Comments Off on Recent studies show how a migraine can be predicted.
by SadofNE
Sleep quality and energy levels are two of the biggest indicators of an impending migraine attack, the study showed. Get inspired by a weekly roundup on living well, made simple.
Wouldn’t it be helpful to have a sense of when a debilitating migraine may be on the way?
You may be able to do so, a new study has shown.
“The major finding from this study was that changes in sleep quality and energy on the prior day were related to incident headache in the next day,” said Dr. Kathleen Merikangas, principal investigator of the study that published Wednesday in the journal Neurology.
Migraines are nothing to shake your head at, and they certainly aren’t just nuisance headaches. Chronic migraines are the leading cause of disability in people younger than 50, according to a February 2018 study.
The study team found that sleep quality and energy were important indicators of a migraine attack on the following day.
Those who had bad sleep quality and low energy one day were more likely to have migraines the next morning, the data showed. An increase in energy and greater-than-average stress usually foretold a migraine would appear later the next day.
“It’s a very exciting study because of how well done and how detailed and how large it is,” said Dr. Stewart Tepper, vice president of the New England Institute for Neurology and Headache in Stamford, Connecticut. Tepper was not involved in the research.
The differences point to the importance of your circadian rhythm — which regulates your cycles of sleep and wakefulness — in how headaches manifest. The findings may inform the treatment and prevention of migraine attacks.
Migraine prevention
Knowing when a migraine is coming can make all the difference — especially with growing interest in treating one before it starts, Tepper said.
“If we can identify things in the environment that people can change, then we’d like to be able to prevent the attack in the first place,” Merikangas said. “If we can do that with behavioral interventions … then they may be able to prevent it by either going to sleep to offset it or some other intervention that would prevent us from having to use medication to prevent the attack.”
Tepper, however, said he is not so sure if changes in behavior can always prevent a migraine attack.
A migraine attack isn’t just a headache. And warning signs such as fatigue, neck pain and sleep disturbance may be early symptoms of an attack — not only a trigger of one, he added.
Instead, Tepper advises intervening with medication before the head pain starts in hopes of warding off any pain at all.
How much is too much?
It makes sense that people might be conservative about using medication for migraine pain, Tepper said.
An older class of medications, called triptans, was associated with more migraines and a resulting chronic migraine conditionif used more than 10 days in a month, he said.
But a newer option, rimegepant — sold as Nurtec — doesn’t seem to carry the same risk.
“There’s no downside because rimegepant has almost no side effects and is not associated with transformation into chronic migraine,” Tepper said.
What you can do about migraines
Your doctor can recommend pain medication to address your migraines, but it also helps to know the signs of an upcoming attack, Tepper said.
As well as monitoring sleep, exercise and diet, Merikangas suggests finding a way to monitor stress to be able to track the indicators of a migraine.
There are five typical signs of an oncoming migraine headache, Tepper said. Those are sensitivity to light, fatigue, neck pain, and sensitivity to noise and dizziness, he said.
Cognitive behavioral therapy is often useful to help manage the stress that can trigger migraine attacks. What’s more, taking vitamins and supplements, such as magnesium and riboflavin, can be effective in reducing migraine frequency, Kylie Petrarca, a nurse and education program director at the Association of Migraine Disorders, said in a previous CNN article.
It isn’t just about avoiding the pain, Merikangas said.
“It’s really important to think of the full context of our health,” she said. “By being able to characterize not just headaches, but also all these other systems, we might be able then to get a handle on causes of negative health events.”
Dementia is also associated with abnormalities in the brain’s white matter that are hallmarks or markers of cerebrovascular diseases.
A recent observational study shows that severe obstructive sleep apnea and reduced deep sleep were independently associated with white matter abnormalities related to cerebrovascular diseases in cognitively unimpaired older adults.
These findings show that severe obstructive sleep apnea and poor sleep quality can lead to an increase in the biomarkers of cerebrovascular disease, potentially increasing the risk of cognitive decline and stroke.
Obstructive sleep apnea is the most common type of sleep-breathing disorder that affects nearly a billionTrusted Source individuals across the globe.
A recent study published in Neurology suggests that obstructive sleep apnea and a reduction in deep sleep, also known as slow-wave sleep, were independently associated with an increase in white matter abnormalities in the brain.
The white matter abnormalities assessed in the study are known markers of cerebrovascular disease and are also observed in mild cognitive impairment and Alzheimer’s disease.
The findings from this observational study thus suggest that obstructive sleep apnea and poor sleep quality could potentially lead to increased white matter abnormalities, subsequently increasing the risk of dementia and stroke.
The study’s author Dr. Diego Carvalho, a neurologist at the Mayo Clinic in Rochester, MN, told Medical News Today:
“White matter abnormalities increase with aging and may contribute to cognitive decline, dementia, and stroke. Since there is no treatment to reverse or slow them down other than risk factor prevention, it is important to understand what may contribute to their development.”
“In our study, we found that severe sleep apnea and decreased deep sleep were associated with more white matter abnormalities. Although we cannot infer a direct causal relationship with a cross-sectional study design, the findings raise the possibility that sleep interventions may prevent the progression of white matter disease. Although there is already compelling evidence that sleep apnea is involved in white matter abnormalities, the potential role of slow-wave sleep (or deep sleep) in white matter health is much less understood,” added Dr. Carvalho.
Obstructive sleep apneaTrusted Source is a sleep-breathing disorder characterized by episodes of interruption of breathing due to partial or complete blockage of the upper airway. The episodes of reduced breathing are known as hypopnea, whereas apnea refers to events involving a complete blockage of the upper airway.
The apnea-hypopnea index (AHI) describes the number of apnea and hypopnea events per hour. Specifically, obstructive sleep apnea involves at least five such episodes of apnea or hypopnea per hour.
The interruption of breathing triggers a compensatory response that leads to arousal from sleep. Thus, obstructive sleep apnea leads to sleep disturbances and an experience of feeling unrefreshed after sleep.
Several studies have shown that poor sleep quality is associated with an increased risk of cognitive decline and dementia.
The accumulation of misfolded deposits of the amyloid-beta and tau proteins is a hallmark of Alzheimer’s disease. A previous study showed a higher accumulation of the amyloid-beta protein in the brains of individuals experiencing excessive daytime sleepiness.
In contrast, a brain imaging studyTrusted Source showed that cognitively unimpaired individuals with higher tau levels in their brains were at an increased risk of obstructive sleep apnea.
These studies suggest a bidirectional relationship between sleep quality and pathological changes associated with Alzheimer’s disease.
In addition to the accumulation of misfolded proteins, individuals with dementia also show damage to neurons.
The brain tissue can be categorized into white matter and gray matter. The gray matter consists of the cell bodies of neurons, whereas the white matter consists of axons that transmit information.
Several of the axonal processes in the white matter are encased in an insulating layer called the myelin sheath. The myelin sheath gives white matter its color and allows the axons to conduct electrical impulses more rapidly and efficiently.
Individuals with dementia and mild cognitive impairment show abnormalities in the white matter. Some of these white matter abnormalities, such as white matter hyperintensitiesTrusted Source and a decline in the integrity of the white matter tract, are also markers for cerebrovascular diseases, which are diseases of the blood vessels in the brain.
White matter hyperintensities are hyperintense regions identified using MRI that represent lesions of white matter generally caused by cerebral small vessel disease.
The integrity of the white matter tract is measured in terms of fractional anisotropy using a technique called diffusion tensor imaging. These white matter abnormalities due to damage to blood vessels may contribute to cognitive decline.
Sleep disorders such as obstructive sleep apnea are also associatedTrusted Source with increased risk of cerebrovascular diseases. Thus, sleep disorders could potentially lead to cerebrovascular disease-related white matter abnormalities and increase the risk of dementia.
For instance, there is evidence from the authors’ own work showing that individuals with daytime sleepiness have elevated levels of the neurofilament light chain protein in their blood, though research evidence is contradictoryTrusted Source.
The neurofilament light chain protein is a protein associated with the myelin sheath covering the axons of neurons. Thus, elevated neurofilament light chain protein levels suggest damage to myelinated axons and, thus, white matter damage.
In the present study, the researchers examined the association between sleep quality, including the presence of obstructive sleep apnea, with white matter abnormalities in the brain of cognitively unimpaired individuals.
The new study consisted of 140 individuals participating in the Mayo Clinic Study of Aging (MCSA), a population-based cohort study that aims to characterize the prevalence and risk factors associated with mild cognitive impairment and dementia.
The study included individuals who had previously undergone a brain MRI scan and at least one polysomnography test as a part of the MCSA study.
A polysomnographic study is a sleep study that assesses multiple parameters associated with sleep, including brain waves, breathing and heart rate, and blood oxygen levels. The average duration between the brain MRI scan and the polysomnography test was 1.74 years.
The researchers aimed to only include participants who were cognitively unimpaired at the time of both the MRI and the polysomnography test. The study consisted of 90.7% of the participants who were cognitively unimpaired at the time of both assessments.
Only participants with obstructive sleep apnea were included in the study. These participants were categorized as having either mild, moderate, or severe obstructive sleep apnea on the basis of the number of episodes of apnea and hypopnea per hour.
The researchers first examined the association between sleep patterns and white matter abnormalities. Sleep can be dividedTrusted Source into the non-rapid eye movement (NREM) and rapid eye movement (REM) phases.
Furthermore, the NREM phase can be further subdivided into N1-N3 phases, with the N1 being the lightest sleep phase and N3 involving deep sleep. These phases show differences in their patterns of brain waves, eye movements, and muscle tone.
Using brain waves collected during polysomnography, the researchers found that a lower fraction of time spent in the N3 phase or slow wave sleep was associated with elevated levels of white matter damage.
This association was present after accounting for variables such as age, sex, genetic risk of Alzheimer’s disease, and cardiovascular risk factors.
In a separate analysis, the researchers looked at the association between obstructive sleep apnea severity and markers of white matter damage. They categorized patients as either having severe or mild-to-moderate obstructive sleep apnea and matched individuals from the two groups for age, sex, and N3 sleep levels for this analysis.
Individuals with severe obstructive sleep apnea showed higher white matter abnormalities than those with mild-to-moderate.
Individuals in the two groups did not show differences in cardiometabolic risk factors, but the individuals with severe obstructive sleep apnea showed higher arousal levels. This indicates the fragmentation of sleep in individuals with severe obstructive sleep apnea.
Dr. Sandra Narayanan, a board-certified vascular neurologist and neuro-interventional surgeon at Pacific Stroke & Neurovascular Center at Pacific Neuroscience Institute in Santa Monica, CA, not involved in the research told us that these findings show that, while obstructive sleep apnea is associated with cardiovascular disease, it could independently increase the risk of cerebrovascular diseases.
Dr. Narayanan said: “[Obstructive sleep apnea] is an important vascular comorbidity, as it is significantly associated with an increased risk of hypertension, cardiovascular disease, and stroke. This study demonstrates a separate association of OSA with imaging biomarkers of cerebrovascular disease.”
Some of the previous studies showing a link between sleep quality and white matter abnormalities have not controlled for cardiometabolic risk factors. These cardiometabolic factors can increase the risk of cerebrovascular conditions, such as stroke, thus potentially biasing the results.
One of the strengths of the present study was that the researchers controlled for cardiometabolic risk factors.
The authors acknowledged that their study had a few limitations. They noted that they only collected sleep data during the initial few hours of sleep.
This could have biased the data on sleep patterns. For instance, the period of REM sleep tends to increase during the night, whereas the duration of deep sleep tends to decline.
Dr. Narayanan noted: “While the imaging biomarkers of CVD noted in this study were not independently linked during the course of this study to the development of incident stroke, the presence of white matter hyperintensities is strongly associated with cognitive impairment, stroke, and death in numerous other studies.”
“Fractional anisotropy (FA) is a marker of white matter integrity, as noted in diffusion tensor imaging (DTI),“ she explained. “Decreased FA is associated with other neurodegenerative disorders such as Alzheimer’s dementia and Parkinson’s disease, but has a poor prognostic value for motor recovery following stroke.”
The authors also noted that the study had an observational design, and further studies are needed to show that obstructive sleep apnea and reduced slow-wave sleep can cause an increase in the biomarker of cerebrovascular disease.
Comments Off on From Caffeine to Screens: Everyday Habits That Might Be Ruining Your Sleep
by SadofNE
A peaceful night’s sleep often remains an elusive dream for many, with daily habits being significant culprits. The subtle interplay of what we consume, our digital indulgence, and even our bedtime activities can significantly influence the quality of our slumber.
What Habits Could Ruin Your Sleep?
Take caffeine, for example. Renowned as a morning pick-me-up, caffeine does more than just jolt you awake. Research suggests that caffeine can linger in your system for 3 to 5 hours, potentially disrupting the sleep cycle. To circumvent this, consider wrapping up your caffeine consumption by early afternoon. If you’re hankering for a warm drink later on, herbal tea, notably devoid of caffeine, could be your go-to.
Then there’s the omnipresent screen. The blue light emitted from our beloved devices is notorious for meddling with our melatonin production, a hormone pivotal for sleep. Frequent screen interaction, particularly in the twilight hours, could spell sleep trouble. Employing blue light filters on gadgets or designating the hour before bed as screen-free could pave the way for better rest.
Late-night munching, though seemingly harmless, brings its set of sleep challenges. Certain foods, notably those rich in spice or acid, can potentially disrupt sleep. In case of late-night hunger pangs, foods like bananas or almonds, known to promote sleep, might be apt choices.
But Wait, There’s More
Alcohol, contrary to popular belief, isn’t the sleep ally it’s made out to be. While it might propel you into slumber initially, it notably compromises sleep quality, especially the NREM and REM phase, vital for memory and mood regulation. Moderating alcohol intake or consuming it well before bedtime could better your sleep odds.
Engaging in rigorous physical activity late in the evening or succumbing to stress-laden thoughts can keep sleep at bay. The adrenaline surge post an intense workout can push sleep away, while stress can send the mind into an overdrive. Positioning workouts earlier in the day and carving out pre-bed relaxation routines can be beneficial.
Lastly, the ambiance of your sleep quarters wields considerable influence. Studies emphasize the correlation between optimal room temperature and enhanced sleep quality. Moreover, noise can disturb sleep, impeding its depth and quality. Fine-tuning room temperature and possibly integrating tools like white noise machines can make a tangible difference.
Better Habits is Better Sleep
In sum, our day-to-day habits silently script our sleep narrative. Tweaking these can be a step towards improved sleep and, by extension, heightened well-being. For those keen on further sleep enhancement, exploring specialized sleep solutions or engaging with experts can provide tailored recommendations.
The American Academy of Pediatrics is warning parents and caregivers that excessive exposure to loud noises can be detrimental to children, and sound machines can cause more harm to children than previously thought.
In a statement released Saturday, the AAP said: “What families may not realize is that children are exposed to potentially harmful noise from infancy and that the effects are cumulative over a lifetime.”
ABC News medical correspondent Dr. Darien Sutton told “Good Morning America” that millions of children are at risk of some form of hearing loss.
“One of the reasons why is because children have smaller ear canals. That exposes them to intensification of that higher frequency sound and [makes] them at risk for damage,” Sutton explained.
According to one study published in BMJ Global Health in 2022, more than 1 billion young people are at risk of hearing loss around the world due to unsafe high listening volumes. The AAP cited another study that estimated 60% of adolescents listened to music and audio that was greater than the maximum recommended daily noise intake of 85 decibels averaged over eight hours, a standard that is also for adults and not children.
“The average volume that kids listen to music at is 70 to 100 [decibels],” Sutton said. “That’s the upper limit of normal or the range for most of our headphone outputs.”
“Now, noise above 70 [decibels] for prolonged periods of time can cause damage. Noise at 100, which is the maximum, can cause damage in minutes. And noise over 120 can cause immediate harm,” Sutton continued. “So it’s important to pay attention to those volume settings [and] keep them at least 60 to 70% total.”
With sound machines, often used to lull infants and children to sleep, the AAP warns that they are often too loud for healthy listening.
“The AAP recommends that parents and caregivers consider that if an environment sounds too loud for an adult, it probably is too loud for a child. ‘Too loud’ can mean having to raise your voice to speak with someone just an arm’s length away,” the pediatricians’ group said.
“The Academy of Pediatrics recommends, for example, that nurseries have a volume maximum of around 50 decibels,” Sutton said. “That’s a volume that you and I can speak at without raising our voice. Most of these machines go above that. So if you’re going to use them, turn that volume down, place it away from the bed at least seven feet and make sure that you give limits.”
Signs of hearing loss in children
Early speech and language delays
No reaction or a startled reaction to loud noises
Trouble hearing at schools
Sutton recommended parents pay attention to their child’s communication.
“It’s about paying attention to that communication. If you’re finding that your child is speaking loudly, having difficulties with pronunciation, if you’re finding that they’re not reacting to loud noises — these are all some of the reasons why you should get them checked, their hearing checked, because it can help with their learning comprehension and, of course, reduce their risk long-term,” Sutton said.
Comments Off on Too Little Sleep Might Raise a Woman’s Odds for Diabetes
by SadofNE
Original Article | Dennis Thompson, Published in HealthDay Magazine
Key Takeaways
Women who get poor sleep might have an increased risk of diabetes
Getting just 90 minutes less sleep increased insulin resistance in women
Researchers will look at whether better sleep helps control diabetes
TUESDAY, Nov. 14, 2023 (HealthDay News) — Women who don’t get enough sleep might have an increased risk of diabetes, an effect even more pronounced in postmenopausal females, a new study finds.
Shortening sleep by just 90 minutes increased insulin resistance in women used to getting adequate sleep, researchers at Columbia University.
The findings are the first to show that even a mild sleep deficit maintained for six weeks can raise the risk of diabetes, researchers said.
“Throughout their lifespan, women face many changes in their sleep habits due to childbearing, child-rearing and menopause,” said lead researcher Marie-Pierre St-Onge, director of the Center of Excellence for Sleep and Circadian Research at Columbia University in New York City. “And more women than men have the perception they aren’t getting enough sleep.”
For this study, St-Onge and her colleagues enrolled 38 healthy women, 11 of whom had gone through menopause.
All of the women routinely slept at least seven hours each night. The recommended amount of sleep for optimal health is between seven and nine hours, researchers said, but about a third of Americans get less sleep than that.
Each of the women were asked to participate in two different phases of the study, in random order.
Women were asked to maintain their regular adequate sleep in one phase, but in the other phase they were asked to delay their bedtime by an hour and a half, shortening their total sleep to around six hours. Each phase lasted six weeks.
Curtailing sleep by 90 minutes for six weeks increased fasting insulin levels by more than 12% overall, and by 15% among premenopausal women.
Insulin resistance increased by nearly 15% overall, and by more than 20% among postmenopausal women.
Average blood sugar levels remained stable for all participants throughout the study, but researchers said the changes in insulin resistance could cause them to start rising in the long-term.
Although increased belly fat is a key driver of insulin resistance, the researchers found that the effects of sleep loss on insulin resistance were not linked to any increases in fat.
“The fact that we saw these results independent of any changes in body fat, which is a known risk factor for type 2 diabetes, speaks to the impact of mild sleep reduction on insulin-producing cells and metabolism,” St-Onge said.
Researchers will next investigate whether better sleep can improve blood sugar control and glucose metabolism.
The study was published Nov. 13 in the journal Diabetes Care.
More information
The U.S. Centers for Disease Control and Prevention has more about sleep and diabetes.
SOURCE: Columbia University, news release, Nov. 13, 2023
Bipolar disorder is characterized by transitions between depression and mania. Credit: Wikipedia
New research from Western Sydney University has revealed that simple self-care strategies, such as spending time with animals and getting enough sleep, are helpful for people managing bipolar disorder symptoms.
The research, published in Clinical Psychologist this week, involved 80 participants with bipolar disorder reviewing the frequency and perceived helpfulness of 69 self-care strategies. These strategies were diverse, and included things such as abstaining from drugs and alcohol, practising yoga and finding things that make you laugh.
The study found that an increased engagement in self-care strategies was associated with improved quality of life, reduced the impact of the illness, and reduced depression, anxiety and stress. Getting enough sleep was the most commonly rated strategy as “very helpful,” with “spending time with pets,” also rating highly.
Lead researcher, honours student Edward Wynter from Western Sydney University’s School of Social Sciences and Psychology, says the study provides encouraging findings about the relationship between self-care and important functional and symptomatic outcomes, i.e. the ability of these strategies to alleviate the impact of the disorder.
“The benefits of self-care have been reported in other chronic illnesses, but bipolar disorder research has focused primarily on medication management,” Mr Wynter says.
“This research reveals support for strategies already well known to professionals and people living with bipolar disorder, including those relating to quality and quantity of sleep, and drug and alcohol abstinence; but this study also highlights the effectiveness of several strategies yet to be explored such as spending time with pets and engaging in creative pursuits.”
Mr Wynter says he hopes this research leads to further exploration of self-care strategies used by people living with bipolar disorder, and their relationship with long-term quality of life.
“I hope that knowledge of effective strategies can inspire proactive therapeutic engagement and empower people living with bipolar disorder to improve their health and wellbeing,” he says.
