An unbroken night’s sleep is a myth. Here’s what good sleep looks like
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What do you imagine a good night’s sleep to be?
Often when people come into our sleep clinic seeking treatment, they share ideas about healthy sleep.
Many think when their head hits the pillow, they should fall into a deep and restorative sleep, and emerge after about eight hours feeling refreshed. They’re in good company – many Australians hold the same belief.
In reality, healthy sleep is cyclic across the night, as you move in and out of the different stages of sleep, often waking up several times. Some people remember one or more of these awakenings, others do not. Let’s consider what a healthy night’s sleep looks like.
Sleep cycles are a roller-coaster
As an adult, our sleep moves through different cycles and brief awakenings during the night. Sleep cycles last roughly 90 minutes each.
We typically start the night with lighter sleep, before moving into deeper sleep stages, and rising again into rapid eye movement (REM) sleep – the stage of sleep often linked to vivid dreaming.
If sleeping well, we get most of our deep sleep in the first half of the night, with REM sleep more common in the second half of the night.
Adults usually move through five or six sleep cycles in a night, and it is entirely normal to wake up briefly at the end of each one. That means we might be waking up five times during the night. This can increase with older age and still be healthy. If you’re not remembering these awakenings that’s OK – they can be quite brief.
What does getting a ‘good’ sleep actually mean?
You’ll often hear that adults need between seven and nine hours of sleep per night. But good sleep is about more than the number of hours – it’s also about the quality.
For most people, sleeping well means being able to fall asleep soon after getting into bed (within around 30 minutes), sleeping without waking up for long periods, and waking feeling rested and ready for the day.
You shouldn’t be feeling excessively sleepy during the day, especially if you’re regularly getting at least seven hours of refreshing sleep a night (this is a rough rule of thumb).
But are you noticing you’re feeling physically tired, needing to nap regularly and still not feeling refreshed? It may be worthwhile touching base with your general practitioner, as there a range of possible reasons.
Common issues
Sleep disorders are common. Up to 25% of adults have insomnia, a sleep disorder where it may be hard to fall or stay asleep, or you may wake earlier in the morning than you’d like.
Rates of common sleep disorders such as insomnia and sleep apnoea – where your breathing can partially or completely stop many times during the night – also increase with age, affecting 20% of early adults and 40% of people in middle age. There are effective treatments, so asking for help is important.
Beyond sleep disorders, our sleep can also be disrupted by chronic health conditions – such as pain – and by certain medications.
There can also be other reasons we’re not sleeping well. Some of us are woken by children, pets or traffic noise during the night. These “forced awakenings” mean we may find it harder to get up in the morning, take longer to leave bed and feel less satisfied with our sleep. For some people, night awakenings may have no clear cause.
A good way to tell if these awakenings are a problem for you is by thinking about how they affect you. When they cause feelings of frustration or worry, or are impacting how we feel and function during the day, it might be a sign to seek some help.
We also may struggle to get up in the morning. This could be for a range of reasons, including not sleeping long enough, going to bed or waking up at irregular times – or even your own internal clock, which can influence the time your body prefers to sleep.
If you’re regularly struggling to get up for work or family needs, it can be an indication you may need to seek help. Some of these factors can be explored with a sleep psychologist if they are causing concern.
Can my smart watch help?
It is important to remember sleep-tracking devices can vary in accuracy for looking at the different sleep stages. While they can give a rough estimate, they are not a perfect measure.
In-laboratory polysomnography, or PSG, is the best standard measure to examine your sleep stages. A PSG examines breathing, oxygen saturation, brain waves and heart rate during sleep.
Rather than closely examining nightly data (including sleep stages) from a sleep tracker, it may be more helpful to look at the patterns of your sleep (bed and wake times) over time.
Understanding your sleep patterns may help identify and adjust behaviours that negatively impact your sleep, such as your bedtime routine and sleeping environment.
And if you find viewing your sleep data is making you feel worried about your sleep, this may not be useful for you. Most importantly, if you are concerned it is important to discuss it with your GP who can refer you to the appropriate specialist sleep health provider.
Amy Reynolds, Associate Professor in Clinical Sleep Health, Flinders University; Claire Dunbar, Research Associate, Sleep Health, Flinders University; Gorica Micic, Postdoctoral Research Fellow, Clinical Psychologist, Flinders University; Hannah Scott, Research Fellow in Sleep Health, Flinders University, and Nicole Lovato, Associate Professor, Adelaide Institute for Sleep Health, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Never Enough – by Dr. Judith Grisel
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We’ve reviewed books about addiction before—specifically about alcohol, at least. This one’s more general in that it covers different addictions.
On the other hand, it’s also more specific, in that it covers them from the author’s field: neuroscience.
…and experience too. The author had a plethora of addictions (the serious kind), got sober, and then undertook to study neuroscience. Her hope was to help others avoid, or escape from the same as‚ what she went through.
Dr. Grisel (as she now is) takes a methodical approach in this book. She works her way through the addictive mechanisms of a broad selection of common drugs, explaining each.
The focus here is on neutral explanations, rather than the propagandizing scaremongering that failed at least one generation. Why each drug is alluring, what it really does do—and the neurological price it exacts, down to the molecular level.
She also covers risk factors for addiction; genetic, epigenetic, and environmental. There’s no “if you were stronger”, or “these people made bad choices”, so much as… Many addicts were, in effect, sabotaged from before birth.
That doesn’t mean that to become addicted or not is just fate, but it does mean… There but for the grace of factors completely outside of our control go we.
Why is this useful to us, be we a reader without any meaningful addiction (we’re not counting coffee etc here)? Well, as this book illustrates and explains, many of us could be one (more) mishap away from a crippling addiction and not know it. Forewarned is forearmed.
Bottom line: almost all of us are, have been, or will be touched by addiction in some way. Either directly, or a loved one, or a loved one’s loved one, or perhaps a parent who gave us an epigenetic misfortune. This book gives understanding that can help.
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‘Naked carbs’ and ‘net carbs’ – what are they and should you count them?
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According to social media, carbs come in various guises: naked carbs, net carbs, complex carbs and more.
You might be wondering what these terms mean or if all carbs are really the same. If you are into “carb counting” or “cutting carbs”, it’s important to make informed decisions about what you eat.
What are carbs?
Carbohydrates, or “carbs” for short, are one of the main sources of energy we need for brain function, muscle movement, digestion and pretty much everything our bodies do.
There are two classifications of carbs, simple and complex. Simple carbs have one or two sugar molecules, while complex carbs are three or more sugar molecules joined together. For example, table sugar is a simple carb, but starch in potatoes is a complex carb.
All carbs need to be broken down into individual molecules by our digestive enzymes to be absorbed. Digestion of complex carbs is a much slower process than simple carbs, leading to a more gradual blood sugar increase.
Fibre is also considered a complex carb, but it has a structure our body is not capable of digesting. This means we don’t absorb it, but it helps with the movement of our stool and prevents constipation. Our good gut bacteria also love fibre as they can digest it and use it for energy – important for a healthy gut.
What about ‘naked carbs’?
“Naked carbs” is a popular term usually used to refer to foods that are mostly simple carbs, without fibre or accompanying protein or fat. White bread, sugary drinks, jams, sweets, white rice, white flour, crackers and fruit juice are examples of these foods. Ultra-processed foods, where the grains are stripped of their outer layers (including fibre and most nutrients) leaving “refined carbs”, also fall into this category.
One of the problems with naked carbs or refined carbs is they digest and absorb quickly, causing an immediate rise in blood sugar. This is followed by a rapid spike in insulin (a hormone that signals cells to remove sugar from blood) and then a drop in blood sugar. This can lead to hunger and cravings – a vicious cycle that only gets worse with eating more of the same foods.
What about ‘net carbs’?
This is another popular term tossed around in dieting discussions. Net carbs refer to the part of the carb food that we actually absorb.
Again, fibre is not easily digestible. And some carb-rich foods contain sugar alcohols, such as sweeteners (like xylitol and sorbitol) that have limited absorption and little to no effect on blood sugar. Deducting the value of fibre and sugar alcohols from the total carbohydrate content of a food gives what’s considered its net carb value.
For example, canned pear in juice has around 12.3g of “total carbohydrates” per 100g, including 1.7g carb + 1.7g fibre + 1.9g sugar alcohol. So its net carb is 12.3g – 1.7g – 1.9g = 8.7g. This means 8.7g of the 12.3g total carbs impacts blood sugar.
The nutrition labels on packaged foods in Australia and New Zealand usually list fibre separately to carbohydrates, so the net carbs have already been calculated. This is not the case in other countries, where “total carbohydrates” are listed.
Does it matter though?
Whether or not you should care about net or naked carbs depends on your dietary preferences, health goals, food accessibility and overall nutritional needs. Generally speaking, we should try to limit our consumption of simple and refined carbs.
The latest World Health Organization guidelines recommend our carbohydrate intake should ideally come primarily from whole grains, vegetables, fruits and pulses, which are rich in complex carbs and fibre. This can have significant health benefits (to regulate hunger, improve cholesterol or help with weight management) and reduce the risk of conditions such as heart disease, obesity and colon cancer.
In moderation, naked carbs aren’t necessarily bad. But pairing them with fats, protein or fibre can slow down the digestion and absorption of sugar. This can help to stabilise blood sugar levels, prevent spikes and crashes and support personal weight management goals. If you’re managing diabetes or insulin resistance, paying attention to the composition of your meals, and the quality of your carbohydrate sources is essential.
A ketogenic (high fat, low carb) diet typically restricts carb intake to between 20 and 50g each day. But this carb amount refers to net carbs – so it is possible to eat more carbs from high-fibre sources.
Some tips to try
Some simple strategies can help you get the most out of your carb intake:
reduce your intake of naked carbs and foods high in sugar and white flour, such as white bread, table sugar, honey, lollies, maple syrup, jam, and fruit juice
opt for protein- and fibre-rich carbs. These include oats, sweet potatoes, nuts, avocados, beans, whole grains and broccoli
if you are eating naked carbs, dress them up with some protein, fat and fibre. For example, top white bread with a nut butter rather than jam
if you are trying to reduce the carb content in your diet, be wary of any symptoms of low blood glucose, including headaches, nausea, and dizziness
- working with a health-care professional such as an accredited practising dietitian or your GP can help develop an individualised diet plan that meets your specific needs and goals.
Correction: this article has been updated to indicate how carbohydrates are listed on food nutrition labels in Australia and New Zealand.
Saman Khalesi, Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, CQUniversity Australia; Anna Balzer, Lecturer, Medical Science School of Health, Medical and Applied Sciences, CQUniversity Australia; Charlotte Gupta, Postdoctoral research fellow, CQUniversity Australia; Chris Irwin, Senior Lecturer in Nutrition and Dietetics, School of Health Sciences & Social Work, Griffith University, and Grace Vincent, Senior Lecturer, Appleton Institute, CQUniversity Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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8 Signs Of High Cortisol & How To Reverse “Cortisol Face”
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Dr. Shereene Idriss has insights about the facial features that might indicate chronically elevated cortisol levels, and what to do about same:
At face value
Dr. Idriss notes that for most people, this should not be cause for undue concern, although hypercortisolism can also be associated with genetic disorders such as Cushing’s syndrome, as well as prolonged use of certain medication, or the presence of certain tumors. As well as facial swelling, hypercortisolism can also result in other physical changes like acne, weight gain, skin thinning, stretch marks, infections, and hair loss.
As for what to do about it, she recommends addressing lifestyle factors like poor sleep, unhealthy diet, alcohol consumption, and lack of hydration to reduce facial puffiness related to stress. Diet suggestions include incorporating foods rich in magnesium, vitamin C, and omega-3s, such as leafy greens, fatty fish, nuts and seeds, and berries.
She also suggests some supplements to consider, such as ashwagandha, magnesium, omega-3s, and/or l-theanine, but you might want to speak to your doctor/pharmacist to check in case of contraindications per any other conditions you may have, or medications you may be on.
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
- Lower Your Cortisol! (Here’s Why & How)
- Ashwagandha: The Root of All Even-Mindedness?
- L-Theanine: What’s The Tea?
Take care!
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Is owning a dog good for your health?
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Australia loves dogs. We have one of the highest rates of pet ownership in the world, and one in two households has at least one dog.
But are they good for our health?
Mental health is the second-most common reason cited for getting a dog, after companionship. And many of us say we “feel healthier” for having a dog – and let them sleep in our bedroom.
Here’s what it means for our physical and mental health to share our homes (and doonas) with our canine companions.
Are there physical health benefits to having a dog?
Having a dog is linked to lower risk of death over the long term. In 2019, a systematic review gathered evidence published over 70 years, involving nearly four million individual medical cases. It found people who owned a dog had a 24% lower risk of dying from any cause compared to those who did not own a dog.
Dog ownership was linked to increased physical activity. This lowered blood pressure and helped reduce the risk of stroke and heart disease.
The review found for those with previous heart-related medical issues (such as heart attack), living with a dog reduced their subsequent risk of dying by 35%, compared to people with the same history but no dog.
Another recent UK study found adult dog owners were almost four times as likely to meet daily physical activity targets as non-owners. Children in households with a dog were also more active and engaged in more unstructured play, compared to children whose family didn’t have a dog.
Exposure to dirt and microbes carried in from outdoors may also strengthen immune systems and lead to less use of antibiotics in young children who grow up with dogs.
Health risks
However, dogs can also pose risks to our physical health. One of the most common health issues for pet owners is allergies.
Dogs’ saliva, urine and dander (the skin cells they shed) can trigger allergic reactions resulting in a range of symptoms, from itchy eyes and runny nose to breathing difficulties.
A recent meta-analysis pooled data from nearly two million children. Findings suggested early exposure to dogs may increase the risk of developing asthma (although not quite as much as having a cat does). The child’s age, how much contact they have with the dog and their individual risk all play a part.
Slips, trips and falls are another risk – more people fall over due to dogs than cats.
Having a dog can also expose you to bites and scratches which may become infected and pose a risk for those with compromised immune systems. And they can introduce zoonotic diseases into your home, including ring worm and Campylobacter, a disease that causes diarrhoea.
For those sharing the bed there is an elevated the risk of allergies and picking up ringworm. It may result in lost sleep, as dogs move around at night.
On the other hand some owners report feeling more secure while co-sleeping with their dogs, with the emotional benefit outweighing the possibility of sleep disturbance or waking up with flea bites.
Proper veterinary care and hygiene practices are essential to minimise these risks.
What about mental health?
Many people know the benefits of having a dog are not only physical.
As companions, dogs can provide significant emotional support helping to alleviate symptoms of anxiety, depression and post-traumatic stress. Their presence may offer comfort and a sense of purpose to individuals facing mental health challenges.
Loneliness is a significant and growing public health issue in Australia.
In the dog park and your neighbourhood, dogs can make it easier to strike up conversations with strangers and make new friends. These social interactions can help build a sense of community belonging and reduce feelings of social isolation.
For older adults, dog walking can be a valuable loneliness intervention that encourages social interaction with neighbours, while also combating declining physical activity.
However, if you’re experiencing chronic loneliness, it may be hard to engage with other people during walks. An Australian study found simply getting a dog was linked to decreased loneliness. People reported an improved mood – possibly due to the benefits of strengthening bonds with their dog.
What are the drawbacks?
While dogs can bring immense joy and numerous health benefits, there are also downsides and challenges. The responsibility of caring for a dog, especially one with behavioural issues or health problems, can be overwhelming and create financial stress.
Dogs have shorter lifespans than humans, and the loss of a beloved companion can lead to depression or exacerbate existing mental health conditions.
Lifestyle compatibility and housing conditions also play a significant role in whether having a dog is a good fit.
The so-called pet effect suggests that pets, often dogs, improve human physical and mental health in all situations and for all people. The reality is more nuanced. For some, having a pet may be more stressful than beneficial.
Importantly, the animals that share our homes are not just “tools” for human health. Owners and dogs can mutually benefit when the welfare and wellbeing of both are maintained.
Tania Signal, Professor of Psychology, School of Health, Medical and Applied Sciences, CQUniversity Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Power of Fun – by Catherine Price
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It’s said that nobody’s dying regret is to wish they’d spent more time at the office, yet many of don’t make enough time for fun.
This book has been published with two different subtitles:
- Why fun is the key to a happy and healthy life
- How to feel alive again
One offers a sensible reason to read this book; the other offers a deeply emotional reason. Both are entirely valid.
Catherine Price sets out in this work to identify what fun actually is (she puts it at the intersection of playfulness, connection and flow) and how to have more of it (she gives a five-step method to build and integrate it into life).
In the category of criticism, this 334-page book is (in this reviewer’s opinion) a little padded and could have been an article instead. But the advice contained within it is sound, and the impact it can have might be profound.
Bottom line: if you find you’ve settled into a routine that’s perhaps comfortable, but not actually that much fun, this book will help you to liven things up.
Click here to check out The Power Of Fun, and feel more alive!
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The Many Faces Of Cosmetic Surgery
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Cosmetic Surgery: What’s The Truth?
In Tuesday’s newsletter, we asked you your opinion on elective cosmetic surgeries, and got the above-depicted, below-described, set of responses:
- About 48% said “Everyone should be able to get what they want, assuming informed consent”
- About 28% said “It can ease discomfort to bring features more in line with normalcy”
- 15% said “They should be available in the case of extreme disfigurement only”
- 10% said “No elective cosmetic surgery should ever be performed; needless danger”
Well, there was a clear gradient of responses there! Not so polarizing as we might have expected, but still enough dissent for discussion
So what does the science say?
The risks of cosmetic surgery outweigh the benefits: True or False?
False, subjectively (but this is important).
You may be wondering: how is science subjective?
And the answer is: the science is not subjective, but people’s cost:worth calculations are. What’s worth it to one person absolutely may not be worth it to another. Which means: for those for whom it wouldn’t be worth it, they are usually the people who will not choose the elective surgery.
Let’s look at some numbers (specifically, regret rates for various surgeries, elective/cosmetic or otherwise):
- Regret rate for elective cosmetic surgery in general: 20%
- Regret rate for knee replacement (i.e., not cosmetic): 17.1%
- Regret rate for hip replacement (i.e., not cosmetic): 4.8%
- Regret rate for gender-affirming surgeries (for transgender patients): 1%
So we can see, elective surgeries have an 80–99% satisfaction rate, depending on what they are. In comparison, the two joint replacements we mentioned have a 82.9–95.2% satisfaction rate. Not too dissimilar, taken in aggregate!
In other words: if a person has studied the risks and benefits of a surgery and decides to go ahead, they’re probably going to be happy with the results, and for them, the benefits will have outweighed the risks.
Sources for the above numbers, by the way:
- What is the regret rate for plastic surgery?
- Decision regret after primary hip and knee replacement surgery
- A systematic review of patient regret after surgery—a common phenomenon in many specialties but rare within gender-affirmation surgery
But it’s just a vanity; therapy is what’s needed instead: True or False?
False, generally. True, sometimes. Whatever the reasons for why someone feels the way they do about their appearance—whether their face got burned in a fire or they just have triple-J cups that they’d like reduced, it’s generally something they’ve already done a lot of thinking about. Nevertheless, it does also sometimes happen that it’s a case of someone hoping it’ll be the magical solution, when in reality something else is also needed.
How to know the difference? One factor is whether the surgery is “type change” or “restorative”, and both have their pros and cons.
- In “type change” (e.g. rhinoplasty), more psychological adjustment is needed, but when it’s all over, the person has a new nose and, statistically speaking, is usually happy with it.
- In “restorative” (e.g. facelift), less psychological adjustment is needed (as it’s just a return to a previous state), so a person will usually be happy quickly, but ultimately it is merely “kicking the can down the road” if the underlying problem is “fear of aging”, for example. In such a case, likely talking therapy would be beneficial—whether in place of, or alongside, cosmetic surgery.
Here’s an interesting paper on that; the sample sizes are small, but the discussion about the ideas at hand is a worthwhile read:
Does cosmetic surgery improve psychosocial wellbeing?
Some people will never be happy no matter how many surgeries they get: True or False?
True! We’re going to refer to the above paper again for this one. In particular, here’s what it said about one group for whom surgeries will not usually be helpful:
❝There is a particular subgroup of people who appear to respond poorly to cosmetic procedures. These are people with the psychiatric disorder known as “body dysmorphic disorder” (BDD). BDD is characterised by a preoccupation with an objectively absent or minimal deformity that causes clinically significant distress or impairment in social, occupational, or other areas of functioning.
For several reasons, it is important to recognise BDD in cosmetic surgery settings:
Firstly, it appears that cosmetic procedures are rarely beneficial for these people. Most patients with BDD who have had a cosmetic procedure report that it was unsatisfactory and did not diminish concerns about their appearance.
Secondly, BDD is a treatable disorder. Serotonin-reuptake inhibitors and cognitive behaviour therapy have been shown to be effective in about two-thirds of patients with BDD❞
~ Dr. David Castle et al. (lightly edited for brevity)
Which is a big difference compared to, for example, someone having triple-J breasts that need reducing, or the wrong genitals for their gender, or a face whose features are distinct outliers.
Whether that’s a reason people with BDD shouldn’t be able to get it is an ethical question rather than a scientific one, so we’ll not try to address that with science.
After all, many people (in general) will try to fix their woes with a haircut, a tattoo, or even a new sportscar, and those might sometimes be bad decisions, but they are still the person’s decision to make.
And even so, there can be protectionist laws/regulations that may provide a speed-bump, for example:
Take care!
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