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Tips for better sleep
If you don't sleep comfortably through the night you'll have a hard time waking up
7 Tips for a Better Night's Sleep
By Jennifer Gruenemay, ACE-Certified, Staff Writer
If you don’t sleep comfortably through the night, you’ll have a hard time waking up. Being groggy and cranky is not the ideal way to start out a brand new day full of possibilities. And even if you aim for eight full hours of sleep every night, you’re not guaranteed a restful night. So if you find that you wake up at odd hours of the night or constantly toss and turn during sleep, you could really use a better night’s sleep. Plus: Test your sleep IQ…
1. Dark, Quiet & Cool
The three fundamentals of a great night’s sleep are dark, quiet and cool.
To create a dark, quiet environment and get rid of distracting lights and sounds:
- Shut all the curtains or blinds in your bedroom, and turn off the night light (you’re an adult now.)
- If other family members are going to be staying up later than you and keeping the lights or television on, keep your door closed and ask them not to bother you once you’re in bed.
- Open your window (as long as it’s quiet outside) or keep the fan or air conditioner on to keep a comfortably cool temperature in the room.
A dark, quiet and cool room will help your body realize it’s time for bed, and will help you stay asleep longer.
2. Early Exercise
If you’re restless in the evening and can’t wind down by the time you climb into bed, it could be because you’re not using up enough energy during the day.
Believe it or not, exercising early on in the day helps you better utilize your energy stores during the day.
It also boosts your metabolism and helps you think more clearly.
Better yet, the old restless, agitated feeling you used to experience at night will be replaced by the need to rest your tired body and mind.
By the end of a day that began with exercise, you'll be so exhausted that you won’t want to wait to hit the sack.
3. Food Police
Watch what you eat!
Are you eating or drinking caffeinated foods late in the day?
Do you eat too close to bedtime?
Caffeine’s effects can last for up to seven hours, so lay off the caffeine after noon to ensure that any caffeine left in your system will be used up by the time you’re ready to lie down.
This includes coffee, chocolate and soda, which means that you may have to adjust your evening snack to something healthier, like fruit or popcorn, which is a win-win situation for your waistline.
Also, stop eating at least two hours before you go to bed. The digestive process can disrupt your sleep cycle and may even trigger strange dreams and nightmares.
4. Stress Less
Do the day’s events run through your head non-stop when all you want to do is shut off your mind and drift off to sleep?
Letting stress get the better of you during the day can affect your sleep cycle, making a bad problem worse.
Stress is also linked to countless diseases and a weakened immune system.
5. Get into a Routine
Think about how your heart beats – it’s a steady rhythm: buh-boom, buh-boom, buh-boom. Well your body craves routine, too, particularly during the sleep cycle.
If you’re having a difficult time getting a full eight hours of sleep every night, set yourself some boundaries.
If your bedtime is 10 p.m., and it takes you 30 minutes to fall asleep, set your alarm for 6:30 a.m.
Not only will you ensure that you'll be getting a full eight hours of sleep every night, you’ll also give your body the routine it needs.
Soon, this routine will become familiar to your body. You'll recognize the change once you can't help but be sleepy by 10 p.m. every night.
6. Turn Off the Television
This should be the easiest tip to follow, yet it’s often the most difficult to enforce: turn off the TV, log off the computer, put away the game, turn off the lights, and go to sleep on time!
A full night’s sleep allows your body to rest and prepares you for the day ahead – it’s just that simple.
TV might seem like a great way to lull you to sleep, but you’re actually prolonging the time between crawling into bed and actually falling asleep.
And if you’re not asleep, it doesn’t count as sleep time.
TV also captivates the mind and the imagination, stimulating your brain with vibrant colors and sounds and keeping you awake longer.
Watching TV or a scary movie can also affect the types of dreams you have.
If you really need some entertainment before bed, read a book under a soft light, which is sure to send you dozing in no time at all.
7. Smart Supplements
Certain supplements may help you to relax naturally. For example, taking a daily dose of valerian root extract is said to promote restful sleep.
5-HTP, a derivative of the amino acid Tryptophan, can induce a restful sleep because it boosts serotonin levels, which help you relax. This is the same amino acid that is found in high amounts in turkey; and we all know what happens after a big Thanksgiving meal!
If you prefer a nice, hot cup of tea to popping pills, just make sure it’s decaffeinated.
Try chamomile tea, which promotes restful sleep and will peacefully send you off to dream land.
Are You Smart About Sleep?
Do you wake up feeling rested on most days of the week, or are you just not a morning person? Getting a good night’s sleep affects every aspect of your day, including your mood and your ability to be productive.
Heart Disease & Depression
From heartwire - a professional news service of webmd
September 30, 2008 — Clinicians should routinely screen their patients with heart disease for signs of depression, refer those in whom it's suspected to a qualified mental health professional, and monitor the management of any patient receiving treatment for both disorders, according to a new advisory issued by the American Heart Association (AHA) and endorsed by the American Psychiatric Association .
Their document, the authors say, represents the AHA's first standalone set of recommendations to confront the well-recognized links between the psychiatric disorder and cardiovascular disease, which frequently exist together.
"There is currently no direct evidence that screening for depression leads to improved outcomes in cardiovascular populations," cautions the report's authors, led by Dr Judith H Lichtman (Yale University, New Haven, CT), who, along with Dr Erika Froelicher (University of California, San Francisco), co chaired the report's writing group. But there is abundant evidence that treating depression in patients with coronary heart disease (CHD) can help them, notes the report, which was published online September 29, 2008 in Circulation and scheduled for the journal's October 21 issue.
Even without such indications, though, "there's certainly compelling evidence that untreated depression is associated with worse outcomes and that there's almost a dose-response effect," Lichtman told heartwire. "And even if we don't understand all the mechanisms, there really is a large body of evidence showing that people who are depressed are less likely to follow through on a variety of things that are important for risk-factor management and certainly associated with recovery and outcomes, like medication adherence or going to rehab."
The report says that to maximize opportunities for identifying depressed patients, screening can be performed in the range of settings CHD patients are seen in, such as the clinician's office, the hospital, clinics, and rehabilitation centres.
The "pretty quick, pretty simple" screening
For most patients, the initial screening could "at a minimum" consist of the two-question Patient Health Questionnaire (PHQ-2). If either answers points to the possibility of depression, the nine-item PHQ-9 would then be administered.
The PHQ-2 asks the patient "have you been bothered" in the past two weeks by "little interest or pleasure in doing things" or "feeling down, depressed, or hopeless." The PHQ-9 asks similar questions with the goal of identifying symptom frequency.
"For patients with mild symptoms, follow-up during a subsequent visit are advised," the report notes; also, patients with scores indicating a high likelihood of depression should be referred for a more comprehensive evaluation by an appropriate specialist.
Lichtman said that the PHQ forms are suggested instruments but not required. "There are a number of screening devices available.
We wanted to present one that was pretty quick, pretty simple, pretty easy, that you didn't have to purchase to use and would give a quick indication, with the idea that if someone comes up positive, [the provider] refers them for more comprehensive evaluation by someone who is qualified.
" The two questions on the initial PHQ, she said, "give a reasonable indication of whether or not there's something that needs to be pursued more thoroughly."
Dr Karina W Davidson (Columbia University and Mount Sinai School of Medicine, New York, NY), who isn't connected with the new report, said that the PHQ screening questionnaires are validated tools and "an efficient, evidence-based way of finding possible cases and referring them on for further assessment and treatment."
Performing the screening, she told heartwire, is well worth the minimal extra time and effort it takes.
The PHQ questions can point to patients with depressive symptoms that independently increase mortality and the risk of major adverse cardiovascular events.
Such patients are just the kind cardiologists and other cardiac-care professionals would want to be targeting with follow-up calls, monitoring, and reminders to get into a cardiac rehabilitation program, Davidson said.
"These are questions that are perfectly appropriate for a nurse or other allied health professional to be doing on the floor," she said.
According to an editorial on the recommendations published online the same day , "We should no longer ignore depression in the cardiac patient.
One cannot expect a detailed evaluation of coexisting illnesses in the busy cardiology office; however, recognition of a key co morbidity, such as depression, can lead to the delivery of higher-quality care."
Noting that current guidelines actually do recommend evaluation for symptoms of depression in patients with established cardiac disease, the editorialist, Dr Viola Vaccarino (Emory University, Atlanta, GA), writes that "the availability of simple instruments, such as those described in the AHA advisory, makes this task easier and makes it possible to integrate the management of depression into routine cardiac care."
Treatment and follow-up
The AHA report strongly advises that patients found to have depression be referred to providers qualified to treat depression and also that "coordination of care between healthcare providers is essential" in patients with both cardiovascular and psychiatric diagnoses.
As for treatment, the selective serotonin reuptake inhibitors sertraline and citalopram "are the first-line antidepressants drugs for patients with CHD," the report states.
It notes that patients who fared well on other medications can generally resume taking them but cautions that tricyclic antidepressants and monoamine oxidise inhibitors can be cardiotoxic and so are contraindicated in many CHD patients.
Cognitive behaviour therapy, notes the report, can be an alternative to drug therapy "for cardiac patients who cannot tolerate antidepressants or who may prefer a nonpharmacologic or counselling approach to treatment"; some patients will respond best to a combination of pharmacologic therapy and psychotherapy.
Davidson has some advice for cardiac-care providers whose patients are also diagnosed with depression.
Typically, she said, such providers "are used to ensuring that patients truly understand the seriousness of their diagnosis.
The opposite approach is needed with depression," she said. A patient with depression who is not anticipating a psychiatric diagnosis "won't really appreciate hearing that now they've got yet another disease. . . . What often works better is to say, you're telling me that you're upset, or sad, or alarmed.
So I'm going to find you help for that."
Also, Davidson said, "patients have strong preferences for the type of treatment they will accept for depression. It's unlike the choice, for example, of PCI [percutaneous coronary intervention] vs. CABG [coronary artery bypass graft], where the doctor's recommendation about what is best for that case is usually accepted by the patient.
Those who have strong beliefs against psychiatric medication will not accept it, even if it's recommended." The same is true for psychotherapy, she said. "I would strongly urge cardiologists to ask the patient which they prefer, medicine or talking, and then prescribe the patient's preference."
Disclosures for the writing committee members are listed in the article.
1. Lichtman JH, Bigger Jr JT, Blumenthal JA, et al. Depression and coronary heart disease. Recommendations for screening, referral, and treatment. A science advisory from the Prevention Committee of the American Heart Association Cardiovascular Nursing Council, Clinical Cardiology Council, Epidemiology and Prevention Council, and Interdisciplinary Council on Quality of Care and Outcome Research. Circulation 2008; DOI:10.1161/CIRCULATIONAHA.108.190769. Available at: http://circ.ahajournals.org.
Arthritis and Diet
Arthritis is a general term describing over 100 different conditions that cause pain
Arthritis is a general term describing over 100 different conditions that cause pain, stiffness and (often) inflammation in one or more joints. Everyone with arthritis can benefit from eating a healthy well balanced diet. There is no special diet or ‘miracle food’ that cures arthritis, but some conditions may be helped by avoiding or including certain foods. For example, osteoarthritis and rheumatoid arthritis seem to respond to an increased dietary intake of fish oils, while gout benefits from avoidance of alcohol and offal meats.
Always seek the advice of your doctor or dietician before changing your diet in an attempt to treat arthritis. You may be restricting your food intake unnecessarily, or overdosing on products (such as mineral supplements) that may have no impact on your condition at all.
General dietary recommendations for a person with arthritis include:
- Eat a well balanced diet.
- Avoid crash dieting or fasting.
- Increase dietary calcium to reduce the risk of osteoporosis in later life.
- Drink plenty of non-alcoholic fluids.
- Keep your weight within the normal range, by reducing the amount of dietary fats you consume.
Dietary modification for gout
Uric acid is a waste product that is normally excreted from the body in urine. Gout is a type of arthritis characterised by the build-up of uric acid in the joints (such as the big toe), which causes inflammation and pain. Some of the dietary recommendations that may help to ease the symptoms of gout include:
- Restrict or avoid alcohol
- Restrict or avoid offal meats, such as liver, kidneys and brains
- Restrict or avoid shellfish and anchovies
- Drink plenty of non-alcoholic fluids
- Make sure you don’t overeat on a regular basis
- Be sure to take your time when eating.
Rheumatoid arthritis and osteoarthritis
Fish oils that contain omega-3 fatty acids have been found, in various studies, to help reduce the inflammation associated with some sorts of arthritis. These forms of arthritis, like rheumatoid arthritis and osteoarthritis, are characterised by inflammation.
The fish oil seems to work by reducing the number of inflammatory ‘messenger’ molecules made by the body’s immune system. There may be additional benefits to eating fish once or twice every week - researchers from around the world have discovered that the regular consumption of fish can reduce the risk of diseases ranging from childhood asthma to prostate cancer.
Obesity may worsen arthritis symptoms
Being overweight does affect people with arthritis. Joints affected by arthritis are already under strain. If you are overweight or obese, the extra load on your joints may be exacerbating your symptoms, especially if your affected joints include those of the hip, knee or spine. There is also a clear link between being overweight and an increased risk of developing osteoarthritis.
To lose excess weight, you must be active, but this can be difficult for people with arthritis due to pain or stiffness. See your doctor, dietician or health professional for information and advice.
Weight reduction strategies may include:
- Switch to a diet that is high in nutrition, while low in kilojoules.
- Experiment with different sorts of activities - for example, it may be possible to enjoy swimming or some kinds of low impact exercises.
- Limit your exercise activities to unaffected joints - for example, if your hands are affected, you may be able to comfortably ride on a stationary bicycle.
Current evidence for dietary cures is sparse
There is no substantial scientific evidence that would support a person with arthritis avoiding particular foods; unless that person has specifically shown intolerance to them (the exception is gout). However, as research reveals more connections between diet and health, it is possible that stronger connections between particular foods and arthritis may emerge.
With some foods - such as tomatoes, potatoes, eggplants and peppers - there is much anecdotal evidence (stories about individuals), but again there is no strong scientific evidence.
If you think a particular food may aggravate your arthritis, it can be useful to keep a food diary. After a month, you may have some idea about which food could be provoking symptoms. You could then try eliminating that food from your diet for two weeks to see what happens. Don’t cut out a whole food category, and make sure you are getting the vitamins and minerals that this food provides from other sources. It is important to let your doctor know that you are doing this.
Remember that remission may be coincidental
The symptoms of arthritis, particularly the inflammatory types, can wax and wane for no apparent reason. If you are experimenting with a dietary change, don’t automatically assume the remission or reduction of symptoms was due to what you did or didn’t eat. Be guided by your health professional.
Where to get help
- Your doctor
- An accredited practising dietician, contact the Dieticians Association of Australia
- Arthritis Foundation of Victoria Tel. (03) 8531 8000
Things to remember
- Arthritis is a general term describing over 150 different conditions that cause pain, stiffness and (perhaps) inflammation in one or more joints.
- There is no special diet or ‘miracle food’ that cures arthritis, but some conditions may be helped by avoiding or including certain foods.
- Fish oil can ease the symptoms of inflammatory types of arthritis, such as rheumatoid arthritis and osteoarthritis.
- The symptoms of gout can be eased by avoiding alcohol and offal meats, and by drinking plenty of water.
- There is a link between being overweight and an increased risk of developing osteoarthritis.