USA Today Highlights Sleep Deprivation


New Centers for Disease Control (CDC) data has spawned more consumer press on the negative effects of sleep deprivation. The latest comes courtesy of the June 22 USA Today via reporter Nanci Hellmich.

The USA Today piece reiterates that sleep deprivation is associated with an increased risk of many serious health problems, including obesity, high blood pressure, type 2 diabetes, depression, heart attacks and strokes, as well as premature death and reduced quality of life and productivity.

“CDC data show that 28% of U.S. adults report sleeping six hours or less each night, and that’s just not enough for most people, experts say,” writes Hellmich. “It’s no wonder that the CDC calls insufficient sleep ‘a public health epidemic.’”

Sleep is so critical to good health that it should be thought of “as one of the components of a three-legged stool of wellness: nutrition, exercise and sleep,” says Safwan Badr, a past president of the American Academy of Sleep Medicine and a sleep expert with Detroit Medical Center and Wayne State University, in the article. “The three are synergistic. It’s hard to lose weight if you are sleep deprived. It’s hard to eat healthy if you are sleep deprived. It is hard to exercise if you’re tired.”

Although people’s sleep needs vary, the sleep medicine group quoted in USA Today recommends that adults get about seven to nine hours a night for optimal health, productivity and daytime alertness. “That’s a conservative estimate when it comes to the number of people with sleep disorders or those who have difficulty sleeping,” says Michael Twery, director of the Detroit Medical Center. “There are more than 70 sleep disorders.”

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Connection Between Circadian Rhythms and Timing of Chemotherapy?


Research at the cellular level recently revealed that the cycle of cell division in mammalian cells synchronizes with the body’s own circadian clock. The research, led by the University of Warwick’s Systems Biology Centre and Medical School, helps explain why people with sustained disrupted circadian rhythms can be more susceptible to cancer. It may also help establish the optimal time of day to administer chemotherapy.


The original paper, entitled Phase Locking and Multiple Oscillating Attractors for the Coupled Mammalian Clock and Cell Cycle was published in PNAS (Proceedings of the National Academy of Sciences). Researchers reportedly drew on an idea of clock synchronization first demonstrated in the 18th century when Dutch scientist Christian Huygens observed the synchronization of two pendulum clocks.


Click Here for Abstract


According to News-Medical, the University of Warwick led research team wanted to establish if the two clocks within a mammalian cell (the gene based “clock” regulating the cycle of cell division and the separate gene based clock within the same cell that was regulated by the body’s circadian) were or could be synchronized in the same way.


“Past researchers had failed to measure the clock mechanism behind normal circadian rhythms in single cells,” writes News-Medical. “The Warwick research team solved that by using multispectral imaging of single live cells, computational methods, and mathematical modeling to track the cycles of the two clocks and were able to observe (by making copies of the key genes that fluoresce) that that they were indeed synchronized with each other…These new findings could provide a significant clue as to why people with sustained disrupted circadian rhythms such as those doing shift work can be more susceptible to cancer.”

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Connection Between Sleep and High Testosterone?


A presentation at the 2014 Joint Meeting of the International Society of Endocrinology and the Endocrine Society reveals that higher levels of testosterone resulted in poorer sleep for study subjects. The consequences of low testosterone have been widely reported, but these findings from Eve Van Cauter, PHD, senior investigator and director of the University of Chicago Sleep, Metabolism and Health Center, cast a different light on the hormone question.


“This finding could have clinical relevance in the context of the recent increase in testosterone prescriptions in middle-aged men, as poor sleep quality has been linked to increased risk of diabetes and hypertension,” said Van Cauter.


Recent studies have shown that three out of four men in America are overweight or obese, and the presented study looked at factors which contributed to OSA. According to HCP Live, Van Cauter’s team used a group of 44 nonsmoking men between the ages of 20 and 50 who were overweight or obese but were otherwise healthy.


After undergoing a polysomnogram, results showed that 66% of participants had OSA which was determined to be moderately severe in most of the 29 cases. “The men were also asked to give a blood sample the morning after the study to measure testosterone level,” wrote HCP reporters. “Results were also attained by statistical analysis of subjects’ demographics including age and race to look at slow-wave activity.”

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Latest Fitness Wearable Incorporates Sleep


The “wearables” craze started with counting miles and tracking heart rate, but those measurables have expanded to include sleep. The trend is a sign that sleep is fast becoming a known harbinger of true fitness.


The latest biosensing wearable is the LifeTrak Core C210 from Salutron. The Core C210 tracks 24/7 activity and heart rate, including sleep, calories burned, steps taken and distance traveled, to help users get active, lose weight, sleep better and live healthy.


The Core C210 offers automatic sleep detection and monitoring – while other devices require users to remember to manually prompt the device when they are going to sleep, taking a nap and waking up.


LifeTrak activity monitors incorporate heart rate and physical motion into the calorie burn calculation, which is considered a more precise way to determine calorie expenditure. They also provide the most sophisticated science and accurate data calculation of any activity tracker on the market, giving users the ability to make more informed changes to their health.


Features include:

  • Automatic sleep detection and monitoring – Knows when users fall asleep, monitors sleep quality and detects when users wake up, without the need to prompt
  • Accurate Heart Rate – Heart rate detection with a simple press of a button
  • 24/7 automatic tracking – Includes sleep, calorie burn, steps and distance
  • Weekly and hourly records – View results from the past 7 days, and throughout the day with a  24-hour chart
  • Long-lasting battery life – One year and no charging required

Waterproof Fully submersible up to 90 feet

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Termination of Sleep Services at Gaylord Hospital Sparks Access Debate


According to a report in the New Haven Register, Connecticutt-based Gaylord Hospital’s decision to close its four sleep centers, and sell its North Haven facility to Yale-New Haven Hospital, could make it difficult for New Haven patients to access continuing care, while also increasing the cost.


Vincent Petrini, a vice president at the hospital, said in the article that they will provide the same transportation options for patients that Gaylord now provides to maintain access, and the cost will be assessed the same way Gaylord now does it.


Reporter Mary E. O’Leary writes that two officers from the state Office of Health Care Access held a hearing on the termination of sleep center services by Gaylord at Gateway Community College in New Haven, where the majority testifying and in attendance either worked at Yale-New Haven Hospital or Yale University.


“The union says the issue isn’t the closing of a facility, but a three-way transaction in which Y-NH will take over the sleep medicine practice from Yale Medical School and is in the process of purchasing Gaylord’s North Haven sleep center assets,” writes O’Leary. “A worker at the medical school said she was told to tell patients that their medical records would be sent to Y-NH which would open locations in North Haven and Madison.”


The consolidation of hospitals and the purchase of physician practices (and its effect on patients) is part of a national discussion. O’Leary points out that New Haven Mayor Toni Harp said the Union should not make a decision on Gaylord until it has more information on the impact on low-income residents and particularly African-American men, who have higher instances of sleep apnea.

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Truckers Continue to Resist Rules on Sleep


Once again, truck drivers working hours in the U.S. are gaining national attention due to media coverage of the recent New Jersey turnpike collision that injured comedian Tracy Morgan and killed another person. On Tuesday of this week 6/17 a New York Times editorial was published reporting that truck drivers are still resisting the mandate regarding sleep, breaks and work hours.

According to federal officials, drowsy driving is a leading cause of highway fatalities and crashes. For this month alone, driver fatigue has been blamed in deadly accidents in Madison County, Ohio, Austin, Texas, and Marseilles, Illinois. It is estimated that over 30,000 people have died on the highways annually in the U.S. from crashes that involve large trucks.

The NYT reported that despite the emphasis of following rules on truckers needing to get ample rest before a work shift and by taking breaks to ensure that drowsy sleeping does not happen, commercial truck operators, for one, resisted following the rules as they argued that Washington cannot regulate one’s sleep.

Last year, federal rules have reduced the number of maximum workweek hours for truck drivers from 82 to 70. Drivers who have logged the maximum number are required to rest for 34 hours before starting another workweek. Moreover, it has been declared that drivers should not drive more than 11 hours a day and should have a 30-minute break in their work schedules.

On the other hand, it is to note that the trucking industry has not been receptive of the mandate. Moreover, the industry has said that truck drivers should instead be afforded maximum flexibility and should not be told when to take a rest.

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CPAP, Weight Loss, or Both for Obstructive Sleep Apnea?


In a study published in the New England Journal of Medicine, researchers attempted to determine whether C-reactive protein (CRP) levels, insulin resistance, and serum triglyceride levels would go down as a result of various treatment combinations.

According to article titled “CPAP versus Oxygen in Obstructive Sleep Apnea”, among the 146 participants for whom there were follow-up data, those assigned to weight loss only and those assigned to the combined interventions had reductions in CRP levels, insulin resistance, and serum triglyceride levels.

Click Here for Abstract

“None of these changes were observed in the group receiving CPAP alone,” wrote researchers. “Blood pressure was reduced in all three groups. No significant incremental effect on CRP levels was found for the combined interventions as compared with either weight loss or CPAP alone. Reductions in insulin resistance and serum triglyceride levels were greater in the combined-intervention group than in the group receiving CPAP only, but there were no significant differences in these values between the combined-intervention group and the weight-loss group.”


Researchers concluded: “In adults with obesity and obstructive sleep apnea, CPAP combined with a weight-loss intervention did not reduce CRP levels more than either intervention alone. In secondary analyses, weight loss provided an incremental reduction in insulin resistance and serum triglyceride levels when combined with CPAP.”

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Medtronic to Acquire Covidien in Billion Dollar Deal


MINNEAPOLIS AND DUBLIN – In a deal that reverberated from the land of 10,000 lakes to the emerald isle, Dublin-based Medtronic Inc acquired Covidien, Minneapolis, in a cash-and-stock transaction valued at $93.22 per Covidien share, or a total of approximately $42.9 billion.


Once the transaction is completed, Medtronic will have significantly advanced its position as an international medical technology and services company. The combined company will have a comprehensive product portfolio, a diversified growth profile, and broad geographic reach, with 87,000 employees in more than 150 countries.


The Boards of Directors of both companies have unanimously approved the transaction. “We are excited to reach this agreement with Covidien, which further advances our mission to alleviate pain, restore health and extend life for patients around the world,” said Omar Ishrak, chairman and CEO of Medtronic. “This acquisition will allow Medtronic to reach more patients, in more ways and in more places. Our expertise and portfolio of services will allow us to serve our customers more efficiently and better address the demands of the current healthcare marketplace. We also look forward to welcoming the Covidien team to Medtronic and working together to improve healthcare outcomes globally.”


“Covidien and Medtronic, when combined, will provide patients, physicians and hospitals with a compelling portfolio of offerings that will help improve care and surgical performance,” said José E. Almeida, chairman, president and CEO of Covidien. “This transaction provides our shareholders with immediate value and the opportunity to participate in the significant upside potential of the combined organization. I’d like to thank our 38,000 employees whose hard work and dedication has enabled Covidien to deliver innovative health solutions that improve patient outcomes.”

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Medicare Dollars Toward DME Are Cost Effective for CPAP


A study about Medicare investment in DME concludes that substantial cost savings are realized when mobility, supplemental oxygen, and CPAP therapy are covered by Medicare.


The Case for Medicare Investment in DME – 2014 Update was done by Brian Leitten of Leitten Consulting. It is a follow-up to a 2011 study that concluded when Medicare pays for DME, it saves substantially more money in health care costs than it pays for the equipment.


“This certainly is not news to those of us in the industry,” said John Gallagher, VGM, vice president-government relations. “We know that Mom wants to be at home, not in a home, and that DME makes that possible.”

The study looked at three major categories of DME:

• CPAP therapy: Obstructive sleep apnea occurs in 70 percent of men over 65, and 56 percent of women. OSA contributes to many serious medical conditions, and is usually treated by continuous positive airway pressure therapy. When Medicare pays for CPAP therapy, the cost of treating medical complications caused by OSA drops dramatically.

• Mobility equipment: Falls are the leading cause of unintentional injury and death in the U.S. for adults 65 and older. When Medicare pays for mobility equipment, falls are reduced and significant net spending savings are realized.

• Supplemental oxygen therapy: COPD is the second leading cause of disability and the third leading cause of death in the U.S. When Medicare pays for supplemental oxygen therapy, the cost of treating medical complications of COPD drops dramatically, and significant net spending savings are realized.

“The message is clear: HME does save Medicare money, and helps beneficiaries live where they want to be – at home,” said Gallagher. The study was discussed at a June 11 Town Hall meeting during the VGM Heartland Conference, attended by mobility users, HME providers, legislators and legislative staff.

To view the complete study, go to

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Sleep Cements Memories According to New Study


Pulling an all-night study marathon may be tempting, but students would do well to study, then rest. The old-fashioned advice now has some research to back it up, thanks to a computer simulation showing the long branched dendrites of pyramidal neurons in the cerebral cortex.


According to a report, Wenbiao Gan of the Langone Medical Center at New York University, and his colleagues, trained mice to run backwards or forwards on a rotating rod, then left some of them to sleep while keeping the rest awake, using confocal and two-photon microscopy to monitor the motor cortex, which is involved in controlling movement, through ‘windows’ scraped into animals’ skulls.


“We found that about 5% of spines in the motor cortex were formed anew in response to the learning task over 8-24 hours,” says Gan, “and our previous studies show that a fraction of these rapidly formed new spines – about 10% – are maintained over the subsequent weeks to months.”


The experiments also showed that the same neurons that were activated during learning of the task were reactivated during sleep, and this apparently stablized the newly-formed spines, because no new spines were seen when reactivation was blocked with a drug.


The researchers reportedly did not re-test learning behavior after blocking spine formation, however, or determine whether the new spines actually paired up with nerve terminals to form functioning synapses. Even if they did form synapses, it’s not clear that such a small number of them could contribute to information processing, so more work is needed to confirm that the new spines that sprout during sleep are indeed involved in memory.

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