Asthma, Sleep Quality, and School Performance in Children

Asthma is a chronic lung disorder whereby the airway becomes narrowed or inflamed, making it difficult to breathe easily. A number or factors can trigger asthma symptoms including environmental factors such as pollen and cold air. Statistics Canada estimates that 13% of Canadian children aged 0 through 11 suffer from asthma.

One problem that has been linked to asthma in children is sleep disruption. Unfortunately asthma symptoms tend to spike at night, and with symptoms like wheezing, coughing and difficulty breathing, sleep loss is bound to happen.  New research from Brown University’s Alpert Medical School in Providence, Rhode Island delved a little further into this issue by analyzing the impact of asthma-related sleep loss on school performance. Principal investigator Daphne Koinis-Mitchell, PhD, Associate Professor of Psychiatry and Human Behavior (Research) and Associate Professor of Pediatrics (Research) explains, “While it has been recognized that missed sleep and school absences are important indicators of asthma morbidity in children, our study is the first to explore the associations between asthma, sleep quality, and academic performance in real time, prospectively, using both objective and subjective measures.”

The study examined data from 170 asthmatic children, aged 7 to 9. The following methods were used to obtain a complete picture of how asthma was affecting sleep and school performance.

  • Severity of the participants’ asthma symptoms were measured using spirometry–a pulmonary function test which tracks the speed and amount of air exhaled.
  • Sleep quality was measured by detecting body movements during the night.
  •  The children and their caregivers used diaries to report on their symptoms and how they attempted to control them.
  • The children’s teachers kept reports on the children’s behaviour and performance in school.

The study found that compared to children with well-controlled asthma, those with poorly-controlled asthma struggled more in school and showed carelessness with their school work. “Children can experience more symptoms at night because they are not taking their medications consistently,” said Koinis-Mitchell. “They end up missing sleep. When they wake, they are groggy, not alert and they attend school this way. That has an impact on their level of concentration. The quality of their work is compromised. In general, their academic function is negatively affected.”

Children under 12 should get 10-11 hours of sleep each night, while those in middle school and high school should aim for a solid nine hours. If you believe your child is struggling academically due to asthma-related sleep loss, talk to your doctor about the problem.  Controlling environmental factors and taking proper medication may help to alleviate your children’s asthma symptoms at night. A sleep specialist may also be able to provide advice on how to improve the sleep environment, to keep environmental triggers to a minimum.


More couples choosing a sleep divorce. Could it be the answer to your insomnia?

Do you ever blame your spouse for a restless night’s sleep? It turns out that more and more couples are considering a “sleep divorce,” that is, sleeping apart from your partner in another room.  According to British sleep specialist, Dr. Neil Stanley, “We sleep better when we sleep alone.” A recent article published in the Toronto Star caught the public’s attention on this divided topic:
Experts predict that about a quarter of couples in the U.S. have chosen to take a sleep divorce.  Moreover, home developers are increasingly designing homes with two master bedrooms. Why is it so hard for some couples to sleep soundly—together? A number of reasons: Firstly, consider the size of the bed. A couple sharing a double bed translates into nine inches less per person than a child in a single bed…Now that’s potential for a problem.  Secondly, if one’s partner has a bothersome behaviour during sleep, perhaps snoring loudly, sleep talking or stealing the covers, the other is bound to lose some sleep over it. Another reason is in a couple’s sleep routines. For example, one partner may work late or enjoy staying up late to read or watch television.
The consequences of sleep deprivation include a lengthy list of health problems: diabetes, heart disease, stroke and obesity to name a few. Studies have also shown that sleep deprived couples show less affection towards each other, and hence it has a negative impact on the relationship. So is a sleep divorce just a practical solution to a common and dangerous problem? There is still some debate among experts, but there’s no doubt that it’s been a successful choice for some couples.
If a sleep divorce seems unfathomable to you, try addressing the key sleep issues:

  • If the mattress is the problem, invest in a new mattress that fits your sleep needs and is big enough for both of you to have you own space. Talk to the sales rep about a mattress that minimizes the impact of nighttime movements.
  • Compromise on a sleep routine. If one partner is an early bird and the other a night owl, try to agree one some middle ground. Even if it’s only a few night’s a week, it will help.
  • Be aware of sleep disorders. Have you ever considered that there may be more to blame for your sleep trouble than your spouse? There could be an underlying, treatable sleep disorder that’s causing snoring, insomnia or daytime fatigue. Talk to your doctor.
  • Know the basics of sleep hygiene. Here’s a previous blog post discussing the worst sleep offenders (not including your partner) –

To answer the original question, a sleep divorce could be a practical solution to insomnia amongst couples. Before resorting to a sleep divorce, a better place to start is to look at your sleep routines and overall sleep hygiene. Try to curb sloppy sleep habits and come up with solutions that work for both you and your partner. Never be afraid or ashamed to talk to your doctor about sleep trouble – not only could it save your relationship but it could also save your life.

“Sound” sleep gets a new meaning

April – To students across the country, it’s a month of unwanted studying, cramming, and writing exams. It’s also a month when sleep gets put on the back-burner. There is promising news for those looking for a new technique to boost their memory, and it doesn’t involve pulling an all-nighter: A new study has found that exposure to sounds at certain times during sleep can boost memory formation.

Jan Born, a researcher at the University of Tubingen explained that previous research has found that memory consolidation occurs in sleep when brain waves are generating a slow oscillating rhythm. The new study, published in the journal Neuron, found that if a person is exposed to sound stimulation that is in sync with this rhythm, the oscillations become amplified and last longer – and hence memory is strengthened.

The researchers monitored 11 participants while they slept on various nights. When exposed to stimulating sounds that were in sync with the brain’s slow oscillating rhythms, the participants were better able to recall word associations they had learned the evening prior.

There is currently no commercial device that can mimic this study, however the research does offer interesting insight that could potentially lead to a commercial innovation.

While you may not be able to benefit from this study, yet at least, what you can do is make an effort to get a good night’s sleep–especially when you’re trying to remember a day’s worth of studying.  Several studies have linked sleep disruption to impaired memory, as per a previous blog posting:

Do your memory a favour and get the recommended 7 to 9 hours of sleep each night. And you never know, one day, you may be able to sleep “soundly” with a sleep-synced-sound-emitting device.

Exercise and Sleep: New findings from the National Sleep Foundation

The 2013 National Sleep Foundation poll was released earlier this month. Past research has shown that exercise can have a positive impact on sleep, and this year, the poll looked a little deeper into the relationship. Here is a quick summary of the findings.

  • Exercisers say they sleep better. Those who exercise at any intensity level (vigorous, moderate or light) are all more likely to say “I had a good night’s sleep” than non-exercisers. According to Max Hirshkowitz, PhD, and poll task force chair, “If you are inactive, adding a 10 minute walk every day could improve your likelihood of a good night’s sleep. Making this small change and gradually working your way up to more intense activities like running or swimming could help you sleep better.”
  • Sleep quality improves with exercise intensity. Overall, exercisers report better sleep than non-exercisers. But sleep quality also appears to improve with the amount and intensity of exercise you are getting. More than two-thirds of vigorous exercisers say they rarely or never  had symptoms of insomnia (e.g. waking up too early and not being able to fall back to sleep or difficulty falling asleep.) To the contrary, half of non-exercisers wake up during the night, and once-fourth have difficulty falling asleep most nights.
  • Non-exercisers are sleepier and have a lower quality of life. About a quarter of non-exercisers are considered sleepy during the day–this is twice the incidence of sleepiness as those who exercise. Unfortunately the study also found that sleepiness interferes with the safety and quality of life of non-exercisers–they report difficulty staying awake while driving, eating or engaging in social activities.
  • Exercising reduces the risk of sleep apnea. Sleep apnea is a medical condition which causes a person to periodically stop breathing during sleep. It is associated with a number of other medical conditions including obesity, diabetes and heart disease. Nearly half of non-exercisers are at a moderate risk of developing sleep apnea.  The risk becomes much lower in those who exercise: 26%, 22%, and 19% in light, moderate and vigorous exercisers respectively.
  • The less you sit, the better you’ll sleep. While standing up during the day may not be considered exercise, the study did delve into the impact of the amount of time a person spends sitting on their sleep. It found that those who sit for less than eight hours a day are significantly more likely to say they have “very good” sleep quality than those who sit for over eight hours. For those that work in an office, it can be tough to spend less than eight hours sitting. You may want to consider standing at your desk occasionally or taking frequent breaks to stretch your legs.
  • Exercise at any time of day appears to be good for sleep. This study contradicted past beliefs that exercising close to bedtime can hinder sleep. In fact, it found that exercising at any time is better for sleep than no exercise at all. As Dr. Barbara Phillips, poll task force member explains, “Exercise is beneficial to sleep. It’s time to revise global recommendations for improving sleep and put exercise—any time—at the top of our list for healthy sleep habits.”


Lack of sleep can alter genes

Many studies have documented a connection between sleep loss and poor health and recognize that sleep deprivation contributes to cardiovascular diseases, diabetes and obesity. A recent study published in Proceedings of the National Academy of Sciences was the first of its kind to analyze the affect of sleep loss at the molecular level. The findings? It turns out that sleep deprivation alters hundreds of genes involved with inflammation, immunity and cells’ response to stress.

Completed by the University of Surrey, the study took whole-blood RNA samples from 26 participants. For one week, half of them slept for over 8 hours a night, and the other half had less than 6 hours of sleep. During the second week, the participants switched. At the end of the two weeks, both groups were kept awake for 40 hours straight and underwent regular blood and cognitive tests during this time.

The group that was well-rested during the second week of the study recovered from the sleepless 40 hours and had no signs of cell damage.  The sleep deprived group, however, showed alterations in 711 genes– all related to circadian rhythms, metabolism, inflammation, immune response and stress. As Colin Smith, genomist at the University of Surrey explains, “Precisely the genes required to make new proteins and new cells were inhibited. The ability to restore the balance in their bodies was upset. That nurturing and self-renewal that sleep brings is not happening.”

While it is good news that catching up on sleep helps to repair gene damage, more research is required to determine how long one can endure sleep deprivation before the effects become permanent.

In must industrialized countries, including Canada, about 30% of the population does not get the recommended 7 to 9 hours of shut-eye each night. Sleeping well comes with a plethora of health benefits, and we can now add protecting your genes to the list.

Diet and Sleep: New Research

What’s causing your poor night’s sleep? New research suggests that it may be your diet. Although it’s been well-documented that overeating can hinder sleep, especially too close to bedtime, two new studies have shed more light on the relationship between sleep and diet.

There has been little research done to understand how types of foods an individual consumes impacts their sleep.  We know that tryptophan-rich foods make the best bedtime snacks, but what about all the foods you consume earlier in the day? A recent study completed by the Perelman School of Medicine at the University of Pennsylvania, and published in Appetite, sought to understand how the the types of foods a person eats affects their sleep. Analyzing data from over 4500 people, the researchers divided the participants into four groups based on their sleep patterns: “Very Short” sleepers were those that slept less than 5 hours per night, ”Short” slept 5-6 hours per night, ”Standard’’ got 7-8 hours of shut-eye, and ”Long” sleepers slept for 9 hours or more.

Interestingly, the researchers identified very distinct dietary consumption patterns amongst the three groups.  For example, the “Very Short” sleepers ate less red and orange-coloured fruits and vegetables (i.e., foods which are rich in antioxidants and vitamins.) Short sleepers ate more lutein –  a substance found in leafy greens, but had a lower intake of vitamin C and tap water. Longer sleepers consumed the most alcohol. The “Standard” sleepers were found to have the most varied and well-rounded diet.

In a second recent study, researchers at Uppsala University in Sweden looked at how eating patterns changed after a restless night.  They monitored the food choices of 16 normal-weight male participants under buffet-like conditions after they were forced to stay awake all night, and then again after a night with eight hours of rest. According to lead researcher Pleunie Hogenkamp: “After a night of total sleep loss, [the sleep-deprived] males chose greater portion sizes of the energy-dense foods. Interestingly, they did so both before and after a breakfast, suggesting that sleep deprivation enhances food intake regardless of satiety.”

While we can expect to see more studies dig further into the relationship between sleep and diet, these two studies are certainly sleep-supportive. The bottom line is that getting 7-8 hours sleep per night will help you to make wiser food choices and maintain a well-balanced diet.

More businesses waking up to the reality of corporate fatigue

Investing in employee health is a growing trend among businesses. Wellness weeks,  discounts  at fitness clubs, and healthy lunch menu options are a few of the steps companies are taking to boost employee health. Most organizations, however, have been slow to grasp the effects of sleep deprivation on productivity. Thankfully, an increasing number are putting the consequences of sleep deprivation on their radar and seeking expert help to minimize employee fatigue.

Around one third of the work force does not get enough sleep, and the productivity loss is costly. Harvard Researchers estimate that in the U.S.,  sleep deprivation costs the economy as much as  $63.2 billion per year. James Maas, a former Cornell University psychologist and author of “Sleep for Success” summarizes the situation well: “If we treated machinery like we treat the human body, there would be breakdowns all the time.”

In fields such as healthcare, manufacturing and truck driving, the negative impact of sleep deprivation goes beyond productivity loss – it can potentially put lives in danger. Sadly, in some industries, working around the clock is glorified. Instead of looking for advice on how to sleep better, they seek experts to help them function better on only a few hours of sleep.

Organizations including Proctor & Gamble and Goldman Sachs are investing in programs to address the sleep situation – from sleep-hygiene courses to melatonin-regulating lighting to help employees improve their sleep quality.  Implementing fatigue-management solutions can bring a plethora of benefits such as reduced absenteeism, fewer accidents and liabilities, improved productivity and enhanced employee quality of life.

If you work in a 24/7 business, or have a high-pressure job, talk to your employer about implementing fatigue-management solutions in your workplace. While there is still a long way to go, it is great to see that some major organizations are waking up to the impact of sleep deprivation.