Insomniacs' Brains May Work Differently

Small study suggests more 'plasticity' might keep active brains too busy at night

WebMD News from HealthDay

By Randy Dotinga

HealthDay Reporter

FRIDAY, Feb. 28, 2014 (HealthDay News) -- The brains of insomniacs buzz with more activity during the day, preliminary new research suggests, offering possible insight into why people with sleep problems complain that their minds won't shut down at night.

The findings, based on a small study of 28 people aged 50 and older, aren't definitive and won't immediately lead to help for insomniacs. But the results are "potentially getting us closer to different types of treatment to treat this excitability they're having in the brain," said study lead author Dr. Rachel Salas, a neurologist and assistant professor at the Johns Hopkins Medical Institution, in Baltimore.

At issue: The millions of people who suffer from insomnia. About 10 percent to 15 percent of adults in the United States think they have chronic insomnia, according to the U.S. National Institutes of Health, while surveys by the National Sleep Foundation report that many more suffer from symptoms of troubled sleep.

Insomnia has many causes, such as sleep apnea, side effects of medications and consumption of caffeine. It is often difficult to treat.

In the new study, researchers used a type of noninvasive electromagnetic stimulation to look at "plasticity" -- the brain's ability to remake itself moment by moment as we learn new things and make new memories.

"The more plastic your brain, the better it's able to adapt to new memories and new learning or an event like a stroke," Salas said. "It's usually a good thing. You want your brain to be able to adapt and change to keep up with what you need it to do."

The researchers thought the brains of insomniacs would be more sluggish. But the study, which tracked brain activity in 18 people with sleep problems and 10 people who didn't have trouble sleeping, found the opposite, at least when they were awake.

The brains of insomniacs were busier than those of the normal sleepers, Salas said. "It's like they're constantly on, constantly being activated," she explained.

This fits in with the experiences of some insomniacs who say they can't sleep because their brains are always revved up, she said.

Still, these revved-up brains may not be able to compensate for the daytime troubles caused by sleeplessness, such as the accidents and mistakes that plague insomniacs. And then there's the fact that scientists theorize that sleep -- whose very purpose is unknown -- "is important for brain plasticity," said Marcos Frank, an associate professor of neuroscience at the University of Pennsylvania School of Medicine.

If insomnia makes the brain busier and more plastic, how would that fit in with the idea that sleep is supposed to do that? One possibility is that an overactive brain has trouble prioritizing things and overreacts to "innocuous events," said Frank, who's familiar with the new study findings.

He praised the study, but noted that it's small and limited. "It would have been more interesting if tests of other types of plasticity were also performed, but it's a good start," he said.

Study author Salas said the research could eventually lead to ways to calm the thinking of overactive brains in insomniacs. "Perhaps," she said, "that can transition them to sleep."

The study is published in the March issue of the journal Sleep.

source : Insomniacs' Brains May Work Differently

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FAQ: New Nutrition Facts Label

By Kathleen Doheny
WebMD Health News

Reviewed by Michael W. Smith, MD

Feb. 28, 2014 -- The time is past due for an overhaul of the ''Nutrition Facts'' labels on food products, according to the FDA, which unveiled its proposed changes on Thursday.

The most talked-about changes to the labels are that they would:

• Show the number of calories in bigger, bolder type
• Update serving sizes to reflect what is typically eaten
• List added sugars separately from natural sugars

Now, the proposal enters the typical 90-day period for comments before a final ruling is made.

Industry groups said Thursday they will work with the FDA. "For 20 years, the Nutrition Facts panel has been an invaluable tool to help consumers build more healthful diets for themselves and their families, and the time is right for an update," said Pamela G. Bailey, president and CEO of the Grocery Manufacturers Association.

WebMD asked two experts to explain what the changes would mean -- and why they may help shoppers make better nutrition choices. 

What are the biggest changes?

''I think the biggest is the serving size, especially if it moves to something more realistic," says Connie Diekman, director of university nutrition at Washington University in St. Louis. That could be behavior-changing, she says.

Take, for example, a package of candy with two pieces that are not individually wrapped. "If you buy a two-pack of candy, it may say the serving size is one,'' Diekman says. "And who eats just one?"

So a shopper may look at the calorie label, figure it's for the whole package -- not one serving -- and end up eating double or triple the calories they think they're having.

Under the new labels, food that could be eaten in one sitting should give calorie and nutrition information for the whole package.

Why the focus on listing added sugars?

Calling out the added sugars has been a point of discussion among nutrition experts for a while, Diekman says. "Natural sugars, like milk sugars and fruit sugars, provide health benefits. Many people don’t know natural sugars exist."

The main reason for singling out added sugars is concern that most Americans eat too much of it, Diekman says. Some experts say it is helping to drive the obesity epidemic.

Seeing the amount of sugar added to a product would help people compare, she says.

"Suppose you pick up a yogurt that says 20 grams of sugar, and the one next to it has 25. But one only has 5 grams of added sugar, and let's say the other has 10 grams of added sugar." That information could help you pick the product with less added sugars, she says.

"My concern is that no single nutrient is the cause of obesity," Diekman says. "It's a much more complex issue than blaming a single nutrient. We learned that with fat, with carbohydrates.''

source : FAQ: New Nutrition Facts Label

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Common Asthma Meds May Raise Sleep Apnea Risk, Study Says

Preliminary finding saw possible link between certain inhaler drugs and the sleep disorder, but more research needed

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

FRIDAY, Feb. 28, 2014 (HealthDay News) -- Medicines commonly used to control asthma may increase the risk of a potentially serious sleep problem in some people, a small, early study suggests.

"Inhaled corticosteroids may predispose to sleep apnea in some asthma patients," said study author Dr. Mihaela Teodorescu, an associate professor of medicine at the University of Wisconsin School of Medicine and Public Health, in Madison.

In sleep apnea, breathing periodically stops during sleep, for a few seconds or even minutes at a time, according to the U.S. National Heart, Lung, and Blood Institute. The pauses can occur as often as 30 times or more in a single hour. In the most common type of apnea, the airway becomes blocked or collapses during sleep. If untreated, apnea can increase the risk of high blood pressure, heart attack, stroke and other problems.

However, the new study linking asthma medicines with an increased apnea risk was very small -- including just 18 patients. And the researchers found a link, not cause and effect, and don't yet know what that connection means.

An expert not involved in the study was skeptical of the findings, emphasizing that more work is needed.

Teodorescu agreed, and is continuing to look at the medicines.

In the new study, the 18 men and women evaluated were taking 1,760 micrograms a day of inhaled fluticasone (Flonase). (Another inhaled corticosteroid is budesonide, or Pulmicort.)

The researchers monitored the men and women for changes in the "collapsibility" of their upper airways during sleep and their tongue function. Three patients had the amount of fat in their soft palates measured with MRIs, which found a redistribution of fat to the neck area, which can narrow the airway.

All the patients had changes in their tongue function and upper airway consistent with sleep apnea, said Teodorescu, who is also the director of the James B. Skatrud Pulmonary Sleep Research Laboratory at the Middleton Memorial Veterans Hospital, in Madison, Wisc.

Some patients were more affected than others, Teodorescu said. More vulnerable, she said, were the patients who were mid-30s or older, men and those whose asthma was poorly controlled at the start.

Teodorescu decided to study the effect of the corticosteroids after she said she found growing evidence that sleep apnea is more prevalent among people with more severe asthma. The current study is a pilot study.

The study appears in the February issue of the Journal of Clinical Sleep Medicine.

One expert called for more research into the link.

"We need a larger study," said Dr. Len Horovitz, a pulmonologist and internist at Lenox Hill Hospital in New York City. The steroids studied by the Wisconsin researchers are a mainstay of treatment for moderate asthma, he said, and can work well to control the asthma.

The findings cited by the researchers -- floppiness of the tongue and oral membranes -- would typically also be linked with noticeable speech changes and vocal quality changes, he said. The researchers should consider including evaluations by a speech pathologist and ear-nose-throat specialists, he added.

"Time will tell when we look at a larger study," Horovitz said.

Michele Meixell, a spokesperson for AstraZeneca, said that her company's Pulmicort (budesonide) is safe and effective "when used in accordance with the FDA-approved indications."

Meanwhile, Teodorescu said if asthma patients are getting control of their asthma on prescribed steroids, "they should continue." She suggested the medicine and dose be tailored to each patient's needs.

"If people with asthma are told they snore, they should talk to their physician about the possibility of sleep apnea," she added.

source : Common Asthma Meds May Raise Sleep Apnea Risk, Study Says

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