Researchers used a comprehensive and contemporary form of group-based cognitive-behavioral therapy to treat child war and sexual violence victims in the Democratic Republic of Congo (DRC) in central Africa. Cognitive-behavioral therapy has been successfully used to treat child victims of sexual violence in the West, although this was the first attempt to adapt the intervention for use in developing countries affected by war and sexual violence.

Amazingly, researchers discovered the intervention reduced the trauma experienced by child victims of war, rape and sexual abuse by more than 50 percent.

Researchers at Queen’s University Belfast pioneered the intervention in conjunction with the international NGO World Vision.

The trial setting, Eastern Congo, has the world’s highest rate of sexual violence. Known as “the rape capital of the world,it is estimated that girls and women in the eastern DRC are 134 times more likely to be raped than their counterparts in the West.

After only 15 sessions of the new group-based Trauma-Focused Cognitive Behavior Therapy (TF-CBT), Queen’s researchers found reductions of:

• 72 percent in trauma symptoms in female victims of rape and sexual abuse;
• 81 percent in feelings of depression and anxiety;
• 72 percent decrease in conduct disorder;
• 64 percent decrease in anti-social behavior.

Researchers believe the knowledge gained in the multifaceted intervention can also be used to improved group-based cognitive interventions in the West. Sadly, in war-affected countries, such as the DRC, victims of rape and sexual violence often do not receive any psychological or even medical help.

In the Queen’s study, the children received sessions of trauma psychoeducation, relaxation techniques, mental imagery techniques, and tips on how to identify and change particular inaccurate or unhelpful cognitions.

The girls also drew pictures of their most traumatic events and were encouraged to talk about these events in individual sessions with Queen’s psychologists and a team of Congolese counselors.

Speaking about the implications of the results for treating child victims of war and sexual abuse worldwide, Paul O’Callaghan, from Queen’s School of Psychology, said, “It is not surprising that studies show sexual abuse to have a profoundly detrimental effect on the mental health of girls in war-affected countries, but what is surprising was just how successful the intervention was in reducing psychological distress.

“The dramatic reduction in trauma, depression and anxiety, conduct problems and anti-social behavior shows that this kind of therapy is very effective in treating war-affected children who have been exposed to rape and sexual violence. In addition to the statistical results of the therapy, many of the girls attested to how the intervention helped reduced their terrible nightmares, disturbing flashbacks and suicidal thinking,” O’Callaghan said.

“For me, that was the most rewarding part of our work in the DRC.”

The study, which took place over five weeks in 2011, also treated the psychological distress of 50 war-affected boys between the ages of 12 and 17. It was shown to dramatically reduce levels of trauma, depression and anxiety, conduct disorder and anti-social behavior in male child soldiers and street children.

Source: Queen’s University Belfast

Child looking out door photo by shutterstock.

“OSA is known to be associated with deficits in attention, cognition, and executive function,” said lead author Ann Halbower, MD, associate professor at the Children’s Hospital Sleep Center and University of Colorado-Denver. “Our study is the first to show that treatment of OSA in children can reverse neuronal brain injury, correlated with improvements in attention and verbal memory in these patients.”

In the study, children between the ages of 8 and 11 with moderate to severe OSA were compared to healthy children. Brain imaging with magnetic resonance spectroscopy imaging was performed before treatment in 15 OSA patients and seven healthy children, along with neuropsychological testing.

Treatment included an adenotonsillectomy — surgical removal of the tonsils and adenoids — followed by monitored continuous positive airway pressure (CPAP) or nasal treatments.

Brain imaging and neuropsychological testing was performed again in 11 OSA patients and the seven other children six months after treatment.

Before treatment, children with OSA exhibited significantly decreased N-acetyl aspartate to choline ratios (NAA/Cho) in the left hippocampus and left frontal cortex, along with significant decreases in the executive functions of verbal memory and attention, according to the research. Following treatment, both left and right frontal cortex neuronal metabolites normalized, and hippocampal metabolites improved. Improvements in attention and verbal memory were correlated with normalization of NAA/Cho in the right and left frontal cortex, Halbower said.

“We have demonstrated for the first time that treatment of OSA in children normalizes brain metabolites in portions of the neuronal network responsible for attention and executive function,” she said. “We speculate that if OSA is treated earlier, there may be a more brisk improvement in the hippocampus, a relay station for executive function, learning, and memory. Our results point to the importance of early diagnosis and treatment of OSA in children, as it could potentially have profound effects on their development.”

Source: American Thoracic Society

While testing the role of a gene called Glo1 in anxiety, scientists uncovered a new inhibitory factor in the brain: the metabolic byproduct methylglyoxal (MG). The study, published in the Journal of Clinical Investigation, found that animals with multiple copies of the Glo1 gene were more likely to exhibit anxiety-like behavior in laboratory tests, said Abraham Palmer, Ph.D., assistant professor of human genetics at the University of Chicago Medicine and senior author of the study.

“We showed that Glo1 was causally related to anxiety-like behavior, rather than merely correlated,” he said.

Further experiments showed that Glo1 increased anxiety-like behavior by lowering levels of MG. When researchers inhibited Glo1 or raised MG levels, it reduced anxiety behaviors.

In 2005, a comparison of different mouse strains found a link between anxiety-like behaviors and Glo1, the gene encoding the metabolic enzyme glyoxylase 1. However, subsequent studies questioned the link, and the lack of an obvious connection between glyoxylase 1 and brain function or behavior made some scientists skeptical, according to the researcher.

“When people discover a gene, they’re always most comfortable when they discover something they already knew,” Palmer said. “The alarming thing here was there was a discovery of something that nobody knew, and therefore it seemed less likely to actually be correct.”

A 2009 study from Palmer’s laboratory suggested that differences in Glo1 expression between mouse strains were due to copy number variants, where the segment of the genome containing the gene is repeated multiple times. To test this hypothesis, lead author Margaret Distler inserted two, eight or 10 copies of the Glo1 gene into mouse lines. She then ran experiments, such as the open field test, in which researchers measure how much time a mouse spends in the center of an arena versus along the walls, to detect changes in anxiety.

The results confirmed that mice with more copies of the Glo1 gene exhibited higher anxiety-like behavior, the researchers said.

“It’s the first study to show that it’s the copy number variant that has the potential to change Glo1 expression and behavior,” said Distler, an M.D./Ph.D. student in the Pritzker School of Medicine’s Medical Scientist Training Program.

The researchers then set about solving the mystery of how Glo1 influences anxiety-like behaviors. The primary function of Glo1 is to metabolize and lower cellular levels of MG, a waste product of glycolysis. Distler produced the opposite effect by injecting MG to artificially increase its levels in the brain, finding that raising MG levels quickly reduced anxiety symptoms in mice.

“Methylglyoxal changed behavior within 10 minutes of administration, which means it’s a rapid onset. It’s not changing gene expression, and it’s not having long-term downstream effects,” Distler said. “That was our first breakthrough.”

The short time suggested that MG might have a direct effect on neuronal activity, she said. MG also demonstrated sedative effects at high doses, a hallmark of drugs that activate inhibitory GABA receptors on neurons, the researchers add. In collaboration with Leigh Plant, Ph.D., now at Brandeis University, the researchers demonstrated that MG activated GABA-A receptors on neurons, a previously unknown inhibitory mechanism.

“It’s a completely different system that is tying neuronal inhibitory tone into metabolic activity,” Palmer said. “It turns out now that methylglyoxal, which has been around ever since glycolysis evolved, was also acting at these receptors, and nobody knew that.”

Anxiety is usually treated with drugs that activate the GABA-A receptor, such as benzodiazepines and barbiturates, which are prone to abuse and dangerous side effects. The researchers theorized that targeting the Glo1/MG interaction could provide a more selective strategy for reducing anxiety by subtly influencing inhibitory tone.

“The GABA-A receptor agents already out there have a lot of side effects, such as sedation and hypothermia, as well as a high abuse liability,” Distler said. “It’s possible that taking a Glo1 inhibitor will increase only MG levels to a certain maximum. You could have the potential for more specificity, given that you’re activating a system that’s already in place, not just dumping methylglyoxal or some other GABA-A receptor agent throughout the brain.”

Preliminary experiments with a small molecule inhibitor of Glo1 supported the theory. Injections of the inhibitor, developed by John Termini at the Beckman Research Institute of the City of Hope, reduced anxiety-like symptoms in mice.

“It’s a different way of hitting these GABA-A receptors,” Palmer said. “We have yet to determine if that’s a better way of doing it, but it’s certainly different, and it gives us a unique angle of attack on this system and potential advantages that we have yet to evaluate.”

Such a drug may also be useful in treating epilepsy and sleep disorders, where GABA-A drugs have shown success, he added.

While the therapeutic potential is yet to be determined, the research clears the fog around the role of Glo1 in anxiety by adding behavioral and cellular evidence, the researchers note.

“What’s neat is that we started with exploratory, open-ended genetic studies in mice, and we’ve now gotten into some fundamental new physiology that nobody had appreciated or put together before,” Palmer said. “Now we’re starting to reap some of the fruit from those types of genetic studies to enrich our understanding of more classical aspects of biology.”

Source: University of Chicago Medical Center

The study “underscores that fact that sleepwalking is much more prevalent in adults than previously appreciated,” noted Maurice Ohayon, M.D., D.Sc., Ph.D., professor of psychiatry and behavioral sciences, who is the lead author of the paper. It will appear in the May 15 issue of Neurology, the medical journal of the American Academy of Neurology.

Sleepwalking, a disorder “of arousal from non-REM sleep,” can have serious consequences, resulting in injuries to the sleepwalker or others, as well as impaired psychosocial functioning, the researchers noted.

It is thought that the use of medication and certain psychological and psychiatric conditions can trigger sleepwalking, but the exact causes are unknown, the researchers added. Also unknown to experts in the field: its prevalence.

“Apart from a study we did 10 years ago in the European general population, where we reported a prevalence of 2 percent of sleepwalking, there are nearly no data regarding the prevalence of nocturnal wanderings in the adult general population,” the researchers said in their published paper. “In the United States, the only prevalence rate was published 30 years ago.”

The latest study was the first to use a large, representative sample of the U.S. population to demonstrate the number of sleepwalkers, according to the researchers, who also aimed to evaluate the importance of medication use and mental disorders associated with sleepwalking. Ohayon and his colleagues secured a sample of 19,136 individuals from 15 states and then used phone surveys to gather information on mental health, medical history, and medication use.

Participants were asked specific questions related to sleepwalking, including frequency of episodes during sleep, duration of the sleep disorder, and any inappropriate or potentially dangerous behaviors during sleep. Those who didn’t report any episodes in the last year were asked if they had sleepwalked during their childhood. Participants were also asked whether there was a family history of sleepwalking and whether they had other symptoms, such as sleep terrors and violent behaviors during sleep.

The researchers determined that as many as 3.6 percent of the sample reported at least one episode of sleepwalking in the previous year, with 1 percent saying they had two or more episodes in a month. Because of the number of respondents who reported having episodes during childhood or adolescence, lifetime prevalence of sleepwalking was found to be 29.2 percent.

The study also showed that people with depression were 3.5 times more likely to sleepwalk than those without, and people dependent on alcohol or who had obsessive-compulsive disorder were also significantly more likely to have sleepwalking episodes. Additionally, people taking SSRI antidepressants were three times more likely to sleepwalk twice a month or more than those who didn’t.

“There is no doubt an association between nocturnal wanderings and certain conditions, but we don’t know the direction of the causality,” said Ohayon. “Are the medical conditions provoking sleepwalking, or is it vice versa? Or perhaps it’s the treatment that is responsible.”

Although more research is needed, the work could help raise awareness of this association among primary care physicians, he added. “We’re not expecting them to diagnose sleepwalking, but they might detect symptoms that could be indices of sleepwalking,” said Ohayon.

Among the researchers’ other findings:

• The duration of sleepwalking was mostly chronic, with just over 80 percent of those who have sleepwalked reporting they’ve done so for more than five years.
• Sleepwalking was not associated with gender and seemed to decrease with age.
• Nearly one-third of individuals with nocturnal wandering had a family history of the disorder.
• People using over-the-counter sleeping pills had a higher likelihood of reporting sleepwalking episodes at least two times per month.

Source: The Stanford University School of Medicine

“We have identified a syndrome in modern society that has not been recognized until recently,” said Till Roenneberg of the University of Munich. “It concerns an increasing discrepancy between the daily timing of the physiological clock and the social clock. As a result of this social jetlag, people are chronically sleep-deprived. They are also more likely to smoke and drink more alcohol and caffeine. Now, we show that social jetlag also contributes to obesity — the plot that social jetlag is really bad for our health is thickening.”

Each of us has a biological clock, he said, adding that those clocks are regulated by daylight and darkness to provide the optimal window for sleep and waking. In modern society, however, we listen to those clocks “less and less due to the increasing discrepancy between what the body clock tells us and what the boss tells us,” he said.

Roenneberg’s team is compiling a database on human sleeping and waking behavior, which they plan to eventually use to produce a world sleep map. Now 10 years into the effort, they have compiled lots of information, including participants’ height, weight, and sleep patterns.

Their analysis shows that people with more severe social jetlag are also more likely to be overweight.

The findings should factor into decisions about Daylight Saving Time, as well as work and school times, the researchers said. It would also help if people began spending more time outdoors in open daylight or at least sitting by a window, they add. As people fail to do this, their body clocks get set later and later, leaving them awake into the night and tired by day.

“Waking up with an alarm clock is a relatively new facet of our lives,” Roenneberg says. “It simply means that we haven’t slept enough and this is the reason why we are chronically tired. Good sleep and enough sleep is not a waste of time but a guarantee for better work performance and more fun with friends and family during off-work times.”

Source: Cell Press

Investigators learned that despite little indication of short sleep from traditional measurements, EDS was more likely to occur in children who were experiencing learning, attention/hyperactivity and conduct problems.

Researchers believe a variety of factors contribute to EDS in this cohort. Investigators posit obesity, symptoms of inattention, depression and anxiety, asthma and parent-reported trouble falling asleep were contributory factors to EDS even among children with no signs of diminished sleep time or sleep apnea.

“Impairment due to EDS in cognitive and behavioral functioning can have a serious impact on a child’s development,” said Susan Calhoun, Ph.D., the study’s lead author.

“When children are referred for neurobehavioral problems, they should be assessed for potential risk factors for EDS. Recognizing and treating EDS can offer new strategies to address some of the most common neurobehavioral challenges in young school-age children.”

An important lesson learned from the study was that most of the 500 children studied by Penn State researchers showed few signs of short sleep when tested, nor was short sleep associated with any of the learning, attention and behavior problems. This implies that conventional testing may not capture sleep problems for this population.

Calhoun says that parents and educators are good resources for determining if a child seems excessively sleepy in the daytime and the complaint should be taken seriously.

Fifteen percent of children normally have EDS, although this study suggests the percent is higher among children with learning, attention and behavior problems.

Source: American Academy of Sleep Medicine

Child in bed photo by shutterstock.

The research, experts say, doesn’t give the ‘go-ahead’ to heavy caffeine consumption during pregnancy or breastfeeding. However, the findings support the theory that moderate amounts of caffeine may be okay.

Over the years, smaller studies have had mixed results on whether caffeine during pregnancy is linked to increased risks of miscarriage or premature birth.

Larger, more recent studies also have failed to show any increased risk. And in 2010, the American College of Obstetricians and Gynecologists (ACOG) announced that 200 milligrams of caffeine a day (about equal to a 12-ounce cup of coffee) probably did not carry pregnancy risks.

Not much, however, was known about whether caffeine, during pregnancy or breastfeeding, might disturb an infant’s sleep.

For the study, Dr. Ina Santos and her colleagues at Federal University of Pelotas, in Brazil, interviewed 885 new moms, who reported their own caffeine consumption as well as their infants’ sleep habits at the age of three months.

All but one mom said they drank caffeinated beverages while pregnant. About 20 percent were heavy consumers–consuming at least 300 mg per day during pregnancy. And just over 14 percent had a heavy caffeine intake three months after giving birth.

Overall, the researchers found no clear link between moms’ caffeine consumption and infant sleeping problems. Nearly 14 percent of mothers said their three-month-old woke up more than three times each night—considered “frequent.”  But the baby wakeups were not statistically higher for moms who consumed large amounts of caffeine vs. lighter consumers, Santos’s team reports in the journal Pediatrics.

“I think this report adds to the growing body of literature suggesting that moderate caffeine consumption during pregnancy is generally safe,” said Dr. William H. Barth Jr., chief of maternal-fetal medicine at Massachusetts General Hospital in Boston.

Barth, who was not involved in the study, chaired the ACOG committee that wrote the 2010 report.  He noted that up to a cup or two of coffee per day appears safe during pregnancy.

“However,” Barth said, “we do not know if there are adverse effects of higher levels of caffeine consumption.”

As for breastfeeding, it’s generally thought that 300 mg of caffeine or less each day is OK, according to Dr. Lauren Hanley, an obstetrician at Mass General who specializes in breastfeeding issues.

And studies suggest that much higher amounts of caffeine during breastfeeding—more than 300 mg per day, according to Hanley—are related to ‘jitteriness,’ fussiness and poor sleep in babies.

Source: Federal University of Pelotas

Now, a new instrument developed by researchers from Norway and the United Kingdom will help us know if we are addicted to work.

The tool, called The Bergen Work Addiction Scale, is based on core elements of addiction that are recognized as diagnostic criteria for several addictions.

Some people seem to be driven to work excessively and compulsively. These are denoted as work addicts — or workaholics. Work addictions are a global pandemic, a result of a worldwide economy and globalization, new technology, and blurred boundaries between work and private life, said University of Bergen’s Cecilie Schou Andreassen, Ph.D.

A number of studies show that work addiction has been associated with insomnia, health problems, burnout and stress as well as creating conflict between work and family life, Andreassen said.

Her team developed the new first-of-its-kind instrument; the Bergen Work Addiction Scale is presented in an article in the Scandinavian Journal of Psychology.

By testing themselves with the scale, people can find out their degree of work addiction: non-addicted, mildly addicted or workaholic, Andreassen said.

12,135 Norwegian employees from 25 different industries participated in the development of the Bergen Work Addiction Scale. The scale was administrated to two cross-occupational samples. The scale reflects the seven core elements of addiction: Salience, mood modification, tolerance, withdrawal, conflict, relapse and problems.

The results show the scale as reliably differentiating between workaholics and non-workaholics.

Researchers believe the scale may add value to work addiction research and practice, particularly when it comes to facilitating treatment and estimating prevalence of work addiction in the general population worldwide.

The Bergen Work Addiction Scale uses seven basic criteria to identify work addiction, where all items are scored on the following scale: (1) Never, (2) Rarely, (3) Sometimes, (4) Often, and (5) Always:

• You think of how you can free up more time to work;
• You spend much more time working than initially intended;
• You work in order to reduce feelings of guilt, anxiety, helplessness and depression;
• You have been told by others to cut down on work without listening to them;
• You become stressed if you are prohibited from working;
• You deprioritize hobbies, leisure activities, and exercise because of your work;
• You work so much that it has negatively influenced your health.

Andreassen’s study shows that scoring of “often” or “always” on at least four of the seven items may suggest that you are a workaholic.

Source: The University of Bergen

“We found that mothers with high depressive symptom levels are more likely to excessively worry about their infants at night than mothers with low symptom levels, and that such mothers were more likely to seek out their babies at night and spend more time with their infants than mothers with low symptom levels,” said Douglas M. Teti, Ph.D., associate director of the Social Science Research Institute and professor of human development, psychology and pediatrics at Penn State.

“This in turn was associated with increased night waking in the infants of depressed mothers, compared to the infants of non-depressed mothers,” Teti said.

“Especially interesting about this was that when depressed mothers sought out their infants at night, their infants did not appear to be in need of parental help. They were either sound asleep or perhaps awake, but not distressed.”

Investigators determined mothers possessing low levels of worry and depressive symptoms rarely woke their infants out of a sound sleep and hardly went to their infants at night unless the infants were distressed.

Researchers also found some evidence that infants who wake often during the night can lead to higher depressive symptoms in mothers. However, evidence for this association was not as strong.

Pediatricians report that the two main concerns voiced by new parents are sleeping problems and feeding problems.

Researchers say there is probably no reason to wake a soundly sleeping baby if the child is not experiencing any distress. They emphasize that if parental depression or worry disrupts both the parents’ and the infant’s sleep, it could have negative consequences for the parent-child relationship over the long term.

Identifying these situations is key as subsequent actions might be considered to help reduce parents’ distress.

The report is found in the journal Child Development.

“One has to examine the health of the family system and address the problem at that level,” said Teti. “If frequent infant night waking is waking parents up every night and causing parental distress, there are established interventions to help babies learn how to develop self-regulated sleep.”

On the other hand, if increased infant night waking is caused by distressed mothers waking their babies out of a sound sleep or keeping them up at night unnecessarily, other approaches might be considered.

Researchers believe interventions to reduce maternal depressive symptoms may be indicated, also education to ease worries about infant sleep behavior, as well as information to both parents about the benefits of a good night’s sleep for both the parent and the baby.

The researchers found mothers’ depressive symptoms were significantly correlated with the mothers’ feelings of helplessness and loss of control.

Mothers’ feelings of helplessness and loss of control, in turn, were related to close physical contact between mothers and babies, but were not related to night waking.

Only mothers’ nighttime behavior with their infants, not their behavior with their infants at bedtime correlated with infant night waking.

As part of the larger Study of Infants’ Emergent Sleep Trajectories (SIESTA), Teti and Crosby collected data on 45 infants — from one to 24 months — and their parents over seven consecutive days, including an infant sleep diary that the mother kept.

At the start of the week, the mothers also completed two surveys – one looked at depressive symptoms, while the other measured mothers’ worries about their infants when they woke up at night.

Researcher also videotaped where the baby slept, one focused on the door to the baby’s room to see who was coming in and out of the room, and an additional one or two cameras focused on areas where the parent took the infant during any nighttime interventions. The cameras captured between 10 and 12 hours of video for each family, starting with the infant’s bedtime.

What the researchers observed on the videos correlated with what the parents reported.

“In terms of understanding what predicts parenting at night, and how parenting at night affects children, it’s important to examine parenting at night much more closely than we have,” said Teti.

“There’s probably a lot going on at night that we need to understand, and we need to use actual observations of what parents are doing. We know very little about nighttime parenting.”

Source: Penn State

During a recent conference on the topic, Michael J. Twery, Ph.D., Director of the National Center on Sleep Disorders Research, National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), explained that shift work, long work hours, and untreated and chronic sleep disorders are major contributors to America’s sleep deficiency.

Unknown to many is the fact that sleep disorders are more widely reported in women than men with women 1.4 times more likely to experience insomnia than men.

Sleep disorders “affect all racial groups and genders,” said Twery. They “increase the risk of stroke, cardiovascular disease, mortality, hypertension, and obesity.” Sleep controls our memory filters, affects our dreams, inspirations, and emotional responses, so not getting enough can be very detrimental to our health.

Helene A. Emsellem, M.D., said pregnancy can influence sleep patterns because of different hormonal levels in different trimesters. As a result, pregnancy can either increase or decrease sleepiness, and raises the risk of Restless Legs Syndrome (RLS) in the third trimester. However, Emsellem noted “35-40 percent of menopausal women report sleep problems as well.”

Emsellem explains that a lack of sleep causes cognitive impairment, difficulty focusing, impaired memory, delayed visual reaction time, and impaired motor function.

Men and women should set aside the requisite 7-9 hours for sleep to maintain high cognitive function and motor abilities. Emsellem suggests exercise, maintaining a regular sleep schedule, and other healthy lifestyle habits to help fall and stay asleep.

Ronald Farkas, M.D., Ph.D., clinical team leader, Division of Neurology Products at the Food and Drug Administration (FDA) explains that the drug manufacturers must provide information on sleep drugs and dosing requirements that account for gender differences.

Farkas said, “To support FDA approval of drugs for sleep disorders (and most disorders), data is required about potential gender differences in safety and efficacy.”

For example, Zolpidem (brand name Ambien) – the most popular type of sleep drug – has a known gender difference.

It’s “known that women clear zolpidem from the body more slowly than men,” said Farkas. Because of this difference, women are prescribed a lower dose than men (1.75 mg for women vs. 3.5 mg for men).

Source: Society for Women’s Health Research (SWHR)

Although the sleep-deprived burn about the same amount of calories, they consume about 300 more per day.  Since it only takes about 3,500 calories to add one pound to your body, a few hundred calories a day can quickly turn into extra weight.

According to sleep disorder specialist Michael Breus, Ph.D., when a person gets too little sleep, his metabolism slows down to save energy. That slowdown triggers the release of the hormone cortisol, which in turn increases appetite. The body senses that it needs more energy, so it asks for more food.

Lack of sleep also causes the body to release more ghrelin, a hormone that signals hunger, and less leptin, the hormone that tells your stomach that it’s full. This causes the body to crave more food but lacks the sensitivity to know when to quit eating. And, of course, being awake more hours gives you more time to eat.

“The later you’re up at night, the greater the likelihood that you’re going to eat,” Breus says. And “you’re more likely to eat high-fat, high-carb foods.”

Furthermore, the body burns the most calories during REM sleep, a deeply restful phase, and a lack of sleep means less time in REM.

For best results, experts suggest getting 7.5 hours of sleep a night. If you have trouble sleeping, they advise that you stick to a nightly routine, exercise during the day, write your worries in a journal, and keep pre-bedtime activities relaxing.

The research is published in the American Journal of Clinical Nutrition.

Source:  New York Obesity Nutrition Research Center

Researchers from the Centers for Disease Control and Prevention say obstructive sleep apnea and other symptoms of OSA are associated with probable major depression, regardless of factors like weight, age, sex or race.

However, researchers did not determine a link between depression and snoring.

“Snorting, gasping or stopping breathing while asleep was associated with nearly all depression symptoms, including feeling hopeless and feeling like a failure,” said Anne G. Wheaton, Ph.D., lead author of the study.

“We expected persons with sleep-disordered breathing to report trouble sleeping or sleeping too much, or feeling tired and having little energy, but not the other symptoms.”

Researchers surveyed 9,714 American adults in the first nationally representative sampling to examine this relationship. Previous studies have focused on smaller samples of specific populations, such as people suffering from obstructive sleep apnea (OSA), depression or other health conditions.

The findings are found in the April issue of the journal SLEEP.

Wheaton said the likelihood of depression increased with the reported frequency of snorting and/or instances when breathing stopped in the study. She suggested screening for these disorders in the presence of the other could help address the high prevalence and underdiagnosis of sleep apnea and depression, especially if sleepiness is a chief complaint.

Experts report that snorting, gasping and pauses in breathing during sleep are all signs of OSA. Six percent of men and 3 percent of women in the study reported having physician-diagnosed sleep apnea. OSA occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway.

Source: American Academy of Sleep Medicine

Notre Dame psychologist Jessica Payne and colleagues studied 207 students who habitually slept for at least six hours each night. Participants were randomly assigned to study declarative, semantically related or unrelated word pairs at 9 a.m. or 9 p.m., and returned for testing 30 minutes, 12 hours or 24 hours later.

Declarative memory refers to the ability to consciously remember facts and events. It can be broken down into memory for events — known as episodic memory — and semantic memory, which is memory for facts about the world.

People routinely use both types of memory every day, such as recalling where we parked or learning how a colleague prefers to be addressed, Payne said.

At the 12-hour retest, memory was superior following a night of sleep compared to a day of wakefulness, she said.

However, this performance difference was a result of a pronounced deterioration in memory for unrelated word pairs, she said, noting there was no difference for related word pairs. At the 24-hour retest, with all subjects having received both a full night of sleep and a full day of wakefulness, memories were superior when sleep occurred shortly after learning, rather than following a full day of wakefulness.

“Our study confirms that sleeping directly after learning something new is beneficial for memory,” she said. “What’s novel about this study is that we tried to shine light on sleep’s influence on both types of declarative memory by studying semantically unrelated and related word pairs.”

“Since we found that sleeping soon after learning benefited both types of memory, this means that it would be a good thing to rehearse any information you need to remember just prior to going to bed,” she continued. “In some sense, you may be ‘telling’ the sleeping brain what to consolidate.”

Titled “Memory for Semantically Related and Unrelated Declarative Information: The Benefit of Sleep, the Cost of Wake,” the study was published March 22 in PLOS One.

Source: University of Notre Dame 

Mayo Clinic researchers discovered the risk of developing mild cognitive impairment or Parkinson’s disease comes within four years of diagnosis of the sleep disorder.

The muscle relaxation that occurs during REM sleep leaves a person in a state of paralysis; in contrast, people with rapid eye movement sleep behavior disorder (RBD) appear to act out their dreams when they are in REM sleep.

Investigators were able to diagnose RBD by using the Mayo Sleep Questionnaire among people who were otherwise neurologically normal.

Investigators found that approximately 34 percent of people diagnosed with probable RBD developed mild cognitive impairment or Parkinson’s disease within four years of entering the study, a rate 2.2 times greater than those with normal rapid eye movement sleep.

“Understanding that certain patients are at greater risk for mild cognitive impairment or Parkinson’s disease will allow for early intervention, which is vital in the case of such disorders that destroy brain cells. Although we are still searching for effective treatments, our best chance of success is to identify and treat these disorders early, before cell death,” said co-author Brad Boeve, M.D., a Mayo Clinic neurologist.

Previous studies have shown that an estimated 45 percent of people who suffer from rapid eye movement sleep behavior disorder will develop a neurodegenerative syndrome such as mild cognitive impairment or Parkinson’s disease within five years of diagnosis.

“This study is the first to quantify the risk associated with probable RBD in average people, not clinical patients, and it shows that we can predict the onset of some neurodegenerative disorders simply by asking a few critical questions,” said lead author Brendon P. Boot, M.D., a behavioral neurologist. 

• MCI is an intermediate stage between the expected cognitive decline of normal aging and the more pronounced decline of dementia. It involves problems with memory, language, thinking and judgment that are greater than typical age-related changes.
• An estimated 500,000 Americans suffer from Parkinson’s disease, which is characterized by tremor or shakiness, stiffness of the limbs and trunk, slowness of movement, and impaired balance and coordination.

The study is published in the journal Annals of Neurology.

Source: Mayo Clinic

Lexapro is one of the most widely prescribed psychiatric medications in the U.S., in a 2009 article from IMS Health (cited on PsychCentral) second only to the anxiolytic Xanax (alprazolam).

Depression is characterized by symptoms that interfere with a person’s ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Episodes of depression often recur throughout a person’s lifetime.

Signs and symptoms of major depression include: depressed mood, loss of interest in usual activities, change in weight or appetite, insomnia or excessive sleeping (hypersomnia), restlessness, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, and suicide attempts or thoughts of suicide.

People with generalized anxiety disorder (GAD) are filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least six months. People with GAD have difficulty relaxing and concentrating.

“These psychiatric conditions can be disabling and prevent a person from doing everyday activities,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “This medication is widely used by people who must manage their condition over time, so it is important to have affordable treatment options.”

Teva Pharmaceutical Industries/IVAX Pharmaceuticals gained FDA approval to market generic escitalopram in 5 mg, 10 mg, and 20 mg strengths.

In the clinical trials for Lexapro, the most commonly observed adverse reactions were: sleeplessness (insomnia), ejaculation disorder, nausea, increase in sweating, fatigue and drowsiness, and low sex drive (decreased libido). 

Escitalopram and all other antidepressant drugs have a boxed warning and a patient medication guide describing the increased risk of suicidal thinking and behavior in children, adolescents, and young adults ages 18 to 24 during initial treatment.

The warning also says data did not show this increased risk in those older than 24 years and that patients ages 65 and older who take antidepressants have a decreased risk of suicidal thinking and behavior. The warning says depression and other serious psychiatric disorders themselves are the most important causes of suicide and that close monitoring of patients starting these medications is necessary.

Teva has been granted a 180-day period of generic drug exclusivity, which means that the FDA cannot approve another generic version of escitalopram tablets before the end of that period. Generic drugs approved by the FDA have the same high quality and strength as brand-name drugs. The generic manufacturing and packaging sites must pass the same quality standards as those of brand-name drugs.

Source: U.S. Food and Drug Administration