Thursday, March 27, 2014

Learn about how your sleeping habits affect your epilepsy and what you can do to improve your health

The Epilepsy Awareness Houston Support Group presents a program on 
"How your sleeping habits affect your epilepsy and what you can do to improve your health."

Tuesday, April 8, 2014 from 6:00 to 8:00 pm., 
at 2401 Fountain View Dr.,Suite 900, (9th Floor),
Houston, Texas 77057

With special guest speaker Dr. Jerald H. Simmons:
Triple board-certified in Neurology, Sleep Medicine and Epilepsy, Dr. Simmons’ main focus has always been the specialty of Sleep Disorders Medicine. He trained in Sleep Medicine at Stanford University, then co-directed the University of California Sleep Disorders Center in Los Angeles. He was recruited to Houston to develop and direct the Sadler Clinic Sleep Disorders Center, which he did for 13 years, while also founding his private practice, Comprehensive Sleep Medicine Associates. Always eager to teach, he is the founding director of the Sleep Education Consortium, a nationally recognized, non-profit organization that provides medical education seminars on sleep disorders to phy- sicians, dentists, health care professionals and the community. He continues to be published by many peer reviewed journals and conducts research studies to improve the field of sleep medicine

Friday, March 14, 2014

Sleep disorders may cause ADD/ADHD

For more than three decades, there has been a growing recognition that some people have difficulty focusing and maintaining attention; in various instances, they also may have difficulty sitting peacefully in a classroom
or calm setting. These individuals have been labeled with attention deficit disorder - with or without hyperactivity -known as ADD/ADHD.

Traditional treatment for ADD/ADHD has been with stimulant medications, such as Ritalin or Adderall, which provide improvement by stimulating a fatigued, unrested brain. It is now known that problems with sleep can result in difficulties with concentration and the ability to stay focused during the day. The increased physical activity -hyperactivity - displayed by many of those affected is a way of remaining stimulated, thus overcoming the sleepiness. This difficulty is most noted when sitting inactive and under-stimulated.

About 30 percent of these patients have a sleep disturbance as a fundamental cause according to Dr. Simmons, who has treated these types of patients for over 20 years. If a sleep disorder is present, there are other treatment options for improvement of the ADD/ADHD symptoms.
"If there is a concern that a child or adult has ADD/ADHD, then it is imperative to first make a few observations regarding the person's sleep in order to determine whether a sleep disorder center consultation is necessary, prior to starting stimulant drugs," Dr. Simmons continued. "In many cases, those who have been placed on stimulants can be successfully taken off them if a sleep problem has been properly diagnosed and treated. For years now, I have taken this approach and many patients labeled with ADD/ADHD in whom we have diagnosed with a sleep disturbance have demonstrated dramatic improvement after treating the sleep disorder. This treatment has minimized or eliminated their reliance on stimulant medications."

The main causes for the disturbed sleep in the ADD/ADHD population are lack of sleep due to domestic/environmental factors in the home, restless legs syndrome or obstructive sleep apnea, or an associated condition known as the Upper Airway Resistance Syndrome.

UARS is a subtle breathing disorder not properly diagnosed at most sleep centers; but by utilizing extra measures Dr. Simmons' team is able to recognize and treat this disorder properly. "We look at a whole battery of issues when someone complains of ADD/ ADHD, including both psychological and physiological factors," Simmons said. "I've seen many patients improve when we treat their sleep without the need for stimulants."

An example of one such patient is Trey Girlinghouse, a 9-year-old whose teachers became concerned with his difficulties in school. They encouraged his mother to find medical assistance for what they labeled as ADD; he was placed on stimulant medication treatment, but his mother was concerned about medication usage and looked for alternative treatments.
She had Trey evaluated by Dr. Simmons, and after a comprehensive sleep test he was found to have UARS. He then began treatment for this breathing disorder and is no longer on stimulants: he has also markedly improved his performance at school.
"Now that his sleep is better and he does better at school, the teachers agree that he no longer needs to be on medications," his mother said.

Dr. Simmons provides this partial list of signs which should raise concerns when considering whether ADD/ADHD may be associated with a sleep disturbance:
  •  Difficulty falling asleep 
  • Difficulty staying asleep 
  • Snoring or labored breathing 
  • Kicking repetitively during the night 
  • Excessively grinding or clenching teeth 
  • Difficulty awakening in the morning 
  • Sleep walking or sleep talking 
  •  Noticeable sleepiness during the day when not active

If someone has any of these indicators and appears to suffer with ADD/ADHD symptoms, then a proper sleep evaluation would be warranted. Patients can be evaluated by contacting CSMA's sleep centers throughout Greater Houston at 281-407-6222.
Visit for more information and fill out our questionnaire to initiate an evaluation.

Wednesday, March 5, 2014

"Infant sleep machines" could damage babies' hearing

Sleep machines are devices designed placed next to the baby's crib and designed to help babies sleep more soundly. They work by generating ambient or "white" noise, masking other noises from around the house or outside that could disturb the baby. Websites promoting these machines often suggest that parents and childminders should have the device on continually while a child is sleeping: a common recommendation is that the volume of the sounds played by the machine should be equal to or louder than the cry of an infant. Many parents say their babies become so used to the sounds of rainfall or birds that they will not nap without them.

But researchers at the University of Toronto evaluated 14 popular sleep machines at maximum volume and found they produced between 68.8 to 92.9 decibels at 30 centimeters, about the distance one might be placed from an infant’s head. Three exceeded 85 decibels, the workplace safety limit for adults on an eight-hour shift for accumulated exposure as determined by National Institute for Occupational Safety and Health. One machine was so loud that two hours of use would exceed workplace noise limits.

At 100 centimeters, all the machines tested were louder than the 50-decibel limit averaged over an hour set for hospital nurseries in 1999 by an expert panel concerned with improving newborn sleep and their speech intelligibility. 

As infants are still developing and have much smaller ear canals than adults, it is possible that babies are more susceptible to the adverse effects of noise levels than adults.

The researchers think that safe use of these devices could be possible, but only with policy recommendations that set appropriate limits on the manufacture and use of the devices.
They recommend that families using infant sleep machines should place the device as far away as possible from the baby, and never in the crib or on the rail of the crib, only play the sleep machine at a low volume and only play the sleep machine for a short duration of time.
The study authors also recommended that manufacturers limit the maximum noise level of infant sleep machines. 

Another concern briefly raised in the Pediatrics study is whether listening to white noise can be detrimental to auditory development. A 2003 study published in the journal Science found continuous white noise delayed development of the brain’s hearing center in newborn rats.
In humans, the brain of a newborn is learning to differentiate sounds at different pitches even during sleep, said Lisa L. Hunter, scientific director of research in the division of audiology at Cincinnati Children’s Hospital.
“If you’ve conditioned them to white noise, there’s every indication that they might not be as responsive as they otherwise should be to soft speech,” she said.

Infant Sleep Machines and Hazardous Sound Pressure Levels: PEDIATRICS ( journal of the American Academy of Pediatrics);