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September 12, 2011, 4:13 pm

Understanding a Child’s Nap Time

By TARA PARKER-POPE

In this week’s 18 and Under column, Dr. Perri Klass focuses on every parent’s favorite subject, the childhood nap. She writes:

What makes a child nap? Most parents cherish toddlers’ naps as moments of respite and recharging, for parent and child alike; we are all familiar with the increased crankiness that comes when a nap is unduly delayed or evaded. But napping behavior has been somewhat taken for granted, even by sleep scientists, and napping problems have often been treated by pediatricians as parents’ “limit-setting” problems.

Now, researchers are learning that it is not so simple: napping in children actually is a complex behavior, a mix of individual biology, including neurologic and hormonal development, cultural expectations and family dynamics.

To learn more, read the full column, “A Child’s Nap Is More Complicated Than It Looks,” and then please join the discussion below.

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September 7, 2011, 12:35 pm

Need Sleep? Stay Out of the Hospital

By THERESA BROWN, R.N.

During nursing school, I remember my first clinical instructor initiating us into one of the paradoxical truths of health care: “You don’t come to the hospital to sleep.”

Patients need to sleep — for emotional health, for wound healing, to maintain a strong immune system — and yet the drama of fractured and broken sleep plays out night after night in hospitals around the country.

Theresa BrownJeff Swensen for The New York Times Theresa Brown, R.N.

Recently, a patient was set to be discharged the next day. But he needed a transfusion of platelets before we could remove the intravenous line that had been used to deliver chemotherapy. Thinking through the timing, the physician assistant realized that to get everything done, and to get the patient discharged on time, his treatment would have to start early in the morning. She scheduled the transfusion for 4 a.m, which meant the patient had to be woken at 3:30 a.m. to take the medications required before a transfusion.

For practical reasons, it made sense. But the patient didn’t see it that way.

“Can’t it be later so that I can sleep?” he asked.

I started explaining why the transfusion had to be at 4 in the morning, but the patient wasn’t buying it. A kind and gentle man, he had had enough of being woken in the middle of the night. After several weeks in the hospital, he was tired. He wanted to sleep. Read more…

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August 31, 2011, 9:00 am

Lack of Deep Sleep Tied to Hypertension

By ANAHAD O'CONNOR

Men who get the least deep sleep each night have a higher risk of hypertension, new research shows.

Rahav Segev for The New York Times

Earlier studies have tied chronic sleep disorders and low levels of sleep to greater risks of heart disease and obesity, and even reduced life span. But the new study, published in the journal Hypertension, is one of the first to find that it’s not just how much you sleep, but the the quality of your nightly slumber that can affect your risk for high blood pressure.

The goal of the study, carried out by researchers at Harvard Medical School and elsewhere, was to look specifically at the slow-wave stages of sleep, which make up about 90 minutes to two hours of a normal night’s rest and represent the deepest hours of sleep. To study the effect of deep sleep on health, the scientists followed 784 healthy men who were part of an ongoing sleep study and did not have signs of high blood pressure at the start of the research. During the three-and-a-half year study, the men had their blood pressure checked at various times, and their levels of slow-wave sleep were monitored at home by a machine.

After controlling for a number of variables, the researchers found that the men who spent the least time in slow-wave or deep sleep were the most likely to develop high blood pressure. Although a night of normal sleep should consist of about 25 percent slow-wave sleep, the men in the study who were at highest risk for hypertension managed to enjoy deep sleep for no more than 4 percent of their total sleep each night. Read more…

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July 11, 2011, 1:51 pm

Really? The Claim: A Tennis Ball on the Back of Pajamas Can Cut Snoring

By ANAHAD O'CONNOR
Christoph Niemann

THE FACTS

For some people who snore, a slight tweak in sleeping position — lying on one side instead of the back — can lead to a better night’s rest. Yet staying put in that position, while wrapped in slumber, is not always an easy feat.

One of the oldest and simplest solutions involves a tennis ball, which is taped or sewn into the back of the pajamas to prevent a snorer from rolling onto his or her back at night. The technique is widely recommended by sleep experts, but studies have found it may not work for many chronic snorers.

In 2009 a team of researchers studied whether this trick could reduce snoring in 67 people with obstructive sleep apnea, which causes snoring and breathing interruptions throughout the night. The patients had an average of 30 breathing pauses per hour of sleep, which climbed to over 50 interruptions when they were on their backs, but was roughly 14 when they slept on their sides. They were taught to use the tennis ball technique, then followed for an average of over two years.

At the end of the study, which was published in The Journal of Clinical Sleep Medicine, the researchers found that most patients gave it up. Less than 10 percent still used the technique. Those who stopped said that it was ineffective or caused backaches, or that the ball moved around too much, among other problems.

For those in need of a more promising strategy, devices that provide continuous positive airway pressure, or C.P.A.P., help keep the airways open and are extremely effective. Some doctors also offer noninvasive treatments that tighten the throat tissue and improve breathing, taking the roar out of your snore.

THE BOTTOM LINE

Research shows that for many people, the tennis ball trick is not a very effective anti-snoring technique.

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June 2, 2011, 4:03 pm

The School Bully Is Sleepy

By TARA PARKER-POPE
Is the class bully simply in need of a nap?Is the class bully simply in need of a nap?

School bullies and children who are disruptive in class are twice as likely to show signs of sleep problems compared with well-behaved children, new research shows.

The findings, based on data collected from 341 Michigan elementary school children, suggests a novel approaching to solving school bullying. Currently, most efforts to curb bullying have focused on protecting victims as well as discipline and legal actions against the bullies. The new data suggests that the problem may be better addressed, at least in part, at the source, by paying attention to some of the unique health issues associated with aggressive behavior. Read more…

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May 23, 2011, 1:45 pm

How Much Do Your Children Sleep?

By TARA PARKER-POPE
Yvetta Fedorova

In this week’s Personal Health column, Jane Brody writes about the sleep needs of children and teenagers, finding that many young people are not getting nearly enough sleep.

Although young children are likely to arouse their groggy parents every morning, with no respect for weekends, after puberty the tables turn. Often I hear a familiar lament from parents of adolescents: Every day it’s a struggle to get the kids up and out to school on time.

Many youngsters and most teenagers do not get enough sleep, and this can result in serious consequences, impairing school performance and even raising the risk of depression and other mood disorders.

To learn more, read the full column, “Zombie Prevention: Your Child’s Sleep,” and then please join the discussion below.

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February 7, 2011, 5:22 pm

A Doctor’s Guide to the Sleepover

By TARA PARKER-POPE
Britt Erlanson/Getty Images

Sleepovers and slumber parties are now an intrinsic part of childhood, but a night away from home can create problems for both children and parents, writes Dr. Perri Klass, a pediatrician, in the “18 and Under” column.

Sleepovers raise a whole array of emotional issues for children and parents: separation, sleeping in a strange place, playing by another family’s rules. This is a case where you really have to know your own child, the other family, the whole situation — and the other family needs to know about your child, too.

Many children as young as 8 or 9 (or even younger) do fine with a good friend and a familiar family. But anxieties can loom at any age. The classic children’s book on the subject is “Ira Sleeps Over,” by Bernard Waber (Sandpiper, 1975), in which a boy worries about taking his beloved teddy bear to a sleepover while his older sister warns darkly that if he does he will be mocked.

“Clearly, kids who have some separation anxiety issues — it’s not a sleep disorder per se — may have some difficulty negotiating the sleepover experience,” said Dr. Judith Owens, a pediatrician who is director of sleep medicine at Children’s National Medical Center in Washington. “I certainly have had some kids come to our house who I ended up driving home at 10 at night.”

To hear more from Dr. Klass about the sleepover, read the full column, “Ensuring Domestic Tranquillity During Sleepovers,” and then please join the discussion below.

December 14, 2010, 9:39 am

Do Vitamins Interfere With Sleep?

By TARA PARKER-POPE
Christoph Niemann

Millions of Americans take a daily multivitamin, but anecdotal reports have suggested the pills may interfere with sleep. In today’s “Really?” column, Anahad O’Connor takes a look at the research.

In one study in 2007, researchers recruited hundreds of subjects and investigated their sleep habits — including looking at their use of vitamins and medications — then had them keep sleep diaries for two weeks.

After controlling for age, sex and other variables, the scientists found a slightly higher rate of poor or interrupted sleep in people taking multivitamins. But because they found only an association, they could not rule out the possibility that people with poorer sleep are simply more likely to seek out multivitamins.

To learn more, read the full report, “The Claim: Multivitamins Can Disrupt Users Sleep,” and then please join the discussion below.

December 10, 2010, 11:14 am

Searching for a Snoring Solution

By TARA PARKER-POPE
Dr. Elizabeth Walton at her home in Atlanta with an oral appliance she uses for sleep apnea.Tami Chappell for The New York Times Dr. Elizabeth Walton at her home in Atlanta with an oral appliance she uses to treat her sleep apnea.

Almost half of the adult population snores at least occasionally, and for many people snoring is a source of embarrassment or friction with a spouse. Finding a treatment can be frustrating and expensive, as explained in this week’s Patient Money column.

Dr. Elizabeth Walton, a 43-year-old internist in Atlanta and the mother of twin 4-year-old boys, has a common, if sometimes embarrassing, health problem. She snores — loudly. And she has tried to fix it with a variety of things, including a machine that blows air down her throat and an oral appliance that looks something like a mouthguard worn by a hockey player.

The appliance works, and Dr. Walton is finally sleeping more easily. (So is her partner.) And because she was diagnosed with obstructive sleep apnea, a more serious disorder than simple snoring, her treatments have been mostly covered by insurance. Still, she estimates she has spent hundreds of dollars in deductibles, co-payments and fees.

Dr. Walton would have preferred not to go through so much expensive trial and error: “Unfortunately, it’s the nature of this condition.”

To learn about the various options to treat snoring, read the full column, “Snoring? It’s Trial and Error Time,” and then please join the discussion below. Has snoring disrupted your life? Have you found a treatment that works?

August 9, 2010, 1:18 pm

Do Noises Wake You Up at Night?

By TARA PARKER-POPE
Sleep spindles Sleep spindles, shown here between the red lines, are a distinctive brain wave pattern that resembles yarn wrapped around a dowel and may influence whether noise interrupts your sleep.

Why can some people sleep through noises like a honking car or flushing toilet, while others are awakened by the lightest sound?

To find the answer, sleep researchers at Massachusetts General Hospital conducted an unusual study of 12 self-described deep sleepers. After tests confirmed that the healthy volunteers were solid sleepers, they took part in a three-night study in the university’s sleep laboratory. The participants spent the night in a luxurious and comfortable room reminiscent of a hotel suite with soft pillows and cozy sheets. But the room also included four speakers positioned near the top of the bed. Read more…

July 26, 2010, 5:24 pm

Should Nightmares Have Happy Endings?

By TARA PARKER-POPE
<strong/>THERAPY Computers track data at the Maimonides clinic in Albuquerque.Mark Holm for The New York Times THERAPY Computers track data at the Maimonides clinic in Albuquerque.

Therapy may help people who suffer from chronic nightmares learn how to turn bad dreams into good ones. But now some experts wonder if changing your nightmares from scary to safe is always a good idea, reports Sarah Kershaw in Science Times.

The technique, used while patients are awake, is called scripting or dream mastery and is part of imagery rehearsal therapy. The therapy is being used to treat a growing number of nightmare sufferers. In recent years, nightmares have increasingly been viewed as a distinct disorder, and researchers have produced a growing body of empirical evidence that this kind of cognitive therapy can help reduce their frequency and intensity, or even eliminate them.

The treatments are controversial. Some therapists, particularly Jungian analysts, take issue with changing nightmares’ content, arguing that dreams send crucial messages to the waking mind.

To learn more, read the full article, “Following a Script to Escape a Nightmare,” then please join the discussion below.

May 26, 2010, 12:01 am

Phys Ed: Does Exercise Help You Sleep Better?

By GRETCHEN REYNOLDS
Tim Klein/Getty Images

Most of us think that exercise improves sleep. But it may be that thinking that exercise improves sleep improves sleep. That, at any rate, is the provocative finding of a new study completed recently in Switzerland and published last month in the journal of the American College of Sports Medicine. Read more…

May 24, 2010, 3:11 pm

Throat Exercise for Sleep Apnea

By TARA PARKER-POPE
DESCRIPTION

In today’s “Really?” column, Anahad O’Connor explores an alternative treatment for sleep apnea — throat exercises.

While they aren’t as established or as well studied as breathing machines, some research suggests they may reduce the severity of sleep apnea by building up muscles around the airway, making them less likely to collapse at night.

To learn more, read the full story, “The Claim: Throat Exercises Can Relieve Sleep Apnea,” and then please join the discussion below. Have you used a machine or mouthpiece as a treatment for sleep apnea? Tell us about your experience.

April 26, 2010, 3:12 pm

Less Sleep Linked With More Eating

By TARA PARKER-POPE
DESCRIPTIONChristoph Niemann

People who sleep less appear to eat more the next day.

Scientists have known for years that less sleep is associated with weight gain. Now new research, reported in this week’s “Really?” column, may help explain why. In one study, men were asked to sleep either four or eight hours. When the men slept less, they ate roughly 22 percent additional calories the next day compared with nights when they got more sleep.

To learn more about the link between sleep and obesity, read the full column, “The Claim: Lack of Sleep Increases Weight,” and then please join the discussion below.

April 22, 2010, 1:25 pm

Learning While You Dream

By TARA PARKER-POPE
Kutay Tanir/Getty Images

Why do we dream? It’s a question dream analysts and sleep researchers have been studying for years. Now new research suggests that some dreams may actually result from the brain’s effort to keep learning, even as we sleep.

In a study led by researchers at Beth Israel Deaconess Medical Center in Boston, 99 volunteers trained for an hour on a virtual maze, trying to find their way through the complicated, three-dimensional puzzle as quickly as possible. Then half the volunteers were allowed to sleep for 90 minutes. The other half stayed awake, reading or relaxing. During the resting period, the subjects were interrupted or awakened and asked to describe their thoughts or dreams.

After the resting period, the participants were asked to again tackle the maze. Those who hadn’t napped showed no improvement or did even worse after the break. Nappers who were rested but didn’t report any maze-related dreams did better but showed only marginal improvement.

However, four nappers who reported dreaming about the maze showed a startling improvement, cutting their completion time in half. The difference in scores before and after sleeping was 10 times higher for the maze dreamers than those who hadn’t dreamed about the task, according to the findings published Thursday in the journal Current Biology.

Even though the number of dreamers was small, the researchers noted that the gap in learning between the dreamers and nondreamers was so wide that the finding was highly statistically significant.

Notably, the dreamers had all performed poorly on the test prior to dreaming about it. That suggests that struggling with a task might be the trigger that prompts the sleeping brain to focus on the subject and work on getting better, explained the lead author, Robert Stickgold, a cognitive neuroscientist at Harvard Medical School.

“It’s almost as if your brain is rummaging through everything that happened today and deciding that you’re not done with it,” Dr. Stickgold said. “The things that really grip you, the ones you decide at an emotional level are really important, those are the ones you dream about. The things you’re obsessed with are the ones that your brain forces you to continue to process.”

The study subjects who dreamed about the maze didn’t dream about trying to complete it over and over. Instead, they simply dreamed about it in a variety of ways. One person said he dreamed about the music that played along with the task. Another dreamed about seeing people along checkpoints in the maze and remembering a bat cave he had once toured. Another dreamed of searching for something in a maze. The lesson may be that dreams don’t necessarily have to make sense or be obvious to the awake mind in order to have a learning benefit.

“It might be that sleep is the time when the brain is tuned to find those types of association you wouldn’t notice during waking,” Dr. Stickgold said. “It does this by focusing on weak associations. If that’s the case, the dreams you have in REM sleep might be so bizarre for exactly the same reasons. It’s not that the dreams make no sense. They make wacky sense.”

More study is needed to fully understand the power of dreams in learning. The researchers are planning a new study that “spiffs up” the maze tests using colors and images in a way that most likely will trigger an increase in dreaming among the study participants.

Whether someone can ultimately harness the power of dreaming to improve learning is an open question, but Dr. Stickgold does have a suggestion for students or others trying to master a task or study subject.

“If you’re a student and you want to do better on the test, you might need to dream about it,” Dr. Stickgold said. “The question is, ‘How do I get myself to dream about it?’ The answer is to get excited about it. That seems to be what you dream about.”

October 7, 2011
Feeding Teenagers With Cookies and Bars

Teenagers always seem to be hungry, but they also always seem to be busy, with no time to eat. Martha Rose Shulman offers a solution in this week’s Recipes for Health: tasty and nutritious cookies and bars that busy teenagers can eat on the run.

September 23, 2011
Fall Cooking With Greens

Recipes for Health columnist Martha Rose Shulman offers entree ideas made with some of her favorite greens: Swiss chard, broccoli rabe, beet greens and bok choy, among others.

More From Eat Well »

October 6, 2011
Answering Questions About the P.S.A. Test

News that an influential panel of experts is advising healthy men not to be screened for prostate cancer with a widely used test is certain to cause confusion and anxiety among men and their doctors, and reignites a debate about the benefits and risks of screening tests.

September 24, 2011
Telling Men the Truth about Sex and Prostate Cancer

For years, men facing prostate cancer surgery have been reassured by their doctors, who could cite studies in prominent medical journals, that their sex lives would be just fine after treatment. The reality, men discover, is somewhat different.

More From Cancer »

October 6, 2011
‘So, Doc, How Much Time I Got?’

There are few situations more horrible than having to tell another human being that he or she is going to die. And it doesn’t get any easier with experience, writes Dr. Danielle Ofri.

October 5, 2011
A Hollywood Movie Takes on Cancer

A new movie, “50/50,” makes clear what every cancer patient already knows: Cancer may be life-changing, but it doesn’t necessarily change your life.

More From Doctors and Patients »

October 5, 2011
How Much to Drink During a Marathon

Marathon runners are drinking too much or too little — or just aren’t concerned about what they drink, which could have life-threatening consequences, two new studies show.

September 28, 2011
How Exercise Can Strengthen the Brain

For the first time scientists showed that, in mice at least, exercise spurs the development of mitochondria in brain cells and may make the brain more fit, similar to the way exercise makes muscles stronger.

More From Phys Ed »

October 5, 2011
How Much to Drink During a Marathon

Marathon runners are drinking too much or too little — or just aren’t concerned about what they drink, which could have life-threatening consequences, two new studies show.

October 4, 2011
Queen of the Football Field

In his 18 years at Pinckney Community High School, Jim Darga, the principal, said, the homecoming queen had always been crowned at halftime of the school’s football game. Never before, though, had she had to be summoned from the team’s locker room.

More From Fitness »

September 29, 2011
Questioning the Claims of Toning Sneakers

Those fancy Reebok sneakers that promise better legs and a better behind “with every step” may be just like every other sneaker.

September 14, 2011
Brazilian Hair Treatment Comes Under F.D.A. Fire

The agency has warned the maker of the popular Brazilian Blowout hair straightener that its product contains formaldehyde, a “poisonous or deleterious substance.”

More From Healthy Consumer »

September 28, 2011
Things Every Dog Should Know

What are the essential skills or commands every dog should know? Veteran dog trainers weigh in.

September 21, 2011
The Importance of Pet Tags

Research shows that 80 percent of pet owners believe it’s important that dogs and cats wear personal identification tags, but only one in three pet owners say their pets always wear them.

More From Well Pets »

September 26, 2011
Coffee Drinking Linked to Less Depression in Women

Women who regularly drink caffeinated coffee have a 20 percent lower risk of depression than nondrinkers.

September 13, 2011
Has Your Therapist Been to Therapy?

Lawyers have their own lawyers, doctors see their own doctors. Chefs eat meals made by other chefs. But when a therapist seeks therapy, some patients may view it as a weakness.

More From On Your Mind »

September 21, 2011
Suicide Draws Attention to Gay Bullying

Five months ago, a Buffalo junior high school student, Jamey Rodemeyer, created a video urging other gay teenagers to remain hopeful in the face of bullying. But for Jamey, the taunting didn’t stop.

September 20, 2011
Exercise Spurs Teenage Boys to Stop Smoking

Teenage boys who took part in a smoking cessation program and combined it with exercise were several times less likely to continue smoking than those who received only traditional anti-smoking advice.

More From Family Matters »

September 16, 2011
Love, Divorce and Alzheimer’s

Television evangelist Pat Robertson has sparked controversy with his suggestion that a man could divorce his wife with Alzheimer’s once she no longer recognized him.

August 22, 2011
A Validation for Bisexual Men

Two new studies document the unique patterns of arousal for bisexual men.

More From Love Well »

September 15, 2011
The Voices of Sjogren’s Syndrome

Most people probably never heard of Sjogren’s syndrome until Venus Williams announced she suffered from the condition. But an estimated four million Americans have Sjogren’s, making it one of the most prevalent autoimmune disorders.

September 2, 2011
Venus Williams Brings Attention to Sjogren’s Syndrome

Tennis star Venus Williams’s announcement that she is suffering from Sjorgen’s syndrome called new attention to a little known autoimmune disorder.

More From Patient Voices »

August 22, 2011
Really? The Claim: Drinking Green Tea Can Help Lower Cholesterol

Researchers found that subjects who drank more green tea had a slight drop in levels of LDL cholesterol.

May 10, 2011
Lowering Stress Improves Fertility Treatment

Women undergoing certain infertility treatments are more likely to get pregnant if they take part in a simultaneous stress reduction program, new research shows.

More From Alternative Medicine »

August 17, 2011
Asthma More Likely Among Children of Overweight Mothers

Teenagers whose mothers had been overweight or obese just before they became pregnant were 20 to 30 percent more likely to have asthma or a history of wheezing.

July 11, 2011
When Fatty Feasts Are Driven by Automatic Pilot

Recent findings add complexity to the obesity debate, suggesting that certain foods set off powerful chemical reactions in the body and the brain.

More From Weigh In »

June 16, 2011
For Children on Medicaid, the Doctor Is Out

Children with Medicaid are more likely to be turned away by medical specialists compared to those with private insurance, a new study finds.

April 15, 2011
Hypnosis as a Health Option

Today’s Patient Money column looks into the costs and potential benefits of hypnosis for dealing with anxiety, pain management and other health issues.

More From Patient Money »

June 16, 2011
For Children on Medicaid, the Doctor Is Out

Children with Medicaid are more likely to be turned away by medical specialists compared to those with private insurance, a new study finds.

April 15, 2011
Hypnosis as a Health Option

Today’s Patient Money column looks into the costs and potential benefits of hypnosis for dealing with anxiety, pain management and other health issues.

More From Patient Money »

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A special issue of Science Times looks at the explosion of information about health and medicine and offers some guidelines on how to sort it all out

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Small Steps: A Good Health Guide

Trying to raise a healthy child can feel overwhelming, but it doesn’t have to be.

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A Guided Tour of Your Body

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About Well

Tara Parker-Pope on HealthHealthy living doesn’t happen at the doctor’s office. The road to better health is paved with the small decisions we make every day. It’s about the choices we make when we buy groceries, drive our cars and hang out with our kids. Join columnist Tara Parker-Pope as she sifts through medical research and expert opinions for practical advice to help readers take control of their health and live well every day. You can reach Ms. Parker-Pope at well@nytimes.com.

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