Binge eating causes sleep issues during, after pregnancy

Binge eating or consuming unusually large amounts of food, before or during pregnancy, can cause sleep problems during pregnancy. Those sleep problems can also last as long as 18 months after childbirth.
Scientists found that women with binge eating disorder symptoms before and during pregnancy had more sleep problems than a group of women with no reported symptoms. They also had increased sleep dissatisfaction 18 months after childbirth.

Participants with binge eating disorder symptoms before and during pregnancy, pre-pregnancy symptoms that went away during pregnancy, or pregnant women who binge eat for emotional reasons, were 26 percent more likely, to report sleeping problems than participants with no reported eating disorder symptoms.

All women, regardless of eating disorder status, reported more sleep problems during the first 18 weeks of pregnancy. This is because women experience changes in their sleep patterns by their 11-12th week of pregnancy. As a result, they get more hours of sleep, but less deep sleep, and more waking up during the night. In addition to hormonal changes and the physical discomfort, conditions like sleep-disordered breathing and restless leg syndrome sometimes appear during pregnancy.

The authors of the study, published in the journal SLEEP recommend comprehensive mental health screening during pregnancy. To their knowledge, their study is the only one to examine sleep and binge eating symptoms during pregnancy.

Melatonin improves sleep during hypertension treatment

Melatonin supplements may improve sleep in hypertension patients who are on beta-blockers.
Scientists found that three weeks of melatonin use significantly improved their sleep quality and helped them stay asleep compared with a placebo.

Patients taking melatonin increased total sleep time by 37 minutes. They also spent less time awake in bed, and fell asleep quicker. The authors of the study, published in the journal SLEEP observed that the melatonin improved sleep tolerence without the common side effects of drug tolerance or rebound insomnia.

Beta-blockers are drugs that affect the body’s response to certain nerve impulses and are sometimes used in hypertension patients. These medications suppress endogenous nighttime melatonin secretion, which may explain a reported side effect of insomnia.

Melatonin is effective in resetting the body's circadian rhythms, and is used frequently for jet lag. Findings are mixed on whether melatonin helps improve sleep in otherwise healthy patients with insomnia.

If you have insomnia and are not on a beta-blocker, there are other ways you can tackle your insomnia. These include cognitive behavioral therapy and medications. The AASM advises you to talk to your doctor before taking melatonin or any medication. Your doctor may refer you a sleep medicine physician at an AASM-accredited sleep disorders center. Visit www.sleepcenters.org to find an AASM-accredited sleep center near you.

Review: Sleepwalk With Me

Don't mistake "Sleepwalk With Me" as a story about a man coming to terms with the rare and intriguing REM sleep behavior disorder. Mike Birbiglia's semi-autobiographical new film is a highly personal and often understated account of a struggling comedian in a troubled relationship. The sleep disorder gets little screen time, but those moments are memorable and pivotal to the story.



Birbiglia, a comedian and regular on the popular radio show This American Life, co-wrote, co-directed and stars as his thinly veiled doppelganger Matt Pandamiglio. Matt is a thirty-something who is facing not-so-subtle pressure from his long-time girlfriend and family to get married. He adores his girlfriend, who is played by Lauren Ambrose, but he just can't bring himself to marry her. On top of that, his aspirations to become a stand-up comedian are going nowhere. He spends his evenings bartending at a comedy club, where he occasionally gets to perform.

Matt's anxieties begin to bubble over into strange and vivid dreams, which he acts out in his bedroom. His father is quick to notice that he may have REM Sleep Behavior Disorder, a rare and dangerous parasomnia that gets worse over time.

Instead of seeing a doctor, Matt gets swept away by an opportunity to jump-start his comedy career. While he's on the road, the sleep disorder causes a near-fatal accident, which happened to Birbiglia in real life. A dream about a missile attack caused him to jump out of a second story window of a La Quinta Inn.

"Sleepwalk With Me" succeeds as a small independent release and as an introduction to a very serious sleep disorder. The movie tastefully mixes Birbiglia's joke-laced narrative driven approach to stand-up comedy with the modest, thoughtful storytelling of This American Life. This is no surprise: the film was produced and co-written by Ira Glass, the host and creator of This American Life.

The film provides a fairly realistic view of REM sleep behavior disorder, and the dream sequences involving the disorder are especially imaginative (see below). Also novel is the method in which the film explains REM sleep behavior disorder to the audience. Without spoiling anything, it involves a cameo by Dr. William Dement, the real-life father of sleep medicine. For this reason alone, "Sleepwalk With Me" is worth viewing for anyone with an interest in sleep medicine.



As bizarre as it sounds, REM sleep behavior disorder is a real sleep disorder recognized by the International Classification of Sleep Disorders - Second Edition. People with REM sleep behavior disorder often flail, shout, punch, kick or leap as they act out their vivid dreams. The sleep disorder gets worse over time when left untreated, and injury is likely. In extreme cases, the dreamer may injure or kill themselves or a partner.

A board certified sleep physician diagnoses REM sleep behavior disorder using an overnight sleep study. The disorder is treatable with medications such as Clonazepam combined with bedroom safety precautions. Birbiglia has stated before that he confines himself in a sleeping bag while wearing mittens, so he doesn’t injure himself as he sleeps. People with REM sleep behavior disorder should also move any objects away from the bed, and block any windows.

Sleepwalk With Me opens on August 24, and is showing in a limited run at these theaters.

Exercise may help alleviate daytime effects of sleep apnea

A daily trip to the gym can help dampen the daytime misery due to sleep apnea, new research shows. A study in the Journal of Clinical Sleep Medicine found that a 12-week exercise program helped improve daytime functioning in a small sample of adults with sleep apnea.

The study randomly assigned 43 sedentary and overweight adults with untreated sleep apnea to an aerobic and resistance training program or a low-intensity stretching routine. Subjects in the training group ran on a treadmill for about 40 minutes a day, four days a week. The group also lifted weights twice a week. The exercises were designed to work each major muscle group, and included shoulder and chest press, row, leg and bicep curls and abdominal crunches.

After 12 weeks, the group that participated in the exercise program reported improved daytime functioning. They were less sleepy, less depressed and in a better overall mood. The results are promising, but due to a relatively small sample size further research is needed on the benefits of exercise for patients with untreated sleep apnea.

Even if you don't have sleep apnea, regular exercise can boost your energy, reduce your stress and improve your mood. Exercise can also help slow or prevent health conditions such as heart disease, stroke and diabetes. Some research has also suggested that it can help you sleep better.

Image by SashaW

The danger of Googling for health advice

We're trained as internet users to Google (or Bing) any question we need answered. Thanks to an ever-evolving algorithm, most of the time these search engines return useful websites and information. But don't use Dr. Google to find medical advice. Medical information offered up by search engines can be inaccurate or irrelevant, a study published in the Journal of Pediatrics suggests.

A group of pediatric researchers evaluated the quality of search results related to infant safety issues. Out of 1,300 results from 13 search phrases such as "infant sleep position" and "pacifier infant", only 43.5 percent provided relevant information.

One example the researchers cited was a website that sells infant sleep consulting services that suggested that children can sleep on their stomachs after they have the ability to roll onto their bellies. The American Academy of Pediatrics cautions against this, recommending only supervised, awake stomach time for children up to one-year-old.

Consider the source when you are looking up health information on the web. Credible organizations such as health care leaders, government organization and professional medical nonprofits are more likely to provide trustworthy information than .coms hawking health products or services. There's one source that's always reliable to answer health questions: a board-certified physician. Always consult your primary care physician, rather than self-diagnose, if you think you may have a medical problem based on the signs and symptoms you read about on the web. If you suspect you may have sleep apnea or another sleep disorder, see a board-certified sleep specialist.

Below are some of the more trustworthy patient information websites:

National Institutes of Health
Centers for Disease Control and Prevention
Mayo Clinic
WebMD
Yoursleep from the American Academy of Sleep Medicine

Short sleep reduces effectiveness of vaccines

Sleep length may affect how your body responds to vaccines, increasing your risk for illness. A study published in the August issue of the journal SLEEP found that people who had insufficient sleep were far more likely to be unprotected by a vaccine.

The study involved a sample of 125 healthy people between the ages of 40 and 60. Each subject received a three-dose hepatitis B vaccine over a six month period. Researchers measured the antibody response levels before the second and third vaccination, and six months after the final injection. During that time span, each of the participants kept a sleep diary and many of wore electronic sleep monitors as they slept.

Participants who slept fewer than six hours per night were more 11.5 times more likely to be unprotected by the hepatitis B vaccine compared to people who slept more than seven hours. The researchers found that sleep length, but not sleep quality, affected response to the vaccine.

This study adds to a growing body of research that suggests that quality of sleep has a considerable impact on your immune system. Last month, researchers in the Netherlands and the United Kingdom found that healthy young men in severely sleep-deprived circumstances had compromised blood cell counts.

Insufficient sleep is also linked to obesity, diabetes and reduced workplace productivity. The American Academy of Sleep Medicine recommends that healthy adults get 7-8 hours of sleep per night.

Image by Sanofi Pasteur

SAFE-D: Teaching Sleep, Alertness and Fatigue Education to Drivers

In the middle of summer’s peak driving season, the American Academy of Sleep Medicine (AASM) offers a free online presentation describing the signs, causes and effects of driver fatigue and some strategies to manage it.

SAFE-D: Sleep, Alertness and Fatigue Education for Drivers is available on Vimeo, which has been posted below. The presentation also is on YouTube (part 1, part 2) to share or embed.


SAFE-D: Sleep, Alertness and Fatigue Education for Drivers from AASMorg on Vimeo.

The 30-minute narrated slide presentation explores the causes of fatigue, which stretch beyond the simple lack of sleep. For example, people who work outside of a typical nine-to-five schedule or work unpredictable schedules are at a high risk for fatigue.

Most people think that sleepiness and drowsiness are due only to lack of sleep, but there are other factors that affect your levels of alertness throughout the day, SAFE-D warns. These include staying awake for 16 hours or more, sleeping less than seven or eight hours a night, having interrupted sleep or suffering from an untreated sleep disorder such as obstructive sleep apnea. Fatigue and exhaustion can impair your performance even if you do not feel sleepy. As you become more fatigued, it becomes more difficult to pay attention and react quickly while driving.

According to a recent study by the AAA Foundation for Traffic Safety, an estimated 16.5 percent of all fatal motor vehicle crashes in the United States from 1999 to 2008 involved a fatigued driver.

And studies have shown that the effects of sleep loss are similar to having a blood-alcohol content over the legal driving limit.

The AASM recommends these strategies for managing fatigue:

• Develop a healthy lifestyle by getting regular exercise, avoiding nicotine and eating plenty of fresh fruits and vegetables.
• Practice good sleep hygiene by following a regular sleep schedule and creating a comfortable sleep environment. Keep your bedroom dark, quiet and comfortably cool or warm. Limit food/liquid and alcohol intake, as well as electronic device usage before bedtime.
• For greatest effectiveness, use caffeine as-needed instead of daily, and use it in moderation.
• On longer road trips, use “activity breaks” to improve alertness. Pull over in a safe location and take 15 to 20 minutes to walk around and stretch.

Do not rely on turning the radio volume up, opening a window or chewing gum to try to stay alert, the SAFE-D presentation cautions. The only way to reverse fatigue and sleepiness is to get more sleep. And using illegal drugs or abusing prescription medication in order to fall asleep or stay awake is dangerous for your safety and health.