‘I can’t quite shut it off’: Prevalence of insomnia a growing concern for women
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Tasha Werner, 43, gets up at 3:30 a.m. twice a week for her part-time job at a fitness centre in Calgary. After a five-hour shift, she is back home by 9 a.m. to homeschool her two children, aged 9 and 12. The hardest part of her position – stay-at-home mom, homeschool teacher and part-time worker – is the downtime “lost from my life,” says Werner.
A study by Howard M. Kravitz, a psychiatrist in Chicago, showed that up to 60 per cent of women experience sleep disorders due to hormonal changes linked to menopause. But there is an increasing prevalence of insomnia symptoms in women that may be attributed, in part, to societal changes.
“We live in a world that didn’t exist a generation ago. Now everyone is trying to figure it out,” says Michael Grandner, director of the Sleep and Health Research Program at the University of Arizona.
While women are no longer expected to stay at home, many who are employed outside the home also have the primary responsibility for family matters. And women aged 40 to 60 commonly fall within the “sandwich generation,” caring for both children and parents.
As women juggle their responsibilities, these duties can take a toll, both emotionally and practically.
Both Werner and her husband were raised in traditional homes; their mothers stayed at home to oversee childcare, cooking, grocery shopping and household duties. Initially, Werner and her husband followed a similar path, mirroring their parents’ lives as homemakers. “I think we just fell into what we were used to,” says Werner.
However, a notable shift in their family dynamics occurred once she started working outside the home.
Her children’s physical needs and illnesses have had major consequences on her sleep. If one of the children is sick with the flu, that’s “a week of not a lot of sleep during the night,” she says, “because that’s my job.” Many nights, she finds herself waking up between 1 a.m. and 3 a.m., worrying about how the kids are doing academically or behaviourally.
“We face a specific set of anxieties and a different set of pressures than men,” says Emma Kobil, who has been a therapist in Denver, Colo., for 15 years and is now an insomnia coach. There is so much pressure to be everything as a woman – to be an amazing homemaker and worker while maintaining a hot-rocking body and having a cool personality, to “be the cool mom but also the CEO, to follow your dreams and be the boss b****,” says Kobil.
And there’s an appeal to that concept. Daughters grow up viewing their moms as superwomen juggling responsibilities. But what isn’t always obvious are the challenges women face while managing their lives and the health issues they may encounter.
A study revealed that women are 41 per cent more at risk of insomnia than men.
A thorough study revealed that women are 41 per cent more at risk of insomnia than men. Beyond menopausal hormonal shifts, societal pressures, maternal concerns and the challenge of balancing multiple roles contribute to women’s increased susceptibility to insomnia.
Cyndi Aarrestad, 57, lives on a farm in Saskatchewan with her husband, Denis. Now an empty nester, Aarrestad fills her time working on the farm, keeping house, volunteering at her church and managing her small woodworking business. And she struggles with sleep.
Despite implementing some remedies, including stretching, drinking calming teas and rubbing her feet before bed, Aarrestad says achieving restful sleep has remained elusive for the past decade.
Two primary factors contribute to her sleep challenges — her inability to quiet her mind and hormonal hot flashes due to menopause. Faced with family and outside commitments, Aarrestad finds it challenging to escape night time’s mental chatter. “It’s a mom thing for me … I can’t quite shut it off.” Even as her children transitioned to young adulthood and moved out, the worries persisted, highlighting the lasting concerns moms have about their kids’ jobs, relationships and overall well-being.
Therapist Kobil says that every woman she’s ever worked with experiences this pressure to do everything, to be perfect. These women feel like they’re not measuring up. They’re encouraged to take on other people’s burdens; to be the confidante and the saviour in many ways; to sacrifice themselves. Sleep disruptions simply reflect the consequences of this pressure.
“They’re trying to fit 20 hours in a 24-hour day, and it doesn’t work,” says Grandner, the sleep specialist.
Grandner says that consistently sleeping six hours or less as an adult makes one 55 per cent more likely to become obese, 20 per cent more likely to develop high blood pressure, and 30 per cent more likely to develop Type 2 diabetes if you didn’t have it already. This lack of sleep makes you more likely to catch the flu. It makes vaccines less effective, and it increases your likelihood of developing depression and anxiety.
When is the time to change? Yesterday. Grandner warns that the sleep sacrifices made at a young age impact health later. But it’s never too late to make changes, he says, and “you do the best with what you’ve got.”
Kobil suggests a practical approach for women struggling with sleep. She emphasizes understanding that sleeplessness isn’t a threat and encourages a shift in mindset about being awake. Instead of fighting sleeplessness, she advises treating oneself kindly, recognizing the difficulty.
Kobil recommends creating a simple playbook with comforting activities for awake moments during the night. Just as you would comfort a child who’s afraid, she suggests being gentle with yourself, gradually changing the perception of wakefulness into a positive experience.
This article is republished from HealthyDebate under a Creative Commons license. Read the original article.
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How stigma perpetuates substance use
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In 2022, 54.6 million people 12 and older in the United States needed substance use disorder (SUD) treatment. Of those, only 24 percent received treatment, according to the most recent National Survey on Drug Use and Health.
SUD is a treatable, chronic medical condition that causes people to have difficulty controlling their use of legal or illegal substances, such as alcohol, tobacco, prescription opioids, heroin, methamphetamine, or cocaine. Using these substances may impact people’s health and ability to function in their daily life.
While help is available for people with SUD, the stigma they face—negative attitudes, stereotypes, and discrimination—often leads to shame, worsens their condition, and keeps them from seeking help.
Read on to find out more about how stigma perpetuates substance use.
Stigma can keep people from seeking treatment
Suzan M. Walters, assistant professor at New York University’s Grossman School of Medicine, has seen this firsthand in her research on stigma and health disparities.
She explains that people with SUD may be treated differently at a hospital or another health care setting because of their drug use, appearance (including track marks on their arms), or housing situation, which may discourage them from seeking care.
“And this is not just one case; this is a trend that I’m seeing with people who use drugs,” Walters tells PGN. “Someone said, ‘If I overdose, I’m not even going to the [emergency room] to get help because of this, because of the way I’m treated. Because I know I’m going to be treated differently.’”
People experience stigma not only because of their addiction, but also because of other aspects of their identities, Walters says, including “immigration or race and ethnicity. Hispanic folks, brown folks, Black folks [are] being treated differently and experiencing different outcomes.”
And despite the effective harm reduction tools and treatment options available for SUD, research has shown that stigma creates barriers to access.
Syringe services programs, for example, provide infectious disease testing, Narcan, and fentanyl test strips. These programs have been proven to save lives and reduce the spread of HIV and hepatitis C. SSPs don’t increase crime, but they’re often mistakenly “viewed by communities as potential settings of drug-related crime;” this myth persists despite decades of research proving that SSPs make communities safer.
To improve this bias, Walters says it’s helpful for people to take a step back and recognize how we use substances, like alcohol, in our own lives, while also humanizing those with addiction. She says, “There’s a lack of understanding that these are human beings and people … [who] are living lives, and many times very functional lives.”
Misconceptions lead to stigma
SUD results from changes in the brain that make it difficult for a person to stop using a substance. But research has shown that a big misconception that leads to stigma is that addiction is a choice and reflects a person’s willpower.
Michelle Maloney, executive clinical director of mental health and addiction recovery services for Rogers Behavioral Health, tells PGN that statements such as “you should be able to stop” can keep a patient from seeking treatment. This belief goes back to the 1980s and the War on Drugs, she adds.
“We think about public service announcements that occurred during that time: ‘Just say no to drugs,’” Maloney says. “People who have struggled, whether that be with nicotine, alcohol, or opioids, [know] it’s not as easy as just saying no.”
Stigma can worsen addiction
Stigma can also lead people with SUD to feel guilt and shame and blame themselves for their medical condition. These feelings, according to the National Institute on Drug Abuse, may “reinforce drug-seeking behavior.”
In a 2020 article, Dr. Nora D. Volkow, the director of NIDA, said that “when internalized, stigma and the painful isolation it produces encourage further drug taking, directly exacerbating the disease.”
Overall, research agrees that stigma harms people experiencing addiction and can make the condition worse. Experts also agree that debunking myths about the condition and using non-stigmatizing language (like saying someone is a person with a substance use disorder, not an addict) can go a long way toward reducing stigma.
Resources to mitigate stigma:
- CDC: Stigma Reduction
- National Harm Reduction Coalition: Respect To Connect: Undoing Stigma
- NIDA:
- Shatterproof: Addiction language guide (Disclosure: The Public Good Projects, PGN’s parent company, is a Shatterproof partner)
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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The Truth About Vaccines
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The Truth About Vaccines
Yesterday we asked your views on vaccines, and we got an interesting spread of answers. Of those who responded to the poll, most were in favour of vaccines. We got quite a lot of comments this time too; we can’t feature them all, but we’ll include extracts from a few in our article today, as they raised interesting points!
Vaccines contain dangerous ingredients that will harm us more than the disease would: True or False?
False, contextually.
Many people are very understandably wary of things they know full well to be toxic, being injected into them.
One subscriber who voted for “Vaccines are poison, and/or are some manner of conspiracy ” wrote:
❝I think vaccines from 50–60 years ago are true vaccines and were safer than vaccines today. I have not had a vaccine for many, many years, and I never plan to have any kind of vaccine/shot again.❞
They didn’t say why they personally felt this way, but the notion that “things were simpler back in the day” is a common (and often correct!) observation regards health, especially when it comes to unwanted additives and ultraprocessing of food.
Things like aluminum or mercury in vaccines are much like sodium and chlorine in table salt. Sodium and chlorine are indeed both toxic to us. But in the form of sodium chloride, it’s a normal part of our diet, provided we don’t overdo it.
Additionally, the amount of unwanted metals (e.g. aluminum, mercury) in vaccines is orders of magnitude smaller than the amount in dietary sources—even if you’re a baby and your “dietary sources” are breast milk and/or formula milk.
In the case of formaldehyde (an inactivating agent), it’s also the dose that makes the poison (and the quantity in vaccines is truly miniscule).
This academic paper alone cites more sources than we could here without making today’s newsletter longer than it already is:
Vaccine Safety: Myths and Misinformation
I have a perfectly good immune system, it can handle the disease: True or False?
True! Contingently.
In fact, our immune system is so good at defending against disease, that the best thing we can do to protect ourselves is show our immune system a dead or deactivated version of a pathogen, so that when the real pathogen comes along, our immune system knows exactly what it is and what to do about it.
In other words, a vaccine.
One subscriber who voted for “Vaccines are important but in some cases the side effects can be worse ” wrote:
❝In some ways I’m vacd out. I got COVid a few months ago and had no symptoms except a cough. I have asthma and it didn’t trigger a lot of congestion. No issues. I am fully vaccinated but not sure I’ll get one in fall.❞
We’re glad this subscriber didn’t get too ill! A testimony to their robust immune system doing what it’s supposed to, after being shown a recent-ish edition of the pathogen, in deactivated form.
It’s very reasonable to start wondering: “surely I’m vaccinated enough by now”
And, hopefully, you are! But, as any given pathogen mutates over time, we eventually need to show our immune system what the new version looks like, or else it won’t recognize it.
See also: Why Experts Think You’ll Need a COVID-19 Booster Shot in the Future
So why don’t we need booster shots for everything? Often, it’s because a pathogen has stopped mutating at any meaningful rate. Polio is an example of this—no booster is needed for most people in most places.
Others, like flu, require annual boosters to keep up with the pathogens.
Herd immunity will keep us safe: True or False?
True! Ish.
But it doesn’t mean what a lot of people think it means. For example, in the UK, “herd immunity” was the strategy promoted by Prime Minister of the hour, Boris Johnson. But he misunderstood what it meant:
- What he thought it meant: everyone gets the disease, then everyone who doesn’t die is now immune
- What it actually means: if most people are immune to the disease (for example: due to having been vaccinated), it can’t easily get to the people who aren’t immune
One subscriber who voted for “Vaccines are critical for our health; vax to the max! ” wrote:
❝I had a chiropractor a few years ago, who explained to me that if the general public took vaccines, then she would not have to vaccinate her children and take a risk of having side effects❞
Obviously, we can’t speak for this subscriber’s chiropractor’s children, but this raises a good example: some people can’t safely have a given vaccine, due to underlying medical conditions—or perhaps it is not available to them, for example if they are under a certain age.
In such cases, herd immunity—other people around having been vaccinated and thus not passing on the disease—is what will keep them safe.
Here’s a useful guide from the US Dept of Health and Human Services:
How does community immunity (a.k.a. herd immunity) work?
And, for those who are more visually inclined, here’s a graphical representation of a mathematical model of how herd immunity works (you can run a simulation)!
Stay safe!
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Coach’s Plan – by Mike Kavanagh
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A sports coach’s job is to prepare a plan, give it to the player(s), and hold them accountable to it. Change the strategy if needs be, call the shots. The job of the player(s) is then to follow those instructions.
If you have trouble keeping yourself accountable, Kavanagh argues that it can be good to separate how you approach things.
Not just “coach yourself”, but put yourself entirely in the coach’s shoes, as though you were a separate person, then switch back, and follow those instructions, trusting in your coach’s guidance.
The book also provides illustrative examples and guides the reader through some potential pitfalls—for example, what happens when morning you doesn’t want to do the things that evening you decided would be best?
The absolute backbone of this method is that it takes away the paralysing self-doubt that can occur when we second-guess ourselves mid-task.
In short, this book will fire up your enthusiasm and give you a reliable fall-back for when your motivation’s flagging.
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The Four Pillar Plan – by Dr. Rangan Chatterjee
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Dr. Rangan Chatterjee, a medical doctor, felt frustrated with how many doctors in his field focus on treating the symptoms of disease, rather than the cause. Sometimes, of course, treating the symptom is necessary too! But neglecting the cause is a recipe for long-term woes.
What he does differently is take lifestyle as a foundation, and even that, he does differently than many authors on the topic. How so, you may wonder?
Rather than look first at exercise and diet, he starts with “relax”. His rationale is reasonable: diving straight in with marathon training or a whole new diet plan can be unsustainable without this as a foundation to fall back on.
Many sources look first at exercise (because it can be a very simple “prescription”) before diet (often more complex)… but how does one exercise well with the wrong fuel in the tank? So Dr. Chatterjee’s titular “Four Pillars” come in the following order:
- Relax
- Eat
- Move
- Sleep
He also goes for “move” rather than “exercise” as the focus here is more on minimizing time spent sitting, and thus involving a lot of much more frequent gentle activities… rather than intensive training programs and the like.
And as for sleep? Yes, that comes last because—no matter how important it is—the other things are easier to directly control. After all, one can improve conditions for sleep, but one cannot simply choose to sleep better! So with the other three things covered first, good sleep is the fourth and final thing to fall into place.
All in all, this is a great book to cut through the catch-22 problem of lifestyle factors negatively impacting each other.
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Who will look after us in our final years? A pay rise alone won’t solve aged-care workforce shortages
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Aged-care workers will receive a significant pay increase after the Fair Work Commission ruled they deserved substantial wage rises of up to 28%. The federal government has committed to the increases, but is yet to announce when they will start.
But while wage rises for aged-care workers are welcome, this measure alone will not fix all workforce problems in the sector. The number of people over 80 is expected to triple over the next 40 years, driving an increase in the number of aged care workers needed.
How did we get here?
The Royal Commission into Aged Care Quality and Safety, which delivered its final report in March 2021, identified a litany of tragic failures in the regulation and delivery of aged care.
The former Liberal government was dragged reluctantly to accept that a total revamp of the aged-care system was needed. But its weak response left the heavy lifting to the incoming Labor government.
The current government’s response started well, with a significant injection of funding and a promising regulatory response. But it too has failed to pursue a visionary response to the problems identified by the Royal Commission.
Action was needed on four fronts:
- ensuring enough staff to provide care
- building a functioning regulatory system to encourage good care and weed out bad providers
- designing and introducing a fair payment system to distribute funds to providers and
- implementing a financing system to pay for it all and achieve intergenerational equity.
A government taskforce which proposed a timid response to the fourth challenge – an equitable financing system – was released at the start of last week.
Consultation closed on a very poorly designed new regulatory regime the week before.
But the big news came at end of the week when the Fair Work Commission handed down a further determination on what aged-care workers should be paid, confirming and going beyond a previous interim determination.
What did the Fair Work Commission find?
Essentially, the commission determined that work in industries with a high proportion of women workers has been traditionally undervalued in wage-setting. This had consequences for both care workers in the aged-care industry (nurses and Certificate III-qualified personal-care workers) and indirect care workers (cleaners, food services assistants).
Aged-care staff will now get significant pay increases – 18–28% increase for personal care workers employed under the Aged Care Award, inclusive of the increase awarded in the interim decision.
Indirect care workers were awarded a general increase of 3%. Laundry hands, cleaners and food services assistants will receive a further 3.96% on the grounds they “interact with residents significantly more regularly than other indirect care employees”.
The final increases for registered and enrolled nurses will be determined in the next few months.
How has the sector responded?
There has been no push-back from employer groups or conservative politicians. This suggests the uplift is accepted as fair by all concerned.
The interim increases of up to 15% probably facilitated this acceptance, with the recognition of the community that care workers should be paid more than fast food workers.
There was no criticism from aged-care providers either. This is probably because they are facing difficulty in recruiting staff at current wage rates. And because government payments to providers reflect the actual cost of aged care, increased payments will automatically flow to providers.
When the increases will flow has yet to be determined. The government is due to give its recommendations for staging implementation by mid-April.
Is the workforce problem fixed?
An increase in wages is necessary, but alone is not sufficient to solve workforce shortages.
The health- and social-care workforce is predicted to grow faster than any other sector over the next decade. The “care economy” will grow from around 8% to around 15% of GDP over the next 40 years.
This means a greater proportion of school-leavers will need to be attracted to the aged-care sector. Aged care will also need to attract and retrain workers displaced from industries in decline and attract suitably skilled migrants and refugees with appropriate language skills.
The caps on university and college enrolments imposed by the previous government, coupled with weak student demand for places in key professions (such as nursing), has meant workforce shortages will continue for a few more years, despite the allure of increased wages.
A significant increase in intakes into university and vocational education college courses preparing students for health and social care is still required. Better pay will help to increase student demand, but funding to expand place numbers will ensure there are enough qualified staff for the aged-care system of the future.
Stephen Duckett, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice and Primary Care, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Eat to Beat Your Diet – by Dr. William Li
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We previously reviewed Dr. Li’s excellent “Eat To Beat Disease”, so you may be wondering how much overlap there is. While he does still cover such topics as angiogenesis, organ regeneration, microbiome health, DNA protection, and immunological considerations, and much of the dietary advice is similar, most of the explanation is different.
Because, this time, rather than looking at beating disease in general, there’s a much stronger focus on metabolic disease in particular, and yes, for those who want to do so, losing fat.
The scientific explanations are in-depth, such that you come way with not merely “I should eat an avocado once in a while”, but a comprehensive understanding of the body’s metabolic processes, from the chemistry to the organs involved, from the cellular to the systemic.
The style is on the hard end of pop-science. It’s approachably readable, while having a lot of densely-packed information with minimal fluff. You will be more than getting your money’s worth out of its 496 pages.
Bottom line: if you’d like to perk up your metabolism with a dietary approach that’s enjoyable and very restrictive, then this book will arm you with the knowledge to do that.
Click here to check out Eat To Beat Your Diet, and eat to beat your diet!
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