A Better Sleep

10/04/2026

Napping: Countermeasure, Warning Sign—or Both?

Napping sounds simple. We become tired, we sleep for a while, and we feel better. But for healthcare workers, drivers, military personnel, shift workers and others working in safety-sensitive environments, the question is considerably more important: can a nap actually restore performance after sleep loss, and when might frequent napping instead indicate an underlying problem?

Two recent studies provide complementary answers.

When sleep loss is unavoidable, a short nap can help

The first, published in Anesthesiology, examined 35 anesthesia and intensive-care residents. Participants were assessed when rested and again following a 24-hour shift. During the sleep-deprived condition, they were randomly assigned either a 30-minute nap opportunity or a control condition before undertaking a simulated medical crisis. Sleep was objectively monitored using actigraphy.

The results are important. In the primary analysis, clinical performance following the nap opportunity was 7.4% better than in the control group. The greatest benefit was seen in non-technical skills, including leadership and resource utilization. Technical performance did not differ significantly between groups, although greater sleep duration was associated with better technical performance.

Most residents offered the nap actually slept, averaging approximately 22 minutes.

This was a small study and performance was measured in a simulation rather than through actual patient outcomes. It therefore does not prove that a 30-minute nap prevents medical errors. What it does provide is randomized evidence that a brief opportunity to sleep can measurably improve aspects of performance after substantial sleep loss.

But frequent napping can tell a different story

The second study, wonderfully titled Snoozing While Cruising, examined napping among 10,590 active-duty US Navy sailors.

Researchers Dale Russell and Anne Germain found something apparently contradictory. More frequent napping was associated with lower odds of high job stress and impaired functioning, supporting the concept of napping as an effective acute fatigue-management strategy.

But there was another side to the findings.

More frequent napping was also associated with greater odds of burnout, while sailors napping on five or more days each week had higher odds of reporting an elevated number of poor mental-health days. Nap frequency was not significantly associated with poor physical-health days.

This does not mean that naps cause burnout or poor mental health. The study was observational and demonstrates associations rather than causation.

Instead, frequent napping may sometimes be a marker of the conditions creating the need to nap—insufficient sleep opportunity, demanding schedules, fatigue or chronic occupational strain.

So, should we nap?

The two studies together provide a useful answer.

Strategic napping can be an effective fatigue countermeasure. Frequent dependence upon napping, however, may be a signal that we should ask why the person is so tired in the first place.

That distinction matters.

Someone who has experienced unavoidable acute sleep loss—a physician completing an overnight shift, for example—may benefit from a planned nap. In these circumstances, napping is being used deliberately to reduce an immediate physiological consequence of inadequate sleep.

But if someone routinely struggles to remain awake during the day or needs frequent naps despite apparently adequate opportunity for nighttime sleep, simply recommending more naps risks overlooking the underlying problem.

That problem might be chronic insufficient sleep, an unsuitable work schedule, circadian disruption or potentially a sleep disorder requiring assessment.

Naps don't replace sleep

Perhaps the most important message from both studies is what they do not show.

Neither provides evidence that people can routinely shorten their main sleep period and simply compensate with occasional naps. Russell and Germain specifically caution that nap frequency should not be regarded as a substitute for sufficient total sleep opportunity or for addressing chronic occupational strain.

This is particularly important in fatigue-related safety messaging. Telling a sleepy driver simply to “take a nap” can inadvertently suggest that sleep deprivation has been corrected. A nap may temporarily improve alertness, but it does not erase accumulated sleep debt or make chronic insufficient sleep safe.

The same principle applies in medicine, aviation, transportation, military operations and shift work.

We therefore need to stop thinking of napping as either “good” or “bad.”

A better question is:

Why is the person napping?

A strategically planned nap during unavoidable sleep loss can be a valuable tool. Repeatedly needing naps to function may instead be telling us something important about sleep health, workload or the way work itself has been organized.

In other words, the nap can be both a treatment for fatigue and a symptom of the problem causing it.

For individuals and organizations concerned with safety, that distinction is worth understanding.

10/03/2026

“Looking forward to a good mission after some sleep. That’s what I’m going to go do next,” Canadian astronaut Joshua Kutryk said on the NASA broadcast.

Canadian astronaut Joshua Kutryk’s first thought after being told Thursday he had made it to space was one of disbelief.

“I don’t really believe it yet,” Kutryk said after being told the crew was in orbit, about 10 minutes after blasting off from Florida as part of the NASA SpaceX Crew 13 mission to the International Space Station.

“It does feel weird, though.”

The 44-year-old is a mission specialist on the four-person crew, which also includes commander Jessica Watkins and pilot Luke Delaney — both of NASA — and Roscosmos cosmonaut Sergey Teteryatnikov, another mission specialist.

NASA says the Crew 13 mission had the fastest flight ever to the International Space Station, taking just under eight hours to reach the facility.

After another two hours or so of docking procedures, Kutryk and his crewmates emerged from a hatch and were greeted with hugs and handshakes from the seven people aboard the station.

Speaking during a brief welcome ceremony, Kutryk expressed disbelief at finally being on the space station and said it’s great to have Canada represented there again.

“Looking forward to a good mission after some sleep. That’s what I’m going to go do next,” he said on the NASA broadcast.

The crew is to spend six months at the station conducting experiments, doing research and taking part in critical maintenance work.

Kutryk also faces a unique situation during his months-long deployment off Earth — his wife is set to give birth to their third child.

The space station is a long way from the Alberta cattle farm where Kutryk grew up. Before the launch, Kutryk said the crew members felt like “some of the luckiest people on Earth.”

Industry Minister Mélanie Joly watched the launch from the ground. It was the first she had ever attended.

“It was absolutely fantastic,” Joly said with a smile at the Kennedy Space Center. “It’s a very humbling experience as well because ultimately we’re very, very small humans in an extremely vast universe.”

Joly said the launch offered an important symbol of international co-operation during “tense geopolitical times.”

“When it comes to space, I think this is a place where we can collaborate and co-operate,” she said. “That’s what we’ve done.”

Collaboration on space innovation has continued despite U.S. President Donald Trump’s tariffs and continued threats of annexation.

Joly has been on the front lines of Trump’s trade war with Canada, first as foreign minister and now in her current portfolio, where she’s tasked with mitigating many of the tariffs’ effects.

She met with NASA administrator Jared Isaacman for about 30 minutes Thursday. She said they spoke about how the Canadian Space Agency can contribute to exploration, particularly of the moon and Mars.

Joly said she always talks about the importance of ending the trade war when she meets members of the Trump administration and other American politicians.

At a post-launch news conference, Isaacman said he has fruitful discussions with Canada, particularly on a future lunar base. Pointing to the well-known Canadarm and its followup Dextre, Isaacman said Canada’s robotics expertise would play an important role in achieving America’s lofty ambitions in space.

“We are going to be counting on it as part of the architecture,” he said.

Kutryk’s mission adds to a memorable year for Canadian space exploration and research.

Canadian Jeremy Hansen was one of four astronauts aboard the Artemis II mission in April — humanity’s first trip to the moon in more than 50 years. The 10-day lunar fly-around saw Hansen and his crewmates travel farther from the surface of the Earth than anyone before them.

Mathieu Caron, director of astronauts, life sciences and space medicine at the Canadian Space Agency, told Thursday’s news conference that for the first time in his three-decade-long career, his children think he’s cool.

“Across Canada, we really see a renewed enthusiasm for human space exploration,” Caron said.

Joly said Canada was looking to push its space capabilities further by diversifying space partnerships and working more closely with the European and Japanese space industries, as well as other middle-power countries.

But Ottawa wants to do things faster and with more ambition, she added.

Joly said Canada’s defence industrial plan recognizes the importance of the space sector and new funds have been dedicated to the Canadian Space Agency. She said Canada must embrace the industrial part of space investment to create domestic jobs while also doubling down on science and civilian research.

A new president for the Canadian Space Agency is to be named in the coming weeks, Joly said. A new space strategy would also be unveiled in the coming months, which will promote Canada’s goals of creating opportunities, playing a larger role in the sector and sending more astronauts off Earth, she added.

“I think space exploration is important for our country,” she said.

“Also we benefit from the different research done … for our industry, for creating jobs but also to protect our sovereignty and also when it comes to science and the betterment of humankind.”

10/03/2026

“You need to lose weight.”

It is advice many people with obstructive sleep apnea (OSA) have heard.

And there is good reason for it. Excess weight is an important risk factor for OSA, and meaningful weight loss can substantially improve OSA severity in many patients.

But there is another side to the story that deserves considerably more attention:

Losing weight and maintaining weight loss are not the same biological challenge.

Following weight loss, the body actively responds. Appetite signals can increase, satiety signals change, energy expenditure falls, and the body becomes more efficient at conserving energy. These adaptations can persist long after the initial weight has been lost.

Add changes in physical activity, stress, sleep, eating behaviour and an environment in which calorie-dense food is constantly available, and weight regain becomes understandable — not simply a matter of “willpower.”

The same principle is becoming particularly apparent with modern obesity medications. When effective treatment is withdrawn, substantial weight regain is common. Weight regain can also occur following bariatric surgery.

Why does this matter in sleep medicine?

Because weight loss can improve OSA, but weight regain may allow OSA severity to increase again. And untreated OSA itself may contribute to fatigue, reduced activity, disrupted metabolic regulation and greater difficulty maintaining healthy behaviours.

So perhaps the conversation shouldn't simply be:

“Lose weight and your sleep apnea will improve.”

It should be:

“How can we treat the OSA, address weight where appropriate, and help the patient maintain those improvements over the long term?”

Obesity is a chronic disease. OSA is a chronic disease.

For many patients, both require long-term management — not a short-term instruction.

10/03/2026

MILD?

I made this point a few months ago, but I think it is worth making again.

We routinely describe obstructive sleep apnea as mild, moderate or severe largely according to the apnea-hypopnea index (AHI).

But “mild OSA” does not necessarily mean mild consequences for the patient.

In clinical practice, some patients with relatively modest AHIs report significant brain fog, impaired concentration, poor memory, irritability, reduced stress tolerance and difficulty with executive functioning. Others may have been treated for anxiety, depression, ADHD, insomnia or “burnout” before sleep-disordered breathing is fully considered.

The AHI is important — but it counts respiratory events. It does not directly measure the cumulative neurological effects of repeated sleep fragmentation, intermittent hypoxia, autonomic activation and disrupted sleep architecture.

Research has associated OSA with impairments in attention, vigilance, memory and executive function, although the relationship between AHI severity and neurocognitive impairment is complex and varies considerably between individuals.

That distinction matters.

A patient can have “mild” OSA by AHI and symptoms that are anything but mild.

Perhaps we need to be more careful about what we are actually calling mild.

09/23/2026

𝗵𝘆 𝗗𝗼𝗲𝘀 𝗧𝗵𝗲 𝗕𝗿𝗮𝗶𝗻 𝗦𝗼𝗺𝗲𝘁𝗶𝗺𝗲𝘀 𝗠𝗮𝗸𝗲 𝗬𝗼𝘂 𝗙𝗲𝗲𝗹 𝗟𝗶𝗸𝗲 𝗬𝗼𝘂'𝗿𝗲 𝗙𝗮𝗹𝗹𝗶𝗻𝗴 — 𝗪𝗵𝗲𝗻 𝗬𝗼𝘂 𝗔𝗿𝗲𝗻'𝘁?

Have you ever suddenly felt as if the ground dropped beneath you?
You may not actually be falling.
Yet for a brief moment, the brain can generate a powerful sensation of movement, instability, or falling.
Why?
Because the brain does not directly “feel” balance.
It constructs a sense of body position and movement by combining multiple sensory signals.

⚡ 𝗪𝗵𝗲𝗻 𝗧𝗵𝗲 𝗦𝗶𝗴𝗻𝗮𝗹𝘀 𝗗𝗼𝗻'𝘁 𝗔𝗴𝗿𝗲𝗲
Imagine the vestibular system signaling:
“We are moving.”
while your eyes and proprioceptive system suggest:
“We are still.”
The brain suddenly has conflicting information.
This sensory mismatch can contribute to sensations such as:
🔹 Dizziness
🔹 Disequilibrium
🔹 Tilting
🔹 Swaying
🔹 Illusory movement
🔹 A sudden sensation of falling

🧠 𝗪𝗵𝗲𝗿𝗲 𝗗𝗼𝗲𝘀 𝗧𝗵𝗲 𝗕𝗿𝗮𝗶𝗻 𝗣𝗿𝗼𝗰𝗲𝘀𝘀 𝗧𝗵𝗶𝘀?
Balance information is distributed across several interconnected regions, including:
🔹 Vestibular nuclei in the brainstem
🔹 Cerebellum
🔹 Thalamus
🔹 Vestibular cortical networks
🔹 Parietal and multisensory regions
The cerebellum is particularly important for comparing sensory information with expected movement and helping coordinate appropriate responses.

🧩 𝗧𝗵𝗲 𝗦𝘂𝗿𝗽𝗿𝗶𝘀𝗶𝗻𝗴 𝗣𝗮𝗿𝘁
The brain does not simply wait for sensory information.
It continuously makes predictions about how the body should be moving.
When incoming signals differ from those expectations, the resulting mismatch can contribute to an illusion of movement.
This is one reason why the experience of dizziness can be so complex.
It may not be a problem with a single “balance center.”
It can involve a network responsible for integrating multiple sources of sensory information.

🔬 𝗪𝗵𝗲𝗻 𝗧𝗵𝗶𝘀 𝗦𝘆𝘀𝘁𝗲𝗺 𝗙𝗮𝗶𝗹𝘀
Disorders affecting vestibular or central neurological pathways can produce abnormal sensations of:
👂 Spinning
🧭 Tilting
🌊 Swaying
⬇️ Falling
🌀 Environmental movement
These symptoms can occur in conditions involving the vestibular system, cerebellum, brainstem, or broader sensory-integration networks.
The important neurological question is therefore not simply:
“Why am I dizzy?”
but:
“Which sensory signals is the brain receiving—and how is it combining them?”

09/19/2026

Sleep Study Options: HSAT vs. Polysomnography Explained
If your doctor suspects you have sleep apnea, the next step is usually a sleep study. But not all sleep studies are the same. There are two main options, and choosing the right one depends on your specific situation. Getting that choice right matters more than most people realize.

The first option is a home sleep apnea test, often called an HSAT. As the name suggests, you do this test at home. You are given a small device to wear while you sleep. It records your airflow, blood oxygen levels, and respiratory effort. From that data, a score called the apnea-hypopnea index, or AHI, is calculated. The AHI reflects how many times per hour your breathing is disrupted.

HSAT works well for straightforward cases. If you snore loudly, your bed partner has witnessed you stop breathing during sleep, and you have no other significant health problems, a home test is often enough to confirm a diagnosis of obstructive sleep apnea. It is convenient, lower cost, and widely available. For many patients, it gets them to a diagnosis and into treatment quickly.

But HSAT has limits. It records over total time wearing the device, not just time spent actually asleep. That means the AHI it calculates can underestimate how severe the problem is. It also cannot measure brain activity or sleep stages. It tells you whether obstructive sleep apnea is likely. It does not show you the full picture of how your sleep is affected.

The second option is polysomnography, commonly called a PSG. This is a full sleep study done in a sleep laboratory. You spend the night at a clinic while sensors monitor your brain activity, eye movements, muscle tone, heart rhythm, breathing effort, oxygen levels, body position, and sleep stages. The AHI from a PSG reflects events during actual confirmed sleep, across both REM and non-REM stages. That makes it a more precise measurement.

PSG is the diagnostic reference standard. It is preferred in situations where the picture is more complex. If you have significant daytime sleepiness that does not match your symptoms, cardiovascular or neurological conditions, trouble falling or staying asleep, or if a home test came back inconclusive, a lab study provides a deeper look. It can detect things an HSAT cannot, including sleep fragmentation, arousals, and patterns associated with conditions other than obstructive sleep apnea.

One important point: the same AHI number can mean different things depending on how it was measured. An AHI of 15 from an HSAT and an AHI of 15 from a PSG are not equivalent. The PSG figure reflects real sleep time and captures events the home test might miss. This matters when clinicians decide what treatment is appropriate.

For many patients, an HSAT is the right starting point. It is fast, accessible, and accurate enough for clear-cut cases. For patients with a more complex health history or ambiguous results, a lab-based PSG provides information that cannot be obtained any other way.

The bottom line is that the test you take shapes how your results are interpreted. And how your results are interpreted shapes the treatment you receive. If you are about to undergo sleep testing, it is worth asking your doctor which type is most appropriate for your situation and why.

Key Takeaway: Home sleep tests are convenient and work well for straightforward sleep apnea cases, but a full lab sleep study captures information no home device can provide. The right test leads to the right diagnosis and the right treatment.

09/16/2026

The Canadian Association for Dental Sleep Medicine (CADSM) is coming!

Learn what sleep apnea is, how oral appliance therapy works, and how custom dental devices improve airflow for safer, more effective sleep treatment.

09/13/2026

THE NEXT STEP FOR DENTAL SLEEP MEDICINE IN CANADA.

For many years, Canadian dentists involved in Dental Sleep Medicine have benefited enormously from the leadership, education and professional standards developed by our American colleagues. That relationship should continue, and there is much to be gained from ongoing collaboration across our borders.

But collaboration is different from dependence.

Canada has its own healthcare system, dental regulatory framework, universities, research community and professional environment. As Dental Sleep Medicine continues to develop, the time has come for Canadian dentists to build the professional and educational infrastructure needed to support the discipline within Canada.

That does not mean duplicating what already exists or turning away from the excellent organizations and educational opportunities available internationally. It means developing Canadian resources alongside them: education relevant to Canadian practice, stronger connections between dentists and other Canadian sleep professionals, opportunities for Canadian research and continuing education, and ultimately Canadian pathways for professional recognition and standards.

Encouragingly, discussions have already begun with several Canadian dental schools, with interest in how universities might contribute their individual strengths to a shared national educational framework. Different institutions need not teach identical programmes; collectively, they can help build something stronger than any one organization could provide alone.

CADSM is also looking to the AMMDS for advice and direction, The Sleep Society for drive and support, and SleepSafeCanada for greater recognition of the role Canadian dentists can play in the management of sleep-disordered breathing and associated conditions such as snoring and bruxism.

CADSM therefore represents more than the return of a Canadian dental sleep organization. It is an opportunity for Canadian dentists, academics and universities to determine together what Dental Sleep Medicine in Canada should become. The next steps in the development of Dental Sleep Medicine in Canada are looking good.

We should continue learning from our international colleagues, but Canada is ready to stand on its own two feet.

(Thanks to Redbubble for the image 😀)

09/05/2026

SIDAC - Could we not do more in education?

Yes. I think we could.

In Canada, parents who lose a child can access general bereavement support through The Compassionate Friends of Canada. But the loss of children who either fell asleep at the wheel, or were hit and killed by someone who did, needs far greater recognition.

MADD Canada provides extensive support for families affected by alcohol- and drug-impaired driving. Sleep impairment, however, is not part of that mandate.

Sleep-Impaired Driving Awareness Canada (SIDAC) wants to help change that.

Sleep impairment is driving impairment, and the consequences can be fatal. Yet it remains a largely unrecognised and preventable problem. Greater awareness, behavioural change, recognition of sleep disorders and appropriate treatment can all make a difference.

We call upon families who have lost children or loved ones through sleep-impaired driving, and organisations that support them, to help us make this problem visible. Their experiences can help educate others and prevent another family suffering the same devastating loss.

Could we do more through education? Absolutely.

If greater awareness saves just one young person's life, everything we do will have been worthwhile.

Sleep impairment is driving impairment.
Sleep is a biological necessity. There is no substitute.



SLEEPSAFECANADA

07/01/2026

🍁 HAPPY CANADA DAY 🍁