Researchers in The Netherlands found that healthy people who had just one night of short sleep can show signs of insulin resistance, a condition that often precedes Type 2 diabetes.

You can a read paper on the study, led by Dr Esther Donga of Leiden University Medical Center, which is about to be published in the May print issue of The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, JCEM, in an early online April issue of the journal.

Donga told the press that over the last ten years the average night’s sleep in western societies has shortened, coinciding with a rise in cases of insulin resistance and type 2 diabetes. These findings suggest this may be more than a coincidence, and that:

“… a short night of sleep has more profound effects on metabolic regulation than previously appreciated,” said Donga.

Other studies have already shown that several nights of shorter sleep can lead to impaired glucose tolerance, but this is the first to show insulin sensitivity can change after only one night of partial sleep.

For their study, Donga and colleagues recruited 9 healthy participants, and measured their insulin sensitivy following one night of about 8 hours of normal sleep and again following one night of only 4 hours of partial sleep.

They measured the participants’ insulin sensitivity using the “hyperinsulinemic euglycemic clamp method” which infuses glucose and insulin into the bloodstream via catheters and allows you to work out how much glucose is necessary to compensate for an increased insulin level without causing hypoglycemia.

Donga said their results suggest that day to day insulin sensitivity is not fixed in healthy people, but depends on how much sleep they have had the previous night.

“In fact it is tempting to speculate that the negative effects of multiple nights of shortened sleep on glucose tolerance can be reproduced, at least in part, by just one sleepless night,” she added.

Prompted by their findings the researchers suggested further investigations should be done to find out whether improving sleep duration could help stabilize glucose levels in patients with diabetes.

“A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects.”

“A good night’s sleep” has long been the intention of millions of people suffering from sleep disorders around the world. However, this objective is scarcely met with ease. The reality of this scenario is that many will not seek the professional help to address the serious sleep disorders that plague them, resulting in numerous health consequences. The World Association of Sleep Medicine (WASM) will be holding the third annual World Sleep Day on Friday, March 19, 2010. The event is organized by the World Sleep Day Committee and is regarded as a platform for medical professionals to deliver the message of the importance of healthy sleep to the public.

Sleep is a function in which all vertebrates and some invertebrates participate, however the physiological purpose of sleep has yet to be discovered. While sleep is necessary to be alert to optimally navigate daily tasks, research shows sleep may also be a factor in growth, regeneration, and memory. With an estimated one third of adults suffering from clinically recognizable insomnia and approximately 80 additional sleep-related disorders, there is significant concern for the health consequences that occur with the lack of quality sleep. Studies suggest that a lack of sleep is detrimental to health in ways such as the development of high blood pressure, obesity, diabetes and other chronic ailments in those who consume less than 6 hours nightly.

The 10 Commandments of Sleep Hygiene listed below make common sense recommendations that are rarely complied with fully.

1. Fix a bedtime and an awakening time.

2. If you are in the habit of taking siestas do not exceed 45 minutes of daytime sleep.

3. Avoid excessive alcohol ingestion 4 hours before bedtime and do not smoke.

4. Avoid caffeine 6 hours before bedtime. This includes coffee, tea and many sodas, as well as chocolate.

5. Avoid heavy, spicy, or sugary foods 4 hours before bedtime. A light snack before bed is acceptable.

6. Exercise regularly, but not right before bed.

7. Use comfortable bedding.

8. Find a comfortable temperature setting for sleeping and keep the room well ventilated.

9. Block out all distracting noise and eliminate as much light as possible.

10. Reserve the bed for sleep and sex. Don’t use the bed as an office, workroom or recreation room.

Violation of these commandments causes poor quality of nocturnal sleep, short duration of sleep, fragmentation of sleep and serious sleep deprivation. These infringements may lead to poor alertness, lack of attention, reduced concentration, decreased work and academic productivity, and even motor vehicle accidents. Physical health problems come next.

It is due to the widespread effects of sleep disorders and increasing number of sufferers worldwide, that World Sleep Day dedicates its efforts in 2010 to educate the world on important sleep topics. The day’s events will take place online, featuring the organization of local groups promoting sleep health, presentation of educational materials, an award presentation to the best creation and exhibition of historic videos.

Daylight Savings Time can be hazardous for your health.

On average, people go to work or school on the first Monday of Daylight Savings after sleeping 40 fewer minutes than normal. And recent studies have found there’s a higher risk of heart attacks, traffic accidents and workplace injuries on the first Monday of Daylight Savings.

“Many people already are chronically sleep-deprived, and Daylight Savings Time can make them even more tired for a few days,” said Dr. Nidhi Undevia, medical director of the Sleep Program at Loyola University Health System.

Undevia offers these tips for getting enough sleep after moving the clock forward an hour:

– In the days before the time change, go to bed and wake up 10 or 15 minutes earlier each day.

– Don’t nap on the Saturday before the time change.

– To help reset your internal body clock, expose yourself to sunlight in the morning as early as you can.

Loyola offers a comprehensive and multidisciplinary program to help identify and treat sleep disorders. The sleep laboratory and sleep clinic diagnose and treat a full range of sleep disorders, including insomnia, sleep walking, obstructive sleep apnea, narcolepsy, circadian rhythm disorders, restless legs syndrome and periodic limb movement disorders.

A study in the March 1 issue of the journal SLEEP shows that African-American and Hispanic young adults with short or long sleep durations had greater increases in belly fat over a five-year period compared with those who reported sleeping six to seven hours a night.

Results show that in participants younger than 40 years of age, both short and long sleep durations were associated with significant increases in body mass index (BMI), as well as in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) fat accumulation. Compared with people who reported a nightly sleep duration of six to seven hours, those with a self-reported sleep duration of five hours or less per night had an average BMI increase over a five-year period that was 1.8 kg/m2 higher, and greater accumulations of SAT (42 cm2) and VAT (13 cm2); and those who reported sleeping eight hours or more had a BMI increase that was 0.8 kg/m2 higher, as well as greater accumulations of SAT (20cm2) and VAT (6 cm2). No significant relationship existed between sleep duration and abdominal fat change in participants older than 40 years of age.

Lead author Kristen G. Hairston, M.D., assistant professor of internal medicine at Wake Forest University School of Medicine in Winston-Salem, N.C., said that obtaining a sufficient amount of sleep is important for people of all races and ethnicities. However, ethnic minorities disproportionately report extremes in sleep duration, putting them at risk for negative metabolic outcomes such as obesity and type 2 diabetes.

“Appropriate amounts of sleep are important for maintenance of healthy weight,” said Hairston. “In a group of African-American and Hispanic participants, those who slept less than this had greater increases in belly fat over a five-year period.”

Information was obtained from 1,107 people in the IRAS Family Study, an extension of the Insulin Resistance Atherosclerosis Study (IRAS). Data were collected from 332 African-Americans and 775 Hispanics with a mean age of 41.7 years at baseline and an age range from 18 to 81 years. Sixty-two percent of participants were female. Mean sleep duration at baseline was 6.7 hours in response to the question, “On average, about how many hours of sleep do you get a night?” Seventeen percent of the sample reported sleeping five hours or less per night, 55 percent slept six to seven hours per night and 28 percent averaged eight or more hours of sleep per night.

Abdominal computed tomography (CT) scans and BMI were obtained at a five-year interval. Dietary intake was assessed using a short, retrospective, one-year, semi-quantitative food-frequency interview. An estimate of usual frequency of participation in vigorous activities also was obtained. Generalized estimating equations using linear regression models assessed the association between sleep duration and five-year fat accumulation with adjustment for age, race, gender, study site, baseline fat measure, physical activity, total calorie intake, smoking status and education.

In those younger than 40 years old, a short sleep duration of five hours or less was most frequently reported by Hispanic men (30 percent), and a long sleep duration of eight or more hours was most frequently reported by Hispanic women (53 percent). Participants reporting five hours of sleep or less consumed more total calories (2,224 kcal) than those reporting six to seven hours (1,920 kcal) or eight or more hours (2,199 kcal).

The authors proposed that short sleep may impact fat accumulation by promoting increased caloric intake via increased hunger, or by reducing energy expenditure via altered thermoregulation and increased fatigue. Both increased caloric intake and decreased vigorous activity were observed in the short sleep group.

The authors also suggested that it is just as important for doctors to encourage patients to get adequate sleep as it is for them to promote a healthy diet and physical activity. This is particularly relevant when young adults make transitions involving college, marriage and childbearing, because these life stages often are associated with sleep deprivation.

A study in the March 1 issue of the journal Sleep shows that frequent napping is associated with an elevated prevalence of type 2 diabetes and impaired fasting glucose in an older Chinese population.

Results show that the prevalence of type 2 diabetes was 36 percent higher (adjusted odds ratio = 1.36) in participants who reported napping four to six times a week and 28 percent higher (OR = 1.28) in those who napped daily. Similar associations were found between napping and impaired fasting glucose. The observed associations were unaltered in statistical analyses that removed participants with potential ill health and daytime sleepiness, suggesting it is less likely that diabetes leads to daytime sleepiness and raising the possibility that napping may increase the risk of diabetes.

According to the authors, napping in China is a social norm, which is practiced by all ages primarily as a habit started in childhood. In Western countries, napping is less common and is often unplanned and prompted by sleepiness likely caused by aging, deteriorating health status or nighttime complaints.
Lead author Neil Thomas, PhD, reader in epidemiology at the University of Birmingham, U.K., said that additional research is needed to determine if napping itself plays a causative role in the development of type 2 diabetes, or if other factors are involved.

“In many non-Mediterranean, Western countries a large proportion of those that nap are generally older or have other conditions that cause tiredness and create an urge to nap,” said Thomas. “The napping can therefore be a marker of disease.”

This cross-sectional study analyzed baseline data from the Guangzhou Biobank Cohort Study, a collaboration between the Guangzhou Number 12 People’s Hospital and the Universities of Birmingham and Hong Kong. The community-based study took place in Guangzhou, China, where 19,567 participants between the ages of 50 and 93 years were recruited from 2003 to 2004 and 2005 to 2006. The sample comprised 13,972 women with a mean age of 61.4 years and 5,595 men with an average age of 64.2 years.

Participants underwent a half-day assessment, which included a structured interview on lifestyle and medical history, and a physical examination. Self-reported frequency of napping was obtained by questionnaire, and type 2 diabetes was assessed by a fasting blood glucose sample and/or self-reports of physician diagnosis or treatment. Participants were asked to describe their napping habits and daytime sleepiness.

Type 2 diabetes was identified in 13.5 percent of the sample and was more prevalent in people who reported napping daily (15.1 percent) and in those who napped four to six times per week (14.7 percent). Logistic regression models were constructed to assess the relationship between napping and diabetes and impaired fasting glucose, adjusting for demographics, lifestyle, sleep habits, health status, body fat and metabolic markers.

At least one nap per week was reported by 67.2 percent of participants, more commonly in males (76.4 percent) than in females (63.6 percent). About 59.4 percent of these people reported napping daily. Total sleep duration was longer and daytime sleepiness was reported less often in more frequent nappers than in people who never napped.

In a sub-sample of 3,822 participants who were re-contacted for additional information about sleep habits, there was a statistically significant trend of increasing risk of diabetes with longer nap duration. Compared with people who never took naps, the risk of diabetes was 41 percent higher (OR = 1.41) for people who took naps that lasted longer than 30 minutes and 35 percent higher (OR = 1.35) for people whose naps lasted 30 minutes or less.

The authors noted that the association between napping and diabetes was observed despite the fact that nappers had higher levels of physical activity, which has been shown to reduce the risk of diabetes. This suggests that the relationship between napping and diabetes might have been stronger had it not been offset by the protective effects of physical activity. The authors added that there will be profound public health implications in China if the relationship between napping and increased risk of type 2 diabetes is confirmed in longitudinal studies, as the nation is currently affected by an emerging diabetes epidemic.

If you are among those who suffer from sleep deprivation, getting one night of good sleep won’t make up for the deficit. Chronic sleep deficit causes detrimental effects on one’s ability to remain alert and attentive, and leads to cumulative effects on performance that could become a safety risk.

The information comes from a report based on the findings of an analysis performed by U.S. researchers that was recently published in the journal Science Translational Medicine. In a telephone interview, lead author Daniel Cohen, a neurologist at Brigham and Women’s Hospital in Boston, said, “Insufficient sleep over multiple sleep-wake cycles causes performance to deteriorate much faster for every additional hour we spend awake, particularly during the biological night.” According to Cohen, the average person needs about eight hours of sleep nightly to preserve performance. He explained that chronic sleep loss occurs when a person gets only four to seven hours of sleep per night, whereas acute sleep loss occurs when a person is awake for more than 24 hours in a row.

During the study, the researchers followed a group of nine healthy participants, including five men and four women, in a hospital setting for a period of 38 days. They were each given five days to “catch up” on their sleep, followed by 21 days of a sleep cycle of approximately 33 waking hours and 10 sleeping hours.

The study participants were tested every four hours to measure their alertness and attentiveness, with three factors being considered. These included the number of consecutive hours a participant was awake, the period of time of chronic sleep reduction, measured in days or even weeks, and what time of day it was for the participant. Cohen explained, “How those three factors combine determine how well we perform at any moment.” Results revealed that although the majority of the participants were able to make up for acute sleep loss in just one night with 10 hours of sleep, participants having chronic deficit demonstrated deterioration in performance for every waking hour. Although the researchers know that three days is not a sufficient amount of time for recovery from chronic sleep loss, just how many days or weeks may be needed remains unclear.
The results suggest that sleep loss affects people in two different ways, including one that builds over the number of hours spent awake, and another that builds over days, or even weeks of getting too little sleep. The authors believe that the study findings may be of use in the development of healthier schedules for people who work shift jobs, and could also be helpful in the treatment of patients with sleep disorders.

Cohen pointed out that people may not be aware that they are suffering from chronic sleep deficit, as it builds slowly over weeks. He said, “We can falsely feel like we’ve recovered quickly from chronic sleep loss because recent sleep makes us feel relatively restored early the next day.” He then added, “People may be largely unaware that they are chronically sleep-deprived. It’s when they then stay up and try to pull an all-nighter that they are much more vulnerable to sudden sleepiness, inattentiveness, and potentially accidents and errors.”

Obstructive Sleep Apnea (OSA) adversely affects glucose control in patients with type 2 diabetes, according to a study conducted by researchers at the University of Chicago.

The study “demonstrates for the first time that there is a clear, graded, inverse relationship between OSA severity and glucose control in patients with type 2 diabetes,” wrote lead author, Renee S. Aronsohn, M.D., instructor of medicine at the University of Chicago.

The study also confirmed other reports that undiagnosed OSA is very common among patients with type 2 diabetes, indicating that it is largely unrecognized additional medical risk factor in these patients.

The findings have been published online ahead of print publication in the American Thoracic Soceity’s American Journal of Respiratory and Critical Care Medicine.

Dr. Aronsohn and colleagues consecutively recruited patients with type 2 diabetes from outpatient clinics to participate in the study. The participants were interviewed to assess their diabetes history, medical history and medications, and level of physical activity. Height and weight measurements were also taken, and each participant’s sleep/wake cycles were monitored for five days using wrist actigraphy and self-reported sleep logs. Finally, participants underwent an overnight polysomnography test for OSA , and glucose control was assessed by obtaining a blood sample for hemoglobin A1c (HbA1c) measurement, the main clinical marker of glycemic control in diabetes

In total, 60 patients were included in the study’s final analysis. More than three-quarters (77 percent) of participants had OSA, but only five had been previously evaluated for the disease, and none were undergoing treatment. Of the study sample, 38 percent (23) were classified as having mild OSA, 25 percent (15) had moderate OSA and the 13 percent (8) had severe OSA.

The researchers found that more severe OSA was associated with poorer glucose control, implying a role more severe diabetes with potentially more complications. Relative to patients without OSA, the presence of mild, moderate or severe OSA significantly increased mean adjusted HbA1c values by 1.49 percent, 1.93 percent, and 3.69 percent respectively. These effect sizes are comparable to those of widely used hypoglycemic medications, meaning that having OSA may negate the beneficial effects of anti-diabetic drugs.

“Our findings have important clinical implications as they support the hypothesis that reducing the severity of OSA may improve glycemic control,” said Dr. Aronsohn. “Thus effective treatment of OSA may represent a novel and non-pharmacologic intervention in the management of type 2 diabetes.”

“Physicians who manage patients with type 2 diabetes should screen their patients for OSA,” commented John Heffner, M.D., past president of the ATS. “At least 80 percent of their patients, if properly screened and studied, will be found to have OSA, which is a treatable condition. Treating their breathing problem might improve their glycemic control and long-term complications from diabetes.”

Wives of soldiers deployed to Iraq and Afghanistan are more likely to be diagnosed with depression, anxiety, sleep disorders and other mental health conditions than women whose husbands are not deployed, according to a new study by researchers at the University of North Carolina at Chapel Hill and the Uniformed Services University of the Health Sciences.

The study, published Jan. 14, 2010, in The New England Journal of Medicine, examined medical records of the wives of active duty U.S. Army personnel, comparing those whose husbands were serving abroad with those whose husbands were not deployed.

“This study confirms what many people have long suspected,” said Alyssa Mansfield, Ph.D., the study’s lead author, who conducted the research as a doctoral student at the UNC Gillings School of Global Public Health and is now a research epidemiologist at RTI International. “It provides compelling evidence that Army spouses are feeling the impact of recent deployments to Iraq and Afghanistan. The result is more depression, more stress, more sleepless nights.”

Understanding the scope of the problem can help the U.S. military better plan mental health prevention and treatment programs for the families of active duty personnel, she said. The study also may provide insight into families’ long-term medical needs.

The researchers examined medical records of more than 250,000 female spouses of active duty Army personnel for outpatient care received between 2003 and 2006. About 31 percent of the wives’ husbands were not deployed during that period, while about 34 percent were overseas for between one and 11 months and 35 percent were deployed for longer.

Although the three groups were similar in size, the study found almost 3,500 more diagnoses of mental health conditions among wives of soldiers deployed for less than a year, compared to the group of wives of non-deployed soldiers. Also, there were more than 5,300 additional diagnoses among wives of soldiers deployed for a year or longer.

Depression, anxiety, sleep disorders and acute stress reaction and adjustment disorders were the most commonly diagnosed conditions among both groups.

Spouses of deployed military personal naturally fear for their loved ones’ safety, Mansfield said. But they also often face challenges maintaining a household, coping as a single parent and dealing with the marital strain that comes with being apart for an uncertain amount of time.

“The majority of active duty soldiers are married, so we need to pay attention to the needs of their families, both short and long term,” Mansfield said. “These findings should help the military medical system better plan mental health programs not only for treatment, but also for support and prevention.”

Only about 8 percent of high school students get enough sleep on an average school night, a large new study finds. The others are living with borderline-to-serious sleep deficits that could lead to daytime drowsiness, depression, headaches and poor performance at school.

The study, which appears online in the Journal of Adolescent Health, evaluated responses from 12,000 students in grades 9 through 12 who participated in the 2007 national Youth Risk Behavior Survey.

The authors found that 10 percent of adolescents sleep only five hours and 23 percent sleep only six hours on an average school night. More females than males have sleep deficits as do more African-Americans and whites compared to Hispanics. Nearly 20 percent more 12th-grade students have sleep deficits than do those in ninth grade.

The findings of this study were consistent with those reported from the National Sleep Foundation’s 2006 Sleep in America Poll, the authors say, adding that that although no formally accepted sleep guidelines exist, the foundation defines nine hours a night as optimal for adolescents, eight hours as borderline and anything under eight hours as not enough.

“The natural sleep-wake pattern shifts during adolescence, making earlier bed time and wake times more difficult. The result for students with early school start-times is a chronic sleep deficit,” said lead study author Danice Eaton, Ph.D., of the Centers for Disease Control and Prevention.

As students progress through high school, demands on their time from hectic social activities, jobs, homework and family obligations increase and they sleep less to fit them in, as the study shows. Compounded with their delayed sleep-wake pattern, many students are getting up for school when their bodies tell them it is still the middle of the night.

National Sleep Foundation research shows that delaying school start-times by an hour or more increases the amount of sleep adolescents get and improves their performance in school. However, to promote optimal sleep, Eaton said that adolescents should have set bedtimes before 10 p.m. on school nights and consistent wake-sleep times every night.

Brandy Roane, an expert in adolescent sleep patterns at the Munroe-Meyer Institute of Genetics and Rehabilitation of the University of Nebraska Medical Center, said, “Given adolescents’ downward spiraling tendency of depriving themselves of sleep during the week and playing catch-up on the weekend, more research exploring ways to intervene would be beneficial.”

Adolescents and teens that get to bed at a “decent” time are far less likely to encounter depression or even having suicidal thoughts. In the study done at Columbia University Medical Center in New York, researchers found that children’s guardians who set bedtimes of midnight or later were 24% more likely to suffer from depression and 20% more apt to have thoughts of suicide then kids who went to bed 10:00pm or earlier .

Researchers report in the Jan. 1 issue of the journal SLEEP, that sufficient sleep may offer youngsters some protection from depression and thoughts of suicide. Researchers found that teens who stated they slept five or fewer hours per night were 71% more likely to report depression, and 48% more likely to have thoughts of committing suicide, compared to young people reporting eight hours of sleep. “Our results are consistent with the theory that inadequate sleep is a risk factor for depression,” says study researcher James E. Gangwisch, PhD.

Gangwisch and his colleagues studied more than 15,000 students and their parents at US schools from age 12 to 17. The normal sleep duration was seven hours and 53 minutes, against the nine or more hours of nightly sleep recommended for adolescents. Adolescents who went to bed at 10pm or earlier slept on average eight hours and ten minutes which is 33 minutes longer than those who went to bed at 11pm, and 40 minutes more than those who went to bed past midnight.

Gangwisch states, “Adequate quality sleep could therefore be a preventative measure against depression and a treatment for depression.” Of the parents questioned, 54 per cent of parents said their child had to go to bed by 10pm or earlier on weeknights, 21 per cent reported setting a bedtime of 11pm, and 25 per cent reported setting a bedtime of midnight or later.

Researchers believe that sleep deprivation is directly linked to depression and suicidal thoughts, leaving kids less able to cope with daily stress and with more difficulties in engaging with peers and adults. In addition, less sleep is more likely to make them moody.

The research backs up prior findings that demonstrated having trouble sleeping could lead to illnesses including psychiatric conditions, attention deficit disorder, post traumatic stress and depression. Some scientists suggest that a lack of sleep can cause fluctuations in hormones in the body, including those which relate to how we deal with stress. Researchers also think that dreaming about problems may help the body to process painful memories and promote good mental health.

Gangwisch and researchers conclude that parents of adolescents should set earlier bedtimes to make sure their teens get adequate sleep and avoid depression and thoughts of suicide.