Lack of sleep and regular snoring linked to poorer breast cancer survival

A new study from the USA reports that short sleep duration combined with frequent snoring reported prior to cancer diagnosis may influence subsequent breast cancer survival.

Lack of sleep and breast cancer

 

Results show that women who typically slept less than the recommended 7 hours of sleep per night and were frequent snorers in the years before their cancer diagnosis experienced a poorer cancer prognosis.

The findings were especially robust for women who were diagnosed with breast cancer. Breast cancer patients who reported sleeping 6 hours or less per night and snoring 5 or more nights per week before their diagnosis were 2 times more likely to die from breast cancer (hazard ratio = 2.14) than patients who reported sleeping 7 to 8 hours per night and rarely snored.

The study results are published in the April 15 issue of the Journal of Clinical Sleep Medicine.

In a week where scientists have revealed extensive data on the world’s sleeping patterns, leading researchers have told the BBC that society has become “supremely arrogant” in ignoring the importance of sleep. They say people and governments really need to take the problem seriously.

The body clock drives huge changes in the human body. Cancer, heart disease, type-2 diabetes, infections and obesity have all been linked to reduced sleep. It alters alertness, mood, physical strength and even the risk of a heart attack in a daily rhythm.

Sleep experts worldwide, including many who are based in the UK, endorse these statements. They include Dr Akhilesh Reddy, from the University of Cambridge, who said that the body clock influences every biological process in the human body and the health consequences of living against the clock were “pretty clear cut”, particularly in the case of breast cancer.

But the pressures of work and social lives mean many people cut their sleep during the week and catch up at the weekend. Researchers are investigating whether there is a health impact.

The study, by a team at the University of Bristol in the UK and Weill Cornell Medical College in Qatar, assessed “sleep debt” – a measure of the difference in the nightly hours asleep on weekdays and at the weekend.

“We found that as little as 30 minutes a day sleep debt can have significant effects on obesity and insulin resistance,” said Prof Shahrad Taheri from Weill Cornell. He added: “Sleep loss is widespread in modern society, but only in the last decade have we realised its metabolic consequences.

“Our findings suggest that avoiding sleep debt could have positive benefits for waistlines and metabolism and that incorporating sleep into lifestyle interventions for weight loss and diabetes might improve their success.”

The study was funded by the UK’s Department of Health, where 10% of healthcare budgets are already spent on treating diabetes. Perhaps they’ll act on it accordingly.

Information on global sleep habits has been equally informative and it was clearly evident that there was a conflict between our desire to stay up late and our bodies urging us to get up in the morning.

Prof Daniel Forger, one of the researchers, said “Society is pushing us to stay up late, our body clocks are trying to get us up earlier, and in the middle the amount of sleep that we have is being sacrificed; that’s what we think is going on in global sleep crisis.

The study found people in Japan and Singapore had an average of seven hours and 24 minutes sleep while the people in the Netherlands had eight hours and 12 minutes. People in the UK averaged just under eight hours – a little less than the French. The study also showed women had about 30 minutes more per night in bed than men, particularly between the ages of 30 and 60.

The message to everyone is very evident.
Sleep enough – Stop Snoring – and don’t ignore the opinions of the experts.

John Redfern


The dangers of driving with sleep apnoea – and the legal situation

The dangers of driving with sleep apnoea – and the legal situation

The most common symptom of obstructive sleep apnoea, and the most dangerous by far, is daytime drowsiness. This is accompanied when you sleep by heavy snoring, and choking sounds or gasping for breath on numerous occasions throughout the night. It’s a deadly problem to have.

OSA and driving

Drowsy driving may result and this is defined as operating a motor vehicle while being cognitively impaired by lack of sleep. Leading Motoring Associations in the UK and USA state that drivers with untreated sleep apnoea pay less attention to the road, react more slowly when braking suddenly, and make bad driving decisions that may lead to an accident.

Obstructive Sleep Apnoea is very common among middle-aged men, especially if they are overweight. Studies show that drivers with untreated OSA are five times more likely to be involved in road accidents with 25% of motorway or expressway accidents can be attributed to drowsiness. Most countries have had numerous examples in the headlines recently where this has caused tragedy both on the roads and on the rail systems.

In December 2014 a bin lorry careered out of control in a busy shopping street in Glasgow leading to the tragic death of six people. The accident inquiry into the incident has led to increased concern among doctors about their responsibility to disclose information about their patients to the DVLA.

A Doctor’s responsibility is to explain to the patient that they have a medical condition that may affect their ability to drive and that they have a legal obligation to inform the DVLA or DVA, and to stop driving if they are not having treatment for the problem. It is the driver’s legal responsibility to inform the authorities and it is a criminal offence for the driver to fail to do so.  The decision on whether the patient’s licence will be withdrawn rests with the DVLA or DVA and not the doctor.

Doctors in the UK have said they are anxious about disclosing information to the DVLA or DVA but have now been issued with a step-by-step approach by the General Medical Council approach that will allow them to deal with these difficult discussions more confidently. It runs as follows:

  1. Tell the patient to inform the Licensing Authority (DVLA)
  2. Assess the patient’s medical condition against required standards
  3. Try to persuade the patient to stop driving
  4. Only disclose the minimum information
  5. Keep detailed records

In Australia, NSW will soon have instant health checks for the 400,000 motorists who need to prove they are capable of driving. The checks are for elderly drivers who need to prove they can drive safely, heavy ­vehicle drivers, and motorists with epilepsy, sleep disorders and diabetes.

Doctors assess elderly drivers aged 75 or over each year to determine if their eyesight, motor function and attention is at a level where it is safe to drive. For holders of a class MC licence drivers have to be assessed at age 21 and then every 10 years, and after then at age 40 and then every five years

The state government will automate fitness-to-drive medical assessments, so GPs can send them to Roads and Maritime Services instantly. Roads Minister Duncan Gay said it meant doctors could instantly send applications to the RMS licence ­review unit, and elderly drivers would not be forced to queue at service centres or post offices to send application forms.

Although drinking while driving is a very serious problem, the deadliest habit is proving to be even more widespread: drowsy driving. In 2014, over 33 per cent of all U.S. drivers fell asleep behind the wheel of a car.

There are 42 drowsy drivers for every drunk driver on the road today.

In the USA however the greatest focus has been on commercial drivers, who are required to pass a health screening in order to drive. Regulators overhauled the system in 2014 and have disqualified roughly 70,000 truckers since then, out of some 8.5 million.

Treatment for OSA, bringing high restorative sleep, has been proved in research to overcome the problem. Oral appliances are approved and available for a very small cost and without any form of prescription so the solution is seen to be in the hands of those who wish to continue driving.

It brings a whole new meaning to the old phrase ‘Keep Death off the road’.

John Redfern


A good night’s sleep keeps you healthy – but snoring prevents it happening

Of late you must have noticed how doctors and healthcare professionals have given extra attention to the importance of undisturbed quality sleep. Increasing number of studies have linked sleep deprivation to serious health issues, ranging from high blood pressure, stroke, heart attacks, obesity, mood disorders, attention deficit disorder, foetal and childhood growth retardation, besides making one accident-prone in the car and at work.

Stop snoring week

 

There’s much more than that however, so whether you are up until the early hours of the morning watching the shows on Netflix, or simply staying up late because there’s too much work to do, one thing’s for sure – your body’s taking the brunt of your actions. But why is sleep so important? Not getting enough shut-eye can lead to other bad results as well as health and here are just some of the problems with comments from the experts in each case.

You gain weight

If you’re looking to shave off those stubborn extra pounds then lack of sleep certainly doesn’t help. In fact, it does the very opposite says nutritionist Dr Marilyn Glenville, author of the Natural Health Bible for Women.

“People who are sleep-deprived have an increased appetite. Inadequate sleep lowers the levels of leptin, a hormone that suppresses appetite. At the same time it increases leels of grehlin – a hormone that increases food intake and plays a role in long-term regulation of body weight. Sleep deprivation makes weight loss harder because it causes your body to work against you.”

Your immune system is compromised

Lack of sleep is known to lower the body’s immune response. A recent study found reducing the amount of sleep time every night lowered the number of “natural killer cells” which are responsible for fighting off invaders such as bacteria and viruses. Nutritional therapist Geeta Sidhu-Robb, who is the founder of Nosh Detox, says “A lack of sleep can impair the body’s ability to fend off diseases and inflammation, which in turn, can cause us to catch more colds or slow down the processes of recovery. No sleep means your body doesn’t have time to build up its defence system – the antibodies and cells that attack viruses and unfriendly bacteria.”

Your stress levels rocket

Inadequate sleep can also affect your cortisol levels – the hormone that help us manage stress, and Sidhu-Robb adds “Lack of sleep increases stress which produces the hormone cortisol, and it can also reduce collagen in the skin, which is what keeps it looking young and provides elasticity.”

Stress and ageing skin is not a combination worth losing your sleep for.

Your heart weakens

During sleep, the heart powers down significantly – reducing both your blood pressure and the heart rate, which is important for the health of the organ. By not getting enough sleep, your heart might not have enough time to lower your blood pressure to necessary levels.

“Research shows that those who sleep five hours or less a night are twice as likely to suffer from hypertension (high blood pressure) and heart disease as those who sleep for seven hours or more,” says Dr Marilyn Glenville.

A study conducted by a team from Mount Sinai Hospital showed having less than five hours of sleep each night had an 83% increased risk of stroke compared to sleepers who got seven to eight hours of shut-eye.

Your brain becomes foggy

Sleep deprivation affects our ability to learn and retain new information and can lead to poor long and short-term memory, as well as poor decision-making. “When we sleep our body and brain don’t actually shut off – we have light sleep phases and deeper ones,” says Neil Robinson, Sealy UK‘s resident sleep expert. “While we sleep in the deeper phases, our brain stays busy, overseeing an internal maintenance schedule that keeps us running in top condition. This helps the body repair itself and build energy for the day ahead – our muscles and tissues recover, our immune system gets a boost and all the information we have absorbed during the day gets consolidated in our memory. Without enough hours of this type of restorative sleep, we won’t function, work, learn, create, and communicate at effective levels.”

Your skin starts to age

Sleep deprivation leads to inflammation that can lead to poor skin conditions such as dullness, dryness, spots and dark circles under the eyes, and It can also age your skin.

“We all know that we look and feel worse after a bad night’s sleep,” says Georgie Cleeve, founder of skincare company OSKIA. “There is a real biological reason why a bad night’s sleep can play havoc with your skin.

“When we sleep the brain produces a brilliant chemical called Adenosine Triphosphate, or ATP for short. It’s essentially our cell battery power and runs all our cellular processes throughout the day. So less sleep equals less ATP. And that means less collagen production.”

It’s Stop Snoring Week – Be sensible and act on it.

John Redfern


The dangers of snoring and sleep apnoea during pregnancy

The period of time between conception and birth is a critically important one for the lifetime health of the easily influenced growing human baby. During this 35-40 week pregnancy span an expectant mother must be in optimal health so that she can adequately supply her unborn child with the nutrients needed for healthy development, including oxygen.

Pregnant woman with doctor . Isolated.

Oxygen is a primary resource necessary to make a healthy baby possible and if oxygen is cut off from the baby, they are at risk for any number of health complications.

Snoring and sleep apnoea a common problem in pregnancy, and nearly 30% of all pregnant women experience a worsening of OSA during their pregnancy. However, OSA is not commonly assessed during routine prenatal care. In one study, although 32% of patients reported snoring, less than 3% of physicians and nurses asked about snoring during a prenatal visit.

According to findings presented by researchers to the Australian Sleep Association, 50% of pregnant women will develop snoring by their final trimester – bringing dangerous health problems for both mother and baby.

The 2 main factors causing this are related to Hormones and Weight gain.

Changes in hormone levels dilate blood vessels, and cause the mucous membrane to swell in the nose, causing congestion and a narrowing of your nasal passages that results in forcing you to breathe through your mouth as you sleep, with the outcomes being snoring.

“As you gain weight in pregnancy, your lungs have less space and also a build-up of fat in the neck tissues narrows your airways which can cause more throat breathing – in other words, snoring,” says Professor Advisor of Education for the Royal College of UK Midwives, Michelle Lyne. She adds, “If snoring began during pregnancy, then it will almost definitely stop soon after you’ve had the baby. Your hormones settle down and you lose the excess weight and fluid you’ve been carrying for 9 months – which are the main causes for starting to snore when you’re expecting”.

According to US scientists, chronic snoring may be a sign of breathing problems that could possibly affect your oxygen supply to the baby. However, chronic snoring refers to women who snore regularly and badly both before they get pregnant as well as during their pregnancy.

The study showed that a chronic snorer might be up to two thirds more likely to have a low birth-weight baby, and twice as likely to need a C-section. Chronic snoring can easily be treated,” says lead researcher, Dr Louise O’Brien, from the University of Michigan’s Sleep Disorders Centre.

Sleep apnoea is at epidemic proportions in many countries and has become increasingly common among pregnant women. Oxygen restriction places the intrauterine baby at risk for: growth restriction (IUGR), diabetes or a stillbirth. Sleep apnoea and pregnancy share a few similar symptoms, blurring the line between healthy and unhealthy body changes.

Obstructive sleep apnoea (OSA) during pregnancy presents significant potential risks to both the mother and her foetus.  Symptoms of OSA in pregnant women should not be ignored.

There are four things that make OSA during pregnancy unique:

  • It affects not just one but two patients – the mother and the foetus.
  •  Pregnancy itself is often associated with symptoms that might mimic OSA, including sleep disturbance and daytime fatigue
  •  Sleep apnoea can worsen as pregnancy progresses and changes in the condition can occur rapidly. OSA should always be diagnosed and treated promptly.
  •  OSA may be temporary, and in those cases it should end after the birth. Women diagnosed with OSA during pregnancy should be checked again following the birth as the problem with all its associated health dangers may continue undiagnosed otherwise.

Approximately 85% of adults who have sleep apnoea are undiagnosed but Sleep apnoea during pregnancy is something that can be treated and the harmful effects to the baby from lack of oxygen can most certainly be prevented. There is no reason for a mother or her baby to have insufficient access to oxygen. Instead of worrying if her baby is getting the nutrients needed for healthy development, an expectant mother can prepare for an exciting future.

John Redfern