For Teens, Sleep Habits Run in the Family

ENLARGE

Illustration: Thomas Pitilli

To understand teenagers’ sleep habits, look at their parents, a study suggests. When parents go to bed, how long they sleep and when they wake up may help to shape their children’s sleep patterns during adolescence, according to the study, in the February issue of the Journal of Adolescent Health.

Lack of sleep has been linked to obesity, accidents, substance abuse and other health problems during high school, researchers said. Efforts to improve teen sleep should consider the sleep routines of parents and possibly other family members, they said.

The study, at the University of California in Los Angeles, involved 336 pairs of teens and parents, ages 15 and 42 years old, on average, respectively. Most of the teens, 87%, were born in the U.S. while 81% of parents, mostly mothers, emigrated from Mexico. The researchers said family togetherness is emphasized in Mexican-American families but it wasn’t known if it played a factor in the sleep patterns of parents and teens.

Over a two-year period, teens and parents documented their sleep habits and daily activities nightly for two weeks in each of the years. Parent-teen relationships were assessed.

On average, teens slept 8.6 hours on non-school nights and about 30 minutes less on school nights. Parents went to bed and woke up earlier than teens and slept about 17 minutes less on school nights. Although parents and teens didn’t always go to bed at the same time, the similarity in their sleep habits was significant: If parents stayed up later or went to bed earlier, teens also stayed up later or went to bed earlier. The variability in parental bedtimes was more closely related to variability in girls’ bedtimes.

The association between the sleep habits of parents and teens remained significant after adjusting for other factors, such as studying, suggesting family sleep routines may shape adolescent sleep over and above other events in their life, researchers said. The relationship between parent-teen sleep was strongest in larger families and those with greater parental support.

Caveat: The size of the home, type of neighborhood, lighting, noise and family members’ morning and evening preferences weren’t known. It isn’t known if similar sleep patterns would be seen among other ethnic groups, researchers said.

Title: Daily Concordance Between Parent and Adolescent Sleep Habits

Fatty glutes and falls: Progressive loss of muscle in the glutes, a group of muscles that supports the hips, may increase the risk of falls in older people, suggests a study in the current issue of Archives of Gerontology and Geriatrics. Patients who experienced a fall had significantly more fat than muscle in two of the three glutes compared with controls who didn’t fall, the study found.

The three glutes—gluteus maximus, medius and minimus—are located in the buttocks and work together to stabilize the pelvis and hips during walking and other activities. As people age, fatty streaks begin to appear in the gluteus maximus, the largest of the three, and progress to the other two muscles, undermining hip stability, the study suggests.

From 2010 to 2013, researchers in Japan used magnetic resonance imaging to compare muscle atrophy in the glutes and adjacent abdominal, pelvic and thigh muscles in two groups of patients, mostly women, ages 66 to 97 years old. One group of 38 had suspected hip fractures due to falls that weren’t detectable with X-rays. A control group, with 45 patients, had no history of falls. Muscle atrophy was rated from stage 0 (normal muscle) to 4 (more fat than muscle).

Fatty degeneration in the gluteus maximus was stage 2 or higher in both groups and stage 3 or 4 in half of the subjects. But the gluteus minimus was stage 3 and 4 in more than 60% of the falls group compared with 25% of the control group. Muscle atrophy in the gluteus medius was less advanced in the falls group and just beginning in controls.

Fatty degeneration appears to affect the minimus muscle before the medius muscle, which plays the most important role in stabilizing the pelvis and hip joint, researchers said. Evaluating fatty streaks in the minimus could be an early indication of fall risk, they said. Muscle atrophy in other muscle groups was stage 2 or less, the study found.

Caveat: The study was small and only included Japanese women.

Title: Fatty degeneration of gluteus minimus muscle as a predictor of falls

Digestive aid: To avoid indigestion after a meal, lie down on your left side, says a small study in the February issue of the Scandinavian Journal of Gastroenterology. Feelings of fullness and stomach discomfort were significantly more pronounced when subjects were lying on the right compared with the left side after eating, the study found.

Researchers suggest gravity plays a role in indigestion. Lying on the left side allows food to flow along the curvatures of the stomach, which naturally orients to the left, they said. But lying on the right side pushes food toward the antrum, the cavity that separates the stomach from the small intestine. This can cause the antrum to distend, causing nausea and bloating, and allow food to pass through the pylorus, or opening to the intestine, they said.

The study, in Norway, involved eight normal-weight adolescents, four girls and four boys, 14 years old, on average. The subjects fasted for six hours before undergoing two ultrasound examinations four days apart. At each scan, the subjects consumed approximately two cups of clear, low-fat meat soup in four minutes while lying on the left or right side. Gastrointestinal symptoms, such as nausea and fullness, were assessed immediately and after 10 and 20 minutes. Ultrasound images of the stomach and antrum were analyzed.

The movement of food from the stomach into the small intestine, called gastric emptying, was significantly slower when subjects were on their left side. After 10 minutes, 82% of the meal remained in the stomach when subjects were lying on their left side compared with 58% on the right side.

The antrum more doubled in width in the right-side position after 10 and 20 minutes compared with the left side. A wider antrum and faster gastric emptying may activate gastrointestinal receptors that contribute to discomfort after eating, researchers said. Gender and body weight were unrelated to gastric emptying and antral area.

Caveat: The study tested one particular meal in a small number of healthy adolescents and the results may not apply to adults with chronic indigestion, researchers said.

Title: The effect of body position on postprandial perceptions, gastric emptying, and intragastric meal distribution: An ultrasonographic study in reclining healthy subjects

Pain-relief delay: Older patients with impaired cognition waited twice as long as those with normal cognition to receive pain medication for bone fractures in hospital emergency rooms, according to a study in the February issue of International Psychogeriatrics.

Two-thirds of all patients over 60 years old waited more than an hour before receiving pain-relieving drugs, regardless of their cognitive status, the research showed.

Previous studies have shown older patients are less likely than younger patients to receive prompt pain treatment in emergency departments, but this study suggests cognitive impairment increases the risk of delayed or inappropriate pain management. Emergency physicians may not have access to pain-assessment tools that are sensitive to the signs and expressions of pain in people with impaired language, thinking and communications abilities, the study said.

Researchers in Sydney, Australia, reviewed the medical records of 255 patients treated for fractures in four emergency departments in 2012. The subjects were 81 years old, on average, and 78% were women; 73 had conditions such as Alzheimer’s disease, Parkinson’s syndrome and dementia, which are associated with impaired cognition. Just under half of all patients, 48%, had broken femurs, the long leg bone, and the rest had arm, pelvic and lower leg fractures.

On average, all patients were seen by a doctor within 37 minutes and 80% were treated with pain medication. Those with impaired cognition waited approximately 150 minutes before receiving the medication while nonimpaired patients were treated in about 72 minutes. The longest wait for analgesia was 180 minutes.

Pain scores were documented for 68% of the patients with a standard assessment tool that requires patients to rate their pain on a visual or verbal scale.

Caveat: Patient records may not be an accurate reflection of pain assessments and treatments, researchers said.

Title: Cognitive impairment is a risk factor for delayed analgesia in older people with long bone fracture: a multicenter exploratory study

Text neck: Text messaging on a smartphone may cause greater stress on neck muscles than browsing the Web or watching videos, especially if the person texting is sitting, says a small study in the February issue of Ergonomics.

Smartphone users typically look down to type or touch the screen, researchers said. Holding this position for prolonged periods has been associated with neck pain—termed text neck—but few studies have examined the range of head movements during different smartphone tasks, they said.

Researchers in South Korea recruited 18 subjects, nine men and nine women ages 20 years old, on average. The subjects used smartphones to text message, browse the Web and watch a short video. Each activity was performed for two minutes in a sitting and standing position. Head angle, or forward head tilt, was measured with special motion-capturing cameras.

Compared with sitting upright, head angle ranged from 37.2 to 46.8 degrees during texting. During Web browsing, the angle ranged from 33.4 to 42.5 degrees; watching videos, from 30.2 to 44.3 degrees. Subjects tilted their head more using a smartphone while sitting than standing, though the angle was larger during text messaging.

The differences may be due to the way smartphones are held, researchers said. Subjects may lower the phone for two-handed text messaging, increasing head angle. In contrast, only one hand is needed to watch video clips or to hold the phone while the other taps and scrolls, requiring less head flexing, they said.

Caveat: Posture was only assessed for two minutes and subjects were instructed not to lean against the back rest of the chair in the sitting position, which may not be common practice, researchers said.

Title: Head flexion angle while using a smartphone