Here’s a wake-up call for snorers: Snoring may put you at a greater risk than those who are overweight, smoke or have high cholesterol to have thickening or abnormalities in the carotid artery, according to researchers at Henry Ford Hospital in Detroit.
The increased thickening in the lining of the two large blood vessels that supply the brain with oxygenated blood is a precursor to atherosclerosis, a hardening of the arteries responsible for many vascular diseases.
“Snoring is more than a bedtime annoyance and it shouldn’t be ignored. Patients need to seek treatment in the same way they would if they had sleep apnea, high blood pressure or other risk factors for cardiovascular disease,” said lead study author Robert Deeb, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.
“Our study adds to the growing body of evidence suggesting that isolated snoring may not be as benign as first suspected,” said Deeb.”So instead of kicking your snoring bed partner out of the room or spending sleepless nights elbowing him or her, seek out medical treatment for the snorer.”
The study reveals changes in the carotid artery with snorers – even for those without sleep apnea – likely due to the trauma and subsequent inflammation caused by the vibrations of snoring.
Study results will be presented Friday at the 2013 Combined Sections Meeting of the Triological Society in Scottsdale, Ariz. It has been submitted to The Laryngoscope journal for publication.
Obstructive sleep apnea (OSA) – a sleep disorder that occurs due to the collapse of the airway in the throat during sleep and causes loud snoring and periodic pauses in breathing – has long been linked to cardiovascular disease, along with a host of other serious health issues.
But the risk for cardiovascular disease may actually begin with snoring, long before it becomes OSA. Until now, there was little evidence in humans to show a similar connection between snoring and cardiovascular risk.
For the Henry Ford study, Dr. Deeb and senior study author Kathleen Yaremchuk, M.D., reviewed data for 913 patients who had been evaluated by the institution’s sleep center.
Patients, ages 18-50, who had participated in a diagnostic sleep study between December 2006 and January 2012 were included in the study. None of the participants had sleep apnea.
In all, 54 patients completed the snore outcomes survey regarding their snoring habits, as well as underwent a carotid artery duplex ultrasound to measure the intima-media thickness of the carotid arteries.
Carotid intima-media thickness, a measurement of the thickness of the innermost two layers of the arterial wall, may be used to detect the presence and to track the progression of atherosclerotic disease. Intima-media thickness is the first sign of carotid artery disease.
Compared to non-snorers, snorers were found to have a significantly greater intima-media thickness of the carotid arteries, the study finds.
The study also revealed no statistically significant differences in intima-media thickness for patients with or without some of the traditional risk factors for cardiovascular disease – smoking, diabetes, hypertension or hypercholesterolemia.
“Snoring is generally regarded as a cosmetic issue by health insurance, requiring significant out-of-pocket expenses by patients. We’re hoping to change that thinking so patients can get the early treatment they need, before more serious health issues arise.”
The Henry Ford research team plans to conduct another long-term study on this topic, particularly to determine if there’s an increased incidence of cardiovascular events in patients who snore.
The connection between poor sleep, memory loss and brain deterioration as we grow older has been elusive.
But for the first time, scientists at the University of California, Berkeley, have found a link between these hallmark maladies of old age.
Their discovery opens the door to boosting the quality of sleep in elderly people to improve memory.
UC Berkeley neuroscientists have found that the slow brain waves generated during the deep, restorative sleep we typically experience in youth play a key role in transporting memories from the hippocampus – which provides short-term storage for memories – to the prefrontal cortex’s longer term “hard drive.”
However, in older adults, memories may be getting stuck in the hippocampus due to the poor quality of deep ‘slow wave’ sleep, and are then overwritten by new memories, the findings suggest.
“What we have discovered is a dysfunctional pathway that helps explain the relationship between brain deterioration, sleep disruption and memory loss as we get older – and with that, a potentially new treatment avenue,” said UC Berkeley sleep researcher Matthew Walker, an associate professor of psychology and neuroscience at UC Berkeley and senior author of the study to be published this Sunday, Jan. 27, in the journal Nature Neuroscience.
The findings shed new light on some of the forgetfulness common to the elderly that includes difficulty remembering people’s names.
“When we are young, we have deep sleep that helps the brain store and retain new facts and information,” Walker said. “But as we get older, the quality of our sleep deteriorates and prevents those memories from being saved by the brain at night.”
Healthy adults typically spend one-quarter of the night in deep, non-rapid-eye-movement (REM) sleep. Slow waves are generated by the brain’s middle frontal lobe. Deterioration of this frontal region of the brain in elderly people is linked to their failure to generate deep sleep, the study found.
The discovery that slow waves in the frontal brain help strengthen memories paves the way for therapeutic treatments for memory loss in the elderly, such as transcranial direct current stimulation or pharmaceutical remedies.
For example, in an earlier study, neuroscientists in Germany successfully used electrical stimulation of the brain in young adults to enhance deep sleep and doubled their overnight memory.
UC Berkeley researchers will be conducting a similar sleep-enhancing study in older adults to see if it will improve their overnight memory. “Can you jumpstart slow wave sleep and help people remember their lives and memories better? It’s an exciting possibility,” said Bryce Mander, a postdoctoral fellow in psychology at UC Berkeley and lead author of this latest study.
For the UC Berkeley study, Mander and fellow researchers tested the memory of 18 healthy young adults (mostly in their 20s) and 15 healthy older adults (mostly in their 70s) after a full night’s sleep. Before going to bed, participants learned and were tested on 120 word sets that taxed their memories.
As they slept, an electroencephalographic (EEG) machine measured their brain wave activity. The next morning, they were tested again on the word pairs, but this time while undergoing functional and structural Magnetic Resonance Imaging (fMRI) scans.
In older adults, the results showed a clear link between the degree of brain deterioration in the middle frontal lobe and the severity of impaired “slow wave activity” during sleep. On average, the quality of their deep sleep was 75 percent lower than that of the younger participants, and their memory of the word pairs the next day was 55 percent worse.
Meanwhile, in younger adults, brain scans showed that deep sleep had efficiently helped to shift their memories from the short-term storage of the hippocampus to the long-term storage of the prefrontal cortex.
Co-authors of the study are William Jagust, Vikram Rao, Jared Saletin and John Lindquist of UC Berkeley; Brandon Lu of the California Pacific Medical Center and Sonia Ancoli-Israel of UC San Diego.
The research was funded by the National Institute of Aging of the National Institutes of Health.
Yasmin Anwar writes for the UC Berkeley News Center.
A survey of voters in rural California counties, including Mendocino, found broad agreement that obesity is a major problem and strong support for community action to prevent obesity and related chronic diseases.
The survey found that 85 percent of Mendocino voters describe obesity as a “serious problem,” and 85 percent agree that the neighborhoods where people live affect their risk for obesity.
“Local data collected from recent health information surveys show that 56 percent of Mendocino adults and 43 percent of its children and teens are either obese or overweight, so it’s not surprising that community concern about obesity is so high,” said Colleen Schenck, program administrator with Mendocino County Public Health Services.
The 12 rural California counties included in the survey are part of the CA4Health Community Transformation Grant initiative funded by the Centers for Disease Control & Prevention and the Public Health Institute.
Mendocino County was awarded $1.2 million over five years under CA4Health to implement proven strategies aimed at improving the health and well being of those living and working in the county.
Other participating counties include Calaveras, Humboldt, Imperial, Madera, Merced, Monterey, Shasta, Siskiyou, Solano, Tulare and Tuolumne.
The survey found that Mendocino County residents strongly support a community-wide approach to preventing obesity, seeing roles for health care providers (92 percent), community and civic organizations (78 percent), local schools (95 percent), food retailers (82 percent), restaurants (76 percent), churches and other faith-based organizations (70 percent), employers (71 percent) and local government (79 percent).
The poll also highlighted strong support for community actions intended to reduce consumption of soda and other sugary drinks, such as strengthening school nutrition standards to limit the sale of unhealthy foods and drinks (74 percent) and improving access to fresh drinking water in parks, schools, and public buildings (89 percent).
According to the survey, an overwhelming majority of Mendocino County residents recognize that the added sugar in sugary beverages increases a person’s chances of becoming overweight and obese (92 percent), developing Type 2 diabetes (88 percent), high blood pressure (79 percent), and heart disease (78 percent).
“These poll results show that we are on the right path with the local efforts already underway with the support of our Community Transformation Grant funding,” said Schenck.
“Residents are seeing the value of different sectors working together to create a healthier community,” she said. “That’s why we’re working closely with schools, community organizations, businesses and other leaders to achieve goals like making it easier and safer for our kids to walk or bike to school and encouraging them to choose water instead of soda and other sugar-filled beverages. When healthier options are readily available, people can make healthier choices for themselves and their families.”
The Mendocino County poll also found strong local support for the roles that Community Health Workers can play to help people manage chronic diseases and their risk factors, such as high blood pressure and high cholesterol.
Community Health Workers are individuals specially trained to provide the information and skills people need to better manage their own health.
According to the survey, 96 percent of Mendocino County residents believe community health workers would be valuable in teaching people how to manage and monitor their medical conditions, be physically active and eat healthier, take their medication properly, and improve communications with doctors and other health care providers.
According to the poll, Mendocino County residents strongly support covering the services provided by Community Health Workers through private health plans (94 percent), Medicare (99 percent) and Medi-Cal (96 percent).
The 12-county sample size was 1,810, approximately 150 interviews per county. Surveys were conducted via telephone (both landline and cellular phones), among representative samples of registered voters. Surveys were completed between Aug. 3 and Aug. 19, 2012.
Maternal inflammation during early pregnancy may be related to an increased risk of autism in children, according to new findings supported by the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health.
Researchers found this in children of mothers with elevated C-reactive protein (CRP), a well-established marker of systemic inflammation.
The risk of autism among children in the study was increased by 43 percent among mothers with CRP levels in the top 20th percentile, and by 80 percent for maternal CRP in the top 10th percentile.
The findings appear in the journal Molecular Psychiatry and add to mounting evidence that an overactive immune response can alter the development of the central nervous system in the fetus.
“Elevated CRP is a signal that the body is undergoing a response to inflammation from, for example, a viral or bacterial infection,” said lead scientist on the study, Alan Brown, M.D., professor of clinical psychiatry and epidemiology at Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, and Mailman School of Public Health. “The higher the level of CRP in the mother, the greater the risk of autism in the child.”
Brown cautioned that the results should be viewed in perspective since the prevalence of inflammation during pregnancy is substantially higher than the prevalence of autism.
“The vast majority of mothers with increased CRP levels will not give birth to children with autism,” Brown said. “We don’t know enough yet to suggest routine testing of pregnant mothers for CRP for this reason alone; however, exercising precautionary measures to prevent infections during pregnancy may be of considerable value.”
“The brain develops rapidly throughout pregnancy,” said Linda Birnbaum, Ph.D., director of NIEHS, which funds a broad portfolio of autism and neurodevelopmental-related research. “This has important implications for understanding how the environment and our genes interact to cause autism and other neurodevelopmental disorders.”
The study capitalized on a unique national birth cohort known as the Finnish Maternity Cohort (FMC), which contains an archive of samples collected from pregnant women in Finland, where a component of whole blood, referred to as serum, is systematically collected during the early part of pregnancy.
The FMC consists of 1.6 million specimens from about 810,000 women, archived in a single, centralized biorepository. Finland also maintains diagnoses of virtually all childhood autism cases from national registries of both hospital admissions and outpatient treatment.
From this large national sample, the researchers analyzed CRP in archived maternal serum corresponding to 677 childhood autism cases and an equal number of matched controls.
The findings were not explained by maternal age, paternal age, gender, previous births, socioeconomic status, preterm birth, or birth weight.
The work was conducted in collaboration with investigators in Finland, including the University of Turku and the National Institute for Health and Welfare in Oulu and Helsinki.
“Studying autism can be challenging, because symptoms may not be apparent in children until certain brain functions, such as language, come on line,” said Cindy Lawler, Ph.D., head of the NIEHS Cellular, Organ, and Systems Pathobiology Branch and program lead for the Institute’s extramural portfolio of autism research. “This study is remarkable, because it uses biomarker data to give us a glimpse back to a critical time in early pregnancy.”
This work is expected to stimulate further research on autism, which is complex and challenging to identify causes.
Future studies may help define how infections, other inflammatory insults, and the body’s immune response interact with genes to elevate the risk for autism and other neurodevelopmental disorders.
Preventative approaches addressing environmental causes of autism may also benefit from additional research.
The study was funded primarily by an American Recovery and Reinvestment Act grant from NIEHS, with additional support from the National Institute of Mental Health.