ST-article

Did you know a dentist can help you stop snoring?

If you snore or fear you suffer from sleep apnea, your dentist may have a solution for you

Who can diagnose if I have a snoring problem or sleep apnea?

If you suspect that you have a snoring problem, severe teeth grinding or sleep apnea, you can visit your dentist for advice.

By examining the conditions of your mouth, throat and teeth, together with detailed discussions with you and your spouse as well as a sleep test, a dentist can gather more information on your risks of snoring or sleep apnea.

For example, your dentist will be able to tell if you grind your teeth, which is something your brain makes you do in an attempt to open your airways.

Headaches, sore jaws, and worn-down or sensitive teeth are some ways that your dentist can tell if you grind your teeth.

How can the dentist help me deal with my snoring or sleep apnea problem?

Treatment for sleep apnea is to use the Continuous Positive Airway Pressure (CPAP) machine. However, for snorers and patients who cannot tolerate the CPAP, your dentist will be able to provide an alternative solution.

Worn during sleep, the custom-fitted oral positioning appliance is similar to an orthodontic retainer or a sports mouthguard. It brings the lower jaw slightly forward and prevents the airway from closing so you can breathe comfortably and reduce snoring.

According to research studies, 91 per cent of patients reported improvement in sleep quality after wearing a snoring appliance.

The best way to find out what type of treatment you need is to schedule for an appointment with your dentist, who may send you for a sleep test if he/she suspects that you suffer from sleep apnea.

CAN-article

Why snoring loudly could be linked to heart disease, hypertension or worse

Obstructive sleep apnoea is a common condition among Singaporeans. Experts from SingHealth Polyclinics explain how to deal with it – including doing mouth exercises like ‘tongue tai chi’, what we call myofunctional therapy (MFT).

OSA is a common condition seen among Singaporeans, as it turns out. According to Dr Tan, over 1,000 patients visit SingHealth Polyclinics every month, and a telltale sign they have it: Snoring.

“The danger of sleep apnoea is the combination of disturbed sleep and oxygen starvation, which may lead to hypertension, heart disease, heart failure, abnormal heart rhythms, or even stroke,” said Dr Tan Teck Shi, the clinical lead for a respiratory workshop with SingHealth Polyclinics.

FDI

Dentistry and Sleep-Related Breathing Disorders

Context

Sleep-related Breathing Disorders (SRBD) affect millions of people of all ages worldwide. They can be the cause of a wide range of physical, dental and mental health problems, ranging from simple day-time sleepiness to life-threatening cardiovascular complications. In addition, SRBDs can increase the risk of psychological problems, including depression and drug dependency, which can damage their social relations and adversely affect their on-the-job performance. Therefore, SRBDs can affect quality of life and have very serious socio-economic consequences including employment loss and traffic accidents.

Scope

This Policy Statement aims to highlight the important role of dentists in prevention, early screening and treatment of young or adult patients with SRBDs by establishing effective inter-professional collaboration with medical sleep doctors.

Definitions

Sleep-related Breathing Disorders (SRBD): disturbance of the normal breathing pattern during sleep.

The most common types of SRBDs are: snoring, Upper Airway Resistance Syndrome (UARS) and Obstructive Sleep Apnea (OSA). They occur when a person’s airway repeatedly becomes blocked during sleep despite efforts to breathe. The posterior section of the tongue falls back against the throat and airflow is interrupted. This results in loud snoring and pauses in breathing while asleep resulting a change from deeper sleep stage to a lighter stage even sometimes with episodes of waking up at night, feeling short of breath or gasping for air.

Mandibular Advancement Device (MAD): a therapeutic oral appliance designed to place the mandible, during sleep, in a forward position, keeping the tongue from closing the airway and allowing the patient to breathe more easily. MADs, used in mild to moderate OSA cases, are easier and more comfortable to use than the Continuous Positive Airway Pressure (CPAP) appliances. Therefore, the patient’s compliance rate is believed to be higher with MAD than with CPAP appliances. CPAP appliances are used in moderate to severe cases, but MADs should be tried even in severe OSA when the patient is non-compliant to CPAP, Surgery could in certain cases be applied but limited to careful patients selection and special indications.

Principles

After a careful screening has been performed by either or both a medical sleep doctor and a dentist (consistent with local licensure requirements), a treatment plan can be established and the appropriate appliance is decided accordingly.

Policy

FDI recommends:

universities and national dental associations to provide students and dentists with basic knowledge regarding the important role of dentistry in preventing and treating SRBD, in particular early detection in children and prevention of late onset forms. This can include immediate management as well;
all dental and medical health forms to include questions about the patient’s sleep quality and related data to do the screening of SRBDs;
dentists to provide proper information to patients to understand the process of screening, treatment options and the role of the care providers involved;
a detailed comprehensive medical, functional and dental screening and an individually tailored treatment plan are necessary to treat patients with an appropriate MAD;
dentists to maintain regular communications with the medical sleep doctor for a more patient-focused, efficient and positive result;
treatments to be subjectively and objectively evaluated for efficacy. In case of unsuccessful treatment, all etiological and diagnostic factors should be carefully re-evaluated and the appliance should be re-adjusted. If the treatment is still not satisfactory, the patient should be referred for other means of treatment;
dentists to have the training to treat SRBD patients within the ethical limits of their profession in collaboration with the medical sleep doctor involved for successful treatment outcome and higher patient satisfaction.

Disclaimer

The information in this policy statement was based on the best scientific evidence available at the time. It may be interpreted to reflect prevailing cultural sensitivities and socio-economic constraints.

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The Dangers Of Drowsy Driving

Drowsy driving, the dangerous combination of sleepiness and driving or driving while fatigued, and can result from many underlying causes, including excessive sleepiness, sleep deprivation, changes in circadian rhythm due to shift work, fatigue, medications with sedatives and consuming alcohol when tired. The cumulative effects of these factors have severe effects on performance, alertness, memory, concentration and reaction times. Drowsy Driving is a growing problem in the United States, and the risk, danger and often tragic outcomes of drowsy driving are sobering. According to a survey, nine of 10 police officers reported stopping a driver who they believed was drunk but turned out to be drowsy. Further, data indicate 80,000 individuals fall asleep at the wheel each day and there are more than 250,000 sleep-related motor vehicle accidents each year. It is estimated that twenty percent of all serious transportation injuries on the nation’s highways are related to sleep.

Who is at Risk for Driving while Drowsy?

  • Young people, particularly males
  • Shift workers
  • People who work long hours
  • Commercial drivers, especially those who drive a significant number of miles at night
  • Sleep deprived individuals
  • Persons with undiagnosed or untreated sleep disorders
  • Those who have consumed alcohol
  • People taking prescription medication that contain sedatives

Tips to avoid becoming drowsy while driving:

  • Get enough sleep American Academy of Sleep Medicine recommends adults get seven to eight hours of sleep each night in order to maintain good health and optimum performance.
  • Take breaks while driving If one becomes drowsy while driving, it is recommended he or she pulls off to a rest area and takes a short nap, preferably 15 to 20 minutes in length.
  • Do not drink alcohol Alcohol can further impair a person’s ability to stay awake and make decisions; taking the wheel after having just one glass of alcohol can affect one’s level of fatigue.
  • Do not drive late at night Avoid driving after midnight, which is a natural period of sleepiness.
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Does Your Child Keep You Up At Night?

Sleep affects your child’s development in many important ways, including mental and social development, physical health, and emotional regulation. When a child has trouble sleeping, it limits their ability to function well during the day, disrupts the household, and is a source of stress for parents and other family members. Sleep problems in children are common. Some problems are brief and resolve on their own. When sleep problems persist for more than a few weeks, they may begin to affect a child’s mood, behavior, and relationships in the home and at school.

Common behavioral sleep problems found in children include: If you feel that you are no longer in control of your child’s sleep patterns, do not know what to do to get your child to sleep on their own, or feel that you have tried everything to get your child to sleep through the night, our behavioral sleep medicine services are a great treatment option to consider!

  • Bedtime resistance or refusal
  • “Musical beds” or difficulty sleeping alone
  • Sleep schedule problems
  • Poor sleep habits and routines
  • Nighttime awakenings
  • Nighttime fears and nightmares
  • Bedwetting
  • Sleep walking / Sleep talking

If you feel that you are no longer in control of your child’s sleep patterns, do not know what to do to get your child to sleep on their own, or feel that you have tried everything to get your child to sleep through the night, our behavioral sleep medicine services are a great treatment option to consider!

We Can Help Your Child Sleep

Effective behavioral treatments are the recommended option for many common childhood sleep problems. Parents often feel overwhelmed by conflicting instructions offered by books or friends, or find that “textbook” approaches do not work for them. An understanding of individual developmental needs, behavioral and reinforcing factors, as well as the influence of unique family dynamics and parenting styles on your child’s sleep is important to developing a treatment plan that effectively addresses your child’s behavioral sleep problem.

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Attention Problems May Be Sleep-Related

Diagnoses of attention hyperactivity disorder among children have increased dramatically in recent years, rising 22 percent from 2003 to 2007, according to the Centers for Disease Control and Prevention. But many experts believe that this may not be the epidemic it appears to be.

Many children are given a diagnosis of A.D.H.D., researchers say, when in fact they have another problem: a sleep disorder, like sleep apnea. The confusion may account for a significant number of A.D.H.D. cases in children, and the drugs used to treat them may only be exacerbating the problem.

“No one is saying A.D.H.D. does not exist, but there’s a strong feeling now that we need to rule out sleep issues first,” said Dr. Merrill Wise, a pediatric neurologist and sleep medicine specialist at the Methodist Healthcare Sleep Disorders Center in Memphis.

The symptoms of sleep deprivation in children resemble those of A.D.H.D. While adults experience sleep deprivation as drowsiness and sluggishness, sleepless children often become wired, moody and obstinate; they may have trouble focusing, sitting still and getting along with peers.

The latest study suggesting a link between inadequate sleep and A.D.H.D. symptoms appeared last month in the journal Pediatrics. Researchers followed 11,000 British children for six years, starting when they were 6 months old. The children whose sleep was affected by breathing problems like snoring, mouth breathing or apnea were 40 percent to 100 percent more likely than normal breathers to develop behavioral problems resembling A.D.H.D.

Children at highest risk of developing A.D.H.D.-like behaviors had sleep-disordered breathing that persisted throughout the study but was most severe at age 2 1/2.

“Lack of sleep is an insult to a child’s developing body and mind that can have a huge impact,” said Karen Bonuck, the study’s lead author and a professor of family and social medicine at Albert Einstein College of Medicine in New York. “It’s incredible that we don’t screen for sleep problems the way we screen for vision and hearing problems.”

Her research builds on earlier, smaller studies showing that children with nighttime breathing problems did better with cognitive and attention-directed tasks and had fewer behavioral issues after their adenoids and tonsils were removed. The children were significantly less likely than untreated children with sleep-disordered breathing to be given an A.D.H.D. diagnosis in the ensuing months and years.

Most important, perhaps, those already found to have A.D.H.D. before surgery subsequently behaved so much better in many cases that they no longer fit the criteria. The National Institutes of Health has begun a study, called the Childhood Adenotonsillectomy Study, to understand the effect of surgically removing adenoids and tonsils on the health and behavior of 400 children. Results are expected this year.

“We’re getting closer and closer to a causal claim” between breathing problems during sleep and A.D.H.D. symptoms in children, said Dr. Ronald Chervin, a neurologist and director of University of Michigan Sleep Disorders Center in Ann Arbor.

In his view, behavioral problems linked to nighttime breathing difficulties are more likely a result of inadequate sleep than possible oxygen deprivation. “We see the same types of behavioral symptoms in children with other kinds of sleep disruptions,” he said.

Indeed, sleep experts note that children who lose as little as half an hour of needed sleep per night — whether because of a sleep disorder or just staying up too late texting or playing video games — can exhibit behaviors typical of A.D.H.D.

Not only is a misdiagnosis stigmatizing, but treatment of A.D.H.D. can exacerbate sleeplessness, the real problem. The drugs used to treat A.D.H.D., like Ritalin, Adderall or Concerta, can cause insomnia.

“It can become a vicious, compounding cycle,” said Dr. David Gozal, chairman of the department of pediatrics at the University of Chicago Pritzker School of Medicine, whose clinical practice focuses on children with sleep disorders.

Sleep deprivation is difficult to spot in children. Of the 10,000 members of the American Academy of Sleep Medicine, only 500 have specialty training in pediatric sleep issues. And pediatricians may not even know to make a referral, because they often depend on parents to bring up their children’s sleep problems during checkups.

But parents themselves often are uninformed about healthy sleep habits. A study conducted last year by researchers at Penn State University-Harrisburg and published in The Journal of Sleep Research showed that of 170 participating parents, fewer than 10 percent could correctly answer basic questions like the number of hours of sleep a child needs.

“Parents didn’t know what was normal sleep behavior,” said Kimberly Anne Schreck, a psychologist and behavioral analyst at Penn State who was the study’s lead author. “Many thought snoring was cute and meant their child was sleeping deeply and soundly.”

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Losing just half an hour of sleep ‘can impact body weight and metabolism’

The findings of new research presented at ENDO 2015, the annual meeting of the Endocrine Society in San Diego, CA, suggest that losing just half an hour of sleep can have long-term consequences for body weight and metabolism.

For the study, researchers from Weill Cornell Medical College in Doha, Qatar, recruited 522 patients who had been recently diagnosed with type 2 diabetes.

At the start of the study, the participants’ height, weight and waist circumference were measured and samples of their blood were analyzed for insulin sensitivity.

The participants were required to keep sleep diaries, from which their weekday “sleep debt” was calculated.

The participants at the start of the study who had weekday sleep debt were found to be 72% more likely to be obese, compared with participants who had no weekday sleep debt. By follow-up at 6 months, the association between weekday sleep debt and obesity and insulin resistance was found to be significant.

At 12-month follow-up, the researchers calculated that for every 30 minutes of weekday sleep debt there was an associated 17% increased risk of obesity and 39% increased risk of insulin resistance.

“While previous studies have shown that short sleep duration is associated with obesity and diabetes, we found that as little as 30 minutes a day sleep debt can have significant effects on obesity and insulin resistance at follow-up,” says lead study author Prof. Shahrad Taheri.

The authors suggest in a statement that future interventions designed to combat metabolic disease should also consider sleep and other factors affecting metabolic function. Sleep hygiene and education may be a key component of future trials studying metabolic control, they add.

People often miss out on sleep during the week and try to catch up at weekends

People often accumulate sleep debt during weekdays as a consequence of social and work commitments, making up for the lost sleep at the weekend. However, Prof. Taheri explains that the results reinforce the notion that sleep loss is additive and has metabolic consequences:

Sleep loss is widespread in modern society, but only in the last decade have we realized its metabolic consequences. Our findings suggest that avoiding sleep debt could have positive benefits for waistlines and metabolism and that incorporating sleep into lifestyle interventions for weight loss and diabetes might improve their success.”

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Sleep Therapy Seen as an Aid for Depression

Curing insomnia in people with depression could double their chance of a full recovery, scientists are reporting. The findings, based on an insomnia treatment that uses talk therapy rather than drugs, are the first to emerge from a series of closely watched studies of sleep and depression to be released in the coming year.

The new report affirms the results of a smaller pilot study, giving scientists confidence that the effects of the insomnia treatment are real. If the figures continue to hold up, the advance will be the most significant in the treatment of depression since the introduction of Prozac in 1987.

Depression is the most common mental disorder, affecting some 18 million Americans in any given year, according to government figures, and more than half of them also have insomnia.

Experts familiar with the new report said that the results were plausible and that if supported by other studies, they should lead to major changes in treatment.

“It would be an absolute boon to the field,” said Dr. Nada L. Stotland, professor of psychiatry at Rush Medical College in Chicago, who was not connected with the latest research.

“It makes good common sense clinically,” she continued. “If you have a depression, you’re often awake all night, it’s extremely lonely, it’s dark, you’re aware every moment that the world around you is sleeping, every concern you have is magnified.”

The study is the first of four on sleep and depression nearing completion, all financed by the National Institute of Mental Health. They are evaluating a type of talk therapy for insomnia that is cheap, relatively brief and usually effective, but not currently a part of standard treatment.

The new report, from a team at Ryerson University in Toronto, found that 87 percent of patients who resolved their insomnia in four biweekly talk therapy sessions also saw their depression symptoms dissolve after eight weeks of treatment, either with an antidepressant drug or a placebo pill — almost twice the rate of those who could not shake their insomnia. Those numbers are in line with a previous pilot study of insomnia treatment at Stanford.

In an interview, the report’s lead author, Colleen E. Carney, said, “The way this story is unfolding, I think we need to start augmenting standard depression treatment with therapy focused on insomnia.”

Dr. Carney acknowledged that the study was small — just 66 patients — and said a clearer picture should emerge as the other teams of scientists released their results. Those studies are being done at Stanford, Duke and the University of Pittsburgh and include about 70 subjects each. Dr. Carney will present her data on Saturday at a convention of the Association for Behavioral and Cognitive Therapies, in Nashville.

Doctors have known for years that sleep problems are intertwined with mood disorders. But only recently have they begun to investigate the effects of treating both at the same time. Antidepressant drugs like Prozac help many people, as does talk therapy, but in rigorous studies the treatments, administered individually, only slightly outperform placebo pills. Used together the treatments produce a cure rate — full recovery — for about 40 percent of patients.

Adding insomnia therapy, however, to an antidepressant would sharply lift the cure rate, Dr. Carney’s data suggests, as do the findings from the Stanford pilot study, which included 30 people.

Doctors have long considered poor sleep to be a symptom of depression that would clear up with treatments, said Rachel Manber, a professor in the psychiatry and behavioral sciences department at Stanford, whose 2008 pilot trial of insomnia therapy provided the rationale for larger studies. “But we now know that’s not the case,” she said. “The relationship is bidirectional — that insomnia can precede the depression.”

Full-blown insomnia is more serious than the sleep problems most people occasionally have. To qualify for a diagnosis, people must have endured at least a month of chronic sleep loss that has caused problems at work, at home or in important relationships. Several studies now suggest that developing insomnia doubles a person’s risk of later becoming depressed — the sleep problem preceding the mood disorder, rather than the other way around.

The therapy that Dr. Manber, Dr. Carney and the other researchers are using is called cognitive behavior therapy for insomnia, or CBT-I for short. The therapist teaches people to establish a regular wake-up time and stick to it; get out of bed during waking periods; avoid eating, reading, watching TV or similar activities in bed; and eliminate daytime napping.

The aim is to reserve time in bed for only sleeping and — at least as important — to “curb this idea that sleeping requires effort, that it’s something you have to fix,” Dr. Carney said. “That’s when people get in trouble, when they begin to think they have to do something to get to sleep.”

This kind of therapy is distinct from what is commonly known as sleep hygiene: exercising regularly, but not too close to bedtime, and avoiding coffee and too much alcohol in the evening. These healthful habits do not amount to an effective treatment for insomnia.

In her 2008 pilot study testing CBT-I in people with depression, Dr. Manber of Stanford used sleep hygiene as part of her control treatment. She found that 60 percent of patients who received seven sessions of the talk therapy and an antidepressant fully recovered from their depression, compared with 33 percent who got the same drug and the sleep hygiene therapy.

In the four larger trials expected to be published in 2014, researchers had participants keep sleep journals to track the effect of the CBT-I therapy, writing down what time they went to bed every night, what time they tried to fall asleep, how long it took, how many awakenings they had and what time they woke up.

When the diaries show consistent, seldom-interrupted, good-quality slumber, the therapist conducts an interview to determine if there are any lingering issues. If there are none, the person has recovered. The therapy results in sharp reductions in nighttime wakefulness for most people who follow through.

In interviews, several researchers noted that the National Institute of Mental Health had sharply curtailed funding for work in sleep treatment. Aleksandra Vicentic, the acting chief of the agency’s behavioral and integrative neuroscience research branch, said that in 2009 the funding strategy changed for sleep projects.

In an effort to illuminate the biology of sleep’s impact on behavior, the agency is now focusing on how sleep affects the functioning of neural circuits. But Dr. Vicentic added that the agency continued to fund clinical work like the depression trials.

Dr. Andrew Krystal, who is running the CBT-I study at Duke, called sleep “this huge, still unexplored frontier of psychiatry.”

“The body has complex circadian cycles, and mostly in psychiatry we’ve ignored them,” he said. “Our treatments are driven by convenience. We treat during the day and make little effort to find out what’s happening at night.”

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Sleep Apnea May Boost Risk of Sudden Cardiac Death

Sleep apnea raises the risk of sudden cardiac death, according to a long-term study that strengthens a link doctors have suspected.

“The presence and severity of sleep apnea are associated with a significantly increased risk of sudden cardiac death,” said study leader Dr. Apoor Gami, a cardiac electrophysiologist at Midwest Heart Specialists-Advocate Medical Group in Elmhurst, Ill.

The new research is published online June 11 in the Journal of the American College of Cardiology.

Sleep apnea — in which a person stops breathing frequently during sleep — affects about 12 million American adults, although many are not diagnosed. The diagnosis is made after sleep tests determine that a person stops breathing for 10 seconds or more at least five times hourly while sleeping.

Some research suggests that sleep apnea is on the rise, in part because of the current obesity epidemic.

Sudden cardiac death kills 450,000 people a year in the United States, according to study background information. It occurs when the heart unexpectedly and suddenly stops beating due to problems with the heart’s electrical system. Those problems cause irregular heartbeats. The condition must be treated within minutes if the person is to survive.

Electrophysiologists are cardiologists who treat these heart rhythm problems.

In earlier research, Gami and his team had found that patients with sleep apnea who suffered sudden cardiac death often did so at night, a completely opposite pattern than found in others without sleep apnea who had sudden cardiac death.

“That was the first direct link [found] between sudden cardiac death and sleep apnea,” Gami said.

In the new study, the researchers tracked more than 10,000 men and women, average age 53, who were referred for sleep studies at the Mayo Clinic Sleep Disorders Center, mostly due to suspected sleep apnea, from 1987 through 2003. After sleep tests, 78 percent were found to have sleep apnea.

During the follow-up of up to 15 years, they found that 142 had sudden cardiac arrest, either fatal or resuscitated.

Three measures strongly predicted the risk of sudden cardiac death, Gami said. These include being 60 or older, having 20 apnea episodes an hour or having low blood levels of oxygen.

This “oxygen saturation” drops when air doesn’t flow into the lungs. “If the lowest oxygen saturation was 78 percent, or less, their risk of [sudden cardiac death] increased by 80 percent,” Gami said. In a healthy person, 95 percent to 100 percent is normal.

Having 20 events an hour would be termed moderate sleep apnea, Gami said.

Gami found a link, not a cause-and-effect relationship, between sleep apnea and sudden cardiac death. He can’t explain the connection with certainty, but said there are several possible explanations. For example, sleep apnea is related to the type of heart rhythm problem that causes sudden cardiac death, he said.

The study findings should be taken seriously by those who have sleep apnea or suspect they do, said Dr. Neil Sanghvi, an electrophysiologist at Lenox Hill Hospital, in New York City, who reviewed the findings.

People with sleep apnea are often but not always obese, and many have other heart risk factors such as heart failure or heart disease. Having these other risk factors already puts a person at risk of sudden cardiac death, Sanghvi said. “The sleep apnea may be the tipping point. Each of these factors adds a level of risk. When you add sleep apnea, you could have a worse outcome.”

Anyone who suspects they have sleep apnea should ask their doctor about a sleep test, Sanghvi said. Daytime sleepiness and fatigue are frequent symptoms. Another tipoff is a bed partner who complains of snoring.

The study didn’t address whether those who used sleep apnea treatments — such as the CPAP machine (continuous positive airway pressure) prescribed during sleep to help breathing — would reduce risk. “It would be fair to say we suspect it would,” Gami said.

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Want a good night’s sleep? Quit smoking

As if cancer, heart disease and other diseases were not enough motivation to make quitting smoking your New Year’s resolution, here’s another wake-up call: New research published in the January 2014 issue of The FASEB Journal suggests that smoking disrupts the circadian clock function in both the lungs and the brain. Translation: Smoking ruins productive sleep, leading to cognitive dysfunction, mood disorders, depression and anxiety.

“This study has found a common pathway whereby cigarette smoke impacts both pulmonary and neurophysiological function. Further, the results suggest the possible therapeutic value of targeting this pathway with compounds that could improve both lung and brain functions in smokers,” said Irfan Rahman, Ph.D., a researcher involved in the work from the Department of Environmental Medicine at the University of Rochester Medical Center in Rochester, N.Y. “We envisage that our findings will be the basis for future developments in the treatment of those patients who are suffering with tobacco smoke-mediated injuries and diseases.

Rahman and colleagues found that tobacco smoke affects clock gene expression rhythms in the lung by producing parallel inflammation and depressed levels of brain locomotor activity. Short- and long- term smoking decreased a molecule known as SIRTUIN1 (SIRT1, an anti-aging molecule) and this reduction altered the level of the clock protein (BMAL1) in both lung and brain tissues in mice. A similar reduction was seen in lung tissue from human smokers and patients with chronic obstructive pulmonary disease (COPD). They made this discovery using two groups of mice which were placed in smoking chambers for short-term and long-term tobacco inhalation. One of the groups was exposed to clean air only and the other was exposed to different numbers of cigarettes during the day. Researchers monitored their daily activity patterns and found that these mice were considerably less active following smoke exposure.

Scientists then used mice deficient in SIRT1 and found that tobacco smoke caused a dramatic decline in activity but this effect was attenuated in mice that over expressed this protein or were treated with a small pharmacological activator of the anti-aging protein. Further results suggest that the clock protein, BMAL1, was regulated by SIRT1, and the decrease in SIRT1 damaged BMAL1, resulting in a disturbance in the sleep cycle/molecular clock in mice and human smokers. However, this defect was restored by a small molecule activator of SIRT1.

“If you only stick to one New Year’s resolution this year, make it quitting smoking,” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. “Only Santa Claus has a list longer than that of the ailments caused or worsened by smoking. If you like having a good night’s sleep, then that’s just another reason to never smoke.”