Allegra

An inadequate amount of nightly sleep on a recurring basis, coupled with a sedentary lifestyle and overeating, may fuel the development of diabetes, results of a new study hint.

“Our findings suggest that combining the unhealthy aspects of the Westernized lifestyle with insufficient sleep may add to the risk of overweight and sedentary individuals to develop diabetes,” Dr. Plamen Penev, of the University of Chicago, Illinois, and a senior author of the study, told Reuters Health.

Penev and colleagues subjected 11 healthy but sedentary middle-aged men and women to two 14-day periods of sedentary living with free access to food and either 5.5 hours or 8.5 hours of sleep each night.

As nightly sleep times changed from 8.5 to 5.5 hours, the participants went to bed later and got out of bed earlier and, as a result, average sleep duration was reduced by about two hours a day.

When the adults had their bedtimes decreased from a healthy 8.5 hours to 5.5 hours they showed changes in their response to two common sugar tests, which were similar to those seen in people with an increased risk of developing diabetes.

“If confirmed by future larger studies,” Penev told Reuters Health, “these results would indicate that a healthy lifestyle should include not only healthy eating habits and adequate amounts of physical activity, but also obtaining a sufficient amount of sleep.”

People with chronic respiratory disorders who receive early non-invasive ventilation after a breathing tube has been removed are less likely to suffer respiratory failure or die, a Spanish study has found.

The study included 106 people on mechanical ventilation. All of them had high levels of carbon dioxide in their blood, a condition known as hypercapnia. After their internal breathing tubes were removed, in a procedure called extubation, 54 people received non-invasive ventilation for 24 hours and 52 were given conventional oxygen treatment, the according to the study.

Respiratory failure after extubation occurred in 15 percent of those who received non-invasive ventilation and in 48 percent of people given conventional oxygen therapy. Non-invasive ventilation was associated with an 83 percent decreased risk for respiratory failure after extubation, the researchers found.

They also found that the death rate after 90 days was much lower among people in the non-invasive ventilation group (11 percent) than among those who received conventional oxygen therapy (31 percent).

“Early non-invasive ventilation after extubation diminished risk of respiratory failure and lowered 90-day mortality in patients with hypercapnia during a spontaneous breathing trial,” concluded Dr. Miquel Ferrer, of the Hospital Clinic of Barcelona, and his research colleagues. “Routine implementation of this strategy for management of mechanically ventilated patients with chronic respiratory disorders is advisable.”

The study appears online this week and in an upcoming print issue of The Lancet.

Most generally healthy adults starting an exercise program do not need to see their doctor first, researchers say.

Routine medical screening before starting a regular exercise regimen with the goal of reducing the risk of sudden exercise-induced death is not recommended, the researchers wrote in a report published this month.

“Sudden death is a rare adverse effect of exercise,” Dr. Mayer Brezis, of Hadassah Hebrew University Medical Center, Jerusalem, Israel, told Reuters Health in an interview.

“Medical screening before initiating regular exercise is often advised but without scientific basis,” Brezis noted.

An exercise electrocardiogram — a test that detects and records the heart’s electrical activity — is thought to help identify people at risk but the test yields “many” falsely positive and falsely negative test results, the researcher warned.

In a “simulation study,” Brezis and colleagues found that routine screening decreases deaths in intermediate to high-risk people but not in those who are at low risk.

“Actually, medical screening may cause damage,” Brezis said, “for instance because of labeling healthy people as sick or because of the side effects” of tests to check for heart disease.

“Medical screening may actually prevent the known benefit from exercise by diverting attention from the main goal: i.e., to have people exercise,” Brezis said.

“Sedentary people should be encouraged to initiate exercise gradually and go to a physician if they feel chest discomfort or dizziness during exercise,” Brezis said.

“Gyms should post boards explaining these warning signs. Exercise coaches should understand and explain these warning signs to customers,” he added.

Still, Brezis emphasized that this advice does not apply to individuals with known heart disease. “These people should be referred to cardiac rehabilitation centers where they can resume physical activity under supervision.”