Saturday, 22 October 2022

Tips For Getting Better Sleep When Dealing With Arthritis Pain

From healthdigest.com

Even if you're not that familiar with arthritis, it's not difficult to see why it might interfere with someone's sleep. After all, as the Mayo Clinic points out, common symptoms of multiple types of arthritis include pain, swelling, and/or stiffness in the joints — all of which could make falling and staying asleep challenging (per WebMD). But that doesn't mean there aren't possible options for getting a better night's sleep even with arthritis.

Before we go any further, let's first discuss what exactly arthritis is, since it can go well beyond just stiffness in one's hands. According to the Mayo Clinic, arthritis affects joints throughout the body, meaning that areas like the knees, the elbows, and even the neck and spine can all be arthritic. And while usually the older a person is, the worse their arthritis becomes, this health issue isn't exclusive to elderly individuals. Common types of arthritis include rheumatoid arthritis and osteoarthritis (both of which are very common), as well as gout and ankylosing spondylitis.

Of course, no matter what form of arthritis someone has, getting enough good quality sleep can be especially important not just for managing their condition, but also for their overall health (via WebMD). So, we'll be exploring some possible ways to get a better night's rest even with arthritis. However, if you have arthritis and are experiencing sleeping issues, you should first speak with a medical professional.

Skip the nightcap

As the Arthritis Foundation points out, some research supports a connection between consuming moderate amounts of alcohol regularly and a lower chance of developing rheumatoid arthritis (RA). So, an arthritis patient might think a nightcap before bed is a good idea when, in fact, it might be contributing to their sleep problems.

Despite the popular belief that drinking alcohol before bed might help one get a good night's sleep, alcohol could interfere with someone falling asleep, staying asleep, and sleeping deeply (via Medical News Today). Now to be fair, according to a research review published in Alcoholism: Clinical & Experimental Research, there are studies supporting that alcohol might help a healthy person drift off and even put them in a temporary deep sleep. However, it's believed that we get that truly restful restorative sleep during the stage of sleep known as rapid eye movement (REM) sleep. And these same studies found that alcohol can cut down on the time one spends in this sleep stage. Additionally, one of the review's authors, Dr. Irshaad Ebrahim, told WebMD that, "Alcohol also suppresses breathing and can precipitate sleep apnoea."

Okay, but what about alcohol and arthritis-related sleep issues specifically? Well, as rheumatologist Dr. Karen Costenbader told the Arthritis Foundation, "Gout attacks can be brought on by purine-rich foods or drinks, and beer is high in purines." And these attacks can be disruptive to one's sleep. Finally, speak with a medical professional about alcohol consumption if you're taking any medications for arthritis.

Try therapy gloves

As WebMD explains, it's common for someone with rheumatoid arthritis (RA) to feel pain, swelling, and stiffness in the joints of their hands. In fact, it's often the first red flag of this health issue. And, of course, having pain in any part of one's body can be disruptive to sleep. But there are special gloves that when used as directed might help.

Before we go any further, it's important to note that you should always work with a medical professional when using any type of therapy glove. For one thing, there are different kinds, and so you should talk to your healthcare team to choose the best type to fit your needs. For example, thermals are therapy gloves that warm your hands. Compression gloves do just that: Compress your hands, which can help with finger and joint issues. Glove splints can act like a brace to support your hands. Any one of these might help reduce discomfort and promote a good night's sleep. Plus, some therapy gloves can be a combination of thermals, glove splints, and/or compression gloves.

No matter which type of glove you try, keep in mind that they're only supposed to be worn for eight hours. And, yes, these gloves don't work for everyone. But with that said, they're worth considering not only because they might help an RA patient get a good night's sleep, but also because they can have other benefits like improving one's grip.

Don't avoid exercising

Let's be honest. If someone has arthritis, then exercising might sound like the last thing they want to do. But as the American College of Rheumatology explains, exercise can be beneficial for someone with arthritis in multiple ways, including helping them get a better night's sleep. However, there are a couple of things to remember when setting up a workout schedule with your healthcare professional.

To start, exercises can be divided into four basic categories: body awareness, flexibility, strengthening, and aerobic. Now to be clear, all of these exercises can be beneficial for someone with arthritis. But aerobic exercises could help an arthritis patient who is having difficulty with getting a good night's rest. So too can flexibility exercises (specifically stretching exercises), as well as body awareness exercises that promote relaxation. But as the old saying goes, timing is everything, so when you choose to do any of these exercises can make a difference when it comes to sleep.

For example, if you go to bed at 10:00 p.m., then doing aerobic exercises between 8:00 p.m. and 10:00 p.m. might not help you sleep, according to the American College of Rheumatology. On the other hand, stretching and/or exercises that promote relaxation before bed can both help with sleeping problems. Just remember, when it comes to exercise in general, start slow, especially if you haven't exercised in a while.

Try warm water

If you research arthritis, chances are you'll see both heat and cold therapies listed as possible treatments for pain relief (via WebMD). While this might seem contradictory, both can be helpful for arthritis patients, although some might respond better to heat than cold and vice versa. Also, a combination of heat and cold therapies is sometimes the key to easing arthritis-related discomfort. For the moment, however, let's focus on a type of heat therapy and how it might help with sleep.

Remember, when you apply heat to an area of the body, it causes the blood vessels in that area to expand, which can help with circulation. Plus, heat can help with pain and muscle spasms. So, if you have arthritis, a soothing warm bath before bed might help you get a good night's rest. The Orthopaedic Specialty Group, P.C. explains that a bath can help with stiff joints, as well as help one relax. Also, according to Winchester Hospital, balneotherapy (treating diseases with baths) might help with conditions like osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.

If you prefer showers over baths, then good news: A warm shower can also help with joint stiffness and so might promote a good night's sleep, per Medical News Today. And if you have a hot tub, that can help with pain from arthritis since it involves both heat therapy and hydrotherapy. However, hot tubs aren't recommended for people with certain health problems, including acute inflammation, dementia, and open wounds.

Heating pads can help

If you have osteoarthritis, then this next suggestion might really help with your sleep quality. According to the Cleveland Clinic, heat therapy can be especially beneficial for someone with osteoarthritis-related pain. So, you might want to try a heating pad for a better night's rest. However, there are some important dos and don'ts.

As the Cleveland Clinic explains, you should keep a heating pad on low or medium heat, and even if it's soothing, don't sleep with an electric heating pad, per Alberta Health Services. Instead, Granite Bay Advanced Joint Pain Relief Solutions recommends only using a heating pad for 15 to 20 minutes and then letting the area cool off before turning in for the night. With that said, some arthritis patients find a heated mattress cover can help promote a good night's sleep (via Health Central). So too can an electric blanket, via WebMD. But you should speak with a medical professional before using any of these products.

If you don't own a heating pad, you can improvise one by heating a wet washcloth in the microwave (per Cleveland Clinic). However, be careful not to heat it for too long (20 seconds should be enough time) and test its temperature before applying to avoid putting something too hot against an area of your body that's already in discomfort. Finally, wrap the washcloth in a dry towel before using it.

What about cold therapies?

Even though widening blood vessels with heat might help with arthritis, so too can constricting them with cold since that can bring down swelling (via WebMD). And using cold packs might help numb deep pain. So, yes, cold therapies can help with arthritis-related issues and promote good sleep, but there are some things to keep in mind.

According to Health Central, joint pain interfering with sleep is a common problem for rheumatoid arthritis (RA) patients. But using ice alone or with heat during the day might help reduce pain at night. Also, one psoriatic arthritis patient told CreakyJoints that "Heat makes the rashes from my psoriatic arthritis feel worse, so I have ice packs I keep in the freezer and put them down my pyjamas at bedtime." 

If you want to try an ice pack, Healthline recommends wrapping it in a towel rather than applying it directly to your skin. If you don't have an ice pack, you can substitute a bag of ice or frozen food, as well as a frozen wet towel or sponge, as long as you wrap whatever you use in a towel. Use it for 20 minutes, but remove it sooner if you feel numbness in your skin. Also, you can try massaging an arthritic area with an ice cube. However, speak with a medical professional before trying any cold therapies.

The right pillow or pillows can help

Pillows can make a difference when it comes to sleep. But according to the Arthritis Foundation, when choosing pillows, you need to keep in mind which part of your body is affected by arthritis, as well as your favoured sleeping position.

For example, if you have neck issues and sleep on your back, you might want to try a thin pillow. On the other hand, if you sleep on your side, then a taller pillow positioned under your neck might give you better support. If you have arthritis in your back, then a thin pillow under your head along with a second and a third pillow under your knees and the small of your back respectively might help. But if you sleep on your side, then you might try placing a pillow between your knees and another under the curve at your waist. Back sleepers with shoulder problems might try sleeping either with a pillow under each arm or with a wedge under their trunk and a pillow under their knees.

If you have arthritis-related problems with your hips, you might try two pillows — one beneath your knees and one beneath the small of your back — if you sleep on your back. And you might want to try keeping a pillow between your knees if you have knee issues and sleep on your side. A medical professional might have further suggestions about pillow placements.

Try cooling down the room

While certain therapies can help with arthritis especially at night, they also can add to one's discomfort in other ways. For instance, one rheumatoid arthritis (RA) patient told CreakyJoints that, "My rheumatoid arthritis kills my sleep; I can never find a comfortable position without using tons of pillows and [heating] pads, but then those things make me too hot." This is where controlling the temperature of one's room can make a big difference. Some options CreakyJoints points out are to open the bedroom window, turn up the air conditioning, or invest in a high-powered ceiling fan.

Even though cooling down one's room might help with sleep, there are some recommendations for how low the temperature should go. While the National Sleep Foundation advises sleeping at 60 to 67 degrees Fahrenheit, physical therapist Dr. Varsha Seemangal told CreakyJoints she recommends sleeping in a room that's a bit warmer since, "colder temperatures can cause the joints to stiffen and tighten up even more, leading to a more uncomfortable sleep."

Consider buying a new mattress

Okay, let's be frank. Buying a mattress can be a major purchase. But it could be a valuable investment in your health, especially if you have arthritis and are having trouble sleeping. And while we can't guarantee that a new bed will solve your sleep problems, there are some indicators that you might be due for a mattress upgrade.

The Sleep Foundation notes that a mattress that's six to eight years old might be too old. Also, is your mattress sagging anywhere or in any way damaged? That too can contribute to arthritis pain and joint stiffness. Even if neither of these things is the case, ask yourself if you slept better on your last trip when you stayed at a hotel. If so, then it might be time to consider a new mattress. And while the ideal mattress for every person can vary, physical therapist Dr. Varsha Seemangal told CreakyJoints that "A firm mattress is advised because it supports the joints of the body better than a soft mattress, which will allow the body to sink into it, thus creating an unsupportive environment for the joints while the body is relaxed."

Besides the mattress, the height of one's bed can also make a difference when it comes to arthritis. Dr. Seemangal noted that having a bed that's too low can be rough on one's joints not just when climbing into bed, but also when getting up in the morning.

Choose the right bedding and sleepwear

Picking the right fabrics for bedding and sleepwear can have a beneficial impact on someone with arthritis-related sleep issues. For instance, while a person without arthritis might see blankets and sheets as comfortable and even soothing, an arthritis patient might view these types of bedding as added weight to common arthritic areas like the knees, the ankles, and the feet (via CreakyJoints). This is why physical therapist Dr. Varsha Seemangal told CreakyJoints that "Sheets and blankets, as well as sleepwear, are all recommended to be a breathable fabric to allow for air flow from the body throughout the night." And Dr. Meryl Picard, assistant professor in the Department of Occupational Therapy at Seton Hall University, advised the Arthritis Foundation that smooth fabrics like microfiber, cotton, or silk are best because an arthritis patient can move easily in them, which reduces the chances of stiffness in the morning.

Additionally, CreakyJoints states that a lightweight blanket can be a good choice for someone with arthritis. But if you're still having difficulty with the weight of your bedding, Dr. Picard tells the Arthritis Foundation that blanket lifters might help.

Diet might help gout patients sleep better

Some forms of arthritis like osteoarthritis literally have the word "arthritis" in their name. But don't make the mistake of thinking that's always the case. Gout, for example, is also a type of arthritis and is known for sudden attacks that can be disruptive to one's sleep (via Mayo Clinic). Managing one's gout through diet might help patients with this form of arthritis get a better night's rest.

When your body has large amounts of uric acid, that can set the stage for gout. And, as Health Central points out, some foods might increase the amount of uric acid in one's body, which raises the likelihood of having a gout flare. These include foods and beverages high in sugar, as well as seafood and red meat. However, a gout management diet isn't only about eliminating foods, but also adding the right ones into your meals and snacks. For instance, cherries might help lower the amount of uric acid in one's body. Yogurt and cheese might also be beneficial. And you might want to consider adding more beans to your meal plan. Plus, it's important to stay properly hydrated; however, drinking water and other types of beverages too close to bedtime can also disrupt one's sleep. But before you make any changes to your diet, speak with a health care professional.

No screens before bed

This next tip is actually good for just about anyone having trouble getting a good night's sleep. However, the Mayo Clinic specifically says it can be helpful for someone with psoriatic arthritis not to use screen devices for at least half an hour before bedtime.

Before we go any further, let's discuss what exactly is psoriatic arthritis. And, yes, there is a connection between it and the skin disease psoriasis (via Mayo Clinic). Basically, if you have psoriasis (which typically causes red, scaly skin), then there's a chance you might develop psoriatic arthritis. Like other forms of arthritis, psoriatic arthritis can cause swelling, pain, and stiffness in one's joints. And patients with psoriatic arthritis can have difficulty drifting off to sleep, staying asleep, and getting a good-quality night's rest. Compounding this situation are devices with screens like tablets and smartphones, because the light from them can throw off our bodies, making it harder to sleep. Also, let's not forget that poor sleep can worsen psoriatic arthritis pain, which has the potential to create an unhealthy cycle. So, if you're having trouble sleeping, you might want to put away screen devices well before going to bed. Instead try reading a book or a magazine (just not electronically) at bedtime (via HuffPost). Or you might want to listen to some relaxing music.

Keep a sleep diary

Sometimes it can seem obvious why arthritis would keep someone up at night. Namely, it can cause pain and discomfort. But sometimes an arthritis patient could be overlooking other factors that might improve their sleep quality. Therefore, keeping a sleep diary might help.

According to the Sleep Foundation, there's a great deal more to journaling about one's sleep than just noting what days you slept well or poorly. When you went to sleep, the amount of time it took for you to fall asleep, and whether or not you slept throughout the night can all be useful pieces of information for a sleep diary. Also, the Arthritis Foundation notes that the time you woke up the next day and if you napped during the day are also important. You should also note any medications you're taking. And don't forget, exercise can impact sleep, so you should write down when you worked out and for how long, as well as what types of exercises you did. Additionally, jotting down when and how much alcohol or caffeine you consumed during a 24-hour period can be valuable information. Furthermore, you should include any stressful happenings or events in your sleep diary.

If you're working with a medical professional, they might have a sleep diary form that could include the above details, as well as other ones (via The Sleep Foundation). Just make sure to fill out the form daily to avoid forgetting anything.

Stick to a fixed sleep schedule

If you heard the phrase "it's past your bedtime," you'd probably think it's being said to a child. In fact, Healthline notes that there's data supporting that going to bed at the same time every night is beneficial for children. But maintaining a sleep routine can also be helpful for adults, including patients with arthritis.

As a study in Scientific Reports notes, getting your sleep on a schedule might help lower the odds of developing chronic health problems. In other words, it's better to go to bed at (for example) 10:00 pm every night and wake up at the same time every morning than to keep going to bed at different times and adjusting your alarm clock to make up the difference. And the Arthritis Foundation recommends that patients maintain a consistent sleep schedule all seven days a week, as well as on vacations.

Besides going to bed and getting up at the same time every day, the Arthritis Foundation also advises not napping in order to get a better night's rest. Now, so there are no misunderstandings, napping in and of itself isn't a bad thing. But if you're having trouble sleeping at night, napping could be throwing off your sleep cycle and contributing to your difficulty getting the amount of restorative sleep that you need.

https://www.healthdigest.com/1065584/tips-for-getting-better-sleep-when-dealing-with-arthritis-pain/  

Thursday, 20 October 2022

Insomnia in Aging Adults: Why It Happens and How to Beat It

From cnet.com

Nearly one in two older adults aren't getting the restful sleep needed for a healthy body and mind. Here are five ways to get sleep back on track 

Aging typically comes with more nights of poor rest. The National Library of Medicine reports that about 50% of adults aged 60 and older struggle with poor sleep. Our bodies are constantly changing as years pass, and our sleep tends to be an unfortunate casualty of ripened age. 

The natural processes that occur as you get older combined with common external factors is a recipe for worsened sleep quality, and it's important to understand what's happening so you can get ahead and try to put poor sleep to rest. 

Sleep plays a key role in maintaining our mental and physical health. Habitual sleep deprivation increases the risk of significant health conditions including heart disease, diabetes, stroke, depression and even dementia. For help getting you back to a healthy sleep schedule and more information about the effects of aging on sleep, continue on below. 

Aging changes sleep patterns

CNET Sleep Tips logo

Putting external factors aside, it's common for older adults to experience a change in sleeping patterns because of disruptions to the circadian rhythm. The area of the brain called the suprachiasmatic nucleus responsible for regulating our body's circadian rhythm, otherwise known as our internal clock, weakens in older age. As a result, it disrupts your usual rhythms causing changes in your sleep and hunger cycles.  

Aging also seems to affect the body's production of important sleep-inducing hormones. In old age, the body produces less melatonin, a hormone influenced by darkness that's released around bedtime and promotes feelings of sleepiness. 

Research shows that seniors spend more time in lighter sleep stages and less time in REM or deep sleep, which causes more frequent wakeups.

Other common sleep disruptions for older adults

Becoming older in itself isn't the cause for poor sleep. Other factors like health conditions and daily habits can contribute to the development of sleep disorders. Let's take a look.

Health conditions

A stethoscope around a doctor's neck
boonchai wedmakawand/ Getty Images

Physical and mental health conditions also play a significant role in an aging adult's sleep quality. A study by the Sleep Foundation found almost a quarter of adults between the ages of 65 and 84 were diagnosed with four or more health conditions and received less than 6 hours of sleep a night.

Pain-inducing ailments like arthritis and fibromyalgia cause discomfort and sleep disruptions in older adults, in addition to other medical issues such as sleep apnoea, diabetes, stress, anxiety, heart disease and depression. For those diagnosed with a combination of these conditions, a night of restful sleep may feel difficult to achieve. 

Medications

Almost 9 out of 10 adults aged 65 years or older report taking prescription medication, and not all meds are sleep-friendly. Certain prescriptions like amphetamines, antidepressants and beta-blockers or medications for high blood pressure can harm your quality of rest, while antihistamines and antipsychotics can cause daytime drowsiness. 

Daily habits

With older age comes a slower routine and daily habits that play a part in reducing quality rest. Daytime naps, less time spent outside and low exposure to natural light can disrupt your circadian rhythm. People who feel loneliness from low social interaction may also feel increased anxiety and stress, playing a part in poor sleep.

Combat poor sleep using these tips

Practice good sleep hygiene: Help maintain your circadian rhythm and promote sleepiness by following a nightly routine. Go to bed at a regular time each night. Have a bedtime routine where you practice a relaxing activity like reading, taking a bath or stretching. Stay off tech devices an hour and a half before bed and avoid substances like alcohol or tobacco that might disrupt your sleep.

Exercise: Just 30 minutes a day a day of exercise can help promote better sleep in older adults, alongside other benefits such as improved mental health, disease prevention and increased social engagement.

Curate your bedroom for good sleep: Your bedroom should be a distraction-free zone that limits sleep disruption and promotes total comfort. Have a mattress that's comfy and accommodating for your specific needs, whether it helps improve back pain, cools down hot sleepers or provides a soft pressure relief for those who struggle with joint pain. It should also be dark and cool. Cover windows with curtains and reduce light in your bedroom as much as possible.

Participate in local activities or clubs: Anxiety is a huge detriment to sleep. If you feel lonely and think low social-interaction is leading to poor sleep quality and general mental health, seek out a local group or club that practices activities you enjoy. According to Harvard, spending time with others can help improve well-being, decrease risk of depression and even increase lifespan.

Adopt a pet: If medical conditions or other limitations keep you from moving as much as you'd wish, adopting a pet to keep you company inside the home can help decrease loneliness. Pet owners are less likely to experience depression, feel less anxiety, increased serotonin and dopamine, and even make 30% fewer visits to the doctor than those without.

For more help getting better sleep, try these six natural sleep aids and ways to help relieve anxiety before bed.  

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

https://www.cnet.com/health/sleep/insomnia-in-aging-adults-why-it-happens-and-how-to-beat-it/

Tuesday, 18 October 2022

For one year, I desperately chased sleep. Once I stopped trying, it found me

From cbc.ca

By Saniya Warwaruk 

Anxiety was the oxygen fuelling my insomnia. I had to stop fanning the flames


"Please, just come to bed."

I can't. I can't bring myself to go inside my bedroom. I'm crying and my husband is doing his best to calm me. I don't know what to do. I can't stay out in the hallway all night, but the idea of getting in bed is equally torturous. It's a reminder of my failure to do what most other living things accomplish with seemingly no effort. 

2021 should have been the best year of my life. How many millennials fantasize about quitting their toxic corporate job and returning to school to follow their calling?

That June, I received that second chance — an acceptance letter into the University of Alberta's dietetics program. I had been dreaming about this letter since the moment I turned in my resignation the previous year.

But my reality had become a nightmare because, for the last two months, I had barely slept more than an hour a night.

It started the first week of May with a few nights of 3 a.m. wake-ups. At first, I assumed I was nervous about program admission interviews. The selection process came and went, but my sleep problems persisted and I grew more concerned.

So I turned to supplements. Then came the appointments — the blood work checking for tumours and hormones, the electrocardiogram, the sleep study. Aggravatingly, the results showed I was perfectly healthy. Yet the more I chased after sleep, the less I slept. 

Chasing sleep

When I would talk about my insomnia, a standard response was, "Have you tried …?" 

Yes. I have.

Melatonin, valerian, passionflower, eating before bed, not eating before bed, low-carb diet, acupuncture, meditation, breath work, sleep stories, white noise, psychotherapy, naturopathy, GABA, tryptophan, CBD oil, rhodiola, zopiclone, Zoloft, trazodone, olanzapine, psychiatry, chiropractic treatment and hypnotherapy. I have tried it all. 

A selection of bottles containing different types of sleep aids.
Herbs, pills, acupuncture and hypnotherapy were among the dozens of solutions Warwaruk tried to cure her sleep issues, but to no avail. (Submitted by Saniya Warwaruk)

Another response is "I get that too!"

I say this with respect, "You do not."

For one full year, I slept an average of two to three hours a night. Some nights, I fell asleep standing upright only to be shaken awake by heart palpitations. Every sunrise was a countdown to the torture that awaited me that night. 

I lost interest in anything that formerly gave me joy. Exercise became a Herculean task. My diet consisted of plain oatmeal and boiled potatoes — a real warning sign for anyone who knows my culinary prowess. 

Hitting rock bottom

At three months, insomnia is classified as "chronic" if a person has trouble sleeping for three or more nights a week. I was petrified.

I started having severe panic attacks and most of my waking moments (there were many) were filled with uncontrollable sobbing. I dwelled on the idea of suicide and fantasized about escaping the torment. My concerned husband hid my sleeping pills, which were ineffective by this point anyway, and checked in on me as best as he could while working from home.

Soon after receiving my admission letter, I broke. Battling anxiety, nauseating dizziness and a physical weakness that made walking difficult, I made the hard decision to return to my parents' home in Calgary so they could care for me. I remember haphazardly tossing my things into a duffel bag and thinking I'd hit rock bottom. I was 32 and deeply ashamed.

But there is a happy ending. And it starts with a camping trip. 

A friend convinced me to join her for a weekend in Banff National Park in August 2021.  I was perpetually miserable anyway, so I figured I might as well be miserable in a tent. I knew I wasn't going to sleep so I shifted my energy toward enjoying the sunshine, mountain air and deep belly laughs. I was almost surprised by the inexplicable lightness I felt. It was as if I didn't realize how heavy my burden truly was. 

Both nights, I slept. Deeply.

I created the monster

Two smiling woman stand in front of a lake with the mountains in the background.
When Warwaruk's friend Krista Burdeyney, right, suggested a camping trip, she figured not sleeping in a tent couldn’t be worse than not sleeping in her bed. (Ed Warwaruk)

In the back of my mind, I knew I had stumbled across something significant. 

Capital-I insomnia — long-term, chronic insomnia — is not a sleep problem. 

Most people don't need to think about sleeping. Attention, however, is the oxygen to the insomnia flames. That weekend in Banff, I finally stopped fanning the fire. 

The turning point for me was finding the work of Daniel Erichsen, a sleep coach who trained as a doctor, with an interesting perspective on chronic insomnia. He says it is a phobia, a fear of wakefulness that is reinforced by the very attempt to escape it. 

I had spent months following sleep hygiene rules, taking supplements and forming strict bedtime routines, all to no avail. I had created this monster. 

So, instead of techniques like box breathing, body scans and counting, I decided to do nothing. I handled my lizard brain like a toddler throwing a tantrum and ignored it. And with this in mind, I started to treat my insomnia with exposure therapy.

Every wakeful night became an opportunity to have fun. I would lie in bed and relive vacations, read books, even watch TV. That's right, I exposed myself to blue light that the internet would have you believe makes your eyeballs burst into flames. Instead, I started falling asleep to Seinfeld

Gradually, my fear subsided and I started sleeping more. 

Time, courage. And more time

I wish I could tell you the progress was linear and that it culminated in closing credits with a heartwarming instrumental. The truth is learning a fear is instantaneous. Unlearning one takes time, courage and more time.

Overcoming my insomnia has taken me through the lowest of lows. I have found myself broken beyond recognition, each time certain that I would never come back from this trauma. Back then, I could never fathom living a normal life again and yet here I am today. I moved back in with my husband in time for school in September and began the arduous path to normalcy.

A tattoo of a chemical structure on a forearm.
A tattoo representing the chemical structure of melatonin is on Warwaruk’s forearm, a permanent reminder of her battle with insomnia. (Submitted by Saniya Warwaruk)

During my recovery, every waking night required me to find joy and light amid an ocean of fear. I had to ignore the adrenalin pumping through my blood and remain calm.

It is in our nature to minimize suffering; we crave relief and many of us find it challenging to sit with discomfort. Rumi, the 13th century Persian poet, said, "When the world pushes you to your knees, you are in the perfect position to pray." 

During many nights on my knees, I would say a little prayer to myself, because, deep down, I knew that I could save myself from myself.

Sunday, 16 October 2022

Beat insomnia with better habits

From nst.com.my

ACCORDING to the World Health Organisation (WHO), an estimated 1 in 8 people globally were living with mental disorders in 2019 before the pandemic happened.

While the pandemic has, and continues to take a toll on mental health, we have the opportunity to strengthen efforts to protect and improve mental health.

Good sleep is an essential factor for mental wellbeing. All of us may have experienced sleep problems before, from difficulty in falling asleep or maintaining sleep to early awakening. Sleep issues may affect sleep duration and quality.

Long standing insomnia may have a negative impact on physical and mental health, safety, relationships, as well as performance, says Sunway Medical Centre clinical psychologist, Yap Chee Khong.

Higher stimulation at night increases the likelihood of being awake despite physical tiredness.

Stimulants such as caffeine and nicotine, strenuous exercise, excitement, anxiety and excessive thoughts may induce the mind and body's level of alertness.

Moreover, overthinking about the consequences of sleepless nights and anxiety may form a vicious cycle that prolongs this stimulation.

"You may be experiencing insomnia due to conditioned stimulation, a learned reaction. When you are repeatedly exposed to the vicious cycle between overthinking and stress in bed, unhelpful thoughts and negative emotions are established," explains Yap.

As a result, you may learn to anticipate distress when going to bed, which automatically triggers stimulation.

Those who suffer from insomnia might also show behaviour that is not helpful to improve sleep. This includes:

*Going to bed early without a strong sleep drive

Given that the mind and body are not ready to sleep, you may end up tossing and turning in bed.

*Checking time frequently

Knowing how little sleep you have gotten or how little time is left to continue sleeping may contribute to stress.

*Sleeping in and taking long naps

This may disrupt the biological clock, resulting in delayed sleepiness at night.

*Eating too much before sleep

A heavy meal before sleep may increase the risk of indigestion and heartburn, while drinking a lot of water in the evening may lead to frequent urination throughout the night.

*Drinking alcohol

Alcohol may affect sleep quality and cause sleep disruptions.

*Relying on sleeping pills

Long-term use of sleep medicine may contribute to the risk of drug dependence.

*Doing things other than sleep in bed

Worrying, planning, problem solving, or doing work in bed may condition the brain to be stirred in bed.

Healthy habits promote good sleep.
Healthy habits promote good sleep.

Steps for Sleep Improvement

Yap advises those living with insomnia to take the following steps:

*Avoid caffeine in the afternoon.

*Avoid tobacco and alcohol, strenuous exercise, and overeating three hours before bedtime.

*Organise your thoughts one hour before bedtime. List down worries and their solutions. For items that have no solution, write down when to revisit the issues.

*Engage in relaxing activities before sleep and only go to bed when there is a clear sign of sleepiness.

https://www.nst.com.my/lifestyle/heal/2022/10/840845/health-beat-insomnia-better-habits

Relaxation activities include reading and listening to music or relaxation techniques such as abdominal breathing, progressive muscle relaxation and meditation.

*Avoid stressful or emotionally charged activities such as work, unpleasant conversation or watching a horror movie before bedtime.

*Get up and do a relaxing activity if you cannot fall asleep within 30 minutes. Avoid checking the time, and tossing and turning in bed. Go back to bed only when you feel sleepy.

*Get up on time regularly. Avoid sleeping in and napping.

Yap says sleep improvement certainly requires self-discipline. It may take a few weeks to observe the effect.

Long standing insomnia can be attributed to biological, psychological, and social factors.

A clinical psychologist may conduct an assessment and provide non-pharmacological intervention to address psychological factors related to sleep issues. 

Tuesday, 11 October 2022

6 Eating Habits That Can Trigger Insomnia

From eatthis.com

Find out if any of part of your diet is causing you to toss and turn when it's time to sleep 

You're lying there, staring at the clock, waiting for sleep to set in, but for some reason, you just can't seem to wind down. Was it something you ate? Possibly. There's definitely a connection between your diet and your night-time rest. A variety of eating habits can trigger an episode of insomnia—or even create chronic sleep problems.

If you're wondering whether the contents of your dinner are causing you to toss and turn at bedtime, read on to learn more about six common eating and drinking habits that can affect sleep. And for more, don't miss the 40 Best & Worst Foods to Eat Before Sleep. (After all, you're awake anyway!)

1

Overdoing it on caffeine

too much caffeine
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No surprise here! Caffeine is notorious for its stimulant effects. This natural substance—found in coffee, tea, soda, chocolate, certain supplements, and various other products—blocks the brain's receptors for adenosine, a chemical that promotes sleep. Overconsuming caffeine throughout the day (or eating and drinking caffeine-containing foods and drinks too close to bedtime) is a recipe for night-time wakefulness.

Caffeine's effects tend to peak about 30-60 minutes after consumption, but it may take some mindful attention to determine your own tolerance. Some people are so caffeine-sensitive that even their morning cup could disrupt their sleep. With trial and error, you should be able to identify your personal coffee cut-off hour.

2

Indulging in energy drinks

energy drinks
Jorge Franganillo/ Unsplash

Not all pick-me-up drinks are caffeinated. Some, like certain herbal energy drinks, contain other substances designed to perk you up. While this can be a boon during the afternoon slump, it's not such a great idea as bedtime nears, as (like caffeine) they can keep you bright-eyed and bushy-tailed when you'd really rather sleep.

If you favour drinks with stimulant ingredients like ginseng, Rhodiola rosea, and maca root, be sure to imbibe early in the day to avoid disrupted sleep. (And find out the surprising effects of giving up energy drinks.)

3

Eating spicy foods before bed

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There's nothing wrong with the occasional midnight snack. But, for better rest, just don't make it a taco or a curry. Eating spicy foods can cause heartburn at any time, but especially when you lie down. Without gravity to keep stomach acid in place, it travels more easily up the oesophagus, leading to pain, sour belches, and indigestion of GERD (gastroesophageal reflux disease). Research shows that people with GERD are more likely to report sleep problems than the general population.

Of course, that doesn't mean foods with a kick are off the menu entirely! Try opting for spicy items at lunchtime and stick to milder foods for your evening meal.

4

Eating too much saturated fat

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Some studies have raised the question of how saturated fat impacts sleep—and the results aren't good. According to 2020 research that reviewed multiple such studies, high saturated fat consumption during the day caused sleep quality to deteriorate at night. One study in the review found that people with a higher saturated fat diet were more likely to have frequent night-time wakings and less restorative sleep overall.

Fortunately, not all fat will mess with your rest. Omega-3 fatty acids have a track record of actually promoting sleep! DHA and EPA-rich oils have been shown to increase sleep efficiency and reduce the time it takes to fall asleep. To get more of these beneficial oils, reach for flax seeds, walnuts, and fatty fish like tuna and salmon.

Need a sleep-inducing bedtime snack to choose from instead? Check out the #1 best food to eat for better sleep.

5

Eating too many refined carbs

pasta with lentils
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A diet high in refined carbs can increase the risk of weight gain, heart disease, and diabetes. You can add one more downside to the list: insomnia.

According to a large 2019 study, older women who consumed the highest amounts of refined carbohydrates (think: white bread, pastries, and pasta) were more likely to have difficulty getting a good night's rest. They were also more likely to develop new insomnia at a three-year follow-up.

The likely explanation for the connection between refined carbs and poor sleep: these types of carbohydrates rapidly spike blood sugar. High blood sugar has consistently been linked with sleep disruptions like sleep apnoea and general insomnia. 

6

Not getting enough of certain nutrients

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The best sleeping pill just might be a multivitamin. There's a fascinating interplay between healthy sleep and the micronutrients in food. You may have heard magnesium recommended for shut-eye, but it's not the only option in your micronutrient arsenal. Research from 2019 found that people with short sleep duration had a lower-than-usual intake of various vitamins and minerals, including calcium, vitamin D, vitamin K, and (yes) magnesium. Similarly, a 2016 study associated sleep deprivation with low levels of iron, zinc, and magnesium.

The best way to ensure you're meeting your daily target of vitamins and minerals is to eat a healthy, varied diet—but talk to your doctor if you feel you could use some extra nutritional oomph from a supplement.

https://www.eatthis.com/eating-habits-insomnia/