Is there a link between sleep and diabetes?

"You know that your family medical history, along with what you eat and how much you weigh, can affect your risk of developing type 2 diabetes. But did you know that your sleep habits can also play a role? It’s true. In fact, sleep deprivation is an often overlooked but significant risk factor for type 2 diabetes, a disease that involves too much glucose (or sugar) in the blood and increases the risk of heart disease.

The connection may be hard to imagine. But the primary reason that regularly skimping on shuteye can increase your risk of type 2 diabetes is because your hormone levels get thrown out of whack. Specifically, with ongoing sleep loss, less insulin (a hormone that regulates blood sugar) is released in the body after you eat. Meanwhile, your body secretes more stress hormones (such as cortisol), which helps you stay awake but makes it harder for insulin to do its job effectively. The net effect: Too much glucose stays in the bloodstream, which can increase your risk of developing type 2 diabetes."

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Are you getting too much sleep?

"Most people know that sleep is integral to our mental and physical health, and that sleepiness takes a major toll on work, school, and relationships. Unfortunately, a lot of people go about their daily lives feeling excessively sleepy without mentioning this to their doctor. In fact, a National Sleep Foundation poll found that less than half of people say they would talk to their doctor if they thought they had a sleep problem, and seven in ten said that their doctor had never asked them about their sleep.

If you feel sleepy on a regular basis and it interferes with your productivity, your ability to think clearly and quickly, or to take care of and enjoy your family, treat this symptom seriously and talk to your doctor. If you have an upcoming well visit, you can discuss it then. You could also make a special appointment with your primary care doctor to discuss this, or simply call to ask for a referral to a doctor with a specialty in sleep medicine."

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Sleep Disorders: REM Sleep Behavior Disorder


"For most people, dreaming is purely a "mental" activity: dreams occur in the mind while the body is at rest. But people who suffer from REM sleep behavior disorder (RBD) act out their dreams. They physically move limbs or even get up and engage in activities associated with waking. Some engage in sleep talking, shouting, screaming, hitting or punching. Some even fly out of bed while sleeping! RBD is usually noticed when it causes danger to the sleeping person, their bed partner, or others they encounter. Sometimes ill effects such as injury to self or bed partner sustained while asleep trigger a diagnosis of RBD. The good news is that RBD can usually be treated successfully.

What we call "sleep" involves transitions between three different states: wakefulness, rapid eye movement (REM) sleep, which is associated with dreaming, and non rapid eye movement (N-REM) sleep. There are a variety of characteristics that define each state, but to understand REM sleep behavior disorder it is important to know that it occurs during REM sleep. During this state, the electrical activity of the brain, as recorded by an electroencephalogram, looks similar to the electrical activity that occurs during waking. Although neurons in the brain during REM sleep are functioning much as they do during waking, REM sleep is also characterized by temporary muscle paralysis."

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Sleep Studies: Part 2

"It's time for consumers to wake up to the risks of sleep disorders, scientists say.

More than 50 million adults in the U.S. have a disorder such as insomnia, restless leg syndrome or sleep apnea, according to an Institute of Medicine report. And it's now clear that a lack of sleep "not only increases the risk of errors and accidents, it also has adverse effects on the body and brain," according to Charles Czeisler, chief of the division of sleep and circadian disorders at Brigham and Women's Hospital in Boston."

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Sleep Studies: Part 1

"50 to 70 million Americans are affected by chronic sleep disorders and intermittent sleep problems that can significantly diminish health, alertness and safety. Untreated sleep disorders have been linked to hypertension, heart disease, stroke, depression, diabetes and other chronic diseases. Sleep problems can take many forms and can involve too little sleep, too much sleep or inadequate quality of sleep.

The Institute of Medicine recently estimated in its report, Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem , that “hundreds of billions of dollars a year are spent on direct medical costs related to sleep disorders such as doctor visits, hospital services, prescriptions, and over-the-counter medications.” Sleep problems and lack of sleep can affect everything from personal and work productivity to behavioral and relationship problems. Sleep problems can have serious consequences. According to the National Highway Traffic Safety Administration, drowsy driving claims more than 1,500 lives and causes at least 100,000 motor vehicle crashes each year."

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How Much Sleep Do We Need?

"The amount of sleep each person needs depends on many factors, including age. Infants generally require about 16 hours a day, while teenagers need about 9 hours on average. For most adults, 7 to 8 hours a night appears to be the best amount of sleep. Women in the first 3 months of pregnancy often need several more hours of sleep than usual. The amount of sleep a person needs also increases if he or she has been deprived of sleep in previous days. Getting too little sleep creates a "sleep debt," which is much like being overdrawn at a bank. Eventually, your body will demand that the debt be repaid. We don't seem to adapt to getting less sleep than we need; while we may get used to a sleep-depriving schedule, our judgment, reaction time, and other functions are still impaired."

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Obstructive Sleep Apnea (OSA)

"A sleep disorder that is marked by pauses in breathing of 10 seconds or more during sleep, and causes unrestful sleep. Symptoms include loud or abnormal snoring, daytime sleepiness, irritability, and depression."

"What is sleep apnea?

Obstructive sleep apnea (pronounced AP-nee-ah), also called OSA, is a chronic (ongoing) disorder. People with OSA stop or "pause" their breathing or have shallow breathing when they sleep.

Almost everyone has brief times when they stop breathing while they sleep. People with OSA:

  • Pause their breathing or flow of air (called "hypoapnea") more often than normal.
  • May start breathing again with a loud snort or choking sound.
  • Have breathing pauses five or more times an hour; sometimes as often as once or twice each minute.

OSA can be mild, moderate, or severe, depending on:

  • How many times a person pauses their breathing or has lower airflow per hour.
  • How low a person's oxygen level in their blood drops during those times.
  • The amount of sleepiness a person feels during the day."

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Sleeping Soundly.. or maybe not?

"Depending on your symptoms, it may help you to gather information on your sleep behaviors. Your healthcare provider will review this information and consider several possible tests when trying to diagnose a sleep disorder:"

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Healthy Sleep Newsletter | Fall 2016

Sleep Recharges You

The National Healthy Sleep Awareness Project has launched the “Sleep Recharges You” campaign, urging teens to make sleep a top priority. Parents and teachers can also play an important role by helping teens to understand the importance of sleep.

The American Academy of Sleep Medicine recommends that teens should sleep 8 to 10 hours each night to promote optimal health. CDC data shows that insufficient sleep is common among teens. About 69 percent of high school students report sleeping 7 hours or less on school nights.  Chronic sleep loss can hinder teens’ academic performance and increase the risk of health and safety problems. Make sleep a priority!

Coming Soon: High School Start Times and Related Outcomes

One of the objectives for the National Healthy Sleep Awareness Project is to perform a critical review of published evidence regarding the effect of high school start times on sleep and other related outcomes in teenagers.

The Surveillance and Epidemiology Workgroup cataloged functional concerns following a comprehensive search using keywords ‘schools’ and ‘sleep’ and ‘start time’ from relevant publications. Total sleep time, academic performance, behavioral health problems and motor vehicular accidents were the prime outcomes that were included for meta-analyses. 

The review, which will be published this fall, reinforces the benefits of a delayed high school start time as it relates to physical and mental health and learning, motor vehicle accidents, and overall student well-being. 


OSA Self-Assessment Tool

A new self-assessment tool developed as part of the National Healthy Sleep Awareness Project helps patients identify the common symptoms of sleep apnea and understand their risk factors for this chronic disease.

Patients can download, print and complete this self-assessment to discuss their sleep apnea risk with their health care provider. The self-assessment tool is available on the Sleep Education website along with other resources for health care professionals, including consensus statements and provider education articles.

The Healthy Sleep Project is funded by the Centers for Disease Control and Prevention (CDC) and led by the AASM in collaboration with the Sleep Research Society (SRS) and other partners.


Looking Ahead: Getting to the Heart of Sleep and Health
The Healthy Sleep Project is about to begin the fourth year of its 5-year plan, and the focus for the upcoming program year will be the relationship between sleep and heart health. A recent review of the evidence confirmed a link between sleep duration and heart problems. Data show that sleep durations of less than 6 hours are associated with an elevated risk for both overall heart disease and high blood pressure.

There also is a strong link between obstructive sleep apnea and heart health. Sleep apnea is a significant risk factor for the development of high blood pressure. It also may increase the risk for heart disease, atrial fibrillation and stroke. Get ready to join us in raising awareness about the importance of healthy sleep for a healthy heart!

Sleep is key to help teens recharge for success this school year

Teens need to get eight to 10 hours of sleep per night to promote optimal health

Teens need to get eight to 10 hours of sleep per night to promote optimal health

Darien, IL - For most teens, back to school time means stocking up on school supplies, picking out new clothes and finalizing class schedules. But one of the best ways they can prepare for success this school year is to commit to getting enough sleep. 

As students head back to school, the National Healthy Sleep Awareness Project is launching the “Sleep Recharges You” campaign, urging teens to get eight to 10 hours of sleep per night to promote optimal health. When well-rested, teens are more likely to be healthy, energetic and have a positive attitude toward life in general — helping them to be their best and do their best this school year. 

“As teens get ready for the new school year, it’s important for them to make sleep a priority,” said Dr. Ronald Chervin, president of the American Academy of Sleep Medicine (AASM) and spokesperson for the National Healthy Sleep Awareness Project. “Setting and sticking to a routine to get as much sleep as possible is one of the best things teens can do for their health, academic achievement and athletic performance this school year.” 


Lack of sleep means real risks for teens’ academic performance, health and well-being

More than two-thirds of high school students in the U.S. are failing to get enough sleep on school nights, according to a 2016 studypublished by the Centers for Disease Control and Prevention (CDC). Results show that 69 percent of surveyed students in grades 9 to 12 reported sleeping less than eight hours on an average school night. Insufficient sleep in teens can impact everything from grades to safety. 

Sleepy teens may fare worse in school than their well-rested peers. Studies have shown that teens who are sleep deprived may be more easily distracted and recall information more slowly. Sleeping fewer than the recommended hours also is associated with attention, behavior and learning problems. 

Lack of sleep may impact teens’ athletic performance. When teens sleep, hormones are released that help them grow taller and develop muscles. Sleep also helps restore energy to the brain and body.

Teens who lack sufficient sleep face dire health and behavioral consequences. Studies show teens who sleep less than the recommended hours are more likely to be overweight and develop hypertension and diabetes. Additionally, insufficient sleep in teenagers has been found to increase the risk of depression and is associated with increased risk of self-harm, suicidal thoughts and suicide attempts.

Insufficient sleep also significantly increases teens’ risk for drowsy driving accidents. A 2014 study found teen drivers who start class earlier in the morning are involved in significantly more motor vehicle accidents than those with later start times. Motor vehicle crashes are the leading cause of death for teens in the U.S., according to the CDC

Parents, caregivers play crucial role

Teens should be encouraged to take the initiative to make sure they get enough sleep every night to recharge. The AASM advises parents and caregivers to help by modeling healthy sleep habits, promoting a consistent sleep schedule and creating a quiet sleep environment for their teens. 

Additionally, setting restrictions on screen time before bed is key to helping teens get to sleep on time. Teens may be tempted to keep using their laptops, smartphones and game consoles late into the night rather than going to sleep. 

“Teens are still growing and developing, and sleep is a crucial part of these processes,” said Chervin. “One of the best things parents and caregivers can do for their children’s health and well-being is to encourage routines that will help them get enough sleep.”

According to the AASM, a natural shift in the timing of the body’s internal “circadian” clock occurs during puberty, causing most teens to have a biological preference for a late-night bedtime. Returning to an early morning school schedule can be a shock to the system for teens who have been free to be night owls during the summer. 

As teens prepare to go back to school, they should gradually go to bed at least 15 minutes earlier each night and wake up 15 minutes earlier each morning until they are on their school schedule. It also is important that parents and local school boards work together to implement high school start times that allow teens to get the healthy sleep they need to meet their full potential. 


Official consensus

The AASM recommends that teens between 13 and 18 years of age should sleep eight to 10 hours per night on a regular basis to promote optimal health. 

This recommendation, which was released by the AASM in June, followed a 10-month project conducted by a Pediatric Consensus Panel of 13 of the nation’s foremost sleep experts, and is endorsed by the American Academy of Pediatrics, the Sleep Research Society and the American Association of Sleep Technologists. The expert panel reviewed 864 published scientific articles addressing the relationship between sleep duration and health in children, evaluated the evidence using a formal grading system and arrived at the final recommendation after multiple rounds of voting.

Parents who are concerned that their teen is sleeping too little or too much can call us at 731-660-6199 to make an appointment.

How Is Sleep Apnea Treated?

Sleep apnea is treated with lifestyle changes, mouthpieces, breathing devices, and surgery. Medicines typically aren't used to treat the condition.

The goals of treating sleep apnea are to:

  • Restore regular breathing during sleep
  • Relieve symptoms such as loud snoring and daytime sleepiness

Treatment may improve other medical problems linked to sleep apnea, such as high blood pressure. Treatment also can reduce your risk for heart disease, stroke, and diabetes.

If you have sleep apnea, talk with your doctor or sleep specialist about the treatment options that will work best for you.

Lifestyle changes and/or mouthpieces may relieve mild sleep apnea. People who have moderate or severe sleep apnea may need breathing devices or surgery.

If you continue to have daytime sleepiness despite treatment, your doctor may ask whether you're getting enough sleep. (Adults should get at least 7 to 8 hours of sleep; children and teens need more. For more information, go to the Health Topics Sleep Deprivation and Deficiency article.)

If treatment and enough sleep don't relieve your daytime sleepiness, your doctor will consider other treatment options.

Lifestyle Changes

If you have mild sleep apnea, some changes in daily activities or habits might be all the treatment you need.

  • Avoid alcohol and medicines that make you sleepy. They make it harder for your throat to stay open while you sleep.
  • Lose weight if you're overweight or obese. Even a little weight loss can improve your symptoms.
  • Sleep on your side instead of your back to help keep your throat open. You can sleep with special pillows or shirts that prevent you from sleeping on your back.
  • Keep your nasal passages open at night with nasal sprays or allergy medicines, if needed. Talk with your doctor about whether these treatments might help you.
  • If you smoke, quit. Talk with your doctor about programs and products that can help you quit smoking.


A mouthpiece, sometimes called an oral appliance, may help some people who have mild sleep apnea. Your doctor also may recommend a mouthpiece if you snore loudly but don't have sleep apnea.

A dentist or orthodontist can make a custom-fit plastic mouthpiece for treating sleep apnea. (An orthodontist specializes in correcting teeth or jaw problems.) The mouthpiece will adjust your lower jaw and your tongue to help keep your airways open while you sleep.

If you use a mouthpiece, tell your doctor if you have discomfort or pain while using the device. You may need periodic office visits so your doctor can adjust your mouthpiece to fit better.

Breathing Devices

CPAP (continuous positive airway pressure) is the most common treatment for moderate to severe sleep apnea in adults. A CPAP machine uses a mask that fits over your mouth and nose, or just over your nose.

The machine gently blows air into your throat. The pressure from the air helps keep your airway open while you sleep.

Treating sleep apnea may help you stop snoring. But not snoring doesn't mean that you no longer have sleep apnea or can stop using CPAP. Your sleep apnea will return if you stop using your CPAP machine or don’t use it correctly.

Usually, a technician will come to your home to bring the CPAP equipment. The technician will set up the CPAP machine and adjust it based on your doctor's prescription. After the initial setup, you may need to have the CPAP adjusted from time to time for the best results.

CPAP treatment may cause side effects in some people. These side effects include a dry or stuffy nose, irritated skin on your face, dry mouth, and headaches. If your CPAP isn't adjusted properly, you may get stomach bloating and discomfort while wearing the mask.

If you're having trouble with CPAP side effects, work with your sleep specialist, his or her nursing staff, and the CPAP technician. Together, you can take steps to reduce the side effects.

For example, the CPAP settings or size/fit of the mask might need to be adjusted. Adding moisture to the air as it flows through the mask or using nasal spray can help relieve a dry, stuffy, or runny nose.

There are many types of CPAP machines and masks. Tell your doctor if you're not happy with the type you're using. He or she may suggest switching to a different type that might work better for you.

People who have severe sleep apnea symptoms generally feel much better once they begin treatment with CPAP.


Some people who have sleep apnea might benefit from surgery. The type of surgery and how well it works depend on the cause of the sleep apnea.

Surgery is done to widen breathing passages. It usually involves shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw.

Surgery to shrink or stiffen excess tissue is done in a doctor's office or a hospital. Shrinking tissue may involve small shots or other treatments to the tissue. You may need a series of treatments to shrink the excess tissue. To stiffen excess tissue, the doctor makes a small cut in the tissue and inserts a piece of stiff plastic.

Surgery to remove excess tissue is done in a hospital. You're given medicine to help you sleep during the surgery. After surgery, you may have throat pain that lasts for 1 to 2 weeks.

Surgery to remove the tonsils, if they're blocking the airway, might be helpful for some children. Your child's doctor may suggest waiting some time to see whether these tissues shrink on their own. This is common as small children grow.

CPAP Devices for Sleep Apnea

What is a CPAP device?

One way to treat people who have sleep apnea is a continuous positive airway pressure (CPAP) device. A CPAP device includes a mask, tubes and a fan. It uses air pressure to push your tongue forward and open your throat. This allows air to pass through your throat. It reduces snoring and prevents apnea disturbances.

You should put your CPAP device on whenever you sleep, even for naps. A CPAP device does not cure sleep apnea. But, when you use the device correctly, your sleep problems should get much better.

Do I need a CPAP device?

Talk to your doctor if you think you have sleep apnea. Your doctor may ask you to go to a sleep center for a sleep study. During your sleep study, you may try different levels of air pressure with a CPAP device to see which level helps. In general, heavier people and people who have severe apnea need higher air pressures. If you need a CPAP device, your doctor will help you choose one that is right for you.

What if I have problems with my CPAP device?

Many people have problems with their CPAP device, especially at first. It's important to not give up. Often, the problems go away when you get used to wearing the device. It may also be helpful for you to find a support group in your area so that you can talk with other people who have sleep apnea.

The following are some common problems you may have with your CPAP device, and some possible solutions: 

  • The mask feels uncomfortable. Because everyone's face has a different shape, you may need to try different masks to find one that fits you well.
  • Your nose feels dry and stuffy. You can try using a humidifier to moisten the air from the CPAP device.
  • Your nose feels blocked up. Some people who have sleep apnea also have nose problems. Ask your doctor if you have a nose problem that can be treated with a nasal spray. Surgery is sometimes also an option. People who breathe through their mouths don't do as well with CPAP nose masks. In this case, a full-face mask that covers both the nose and the mouth may help (see the picture below).
  • The mask bothers your skin and nose. Because the mask must fit firmly over your nose and cheeks, it may irritate your skin. A different size or kind of mask may help. There are also special skin moisturizers made for CPAP device users. Some petroleum-based products can damage the mask, so ask your doctor for more information. Some people also benefit from using nasal pillows that fit into the nostrils and relieve pressure on the bridge of the nose (see the picture below). Using a regular CPAP mask one night and nasal pillows the next night may help you feel more comfortable.
  • The mask leaks air. Some people can't keep their jaw closed while wearing the mask. A chin strap can help hold up your jaw to keep the air in (see the picture below).
  • You don't like the pressure. You may find that breathing out against the air pressure keeps you from sleeping deeply. Your doctor may ask you to use a bi-level machine that lowers the air pressure when you breathe out. The same mask may be used with CPAP and bi-level machines.
  • You take the mask off during your sleep or don't wear it every night. Most people can't wear the mask all night long, every night, right from the start. Keep trying, even if you can only use the mask for an hour a night at first. Once you solve your comfort problems, you should be able to increase the time you wear the mask.
  • You just can't get used to the mask. Some people find that wearing a dental device that pushes their tongue forward helps. You may want to talk with your doctor about whether throat or jaw surgery could help.

A Guide to Understanding Your Sleep Study

If you are reading this, you've probably had a sleep study. Which means that you've spent a night in a polysomnographic laboratory, hooked up to devices that generate an encyclopedic amount of information on what's going on in your brain and blood, your lungs and limbs.

Neither you--nor the doctor treating you--will view more than a minuscule fraction of this data. The sleep lab will reduce the 1,000 or so pages of material down to its essence. Depending on the lab, whether you self-referred, and how your doctor practices, you might ee a paragraph, a one-page summary, or a six-page document complete with graphs. But even in a short format, there's an awful lot of information, and it can be awfully confusing. "People do tend to get lost in the numbers," admits Dr. Rochelle Goldberg, a specialist in sleep medicine who is past president of the American Sleep Apnea Association. And it's not just numbers-there are all kinds of acronyms and jargon to master.

In order to help you get a better handle on these numbers and alphabet soups, and a better comprehension of what they quantify and signify, here is a guide to polysomnography. The material in this guide comes from current and former associates of the ASAA: Dr. Richard E. Waldhorn, a professor and clinician at Georgetown University and former association president; Goldberg; and registered polysomnographic technologist David Polaski. In addition, we drew from a report of the American Academy of Sleep Medicine Task Force, chaired by Dr. W. Ward Flemons, published in the May 1999 issue of Sleep.

Quantity of Sleep

The first thing looked at is the total sleep time, or TST. This is an objective measure, based on the readings from electrodes recording brain waves, of the amount of time you actually sleep during your study. Very often, this measurement is at odds with people's subjective perception of how much they slept. They will feel as if they hardly slept a wink, but the report indicates they were out for six hours. The electrodes don't lie.

Sleep Efficiency and Latency

The ratio between the total sleep time and the total recording time, or TRT, is called the sleep efficiency. People who have significant difficulties in either initiating or maintaining sleep have diminished sleep efficiency, which can be related to various conditions and disorders, including depression. The number of minutes between the time the light is turned out and the person falls asleep is the sleep onset latency. Normally, it takes about 15 minutes to fall asleep. A significantly shorter onset latency--the proverbial falling asleep as soon as your head hits the pillow--might seem desirable, but in fact is an indicator of sleep deprivation. This could suggest a disorder, or it could be just a sign to slow down. Regardless of the demands of work and family, and the enticements of television and the web, you need at least seven and a half hours of sleep a night.

Sleep Stages

Once you drop off, you should progress through four stages of increasingly deep, dreamless sleep and into a fifth stage during which dreaming--characterized by rapid eye movement--occurs. Over the course of the night, you will cycle repeatedly between Non-REM and REM sleep. The structure of these cycles--poetically known as "sleep architecture"--reveals whether you are getting the restorative sleep you need to feel and be well. Stage 1, the very lightest sleep, should only be 5 percent of the total sleep time, and should only occur at the beginning of the night. The still fairly light Stage 2 sleep should represent about 55 to 60 percent of the TST. Deep sleep--also known as "slow wave" sleep--takes place in Stages 3 and 4, and should account for about 20 percent of the TST. This is the form of sleep that, as Shakespeare wrote, "knits up the raveled sleave of care." If it is truncated or absent, you will not feel rested the next day. Your sleep study measures the time spent in each stage, in minutes and as a percentage, and the latencies between the time you fall asleep and the time you enter Stage 4 and REM sleep, respectively.

Arousals and Awakenings

Arousals--interruptions of sleep lasting 3 to 15 seconds--can occur spontaneously or as a result of sleep-disordered breathing or other sleep disorders. Each arousal sends you back to a lighter stage of sleep. If the arousal last more than 15 seconds, it becomes an awakening. You are usually not aware of arousals, but may be aware of awakenings. The number of arousals and awakenings is registered in the study, and reported as a total number and as a frequency per hour of sleep, which is referred to as an index. The higher the arousal index, the more tired you are likely to feel, though people vary in their tolerance of sleep disruptions. As few as five arousals per hour can make some people feel chronically sleepy. In the worst cases of SDB, the index can be 100 or more.

Respiratory Parameters

The arousals and awakenings that occur when things go awry in your breathing while you're asleep can arise from a glitch in the central nervous system--i.e., the brain "forgets" to breathe--but more commonly have a mechanical cause. (There are also "mixed" episodes, involving both elements, but these are relatively rare.) The mechanical malfunction occurs when the soft structures in the back of the throat collapse into the airway, reducing the amount of air that makes its way into your lungs and, as a consequence, the amount of oxygen in your bloodstream. In an apnea, airflow is reduced by at least 80 percent; in a hypopnea, the range of the reduction is 50 to 80 percent. The report indicates the number of times each occurs, as a nighttime total and as an index of events per hour. This latter number is referred to as either the apnea-hypopnea index or the respiratory disturbance index. An index of 5 to 14 indicates a mild level of breathing--and sleep--disturbance. From 15 to 30 is moderate; greater than 30 is severe. The associated drops in blood oxygen levels, known as desaturations, are also measured and categorized. Normal saturation is around 95 percent. A desaturation to 86 percent is mild, a reduction to 80 to 85 percent is moderate, and a drop to 79 percent or less is severe.


These indexes, Goldberg stresses, are not fuzzy concepts, but hard data generated by easily measured electrical systems. Nevertheless, they don't tell the whole story. The severity of your sleep apnea (and what treatment you need) can't really be gauged by a machine. Your doctor will look at the numbers, but will need to put them into a clinical context. Consequently, it's vital that you track and report what you experience from day to day. Do you get sleepy while reading or watching television? That's a very mild level of impairment, and might not be cause for concern. Or are you fighting off sleep--or falling asleep--during activities such as eating, talking, walking, and driving? That's a medical emergency. So don't get too hung up in the numbers; they're enormously helpful, but they don't replace words.


In addition to the items covered above, the polysomnogram looks at your heart rhythm, and determines if there are any abnormalities. Another important part of the study is the assessment of limb movement, since leg movement can constitute another sleep disorder. And yes, someone is listening to--though not measuring in decibels--your snoring, which is probably the symptom that got you to the lab in the first place.

What Are Sleep Studies?

Sleep studies are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is.

Sleep studies are important because untreated sleep disorders can raise your risk for heart disease, high blood pressure, stroke, and other medical conditions. Sleep disorders also have been linked to an increased risk of injury, such as falling (in the elderly) and car accidents.

People usually aren't aware of their breathing and movements while sleeping. They may never think to talk to their doctors about issues that might be related to sleep problems.

However, sleep disorders can be treated. Talk with your doctor if you snore regularly or feel very tired while at work or school most days of the week.

You also may want to talk with your doctor if you often have trouble falling or staying asleep, or if you wake up too early and aren't able to go back to sleep. These are common signs of a sleep disorder.

Your doctor might be able to diagnose a sleep disorder based on your sleep schedule and habits. However, he or she also might need the results from sleep studies and other medical tests to diagnose a sleep disorder.

Sleep studies can help diagnose:

  • Sleep-related breathing disorders, such as sleep apnea
  • Sleep-related seizure disorders
  • Sleep-related movement disorders, such as periodic limb movement disorder
  • Sleep disorders that cause extreme daytime tiredness, such as narcolepsy

Doctors might use sleep studies to help diagnose or rule out restless legs syndrome (RLS). However, RLS usually is diagnosed based on signs and symptoms, medical history, and a physical exam.

You can find more information about sleep and sleep disorders in the National Heart, Lung, and Blood Institute's "Your Guide to Healthy Sleep."

How Is Insomnia Treated?

Lifestyle changes often can help relieve acute (short-term) insomnia. These changes might make it easier to fall asleep and stay asleep.

A type of counseling called cognitive-behavioral therapy (CBT) can help relieve the anxiety linked to chronic (ongoing) insomnia. Anxiety tends to prolong insomnia.

Several medicines also can help relieve insomnia and re-establish a regular sleep schedule. However, if your insomnia is the symptom or side effect of another problem, it's important to treat the underlying cause (if possible).

Lifestyle Changes

If you have insomnia, avoid substances that make it worse, such as:

  • Caffeine, tobacco, and other stimulants. The effects of these substances can last as long as 8 hours.
  • Certain over-the-counter and prescription medicines that can disrupt sleep (for example, some cold and allergy medicines). Talk with your doctor about which medicines won't disrupt your sleep.
  • Alcohol. An alcoholic drink before bedtime might make it easier for you to fall asleep. However, alcohol triggers sleep that tends to be lighter than normal. This makes it more likely that you will wake up during the night.

Try to adopt bedtime habits that make it easier to fall asleep and stay asleep. Follow a routine that helps you wind down and relax before bed. For example, read a book, listen to soothing music, or take a hot bath.

Try to schedule your daily exercise at least 5 to 6 hours before going to bed. Don't eat heavy meals or drink a lot before bedtime.

Make your bedroom sleep-friendly. Avoid bright lighting while winding down. Try to limit possible distractions, such as a TV, computer, or pet. Make sure the temperature of your bedroom is cool and comfortable. Your bedroom also should be dark and quiet.

Go to sleep around the same time each night and wake up around the same time each morning, even on weekends. If you can, avoid night shifts, alternating schedules, or other things that may disrupt your sleep schedule.

Cognitive-Behavioral Therapy

CBT for insomnia targets the thoughts and actions that can disrupt sleep. This therapy encourages good sleep habits and uses several methods to relieve sleep anxiety.

For example, relaxation techniques and biofeedback are used to reduce anxiety. These strategies help you better control your breathing, heart rate, muscles, and mood.

CBT also aims to replace sleep anxiety with more positive thinking that links being in bed with being asleep. This method also teaches you what to do if you're unable to fall asleep within a reasonable time.

CBT also may involve talking with a therapist one-on-one or in group sessions to help you consider your thoughts and feelings about sleep. This method may encourage you to describe thoughts racing through your mind in terms of how they look, feel, and sound. The goal is for your mind to settle down and stop racing.

CBT also focuses on limiting the time you spend in bed while awake. This method involves setting a sleep schedule. At first, you will limit your total time in bed to the typical short length of time you're usually asleep.

This schedule might make you even more tired because some of the allotted time in bed will be taken up by problems falling asleep. However, the resulting tiredness is intended to help you get to sleep more quickly. Over time, the length of time spent in bed is increased until you get a full night of sleep.

For success with CBT, you may need to see a therapist who is skilled in this approach weekly over 2 to 3 months. CBT works as well as prescription medicine for many people who have chronic insomnia. It also may provide better long-term relief than medicine alone.

For people who have insomnia and major depressive disorder, CBT combined with antidepression medicines has shown promise in relieving both conditions.


Prescription Medicines

Many prescription medicines are used to treat insomnia. Some are meant for short-term use, while others are meant for longer use.

Talk to your doctor about the benefits and side effects of insomnia medicines. For example, insomnia medicines can help you fall asleep, but you may feel groggy in the morning after taking them.

Rare side effects of these medicines include sleep eating, sleep walking, or driving while asleep. If you have side effects from an insomnia medicine, or if it doesn't work well, tell your doctor. He or she might prescribe a different medicine.

Some insomnia medicines can be habit forming. Ask your doctor about the benefits and risks of insomnia medicines.

Over-the-Counter Products

Some over-the-counter (OTC) products claim to treat insomnia. These products include melatonin, L-tryptophan supplements, and valerian teas or extracts.

The Food and Drug Administration doesn't regulate “natural” products and some food supplements. Thus, the dose and purity of these substances can vary. How well these products work and how safe they are isn't well understood.

Some OTC products that contain antihistamines are sold as sleep aids. Although these products might make you sleepy, talk to your doctor before taking them.

Antihistamines pose risks for some people. Also, these products may not offer the best treatment for your insomnia. Your doctor can advise you whether these products will benefit you.


Insomnia is a common sleep disorder. If you have it, you may have trouble falling asleep, staying asleep, or both. As a result, you may get too little sleep or have poor-quality sleep. You may not feel refreshed when you wake up.

Symptoms of insomnia include:

  • Lying awake for a long time before you fall asleep
  • Sleeping for only short periods
  • Being awake for much of the night
  • Feeling as if you haven't slept at all
  • Waking up too early

Your doctor will diagnose insomnia based on your medical and sleep histories and a physical exam. He or she also may recommend a sleep study. A sleep study measures how well you sleep and how your body responds to sleep problems. Treatments include lifestyle changes, counseling, and medicines.

Are you getting enough sleep?

Sleep is important for people of all ages to stay in good health. Read more to learn how much sleep your body needs. 

How you feel and perform during the day is related to how much sleep you get the night before. If sleepiness interferes with your daily activities, more sleep each night will improve the quality of your waking hours. Yet many adults report experiencing a sleeping problem one or more nights a week.

Insufficient sleep is associated with a number of chronic diseases and conditions—such as diabetes, cardiovascular disease, obesity, and depression—which threaten our nation’s health. Not getting enough sleep is associated with the onset of these diseases and also may complicate their management and outcome.

Sufficient sleep is increasingly being recognized as an essential aspect of chronic disease prevention and health promotion. How much sleep is enough? Sleep needs vary from person to person and change as people age.

Consider these sleep guidelines for different age groups.

How much sleep do you need?


  • 16-18 hours

Preschool-aged Children

  • 11-12 hours

School-aged Children

  • At least 10 hours


  • 9-10 hours

Adults (including older adults)

  • 7-8 hours

“… Sufficient sleep is not a luxury—it is a necessity—and should be thought of as a vital sign of good health.”

Wayne H. Giles, MD, MS, Director, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion.

*Data from the National Institutes of Health

Sleep Hygiene

The promotion of regular sleep is known as sleep hygiene. Here are some simple sleep hygiene tips:

  • Go to bed at the same time each night, and rise at the same time each morning.
  • Sleep in a quiet, dark, and relaxing environment, which is neither too hot nor too cold.
  • Make your bed comfortable and use it only for sleeping and not for other activities, such as reading, watching TV, or listening to music.
  • Remove all TVs, computers, and other "gadgets" from the bedroom.
  • Avoid large meals before bedtime.

You can promote sleep hygiene by sending a sleep Health e-Card.

Sleep Disorders

Sleep-related difficulties – typically called sleep disorders – affect many people. Major sleep disorders include:

  • Insomnia – an inability to fall or stay asleep that can result in functional impairment throughout the day.
  • Narcolepsy – excessive daytime sleepiness combined with sudden muscle weakness; episodes of narcolepsy are sometimes called "sleep attacks" and may occur in unusual circumstances.
  • Restless Legs Syndrome (RLS) – an unpleasant "creeping" sensation associated with aches and pains throughout the legs that can make it difficult to fall asleep.
  • Sleep Apnea – interrupted sleep caused by periodic gasping or "snorting" noises or momentarily suspension of breathing.

If you or someone you know is experiencing a sleep disorder, it may be important to receive an evaluation by a healthcare provider.

Sleep Disorders

Is it hard for you to fall asleep or stay asleep through the night? Do you wake up feeling tired or feel very sleepy during the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are

Nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding your teeth are kinds of sleep problems called parasomnias. There are treatments for most sleep disorders. Sometimes just having regular sleep habits can help.

Sleep Could Help Stave Off Alzheimer's And Memory Loss, According To New Study

We've long known that people with Alzheimer's disease often experience problems with their sleep. But according to a new study from the University of California, Berkeley, poor shut-eye in older adults may play a role in the development of the disease in the first place.

Scientists researching the potential connections between deep, restorative sleep and the protein fragment beta-amyloid recently found that poor sleep not only hinders the brain's ability to save new memories, but also creates a channel through which this Alzheimer's-triggering protein is able to travel and attack long-term memory storage.

"Over the past few years, the links between sleep, beta-amyloid, memory, and Alzheimer's disease have been growing stronger," William Jagust, a UC Berkeley neuroscientist, Alzheimer's disease expert and co-leader of the study said in a statement. "Our study shows that this beta-amyloid deposition may lead to a vicious cycle in which sleep is further disturbed and memory impaired."

This study is also one of the first of its kind to use human subjects, thanks to Jagust. He recruited 26 adult participants between the ages of 65 to 81 who had not yet been diagnosed with any form of dementia, or neurodegenerative, sleep or psychiatric disorders. They each received a PET scan to measure the accumulation of beta-amyloid in their brains, and were subsequently given 120 word pairs to memorize.

Each participant then slept for eight hours while an electroencephalographic test measured their brain waves. When they awoke the following morning, they received functional MRI scans to measure the activity occurring in the brain as they attempted to recall the word pairs from the night before. The results revealed that those with the highest levels of beta-amyloid residing in the medial frontal cortex not only had the poorest quality of sleep, but also performed the worst on the memory test. Some forgot more than half of the information they had consumed the previous day.

"The data we've collected are very suggestive that there's a causal link," said study co-leader Bryce Mander in a statement. "If we intervene to improve sleep, perhaps we can break that causal chain."

Previous research has implicated the deposits of beta-amyloid in the development of Alzheimer’s disease, because it begins destroying synapses before clumping them into plaques in the brain that lead to the death of important nerve cells. But this new study suggests that, while poor sleep creates the pathway for this nerve damage to occur, it is an entirely treatable issue. According to Matthew Walker, a UC Berkeley neuroscience professor and senior author of this study, exercise, behavioral therapy and electrical stimulation of brain waves during sleep are all viable ways for young adults to increase their overnight memory -- and protect against the build-up of beta-amyloid proteins.

"Sleep is helping wash away toxic proteins at night, preventing them from building up and from potentially destroying brain cells," Walker said in a statement. "It's providing a power cleanse for the brain."

The aging of the baby boomer generation is expected to make Alzheimer's disease one of the world's fastest-growing and most debilitating public health issues, so this discovery offers a sense of hope. Sleep won't just leave people feeling well rested -- it may help them fight future memory loss, and even limit the degradation that is already occurring in those with dementia.

The study was published in the journal Nature Neuroscience earlier this week.