Monthly Archives: August 2013

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Archaeopteryx, a dinosaur the size of a turkey, has often been viewed as the Kitty Hawk of bird flight. Around 150 million years ago, this early bird changed the way dinosaurs moved around in the world, from running, climbing, slithering, leaping or swimming to soaring through the air.

This celebrated species glided above the spike-backed Stegosaurus and the long-necked Brachiosaurus of the Jurassic period.

Feathers, hollow bones and a brain capable of processing information to make flight possible all came together, distinguishing Archaeopteryx from its land-limited cousins.

And yet, recent research suggests that while this creature may have been among the first to fly, it was likely not the first to have the brain power to make flight possible.

Led by Stony Brook University research instructor Amy Balanoff, a team of scientists used CT scanners to examine the brains of older dinosaurs that are considered the distant cousins of Archaeopteryx, modern birds and Archaeopteryx itself.

While the researchers weren’t able to look at the brains themselves, they were able to study the relative size of different areas by looking at the skulls. It is like examining the outline of a hard suitcase stuffed to capacity. By looking at different compartments, scientists could see what was there and how much space it filled. In the scientists’ case, they used CT scanners to determine the volume of different brain regions.

Archaeopteryx, it seems, wasn’t alone among its contemporaries and even, in some cases, its predecessors in having a bird-like brain capable of flight.

“This feature that we thought was more restricted in its nature now needs to be expanded to include more groups,” said Balanoff, who is also a research associate in paleontology at the American Museum of Natural History.

Creatures that have an enlarged or hyperinflated forebrain, which is important in providing superior vision and the coordination necessary for flight, include oviraptorosaurs and troodontids.

This study “establishes that the evolutionary origin of the relatively large brain of Archaeopteryx was not the result of nature selecting for flight capability,” explained Gabriel Bever, an assistant professor of anatomy at the New York Institute of Technology, a co-author on the study and Balanoff’s husband. “Large brains evolved prior to flight and were simply inherited by Archaeopteryx and other early birds.”

This, Bever, continued, is an important example of evolution taking existing structures and assembling them in a way that moves the group along its evolutionary trajectory.

The forebrain is what really expanded along bird lineage, Balanoff added. That part of the brain is larger among species with stronger cognition.

“A lot of characteristics that we’ve associated with flying birds are not unique to flying birds,” she said. “They show up much earlier with nonavian dinosaurs.”

Balanoff described the finding as further evidence of a random process, rather than being directional.

She said the result wasn’t surprising, given that other bird-like features, like feathers and hollow bones, were present before Archaeopteryx. One of the first-known dinosaurs capable of powered flight, Archaeopteryx was discovered only two years after Darwin predicted in “The Origin of Species” that there should be “transitional fossils,” Balanoff said.

The latest findings were published in the journal Nature in July of this year.

Balanoff joined SBU this summer and will be one of several teachers in a gross anatomy class for medical students this fall. “Paleontologists in general are often found in anatomy departments, teaching human gross anatomy,” she said.

Balanoff and Bever met when they were at the University of Texas, when Balanoff was working on her master’s degree and Bever was conducting research for his doctorate.

Balanoff didn’t grow up in Texas with a burning desire to uncover more information about dinosaurs or dinosaur brains.

“My father [Howard Balanoff, a professor at Texas State] is a political scientist. I was thinking more along the lines of politics,” she said.

As a freshman in college at the University of Texas, however, she took a course with Timothy Rowe — a collaborator on the Nature article — and switched her major to geology.

Going forward, Balanoff plans to focus on an area of the modern bird brain called the wulst, which may have a similarity to a structure in the brain in the Archaeopteryx.

“The scientific importance of the wulst to our understanding of neurological evolution,” predicted Bever, “will eventually far outweigh its importance as a systematic character supporting Archaeopteryx as an early bird.”

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The brain is like an enormous orchestra, as neurological signals from different regions work together to create a symphony of thought, emotion and behavior. When some of those signals are out of tune or come at the wrong time, the melody, and indeed the thought process, can become difficult to follow.

Pavel Osten, an associate professor at Cold Spring Harbor Laboratory, has helped develop ways to compare the signals from mouse brains that are functioning within the range of normal with those that have wiring or signaling problems because of mouse models of disorders like schizophrenia or autism.

“There are disorders linked to brain development that are, in a way, subtle,” he said. “There is nothing dramatically wrong with the brains of patients” on a larger scale. Autism and schizophrenia are likely caused by different wirings of brain connections, without dramatic changes, such as the cell loss in neurodegenerative disorders like Parkinson’s and Alzheimer’s, Osten explained.

To understand what happens in the brains of people with schizophrenia and autism, Osten worked with TissueVision, a Cambridge, Mass., company, to develop an imaging system called serial two-photon tomography. In the past, scientists would take one to two months to image the entire brain at the same resolution that this technique can now do in a day.

It works by integrating automated images of thin parts of the brain, starting with the top. By looking at which regions of a brain are active, scientists can see how the communication among circuits may be disrupted in disease and can look at what drugs might correct these problems.

“When we got to that point, we realized that we have a really good drug-screening method,” he said. This process can map out how drugs affect different regions of the brain.

Indeed, Osten and MIT professor Sebastian Seung started a company called Certerra, which provides a rapid analysis of brain activity at different times. Based at Cold Spring Harbor, the company employs three people. Osten hopes to increase that to 10 to 15 staff members in the next few years.

Osten works one day a week at that company, named for the “territory of the brain,” while he spends the rest of a work week that often exceeds five days in his lab. Osten said tomography can reveal unexpected benefits of drugs by suggesting ways medicines affect the brain.

Many drugs used for depression were “prescribed for something else,” he said. When patients took them, however, they got better. By seeing the effect of a wide range of remedies, researchers can depend “less on serendipity. They can see the clinical effect.”

The CSHL scientist said that seeing which regions of the brain are active doesn’t necessarily reveal every cellular and molecular detail linked to a specific disorder.

“We focus on the large picture,” he explained.

Peter Seeburg, a professor in the Department of Molecular Neurobiology at the Max Planck Institute for Medical Research in Germany, who has known Osten since 1999, described serial two-photon tomography as a “promising way to determine the brain circuitry. Whether it will allow [researchers] to see differences in schizophrenia or autism is at this point unclear.” He explained that the key to its effectiveness lies in the ability to see how the circuitry determined by tomography differed from “normal” individuals which, he contended, was still a “huge amount of work.”

Seeburg described Osten as a driven scientist with an excellent reputation and an international renown, adding, “He has a passion for medically relevant science and a nose for excellent projects.”

A scientist at CSHL for five years, Osten lives in Huntington with his wife, Julia Kuhl, a fine and graphic artist who works part-time at Cold Spring Harbor. The gallery Frosch & Portmann in New York has exhibited her work, which is available at the website www.juliakuhl.com. This year, she had a solo exhibit at the gallery.

The couple, who also have a residence on the lower East Side, enjoy viewing the countryside on Long Island and in the area from their 1967 butternut-yellow Camaro Convertible.

Osten, who grew up in Czechoslovakia, is pleased with his decision to join Cold Spring Harbor Laboratory, where he feels the collaborations with colleagues in the neuroscience department make it a “pretty spectacular place to work.”

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Some natural treatments can greatly reduce condition

I thought a discussion of insomnia would be a good follow-up to my recent article on sleep deprivation. Like sleep deprivation, insomnia is an all-too-common complaint. Though the statistics vary widely, about 30 percent of Americans are affected, according to the most frequently used estimate (Sleep. 2009;32(8):1027). Women tend to be affected more than men. Insomnia is thought to have several main components: difficulty falling asleep, difficulty staying asleep, waking up before a full night’s sleep, and sleep that is not restorative or restful (American Academy of Sleep Medicine 2nd edition 2005).

Unlike sleep deprivation, patients have plenty of time for sleep. Having one or all of these components is considered insomnia. There is debate about whether or not it is actually a disease, though it certainly has a significant impact on patients’ functioning (Arch Intern Med. 1998;158(10):1099).

Insomnia is frustrating, because it does not necessarily have one cause. Causes can include aging; stress; psychiatric disorders; disease states, such as obstructive sleep apnea and thyroid dysfunction; asthma; medication; and it may even be idiopathic (of unknown cause). It can occur on an acute (short-term), intermittent, or chronic basis. Regardless of the cause, it may have a significant impact on quality of life. Insomnia also may cause comorbidities (diseases), two of which we will investigate further: heart failure and prostate cancer.

Fortunately, there are numerous treatments. These can involve medications, such as benzodiazepines like Ativan and Xanax. The downside of these medications is they may be habit-forming. Nonbenzodiazepine hypnotics (therapies) include sleep medications, such as Lunesta (eszopiclone) and Ambien (zolpidem). All of these medications have side effects. We will investigate Ambien further, because of recent warnings.

There are also natural treatments, involving supplements, cognitive behavioral therapy, and lifestyle changes.

Let’s look at the evidence.

 

Heart Failure

Insomnia may perpetuate heart failure, which can be a difficult disease to treat. In the HUNT analysis (Nord-Trøndelag Health Study) , an observational study, results showed insomnia patients had a dose-dependent response for increased risk of developing heart failure (Eur Heart J. online 2013;Mar 5). In other words, the more components of insomnia involved, the higher the risk of developing heart disease.

There were three components: difficulty falling asleep, difficulty maintaining sleep, and nonrestorative sleep that is not restful. If one component was involved, there was no increased risk. If two components were involved, there was a 35 percent increased risk, although not statistically-significant.

However, if all three components were involved, there was 350 percent increased risk of developing heart failure, even after adjusting for other factors. This was a large study, involving 54,000 Norwegians, with a long duration of 11 years.

 

Prostate Cancer

Prostate cancer has a plethora of possible causes, and insomnia may be a contributor. Having either of two components of insomnia, difficulty falling asleep or staying asleep (sleep disruption), increased the risk of prostate cancer by 1.7 and 2.1 times, respectively, according to a recent observational study (Cancer Epidemiol Biomarkers Prev; 2013;22(5):872–9).

However, when looking at a subset of data related to advanced or lethal prostate cancer, both components, difficulty falling asleep and sleep disruption, independently increased the risk even further, 2.1 and 3.2 times, respectively.

This suggests that sleep is a powerful factor in prostate cancer, and other studies have shown that it may have an impact on other cancers, as well. There were 2,102 men involved in the study with a duration of five years. While there are potentially strong associations, this and other studies have been mostly observational. Further studies are required before any definitive conclusions can be made.

What about potential treatments?

 

Ambien

While nonbenzodiazepine hypnotics may be beneficial, this may come at a price. In a recent report by the Drug Abuse Warning Network part of the Substance Abuse and Mental Health Services Administration, the number of reported adverse events with Ambien that perpetuated emergency department visits increased by more than two-fold over a five-year period from 2005 to 2010 (SAMSHA.gov). Insomnia patients most susceptible to having significant side effects are women and the elderly. The director of SAMHSA recommended focusing on lifestyle changes for treating insomnia: by making sure the bedroom is sufficiently dark, getting frequent exercise, and avoiding caffeine.

In reaction to this data, the FDA is requiring the manufacturer of Ambien to reduce the dose recommended for women by 50 percent (FDA.gov). Ironically, sleep medication like Ambien may cause drowsiness the next day — the FDA is investigating if it is safe to drive after taking these medications the night before.

 

Magnesium

The elderly population tends to suffer the most from insomnia, as well as nutrient deficiencies. In a double-blinded, randomized controlled trial, the gold standard of studies, results show that magnesium had resoundingly positive effects on elderly patients suffering from insomnia (J Res Med Sci. 2012 Dec;17(12):1161-9).

Compared to a placebo group, participants given 500 mg of magnesium daily for eight weeks had significant improvements in sleep quality, sleep duration, and time to fall asleep, as well as improvement in the body’s levels of melatonin, a hormone that helps control the circadian rhythm.

The strength of the study is that it is an RCT, however, it was small, involving 46 patients over a relatively short duration.

Cognitive Behavioral Therapy

In a recent study, just one 2½-hour session of cognitive behavioral therapy delivered to a group of twenty patients suffering from chronic insomnia saw subjective, yet dramatic, improvements in sleep duration from 5 to 6½ hours and decreases in sleep latency from 51 to 22 minutes (APSS 27th Annual Meeting 2013; Abstract 0555). The patients who were taking medication to treat insomnia experienced a 33 percent reduction in their required medication frequency per week. The topics covered in the session included relaxation techniques, sleep hygiene, sleep restriction, sleep positions, and beliefs and obsessions pertaining to sleep. These results are encouraging.

It is important to emphasize the need for sufficient and good-quality sleep to help prevent, as well as not contribute to, chronic diseases, such as cardiovascular disease and prostate cancer. While medications may be necessary in some circumstances, they should be used with the lowest possible dose for the shortest amount of time and with caution, reviewing possible drug-drug and drug-supplement interactions. Supplementation with magnesium may be a valuable step toward improving insomnia. Lifestyle changes including sleep hygiene and exercise should be sought, regardless of whether or not medications are used.

 

Dr. Dunaief is a speaker, author and local lifestyle-medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com or consult your personal physician.

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Coming from an international team of researchers out of Japan, physicists confirmed a small, but potentially powerful, quirk in the world of matter. If, as they believe it may, those small details don’t behave in the same way with antimatter, this finding could help explain how tables, chairs, lions and bears all exist.

They are focusing on neutrinos, which are so small that 50 billion of them pass through a finger in a second. Most neutrinos come from the sun, although scientists can produce them in a lab and shoot them underground to a detector miles away. In the case of T2K, scientists sent neutrinos 185 miles from Tokai village along the east coast of Japan to Kamioka, near the west coast of Japan.

Neutrinos come in three types: tau, muon and electron. The scientists shot muon neutrinos across Japan and expected, for the most part, to find tau neutrinos. Confirming with a much higher degree of accuracy a discovery from 2011, scientists found that 5% of those neutrinos became electron neutrinos.

“Nature was kind to us,” said Chang Kee Jung, a co-spokesman for T2K and a physics professor at Stony Brook. The oscillation to electron neutrinos “came out much earlier” than expected. So far, the scientists have only examined about 8% of the data they proposed to generate.

The next step in this long-term project is to collect considerably more data to explore on a larger scale the oscillations between muon and electron neutrinos.

Later, in Japan and elsewhere, scientists plan to conduct the same experiment with antineutrinos, to see if the transformation from one type of antineutrino to another follows the same pattern.

Like the conservation of energy, charge parity suggests the laws of physics would be the same if a particle were swapped for its antiparticle. In 1956, however, this was violated when several scientists showed that some reactions did not occur as often as their mirror images.

Scientists who work with particle physics were buzzing about the recent findings in Japan. “We at BNL are extremely thrilled at the T2K results,” offered Milind Diwan, a physicist at Brookhaven National Laboratory, who described Jung as “well recognized as a leader in our community.”

Jung marveled at the predictive ability of the science of physics. “When we observe certain things, we put all our observations and experimental data into mathematical equations,” he said. “Those equations will predict things we haven’t seen. We are almost the only science that has a predictable power using math.”

The Higgs particle, he said, was one such prediction physicists had been seeking for over 40 years. This particle provided something of an explanation for how particles with considerable energy acquired mass.

Jung expects to continue the T2K experiments for another five to 10 years.

At the same time, scientists including Diwan are working to turn the Long-Baseline Neutrino Experiment into a reality. The LBNE will shoot neutrinos 800 miles from the Fermilab near Chicago to a former gold mine in Lead, S.D. The experiment hopes to begin producing data in 2022.

An adventurer in his earlier years, Jung climbed mountains and went skydiving. In a physics of sports course he teaches at Stony Brook, he shows a video of himself on a tandem skydive in Florida with an instructor.

Jung also takes a close look at former Mets ace R.A. Dickey’s knuckleball, Usain Bolt’s 100-meter dash and the hang time of NBA basketball players.

An avid baseball fan who would choose the Mets over the Yankees because he loves the underdog, Jung considers himself a “hard-core Knicks fan.”

Jung is a resident of Setauket, where he lives with his wife, Vivan Piccone-Jung, who teaches Pilates and does video/film production and Web page design. The couple have three children, Daldeze, who attends Stony Brook, Wainabi, who will matriculate at SUNY New Paltz in the fall and Heoliny, who will be a ninth-grader at Murphy in September.

Jung has a picture in his office and on his website of him standing with the late Maurice Goldhaber, who was the director of BNL in the 1960s. A physicist in the generation immediately after Albert Einstein, Goldhaber visited Jung at his house on a day when it was raining. Standing in similar tan trench coats, the physicists are holding pink and red umbrellas, which they borrowed from Jung’s daughters.

“He’s willing to be silly and I have a similar spirit,” Jung said.

As for his work, Jung recognizes that there is “no guarantee” that scientists will discover CP violation when they look at antineutrinos, although he is “confident” it is there. Still, he doesn’t think he should “bet on this. I lost a few bets by betting on my New York Knicks, so my track record is not perfect.”

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District wants more emphasis on science, math

The Middle Country school district is moving forward with plans to redesign science and math offerings in the middle schools to provide students with an enhanced education in the subjects of science, technology, engineering and mathematics.

The three-year plan, which would begin in the 2014-15 school year, includes offering an additional math period every other day for seventh- and eighth-graders who are not taking living environment, and extended math offerings during the sixth-graders’ flex period.

“I think there will be a lot of support for it,” Deputy Superintendent for Instruction Francine McMahon said at a school board workshop on July 31. “There is more time for something we all feel is important.”

In order to make the change, band and orchestra will be offered every other day instead of daily, while health and home and careers classes, which are both required for middle school students, would be moved to sixth grade.

McMahon said the changes mark a major paradigm shift within the district, but it was important for class offerings like music to be maintained.

The change is suggested “not to destroy the music program, but yet to be able to maintain a quality program and at the same time increase the offerings that our youngsters would have in other areas so we end up with well-rounded students that perform well,” McMahon said.

According to McMahon, the program’s first year is projected to cost $598,000, as about nine additional staff members are needed, but the following school year, the district would save $104,000, as health classes will no longer be offered to seventh-graders as they would have already satisfied their health requirements.

By 2016-17 school year, McMahon said the district would be able to offer a science research lab, as declining enrollment at the elementary school-level would offset associated costs. Staff needed for the lab class would relocate to the middle school from the elementary school.

“We now have the ability because of the way we have reallocated and watched our funds to have a science research lab to be offered to all seventh- and eighth-grade and non-living environment students in grade eight for the first time,” McMahon said.

In addition to positively helping students, McMahon said the plan also acts as a professional development tool as seventh- and eighth-grade teachers will step in to assist sixth-grade teachers during flex periods when they aren’t teaching a double period of math to the seventh- and eighth-graders.

Superintendent Roberta Gerold said the plan would also help the district reach its long-term goal of requiring graduating seniors to complete a research project “that capitalizes on their interests, but uses the STEM underpinnings,” she said referring to science, technology, engineering and math courses.

While some board members raised concerns over the amount of available science lab space in the middle schools, Gerold said that because of declining enrollment, more space could become available.

“We didn’t want to stop the planning because we didn’t have the traditional lab space,” Gerold said.

Board of Education President Karen Lessler said she wouldn’t want the plans to be delayed either, but also asked her fellow board members to keep in mind of the need for lab space.

“We want to move to move through the obstacles,” she said.

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Eating and sleeping. Sleeping and eating. They may be linked in more than making it onto the list of life’s necessities.

Among teenagers from 13 to 18 years old, those who slept fewer than seven hours also tended to eat unhealthier foods, according to a recent study. Even further, though, those same sleep-deprived teens were less likely to have eaten a fruit and vegetable in the prior day.

“We are showing that there are patterns that vary by sleep duration,” said Lauren Hale, an associate professor of Preventive Medicine at Stony Brook University. The recommendation for teenagers is at least nine hours of sleep, she said.

The information for the study came from a survey conducted on teens in 1996 and was the second wave of a health study. In the questionnaire, teenagers were asked how many times they had eaten at a fast food restaurant in the past week. The study didn’t specifically request information on what they ate.

In this sample, 70% of the teenagers reported less than the recommended hours of sleep. Hale said even more of today’s teenagers are probably in that category as well.

By looking at a collection of data that included over 13,000 teenagers, Hale and her associates could break the information apart to seek answers to other questions, such as whether there were any differences among boys and girls.

“There was a similar pattern for both,” she concluded. “Being a regular short sleeper was associated with increased unhealthy and decreased healthy [food] choices.”

The main benefit to this study, she said, is that the sample size is so large that it allows for generalizability, she said. The data from this study are publicly available, although Hale paid for some restricted data.

“We used the best available data set for answering this question, using nationally representative data,” she said.

Hale, who is a few years older than some of the original teenagers sampled in the study (she graduated from high school in 1994), said there are some elements to this study and analysis that reflect other research.

Hale said she is interested in the determinants and consequences of sleep in the entire population. Adolescence, she continued, is an important period in which teens make their own choices. Some of the decisions teens make can set them on health trajectories that last into adulthood, she said.

Teens “are developing [and] they might not be making the best choices,” of what to eat, she said. “Kids who are sleep deprived are not making decisions that have their long run interests in mind. Maybe not all kids are interested in their long run health: they are interested in short run outcomes, like the pleasure of eating, fitting in with other kids, or [choosing] what’s easy, what’s fast and what’s cheap.”

Additionally, snacking teenagers don’t tend to raid the refrigerator for something healthy at 1 am. They are more likely to choose something gooey and sweet, she said.

Hale cautioned that the data, while compelling, doesn’t claim a causal link. The information correlates insufficient sleep with poor eating habits, but it is possible that the link could go in the other direction: poor eating habits may affect sleep. Poor eating choices and below recommended rest could also be by products of other health-related issues, including depression.

In her next study, she is planning to collect week-long sleep and physical activity data on 1,000 15-year-olds. During that week, she will be asking participants to fill out a diary about their food consumption.

Hale, who joined Stony Brook in 2005, is one of the first founding faculty members of the Program in Public Health at SBU. She is chair of the admissions committee. The Master’s in Public Health program has a class size of around 30.

Hale lives in Northport with her husband, Matt Aibel, a psychotherapist with offices in Manhattan and Stony Brook, and their two-year-old son, Isaac.

She said the couple feel like they “live in a vacation town.” They enjoy the access to water harbors, playgrounds, parks and beaches. They go to the Lewis Oliver Farm in Northport with Isaac.

She said it’s difficult for her, a sleep researcher, to overcome the fact that her son has some bedtime resistance.

As for her work, Hale said teenagers are “naturally staying up later, but they are going to schools that start earlier.”

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Metabolic aging of your cells may accelerate with lack of sleep

If you’ve ever felt sleep deprived, this article is for you. Fatigue is a common patient complaint, and there is a long list of maladies that may be responsible: sleep deprivation, infectious diseases (such as Lyme) and hypothyroidism (low thyroid functioning), to name a few.

We are going to focus on sleep deprivation, since it may impact our quality of life, influencing weight gain, disorders involving insulin resistance, kidney function and cognition, as well as chronic diseases, like diabetes. Even a short duration of inadequate sleep can have a surprising impact.

How much sleep do we need? Conventional wisdom has always been eight hours (Sleep. 1995;18:908). However, it varies depending on the individual. About 26% of Americans get eight or more hours of sleep per night (National Sleep Foundation, 2005). During the work week, approximately 30% of individuals in the U.S. get fewer than six hours of sleep.

The evidence suggests that, when you get to five hours or fewer per night, most people get into trouble.

 

Weight gain

In a recent, small prospective (forward-looking) study, results show that sleep deprivation results in weight-gain. Why is this? You actually burn more calories (about 5% more) when you sleep fewer hours, but you consume significantly more calories than you metabolize (Proc Natl Acad Sci USA. 2013;110:5695-5700). The individuals who were sleep-restricted gained about two pounds. That may not sound like much but the scary part is it occurred over a short time period — one work week, or five days.

Study participants were in a controlled setting, with half of them restricted to five hours of sleep and half of them permitted to sleep up to nine hours. Everyone was given access to ample amounts of food. Interestingly, not only did the amount of food consumed by those who were sleep deprived increase, but carbohydrate consumption became dominant. When participants who had been sleep deprived were transitioning toward adequate sleep in the second week, they began to make better food choices and started to lose weight.

In addition, researchers found that natural melatonin levels are altered by sleep deprivation, resulting in a change in our circadian rhythms or biological clocks that make it harder to fall asleep.

In another study, the results were similar (Sleep. 2013;36:981-990). This one involved 225 healthy participants. Those who were sleep restricted gained ironically about two pounds of weight over five days. Just like the previous study, participants were in a controlled laboratory where food was provided and their sleep monitored. In both studies, significant late night eating was common.

In a Nurses’ Health Study, results show that, for participants who regularly slept five hours or fewer, there was a 32% increased risk of gaining more than 30 pounds (Am. J. Epidemiol. 2006;164:947-954). This observational study involved approximately 68,000 women and was 16 years in duration.

 

Effects on aging

In a very small, but well-designed, randomized prospective study, adipocytes (fat cells) in sleep-deprived individuals became resistant or insensitive to ever-higher levels of insulin (Ann Intern Med. 2012;157:549-557). This may be a precursor to increased risk of weight gain and diabetes. The sleep-deprived participants were allowed four-and-a-half hours of sleep per night over a period of four days compared to the control group, which was allowed eight-and-a-half hours per night. The most surprising effect found was that the fat cells of sleep deprived individuals aged approximately two decades metabolically, so that participants in their 20s had fat cells that functioned similar to those in their 40s.

 

Diabetes

In the Millennium Cohort Study, participants with inadequate sleep were at significantly greater risk of developing type 2 diabetes than those with sufficient sleep (Diabetes Care Online. July 2013). In fact, participants who had five hours of sleep per night were at a 28% increased risk, and those who had fewer than five hours a night had a 52% greater risk. Adequate sleep was defined as at least seven hours. This was a prospective (forward-looking) observational study involving over 47,000 military personnel. The researchers brought up a good point: while sleep is on the decline, diabetes has been on the rise over the last three decades.

 

Cognition

Sleep deprivation’s impact on cognition may be immediate. In a study, healthy participants were subjected to sleep deprivation that resulted in decreased neurobehavorial functioning, or cognition, when compared to controls (Sleep. 2010;33:1013-1026). Those in the sleep-deprivation group were restricted for five days to four hours per night in bed, while those in the control group were allowed 10 hours per night. The sleep-deprived group was then allowed one night of 10 hours of sleep. While they recovered some neurobehavorial functioning, they didn’t reach their previous baseline levels. This study simulated the work week followed by one day of recovery. The study was an in-laboratory, well-controlled study involving 159 healthy participants.

In the Familial Adult Children Study (FACS), presented at the prestigious 64th Annual American Academy of Neurology Meeting, participants with poor quality sleep were more likely to have high levels of amyloid beta plaques (AAN Abstract 703). The significance of these plaques is that they may be precursors to Alzheimer’s disease. The researchers discovered that participants who woke five times in each hour of sleep had a substantially greater risk of developing amyloid beta plaques. Thus, those with lesser sleep efficiency were more likely to have preclinical Alzheimer’s disease. None of the patients showed any symptomatic cognitive deficits, only early preclinical signs of Alzheimer’s. This is a very preliminary study that requires further prospective and randomized clinical trials.

At this point, we can agree that sleep deprivation is something to be taken seriously. If you are fatigued, it may not be a bad idea to have your glucose (sugars) checked. Also, getting sufficient sleep may help slow the metabolic aging of your cells — and most of us want to forestall the aging process. As we age, cognition is a central issue. If we can decrease our risk of cognitive decline while aging, this is an ideal scenario. So, make sure you are getting good quality and quantity of sleep that fits your individual needs. It is not just an inconvenience to be tired, it actually affects your health.

 

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com and/or consult your personal physician.

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