Why Driving and Sleep Drugs Don't Mix

"PHOTO: ABC News' Lisa Stark demonstrates the dangers of driving after taking sleeping medication at the University of Iowa, home of the most advanced driving simulator in the country." title

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Poor Sleep Hampers Vaccine Effectiveness: Study

HealthDay – 1 min 39 secs ago WEDNESDAY, Aug. 1 (HealthDay News) -- Lack of sleep can reduce the effectiveness of vaccinations, according to a new study.

Researchers measured the sleep patterns of 125 adults who received the three-shot course of the vaccine to protect against hepatitis B. The immune systems of participants who slept less produced fewer antibodies in response to the vaccine and blood tests showed that they did not meet the standard of protection from the virus.

People who slept less than six hours per night were nearly 12 times more likely to be left unprotected by the vaccine than those who slept more than seven hours per night.

Only the amount of sleep, not the quality of sleep, affected the amount of antibodies produced in response to the vaccine.

"Given that more and more Americans are grappling with chronic sleep deprivation, these findings should be a wake-up call to the public health community about the clear connection between sleep and health," study author Aric Prather, a Robert Wood Johnson Foundation Health and Society Scholar at the University of California, both at Berkeley and San Francisco, said in a foundation news release.

The study, published in the Aug. 1 issue of the journal Sleep, is the first outside a sleep laboratory to confirm that the amount of sleep people get affects how they respond to vaccinations, according to Prather.

"Based on our findings and laboratory evidence, physicians and other health professionals who are administering vaccines may want to consider asking their patients about their sleep patterns first, since a lack of sleep may affect the efficacy of the vaccine," Prather said.

Adults should get seven to nine hours of sleep per night, according to the National Sleep Foundation.

While the study found an association between sleep and vaccine effectiveness, it did not prove a cause-and-effect relationship.

More information

The U.S. Centers for Disease Control and Prevention has more about adults and vaccinations.

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Health Tip: Help Baby Develop Healthy Sleep Habits

HealthDay – 1 hr 4 mins ago (HealthDay News) -- It's never too early to teach infants sleep habits that will help prepare them for a lifetime of healthy sleep.

The National Sleep Foundation offers these guidelines:

Look for baby's natural sleep patterns and when he or she starts to get sleepy.Place baby in the crib sleepy, but not asleep.Create a consistent daytime and nighttime sleep schedule, and a soothing bedtime routine.Make sure the environment is dark, cool, and otherwise conducive to sleep.Teach baby to fall asleep on his or her own and to self-soothe to sleep.

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Work-Linked Sleep Loss May Harm Police Officers' Health

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Weight gain induced by high-fat diet increases active-period sleep and sleep fragmentation

ScienceDaily (July 10, 2012) — Research presented at the Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB) finds that prolonged exposure to a high-fat diet reduces the quality of sleep in rats.

See Also:Health & MedicineSleep Disorder ResearchDiet and Weight LossInsomnia ResearchObesityCholesterolNutritionReferenceCircadian rhythm sleep disorderSleep deprivationSeparation anxiety disorderRapid eye movement

Using radio-telemetry, the authors measured 24-hour sleep and wake states after rats consumed a high fat diet for 8 weeks. Compared to rats that consumed a standard laboratory chow, the rats on the high-fat diet slept more but sleep was fragmented. The increased sleep time of the rats on the high-fat diet occurred mainly during the normally active phase of the day, resembling excessive daytime sleepiness observed in obese humans.

According to lead author, Catherine Kotz, "Studies in humans indicate a relationship between sleep quality and obesity. Our previous work in animals shows a link between good quality sleep, resistance to weight gain and increased sensitivity to orexin, a brain chemical important in stabilizing sleep and wake states. The current studies show that after high-fat diet-induced weight gain in rats, sleep quality is poor and orexin sensitivity is decreased. These findings suggest that poor sleep associated with weight gain due to a high-fat diet may be a consequence of reduced orexin sensitivity."

These studies highlight the impact of weight gain on sleep quality and a potential brain mechanism underlying these diet and weight-gain induced changes in sleep behavior.

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Should we sleep more to lose weight?

ScienceDaily (July 10, 2012) — Research to be presented at the Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB) suggests that sleep behavior affects body weight control and that sleep loss has ramifications not only for how many calories we consume but also for how much energy we burn off.

See Also:Health & MedicineSleep Disorder ResearchInsomnia ResearchFitnessDiet and Weight LossObesityStaying HealthyLiving WellReferenceCircadian rhythm sleep disorderSleep deprivationRapid eye movementNight terror

In recent years an increasing number of epidemiological studies have found a relationship between how long we sleep for and obesity as well as type 2 diabetes, suggesting that insufficient sleep increases the risk of gaining weight and developing diabetes.

Work carried out by researchers from the German Universities Tubingen and Lubeck and Uppsala University in Sweden has investigated the effect of short term sleep deprivation on hunger as well as on physical activity and energy used by the body. Physical activity was measured by special devices worn on the wrist that detect acceleration. Energy used by the body was assessed by indirect calorimetry, a method which estimates how much heat is produced by a person as they use oxygen.

Sleep deprivation increased how hungry participants felt and also raised the amount of the "hunger hormone" ghrelin detected in their blood. In fact, the shorter the amount of sleep a person had experienced the hungrier they were. After just one night of disrupted sleep volunteers moved around less although this was not surprising considering they also felt more tired. In addition, staying awake for one complete night reduced the amount of energy used by the body when resting. This research tells us when we are sleep deprived we are likely to eat more calories because we are hungrier. This alone might cause us to gain weight over time. However sleep loss also means we burn off fewer calories which adds to the risk of gaining weight.

Ongoing studies aim to find out if increasing sleep time might help with weight control efforts. While there is still some way to go before sleep improvement is used to treat obesity and diabetes, the available research results clearly supports the notion that sleep is involved in the balance between the amount of calories we eat and the amount we use up through activity and metabolism.

The research was funded by the German Research Foundation (DFG).

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Sleep apnea gets worse in the winter

Reuters – 13 hrs ago NEW YORK (Reuters Health) - The breathing problems caused by sleep apnea appear to worsen during the colder months of the year, according to a new study from Brazil.

People with the common sleep disorder stop breathing multiple times throughout the night, each bout lasting from seconds to minutes.

Jerome Dempsey, who studies breathing problems at the University of Wisconsin and was not involved in the new study, said it makes sense that airway infections and weather would have an effect on sleep apnea.

But the changes in sleep apnea across seasons are small, Dempsey added, and the study does not prove that winter weather in itself makes sleep apnea worse.

According to the National Heart, Lung, and Blood Institute, one in 10 adults over age 65 has sleep apnea.

Seasonal changes in weight and allergies can affect sleep apnea, and the Brazilian researchers, led by Cristiane Maria Cassol at Universidade Federal do Rio Grande do Sul, wanted to see if weather changes might also have any impact on the disorder.

They used data from patients who came in for testing at a sleep clinic on how many times their sleep was disturbed by breaks in breathing. The study included one night of sleep for more than 7,500 patients over a 10-year period.

The researchers then compared the severity of the patients' apnea to the weather conditions at the time, including humidity, temperature and air pollution.

Patients who came in during the colder months had more nighttime breaks in breathing than those who sought treatment during the warmer months. For instance, during the winter, patients stopped breathing an average of 18 times per hour, compared to 15 times an hour during the summer.

Similarly, the sleep clinic was more likely to see the most severe cases - people who stopped breathing more than 30 times an hour - in the colder months.

About 34 percent of patients who came in during cold weather had severe apnea, while 28 percent of patients during warm weather had severe apnea.

The team found that certain weather conditions - high atmospheric pressure and humidity and high levels of the air pollutant carbon monoxide - were tied to worse cases of apnea.

But the study could not determine whether it's the weather that's responsible for the more severe sleep apneas.

The researchers write in their report, published in the journal Chest, that more severe apnea in the winter "can be due to several circumstances, including winter-related upper-airway problems that intensify the severity of (sleep apnea) symptoms."

Another possibility is that wood burning to heat homes during the winter can cause irritation in the airways and aggravate sleep apnea.

"There are so many things that affect sleep apnea, including the decision of when to come visit" a sleep clinic, Dempsey told Reuters Health.

In other words, it might not be the weather, but the time of year that makes it more convenient for patients to take the time to seek treatment.

Dempsey said researchers would have to follow patients for at least a year and observe how their conditions change in order to say whether sleep apnea really does worsen in the winter.

While winter-related conditions such as colds or allergies might intensify sleep apnea, Dempsey said the biggest risk factor is obesity.

SOURCE: http://bit.ly/MqNmmE Chest, online June 14, 2012.

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Sleep apnea gets worse in the winter: study

Reuters – 3 hrs ago (Reuters) - Respiration problems in sleep apnea - which causes people to momentarily stop breathing multiple times throughout the night, for seconds to minutes at a time - appear to worsen during the colder months of the year, according to a study from Brazil.

Changes in weight and seasonal allergies can affect sleep apnea, and researchers writing in the journal Chest wanted to see if weather changes might also have an impact.

"More sleep disordered breathing events were recorded in wintertime than in other seasons," wrote study leader Cristiane Maria Cassol from the Universidade Federal do Rio Grande do Sul.

Cassol and her team said it could be due to several causes, including winter-related upper-airway problems that intensify the severity of symptoms and the use of burning wood to heat homes during the winter.

The team utilized data from sleep clinic patients and looked at how many times their rest was disturbed by breaks in breathing. The study included one night of sleep for more than 7,500 patients over a 10-year-period.

Researchers then compared the severity of the patients' apnea to the weather conditions at the time, including humidity, temperature and air pollution.

Patients who came in during colder months had more nighttime breaks in breathing than those who sought treatment during warmer months. During the winter, patients stopped breathing an average of 18 times an hour compared to 15 times an hour during the summer.

Similarly, the sleep clinic was more likely to see the most severe cases - people who stopped breathing more than 30 times an hour - during the colder months.

About 34 percent of patients who came in during cold weather had severe apnea, compared to 28 percent of patients during warmer weather.

The team found that certain weather conditions, such as high atmospheric pressure and humidity and high levels of the air pollutant carbon monoxide - were tied to worse cases of apnea.

But the study could not determine whether it was the weather itself that was responsible for the more severe apneas.

Jerome Dempsey, who studies breathing problems at the University of Wisconsin and wasn't involved in the study, said it makes sense that airway infections and weather could have an effect on sleep apnea, but that the changes across the seasons were small.

"There are so many things that affect sleep apnea, including the decision of when to come visit" a sleep clinic, Dempsey told Reuters Health.

In other words, it might not be the weather but the time of year that makes it more convenient for patients to take the time to seek treatment.

He added that while winter-related conditions such as colds or allergies might intensify sleep apnea, the biggest risk factor is obesity. SOURCE: http://bit.ly/MqNmmE

(Reporting from New York by Kerry Grens at Reuters Health; editing by Elaine Lies and Bob Tourtellotte)

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Poor Sleep Affects Immune System Much Like Physical Stress

HealthDay – 7 mins ago MONDAY, July 2 (HealthDay News) -- Severe sleep deprivation has the same effect on the immune system as physical stress, according to a new study.

Researchers in the Netherlands and the United Kingdom found sleep loss triggers the production of white blood cells, known as granulocytes, particularly at night.

"The granulocytes reacted immediately to the physical stress of sleep loss and directly mirrored the body's stress response," explained the study's lead author, Katrin Ackermann, a postdoctoral researcher at the Eramus MC University Medical Center Rotterdam in the Netherlands, in a news release from the American Academy of Sleep Medicine.

In conducting the study, the researchers tracked the white blood cell count of 15 healthy young men who followed a strict schedule of eight hours of sleep every day for a week, then compared that with their white blood cell counts during 29 hours of sleep deprivation.

The investigators found that the white blood cells showed a loss of day-night rhythmicity and also increased during the sleep deprivation.

The research was published in the July issue of the journal Sleep.

Previous studies have shown sleep deprivation is linked to the development of diseases, including obesity, diabetes and high blood pressure. Prior research has also suggested that chronic sleep loss is a risk factor for impairment of the immune system.

Looking ahead, the study authors concluded that future research should examine exactly how sleep loss contributes to the development of certain diseases.

"Future research will reveal the molecular mechanisms behind this immediate stress response and elucidate its role in the development of diseases associated with chronic sleep loss," said Ackermann in the news release. "If confirmed with more data, this will have implications for clinical practice and for professions associated with long-term sleep loss, such as rotating shift work."

More information

The American Psychological Association has more about the importance of sleep.

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Sleep May Ease Symptoms of Parkinson's Disease: Study

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Sleep Apnea May Be Linked to Nerve Damage in Diabetics

HealthDay – 4 hrs ago MONDAY, June 18 (HealthDay News) -- Obstructive sleep apnea is associated with nerve damage in people with type 2 diabetes, according to a new study.

The severity of this type of nerve damage -- called diabetic peripheral neuropathy -- is linked with the extent of sleep apnea and the degree of low blood oxygen levels that occur while patients sleep, the researchers found.

People with obstructive sleep apnea subconsciously awaken many times a night -- even dozens of times an hour -- because their airways close, disrupting their breathing. Those with diabetic peripheral neuropathy may have numbness or tingling in their extremities, or damage to their major organs.

The study of 234 adults with type 2 diabetes found that sleep apnea was independently associated with diabetic peripheral neuropathy even after the researchers accounted for a number of other possible factors, including obesity, ethnicity, gender, age at diabetes diagnosis, and the length of time a person had diabetes.

The findings were published online ahead of print in the American Journal of Respiratory and Critical Care Medicine.

"Obstructive sleep apnea is known to be associated with inflammation and oxidative stress, so we hypothesized that it would be associated with peripheral neuropathy in patients with type 2 diabetes," lead author Dr. Abd Tahrani, a clinical lecturer in endocrinology and diabetes at the University of Birmingham in England, said in a news release from the American Thoracic Society.

However, while the study uncovered an association between obstructive sleep apnea and peripheral neuropathy in diabetic patients, it did not prove a cause-and-effect relationship.

Further research is needed to determine the role of sleep apnea and low blood oxygen levels in the development and progression of nerve damage in patients with type 2 diabetes, and to assess the potential impact of continuous positive airway pressure treatment on diabetic peripheral neuropathy, the study authors said.

Continuous positive airway pressure treatment, or CPAP, keeps obstructive sleep apnea patients' airways open while they sleep.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about diabetic neuropathy.

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Sleep Apnea Treatment Might Boost Men's Sex Lives

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Sleep Habits in U.S. Vary by Race, Native Country: Study

HealthDay – 4 mins 40 secs ago WEDNESDAY, June 13 (HealthDay News) -- Race, ethnicity and country of origin appear to be factors in how much sleep Americans get each night, according to two new studies.

In one report, State University of New York researchers examined data from 400,000 participants in the U.S. National Health Interview Surveys between 2004 and 2010 and found that those born in the United States were more likely to report sleeping longer than the recommended seven to nine hours each night.

Previous research has found that adults who regularly sleep less or more than the recommended seven to nine hours may be at increased risk for health problems such as cardiovascular disease, stroke and depression.

In comparison, African-born Americans were more likely to report sleeping six hours or less per night, and Indian-born Americans were more likely to report sleeping six to eight hours a night.

However, foreign-born Americans were less likely than U.S.-born Americans to report getting too little or too much sleep after the researchers adjusted for the effects of age, sex, education, income, smoking, alcohol use, body mass index and emotional distress.

In the other study, researchers randomly selected 439 adults in Chicago and found that whites slept significantly longer than other racial/ethnic groups, blacks reported the worst sleep quality, and Asians were most likely to report daytime sleepiness.

"These racial/ethnic differences in sleep persisted even following statistical adjustment for cardiovascular disease risk factors that we already know to be associated with poor sleep, such as body mass index, high blood pressure and diabetes," study lead author Mercedes Carnethon, of Northwestern University Feinberg School of Medicine in Chicago, said in an American Academy of Sleep Medicine news release.

"And we excluded participants who had evidence of mild to moderate sleep apnea. Consequently, these differences in sleep are not attributable to underlying sleep disorders but represent the sleep experience of a 'healthy' subset of the population," she added.

The studies were to be presented Wednesday at the annual meeting of the Associated Professional Sleep Societies in Boston. Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Heart, Lung, and Blood Institute offers strategies for getting enough sleep.

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Violence Takes a Toll on Children's Sleep

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Sleep Apnea Treatment Might Boost Men's Sex Lives

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Watch: Sleep Apnea Linked to Risk of Hypertension

Skydiver Survives Fall Without...More Popular VideoBill Clinton and the Porn StarsNuts for NutsHunt for Bin Laden in :60George Zimmerman in Sanford Police Station5 Revealing Clues Into the 'Real' Bin LadenIn The NewsU.S.PoliticsEntertainmentWeird and WackySleep Apnea Linked to Risk of HypertensionDr. Harneet Walia says new treatments for sleep apnea show positive results.01:46

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Sleep Apnea Linked to Higher Cancer Death Risk

HealthDay – 1 hr 30 mins ago SUNDAY, May 20 (HealthDay News) -- Sleep apnea has already been linked to a host of adverse health problems, such as high blood pressure and heart disease. Now, new research suggests that in people who already have cancer, the sleep disorder may raise their risk of dying from cancer.

People with the most severe sleep apnea -- those who have 30 or more episodes of low or no oxygen in an hour of sleep -- had almost five times the risk of cancer death compared to someone without sleep apnea.

"Sleep apnea is the periodic pausing of breathing during sleep that results in drops in oxygen levels in your blood. It causes snoring and sleepiness during the day," explained study author Dr. Javier Nieto, chair of the department of population health sciences at the University of Wisconsin School of Medicine and Public Health, in Madison.

"Aside from being an annoyance to your spouse, family members and maybe even your neighbors depending on how loud your snoring is, sleep apnea is a severe problem. Drowsiness and sleepiness during the day increase the risk of accidents, and sleep apnea is associated with cardiovascular disease, heart disease, strokes, hypertension and cardiovascular mortality. Now, we see this new angle: an increase in cancer mortality," said Nieto.

Nieto is scheduled to present the study Sunday at the American Thoracic Society International Conference, in San Francisco.

Nieto said the new study was suggested by researchers from the University of Barcelona in Spain who found that when mice were deprived of oxygen periodically, skin cancer tumors grew faster in the mice. And, cancer cells in the lab that are deprived of oxygen produce molecules that stimulate the growth of blood vessels in an attempt to get more oxygen, he said.

Nieto and the Spanish researchers wondered if this effect was the same in humans. To test that theory, they reviewed data from more than 1,500 people included in the Wisconsin Sleep Cohort. This study included 22 years of mortality data, as well as information from sleep studies.

The researchers adjusted the data to account for age, sex, body mass, smoking and other factors that might affect the risk of cancer death, and they found that sleep apnea increased the risk of cancer death. They also found that the more severe the sleep apnea, the more likely someone was to die from cancer.

People with mild sleep apnea -- five to 14.9 episodes of low or no oxygen in an hour -- had a 10 percent increased risk of cancer death, while those with moderate sleep apnea -- 15 to 29.9 episodes of low or no oxygen in an hour -- had double the risk of cancer death. Those with severe sleep apnea -- more than 30 episodes of low or no oxygen in an hour -- had a 4.8 times higher risk of cancer death.

Nieto said the study didn't prove a cause-and-effect relationship, but the association was quite strong. And, he noted that the findings were consistent in humans, animals and in cells.

He added that there is also a plausible mechanism for this association. When you have cancer and you repeatedly have episodes of low or no oxygen, the cancer cells "try to compensate for the lack of oxygen by growing additional blood vessels to get more oxygen. It's a defense mechanism," Nieto said. And, as those blood vessels keep growing, it helps the tumor to spread, he explained.

Dr. Steven Park, a sleep medicine specialist and otorhinolaryngologist at Montefiore Medical Center in New York City, said he wasn't surprised by the findings.

"This goes along with the link between sleep apnea and pretty much every chronic medical condition out there," Park said. But, he added that this study's findings need to be confirmed in other studies, and ideally be published in a peer-reviewed journal. Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

"Anyone with snoring, severe daytime fatigue, lack of memory or focus, high blood pressure, diabetes, and even someone who has to get up to go to the bathroom at night should be screened for sleep apnea," Park said. He added that it's possible to have sleep apnea without snoring, especially for women. So, if you're getting enough sleep at night, yet still feel tired during the day, it's important to bring this up to your doctor.

Park said there are home-monitoring devices that can be used to screen people at home initially.

Nieto said that treating sleep apnea will improve your quality of life, as well as reduce your risk of high blood pressure and cardiovascular disease. And, if you have cancer, he said, treating sleep apnea may help increase your odds of surviving cancer.

More information

Learn more about sleep apnea from the U.S. National Heart, Lung and Blood Institute.

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Overweight? New research explains how proper sleep is important for healthy weight

ScienceDaily (May 7, 2012) — If you're counting calories to lose weight, that may be only part of the weight loss equation says a new research report published online in The FASEB Journal. In the report, French scientists show that impairments to a gene known to be responsible for our internal body clocks, called "Rev-Erb alpha," leads to excessive weight gain and related health problems. This provides new insights into the importance of proper alignment between the body's internal timing and natural environmental light cycles to prevent or limit excessive weight gain and the problems this weight gain causes.

See Also:Health & MedicineDiet and Weight LossObesityFitnessWorkplace HealthGene TherapyDiseases and ConditionsReferenceCalorie restricted dietCircadian rhythm sleep disorderSeasonal affective disorderCircadian rhythm

According to Etienne Challet, Ph.D., a researcher involved in the work from the Department of Neurobiology of Rhythms at the Institute of Cellular and Integrative Neurosciences at the University of Strasbourg in Pascal, France, "It is now clear that impairment of daily rhythms such as shift-work, exposure to artificial lighting, or jet-lag has multiple adverse effects on human health, every effort should be made to maintain or restore normal temporal organization and to avoid potentially disruptive behaviors such as nocturnal meals or light exposure at night."

To make this discovery, Challet and colleagues studied two groups of mice. One group was normal and the other group lacked the Rev-Erb alpha gene. In the mice lacking the Rev-Erb alpha gene, it was determined that they became obese and hyperglycaemic even if they ate the same quantity of food at the same time as normal mice. Further scientific investigation showed that when the Rev-Erb alpha-deficient mice were compared to the normal mice, there was a major difference in the way Rev-Erb alpha-deficient mice metabolized the food they ate. The Rev-Erb alpha deficient mice created much more fat than the normal mice, and this occurred specifically during the feeding period. Additionally, the Rev-Erb-alpha deficient mice relied less on carbohydrate stores when at rest.

"The phrase 'sick and tired' could never be more true," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "This research shows that we evolved to live in synch with the natural light and dark cycles of our planet. Strasbourg has long taught us the finer aspects of cuisine; its scientists now explain how night and day can influence whether we are fat or lean."

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Longer sleep times may counteract genetic factors related to weight gain

ScienceDaily (May 1, 2012) — Toss out another old wives' tale: Sleeping too much does not make you fat. Quite the opposite, according to a new study examining sleep and body mass index (BMI) in twins, which found that sleeping more than nine hours a night may actually suppress genetic influences on body weight.

See Also:Health & MedicineObesitySleep Disorder ResearchDiet and Weight LossMind & BrainSleep DisordersInsomniaObstructive Sleep ApneaLiving WellReferenceCircadian rhythm sleep disorderOverweightBody mass indexSleep deprivation

The study looked at 1,088 pairs of twins and found that sleeping less than seven hours a night was associated with both increased BMI and greater genetic influences on BMI. Previous research has shown that genetic influences include things like glucose metabolism, energy use, fatty acid storage and satiety. In this study, the heritability of BMI was twice as high for the short sleepers than for twins who slept longer than nine hours a night.

"The results suggest that shorter sleep provides a more permissive environment for the expression of obesity related genes," said principal investigator Nathaniel Watson, MD, MSc, of the University of Washington. "Or it may be that extended sleep is protective by suppressing expression of obesity genes."

Watson and colleagues determined that for twins sleeping less than seven hours, genetic influences accounted for 70 percent of the differences in BMI, with common environment accounting for just 4 percent and unique environment 26 percent. For twins averaging more than nine hours of sleep, genetic factors were attributed to 32 percent of weight variations, with common environment accounting for 51 percent and unique environment 17 percent.

More research is needed, Watson said, but these preliminary results may suggest that behavioral weight loss measures would be most effective when genetic drivers of body weight are mitigated through sleep extension.

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Adjusting Your Attitude About Chronic Pain May Help You Sleep

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