Sleep Issues Impact Health in Myriad of Ways

Sleep is something we all need but few of us realize just how important it is for our overall health. Too little sleep on a chronic basis can increase the chance of you having issues with weight gain. It also impacts how alert you are when driving or going about your day.

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There is a linear correlation between obesity and obstructive sleep apnea (OSA). A four-year study of overweight and obese American adults showed a change I weight directly proportionate to sleep-disordered breathing. Those with the most weight gain had a more severe apnea-hypopnea index (AHI). The risk of OSA increases with age and body mass index (BMI); other associated factors seen in a cohort of Australian men included sedentary lifestyle, tobacco abuse, and heavy alcohol use. OSA is also strongly correlated with multiple disease conditions including type 2 diabetes, hypertension, heart failure, and depression.
CPAP (continuous positive airway pressure) is a machine used to deliver constant airflow to patients airway via nasal, facial, or oral devices. In young adults, disturbed sleep management should include attention to stress and depression. The impact of obesity on OSA is evident in several populations across different cultures. The positive relationship between obesity and OSA has been confirmed by this study. This is an important public health crisis that demands multi-layered intervention. Stress needs to be on a change in dietary habits; fresh fruit/vegetables rather than junk food, water rather than soda. Solving this issue is not only the responsibility of an individual but should be addressed by government officials to improve the health of individuals and make an overall healthier society (Jehan et al, 2018).

Circadian abnormalities have been associated with Autism Spectrum Disorder (ASD) based on separate reports of sleep and hormone irregularities. ASD is only diagnosed reliably after two to three years of age so this study was tracking the developmental trajectory of sleep and hormone rhythms of infants at greater risk because of a sibling with ASD. Sleep disturbances are a useful clinical marker of more severe learning problems related to working memory deficits in higher functioning ASD. EEG (electroencephalogram) in Autistic children has shown that the activity is slowed during sleep. This difference is thought to make sleep difficult and mood disorders are common co-morbidities in children with ASD. Some studies have shown children with ASD have less REM sleep compared to other children without ASD. In addition, there are associations between REM sleep and emotional state has been reported.

The study shows the autistic brain is an atypical organized brain network. However, parental reports of sleep problems may not be sufficient in screening whether children are getting enough sleep. It is felt parental perceptions of what is a sleep problem or lack of awareness regarding healthy sleep guidelines. Screening for sleep disorders should be part of the early ASD treatment plan (Harrison et al, 2017).

Since pioneering work of defining REM sleep and demonstrating neural circuits in the brainstem are necessary and sufficient for REM sleep generation, our knowledge of neural circuitry for regulating REM sleep had been steadily advancing. However, the essential molecular factors for defining the output of the brainstem circuit have been elusive. Sleep is known to allow animals to re-energize themselves and consolidate memories. REM sleep is known to play an important role in maintaining a healthy mental and physical life. A study done in Japan has finally identified a pair of genes that regulate how much REM and non-REM sleep an animal experiences.

Sleep is a universal and vital behavior for higher vertebrates as well. Their sleep is classified into two phases; REM and non-REM. During REM sleep our brain is as active as it is during wakefulness. It is this stage that is believed to function in memory consolidation. A research team has identified two essential genes involved in the regulation of REM sleep. The amount of REM sleep was drastically decreased down to almost undetectable levels which the two identified genes were knocked out. The findings suggest that the two identified receptors are essential for sleep regulation, especially REM, and function in different ways. One surprising result was that the mice are viable despite the almost complete loss of REM sleep. This will allow researchers to verify whether REM sleep plays a crucial role in fundamental biological function like learning and memory (Niwa et al, 2018).

Sleep problems especially delayed sleep onset, predict worse behavior problems in youth. There is increasing evidence that sleep problems are a risk factor for a wide range of internalizing and externalizing disorders. This information has led to suggestions that normalization of sleep patterns in children could improve mood and behavior.

Sleep loss acutely impairs the executive functions necessary for effective emotion regulation, especially when faced with frustration. Sleep debt impacts the capacity to understand ambiguous situations, recognize facial affects, and process negative emotional stimuli. Sleep problems have been associated with a wide variety of psychological disorders from ADHD to depression. Chronic sleep problems may be more likely to lead to an increase in irritability and temper outbursts in children already at risk for behaviors due to the presence of other regulatory deficits.

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Between 25% and 50% of youth with ADHD have impairments in emotional regulation. Chronic sleep problems may lead to the development of persistent irritability and frequent temper outbursts. Numerous studies have observed elevated rates of parent-reported sleep problems in youth with behavior problems. Sleep problems have also been linked to oppositional behavior. Difficulty falling asleep and restless sleep was frequently reported by parents of ADHD children. Unfortunately, as promising as the research reported in this article, if sleep is simply normalized without also addressing co-existing psychological problems, little change will be seen or reported (Waxmonsky et al, 2017).

Approximately 25% of US adults report insufficient sleep or rest. Insufficient sleep is associated with numerous health issues. Evidence has shown a correlation between sleep quality and BMI with individuals who report fewer hours of sleep are more likely to be overweight or obese. Young adults appear to be particularly at risk as it has been reported a majority of college students get less than 8 hours of sleep a night. Some of the reasons for this have been attributed to excessive alcohol use, caffeine use, and electronic media before going to bed.

This study looked at whether stress and depression were predictive of sleep quantity and quality. The study reported that nearly one third had difficulties falling asleep and nearly 10% reported they had trouble staying awake more than three days a week. The study also found that sleep quality the strongest predictor of well being among college students. The study noted it is important to not only assessing sleep duration but also sleep quality as a better measure of sleep problems versus sleep quantity. It is suggested that college administrators need to continue to address levels of both chronic stress and depression of their student body. And although most college offer counseling to students few make use of it because of time constraints and stigma (Wallace et al, 2017).

Work Cited
Harrison, E.M.; Dobkins, K.; & Glickman, G.L. (2017). Sleep and Neuroendocrine Profiles in three and nine-month-old infants with a family history of Autism. Sleep, 40. Clinical Sleep Science. http://www.sleepmeeting.org

Jehan, S. et al. (2018). Obstructive sleep apnea and obesity: Implications for public health. Department of Health and Human Services Public Access. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836788/pdf/nihms932293.pdf

Niwa, Y. et al. (2018). Muscarinic acetylcholine receptors Chrml and Chrm3 are essential for REM sleep. Cell Reports,24(6).doi:10.1016/j.cellrep.2018.07.082

Wallace, D.D.; Boynton, M.H.; & Lytle, L.A. (2017). Multilevel analysis exploring the levels between stress, depression, and sleep problems among two-year college students. American College Health,65(3). Department of Health and Human Services. Doi:10.1080/0744848.2016.1269111

Waxmonsky, J.G. et al. (2017). Association between disruptive mood dysregulation disorder symptoms and sleep problems in children with and without ADHD. Sleep Medicine,37(9). Elsiever.http://dx.doi.org/10.1016/j.sleep.2017.02.006

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