Melatonin – should you ever take it?
Melatonin – should you ever take it? Melatonin is much over-hyped for sleep problems. Its usefulness for insomnia is limited. However, it is clearly useful for disorders of the sleep-wake rhythm. It is useful in delayed sleep phase syndrome, shift work disorder, jet lag syndrome. For delayed sleep phase syndrome, along with behavioral treatment and…
Morning start times should be after 8:30 am The American Academy of Pediatrics, the American Academy of Sleep Medicine, and the Centers for Disease Control and Prevention agree that school morning start times should be after 8:30 am. Yet only one in six middle and high schools start after 8:30 am. High schools are particularly…
Insurance Company Hall of Shame – United Health Care Recognizing that a private health insurance companies primary purpose is to make profits for itself, most insurance companies still try to do right by their members. There should be an Insurance Company Hall of Shame for those insurance companies that do not. Many private insurance companies…
Sleepy people and people with attention deficit have increased risk of accidents Why do sleepy people and people with attention deficit (ADD, ADHD) have about an equal increase in risk of motor vehicle accidents? Normal people who are texting or using the cell phone (even hands-free) also have a higher risk of accidents. As do…
Which is the Best Mattress? Patients (and even referring physicians) often ask me which is the best mattress? Which mattress should they buy? What they want to know is which mattress will help them sleep better. There is astonishingly little scientific evidence on what makes for a good mattress. We do know that support of…
Cannot tolerate APAP? You are not alone! Are you one of those who cannot tolerate APAP (Auto-titrating Positive Airway Pressure) for sleep apnea? You are not alone! Sleep apnea is diagnosed based on finding apneas (90% decrease in airflow) and hypopneas (30% decrease in airflow plus 4% drop in blood oxygen). APAP works by supposedly…
Not getting enough sleep may set you up for brain damage We know sleep is necessary to clear toxins from the brain. Researchers just showed that even after one night of sleep deprivation, brain cells (astrocytes) that eat up connections between nerve cells become more active. This, in itself, may be an adaptive and necessary response…
Is it Necessary to Test for or Treat Sleep Apnea without other Symptoms? The US Preventive Services Task Force states it is not clear whether people without symptoms should be evaluated or treated for obstructive sleep apnea. I agree. We should not go out and test everyone for sleep apnea. We probably should not treat…
Sleep Apnea Hurts Hearts According to the National Healthy Sleep Awareness Project (full disclosure: I am the Chair of the Public Communication Workgroup, but this blog is my personal work and is not written in an official capacity), sleep apnea hurts hearts. H = heart attacks E= elevated blood pressure A = atrial fibrillation (A-fib)…
Happy Patients and Unhappy Patients Every good doctor has happy patients and unhappy patients. There are many physician review websites, and patients use these often. They check out physicians on these website before they see them. They write reviews on these websites. However, the highest rated doctors may not provide the best care. Doing the…
When and how much should we sleep? Most adults generally need 7-9 hours a day in bed (or the chair or wherever it is that they sleep), and will sleep 6-8 hours of this time. If they get less time in bed or less sleep, their performance is impaired and they may feel tired and…
Evidence Based Policy is the Best Policy – Evidence Based Knowledge is called Science Yesterday, we were at the March for Science at the Capitol in Lansing, MI. Science is fundamental to our civilization. The internet and the computer (desktop or mobile) you use to read this is a result of science. Scientific agriculture gives…
Poor Patient Compliance – Does the Physician Share Responsibility? We physicians shrug our shoulders when patients do not comply with or adhere to their treatment. Should we look at our responsibility for patient compliance and adherence? There is recent evidence that whether you become addicted to opioid painkillers depends on which physician prescribes gets you…
Fist Bumps Spread Fewer Germs than Handshakes This image shows powder transferred during a handshake, to demonstrate that the custom is far less hygienic than the modern fist bump. (Prifysgol Aberystwyth University) A fist bump is 20 times more hygienic than a traditional handshake, researchers report. Public health experts are urging handshakes to go the way…
Does the Fitbit really measure sleep? The Fitbit (and similar devices) has an accelerometer. It measures change in motion. That’s all. It does not measure brain waves, or breathing, or blood oxygen. It can tell whether there is a change in your movement. So if you are lying quietly and then start moving, it senses…
99th Percentile on Sleep Medicine Boards I retook the Sleep Medicine Board Examination this winter. The American Board of Medical Specialties requires us to retake them every 10 years now. Although I keep abreast of what is happening, I wondered how well I would do. After all, I completed my training trained 33 years ago. I…
Does Melatonin Help Insomnia? Does Melatonin really help insomnia? It is a hormone produced in the brain. We secret it continuously when it is dark outside. One purpose seems to be to signal that it is dark outside. We do not know what other purposes it has. Taking it by mouth is helpful in changing our body’s…
Tonsillectomy can be dangerous – test your child for sleep apnea before tonsillectomy for snoring Tonsillectomy or removal of the tonsils is the third most common surgery in children. There are more than half a million child tonsillectomies a year in the USA. Common reasons include repeated infections and snoring or sleep apnea (stopping breathing…
These are the top ten conditions to screen for obstructive sleep apnea. Obstructive sleep apnea is a potentially dangerous disorder that can wreck hearts and cause deaths. 1. Obesity (BMI ≥30): About one-thirds of US adults have BMI of 30 or greater. About half of those with BMI ≥30 have obstructive sleep apnea 2. …
Remember the New Jersey transit train crash in Hoboken, NJ recently? It appears the driver, Thomas Gallagher, fell asleep at the controls. After the accident, he has been diagnosed with Sleep Apnea. Sleep apnea is found in people who snore heavily. It may cause daytime sleepiness and increased risk of accidents. So, maybe sleep apnea…
Ten things to keep in mind for your snoring child: The snoring child may have sleep apnea. Here are some things to consider if your child snores. 1. Snoring is not normal in children. If your child snores, this may suggest sleep apnea, which means stopping breathing in sleep. This can lead to high…
Through most of my career in Sleep Medicine, it has not been clear why we need sleep. The answer is now becoming clear. A big reason we need sleep is to remove toxic materials from the brain. In addition to arteries and veins, the body has lymph vessels. These lymph vessels remove waste from our…
Long gone are the days when sleep was considered a luxury. A good night’s sleep is now understood to be just as, and possibly more, important than a balanced diet and exercise. In fact, the Centers for Disease Control and Prevention currently classify insufficient sleep as a full-blown public health problem. Lack of sleep not…
What is the relationship between ADHD and sleep? Children who have sleep disorders and attention deficit hyperactivity disorder (ADHD) may have similar symptoms, such as inattentiveness, overactivity and restlessness. Unlike adults who become drowsy and less active when sleep is disturbed, children may have the opposite response. The interplay between these disorders is significant, and diagnoses may…
A Michigan teen was nearly impaled after careening off the road when he temporarily fell asleep while driving. This case should serve as a sobering reminder of how sleep disorders can wreak havoc on people’s lives, and cause incidents of drowsy driving that can result in accidents and deaths. According to the National Highway Traffic…
A good night’s sleep is essential for proper childhood development and yet pediatric sleep disorders aren’t often talked about in parenting books and classes. Children can be afflicted by the same problems that adults have, though often with very different needs to resolve the issues. About 1 in 100 children are affected by a sleep…
Investigators have found that the driver of a Metro-North Railroad train wasn’t fully alert moments before the train rounded a curve at almost three times the speed limit and jumped the tracks, killing four people and seriously injuring 11, said a person familiar with the probe. The driver, William Rockefeller, 46, wasn’t paying attention, based…
Many people dismiss sleep, or treat it like a luxury they can barely afford. Our busy lives are making it much more commonplace to accept as a badge of honor our sleepless nights- but to what consequence? New research indicates how high a price we may pay for overlooking signs of insomnia. Scientists at Massachusetts’ Brigham & Women’s…
