Sleep Duration & Risk of Death

The AASM reports that most adults need about seven to eight hours of nightly sleep to feel alert and well rested during the day. But is it dangerous if you regularly get less sleep or more sleep? Does “short sleep” or “long sleep” increase your risk of death?

A new study took a look at the evidence. The systematic review analyzed data from other studies. In each study sleep duration was measured by self-report.

Sixteen studies measured short sleep and mortality. The combined results show that having a short sleep duration was associated with a 10 percent increase in the risk of death.

Why? Other research offers possible explanations. Studies have linked short sleep to an increased risk of diabetes, obesity and hypertension.

What about long sleep duration? Seventeen studies reported data on long sleep duration and mortality. The risk of death for long sleepers was increased by 23 percent; their risk of cardiovascular-related death was increased by 38 percent.

A 2008 study in the journal Sleep suggested a possible explanation for this relationship. The study involved 9,789 U.S. adults between 32 and 86 years of age.

There was no link between sleep duration and mortality in middle-aged adults between the ages of 32 and 59. But in elderly adults between 60 and 86 years of age, both short sleep and long sleep were associated with an increased risk of death.

The mortality risk was increased by 27 percent in elderly adults who reported that they usually sleep five hours or less; the risk was increased by 36 percent in older adults who reported sleeping nine hours or more.

“The relationship between sleep duration and mortality is largely influenced by deaths in elderly subjects,” the authors concluded. “Long sleep duration is unlikely to contribute toward mortality.”

Brain Activity & Muscle Force in Morning and Evening Types

A new study measured changes in brain activity and muscle force from morning to night in morning and evening types.

The study involved 18 people. Nine were “evening types” who prefer to stay up late at night and sleep late in the morning; nine were “morning types” who prefer to go to bed early and wake up early. Data were collected four times in one day: at 9 a.m., 1 p.m., 5 p.m. and 9 p.m.



Results show a difference in brain activity between the two groups. In morning types their “cortical excitability” was highest at 9 a.m.; this level decreased throughout the day. The brain activity of evening types was highest at 9 p.m.

The study also tested reflex response and maximum muscle force. Reflex response was tested using spinal-cord stimulation; muscle force was measured by maximum contractions of the calf muscle.

Evening types became physically stronger during the day. Their reflex response improved and their muscle torque increased.

For morning types the results were mixed. Their reflex response improved throughout the day; but there was no change in the muscle force that they generated.

"We are suggesting that morning people may never reach their true maximum performance,” study co-author Dave Collins said in a University of Alberta article. “Their brain [activity] is going one way and their spinal cord activity is going the other, so it's offsetting. In evening people, both brain and spinal cord are at maximum in the evening, and they get maximum performance at night."

The authors suggest that these results may have implications for people who perform shift work.

Another recent study found that both morning and evening types performed well when tested 1.5 hours after waking. But the evening types pulled ahead when both groups were tested after being awake for 10.5 hours. They were more alert and had faster reaction times.

Learn more about chronotypes on the Sleep Education Blog.

Michael Jackson’s Struggle with Insomnia

The Associated Press reports today that Michael Jackson struggled with severe and chronic insomnia. A nurse told the AP that he wanted to obtain the drug Diprivan to help him sleep.

Diprivan is a powerful sedative that is injected into a vein. It is given to patients before an operation or medical test.

Jackson’s insomnia may have had a variety of causes.

The AP reports that the 50-year-old singer was rehearsing hard for his upcoming “This Is It” tour. This may have caused adjustment insomnia. This type of insomnia results from a source of stress.

His concern about being unable to sleep may have developed into psychophysiological insomnia. People with this sleep disorder worry too much about insomnia and about being tired the next day. As a result, they learn to become tense and anxious as bedtime approaches.

The AP article notes that Jackson would sleep with a computer on the bed. This is a sign that he may have developed bad habits that prevented him from sleeping well. This is called inadequate sleep hygiene.

The AP also reports that Jackson often was in pain. Painful medical problems often cause insomnia due to medical condition.

Jackson may have been taking a variety of prescription medications. Many medications can suppress or disrupt sleep. Insomnia due to drug or substance may result.

His insomnia also may have been related to a mental health problem. The AASM reports that insomnia due to mental disorder is the most common disorder in people who seek help from a sleep center for ongoing insomnia. Often it is related to depression or anxiety.

Do you struggle with insomnia? You can get help at an AASM-accredited sleep center near you.

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Michael Jackson’s Death & Prescription Drug Abuse

Soon after Michael Jackson’s death questions arose about his possible abuse of prescription drugs. Five days later those questions remain. Investigators recently took more medications from the rented house where Jackson collapsed.

The controversy has focused attention on the nationwide problem of prescription drug abuse. The risk of addiction extends far beyond the rich and famous.

The National Institute on Drug Abuse reports that millions of people in the U.S. abuse prescription drugs each year. The NIDA estimates that 48 million people have abused or misused prescription drugs in their lifetime.

Which drugs are most likely to be abused? The NIDA warns that three classes of drugs carry the greatest risk.

Opioids are commonly abused. These drugs are used to treat pain. Examples include morphine, codeine, OxyContin, Vicodin and Demerol.

Stimulants also may be abused. These drugs are used for problems such as narcolepsy. Examples include dextroamphetamine and methylphenidate.

Central nervous system depressants also are commonly abused. This class of drugs includes barbiturates such as Nembutal. It also includes benzodiazepines such as Valium and Xanax.

Some benzodiazepines are used to treat insomnia. Examples include Dalmane, Doral, Halcion, Prosom and Restoril.

But newer “nonbenzodiazepines” have a lower risk of addiction. Examples include Ambien, Lunesta and Sonata.

Another low-risk sleep aid is ramelteon. It is marketed as Rozerem. This drug is a melatonin receptor agonist. It targets the part of the brain that regulates the sleep-wake cycle.

The AASM offers these Guidelines for Taking Sleep Medications. Contact your doctor or pharmacist if you have any other questions about taking sleeping pills. You also should ask your doctor about cognitive behavioral therapy for insomnia. It is a safe and effective treatment option.

The NIDA reports that drug addiction is a brain disease that can be treated effectively. Treatments include detoxification, counseling and drug therapy.

To get help call 1-800-662-HELP or go online to http://findtreatment.samhsa.gov/.

Learn more about prescription drug abuse on SleepEducation.com.

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Sleep Deprivation: Your Genetic Vulnerability

Why does sleep deprivation affect some people more than others? A new study found that it has to do with your brain’s response to sleep loss.

The study involved two groups of people. Members of one group all had a short variant of the PERIOD3 gene. The authors report that people with this genetic variant are more resilient to sleep loss; they tend to function well even after a period of sleep deprivation.

Participants in the other group all had a long variant of the PER3 gene. People with this genetic variant are more vulnerable to sleep loss; their cognitive performance suffers when they are sleep deprived.

“The extent to which individuals are affected by sleep deprivation varies, with some crashing out and others holding up well after a night without sleep,” said Dr. Michael Chee, an expert on sleep deprivation who commented on the study in a prepared statement.

To explain this difference, the researchers performed brain imaging during a working memory task.

Results show that the people with the short PER3 gene had increased brain activity when tested after a sleepless night. They compensated for sleep loss by “recruiting” help from other parts of the brain. This enabled them to maintain their performance when sleep deprived.

In contrast, brain imaging showed that people with the long PER3 gene had reduced brain activity after a night of sleep loss. In one brain region, their activity also was reduced when tested at night after a normal waking day. This suggests that people with the long PER3 gene perform better earlier in the day.

“This study and others like it could help in identifying those who may be at risk for performance decline in jobs where sleep deprivation is an integral feature,” said Chee.

Are you sleep deprived? Check out the seven signs you need sleep on SleepEducation.com.