Sleep & Telomeres PDF

Sleep & Generativity Overcoming the ‘Sleep is Optional’ Error This ‘take home’ message is based on evidence that ‘we’ as a population are ‘not sleeping enough’ If not sleeping enough, personally, you may think you’ll just be affected in the ‘short term’. But evidence indicates you will be affected o...

Sleep & Generativity Overcoming the ‘Sleep is Optional’ Error This ‘take home’ message is based on evidence that ‘we’ as a population are ‘not sleeping enough’ If not sleeping enough, personally, you may think you’ll just be affected in the ‘short term’. But evidence indicates you will be affected over short term & long term We will investigate this in the science of sleep… And solutions to the ‘sleep as option’ error Matthew Walker, PhD - Researcher - Sleep Advocate Emphasis on Sleep & Brain function: Sleep prepares the brain for learning Sleep enables working memory retention Emphasis on Sleep & Cardiovascular health Every time-change (to daylight savings time each spring) is associated with a 24% increase in heart attacks Every time change (from daylight savings back to regular time in the fall) is associated with a 21% decrease in heart attacks Matthew Walker, PhD - Researcher & Sleep Advocate Emphasis on Sleep & Immune function: Sleep restrictions to 4 hours sleep/night are associated with 70% reduction in natural killer cell activity Sleep restrictions to 4 hours sleep/night increases inflammation World Health Organization classifies shift work (resulting in sleep deprivation) as a risk-increasing ‘carcinogen’ The History of Sleep Apnea is Associated with Shorter Leukocyte Telomere Length: the Helsinki Birth Cohort Study Savolainen et al. Sleep Medicine 15 (2014) 209–212 Why this study? - Well defined, diagnosed sleep disorder - sleep apnea Large ‘base’ population - n = 1948 individuals followed consistently for health status (Helsinki Birth Cohort) N = 44 selected for sleep apnea compared to N = 29 for snoring Hypothesis: Accelerated cellular aging is reflected in shorter Leukocyte Telomere Length (LTL) in people with medically documented hx. of sleep apnea. Results Accelerated cell aging (shorter LTL) in people with sleep apnea Measurement by real time quantitative polymerase chain reaction (PCR) Participant mean age = 61.5 years Shorter LTL (P =.01). Adjustment for multiple covariates didn’t alter association: Age, body mass index (BMI), cholesterol, triglycerides, glucose blood levels, uric acid, smoking, hypertension Apnea vs. Snoring Apnea vs. Controls Apnea vs Snoring + Controls P =.01 How to Improve Sleep? Ong et al., Mindfulness Meditation - Insomnia (2014) Design: 3 - arm RCT Population: n = 54 adults with chronic insomnia Interventions: Mindfulness-Based Stress Reduction vs. Mindfulness-Based Therapy for Insomnia (MBSR vs. MBTI) Measurement (self report): Total Wake Time (TWT); Pre-Sleep Arousal Scale (PSAS); Insomnia Severity Index (ISI) Measurement (objective/physiological) : Lab Polysomnography; Wrist Actigraphy Strengths of Study - 1 Population diagnosed with Chronic Insomnia 3 - way randomized allocation Self Monitoring (SM) (no intervention but self observation); Mindfulness Based Stress Reduction (MBSR); (generic mindfulness) Mindfulness Based Therapy for Insomnia (MBTI) Strengths of Study - 2 Self Report (n = 3 self report measures): Total Wake Time (TWT) from sleep diaries, Pre-Sleep Arousal Scale (PSAS), Insomnia Severity Index (ISI) Objective Measurement (n = 2 objective measures) Physical sleep measures based on polysomnography/actigraphy Long Term Follow-up (baseline to 6 months) (post-intervention, 3 mos. & 6 mos follow-up) SM Equal at 6 months MBTI is better MBTI is better Total Wake Time Total Wake Time: Comparison of the mean effects of the meditation arms vs SM revealed a significant interaction (P = 0.004) Both Meditation arms - significantly greater rates of TWT reduction compared to SM (between-group difference - Cohen’s d = 0.67) [Cohen’s d effect sizes - d = 0.2 (small), d = 0.5 (medium), d = 0.8 or above (large)] PSAS - Sleep-related arousal Meditation arms’ mean reduction > SM (Cohen’s d = 0.58) (P =.002) Post hoc comparisons: MBSR showed > reduction vs. SM (P < 0.01) MBTI showed > reduction vs. SM (P < 0.01). Long-term f/up: MBTI maintained a more stable reduction in PSAS (significant between-group difference, Cohen’s d = 0.75). Insomnia Severity Index 2 meditation arms vs. SM - significant interaction (P < 0.0001) Meditation arms > reduction vs. SM post intervention. Post hoc comparisons for intervention arms vs SM. MBSR had a mean reduction significantly > SM (P < 0.05). MBTI had a mean reduction significantly > SM (P < 0.01). MBTI had > reduction on ISI scores vs. MBSR at 6-mo follow-up. Remission %s Responder %’s - % who reached criteria for a minimally important treatment response What are the practical & theoretical ‘Take aways’? Health-Behaviour Cycles can be initiated & sustained Telomere extension is likely the final ‘link’ in ‘chain of healthy interactions’’ Use of multiple health-behaviour cycles - with 3 criteria 1. Do-able starting point - starts w/small changes that ‘everyone can do’ & builds to & reinforces larger changes 2. Activation of bodily wisdoms/resources resulting in gratifying outcomes 3. Scientifically verifiable; not solely placebo responses Health-Behaviour Cycles can be initiated & sustained Telomere extension is likely the final ‘link’ in a ‘chain of healthy interactions’’ Do-able starting point - small changes.. ‘everyone can do’.... ‘be aware of breathing sensations’ (in present moment)...meta-attention - abilities to direct & sustain attention (attentional control) - Activation of bodily wisdoms/resources resulting in gratifying outcomes...Relaxation effects lead to autonomic balance...it feels better to feel ‘more in control’... Attentional control can increase without increases in experienced tension ‘Calm Competence’ Scientifically verifiable; not solely placebo responses Follow the science... debate & convey the science ANS = Autonomic Nervous System Vagus Nerve Follow the yellow-highlighted structure