Friday, April 19, 2019
Wake up, people: You're fooling yourself about sleep, study says
Updated 2:06 PM EDT April 17, 2019
Hey, sleepyheads. What you believe about sleep may be nothing but a pipe dream.
Many of us have notions about sleep that have little basis in fact and may even be harmful to our health, according to researchers at NYU Langone Health's School of Medicine, who conducted a study published Tuesday in the journal Sleep Health.
"There's such a link between good sleep and our waking success," said lead study investigator Rebecca Robbins, a postdoctoral research fellow in the Department of Population Health at NYU Langone Health. "And yet we often find ourselves debunking myths, whether it's to news outlets, friends, family or a patient."
Robbins and her colleagues combed through 8,000 websites to discover what we thought we knew about healthy sleep habits and then presented those beliefs to a hand-picked team of sleep medicine experts. They determined which were myths and then ranked them by degree of falsehood and importance to health.
Here are 10 very wrong, unhealthy assumptions we often make about sleep, an act in which we spend an estimated third of our lives -- or, if we lived to 100, about 12,227 combined days.
Stop yawning. It's time to put these unsound sleep myths to bed.
1. Adults need five or fewer hours of sleep
"If you wanted to have the ability to function at your best during the day, not to be sick, to be mentally strong, to be able to have the lifestyle that you would enjoy, how many hours do you have to sleep?" asked senior study investigator Girardin Jean-Louis, a professor in the Department of Population Health.
"It turns out a lot of people felt less than five hours of sleep a night was just fine," he said. "That's the most problematic assumption we found."
We're supposed to get between seven and 10 hours of sleep each night, depending on our age, but the US Centers for Disease Control and Prevention says that a third of Americans sleep fewer than seven hours a night. According to World Sleep Day statistics, sleep deprivation is threatening the health of up to 45% of the global population.
"We have extensive evidence to show that sleeping five hours a night or less, consistently, increases your risk greatly for adverse health consequences, including cardiovascular disease and early mortality," Robbins said.
In a longitudinal study of 10,308 British civil servants published in 2007, researchers found that those who reduced their sleep from seven to five hours or fewer a night were almost twice as likely to die from all causes, especially cardiovascular disease.
Science has also linked poor slumber with high blood pressure, a weakened immune system, weight gain, a lack of libido, mood swings, paranoia, depression and a higher risk of diabetes, stroke, dementia and some cancers.
2. It's healthy to be able to fall asleep 'anywhere, anytime'
Falling asleep as soon as the car/train/airplane starts moving is not a sign of a well-rested person, sleep experts say. In fact, it's just the opposite.
"Falling asleep instantly anywhere, anytime, is a sign that you are not getting enough sleep and you're falling into 'micro sleeps' or mini-sleep episodes," Robbins said. 'It means your body is so exhausted that whenever it has a moment, it's going to start to repay its sleep debt."
You feel sleepy because of a buildup of a chemical called adenosine in the brain, which happens throughout the day as you head toward night. Sleeping soundly reduces that chemical so that when you wake up, the levels are at their lowest, and you feel refreshed.
But the longer you stay awake and the less sleep you get, the more your adenosine levels rise, creating what's called a sleep load or sleep debt.
Want to check your level of sleepiness? Look at the Epworth sleepiness scale, and if you're worried, check in with a sleep doctor who can do more extensive testing in a sleep lab.
3. Your brain and body can adapt to less sleep
People also believed that the brain and body could adapt and learn to function optimally with less sleep. That too is a myth, experts say. That's because your body cycles through four distinct phases of sleep to fully restore itself.
In stage one, you start to lightly sleep, and you become disengaged from your environment in stage two, where you will spend most of your total sleep time. Stages three and four contain the deepest, most restorative sleep and the dreamy state of REM, or rapid eye movement sleep.
"During REM, the brain is highly reactive," Robbins said. "It almost looks like your brain is awake if we hook you up to two more electrodes and were able to monitor your brain waves."
REM can occur any time during the sleep cycle, but on average, it starts about 90 minutes after you've fallen asleep. REM is when your body and brain are busy storing memories, regulating mood and learning. It's also when you dream. Your arm and leg muscles are temporarily paralyzed during REM sleep, so you can't act out your dreams and injure yourself.
Because a good night's sleep gives your sleep cycle time to repeat, you'll go through several REM cycles, which take up about 25% of your total sleeping time.
Another important stage of sleep is deep sleep, when your brain waves slow into what is called delta waves or slow-wave sleep. It's the time when human growth hormone is released and memories are further processed.
"The deeper stages of sleep are really important for generation of neurons, repairing muscle and restoring the immune system," Robbins said.
It's tough to wake a person from deep sleep. If you do wake, you can feel groggy and fatigued; mental performance can be affected for up to 30 minutes, studies show.
4. Snoring, although annoying, is mostly harmless
In your dreams, maybe. In fact, "loud, raucous snores interrupted by pauses in breathing" is a marker for sleep apnea, a dangerous sleep disorder that, according to the National Heart, Lung and Blood Institute, increases risk for heart attacks, atrial fibrillation, asthma, high blood pressure, glaucoma, cancer, diabetes, kidney disease and cognitive and behavior disorders.
"Sleep apnea is extremely exhausting," Robbins said. "These patients sleep and then they wake up over and over; then they are fighting sleep all day long because they're so exhausted. It's also very underdiagnosed. We believe it affects about 30% of the population, and around 10% are diagnosed."
5. Drinking alcohol before bed helps you fall sleep
Do you think a nightcap before bed will help you fall asleep and stay asleep? Dream on.
Alcohol may help you fall asleep, but that's where the benefits end, Robbins said. Instead, it traps you in the lighter stages of sleep and "dramatically reduces the quality of your rest at night."
"It continues to pull you out of rapid eye movement and the deeper stages of sleep, causing you to wake up not feeling restored," Robbins said.
6. Not sleeping? Stay in bed with eyes closed and try and try
You have to admit, it makes sense: How can you fall asleep if you're not in the bed trying? Yet sleep experts say that continuing to count sheep for more than 15 minutes isn't the smartest move.
"If we stay in bed, we'll start to associate the bed with insomnia," Robbins said. She equates it to "going to the gym and standing on a treadmill and not doing anything."
In reality, Robbins said, it takes a healthy sleeper about 15 minutes to fall asleep. If you're tossing and turning much longer than that, you should get out of bed, change the environment and do something mindless: "Keep the lights low and fold socks," she suggested.
Some people also believe that it's just as refreshing to your body to lie in bed with eyes closed but not sleeping. Nope. That's another pipe dream, experts say.
7. It doesn't matter what time of day you sleep
Sleep experts say that's another myth that can negatively affect your health.
"We recommend that people have a regular sleep schedule because it controls what we call the biological clock, or circadian rhythm, of the body," Jean-Louis said. "That controls all the hormones of the body, body temperature, eating and digestion, and sleep-wake cycles."
When your inner clock and the outside world are out of phase, you can feel disoriented, mentally foggy and sleepy at times when you need to be functioning at optimal levels. Just think of what happens when you travel across time zones or when daylight savings time kicks in.
Studies of shift workers, who work unusual hours and live out of sync with their normal biological rhythm, show that they are at increased risk for heart disease, ulcers, depression, obesity and certain cancers, as well as a higher rate of workplace accidents and injuries due to a slower reaction rate and poor decision-making.
8. Watching TV in bed helps you relax
Come on, we all do it -- or we check our laptop or smartphone before we power down for the night. Unfortunately, that sets us up for a bad night.
"These devices emit bright blue light, and that blue light is what tells our brain to become alive and alert in the morning," Robbins explained. "We want to avoid blue light before bed, from sources like a television or your smartphone, and do things that relax you."
According to the National Sleep Foundation, blue light affects the release of melatonin, the sleep hormone, more than any other wavelength of light. Watching TV or using an electronic device within two hours of bedtime means it will take you longer to fall asleep, you'll have less dream state or REM sleep, and even if you do sleep eight or more hours, you'll wake feeling groggy.
If you or your children can't make that two-hour cutoff because of homework or late-night work demands, experts suggest dimming the brightness of the screen or installing an app that can warm the screen to the sunset colors. Red and yellow have higher wavelengths and don't affect melatonin.
9. Hitting snooze is great! No need to get up right away.
Raise your hand if you hit the snooze button. Why not, right?
"Resist the temptation to snooze, because unfortunately, your body will go back to sleep -- a very light, low-quality sleep," Robbins said.
As you near the end of your sleep, your body is probably nearing the end of its last REM cycle. Hit that snooze button, and the brain falls right back into a new REM cycle. Now, when the alarm goes off a few minutes later, you'll be in the middle, not the end, of that cycle, and you'll wake up groggy and stay that way longer.
Having trouble kicking the snooze button habit? Put the alarm on the other side of the room, so you have to get out of bed to turn it off.
And no, you can't tell Google or Alexa to turn it off. That's cheating.
10. Remembering your dreams is a sign of good sleep.
"That's a myth, because all of us do experience dreams four to five times a night," Jean-Louis said. "And we don't remember because we've not woken up and disrupted our sleep."
A study out of France showed that people who frequently remember their dreams have higher brain activity in the information-processing hub of the brains. They also woke twice as often during the night and were more sensitive to sounds when sleeping and awake.
"Now, I will tell you if you have a dream with a strong emotional context, it may come back to you at say, two o'clock in the afternoon, when you have some downtime to relax," Jean-Louis said. "Sometimes, something would trigger that. But if it is a weird little mundane dream, most of us who sleep well don't remember those."
The research team found more myths that we tend to accept as fact, Jean-Louis said, such as "more sleep is always better" (no, you really can sleep too much and harm your health), "taking a nap in the afternoon can fix insomnia" (actually, if you sleep long enough to enter a REM or deep sleep cycle, it can mess up your body clock even more), and "it's better to have a warm than cool bedroom" (no, you sleep better in cooler temps).
Which means that we could all use a bit of education about good sleep hygiene, a set of habits to form that will set you up for a lifetime of healthy sleep. The National Sleep Foundation has tips, as does the CDC.
After all, there's no amount of caffeine that can help you deal with the adverse implications of insufficient sleep, nor can you train yourself to adapt to sleep deprivation, Robbins said.
"Sleep is a highly active process," she said. "It's crucial, actually, in restoring the body and is in fact the most efficient, effective way to do so."
Saturday, March 30, 2019
Monday, December 3, 2018
SANDHYA RAMESH 6 November, 2018
Patients receiving chemotherapy (Representational image) | Daniel Bockwoldt/picture alliance via Getty Images
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IIT-Bombay team has devised a drug carrier that can be used in combination with chemo to deliver treatment to exact site of tumour, keeping healthy cells safe.
Bengaluru: IIT-Bombay scientists have developed a therapy whereby two microscopic “bubbles” can deliver drugs straight to tumours, thus reducing the amount of healthy cells that would be affected in chemotherapy.
The mice on which the study was carried out reportedly demonstrated a 100 per cent survival rate.
The research has been published in the journal Scientific Reports.
Cancer has affected humans for millennia, and, so far, chemotherapy has proved to be one of the most effective treatments.
However, cancer cells tend to multiply quickly and chemotherapy simply targets the cells that are dividing.
This means that even healthy cells that aren’t affected by cancer will be targeted by chemo drugs, which induce suicide in cells. Thus, whether the treatment is effective or not, the patient invariably tends to be in a lot of pain.
To improve the accuracy of drugs — so they target only an infected tumour and not healthy cells — as well as to reduce cancer cells developing immunity to drugs, lots of experimental work is underway around the world on ‘combination therapy’.
These include the administration of two or more drugs to treat the same disease. With cancer, this is increasingly becoming the norm.
The IIT-Bombay team has devised a drug carrier that can be used in combination with chemotherapy to deliver treatment to the exact location of a solid cancerous tumour, keeping healthy cells safe.
The study has been performed on both lab-grown cells (in-vitro), as well as animals (in-vivo), with promising results.
The injectable consists of two microscopic ball-shaped carriers attached together: The smaller one is a capsule that will contain the potent drug to fight a cancer cell, and the bigger one a gas bubble that will act as a tracker that can be seen using ultrasound imaging.
The latter is 500 nanometres in diameter, and known as a “nanobubble”, while the drug carrier is about 200 nanometres and called a “nanocapsule”.
The tiny blobs will have two different effects in the body. First, they will be able to allow tracking through ultrasound as they travel through the bloodstream.
We can monitor their progress and wait for them to reach the precise point of the cancerous tumour. When they hit the region where the affected tumour is, ultrasound therapy can be administered to the exact target area. This process is known as guided cancer therapy.
The second occurs as tissues loosen when ultrasound is applied to the right spot. As the tumour area is administered ultrasound, the tumour tissues relax. The gas bubble undergoes multiple expansions and contractions, before eventually bursting.
The tiny nanocapsule has now been given an easy passageway to enter the tumour, thanks to tissue expansion. The capsule is made up of lipids that occur naturally in our bodies, and thus they are compatible to deliver the drug within the tumour at a precise location.
“This research presents an image-guided, ultrasound trigger-responsive platform for improved tumour cell targeting, along with real-time monitoring of the disease,” said Rinti Banerjee from the department of biosciences and bioengineering at IIT-Bombay, who led the study.
The two individual bubbles aren’t a new invention. Both technologies exist independently. But they have not been used in conjunction before for treating cancer.
“To the best of our knowledge this is the first time a smart combination therapy with a pro-apoptotic biomolecule, a drug, and nanobubbles have been used together,” said Banerjee.
The study showed that ultrasound with the combination of the two bubbles is much more effective than any other combination of treatments and components.
Ultrasound image-guided therapy and ultrasound application therapy are growing fields in cancer research, and this study could help expedite more efficient treatments based on this technology.
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Saturday, March 3, 2018
Could there be five types of diabetes rather than just two?
Scientists say diabetes is five separate diseases, and treatment could be tailored to each form.
Diabetes - or uncontrolled blood sugar levels - is normally split into type 1 and type 2.
But researchers in Sweden and Finland think the more complicated picture they have uncovered will usher in an era of personalised medicine for diabetes.
Experts said the study was a herald of the future of diabetes care but changes to treatment would not be immediate.
Diabetes affects about one in 11 adults worldwide and increases the risk of heart attack, stroke, blindness, kidney failure and limb amputation.
Type 1 diabetes is a disease of the immune system, which affects around 10% of people with the condition in the UK. It errantly attacks the body's insulin factories (beta-cells) so there is not enough of the hormone to control blood sugar levels.
Type 2 diabetes is largely seen as a disease of poor lifestyle as body fat can affect the way the insulin works.
The study, by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland, looked at 14,775 patients including a detailed analysis of their blood.
The results, published in The Lancet Diabetes and Endocrinology, showed the patients could be separated into five distinct clusters.
- Cluster 1 - severe autoimmune diabetes is broadly the same as the classical type 1 - it hit people when they were young, seemingly healthy and an immune disease left them unable to produce insulin
- Cluster 2 - severe insulin-deficient diabetes patients initially looked very similar to those in cluster 1 - they were young, had a healthy weight and struggled to make insulin, but the immune system was not at fault
- Cluster 3 - severe insulin-resistant diabetes patients were generally overweight and making insulin but their body was no longer responding to it
- Cluster 4 - mild obesity-related diabetes was mainly seen in people who were very overweight but metabolically much closer to normal than those in cluster 3
- Cluster 5 - mild age-related diabetes patients developed symptoms when they were significantly older than in other groups and their disease tended to be milder
Prof Leif Groop, one of the researchers, told the BBC: "This is extremely important, we're taking a real step towards precision medicine.
"In the ideal scenario, this is applied at diagnosis and we target treatment better."
The three severe forms could be treated more aggressively than the two milder ones, he said.
Cluster 2 patients would currently be classified as type 2 as they do not have an autoimmune disease.
However, the study suggests their disease is probably caused by a defect in their beta-cells rather than being too fat.
And perhaps their treatment should more closely mirror patients who are currently classed as type 1.
Cluster 2 had a higher risk of blindness while cluster 3 had the greatest risk of kidney disease, so some clusters may benefit from enhanced screening.
Dr Victoria Salem, a consultant and clinical scientist at Imperial College London, said most specialists knew that type 1 and type 2 was "not a terribly accurate classification system".
She told the BBC: "This is definitely the future of how we think about diabetes as a disease."
But she cautioned the study would not change practice today.
The study was only on Scandinavians and the risk of diabetes varies considerably around the world, such as the increased risk in South Asians.
Dr Salem said: "There is still a massively unknown quantity - it may well be that worldwide there are 500 subgroups depending on genetic and local environment effects.
"Their analysis has five clusters, but that may grow."
Sudhesh Kumar, a professor of medicine at Warwick Medical School, said: "Clearly this is only the first step.
"We also need to know if treating these groups differently would produce better outcomes."
Dr Emily Burns, from Diabetes UK, said understanding the diseases could help "personalise treatments and potentially reduce the risk of diabetes-related complications in the future".
She added: "This research takes a promising step toward breaking down type 2 diabetes in more detail, but we still need to know more about these subtypes before we can understand what this means for people living with the condition."