Comments Off on Sleep-disordered breathing tied to greater preeclampsia risk
Women with high-risk pregnancies who experience sleep-disordered breathing have an increased risk for preeclampsia, according to a study published in the American Journal of Obstetrics & Gynecology.
The prospective observational cohort study involved women with high-risk singleton pregnancies, author Stella S. Daskalopoulou, MD, MSc, PhD, of the department of medicine’s division of internal medicine at McGill University Health Centre in Montreal, and colleagues reported in the study.
High-risk factors included age of at least 35 years, BMI of at least 25 kg/m2, chronic hypertension, pre-existing diabetes or renal disease, conception via in vitro fertilization and personal or first-degree relative family history of preeclampsia.
Of the 235 women recruited between 10 and 13 weeks of gestation at two tertiary obstetric clinics in Montreal, 181 women completed questionnaires about their sleep based on the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index and restless legs syndrome during each trimester.
Women identified with sleep disordered breathing (SDB), defined as three or more incidences of loud snoring or witnessed apneas each week, in the first or second trimester were diagnosed with mid-gestation SDB. Women identified with SDB in the third trimester were diagnosed with late-gestation SDB.
The researchers also conducted arterial stiffness, wave reflection and hemodynamic assessments between 10 and 13 weeks and again six more times at approximately 4-week intervals through the rest of the pregnancy.
Carotid-femoral pulse wave velocity (cfPWV), which is considered the gold standard for predicting arterial stiffness and is predictive of preeclampsia, and carotid-radial PWV were calculated to determine aortic and peripheral arterial stiffness, respectively.
According to the study, the 41 women (23%) who had SDB also had increased cfPWV across gestation independent of blood pressure and BMI (P = .042). Also, only women with SDB saw an association between excessive daytime sleepiness and increased cfPWV.
After 20 weeks’ gestation, women who had BP of at least 140 mm Hg/90 mm Hg were diagnosed with preeclampsia.
Women with mid-gestation SDB had an OR of 3.4 (95% CI, 0.9-12.9; P = .063) for preeclampsia, which increased to an OR of 5.7 (95% CI, 1.1-26; P = .028) for women who also experienced hypersomnolence. Women with late-gestation SDB had an OR of 8.2 (95% CI, 1.5-39.5; P = .009) for preeclampsia.
Additionally, the researchers reported a positive association between excessive daytime sleepiness and central arterial stiffness in women with SDB but not in women who did not have SDB. Women who reported SDB and excessive daytime sleepiness appeared to have a greater risk for preeclampsia than women with SDB alone as well.
However, women who had positive restless legs syndrome scores did not see increased odds for developing preeclampsia either in mid-gestation (OR = 1.23; 95% CI, 0.25-4.68) or late gestation (OR = 1.01; 95% CI, 0.21-3.75). The same held true for women who had positive Pittsburgh Sleep Quality Index scores in mid-gestation (OR = 2.11; 95% CI, 0.58-8.66) or late gestation (OR = 2.83; 95% CI, 0.65-19.81).
Overall, the researchers said, there was an association between SDB in the first or second trimester and greater central arterial stiffness starting at 10 to 13 weeks’ gestation for women with high-risk pregnancies.
Further, the researchers said, their results provide supporting evidence for arterial stiffness as an important mediator and promising surrogate endpoint for vascular dysfunction in preeclampsia, as well as for the need to screen for SDB throughout pregnancy.
Research on the exact cause of insomnia during menopause does not point to one clear cause. Several things may contribute to it, including:
Some evidence suggests that low hormone levels can increase the likelihood of insomnia during menopause.
According to the SWANTrusted Source, previous longitudinal studies have found a correlation between lower levels of estradiol and poorer sleep. This is especially true if the decline in hormones happens quickly, as it does after a person undergoes surgery to remove the ovaries.
Sometimes, insomnia happens during menopause because of hot flashes or night sweats. These symptoms can disrupt sleep, causing frequent waking.
Hot flashes cause a sudden sense of heat around the face and neck and often occur with sweating and a fast heartbeat.
Reduction in melatonin
Melatonin is a hormone that plays a key role in the sleep-wake cycle, helping keep people asleep. It is especially important at the start of sleep.
However, melatonin levels appear to decrease with age, which may cause sleep disturbances.
It is not clear whether there is a link between menopause and a decline in melatonin. Some evidenceTrusted Source suggests that there is and that individuals during postmenopause have less melatonin than those during premenopause.
For many people, menopause signals a major change. It is also a sign that a person is getting older. This, along with the symptoms of menopause, can have an impact on an individual’s mental health.
How long insomnia lasts during and after menopause depends on many factors. Every person who goes through menopause has a different experience. Some will find that the symptoms last longer than they do for others.
A person’s hormone levels can start to change 7–10 yearsTrusted Source before a person’s last period. After this point, people can continue to have symptoms such as hot flashes for several years.
Estradiol levels continue to decline for the first 1–6 years in early postmenopause, which may result in continued symptoms.
It is of note, however, that there are treatments and therapies available that can reduce sleep difficulties. It is also important to address any other factors that may be contributing to poor sleep quality.powered by Rubicon Project
The main treatment for menopause-related insomnia is hormone therapy. This works by replacing the lost hormones, which can improve many menopause symptoms. People may find that they sleep better and experience fewer hot flashes while using this treatment.
Hormone therapy is available in topical gels, creams, and patches. People can also take it internally via tablets or an implant.
Doctors typically prescribe SSRIs for mental health conditions, but these medications can also reduce the frequency of hot flashes, which may help with sleep. However, it is of note that insomnia can also occur as a side effect of SSRIs.
For those who are experiencing mood changes, anxiety, or depression, talk therapy may help them understand and cope with these feelings. Lessening the impact of mental health conditions may also benefit sleep.
Doctors rarely prescribe sleeping pills to treat insomnia, as these can have serious side effects. Many are also addictive and are not suitable for managing a long-term sleep problem.
According to a 2019 review, no study has found that herbal or dietary supplements consistently help with menopause symptoms. However, there are many other ways people can try to make sleep easier during menopause.
Below are some evidence-based approaches:
Avoiding caffeine, nicotine, and alcohol
Smoking, consuming caffeine, and drinking alcohol can all make it more difficult to sleep. While it may seem that alcohol makes people drowsy, even a small amount reduces overall sleep quality.
A person can try to reduce or avoid any of these, especially in the afternoon and evening.
Aromatherapy may be helpful in inducing relaxation and reducing hot flashes.
In a clinical trial involving 100 women, researchers found that after 12 weeks of lavender essential oil inhalation, the participants had 50% fewer hot flashes.
Other studies have also found that aromatherapy together with massage was more effective than massage or aromatherapy by themselves.
A 2019 review notes that there is evidence that hypnosis may reduce the frequency and severity of hot flashes by up to 50%.
Moreover, for people whose insomnia results from hot flashes, hypnosis may be a helpful complementary treatment.
Some studies have found that yoga has a beneficial impact on the psychological symptoms of menopause. If a person is having difficulty sleeping due to stress or anxiety, yoga practice may help reduce these symptoms.
However, the results of other studies on yoga have been mixed. This is partly because there are many styles of yoga and numerous ways of practicing, which may lead to inconsistent results.
If you’ve ever spent a night tossing and turning, you already know how you’ll feel the next day — tired, cranky, and out of sorts. But missing out on the recommended 7 to 9 hours of shut-eye nightly does more than make you feel groggy and grumpy.
The long-term effects of sleep deprivation are real.
It drains your mental abilities and puts your physical health at real risk. Science has linked poor slumber with a number of health problems, from weight gain to a weakened immune system.
Read on to learn the causes of sleep deprivation and exactly how it affects specific body functions and systems.
In a nutshell, sleep deprivation is caused by consistent lack of sleep or reduced quality of sleep. Getting less than 7 hours of sleep on a regular basis can eventually lead to health consequences that affect your entire body. This may also be caused by an underlying sleep disorder.
Your body needs sleep, just as it needs air and food to function at its best. During sleep, your body heals itself and restores its chemical balance. Your brain forges new thought connections and helps memory retention.
Without enough sleep, your brain and body systems won’t function normally. It can also dramatically lower your quality of life.
Your central nervous system is the main information highway of your body. Sleep is necessary to keep it functioning properly, but chronic insomnia can disrupt how your body usually sends and processes information.
During sleep, pathways form between nerve cells (neurons) in your brain that help you remember new information you’ve learned. Sleep deprivation leaves your brain exhausted, so it can’t perform its duties as well.
You may also find it more difficult to concentrate or learn new things. The signals your body sends may also be delayed, decreasing your coordination and increasing your risk for accidents.
Sleep deprivation also negatively affects your mental abilities and emotional state. You may feel more impatient or prone to mood swings. It can also compromise decision-making processes and creativity.
If sleep deprivation continues long enough, you could start having hallucinations — seeing or hearing things that aren’t really there. A lack of sleep can also trigger mania in people who have bipolar mood disorder. Other psychological risks include:
While you sleep, your immune system produces protective, infection-fighting substances like antibodies and cytokines. It uses these substances to combat foreign invaders such as bacteria and viruses.
Certain cytokines also help you to sleep, giving your immune system more efficiency to defend your body against illness.
Sleep deprivation prevents your immune system from building up its forces. If you don’t get enough sleep, your body may not be able to fend off invaders, and it may also take you longer to recover from illness.
The relationship between sleep and the respiratory system goes both ways. A nighttime breathing disorder called obstructive sleep apnea (OSA) can interrupt your sleep and lower sleep quality.
As you wake up throughout the night, this can cause sleep deprivation, which leaves you more vulnerable to respiratory infections like the common cold and flu. Sleep deprivation can also make existing respiratory diseases worse, such as chronic lung illness.
HEALTHLINE CHALLENGEBuild a routine for better sleep
Most of what affects your sleep happens when it’s still light. Learn healthy habits for superior shut-eye in our 12-day Clean Up Your Sleep Challenge.Enter your emailJOIN IN
Along with eating too much and not exercising, sleep deprivation is another risk factor for becoming overweight and obese. Sleep affects the levels of two hormones, leptin and ghrelin, which control feelings of hunger and fullness.
Leptin tells your brain that you’ve had enough to eat. Without enough sleep, your brain reduces leptin and raises ghrelin, which is an appetite stimulant. The flux of these hormones could explain nighttime snacking or why someone may overeat later in the night.
A lack of sleep can also make you feel too tired to exercise. Over time, reduced physical activity can make you gain weight because you’re not burning enough calories and not building muscle mass.
Sleep deprivation also causes your body to release less insulin after you eat. Insulin helps to reduce your blood sugar (glucose) level.
Sleep deprivation also lowers the body’s tolerance for glucose and is associated with insulin resistance. These disruptions can lead to diabetes mellitus and obesity.
Sleep affects processes that keep your heart and blood vessels healthy, including those that affect your blood sugar, blood pressure, and inflammation levels. It also plays a vital role in your body’s ability to heal and repair the blood vessels and heart.
People who don’t sleep enough are more likely to get cardiovascular disease. One analysis linked insomnia to an increased risk of heart attack and stroke.
Hormone production is dependent on your sleep. For testosterone production, you need at least 3 hours of uninterrupted sleep, which is about the time of your first R.E.M. episode. Waking up throughout the night could affect hormone production.
This interruption can also affect growth hormone production, especially in children and adolescents. These hormones help the body build muscle mass and repair cells and tissues, in addition to other growth functions.
The pituitary gland releases growth hormone throughout each day, but adequate sleep and exercise also help the release of this hormone.
The most basic form of sleep deprivation treatment is getting an adequate amount of sleep, typically 7 to 9 hours each night.
This is often easier said than done, especially if you’ve been deprived of precious shut-eye for several weeks or longer. After this point, you may need help from your doctor or a sleep specialist who, if needed, can diagnose and treat a possible sleep disorder.
Sleep disorders may make it difficult to get quality sleep at night. They may also increase your risk for the above effects of sleep deprivation on the body.
The following are some of the most common types of sleep disorders:
To diagnose these conditions, your doctor may order a sleep study. This is traditionally conducted at a formal sleep center, but now there are options to measure your sleep quality at home, too.
If you’re diagnosed with a sleep disorder, you may be given medication or a device to keep your airway open at night (in the case of obstructive sleep apnea) to help combat the disorder so you can get a better night’s sleep on a regular basis.
The best way to prevent sleep deprivation is to make sure you get adequate sleep. Follow the recommended guidelines for your age group, which is 7 to 9 hours for most adults ages 18 to 64.
Other ways you can get back on track with a healthy sleep schedule include:
limiting daytime naps (or avoiding them altogether)
refraining from caffeine past noon or at least a few hours prior to bedtime
going to bed at the same time each night
waking up at the same time every morning
sticking to your bedtime schedule during weekends and holidays
spending an hour before bed doing relaxing activities, such as reading, meditating, or taking a bath
avoiding heavy meals within a few hours before bedtime
refraining from using electronic devices right before bed
exercising regularly, but not in the evening hours close to bedtime
reducing alcohol intake
If you continue to have problems sleeping at night and are fighting daytime fatigue, talk to your doctor. They can test for underlying health conditions that might be getting in the way of your sleep schedule.
It’s no secret that sleep is essential for a number of our body’s functions—from cellular repair to muscle growth and, of course, brain health. And one study published in the journal Nature Communications just put forward some new evidence on the link between sleep duration and dementia risk in middle-aged adults. Here’s what it found.
Studying the connection between dementia and sleep.
This research analyzed existing data from a long-term study on nearly 8,000 British people since 1985, conducted by University College London. As part of the research project, participants reported how long they slept multiple times over 25 years. Some of them also wore sleep-tracking devices to make sure they were giving accurate numbers on their sleep duration.
A team of researchers then looked for any correlation between poor sleep and a greater risk for dementia down the line.
Researchers have long suspected that there is a link between sleep and dementia risk, but they’ve been unsure where that link begins. That is, we don’t know if a lack of sleep can predispose people to dementia or if dementia throws off people’s sleep.
The important thing about this study is that it started following the sleep patterns of people who were in their 50s, presumably before dementia had set in.
What they found.
Sure enough, a correlation was found—though the study authors are careful to note their research still can’t prove a direct cause-and-effect relationship between sleep and dementia.
That said, within the group of almost 8,000 participants, researchers found that middle-aged adults who consistently clocked low sleep durations were 30% more likely to develop dementia—regardless of sociodemographic, behavioral, cardiometabolic, and mental health factors.
The study authors considered seven hours to be a normal sleep duration, compared to six hours or less, which was considered short.
While the jury is still out on whether this connection is a direct cause-and-effect, it’s certainly a good reason to consider getting at least seven hours of sleep per night, particularly if you’re in your 50s or 60s and/or have a history of dementia in your family.
The study authors note that more research is needed to better understand the relationship between sleep and dementia risk, but given how important sleep is for so many bodily functions, there’s really no reason not to aim for a full night of quality sleep, every night.
Insomnia, disrupted sleep, and daily burnout are linked to a heightened risk of not only becoming infected with coronavirus, but also having more severe disease and a longer recovery period, suggests an international study of healthcare workers, published in the online journal BMJ Nutrition Prevention & Health.
Every 1-hour increase in the amount of time spent asleep at night was associated with 12% lower odds of becoming infected with COVID-19, the findings indicate.
Disrupted/insufficient sleep and work burnout have been linked to a heightened risk of viral and bacterial infections, but it’s not clear if these are also risk factors for COVID-19, say the researchers.
To explore this further, they drew on the responses to an online survey for healthcare workers repeatedly exposed to patients with COVID-19 infection, such as those working in emergency or intensive care, and so at heightened risk of becoming infected themselves.
The survey ran from 17 July to 25 September 2020, and was open to healthcare workers in France, Germany, Italy, Spain, the UK, and the USA.
Respondents provided personal details on lifestyle, health, and use of prescription meds and dietary supplements plus information on the amount of sleep they got at night and in daytime naps over the preceding year; any sleep problems; burnout from work; and workplace exposure to COVID-19 infection.
Some 2884 healthcare workers responded, 568 of whom had COVID-19, ascertained either by self-reported diagnostic symptoms and/or a positive swab test result.
Infection severity was defined as: very mild – no or hardly any symptoms; mild – fever with or without cough, requiring no treatment; moderate – fever, respiratory symptoms and/or pneumonia; severe – breathing difficulties and low oxygen saturation; and critical – respiratory failure requiring mechanical assistance and intensive care.
The amount of reported nightly sleep averaged under 7 hours, but more than 6. After accounting for potentially influential factors, every extra hour of sleep at night was associated with 12% lower odds of COVID-19 infection.
But an extra hour acquired in daytime napping was associated with 6% higher odds, although this association varied by country.
Around 1 in 4 (137;24%) of those with COVID-19 reported difficulties sleeping at night compared with around 1 in 5 (21%;495) of those without the infection.
And 1 in 20 (5%;28) of those with COVID-19 said they had 3 or more sleep problems, including difficulties falling asleep, staying asleep, or needing to use sleeping pills on 3 or more nights of the week, compared with 65 (3%) of those without the infection.
Compared with those who had no sleep problems, those with three had 88% greater odds of COVID-19 infection.
Proportionally more of those with COVID-19 reported daily burnout than did those without the infection: 31 (5.5%) compared with 71 (3%).
Compared with those who didn’t report any burnout, those for whom this was a daily occurrence were more than twice as likely to have COVID-19. Similarly, these respondents were also around 3 times as likely to say that their infection was severe and that they needed a longer recovery period.
These findings held true, irrespective of the frequency of COVID-19 workplace exposure.
This is an observational study, and as such, can’t establish cause. And the researchers acknowledge several limitations to their study.
These include subjective assessment of exposure levels, sleep issues, and infection severity, all of which may have been incorrectly remembered. And the sample included only cases of very mild to moderately severe COVID-19.
By way of an explanation for their findings, the researchers note: “The mechanism underlying these associations remains unclear, but it has been hypothesized that lack of sleep and sleep disorders may adversely influence the immune system by increasing proinflammatory cytokines and histamines.”
And they point to studies linking burnout to a heightened risk of colds and flu as well as long term conditions, such as diabetes, cardiovascular disease, musculoskeletal disease and death from all causes.
“These studies have suggested that burnout may directly or indirectly predict illnesses by occupational stress impairing the immune system and changing cortisol levels,” they write.
And they conclude:”We found that lack of sleep at night, severe sleep problems and high level of burnout may be risk factors for COVID-19 in frontline [healthcare workers]. Our results highlight the importance of healthcare professionals’ well-being during the pandemic.”
CELEBRATE WORLD SLEEP DAY® ON MARCH 13 TO ADVANCE SLEEP HEALTH WORLDWIDE
ROCHESTER, MN – January 2, 2020—World Sleep Society is issuing a global call to action about the importance of healthy sleep. Friday, March 13, 2020 is the 13th annual World Sleep Day®. Created and hosted by World Sleep Society, World Sleep Day is an internationally recognized awareness event bringing researchers, health professionals and patients together to recognize sleep and its important impact on our health.
World Sleep Day 2020 will incorporate the slogan, ‘Better Sleep, Bette Life, Better Planet,’ highlighting sleep’s important place as a pillar of health, allowing for better decision making and cognitive understanding in even big issues, such as our planet. This focus is purposefully broad in meaning, surrounding the message that quality of life can be improved with healthy sleep. Conversely, when sleep fails, health declines, decreasing quality of life. Sound sleep is a treasured function. World Sleep Society has compiled ten tips for healthier sleep. These recommendations for children and adults can be viewed on worldsleepday.org under resources.
Phyllis C. Zee, MD, PhD, Professor of Neurology and Director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine goes on to suggest, “Actions we can take include prioritizing sleep with exercise and nutrition, maintaining regular sleep and wake timing, averaging 7-9 hours of sleep duration and if suffering from a chronic sleep disturbance, by discussing sleep with your doctor.” Over the past decade, there have been major advances in our understanding of neural mechanisms, linking the important relationship between sleep and cognitive health. Mounting evidence indicates that sleep is an active process in which recently-encoded memories are consolidated and transferred for long-term storage. Dr. Zee adds, “Sleep enhances the ability to remove waste products from the brain—which can harm brain function.”
Professor Fang Han, MD of The Sleep Center, Peking University People’s Hospital in Beijing, China states, “Sleep is important for one’s cognitive health. Sleep can restore your brain function in many aspects, such as learning, memory, and mood.” Sleep disorders may cause impairment of a person’s oxygen supply, disturb your immunological system, or damage your brain structure. Dr. Han states, “World Sleep Day is an opportunity to be aware, sleep regularly, sleep enough, and treat sleep disorders.”
CALL TO ACTION
To participate in World Sleep Day,
Organizing an event to create excitement and generate
interest in World Sleep Day.
Circulating the official press release with sleep experts
and local media.
Distributing sleep patient literature such as booklets,
leaflets and newsletters.
Finding other ideas at worldsleepday.org.
Spreading the word on social media about #WorldSleepDay.
The 13th Annual World Sleep Day has partnered with Arianna Huffington’s Thrive Global and AmLife. More sponsors will be included before March.
Arianna Huffington, founder and CEO of Thrive Global says, “Sleep is central to every aspect of our well-being—our physical health, our mental health, our productivity and our decision-making. Our world is facing huge crises on multiple fronts, and we need all the resilience, wisdom and sound decision-making we can muster. We can’t take care of our world if we don’t take care of ourselves—and that begins with sleep.”
Mr. Lew Mun Yee, the founder of AmLife states, “AmLife is fully devoted in the noble mission of World Sleep Society in advocating better-quality sleep in mankind. AmLife proudly joins the call for Better Sleep, Better Life, Better Planet, this year’s World Sleep Day theme. AmLife’s new tagline—Life. Redefined.—dovetails the 2020 theme. With better quality of sleep, life certainly can be redefined.”
World Sleep Day is organized by World Sleep Society, an international association whose mission is to advance sleep health worldwide. WorldSleep Society hosts a biennial scientific congress on sleep medicine aiming to globally connect sleep professionals and researchers to advance current knowledge on sleep. A job board has also been created for sleep medicine professionals on http://www.worldsleepsociety.org. Follow the excitement on Twitter @_WorldSleep and facebook.com/WASMF.
About AmLife International
AmLife established its sleep healthcare business to help consumers achieve optimal health in their daily sleep as well as enjoy the wonderful health lifting and recuperative effects of its products. AmLife has pioneered the combination of bedding equipment and Japan’s state-of-the-art technology to expand the unlimited potential of the sleep healthcare market, providing a brand-new health solution for modern-day people, which they can use every day.