Reading on iPad before bed disrupts sleep - Kindle is OK, with the exception of Kindle Fire

As well know, the iPad contains a touchscreen liquid crystal display that, like computer screens and television sets, emits light. Exposure to such abnormal light sources inhibits the body's secretion of melatonin.

All light-emitting devices, including cellphones, "tell the brain to stay alert." Because users hold those devices so close to their face, staring directly into the light, the effect is amplified compared with, for example, a TV across the room or a bedside lamp.

References:

Reading on iPad before bed can affect sleep habits. LA Times.

Comments from Twitter:

@UChicagoMed: Is that mostly from the light? The Kindle app and Instapaper both have dark modes that aren't as bright.

Comments from Twitter:

@DrVes: Why are some doctors and nurses giving back their iPads? http://j.mp/Hq15aD - Easy: iPad works great for pt education, NOT for data entry. Only 10% of doctors currently use an iPad at work http://j.mp/Hq15aD - I use iPad daily to discuss these diagrams: http://j.mp/Hq1k5v

iPad is a great teaching tool @CraigCCRNCEN was able to explain to Vietnamese family AFib and clots by showing them animation from YouTube.

Brian S. McGowan PhD @BrianSMcGowan: so is the best option for docs still a touch screen laptop? teach w/ touch screen, work w/ full keyboard? #hcsm

@DrVes: iPad works well for discussing DDx, Tx options with pts. Much more portable than laptop. Full-keyboard COWs best for typing.

Jeff Bray @jeffkbray: I have been scanning all my medical reference books and store them on my iPad for quick use and no weight - great tool and mobile

Related products from Amazon:

"Six hours sleep for a man, seven for a woman and eight for a fool". Was Napoleon right?

New ideas in chronobiology - Dr. Dieter Kunz of the Charité Hospital in Berlin talks about some of the latest ideas in chronobiology, and to what extent they do - and don't - affect our daily lives:



From the TV program Tomorrow Today | DW.DE http://bit.ly/USMQlx

40% of police officers have a sleep disorder according to a JAMA study

More than a third of police officers have a sleep disorder, and those who do are more likely to experience heart disease, problems with job performance and rage toward suspects and citizens, says the NYTimes, citing a study in the JAMA. That figure is at least double the estimated 15-20% rate of sleep disorders seen in the general population.

Having a sleep disorder raised the odds of heart disease by 45%, and the odds of depression by 120%. It also raised the odds of being injured on the job by 22% and falling asleep while driving by 51%.


The JAMA report video.

The officers who had sleep disorders reported more instances of “uncontrolled anger” toward suspects and citizens and serious administrative errors. Sleep deprivation may affect the amygdala, a part of the brain where emotion is governed.

Of the 5,000 study participants, 40% screened positive for at least 1 sleep disorder, most of whom had not been diagnosed previously:

- 34% screened positive for obstructive sleep apnea
- 6.5% for moderate to severe insomnia
- 5.4% for shift work disorder

Not surprisingly, the police officer who had smaller body mass indexes were far less likely to have sleep apnea. System-wide practices can have a significant impact. For example, state police officers in Massachusetts are given one hour of paid exercise time four days a week to help them stay fit. They were less liekly to have sleep apnea.

References:

Sleep Problems in Police Officers Take Heavy Toll. NYTimes.
Sleep Disorders, Health, and Safety in Police Officers. JAMA.

Comments from Twitter:

WendySueSwanson MD (@SeattleMamaDoc): Geesh.

@CrumbedOxygen: wonder if EMS similar.

Dr John Weiner @AllergyNet:  Can CPAP Cure Cops?

Martin Wilson @ChInspMWilson: what is CPAP then ...??

@DrVes CPAP (continuous positive airway pressure) is a treatment option for sleep apnea. Here is more info from the Mayo Clinic: http://www.mayoclinic.com/health/cpap/MM00716

Chronic sleep loss decreases performance - One night of good sleep is not enough to recover from chronic sleep deficit

On average, a person needs about eight hours a night to preserve performance.

Acute sleep loss is being awake for more than 24 hours in a row and chronic sleep loss is getting only about four to seven hours of sleep per night.

While most people caught up on acute sleep loss with a single night of 10 hours sleep, those with chronic sleep loss showed deteriorating performance for each hour spent awake.

People are largely unaware that they are chronically sleep-deprived but they are more vulnerable to sudden sleepiness, inattentiveness, and potentially, accidents and errors.

Three days is not enough to recover from chronic sleep loss, but they still do not know how many days or weeks may be needed.

References:
Chronic sleep loss hampers performance. Reuters, 2010.

Image source: Sleeping kitten. Wikipedia, Tilman Piesk, public domain.

Better Sleep, Better Learning? Obstructive sleep apnea can reduce a child’s IQ by 10 points

From Science Life Blog at the University of Chicago:

Pediatric obstructive sleep apnea, or OSA, can have long-term, detrimental effects on a child’s cardiovascular and respiratory health. But it can also create neurocognitive effects, such as a reduced ability to learn and retain information.

OSA can reduce a child’s IQ by as many as 10 points, while treatment in children with OSA can improve grades.

References:

Better Sleep, Better Learning? « Science Life Blog « University of Chicago.
http://sciencelife.uchospitals.edu/2010/02/15/better-sleep-better-learning

Sleep duration is shorter in obese children http://goo.gl/z5JFs
Sleepiness and sleep-disordered breathing may be found in 19-29% of children with positive allergy test (http://goo.gl/AfCWZ).

People who get less than 6 hours sleep per night have an increased risk of dying prematurely

People who get less than 6 hours sleep per night had an increased risk of dying prematurely in a recent study. Those who slept for less than that amount of time were 12% more likely to die early, though researchers also found a link between sleeping more than 9 hours and premature death.

The study aggregated decade-long studies from around the world involving more than 1.3 million people and found "unequivocal evidence of the direct link" between lack of sleep and premature death.

Just one sleepless night can hamper the body's ability to use insulin to process sugar in the bloodstream. Insulin sensitivity is not fixed in healthy people, but depends on the duration of sleep in the preceding night.

"Society pushes us to sleep less and less," one of the study investigators said, adding that about 20% of the population in the United States and Britain sleeps less than 5 hours.

Adults typically need between 7 and 9 hours sleep a night. If you sleep little, you can develop diabetes, obesity, hypertension and high cholesterol.

References:
Bad night's sleep can hamper body's insulin use. Reuters.

Image source: A halo around the Moon. Wikipedia, GNU Free Documentation License.

What's new in pulmonary, critical care, and sleep medicine from UpToDate

35% of UpToDate topics are updated every four months. The editors select a small number of the most important updates and share them via "What's new" page. I selected the brief excerpts below from What's new in hematology:

Asthma

When evaluating patients for occupational asthma, sputum eosinophil counts at 7 and 24 hours after specific inhalation challenge have a greater sensitivity and positive predictive value than exhaled nitric oxide (eNO).

Critical care

Proton pump inhibitors (PPIs) may be slightly more effective than histamine-2 (H2) blockers at preventing gastrointestinal (GI) bleeding in critically ill patients. However, the difference is small if real.

Idiopathic pulmonary fibrosis

Sildenafil, tyrosine kinase inhibitor imatinib, and pirfenidone, an anti-fibrotic agent, were each no more effective than placebo for treatment of idiopathic pulmonary fibrosis.

Pleural effusion

Using ultrasonography to identify a site for diagnostic thoracentesis is associated with significantly lower risk of pneumothorax, than using the physical exam for site selection.

Pulmonary embolism

PE is frequently asymptomatic. Among 5233 patients with a DVT, 32 percent had asymptomatic PE.

References:
What's new in pulmonary, critical care, and sleep medicine. UpToDate.

How to succeed? Get more sleep

In this 4-minute talk, Arianna Huffington (founder of The Huffington Post) shares a small idea that can awaken much bigger ones: the power of a good night's sleep. Instead of bragging about our sleep deficits, she urges us to sleep our way to increased productivity and happiness -- and smarter decision-making.

Quotes from the talk:

"I was recently having dinner with a guy who bragged that he had only gotten four hours sleep the night before. And I felt like saying to him, "You know what? If you had gotten five, this dinner would have been a lot more interesting."

There is now a kind of sleep deprivation one-upmanship. Especially here in Washington, if you try to make a breakfast date, and you say, "How about eight o'clock?" they're likely to tell you, "Eight o'clock is too late for me, but that's okay, I can get a game of tennis in and do a few conference calls and meet you at eight." And they think that means that they are so incredibly busy and productive, but the truth is they're not."

CPAP for sleep apnea - BMJ video

BMJ: Sleep apnoea (apnea, in its American spelling) is a condition that causes a patient to stop breathing for short periods during their sleep. In this video researchers Joaquín Durán-Cantolla and Jose María Montserrat discuss their work into the use of CPAP (continuous positive airway pressure) to treat the condition.

People with OSA may be twice as likely to develop a stroke.

Did you know that obstructive sleep apnea (OSA) can reduce a child’s IQ by as many as 10 points, while treatment in children with OSA can improve school grades?

Related:

Mavs Fan at the Finals - Photos - SI.com http://goo.gl/tIdL3

Understanding PAP Therapy for your Sleep Apnea - video from Cleveland Clinic (2013):

Sleep Habits Differ by Ethnicity but All Groups Are Sleep Deprived

All ethnic groups said they missed work or family functions because they were too sleepy, with the percentage ranging up to 24%, according to a 2010 "Sleep in America" survey by the National Sleep Foundation (NSF).

Some distinct differences are listed below:

On weekdays or workdays, African Americans reported they slept the least - 6 hours, 14 minutes, compared to 6 hours, 34 minutes for Hispanics, 6 hours, 48 minutes for Asians, and 6 hours, 52 minutes for Caucasians.

10% of African Americans and Hispanics reported having sex every night or nearly every night in the hour before bedtime, compared to 4% of Caucasians and 1% of Asians.

African Americans had different pre-bedtime activities and tended to pray in the hour before bedtime - 71% of them said they prayed but only 18% of Asians did so.

Asians were least likely to drink alcohol an hour before bed - a practice that many mistakenly think will help sleep. Only 1% of Asians had a nightcap every night or nearly every night, compared to 7% of whites, 4% of African Americans and Hispanics.

Caucasians were most likely to sleep with their pets - as well as more likely to sleep with their spouse or significant others: 16% of them say they sleep with a pet, and 72% say they sleep with their partners. In comparison, only 4% of Asians, 4% of Hispanics, and 2% of African Americans let the pet on the bed.

References:

The 2010 Sleep in America poll by the National Sleep Foundation (NSF).

Sleep Habits Vary by Ethnicity. WebMD, 2010.
Sleepiness and sleep-disordered breathing may be found in 19-29% of children with positive allergy test (http://goo.gl/AfCWZ).

Image source: A halo around the Moon. Wikipedia, GNU Free Documentation License.

"Sleep eaters" binge on sugary, high-calorie snacks, sometimes 5 times a night

Consequences of nighttime eating can include injuries like black eyes from walking into a wall or hand cuts from a prep knife, or dental problems from gnawing on frozen food.

Upwards of 10 percent of adults suffer from some sort of parasomnia, or sleep disorder, like sleepwalking or night terrors. Some have driven cars or performed inappropriate sexual acts — all while in a sleep-induced fog. About 1 percent, mostly women, raid the refrigerator.

References:
Raiding the Refrigerator, but Still Asleep - NYTimes.com.

Image source: A halo around the Moon. Wikipedia, GNU Free Documentation License.