How Useful Are Our Dreams
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What’s In A Dream?
We were recently asked:
❝I have a question or a suggestion for coverage in your “Psychology Sunday”. Dreams: their relevance, meanings ( if any) interpretations? I just wondered what the modern psychological opinions are about dreams in general.❞
~ 10almonds subscriber
There are two main schools of thought, and one main effort to reconcile those two. The third one hasn’t quite caught on so far as to be considered a “school of thought” yet though.
The Top-Down Model (Psychoanalysts)
Psychoanalysts broadly follow the theories of Freud, or at least evolved from there. Freud was demonstrably wrong about very many things. Most of his theories have been debunked and ditched—hence the charitable “or at least evolved from there” phrasing when it comes to modern psychoanalytic schools of thought. Perhaps another day, we’ll go into all the ways Freud went wrong. However, for today, one thing he wasn’t bad at…
According to Freud, our dreams reveal our subconscious desires and fears, sometimes directly and sometimes dressed in metaphor.
Examples of literal representations might be:
- sex dreams (revealing our subconscious desires; perhaps consciously we had not thought about that person that way, or had not considered that sex act desirable)
- getting killed and dying (revealing our subconscious fear of death, not something most people give a lot of conscious thought to most of the time)
Examples of metaphorical representations might be:
- dreams of childhood (revealing our subconscious desires to feel safe and nurtured, or perhaps something else depending on the nature of the dream; maybe a return to innocence, or a clean slate)
- dreams of being pursued (revealing our subconscious fear of bad consequences of our actions/inactions, for example, responsibilities to which we have not attended, debts are a good example for many people; or social contact where the ball was left in our court and we dropped it, that kind of thing)
One can read all kinds of guides to dream symbology, and learn such arcane lore as “if you dream of your teeth crumbling, you have financial worries”, but the truth is that “this thing means that other thing” symbolic equations are not only highly personal, but also incredibly culture-bound.
For example:
- To one person, bees could be a symbol of feeling plagued by uncountable small threats; to another, they could be a symbol of abundance, or of teamwork
- One culture’s “crow as an omen of death” is another culture’s “crow as a symbol of wisdom”
- For that matter, in some cultures, white means purity; in others, it means death.
Even such classically Freudian things as dreaming of one’s mother and/or father (in whatever context) will be strongly informed by one’s own waking-world relationship (or lack thereof) with same. Even in Freud’s own psychoanalysis, the “mother” for the sake of such analysis was the person who nurtured, and the “father” was the person who drew the nurturer’s attention away, so they could be switched gender roles, or even different people entirely than one’s parents.
The only real way to know what, if anything, your dreams are trying to tell you, is to ask yourself. You can do that…
- by reflection and personal interrogation (see for example: The Easiest Way To Take Up Journaling)
- or by externalising parts of your subconscious (as in Internal Family Systems therapy)
- or by talking directly to your subconscious where it is, by means of lucid dreaming.
The idea with lucid dreaming is that since any dream character is a facet of your subconscious generated by your own mind, by talking to that character you can ask questions directly of your subconscious (the popular 2010 movie “Inception” was actually quite accurate in this regard, by the way).
To read more about how to do this kind of self-therapy through lucid dreaming, you might want to check out this book we reviewed previously; it is the go-to book of lucid dreaming enthusiasts, and will honestly give you everything you need in one go:
Lucid Dreaming: A Concise Guide to Awakening in Your Dreams and in Your Life – by Dr. Stephen LaBerge
The Bottom-Up Model (Neuroscientists)
This will take a lot less writing, because it’s practically a null hypothesis (i.e., the simplest default assumption before considering any additional evidence that might support or refute it; usually some variant of “nothing unusual going on here”).
The Bottom-Up model holds that our brains run regular maintenance cycles during REM sleep (a biological equivalent of defragging a computer), and the brain interprets these pieces of information flying by and, because of the mind’s tendency to look for patterns, fills in the rest (much like how modern generative AI can “expand” a source image to create more of the same and fill in the blanks), resulting in the often narratively wacky, but ultimately random, vivid hallucinations that we call dreams.
The Hybrid Model (per Cartwright, 2012)
This is really just one woman’s vision, but it’s an incredibly compelling one, that takes the Bottom-Up model and asks “what if we did all that bio-stuff, and then our subconscious mind influenced the interpretation of the random patterns, to create dreams that are subjectively meaningful, and thus do indeed represent our subconscious?
It’s best explained in her own words, though, so it’s time for another book recommendation (we’ve reviewed this one before, too):
Enjoy!
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How Not to Die – by Dr. Michael Greger
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Dr. Greger (of “Dr. Greger’s Daily Dozen” fame) outlines for us in cold hard facts and stats what’s most likely to be our cause of death. While this is not a cheery premise for a book, he then sets out to work back from there—what could have prevented those specific things?
Some of the advice is what you might expect: eat green things and whole grains, skip the bacon. Other advice is less well-known: get a daily dose of curcumin/turmeric, take it with black pepper. Works wonders. If you want to add in daily exercises, just lifting the book could be a start; weighing in at 678 pages, it’s an information-dense tome that’s more likely to be sifted through than read cover-to-cover.
If you’re a more cynical sort, you might note that since the book doesn’t confer immortality, but does help us avoid statistically likely causes of death, logically it significantly increases our chances of dying in a statistically unlikely way. (Ha! Your mental exercise for today will be decoding that sentence )
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What Does Lion’s Mane Actually Do, Anyway?
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Peripheral neuropathy (and what can be done about it)
Peripheral neuropathy is nerve damage, usually of the extremities. It can be caused by such things as:
- Diabetes
- Alcoholism
- Infection
- Injury
The manifestations can be different:
- In the case of diabetes, it’s also called diabetic neuropathy, and almost always affects the feet first.
- In the case of alcoholism, it is more generalized, but tends towards affecting the extremities first.
- In the case of infection, a lot depends on the nature of the infection and the body’s response.
- In the case of injury, it’ll naturally be the injured part, or a little “downstream” of the injured part.
- This could be the case of a single traumatic injury (e.g. hand got trapped in a slammed door)
This could be the case of a repetitive injury (carpal tunnel syndrome is a kind of peripheral neuropathy, and is usually caused by consistent misalignment of the carpal tunnel, the aperture through which a bundle of nerves make their way from the forearm to the hand)
Prevention is better than cure
If you already have peripheral neuropathy, don’t worry, we’ll get to that. But, if you can, prevention is better than cure. This means:
- Diabetes: if you can, avoid. This may seem like no-brainer advice, but it’s often something people don’t think about until hitting a pre-diabetic stage. Obviously, if you are Type 1 Diabetic, you don’t have this luxury. But in any case, whatever your current status, take care of your blood sugars as best you can, so that your blood can take care of you (and your nerves) in turn. You might want to check out our previous main feature about this:
- Alcoholism: obviously avoid, if you can. You might like this previous edition of 10almonds addressing this:
- Infection: this is so varied that one-liner advice is really just “try to look after your immune health”.
- We’ll do a main feature on this soon!
- Injury: obviously, try to be careful. But that goes for the more insidious version too! For example, if you spend a lot of time at your computer, consider an ergonomic mouse and keyboard.
- There are many kinds available, so read reviews, but here’s an example product on Amazon
Writer’s note: as you might guess, I spend a lot of time at my computer, and a lot of that time, writing. I additionally spend a lot of time reading. I also have assorted old injuries from my more exciting life long ago. Because of this, it’s been an investment in my health to have:
A standing desk
A vertical ergonomic mouse
An ergonomic split keyboard
A Kindle*
*Far lighter and more ergonomic than paper books. Don’t get me wrong, I’m writing to you from a room that also contains about a thousand paper books and I dearly love those too, but more often than not, I read on my e-reader for comfort and ease.
If you already have peripheral neuropathy
Most advice popular on the Internet is just about pain management, but what if we want to treat the cause rather than the symptom?
Let’s look at the things commonly suggested: try ice, try heat, try acupuncture, try spicy rubs (from brand names like Tiger Balm, to home-made chilli ointments), try meditation, try a warm bath, try massage.
And, all of these are good options; do you see what they have in common?
It’s about blood flow. And that’s why they can help even in the case of peripheral neuropathy that’s not painful (it can also manifest as numbness, and/or tingling sensations).
By getting the blood flowing nicely through the affected body part, the blood can nourish the nerves and help them function correctly. This is, in effect, the opposite of what the causes of peripheral neuropathy do.
But also don’t forget: rest
- Put your feet up (literally! But we’re talking horizontal here, not elevated past the height of your heart)
- Rest that weary wrist that has carpal tunnel syndrome (again, resting it flat, so your hand position is aligned with your forearm, so the nerves between are not kinked)
- Use a brace if necessary to help the affected part stay aligned correctly
- You can get made-for-purpose wrist and ankle braces—you can also get versions that are made for administering hot/cold therapy, too. That’s just an example product linked that we can recommend; by all means read reviews and choose for yourself, though. Try them and see what helps.
One more top tip
We did a feature not long back on lion’s mane mushroom, and it’s single most well-established, well-researched, well-evidenced, completely uncontested benefit is that it aids peripheral neurogenesis, that is to say, the regrowth and healing of the peripheral nervous system.
So you might want to check that out:
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The Case of the Armadillo: Is It Spreading Leprosy in Florida?
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GAINESVILLE, Fla. — In an open-air barn at the edge of the University of Florida, veterinarian Juan Campos Krauer examines a dead armadillo’s footpads and ears for signs of infection.
Its claws are curled tight and covered in blood. Campos Krauer thinks it was struck in the head while crossing a nearby road.
He then runs a scalpel down its underside. He removes all the important organs: heart, liver, kidneys. Once the specimens are bottled up, they’re destined for an ultra-cold freezer in his lab at the college.
Campos Krauer plans to test the armadillo for leprosy, an ancient illness also known as Hansen’s disease that can lead to nerve damage and disfigurement in humans. He and other scientists are trying to solve a medical mystery: why Central Florida has become a hot spot for the age-old bacteria that cause it.
Leprosy remains rare in the United States. But Florida, which often reports the most cases of any state, has seen an uptick in patients. The epicenter is east of Orlando. Brevard County reported a staggering 13% of the nation’s 159 leprosy cases in 2020, according to a Tampa Bay Times analysis of state and federal data.
Many questions about the phenomenon remain unanswered. But leprosy experts believe armadillos play a role in spreading the illness to people. To better understand who’s at risk and to prevent infections, about 10 scientists teamed up last year to investigate. The group includes researchers from the University of Florida, Colorado State University, and Emory University in Atlanta.
“How this transmission is happening, we really don’t know,” said Ramanuj Lahiri, chief of the laboratory research branch for the National Hansen’s Disease Program, which studies the bacteria involved and cares for leprosy patients across the country.
‘Nothing Was Adding Up’
Leprosy is believed to be the oldest human infection in history. It probably has been sickening people for at least 100,000 years. The disease is highly stigmatized — in the Bible, it was described as a punishment for sin. In more modern times, patients were isolated in “colonies” around the world, including in Hawaii and Louisiana.
In mild cases, the slow-growing bacteria cause a few lesions. If left untreated, they can paralyze the hands and feet.
But it’s actually difficult to fall ill with leprosy, as the infection isn’t very contagious. Antibiotics can cure the ailment in a year or two. They’re available for free through the federal government and the World Health Organization, which launched a campaign in the 1990s to eliminate leprosy as a public health problem.
In 2000, reported U.S. cases dropped to their lowest point in decades with 77 infections. But they later increased, averaging about 180 per year from 2011 to 2020, according to data from the National Hansen’s Disease Program.
During that time, a curious trend emerged in Florida.
In the first decade of the 21st century, the state logged 67 cases. Miami-Dade County noted 20 infections — the most of any Florida county. The vast majority of its cases were acquired outside the U.S., according to a Times analysis of Florida Department of Health data.
But over the next 10 years, recorded cases in the state more than doubled to 176 as Brevard County took center stage.
The county, whose population is about a fifth the size of Miami-Dade’s, logged 85 infections during that time — by far the most of any county in the state and nearly half of all Florida cases. In the previous decade, Brevard noted just five cases.
Remarkably, at least a quarter of Brevard’s infections were acquired within the state, not while the individuals were abroad. India, Brazil, and Indonesia diagnose more leprosy cases than anywhere, reporting over 135,000 infections combined in 2022 alone. People were getting sick even though they hadn’t traveled to such areas or been in close contact with existing leprosy patients, said Barry Inman, a former epidemiologist at the Brevard health department who investigated the cases and retired in 2021.
“Nothing was adding up,” Inman said.
A few patients recalled touching armadillos, which are known to carry the bacteria. But most didn’t, he said. Many spent a lot of time outdoors, including lawn workers and avid gardeners. The cases were usually mild.
It was difficult to nail down where people got the illness, he added. Because the bacteria grow so slowly, it can take anywhere from nine months to 20 years for symptoms to begin.
Amoeba or Insect Culprits?
Heightened awareness of leprosy could play a role in Brevard’s groundswell of cases.
Doctors must report leprosy to the health department. Yet Inman said many in the county didn’t know that, so he tried to educate them after noticing cases in the late 2000s.
But that’s not the sole factor at play, Inman said.
“I don’t think there’s any doubt in my mind that something new is going on,” he said.
Other parts of Central Florida have also recorded more infections. From 2011 to 2020, Polk County logged 12 cases, tripling its numbers compared with the previous 10 years. Volusia County noted 10 cases. It reported none the prior decade.
Scientists are honing in on armadillos. They suspect the burrowing critters may indirectly cause infections through soil contamination.
Armadillos, which are protected by hard shells, serve as good hosts for the bacteria, which don’t like heat and can thrive in the animals whose body temperatures range from a cool 86-95 degrees.
Colonists probably brought the disease to the New World hundreds of years ago, and somehow armadillos became infected, said Lahiri, the National Hansen’s Disease Program scientist. The nocturnal mammals can develop lesions from the illness just as humans can. More than 1 million armadillos occupy Florida, estimated Campos Krauer, an assistant professor in the University of Florida’s Department of Large Animal Clinical Sciences.
How many carry leprosy is unclear. A study published in 2015 of more than 600 armadillos in Alabama, Florida, Georgia, and Mississippi found that about 16% showed evidence of infection. Public health experts believe leprosy was previously confined to armadillos west of the Mississippi River, then spread east.
Handling the critters is a known hazard. Lab research shows that single-cell amoebas, which live in soil, can also carry the bacteria.
Armadillos love to dig up and eat earthworms, frustrating homeowners whose yards they damage. The animals may shed the bacteria while hunting for food, passing it to amoebas, which could later infect people.
Leprosy experts also wonder if insects help spread the disease. Blood-sucking ticks might be a culprit, lab research shows.
“Some people who are infected have little to no exposure to the armadillo,” said Norman Beatty, an assistant professor of medicine at the University of Florida. “There is likely another source of transmission in the environment.”
Campos Krauer, who’s been searching Gainesville streets for armadillo roadkill, wants to gather infected animals and let them decompose in a fenced-off area, allowing the remains to soak into a tray of soil while flies lay eggs. He hopes to test the dirt and larvae to see if they pick up the bacteria.
Adding to the intrigue is a leprosy strain found only in Florida, according to scientists.
In the 2015 study, researchers discovered that seven armadillos from the Merritt Island National Wildlife Refuge, which is mostly in Brevard but crosses into Volusia, carried a previously unseen version of the pathogen.
Ten patients in the region were stricken with it, too. At the genetic level, the strain is similar to another type found in U.S. armadillos, said Charlotte Avanzi, a Colorado State University researcher who specializes in leprosy.
It’s unknown if the strain causes more severe disease, Lahiri said.
Reducing Risk
The public should not panic about leprosy, nor should people race to euthanize armadillos, researchers warn.
Scientists estimate that over 95% of the global human population has a natural ability to ward off the disease. They believe months of exposure to respiratory droplets is needed for person-to-person transmission to occur.
But when infections do happen, they can be devastating.
“If we better understand it,” Campos Krauer said, “the better we can learn to live with it and reduce the risk.”
The new research may also provide insight for other Southern states. Armadillos, which don’t hibernate, have been moving north, Campos Krauer said, reaching areas like Indiana and Virginia. They could go farther due to climate change.
People concerned about leprosy can take simple precautions, medical experts say. Those working in dirt should wear gloves and wash their hands afterward. Raising garden beds or surrounding them with a fence may limit the chances of soil contamination. If digging up an armadillo burrow, consider wearing a face mask, Campos Krauer said.
Don’t play with or eat the animals, added John Spencer, a scientist at Colorado State University who studies leprosy transmission in Brazil. They’re legal to hunt year-round in Florida without a license.
Campos Krauer’s team has so far examined 16 dead armadillos found on Gainesville area roads, more than 100 miles from the state’s leprosy epicenter, trying to get a preliminary idea of how many carry the bacteria.
None has tested positive yet.
This article was produced through a partnership between KFF Health News and the Tampa Bay Times.
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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Self-Compassion In A Relationship (Positives & Pitfalls)
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Practise Self-Compassion In Your Relationship (But Watch Out!)
Let’s make clear up-front: this is not about “…but not too much”.
With that in mind…
Now let’s set the scene: you, a happily-partnered person, have inadvertently erred and upset your partner. They may or may not have already forgiven you, but you are still angry at yourself.
Likely next steps include all or any of:
- continuing to apologise and try to explain
- self-deprecatory diatribes
- self-flagellation, probably not literally but in the sense of “I don’t deserve…” and acting on that feeling
- self-removal, because you don’t want to further inflict your bad self on your partner
As you might guess, these are quite varied in their degree of healthiness:
- apologising is good, as even is explaining, but once it’s done, it’s done; let it go
- self-deprecation is pretty much never useful, let alone healthy
- self-flagellation likewise; it is not only inherently self-destructive, but will likely create an additional problem for your partner too
- self-removal can be good or bad depending on the manner of that removal: there’s a difference between just going cold and distant on your partner, and saying “I’m sorry; this is my fault not yours, I don’t want to take it out on you, so please give me half an hour by myself to regain my composure, and I will come back with love then if that’s ok with you”
About that last: mentioning the specific timeframe e.g. “half an hour” is critical, by the way—don’t leave your partner hanging! And then do also follow through on that; come back with love after the half-hour elapses. We suggest mindfulness meditation in the interim (here’s our guide to how), if you’re not sure what to do to get you there.
To Err Is Human; To Forgive, Healthy (Here’s How To Do It) ← this goes for when the forgiveness in question is for yourself, too—and we do write about that there (and how)!
This is important, by the way; not forgiving yourself can cause more serious issues down the line:
If, by the way, you’re hand-wringing over “but was my apology good enough really, or should I…” then here is how to do it. Basically, do this, and then draw a line under it and consider it done:
The Apology Checklist ← you’ll want to keep a copy of this, perhaps in the notes app on your phone, or a screenshot if you prefer
(the checklist is at the bottom of that page)
The catch
It’s you, you’re the catch 👈👈😎
Ok, that being said, there is actually a catch in the less cheery sense of the word, and it is:
“It is important to be compassionate about one’s occasional failings in a relationship” does not mean “It is healthy to be neglectful of one’s partner’s emotional needs; that’s self-care, looking after #1; let them take care of themself too”
…because that’s simply not being a couple at all.
Think about it this way: the famous airline advice,
“Put on your own oxygen mask before helping others with theirs”
…does not mean “Put on your own oxygen mask and then watch those kids suffocate; it’s everyone for themself”
So, the same goes in relationships too. And, as ever, we have science for this. There was a recent (2024) study, involving hundreds of heterosexual couples aged 18–73, which looked at two things, each measured with a scaled questionnaire:
- Subjective levels of self-compassion
- Subjective levels of relationship satisfaction
For example, questions included asking participants to rate, from 1–5 depending on how much they felt the statements described them, e.g:
In my relationship with my partner, I:
- treat myself kindly when I experience sorrow and suffering.
- accept my faults and weaknesses.
- try to see my mistakes as part of human nature.
- see difficulties as part of every relationship that everyone goes through once.
- try to get a balanced view of the situation when something unpleasant happens.
- try to keep my feelings in balance when something upsets me.
Note: that’s not multiple choice! It’s asking participants to rate each response as applicable or not to them, on a scale of 1–5.
And…
❝Women’s self-compassion was also positively linked with men’s total relationship satisfaction. Thus, men seem to experience overall satisfaction with the relationship when their female partner is self-kind and self-caring in difficult situations.
Unexpectedly, however, we found that men’s relationship-specific self-compassion was negatively associated with women’s fulfillment.
Baker and McNulty (2011) reported that, only for men, a Self-Compassion x Conscientiousness interaction explained whether the positive effects of self-compassion on the relationship emerged, but such an interaction was not found for women.
Highly self-compassionate men who were low in conscientiousness were less motivated than others to remedy interpersonal mistakes in their romantic relationships, and this tendency was in turn related to lower relationship satisfaction❞
~ Dr. Astrid Schütz et al. (2024)
And if you’d like to read the cited older paper from 2011, here it is:
Read in full: Self-compassion and relationship maintenance: the moderating roles of conscientiousness and gender
The take-away here is not: “men should not practice self-compassion”
(rather, they absolutely should)
The take-away is: we must each take responsibility for managing our own mood as best we are able; practice self-forgiveness where applicable and forgive our partner where applicable (and communicate that!)…. And then go consciously back to the mutual care on which the relationship is hopefully founded.
Which doesn’t just mean love-bombing, by the way, it also means listening:
The Problem With Active Listening (And How To Do Better)
To close… We say this often, but we mean it every time: take care!
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Why 7 Hours Sleep Is Not Enough
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How Sleep-Deprived Are You, Really?
This is Dr. Matthew Walker. He’s a neuroscientist and sleep specialist, and is the Director of the Center for Human Sleep Science at UC Berkeley’s Department of Psychology. He’s also the author of the international bestseller “Why We Sleep”.
What does he want us to know?
Sleep deprivation is more serious than many people think it is. After about 16 hours without sleep, the brain begins to fail, and needs more than 7 hours of sleep to “reset” cognitive performance.
Note: note “seven or more”, but “more than seven”.
After ten days with only 7 hours sleep (per day), Dr. Walker points out, the brain is as dysfunctional as it would be after going without sleep for 24 hours.
Here’s the study that sparked a lot of Dr. Walker’s work:
Importantly, in Dr. Walker’s own words:
❝Three full nights of recovery sleep (i.e., more nights than a weekend) are insufficient to restore performance back to normal levels after a week of short sleeping❞
~ Dr. Matthew Walker
See also: Why You Probably Need More Sleep
Furthermore: the sleep-deprived mind is unaware of how sleep-deprived it is.
You know how a drunk person thinks they can drive safely? It’s like that.
You do not know how sleep-deprived you are, when you are sleep-deprived!
For example:
❝(60.7%) did not signal sleepiness before a sleep fragment occurred in at least one of the four MWT trials❞
Source: Sleepiness is not always perceived before falling asleep in healthy, sleep-deprived subjects
Sleep efficiency matters
With regard to the 7–9 hours band for optimal health, Dr. Walker points out that the sleep we’re getting is not always the sleep we think we’re getting:
❝Assuming you have a healthy sleep efficiency (85%), to sleep 9 hours in terms of duration (i.e. to be a long-sleeper), you would need to be consistently in bed for 10 hours and 36 minutes a night. ❞
~ Dr. Matthew Walker
At the bottom end of that, by the way, doing the same math: to get only the insufficient 7 hours sleep discussed earlier, a with a healthy 85% sleep efficiency, you’d need to be in bed for 8 hours and 14 minutes per night.
The unfortunate implication of this: if you are consistently in bed for 8 hours and 14 minutes (or under) per night, you are not getting enough sleep.
“But what if my sleep efficiency is higher than 85%?”
It shouldn’t be.If your sleep efficiency is higher than 85%, you are sleep-deprived and your body is having to enforce things.
Want to know what your sleep efficiency is?
We recommend knowing this, by the way, so you might want to check out:
Head-To-Head Comparison of Google and Apple’s Top Sleep-Monitoring Apps
(they will monitor your sleep and tell you your sleep efficiency, amongst other things)
Want to know more?
You might like his book:
Why We Sleep: Unlocking the Power of Sleep and Dreams
…and/or his podcast:
…and for those who like videos, here’s his (very informative) TED talk:
Prefer text? Click here to read the transcript
Want to watch it, but not right now? Bookmark it for later
Enjoy!
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Heart Health vs Systemic Stress
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At The Heart Of Good Health
This is Dr. Michelle Albert. She’s a cardiologist with a decades-long impressive career, recently including a term as the president of the American Heart Association. She’s the current Admissions Dean at UCSF Medical School. She’s accumulated enough awards and honors that if we list them, this email will not fit in your inbox without getting clipped.
What does she want us to know?
First, lifestyle
Although Dr. Albert is also known for her work with statins (which found that pravastatin may have anti-inflammatory effects in addition to lipid-lowering effects, which is especially good news for women, for whom the lipid-lowering effects may be less useful than for men), she is keen to emphasize that they should not be anyone’s first port-of-call unless “first” here means “didn’t see the risk until it was too late and now LDL levels are already ≥190 mg/dL”.
Instead, she recommends taking seriously the guidelines on:
- getting plenty of fruit, vegetables, whole grains, lean protein
- avoiding red meat, processed meats, refined carbohydrates, and sweetened beverages
- getting your 150 minutes per week of moderate exercise
- avoiding alcohol, and definitely abstaining from smoking
See also: These Top Five Things Make The Biggest Difference To Health
Next, get your house in order
No, not your home gym—though sure, that too!
But rather: after the “Top Five Things” we linked just above, the sixth on the list would be “reduce stress”. Indeed, as Dr. Albert says:
❝Heart health is not just about the physical heart but also about emotional well-being. Stress management is crucial for a healthy heart❞
~ Dr. Michelle Albert
This is where a lot of people would advise mindfulness meditation, CBT, somatic therapies, and the like. And these things are useful! See for example:
No-Frills, Evidence-Based Mindfulness
…and:
However, Dr. Albert also advocates for awareness of what some professionals have called “Shit Life Syndrome”.
This is more about socioeconomic factors. There are many of those that can’t be controlled by the individual, for example:
❝Adverse maternal experiences such as depression, economic issues and low social status can lead to poor cognitive outcomes as well as cardiovascular disease.
Many jarring statistics illuminate a marked wealth gap by race and ethnicity… You might be thinking education could help bridge that gap. But it is not that simple.
While education does increase wealth, the returns are not the same for everyone. Black persons need a post-graduate degree just to attain similar wealth as white individuals with a high school degree.❞
~ Dr. Michelle Albert
Read in full: AHA president: The connection between economic adversity and cardiovascular health
What this means in practical terms (besides advocating for structural change to tackle the things such as the racism that has been baked into a lot of systems for generations) is:
Be aware not just of your obvious health risk factors, but also your socioeconomic risk factors, if you want to have good general health outcomes.
So for example, let’s say that you, dear reader, are wealthy and white, in which case you have some very big things in your favor, but are you also a woman? Because if so…
Women and Minorities Bear the Brunt of Medical Misdiagnosis
See also, relevant for some: Obesity Discrimination In Healthcare Settings ← you’ll need to scroll to the penultimate section for this one.
In other words… If you are one of the majority of people who is a woman and/or some kind of minority, things are already stacked against you, and not only will this have its own direct harmful effect, but also, it’s going to make your life harder and that stress increases CVD risk more than salt.
In short…
This means: tackle not just your stress, but also the things that cause that. Look after your finances, gather social support, know your rights and be prepared to self-advocate / have someone advocate for you, and go into medical appointments with calm well-prepared confidence.
Take care!
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