Depression linked to increased risk of stroke in women

August 12, 2011

Science Daily/American Heart Association

Depression is associated with a moderately increased risk of stroke. Depressed women taking anti-depressant drugs -- particularly selective serotonin reuptake inhibitors -- had an increased stroke risk, which researchers said may not be a cause but rather an indicator of depression severity. Researchers said patients should continue taking their anti-depressant medication.

In six years of follow-up of women in the Nurses' Health Study, researchers found that a history of depression was associated with a 29 percent increased risk of total stroke -- even after considering other stroke risk factors. Women who used anti-depressant medication -- particularly selective serotonin reuptake inhibitors -- had a 39 percent increased risk of stroke. Examples of these drugs are Prozac, Zoloft, and Celexa.

Anti-depressant medication use may be an indicator of depression severity, said Kathryn Rexrode, M.D., the study's senior author and Associate Physician at Brigham and Women's Hospital in Boston, Mass. "I don't think the medications themselves are the primary cause of the risk. This study does not suggest that people should stop their medications to reduce the risk of stroke."

http://www.sciencedaily.com/releases/2011/08/110811162820.htm

Sleep-disordered breathing may increase risk of cognitive impairment, dementia among older women

August 10, 2011

Science Daily/JAMA and Archives Journals

Older women with sleep-disordered breathing, as indicated by measures of hypoxia (oxygen deficiency), were more likely to develop cognitive impairment or dementia than women without this disorder, according to a new study.

"Sleep-disordered breathing, a disorder characterized by recurrent arousals from sleep and intermittent hypoxemia, is common among older adults and affects up to 60 percent of elderly populations. A number of adverse health outcomes including hypertension, cardiovascular disease, and diabetes have been associated with sleep-disordered breathing," according to background information in the article.

Cognitive impairment also has been linked to sleep-disordered breathing in some studies, but the design of most of these studies has limited the ability to draw conclusions regarding this association. "Given the high prevalence and significant morbidity associated with both sleep-disordered breathing and cognitive impairment in older populations, establishing whether a prospective association exists between sleep-disordered breathing and cognition is important. This is especially important because effective treatments for sleep-disordered breathing exist."

"Moreover, in trials evaluating the effects of pharmacological and nonpharmacological (e.g., cognitive training and rehabilitation) interventions on cognitive function in patients with mild cognitive impairment or dementia, the possible coexistence of sleep-disordered breathing should be considered. Finally, physicians of patients with mild cognitive impairment and sleep-disordered breathing for whom treatment with CPAP may be indicated should consider these results, and future guidelines to formalize the clinical management of patients with mild cognitive impairment should consider the implications of this study and related research."

http://www.sciencedaily.com/releases/2011/08/110809161957.htm

Prenatal exposure to stress linked to accelerated cell aging

September 16, 2011

Science Daily/University of California - Irvine

Young adults whose mothers experienced psychological trauma during their pregnancies show signs of accelerated aging, a new study has found. The researchers discovered that this prenatal exposure to stress affected the development of chromosome regions that control cell aging processes.

The researchers discovered that this prenatal exposure to stress affected the development of chromosome regions that control cell aging processes. The study results, which appear online this week in the Proceedings of the National Academy of Sciences, point to the importance of maternal health and well-being during pregnancy.

"Our previous research on prenatal stress exposure has shown its effects on long-term metabolic, immune, endocrine and cognitive function," said the paper's lead author, Dr. Pathik D. Wadhwa, UCI professor of psychiatry & human behavior, obstetrics & gynecology, pediatrics, and epidemiology. "But this is the first to show the impact of prenatal stress on cell aging in humans, and it sheds light on an important biological pathway underlying the developmental origins of adult disease risk."

"These results indicate that stress exposure in intrauterine life is a significant predictor of adult telomere length -- even after accounting for other established prenatal and postnatal influences on telomere length," said Sonja Entringer, UCI assistant professor of pediatrics and first author on the paper.

A rapidly emerging body of human and animal research indicates that intrauterine conditions play an important role not only in all aspects of fetal development and health across gestation and birth, but also in a wide range of physical and mental health outcomes over an individual's entire lifespan.

http://www.sciencedaily.com/releases/2011/08/110801160227.htm

Chemotherapy Is Associated With Disruption Of Sleep-Wake Rhythm In Women

Sep. 7, 2009 —

Science Daily/American Academy of Sleep Medicine

A study in the Sept.1 issue of the journal Sleep shows that the sleep-wake activity rhythms of breast cancer patients are impaired during the administration of chemotherapy. Results indicate that the first cycle of chemotherapy is associated with a temporary disruption of these rhythms, while repeated administration of chemotherapy results in progressively worse and more enduring impairments.

During week one of the first cycle of chemotherapy, participants switched from low to high activity about 30 minutes later in the day and decreased their level of activity about 50 minutes earlier at night, suggesting that their days were shorter. During the first week of the fourth cycle of chemotherapy, the women increased their level of activity about 37 minutes later in the day and switched from high to low activity about 34 minutes earlier at night. Although most variables returned to baseline levels in the second and third weeks of the first cycle of chemotherapy, circadian impairments were maintained on several variables in the second

http://www.sciencedaily.com/releases/2009/09/090901082355.htm

Lack Of Sleep Could Be More Dangerous For Women Than Men

- July 1, 2009 —

Science Daily/University of Warwick

Women who get less than the recommended eight hours sleep a night are at higher risk of heart disease and heart-related problems than men with the same sleeping patterns.

Research by the University of Warwick and University College London has found that levels of inflammatory markers vary significantly with sleep duration in women, but not men.

Lead author of the study, Associate Professor of Biochemical Medicine at Warwick Medical School Michelle Miller said short-term sleep deprivation studies have shown that inflammatory markers are elevated in sleep-deprived individuals, suggesting that inflammatory mechanisms may play a role in the cardiovascular risk associated with sleep deprivation. 

She said: “Our study may provide some insight into a potential mechanism for the observation in previous studies which indicates an increased risk of death from cardiovascular disease in individuals who have less than five hours sleep per night and increased risk of non-cardiovascular death in long sleepers.”

This is the first large-scale study to describe the associations between measures of inflammation and sleep duration in both men and women.

Dr Miller added: “These findings add to the growing body of evidence which suggests that there is a non-linear relationship between cardiovascular risk factors and duration of sleep. Furthermore, they support the idea that short sleep is associated with an increase in cardiovascular risk and that the association between sleep duration and cardiovascular risk factors is markedly different in men and women. 

“Further prospective studies are required to ascertain causality but the results also are consistent with the idea that sleeping seven or eight hours per night appears to be optimal for health.”

http://www.sciencedaily.com/releases/2009/07/090701083523.htm

Poor Sleep Quality Linked to Postpartum Depression

- Dec. 24, 2008 —

Science Daily/Wiley-Blackwell

Postpartum depression (PPD) can lead to poor sleep quality, recent research shows. A new study shows that depression symptoms worsen in PPD patients when their quality of sleep declines.

Sleep deprivation can hamper a mother’s ability to care for her infant, as judgment and concentration decline. Sleep-deprived mothers also may inadvertently compromise their infants’ sleep quality because infants often adopt their mothers’ circadian sleep rhythms.

All new mothers experience some sleep loss following childbirth, as their estrogen and progesterone hormone levels plunge. They typically spend 20 percent more of the day awake than average during the first six weeks postpartum. Postpartum women wake more frequently and have less dream sleep than non-postpartum women, with women in their first month postpartum spending only 81 percent of their time in bed actually sleeping.

Neurotransmitters that influence sleep quality also affect mood, raising sleep-deprived mothers’ risk for depression. Approximately 6.5 to 13 percent of new mothers suffer from PPD in the United States, with there being more than 4.2 million births per year. This rate is nearly 50 percent among mothers in the lowest socioeconomic levels

Posmontier recommends clinicians treating women for PPD to address the importance of adequate sleep. “Mothers can develop a plan to have other family members help care for the baby at night,” she said. “They also should practice good sleep hygiene. That includes going to bed at the same time every night, avoiding naps and steering clear of caffeine, exercise, nicotine and alcohol within four hours of bedtime.”

http://www.sciencedaily.com/releases/2008/12/081210122236.htm

Delayed Sleep Phase Syndrome Linked to Irregular Premenstrual Symptoms

- June 13, 2008 —

Science Daily/American Academy of Sleep Medicine

Women with delayed sleep phase syndrome are more likely to report irregular menstrual cycles and premenstrual symptoms.

According to the results, twice as many subjects with delayed sleep phase syndrome reported an irregular menstrual cycle compared to controls. For those not using birth control, three times as many subjects with delayed sleep phase syndrome reported irregular menstruation, compared to controls. Pre-menstrual problems, such as cramps and mood swings, were reported by 69 percent of those with delayed sleep phase syndrome, compared to 16.67 percent of controls.

Obstructive sleep apnea (OSA) is much more common in postmenopausal women. This increase may be due in part to menopause-related weight gain. But it also appears to be hormone-related. Estrogen seems to help protect women against OSA.

It is recommended that women get between seven and eight hours of nightly sleep.

The following tips are provided by the American Academy of Sleep Medicine (AASM) to help women get the most out of their sleep:

·      Make your bedroom a comfortable and safe place. Reduce noises and extreme temperatures that might disturb you.

·      Use light and comfortable bed linens and garments.

·      Go to bed only when you are sleepy and use the bed only for sleeping and sex.

·      Begin rituals to help you relax at bedtime, such as taking a soothing bath or enjoying a light snack.

·      Go to bed and get up at the same time every day, including weekends and holidays.

·      If you need to take a nap, keep it to less than one hour and take it before 3 p.m.

·      Only drink caffeine in the morning, and avoid alcohol and cigarettes late in the day.

·      Stay away from fatty, spicy foods that are likely to upset your stomach or cause heartburn.

·      Set aside time during the day to get all of your worries out of your system.

·      Increase vitamin E in your diet, or take a vitamin E supplement.

·      Hormone replacement therapy may help you sleep better by relieving severe hot flashes related to menopause. Ask your doctor for advice about this kind of treatment.

·      Only use sleeping pills when supervised by a doctor.

Those who suspect that they might be suffering from a sleep disorder are encouraged to consult with their primary care physician or a sleep specialist.

http://www.sciencedaily.com/releases/2008/06/080610072156.htm

Normal Sleep Linked to Successful Aging

- June 11, 2008 —

Science Daily/American Academy of Sleep Medicine

A research abstract that will be presented on June 11 at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), finds a link between normal sleep and healthy aging.

The study, authored by Sonia Ancoli-Israel, PhD, of the University of California at San Diego, and colleagues, focused on 2,226 women 60 years of age or older. Reports of use of sleeping aids, daytime somnolence, napping, sleep latency, sleep maintenance insomnia, early morning awakening, snoring, overall perceived sleep quality, and sleep duration were all assessed.

According to the results, 20.8 percent of the women were categorized as "successful agers". Items related to less daytime napping and fewer complaints of sleep maintenance insomnia best predicted successful aging. There was no direct relationship between use of sedative-hypnotics and successful aging. Increased severity of sleep disturbance also predicted lower self-rated "successful aging" and a greater difference between perceived and actual age, and this result again remained significant after controlling for depressive symptom severity.

"Our findings that reports of better sleep are related to successful aging reinforce the idea that good sleep is of utmost importance for good health," said Dr. Ancoli-Israel. "Health care professionals need to ask their patients -- of all ages -- about sleep and help those with poor sleep to find ways for improvement."

Unfortunately, many older adults often get less sleep than they need. One reason is that they often have more trouble falling asleep. A study of adults over 65 found that 13 percent of men and 36 percent of women take more than 30 minutes to fall asleep.

Also, older people often sleep less deeply and wake up more often throughout the night, which may be why they may nap more often during the daytime. Nighttime sleep schedules may change with age too. Many older adults tend to get sleepier earlier in the evening and awaken earlier in the morning.

Not sleeping well can lead to a number of problems. Older adults who have poor nighttime sleep are more likely to have a depressed mood, attention and memory problems, excessive daytime sleepiness, more nighttime falls and use more over-the-counter or prescription sleep aids. In addition, recent studies associate lack of sleep with serious health problems such as an increased risk of obesity, cardiovascular disease and diabetes.

While most people require seven to eight hours of sleep a night to perform optimally the next day, older adults might find it harder to obtain the sleep they need. Older adults must be more aware of their sleep and maintain good sleep hygiene by following these tips:

Establishing a routine sleep schedule.

Avoiding utilizing bed for activities other than sleep or intimacy.

Avoiding substances that disturb your sleep, like alcohol or caffeine.

Not napping during the day. If you must snooze, limit the time to less than one hour and no later than 3 p.m.

Stick to rituals that help you relax each night before bed. This can include such things as a warm bath, a light snack or a few minutes of reading.

Don't take your worries to bed. Bedtime is a time to relax, not to hash out the stresses of the day.

If you can't fall asleep, leave your bedroom and engage in a quiet activity. Return to bed only when you are tired.

Keep your bedroom dark, quiet and a little cool.

Although sleep patterns change as people age, disturbed sleep and waking up tired every day are not part of normal aging. Those who have trouble sleeping are advised to see a sleep specialist at a facility accredited by the American Academy of Sleep Medicine (AASM).

http://www.sciencedaily.com/releases/2008/06/080611071051.htm

Bright Light Therapy May Improve Nocturnal Sleep In Mothers

- June 10, 2008 —

Science Daily/American Academy of Sleep Medicine

Bright light therapy may improve a mother's nocturnal sleep, decrease daytime sleepiness and be beneficial to her well-being, according to a research abstract that will be presented on June 9 at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).

According to the results, the post-treatment average nocturnal total sleep time increased from 383 minutes (6.38 hours) at the baseline to 424 minutes (7.07 hours) for the treatment group mothers. However, the total sleep time in the control group mothers worsened from 413 minutes (6.88 hours) to 373 minutes (6.22 hours). After the four-week intervention, the treatment group mothers' daytime total sleep time decreased from 114 to 39 minutes.

"Having a low birth weight infant in the ICU can intensify sleep disturbances for mothers because of extended periods of exposure to the artificial dim light in the ICU and stress related to the infant's medical condition," said Dr. Lee. "Impaired sleep may have negative impact on the mother's well-being. In our research, we were looking for an intervention to help mothers that would be feasible for them to use even when their infant is hospitalized. The preliminary findings from our pilot study indicate that bright light therapy given through use of the special visor may improve mothers' nocturnal sleep, decrease daytime sleepiness, and be beneficial to their well-being. While our results are promising, a larger scale randomized clinical trial is needed to establish if this would be an effective therapy in this population."

Sleep plays a vital role in promoting a woman's health and well being. Getting the required amount of sleep is likely to enhance a woman's overall quality of life. Yet, women face many potential barriers -- such as life events, depression, illness, bad sleep habits and medication use -- that can disrupt and disturb her sleep. Overcoming these challenges can help her enjoy the daily benefits of feeling alert and well rested.

http://www.sciencedaily.com/releases/2008/06/080609071132.htm

Low Melatonin Associated with Risk of Breast Cancer in Postmenopausal Women

- June 16, 2008 —

Science Daily/Journal of the National Cancer Institute

Low melatonin levels are associated with an increased risk of breast cancer in postmenopausal women, according to a prospective case-control study.

Melatonin is primarily secreted during the dark hours of a light-dark cycle and has been shown to be low in some night workers. Researchers have found that low melatonin levels in premenopausal women are associated with an increased risk of breast cancer.

The researchers found that women with the lowest levels of melatonin had a statistically significantly higher incidence of breast cancer than those with the highest levels.

The researchers conclude that low melatonin levels are associated with an increased risk of breast cancer. Further studies need to confirm these data and should investigate the mechanisms that underlie the association.

http://www.sciencedaily.com/releases/2008/06/080610161255.htm

Poor Sleep More Dangerous for Women

- Mar. 11, 2008 —

Science Daily/Duke University Medical Center

Researchers at Duke University Medical Center say they may have figured out why poor sleep does more harm to cardiovascular health in women than in men.

"This is the first empirical evidence that supports what we have observed about the role of gender and its effects upon sleep and health," says Edward Suarez, an associate professor in the department of psychiatry and behavioral sciences at Duke and the lead author of the study. "The study suggests that poor sleep -- measured by the total amount of sleep, the degree of awakening during the night, and most importantly, how long it takes to get to sleep -- may have more serious health consequences for women than for men."

The researchers found that about 40 percent of the men and the women were classified as poor sleepers, defined as having frequent problems falling asleep, taking 30 or more minutes to fall asleep or awakening frequently during the night. But while their sleep quality ratings were similar, men and women had dramatically different risk profiles.

"We found that for women, poor sleep is strongly associated with high levels of psychological distress, and greater feelings of hostility, depression and anger. In contrast, these feelings were not associated with the same degree of sleep disruption in men," says Suarez.

Women who reported higher degree of sleep disruption also had higher levels of all the biomarkers tested. For women, poor sleep was associated with higher levels of C-reactive protein and interleukin-6, measures of inflammation that have been associated with increased risk of heart disease, and higher levels of insulin. The results were so dramatic that of those women considered poor sleepers, 33 per cent had C-reactive protein levels associated with high risk of heart disease, says Suarez.

"Interestingly, it appears that it's not so much the overall poor sleep quality that was associated with greater risk, but rather the length of time it takes a person to fall asleep that takes the highest toll," says Suarez. "Women who reported taking a half an hour or more to fall asleep showed the worst risk profile."

http://www.sciencedaily.com/releases/2008/03/080310131529.htm