Keep a Cool Head For a Better SleepKeep a Cool Head For a Better Sleep

Keep a Cool Head For a Better Sleep

DARIEN, IL – People with primary insomnia may be able to find relief by wearing a cap that cools the brain during sleep, suggests a research abstract that will be presented Monday, June 13, in Minneapolis, Minn., at SLEEP 2011, the 25th Anniversary Meeting of the Associated Professional Sleep Societies LLC (APSS).

According to the authors, a reduction in metabolism in the brain’s frontal cortex occurs while falling asleep and is associated with restorative sleep. However, insomnia is associated with increased metabolism in this same brain region. One way to reduce cerebral metabolic activity is to use frontal cerebral thermal transfer to cool the brain, a process known as “cerebral hypothermia.”

Results show that there were linear effects of all-night thermal transfer intensities on sleep latency and sleep efficiency. The time that it took subjects with primary insomnia to fall asleep (13 minutes) and the percentage of time in bed that they slept (89 percent) during treatment at the maximal cooling intensity were similar to healthy controls (16 minutes and 89 percent).

“The most significant finding from this study is that we can have a beneficial impact on the sleep of insomnia patients via a safe, non-pharmaceutical mechanism that can be made widely available for home use by insomnia sufferers,” said principal investigator and lead author Dr. Eric Nofzinger, professor and director of the Sleep Neuroimaging Research Program at the University of Pittsburgh School of Medicine. “The finding of a linear dose response effect of the treatment implies a direct beneficial impact on the neurobiology of insomnia that can improve the sleep of insomnia patients. We believe this has far-ranging implications for how insomnia can be managed in the future.”

In this crossover study, Nofzinger and co-investigator Dr. Daniel Buysse screened 110 people, enrolling 12 people with primary insomnia and 12 healthy, age-and gender-matched controls. Participants with insomnia had an average age of about 45 years, and nine of the 12 subjects were women.

Participants received all-night frontal cerebral thermal transfer by wearing a soft plastic cap on their head. The cap contained tubes that were filled with circulating water. The effectiveness of varying thermal transfer intensities was investigated by implementing multiple conditions: no cooling cap, and cooling cap with either neutral, moderate or maximal cooling intensity.

According to Nofzinger, the simplicity and effectiveness of this natural treatment could be a long-awaited breakthrough for insomnia sufferers.

“The primary medical treatment for insomnia has long been the prescription of hypnotics, or sleeping pills, yet only about 25 percent of patients using these treatments are satisfied, citing concerns regarding side effects and the possibility of dependence on a pill to help them sleep at night,” he said. “There exists a large gap between what patients with insomnia are looking for to help them and what is currently available. Patients have long sought a more natural, non-pharmaceutical means to help them with their sleep at night. The identification of a dose-dependent improvement by the device used in this study opens the door to a novel, safe and more natural way to achieve restorative sleep in insomnia care.”

The study was supported by the National Institutes of Health through the National Institute on Aging, National Institute of Mental Health and National Center for Research Resources; as well as by the Respironics Foundation.

The American Academy of Sleep Medicine reports that chronic insomnia, or symptoms that last for at least a month, affects about 10 percent of adults. Most often insomnia is a “comorbid” disorder, occurring with another medical illness, mental disorder or sleep disorder, or associated with certain medications or substances. Fewer people suffering from insomnia are considered to have primary insomnia, which is defined as a difficulty falling asleep or maintaining sleep in the absence of coexisting conditions.

In a study published in 2006 in the Journal of Clinical Sleep Medicine, Nofzinger and Buysse reported that increased relative metabolism in several brain regions during non-REM sleep in patients with insomnia is associated with increased wakefulness after sleep onset. They speculated that these effects may result from increased activity in arousal systems during sleep or heightened cognitive activity related to processes such as conflict, anxiety, and fear.

Help for people with insomnia is available at more than 2,200 AASM-accredited sleep disorders centers across the U.S.

The SLEEP 2011 abstract supplement is available for download on the website of the journal SLEEP at http://www.journalsleep.org/ViewAbstractSupplement.aspx.

A joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, the annual SLEEP meeting brings together an international body of more than 5,000 leading clinicians and scientists in the fields of sleep medicine and sleep research. At SLEEP 2011 (www.sleepmeeting.org), more than 1,000 research abstract presentations will showcase new findings that contribute to the understanding of sleep and the effective diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

TUESDAY, June 14 (HealthDay News) — Not only do cooler heads prevail, they might also sleep better, according to researchers who say they have developed a cooling cap that, when worn during sleeptime, may help treat insomnia.

Previous research has shown that the brains of people with insomnia are “hyperaroused” and have a higher brain metabolism in the frontal lobes, which helps explain why they have trouble drifting off to sleep and staying asleep, said study co-author Dr. Daniel Buysse, a professor of psychiatry and clinical and translational science at University of Pittsburgh School of Medicine.

To help the brain cool down, researchers outfitted 12 primary insomnia patients with a temperature-controlled cap that has cool water flowing through it and recruited 12 healthy controls matched for age and gender. (“Primary insomnia” means that medical problems, medicines, or other substances have been ruled out as a cause of sleep difficulties. The more common type of insomnia is “secondary insomnia,” in which medical issues or medications contribute.)

Of the patients with insomnia, the average age was 45 and nine were women. Participants slept for two nights in a sleep lab with no cap; two nights with the cap set at a “neutral” temperature (about 86 degrees Fahrenheit); two nights at a moderately cool temperature (72 degrees Fahrenheit); and two nights with the coolest temperature (57 degrees Fahrenheit).

While the participants slept, researchers monitored their brain electrical activity, eye movements (to determine if someone was in REM, or rapid eye movement sleep) and jaw muscle tone (during REM, the muscles go slack due to ‘sleep paralysis’).

In this preliminary study, about three-quarters of those with insomnia said the cap helped them sleep better when the water temperature was about 57 degrees Fahrenheit.

At higher temperatures — 72 and 86 degrees — patients reported no benefit, according to the study presented Monday at SLEEP 2011, the Associated Professional Sleep Societies meeting in Minneapolis.

While wearing the cooling cap, it took insomnia patients an average of 13 minutes to fall asleep and they spent 89 percent of their time in bed actually sleeping, about the same as controls who didn’t have insomnia (the latter group averaged 16 minutes to fall asleep and 89 percent of the time in bed sleeping) .

The cooling cap was, however, associated with an increased amount of slow-wave sleep — or the deepest, restorative portion of sleep, the researchers reported.

“What we wanted to find out was: ‘Would cooling the surface of the brain of insomnia patients result in lower metabolism and improved sleep? The basic answer in this preliminary study, is yes, it seems to work, and it works in two ways,” said Buysse. “It does reduce brain metabolism in the frontal lobes, and it improves sleep.”

Dr. William Kohler, medical director of the Florida Sleep Institute, said the concept was exciting and worth further research in larger studies that include body temperature measurements and brain imaging tests.

“The theoretical concept is correct, in that we do know from many previous studies that as the body core temperature cools, our sleep improves, and with warming of the core temperature, we have more restless sleep,” Kohler said.

Chronic insomnia — which the American Academy of Sleep Medicine attributes to about one out of every 10 Americans — can be difficult to treat. Medications can help, although many people complain of side effects, Kohler said. The most effective treatment is cognitive behavior therapy, which involves changes such as avoiding cigarettes, alcohol and caffeine before bed, and getting plenty of bright light in the morning but turning off the TV, computer and dimming the lights during a wind-down period, among other techniques for improving “sleep hygiene.”

“It’s in the brain where the chemical changes are occurring that lead to sleep,” he said.

The cap is not yet available to consumers, although the lead researcher, Dr. Eric Nofzinger, has plans to bring it to market, Buysse said.

Because this study was extremely small and presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal and confirmed in larger studies.

Source : http://health.usnews.com/health-news/family-health/sleep/articles/2011/06/14/sleeptime-head-cooling-cap-eases-insomnia-study-finds

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