A quarter of problematic pot users have anxiety disorders, many since childhood

Regional data also suggest some teens who abuse pot outgrow habit in adulthood

October 24, 2017

Science Daily/Duke University Medical Center

About a quarter of adults whose marijuana use is problematic in early adulthood have anxiety disorders in childhood and late adolescence, according to new data.

The findings, publishing this week in the November issue of the Journal of the American Academy of Child and Adolescent Psychiatry, also shed light on an estimated 4 percent of adults who endured childhood maltreatment and peer bullying without resorting to chronic marijuana abuse, only to develop problems with the drug between the ages of 26 and 30.

"Given that more states may be moving towards legalization of cannabis for medicinal and recreational purposes, this study raises attention about what we anticipate will be the fastest growing demographic of users -- adults," said lead author Sherika Hill, Ph.D., an adjunct faculty associate at the Duke University School of Medicine. "A lot of current interventions and policies in the U.S. are aimed at early adolescent users. We have to start thinking about how we are going to address problematic use that may arise in a growing population of older users."

The findings are based on data from 1,229 participants in the Great Smoky Mountains Study, a long-term study of residents in 11 counties near the Appalachian Mountains in western North Carolina, where Hispanics and Latinos are underrepresented and Native Americans are overrepresented compared to the rest of the U.S.

A cohort of children in the study were enrolled as young as age 9 and have now reached their 30s. From 1993 to 2015, researchers tracked data in numerous areas of interest, including mental health, education, work attainment, and use of drugs and alcohol.

The researchers defined problematic cannabis or marijuana use as daily consumption or a habit that meets diagnostic guidelines for addiction. They tracked participants' patterns of use from the college years (ages 19-21) into adulthood (ages 26-30).

They found more than three-fourths (76.3 percent) of participants didn't use or develop a problem with marijuana during this period.

The remaining quarter developed problems that researchers grouped into three profiles -- those with limited problems, persistent problems and delayed problems.

Limited users (13 percent)

·      Limited problematic users had trouble with marijuana either while in school before age 16 or in their late teens and early 20s, but their habits dropped off as they aged.

·      Researchers were somewhat surprised that this group reported the highest levels of family conflict and instability during childhood as compared to others in the study; these factors are often associated with more drug use.

·      "When this group of children left home, they seemed to do better," Hill said. "They didn't have as many children at a young age, and they went further in their education when they were 19 to 21 compared to those with persistent and delayed profiles."

Persistent users (7 percent)

·      This group had trouble with marijuana beginning as young as 9 years old and their chronic use continued into their late 20s and early 30s, the data showed.

·      Large portions of this group had anxiety disorders in both childhood (27 percent) and at ages 19-21 (23 percent).

·      They had the highest rates of psychiatric disorders and involvement in the criminal justice system, and most said the majority of their friends were drug users, too.

·      "This suggests that a focus on mental health and well-being could go a long way to prevent the most problematic use," Hill said.

Delayed users (4 percent)

·      This was a small but unique group that made it through adolescence and early adulthood without problematic marijuana use, only to become habitual users between ages 26 and 30.

·      Blacks were five times as likely as whites to be delayed problematic users in the late 20s and early 30s after not having trouble with the between the ages 19-21 -- a peak time for most marijuana users.

·      More than half of delayed users were both bullied by peers and mistreated by caregivers as children, yet also had lower rates of anxiety, alcohol use, and other hard drug use compared to persistent users.

·      "What we don't yet understand is how childhood maltreatment didn't prompt earlier problematic use of cannabis between ages 19 and 21 -- how individuals could be resilient to that kind of adverse experience for so long," Hill said. "One theory is that they were somewhat protected by having fewer peers in late adolescence who were substance users, but this is one of the questions we will continue to seek answers for."

https://www.sciencedaily.com/releases/2017/10/171024141720.htm

Depression strongly linked to higher long-term risk of early death for both women, men

Science Daily/October 23, 2017

Canadian Medical Association Journal

Despite increased awareness about mental illness, depression remains strongly linked to a higher risk of early death -- and this risk has increased for women in recent years -- according to results from the 60-year Stirling County Study.

"There is less stigma associated with depression, better treatments are available, but depression's link to mortality still persists," said Dr. Stephen Gilman of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, part of the National Institutes of Health in Bethesda, Maryland. "At first, the association was limited to men, but in later years it was seen for women as well."

The Stirling County Study, begun in 1952 in Atlantic Canada, is well-known internationally as one of the first community-based studies on mental illness. A researcher from the original study, Dr. Jane Murphy with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, is a coauthor on this latest research study.

An international team of researchers looked at 60 years of mental health data on 3410 adults during 3 periods (1952-1967, 1968-1990 and 1991-2011) from a region in Atlantic Canada and linked the data to deaths in the Canadian Mortality Database. They found that the link between depression and an increased risk of death was observed in all decades of the study among men, whereas it emerged among women beginning in the 1990s. The risk of death associated with depression appeared strongest in the years following a depressive episode, leading the authors to speculate that this risk could be reversed by achieving remission of depression.

The mean age of participants at enrolment in the study was about 49 years. "The lifespan for young adults with depression at age 25 was markedly shorter over the 60-year period, ranging from 10 to 12 fewer years of life in the first group, 4 to 7 years in the second group and 7 to 18 fewer years of life in the 1992 group," says Dr. Ian Colman, Canada Research Chair in the School of Epidemiology, University of Ottawa, Ottawa, Ontario. "Most disturbing is the 50% increase in the risk of death for women with depression between 1992 and 2011."

Though depression has also been linked with poorer diet, lack of exercise, smoking and alcohol consumption -- all factors that can result in chronic health conditions -- these did not explain the increased risk of death associated with depression in this study.

Societal change may help explain the emergent risk of death for women with depression.

"During the last 20 years of the study in which women's risk of death increased significantly, roles have changed dramatically both at home and in the workplace, and many women shoulder multiple responsibilities and expectations," says Dr. Colman.

The authors suggest that family physicians should monitor patients for mood disturbances, especially recurrent episodes of depression, so that they may offer treatment and support.

Limitations include a long interval between participant interviews which prevented determining the exact timing of depression and the participants' experiences of recurrent episodes of depression between interviews.

https://www.sciencedaily.com/releases/2017/10/171023094625.htm

Want to control your dreams? Here's how you can

October 19, 2017

Science Daily/University of Adelaide

New research has found that a specific combination of techniques will increase people's chances of having lucid dreams, in which the dreamer is aware they're dreaming while it's still happening and can control the experience.

Although many techniques exist for inducing lucid dreams, previous studies have reported low success rates, preventing researchers from being able to study the potential benefits and applications of lucid dreaming.

Dr Denholm Aspy's research in the University of Adelaide's School of Psychology is aimed at addressing this problem and developing more effective lucid dream induction techniques.

The results from his studies, now published in the journal Dreaming, have confirmed that people can increase their chances of having a lucid dream.

The study involved three groups of participants, and investigated the effectiveness of three different lucid dream induction techniques:

1. reality testing -- which involves checking your environment several times a day to see whether or not you're dreaming.

2. wake back to bed -- waking up after five hours, staying awake for a short period, then going back to sleep in order to enter a REM sleep period, in which dreams are more likely to occur.

3. MILD (mnemonic induction of lucid dreams) -- which involves waking up after five hours of sleep and then developing the intention to remember that you are dreaming before returning to sleep, by repeating the phrase: "The next time I'm dreaming, I will remember that I'm dreaming." You also imagine yourself in a lucid dream.

Among the group of 47 people who combined all three techniques, participants achieved a 17% success rate in having lucid dreams over the period of just one week -- significantly higher compared to a baseline week where they didn't practise any techniques. Among those who were able to go to sleep within the first five minutes of completing the MILD technique, the success rate of lucid dreaming was much higher, at almost 46% of attempts.

"The MILD technique works on what we call 'prospective memory' -- that is, your ability to remember to do things in the future. By repeating a phrase that you will remember you're dreaming, it forms an intention in your mind that you will, in fact, remember that you are dreaming, leading to a lucid dream," says Dr Aspy, Visiting Research Fellow in the University's School of Psychology.

"Importantly, those who reported success using the MILD technique were significantly less sleep deprived the next day, indicating that lucid dreaming did not have any negative effect on sleep quality," he says.

"These results take us one step closer to developing highly effective lucid dream induction techniques that will allow us to study the many potential benefits of lucid dreaming, such as treatment for nightmares and improvement of physical skills and abilities through rehearsal in the lucid dream environment," Dr Aspy says.

https://www.sciencedaily.com/releases/2017/10/171019100812.htm

Life in the city: Living near a forest keeps your amygdala healthier

MRI study analyzes stress-processing brain regions in older city dwellers

October 18, 2017

Science Daily/Max-Planck-Gesellschaft

A new study examined the relationship between the availability of nature near city dwellers' homes and their brain health. Its findings are relevant for urban planners among others.

Noise, pollution, and many people in a confined space: Life in a city can cause chronic stress. City dwellers are at a higher risk of psychiatric illnesses such as depression, anxiety disorders, and schizophrenia than country dwellers. Comparisons show higher activity levels in city dwellers' than in country dwellers' amygdala -- a central nucleus in the brain that plays an important role in stress processing and reactions to danger. Which factors can have a protective influence? A research team led by psychologist Simone Kühn has examined which effects nature near people's homes such as forest, urban green, or wasteland has on stress-processing brain regions such as the amygdala. "Research on brain plasticity supports the assumption that the environment can shape brain structure and function. That is why we are interested in the environmental conditions that may have positive effects on brain development. Studies of people in the countryside have already shown that living close to nature is good for their mental health and well-being. We therefore decided to examine city dwellers," explains first author Simone Kühn, who led the study at the Max Planck Institute for Human Development and now works at the University Medical Center Hamburg-Eppendorf (UKE).

Indeed, the researchers found a relationship between place of residence and brain health: those city dwellers living close to a forest were more likely to show indications of a physiologically healthy amygdala structure und were therefore presumably better able to cope with stress. This effect remained stable when differences in educational qualifications and income levels were controlled for. However, it was not possible to find an association between the examined brain regions and urban green, water, or wasteland. With these data, it is not possible to distinguish whether living close to a forest really has positive effects on the amygdala or whether people with a healthier amygdala might be more likely to select residential areas close to a forest. Based on present knowledge, however, the researchers regard the first explanation as more probable. Further longitudinal studies are necessary to accumulate evidence.

The participants in the present study are from the Berlin Aging Study II (BASE-II) -- a larger longitudinal study examining the physical, psychological, and social conditions for healthy aging. In total, 341 adults aged 61 to 82 years took part in the present study. Apart from carrying out memory and reasoning tests, the structure of stress-processing brain regions, especially the amygdala, was assessed using magnetic resonance imaging (MRI). In order to examine the influence of nature close to peoples' homes on these brain regions, the researchers combined the MRI data with geoinformation about the participants' places of residence. This information stemmed from the European Environment Agency's Urban Atlas, which provides an overview of urban land use in Europe.

"Our study investigates the connection between urban planning features and brain health for the first time," says co-author Ulman Lindenberger, Director of the Center for Lifespan Psychology at the Max Planck Institute for Human Development. By 2050, almost 70 percent of the world population is expected to be living in cities. These results could therefore be very important for urban planning. In the near future, however, the observed association between the brain and closeness to forests would need to be confirmed in further studies and other cities, stated Ulman Lindenberger.

https://www.sciencedaily.com/releases/2017/10/171018113515.htm

Importance of studying sleep and eating in tandem

October 13, 2017

Science Daily/Scripps Research Institute

A new study from scientists on the Florida campus of The Scripps Research Institute (TSRI) offers important insights into possible links between sleep and hunger -- and the benefits of studying the two in tandem. A related paper from the same lab is providing researchers an accessible tool for pursuing further investigations involving multiple fruit fly behaviors.

While many humans enjoy a daily caffeine fix, scientists have found that caffeine repels Drosophila melanogaster -- a species of fruit fly often used as a model for studying human conditions and genetics. Scientists believe that plants produce the caffeine molecule as a defense mechanism to prevent organisms such as fruit flies from eating them. Regardless of the cause of the fly's aversion, caffeine does seem to negatively impact their sleep, much like it does in humans.

Caffeine is known to stave off sleep in humans through pharmacological effects on the adenosine receptor. Nonetheless, many studies in mammals have shown genetic differences in responses to caffeine. Interestingly, caffeine apparently can prevent sleep in fruit flies despite the fact that it doesn't act through their adenosine receptor.

Erin Keebaugh, Ph.D., a postdoctoral researcher in Associate Professor William Ja's Laboratory at TSRI, suspected that the systems responsible for caffeine's impact on fly (and maybe human) sleep patterns are more complex than a single caffeine and receptor interaction.

In her study, published in the journal Sleep on October 3, 2017, her team gave groups of flies varying levels of dietary caffeine. They then measured how much the flies slept in the following 24 hours while on those diets. They also studied whether varying levels of caffeine impacted the insects' feeding behavior by measuring how much they ate over the same 24-hour period.

Interestingly, the team found that sleep loss couldn't be explained by caffeine intake alone. Instead, they believe that the sleep loss was mediated by changes in the animal's feeding behavior. "There could still be a pharmacological effect, but there's definitely dietary inputs to that," said Keebaugh.

The study reinforced the idea that the processes of sleep and eating need to be studied together, explained the scientists, especially as a growing number of researchers investigate the relationship between sleep and metabolic disorders. Further studies into this relationship could lead to the development of therapies that treat disorders such as obesity and diabetes.

A Closer Look at Fly Behavior

To that end, another member of the Ja Laboratory, Graduate Student Keith Murphy, has developed a new open-source, customizable technique for jointly studying multiple fly behaviors. Many studies designed to understand the interactions between multiple fly behaviors require researchers to measure each behavior separately; for example, one study measures how much the flies eat while a second study measures how much they sleep, and then the data are combined and compared. With Murphy's device, the Activity Recording CAFE (ARC), researchers could measure both behaviors simultaneously, giving the researchers a cleaner, simpler strategy to investigate previously convoluted questions.

Using the ARC protocol, as described in a paper recently published in Nature Protocols, anyone with access to a 3D printer can print the chamber and set it up in two hours or less to collect fly data. The chamber is hooked up to a computer that continuously tracks both the amount of food that a fly consumes and its position in the chamber, which can tell a researcher whether or not it's sleeping.

Though the protocol is specifically designed for studying sleep and feeding behaviors, Murphy emphasized that the ARC could be customized to study a variety of behaviors in flies. Researchers could program the machine vision program on the computer to apply optogenetic controls tied to certain behaviors, deliver vibrations or cause the fly's food to move to assess memory, motivation and other behaviors.

"We're hoping that this paper creates a community around the tool and people come up with new uses," said Murphy. "If others get on board, this thing could change what a small lab can do."

https://www.sciencedaily.com/releases/2017/10/171013132234.htm

'Magic mushrooms' may 'reset' the brains of depressed patients

October 13, 2017

Science Daily/Imperial College London

Patients taking psilocybin to treat depression show reduced symptoms weeks after treatment following a 'reset' of their brain activity.

The findings come from a study in which researchers from Imperial College London used psilocybin -- the psychoactive compound that occurs naturally in magic mushrooms -- to treat a small number of patients with depression in whom conventional treatment had failed.

In a paper, published today in the journal Scientific Reports, the researchers describe patient-reported benefits lasting up to five weeks after treatment, and believe the psychedelic compound may effectively reset the activity of key brain circuits known to play a role in depression.

Comparison of images of patients' brains before and one day after they received the drug treatment revealed changes in brain activity that were associated with marked and lasting reductions in depressive symptoms.

The authors note that while the initial results of the experimental therapy are exciting, they are limited by the small sample size as well as the absence of a control group -- such as a placebo group -- to directly contrast with the patients.

Dr Robin Carhart-Harris, Head of Psychedelic Research at Imperial, who led the study, said: "We have shown for the first time clear changes in brain activity in depressed people treated with psilocybin after failing to respond to conventional treatments.

"Several of our patients described feeling 'reset' after the treatment and often used computer analogies. For example, one said he felt like his brain had been 'defragged' like a computer hard drive, and another said he felt 'rebooted'. Psilocybin may be giving these individuals the temporary 'kick start' they need to break out of their depressive states and these imaging results do tentatively support a 'reset' analogy. Similar brain effects to these have been seen with electroconvulsive therapy."

Over the last decade or so, a number of clinical trials have been conducted into the safety and effectiveness of psychedelics in patients with conditions such as depression and addictions, yielding promising results.

In the recent Imperial trial, the first with psilocybin in depression, 20 patients with treatment-resistant form of the disorder were given two doses of psilocybin (10 mg and 25 mg), with the second dose a week after the first.

Nineteen of these underwent initial brain imaging and then a second scan one day after the high dose treatment. Carhart-Harris and team used two main brain imaging methods to measure changes in blood flow and the crosstalk between brain regions, with patients reporting their depressive symptoms through completing clinical questionnaires.

Immediately following treatment with psilocybin, patients reported a decrease in depressive symptoms -- corresponding with anecdotal reports of an 'after-glow' effect characterised by improvements in mood and stress relief.

Functional MRI imaging revealed reduced blood flow in areas of the brain, including the amygdala, a small, almond-shaped region of the brain known to be involved in processing emotional responses, stress and fear. They also found increased stability in another brain network, previously linked to psilocybin's immediate effects as well as to depression itself.

These findings provide a new window into what happens in the brains of people after they have 'come down' from a psychedelic, where an initial disintegration of brain networks during the drug 'trip', is followed by a re-integration afterwards.

Dr Carhart-Harris explained: "Through collecting these imaging data we have been able to provide a window into the after effects of psilocybin treatment in the brains of patients with chronic depression. Based on what we know from various brain imaging studies with psychedelics, as well as taking heed of what people say about their experiences, it may be that psychedelics do indeed 'reset' the brain networks associated with depression, effectively enabling them to be lifted from the depressed state.

The authors warn that while the initial findings are encouraging, the research is at an early stage and that patients with depression should not attempt to self-medicate, as the team provided a special therapeutic context for the drug experience and things may go awry if the extensive psychological component of the treatment is neglected. They add that future studies will include more robust designs and currently plan to test psilocybin against a leading antidepressant in a trial set to start early next year.

Professor David Nutt, Edmond J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit in the Division of Brain Sciences, and senior author of the paper, added: "Larger studies are needed to see if this positive effect can be reproduced in more patients. But these initial findings are exciting and provide another treatment avenue to explore."

https://www.sciencedaily.com/releases/2017/10/171013091018.htm

Bright light therapy at midday helped patients with bipolar depression

Six weeks of light therapy decreased depression, increased daily functioning in patients

October 10, 2017

Science Daily/Northwestern University

Daily exposure to bright white light at midday significantly decreased symptoms of depression and increased functioning in people with bipolar disorder, a recent study found. More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received a dim placebo light.

Previous studies found morning bright light therapy reduced symptoms of depression in patients with Seasonal Affective Disorder (SAD.). But patients with bipolar disorder can experience side effects such as mania or mixed symptoms from this type of depression treatment. This study implemented a novel midday light therapy intervention in an effort to provide relief for bipolar depression and avoid those side effects.

Compared to dim placebo light, study particpants assigned to bright white light between noon and 2:30 p.m. for six weeks experienced a significantly higher remission rate (minimal depression and return to normal functioning). More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received the placebo light.

The group receiving bright light therapy also had a much lower average depression score of 9.2 compared to 14.9 for the placebo group and significantly higher functioning, meaning they could go back to work or complete tasks around the house they hadn't been able to finish prior to treatment.

The study was published Oct. 3 in the American Journal of Psychiatry.

"Effective treatments for bipolar depression are very limited," said lead author Dr. Dorothy Sit, associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. "This gives us a new treatment option for bipolar patients that we know gets us a robust response within four to six weeks."

Patients also experienced minimal side effects from the therapy. No one experienced mania or hypomania, a condition that includes a period of elation, euphoria, irritability, agitation, rapid speech, racing thoughts, a lack of focus and risk-taking behaviors.

"As clinicians, we need to find treatments that avoid these side effects and allow for a nice, stable response. Treatment with bright light at midday can provide this," said Sit, also a Northwestern Medicine psychiatrist.

The study included 46 participants who had at least moderate depression, bipolar disorder and who were on a mood stabilizer. Patients were randomly assigned to either a 7,000 lux bright white light or a 50 lux placebo light. The light therapy patients were instructed to place the light box about one foot from their face for 15-minute sessions to start. Every week, they increased their exposure to the light therapy by 15-minute increments until they reached a dose of 60 minutes per day or experienced a significant change in their mood.

"By starting at a lower dose and slowly marching that dose up over time, we were able to adjust for tolerability and make the treatment suitable for most patients," Sit said.

Sit and her colleagues also observed a noticeable effect of bright light therapy by four weeks, which is similar to other studies that test light therapy for non-seasonal depression and depression during pregnancy.

Light therapy has conventionally been tested using morning light at awakening because previous research has suggested that morning light helps reset circadian rhythms and can be helpful in the treatment of SAD, Sit said. However, the mechanism of response is unclear in bipolar disorder. To understand the possible effects of midday bright light on circadian rhythms in patients with depression and bipolar disorder, Sit and colleagues are planning new studies to investigate.

https://www.sciencedaily.com/releases/2017/10/171010143231.htm

An epidemic of dream deprivation: Unrecognized health hazard of sleep loss

September 29, 2017

Science Daily/University of Arizona Health Sciences

A sleep and dream specialist has completed a comprehensive review of data about the causes, extent and consequences of dream loss includes recommendations for restoring healthy dreaming.

A silent epidemic of dream loss is at the root of many of the health concerns attributed to sleep loss, according to Rubin Naiman, PhD, a sleep and dream specialist at the University of Arizona Center for Integrative Medicine, who recently published a comprehensive review of data.

His review, "Dreamless: the silent epidemic of REM sleep loss" in the "Unlocking the Unconscious: Exploring the Undiscovered Self" issue of the Annals of the New York Academy of Sciences, details the various factors that cause rapid eye movement (REM) sleep and dream loss. Typical sleep follows a pattern in which deeper, non-REM sleep is prioritized by the body. Only later in the night and into the early morning do people experience dreaming, during REM sleep.

"We are at least as dream-deprived as we are sleep-deprived," noted Dr. Naiman, UA clinical assistant professor of medicine. He sees REM/dream loss as an unrecognized public health hazard that silently wreaks havoc by contributing to illness, depression and an erosion of consciousness. "Many of our health concerns attributed to sleep loss actually result from REM sleep deprivation."

The review examines data about the causes and extent of REM/dream loss associated with medications, substance use disorders, sleep disorders and behavioral and lifestyle factors. Dr. Naiman further reviews the consequences of REM/dream loss and concludes with recommendations for restoring healthy REM sleep and dreaming.

https://www.sciencedaily.com/releases/2017/09/170929093254.htm

One in three older adults take something to help them sleep but many don't talk to their doctors

1 in 12 people over age 65 take prescription sleep medications, which carry health risks for older people

September 27, 2017

Science Daily/Michigan Medicine - University of Michigan

Sleep doesn't come easily for nearly half of older Americans, and more than a third have resorted to some sort of medication to help them doze off at night, a new national poll finds. But most said they hadn't talked to their doctor about their sleep, even though more than a third said their sleep posed a problem. Half believe -- incorrectly -- that sleep problems just come naturally with age.

But most poll respondents said they hadn't talked to their doctor about their sleep, even though more than a third said their sleep posed a problem. Half believe -- incorrectly -- that sleep problems just come naturally with age.

The poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and is sponsored by AARP and Michigan Medicine, U-M's academic medical center.

Those who turn to medications may not realize that prescription, over-the-counter and even "natural" sleep aids carry health risks, especially for older adults, either alone or in combination with other substances. In fact, national guidelines strongly warn against prescription sleep medicine use by people over age 65.

Despite this, the nationally representative poll of people ages 65 to 80 finds that 8 percent of older people take prescription sleep medicine regularly or occasionally. Among those who report sleep troubles three or more nights a week, 23 percent use a prescription sleep aid. Most who use such drugs to help them sleep had been taking them for years. Manufacturers and the U.S. Food and Drug Administration say such drugs are only for short-term use.

Medication: not the only option

"Although sleep problems can happen at any age and for many reasons, they can't be cured by taking a pill, either prescription, over-the-counter or herbal, no matter what the ads on TV say," says poll director Preeti Malani, M.D., a U-M physician trained in geriatric medicine. "Some of these medications can create big concerns for older adults, from falls and memory issues to confusion and constipation," even if they're sold without a prescription.

"The first step for anyone having trouble sleeping on a regular basis should be to talk to a doctor about it," she continues. "Our poll shows that nearly two-thirds of those who did so got helpful advice -- but a large percentage of those with sleep problems simply weren't talking about it."

She notes that non-medication-based sleep habits are the first choice for improving sleep in older people. Sleep and health

In all, 46 percent of those polled had trouble falling asleep one or more nights a week. Fifteen percent of the poll respondents said they had trouble falling asleep three or more nights a week.

Other health conditions can contribute to sleep difficulties. Twenty-three percent of poll respondents who had trouble sleeping said it was because of pain. And 40 percent of those with frequent sleep problems said their overall health was fair or poor. Other reasons for sleep troubles included having to get up to use the bathroom at night, and worry or stress.

Insomnia and other irregular sleep patterns can interfere with daytime functioning, and are associated with memory issues, depression and an increased risk of falls and accidents. Even so, many said they didn't see sleep issues as a health problem -- in fact, this belief was the most common reason that poll respondents said they didn't talk to their doctor about sleep.

This also highlights the need for doctors to ask their older patients about their sleep habits and what they're doing to address any issues they may be having

"We know that sleep is a critical factor for overall health as we age, and this new research highlights sleep problems as both a significant health issue for older adults and an underacknowledged one both by patients and their providers," says Alison Bryant, Ph.D., senior vice president of research for AARP. "We need to help people understand that lack of sleep is not just a natural part of aging."

More about medication use

In all, 14 percent of the poll respondents said they regularly took a prescription sleep medication, prescription pain medication, OTC sleep aid or herbal supplement to help them sleep. Another 23 percent took one of these options occasionally; most of the occasional users said they chose OTC sleep aids.

The most recent Beers Criteria established by the American Geriatrics Society, which guides the use of medications among older people, gives a strong warning against use of prescription sleep drugs, which are sold under such names as Ambien, Lunesta and Sonata.

Meanwhile, even though OTC sleep aids can be purchased without a doctor's guidance or prescription, they still carry health risks for older people, Malani notes. Most of them contain diphenhydramine, an antihistamine that can cause side effects such as confusion, urinary retention and constipation.

Among poll respondents with frequent sleep problems who took something occasionally to help them sleep, OTC sleep remedies were the most common choice. But among those with frequent sleep issues who took something on a regular basis to try to sleep, prescription sleep medications were the most common option, with 17 percent reporting use.

Use of melatonin and other herbal remedies may be perceived as safer, but less is known about their potential side effects and they are not subject to the FDA's approval process for medications, says Malani. But any issue that prompts someone to buy an OTC or herbal remedy on a regular basis is something they should discuss with their doctor, she adds.

The poll results are based on answers from a nationally representative sample of 1,065 people ages 65 to 80, who answered a wide range of questions online. Questions were written, and data interpreted and compiled, by the IHPI team. Laptops and Internet access were provided to poll respondents who did not already have it.

https://www.sciencedaily.com/releases/2017/09/170927093322.htm

Beer can lift your spirits due to malted barley ingredient

September 27, 2017

Science Daily/Friedrich-Alexander-Universität Erlangen-Nürnberg

Visitors to the Oktoberfest have always known it and now it has been scientifically -- beer can lift your spirits. Scientists examined 13,000 food components to find out whether they stimulate the reward center in the brain and make people feel good. Hordenine which is found in malted barley and beer seems to do the job quite well.

Some foods make us happy. Well, maybe not happy but they make us feel good. That is why we cannot stop eating when we have had enough. Scientists call this hedonic hunger -- the drive to eat for pleasure rather than to satisfy an actual biological need. This feel-good effect is caused by the neurotransmitter dopamine -- tempting foods stimulate the reward centre in the brain where the dopamine D2 receptor is located. Researchers of the Chair of Food Chemistry at FAU investigated whether there are special substances in foods that activate the dopamine D2 receptor in the same way as dopamine.

The team worked with FAU's Computer Chemistry Centre using a virtual screening approach which is often used in pharmaceutical research. This process analyses food components in a computer simulation rather than in the laboratory. Using computer simulations means that all types of known substance can be investigated. In the laboratory, it is only feasible to test a small selection of foodstuff extracts using standard screening techniques.

13,000 molecules, 17 hits

Initially, the scientists set up a database of 13,000 molecules which are present in foodstuffs. Using this database, the objective was to find those molecules that fit the dopamine D2 receptor -- rather like finding the right key for a lock. The system was then used to identify which molecules could interact with the dopamine D2 receptor; these might be present in synthetic substances already known to interact with the receptor, such as medicines for treating Parkinson's and schizophrenia, or which might be candidates for interaction due to the three-dimensional structure of the receptor. In the end, 17 of the original 13,000 options were selected and these were analysed in the laboratory in cooperation with the Division of Medicinal Chemistry at FAU.

Beer -- a surprise finding

The most promising results were obtained for hordenine, a substance present in malted barley and beer. 'It came as a bit of surprise that a substance in beer activates the dopamine D2 receptor, especially as we were not specifically looking at stimulant foodstuffs,' explains Prof. Dr. Monika Pischetsrieder.

Just like dopamine, hordenine stimulates the dopamine D2 receptor, however it uses a different signalling pathway. In contrast with dopamine, hordenine activates the receptor solely through G proteins, potentially leading to a more prolonged effect on the reward centre of the brain. The team is now investigating whether hordenine levels in beer are sufficient to have a significant effect on the reward centre. All things considered, the results indicate that hordenine may well contribute to the mood-boosting effect of beer.

https://www.sciencedaily.com/releases/2017/09/170927152838.htm

Sleep deprivation is an effective anti-depressant for nearly half of depressed patients

September 19, 2017

Science Daily/University of Pennsylvania School of Medicine

Sleep deprivation -- typically administered in controlled, inpatient settings -- rapidly reduces symptoms of depression in roughly half of depression patients, according the first meta-analysis on the subject in nearly 30 years, from researchers at the Perelman School of Medicine at the University of Pennsylvania. Partial sleep deprivation (sleep for three to four hours followed by forced wakefulness for 20-21 hours) was equally as effective as total sleep deprivation (being deprived of sleep for 36 hours), and medication did not appear to significantly influence these results. The results are published today in the Journal of Clinical Psychiatry.

Although total sleep deprivation or partial sleep deprivation can produce clinical improvement in depression symptoms within 24 hours, antidepressants are the most common treatment for depression. Such drugs typically take weeks or longer to experience results, yet 16.7 percent of 242 million U.S. adults filled one or more prescriptions for psychiatric drugs in 2013. The findings of this meta-analysis hope to provide relief for the estimated 16.1 million adults who experienced a major depressive episode in 2014.

Previous studies have shown rapid antidepressant effects from sleep deprivation for roughly 40-60 percent of individuals, yet this response rate has not been analyzed to obtain a more precise percentage since 1990 despite more than 75 studies since then on the subject.

"More than 30 years since the discovery of the antidepressant effects of sleep deprivation, we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results," said study senior author Philip Gehrman, PhD, an associate professor of Psychiatry and member of the Penn Sleep Center, who also treats patients at the Cpl. Michael J. Crescenz VA Medical Center. "Our analysis precisely reports how effective sleep deprivation is and in which populations it should be administered."

Reviewing more than 2,000 studies, the team pulled data from a final group of 66 studies executed over a 36 year period to determine how response may be affected by the type and timing of sleep deprivation performed (total vs early or late partial sleep deprivation), the clinical sample (having depressive or manic episodes, or a combination of both), medication status, and age and gender of the sample. They also explored how response to sleep deprivation may differ across studies according to how "response" is defined in each study.

"These studies in our analysis show that sleep deprivation is effective for many populations," said lead author Elaine Boland, PhD, a clinical associate and research psychologist at the Cpl. Michael J. Crescenz VA Medical Center. "Regardless of how the response was quantified, how the sleep deprivation was delivered, or the type of depression the subject was experiencing, we found a nearly equivalent response rate."

The authors note that further research is needed to identify precisely how sleep deprivation causes rapid and significant reductions in depression severity. Also, future studies are needed to include a more comprehensive assessment of potential predictors of treatment outcome to identify those patients most likely to benefit from sleep deprivation.

https://www.sciencedaily.com/releases/2017/09/170919140416.htm

The wrong first step to revive athletes in cardiac arrest

September 19, 2017

Science Daily/Elsevier

New research suggests that the main obstacle to an appropriate bystander response during athletes' cardiac arrest could be an apparently widespread myth: that 'tongue swallowing' is a common complication of sudden loss of consciousness that must be avoided or relieved at all costs to prevent death from asphyxia.

About three million people have viewed the YouTube video of the death of American collegiate basketball player Frank Gathers from cardiac arrest during a game in 1990. The sequence of the events clearly shows the that for two entire minutes following his collapse, he received no form of cardiopulmonary resuscitation (CPR). New research presented in HeartRhythm, suggests that the main obstacle to an appropriate bystander response during athletes' cardiac arrest could be an apparently widespread myth: that "tongue swallowing" is a common complication of sudden loss of consciousness that must be avoided or relieved at all costs to prevent death from asphyxia.

"As of February 2017, the 'Hands-Only CPR Demo Video' by the American Heart Association (AHA) and the 'Learn Hands-Only CPR' from the American Red Cross had 337,104 and 227,032 views, respectively. These figures shrivel next to the staggering number of views of the videos showing Frank Gathers, who died of cardiac arrest while an entire jam-packed basketball stadium crowd watched in disbelief, without anybody providing any form of appropriate CPR," comments lead investigator Dana Viskin, MD, from the Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel.

To determine whether inadequate responses by fellow team members may well be an unappreciated serious obstacle to successful resuscitation of athletes collapsing with cardiac arrest during competition, investigators reviewed 29 available videos from 1990-2017 of sudden circulatory arrest (SCA), or loss of consciousness. The rescue process of each collapsed player was analyzed with careful attention paid to the first action performed by the first to arrive on the scene. In videos in which the initial intervention was visible, 65% showed actions to prevent tongue swallowing, which included placing the player on his side or tilting his head sideways, and forcefully opening the athlete's mouth placing the rescuer's fingers in the victim's mouth, sometimes with a visible pull at the tongue. Only 38% show chest compressions. Further, a defibrillator was brought to the scene in only two cases, and in one of those, the first shock was not delivered until 10 minutes later. Of the players presenting with cardiac arrest, 36% survived.

According to Dr. Viskin, "The cardiac arrest events of athletes caught on video and available on the internet portray a very disturbing picture of fellow teammates responding to cardiac arrest incorrectly. Prevention and/or 'relief' of tongue swallowing' appears to take priority over chest compression in the majority of video-documented events."

This misplaced priority has also been encouraged by inaccurate reporting by various media, such as a BBC Sports internet article commending inappropriate resuscitation attempts by teammates and medical staff to prevent the athlete from swallowing his tongue as he lost consciousness.

In an accompanying editorial, Peter J. Kudenchuk, MD, of the Division of Cardiology/Arrhythmia Services, University of Washington, Seattle, WA, emphasizes that the initial moments following collapse are arguably the most critical, since all successive emergency actions depend on SCA first being quickly recognized and properly treated. "It is during this time period when the battle for survival can all too easily be lost, particularly if SCA is mistaken for something less immediately life-threatening, therapies are misdirected, or not given at all."

In the past, the traditional approach to resuscitation relied on ABC, or Airway, Breathing and Chest compressions. Although this guideline was revised by the AHA in 2010 to CAB (Chest Compressions, Airway, Breathing), the old technique may still be holding sway. Dr. Kudenchuk notes that the newer guidelines assume that all collapses are due to SCA, and require only two questions to be answered: "Is the patient conscious?" and "Are they breathing normally?" Two "No" answers trigger immediate chest compressions. This "No, No, GO!" algorithm is proving to increase survival where it is being used.

This lag in understanding is of great concern. Dr. Viskin adds, "Since we began our research regarding this topic, at least three more cases had been added to our statistics, including a very recent one, not included in this present study, involving a soccer player in The Netherlands. It is interesting since the world seems to be moving forward in regard to technology, medical equipment, and research, but in a field with media exposure to millions of people worldwide, we seem to be over a decade behind."

While this study focuses on how tragic cardiac arrest might be when it strikes an athlete, Dr. Kudenchuk emphasizes that it also typifies the bystander inaction that occurs in hundreds of thousands of instances of others who fall victim to out-of-hospital cardiac arrest each year across the globe.

https://www.sciencedaily.com/releases/2017/09/170919090958.htm

Why bad sleep doesn't always lead to depression

Brain's reward center activity may protect against negative mental health effects

September 18, 2017

Science Daily/Duke University

Poor sleep is both a risk factor, and a common symptom, of depression. But not everyone who tosses and turns at night becomes depressed. Individuals whose brains are more attuned to rewards may be protected from the negative mental health effects of poor sleep, says a new study.

Individuals whose brains are more attuned to rewards may be protected from the negative mental health effects of poor sleep, says a new study by Duke University neuroscientists.

The researchers found that college students with poor quality sleep were less likely to have symptoms of depression if they also had higher activity in a reward-sensitive region of the brain.

"This helps us begin to understand why some people are more likely to experience depression when they have problems with sleep," said Ahmad Hariri, a professor of psychology and neuroscience at Duke University. "This finding may one day help us identify individuals for whom sleep hygiene may be more effective or more important."

The paper appeared online Sept. 18 in The Journal of Neuroscience.

The researchers examined a region deep within the brain called the ventral striatum (VS), which helps us regulate behavior in response to external feedback. The VS helps reinforce behaviors that are rewarded, while reducing behaviors that are not.

Electrical stimulation of the VS has been shown to reduce symptoms of depression in patients who are resistant to other forms of treatment, and earlier studies by Hariri's team show that people with higher reward-related VS activity are more resilient to stress.

"We've shown that reward-related VS activity may act as a buffer against the negative effects of stress on depressive symptoms," said Reut Avinun, a postdoctoral researcher in Hariri's group at Duke and the lead author of the study. "I was interested in examining whether the same moderating effect would also be seen if we look at sleep disturbances."

Avinun examined the brain activity of 1,129 college students participating in the Duke Neurogenetics Study. Each participant completed a series of questionnaires to evaluate sleep quality and depressive symptoms, and also completed an fMRI scan while engaging in a task that activates the VS.

In the task, students were shown the back of a computer-generated card and asked to guess whether the value of the card was greater than or less than five. After they guessed, they received feedback on whether they were right or wrong. But the game was rigged, so that during different trials the students were either right 80 percent of the time or wrong 80 percent of the time.

To tease out whether general feedback, or specifically reward-related feedback, buffers against depression, the researchers compared VS brain activity during trials when the students were mostly right to those when they were mostly wrong but still received feedback.

They found that those who were less susceptible to the effects of poor sleep showed significantly higher VS activity in response to positive feedback or reward compared to negative feedback.

"Rather than being more or less responsive to the consequences of any actions, we are able to more confidently say it is really the response to positive feedback, to doing something right, that seems to be part of this pattern," Hariri said.

"It is almost like this reward system gives you a deeper reserve," Hariri said. "Poor sleep is not good, but you may have other experiences during your life that are positive. And the more responsive you are to those positive experiences, the less vulnerable you may be to the depressive effects of poor sleep."

https://www.sciencedaily.com/releases/2017/09/170918132735.htm

Cannot sleep due to stress? Here is the cure

September 5, 2017

Science Daily/University of Tsukuba

Everyone empirically knows that stressful events certainly affect sound sleep. Scientists have found that the active component rich in sugarcane and other natural products may ameliorate stress and help having sound sleep.

In today's world ever-changing environment, demanding job works and socio-economic factors enforces sleep deprivation in human population. Sleep deprivation induces tremendous amount of stress, and stress itself is one of the major factors responsible for sleep loss or difficulty in falling into sleep. Currently available sleeping pills does not address stress component and often have severe side effects. Sleep loss is also associated with certain other diseases including obesity, cardiovascular diseases, depression, anxiety, mania deficits etc.

The research group led by Mahesh K. Kaushik and Yoshihiro Urade of the International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, found that octacosanol reduces stress and restores stress-affected sleep back to normal.

Octacosanol is abundantly present in various everyday foods such as sugarcane (thin whitish layer on surface), rice bran, wheat germ oil, bee wax etc. The crude extract is policosanol, where octacosanol is the major constituent. Policosanol and octacosanol have already been used in humans for various other medical conditions.

In the current study, authors made an advancement and investigated the effect of octacosanol on sleep regulation in mildly stressed mice by oral administration. Octacosanol reduced corticosterone level in blood plasma, which is a stress marker. The octacosanol-administered mice also showed normal sleep, which was previously disturbed due to stress. They therefore claim that the octacosanol mitigates stress in mice and restores stress-affected sleep to normal in mice. The sleep induced by octacosanol was similar to natural sleep and physiological in nature. However, authors also claimed that octacosanol does not affect sleep in normal animals. These results clearly demonstrated that octacosanol is an active compound that has potential to reduce stress and to increase sleep, and it could potentially be useful for the therapy of insomnia caused by stress. Octacosanol can be considered safe for human use as a therapy, because it is a food-based compound and believed to show no side effects.

Octacosanol/policosanol supplements are used by humans for functions such as lipid metabolism, cholesterol lowering or to provide strength. However, well-planned clinical studies need to be carried out to confirm its effect on humans for its stress-mitigation and sleep-inducing potentials. "Future studies include the identification of target brain area of octacosanol, its BBB permeability, and the mechanism via which octacosanol lowers stress," Kaushik says.

https://www.sciencedaily.com/releases/2017/09/170905111357.htm

Generous people live happier lives

July 11, 2017

University of Zurich

Generosity makes people happier, even if they are only a little generous. People who act solely out of self-interest are less happy. Merely promising to be more generous is enough to trigger a change in our brains that makes us happier, neuroeconomists found in a recent study.

What some have been aware of for a long time, others find hard to believe: Those who are concerned about the well-being of their fellow human beings are happier than those who focus only on their own advancement. Doing something nice for another person gives many people a pleasant feeling that behavioral economists call a warm glow. In collaboration with international researchers, Philippe Tobler and Ernst Fehr from the Department of Economics at the University of Zurich investigated how brain areas communicate to produce this feeling. The results provide insight into the interplay between altruism and happiness.

Even a little generosity makes people happier

In their experiments, the researchers found that people who behaved generously were happier afterwards than those who behaved more selfishly. However, the amount of generosity did not influence the increase in contentment. "You don't need to become a self-sacrificing martyr to feel happier. Just being a little more generous will suffice," says Philippe Tobler.

Before the experiment started, some of the study participants had verbally committed to behaving generously towards other people. This group was willing to accept higher costs in order to do something nice for someone else. They also considered themselves happier after their generous behavior (but not beforehand) than the control group, who had committed to behaving generously toward themselves.

Intent alone suffices to cause neural changes

While the study participants were making their decision to behave or not to behave generously, the researchers examined activity in three areas of the participants' brains: in the temporoparietal junction (where prosocial behavior and generosity are processed), in the ventral striatum (which is associated with happiness), and in the orbitofrontal cortex (where we weigh the pros and cons during decision-making processes). These three brain areas interacted differently, depending on whether the study participants had committed to generosity or selfishness.

Simply promising to behave generously activated the altruistic area of the brain and intensified the interaction between this area and the area associated with happiness. "It is remarkable that intent alone generates a neural change before the action is actually implemented," says Tobler.

Benefit from the promise to behave generously

"Promising to behave generously could be used as a strategy to reinforce the desired behavior, on the one hand, and to feel happier, on the other," says Tobler. His co-author Soyoung Park adds: "There are still some open questions, such as: Can communication between these brain regions be trained and strengthened? If so, how? And, does the effect last when it is used deliberately, that is, if a person only behaves generously in order to feel happier?"

About the experiment

At the beginning of the experiment, the 50 participants were promised a sum of money that they would receive in the next few weeks and were supposed to spend. Half of the study participants committed to spending the money on someone they knew (experimental group, promise of generosity), while the other half committed to spending the money on themselves (control group).

Subsequently, all of the study participants made a series of decisions concerning generous behavior, namely, whether to giving somebody who is close to them a gift of money. The size of the gift and the cost thereof varied: One could, for example, give the other person five francs at a cost of two francs. Or give twenty francs at a cost of fifteen. While the study participants were making these decisions, the researchers measured activity in three brain areas: in the temporoparietal junction, where prosocial behavior and generosity are processed; in the ventral striatum, which is associated with happiness; and in the orbitofrontal cortex, where we weigh the pros and cons during decision-making processes. The participants were asked about their happiness before and after the experiment.

https://www.sciencedaily.com/releases/2017/07/170711112441.htm

Prebiotics may help to cope with stress

Prebiotic fibers can help to protect beneficial gut bacteria and restore healthy sleep patterns after a stressful event

February 10, 2017

Science Daily/Frontiers

Probiotics are well known to benefit digestive health, but prebiotics are less well understood. Recent study in rats shows that prebiotic fibers may help to protect beneficial gut bacteria and restore healthy sleep patterns after a stressful event.

Probiotics are well known to benefit digestive health, but prebiotics are less well understood. Prebiotics are certain types of non-digestible fibers that probiotic bacteria feed on, such as the fibers found in many plant sources like asparagus, oatmeal, and legumes. Certain bacteria also feed on non-fibers such as the protein lactoferrin, which also acts like a prebiotic and is found in breast milk.

According to a new study published in the online journal, Frontiers in Behavioral Neuroscience by Professor Monika Fleshner, PhD, and her team from the University of Colorado, Boulder, regular intake of prebiotics may promote beneficial gut bacteria and recovery of normal sleep patterns after a stressful episode.

"Acute stress can disrupt the gut microbiome," explained Dr. Agnieszka Mika, a postdoctoral fellow and one of the authors of the study, "and we wanted to test if a diet rich in prebiotics would increase beneficial bacteria as well as protect gut microbes from stress-induced disruptions. We also wanted to look at the effects of prebiotics on the recovery of normal sleep patterns, since they tend to be disrupted after stressful events."

In this experiment, test rats received prebiotic diets for several weeks prior to a stressful test condition and compared with control rats that did not receive the prebiotic-enriched diet. Interestingly, rats that ate prebiotics prior to the stressful event did not experience stress-induced disruption in their gut microbiota, and also recovered healthier sleep patterns sooner than controls.

Given that these experiments were done in rats, are these results relevant for humans? "The stressor the rats received was the equivalent of a single intense acute stressful episode for humans, such as a car accident or the death of a loved one," said Dr. Robert S. Thompson, the lead author of the study. "A next set of studies will be looking exactly at that question -- can prebiotics help humans to protect and restore their gut microflora and recover normal sleep patterns after a traumatic event?"

In the mean time, should we start including prebiotics in our diets to help cope with stress? "So far no adverse effects from prebiotics have been reported," said Dr. Mika, "and they are found widely in many plants, even present in breast milk, and are already commercially available." Healthy gut bacteria and restful sleep could be your benefits.

https://www.sciencedaily.com/releases/2017/02/170210130951.htm

Millennials prefer healthy habits, less likely to choose opioids to manage pain

Survey finds millennials regret opioid use, lack knowledge on proper disposal

August 30, 2017

Science Daily/American Society of Anesthesiologists

Often spending their days hunched over phones, tablets or computers and their free time at spin class or playing sports, millennials are the next generation poised to experience chronic pain. Even at their young age, millennials say acute and chronic pain are already interfering with their quality of life.

Their preferred method to manage pain? Lifestyle changes such as exercising, eating right, quitting smoking and losing weight, according to a nationwide survey commissioned by the American Society of Anesthesiologists (ASA) in conjunction with September's Pain Awareness Month.

The survey also found millennials were half as likely as baby boomers to have turned to opioids to manage pain, and 1 in 5 millennials regret that they used the highly addictive painkillers.

But while the results reflect a positive trend, they also reveal a knowledge gap. The survey found many millennials were:

• ·      More likely to obtain opioids inappropriately. One in 10 millennials obtained opioids through another household member's prescription, compared to 3 percent of Gen Xers, 1 percent of baby boomers and none of the silent generation.
• ·      More likely to think it's OK to take an opioid without a prescription. Nearly 30 percent of millennials thought it was OK to take an opioid without a prescription, compared to 20 percent of Gen Xers, 12 percent of baby boomers and 3 percent of the silent generation.
• ·      AND less likely to dispose of leftover opioids safely. In fact, 1 in 5 millennials said they "did not know" the best way to safely dispose of opioids, and only 37 percent were aware that a collection center at a local police station, hospital pharmacy or drug store was the best method of disposal.

"It's encouraging that millennials see the value of opting for safer and often more effective methods of managing pain," said ASA President Jeffrey Plagenhoef, M.D. "But clearly they are in need of further education when it comes to opioids and chronic pain because using the drugs initially to treat pain can turn into a lifelong struggle with addiction."

Learning how to manage pain safely and effectively is vital: 75 percent of millennials say they have had acute pain (which comes on suddenly and lasts less than three months) and nearly 60 percent have experienced chronic pain (which lasts longer than three months). The source of that pain is reflective of millennials' lifestyle, including technology use (leading to eye strain, neck aches, hand or finger pain, wrist or arm pain), migraines and sports injuries.

According to the survey, millennials (ages 18-36) and members of Generation X (ages 37-52) are most likely to report pain interfered with their work responsibilities, parenting abilities and participation in family activities.

It's important to address pain before it interferes with quality of life by seeing the right specialist for pain management. Whatever the age, people in severe pain who don't find relief through lifestyle changes should see a physician who specializes in pain management, such as a physician anesthesiologist. These specialists have received four years of medical school and additional training in a medical specialty, followed by an additional year of training to become an expert in treating pain. They have the expertise to best help you manage your pain.

But engaging in lifestyle changes before chronic pain can gain a further foothold is preferable. When possible, prevention is best. "Chronic pain does not have to be an automatic response to aging," said Dr. Plagenhoef. "Healthy lifestyle changes such as exercising, proper nutrition and maintaining a healthy weight can keep millennials from dealing with some of the chronic pain their parents and grandparents are experiencing."

To help all generations effectively manage their pain, ASA offers the following tips:

• ·      Take a break from devices and gaming: Aches from smartphone, tablet, gaming and other digital device overuse is common. To avoid it, use devices at eye level instead of looking down for long periods of time, which puts strain on your neck and back. Use the talk to text feature to limit finger and wrist strain. Sit up straight while gaming and get off the couch and stretch occasionally. To avoid digital eye strain, look away from the screen every 20 seconds and position yourself so there is an appropriate distance between your eyes and the screen.
• ·      Don't be a weekend warrior. Whether you plan to hit the basketball court after many years away or do CrossFit weekly, ease into it. Warm up your muscles and stretch to avoid pain and injury. If you think you've been injured after exercise or playing sports see a pain management specialist right away to evaluate the pain.
• ·      Remember to move. Whether you're in the library studying or at a desk job, get up and move at least once an hour, if not more. Sitting and being sedentary can lead to aches and pains, especially lower back pain. Stretch your legs and back by standing and walking on a regular basis rather than sitting for long periods of time.
• ·      Get healthy. Take charge of your health now and engage in healthy lifestyle changes before chronic pain sets in. Participate in low-impact aerobic and strength training exercises regularly. Maintain a healthy weight and eat a balanced diet. Don't smoke, or if you do, talk to a physician about programs available to help you quit.
• ·      Take and dispose of opioids the right way. If a physician prescribes opioids, ask many questions about taking them appropriately. Don't continue taking opioids when your pain subsides. If you have leftover opioids, dispose of them at a collection center at a local police station, hospital pharmacy, or drugstore. This will ensure others who have not been prescribed the opioids do not have access to them.

The 10-question ORC International CARAVAN® Omnibus Survey was conducted online August 7-9, 2017 among 1,011 U.S. adults 18 years or older: 34 percent were millennials, 25 percent were Gen Xers, 35 percent were baby boomers (ages 53-71) and 6 percent were from the silent generation (ages 72-92). The demographically representative sample included 504 men and 507 women.

https://www.sciencedaily.com/releases/2017/08/170830124926.htm

Pain, emotions and the placebo effect

August 29, 2017

Science Daily/University of Luxembourg

In a pioneering study, researchers used fMRI technology to show that a person’s ability to reinterpret negative events and to control feelings influences how strongly a placebo will work to reduce pain

"Brain scans showed researchers that specific regions in the brain react when a person receives a placebo and as a result experiences less pain," explains Dr Marian van der Meulen, neuropsychologist at the University of Luxembourg. "The regions in the brain that process pain become less active, which demonstrates that the placebo effect is real. But the psychological mechanism is still very little understood, and it is unclear why some people show a much stronger placebo response than others. We suspected that the way we can regulate our emotions plays a role and set out to investigate this."

Why is it important to better understand the placebo effect?

"It's important to understand that the placebo effect is not only an imagined improvement when we believe we receive a medication.

The placebo effect had traditionally a negative reputation. During the last decade however, researchers have investigated the placebo effect itself. They have shown that placebos can trigger real biological changes in the body, including the brain, and that the placebo effect plays a role every time we receive a medical treatment. The placebo effect not only happens when administering a bogus treatment, but is a part of every medical procedure. It is triggered by the presence of a white coat and other signs of medical authority, verbal suggestions of improvement and previous experiences with a treatment. Clinicians or psychiatrists may be able to improve the outcome of a medical intervention by optimising the contribution of the placebo effect."

How was the study carried out, and key findings

"The study was conducted in collaboration with the ZithaKlinik and uses fMRI (functional magnetic resonance imaging) of the brain to show a relationship between the regions in the brain that respond to a placebo and the ability to regulate emotions.

First, we assessed participants' ability for 'cognitive reappraisal', which means how well they can reinterpret negative emotions. Participants looked at images that create negative emotions. Their task was to come up with ideas or interpretations that made them feel more positive about an image and we measured how well they managed to do this. At the ZithaKlinik, participants were then put in the MRI scanner and they received painful heat stimuli on their arms. They were then told that they received a powerful pain-relieving cream, which in reality was just a simple skin moisturiser.

All participants reported less pain: the placebo effect was working. Interestingly, those with a higher capacity to control their negative feelings showed the largest responses to the placebo cream in the brain. Their activity in those brain regions that process pain was most reduced. This suggests that your ability to regulate emotions affects how strong your response to a placebo will be."

Which role does brain imaging play?

"When a brain area is more active, it consumes more oxygen and more blood will flow to this area. fMRI measures this change in blood flow and detects which areas of the brain are involved in a certain mental process. In our research we were able to detect decreases in activation in pain-processing regions but also increases in an area involved in emotion regulation.

This is the first study using functional brain imaging that was conducted in Luxembourg. Our next research project will use fMRI to assess, amongst others, the placebo effect in elderly people. We know that older people perceive and report pain differently than young people, yet why this is the case remains poorly understood. With improved understanding, clinicians and caretakers may be able to better diagnose and treat pain conditions in elderly people."

https://www.sciencedaily.com/releases/2017/08/170829131224.htm

Chronic lack of sleep increases risk-seeking

August 28, 2017

Science Daily/University of Zurich

Sleepiness, reduced concentration and performance -- more and more people are suffering from the consequences of a chronic lack of sleep. Researchers have now demonstrated a further consequence: the people affected are subject to more intensive risk-seeking behavior without even noticing.

Young adults have a natural sleep requirement of about 9 hours a day on average, older adults 7.5 hours. Many people in western societies, however, get considerably less sleep. According to studies, about one-third of the persons surveyed in several industrial countries reported too little sleep. If a young adult sleeps less than 8 hours a night, increased attention deficits occur, which can lead to considerable negative consequences. In sleep clinics there is an increasing number of healthy people who are suffering from the negative consequences of insufficient sleep.

Not enough sleep leads to riskier decision-making

Researchers at the University of Zurich and the University Hospital Zurich have now identified a further critical consequence of a chronic lack of sleep: increased risk-seeking. The sleep and neuroeconomics scientists studied the risk behavior of 14 healthy male students aged from 18 to 28 years. If the students slept only 5 hours a night for a week, they displayed clearly riskier behavior in comparison with a normal sleep duration of about 8 hours. Twice a day, they had to choose between obtaining a specified amount of money paid out with a given probability or playing it safe with a lower amount of money paid out for sure. The riskier the decision, the higher the possible prize -- but also the risk of getting nothing.

Riskier behavior remains unnoticed

While a single sleepless night had no effect on risk-seeking, 11 of 14 of the subjects behaved significantly and increasingly riskier as the week of a reduced sleep duration went on. An additional finding is particularly alarming: The students assess their risk-taking behavior to be the same as under regular sleep conditions. "We therefore do not notice ourselves that we are acting riskier when suffering from a lack of sleep," emphasizes Christian Baumann, professor of neurology and the head of the Clinical Research Priority Programs (CRPP) "Sleep and Health" at UZH. According to the authors of the study, we should therefore all strive for a sufficient sleep duration -- especially political and economic leaders who make wide-reaching decisions daily. "The good news is," Baumann says, "that, in the high-powered world of managers, getting enough sleep is increasingly being seen as desirable."

Lack of recovery in important regions of the brain

For the first time, the researchers have proven that a low depth of sleep in the right prefrontal cortex is directly connected with higher risk-seeking behavior. This part of the cerebral cortex has already been associated with risk-taking behavior in earlier studies. "We assume that behavioral changes occur for anatomical-functional reasons to some extent as a result of the right prefrontal cortex not being able to recover properly due to a chronic lack of sleep," Baumann concludes.

https://www.sciencedaily.com/releases/2017/08/170828102725.htm

Yoga and meditation improve mind-body health and stress resilience

New research finds that practicing yoga and meditation has positive effects on mind-body health and stress resilience

August 22, 2017

Science Daily/Frontiers

A new research article investigates the effects of yoga and meditation on people by looking at physiological and immunological markers of stress and inflammation. By studying the participants of an intensive three-month yoga and meditation retreat, the researchers found that the practices positively impacted physiological and immunological markers of stress and inflammation, and in addition improved subjective wellbeing.

Many people report positive health effects from practicing yoga and meditation, and experience both mental and physical benefits from these practices. However, we still have much to learn about how exactly these practices affect mind-body health. A new research article published in Frontiers in Human Neuroscience investigates the effects of yoga and meditation on brain derived neurotrophic factor (BDNF), the activity on the hypothalamic pituitary adrenal (HPA) effects and inflammatory markers. By studying the participants of an intensive 3-month yoga and meditation retreat, the researchers found that the practices positively impacted BDNF signaling, the cortisol awakening response (CAR) and immunological markers, and in addition improved subjective wellbeing.

In this study, the retreat participants were assessed before and after participating in a 3-month yoga and meditation retreat that involved daily meditation and Isha yoga, accompanied by a vegetarian diet. The yogic practices consisted of physical postures, controlled breathing practices, and seated meditations during which the participants focused on mantra repetition, breath, emptying the mind and bodily sensation. The researchers measured psychometric measures, brain derived neurotrophic factor (BDNF), circadian salivary cortisol levels, as well as pro- and anti-inflammatory cytokines. They also collected data on psychometric variables including mindfulness, absorption, depression and anxiety, and investigated the relationship between psychological improvements and biological changes.

The data showed that participation in the retreat was associated with decreases in both self-reported anxiety and depression as well as increases in mindfulness. The research team observed increases in the plasma levels of BDNF, a neuromodulator that plays an important role in learning, memory and the regulation of complex processes such as inflammation, immunity, mood regulation, stress response and metabolism. They also observed increases in the magnitude of the cortisol awakening response (CAR) which is part of the hypothalamic pituitary adrenal axis (HPA), suggesting improved stress resilience. Moreover, there was a decrease in inflammatory processes caused by an increase of the anti-inflammatory cytokine Interleukin-10 and a reduction of the pro-inflammatory cytokine Interleukin-12 after the retreat. "It is likely that at least some of the significant improvements in both HPA axis functioning as exemplified by the CAR as well as neuroimmunologic functioning as exemplified by increases in BDNF levels and alterations in cytokines were due to the intensive meditation practice involved in this retreat," says corresponding author Dr Baruch Rael Cahn (University of Southern California, USA).

The research team hypothesize that the pattern of biological findings observed in their study is linked to enhanced resilience and wellbeing. "The observed increased BDNF signaling possibly related to enhanced neurogenesis and/or neuroplasticity, increased CAR likely related to enhanced alertness and readiness for mind-body engagement, and increased anti- and pro-inflammatory cytokines possibly indicating enhanced immunological readiness," explains Dr Cahn. "An intriguing possible link between the effects on BDNF and the CAR is hippocampal functional integrity, since increased BDNF levels due to physical exercise has previously been shown to relate with hippocampal neurogenesis and likely relate to its positive effects on well-being and depression."

In the light of previous studies of the positive effects of meditation on mental fitness, autonomic homeostasis and inflammatory status, the researchers think that their findings are related to the meditative practices that the retreat participants engaged in. However, they suggest that some of the observed changes may also be related to the physical aspects of the retreat -- yoga practice and diet -- and that the observed change patterns are a reflection of wellbeing and mind-body integration. The next step will be to conduct further research in order to clarify the extent to which the positive changes on mind-body wellness and stress resilience are related to the yoga and meditation practices respectively, and to account for other possible contextual factors such as social dynamics, diet and the impact of the teacher. "To our knowledge, our study is the first to examine a broad range of pro- and anti-inflammatory markers in a healthy population before and after a yoga-meditation intervention. Our findings justify further studies of yoga and meditation retreats assessing for the replicability, specificity and long-term implications of these findings," concludes Dr Cahn.

https://www.sciencedaily.com/releases/2017/08/170822104855.htm