Sleep&Health

editor@sleepandhealth.com May 2008 73 Issue ISSN 1547-1586 EVERYTHING YOU NEED TO KNOW ABOUT SLEEP, ALERTNESS, MOOD & PERFORMANCE May 2008 73 Issue.

Published monthly.

Inside issue 73 Alertness Mood Performance SLEEP AFTER TRAINING MAKES LEARNING PERFECT . . . . . .2

Alternative and Traditiomal Medicine ALTERNATIVE TREATMENT FOR COMMON COLD  GOOD, BUT WATCH FOR SIDE EFFECTS . . . . . . .3 HYPNOTHERAPY COULD TREAT PAINFUL GUTS IRRITABLE BOWEL SYNDROME . . . . . . . . . . . . . . . . . . .3

Memorial day

TYPICAL COMMON AND ATYPICAL UNCOMMON SIDE EFFECTS OF SLEEPING MEDICATIONS . . . . . . . . . . . . . . . . . .7

Alertness Mood Performance

Why Schizophrenics Can’t Catch a Fly and Autistic Kids Change Shorts

Our Celebration AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE CELEBRATES ITS SEVENTEETH YEAR . . . . . . . . . . . . . .5 FEMALE BABY BOOMERS APPROACH THE AGE OF SLEEP PROBLEMS . . . . . . . . . . . . . . . . . . . .5

Art and Sleep JAMES ABBOTT MCNEILL WHISTLER. . . . . . . . . . . . .8

Sleep from A to Zzz TEETH GRINDING OR BRUXISM . . . . . . . . . . . . . . . . . .10

Sleep and Psychiatry SLEEP LOSS LINKED TO PSYCHIATRIC DISORDERS . . . . . . . . . . . . . . . . . . .11

And Many More

By Alexander Golbin, MD

I learned this story during my study of chaos theory or, as physicists called it, “non-linear dynamics.” I was fascinated with possibilities of applying this seemingly abstract mathematics to very concrete medical problems. The following example is adapted from the book of one of the leading physicists and science writers James Gleick, “Chaos: Making a New Science.”

I

t was an unusual gathering in 1986 in Washington, the first major conference on chaos in biology and medicine sponsored by the New York Academy of Science, the National Institute of Health, and the Office of Naval Research. Bernard Huberman, a Jew who emigrated from Argentina to California and transplanted himself from high profile mathematical physicist to a biology researcher, gave a lecture to psychiatrists about the nature of schizophrenia. To complicate the matter, his lecture was on the conference’s last day and dangerously close to lunch time. The presented ideas were difficult to digest.

Huberman presented a physical model based on the theory of nonlinear dynamics (chaos) elegantly explaining why schizophrenics have erratic eye movements.

The problem was that psychiatrists have struggled for generations to define schizophrenia and classify schizophrenics, but this disease has been difficult to describe and impossible to cure. Since 1908, it was noted that schizophrenics as well as most of their relatives have a problem with tracking slow motions. When patients try to watch a slowly swinging pendulum (for example, watching pendulum that was frequently used during hypnotic treatment session at that time) their eyes cannot track the smooth motion.

Ordinary eye is an especially smart instrument of tracking moving objects, otherwise we would not survive.

A healthy person’s eyes stay locked on moving targets without any conscious efforts. Moving images stay frozen in place in our retina. This reflex appears in few weeks after birth. But the eyes of schizophrenic jump around disruptively in small increments, overshooting or undershooting the target and creating a constant haze of extraneous movements. No one knows

why. Attempts to train eye tracking in adult patients were not very successful so far.

Physiologists who tried to solve this puzzle using traditional research logic always came to the dead end. They generally assumed that the fluctuations came from fluctuations in the signal from the central nervous system controlling the eye’s muscles. According to this logic, noisy output implies noisy input, and perhaps some random disturbances afflicting the brains of schizophrenics were reflected in disturbances of their eye movements.

Huberman, as physicist, assumed otherwise and made another model.

He compared slow eye movements with mechanics of swinging pendulum.

There was a unit of measurement for the amplitude of the swinging pendulum and a measurement unit for its frequency. There was a term for the eye’s inertia; there were a term and measurement for damping, or friction, as well as for error correction, to give the eye a way of locking in on the target. He also explained his audience that the resulting equation is similar to another meContinued on p.2

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

2

May 2008

SLEEP & HEALTH

Alertness Mood Performance Continued

Why Schizophrenics Can’t Catch a Fly and Autistic Kids Change Shorts Continued from p.1

chanical system, i.e. a ball rolling in a curved trough while the trough swings from side to side. The side-to-side motions correspond to the motion of the pendulum, and the walls of the trough correspond to the error-correcting mechanism, tending to push the ball back toward the center. In other words, he found everything – order and disorder, and a self-corrective mechanism. In some regimes of bouncing balls the eyes would track smoothly; then, as the degree of nonlinearity was increased, the system would go through a fast perioddoubling sequence and produce a kind of disorder that was indistinguishable from what was seen in schizophrenia.

Based on this model schizophrenic eyes disorder has nothing to do with outside stimuli, but it is an internal disruption of nonlinearity in the system, which in normal situation has selfcorrective features. Some psychiatrists

who just recovered from the dominance of Freudian abstractions were confused and accused Huberman in simplification of human complexity.

Others who were more in tune with medical practice and literature pointed out that the schizophrenics were not alone; a whole range of eye movement problems could be found in different kinds of neurological disorders.

Periodic and aperiodic oscillation, all sorts of dynamic behaviors could be found in many psychiatric, neurological and medical disorders.

To calm the audience, one of the organizers, Arnold Mandell, a psychiatrist with a long-standing interest in medical applications of chaos took the microphone and concluded: “Listen, as a shrink I want to make an interpretation. Here a non-linear dynamicist comes to talk to a biologist.

The idea is that in fact there are universal properties of systems.

There are universal elements in nonlinear motion to stabilize the system or make the system to decompose.”

It is true that this model is very simple, but not primitive. As James Gleick in his comprehensive overview of chaos science elegantly put, “The choice is always the same. You can make the model more complex, and more faithful to reality, or you can make it simple and easier to handle. Only the most naïve scientist believes that the perfect model is the one that perfectly represents reality. Such a model would have the same drawbacks as a map as large and detailed as the city it represents…

Were such a map possible, its specificity would defeat its purpose: to generalize and abstract... Whatever their purpose, maps and models must simplify as much as they mimic the world.”

Huberman’s model as simple as it looks demonstrated development of a few major characteristics of schizophrenia:

1. The origin of the main dysfunction is internal and comes from within.

2. Schizophrenic’s inability to sustain one of the most basic reflexes for survival – to follow the coming object is due to “too much order” so to speak, when natural non-linear “chaotic” eye movements allowing self-correction disappear.

3. The dynamic instability allows us to get adjusted to quick and dynamic, always changing unpredictability of life. If this invisible orderly chaos stops for any reason, we are in trouble. Loss of mental chaos is an explanation why autistic children are so preoccupied with the exact order of things and get extremely agitated when their parents give them new shorts or change direction while driving to school.

Similarly, people with obsessive compulsive disorder are morbidly preoccupied with rituals creating order.

The “moral” of this story is that a little disorder, a little dynamic chaos is necessary for adaptation to ever changing unpredictable life. Simply put - to stay healthy.

Ref: James Gleick. CHAOS: Making a New Science, New York, 1988, pp.275278.

Alertness Mood Performance

SLEEP AFTER TRAINING MAKES LEARNING PERFECT Practicing playing piano or working on your tennis skills will improve your skills, but sleeping afterwards will make it better, according to the recent research by Dr. Matthew Walker, PhD from the Department of Psychiatry at the Harvard Medical School in Boston.

He presented the results of his study on 40 students at the 17th Annual Meeting of Professional Sleep Societies in Chicago in June 2003. He and his colleagues have found that not only does motor skill learning continue AFTER practicing has stopped but that greater performance improvements occurred only after sleeping and were dependent on the certain stage of sleep at a particular time of night.

T

he results of the study suggest that learning of all skilled actions in humans – such as learning motor patterns required for sports, playing music or developing artistic movement control and even surgical skills - may require a good night sleep before the maximum benefit of all that practice has achieved. Furthermore, if you are retested after several nights of sleep, instead of just one night of sleep, there is even more improvements, about 30%.

So getting several nights of good sleep following a skilled learning experience may be critical.

One of the key findings was that subjects who were trained in the

morning and brought back later that day and retested the same complex of finger tapping pattern in the evening showed no significant improvement

compared with where they had finished at the end of their training. They got no worse and no better. However, subjects who were trained in the evening and slept and then were retested the next morning, after an equivalent amount of time, showed a remarkable 20% improvement in their performance just after one night of a good sleep.

The amount of “sleep dependent” learning does not correlate with the amount of practice dependent learning achieved during training. It suggests the existence of two discrete learning mechanisms. It seems that when you sleep, your brain continues to learn, even though you have stopped practicing

Most of the overnight improvement is particularly related to stage 2 NREM, a lighter stage of sleep during the last two hours of sleep. These last two hours of sleep are the most important for determining the amount of improvement you get. Subjects who slept well and achieved lots of stage 2 NREM improved the most the next morning.

It appears that a specific time window exists during sleep that is critical for learning. This is a time that we cut short when we all get up too early in the morning after late bedtime.

Implications Modern life’s erosion of sleep time, particularly with too early morning starts, is seriously shortchanging our brain’s learning potentials. These findings could explain why people with sleep deprivation or those with morning insomnia have learning problems and why infants sleep long after learning new skills. All good night is critical for rehabilitation of motor and other skills after stroke or brain traumas.

The next step in the research is to use brain imaging to find out what actually changes in the brain during learning in sleep and how the brain reorganizes itself during sleep to perfect previously learned skills.

Sources: Neurology Reviews, 11 (9), 2003:26-27 Walker M.P., Brakefield T., Morgan A. et al; Practice with sleep makes perfect sleep-dependent motor skill learning. Neurol, 2002:35:205-211 Walker M.P., Brakefield T., Sedman J. et al: Sleep and the fine course of motor skill learning.

Learn Mem. 2003:10:275-284

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

May 2008

SLEEP & HEALTH

3

Alternative and Traditiomal Medicine Alternative Treatment for Common Cold – Good, but Watch for Side Effects Study Backs Antidepressant-Suicide Link Echinacea Echinacea Purpura is proven to be a good immunostimulant.

It is available in a single form and in combination with other ingredients such as zinc.

Currently, the National Center for Complimentary and Alternative Medicine is supporting studies to find out more about Echinacea and other herbal remedies.

Echinacea as any biological active ingredients (means, like any drugs) might have serious side effects. Echinacea should not be used by pregnant or breast-feeding women, and should not be administered to children less than 2 years of age. It is also contraindicated in people with multiple sclerosis, HIV, leukemia, tuberculosis, lupus erythematous or rheumatoid arthritis. Common adverse effects include dyspepsia, headache, and dizziness.

Zinc Zinc is commonly used as a remedy for cold. High local concentration

of zinc ions reportedly blocks the adhesion of the human rhinovirus to the nasal epithelium. Several studies have revealed that zinc lozenges may reduce the intensity of the symptoms associated with cold, particularly cough, and the length of time that a cold lingers.

Zink is available in tablets, gums, nasal sprays, and gel.

Vitamin C There are studies that demonstrated that the large dosages of Vit C (>1gr/ day) started early in the course of common cold may slightly decrease the duration of the cold (<1 d!) and may decrease the severity of the symptoms by approximately 20%. The risk versus benefits is still a hot topic of debate among scientists.

Potential side effects associated with the routine use of high dosages of Vitamin C include diarrhea, increased iron absorption, kidney stones, nausea, abdominal cramping, and flatulence.

Hypnotherapy Could Treat Painful Guts (Irritable Bowel Syndrome) Alexander Zaler, MD

A

bdominal pain and diarrhea due to Irritable Bowel Syndrome (IBS) are estimated to afflict about 10 to 20% of the US population. In the severe cases IBS may impact on the quality of life as serious as heart attack or stroke. Treatment consists largely of advice, reassurance and symptomatic management of the most troublesome problems with antidiarrhetics, antispasmodics, laxatives, etc. The precise cause of IBS is unknown, but research has shown that the major underlying physiological mechanism is dysregulation of communication between the enteric (intestinal) nervous system and the brain. It is largely not an organic structural problem of the intestinal system, sort of some “hardware” but a disorder of function in central and peripheral nervous system – the socalled “software” problem. The “braingut connection” has a very complex regulation and easily could be disturbed by internal and external triggers. Emotional factors could trigger diarrhea or constipation, intense abdominal pain, anxiety, irritability, and loss of sleep which intensify further IBS symptoms. IRS is a very difficult condition to treat. Medications could help only to relieve acute symptoms. In recent years multiple studies demonstrated and confirmed the long known fact that hypnosis could be a very reliable treatment method.

The UK experience treatment of IBS with hypnotherapy was impressive. The IBS program at the University Hospitals of South Manchester, England, designed by gastroenterologist Peter J. Whorwell, MD who had treated IBS patient with deep hypnotic relaxation for 20 years demonstrated significant symptom relief. Suggestions were giv-

en toward gut function control during deep hypnosis. For example, the patient with diarrhea in a deep hypnotic state was using suggested imagery visualizing digestive tract as a rushing river that can be slowed to a calm stream. Pain can be alleviated by applying worms from the hand on his belly. The hypnotherapy treatment sessions lasted three months (12 sessions).

The study of 30 IBS patients randomly assigned to the regular psychotherapy and hypnotherapy group demonstrated that, compared with a traditional psychotherapy group, patients with hypnosis experienced dramatic improvement in all measures.

The Manchester Center was the first center in England (the British National Health Service) devoted to treatment of IBS with hypnotherapy. Later, the Center was studied the long term effect of hypnotherapy on 204 IBS patients which was as long as 5 years.

According to Dr. Peter Whorwell, the hypnotherapy should be “gut-specific”, which means to individualize suggestions specific to presented symptoms.

The US experience is related to the work of a group of therapists at the University of North Carolina at Chapel Hill with similar success. They focused more on the investigation of the mechanisms by which hypnosis might affect IBS symptoms. They found after the series of tests that hypnotherapy did not change pain thresholds or smooth muscle tone, autonomic activity, or EMG activity. They postulated that the effect of hypnotherapy was due to “primarily by altering the patients focus of attention and/or by changes in their beliefs about the meaning of sensations arising from the gastrointestinal tract.” The good part was that they established a website

he study looked at four drugs and found that suicidal thoughts or attempts were four times more likely during the first 10 days of treatment than they were after three months. Suicide was almost 40 times more common early on than later in treatment, though there were only 17 suicides, all in patients older than 19.

But the study is unlikely to resolve the debate over whether the drugs themselves increase the suicide risk.

And it may not soothe skeptics who maintain that newer drugs such as Paxil and Prozac that increase brain activity of the mood-regulating chemical serotonin are particularly risky for children.

The study found no clear-cut evidence to support that idea, and the researchers did not specifically compare children on antidepressants with those not taking medication.

Some doctors argue that patients just starting on antidepressants are usually in the deepest throes of depression which itself can cause suicidal behavior — and that the risks subside as the drugs take hold. Others say a medication-induced mood boost may give a profoundly depressed person just enough energy to act on suicidal thoughts.

But some relatives of people who have committed suicide blame the drugs themselves, and British health authorities have said that most serotonin-affecting antidepressants are unsuitable for children. GlaxoSmithKline, the maker of Paxil, has been hit with a lawsuit accusing it of suppressing studies indicating the drug might increase suicidal tendencies in children.

The U.S. Food and Drug Administration (news - web sites) is investigating and earlier this year issued a public health advisory asking makers of 10

drugs to add or strengthen suicide-related warnings on their labels. Doctors were warned to watch patients on antidepressants carefully, especially when they first start taking the drugs.

The FDA advisory includes Paxil and Prozac but not the two other drugs studied — amitriptyline and dothiepin, older medications that work differently. The newer drugs have gained favor in part because they have fewer side effects.

The study, by Drs. Herschel and Susan Jick and James Kaye at Boston University, appears in Wednesday’s Journal of the American Medical Association. It was funded by the Boston Collaborative Drug Surveillance Program, which received consultation fees from Glaxo in connection with other research. The authors said Glaxo had no role in the current study’s design.

The data “simply means that antidepressants are being prescribed for the right indication, and that they do not immediately eliminate suicide risk,” Drs. Simon Wessely and Robert Kerwin of London’s Institute of Psychiatry said in a JAMA editorial. Still, careful monitoring of youngsters is essential, they said. Wessely has received funding from pharmaceutical companies including Prozac maker Eli Lilly and Co. The researchers looked at 2,791 firsttime users ages 10 to 69 of any of the four drugs from 1993 to 1999.

Suicidal tendencies were 29 percent more common among Paxil users than among dothiepin users studied.

Kaye said that finding was statistically insignificant and could reflect doctors’ tendency to prescribe the newest drug for more serious cases. Still, he said it “doesn’t exclude the possibility” that Paxil is more risky.

Dr. David Fassler, a Vermont psychiatrist not involved in the research, said the study leaves key questions unresolved: “This study isn’t specific to children and adolescents, and that’s been the area of most recent concern.”

Conclusion: drugs could be helpful, but also could have side effects. To be sure that you use medications correctly, always consult your doctor.

for IBS patients with free advices.

There are many questions still waiting for answers. Among them are: 1. Will the combination of hypnotherapy with medications work better, and 2. What about the possibility of the “real” physiological changes by hypnotic suggestions?

Research studies of Dr. A. Shepovalnikov’s group from Russia’s Academy of Medical Sciences with professional hypnotists and use of the unique neurophysiological equipment for brain study as a whole provide data that suggestions (?) in the somnambulic state of hypnosis can really change the autonomic physiology. At the Sleep and Behavior Medicine Institute in Chicago there are experiments in the process which replicate experiments in Russia.

As a conclusion, Irritable Bowel Syndrome is not a purely in the patients head, just a psychological deviation. The real treatment is not only the change of the patients’ belief system. Irritable Bowl Syndrome is a real medical illness with serious physiological “objective” physiological deviations in need of the active treatment which could really “reprogram” disordered brain-gut physiology.

Hypnosis could be one of such techniques and it needs further professional exploration.

References: Psychosomatic Medicine. March, 2005 Med. Sci. Monit. 2004; 10:RA125-31 Gut 2003; 52: 1623-9.

Dig. Dis. Sci. 2002; 47:2605-14

By LINDSEY TANNER, AP Medical Writer

CHICAGO - A study of nearly 2,800 British adults and children bolsters the evidence that patients are prone to suicidal impulses when they are first put on antidepressants. But it found no difference in risk between newer and older drugs.

T

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

4

May 2008

SLEEP & HEALTH

Alternative and Traditiomal Medicine Continued Bloomberg (4/6, Schwartzkopff) reports that “children who eat lots of grapes, oranges and tomatoes are less likely to have hay fever,” according to a study published in the journal Thorax.

In the study of “690 schoolchildren between the ages of 7 and 18 years,” the researchers found that “children who ate an average Mediterranean diet were 30 percent less likely to have runny noses and itchy eyes than those who didn’t, while kids who ate a high level of those foods were 66 percent less likely.” The UPI (4/6) also reports the study, noting that the results were “based on questionnaires filled out by parents on their children’ diet and respiratory problems.”

HealthDay (4/6) adds that “children who ate nuts at least three times a week were also less likely to wheeze. The researchers noted that nuts are rich in vitamin E, which protects against cellular damage caused by free radicals.

Nuts also contain high levels of magnesium, which may protect against asthma and improve lung power.” Notably, the researchers also found that “eating lots of margarine doubled the risk of asthma and allergic rhinitis.”

Medpage Today (4/6, Phend) also reports the study, adding that, “the Mediterranean diet has been linked in adults to lower risk of heart disease, hypertension, metabolic disorders, as well as to asthma and allergies.” Food Consumer (4/6, Liu) adds that overall, a “good adherence to Mediterranean diet reduced

Mediterranean diet may lower risk of pediatric asthma, rhinitis risk for allergic rhinitis by up to 76 percent.” The traditional Mediterranean diet “is characterized by large amounts of plants foods such as fruits, vegetables, bread cereal (whole grains), legumes and nuts. Olive oil and fish are also included. From a nutrition viewpoint, this diet is low in saturated fat and high in monounsaturated fat and dietary fiber.”

Obesity may increase risk of asthma.

HealthDay (4/6, Mozes) reports, “Overweight and obese individuals are 50 percent more likely to develop asthma than normal-weight men and women,” according to a study appearing in the April issue of the American Journal of Respiratory and Critical Care Medicine. The researchers looked at data from “seven prior studies conducted between 1966 and 2006,” and the “BMI and asthma in more than 333,000 severely asthmatic patients.” The data review revealed that the “odds of developing asthma grew by 50 percent among patients with a BMI of 25 and up, and the risk climbed as the pounds piled on.” Also, “women and men appeared to be equally susceptible to the weight-asthma association.”

Medpage Today (4/3, Phend) noted that the role of gender in the asthma-obesity relationship “has been controversial. Previous findings ranged

from a link only among women to only among men.” Additionally, the researchers pointed out that “even without asthma, obesity causes physiologic impairments in lung function, including reduced lung volume and chest wall restriction. ‘These can result in dyspnea and wheezing, which might be mistaken for asthma by patients and clinicians.’”

WebMD (4/3, Hitti) added that the researchers also noted that “some participants may not have reported their weight and height accurately, and some may have mistakenly thought they had asthma.” Also, “the role of asthma risk factors such as smoking, allergies and family history of asthma isn’t clear in the review. Sutherland’s team also doesn’t promise that losing extra weight will prevent asthma.”

Health habits, exercise vary by ethnicity. In its health highlights section, HealthDay (4/6) reports that “getting enough exercise and eating enough fruits and vegetables -- habits that can shield people from chronic disease -- vary significantly depending on a person’s racial/ethnic background,” the Centers for Disease Control and Prevention said Thursday in its Morbidity and Mortality Weekly Report. Among men, “those classified as multi-racial or of races that

were not Caucasian, African American, Hispanic or Asian were significantly more likely (16.5%) to eat at least five servings of fruits and vegetables each day and get regular physical exercise than were white men (12.6%).” Among women, “significantly more whites (17.4%) got more regular exercise and ate fruits and vegetables than did black women (12.6%) or Hispanic women (14.8%).”

WebMD (4/6, Zwillich) adds that Mary Kay Solera, director of CDC’s fruit and vegetable program and one of the study’s authors, said that the study “may overestimate actual healthy behaviors because it was based on subjects’ self-reports. Research participants are known to routinely overestimate good behaviors and underestimate bad ones.”

Too few Latinos take steps to prevent second heart attacks, poll finds. HealthDay (4/6, Preidt) reports “many Hispanic heart-attack survivors consider their heart attacks a ‘wake-up call’ and fear having another heart attack more than dying,” according to a poll conducted by the National Hispanic Medical Association (NHMA). Notably, the “poll of 501 heartattack survivors also found that nearly a third of them have had more than one heart attack.” The survey also found that even though many Latino heart-attack survivors, “fear having another heart attack, too few are taking the steps -- exercise, healthy eating, taking appropriate medications -- that are needed to prevent another heart attack or heart disease.”

Muira Puama This herb increases levels of testosterone, a hormone that plays a critical role in sexual desire in women as well as men.

Muira puama also contains volatile oils, including camphor and betacarophyllene. They’re thought to restore sex drive by stimulating nerves in the grain’s pleasure center.

Typical dosage: 250 mg three times daily in capsule form.

Side effect: Muira puama may lower blood pressure by as much as 10%.

Check with your doctor before using this herb if you have low blood pressure (hypotension).

Ginseng LIFE HASN’T BEEN THIS EASY SINCE YOU LEFT KINDERGARTEN. INTRODUCING THE REMARKABLY SIMPLE OPTILIFETM, THE FIRST MASK IN THE RESPIRONICS® MY LIFETM SERIES. Life is complicated enough. That’s maintain, it’s easy to live with – even for side sleepers. The OptiLife™ mask is also designed to fit your business, giving you more opportunities for profit and growth. Contact us today for your personal demonstration to learn how the new OptiLife™ mask and our new My Life™ Series might just make life a little easier. ™

OptiLife 800.345.6443

OPTILIFE.RESPIRONICS.COM

724.387.4000

©2007 Respironics, Inc. and its affiliates. All rights reserved.

why we’ve developed a mask that’s not only easy to use and

This herb is an “adaptogen,” meaning it helps the body compensate for extended periods of stress.

Stress can cause sexual desire and performance to plummet.

Compounds in ginseng root stimulate the adrenal glands to release substances that lower the levels of adrenaline and other stress hormones.

These compounds also improve blood flow to the penis, help tissues use oxygen more efficiently and boost production of testosterone in men and progesterone in women.

Typical dosage: Capsules: 10 mg to 50 mg one to three times daily. Tincture: 30 to 60 drops daily.

Side effect: Ginseng may cause diarrhea… high blood pressure… sleepiness.

Ashwaganda A member of the pepper family, this herb contains withanolides, substanc-

es that increase the activity of testosterone and progesterone. Ashwaganda also relieves stress and anxiety.

Typical dosage: Capsules: 1,000 mg once or twice daily. Tincture: 60 to 90 drops two or three times daily.

Side effects: Because Ashwaganda has anti-anxiety properties it should not be used by anyone taking medications to treat anxiety and/or depression.

The herb could intensify the drugs’ actions as well as their side effects.

Ashwaganda may also trigger miscarriages.

For men only The herb yohimbe I is approved by the FDA for treating impotence and low sex drive.

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

May 2008

SLEEP & HEALTH

5

Our Celebration

AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE CELEBRATES ITS SEVENTEETH YEAR Ira L Shapira, DDS, DABDSM, DABPM, FICCMO

Seventeen years ago I was pleased to be one of 20 dentists from around the United States at the first meeting of the Sleep Disorder Dental Society.

The annual meeting is being held in Baltimore June 6-8, 2008.

I

originally became interested in sleep disorders because my 3 year old son Billy would snore loudly and was a poor sleeper and would wake many times during the night often drenched in sweat. My wife Elise and I discussed this with our pediatrician and later with an ENT but our concerns were dismissed. When Billy turned 5 years old we were told that he was not able to start kindergarten and that he had ADHD. At this time we bypassed the pediatrician and took him directly to the Sleep Center at Rush Medical School in Chicago.

It turned out Billy had severe sleep apnea and we treated it with tonsillectomy and orthodontics. This child who was held back from starting kindergarten ended up becoming a straight A student and graduated from college Magna Cum Laude with a double major and a double minor.

He also eliminated his night sweats crabby moods and went from a below normal growth curve to an ac-

celerated growth curve. He does not have ADHD and did not need Ritalin. His drug of choice was oxygen and restful sleep.

Dr Rosalind Cartwright was his sleep doctor and she changed not just my son’s life but also my own as well.

She is a founder of the science of sleep medicine and is probably the most important reason Dental Sleep Medicine is thriving today. Dr Cartwright tested the first Dental Sleep Appliance a TRD or tongue retaining device developed by Dr Charles Samuelson a psychiatrist and professor at the University of Chicago. The sleep lab at the University of Chicago refused to test the device and wanted to do surgery.

Dr Cartwright tested Charlie’s appliance and it worked. Rosalind published the first articles about the TRD and was met with derision but she continued her research and because of her efforts Dental Sleep Medicine and oral appliance therapy for sleep apnea are now considered a first line treatment. I was privileged to work as a visiting assistant professor at Rush with Ros and to work with Charlie in the 1980’s and that is how I ended up at the first meeting of the Sleep Disorder Dental Society. I believe that each of the doctors at that first meeting have their own stories with personal meaning as well.

The Sleep Disorder Dental Society became the American Academy of Dental Sleep Medicine and became associated with the American Academy of Sleep Medicine. The American Board of Dental Sleep Medicine was then established to grant Diplomate

status to Dentists who maintained a high level of knowledge in Dental Sleep Medicine, treated significant numbers of documented patients and passed an exam covering both Sleep Medicine and Dental Sleep Medicine February of 2006 the American Academy of Sleep medicine changed the parameters of care for treating obstructive sleep apnea to include oral appliances as a first line of treatment along with CPAP for treating mild to moderate and that oral appliances are an alternative treatment for severe apnea when patients do not tolerate CPAP. In their guidelines they specifically state that dentists treating sleep apnea should be trained in treating TMJ Disorders. The American Academy has endorsed and accepted these parameters of care.

The National Sleep Foundation in its Journal Sleepmatters declared this year that “Oral for Sleep Disordered Breathing: A Therapy whose time has come.”

And “Oral appliances for snoring and obstructive sleep apnea offer patients a treatment option that is safe, effective and easy to use.”

As the Academy of Dental Sleep Medicine celebrates it 17th year my company I HATE CPAP LLC is celebrating the beginning of its second year. It is devoted to the promotion of Dental Sleep Medicine and to helping patients find help with their sleep problems. Our website http://www. ihatecpap.com has become the premiere site for patients looking for information on Dental Sleep Medicine and sleep apnea dentists and it has brought thousands of patients who had abandoned their CPAP back for treatment.

It is important to add that I do not hate CPAP and that many patients who are not good candidates for oral appliances return for care after they understand how important it is to have treatment of their sleep apnea. There have been over 150,000 unique visitors to the site and millions of his, with thousands of patients spending over a half an hour on the site. On a daily basis I HATE CPAP patients are referred to dentists in the U.S. and abroad who practice Dental Sleep Medicine.

Dr Ira L Shapira practices General Dentistry and Dental Sleep Medicine at Delany Dental Care Ltd in Gurnee, Illinois. He has recently formed Chicagoland Dental Sleep Medicine Associates and will be opening offices in the next few weeks in Bannockburn and Skokie in association with sleep centers and plans to have a network of Dental Sleep Medicine practices across the Chicago Metropolitan area in the next several months.

Dr Shapira teaches courses in Dental Sleep Medicine to Dentists from across the U.S. and has trained three dentists who will be working with him in Chicago and at his Gurnee office. Dr Shapira is a Fellow of ICCMO, the International College of CranioMandibular Orthopedics and is a representative to the TMD Alliance for that group. He is also a member of other TMJ/TMD organizations including the American Equilibration Society and The American Academy of Craniofacial pain.

Dr Shapira can be reached Toll Free at 1-8-NO-PAP-MASK OR 1-800-TMJOINT or thru the I HATE CPAP website at http://www.ihatecpap.com.

FEMALE BABY BOOMERS APPROACH THE AGE OF SLEEP PROBLEMS Dr Ira L Shapira

An interesting article in Sleep Review in April of 2008 by Lisa Feierstein RN, BSN, MBA discusses problems that female boomers are facing as they enter menopause. These problems include hot flashes, which affect 75-85% of patients and have been connected to problems with insomnia. However, many of the sleep problems may be unrelated to the hot flashes. Menopause usually starts from the early to mid forties into the fifties.

T

he February issue of Harvard’s Women Health Watch concluded that primary sleep disorders probably account for much of the distress.

Their study showed that over half of all the patients studied had a primary sleep disorder and they concluded that menopausal women are probably

being under diagnosed in regards to sleep disorders.

The National Sleep Foundations 2007 Sleep in America Poll reported increase in sleep apnea, snoring and restless legs in peri-menopausal women compared to menstruating women. The symptoms of snoring and sleep apnea become even more severe in postmenopausal women. There is over a 100% increase in the percentage of postmenopausal women suffering apnea compared to premenopausal women. Polysomnography is the best choice to evaluate women when a sleep disorder is suspected. Sleep apnea can be treated with CPAP, oral appliances or surgery. Estrogen or Progesterone and Estrogen therapy can be used to treat symptoms of menopause but caution should be exercised as studies have shown a significant risk of adverse consequences from this therapy.

The National Heart, Lung and Blood Institute (NHLBI) consider sleep apnea to be a TMJ Disorder. See their report at: http://www.nhlbi.nih.gov/meetings/ workshops/tmj_wksp.pdf CARDIOVASCULAR AND SLEEPRELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS NHLBI WORKSHOP Sponsors: National Heart, Lung and Blood Institute (NHLBI) NHLBI Division of Heart and Vascular Diseases (DHVD) NHLBI National Center on Sleep Disorders Research (NCSDR) My personal research has shown a correlation between the jaw position of patients with sleep apnea and with TMJ disorders. The literature has shown that the TMJ Pain, Headaches, Migraines, Ear and Si-

nus Pain and other symptoms associated with TMJ Disorders decrease with onset of menopausal symptoms. At the same time sleep disorders increase. Treating these patients with hormone replacement therapy can help the sleep problems but often results in the return of the TMJ/TMD symptoms. This makes sense if you consider both of these disorders to be of a common postural or orthopedic origin. Patients wishing to learn more about TMJ disorders and treatment with neuromuscular dentistry will find information at: http://www.delanydentalcare.com/TMJ_TMD_FAQ.html Additional information on treatment of sleep apnea can be found at http:// www.ihatecpap.com Patients suffering from TMJ Disorders and Sleep Apnea would do well to work with a doctor who has experience with both fields.

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

6

May 2008

SLEEP & HEALTH

Our Celebration Continued PURE POWER MOUTHGUARD UTILIZES POWER OF NEUROMUSCULAR DENTISTRY A RELATIVELY NEW COMPANY IS CHANGING THE WORLD OF SPORTS MEDICINE WITH ORAL APPLIANCES THAT ENHANCE PREFORMANCE Dr Ira L Shapira

S

ports Medicine is discovering Neuromuscular Dentistry, which has been used to treat TMJ Disorders with great success for over 40 years. It has been used to treat chronic pain and sleep disorders and has relieved the suffering and improved the lives of countless patients. An accidental side effect of this treatment has been increased strength and endurance.

Until recently there has been no organized group for athletes dedicated to the enhancement of athletic performance. That has change with the introduction of the Pure Power Mouth guard. Information about the Pure Power Mouthguard can be found at the website: http://ppmmouthguard.com/ The company has committed itself to only allow dentists trained in Neuromuscular Dentistry to participate in the quest for improved

athletic performance. The postural and neuromuscular position that maximizes their results are best obtained utilizing highly sophisticated tools made by only two companies.

The first is Myotronics founded by Dr Barney Jankelson the father of Neuromuscular Dentistry and the force behind the formation of ICCMO, The International College of CranioMandibular Orthopedics the only organization dedicated to the art and science of Neuromuscular Dentistry. A second company BioResearch also has excellent instrumentation to deliver Neuromuscular Dentistry. More information on Neuromuscular Dentistry can be found at my website at: http://www.delanydentalcare.com/ neuromuscular.html The Las Vegas Institute (LVI) best known for cosmetic dentistry and its founder Bill Dickerson are responsible for the recent surge in interest in Neuromuscular Dentistry.

The physiologic position attained

by Neuromuscular Dentistry gave superb esthetic results and at the same time helped eliminate facial pain, headaches and other problems. Dr Norman Thomas DDS, PhD is a Dentist and physiologist who worked with Dr Barney Jankelson when Neuromuscular Dentistry was in its infancy. He is now in charge of research and basic science education at LVI , which will truly make it a world-class dental science training center.

Dr Barry Cooper in New York is probably the best place to start to learn Neuromuscular Dentistry and he gives course to small groups of Dentists who walk away after three days with an incredible understanding or Neuromuscular Dentistry and how to utilize it their offices.

Dr Ira Shapira has been practicing Neuromuscular Dentistry for over 25 years and studied with Dr Barney Jankelson. He is a Fellow and Regent of ICCMO. Barry Cooper and Dr Shapiro are the ICCMO representatives to the TMD Alliance that supports freedom of practice for dentists who treat TMJ/ TMD. Dr Shaira and his partner Dr Mark Amidei can fit athletes with pure power mouthguards.

PERIODONTAL DISEASE A MAJOR CAUSE OF GESTATIONAL DIABETES he April 2008 issue of the JOURNAL OF DENTAL RESEARCH reported on a discovery by New York University researchers that pregnant women with periodontal disease are more likely to develop gestational diabetes. Gestational Diabetes can be responsible for numerous serious problems during pregnancy. It is believed that inflammation is a major cause of the problem due to interference with the normal function of insulin. Insulin regulates glucose metabolism. Other studies have shown that there is a six-fold increase in low birth weight and premature birth in mothers with periodontal disease. A major risk factor for heart disease is being a low birth weight or premature baby. A mother’s periodontal disease may put her child at risk for heart disease that may not show up for 40 or more years.

Periodontal disease has been shown to increase the risks for heart attacks and stroke by as much as 600% as well. Inflammation and periodontal disease have been shown to make drastic changes in the cytokine system that is key to health and immunity. An excellent source for information is a chapter on Anti-Aging Dentistry from the Third volume of Anti-Aging Medicine. A PDF file of this can be downloaded free of charge at: http://www.delanydentalcare.com

T

Dr Ira L Shapira

Alternative and Traditiomal Medicine Continued Typical (Common) and Atypical (Uncommon) Side Effects of Sleeping Medications

By Robert Barkin, Pharm D.

When designing an individual treatment plan doctors evaluate and weight therapeutic effects versus iatrogenic (negative) side effects. The therapeutic effect of new sleep inducing (sopotrophic) medications is a good and restful night sleep.

Achievement of this desired goal is offset by the patient’s perceived iatrogenic (adverse) side effects of medications.

There are no medications without some side effects. The symbol of medicine – a snake around the cap - means: “Any poison could be a medicine; any medicine could be a poison.” Recent explosion of Internet produced an avalanche of information, most of this should be interpreted very carefully otherwise the result might be catastrophic. We see many anxious patients who misinterpreted internet info and “found” all symptoms on the list of real and exotic side effects (opposite placebo). (See in this issue Cyberchondria.Where?)

Below is the list of typical and predicted side effects of a few newly marketed sleep promoting medications. These potential side effects are carefully evaluated by the prescribing physician who should discuss them with you. Once again, it is important to remember that placebo effect (especially negative symptoms) is produced in many cases by anxious insomniacs reading on internet about side effects, looking for rare bad symptoms and finding those symptoms in their own body and mind.

Ramelton (Rozerem) Predictable Side Effects Cephalalgia Dizziness Nausea Diarrhea Insomnia

Atypical and Rare Side Effects Suicidal thoughts Depression resurgence Metabolism Substrate (CYP 488

Joint/muscle pain Depression Taste alterations ↑Prolactin and cortisol ↓ Testosterone

1A2, 2C9, 3A4) These symptoms are from clinical trials and may be more pronounced in clinical practice.

Eszopiclone (Lunesta) Predictable Side Effects Unpleasant taste Cephalalgia, neuralgia, migraine Xerostamia Dizziness Nausea Nausea, vomiting Dyspepsia Nervousness, anxiety, hallucinations Depression, confusion Dermatologic (rash) prurotus Dysmenorrhea, diminished libido, clinical urinary tract infection Gyneco-mastia Pain, peripheral edema

Atypical and Rare Side Effects Depression Suicidal thoughts Aggression Hallucinations Amnestic events, abnormal dreams Metabolism Substrate (CYP 450 2E1, 3A4) These symptoms are generated by the urinary tract infection trials and may be more pronounced in clinical practice

Zolpidem (Ambien CR) Predictable Side Effects headache, backache, myalgia, lightheadedness, lethargy, drowsiness, diarrhea, xerostomia, constipations, palpitation, rush, visual changes

Atypical and Uncommon Side Effects depression, aggression, confusion, complex sleep semiauthomatic behavior (sleepwalking, night eating)

Conclusion. Any and all medications including sleeping pills can help or can produce predictable or unpredictable side effects. The best way to prevent any troubles is to be in close communication with your doctor. If you do not tell your doctor anything, he or she would not know which symptoms to treat. Treatment of sleep problems is individually specific.

Please contact your doctor with any questions.

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

May 2008

SLEEP & HEALTH

7

Travel and Sleep

Returning to Rome: One Traveler’s Experiences

By Louis Keith, MD, PhD

L

ast month I wrote about the dreams that were evoked when I returned to Paris after some years of absence.

This month, I shall continue in Rome, another city where I had not visited for some time. However, unlike Paris, Rome seemed unchangeable, almost as if it was asleep, but clearly that is not the case. Rome has been in the same place for more than two millennia, and certainly it has changed during that time.

Nonetheless, certain aspects remain the same, such as the openness, the proximity of the old with the new, the green spaces and the leisurely way of life. Do these issues themselves relate to sleep?

Not really, but they relate to the dreamy quality of life and some of the things that I saw.

The trip to Paris that occurred so many years ago was my first to Europe and Rome was the next stop. The hotel we selected was one of the great names in hotels at that time, located on the Via Veneto, directly in the heart of the wild night life of the city. Not that I was there for the night life. Rather, I was there to give the first presentation of what would turn out to be hundreds of papers presented at international medical conventions. In this instance, it was an

International Congress on Twins convened by the legendary Italian Professor of Genetics, Luigi Gedda, who was to become a friend and a hero to me, then a young Assistant Professor of Obstetrics and Gynecology at the Chicago Medical School. I worked hard on that first paper and was anxious to present it, as it represented a compilation of all of the cases of leukemia in twins that had been reported in the prior 40 years.

Talk about tables. I had them aplenty.

The year was 1969, and it is funny how one is able to capture things selectively in the memory. The opening ceremony of that congress was etched in my brain because it impressed me in ways that I could not imagine. It was also retained in detail, as I was to find out all to soon. My experience was not déjà vu, the impression that one gets that you have experienced something that you have never encountered previously. Rather, it was another encounter with the same situation but experienced differently.

Let me explain. I decided to play the tourist during my stay in Rome, and the hotel shuttle bus let me off in front of the socalled “Wedding Cake” monument, the splendid marble memorial to King Victor Emmanuel II who unified Italy many years ago. I looked at the imposing structure, but it did not pique my interest. Rather, I started my touristic wanderings at the Palazzo Venetia, a small but elegant museum which I explored ever so leisurely. The attendant who sold me the ticket of admission suggested that I also go to the Capitoline Museum across the square, as it had in recent years become one of the best in the city.

Crossing the street with the other pedestrians who, like the gladiators of old as they threw themselves to the wild beasts, I simply marched off the curb into the onslaught of the traffic with the implicit understanding that by the time two minutes had passed, all of us would either be alive on the other side of the road or dead under the wheels of

the oncoming traffic. The comparison to the gladiators was apt, and I was victoriously smiling as I stood on the other side and contemplated my next move.

Easy, it was to ascend a huge ramp that

took one up to the level above where the museum was situated.

As I started up the stairs and looked at the imposing colossal statues on either side of the top step, they looked strangely familiar, as did the little square that had been laid out by Michelangelo between the surrounding buildings and subsequently adorned with a gilded statue of Marcus Antonius from the days of ancient Roman glory. However, the familiarity did not disarm me, because I had been to Rome on several occasions and this place was pictured in every guide book. Little did I realize that the best was yet to come and it was only minutes away.

I entered the museum and made my choice. I would ascend the monumental staircase rather than trudge thru the basement to the other side. That could be another day. As I made my way up one set of stair to the landing that led to the second floor, the experience of having been there previously literally hit me in the face because, as I proceeded upward, a set of massive doors stood in front of me and, through the doors, I had a clear view of a brilliant room, indeed one of the most brilliant that had been conceived by anyone during the Italian renaissance. I approached cautiously, but there was no need for cau-

tion. It was the room, the very room that I visited on my first trip to Italy for the inauguration of the First International Twin Congress. What made it so memorable was the fact that this room was the former seat of the city council, the statue of the she-wolf nursing Romulus and Remus, the legendary founders of Rome was located in the very next room, and the hall itself was the named after the Horatii and Curiatii, the two sets of triplets who represented Rome and one of its enemies and did the actual fighting rather than the respective armies.

This time it was different, in that there were only a few people in the room compared to the crush of the delegates and city officials at that opening ceremony with most discussions in Italian, some in Latin and very little in English. Moreover, everything looked bright and clean after the last renovation, and well-appointed signposts were present in each room to tell the visitor the specific story of that part of the vast collection. Previously, when we left the hall, we were escorted to the courtyard and missed the museum itself, although entertainment was provided by the famous flag throwers from Sienna.

After satiating myself in that splendid room, I proceeded to tour the entire building, again very leisurely, drinking in the past. What was amazing were some very recent additions to the collections brought about as the result of excavations in Rome for civic improvements. These digs resulted in the discovery of many, many wonderfully intact statues which still had the original polish to the marble because they had been buried in dirt and rubble for centuries. The collection, always renowned, was truly astonishing and makes the collections in other major museum pale in comparison.

How does this trip compare with the recent visit to Paris? Well, to begin with, there were no dreams of remembered experiences. However, there were many opportunities to reflect upon specific objects or visual impressions, which were like having a dream when one is awake. In contrast to the dreams that accompany sleep and which most often cannot be brought on by willful thinking before the night’s rest except by a few individuals, reflections are complements to dreams in that they are available to all. They also assist one in reconstructing the past as well as help one plan for the future, and rarely if ever do they have the disturbing quality of a bad dream. If they do, they can be erased by the person who is experiencing the reflection and the mind can revert to other things.

As noted above, reflections are available to all who want them, but the fact that I was on a trip made them come more easily, as my mind was not occupied with the various tasks that make up- the so-called activities of daily living. In this particular instance they were triggered by a return to a place that had impressed me greatly some years previously, stayed hidden in the mind, but were waiting to come to life at the right moment.

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

8

May 22008

SLEEP & HEALTH

Art and Sleep

By Deena Sherman

J

Alone with the Tide, painted in 1861 depicts a girl asleep on a beach in Brittany, France.

ames Abbott McNeill Whistler lived a life filled with contention, a life in which his artistic abilities were severely questioned and his personal reputation was one of eccentricity and combativeness.

None of this is very important now because Whistler created one of the most recognised paintings of all time – the forbidding portrait of his mother, which he called “Arrangement in Gray and Black.” Interestingly, the painting did not sell for nineteen years, but is now housed in the Musée d’Orsay in Paris.

Whistler was born in Lowell, Massachusetts in 1834.

When he was nine he went to live in Russia where his father was working, and later moved to England. In 1849, his father, Major George Washington Whistler, died and the family returned to America. Whistler attended West Point Military Academy where he was at the top of his class in draftsmanship. This, however, didn’t save him from being expelled from the institution for being so poor in chemistry.

In 1855, he went to France,

James Abbott McNeill Whistler

living in abject poverty, as did many other artists.

Although his paintings were later exhibited in America, Whistler never resided in the country again. In Paris the artist had many friends who were amused by Arrangement in Grey and Black (1871) is a portrait of the his wit, and were artist’s mother who wrote that while she sat for the portrait, she offered up a "mother’s unceasing prayer" that her son prepared to forgive would become successful in his artistic ambitions. his eccentricity. In

1859, his first masterpiece, “At the Piano”, was rejected by the Salon in Paris but was, in 1860, accepted for exhibition at the Royal Academy in England.

The acceptance was significant enough for Whistler to decide to live in Britain where he remained until his death in 1903.

Whistler had three significant relationships; the first two were his mistresses, Jo Hiffer-

nan and later Maud Franklin, with whom he had a daughter.

In 1888, Whistler married Beatrix (better known as Trixie) Godwin, who is believed to be the only woman he loved. She died five years later from cancer leaving the artist bereft. Whistler also had an illegitimate son, Charles Hanson, born in 1870 to a maid with whom Whistler had had a liaison.

Nocturne: Blue and Gold – Old Battersea Bridge (1872-7), was the painting that received such harsh criticism from John Ruskin, prompting Whistler to sue the reviewer for libel.

Perhaps the most controversial event of his life occurred when Whistler sued the famed art critic, John Ruskin. The litigation was a result of Ruskin’s review of the series of now famous works called Nocturnes, started in 1877, which depicted the Thames River at twilight. In response to “Nocturne: Blue and Gold – Old Battersea Bridge”, Ruskin wrote: “I have seen and heard much of Cockney impudence before now, but never expected to hear a coxcomb ask two hundred guineas for flinging a pot of paint in the public’s face.” Whistler won the case, but was awarded only one farthing, a circumstance which If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

May 2008

SLEEP & HEALTH

devastated him financially. The event also made him bitter, as he felt abandoned by fellow artists for whom he felt he was fighting. For all his rejections and bad reviews, Whistler must have been his own worst critic, reportedly destroying seventy percent of his portraits.

Although Whistler continued to live in England, he travelled widely and for long periods, especially to Europe where he completed many commissions. He published two books during his lifetime: Ten O’clock Lecture (1885), and The Gentle Art of Making Enemies (1890). The house in which he was born in Lowell, Massachusetts

Advanced Sleep Therapy, Ltd. is owned and operated by medical professionals with over 40 years of respiratory medical experience Our staff is professional, knowledgeable, respectful, caring and friendly

has become the Whistler House Museum of Art. Sources: James McNeill Whistler. By Richard Dorment and Margaret F. MacDonald, 1995. Harry N. Abrams, Incorporated, New York.

Whistler, a Biography. By Stanley Weintraub, 1974. Da Capo Press, Massachusetts.

Whistler: The Gentle Art of Making Enemies. By James Runcie, 2001. BBC, London. http://www.archiveshub.ac.uk/ news/whistler.html http://en.wikipedia.org/wiki/ James_McNeil_Whistler

Services Include: • CPAP • BIPAP • AUTOPAP • VPAP • NOCTURNAL OXYGEN • PROFESSIONAL MASK FITTING • 30 DAY MASK FIT GUARANTEE • COMPLIANCE MONITORING MONITO OVERNIGHT • OVERNIG OXIMETRY OXIMETR

Believed or Not: The Phenomenon of Michael Kuny From the Editor

W

e all admire geniuses and their work. For the most of us these incredible people are in the far past or far away. But some of the persons with the most unbelievable abilities might be among us in our time. I had a fortune to meet personally two the most incredible persons with extra sensorial abilities - Michael Kuny and Wolf Messing - the humans with scientifically proven super-human abilities. Sleep and Health had published in the past some materials about Wolf Messing, but we had difficulties to find credible information about Michael Kuny until recently, when we learned that Michael M. Kunin, the son of Michael Kuny, lives now in New York, and has published a book about his father: “The Phenomenon of Michael Kuny.”

Michael M. Kunin is himself one of the most distinguished artist and art historians in Russia and USA. He was among the most innovative theatrical producers in the Soviet Union. He is professor of art of acting and has written several internationally known manuals about the science and art of staging. He was the Science Secretary of the Ministry of Culture in USSR, President of Education Committee of the Ministry of Culture in Czechoslovakia.

After immigration to the USA professor M.M. Kunin is working with WMNB and produced more then 200 educational tapes.

His latest book “The Phenomenon of Michael Kuny” (in Russian) is the most carefully selected and the most reliable information about psychological abilities of Michael Kuny.

The following is a short story from the book “The Phenomenon of Michael Kuny” that makes readers amused and wonder… * * * This story told me a Russian pilot Valentin I. Accuratov. His name is very well known among Russian pilots, his information was always accurate, and this report is without any doubts. This story was real.

“Our airport was not far from a small town, where we went many times when we got bored at work. For some reasons

flights were temporarily canceled, and we decided to go to town to see a show of a famous “Extra-sense showman Michael Kuny.” We had heard about him many times and, naturally, decided to go as a group.

The show was spectacular with many mind-boggling effects.

There was a series of experiments with hiding objects by the orients. By “reading” person’s thoughts, Kuny found all objects and he performed many other actions by the “reading” mind requests from orients.

We all were shocked.

Let’s invite Kuny for a dinner with us in our airport’s hotel, - decided pilots.

Kuny has agreed, and we got back to airport together. The discussion at the dinner was light and friendly. We talk about businesses, life, family issues.

Since the War I could not find my brother. The life has spread us in different directions and places, complained a wife of one of the pilots. - You could do everything… Could you look for him during your trips around the country?

His name is Vladimir. The last name is Neustroev.

Let’s try it right now, - Kuny offered suddenly.

What do you mean, right now? We all became tense.

He asked the women to sit down comfortably and asked us to stop talking. We became quiet….

Concentrate your thoughts about your brother. Try to doze off, - firmly said Kuny to the woman.

She soon closed her eyes and became quiet.

Now you are in the city, where today lives your brother, - said Kuny. - What do you see?

I am on a street. This street is unfamiliar to me. Across a street is like a post office… Paper stand…

Excellent. Go to this post office and find the name of the city when you are now!

Breathing heavily and being very tense the women whispered: Old Oskol.

Think about your brother… Why are you sitting? Go to him! He lives somewhere nearby. Go! He is waiting for you.

Continued on p.10

9

phone: 888.860.3100 fax: 847.357.8784 www.advancedsleeptherapy.com

SKILLS, CERTIFICATIONS, JOBS, AND

$800* IN CASH WHILE STUDYING AT CSI

MEDICAL CODING BILLING, PHARMACOLOGY RECORD TECHNOLOGY • Chicago • Skokie • Lombard • Gurnee

Financial Aid available for those who qualify Study for 8 months.

Get Paid $800*.

No High School diploma required to start.

Seating is limited.

To apply, call NOW!

* Offered to all students starting Career or Business English programs at CSI in fall 2007. For more information, contact a CSI representative NOW.

www.csinow.com 800.684.6884 BecomeCCA CCAand and CCS Become CCSCertified.

Certified.

Call CSINOW! NOW! We We can you.

Call CSI canhelp help you.

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

10

May 2008

SLEEP & HEALTH

Sleep from A to Zzz

TEETH GRINDING OR BRUXISM B

ruxism or teeth grinding is a very common but not fully understood phenomenon. It appears as a rhythmic stereotyped grinding or clenching or snapping of the teeth which occurs mostly in sleep, but might occur during the day when the person is in a daydreaming state.

The word “bruxism” is transformed from a Greek word brychein (to gnash the teeth) and was coined in 1931 by Dr. Frohman to specify sleep related “primary bruxism.”

Bruxism is reported in about 80% children and in about 20 % of adults some times in their life. It may occur in any stage in both NREM and REM sleep, but mostly in a stage 2 of NREM. There are multiple causes of bruxism that might be connected with the socalled “organic” disorders such as orofacial dyskinesia, mandibular dystonia, genetic problems, infections, etc (secondary bruxism).

A current concept of primary bruxism is that it is a disorder of sleep, a part of normal maturational process or as a result of the dysfunction in the body and brain.

Bruxism is classified as rhythmic stereotyped parasomnia and, as other parasomnia, is considered as a disorder of the central nervous system and may be ex-

Continued from p.9

acerbated by the emotional stress.

We used to think that bruxism is a benign and insignificant for health habit, but now doctors take it seriously. Chronic bruxism might seriously damage teeth, change the form of the face due to enlarged jaw muscles and decrease the vertical size of the chin. The older the person with bruxism, the more serious pathology, both medical and psychiatric, is associated with this affliction. Medical problems associated with bruxism in adults include hypertension, sleep apneas, seizures, diabetes, and thyroid disease. The caretakers of autistic, retarded or demented persons know how disturbing bruxism might be. Nursing home personnel uses bruxism as a reliable biological marker of the level of consciousness of patients in coma.

The therapy of bruxism includes the wide range of means such as dental appliances (Sleep Dentistry is a big field), non steroidal anti-inflamatory medications, muscle relaxants and even suggestive hypnotherapy.

If you, your child or someone you know was observed with persistent bruxism, please, do not sleep on it, tell your doctor, dentist or a sleep specialist in your area.

Read more about bruxism on our website: www.sleepandhealth.com

Kuny did not ask. He firmly demanded, changing the formal “You” to the casual “you” (which in Russian is used only with friends or subordinates.

– Editor).

The woman was shaking and bended under his powerful demands. She nervously moved in her chair.

Michael Kuny was almost screaming.

- Go to your brother! Faster! Street?

Read the name of the street! The name should be written in the intersection…

Read, loudly!

- Pervomayskaya Street… - Slowly, letter by letter said women without opening her eyes.

Now, you are getting close. Here is the house where your brother lives. Think about your brother. Go ahead! Look carefully. What is the number of your brother’s house? Do not miss it!

I don’t see it, - whispered the woman.

The number should be there, look further….

Number eighteen, - she said after a long pause. Her forehead was sweating.

She was breathing heavily, almost gasping for air..

Go to your brother. Vladimir is waiting for you. He lives somewhere here.

Look for his apartment, - mercilessly demanded Kuny.

I think, he lives on the second floor, whispered the woman.

Go up, he is tired of waiting for you.

Volodya! - suddenly screamed the women. - Is this you?!

Wait! The number of his apartment should be on the door. Go back! Read the number! Than you could hug Volodya! - Kuny ordered.

Number five! Volodya! You, finally…

- This is it! Now you could wake up, - said Kuny with satisfaction. - In the morning send him a telegram: City: Old Oskol Street: Pervomayskaya House No 18. Apartment 5 Name: Vladimir Neustroev.

We were standing around speechless and shocked.

The answer came back the next evening. The telegram was from Vladimir.

He was surprised. They did not see each other for twelve years. He asked his sister how she found out his address. Soon he will come to see her…

The following morning Kuny left this place as if nothing significant had happened.

We followed him to the plane with some anxiety and confusion. Was all of this real? Was all of this possible?

Soon, the women’s brother came to the town… Pilots met him as if he was Christ himself appearing to the people.

All of them were witnesses of the miracle.

Yes, miracles could happen. And, they could happen right here and now, in front of our eyes. But how?

Ref: Michael M. Kunin ‘ The Phenomenon of Michael Kuny.” Moscow.

Russkaya Kniga. 2003.

This part was translated by A. Golbin, MD

DENTAL SLEEP MEDICINE EXPERTS Stephen Chafkin, DMD Boston, Massachusetts Newton.IHateCPAP.com 617-964-0350

Paul Insolera, DDS Madison, Wisconsin DrInsolera.IHateCPAP.com 608-833-0865

William Poe, DDS Los Alamitos, California DrPoe.IHateCPAP.com 562-594-5067

Urszula Firlik, DDS Grand Rapids, Michigan GrandRapids.IHateCPAP.com 616-361-0603

Jess N. Legg III, DDS Houston, Texas Conroe.IHateCPAP.com 936-756-8115

Roger Roubal, DDS Omaha, Nebraska Omaha.IHateCPAP.com 402-493-4865

Martin Gorman, DDS Encino, California Encino.IHateCPAP.com 818-995-1891

James Loye, DDS San Diego, California SanDiego.IHateCPAP.com 858-792-9661

Dr. Rick Schnur, DMD Tampa Bay, Florida TampaBay.IHateCPAP.com 941-776-0885

Brent Gorrell, DDS Mountain View, California DrGorrell.IHateCPAP.com 650-967-1441

Brian Olitsky, DMD Bonita Springs, Florida DrOlitsky.IHateCPAP.com 239-992-9929

Ira L. Shapira, DDS, FICCMO Chicago, Illinois IHateCPAP.com/dr_Shapira.com 847-623-5530

I Marc Siegel, DDS Buffalo, New York Buffalo.IHateCPAP.com 716-839-1470

Donald Swoverland, DDS West Lafayette, Indiana WestLafayette.IHateCPAP.com 866-875-6572

Call a Dental Sleep Medicine expert in your area to learn about alternatives to CPAP or visit www.IHateCPAP.com.

“Oral appliances for snoring and obstructive sleep apnea offer patients a treatment option that is safe, effective and easy to use.” – sleepmatters, National Sleep Foundation, Winter, 2008 If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

May 2008

SLEEP & HEALTH

11

Sleep and Psychiatry

Sleep loss linked to psychiatric disorders

By Yasmin Anwar

I

t has long been assumed that sleep deprivation can play havoc with our emotions.

This is notably apparent in soldiers in combat zones, medical residents and even new parents. Now there’s a neurological basis for this theory, according to new research from the University of California, Berkeley, and Harvard Medical School.

In the first neural investigation into what happens to the emotional brain without sleep, results from a brain imaging study suggest that while a good night’s rest can regulate your mood and help you cope with the next day’s emotional challenges, sleep deprivation does the opposite by excessively boosting the part of the brain most closely connected to depression, anxiety and other psychiatric disorders.

“It’s almost as though, without sleep, the brain had reverted back to more primitive patterns of activity, in that it was unable to put emotional experiences into context and produce controlled, appropriate responses,” said Matthew Walker, director of UC Berkeley’s Sleep and Neuroimaging Laboratory and senior author of the study, which will be published today (Monday, Oct. 22, 2007) in the journal Current Biology.

“Emotionally, you’re not on a level playing field,” Walker added.

That’s because the amygdala, the region of the brain that alerts the body to protect itself in times of danger, goes into overdrive on no sleep, according to the study. This consequently shuts down the prefrontal cortex, which

commands logical reasoning, and thus prevents the release of chemicals needed to calm down the fight-or-flight reflex.

If, for example, the amygdala reacts strongly to a violent movie, the prefrontal cortex lets the brain know that the scene is make-believe and to settle down. But instead of connecting to the prefrontal cortex, the brain on no sleep connects to the locus coeruleus, the oldest part of the brain which releases noradrenalin to ward off imminent threats to survival, posing a volatile mix, according to the study.

The study’s findings lay the groundwork for further investigation into the relationship between sleep and psychiatric illnesses. Clinical evidence has shown that some form of sleep disruption is present in almost all psychiatric disorders.

“This is the first set of experiments that demonstrate that even healthy people’s brains mimic certain pathological psychiatric patterns when deprived of

sleep,” Walker said.

“Before, it was difficult to separate out the effect of sleep versus the disease itself. Now we’re closer to being able to look into whether the person has a psychiatric disease or a sleep disorder.”

Using functioning Magnetic Resonance Imaging (fMRI), Walker and his team found that the amygdala, which is also a key to processing emotions, became hyperactive in response to negative visual stimuli - mutilated bodies, children with tumors and other gory images - in study participants who stayed awake for 35 hours straight. Conversely, brain scans of those who got a full night’s sleep in their own beds showed normal activity in the amygdala.

“The emotional centers of the brain were over 60 percent more reactive under conditions of sleep deprivation than in subjects who had obtained a normal night of sleep,” Walker said.

The team studied 26 healthy participants aged 18 to 30, breaking them into two groups of equal numbers of males and females. The sleep-deprived group stayed awake during day 1, night 1 and day 2, while the sleep-control group stayed awake both days and slept normally during the night. During the fMRI brain scanning, which was performed at the end of day 2, each was

shown 100 images that ranged from neutral to very negative. Using this emotional gradient, the researchers were able to compare the increase in brain response to the increasingly negative pictures.

Since 1998, Walker, an assistant professor of psychology at UC Berkeley and a former sleep researcher at Harvard Medical School, has been studying sleep’s impact on memory, learning and brain plasticity.

During his research, he was struck with the consistency of how graduate students in his studies would turn from affable, rational beings into what he called “emotional JELL-O” after a night without sleep. He and his assistants searched for research that would explain the effect of sleep deprivation on the emotional brain and found none, although there is countless anecdotal evidence that lack of sleep causes emotional swings.

“You can see it in the reaction of a military combatant soldier dealing with a civilian, a tired mother to a meddlesome toddler, the medical resident to a pushy patient. It’s these everyday scenarios that tell us people don’t get enough sleep,” Walker said.

The body alternates between two different phases of sleep during the night: Rapid Eye Movement (REM), when body and brain activity promote dreams, and Non-Rapid Eye Movement (NREM), when the muscles and brain rest.

“All signs point to sleep doing something for emotional regulation and emotional processing,” Walker said.

“My job now is to figure out what kind of sleep.”

In the textbook “Sleep Psychiatry” (Golbin at al, 2005, London) a hypothesis was proposed that sleep is a physiological foundation of daytime emotional programs. If sleep is deviated that will induce deviations in daytime behavior and emotions up to psychosis or suicidal intents.

or call 847-414-6747 If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

12

May 2008

SLEEP & HEALTH

ASK DR. SLEEP Is a Prophetic Dream a Disorder?

Q. Dear Dr. Sleep, About thirteen years ago I woke in sweat from the dream that my father is dying.

Next morning I had learned that my father died for real approximately at the same time. Since that I am waking up at the same time (3.30 am) every night.

After I wake up and realize that nothing bad happened, I go to sleep calmly.

The strange thing: if I do not wake up (which happened a couple of times) the next day I am very nervous expecting a trouble every moment. I was offered treatment, but for some reason I do not want to treat it. What is wrong with me?

Raisa, Boulder, CO

66:152-157) Your awakenings in the middle of the night prevent you from anxiety and depression.

Keep it and be well.

Is Sleeping in the CHAIR Good or Bad? Dear Dr. Sleep, My husband always sleeps in the chair. He is a 54 year old large man who has insomnia for the last 6 or 7 years. He is wearing knee support bracelets and still is in pain.

He stated that he could sleep only in a lazy boy type of Chair and could not sleep in his bed. He is also snoring loudly and visibly in a very uncomfortable position. Is it good or bad that he is sleeping in the chair?

Kristina L. Detroit

Dear Kristina, You would be surprised of how many people could not sleep in the bed and sleep in the chair.

There are many reasons for this habit. Most of all it is pain. Pain is one of the most significant factors disrupting sleep.

In the horizontal position, when extremities are extended or even overextended by involuntary stretching, pain usually increases. When the body is in one position for a long time, pain is also increased due to blood circulation problems. In short, sleep in the horizontal position becomes nightmare. In the chair, pain subjectively decreases.

Another reason for sleep in chair is related to breathing problems. People with nocturnal asthma, chronic pulmonary disease, congestive heart failure need to be in upright position to decrease difficulties to breathe.

Answer: Nothing wrong with you, Raisa.

Awakening with “prophetic” feelings about somebody close to you is very known and proven fact. What is going on with you afterwards is a more interesting story. For some reason, confirmation of no problems after awakening brings you a sense of security and calmness. This ritual became your “security blanket.”

We know now that “disorders”, might be not necessarily a bad thing. Some times a small disorder may help contain a major disease. (See our article in the journal: Medical Hypotheses: Adaptive Chaos: Mild disorder may help contain major disease. 2006

Insomnia patients, who wake up in a middle of the night and cannot not go on with sleeping in the bed, move to a chair, because bed is associated with constant trouble. Plus, they do not want to disturb their spouses.

Thus, at first, sleeping in the chair is not bad, it has compensatory values, but in the long range chair sleeping might bring certain troubles as well. First, sleep is not as efficient and eventually sleep deprivation symptoms will crop in. Secondly, body needs changing positions and sleeping in one position destroys further blood circulation and increases stop breathing episodes.

Diabetic people will experience increased painful sensations in the legs, the so-called diabetic neuropathy.

What is the solution? Sleeping in the chair is good for a short nap during the day and welcome to use. During the night, for persons with pain it is better to try to sleep in bed with a big pillow between knees with a head elevated at about 20 degrees. There are several simple inexpensive head elevators on the market which you could place on the bed. If there is no other choice, then alternating sleeping in the chair a half of the night with attempts to sleep on the bed during the second half of the night might be another solution.

In any case, people who sleep in the chair are sufferers and deserve our understanding.

Best wishes, Dr. Sleep

Monk’s Herb Center Our on-line store is open 24/7, and our retail store has business hours:

ng !!! i r o n S ’re u o Y r Ove n r u ,T a Honey p Apne oms:

Sympt

ent:

Treatm

Monday thru Friday 10am - 7pm Saturday 9:30am - 5pm

e e l S e t ModerMaachine ppliance C-PAPal Snoring A Dent

We Can Fill This Prescription!

4714 North Milwaukee Ave, Chicago, IL 60630 Telephone: 773 205 0639 Our website: http://www.monksherbcenter.com

Dr. Inna Shturman, Member of American Academy of Sleep Medicine and American Academy of Dental Sleep Medicine.

COMPLIMENTARY CONSULTATION

Center for Neuromuscular Dentistry 3000 L Street #104 • Sacramento, CA

(916) 737-6824 www.nomoresnoring.com

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

May 2008

SLEEP & HEALTH

RESEARCH DIGEST

SLEEP PROBLEMS OF DEVELOPMENTALLY REGRESSED VS NONREGRESSED AUTISTIC CHILDREN

A

utism is a long-term neurodevelopmental disorder. Developmental regression occurs in about onethird of autistic children and sleep problems were commonly reported in such population. In a previous study we found that sleep difficulties seem to start during the second year of life, as does regression, and tend to persist. This would support the hypothesis stating the existence in autistic children of a developmentally critical phase. Results of different studies showed that EEG abnormalities and epilepsy were significantly common in regressed children. This study was to assess differences in sleep patterns of regresses versus nonregressed children, and their relationship between EEG abnormalities and epilepsy.

Researchers examined 68 autistic

P

regnant women should eat enough seafood, because if they limit their seafood intake they may put the unborn child at a higher risk for potential neurodevelopmental problems, according to a study in the February Lancet. A total of 11,875 women completed food frequency questionnaires at 32 weeks gestation; those who reported consuming less than 340 grams of seafood per week had greater odds of having child in the lowest quartile for IQ at age 8, compared with women who ate more than the recommended amount.

O

mega-3 fatty acid intake may increase the gray matter volume (which is brain cells), according to reports at the 65th Annual Scientific Conference of the American Psychosomatic Society in Budapest. Fifty-five healthy adults were interviewed regarding average intake of long-chain omega-3 fatty acids. Participants who reported high levels of omega-3 intake had greater volumes of gray matter in the bilateral anterior cingulated cortex, the right amygdale, and the right hippocampus, as determined by high-resolution structural MRI. The researchers noted that the improvements were observed in ar-

eas of the brain related to mood and regulation of emotion, in which gray matter is decreased in persons with mood disorders; however, they said that more research is needed to determine whether fish consumption actually causes the changes.

A

ntidepressant treatment may increase long-term improvement of mental functions in stroke patients, according to a study in the March British Journal of Psychiatry. Forty-seven patients who had experienced a stroke within the prior six months were received 12 weeks of antidepressant treatment (fluoxetine or nortriptyline) or placebo. The researchers reported no significant differences at 12 weeks; however, the long-term follow-up examination of 36 patients revealed that the placebo group experienced deterioration of executive function, while the active treatment group “showed clear and significant improvement independent of depressive symptoms.” Authors concluded that the antidepressants improved the process of neural tissue recovery during the post-stroke period.

March 2007 Neurology Reviews

THE NOCTURNAL FLIP-FLOP DURING SLEEP: IS IT DIFFERENT IN PEDIATRIC SLEEP APNEA? I

n adults with Obstructive Sleep Apneas (OSA), the supine position is consistently associated with increased severity of the respiratory disturbance during sleep. Although data on the relationships between body position and OSA in children are currently conflictive, preferential selection of body positions during sleep could affect (increase or reduce) the risk for upper airway obstructions.

The recent study showed that children with OSA appear to spend in-

creasing proportions of their sleep in the supine position and less time in the side position compared to healthy children. Obese children with OSA were more likely to adopt the prone position, suggesting that this position may help upper airways to function more efficiently in case of OSA in obese children Ref: SLEEP, Volume 29, Abstract Supplement, 2006

13

children (87% males), aged 2.1 - 8.2.

To assess sleep problems, parents completed Children’s Sleep Habits Questionnaire (CSH!). Previous and current child’s sleep was investigated. All children underwent waking and sleeping EEG abnormalities and epilepsy.

Conclusion: Consistent with other studies our children exhibit sleep problems. Unlike their nonregressed peers, regressed children showed more disrupted sleep, more EEG abnormalities and epilepsy. Although the biological basis and possible casual relationships of these associations remain to be explained, they may point to different subgroups of patients with autism.

Ref: SLEEP, Volume 29, Abstract Supplement, 2006

High blood pressure (HBP) affects more than 65 million—or 1 in 3—American adults. HBP often has no warning signs or symptoms. Once it occurs, it usually lasts a lifetime. Uncontrolled high blood pressure can lead to heart and kidney disease, stroke, and blindness.

Take the opportunity in May to get your blood pressure checked and learn more about HBP, how it affects the body, and how to control high blood pressure. Here are some resources from the NHLBI that can help you get started.

Take a Look at Materials for Patients and the Public x

x

x

Visit HBP Internet sites: o Your Guide to Lowering Blood Pressure Web site http://www.nhlbi.nih.gov/hbp o NHLBI’s Diseases and Conditions Index article on HBP http://www.nhlbi.nih.gov/health/dci/D iseases/ Hbp/HBP_WhatIs.html Order Your Guide to Lowering Your Blood Pressure with DASH for ONLY $3.50 each at http://emall.nhlbihin.net/product2.asp? sku=06-4082 Don’t Miss the Recipes for Heart Health starting on page 45. Try Vegetarian Spaghetti Sauce tonight!

Order My Blood Pressure Wallet Card for F|R|E|E single copy* at http://emall.nhlbihin.net/product2.asp? sku=03-5068 Additional copies ONLY 25¢ each See the section on Questions To Ask Your Doctor If You Have High Blood Pressure

Educate Patients, Diagnose, and Treat HBP – Materials for Health Professionals x x x

Check out the Mission Possible Web site’s Activity Ideas page http://hp2010.nhlbihin.net/mission/partner/ideas.htm Utilize the Pocket Guide to Blood Pressure Management in Children. Available at http://emall.nhlbihin.net/product2.asp?sku=07-5268 for ONLY $1.50 each Download The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure - Complete Report at http://emall.nhlbihin.net/product2.asp?sku=04-5230 See the section on Questions To Ask Your Doctor If You Have High Blood Pressure

* Shipping charges may apply.

HIN0408HBPMO

Division for the Application of Research Discoveries National Heart, Lung, and Blood Institute Building 31, Room 4A10 31 Center Drive, MSC 2480 Bethesda, MD 20892-2480

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

14

May 2008

Odds and Ends Interesting Facts DO YOU KNOW THAT SCULPTURE OF DAVID HAS ONE DEFECT. The famous sculpture of Michelangelo “David” in Florence which is considered as the model of male’s harmony and beauty, happened to have a defect: David has cross-eyes.

This conclusion was made by scientist Mark Livoy from Stanford University, who investigated “David” with computerized laser technology.

This defect was not noticed before, because of the large size of the sculpture and high pedestal. Expert came up to the conclusion that Michelangelo made this defect on purpose, because this way the profile of “David” looks ideal from any angle.

WHY SOUTH AMERICAN INDIANS DEFORM THEIR OWN SCULLS? South American Indians, especially men in old Peru, self-mutilated themselves by changing the form of their sculls. They twisted their sculls in the most horrible ways not to increase attraction, but to terrify their neighbor enemies, as historians now believe. Forensic analysis concluded that while terrifying enemies those men became nightmare for their own people, because deformed sculls led to severe brain damage and psychiatric disorders.

WHY GOAT IS THE MOST INTELLIGENT ANIMAL ON EARTH? The Italian philosopher Marciall announced that goat was the most intelligent animal on Earth because it was very comfortable with his beard. It was not a joke. In Italy it was very difficult to shave as it was forced by the religious rituals. There was no soap. The Marciall’s face was cut not from honorable fights, but from shaving. If the barber tried to shave accurately he worked so slowly that while he shaved one side of the face, the beard grew up on the other side.

WHO WAS A PROTOTYPE OF DOCTOR FAUST? Pope Sylvester II (999-1003) was very educated.

He studied mathematical and technical Arabian manuscripts. He knew secrets of metals of many swords. In 972-982, he was teaching in archbishops’ school and was a very famous in his time.

His knowledge became a legend. Ironically, some members of his own church suspected that he had an agreement with devil.

According to this legend Pope Sylvester II was the prototype of Doctor Faust.

SLEEP & HEALTH

The Unicorn

by F. C. Klock

The plush white unicorn stood guard over the pill bottle between its outstretched paws. The dresser where the pills stood was at the foot of my bed, still shrouded in the early morning shadows. I didn’t want to open my eyes to yet another morning. Didn’t want to get out of bed and leave the toasty warmth of the blankets. I didn’t want to take that pill.

When I left Harper on medical leave, they promised to hold my job for six months. That was three weeks ago. Besides getting out of my lease and moving in with my folks, nothing had been accomplished toward getting me healthy again. At first it was all about getting rest. Then it was the testing.

Yesterday, after reviewing the test results, my doctor gave me those pills, saying I was to take one each morning and repeat the blood tests in a week. He offered explanations about antibodies and blood and neuro-somethings. Nothing stayed with me, except that I was sick.

Here I was lying awake in my old room, wanting to escape into my crazy dreams, out of my mind, fearing the worst, and scared to take a simple pill, for that would be admitting that I was really sick. I pulled the blankets up over my head trying to block everything out. This accomplished nothing except to expose my feet to the chilling air of my room.

I got out of bed, wrapped the blankets around me, and padded off to the bathroom.

Back in my room, I stopped at the dresser. I moved the pill bottle to the right and picked up my unicorn. Without thinking, I started to stroke the plush white fur as I thought out loud.

“What is wrong with me? Why am I sick? Why can’t they make it go away? What does this mean? Can’t I be in control of my own life? How is that possible when the doctors don’t even know what’s wrong? I’ve got more tests and medications coming don’t I, Mr. Unicorn?”

Of all my stuffed animals the unicorn was the only one I hadn’t named, but it was the one that I talked to the most. Strange, it seems like I wax philosophical more with my little unicorn than I do with anyone, even Roger. Maybe that’s because I address the unicorn so formally, whatever….

“What would I tell Roger? He’ll want to marry me right away. I can see it now, me walking down the aisle of the hospital chapel, with a veil and a long white hospital gown holding an I.V. stand.”

No…. I can’t think like that. I’m not going to die! I picked up the pill bottle….and put it down again. Picked it up and read the label, it meant nothing to me, put it back on my dresser and turned around.

“Why am I so afraid of admitting I’m sick? Just take the damn pills and get on with it, right Mr. Unicorn? Tell me it’s all right to be sick….it’s all right to be my mom’s little girl again….No, I’m not sick! This is all a bad dream, I’ll be waking up soon in my own apartment…..” I put the unicorn back on the dresser and placed the pills between his paws. Then, I collected the blankets around me and jumped back into bed. My sleep was restless, but I did sleep.

The alarm clock told me it was eleven-thirty. I sat up in bed, gathered the blankets around me, tucking them under my feet, and smoothed the rest out until there were no more wrinkles. Then and only then did I dare to look at the dresser. The plush white unicorn, standing guard over the pill bottle between its outstretched paws, looked back at me.

“Tell me Mr. Unicorn, what does all this mean? Did I do something wrong and upset the cosmic order? Why does a twenty-five year old get sick like this? Will I get better? Or is this just the prelude to some long term condition that will turn me into my mother’s little girl again? Or am I dying? God, I don’t want to die.”

I kept my eyes closed to spite the advancing light, tried to return to sleep, to return to the dreams. For the last three weeks, my dreams had been filled with exotic animals whirling in my mind like they were part of a living carousel. The animals were chasing after something, and would occasionally stop to chat with me on the side of the path. The red tigers and blue lions would talk of a grand adventure, some great hunt they were on, but never spoke of what they were hunting. The smaller animals were in this quest for the fun of it, and kept urging me to come join in their pursuit. It was a most pleasant world in those dreams, not like Wonderland had been for Alice. But, the pills would take away this dream world.

Sleep eluded me. I shut my eyes tighter, and burrowed under the blankets against the morning sun’s further advance into my room.

My room. It hadn’t been my room for years. Not since I had moved out to go to college. But Mom had kept it as a “guest room” just in case, with all of my high school things remaining where I left them.

My parents were so damned understanding when I got sick and couldn’t go to work any longer.

“Mom, I can’t impose on you and dad like this…”

“Impose? Rachel – you’re always welcome. You can have your old room. It’s so sad you lost your apartment, it was so cute. Though, I always thought it was too small for you. Where do you keep all of your things? I’ll have your father help you move your clothes back in here. And, you can store your furniture in the basement….”

“Mother, I’ll have some friends help me. Dad doesn’t have to help….You know this is just a temporary thing until the doctors can figure out what’s wrong.”

“I know dear, we’ll get you better, lots of soup, it’s going to be so good having you back at home…”

I almost nixed the whole deal right then – she was thinking that she was getting her little darling back – I was too independent for that, but I was too sick to argue.

I had a good job with T.J. Harper, a small accounting firm in the Loop. This afforded me the ability to have a modest one bedroom apartment on Ardmore. It took my friends only a few hours to pack and empty that apartment, a testament to the fact that I really had very little despite being on my own for three years.

The 466 heart patients

Do You Know That... ...praying helps?

...women who have severe morning sickness

who were the object of other people’s prayers during their hospital stay had 11% fewer complications than did 524 patients who were not prayed for. Patients did not know prayers were said for then. Those who did the praying knew only the patients’ first names…and prayed only for “a speedy recovery with no complications.”

The researchers note that, statistically, such a difference between the groups would occur by chance only one in 25 times.

tend to give birth to girls?

In a recent study in Sweden, more than 55% of women admitted to the hospital for severe morning sickness eventually gave birth to girls.

Yet only 49% of all births are girls. Theory: Morning sickness during the first trimester of pregnancy is due to high levels of human chorionic gonadotropin, a hormone that has been associated with higher odds of a female birth. The reason for this association is unknown.

Bottom Line Health June 2000 William S. Harris, PhD

Bottom Line Health June 2000 Johan Askling, MD

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

May 2008

SLEEP & HEALTH

Classified & Opportunities

15

SLEEP TECHNICIAN SCHOOL

• ResMed • Source One • Advanced Sleep Therapy • Sleep Solution • Respironics • Integrated • Center for Neuromuscular Dentistry • Delany Dental Care • Long Grove Dental Studio •

If you are considering a career change, the Sleep Technician School would be glad to introduce you to the exciting field of sleep medicine.

WITH QUESTIONS OR TO ENROLL, PLEASE CALL (847) 673-8005 Sign up for the next available course!

MEDICAL AND PUBLISHING STAFF Editor-in-Chief

Sleep & Health is an independent national periodical published monthly published monthly by Health Secrets,Inc. © Copyright 2007. The periodical covers the fields of medical science and industry related to the sleep-alertness cycle, other biological rhythms, their normal development, disorders and treatment options. It also covers the entire spectrum of sleep-like phenomena and conditions. Sleep & Health presents discussions and different viewpoints that may or may not coincide with mainstream thinking on issues. Opinions expressed do not necessarily reflect those of the editors. Sleep & Health attempts to cover the entire scope of practical and theoretical issues associated with sleep medicine and the related industries: research, scientific advances, alternative approaches, social aspects, literature, art, sleep experts’ and patients’ opinions related to sleep health, without endorsement of specific theories or doctrines. The paper does not support any particular product. It is a public forum for open discussion and opinions. Information provided by Sleep & Health should not take the place of medical advice and guidance from your own healthcare provider.

Alexander Golbin, MD, PhD Diplomate, American Board of Sleep Medicine Managing Editor

Dina Golbin, BS, RPSGT Associate Editor

Louis Keith, MD, PhD Associate Editor

Natalie Seliber, BS, MA Section Editor–Sleep Pulmonology

Neil Freedman, MD Diplomate, American Board of Sleep Medicine Our mailing address: Sleep and Health Newspaper 5412 Ebony Ct., Gurnee, IL 60031 Tel: 847-414-6747 | Fax: 847-599-0494

Section Editor–Sleep Dentistry

Ira L. Shapira, DDS, FICCMO, DAPM Jeffrey Pancer, DDS - Canada Edition Editor Section Editor – Art & Sleep

Deena Sherman Marketing Department

Ayzik Okun, Jane Vlassova Designers

Michael Kurov, Fyodor Grek Proofreader

Lev Rozhansky Publishing

Health Secrets, Inc Copyright 2007 Health Secrets, Inc. All Rights Reserved.

We believe in saving you money while we go about saving the earth.

WITHOUT ADVERTISING Smart Clean TERRIBLE Going green doesn’t need to be difficult or THING complicated. Even small steps count, and what you do every day, such as using Shaklee cleaning products, can help keep your family and the planet healthy.

Heffernan, Shaklee Distributor ............ Laura NO THING!!!

Mundelein, IL 60060

To advertise call OLDI(h),Marketing 847-949-4933 847-420-8592 (c) www.shaklee.net/healthyoutlook 847-229-3422

WE ARE LOOKING FOR MEDICAL ASSISTANCE IN OUR NEW MEDICAL CENTER 7933 N Lincoln, Skokie

Fax resume to 847-299-4232, Phone 847-757-0205

Advertising does not cost. It PAYS! Call 847-414-6747 today to find out more about our promotions, special deals & discount packages.

Sleep & Health is not responsible for display advertisements, advertising articles and their content.

Sleep & Health assumes no responsibility to return unsolicited editorial or graphic or other material. Reproduction in whole or in part without written consent is prohibited. Sleep & Health reserves the right to edit any submitted material when necessary for space or clarification.

Copyright ©

by Health Secrets, Inc All Rights Reserved. 2007.

HAVE AN INTERESTING SLEEP STORY? QUESTION? SUGGESTION? SHARE IT WITH US. We welcome your stories and expert comments, all of which might direct our readers to a proper solution, give doctors hints to look for answers and provide industry an opportunity to improve its technology.

Write to: editor@sleepandhealth.com All correspondence is confidential.

We retain the right to review and edit stories, and to accept or not accept them for publication. Accepted letters become the property of Sleep and Health.

If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 • www.sleepandhealth.com

16

May 22008

SLEEP & HEALTH

Integrated

Respiratory Solutions

Offering full line of CPAP/BIPAP Equipment and Supplies All Set-Ups Completed By Licensed Respiratory Professionals Friendly, courteous, and professional Customer Service Patient Compliance Program focused on Improved Patient outcomes

877.426.0202 Fax: 847.426.5227

Toll Free:

Specializing in Sleep Equipment and supplies for the home patient

364) /ÂŤ3ÂŻÂŞ 4)03& .&%*$"- $&/5&3

5)& 1):4*$*"/ $&/5&3 "5 7&3/0/ )*--4

/ ,FOUPO "WF 4VJUF ,Â&#x160; 4LPLJF *- UFM GBY

-BLFWJFX 1BSLXBZ 4VJUF 7FSOPO )JMMT *- UFM GBY

.&%*1-&9 .&%*$"- $&/5&3

8BVLFHBO 3E 4VJUF #BOOPDLCVSO *- UFM GBY

*/%*$"5*0/4 '03 4-&&1 &7"-6"5*0/ Â? Â? Â? Â? Â? Â? Â? Â? Â? Â?

-PVE TOPSJOH 4UPQQFE CSFBUIJOH JO TMFFQ *OTPNOJB .JEOJHIU BXBLFOJOHT /JHIU UFSSPST #BE ESFBNT 3FTUMFTT MFHT $IBSMJF )PSTF

#FEXFUUJOH &OVSFTJT

4MFFQ 3FMBUFE )FBSU "SSIZUINJB &YDFTTJWF EBZUJNF TMFFQJOFTT $ISPOJD GBUJHVF 'JCSPNZBMHJB 1BJO 4ZOESPNFT JO TMFFQ

www.chicagosbmi.com XXX TMFFQBOEIFBMUI DPN If you experience sleep problems, call the Sleep & Health HOTLINE at (847) 673-8005 â&#x20AC;˘ www.sleepandhealth.com

4MFFQ BOE #FIBWJPS .FEJDJOF *OTUJUVUF 4#.*

JT EJSFDUFE CZ

"MFYBOEFS (PMCJO . % 1I %

%JQMPNBUF PG 5IF "NFSJDBO #PBSE PG 4MFFQ .FEJDJOF XJUI ZFBST PG DMJOJDBM FYQFSJFODF JO &VSPQF BOE UIF 6OJUFE 4UBUFT BVUIPS PG UISFF CPPLT BOE OVNFSPVT QVCMJDBUJPOT PO TMFFQ EJTPSEFST JO BEVMUT BOE DIJMESFO