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February 15, 2013
NIH Podcast Episode #0182
Balintfy: Welcome to episode 182 of the new NIH Research Radio. The new NIH Research Radio is your source for weekly news and information about the ongoing medical research at the National Institutes of Health – NIH . . . Turning Discovery Into Health®. I'm your host Joe Balintfy, and coming up in this episode our news summary at the end of the program includes items on:
- How a protein that regulates iron may impact blood pressure,
- How community programs help reduce prescription drug abuse, and
- Research has found that a gene may predict outcomes related to PTSD
But first, our feature story...
Sleep basics and pregnancy
Balintfy: Understanding sleep and its importance, especially for pregnant women. Sleep was long considered just a block of time when your brain and body shut down. But research is showing more and more detail about when, how much, and why we need it. I’m talking with Dr. Michael Twery at the NIH’s National Heart, Lung, and Blood Institute. He’s the director of the National Center on Sleep Disorders Research. So what is sleep Dr. Twery?
Twery: Sleep is a fundamental requirement of life. We require it, but it’s a characteristic of almost form of life on the planet. We all go through cycles of rest and wakefulness, rest and activity. This is something that is characteristic of almost every life form whether you’re a person or an animal, insect, clam, fruit fly. Even plants go through cycles of rest and sleep. It turns out what research has revealed is that this is partly how our biology has been organized evolutionarily. When we disturb these patterns, when we don’t achieve the separation of function that’s accomplished with the cycles of sleep and wake or rest and activity, the health of our cells of our tissues is compromised and we start to experience things that, processes that contribute to the risk of disease.
Balintfy: What are some common problems associated with sleep?
Twery: Probably the most common condition is where we just don’t allow enough time for sleep. Increasingly we can live a 24-hour lifestyle. We all want to live life to the fullest. Many of us have many competing demands on our time. If we’re single parents, you have to take care of your children, it’s just a fact. If you are a shift worker perhaps you work evenings or instead of during the daytime. All these things can put pressure on us to schedule enough time for sleep. In adults, we’re talking about 7 to 8 hours. For teenagers, we certainly would like to see, it’s recommended that teens get at least 8 to 9 hours of sleep or more and then for younger children it can be even longer and it depends on their age.
Balintfy: Are there other kinds of sleep problems Dr. Twery?
Twery: So a second category of difficulty, source of sleep disturbance is actually a sleep disorder. You know, researchers and physicians have identified over 70 different types of sleep disorders and some of them are very common. We’ve all heard people snore loudly. Well it turns out that the sound of snoring is not the sound necessarily of restful sleep but it can sometimes be the sound of someone struggling to breathe due the airway is obstructed and they’re actually struggling and that sound of struggling debris, sucking air in is the sound of snoring. But more also people have trouble initiating going to sleep or staying asleep or staying asleep long enough. These can be problems of insomnia. Sometimes we have difficulty sleeping, second, you know, as a result of other medical condition we have or treatments we have. So this is why we encourage folks to work with their physicians if they feel that they’re not getting enough sleep. You know, your physician is in the best position to evaluate is it part of your current treatment or is it something that needs to be evaluated by a sleep specialist.
Balintfy: I guess sleep or sleepiness is kind of subjective. So how can we tell if we’re really sleeping right, getting quality sleep, are there specific measures or health impacts?
Twery: The qualities of sleep that determine your health seem to boil down into three main areas.
One is the duration of sleep okay and that’s easy to understand. We want adults for instance should try to schedule or allow for at least seven to eight hours of sleep each night.
Another one is the timing of sleep. It’s important. We were all, our biology is designed for us to go to bed at night and wake up in the morning. This is true in some way again for almost every life form on the planet. Even plants change their function, their physiology, their biology. During the sun, they’re manufacturing, you know, taking in sunlight and converting and during night they’re doing other restorative functions. People also change our metabolism changes, our hormones are changing throughout the day and night so the timing is sleep is part of how our bodies maintain that rhythm.
The third quality or third factor, so we have duration of sleep, the timing of sleep but it’s this quality of sleep and this is where sleep disorders comes in. This is where we suggest that folks try to sleep in a space where there’s not a lot of light pollution whether it’s light from outside your window and more commonly and increasingly we have lots of electronic gizmos in our bedroom. You know, to consider is any of this light contributing to helping disturb your sleep is it contributing to that, some people more than others. Our sleep environment, we obviously feel uncomfortable or if it’s an unsafe environment, in some areas these things can all lead to disturbing your sleep.
The reason it’s important for our health is if the duration of sleep, the timing of sleep or the quality of sleep is less than optimal, we find that those deviations contribute to an increased risk of disease. Researchers are showing changes in metabolism. The production of more elevating the level of circulating fats and lipids in our blood, this is not good for cardiovascular health. It’s not good for obesity and it’s one of the problems that we see when people don’t sleep at the right time or get enough sleep or with sleep disorders.
Other effects are metabolism, not getting enough sleep and regular rhythm of sleep contributes to elevated stress hormones. It affects our immune system. Researches have recently discovered that one of the many factors that can improve the strength of vaccinations, so we all get vaccinated for the flu, well people who are vaccinated when they’re unrested, when they haven’t been getting enough sleep develop a weaker protection against infection than people who are on average – compared to people who are well rested on average. So getting a good night’s sleep then getting – you know, being well rested when you go to get your vaccination might improve the strength of the vaccination.
These are all examples of things that are not obvious as we live our lives. These are things that research is helping to bring to light so the physicians can help guide you and you can use this information to produce the best possible health outcome for you as an individual.
Balintfy: How does pregnancy affect sleep, Dr. Twery?
Twery: So this is a fascinating question because we all know that there’s – many people recognize that there is a certain amount of discomfort that comes with being pregnant and that’s perfectly natural. But what researchers have also learned is that all the hormonal changes that go along with pregnancy and these changes in volume as a woman retains some additional fluid would gain about 20 to 30 pounds perhaps during pregnancy, these conditions can contribute to their own categories of sleep problem. So for instance, it may contribute to difficulty breathing as during pregnancy there’s lower levels of estrogen. This loss of estrogen makes the connection between our brain and in certain muscles that maintain the opening of the airway, that connection is not as strong and so during sleep. That muscle may relax more than it should and it can actually begin to collapse. Some women maybe 10%- 20% of women begin to snore during pregnancy. They may actually experience some sleep apnea during pregnancy and this is kind of where – this is the starting point.
We also are looking at women who can’t sleep maybe experiencing some of the same health problems that everyone else who can’t sleep. It affects your outlook on your environment and your interaction with others, your mood, how you view things but it also affects your physical, medical health. The loss of regular sleep cycles can make it more difficult to produce the appropriate amount of growth hormone or the appropriate amount of other hormones and may increase the release of stress hormones and all these could contribute to complications during pregnancy.
Balintfy: Are there easy ways to tell if someone is having sleep problems, are there symptoms?
Twery: So this is where your observations, you as an individual, as a patient have a very important role in working with your physician because if you’re not getting enough sleep regularly, you will probably feel like not sleep or sleepiness or being chronically tired and fatigued. You can bring these symptoms back to your physician. There are many possible reasons why people might not getting enough rest. I mean you could have an infection that may need to be treated. You could have another medical condition or it could be a sleep disorder or it could be that you’re not allowing enough time to sleep or it could be that your environment in which you’re sleeping, perhaps there’s a bright street light outside your window and you need to block that light out. These are all things that need to be discussed or could be discussed with your physician to find out how important are these symptoms to your health and what you can do about it.
Balintfy: And again, this is especially important for pregnant women, right?
Twery: Yes. So we know that not getting enough sleep and not breathing such as women who may be experiencing sleep apnea are associated with many stressful hormonal changes. These hormonal changes in people who are not – women of childbearing age or women who are not pregnant or men all result in elevated blood pressure, increased production of lipids, an abnormal metabolism of glucose, sugar. In pregnancy, well the research now underway indicates that not breathing, not sleeping contributes to your risk of gestational conditions like hypertension, diabetes, preeclampsia, and all the consequences thereof.
What we don’t know yet is to what extent waiting or treating these sleep symptoms is going to improve the results. This again is something where a woman, a patient would want to work with their physician to decide, determine what is the best course to protect their health and that of their unborn child.
Balintfy: Thanks to Dr. Michael Twery at the NIH’s National Heart, Lung and Blood Institute. For more information on sleep and sleep disturbances, visit www.nhlbi.nih.gov/sleep. Also, we’ll have more sleep-related interviews later this year. Coming up, news items on a protein that regulates iron and blood pressure, community programs that reduce prescription drug abuse, and research on a gene that may predict PTSD. That’s next on NIH Research Radio.
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News Summary
Balintfy: Now for this week’s news headlines from NIH, here’s Craig Fritz.
Fritz: A protein that helps to regulate iron levels in the body has an unexpectedly important role in preventing pulmonary hypertension, a form of high blood pressure that affects the lungs. The protein also helps stabilize the concentration of red cells in blood, and prevent a rare disorder in which the body produces too many red blood cells according to researchers at NIH. This discovery may lead to progress in treating both conditions.
Middle school students that received any of 3 community based prevention programs showed significant reductions in prescription drug abuse into late adolescence and young adulthood, according to a new study funded by NIH. Prescription drug abuse has become one of the most serious public health concerns in the United States. The CDC reports that prescription painkillers are involved in more unintentional overdose deaths than heroin and cocaine combined.
In an NIH study of Israeli infantrymen, soldiers preoccupied with threat at the time of enlistment or with avoiding it just before deployment were more likely to develop post-traumatic stress disorder, or PTSD. Such vigilance and avoidance, interacting with combat experience and an emotion-related gene, accounted for more than a third of PTSD symptoms that emerged later. Researchers say that since this preoccupied attention predicted future risk for PTSD, computerized training can help modify such attention might help protect soldiers from the disorder.
For this NIH news update, I’m Craig Fritz.
Balintfy: You can get more information on these news items at www.nih.gov/news.
And that’s it for this episode of the new NIH Research Radio. Please join us again next Friday, February 22 when our next edition will be available. Coming up in that episode…
Basic research is research that is not directly targeted to a particular disease or organ system or stage of life. Rather it’s looking at underlying mechanisms of cells and organisms to understand how they work. And understanding how they work is really a first step in understanding how we might treat diseases for example.
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Balintfy: If you have any questions or comments about this program, or have a story suggestion for a future episode, please let me know. Send an email to NIHRadio@mail.nih.gov. Also, please consider following NIH Radio via Twitter @NIHRadio, or on Facebook. Until next week, I'm your host, Joe Balintfy. Thanks for listening.
Announcer: NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.
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About This Podcast
Date: 02/15/2013
Spokesperson: Dr. Michael Twery
Topic: sleep, sleep disorder, sleep disturbance, sleep cycle, rest, wake, disease, pregnancy, pregnant, snoring, insomnia, sleep apnea, duration, timing, quality, iron, protein, blood pressure, community, drug abuse, prescription painkiller, gene, PTSD, post traumatic stress disorder
Institute(s): NHLBI
Additional Info:
Sleep Disorders Information
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