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Sleep apnea, sleep solutions,
Judith Paley, MD
The University of Louisville 's Dr. David Gozal notes that "Sleep apnea and an unhealthy diet...are a major disaster for the brain."
We know that if the cells responsible for learning and memory formation in your brain's hippocampus aren't happy, you may not remember your doctor's wise advice on a healthy lifestyle by the time you get home from your appointment. For more information about Dr. Gozal's findings on the link between a sharp memory, a good night's sleep, and a brain-healthy diet, read on below.
This newsletter also contains information on a new sleep medication that will soon be available to turn unhappy night owls into morning meadowlarks.
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This information is intended to be general in nature and should not be relied upon for specific treatment. If you need medical attention, please contact your personal physician's office for an appointment.
Sleep apnea and the hippocampus
If your sleep is disrupted by an irregular breathing pattern known as sleep apnea, research suggests that as you snooze, you lose...brain cells that is. Sleep experts have long known that persons who are restless by night from sleep apnea are befuddled by day, and they assumed that such foggy-headedness resulted from fatigue. Investigators in Kentucky beg to differ, however, after they discovered that periodic lack of oxygen in rodents wreaks havoc on the brain's memory center called the hippocampus.
Dr. David Gozal and his colleagues studied ratty little brains and found that intermittent hypoxia (IH)--the episodic drop in blood oxygen levels that occurs during the prolonged respiratory pauses of sleep apnea--causes apoptosis or death of neurons involved in memory and learning. On the other hand, sustained low oxygen levels such as those that might occur in rats residing in Leadville , CO or in a Tibetan monastary, causes protective adaptive changes that spare these vital brain areas.
These research findings suggest that untreated and prolonged sleep apnea may lead to permanent changes in brain functioning. There is good news, however, from the Southern rodents. Those animals who agreed to undertake the rat-sized equivalent of a one hour daily walk in the park were protected against the destructive effects of IH on their brains.
Bad news, on the other hand, from an analysis of the effects of diet on rat brains exposed to IH. The rats who ate a high-fat, refined-carbohydrate diet (as in American convenience foods) were dazed in their mazes, and the inability to figure a route out was magnified if this lousy diet was paired with IH. The combined effect of IH and fast food on rats prompted Dr. Gozal to call such double trouble "a major disaster for the brain."
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Melatonin and beyond
There's more than one way to lose a night's sleep. One primary sleep disturbance is called delayed sleep phase syndrome (DSPS). Insomniacs suffering from DSPS are ticking along to their own internal biological clocks which, unfortunately, are seriously lagging behind the rest of the world. Their ability to fall asleep is delayed relative to the external environment, continually disrupting the expected routine of their daily lives. Their personal night's sleep typically begins at 2 a.m. or later, and, no surprise, they have a terrible time rallying to a 7 a.m. alarm. Persons with DSPS can get plentiful sleep, just not at conventional hours.
The list of treatments for DSPS is distressingly short, and includes a lot of "sleep hygiene" behavioral therapy which is difficult to institute and stick with, especially if the DSPS victim happens to be a know-it-all teenager. Conventional sleep medications are generally not successful over an extended period of time.
Melatonin, a natural hormone produced in the body's pineal gland promotes sleep by soothing the neurons of the internal body clock in the brain's hypothalamus. It has been used with varying success to treat DSPS; a recent review of several studies confirmed that its use in this disorder decreases sleep onset latency--the time between lying down to drifting off .
Enter Rozerem (what is with these drug names?). This drug is a melatonin receptor agonist, acting at the same cell sites as melatonin, only doing a better job of it than melatonin pills. Specifically indicated for use in persons unable to get to sleep, Rozerem is non-addictive and approved for use over a long period of time. It has been shown to carry no risks of abuse, withdrawal, or dependency, and does not create next-day hangovers.
The FDA gave Rozerem the green light last month. A spokesperson for Takeda Pharmaceuticals enthused, "Rozerem represents an exciting new option in sleep medicine that we anticipate can help millions of people who live with sleepless nights and sluggish days."
Perhaps I'll soon see my son bright-eyed at the breakfast table!
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Got DEET?
Denial is a bad strategy when considering West Nile . In the June edition of this newsletter, I mentioned that West Nile fever (a mild version of a West Nile virus--WNV--infection) is generally a mild disease with many persons experiencing few or no symptoms. A recent review in the Annals of Internal Medicine suggests that it may, in fact, be more severe than originally documented.
Illinois investigators interviewed nearly 100 persons with documented WNV infections based on laboratory evidence but no evidence of complications such as meningitis. Notably, 96% of them reported fatigue that, on average, lasted over a month. A majority also had a fever for at least five days, a headache for 10 days, muscle weakness for almost a month, and trouble concentrating for two weeks. Among those who normally attended work or school, a majority missed these activities for at least 10 days.
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Russian birds catch the flu
Speaking of viruses we could live without, Russian officials reported last month that chickens in Siberia hanging out with wild birds have come down with what they believe is H5N1 avian influenza. Unfortunately, Russia 's public health system is seriously deficient in rural areas, and health officials are now worried that the virus will spread into Europe .
This strain of flu has affected millions of birds in Southeast Asia and China . Thus far, it has not presented a serious threat to human health, and there are no definite cases of transmission between persons. Experts are fearful, however, that a mutation in the viral package will someday allow the disease to easily infect and pass from human to human.
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Dr. Paley welcomes comments and questions at judy.paley@femailhealthnews.com. Please see about femailhealthnews for more information on Dr. Paley and this newsletter.
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