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Study of Sleep in Older Adults Suggests Nixing Naps, Striving for 7-9 hours a Night

Laura Williamson wrote . . . . . . . . .

Napping, as well as sleeping too much or too little or having poor sleep patterns, appears to increase the risk for cardiovascular disease in older adults, new research shows.

The study, published Tuesday in the Journal of the American Heart Association, adds to a growing body of evidence supporting sleep’s importance to good health. The American Heart Association recently added sleep duration to its checklist of health and lifestyle factors for cardiovascular health, known as Life’s Essential 8. It says adults should average seven to nine hours of sleep a night.

“Good sleep behavior is essential to preserve cardiovascular health in middle-aged and older adults,” said lead author Weili Xu, a senior researcher at the Aging Research Center in the department of neurobiology, care sciences and society at the Karolinska Institute in Stockholm, Sweden. “We encourage people to keep nighttime sleeping between seven to nine hours and to avoid frequent or excessive napping.”

Prior research has shown poor sleep may put people at higher risk for a range of chronic illnesses and conditions affecting heart and brain health. These include cardiovascular disease, dementia, diabetes, high blood pressure and obesity. According to the Centers for Disease Control and Prevention, nearly 35% of U.S. adults say they get less than seven hours of sleep, while 3.6% say they get 10 or more hours.

Previous sleep duration studies show that sleeping too much or too little both may raise the risk for cardiovascular disease. But whether napping is good or bad has been unclear.

In the new study, researchers analyzed sleep patterns for 12,268 adults in the Swedish Twin Registry. Participants were an average of 70 years old at the start of the study, with no history of major cardiovascular events.

A questionnaire was used to collect data on nighttime sleep duration; daytime napping; daytime sleepiness; the degree to which they considered themselves a night person or morning person, based on the time of day they considered themselves most alert; and symptoms of sleep disorders, such as snoring and insomnia. Participants were followed for up to 18 years to track whether they developed any major cardiovascular problems, including heart disease and stroke.

People who reported sleeping between seven and nine hours each night were least likely to develop cardiovascular disease, a finding in keeping with prior research. Compared with that group, those who reported less than seven hours were 14% more likely to develop cardiovascular disease, and those who reported more than 10 hours were 10% more likely to develop cardiovascular disease.

Compared with people who said they never napped, those who reported napping up to 30 minutes were 11% more likely to develop cardiovascular disease. The risk increased by 23% if naps lasted longer than 30 minutes. Overall, those who reported poor sleep patterns or other sleep issues – including insomnia, heavy snoring, getting too much or too little sleep, frequent daytime sleepiness and considering themselves a night person – had a 22% higher risk

Study participants who reported less than seven hours of sleep at night and napping more than 30 minutes each day had the highest risk for cardiovascular disease – 47% higher than those reporting the optimal amount of sleep and no naps.

The jury is still out on whether naps affect cardiovascular risk across the lifespan, said Marie-Pierre St-Onge, center director for the Sleep Center of Excellence and an associate professor at Columbia University in New York City. She noted that the new research, which she was not involved in, was restricted to older adults.

Rather than trying to recoup sleep time by napping, people should try to develop healthier sleep habits that allow them to get an optimal amount of sleep at night, St-Onge said. This includes making sure the sleep environment is not too hot or cold or too noisy. Reducing exposure to bright light before going to sleep, not eating too late at night, getting enough exercise during the day and eating a healthful diet also help.

“Even if sleep is lost during the night, excessive napping is not suggested during the day,” Xu said. And, if people have persistent trouble getting enough sleep, they should consult a health care professional to figure out why, she said.


Source: American Heart Association

American Heart Association Adds Sleep to Cardiovascular Health Checklist

Sleep duration is now considered an essential component for ideal heart and brain health. Life’s Essential 8™ cardiovascular health score replaces Life’s Simple 7™, according to a new Presidential Advisory, Life’s Essential 8—Updating and Enhancing the American Heart Association’s Construct on Cardiovascular Health, published today in Circulation, the Association’s flagship, peer-reviewed journal.

Other updates to the measures of optimal cardiovascular health, now for anyone ages 2 and older, include a new guide to assess diet; accounting for exposure to secondhand smoke and vaping; using non-HDL cholesterol instead of total cholesterol to measure blood lipids; and expanding the blood sugar measure to include hemoglobin A1c, a key measure to assess Type 2 diabetes risk.

Cardiovascular disease is the number one cause of death in the U.S. and globally. According to the Association’s 2022 Heart Disease and Stroke Statistics Update, approximately 121.5 million people in the U.S. have high blood pressure, 100 million have obesity, more than 28 million people have Type 2 diabetes, and only 1 in 4 adults reported achieving the physical activity and exercise recommended in the U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans, 2nd edition. Various research studies over the past two decades indicate more than 80% of all cardiovascular events may be prevented by healthy lifestyle and management of known cardiovascular risk factors.

“The new metric of sleep duration reflects the latest research findings: sleep impacts overall health, and people who have healthier sleep patterns manage health factors such as weight, blood pressure or risk for Type 2 diabetes more effectively,” said American Heart Association President Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, who led the advisory writing group and is chair of the department of preventive medicine, the Eileen M. Foell Professor of Heart Research and professor of preventive medicine, medicine and pediatrics at Northwestern University’s Feinberg School of Medicine in Chicago. “In addition, advances in ways to measure sleep, such as with wearable devices, now offer people the ability to reliably and routinely monitor their sleep habits at home.”

The Association first defined the 7 metrics for cardiovascular health in 2010 to identify the specific health behaviors and health factors that drive optimal heart and brain health. Brain health in relation to cardiovascular health was defined in a 2017 American Heart Association Presidential Advisory. It was further acknowledged as an important component of optimal cardiovascular health in the Association’s January 2021 Scientific Statement on the mind-heart-body connection. Findings from both papers are incorporated into Life’s Essential 8™.

After 12 years and more than 2,400 scientific papers on the topic, new discoveries in heart and brain health and in the ways to measure cardiovascular health provided an opportunity to revisit each health component in more detail. Four of the original metrics have been redefined for consistency with newer clinical guidelines or compatibility with new measurement tools. Also, the scoring system can now be applied to anyone ages 2 and older.

The Life’s Essential 8™ components of optimal cardiovascular health are divided into two major areas – health behaviors and health factors. Health behaviors include diet, physical activity, nicotine exposure and sleep. Health factors are body mass index, cholesterol levels, blood sugar and blood pressure. “The idea of optimal cardiovascular health is important because it gives people positive goals to work toward at any stage of life,” said Lloyd-Jones.

“Life’s Simple 7™ has served as a proven, powerful tool for understanding how to achieve healthy aging and ways to improve cardiovascular health while decreasing the risks of developing heart disease and stroke, as well as cancer, dementia and many other chronic diseases,” he said. “Given the evolving research, it was important to address some limitations to the original metrics, particularly in ways they’ve been applied to people from diverse racial and ethnic populations.”

Lloyd-Jones explained that some of the previous metrics, such as diet, were not as sensitive to differences among people, or as responsive to changes over time within a single individual. “We felt it was the right time to conduct a comprehensive review of the latest research to refine the existing metrics and consider any new metrics that add value to assessing cardiovascular health for all people.”

Life’s Essential 8™ includes:

1. Diet (updated): A new guide to assess diet quality for adults and children at the individual level (for individual health care and dietary counseling) and at the population level (for research and public health purposes).

  • At the population level, dietary assessment is based on daily intake of elements in the Dietary Approaches to Stop Hypertension (DASH) eating pattern. The DASH-style diet score has eight components: high intake of fruits, vegetables, nuts and legumes, whole grains, low-fat dairy, and low intake of sodium, red and processed meats, and sweetened drinks.
  • For individuals, the Mediterranean Eating Pattern for Americans (MEPA) is used to assess and monitor cardiovascular health. The MEPA is a DASH-style eating pattern that can be measured with 16 yes or no questions about the weekly frequency of eating olive oil, vegetables, berries, meat, fish, dairy, grains, etc. The MEPA screener does not include consumption of sugar-sweetened beverages, so clinicians are encouraged to ask at the time of assessment.

2. Physical activity (no changes): Activity is measured by the total number of minutes of moderate or vigorous physical activity per week, as defined by the U.S. Physical Activity Guidelines for Americans, 2nd edition. The optimal level is 150 minutes of moderate physical activity or more per week or 75 minutes per week of vigorous-intensity physical activity for adults; 420 minutes or more per week for children ages 6 and older; and age-specific modifications for younger children.

3. Nicotine exposure (updated): Use of inhaled nicotine-delivery systems, which includes e-cigarettes or vaping devices, is added since the previous metric only monitored traditional, combustible cigarettes. This reflects use by adults and youth and their implications on long-term health. Life’s Essential 8™ also includes second-hand smoke exposure for children and adults.

4. Sleep duration (new): Sleep duration is associated with cardiovascular health. Measured by average hours of sleep per night, the ideal level is 7-9 hours daily for adults. Ideal daily sleep ranges for children are 10-16 hours per 24 hours for ages 5 and younger; 9-12 hours for ages 6-12 years; and 8-10 hours for ages 13-18 years.

5. Body mass index (no changes): The writing group acknowledges that body mass index (BMI) is an imperfect metric, yet it is easily calculated and widely available; therefore, BMI continues as a reasonable gauge to assess weight categories that may lead to health problems. BMI of 18.5–24.9 is associated with the highest levels of cardiovascular health. The writing group notes that BMI ranges and the subsequent health risks associated with them may differ among people from diverse racial or ethnic backgrounds or ancestry. This aligns with the World Health Organization’s recommendations to adjust BMI ranges for people of Asian or Pacific Islander ancestry because recent evidence indicates their risk of conditions such as CVD or Type 2 diabetes is higher at a lower BMI.

6. Blood lipids (updated): The metric for blood lipids (cholesterol and triglycerides) is updated to use non-HDL cholesterol as the preferred number to monitor, rather than total cholesterol. HDL is the “good” cholesterol. Other forms of cholesterol, when high, are linked to CVD risk. This shift is made because non-HDL cholesterol can be measured without fasting beforehand (thereby increasing its availability at any time of day and implementation at more appointments) and reliably calculated among all people.

7. Blood glucose (updated): This metric is expanded to include the option of hemoglobin A1c readings or blood glucose levels for people with or without Type 1 or Type 2 diabetes or prediabetes. Hemoglobin A1c can better reflect long-term glycemic control.

8. Blood pressure (no changes): Blood pressure criteria remain unchanged from the Association’s 2017 guidelines that established levels less than 120/80 mm Hg as optimal, and hypertension defined as 130-139 mm Hg systolic pressure (the top number in a reading) or 80-89 mm Hg diastolic pressure (bottom number).

Each component of Life’s Essential 8™, which is assessed by the My Life Check tool, has an updated scoring system ranging from 0 to 100 points. The overall cardiovascular health score from 0 to 100 points is the average of the scores for each of the 8 health measures. Overall scores below 50 indicate “poor” cardiovascular health, and 50-79 is considered “moderate” cardiovascular health. Scores of 80 and above indicate “high” cardiovascular health. The advisory recommends measuring cholesterol, blood sugar, blood pressure, height and weight at least every five years for the most complete and accurate Life’s Essential 8™ score.

The writing group also reviewed data about the impacts of stress, mental health and social determinants of health, such as access to health care, income or education level, and structural racism, which are critical to understanding the foundations of health, particularly among people from diverse racial and ethnic populations.

“We considered social determinants of health carefully in our update and determined more research is needed on these components to establish their measurement and inclusion in the future,” said Lloyd-Jones. “Nonetheless, social and structural determinants, as well as psychological health and well-being, are critical, foundational factors in an individual’s or a community’s opportunity to preserve and improve cardiovascular health. We must consider and address all of these issues for people to have the opportunity for a full, healthy life as measured by Life’s Essential 8™.”

“Life’s Essential 8™ is a major step forward in our ability to identify when cardiovascular health can be preserved and when it is sub-optimal. It should energize efforts to improve cardiovascular health for all people and at every life stage,” Lloyd-Jones concluded.


Source: American Heart Association

Tracking Sleep with a Self-powering Smart Pillow

The human body needs sleep as much as it needs food and water. Yet many people fail to get enough, causing both mind and body to suffer. People who struggle for shut-eye could benefit from monitoring their sleep, but they have limited options for doing so. In a new study in ACS Applied Materials & Interfaces, one team describes a potential solution: a self-powering smart pillow that tracks the position of the head.

Studies have linked chronic lack of sleep to physical ailments, such as diabetes and heart disease, as well as mental health issues. Those interested in getting a better handle on what’s happening to them at night have two primary options. They can take a sleep test conducted in a medical facility, or they can use an app through a smartphone or smart watch — a much more convenient, but less accurate choice. Recognizing the need, many groups have begun developing new sleep monitoring systems using triboelectric nanogenerators (TENGs). These self-powering systems have taken the form of eye masks, belts, patches and even bed sheets. Ding Li, Zhong Lin Wang and their colleagues wanted to adapt this approach to create a less restrictive, more comfortable version that focuses on the movement of the head during sleep.

To construct this new smart pillow, the researchers formulated a flexible, porous polymer triboelectric layer. Movement between the head and this layer changes the electric field around nearby electrodes, generating a current. They strung together several of these self-powering sensors to create a flexible and breathable TENG (FB-TENG) array that can be placed atop an ordinary pillow. This system could generate voltage that corresponded to the amount of applied pressure, and it could track the movement of a finger tracing out letters. The FB-TENG also could capture the pressure distribution of a fake human head as it shifted position. This smart pillow could have uses beyond tracking sleep, the researchers say. For example, the system could monitor patients with diseases that affect the movement of the head, such as the degenerative neck disorder cervical spondylosis. What’s more, the smart pillow could be adapted to offer an early warning system for those at risk of falling out of bed, they say.


Source: American Chemical Society

Enhancing Deep Sleep

Peter Rüegg wrote . . . . . . . . .

Many people, especially the elderly, suffer from abnormal sleep. In particular, the deep sleep phases become shorter and shallower with age. Deep sleep is important for the regeneration of the brain and memory, and also has a positive influence on the cardiovascular system.

Researchers have shown that the brain waves characterizing deep sleep, so-​called slow waves, can be improved by playing precisely timed sounds through earphones while sleeping. While this works well in the sleep laboratory under controlled conditions, there has thus far been no at home solution that can be used longer than just one night.

SleepLoop to the rescue

As part of the SleepLoop project (see box), researchers at ETH Zurich have developed a mobile system that can be used at home and aims to promote deep sleep through auditory brain stimulation.

The SleepLoop system consists of a headband that is put on at bedtime and worn throughout the night. This headband contains electrodes and a microchip that constantly measure the brain activity of the person sleeping. Data from this is analysed autonomously in real-​time on the microchip using custom software. As soon as the sleeping person shows slow waves in the brain activity characterising deep sleep, the system triggers a short auditory signal (clicking). This helps to synchronise the neuronal cells and enhance the slow waves. What makes the solution unique is that the person sleeping is not conciously aware of this sound during deep sleep.

The first clinical study

Researchers from ETH Zurich and University Hospital Zurich, led by Caroline Lustenberger, group leader at the Neural Control of Movement Lab, have conducted a clinical study with this device for the first time. The results have just been published in the journal Communications Medicinecall_made.

The study involved equipping participants, between 60 – 80 years old, with the SleepLoop system, which they were required to operate themselves in their own home. The system is designed to function independently even by users with little technical experience. “This worked very well. We had surprisingly little data loss and the participants rated the device as user-​friendly,” says Lustenberger.

Bonnet on before going to bed: The device is designed to be as easy to use as possible. (Photograph: SleepLoop)
They wore the device every night for a total of four weeks, with the auditory stimulation given on a nightly basis for two weeks and no stimulation for the next two weeks. Neither the subjects nor the researchers knew in which two weeks the auditory signals were played and in which two they were not.

Auditory stimulation is indeed feasible

The results of 16 participants of the study show that it was indeed possible to enhance the slow waves through auditory signals during deep sleep in most participants. However, the individual differences were extensive with some of the subjects responding very well to the stimuli, while others responded minimally or not at all.

According to Lustenberger, the question of whether a person reacted to a stimulus did not depend on their well-​being during the day. “Some people generally responded well to the stimuli and clearly showed enhanced slow waves, while others showed no response, regardless of their daily well-​being.”

The researchers have used these individual differences to better predict how a given individual will respond to the auditory stimulus. This in turn helps them to optimise and improve the performance of SleepLoop.

On track for market launch

A spin-​off company Tosoo AG, is currently working on developing the device further and preparing it for the clinical market. It is already clear that it will not be freely available, but only via a doctor’s prescription.

“This is a medical device, not just a wellness consumer product you can order online when you have trouble sleeping,” emphasises Walter Karlen, who developed the technology at ETH Zurich. 1 Karlen has been appointed Director of the Institute of Biomedical Engineering at Ulm University in May 2021. “Use of the device must be medically indicated and supervised by a doctor”, he says. Further development of the technology will now continue also in Ulm.


Source: Eidgenössische Technische Hochschule Zürich

Heart Disease and Sleepless Nights Often Go Together

Insomnia is widespread in heart disease patients and significantly boosts the risk of heart attack, stroke or other major heart event, a new study says.

The findings show the need to check for and treat sleep problems in heart disease patients, according to researchers.

“Our study indicates that insomnia is common in heart disease patients and is linked with subsequent cardiovascular problems regardless of risk factors, coexisting health conditions and symptoms of mental health,” said lead author Lars Frojd, a medical student at the University of Oslo in Norway.

The new study included more than 1,000 heart disease patients (average age: 62). They participated for an average 16 months after a heart attack and/or a procedure to open blocked arteries — either bypass surgery or stent implantation.

At the start, 45% said they had insomnia and 24% said had used sleep medication in the previous week.

During an average 4.2-year follow-up, 225 patients had 364 major heart events. They included hospitalization for heart attack, restoring blocked blood flow, stroke, heart failure and cardiovascular death.

Insomnia accounted for 16% of repeat heart events, ranking it third in importance after smoking (27%) and inactivity (21%), according to findings presented Thursday at a virtual meeting of the European Society of Cardiology. The study was also published in the journal Sleep Advances.

“This means that 16% of recurrent major adverse cardiovascular events might have been avoided if none of the participants had insomnia,” Frojd said in a meeting news release.

He noted more research is needed to learn whether insomnia treatments such as cognitive behavioral therapy and digital applications would help heart patients.


Source: HealthDay

Balance Between Sleep and Exercise May be Key to Help Osteoarthritis Patients Manage Pain

Noah Fromson wrote . . . . . . . . .

It may shoot through the hands while typing or flare in the knees when getting out of the car. Wherever the pain, over 32 million Americans living with osteoarthritis experience it.

To reduce that pain, patients living with the degenerative joint disease are often told to exercise.

It sounds simple.

But people with osteoarthritis may experience pain when they start to move more, which can be a deterrent to taking up, or sticking with, an exercise program.

“Pain during movement is an important reason why this population isn’t more active, and we need to identify ways we can help to change this,” said Daniel Whibley, Ph.D., research assistant professor of physical medicine and rehabilitation at Michigan Medicine. “Otherwise, they may end up in a loop of pain and inactivity that we know can lead to disability later down the line.”

A growing body of research suggests that maintaining good sleep health – specifically good quality sleep for an appropriate duration – in patients with osteoarthritis may reduce pain. There is also strong evidence supporting links between sleep and being physically active.

“If you’re sleeping well, you’re more likely to be able to move more the next day or stick with a planned exercise program,” Whibley said. “And those who are physically active during the day are more likely to get a good night’s sleep.”

Whibley’s team looked to develop a new intervention that brought together insights from previous research that supports these relationships.

“There are many different physical activity or exercise programs for people with osteoarthritis, but they spend relatively little time on sleep,” he said. “Conversely, some researchers have started to investigate the effectiveness of cognitive behavioral therapy, the process of rooting out problematic thoughts and changing cognitive patterns, for insomnia as a way of reducing osteoarthritis-related pain.”

What hasn’t been investigated is whether intensively and simultaneously targeting both sleep and physical activity – and the optimal balance between them – results in better pain outcomes. Alongside a team of researchers, Whibley introduced the concept of a hybrid sleep-exercise program to two focus groups composed of people living with osteoarthritis-related pain and sleep disturbances.

The sleep improvement component involves an automated program called Sleepio, which delivers cognitive-behavioral therapy for insomnia over the internet, as well as components focused on sleep education and behavioral modifications to sleep routines. In tandem with the six-week Sleepio course, users complete an exercise program with remote weekly support from a program coach.

During the focus groups, researchers explained the outline plan for the hybrid program and encouraged discussion between participants about how best to adapt design and delivery plans. These discussions informed the development of prototype materials which were then shared and refined with the same study participants at a second round of focus groups held a month later.

The findings, published in the British Journal of Pain and supported through Versus Arthritis and the Dan Barry Research Program, reveal that motivational language, personal accountability and accessible educational materials are important features to include in a successful program for sleep and exercise for osteoarthritis-related pain.

“The participants wanted to be encouraged to stick to the sleep and exercise components of the program using terms void of negative associations that made it seem like punishment,” Whibley said. “They also wanted to share records of activity with health care professionals without feeling like they have no power in the dynamic.”

These features, however, also present parallel challenges.

Previous negative interactions with health care providers – like feeling patronized or underestimated – and being asked to excessively record sleep and daily physical activity may cause people using the program to feel disinterested or discouraged, said Anna Kratz, Ph.D., a co-investigator on the study and associate professor of physical medicine and rehabilitation at Michigan Medicine.

“Developing an understanding of what factors may present barriers to engaging with the program was a primary reason to conduct the focus groups,” Kratz said. “In response to our findings, we were then able to create intervention materials that would be more attractive to potential users, including a workbook that supports adaptation of intervention content for the individual using it – they can set their own activity or sleep goals and keep track of their progress.”

A test of the program’s feasibility is currently underway with a small group of people living with osteoarthritis. Once complete, the team will conduct a full trial. The results, Whibley hopes, will provide more insight into the relationship between sleep, physical activity and exercise, and how their balance can impact pain in this population.

“People living with osteoarthritis want to improve their sleep, physical activity and exercise behavior and reduce their pain – all of these are valued outcomes,” Whibley said. “I’m not saying this new program will be a magic bullet for everyone, but I think the hybrid approach holds great potential for the future of osteoarthritis-related pain management.”


Source: University of Michigan

Insomnia Tied to Raised Risk of Brain Bleed

Amy Norton wrote . . . . . . . . .

Researchers may have unearthed a surprising risk factor for often-fatal brain bleeds: Sleepless nights.

In a study of about 70,000 adults, researchers found that people with a genetic predisposition to insomnia were at somewhat higher risk of a brain aneurysm. An aneurysm is a weak spot in an artery wall that bulges out and fills with blood. In some cases, it can rupture and cause life-threatening bleeding.

Brain aneurysms are seen in about 3% of adults worldwide, according to the American Heart Association (AHA). The vast majority do not rupture, but about 2.5% of them do.

About 25% of people who suffer those brain bleeds die within 24 hours, according to the U.S. National Institutes of Health.

It’s not always clear why people form brain aneurysms. However, family history, smoking and high blood pressure are the primary known risk factors, said Dr. Larry Goldstein, a volunteer expert with the AHA and chair of neurology at the University of Kentucky.

Goldstein, who was not involved in the new study, said it reinforces smoking and high blood pressure as key risk factors.

Both were linked to a threefold increase in the risk of brain aneurysm. Insomnia, meanwhile, was tied to a significantly smaller increase in risk, at 24%.

According to Goldstein, there is no obvious explanation for why chronic sleep loss would contribute to brain aneurysms.

“The association is a bit unexpected, because it has not been seen in other studies,” he said. “It needs to be verified by further research.”

Senior researcher Susanna Larsson agreed that more work is needed to understand what is going on.

“As this finding was novel, there is a need for studies exploring the potential mechanisms behind the association,” said Larsson, an associate professor at the Karolinska Institute, in Stockholm.

The study, published online in the Journal of the American Heart Association, used genetic data from a large population of European adults. They included over 10,000 people who either had a brain aneurysm or had suffered a ruptured aneurysm. The researchers compared them with over 59,000 people with no known brain aneurysms.

Overall, people who carried gene variants that raise the odds of high blood pressure, smoking or insomnia were all at greater risk of brain aneurysm, versus people without those genetic vulnerabilities.

It’s not known how many of those individuals actually had the conditions, Larsson noted, just that they were genetically predisposed.

Meanwhile, there was only “weak” evidence that genetic vulnerability to obesity, high triglycerides (blood fats) or physical inactivity were related to higher aneurysm risk.

The main take-away is that blood pressure control and smoking cessation are still the best ways to limit aneurysm risk, both Larsson and Goldstein said.

“If you smoke, stop,” Goldstein said. “And if you live with someone who smokes, get them to stop.”

Regular exercise and a healthy diet, along with medication when needed, will help reduce blood pressure. And all of those things together, Goldstein noted, will not only curb the risk of aneurysm, but a host of other, more common ills — including heart disease, kidney disease and many cancers.

Typically, people do not know they have a brain aneurysm unless it ruptures — the signs of which include a sudden, severe headache; double vision; and nausea.

But unruptured aneurysms are sometimes detected incidentally, Goldstein said, during brain imaging tests done for other reasons. In some other cases, the aneurysm causes symptoms — like pain behind the eye — that lead to its detection.

Risk factor control is especially critical for people with known aneurysms, Goldstein said. And depending on the individual circumstances, surgery may be recommended to reduce the risk of a rupture.

For now, it’s not clear that addressing insomnia would have any impact on aneurysm risk, Goldstein said. But the AHA says there is a link between poor sleep and high blood pressure, and that in general, treating sleep disorders may help with blood pressure control.


Source: HealthDay

Study: Too Little and Too Much Sleep Linked to Cognitive Decline

Tamara Bhandari wrote . . . . . . . . .

Like so many other good things in life, sleep is best in moderation. A multiyear study of older adults found that both short and long sleepers experienced greater cognitive decline than people who slept a moderate amount, even when the effects of early Alzheimer’s disease were taken into account. The study was led by researchers at Washington University School of Medicine in St. Louis.

Poor sleep and Alzheimer’s disease are both associated with cognitive decline, and separating out the effects of each has proven challenging. By tracking cognitive function in a large group of older adults over several years and analyzing it against levels of Alzheimer’s-related proteins and measures of brain activity during sleep, the researchers generated crucial data that help untangle the complicated relationship among sleep, Alzheimer’s and cognitive function. The findings could aid efforts to help keep people’s minds sharp as they age.

The findings are published in the journal Brain.

“It’s been challenging to determine how sleep and different stages of Alzheimer’s disease are related, but that’s what you need to know to start designing interventions,” said first author Brendan Lucey, MD, an associate professor of neurology and director of the Washington University Sleep Medicine Center. “Our study suggests that there is a middle range, or ‘sweet spot,’ for total sleep time where cognitive performance was stable over time. Short and long sleep times were associated with worse cognitive performance, perhaps due to insufficient sleep or poor sleep quality. An unanswered question is if we can intervene to improve sleep, such as increasing sleep time for short sleepers by an hour or so, would that have a positive effect on their cognitive performance so they no longer decline? We need more longitudinal data to answer this question.”

Alzheimer’s is the main cause of cognitive decline in older adults, contributing to about 70% of dementia cases. Poor sleep is a common symptom of the disease and a driving force that can accelerate the disease’s progression. Studies have shown that self-reported short and long sleepers are both more likely to perform poorly on cognitive tests, but such sleep studies typically do not include assessments of Alzheimer’s disease.

To tease apart the separate effects of sleep and Alzheimer’s disease on cognition, Lucey and colleagues turned to volunteers who participate in Alzheimer’s studies through the university’s Charles F. and Joanne Knight Alzheimer Disease Research Center. Such volunteers undergo annual clinical and cognitive assessments, and provide a blood sample to be tested for the high-risk Alzheimer’s genetic variant APOE4. For this study, the participants also provided samples of cerebrospinal fluid to measure levels of Alzheimer’s proteins, and each slept with a tiny electroencephalogram (EEG) monitor strapped to their foreheads for four to six nights to measure brain activity during sleep.

In total, the researchers obtained sleep and Alzheimer’s data on 100 participants whose cognitive function had been monitored for an average of 4 1/2 years. Most (88) had no cognitive impairments, 11 were very mildly impaired, and one had mild cognitive impairment. The average age was 75 at the time of the sleep study.

The researchers found a U-shaped relationship between sleep and cognitive decline. Overall, cognitive scores declined for the groups that slept less than 4.5 or more than 6.5 hours per night — as measured by EEG — while scores stayed stable for those in the middle of the range. EEG tends to yield estimates of sleep time that are about an hour shorter than self-reported sleep time, so the findings correspond to 5.5 to 7.5 hours of self-reported sleep, Lucey said.

The U-shaped relationship held true for measures of specific sleep phases, including rapid-eye movement (REM), or dreaming, sleep; and non-REM sleep. Moreover, the relationship held even after adjusting for factors that can affect both sleep and cognition, such as age, sex, levels of Alzheimer’s proteins, and the presence of APOE4.

“It was particularly interesting to see that not only those with short amounts of sleep but also those with long amounts of sleep had more cognitive decline,” said co-senior author David Holtzman, MD, a professor of neurology. “It suggests that sleep quality may be key, as opposed to simply total sleep.”

Each person’s sleep needs are unique, and people who wake up feeling rested on short or long sleep schedules should not feel compelled to change their habits, Lucey said. But those who are not sleeping well should be aware that sleep problems often can be treated.

“I ask many of my patients, ‘How’s your sleep?’” said co-senior author Beau M. Ances, MD, PhD, the Daniel J. Brennan, MD, Professor of Neurology. Ances treats patients with dementia and other neurodegenerative conditions at Barnes-Jewish Hospital. “Often patients report that they’re not sleeping well. Often once their sleep issues are treated, they may have improvements in cognition. Physicians who are seeing patients with cognitive complaints should ask them about their quality of sleep. This is potentially a modifiable factor.”


Source: Washington University School of Medicine

Does Listening to Calming Music at Bedtime Actually Help You Sleep?

A new study published in the Journal of the American Geriatrics Society has found that listening to music can help older adults sleep better.

Researchers from the National Cheng Kung University Hospital in Taiwan combined the results of past studies to understand the effect that listening to music can have on the quality of older adults’ sleep. Their work suggests that:

  • Older adults (ages 60 and up) living at home sleep better when they listen to music for 30 minutes to one hour at bedtime.
  • Calm music improves older adults’ sleep quality better than rhythmic music does.
  • Older adults should listen to music for more than four weeks to see the most benefit from listening to music.

Why Older Adults Have Trouble Getting a Good Night’s Sleep

As we age, our sleep cycles change and make a good night’s sleep harder to achieve. What does it really mean to get a good night’s sleep? If you wake up rested and ready to start your day, you probably slept deeply the night before. But if you’re tired during the day, need coffee to keep you going, or wake up several times during the night, you may not be getting the deep sleep you need. According to the National Institute on Aging, older adults need seven to nine hours of sleep each night.

But studies have shown that 40 to 70 percent of older adults have sleep problems and over 40 percent have insomnia, meaning they wake up often during the night or too early in the morning. Sleep problems can make you feel irritable and depressed, can cause memory problems, and can even lead to falls or accidents.

How the Researchers Studied the Effect of Music on Older Adults’ Quality of Sleep

For their study, the researchers searched for past studies that tested the effect of listening to music on older adults with sleep problems who live at home. They looked at five studies with 288 participants. Half of these people listened to music; the other half got the usual or no treatment for their sleep problems. People who were treated with music listened to either calming or rhythmic music for 30 minutes to one hour, over a period ranging from two days to three months. (Calming music has slow tempo of 60 to 80 beats per minute and a smooth melody, while rhythmic music is faster and louder.) All participants answered questions about how well they thought they were sleeping. Each participant ended up with a score between 0 and 21 for the quality of their sleep.

The researchers looked at the difference in average scores for:

  • people who listened to music compared to people who did not listen to music;
  • people who listened to calm music compared to people who listened to rhythmic music;
  • and people who listened to music for less than four weeks compared to people who listened to music for more than four weeks.

What the Researchers Learned

Listening to calming music at bedtime improved sleep quality in older adults, and calming music was much better at improving sleep quality than rhythmic music. The researchers said that calming music may improve sleep by slowing your heart rate and breathing, and lowering your blood pressure.[3] This, in turn helps lower your levels of stress and anxiety.

Researchers also learned that listening to music for longer than four weeks is better at improving sleep quality than listening to music for a shorter length of time.

Limits of the Study

  • Researchers only looked at studies published in English and Chinese, meaning they may have missed studies in other languages on the effect of listening to music on sleep in older adults.
  • Results may not apply to older adults with Alzheimer’s disease or Parkinson’s disease.
  • In the studies researchers used, people who listened to music received more attention from researchers than did people who got standard or no treatment for their sleep problems. This means that sleep improvements in the music therapy group could be due to that extra attention.
  • Since the different studies used different kinds of music, researchers could not single out which type of calming music improved sleep the most.
  • All of the people in the study had similar kinds of sleep problems. This means listening to music may not help people with other kinds of sleep problems.

What this Study Means for You

If you’re having trouble sleeping, listening to music can be a safe, effective, and easy way to help you fall and stay asleep. It may also reduce your need for medication to help you sleep.


Source: Health in Aging

Study: Music Can Speed Your Way to Sleep – Lullaby Effect

Cara Murez wrote . . . . . . . . .

Music hath charms to soothe you off to slumber, new research suggests.

The study found that calming tunes at bedtime seem to help older people struggling with insomnia.

“We found music therapy was effective for older adults with sleep disturbance,” said study co-author Yen-Chin Chen, an associate professor of nursing at National Cheng Kung University in Tainan, Taiwan.

That’s one of three takeaways from the study.

“Second, listening to sedative music is more effective than listening to rhythmic music,” Chen said. “And listening to music for longer than four weeks is more effective for older adults with sleep disturbance.”

Getting enough sleep can improve a person’s thinking and memory function, as well as energy levels, Chen said.

The findings were published online April 20 in the Journal of the American Geriatrics Society.

The study authors noted that adults aged 60 and up appear to sleep better when they listen to music for 30 minutes to an hour at a time, and that they see the greatest benefit by trying tunes for at least a month.

For the review, the researchers looked at five studies with 288 participants.

About half of the participants listened to bedtime music. The rest either had other treatments for their sleep problems or none at all. The research compared different treatments to music, and rhythmic music to calming music.

Listening to calming music, which has a slower tempo and smoother melody, resulted in better sleep, the investigators found. By slowing your heart rate and breathing, and lowering your blood pressure, calming music can lower your stress and anxiety, the researchers theorized.

Older adults need seven to nine hours of sleep each night, according to the U.S. National Institute on Aging.

About 40% to 70% of older adults have sleep problems, and about 40% experience insomnia, waking often during the night or too early in the morning, the study authors noted in the report.

Sleep problems can contribute to irritability and depression, cause memory problems, and lead to falls and accidents.

Dr. Alayne Markland, an associate professor of medicine in the division of gerontology, geriatrics, and palliative care at the University of Alabama, Birmingham, reviewed the findings.

“I think this is novel work,” she said, adding that more work remains, especially with older adults who have thinking and memory issues. The study did not include people with Alzheimer’s disease, Parkinson’s disease or other neurologic conditions.

“This could be a good thing to try — we just don’t have that data,” Markland said. Music could be a very effective sleep aid for some folks, as long as they don’t leave it on all night long, she added.

Sleep is an important driver of metabolism, activity levels, social interaction and mental health for seniors, so getting recommended amounts is important, Markland stressed.

It’s hard to say based on these findings alone who might be better suited to other strategies, such as cognitive behavioral therapy for insomnia (CBTI) with a trained professional, Markland said. CBTI can target behaviors around falling asleep and staying asleep.

According to a research summary from the American Geriatrics Society, one limitation of the study was that people who listened to music received more attention from researchers, which could be why their sleep improved. Also, all of the study participants had similar sleep problems, so this music strategy many not help folks who are struggling with sleep for other reasons.

Dr. Rafael Pelayo, a sleep specialist at Stanford Sleep Medicine Center in California, noted that most older people who are healthy don’t have any sleep issues at all. Some have poor sleep as a result of other medical conditions, he added.

For example, someone with cataracts may sleep poorly because less light goes into their eyes, which can influence their sleep-wake cycles, he explained. Menopause, depression, sleep apnea, thyroid issues or iron deficiency can also cause sleep issues.

And over time, poor sleep can become a habit, Pelayo pointed out.

People who experience chronic pain or post-traumatic stress disorder have particular sleep challenges, but there are tools to help with even those sleep issues, according to Pelayo.

“There are many reasons an older person may sleep poorly,” he said. “Having said that, most of the conditions will improve when addressed correctly.”

Pelayo sees the greatest potential for music as a sleep aid in those whose sleep issues are stress-related. The predictability of music can help these folks get into the right state of mind and promote serenity, he said.

“People should go to bed, feeling safe, comfortable and loved. That’s the state of mind you want to be in: safe, comfortable and loved,” Pelayo said. “That’s how our children sleep and that’s what we hope to provide our kids and you need to provide for yourself. If you go to bed thinking ‘How bad will it be tonight?’ that will make you sleep lighter.”


Source: HealthDay