Tuesday, June 9, 2009

Second Day of SLEEP 2009 Coming to a Close

The final discussion group, symposia and oral presentations for the second day of SLEEP 2009 are underway and will conclude at 4:45 p.m. Pacific Time.

American Academy of Sleep Medicine section members will be in section meetings from 5 p.m. to 7 p.m.

Day three of the scientific program will begin with six more symposia at 8 a.m. Pacific Time on Wednesday.

Sleep in Posttraumatic Stress Disorder

Dr. Anne Germain, assistant professor of psychiatry at the University of Pittsburgh School of Medicine, is presenting an invited lecture on “Sleep in Posttraumatic Stress Disorder” until 2:30 p.m. Pacific Time. Topics being discussed include sleep disorders reported by patients with PTSD and effective pharmacological and behavioral treatments for sleep disturbances in PTSD.

The AASM reports that nightmares tend to be the most disturbing symptom of PTSD. In these dreams patients may relive a traumatic event in a way that seems shockingly real. View other common signs of PTSD.

In January the Sleep Education Blog reported that the U.S. Defense Department rejected the idea of awarding Purple Hearts to soldiers who have PTSD. Read
the full report.

SRS Installs New Leaders, Honors Award Recipients

Dr. Clifford Saper, the James Jackson Putnam professor of neurology and neuroscience at Harvard Medical School and chairman of the Harvard Department of Neurology at Beth Israel Deaconess Medical Center, was welcomed as the 2009 – 2010 president of the Sleep Research Society during the SRS General Membership Meeting this afternoon at SLEEP 2009.

Saper said that in the year ahead the SRS will continue to meet the educational needs of its diverse membership, promote the development of young scientists, encourage involvement in the membership sections, and support research grants for members through the SRS Foundation. He also announced that two of his personal goals as SRS president will be to marshal long-term grant support for the sleep field and to help forge a national network for sleep clinical studies.

Earlier in the meeting the 2009 – 2010 SRS board of directors was introduced. Joining Saper as officers are past president
Dr. Michael Vitiello, president-elect Dr. James Walsh, and secretary-treasurer Dr. Ronald Szymusiak.

Dr. David Rye, Dr. Gina Poe and Dr. Sean Drummond were introduced as newly elected directors at large, and Sara Nowakowski was welcomed as the new trainee member at large.

Then past president Dr. Eric Nofzinger, Dr. Ronald Chervin, Dr. Susan Redline, and trainee Eliza Van Reen were recognized for completing their terms on the board of directors.

The meeting also included the recognition of outgoing Membership Committee chair Dr. Bob Strecker, and a report from secretary-treasurer Szymusiak. Then Vitiello presented the 2009 SRS Young Investigator Award to three members: Dr. Sara Aton, Dr. Georgina Cano and Dr. Thien Thanh Dang-Vu

Vitiello followed with his president’s report, highlighting SRS initiatives from the past year. He then gave Saper a gavel to symbolize the transfer of leadership.

Ethnicity and Sleep Disorders

A symposium taking place until 12:15 p.m. Pacific Time is focusing on the associations between ethnicity and sleep disorders. Topics of discussion include current research in sleep health disparities and etiological differences in ethnic groups.

study in the Jan. 1 issue of the journal SLEEP reported that independent relationships between race and financial strain with sleep were observed despite statistical adjustment for other factors. Sleep was worse in African-American women than Caucasian women; slow wave sleep differences also were observed between Chinese and Caucasian women.

2008 study in the journal SLEEP reported that the prevalence of periodic limb movements in sleep was lower in African Americans than in Caucasians.

2008 study in the journal Ethnicity & Disease reported that blacks, Hispanics, and Asians were less likely than whites to report frequent sleep insufficiency.

The AASM also reports that in younger age groups,
obstructive sleep apnea has been reported to be more prevalent in African Americans compared with Caucasians.

You can
download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Increased Brain Activation Helps Insomniacs Maintain Daytime Performance

A study (# 0779) being presented this afternoon as an oral presentation used functional MRI to show that adults with primary insomnia have increased cerebral activation relative to good sleepers during a working memory task.

Differences appeared particularly in areas responsible for visual-spatial attention and coordination of cognitive processes. Compared with good sleepers, people with primary insomnia also showed significantly faster reaction times for correct responses and no difference in the number of errors committed.

Results suggest that people with primary insomnia may compensate for the detrimental effects of poor sleep to maintain adequate daytime performance.

You can
download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Discussion of IOM Report on Medical Resident Duty Hours

A discussion group taking place until 12:15 p.m. Pacific Time is reviewing the recommendations made last December by the Institute of Medicine of the National Academies in its report, “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety.”

The IOM report, which was sponsored by the U.S. Agency for Healthcare Research and Quality, is a follow-up to the 2003 duty-hour regulations that were established by the Accreditation Council for Graduate Medical Education (ACGME) for ACGME-accredited residency programs in all 120 ACGME-accredited specialties and subspecialties. The
ACGME regulations for medical resident duty hours, which took effect on July 1, 2003, set a weekly limit of 80 hours, averaged over four weeks, and established other provisions to promote adequate rest for residents.

Read the Dec. 2, 2008,
statement from the AASM about the IOM”s independent analysis of current duty-hour regulations for medical residents.

The Genetics of Insomnia: Stress & Intrusive Thoughts

A study (# 0781) being presented this afternoon as an oral presentation examines the underlying genetics of insomnia. Results of the twin study show that sleep reactivity to stress may mediate the genetic relation between insomnia and intrusive thinking/ruminative thoughts. The study also found an environmental variance in intrusive thinking that predicts insomnia; this suggests that behavioral treatments could be designed to target specific environmental triggers that promote rumination.

A clinical workshop relevant to this study will take place today from 10:15 a.m. to 12:15 p.m. Pacific Time. “Arousal-reducing and Cognitive Techniques in the Treatment of Insomnia” will include discussions on progressive relaxation techniques for insomnia and constructive worry treatment strategies for intrusive thinking.

You can
download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Nightmares & Other Parasomnias

Two studies being presented later this morning as posters focus on parasomnias – undesirable physical events or experiences that occur during entry into sleep, within sleep or during arousals from sleep.

One study (#0600) reports that the prevalence of parasomnia symptoms in patients with obstructive sleep apnea is higher than the prevalence rates of individual parasomnias in the general population. Of 537 adult participants with OSA, 51 (9.5 percent) had at least one type of parasomnia complaint; in the general population, the reported prevalence of common parasomnias is 2 percent to 5 percent. The most commonly reported complaints were sleep paralysis, sleep-related hallucinations and symptoms suggestive of REM sleep behavior disorder.

Another study (#1120) found that self-reported nightmares by adult patients seeking emergency psychiatric evaluation uniquely predicted elevated suicidal symptoms. Results indicate that after controlling for depression, the severity of self-reported disturbing dreams and nightmares independently predicted higher scores for suicide ideation as a non-significant trend; insomnia severity scores were no longer associated with suicide ideation after controlling for depression. The results suggest that nightmares may be an acute warning sign and risk factor for suicide.

You can download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Musicians & the Risk for Obstructive Sleep Apnea

A study (#0715) being presented later this morning as a poster examines the risk of obstructive sleep apnea in 847 professional musicians.

Results show that musicians who played a high-resistance wind instrument had a significantly lower risk for OSA, while playing a high-resistance brass instrument such as the trumpet or horn produced no difference in OSA risk. Specifically, musicians who played double-reed woodwind instruments such as the oboe or the bassoon had the lowest risk for OSA, suggesting that these instruments promote “naturalistic” respiratory muscle training. Overall, 29.2 percent of musicians had a high risk for OSA. Risk also was related to the number of hours spent practicing per week.

In January the Sleep Education Blog
reported on the theory that playing a wind instrument makes the muscles in the upper airway stronger, thus preventing soft tissue in the throat from collapsing and blocking the airway during sleep. The theory gained support from a small study in 2006 in the British Medical Journal. Results show that daytime sleepiness and sleep apnea severity improved in participants who played the didgeridoo.

Another study in the June issue of Sleep Medicine, however, found that wind players were more likely (odds ratio 1.47) than non-wind players to be at high risk for OSA; but this association was no longer statistically significant (adjusted odds ratio 1.12) after adjusting for age, body mass index, and gender. The researchers surveyed 1,111 orchestra members, including 369 wind instrument players.

You can
download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Sleep & Pregnancy

A symposium taking place from 8 a.m. to 10 a.m. Pacific Time is focusing on “Sleep Issues in Pregnancy.” Issues being discussed include alterations in sleep patterns, sleep disturbances and disorders, the impact of sleep problems on maternal-fetal and perinatal outcomes, and management options for sleep problems in pregnancy.

The AASM reports that pregnancy-related sleep disorders can include snoring and obstructive sleep apnea, restless legs syndrome and leg cramps.

Learn more about sleep and pregnancy on SleepEducation.com.

Teen Bedtimes Associated with Suicide, Depression & Grades

Two studies being presented as posters later this morning examine the negative impact of late bedtimes on teens.

One study (#1064) suggests that parental-mandated bedtimes could help protect teens from depression and suicidal thoughts by lengthening sleep duration. Results show that adolescents with parental-mandated bedtimes at midnight or later were 25 percent more likely (adjusted odds ratio 1.25) to suffer from depression and 20 percent more likely (adjusted odds ratio 1.20) to have suicidal ideation compared with adolescents who had parental-mandated bedtimes of 10 p.m. or earlier. Multivariate models show that sleep duration may have acted as a mediator of these associations; thus short sleep may be a risk factor for depression and suicidal ideation.

Another study (#0161) shows that being a “night owl” or “evening type” – preferring to go to bed late at night and wake up later in the day – is associated with lower academic performance in college and a decline in academic performance from college to high school. Results indicate that evening types had significantly lower first year college GPA (2.84) than “morning types” and “intermediate types” (3.18). They also slept on average 41 minutes less on school nights. For all students, “sleep hygiene” was related to academic performance.

You can download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Obstructive Sleep Apnea in Non-Obese Patients

The major predisposing factor for obstructive sleep apnea is excess body weight. But a study (#0565) being presented as a poster later this morning confirms a high prevalence of OSA in non-obese, adult patients who were referred to a sleep center for overnight polysomnography; the primary cause for referral was a complaint of excessive daytime sleepiness.

Each patient was 18 years of age or older; 57 percent were men. Patients were considered non-obese if they had a body mass index (BMI) of 18.5 to 27. Results show that OSA was diagnosed in 2,906 of the 5,426 non-obese patients (54 percent) who were evaluated by polysomnography at one of 18 sleep centers.

You can
download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Wired Teens, Sleep Loss & Obesity

A study (#0320) being presented as a poster later this morning shows that excessive use of technology by children and teens may be related to both sleep loss and obesity. The study involved 320 students between the ages of 10 and 18 years. Results show that children who had more hours of “screen time” (TV, Internet, computer and video games) got less sleep and consumed more caffeine. Having a shorter sleep duration was associated with a higher body mass index (BMI).

similar study (#0200) was presented yesterday and published in the June issue of the journal Pediatrics. Read a summary of the study on the Sleep Education Blog.

You can
download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Treating Insomnia without Drugs

Two studies being presented as posters later this morning show that non-pharmacological treatments for insomnia can be effective.

One study (#0821) concludes that when applied in a “real world” clinical setting, cognitive behavioral therapy for insomnia appears to be an effective treatment approach for various types of chronic insomnia such as sleep-onset insomnia and sleep-maintenance insomnia. Treatment produced significant improvements on presenting complaints as well as other measures such as sleep efficiency, average nightly awakenings, total sleep time and average nights of sleep medication use per week.

small pilot study (#0874) involving 11 adults with chronic primary insomnia shows that another effective behavioral intervention may be Kriya Yoga – a type of meditation that combines different yoga techniques. Results indicate that sleep latency, total sleep time, total wake time, wake after sleep onset, sleep efficiency, sleep quality and depression improved in patients who practiced meditation for two months.

In 2006 the American Academy of Sleep Medicine published, “Practice Parameters for the Psychological and Behavioral Treatment of Insomnia: An Update” in the journal SLEEP. View
the practice parameters online.

You can
download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Primary Insomnia Linked to a Neurochemical Abnormality

A study (#0768) being presented this afternoon as an oral presentation demonstrates a specific neurochemical abnormality in adults with primary insomnia, providing greater insight to the limited understanding of the condition’s pathology.

Results indicate that gamma-aminobutyric acid (GABA), the most common inhibitory transmitter in the brain, is reduced by nearly 30 percent in individuals with primary insomnia. These findings suggest that primary insomnia is a manifestation of a neurobiological state of hyperarousal. Approximately 25 percent of people suffering from insomnia are considered to have primary insomnia, which is defined as a difficulty falling asleep or maintaining sleep in the absence of coexisting conditions.

The research team also published their
study results in the November 1, 2008, issue of the journal SLEEP. Read the AASM press release.

The principal investigator of the study,
Dr. John Winkelman of Brigham and Women’s Hospital, a teaching affiliate of Harvard Medical School in Boston, Mass., will chair a related symposium later this morning at 8 a.m. Pacific Time. The symposium, “Neurobiological Correlates of Insomnia,” will explore the neurophysiologic features of insomnia.

You can download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Insomnia Linked to Diabetes Risk

A study (#0866) being presented later this morning as a poster indicates that insomnia with short sleep duration is associated with an increased risk of diabetes. Yesterday the same research team presented an abstract (#0868) showing that chronic insomnia with objective short sleep duration in men also is associated with an increased risk for mortality.

In the April 1 issue of the journal SLEEP, the researchers also published
a study showing that chronic insomnia with objectively measured short sleep time is an independent and clinically significant risk factor for hypertension. Read an AASM press release about the study.

According to the authors, these results indicate that objective sleep duration may predict the medical severity of chronic insomnia, and they suggest that the medical impact of insomnia has been previously underestimated.

You can download the SLEEP 2009 abstract supplement as an 11 MB file in PDF format.

Day Two of SLEEP 2009 Will Begin at 8 a.m. Pacific Time

The second day of the SLEEP 2009 scientific program will begin in about three hours at 8 a.m. Pacific Time.

The day will begin with six symposia from 8 a.m. to 10 a.m. Research abstracts will be presented as posters from 10:15 a.m. to 12:15 p.m. A variety of other sessions will take place throughout the day until 4:45 p.m.

View today’s
session schedule.