Re: Gray matter matters/Oxygen/brain damage?

[Guest guest]

Whoops -left out the main part of this -the speech part!

How many of you have kids with apraxia that don't have trouble

blowing their nose on command? What age did they learn and did you

have to teach them? Do they ever mess up still and breath in

instead? How many have had a sleep test done on their child and

anyone get back results that there was no sleep apnea/seizures etc?

Seems that all that went through it found something. Should we all

be taking our child for a sleep test?

Another quote from:

Patients With Obstructive Sleep Apnea Have Less Gray Matter

Laurie Barclay, MD

" We propose that early damage to the brain's speech center triggers

problems in the muscles that control the airway. This, in turn,

eventually leads to sleep apnea, " says first author Macey, also

at UCLA. " Because the sleep apnea patients possessed speech

impairments from childhood and their brain's speech center revealed

significant gray matter loss, this brain damage likely originated

early in life. "

According to Harper, patients with OSA often have other symptoms

suggesting subtle brain damage, including problems with memory,

cognition, and motor skills. " The repeated oxygen loss from sleep

apnea may damage other brain structures that regulate memory and

thinking, " he says.

Future research will be to study brain morphology in children with

OSA before they develop secondary hypoxic brain damage.

" Speech impediments may prove an important diagnostic clue for

assessing and treating sleep apnea, " Macey says. " In the future,

doctors may monitor certain brain structures and examine children

for speech or movement problems that may predict a higher sleep

apnea risk. "

Am J Respir Crit Care Med. 2002;166:1382-1387

Laurie Barclay, MD Writer for Medscape Medical News

Reviewed by D. Vogin, MD

=====

[Guest guest]

Hey Karyn -it probably isn't for all OSA children. I believe they are

saying speech impairments could (and should) be used as a

possible warning sign of Obstructive Sleep Apnea (OSA) -and that is

what was proven in the clinical trials (two now?) For example -not

everyone with a cold will develop pneumonia, not everyone with high

blood pressure will have a heart attack. In most things outside of

speech -there are risks for things such as this and the percentage of

risk that is known. I'm just thankful that speech is finally being looked

at in a serious way. It's a step in the right

direction.

I'm sure there are many with OSA who don't have any history of

speech delays...but being how laid back society was up till now for delays that

would be hard to know accurately. In your case specifically -what

is of interest is that you have ADHD -and the most recent studies I

found on this show that:

" Of 27 children and adolescents with ADHD evaluated in this study,

11 were girls and 16 were boys. Compared with 46 controls without

ADHD who were matched for age and sex, those with ADHD had reduced

regional brain size localized predominantly to small areas of the

dorsal prefrontal cortices, as well as in bilateral anterior

temporal areas. The ADHD group also had significant increases in the

gray matter in large regions of the posterior temporal and inferior

parietal cortices. "

http://www.medscape.com/viewarticle/464774?rss

which would mean (in theory) that you would have large amounts of gray matter in

the frontal region which could in fact have protected your speech?

This may explain why more children with ADHD don't have speech

impairments/or severe speech impairments even though they are out

there -but most are mild speech issues like my oldest Dakota -or

mild ADHD in the case of those with more severe speech impairments.

How many here have children with severe ADHD that need medication

and severe speech impairments like apraxia?

Perhaps (just throwing this out here so don't jump) ADHD can answer

questions into how to help speech impaired children in the future?

There may be some answers in where the gray matter is built up, and

why? Does anyone know if that has been studied -comparing gray

matter in ADHD children who have speech impairments to those who do

not?

I'd be curious. Probably not -but here are just a few links of what

I found on gray matter/OCD and speech. It was only published last

year -so not lots yet:

CAUSE OR EFFECT? GRAY MATTER LOSS IN OSA PATIENTS

The OSA patients had significantly less gray matter than did the

control group. The extent of gray matter loss increased with the

severity of OSA. Differences in gray matter between the two groups

varied from 2% to 18%, depending on which region of the brain was

examined.

There were no between-group differences in white matter or

cerebrospinal fluid. Because of the decrease in gray matter in the

OSA patients, however, the ratio of total gray-to-white matter

volume was significantly greater in the control group.

http://www.respiratoryreviews.com/apr03/rr_apr03_graymatter.html

Researchers have long known that obstructive sleep apnea (OSA) is

associated with cognitive deficits. Some have even speculated that

the deficits arise from brain damage suffered when nighttime

interruptions in breathing temporarily choke off the brain's oxygen

supply.

Now, a study in the American Journal of Respiratory and Critical

Care Medicine (Vol. 166, No. 10) offers new evidence to suggest that

OSA patients suffer from mild brain damage. Surprisingly, the study

also hints that some of the damage may actually precede the onset of

OSA and contribute to its development. ..

They found that patients had less gray matter than controls in brain

regions associated with attention, memory, motor control and

respiration.

Most of the reductions occurred on both sides of the brain, a

typical pattern for damage caused by oxygen deprivation. But many of

the OSA patients also showed one-sided reductions in certain areas,

including areas associated with speech and upper airway control.

http://www.apa.org/monitor/feb03/sleep.html

" We propose that early damage to the brain's speech center triggers

problems in the muscles that control the airway, " said Dr.

Macey, first author and assistant researcher of neurobiology at the

Geffen School of Medicine at UCLA. " This, in turn, eventually

leads to sleep apnea. "

" Our findings suggest this sleep apnea is a pre-existing condition --

that abnormal brain wiring from childhood contributes to the onset

of the disorder in adulthood, " Harper said. " The evidence in the

brain is very specific. "

Harper noted that obstructive sleep apnea patients often display

other traits that suggest subtle brain damage, including problems

with memory, thought and motor skills. " The repeated oxygen loss

from sleep apnea may damage other brain structures that regulate

memory and thinking, " he said.

The UCLA researchers uncovered another intriguing finding. In an

online supplement to their article, Harper and Macey wrote that 38

percent of the sleep apnea patients reported a history of stuttering

or speech impairment. Most of the men had struggled with word-

formation problems since childhood, and some still had language

difficulties as adults.

The incidence of stuttering in the general population is 7 percent.

" Because the sleep apnea patients possessed speech impairments from

childhood and their brain's speech center revealed significant gray

matter loss, this brain damage likely originated early in life, "

Macey said.

The next step will be to examine the brain structures of children

afflicted with obstructive sleep apnea, who may not have battled the

disease long enough to develop the brain damage found in adults.

" Speech impediments may prove an important diagnostic clue for

assessing and treating sleep apnea, " Macey said. " In the future,

doctors may monitor certain brain structures and examine children

for speech or movement problems that may predict a higher sleep

apnea risk. "

http://www.sciencedaily.com/releases/2002/11/021121065148.htm

=====

[Guest guest]

Hi all,

just thought I'd put my cents in. Adam who is diagnosed with adhd

along with apraxia, doesn't have severe adhd. Except he has major

problems getting himself to sleep. He was only on adderall xr for a very

short time, he took it after school.. It did help him with his

concentration a bit, but not with his sleeping. My dad was tested at a

sleep clinic, because he is a night owl for many years, and naps in

the car sometimes.He didn't get more than 6 hours sleep. They told

him that he should get to be earlier than 1-2am. As far as I know

both my guys have never stopped breathing or woken up abruptly during

the night. I am considering testing them anyway. Does the insurance

cover this? Jeanne

> Hey Karyn -it probably isn't for all OSA children. I believe they

are

> saying speech impairments could (and should) be used as a

> possible warning sign of Obstructive Sleep Apnea (OSA) -and that is

> what was proven in the clinical trials (two now?) For example -not

> everyone with a cold will develop pneumonia, not everyone with high

> blood pressure will have a heart attack. In most things outside

of

> speech -there are risks for things such as this and the percentage

of

> risk that is known. I'm just thankful that speech is finally being

looked

> at in a serious way. It's a step in the right

> direction.

>

> I'm sure there are many with OSA who don't have any history of

> speech delays...but being how laid back society was up till now for

delays that

> would be hard to know accurately. In your case specifically -what

> is of interest is that you have ADHD -and the most recent studies I

> found on this show that:

> " Of 27 children and adolescents with ADHD evaluated in this study,

> 11 were girls and 16 were boys. Compared with 46 controls without

> ADHD who were matched for age and sex, those with ADHD had reduced

> regional brain size localized predominantly to small areas of the

> dorsal prefrontal cortices, as well as in bilateral anterior

> temporal areas. The ADHD group also had significant increases in

the

> gray matter in large regions of the posterior temporal and inferior

> parietal cortices. "

> http://www.medscape.com/viewarticle/464774?rss

>

> which would mean (in theory) that you would have large amounts of

gray matter in

> the frontal region which could in fact have protected your speech?

>

> This may explain why more children with ADHD don't have speech

> impairments/or severe speech impairments even though they are out

> there -but most are mild speech issues like my oldest Dakota -or

> mild ADHD in the case of those with more severe speech

impairments.

> How many here have children with severe ADHD that need medication

> and severe speech impairments like apraxia?

>

> Perhaps (just throwing this out here so don't jump) ADHD can answer

> questions into how to help speech impaired children in the future?

> There may be some answers in where the gray matter is built up, and

> why? Does anyone know if that has been studied -comparing gray

> matter in ADHD children who have speech impairments to those who do

> not?

>

> I'd be curious. Probably not -but here are just a few links of

what

> I found on gray matter/OCD and speech. It was only published last

> year -so not lots yet:

>

[Guest guest]

If he's having trouble falling asleep, I would look more into

magnesium and calcium (and potassium)issues, and also B12 levels. JMO

going off of things I have read on various autism boards.

W

[Guest guest]

" I actually had to have two tests (these are NOT pleasant, trust

me)........Every epic of your sleep is recorded. After the

pulmonologist reads the study, they then determine whether apnea is

present, or

not. In my case it was SEVERE (go figure). I never realized I woke

up 24 times

an hour. "

Hey Karyn -any chance you woke up 24 times in an hour because you

were hooked up to tests that were NOT pleasant?

(just kidding!)

I believe they found around 30-40% of those with speech

impairments/stuttering had OSA -I'm more curious how many with

speech impairments have OSA or other problems while they sleep.

(PS according to an experiment with USPS -the chicken comes first)

http://www.improb.com/airchives/paperair/volume9/v9i4/chicken_egg.html

=====

[Guest guest]

Hi Toni!

That's why I'm not just counting OSA - Does Hope have seizures while

she sleeps or only when awake? (or did she have seizures while she

slept prior to medication and ProEFA?)

" Hope has seizures and had abnormal spikes on her EEG that arent'

seizures. She's been on Kalonopin for just over a year now and is

doing much better. Her seizures are reduced to one in a great while,

down from 50+ absaunt seizures a day. The abnormal spikes were still

there and are just now starting to decrease since we added ProEFA.

She's also on Periactin for migraines. "

And speaking of seizures... and speaking of speech and gray

matter...there was a study on this!

" The team of researchers studied two groups of children. In one

group were 10 children with selective problems in short term

phonological memory (STPM)—a facet of short-term memory that is

believed to be particularly important for learning language skills,

especially the learning of new words. These children had no other

learning or language difficulties, although they did perform poorly

on reading comprehension tasks. The other group consisted of 13

children who had been diagnosed with specific language impairment

(SLI), which means they had severe difficulties with the

comprehension and/or expression of language, but their non-verbal

intelligence remained intact.

Both groups underwent magnetic resonance imaging (MRI) along with

two control groups of healthy children matched for age, gender, and

non-verbal intelligence. The researchers used a relatively new

technique known as voxel-based morphometry (VBM), which enabled them

to perform statistical tests on the MRI scans to detect subtle

differences between brains that visual inspection alone would not

have picked up.

" We found that the children with selective STPM deficits and those

with SLI had less gray matter in both sides of the cerebellum

compared to the children in the control groups, " says Faraneh Vargha-

Khadem, PhD. " In the SLI group, this was particularly pronounced

around an area of the cerebellum known as the vermis. "

These findings raise interesting questions about the role of the

cerebellum in language and cognition, says Vargha-Khadem. She and

her colleagues plan to next examine the relationship between

phonological memory, language, and other domains of cognitive

function in children diagnosed with SLI. " We want to see if we can

specify the relationship between specific regions of the cerebellum

and different aspects of phonological and language processing, " she

says. " This knowledge would have significant implications for

informing accurate diagnosis of language difficulties and could, in

due course, lead to the development of appropriate rehabilitation

techniques. "

Vargha-Khadem also reports on the seven-year follow-up study of the

remarkable case of , who, despite having the entire left

hemisphere of his brain removed at age 8, has developed from about

the age of 9 1/2 extraordinary speech and language skills in his

right hemisphere. In about 98 percent of right-handed people, most

speech and language skills are represented in the left hemisphere.

" Today, at 18, 's speech and language abilities, which are

entirely represented within his lone right hemisphere, are

remarkably well-developed, " says Vargha-Khadem. " His speech is

fluent and well-structured, and he can understand complex

sentences. " 's case shows, says Vargha-Khadem, that the critical

period for the development of speech and language extends to age 10,

and possibly beyond. It also reveals the remarkable capacity of the

immature brain to reorganize speech and language functions.

was born with Sturge-Weber disease (encephalotrigeminal

angiomatosis), a congenital brain abnormality that often causes

epileptic seizures and a developmental delay of motor and cognitive

skills. As a result of this disease, did not develop speech as

a young child and was severely hyperactive and mentally restricted.

He also had debilitating seizures. To help become seizure-free,

doctors removed the entire left hemisphere of his brain when he was

8:6 years old.

After his surgery, 's awareness of his environment increased,

and at the age of 9 years, 4 months, he started uttering his first

words. His ability to speak and communicate gradually improved, and

by the age of 11 he was a competent speaker.

" The level of speech and language ability that produces is both

qualitatively and quantitatively within the normal range and

consistent with his intellectual capacity, " says Vargha-Khadem.

Interestingly, she adds, functional Magnetic Resonance Imaging

(fMRI) studies show that the network of language regions in 's

right hemisphere is similar to that used by most people in the left

hemisphere.

Vargha-Khadem plans to continue to follow 's progress as he

proceeds into adulthood. " One of the things we hope to establish is

whether functional imaging methods can help us predict

reorganization of speech and language function in other children who

are candidates for brain surgery, " she says. "

http://www.innovations-report.com/html/reports/studies/report-23262.html

So it's been proven that children with specific language

impairment 'do' have less gray matter....just as I suspected. So

back to the questions...how can we increase the gray matter/can we? (and in

addition to EFAs and oxygen -does sleep itself play a role here too?)

=====

[Guest guest]

Toni I found sleep does make a difference in amount of gray matter -

especially in our children. And as we grow old (er?) our sleep

decreases as well as our gray matter. Is that linked? (see links

below) I've never slept much...I wonder what an MRI would show for

me! (actually it did say quality and not quantity is what counts -

and if you feel rested. I was always so " up " and high energy in the

morning that if I drank coffee my eye would twitch!...and I'm more

of a night person -I don't sleep much.)

Well since Thanksgiving is today -many will be smarter tomorrow if sleep has

anything to do with it but " unlikely " from the tryptophan in the turkey!

http://www.ehso.com/ehshome/FoodSafety/foodtryptophan.php

(Happy Thanksgiving again!

http://www.jacquielawson.com/viewcard.asp?code=0183913358 )

I said it would be great if we could find a way to increase gray

matter in a way that compliments the whole body. Interestingly

enough I think I am seeing a pattern in what I'm finding. Not only

do diet (like EFAs) and sleep possibly play a role in larger amounts of gray

matter which is linked to higher IQ and better performance...but so

are music, and exercise (the more challenging and fun the better it

appears)and even math! So back to being healthy - experiencing life

in multisensory ways since the brain responds to multiple

stimuli... In the article I posted about Dr. Oz from this month's

Good Housekeeping -he also recommends varying your routine to

stimulate your brain -taking a new way home -not doing things the

same way each day.

If musicians have larger amount of gray matter in the " hearing " part

of their brain, and our children have thinner gray matter in the

speech areas...then what is around the speech areas (like Broca's or

Wernicke's area) that we can develop outside of speech and language -

which in turn will stimulate more speech and language? (So Karyn -

back to chicken and egg question)

" This distinction between speech and language is key to

understanding the role of Wernicke's area to language. It does not

simply affect spoken language, but also written and signed language.

Wernicke's area works with Broca's area, Wernicke's handling

incoming speech and Broca's handling outgoing speech. "

http://www.molbio.princeton.edu/courses/mb427/2000/projects/0008/normbrainmain.h\

tml

" About three to 10 percent of all school-age children have

expressive language disorder. The disorder probably originates from

a problem in or near Broca's area, the region of the brain a few

inches in front of Wernicke's area in the left hemisphere. Broca's

area is responsible for the physical coordination of speaking and

saying the words that a person thinks.

" Autistic children and people with learning disorders will have

certain processes that are more difficult for them to integrate, but

they'll still be able to do things 'normal' people may not, " said

Dr. Spetzler of the Barrow Neurological Institute in Phoenix.

Spetzler is the director of the institute and a renowned

neurosurgeon.

" The music center is not the same place as the spoken center, "

Spetzler said. The doctor's observation helps explain why Tanner

seems to have perfect control over his musical activities, but still

has difficulty expressing his thoughts the way they would be

understood in American culture.

Singing and speaking may seem too similar to have much distinction

because they both involve pitch changes, rhythm, tempo, tones and

other factors. However, speech requires short-term sequencing

involving short-term memory. Music, on the other hand, usually

involves long-term memory and patterns.

In other words, music therapy can often help patients perform

activities they would otherwise be incapable of doing.

" People who won't speak can sing and vice versa, " Borden said.

Recent findings show that music may be used to treat physical

disorders such as common forms of epilepsy. "

http://cronkite.pp.asu.edu/med/Pages/music.html (and no -not my

Tanner in the story)

I wonder how " ride therapy " plays into all of this? Here are some

more links that may be of interest:

" Force of habit rules the hallways and classrooms. Neither brain

science nor education research has been able to free the majority of

America's schools from their 19th-century roots. If more

administrators were tuned into brain research, scientists argue, not

only would schedules change, but subjects such as foreign language

and geometry would be offered to much younger children. Music and

gym would be daily requirements. Lectures, work sheets and rote

memorization would be replaced by hands-on materials, drama and

project work. And teachers would pay greater attention to children's

emotional connections to subjects. " We do more education research

than anyone else in the world, " says Vellutino, a professor of

educational psychology at State University of New York at

Albany, " and we ignore more as well. "

Plato once said that music " is a more potent instrument than any

other for education. " Now scientists know why. Music, they believe,

trains the brain for higher forms of thinking. Researchers at the

University of California, Irvine, studied the power of music by

observing two groups of preschoolers. One group took piano lessons

and sang daily in chorus. The other did not. After eight months the

musical 3-year-olds were expert puzzlemasters, scoring 80% higher

than their playmates did in spatial intelligence — the ability to

visualize the world accurately.

This skill later translates into complex math and engineering

skills. " Early music training can enhance a child's ability to

reason, " says Irvine physicist Gordon Shaw. Yet music education is

often the first " frill " to be cut when school budgets shrink.

Schools on average have only one music teacher for every 500

children, according to the National Commission on Music Education.

Then there's gym — another expendable hour by most school standards.

Only 36% of schoolchildren today are required to participate in

daily physical education. Yet researchers now know that exercise is

good not only for the heart. It also juices up the brain, feeding it

nutrients in the form of glucose and increasing nerve connections —

all of which make it easier for kids of all ages to learn.

Neuroscientist Greenough confirmed this by watching rats at

his University of Illinois at Urbana-Champaign lab. One group did

nothing. A second exercised on an automatic treadmill. A third was

set loose in a Barnum & obstacle course requiring the rats to

perform acrobatic feats. These " supersmart " rats grew " an enormous

amount of gray matter " compared with their sedentary partners, says

Greenough.

Of course, children don't ordinarily run such gantlets; still,

Greenough believes, the results are significant. Numerous studies,

he says, show that children who exercise regularly do better in

school. "

http://www.ecs.org/clearinghouse/12/76/1276.htm

" Maths ability linked to grey matter - BBC. Researchers at the

Institute of Child Health at Great Ormond Street Hospital, London,

found that children who were bad at calculation had a reduced amount

of gray matter on the left hand side of their brains. Grey matter is

the name given to areas of the brain that are mainly composed of the

heads of nerve cells. They used brain scan images to examine

anatomical abnormalities on the left parietal lobe in the children.

The results were published in the journal Brain. "

http://news.bbc.co.uk/1/hi/sci/tech/1512664.stm

" Scientists have found the brains of musicians are larger and more

sensitive than others.

Scans showed a dramatic difference in one part of the brain between

professional and amateur players and non-musicians.

A region of the auditory cortex " hearing " part of the brain

contained 130% more nerve cell " grey matter " in professionals than

in non-musicians, while amateurs had a volume between the two. "

http://www.ananova.com/news/story/sm_608600.html?menu=news.scienceanddiscovery

" Dr. 's reason for probing the genetic control of brain

structure was to uncover genes that might be involved in mental

diseases that can be inherited, like schizophrenia and autism. But

he and his colleagues also wished to understand the role of brain

modules in healthy individuals, so they gave their subjects

intelligence tests and found that intelligence was significantly

linked with the amount of gray matter in the subjects' frontal

lobes.

Dr. said the findings were " the first maps of the degree to

which the genes control brain structure. " There were only 40

subjects in his study - 10 pairs of identical twins and 10 pairs of

fraternal twins - but the results gave " enough statistical power to

identify the key brain systems, " he said.

He expressed surprise that the amount of gray matter in the frontal

lobes turned out to be correlated with intelligence in his

study " because you wouldn't think something as simple as gray matter

would affect something as complicated as intelligence. " But the

amount of gray matter, which is related to the number of brain

cells, perhaps reflects something that bears more directly on

intelligence, like the number of cell- to-cell connections, he said.

Dr. Plomin, who wrote a commentary on the study in the journal, said

the larger volume of gray matter could be the cause of higher

intelligence, or it could be the other way around - people with a

stronger motivation, say, might exercise their brains harder and

develop a higher density of neurons. "

http://www.loni.ucla.edu/~thompson/MEDIA/NN/nyt.html

" First, the brain overproduces gray matter--bulk neurons that are

not yet permanently " wired " into neural circuits. These cells then

begin to arrange themselves into patterns depending on which

connections are reinforced by mental or physical activity.

Thereafter, the least-used cells and pathways die out in a

phenomenon called " pruning " as white matter (chiefly fibers

interconnecting nerve cells) forms to firm up the most robust

connections.

In the new research, Toga, Giedd and colleagues from UCLA and McGill

University in Canada conducted repeated three-dimensional brain

scans of several normal children over intervals as short as two

weeks and as long as four years.

The group concentrated on size and shape changes in a complex nerve

fiber network called the corpus callosum, which connects the two

hemispheres and is a reliable indicator of the level of activity in

different parts of the brain.

The results indicate that from ages 3 to 6, the most rapid growth

takes place in frontal-lobe areas involved in planning and

organizing new actions, and in maintaining attention to tasks.

By contrast, during the period from 6 to puberty, the scientists

found, the gray-matter spike shifts to the temporal and parietal

lobes that play a major role in language skills and spatial

relations. The growth rate then falls off fast, which may explain

why, as a rule, the ability to learn languages declines sharply

after the age of 12. "

http://www.loni.ucla.edu/media/News/WP_03092000.html

" The typical man or woman loses brain matter as part of the aging

process. In a first, Kramer and colleagues used magnetic-resonance

imaging (MRI) scans to show that individuals 55 and older who

exercise regularly - walking briskly for 20 minutes three times per

week - can preserve gray- and white-matter regions of the brain.

" The great thing is it doesn't take too long to realize these

benefits, " Kramer said. " We saw significant cognitive improvement in

people 55 and older over just six months. "

http://magazines.ivillage.com/goodhousekeeping/hb/news/article/0,,krt_2003_11_22\

_knigt_6563-0062-HEALTH-FEELINGGOOD~TB~ew~xml,00.html

H. Calvin, Ph.D., is a neurophysiologist on the faculty of

the Department of Psychiatry and Behavioral Sciences, University of

Washington.

A. Ojemann, M.D., is a neurosurgeon and neurophysiologist on

the faculty of the Department of Neurological Surgery, University of

Washington.

" In the deeper parts of this " orthodox " sleep is when bed-wetting

occurs, as well as night-walking episodes. Both norepi and serotonin

neurons are ticking along at only about half of their waking rates.

About every 100 minutes or so during sleep, both the norepi

and serotonin systems virtually shut down. Then the sleeper

experiences an episode of " paradoxical " sleep.

If you measure the amount of gray matter using an MRI scan,

individuals with high IQs have significantly more than those of

average IQ.

(Toni -also an interesting easy to understand aspect of seizures and

spikes and the impact on the brain you may want to read)

http://williamcalvin.com/bk7/bk7ch2.htm

" There is a theory that we spend part of the night working on the

brain (paradoxical sleep) and the rest of the night working on the

body (orthodox sleep). Presumably these two restoration jobs would

be taken in turns so that at whatever time it is necessary for us to

wake, we will have received some benefit from each of them. This is

almost certainly an over-simplification but there is some evidence

that fits quite neatly. For example, it has been shown that athletes

whose lifestyle puts a great deal of strain on their bodies need

more orthodox sleep. Children need a greater amount of both kinds of

sleep to allow growth, especially paradoxical sleep in the early

weeks when the gray matter of the brain is developing very quickly.

Sleep is a restorative and recuperative process that facilitates

cellular growth and repair of dam-aged and aging body tissues.

During NREM sleep, metabolic, cardiac, and respiratory ratesdecrease

to basal levels and blood pressure decreases. There is profound

muscle relaxation, bonemarrow mitotic activity, and accelerated

tissue repair and protein synthesis. During REM sleep,the

sympathetic nervous system accelerates, with erratic increases in

cardiac output and heartand respiratory rate. Perfusion to gray

matter doubles, and cognitive and emotional information isstored,

filtered, and organized (Boyd, 2001).

• The active phase of the sleep cycle, ...REM sleep occurs approxi-

mately four or five times a night and is essential to a person's

sense of well-being. REM sleep isinstrumental in facilitating

emotional adaptation; a person needs substantially more REM

sleepafter periods of increased stress or learning (Blissitt, 2001).

• Sleep deprivation results in impaired cognitive functioning

(memory, concentration, judgment)and perception, mental fatigue,

reduced emotional control, and increased suspicion,

irritability,depression, and disorientation. It also lowers the pain

threshold and decreases production of cate-cholamines,

corticosteroids, and hormones (Boyd, 2001; Dines-Kalinowski, 2000).

• The average amount of sleep needed according to age follows:Age

Hours of Sleep

Newborn14 to 18

6 months12 to 16

6 months to 4 years12 to 13

5 to 13 years7 to 8.5

13 to 21 years7 to 8.75

Adults younger than 60 6 to 9

Adults older than 60 7 to 8

• Hammer (1991) identified three subcategories of Disturbed Sleep

Pattern: latency or difficultyfalling asleep, interrupted, and early-

morning awakening.• People with depression report early-morning

awakenings and inability to return to sleep. Peoplewith anxiety

complain of insomnia and multiple awakenings (Boyd, 2001).

• Hypnotics contribute to sleep disturbances by (Abrams, 2004)

Depressing central nervous system (CNS) function

D I S T U R B E D S L E E P P A T T E R

To establish the amount of sleep a person needs, have him or her go

to bed and sleep until waking inthe morning (without an alarm

clock). The person should do this for a few days. Calculate the aver-

age of the total sleeping hours, subtracting 20 to 30 min, which is

the time most people need to fall asleep.

• Sleep affects a child's growth and development as well as the

family unit as a whole (Hunsberger, 1989

• Sleep pattern disturbances are the most frequent complaint among

older adults (Hammer, 1991).• Older adults have more difficulty

falling asleep, are more easily awakened, and spend moretime in the

drowsiness stage and less time in the dream stages than do younger

people(, 2004).• (2004) reports that approximately 70%

of older adults complain of sleep disturbances,usually involving

daytime sleepiness, difficulty falling asleep, and frequent arousals.

Page 5

Objective DataAssess for Defining Characteristics.Physical

characteristicsDrawn appearance (pale, dark circles under eyes,

puffy eyes)YawningDozing during the dayDecreased attention

spanIrritability For more information on Focus Assessment Criteria,

visit http://connection.lww.com .GoalThe person will report an

optimal balance of rest and activity.

Teach the importance of regular exercise (walking, running, aerobic

dance) for at least 30 min threetimes a week (if not

contraindicated) to reduce stress and promote sleep.

D I S T U R B E D S L E E P P A T T E R N

• To feel rested, a person usually must complete an entire sleep

cycle (70 to 100 min) four or fivetimes a night (Cohen & Merritt,

1992; Thelan et al., 1998).• Sedative and hypnotic drugs begin to

lose their effectiveness after 1 week of use, requiringincreasing

dosages and leading to the risk of dependence.• A familiar bedtime

ritual may promote relaxation and sleep (Cohen & Merritt, 1992).•

Warm milk contains L-tryptophan, which is a sleep inducer (Hammer,

1991).• Caffeine and nicotine are CNS stimulants that lengthen sleep

latency and increase nighttimewakening (, 2004).• Alcohol

induces drowsiness but suppresses REM sleep and increases the number

of awakenings(, 2004).• Early-morning naps produce more REM

sleep than do afternoon naps. Naps longer than 90 min long decrease

the stimulus for longer sleep cycles in which REM sleep is obtained

(Thelan et al., 1998

S L E E P D E P R I V A T I O N

Geriatric Interventions Explain the effects of alcohol on sleep (eg,

nightmares, frequent awakenings).Explain that sleeping pills

(prescribed or over-the-counter) are not effective after 1 month and

thatthey interfere with the quality of sleep and daytime

functioning.Instruct client to avoid over-the-counter sleeping pills

because of their antihistamine effects.

http://connection.lww.com/Products/carpenito10e/documents/DisturbedSleepPattern.\

pdf

=====

[Guest guest]

" What Will Happen During My Stay?

When you arrive, you will be greeted, shown the dream suite and

oriented to the unit. You and your child will have use of the

playroom and the kitchen, drinks and snacks will be provided.

Diapers and formula are available. If you would like dinner, please

notify the Center prior to your arrival. "

http://www.valleyhealth.com/valley_hospital/VH_Ped_SD_Ap_Study.html

" Dream suite " ?!!! Karyn that's where you went wrong -you should

have asked for the 'pediatric' sleep study!

Interesting about the study...

=====

[Guest guest]

May not be called " ride therapy " but is this ride education?!

(Anyone in Florida going to Disney/Universal tomorrow (Friday) that

has my number and wants to meet for some Rock 'n' Roller Coaster

ride therapy for our kids -let me know!)

" Education in Motion offers students a chance to use their

traditional classroom knowledge of math, science, social studies,

history, and language arts in an exciting hands-on environment.

Magic Springs will challenge students to think about such things as

energy, angles, slopes, simple machines, mathematical reasoning,

even historical influences and creative writing. Teachers can plan a

special day of learning experiences by using our online resource

guide featuring a variety of worksheets and activities specific to

the rides, water park attractions, and buildings. "

http://www.magicsprings.com/school.html

From bfulton@... Tue, 29 Feb 2000 16:23:20 -0600

Date: Tue, 29 Feb 2000 16:23:20 -0600

From: Bill Fulton bfulton@...

Subject: [sCIENCE] Magic Springs Theme Park " Education In Motion "

program

" Education in Motion "

May 17, 18, and 19, 2000

9:00 a.m. - 4:00 p.m.

www.magicsprings.com

Magic Springs * PO Box 6410 * Hot Springs, AR 71901

What Is " Education In Motion? "

It's the excitement on a student's face after a roller coaster ride

as he

explains when he felt potential energy transferred to kinetic

energy, or

hearing a student say, " Did you feel that G-force? "

At the Magic Springs Theme Park " Education In Motion " program,

students will

experience not only hands-on but literally, " body-on " what they have

studied

in the traditional classroom. They gain a much greater

understanding of

science, math, social studies, and language arts by applying

classroom and

textbook lessons to real life situations. Important to the

educational

experience, students and educators will also have the wonderful

opportunity

of learning more about each other in a relaxed, open and fun

environment.

Magic Springs will challenge students to think about such things as

energy,

angles, polygons and slopes, simple machines, use of color and

sound, and

mathematical reasoning and procedures. Through a helpful resource

guide

featuring a variety of worksheets and activities specific to Magic

Springs

rides, teachers can plan a special day of learning experiences.

To ensure a quality program, a limited number of students will be

admitted

on each " Education In Motion " day and advanced reservations will be

required. All school groups are invited to attend. This event

offers a

unique educational experience, as well as, a lot of fun. This

program also

provides principals, teachers, and support groups a reward vehicle to

encourage and direct students throughout the school year.

The dates for the 2000 " Education In Motion " program will be May

17th, 18th,

and 19th. The cost per person will be $9.00 and the park will

provide one

complimentary adult admission for every ten-student admissions. Bus

drivers

may pick up a complimentary ticket at Guest Services. Season passes

are not

valid on any " Education In Motion " dates. Bus parking will be free

with

cars being charged the regular $3.00 parking fee.

Crystal Falls Water Park and rides suitable for children under 48 "

will not

be operational during " Education In Motion " dates.

FUN DAYS

" Education In Motion " are fun days at Magic Springs and give

educators the

opportunity to offer a day at the park as a reward for perfect

attendance or

for other special reasons.

http://list.k12.ar.us/pipermail/science/2000-March.txt

=====

[Guest guest]

Hi Vicki and all,

According to the NIH " Diets of most adult Americans provide

recommended intakes of vitamin B12, but deficiency may still occur

as a result of an inability to absorb B12 from food. It can also

occur in individuals with dietary patterns that exclude animal or

fortified foods " http://www.cc.nih.gov/ccc/supplements/vitb12.html

Then again according to the CDC " In 2001, neurologic impairment

(including delays in speech, walking, and fine motor skills) and

failure to thrive resulting from vitamin B12 deficiency was

diagnosed in two children in Georgia. The children were breastfed by

mothers who followed vegetarian diets. Vitamin B12 deficiency in

young children is difficult to diagnose because of nonspecific

symptoms. "

http://www.cdc.gov/od/oc/media/mmwrnews/n030131.htm

(nice to learn that delays in walking, speech and motor skills are

nonspecific)

Are you a vegetarian or does your child have celiac disease? Not

sure about children since there have only " nonspecific " warning

signs -but if you check out the NIH site I list above and below they

list the warning signs of B12 deficiency. (for adults only?)

According to the NIH " Fortified breakfast cereals are an excellent

source of vitamin B12 and a particularly valuable source for

vegetarians " Without fortified cereals according to the CDC " only

reliable, unfortified, sources of vitamin B12 are animal products "

If you are interested in fortified foods, you can go to DietFacts

http://www.dietfacts.com/ and check out the nutritional labels of

just about any brand of food you want.

There are many fortified cereals out there -here is just one:

http://www.dietfacts.com/item.asp?itemid=3322

For those who have their child on a gluten casein free diet due to

celiac or not -my celiac disease kept me on a strict diet and back

then (a few years ago) -there were no substitutes. If you were not

allowed it -you did not eat it so it was horrible. Today there are

so many more options/substitutes -and delicious recipes. Deborah

can fill you in if anyone wants to know some.

Just a side note on the Bs, while it's rare to get too much vitamin

B12 -you need to be careful with vitamin B6. Either too much or too

little will cause nerve damage. Some fortified cereals will also

provide 100% of vitamin B6 as well. Here is some information on B6

from the NIH

http://www.cc.nih.gov/ccc/supplements/vitb6.html

said: " I would look more into magnesium and calcium (and

potassium)issues, and also B12 levels "

Here are some ways to find foods that contain the other nutrients

suggested to help your child sleep!

magnesium

http://www.cc.nih.gov/ccc/supplements/magn.html

calcium

http://www.nichd.nih.gov/milk/whycal/sources.cfm

potassium

http://www.americanheart.org/presenter.jhtml?identifier=4680

And here is the info on B12

When is a deficiency of vitamin B12 likely to occur?

Diets of most adult Americans provide recommended intakes of vitamin

B12, but deficiency may still occur as a result of an inability to

absorb B12 from food. It can also occur in individuals with dietary

patterns that exclude animal or fortified foods (9). As a general

rule, most individuals who develop a vitamin B12 deficiency have an

underlying stomach or intestinal disorder that limits the absorption

of vitamin B12 (10). Sometimes the only symptom of these intestinal

disorders is anemia resulting from B12 deficiency

Characteristic signs of B12 deficiency include fatigue, weakness,

nausea, constipation, flatulence (gas), loss of appetite, and weight

loss (1, 3, 11). Deficiency also can lead to neurological changes

such as numbness and tingling in the hands and feet (7, 12).

Additional symptoms of B12 deficiency are difficulty in maintaining

balance, depression, confusion, poor memory, and soreness of the

mouth or tongue (13). Some of these symptoms can also result from a

variety of medical conditions other than vitamin B12 deficiency. It

is important to have a physician evaluate these symptoms so that

appropriate medical care can be given.

Vegetarians

Vegetarians who do not eat meats, fish, eggs, milk or milk products,

or B12 fortified foods consume no vitamin B12 and are at high risk

of developing a deficiency of vitamin B12 (9, 25). When adults adopt

a vegetarian diet, deficiency symptoms can be slow to appear because

it usually takes years to deplete normal body stores of B12.

However, severe symptoms of B12 deficiency, most often featuring

poor neurological development, can show up quickly in children and

breast-fed infants of women who follow a strict vegetarian diet

(26).

Fortified cereals are one of the few plant food sources of vitamin

B12, and are an important dietary source of B12 for vegetarians who

consume no eggs, milk or milk products.

http://www.cc.nih.gov/ccc/supplements/vitb12.html

=====