Reading At Night: Good Or Bad For Sleep? And Other Questions
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It’s Q&A Day at 10almonds!
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In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Would be interested in your views about “reading yourself to sleep”. I find that current affairs magazines and even modern novels do exactly the opposite. But Dickens – ones like David Copperfield and Great Expectations – I find wonderfully effective. It’s like entering a parallel universe where none of your own concerns matter. Any thoughts on the science that may explain this?!❞
Anecdotally: this writer is (like most writers) a prolific reader, and finds reading some fiction last thing at night is a good way to create a buffer between the affairs of the day and the dreams of night—but I could never fall asleep that way, unless I were truly sleep-deprived. The only danger is if I “one more chapter” my way deep into the night! For what it’s worth, bedtime reading for me means a Kindle self-backlit with low, soft lighting.
Scientifically: this hasn’t been a hugely researched area, but there are studies to work from. But there are two questions at hand (at least) here:
- one is about reading, and
- the other is about reading from electronic devices with or without blue light filters.
Here’s a study that didn’t ask the medium of the book, and concluded that reading a book in bed before going to sleep improved sleep quality, compared to not reading a book in bed:
Here’s a study that concluded that reading on an iPad (with no blue light filter) that found no difference in any metrics except EEG (so, there was no difference on time spent in different sleep states or sleep onset latency), but advised against it anyway because of the EEG readings (which showed slow wave activity being delayed by approximately 30 minutes, which is consistent with melatonin production mechanics):
Here’s another study that didn’t take EEG readings, and/but otherwise confirmed no differences being found:
We’re aware this goes against general “sleep hygiene” advice in two different ways:
- General advice is to avoid electronic devices before bedtime
- General advice is to not do activities besides sleep (and sex) in bed
…but, we’re committed to reporting the science as we find it!
Enjoy!
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Elon Musk says ‘disc replacement’ worked for him. But evidence this surgery helps chronic pain is lacking
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Last week in a post on X, owner of the platform Elon Musk recommended people look into disc replacement if they’re experiencing severe neck or back pain.
According to a biography of the billionaire, he’s had chronic back and neck pain since he tried to “judo throw” a 350-pound sumo wrestler in 2013 at a Japanese-themed party for his 42nd birthday, and blew out a disc at the base of his neck.
In comments following the post, Musk said the surgery was a “gamechanger” and reduced his pain significantly.
Musk’s original post has so far had more than 50 million views and generated controversy. So what is disc replacement surgery and what does the evidence tells us about its benefits and harms?
What’s involved in a disc replacement?
Disc replacement is a type of surgery in which one or more spinal discs (a cushion between the spine bones, also known as vertebrae) are removed and replaced with an artificial disc to retain movement between the vertebrae. Artificial discs are made of metal or a combination of metal and plastic.
Disc replacement may be performed for a number of reasons, including slipped discs in the neck, as appears to be the case for Musk.
Disc replacement is major surgery. It requires general anaesthesia and the operation usually takes 2–4 hours. Most people stay in hospital for 2–7 days. After surgery patients can walk but need to avoid things like strenuous exercise and driving for 3–6 weeks. People may be required to wear a neck collar (following neck surgery) or a back brace (following back surgery) for about 6 weeks.
Costs vary depending on whether you have surgery in the public or private health system, if you have private health insurance, and your level of coverage if you do. In Australia, even if you have health insurance, a disc replacement surgery may leave you more than A$12,000 out of pocket.
Disc replacement surgery is not performed as much as other spinal surgeries (for example, spinal fusion) but its use is increasing.
In New South Wales for example, rates of privately-funded disc replacement increased six-fold from 6.2 per million people in 2010–11 to 38.4 per million in 2019–20.
What are the benefits and harms?
People considering surgery will typically weigh that option against not having surgery. But there has been very little research comparing disc replacement surgery with non-surgical treatments.
Clinical trials are the best way to determine if a treatment is effective. You first want to show that a new treatment is better than doing nothing before you start comparisons with other treatments. For surgical procedures, the next step might be to compare the procedure to non-surgical alternatives.
Unfortunately, these crucial first research steps have largely been skipped for disc replacement surgery for both neck and back pain. As a result, there’s a great deal of uncertainty about the treatment.
There are no clinical trials we know of investigating whether disc replacement is effective for neck pain compared to nothing or compared to non-surgical treatments.
For low back pain, the only clinical trial that has been conducted to our knowledge comparing disc replacement to a non-surgical alternative found disc replacement surgery was slightly more effective than an intensive rehabilitation program after two years and eight years.
Complications are not uncommon, and can include disclocation of the artificial disc, fracture (break) of the artificial disc, and infection.
In the clinical trial mentioned above, 26 of the 77 surgical patients had a complication within two years of follow up, including one person who underwent revision surgery that damaged an artery leading to a leg needing to be amputated. Revision surgery means a re-do to the primary surgery if something needs fixing.
Are there effective alternatives?
The first thing to consider is whether you need surgery. Seeking a second opinion may help you feel more informed about your options.
Many surgeons see disc replacement as an alternative to spinal fusion, and this choice is often presented to patients. Indeed, the research evidence used to support disc replacement mainly comes from studies that compare disc replacement to spinal fusion. These studies show people with neck pain may recover and return to work faster after disc replacement compared to spinal fusion and that people with back pain may get slightly better pain relief with disc replacement than with spinal fusion.
However, spinal fusion is similarly not well supported by evidence comparing it to non-surgical alternatives and, like disc replacement, it’s also expensive and associated with considerable risks of harm.
Fortunately for patients, there are new, non-surgical treatments for neck and back pain that evidence is showing are effective – and are far cheaper than surgery. These include treatments that address both physical and psychological factors that contribute to a person’s pain, such as cognitive functional therapy.
While Musk reported a good immediate outcome with disc replacement surgery, given the evidence – or lack thereof – we advise caution when considering this surgery. And if you’re presented with the choice between disc replacement and spinal fusion, you might want to consider a third alternative: not having surgery at all.
Giovanni E Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney, and Joshua Zadro, NHMRC Emerging Leader Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Pain-Free Mindset – by Dr. Deepak Ravindran
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First: please ignore the terrible title. This is not the medical equivalent of “think and grow rich”. A better title would have been something like “The Pain-Free Plan”.
Attentive subscribers may notice that this author was our featured expert yesterday, so you can learn about his “seven steps” described in our article there, without us repeating that in our review here.
This book’s greatest strength is also potentially its greatest weakness, depending on the reader: it contains a lot of detailed medical information.
This is good or bad depending on whether you like lots of detailed medical information. Dr. Ravindran doesn’t assume prior knowledge, so everything is explained as we go. However, this means that after his well-referenced clinical explanations, high quality medical diagrams, etc, you may come out of this book feeling like you’ve just done a semester at medical school.
Knowledge is power, though, so understanding the underlying processes of pain and pain management really does help the reader become a more informed expert on your own pain—and options for reducing that pain.
Bottom line: this, disguised by its cover as a “think healing thoughts” book, is actually a science-centric, information-dense, well-sourced, comprehensive guide to pain management from one of the leading lights in the field.
Click here to check out The Pain-Free Mindset, and manage yours more comfortably!
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Acid Reflux Diet Cookbook – by Dr. Harmony Reynolds
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Notwithstanding the title, this is far more than just a recipe book. Of course, it is common for health-focused recipe books to begin with a preamble about the science that’s going to be applied, but in this case, the science makes up a larger portion of the book than usual, along with practical tips about how to best implement certain things, at home and when out and about.
Dr. Reynolds also gives a lot of information about such things as medications that could be having an effect one way or the other, and even other lifestyle factors such as exercise and so forth, and yes, even stress management. Because for many people, what starts as acid reflux can soon become ulcers, and that’s not good.
The recipes themselves are diverse and fairly simple; they’re written solely with acid reflux in mind and not other health considerations, but they are mostly heathy in the generalized sense too.
The style is straight to the point with zero padding sensationalism, or chit-chat. It can make for a slightly dry read, but let’s face it, nobody is buying this book for its entertainment value.
Bottom line: if you have been troubled by acid reflux, this book will help you to eat your way safely out of it.
Click here to check out the Acid Reflux Diet Cookbook, and enjoy!
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Families including someone with mental illness can experience deep despair. They need support
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In the aftermath of the tragic Bondi knife attack, Joel Cauchi’s parents have spoken about their son’s long history of mental illness, having been diagnosed with schizophrenia at age 17. They said they were “devastated and horrified” by their son’s actions. “To you he’s a monster,” said his father. “But to me he was a very sick boy.”
Globally, one out of every eight people report a mental illness. In Australia, one in five people experience a mental illness in their lifetime.
Mental illness and distress affects not only the person living with the condition, but family members and communities. As the prevalence of mental health problems grows, the flow-on effect to family members, including caregivers, and the impact on families as a unit, is also rising.
While every family is different, the words of the Cauchis draw attention to how families can experience distress, stress, fear, powerlessness, and still love, despite the challenges and trauma. How can they help a loved one? And who can they turn to for support?
The role of caregivers
Informal caregivers help others within the context of an existing relationship, such as a family member. The care they provide goes beyond the usual expectations or demands of such relationships.
Around 2.7 million Australians provide informal care. For almost a third of these the person’s primary medical diagnosis is psychological or psychiatric.
It has long been acknowledged that those supporting a family member with ongoing mental illness need support themselves.
In the 1980s, interest grew in caregiving dynamics within families of people grappling with mental health issues. Subsequent research recognised chronic health conditions not only affect the quality of life and wellbeing of the people experiencing them, but also impose burdens that reverberate within relationships, caregiving roles, and family dynamics over time.
Past studies have shown families of those diagnosed with chronic mental illness are increasingly forced to manage their own depression, experience elevated levels of emotional stress, negative states of mind and decreased overall mental health.
Conditions such as depression, anxiety disorders, bipolar disorder, and schizophrenia can severely impact daily functioning, relationships, and overall quality of life. Living with mental illness is often accompanied by a myriad of challenges. From stigma and discrimination to difficulty accessing adequate health care and support services. Patients and their families navigate a complex and often isolating journey.
The family is a system
The concept of family health acknowledges the physical and psychological wellbeing of a person is significantly affected by the family.
Amid these challenges, family support emerges as a beacon of hope. Research consistently demonstrates strong familial relationships and support systems play a pivotal role in mitigating the adverse effects of mental illness. Families provide emotional support, practical assistance, and a sense of belonging that are vital for people struggling with mental illness.
My recent research highlights the profound impact of mental illness on family dynamics, emphasising the resilience and endurance shown by participants. Families struggling with mental illness often experience heightened emotional fluctuations, with extreme highs and lows. The enduring nature of family caregiving entails both stress and adaptation over an extended period. Stress associated with caregiving and the demands on personal resources and coping mechanisms builds and builds.
Yet families I’ve interviewed find ways to live “a good life”. They prepare for the peaks and troughs, and show endurance and persistence. They make space for mental illness in their daily lives, describing how it spurs adaptation, acceptance and inner strength within the family unit.
When treating a person with mental illness, health practitioners need to consider the entire family’s needs and engage with family members. By fostering open and early dialogue and providing comprehensive support, health-care professionals can empower families to navigate the complexities of mental illness while fostering resilience and hope for the future. Family members express stories of an inner struggle, isolation and exhaustion.
Shifting the focus
There is a pressing need for a shift in research priorities, from illness-centered perspectives to a strengths-based focus when considering families “managing” mental illness.
There is transformative potential in harnessing strengths to respond to challenges posed by mental illnesses, while also supporting family members.
For people facing mental health challenges, having loved ones who listen without judgement and offer empathy can alleviate feelings of despair. Beyond emotional support, families often serve as crucial caregivers, assisting with daily tasks, medication management and navigating the health-care system.
As the Cauchi family so painfully articulated, providing support for a family member with mental illness is intensely challenging. Research shows caregiver burnout, financial strain and strained relationships are common.
Health-care professionals should prioritise support for family members at an early stage. In Australia, there are various support options available for families living with mental illness. Carer Gateway provides information, support and access to services. Headspace offers mental health services and supports to young people and their families.
Beyond these national services, GPs, nurses, nurse practitioners and local community health centres are key to early conversations. Mental health clinics and hospitals often target family involvement in treatment plans.
While Australia has made strides in recognising the importance of family support, challenges persist. Access to services can vary based on geographic location and demand, leaving some families under-served or facing long wait times. And the level of funding and resources allocated to family-oriented mental health support often does not align with the demand or complexity of need.
In the realm of mental illness, family support serves as a lifeline for people navigating the complexities of their conditions.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Amanda Cole, Lead, Mental Health, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Things You Can See Only When You Slow Down – by Haemin Sunim
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First, what this one’s not about: noticing raindrops on roses and whiskers on kittens.
That’s great too, though. This writer particularly loves the cute faces of baby jumping spiders. Sounds unlikely, but have you seen them?
What it’s rather about: noticing what’s between your ears, and paying closer attention to that, so that we can go about our business more mindfully.
This is, fundamentally, a book about living a happier life, whatever the potentially crazy circumstances of the hustle and bustle around us. Not because of disinterest; quite the opposite. Sunim bids us ask the question of ourselves, what are we really doing and why?
The writing style is very light and easy, while being heavy-hitting in terms of the ideas it brings. Little wonder that this one is so highly-rated on Amazon, with more than 5,000 ratings.
Bottom line: if sometimes you feel like the world is a little hectic and all that is around you is out of your control, this is a great book for you.
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Mediterranean Air Fryer Cookbook – by Naomi Lane
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There are Mediterranean Diet cookbooks, and there are air fryer cookbooks. And then there are (a surprisingly large intersection of!) Mediterranean Diet air fryer cookbooks. We wanted to feature one of them in today’s newsletter… And as part of the selection process, looked through quite a stack of them, and honestly, were quite disappointed with many. This one, however, was one of the ones that stood out for its quality of both content and clarity, and after a more thorough reading, we now present it to you:
Naomi Lane is a professional dietician, chef, recipe developer, and food writer… And it shows, on all counts.
She covers what the Mediterranean diet is, and she covers far more than this reviewer knew it was even possible to know about the use of an air fryer. That alone would make the book a worthy purchase already.
The bulk of the book is the promised 200 recipes. They cover assorted dietary requirements (gluten-free, dairy-free, etc) while keeping to the Mediterranean Diet.
The recipes are super clear, just what you need to know, no reading through a nostalgic storytime first to find things. Also no pictures, which will be a plus for some readers and a minus for others. The recipes also come complete with nutritional information for each meal (including sodium), so you don’t have to do your own calculations!
Bottom line: this is the Mediterranean Diet air fryer cook book. Get it, thank us later!
Get your copy of “Mediterranean Air Fryer Cookbook” on Amazon today!
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