What I’m Reading…

An article on public policy vs academic research tackles salt, but I wonder if the same thing could not be said about dieting. 

If you were an academic researcher, you’d have to persuade your institutional review board that you had considered the risks and obtained informed consent from the participants. […]

But if you are the mayor of New York, no such constraints apply. You can simply announce, as Michael Bloomberg did, that the city is starting a “nationwide initiative” to pressure the food industry and restaurant chains to cut salt intake by half over the next decade. Why bother with consent forms when you can automatically enroll everyone in the experiment? 

Meanwhile, CNN reports on a correlation between insomnia and high blood pressure.   (Funny how articles on insomnia always make me worry about getting insomnia… which can make it harder to get to sleep … and stare at the clock all night … until I move it so I can’t see it from the bed … okay, I’ll quit pulling your leg now ;)

Sleep Quote

This quote from the NY Times made me giggle.  Dr. Judith Owens, who directs the Pediatric Sleep Disorders Clinic at Hasbro Children’s Hospital notes that the average early to mid-adolescent needs 9 to 9.25 hours of a sleep a night, then goes on to head off questions about kids who don’t need that much. 

“It’s a bell-shaped curve,” she said, with just 2.5 percent of the population needing significantly less sleep than average.

“The problem,” she went on, “is that 95 percent of us think we’re in that 2.5 percent.” 

Granted, the center of the adults’ bell-shaped curve is 8 hours, not 9.  And, as you get older, you tend to have more “fragile” sleep patterns – you’re more easily woken by things like noise or light.   Personally, I find not getting enough sleep can lead to an adrenaline high, but it can also just guarantee I feel sick all day.

How Goes Daylight Savings Time?

Most of the US switched our clocks forward an hour over the weekend.   At the moment, I’m mostly enjoying that it’s not getting light before 7am and the sun doesn’t set until about 7pm.  (Remember, I’m up at latitude 47 – we get almost 16 hours of sunlight in late June, and less than 9 in late December.)

Usually I hate the switch back to standard time in fall, and am often sleep-deprived for a week after the “spring forward”.  I do tend to adjust to daylight time as spring goes on, probably because the days get longer anyway.  Today’s “Really?” column pulled together some research on how daylight savings time can screw up sleeping and cause other health problems.

How’s it going for you all?

Correlations vs Causation

You may have read that getting less sleep is associated with heart disease.  This one included a well-written description of how correlations are not causation. 

Senior author Diane S. Lauderdale cautioned that the new report does not prove a cause-and-effect relationship between a lack of sleep and heart disease.

“It’s important to say that this is the first report and this does not yet prove the association is causal,” said Dr. Lauderdale, an associate professor of health studies at the University of Chicago Medical Center. “Until we know what the mechanism is — that it’s really a direct or a causal relationship — there is no point in making recommendations based on this.”

Although a number of studies have suggested that people who sleep less are at greater risk of heart disease and death, this is the first investigation to measure how much its subjects actually are sleeping, said Dr. Sanjay Patel, assistant professor of medicine at Case Western Reserve University and expert in sleep medicine. Patients’ own self-assessments can be very inaccurate, he added.

What isn’t clear is whether reduced sleep triggers physiological changes that increase heart disease risk, or whether a third, unrelated factor causes both changes, he said.

“It’s possible, for example, that people who are under more stress may be both sleeping less and at higher risk of heart disease,” Dr. Patel said.

If so, he added, “If we got those people to sleep more but they still were under a lot of stress, it wouldn’t change their risk of heart disease.” 

Pity we don’t see more of this sort of clarifying about, oh, being fat.  When you look up, oh, “obesity” on the CDC website,  it’s “Obesity increases the risk of many diseases and health conditions.”   When you do see it, it’s “[Is] Obesity a Disease or Just a Symptom”?   Suggesting that someone with a BMI of 27 – considered “normal weight” in the early 90s – could be healthy without losing weight is heresy. 

Or maybe I’m just feeling gruntled today :)   Am I overreacting?

Importance of Sleep

So far today I have:

  • Woken up with a headache. 
  • Repeatedly bumped into the bed while getting dressed. 
  • Forgot my yoga bag when leaving for work.  
  • Forgot to use my inhaler before going for a walk.   

I am also feeling generally run down, achey, and lacking in patience/cope.  Also in monster need of a nap.  

Am I sick?  No.  I didn’t get enough sleep last night or the night before.  

I would like to add references on how sleep is good for Health and Wellbeing but I think the fact that I feel like total crap kinda speaks for itself  ;)    Well, okay, here’s one.  And another.  Okay, and a book I found helpful, called The Promise of Sleep.  There.  Time for more coffee.   And I will likely take another walk later. And I did go back for my yoga bag….

Day in the life: Waking up

Often I wake before the alarm. Usually I snuggle under the covers until it goes off.  The man of the house may already be up, but he knows I’m still “sleeping” until my facemask comes off.

I have moderate “obstructive sleep apnea” (OSA)

Image of my CPAP mask

Manufacturer's pic of my CPAP mask

I sleep with a CPAP (Continuous Positive Airway Pressure machine) which is basically a fan with a facemask to keep the airway open.  The CPAP is touted as 100% effective in treating sleep apnea among those who actually, you know, use it, and I actually do.

What is sleeping with a CPAP like?  Initially it was very weird, breathing with all that air inside my windpipe.  Exhaling especially.  I felt like I was drowning in air for the first 20 minutes.  I coped by reading (fortunately the mask doesn’t keep me from reading) and after an hour I felt fine.

What does it do for my sleep?

  • I sleep longer without waking myself up.  I generally feel better after 7 or 8 hours of sleep than I used to feel after 9 or 10.
  • My mouth isn’t dry when I wake up.
  • It’s much rarer for me to have a sore throat when I wake up.

My mask actually has a cap on the top of my head – rather like a bike helmet. The air tube connects on my head, then feeds down between my eyes to the nose. Instead of a cap over the nose there are two ‘nasal pillows’ that feed air to my nostrils. It appealed to me because it seemed less likely that I’d roll onto the air tube in my sleep.  (You can see a picture of the style here.) This style doesn’t touch my face much, which means fewer zits  :)

Sleep apnea is considered to be “obesity-related”

I went in meet with a sleep specialist expecting be told, “Yes, you have apnea, now lose weight”.  I had geared myself up for an argument over the ease of losing weight vs other treatment.  I was ready to point out that I KNOW thin people get sleep apnea, because I grew up hearing my thin, athletic father stop breathing between snores.

I found there was no fight necessary.

Going over the intake paperwork, the doc saw that my parents both snored.  He asked me about their snoring; mom’s was steady, dad’s was loud but interrupted, and I sometimes heard him wake up briefly before resuming snoring.  The man of the house confirmed that I stop breathing, too.

“Sounds like you and your parents have sleep apnea,” he said, “It often runs in families.  Me, my brothers, our father, his brothers – we’re all skinny snorers.”

“Skinny snorers?”  It was a new term for me.

“Yup.  Sleep apnea is related to weight, as a physical thing, becase more weight means the muscles have to work harder to expand the chest.  But it is also related to the size of the airway.  Both weight and airways are hereditary, so.” He pulled out a flashlight.  “Mind if I look at the airway in your mouth?”  He peered in, nodded, and said, “You’d probably be a skinny snorer.  Lose weight if you want – but don’t expect that it’ll fix the sleep apnea.”

Will losing weight fix sleep apnea?

Imagine my surprise when I saw sleep apnea listed as a justification to have weight-loss surgery by the NIH among those who are otherwise not “fat enough”.

A study on how weight-loss surgery affects sleep apnea recently released its results.

A new study shows that obstructive sleep apnea often persists after weight loss surgery, but most patients don’t realize that and wind up taking risks with their health. […]

It’s not that their sleep apnea was unchanged. Their symptoms eased to varying degrees, but not enough to end their obstructive sleep apnea.

You do not have to be fat to have sleep apnea.  Before she died, my mother and I tried to get my father in for a sleep test, both before and after I got my CPAP.  Dad refused.  He still refuses.   I hope others out there have more sense.

(And be glad they have CPAPs now.  Much nicer than a tracheostomy!!)