Hammocks make for deeper sleep

Babies aren't the only ones who benefit from gentle rocking. A new study suggests that when you lie down for some shut-eye, swaying in a hammock will help you fall asleep faster and make you sleep more deeply than napping on a stationary bed or couch.

Swiss researchers monitored the brain activity of 12 men during a 45-minute nap on a stationary bed and a nap of the same length on a gently rocking bed designed to simulate a hammock.

When they were in the "hammock," the men drifted off to sleep one minute faster, on average, and entered a deeper stage of sleep more than three minutes faster than when they napped in the still bed, the researchers found.

In addition, the researchers were surprised to discover that the men, while rocking, spent nearly five more minutes in that second stage of sleep (known as N2), which typically makes up about half of a normal night's rest. They also spent less time in the initial stage that serves as a transition between wakefulness and sleep.

Health.com: Seven tips for the best sleep ever

Although the study is small - even for brain-monitoring research - and the results will need to be confirmed in future experiments, the researchers say their findings could lead to novel treatments for insomnia and other sleep disorders.

"This (research) could be helpful in terms of patients who typically suffer from sleep-onset difficulty and sleep-maintenance difficulty," says Sophie Schwartz, Ph.D., one of the study's authors and a professor of neuroscience at the University of Geneva.

Health.com: Take a backyard vacation

Schwartz and her colleagues aren't certain why hammocks help put us to sleep. One explanation may be simply that people associate the gentle to-and-fro of a hammock with relaxation, leading them to drift off more easily.

But other brain processes may also be at work. Directly or indirectly, the rocking motion may activate regions of the brain that are involved in sleep, such as the amygdala. In fact, the authors say, rocking back and forth may actually "synchronize" brain waves in a way that promotes deeper sleep.

Health.com: Which sleep position is healthiest?

The researchers measured brain activity with electroencephalography (EEG), which uses electrodes placed on the scalp to gauge brain activity. When the men were rocking, the researchers found a higher concentration of "spindles" on their EEG readouts - the defining characteristic of N2 sleep - and evidence of more slow-wave brain activity, an indicator of deep sleep.

The effect of rocking on the brain may even play a role in brain functions besides sleep, such as memory and healing after brain damage, according to the researchers.

"Rocking during a nap or night of sleep might be good for other cognitive functions," Schwartz says.

Gupta: Becoming heart attack proof

Editor's note: Watch Dr. Sanjay Gupta Reports: The Last Heart Attack at 8p and 11p ET on Saturday, September 3rd.

While working on “The Last Heart Attack,” I had a chance to interview some extraordinary people around the country. Patients struggling with heart disease provided lessons that can sometimes be taught only after being smacked in the face with their own mortality. For example, I have never seen former President Clinton so candid. He was convinced he was going to die back in 2004, after feeling chest tightness during a flight back to New York on a small plane.

I interviewed cardiologists who believe we are so darn close to virtually eliminating heart disease. And, the truth is, it doesn’t involve spending any more money, investing in any more research or creating anymore tests. Rather, it will take a strict implementation of what we already know about diet and nutrition. It will also take brave champions to navigate through the clutter of confusing counsel, special interests and shoddy science.

One day, I had a chance to speak to a couple of those champions candidly while waiting for a shoot to begin - Dr. Caldwell Esselstyn and T. Colin Campbell, Ph.D. I had read Campbell’s book, "The China Study," years ago and remember how audacious he was in telling readers that most of what they believed about food and its relationship to health and disease was plain wrong. His findings changed the way people all over the world eat, including me.

And, I will admit, while I had trained my whole life to treat disease after it developed, I wasn’t medically trained in nutrition to be able to help prevent some of these diseases in the first place. Most of what I have learned has been on my own, since leaving medical school, and I think that is true for many doctors of my generation.

Simply put, Campbell’s research team found people who ate the most animal-based foods also had the most chronic disease. As important, people who ate the most plant-based foods were the healthiest. Campbell went on to describe the specific connections between nutrition and heart disease, diabetes and cancer. He also wrote of the ability to use nutrition to reverse these conditions – something that can start at almost any age.

Esselstyn took it a step further. “Sanjay, we want to make you heart attack proof.” Pretty audacious, I thought, but I couldn’t help but be engaged by this Cleveland Clinic surgeon, who was now devoting his life to preventing the diseases he made a living treating.“We are never going to end the epidemic of heart disease with stents, bypasses and medications,” he told me. That was music to my ears, because I didn’t want any of those things. Of course, it would involve essentially eliminating meat, dairy, eggs and oil – even olive oil. “Nothing with a mother, and nothing with a face,” the good doctor added.

Honestly, over the years, I have practiced the adage “eat to live,” not “live to eat.” Still, I knew it was going to be tough to carry out what he was asking. I started with a practical question for him. He was on the road traveling, and I was curious what he ate. “Thai food is always a good bet,” he told me. Sharon Kintz, who is a 66-year-old heart patient, joined me in Times Square to prove she could find a meal that satisfied her vegan requirements. Even former President Clinton says he is a vegan nowadays, and doesn’t at all miss the fast food for which he was once famous.

Virtually eliminating heart disease – it can be done, and truth is, we have known for a very long time how to do it. People have said to me as I was preparing this documentary – “Sanjay, you are advocating a radical change to the way we eat.” Perhaps, but if you really think about it, the way we eat now is in fact more radical. And when we look back on this time, a couple of hundred years from now, I guarantee you that our diet of today will be considered one of the most radical in history.

If we collectively ever want to get to the point where we have “The Last Heart Attack,” a good start would be to stop ignoring what we already know to be true.

Get Some Sleep: Are your kids night-time head-bangers?

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

We were supposed to be talking about Kathy’s insomnia, but, as is often the case, she was wanted to tell me about a loved one’s sleep problem, in this case, her grand-daughter’s.

“She is banging her head up and down every night, sometimes hitting the headboard. It is scaring her parents to death because, well, it is kind of creepy, and they are afraid that she has psychiatric problems, not to mention, they are worried she could hurt herself.”

She nailed every concern that parents have when a child displays rhythmic movements. Sleep-related rhythmic movements are very common; at nine months, research shows that 59% of all infants have rhythmic movement disorder (RMD); by 18 months, the prevalence is 33%; and by age 5, the prevalence has declined to 5%.

Technically speaking, we label these rhythmic movements as a disorder only if they: 1. Cause injury; 2. Interfere with sleep; 3. Result in significant impairment in daytime function. However, for simplicity’s sake, I will use the acronym, RMD to describe the whole phenomenon.

In most cases, RMD occurs, as stated above, in pre-school children who are neurologically normal. It is very unusual to have RMD present in adulthood, and when it does, there is serious concern for seizure disorder. Even in children who present at the classic age, we are careful to keep seizure in mind, and for that reason, an overnight polysomnogram (sleep test) is recommended.

The rhythmic movement usually occur at the transition from wake to sleep, but can continue into sleep. They can occur when children are drowsy. They involve stereotyped, repetitive movements that involve large muscle groups, for example, head banging, head rolling, rocking on hands and knees, body rolling, leg banging or rolling. One way to be sure that this is not seizure is to gently ask the child to stop doing it. In RMD, if the child is awake, she will be able to stop, whereas in seizure, she will not.

We do also see RMD in children who have autism or other developmental delay, but the difference is that they will do the movements while fully awake as well as while drowsy. For this subgroup of patients with RMD, the disorder often persists into later childhood and indeed adulthood.

Some research does show an increase in anxiety levels among children with RMD, but there is little evidence that serious psychiatric problems are a cause. Experts believe that these behaviors are likely a form of self-soothing or self-stimulation if there is a lack of it in the environment. Some studies suggest that for some children there might be an element of attention-getting behavior or passive aggression.

It can run in families, but the genetics have not been described. There seems to be no gender difference and so is just as likely to occur in boys as well as girls.

We diagnose it by clinical history and overnight sleep study. It is important that a sleep center know that there is a specific protocol that needs to be followed as well as specific scoring criteria.

The main reason we treat RMD is real or potential self-injury. It is usually the head banging that poses danger. Medications such as benzodiazepines or tricyclic antidepressants have been tried, but are not well studied, not approved for use in children, and should be considered a last-ditch therapeutic option.

A more creative approach to mitigate the danger of head banging is to have the child practice the movement in the daytime with the difference being that the “game” is to stop just short of the pillow or headboard. Often, the new learned behavior will persist into drowsiness and sleep. Another non-pharmacologic approach that shows promise is hypnosis.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

TV affects sleep of preschoolers

Watching violence on television or TV before bedtime can lead to sleep problems for preschoolers, according to a new study in the journal Pediatrics. Experts have known for some time that too much TV time can negatively impact our sleep, but this new research finds that what young children watch and when they watch it can make a difference as well.

The study looked at the television viewing habits and sleep problems of more than 600 preschoolers in Seattle, Washington. When children watched age appropriate TV in the morning or afternoon, they didn't have problems with their sleep, but when the shows contained violence, young people were more likely to experience nightmares and walk up feeling tired.

Part of the problem, researchers say, is that younger children are watching shows meant for older kids, and preschoolers can't yet distinguish fantasy from reality.

"For a 7- to 10-year-old they are really at a point where cognitively they can grasp that that's not real violence and they can see the humor in it – it's not frightening for them. But 3- to 5-year-olds just aren't developmentally there yet," explains study author Michelle Garrison, Ph.D., with the Seattle Children's Research Institute.

Garrison also found that watching television right before bedtime made it more difficult for children to get to sleep, meant more nightmares and waking up during the night, even if the shows were educational and geared specifically for young children.

"Screen time during the hour before bed can get kids more aroused and then they're going to have a harder time falling asleep," explains Garrison.

She suggests parents turn the TV off at least 60 minutes before kids get tucked in.

Shows that are meant for adults carry risks as well, she says, and she advises parents not to watch potentially violent programs such as the evening news when children are in the room.

"Even if they think the child isn't paying attention, the child is absorbing it and they'll see shootings and war footage and they really don't have the capacity to understand that that's not necessarily happening right there is their neighborhood right now," says Garrison.

Children who had televisions in their rooms tended to watch more than other children and saw more violent programming. When parents were asked about having a set in the bedroom, many said they thought it would help their child sleep, but this is not what the research shows.

"Sometimes parents will look at their child zoned out in front of the TV and think they are really relaxed. But often when kids get that glazed over, zoned out look they are actually over stimulated and not relaxed," explains Garrison.

The American Academy of Pediatrics recommends that preschoolers watch no more than two hours of television a day. High quality programming geared for this age group offers not only educational benefits, the Academy points out, but can help with building social skills as well.

"It can help children learn about cooperative problem solving, about how to negotiate things, help them learn empathy," says Garrison.

Experts offer these tips to help parents with their children's viewing habits. First of all, take the television out of the bedroom and watch TV with your child whenever you can.

"And watch what you watch; in other words, is that something that you think is appropriate for your child. You may want to watch the program first to see if it's ok for your child to watch or if it's too intense. And finally, don't be afraid to turn the TV off," says Pediatrician Don Shifrin, former Chair of the American Academy of Pediatrics' Committee on Communications

Another good source for families is Common Sense Media, according to Garrison. This website offers reviews on TV programs and movies, looking at the levels of violence, scary content and educational value.

Get Some Sleep: Why do we have REM?

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog


It seems that the public is just as fascinated with REM sleep. So are sleep physicians and researchers. But fascination often leads to confusion and controversy, and a lot of both surround the subject of REM sleep.

First, to give a brief history lesson, it is important to understand that REM, or rapid eye movement sleep, was discovered and described only in 1953, so it makes sense that there is still much to learn.

One key aspect of REM sleep is that all physical characteristics studied to date are different in REM when compared with non-REM. In fact, REM sleep more closely resembles the waking state. That is likely why people are more alert when they are awakened out of REM compared with other sleep stages.

REM sleep is when we do most of our dreaming, but not all, as researchers thought in the past. Most scientists agree that it is in REM that we have our most vivid, what I call, our magic-carpet-ride dreams, whereas the mundane kind of dreams can happen in non-REM.

Now, the question of why we dream is a whole other matter that deserves its own discussion. Suffice to say that there are many different theories at this time.

There is some debate as to whether all birds and mammals display REM sleep. Most do, so the important thing to remember is that it is not uniquely human.

Interestingly, the average daily amount of REM sleep for a given species appears strongly correlated with how immature the young are at birth. Animals that born in helpless state, such as the platypus and the armadillo, have high amounts of REM sleep at birth and indeed a high amount in maturity.

But the dolphin, which is born able to swim, feed and defend itself, has such little REM sleep that it has been questioned whether it has any at all. Humans fall somewhere in the middle in terms of amount of REM sleep, even though it strikes me that a human baby is pretty helpless for a long time.

REM sleep is present at birth in humans and it is the non-REM sleep stages that take 2-6 months to distinguish themselves. From 6 months until well into old age, REM sleep remains stable in healthy people and makes up 20-25% of the total sleep time.

REM occurs at the end of the 90-minute sleep cycles that characterize normal human sleep. The amount of REM increases as the night progresses and as one goes through repeated cycles so that although REM might only make up 10 minutes of the first cycle, it can last for 30 minutes during the last cycle.

As I stated earlier, the physiologic changes that occur during REM are closer to wake than to non-REM, with a couple of interesting exceptions. Mammals, including humans, can regulate their body temperature except in REM sleep.

During REM, we all turn into lizards and our body temperature drops or rises with the temperature of the surrounding environment.

The other unusual change is that in REM our large muscle groups are almost paralyzed. We think that this is protective mechanism so that when we are having those wild dreams about running away from the big bad wolf we can’t actually get up and start running in our sleep.

There is a disorder, called REM Behavior Disorder, where people lack this muscle weakness in REM and indeed they often hurt themselves or others.

So why do we have this unusual type of sleep? Briefly, today there are two main theories.

One is that we have sleep that resemble wake so that we can still get the benefits of sleep, but if we need to awaken quickly and be alert and ready to defend ourselves, then we can.

The other, and they are not mutually exclusive, is that because certain neurotransmitters, such as serotonin, histamine and norepinephrine are turned off during REM, then perhaps REM represents the down time that these important substances need in order to replenish themselves or reset their receptors.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

Get Some Sleep: Tips to combat the heat

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays
 (or this week, on Wednesday) on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

The recent heat wave across many parts of the country has been disturbing the sleep of many people who are not fortunate enough to have air conditioning.

This makes perfect sense because sleep is associated with a steady decline in our core body temperature. It should reach its lowest point approximately three hours before we wake.

Therefore, when we are overheated and this natural temperature drop is impeded, then sleep is disrupted.

There is research showing that melatonin has a direct effect on body temperature and that it reinforces the nocturnal decrease in the core body temperature thereby inducing sleep. Melatonin has shown mixed results as a sleeping agent in most studies, but it could be worth a try if you having trouble sleeping specifically because of the heat.

Before starting melatonin, young men and teens should always discuss its use with their physicians because there is some research showing decrease in testosterone as well as decrease in sperm count.

A bath or shower before also might help. It's not so much that hot water is relaxing as the fact that the cooling that takes place afterwards is conducive to sleep. So if your bedroom is like a sauna, it is best to try taking a cool shower before bed.

Another trick to aid sleep in these hot times is to get a small, tabletop water feature and keep it in your bedroom. It is true that the sound of running water makes people feel cooler. Of course, you can use a sound machine, but there is nothing like the real trickle.

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The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

Get Some Sleep: Avoid frequent leg cramping

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

It is frustrating, to both patients and doctors, that modern medical science often lacks understanding of or treatment for common, everyday ailments.

One such ailment, leg cramps, is very common and yet poorly understood. It often plagues people at night, and therefore “sleep-related leg cramps” is recognized as a bona fide sleep disorder by the International Classification of Sleep Disorders.

Most people have had a “charley horse” and know that leg cramps can be quite painful. Leg cramps result from the sudden, intense and involuntary contraction of a muscle or muscle group. They usually occur in the calf muscle or the small muscles of the feet.

If this happens once a year, few people think of this as a medical condition, but there are people who have leg cramps every night, sometimes several times a night. The cramps can prevent people from falling asleep or can awaken them many times during the night, and therefore leg cramps can lead to chronic sleep deprivation.

The painful sensation is usually relieved by strenuous stretching of the affected muscle. Often, people jump out of bed in their attempt to stop the searing pain. Both the prevalence and frequency increase as people age. There is research showing that approximately one-third of all people over the age of 60 and one-half of those over the age of 80 reported having sleep-related leg cramps once in the previous two months. Six percent of adults over the age of 60 have reported having leg cramps that disturb them every night.

Leg cramps are sometimes confused with restless legs syndrome (now known as Willis-Ekbom disease), but the two disorders are quite different, although patients can have both problems.

RLS is not commonly described as a sudden, intense pain. Also, people who suffer from RLS usually have a steady, uncomfortable feeling in the legs that lasts for hours, and this maddening feeling is only temporarily relieved for a few minutes while they move or rub their legs.

There are some medical conditions that seem to predispose people to leg cramps such as diabetes, peripheral vascular disease and neuromuscular disorders. Medications such as oral contraceptives have been associated with leg cramps. They occur in approximately 40% of pregnant women and usually resolve after birth.

If leg cramping is frequent and intense, people should not assume that they have benign, idiopathic (of unknown cause) leg cramps. It is advised to consult a physician in order to differentiate leg cramps from more serious medical conditions such as akathisia, myelopathy, peripheral neuropathy and disorders of calcium imbalance.

There are numerous theories about the cause of leg cramps but little evidence supporting the veracity of any given theory. One common notion is that they result from dehydration, but the little research done does not support this.

Also common is the idea that there is a relative electrolyte imbalance. Magnesium and potassium are popular culprits. Again, there is little research on this. One study attempted to treat leg cramps in a group of pregnant women and found that magnesium was no better than a placebo.

The same is true for potassium deficiency; there is no research showing that low potassium causes leg cramps or that taking extra potassium prevents them. That said, I have patients who swear that a banana before bed takes care of the leg cramping problem. I also know people who report that sitting in a bath of Epsom salts right before bed helps ward off nocturnal leg cramps.

I have patients who think that the leg cramps come upon them only when they exercise strenuously, and then there are those who associate the cramps with lack of exercise. The best theory is the “squatting hypothesis,” which speculates that leg cramping is associated with the modern habit of sitting on chairs and on the toilet instead of squatting as our forebears would have done.

I believe that is just another way of saying that leg cramps could be caused by a lack of strengthening and stretching of the calf and feet muscles.

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The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

Can melatonin prevent jet lag?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu.

'm about to travel to the other side of the world for a week and have to work the day after I get back. I've heard melatonin can help prevent jet lag when I return and would rather take that than medicine. What else can I do?

Expert answer:

Thanks for your question. Traveling across the world and turning your biological clock essentially upside down can definitely cause problems with sleep, both while you are away and when you return.

Melatonin is a hormone found in the body that is also available in synthetic form as a supplement that may help stimulate sleep. As with medications, there may be side effects when taking supplements.

Question asked by Ken from Palm Springs, California:

For melatonin, these can include nausea, headaches, dizziness, confusion and nightmares. Also, supplements may interact with any medications you may be taking. Before your trip, your doctor can advise whether melatonin is a good option for you and if so, the appropriate amount to take and when to take it (usually about an hour before the desired sleep time and either upon your return, during your trip, or both).

Some nonmedical options to try include staying hydrated, exercising or being active during the time you are supposed to be awake, and getting enough overall sleep before, during and after travel if possible.

Using eyeshades or room darkening curtains or blinds and a white noise machine may help you sleep better when you want to. Light therapy (such as from exposure to the sun or another bright light) may also help get you back on track.

Some people find that either increasing or avoiding certain foods (such as eating more protein to stay awake or more carbohydrates when trying to sleep) can help them recover more quickly from jet lag.

Readers, if you have any other tips, please feel free to comment below. Thanks!

Get Some Sleep: Bang in your head waking you? It has a name

 
 


Most of us have drifted off to sleep, only to awaken with a sudden start. This is a benign occurrence known
as a hypnic jerk.

There is a similar condition in which people awaken suddenly because they hear a loud noise in their head. They usually describe it as a loud bang or an explosion. In fact, this phenomenon is called exploding head syndrome.

Like hypnic jerks (or sleep starts), this is a completely benign condition. A hypnic jerk can accompany the clash of cymbals that people hear. Even though benign, it can be very disturbing to experience, and people often think that they are having a stroke.

It is certainly wise to seek medical attention the first time this occurs, especially if it is associated with a headache, because headaches are not a common feature of this disorder. In fact, to make the diagnosis, there should not be a significant pain component. Patients do sometimes report a flash of light occurring simultaneously with the loud bang.

If the headache is severe and persists, then indeed hemorrhagic stroke is a possibility and emergency services should be sought.

When patients bring this to a doctor’s attention, it is usually because it occurs frequently. Patients become concerned that even if the bomb in their head was not a stroke in the past, perhaps it is a symptom foretelling a stroke. There is no evidence that this is the case, even when the awakenings happen frequently.

It could be a sleep-related migraine (even without pain), and simple partial seizures can present with sensory symptoms. However, the symptom would usually not occur only at sleep onset or when awakening, as is the case with exploding head syndrome.

This can present at any age but is most common in people older than 50. Women report it more than men, but as is often the case, it may be that they are more likely than men to seek medical attention.

If many episodes occur in a night or if they are clustered in a time period of days or weeks, then patients can have disrupted sleep and insomnia. Usually, exploding head syndrome has a spontaneous remission. I know of no cases in the literature where this continued relentlessly, although there are reports of cyclical reoccurrence.

As with many medical problems, people report a worsening of attacks when they have an increase in stress or a decrease in sleep. There is a report that a medication used for seizures and migraines, topiramate, was useful in controlling this unpleasant symptom. Again, the first time this happens, it is important to receive a thorough medical evaluation just to be sure that other disorders are ruled out.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

Quiz: August is Immunization Awareness Month

This week's Health Quiz: Steve Jobs' health, premature babies, child window accidents, vaccines and more.

Semi-sweet news for chocolate lovers

 
Editor's note: Watch Dr. Sanjay Gupta Reports: The Last Heart Attack at 8p and 11p ET on Saturday, September 3rd.

If only everything that looked good, felt good, or tasted good was good for us too. It comes as more welcome news for chocolate lovers, then, that yet another study has linked chocolate consumption with improved heart health. Maybe.

Researchers at the University of Cambridge analyzed the results of seven existing studies and concluded that high levels of chocolate consumption might be associated with a notable reduction in the risk of developing heart disease. Five of the seven studies reported a beneficial link between higher levels of chocolate consumptions and the risk of cardiovascular events. They found that “the highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease and a 29% reduction in stroke, compared with the lowest levels [of consumption].”

The studies, notably, did not differentiate between dark or milk chocolate and included consumption of different types of chocolate (bars, shakes, etc.)

"The observations represent associations, not cause and effect," says Alice Lichtenstein, director and senior scientist at Tufts University's Cardiovascular Nutrition Laboratory. "The results of the evidence review provide support for conducting controlled intervention trials using well-defined preparations of chocolate before we can determine the actual effect of chocolate on heart disease risk."

By the year 2030, the World Health Organization estimates that nearly 23.6 million people will die from heart disease. In CNN Chief Medical Correspondent Dr. Sanjay Gupta’s documentary “The Last Heart Attack,” Dr. Caldwell B. Esselstyn, Jr. asserts that simply modifying one’s diet can make a person heart attack-proof in just one month. Should chocolate then be prescribed as part of this diet, which advocates the consumption of a plant-based food plan?

A number of recent studies have shown that eating chocolate has a positive impact on human health, thanks to its antioxidant and anti-inflammatory properties, namely reducing blood pressure and improving insulin sensitivity.

But here’s the caveat. Chocolate, as we all know, is full of calories, and eating too much of it could lead to weight gain, diabetes, or even heart disease – the very ailment some believe chocolate is working to prevent in the first place.

The authors of the study stress that further testing is needed to determine whether chocolate actually causes this reduction in heart problems, or if the health benefits are instead better explained by some other unmeasured factor.

"Were there compounds in cocoa that decrease heart risk," says Lichtenstein, "it will be important to identify them, isolate them, and determine the optimal dose and best route to administer them."

One thing is clear. Chocolate does far more for our bodies than activate our taste buds. Given its apparent health benefits, some resources might now be shifted to exploring the fat and sugar contents of chocolate, and how we might go about lowering them. This new “superfood” would be quite sweet indeed.

Study: Lipitor lowers more than cholesterol

Cholesterol-lowering medications like Lipitor seem to protect the body against more causes of death than just cardiovascular disease.

According to a retrospective study published Sunday in the European Heart Journal, the popular drug atorvastatin – sold by Pfizer under the name Lipitor – can also prevent death from infection and respiratory illness.

A clinical trial measuring the drug’s effectiveness ended in 2003 after having successfully shown to help prevent heart attacks and strokes.

Since then, the group taking atorvastatin has continued to experience “legacy effects” from that study – a 14% lower mortality rate compared to the group taking a placebo for the study.

“The result is very unexpected,” said Peter Sever, the study’s main author. “The benefits of statins for preventing heart attacks and strokes are well-established, but after long-term follow-up the most significant effects seem to be on deaths from other causes. It’s quite remarkable that there is still this difference between the two groups, eight years after the trial finished.”

The lower mortality rate in the atorvastatin group is due largely to a 36% reduction in deaths specifically from infection and respiratory illness, according to the study based on 4,605 participants in the United Kingdom.

Sever receives money from one or more pharmaceutical companies, including Pfizer.

According to the Wall Street Journal, Pfizer wants FDA approval to make Lipitor an over-the-counter medication, which could generate new sales after the company loses U.S. patent protection on the drug in November.

Retrospective studies like this one have their limits.

“It doesn’t sell me that 'Wow, this is now going to prevent infections,' it just doesn’t,” says Dr. Vincent Bufalino, a cardiologist and national spokesman for the American Heart Association.

“I think this is going to need some thought now. It raises a question and what it probably needs now is a go-forward randomized trial to say: is this true?”

Lack of deep sleep contributes to high blood pressure

Alack of deep sleep may be one of the reasons why people develop high blood pressure. A study of older men published Monday found that those who got the least amount of deep sleep were 80% more likely to develop high blood pressure, compared to those who got longer, less interrupted sleep.

Researchers studied almost 800 men over the age of 65 who didn't have hypertension when the study started. They were given at-home sleep tests that looked at their sleep patterns and measured their non-rapid eye movement sleep, also known as "slow wave sleep," or deep sleep. Researchers monitored the men's blood pressure changes for a little more than 3 years. Results were published in Hypertension, a journal of the American Heart Association.

Previous studies have shown that when people get less than 6 hours of sleep per night, it can increase the risk of high blood pressure. If people wake-up frequently, due to sleep apnea, medications, or other health issues and cannot fall back asleep quickly, this can also negatively affect blood pressure.

"Our study shows for the first time that poor quality sleep, reflected by reduced slow wave sleep, puts individuals at significantly increased risk of developing high blood pressure, and that this effect appears to be independent of the influence of breathing pauses during sleep," explains study author Dr. Susan Redline, Professor of Sleep Medicine at Brigham and Women's Hospital and Beth Israel Deaconess Medical Center at Harvard Medical School in Boston.

Experts often refer to slow wave sleep as the time when the body is restoring its energy reserves: Blood pressure goes down, breathing slows and the heart rate drops. People usually fall into deep sleep during the early part of the night.

Redline says this new research suggests that if your blood pressure doesn't drop sufficiently while you're sleeping, it may damage your blood vessels. Too little deep sleep may also cause parts of the brain that control the release of a number of hormones and other substances related to maintaining proper blood pressure to work less efficiently.

So how do you know if you're getting too little deep sleep? First of all, listen to your body and your family.

"If you don't sleep properly, are tired during the day, you snore or your wife or husband says you don't breathe [while asleep], get it checked out to see if you have a sleep problem," explains Dr. Donald LaVan, National Spokesman for the American Heart Association. One way to determine this is by entering a sleep study.

Redline says there are a number of things people can do to increase the likelihood of getting enough deep sleep. Ask your doctor if any of your medications can interfere with your sleep and if there are any alternative drugs you can take. Redline also says there's some evidence that being physically and mentally active may help.

High blood pressure has been called the silent killer and puts people at increase risk for heart disease and other illnesses.

When it comes to your blood pressure, "sleep quality is something to pay attention to," explains Redline, "just as one would pay attention to your diet and physical activity levels."

Get Some Sleep: Back-to-school bedtimes

It is that time of year again. It is starting to get dark earlier. In some parts of the country, there's a chill in the air at night. And the kids have to go back to school.
For many families, there are some rough days and maybe even weeks ahead as they help their children transition back to a schedule that requires them to get up earlier than they did in the summer.

School-aged children need between 10 and 12 hours of sleep a night. If kids have been going to bed at 10 or 11 p.m. in the summer, it is unlikely that they can suddenly fall asleep at 8 p.m. the night before school starts back. It is best to gradually readjust the bedtime one to two weeks before school starts so that the kids are going to bed 15 minutes earlier every couple of nights until the desired bedtime is reached.
If bedtime routines have fallen by the wayside, it is time to reintroduce them. I recommend that the hour before bed be a buffer zone between the hectic day and what we hope is a peaceful night. Homework should be completed by this time.

Although it can be hard to achieve these days, ideally there would be no use of electronics in that hour. And electronics, including cell phones, should be kept out of the kids’ bedrooms. This should be a time for hanging out as a family and then most routines end with bathing and reading.

It is important to keep lights low in that hour before bed. This allows melatonin to be released. It also prevents wake-promoting neurotransmitters from being triggered by the light. Light is the most powerful signal to which the brain responds to know when to be awake and when to be asleep. It is primarily because of our concerns about the wake-promoting properties of light that sleep doctors recommend no electronics near bedtime.

For the same reason, we recommend bright, preferably outdoor light first thing in the morning for one to two hours. Sitting by a bright window can be just as effective.

For many health reasons, it is important for children to have lots of physical activity to regularize their sleep/wake patterns. But again, there should be that downtime before bed. We recommend no strenuous exercise two to three hours before bed.

Remember that any habit you instill or encourage to help your child drift off to sleep should be something that she can do on her own when she awakens in the middle of the night. It is normal for a child to awaken for a few minutes several times during the night, but if the only way he can get back to sleep is to have you rub his back, that is a problem, at least for most parents who are trying to get their own quality sleep.

The start of a new school year is a good time to review your children’s use of caffeinated drinks, and don’t forget to include chocolate on the list. For myriad health reasons, soda should be avoided and certainly children should have none past lunchtime in order to avoid insomnia. Even if it is diet and decaffeinated, it is a bad habit to encourage. Cutting out soda is perhaps the single, easiest health decision that you can make for your kids and yourself.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

Medieval plague bacteria strain probably extinct

Modern outbreaks – swine flu, bird flu, SARS – have been scary and deadly, but they don't hold a candle to a plague called the Black Death. The disease killed an estimated one-third of Europe's population, perhaps 100 million people.

It's been a while, but scientists are now figuring out what caused the Black Death - at least, the one that swept through Europe from 1347 to 1351. They found evidence of the bacterium Yersinia pestis in the teeth of some of the medieval victims of the plague. Results are published in the Proceedings of the National Academy of Sciences.

Researchers screened more than 100 skeletal remains dating from 1348 to 1350 in the East Smithfield mass burial site, located in London, a place where plague victims were known to be buried.

They found a variation of Yersinia pestis that may no longer exist, as it has never been previously reported, study authors said. That suggests that this did not result from contamination from modern bacteria.

There had been some debate about whether there was some other explanation for the medieval plague, such as a different pathogen or bacteria.

The medieval plague is considered the second of three - the first was the Plague of Justinian in 541 A.D., and the third was noted in the 20th century; that disease represents about 2,000 cases per year, worldwide, on average.

A different form of Yersinia pestis is considered the cause of the plague that still exists today. As in the days of knights and castles, modern outbreaks of plague are associated with infected rats and rat fleas, according to the Centers of Disease Control and Prevention.

In the United States, plague cases in humans mostly occur in parts of New Mexico, Arizona, Colorado, California, Oregon and Nevada. Internationally, it can be found in Africa, Asia and South America. The plague can still be deadly without proper care, but antibiotics can fight it off.

Given that the World Health Organization has said that plague is a "reemerging infectious disease," further study of the spread of the older version may be worthwhile.

Could I have irritable bowel disease?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by BH from Milwaukee:

I am a 30-year-old male. I am having episodes of abdominal pain and bloody diarrhea. The doctor says she suspects ulcerative colitis or Crohn's disease and wants to do a colonoscopy. What are these diseases? What else could this be and is it appropriate to do a colonoscopy?

Expert answer:

Dear BH:

There are two major types of inflammatory bowel disease, or IBD: ulcerative colitis and Crohn's disease. It is estimated that inflammatory bowel disease affects about 500,000 Americans. Most IBD is diagnosed between ages 15 and 40 although some is diagnosed as late as age 80

The course of IBD typically consists of intermittent flare-ups of the disease alternating with sometimes long periods without symptoms.

Ulcerative colitis involves inflammation of a part of the colon and rectum. Patients can have episodes of abdominal pain, gaslike pains, bloody diarrhea, even fever during a flare, which can last for weeks or months. In its more severe form patients with UC can also have arthritis, liver problems (sclerosing cholangitis), certain skin rashes and eye problems (uveitis)

The abdominal complaints of mild ulcerative colitis are often confused with gluten allergy (celiac sprue). Other things that can be confused with IBD include amoebic, parasitic and bacterial bowel infections. Of these, Salmonella and Clostridium Difficile are most common. Salmonella can be caught from eating poorly stored or undercooked meats. Clostridium Difficile is a disease that is getting more common. It is caused by use of antibiotics. Most amoebic and parasitic infections are due to drinking contaminated water.

Crohn's disease is an inflammation that can occur anywhere in the GI tract from the mouth to the anus. When in the colon, symptoms can be similar to ulcerative colitis. Crohn's disease can cause fibrosis or scarring of the GI tract, leading to bowel obstruction or blockage, pain and fistulae. A fistula is a hole in the bowel through which bowel fluid and gas can leak. A fistula can track to other organs. Some patients with severe Crohn's can have a fistula track from the rectum to the bladder or rectum to vagina.

Crohn's disease can skip parts of bowel and a patient can have episodes of inflammation in several areas at one time. Most patients do have some small bowel involvement and about a third have disease only in the small bowel. This is often referred to as Crohn's ileitis.

Both diseases are most commonly diagnosed when a physician suspects the disease and a scoping procedure of the GI tract is performed with a fiber-optic scope. Upper endoscopy is done to investigate disease of the esophagus, stomach and small intestine. Colonoscopy is done to assess the colon, and on occasion, the distal ileum, which is the end of the small bowel. The physician can see areas of inflammation or scarring and may do a culture to diagnose infection as well as a biopsy of abnormal areas through the scope. A pathologist can confirm the diagnosis of Crohn's or ulcerative colitis with microscopic examination of the biopsy.

The causes of these diseases are unknown. Both are more common in Jews compared with non-Jews and in white Europeans compared with all other groups. The diseases do tend to run in families. In some studies, 10% to 25% of IBD patients have a first-degree relative with one of the diseases. It is not uncommon for a patient with Crohn's to have a relative with ulcerative colitis or vice versa.

For unknown reasons, there are higher rates of UC in developed countries versus developing countries. Rates are higher in the northern latitudes versus the equatorial climates.

No one knows the cause of the inflammatory bowel diseases. Older literature suggested there was a psychiatric component to these diseases. Today, it is known that stress or getting upset can cause an exacerbation of the disease, but a psychiatric illness is not believed associated with an underlying of the disease.

Interestingly, smoking appears to decrease the risk of UC and increase the risk of Crohn's disease.

While many have tried to link elements in diet as a cause of IBD, data are by no means definite. Most believe that a Western diet of processed, fried and sugary food does increase risk of IBD. It is possible that IBD is an immunologic response to foods. There is some speculation that hypersensitivity to cow's milk in infancy may cause IBD. This has been fueled by some studies to show that IBD patients were less likely to be breast fed as babies.

Patients with IBD are prone to malnutrition due to malabsorption. Children with the disease can have stunted growth.

Treatment includes attention to nutrition. There are medical therapies for the inflammatory bowel diseases and some patients with severe disease will have to have bowel resections. Patients with IBD, and especially ulcerative colitis, affecting the colon and rectum are at higher than normal risk of cancer of the colon or rectum. It is customary that UC patients get regular colonoscopy to detect malignancy. There are gastroenterologists who specialize in the treatment of this disease.

U.S. ranks low for newborn survival

Babies born in Cuba, Malaysia, Portugal, and the United Kingdom have a better chance of surviving the first month compared to those born in the United States, according to researchers at the World Health Organization and Save the Children.

In a 20 year analysis of newborn death rates around the world, the study published in PLoS Medicine revealed the number of infants who die before they are 4 weeks old account for 41% of child deaths worldwide. Newborn deaths in the United States ranked 41 out of 45 among industrialized countries, on par with Qatar and Croatia.