, a sedentary lifestyle — can keep us lying awake at night. Learning to breathe more slowly and deeply in yoga classes can ultimately improve our sleep. A 2004 study found that yoga treated chronic insomnia in patients,

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