Calculate (And Enjoy) The Perfect Night’s Sleep
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This is Dr. Michael Breus, a clinical psychologist and sleep specialist, and he wants you to get a good night’s sleep, every night.
First, let’s assume you know a lot of good advice about how to do that already in terms of environment and preparation, etc. If you want a recap before proceeding, then we recommend:
Get Better Sleep: Beyond The Basics
Now, what does he want to add?
Wake up refreshed
Of course, how obtainable this is will depend on the previous night’s sleep, but there is something important we can do here regardless, and it’s: beat sleep inertia.
Sleep inertia is what happens when we wake up groggy (for reasons other than being ill, drugged, etc) rather than refreshed. It’s not actually related to how much sleep we have, though!
Rather, it pertains to whether we woke up during a sleep cycle, or between cycles:
- If we wake up between sleep cycles, we’ll avoid sleep inertia.
- If we wake up during a sleep cycle, we’ll be groggy.
Deep sleep generally occurs in 90-minute blocks, albeit secretly that is generally 3× 20 minute blocks in a trenchcoat, with transition periods between, during which the brainwaves change frequency.
REM sleep generally occurs in 20 minute blocks, and will usually arrive in series towards the end of our natural sleep period, to fit neatly into the last 90-minute cycle.
Sometimes these will appear a little out of order, because we are complicated organic beings, but those are the general trends.
In any case, the take-away here is: interrupt them at your peril. You need to wake up between cycles. There are two ways you can do this:
- Carefully calculate everything, and set a very precise alarm clock (this will work so long as you are correct in guessing how long it will take you to fall asleep)
- Use a “sunrise” lamp alarm clock, that in the hour approaching your set alarm time, will gradually increase the light. Because the body will not naturally wake up during a cycle unless a threat is perceived (loud noise, physical rousing, etc), the sunrise lamp method means that you will wake up between sleep cycles at some point during that hour (towards the beginning or end, depending on what your sleep balance/debt is like).
Do not sleep in (even if you have a sleep debt); it will throw everything out.
Caffeine will not help much in the morning
Assuming you got a reasonable night’s sleep, your brain has been cleansed of adenosine (a sleepy chemical), and if you are suffering from sleep inertia, the grogginess is due to melatonin (a different sleepy chemical).
Caffeine is an adenosine receptor blocker, so that will do nothing to mitigate the effects of melatonin in your brain that doesn’t have any meaningful quantity of adenosine in it in the morning.
Adenosine gradually accumulates in the brain over the course of the day (and then gets washed out while we sleep), so if you’re sleepy in the afternoon (for reasons other than: you just had a nap and now have sleep inertia again), then caffeine can block that adenosine in the afternoon.
Of course, caffeine is also a stimulant (it increases adrenaline levels and promotes vasoconstriction), but its effects at healthily small doses are modest for most people, and you’d do better by splashing cold water on your face and/or listening to some upbeat music.
Learn more: The Two Sides Of Caffeine
Time your naps correctly (if you take naps)
Dr. Breus has a lot to say about this, based on a lot of clinical research, but as it’s entirely consistent with what we’ve written before (based on the exact same research), to save space we’ll link to that here:
How To Be An Expert Nap-Artist (With No “Sleep-Hangovers”)
Calculate your bedtime correctly
Remember what we said about sleep cycles? This means that that famous “7–9 hours sleep” is actually “either 7½ or 9 hours sleep”—because those are multiples of 90 minutes, whereas 8 hours (for example) is not.
So, consider the time you want to get up (ideally, this should be relatively early, and the same time every day), and then count backwards either 7½ or 9 hours sleep (you choose), add 20–30 minutes to fall asleep, and that’s your bedtime.
So for example: if you want to have 7½ hours sleep and get up at 6am, then your bedtime is anywhere between 10pm and 10:10pm.
Remember how we said not to sleep in, even if you have a sleep debt? Now is the time to pay it off, if you have one. If you normally sleep 7½ hours, then make tonight a 9-hour sleep (plus 20–30 minutes to fall asleep). This means you’ll still get up at 6am, but your bedtime is now anywhere between 8:30pm and 8:40pm.
Want to know more from Dr. Breus?
You might like this excellent book of his that we reviewed a while back:
The Power of When – by Dr. Michael Breus
Enjoy!
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Mung Beans vs Red Lentils – Which is Healthier?
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Our Verdict
When comparing mung beans to red lentils, we picked the lentils.
Why?
Both are great! But the lentils win on overall nutritional density.
In terms of macros, they have approximately the same carbs and fiber, and are both low glycemic index foods. The deciding factor is that the lentils have slightly more protein—but it’s not a huge difference; both are very good sources of protein.
In the category of vitamins, mung beans have more of vitamins A, E, and K, while red lentils have more of vitamins B1, B2, B3, B5, B6, B9, C, and choline. An easy win for lentils.
When it comes to minerals, again both are great, but mung beans have more calcium and magnesium (hence the green color) while red lentils have more copper, iron, manganese, phosphorus, potassium, selenium, and zinc. Another clear win for lentils.
Polyphenols are also a worthy category to note here; both have plenty, but red lentils have more, especially flavonols, anthocyanidins, proanthocyanidins, and anthocyanins (whence the red color).
In short: enjoy both, because diversity is almost always best. But if you’re picking one, red lentils are the most nutritious of the two.
Want to learn more?
You might like to read:
Sprout Your Seeds, Grains, Beans, Etc
Take care!
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Chatter – by Dr. Ethan Kross
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This book is about much more than just one’s internal monologue. It does tackle that, but also the many non-verbal rabbit-holes that our brains can easily disappear into.
The author is an experimental psychologist, and brings his professional knowledge and experience to bear on this problem—citing many studies, including his own studies from his own lab, in which he undertook to answer precisely the implicit questions of “How can I…” in terms of tackling these matters, from root anxiety (for example) to end-state executive dysfunction (for example).
The writing style isn’t dense science though, and is very approachable for all.
The greatest value in this book lies in its prescriptive element, that is to say, its advice, especially in the category of evidence-based things we can do to improve matters for ourselves; beyond generic things like “mindfulness-based stress reduction” to much more specific things like “observe yourself in the 3rd person for a moment” and “take a break to imagine looking back on this later” and “interrupt yourself with a brief manual task”. With these sorts of interventions and more, we can shift the voice in our head from critic to coach.
Bottom line: if you would like your brain to let you get on with the things you actually want to do instead of constantly sidetracking you, this is the book for you.
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Olfactory Training, Better
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Anosmia, by any other name…
The loss of the sense of smell (anosmia) is these days well-associated with COVID and Long-COVID, but also can simply come with age:
National Institute of Aging | How Smell & Taste Change With Age
…although it can also be something else entirely:
❝Another possibility is a problem with part of the nervous system responsible for smell.
Some studies have suggested that loss of smell could be an early sign of a neurodegenerative disease, such as Alzheimer’s or Parkinson’s disease.
However, a recent study of 1,430 people (average age about 80) showed that 76% of people with anosmia had normal cognitive function at the study’s end.❞
Read more: Harvard Health | Is it normal to lose my sense of smell as I age?
We’d love to look at and cite the paper that they cite, but they didn’t actually provide a source. We did find some others, though:
❝Olfactory capacity declines with aging, but increasing evidence shows that smell dysfunction is one of the early signs of prodromal neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease.
The loss of smell is considered a clinical sign of early-stage disease and a marker of the disease’s progression and cognitive impairment.❞
Read more: Neurons, Nose, and Neurodegenerative Diseases: Olfactory Function and Cognitive Impairment
What’s clear is the association; what’s not clear is whether one worsens the other, and what causal role each might play. However, the researchers conclude that both ways are possible, including when there is another, third, underlying potential causal factor:
❝Ongoing studies on COVID-19 anosmia could reveal new molecular aspects unexplored in olfactory impairments due to neurodegenerative diseases, shedding a light on the validity of smell test predictivity of cognitive dementia.
The neuroepithelium might become a new translational research target (Neurons, Nose, and Neurodegenerative diseases) to investigate alternative approaches for intranasal therapy and the treatment of brain disorders. ❞
~ Ibid.
Another study explored the possible mechanisms of action, and found…
❝Olfactory impairment was significantly associated with increased likelihoods of MCI, amnestic MCI, and non-amnestic MCI.
In the subsamples, anosmia was significantly associated with higher plasma total tau and NfL concentrations, smaller hippocampal and entorhinal cortex volumes, and greater WMH volume, and marginally with lower AD-signature cortical thickness.
These results suggest that cerebral neurodegenerative and microvascular lesions are common neuropathologies linking anosmia with MCI in older adults❞
- MCI = Mild Cognitive Impairment
- NfL = Neurofilament Light [Chain]
- WMH = White Matter Hyperintensity
- AD =Alzheimer’s Disease
Read more: Anosmia, mild cognitive impairment, and biomarkers of brain aging in older adults
How to act on this information
You may be wondering, “this is fascinating and maybe even a little bit frightening, but how is this Saturday’s Life Hacks?”
We wanted to set up the “why” before getting to the “how”, because with a big enough “why”, it’s much easier to find the motivation to act on the “how”.
Test yourself
Or more conveniently, you and a partner/friend/relative can test each other.
Simply do like a “blind taste testing”, but for smell. Ideally these will be a range of simple and complex odors, and commercially available smell test kits will provide these, if you don’t want to make do with random items from your kitchen.
If you’d like to use a clinical diagnostic tool, you can check out:
Clinical assessment of patients with smell and taste disorders
…and especially, this really handy diagnostic flowchart:
Algorithm of evaluation of a patient who has olfactory loss
Train yourself
“Olfactory training” has been the got-to for helping people to regain their sense of smell after losing it due to COVID.
In simple terms, this means simply trying to smell things that “should” have a distinctive odor, and gradually working up one’s repertoire of what one can smell.
You can get some great tips here:
AbScent | Useful Insights Into Smell Training
Hack your training
An extra trick was researched deeply in a recent study which found that multisensory integration helped a) initially regain the ability to smell things and b) maintain that ability later without the cross-sensory input.
What that means: you will more likely be able to smell lemon while viewing the color yellow, and most likely of all to be able to smell lemon while actually holding and looking at a slice of lemon. Having done this, you’re more likely to be able to smell (and distinguish) the odor of lemon later in a blind smell test.
In other words: with this method, you may be able to cut out many months of frustration of trying and failing to smell something, and skip straight to the “re-adding specific smells to my brain’s olfactory database” bit.
Read the study: Olfactory training: effects of multisensory integration, attention towards odors and physical activity
Or if you prefer, here’s a pop-science article based on that:
One in twenty people has no sense of smell—here’s how they might get it back
Take care!
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Their First Baby Came With Medical Debt. These Illinois Parents Won’t Have Another.
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JACKSONVILLE, Ill. — Heather Crivilare was a month from her due date when she was rushed to an operating room for an emergency cesarean section.
The first-time mother, a high school teacher in rural Illinois, had developed high blood pressure, a sometimes life-threatening condition in pregnancy that prompted doctors to hospitalize her. Then Crivilare’s blood pressure spiked, and the baby’s heart rate dropped. “It was terrifying,” Crivilare said.
She gave birth to a healthy daughter. What followed, though, was another ordeal: thousands of dollars in medical debt that sent Crivilare and her husband scrambling for nearly a year to keep collectors at bay.
The Crivilares would eventually get on nine payment plans as they juggled close to $5,000 in bills.
“It really felt like a full-time job some days,” Crivilare recalled. “Getting the baby down to sleep and then getting on the phone. I’d set up one payment plan, and then a new bill would come that afternoon. And I’d have to set up another one.”
Crivilare’s pregnancy may have been more dramatic than most. But for millions of new parents, medical debt is now as much a hallmark of having children as long nights and dirty diapers.
About 12% of the 100 million U.S. adults with health care debt attribute at least some of it to pregnancy or childbirth, according to a KFF poll.
These people are more likely to report they’ve had to take on extra work, change their living situation, or make other sacrifices.
Overall, women between 18 and 35 who have had a baby in the past year and a half are twice as likely to have medical debt as women of the same age who haven’t given birth recently, other KFF research conducted for this project found.
“You feel bad for the patient because you know that they want the best for their pregnancy,” said Eilean Attwood, a Rhode Island OB-GYN who said she routinely sees pregnant women anxious about going into debt.
“So often, they may be coming to the office or the hospital with preexisting debt from school, from other financial pressures of starting adult life,” Attwood said. “They are having to make real choices, and what those real choices may entail can include the choice to not get certain services or medications or what may be needed for the care of themselves or their fetus.”
Best-Laid Plans
Crivilare and her husband, Andrew, also a teacher, anticipated some of the costs.
The young couple settled in Jacksonville, in part because the farming community less than two hours north of St. Louis was the kind of place two public school teachers could afford a house. They saved aggressively. They bought life insurance.
And before Crivilare got pregnant in 2021, they enrolled in the most robust health insurance plan they could, paying higher premiums to minimize their deductible and out-of-pocket costs.
Then, two months before their baby was due, Crivilare learned she had developed preeclampsia. Her pregnancy would no longer be routine. Crivilare was put on blood pressure medication, and doctors at the local hospital recommended bed rest at a larger medical center in Springfield, about 35 miles away.
“I remember thinking when they insisted that I ride an ambulance from Jacksonville to Springfield … ‘I’m never going to financially recover from this,’” she said. “‘But I want my baby to be OK.’”
For weeks, Crivilare remained in the hospital alone as covid protocols limited visitors. Meanwhile, doctors steadily upped her medications while monitoring the fetus. It was, she said, “the scariest month of my life.”
Fear turned to relief after her daughter, Rita, was born. The baby was small and had to spend nearly two weeks in the neonatal intensive care unit. But there were no complications. “We were incredibly lucky,” Crivilare said.
When she and Rita finally came home, a stack of medical bills awaited. One was already past due.
Crivilare rushed to set up payment plans with the hospitals in Jacksonville and Springfield, as well as the anesthesiologist, the surgeon, and the labs. Some providers demanded hundreds of dollars a month. Some settled for monthly payments of $20 or $25. Some pushed Crivilare to apply for new credit cards to pay the bills.
“It was a blur of just being on the phone constantly with all the different people collecting money,” she recalled. “That was a nightmare.”
Big Bills, Big Consequences
The Crivilares’ bills weren’t unusual. Parents with private health coverage now face on average more than $3,000 in medical bills related to a pregnancy and childbirth that aren’t covered by insurance, researchers at the University of Michigan found.
Out-of-pocket costs are even higher for families with a newborn who needs to stay in a neonatal ICU, averaging $5,000. And for 1 in 11 of these families, medical bills related to pregnancy and childbirth exceed $10,000, the researchers found.
“This forces very difficult trade-offs for families,” said Michelle Moniz, a University of Michigan OB-GYN who worked on the study. “Even though they have insurance, they still have these very high bills.”
Nationwide polls suggest millions of these families end up in debt, with sometimes devastating consequences.
About three-quarters of U.S. adults with debt related to pregnancy or childbirth have cut spending on food, clothing, or other essentials, KFF polling found.
About half have put off buying a home or delayed their own or their children’s education.
These burdens have spurred calls to limit what families must pay out-of-pocket for medical care related to pregnancy and childbirth.
In Massachusetts, state Sen. Cindy Friedman has proposed legislation to exempt all these bills from copays, deductibles, and other cost sharing. This would parallel federal rules that require health plans to cover recommended preventive services like annual physicals without cost sharing for patients. “We want … healthy children, and that starts with healthy mothers,” Friedman said. Massachusetts health insurers have warned the proposal will raise costs, but an independent state analysis estimated the bill would add only $1.24 to monthly insurance premiums.
Tough Lessons
For her part, Crivilare said she wishes new parents could catch their breath before paying down medical debt.
“No one is in the right frame of mind to deal with that when they have a new baby,” she said, noting that college graduates get such a break. “When I graduated with my college degree, it was like: ‘Hey, new adult, it’s going to take you six months to kind of figure out your life, so we’ll give you this six-month grace period before your student loans kick in and you can get a job.’”
Rita is now 2. The family scraped by on their payment plans, retiring the medical debt within a year, with help from Crivilare’s side job selling resources for teachers online.
But they are now back in debt, after Rita’s recurrent ear infections required surgery last year, leaving the family with thousands of dollars in new medical bills.
Crivilare said the stress has made her think twice about seeing a doctor, even for Rita. And, she added, she and her husband have decided their family is complete.
“It’s not for us to have another child,” she said. “I just hope that we can put some of these big bills behind us and give [Rita] the life that we want to give her.”
About This Project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability.
KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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The Body Is Not an Apology – by Sonya Renee Taylor
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First, a couple of things that this book is not about:
- Self-confidence (it’s about more than merely thinking highly of oneself)
- Self-acceptance (it’s about more than merely settling for “good enough”)
In contrast, it’s about loving and celebrating what is, while striving for better, for oneself and for others.
You may be wondering: whence this “radical” in the title?
The author argues that often, the problem with our bodies is not actually our bodies. If we have cancer, or diabetes, then sure, that’s a problem with the body. But most of the time, the “problem with our bodies” is simply society’s rejection of our “imperfect” bodies as somehow “less than”, and something we must invest time and money to correct. Hence, the need for a radical uprooting of ideas, to fix the real problem.
Bottom line: if, like most of us, you have a body that would not entirely pass for that of a Marvel Comics superhero, this is a book for you. And if you do have a MCU body? This is also a book for you, because we have bad news for you about what happens with age.
Click here to check out The Body Is Not An Apology, and appreciate more about yours!
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Dr. Suzanne Steinbaum’s Heart Book – by Dr. Suzanne Steinbaum
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The book is divided into three parts:
- What you should know
- What you should do
- All about you
This is a very useful format, since it lays out all the foundational knowledge, before offering practical advice and “how to” explanations, before finally wrapping up with personalizing things.
The latter is important, because while our basic risk factors can be assembled in a few lines of data (age, sex, race, genes, diet, exercise habits, etc) there’s a lot more to us than that, and oftentimes the data that doesn’t make the cut, makes the difference. Hormones on high on this list; we can say that a person is a 65-year-old woman and make a guess, but that’s all it is: a guess. Very few of us are the “average person” that statistical models represent accurately. And nor are social and psychological factors irrelevant; in fact often they are deciding factors!
So, it’s important to be able to look at ourselves as the whole persons we are, or else we’ll get a heart-healthy protocol that works on paper but actually falls flat in application, because the mathematical model didn’t take into account that lately we have been very stressed about such-and-such a thing, and deeply anxious about so-and-so, and a hopefully short-term respiratory infection has reduced blood oxygen levels, and all these kinds of things need to be taken into account too, for an overall plan to work.
The greatest strength of this book is that it attends to that.
The style of the book is a little like a long sales pitch (when all that’s being sold, by the way, is the ideas the book is offering; she wants you to take her advice with enthusiasm), but there’s plenty of very good information all the way through, making it quite worth the read.
Bottom line: if you’re a woman and/or love at least one woman, then you can benefit from this important book for understanding heart health that’s not the default.
Click here to check out Dr. Suzanne Steinbaum’s Heart Book, and enjoy a heart-healthy life!
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