Is Your iPad Killing You?

Regular readers and patients know the importance of a good night's sleep to health.  Low quality sleep, and getting fewer than seven hours of sleep per night, have been associated with chronic diseases such as cardiovascular disease, as well as shorter lifespan. Two recent studies highlight some of the hidden thieves of sleep in our modern world.

Researchers at Brigham and Women's Hospital in Boston compared people who read on an iPad screen before bed to those reading a traditional paper book before bed. The study confirmed what has long been suspected: that exposure to a screen decreases sleep quality, shortens the amount of REM sleep, and leads to worse moods and poor productivity the next day. Ideally, you should avoid all light-emitting screens for at least an hour before bedtime.  The main problem seems to be with the blue wavelengths of light, that suppress our body's natural melatonin production. If you really have to read a screen late in the evening, use a physical filter that blocks bluelight, or use free software such as f.lux that achieves the same effect. For Android users, there are several apps available, such as Twilight.

Another problem associated with difficulty sleeping is the presence of intrusive or repetitive thoughts. Interestingly, researchers at Binghamton University have discovered that one of the best way through to cease anxious thoughts is actually to get to bed earlier. Staying up late at night and having a short duration of sleep just aggravate the problem.

It can be a challenge to adjust your habits to get to bed earlier, but it's worthwhile. Maybe you could stop watching those electronic screens late in the evening. If repetitive thoughts are actually preventing you from falling asleep, you could try and herbal sleep aid such as valerian root, or a do-it-yourself behavior modification programs such as SleepStar.

When you sign up for SleepStar, use code PetersND25 for a discount.

Jacob A. Nota, Meredith E. Coles. Duration and Timing of Sleep are Associated with Repetitive Negative Thinking. Cognitive Therapy and Research, 2014; DOI: 10.1007/s10608-014-9651-7

Another Secret to a Smaller Waistline

There has been a lot of speculation about the increasing rates of obesity over the last few decades.  Many of the causes of this phenomenon are well known, and I have covered them in past articles: the move from whole foods to more processed foods, a decrease in physical activity with the rise in technology, and the increasing intake of both regular and diet soda pop.  One factor that often gets overlooked in this equation is the importance of a good night's sleep.

Researchers in the UK (1) recently published the results of a survey of over 100,000 women covering a 10 year period.  They found that light exposure at night disrupted the normal circadian rhythm (day-night cycle), and led to increased body mass index, and increased waist circumference.

If you are trying to shed pounds by increasing exercise, then bravo!  Just don't exercise late in the evening.  Night should be a time for winding down, decreasing activity, and definitely minimizing exposure to light (no falling asleep with the TV on).  The infographic below is a handy reminder of what's known as good sleep hygiene.  Use it to optimize your sleep, and maintain a healthier body weight.

1.  McFadden E et al.  The Relationship Between Obesity and Exposure to Light at Night.  Am J Epidemiol. 2014;180(3):245-250.

Are You Missing This Important Supplement for Childhood Behavioral Problems?

Behavioral problems in children often start during the preschool years.  Making sure that kids have a healthy, balanced diet, as well as plenty of physical activity, can make a big difference in kids' behavior.  One "supplement" that is becoming more overlooked these days is one of the foundations of health in naturopathic medicine: sleep.

Recent research from the Albert Einstein College of Medicine in New York City (1) examined almost 9000 preschool aged children, and looked at the relationship between sleep and behavior.  They found that kids who average fewer than 9.44 hours of sleep per night have a 30 to 40% higher rate of anger, impulsivity, overactivity, and tantrums.  Significantly, these kids were also 80% more likely to be aggressive.  More than two hours of television viewing per night was also associated with worse overall behavior.

Inadequate sleep for adults may result in mood problems, increased pain sensitivity, and even a greater risk of diabetes and cardiovascular disease.  Now, we have further evidence of just one more way that sleep is critical for kids as well.  Follow these guidelines to ensure a good nights rest for your little ones:

• Stick with a scheduled bedtime and wake-up time.  Aim for at least 10 hours of sleep per night.  So if the kids have to be up at 7 AM, make sure they're in bed by 9 PM.
• Turn off all screens (TV, computer, smartphone, tablet, etc.) at least one hour before bedtime.
• Keep the bedroom cool and dark to make falling asleep easier.
• If your child is having trouble falling asleep, consult your naturopathic physician before trying any sleep aid -- even natural ones.

1.  Scharf RJ et al.  Nighttime Sleep Duration and Externalizing Behaviors of Preschool Children.  J Dev Behav Pediatr. 2013;34:384-391.

Ladies, Improve Your Sleep Quality 800% With This Simple Fix

In the dog days of summer, "women of a certain age" probably know well the difficulty of getting a good night's sleep, especially when dealing with postmenopausal hot flashes.  The benefits of sleep cannot be overstated in terms of our overall health.  Inadequate sleep can lead to diabetes, obesity, elevated blood pressure, and even certain types of cancer.  Fortunately, there is a natural remedy for this situation; it is as close as your sneakers, and costs nothing.

Yes, once again, it's my favorite supplement: exercise.  In March 2013, a study published in the journal Menopause found that women with high levels of leisure time physical activity over eight times as likely to experience good sleep quality.  While the authors did not quantify exactly what types or how much physical activity was involved, we can presume that any activity is better than being sedentary.  It's amazing how much of our leisure time is taken up with electronic screens: computers, TVs, iPads, smartphones... we never have to be without these magical devices that keep our brains engaged, while allowing our bodies to wallow in torpor.

So get out there, and enjoy some walking, biking, swimming, or gardening, and get a better night's rest tonight.

Physical activity and sleep among midlife women with vasomotor symptoms.  Menopause. Published online March 25, 2013. 

Pomi-T Follow Up...
My article about the beneficial effects of a new botanical supplement, Pomi-T, for prostate cancer patients brought a flood of interested feedback.  However, I have been hard-pressed to find the actual product.  It was produced by a British company called nature Medical Products, and sold out as a response to the publicity about the research study.  An internet search yielded no further reliable information about the availability of Pomi-T or nature Medical Products.  So until we have a source for Pomi-T in the U.S., keep eating your veggies, and look for other standardized supplements for pomegranate, broccoli, green tea, and curcumin (turmeric extract).

Are You at Risk for Pneumonia with this Medication?

One of the foundations of health is a good night's sleep.  Lack of sleep can lead to consequences including obesity, aggravation of pain conditions like fibromyalgia, poor memory, and even increased risk of cardiovascular disease.  With all the benefits of getting a good night's sleep, it might be tempting to do whatever it takes to correct sleep problems -- including taking pharmaceutical sleep aids.  But let's step back and consider the consequences first.

A common class of medications prescribed for sleep (and anxiety) is the benzodiazepines ("benzos") -- with trade names like Xanax and Valium, or generic names alprazolam, diazepam, and others.  The main problem with these drugs is well known:  they're addictive, and can lead to physiological dependence.

A new study published this month (1) found an unexpected danger with benzos:  a 54% increased risk of pneumonia.  Pneumonia is one of the more serious complications of seasonal influenza, which I wrote about last week.  If you're currently taking benzos for sleep, or considering them, think about all the natural ways you can improve sleep instead.  Of course, discuss changing your medication with the prescribing physician, since it's best to wean down carefully on this type of drug.  Now if you're thinking, "I've tried all that natural stuff before!  It didn't work," my response is... really?  Everything?  Review the list below, and give these suggestions an honest try for a period of several weeks.


IMPROVING THE QUALITY OF YOUR SLEEP

1. Maintain consistent sleep and wake times. Do not push yourself to stay up past the initial signs of sleepiness. This can create epinephrine production, causing more difficulty getting to sleep later. It is good to have a “getting ready for bed” routine to relax and prepare your body for sleep. Avoid taking naps if you have trouble sleeping at night.

2. Reserve the bed for sleep and sex only. Do not read, watch TV, eat, or worry in bed. Solve daily dilemmas outside of the bedroom. If you find that you’ve been lying awake in bed for 15-20 minutes, get out of bed.  Do something mundane until you feel sleepy, and then go back to bed. Repeat this as often as needed.

3. Your sleeping environment should be quiet, cool (70 degrees or less), and comfortable. The room should be clutter-free. Reduce the amount of ambient light as much as possible. Electronic devices such as clocks, stereos, TVs and computers generate electromagnetic fields that can disturb sleep for some people. Experiment with moving these into another room or using EMF shields. Feng Shui, the Chinese art of placement, can be valuable in creating an optimal sleeping environment.

4. Exercise regularly. Exercising during the day or early evening decreases the time it takes to get to sleep and increases the amount of deep sleep obtained. Most people do better avoiding exercise late in the evening.

5. Exposure to sunlight early in the morning and late in the afternoon or evening encourages a strong circadian rhythm. The hormone melatonin, which helps create a sleep state in the body, is suppressed in light and secreted in darkness.

6. As much as possible, ensure complete darkness at night.  Darkness encourages your body’s natural production of melatonin.  Do not fall asleep with the TV or lights on.  Turn off all screens (TV, computer, video games, etc.) 30-60 minutes before bedtime.  If you wake at night to go to the bathroom, do not turn the light on.  Even this brief exposure to light at night may suppress your melatonin significantly, drastically reducing the quality of your sleep.

7. If you have problems with waking during the early hours of the morning, have a small protein snack just before bed to ensure consistent blood sugar levels throughout the night. Consistently get exposure to sunlight as late in the day as possible.

8. Improving overall health will improve the quality of your sleep. Work towards improving or eliminating health problems. Treatment modalities such as Neurostructural Integration Technique will help to relax the body. Effective stress management is essential.


THINGS THAT RELAX THE BODY AND PREPARE IT FOR SLEEP

• Warm baths, possibly adding Epsom salts or lavender oil
• Meditating for 5-30 minutes
• Breathing exercises, progressive muscle relaxation (various recordings are available) or any other means of inducing the “relaxation response”.  Daily practice brings greater results.
• Special acoustic recordings that increase specific brain wave patterns for relaxation and sleep
• Botanical treatments and aromatherapy using herbs and their essential oils (examples include chamomile, valerian, vervain (verbena), hops, lavender, passionflower, avena (oat straw), lemon balm and scutellaria (skull cap).  Consult Dr. Peters for dosages and recommendations.
• Calcium and magnesium supplementation.  Consult Dr. Peters for dosages and recommendations.
• 5-hydroxytryptophan (5-HTP) or melatonin supplementation may be necessary in individual cases.  Consult Dr. Peters for dosages and recommendations.

THINGS THAT INTERFERE WITH SLEEP

• Although alcohol may make you fall asleep, the sleep obtained after drinking is fragmented and light.
• The stimulating effects of caffeine may last up to 10 hours in some people. Avoid it in the afternoon if getting to sleep is a problem. Caffeine is present in coffee, green tea, black tea, chocolate and some medications (pain relievers, decongestants, thermogenic weight loss products, energy supplements, etc.)
• The stimulating effects of nicotine (first- or second-hand smoke) can last several hours.
• Sleeping pills, aside from being highly addictive and full of side effects, decrease the amount of time spent in deep sleep and only increase light sleep.
• B-vitamin supplements can increase energy that keeps some people awake, if taken before bed. Take B-vitamins earlier in the day.
• Do not go to bed with a very full stomach. Large quantities of protein are stimulating to the body as digestion occurs. It’s best to finish eating at least three hours before going to bed.

1.  The impact of benzodiazepines on occurrence of pneumonia and mortality from pneumonia: a nested case-control and survival analysis in a population-based cohort.  Thorax doi:10.1136/thoraxjnl-2012-202374.  

Did You Enjoy that Extra Hour of Sleep this Weekend?

Welcome back to standard time, folks... did you remember to set your clocks back this weekend?
One more question:  did you notice it was much easier to adjust to the time change this weekend than to the switch to daylight savings time in the spring?  It seems logical, since we "gained" an hour of sleep on Saturday night.  But even beyond that, this is the one weekend out of the year when the external clocks match most closely to our internal biological clocks.

Yes, we do have a biological clock -- a part of the brain called the suprachiasmatic nucleus (SCN); its job is to keep track of the daily cycle of our body's functions (also known as our circadian rhythm).  Research has shown that for most folks, the SCN is actually set to a 25-hour cycle, which means that we have to reset it every day based on cues in our environment.  That's why it's easier to stay up late, but harder to wake up earlier in the morning.

Up till about 200 years ago, our biological clocks mostly relied on the signals of sunlight to reset ourselves each day.  With the advent of reliable timekeeping, we now go by a strict 24-hour day; with electric lights, we can give in to our tendency to want to stay up later, if we choose.

Use the "extra" sleep you got this weekend to honor your body's natural circadian rhythm.  Don't complain about the early sunset, but rather use it as a signal to get to bed at a reasonable time -- and enjoy the earlier sunrise these days.  Sleep is one of the foundations of health, and most adults need around 7-8 hours per night.  Getting adequate sleep helps not only with our daytime energy, but also with preventing diabetes, cardiovascular disease, and obesity.

This is a repost of an article that appeared in 2011.

So Obvious, It's Revolutionary

One of my main recommendations for folks who are having trouble sleeping is a simple one:  Turn out the lights.  I've heard folks say they "can't" fall asleep without surfing the web right before bedtime, or having the TV on in the bedroom.  But late night exposure to light suppresses the body's natural production of melatonin, our main sleep hormone.

Melatonin is produced by a tiny gland at the base of the brain called the pineal gland.  The pineal gland releases melatonin in response to darkness, and this signals the brain to go into sleep mode.

Recent findings have shed more light (so to speak) on the importance of darkness and melatonin.  Melatonin has antioxidant effects in the body that protect against cancer.  Nurses who work the night shift (and therefore get round-the-clock light exposure) produce less melatonin, and are at significantly higher risk for breast cancer (1, 2).

A new study found that even low light levels in the sleeping room at night can produce symptoms of depression (3).  Granted, this study was done using hamsters, but the biological effects were clear:  depressive symptoms after four weeks of dim light at night.

Depression?  Insomnia?  Cancer risk?  Turn out the lights:  shut off all screens (TV, computer, iPad, smartphone, etc.) 30-60 minutes before bedtime.  Get rid of the night lights and television in the bedroom.  You might even want to move that bright LED alarm clock away from your head.  Allow a few weeks for your body to readjust to what is becoming a scarce, but highly valuable, commodity:  darkness.

1. Cancer Epidemiol Biomarkers Prev. 2012 Apr;21(4):609-18. Epub 2012 Feb 7.
2. Cancer Causes Control. 2006 May;17(4):539-45.
3. T A Bedrosian, Z M Weil and R J Nelson.  Chronic dim light at night provokes reversible depression-like phenotype: possible role for TNF.   Molecular Psychiatry , (24 July 2012).

If You're Not Getting Enough of This, You're Just Inviting Chronic Disease

If you're a reader of my articles, you might think the "This" I'm referring to is my favorite supplement -- exercise.  While that's true, this time, let's focus on that other foundation of health:  sleep.

A recent study added to the evidence that inadequate or disrupted sleep induces metabolic changes in the body that can lead to diabetes and weight gain.  These changes occurred with sleep at about five and a half hours per night.  Shift work aggravates the problem, with the disruption in circadian rhythm (our body's daily biological clock) making sleep even more difficult.

As the weather gets hot, falling asleep might get harder -- but there are ways to deal with that.  A lack of optimal amount of sleep can lead not only to obesity and diabetes, but also may aggravate high blood pressure, and even raise the risk of certain types of cancer.  Not to mention the fact that this is probably the most common cause of fatigue -- and the first thing to address before we go reaching for "energy drinks," supplements, etc.

How much sleep should we get?  Between 7 and 9 hours per night is what most research indicates.  If you think you're too busy to get that amount, reassess your activities during the day:  If you're staying up to have time to watch TV or surf the web, reconsider your priorities in light of the very real negative health effects.


Lack of sleep linked to disease

Not to Put You to Sleep...

There are always a lot of promises for perfect health from the manufacturers of drugs and nutritional supplements.  As a naturopathic doctor, I can't emphasize often enough the importance of the basics of lifestyle.  Getting a good night's sleep is one that we too often overlook.  Adequate sleep helps protect against obesity, diabetes, heart disease, and high blood pressure.  If you're having trouble getting your 7-8 hours per night, check out these suggestions:

Getting a good night’s rest

Good night....

Sleep has long been considered by naturopathic doctors to be a foundation of health.  We all know that we can be grumpy without adequate sleep, but there's been an explosion of science in recent years that have linked poor quality sleep to everything from high blood pressure to chronic pain to obesity.  A recent article in The Seattle Times focused on the importance of maintaining a cool sleeping environment -- this is something I've told my patients for years.  In addition to this, ensure absolute darkness at night -- this helps to enhance your body's natural production of melatonin, the sleep hormone.  Shut off all screens (TV, computer, whatever electronic devices) at least 30-60 minutes before bedtime.

Insomnia plagues many in these hot months