With summer nearly here it seems like more fun is in the air.
Summertime means longer night walks, hanging out with friends, and BBQ’s. I find myself acting more like a kid and staying outside until dark and enjoying the summer evenings with my dog.
On my way back from Portugal this week, I had 14 hours to read and found a few fun sleep related articles I want to share with you.
Videogames that value sleep?
I don’t know if you remember it, but not that long ago (2016) there was an augmented reality game called Pokémon Go! My kids were obsessed. It was one of the most popular games in history and then just as suddenly as it appeared it disappeared. Well, Pokémon Fans (or maybe you liked the characters like Pikachu?) there’s a new arrival: Pokémon Sleep!
The New York Times (May 29, 2019) reports that the Pokémon CEO, Tsunekazu Ishihara, is planning on releasing Pokémon Sleep in 2020. While the details aren’t fully released yet, the executives said the game itself will reward you for good sleep habits. It appears that the new version Pokémon Sleep will “track sleep patterns and change the game based on how the user sleeps and what time they wake up.” This will be done with a blue tooth enabled sensor under their pillow. CEO of Niantic, partner with Pokémon said:
“We love exploring the world on foot, and that can’t happen unless we have the energy to embark on these adventures”
Sign me up!
The next article was kind of funny; it addresses the question: What is Sleep Laughing?
In a recent article Medical News Today covered this interesting question. Technically it’s called Hypnogely (for all you trivia fans out there), and laughing in your sleep turns out to be somewhat common and thankfully nothing to worry about. In many cases laughing while sleeping is a natural response to something that occurs in a dream. There’s been little research in this area because it’s rarely reported.
Of note, while most sleep laughing is harmless, this could be a symptom of REM Behavior Disorder, where someone is acting out their dreams. Less than 1% of people have RBD and it tends to occur more in older males. As I have written previously, RBD can be a precursor for Parkinson’s Syndrome and vice versa with up to 50% of people with Parkinson’s more likely to develop RBD. I don’t want to scare anyone, but the data speaks for itself. Since many people with Parkinson’s experience RBD, it’s likely sleep laughing will occur more often as well.
There is also a VERY rare disorder that I learned more about from this article. It’s a condition called hypothalamic hamartoma (HH). HH can cause gelastic seizures. These types of seizures present as uncontrolled laughter or giggles, which happens often as the person is falling asleep. This is a congenital disorder, so it runs in families and you’ll know if you have it.
Babies often laugh in their sleep, and we don’t know why. It’s adorable and is harmless, but if the baby is unable to stop there may be reason for alarm. This is especially the case if bouts are uncontrollable and coincide with unusual behaviors.
So laughing in your sleep may be no laughing matter!
Finally, there is new research on a question I’m often asked which is: Is it OK for my children to take melatonin?
An article in Psychiatry Advisor contains the results of a systematic review for this question. In order to determine which types of pediatric patients could benefit from melatonin supplementation (in a pill or liquid format), the authors found 10 studies to include in the review (which is not many, but the results were very interesting).
The authors stated: “Overall, studies that have evaluated the use of melatonin in pediatrics have shown that exogenous melatonin supplementation is safe and likely effective in select patient populations.”
The list of specific populations of patients that appear to benefit from melatonin supplementation, according to the article include:
- patients with atopic dermatitis,
- cystic fibrosis,
- behavioral disorders (ADHD, autism spectrum disorder),
- epilepsy, and
- idiopathic insomnia
Whether melatonin would benefit other pediatric populations is unknown due to a lack of data. Although there is data and evidence supporting melatonin use for patients with cystic fibrosis, atopic dermatitis, and epilepsy, caution is still recommended because the possible impact on these disease states is unknown. More research and data are needed to understand the long-term impact.
Regarding ADHD and autism, the review includes two trials in patients with ADHD (n=278) and two trials in patients with autism (n=124). According to the analysis, overall sleep quality was improved and indicated minimal risk of adverse events in these populations.
The study authors also recommended that melatonin should be used following optimization of stimulant dosing in patients with ADHD.
According to the review, various dosing strategies were utilized among the studies analyzed. Regardless of the dose, “each study and review showed an improvement in sleep-onset latency, with varying improvement in wakefulness, nighttime awakenings, and REM sleep.” 3mg was the most common dose administered, but dosing ranged from .75mg to 9mg and each were found to be effective. The recommendation to start with utilizing the lowest effective dose to improve sleep is to decrease any risk of toxicity.
Remember, NEVER start any form of supplementation without first speaking to your doctor.
Dr. Michael Breus
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