Deirdre Budd’s Blog

Archive for May 2009

Sleep is a natural body process. Within our brain lies a body clock which is cued to sleep when darkness falls. The genetic make up of our bodies means that for some, where parents or grandparents have sleep disorders, we and possibly our children may also have sleep disorders. It has been proved that we can affect this body clock. We have learned to work  and play after dark, because we can extend “light” with electricity. Once we develop a rhythm we can stick to that rhythm and teach our internal clock to follow this. This is what allows shift workers to manage in “un-natural” work patterns.

Recently “jet lag” was looked at as a sleep management issue.  There  was a broadcast on television looking at two athletes who regularly travel from the UK to the USA. The return flight brings issues of sleep disturbance for a few days afterwards so two different approaches were tried. One flew back living on the “bodyclock setting” of the USA, eating the in flight meals and drinking as he wished. The second had no inflight meal and drank only water. Going without food until his return and then having a high carbohydrate meal at a UK mealtime he slept well overnight and woke the next day without any feelings of Jetlag.

The second, who had travelled on the same flight and eaten the inflight meal, returned to the UK and stayed up for a few hours. Had a high protein meal and went to bed at his “normal in the UK ” bedtime, was still experiencing adjustment problems for  the next two days. This was certainly not a scientific study but it does underline the fact that we can “trick” our internal clock into allowing us to alter our wake/sleep pattern to suit our lifestyles.

Sleep disorders can be improved if not resolved by working to change behaviour patterns before they become too entrenched in our psyche.

Advertisements

How many people have a snack before bedtime and then find they cannot sleep? A light snack before bedtime, which contains the amino acid Tryptophan can help promote sleep.  Protein before bedtime has the reverse effect, high protein foods contain Tyrosine an amino acid which stimulates brain activity.

Good bedtime snacks include tryptophan,calcuim and carbohydrate this combination calms the brain and allows you to sleep better. Think about having a glass of warm milk and ;-

  • half a sandwich of turkey, or peanut butter.  or,
  • a banana and a cup of hot chamomile tea or,
  • whole grain low sugar cereal with low fat milk or yogurt.

Narcolepsy is a chronic disorder caused by the brain’s inability to regulate sleep-wake cycles normally. It is relatively rare and accompanied by a significant degree of functional impairment. The hallmark of Narcolepsy is excessive daytime sleepiness. Other symptoms include cataplexy sleep paralysis and hallucinations during sleep onset or awakening. It is not usually definitively diagnosed until about 10-15 years after symptoms appear.

Recent research shows that narcolepsy is related to unique gene variants and auto-immunity. It is reported in Nature Genetics that it is hoped that defining the changes in the T cell receptor associated with narcolepsy and catoplexy it may later be possible to develop drugs which will prevent the onset of narcolepsy.

At the moment the symptoms of narcolepsy are often misdiagnosed, particularly in children and adolescents, as psychiatric or behavioural disorders such as ADHD, depression and even psychosis. Most people find that the symptoms worsen over the two or three decades after they symptoms first appear.

Current treatment of Narcolepsy can usually result in control the daytime sleepiness, and the loss of muscle tone (cataplexy). Each treatment plan includes medication, education and behavioural changes. Narcolepsy is a chronic lifetime disorder that will always require management. The goal of treatment is adaptation and improved quality of life.

One expects that adolescents will sleep for 9-9.5 hours but, when reviewed as a group most only have 7-7.25 hours sleep. Studies suggest that many teens spend a good part of the day with a degree of sleepiness equivalent to people with narcolepsy. This suggests that they become chronically sleep deprived. There are many things that impact on the adolescent and can result in delayed sleep onset. Homework, jobs, after school activities and a distinct variation of sleep-wake patterns at weekends contribute to this sleep deficit. The consequences are easily noted in mood impairment, negative effects on attention, memory, behavioural control, motivation and academic performance.

Data suggests that partial and chronic sleep deprivation is a serious problem in this group and that “high achievers” who are involved in many extracurricular activities may well be at high risk. Around the time of the onset of puberty adolescents develop an approximately 2 hour later sleep onset and wake time. This is as a direct result of pubertal/hormonal influences on the circadian rhythms and on melatonin secretion. In mid to late puberty adolescents have a physiological tendency to develop decreased daytime awareness levels.

Adolescents may suffer from a number of sleep disorders. The prevalence of these is thought to be about 20% and those with chronic medical or psychiatric problems such as depression may be at increased risk. The disorders commonly seen at this stage include;-

  • Insomnia 
  • Delayed Sleep Phase Syndrome
  • Restless Legs /Periodic limb movement disorder
  • Narcolepsy

It is therefore particularly important that the “rules of good sleep hygiene”  are followed during this time. Healthy sleep habits and continuing as far as possible to maintain regular bed time and wake times are important re-enforcers of a good circadian rhythm. Parents should be aware of their child’s circadian preference whether the child has been an “owl” or a “lark” before the arrival of puberty and this needs to be taken into account when setting appropriate bed and wake times.