Get Better Sleep: Beyond The Basics
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First though, for the sake of being methodical, let’s quickly note the basics:
- Aim for 7–9 hours per night
- Set a regular bedtime and (equally important!) regular getting-up time
- Have a 2-hour wind-down period before bed, to decompress from any stresses of the day
- Minimal device/screen usage before bed
- Abstain from stimulants for as long before bed as reasonably possible (caffeine elimination halflife is 4–8 hours depending on your genes, call it 6 hours average to eliminate half (not the whole lot), and you’ll see it’s probably best to put a cap on it earlier rather than later).
- Abstain from alcohol, ideally entirely, but allow at least 1hr/unit before bed. So for example, 1hr for a 1oz single shot of spirits, or 2–3 hours for a glass of wine (depending on size), or 3–4 hours for a martini (depending on recipe). Not that that is not the elimination time, nor even the elimination halflife of alcohol, it’s just a “give your body a chance at least” calculation. If you like to have a drink to relax before bed, then well, only you can decide what you like more: that or actually getting restorative sleep.
- Consider a warm bath/shower before bed, if that suits your schedule.
- Wash and change your bedsheets more often than seems necessary. Or if that’s too onerous, at least change the pillowcases more often, which makes quite a difference already.
- Lower the temperature of your bedroom shortly before bedtime; this will help cue the body to produce melatonin
- Make your bedroom as dark as reasonably possible. Invest in blackout blinds/curtains, and remove any pesky electronics, or at least cover their little LEDs if it’s something that reasonably needs to remain on.
Ok, now, onwards…
Those 7–9 hours? Yes, it goes for you too.
A lot of people mistake getting 6 hours sleep per night for only needing 6 hours sleep per night. Sure, you may still be alive after regularly getting 6 hours, but (unless you have a rare mutation of the ADRB1 gene) it will be causing harm, and yes, that includes later in life; we don’t stop needing so much sleep, even stop getting it:
Why You Probably Need More Sleep
With this in mind, it becomes important to…
Prioritize your sleep—which means planning for it!
When does your bedtime routine start? According to sleep scientist Dr. Lisa Matricciani, it starts before breakfast. This is because the things we do earlier in the day can greatly affect the amount (and quality) of sleep we get later. For example, a morning moderate-to-intense exercise session greatly improves sleep at night:
Planning Ahead For Better Sleep
As for quality, that is as important as quantity, and it’s not just about “soundness” of sleep:
The 6 Dimensions Of Sleep (And Why They Matter)
“What gets measured, gets done” goes for sleep too
Sleep-deprived people usually underestimate how sleep-deprived they are. This is for the same reason as why drunk people usually underestimate how drunk they are—to put it in words that go for both situations: a cognitively impaired person lacks the cognitive function to realize how cognitively impaired they are.
Here’s the science on that, by the way:
How Sleep-Deprived Are You, Really?
For that reason, we recommend using sleep-tracking software (there are many apps for that) on your phone or, ideally, a wearable device (such as a smartwatch or similar).
A benefit of doing so is that we don’t think “well, I slept from 10pm to 6am, so that’s 8 hours”, if our device tells us we slept between 10:43pm and 5:56 am with 74% sleep efficiency because we woke up many times.
As an aside, sleep efficiency should be about 85%, by the way. Why not 100%, you ask? It’s because if your body is truly out like a light for the entire night, something is wrong (either you were very sleep-deprived, or you have been drugged, that kind of thing). See also:
An unbroken night’s sleep is a myth. Here’s what good sleep looks like.
So waking up during the night is normal, and nothing to worry about per se. If you do find trouble getting back to sleep, though:
How to Fall Back Asleep After Waking Up in the Middle of the Night
Be careful about how you try to supplement sleep
This goes both for taking substances of various kinds, and napping. Some sleep aids can help, but many are harmful and/or do not really work as such; here’s a rundown of examples of those:
Safe Effective Sleep Aids For Seniors?
And when it comes to napping, timing is everything:
How To Nap Like A Pro (No More “Sleep Hangovers”!)
Want to know a lot more?
This is the book on sleep:
Why We Sleep – by Dr. Matthew Walker
Enjoy!
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What Happens Every Day When You Quit Sugar For 30 Days
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We all know that sugar isn’t exactly a health food, but it can be hard to quit. How long can cravings be expected to last, and when can we expect to see benefits? Today’s video covers the timeline in a realistic yet inspiring fashion:
What to expect on…
Day 1: expect cravings and withdrawal symptoms including headaches, fatigue, mood swings, and irritability—as well as tiredness, without the crutch of sugar.
Days 2 & 3: more of the same, plus likely objections from the gut, since your Candida albicans content will not be enjoying being starved of its main food source.
Days 4–7: reduction of the above symptoms, better energy levels, improved sleep, and likely the gut will be adapting or have adapted.
Days 8–14: beginning of weight loss, clearer skin, improved complexion; taste buds adapt too, making foods taste sweeter. Continued improvement in energy and focus, as well.
Days 15–21: more of the same improvements, plus the immune system will start getting stronger around now. But watch out, because there may still be some cravings from time to time.
Days 22–30: all of the above positive things, few or no cravings now, and enhanced metabolic health as a whole.
For more specificity on each of these stages, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Not-So-Sweet Science Of Sugar Addiction
Take care!
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Kumquat vs Persimmon – Which is Healthier?
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Our Verdict
When comparing kumquat to persimmon, we picked the kumquat.
Why?
In terms of macros, kumquats have more protein, though like most fruits, it’s unlike anybody’s eating them for the protein content. More importantly, they have a lot more fiber, for less than half the carbs. It bears mentioning though that (again, like most fruits) persimmon isn’t bad for this either, and both fruits are low glycemic index foods.
When it comes to vitamins, it’s not close: kumquats have more of vitamins A, B1, B2, B3, B5, B6, B9, E, and choline, while persimmon has more vitamin C. It’s worth noting that kumquats are already a very good source of vitamin C though; persimmon just has more.
In the category of minerals, kumquats again lead with more calcium, copper, magnesium, manganese, and zinc, while persimmon has more iron, phosphorus, and potassium.
In short, enjoy both, and/or whatever fruit you enjoy the most, but if looking for nutritional density, kumquats are bringing it.
Want to learn more?
You might like to read:
Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
Take care!
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Why Everyone You Don’t Like Is A Narcissist
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We’ve written before about how psychiatry tends to name disorders after how they affect other people, rather than how they affect the bearer, and this is most exemplified when it comes to personality disorders. For example:
“You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”
“You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”
See also: Miss Diagnosis: Anxiety, ADHD, & Women
Antisocial DiagnosesThese days, it is easy to find on YouTube countless videos of how to spot a narcissist, with a list of key traits that all mysteriously describe exactly the exes of everyone in the comments.
And these days it is mostly “narcissist”, because “psychopath” and “sociopath” have fallen out of popular favor a bit:
- perhaps for coming across as overly sensationalized, and thus lacking credibility
- perhaps because “Narcissistic Personality Disorder (NPD)” exists in the DSM-5 (the US’s latest “Diagnostic and Statistical Manual of Mental Disorders”), while psychopathy and sociopathy are not mentioned as existing.
You may be wondering: what do “psychopathy” and “sociopathy” mean?
And the answer is: they mean whatever the speaker wants them to mean. Their definitions and differences/similarities have been vigorously debated by clinicians and lay enthusiasts alike for long enough that the scientific world has pretty much given up on them and moved on.
Stigma vs pathology
Because of the popular media (and social media) representation of NPD, it is easy to armchair diagnose one’s relative/ex/neighbor/in-law/boss/etc as being a narcissist, because the focus is on “narcissists do these bad things that are mean to people”.
If the focus were instead on “narcissists have cripplingly low self-esteem, and are desperate to not show weakness in a world they have learned is harsh and predatory”, then there may not be so many armchair diagnoses—or at the very least, the labels may be attached with a little more compassion, the same way we might with other mental health issues such as depression.
Not that those with depression get an easy time of it socially either—society’s response is generally some manner of “aren’t you better yet, stop being lazy”—but at the very least, depressed people are not typically viewed with hatred.
A quick aside: if you or someone you know is struggling with depression, here are some things that actually help:
The Mental Health First-Aid You’ll Hopefully Never Need
The disorder is not the problem
Maybe your relative, ex, neighbor, etc really is clinically diagnosable as a narcissist. There are still two important things to bear in mind:
- After centuries of diagnosing people with mental health maladies that we now know don’t exist per se (madness, hysteria, etc), and in recent decades countless revisions to the DSM and similar tomes, thank goodness we now have the final and perfect set of definitions that surely won’t be re-written in the next few years or so ← this is irony; it will absolutely be re-written numerous times yet because of course it’s still not a magically perfect descriptor of the broad spectrum of human nature
- The disorder is not the problem; the way they treat (or have treated) you is the problem.
For example, let’s take a key thing generally attributed to narcissists: a lack of empathy
Now, empathy can be divided into:
- affective empathy: the ability to feel what other people are feeling
- cognitive empathy: the ability to intellectually understand what other people are feeling (akin to sympathy, which is the same but with the requisite of having experienced the thing in question oneself)
A narcissist (as well as various other people without NPD) will typically have negligible affective empathy, and their cognitive empathy may be a little sluggish too.
Sluggish = it may take them a beat longer than most people, to realize what an external signifier of emotions means, or correctly guess how something will be felt by others. This can result in gravely misspeaking (or inappropriately emoting), after failing to adequately quickly “read the room” in terms of what would be a socially appropriate response. To save face, they may then either deny/minimize the thing they just said/did, or double-down on it and go on [what for them feels like] the counterattack.
As to why this shutting off of empathy happens: they have learned that the world is painful, and that people are sources of pain, and so—to avoid further pain—have closed themselves off to that, often at a very early age. This will also apply to themselves; narcissists typically have negligible self-empathy too, which is why they will commonly make self-destructive decisions, even while trying to put themselves first.
Important note on how this impacts other people: the “Golden Rule” of “treat others as you would wish to be treated” becomes intangible, as they have no more knowledge of their own emotional needs than they do of anyone else’s, so cannot make that comparison.
Consider: if instead of being blind to empathy, they were colorblind… You would probably not berate them for buying green apples when you asked for red. They were simply incapable of seeing that, and consequently made a mistake. So it is when it’s a part of the brain that’s not working normally.
So… Since the behavior does adversely affect other people, what can be done about it? Even if “hate them for it and call for their eradication from the face of the Earth” is not a reasonable (or compassionate) option, what is?
Take the bull by the horns
Above all, and despite all appearances, a narcissist’s deepest desire is simply to be accepted as good enough. If you throw them a life-ring in that regard, they will generally take it.
So, communicate (gently, because a perceived attack will trigger defensiveness instead, and possibly a counterattack, neither of which are useful to anyone) what behavior is causing a problem and why, and ask them to do an alternative thing instead.
And, this is important, the alternative thing has to be something they are capable of doing. Not merely something that you feel they should be capable of doing, but that they are actually capable of doing.
- So not: “be a bit more sensitive!” because that is like asking the colorblind person to “be a bit more observant about colors”; they are simply not capable of it and it is folly to expect it of them, because no matter how hard they try, they can’t.
- But rather: “it upsets me when you joke about xyz; I know that probably doesn’t make sense to you and that’s ok, it doesn’t have to. I am asking, however, if you will please simply refrain from joking about xyz. Would you do that for me?”
Presented with such, it’s much more likely that the narcissist will drop their previous attempt to be good enough (by joking, because everyone loves someone with a sense of humor, right?) for a new, different attempt to be good enough (by showing “behold, look, I am a good person and doing the thing you asked, of which I am capable”).
That’s just one example, but the same methodology can be applied to most things.
For tricks pertaining to how to communicate such things without causing undue resistance, see:
Seriously Useful Communication Skills
Take care!
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Rebuilding Milo – by Dr. Aaron Horschig
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The author, a doctor of physical therapy, also wrote another book that we reviewed a while ago, “The Squat Bible” (which is also excellent, by the way). This time, it’s all about resistance training in the context of fixing a damaged body.
Resistance training is, of course, very important for general health, especially as we get older. However, it’s easy to do it wrongly and injure oneself, and indeed, if one is carrying some injury and/or chronic pain, it becomes necessary to know how to fix that before continuing—without just giving up on training, because that would be a road to ruin in terms of muscle and bone maintenance.
The book explains all the necessary anatomy, with clear illustrations too. He talks equipment, keeping things simple and practical, letting the reader know which things actually matter in terms of quality, and what things are just unnecessary fanciness and/or counterproductive.
Most of the book is divided into chapters per body part, e.g. back pain, shoulder pain, ankle pain, hip pain, knee pain, etc; what’s going on, and how to fix it to rebuild it stronger.
The style is straightforward and simple, neither overly clinical nor embellished with overly casual fluff. Just, clear simple explanations and instructions.
Bottom line: if you’d like to get stronger and/or level up your resistance training, but are worried about an injury or chronic condition, this book can set you in good order.
Click here to check out Rebuilding Milo, and rebuild yourself!
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America Worries About Health Costs — And Voters Want to Hear From Biden and Republicans
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President Joe Biden is counting on outrage over abortion restrictions to help drive turnout for his reelection. Former President Donald Trump is promising to take another swing at repealing Obamacare.
But around America’s kitchen tables, those are hardly the only health topics voters want to hear about in the 2024 campaigns. A new KFF tracking poll shows that health care tops the list of basic expenses Americans worry about — more than gas, food, and rent. Nearly 3 in 4 adults — and majorities of both parties — say they’re concerned about paying for unexpected medical bills and other health costs.
“Absolutely health care is something on my mind,” Rob Werner, 64, of Concord, New Hampshire, said in an interview at a local coffee shop in January. He’s a Biden supporter and said he wants to make sure the Affordable Care Act, also known as Obamacare, is retained and that there’s more of an effort to control health care costs.
The presidential election is likely to turn on the simple question of whether Americans want Trump back in the White House. (Nikki Haley, the former South Carolina governor and U.S. ambassador to the United Nations, remained in the race for the Republican nomination ahead of Super Tuesday, though she had lost the first four primary contests.) And neither major party is basing their campaigns on health care promises.
But in the KFF poll, 80% of adults said they think it’s “very important” to hear presidential candidates talk about what they’d do to address health care costs — a subject congressional and state-level candidates can also expect to address.
“People are most concerned about out-of-pocket expenses for health care, and rightly so,” said Andrea Ducas, vice president of health policy at the Center for American Progress, a Washington, D.C.-based progressive think tank.
Here’s a look at the major health care issues that could help determine who wins in November.
Abortion
Less than two years after the Supreme Court overturned the constitutional right to an abortion, it is shaping up to be the biggest health issue in this election.
That was also the case in the 2022 midterm elections, when many voters rallied behind candidates who supported abortion rights and bolstered Democrats to an unexpectedly strong showing. Since the Supreme Court’s decision, voters in six states — including Kansas, Kentucky, and Ohio, where Republicans control the legislatures — have approved state constitutional amendments protecting abortion access.
Polls show that abortion is a key issue to some voters, said Robert Blendon, a public opinion researcher and professor emeritus at the Harvard T.H. Chan School of Public Health. He said up to 30% across the board see it as a “personal” issue, rather than policy — and most of those support abortion rights.
“That’s a lot of voters, if they show up and vote,” Blendon said.
Proposals to further protect — or restrict — abortion access could drive voter turnout. Advocates are working to put abortion-related measures on the ballot in such states as Arizona, Florida, Missouri, and South Dakota this November. A push in Washington toward a nationwide abortion policy could also draw more voters to the polls, Blendon said.
A surprise ruling by the Alabama Supreme Court in February that frozen embryos are children could also shake up the election. It’s an issue that divides even the anti-abortion community, with some who believe that a fertilized egg is a unique new person deserving of full legal rights and protections, and others believing that discarding unused embryos as part of the in vitro fertilization process is a morally acceptable way for couples to have children.
Pricey Prescriptions
Drug costs regularly rank high among voters’ concerns.
In the latest tracking poll, more than half — 55% — said they were very worried about being able to afford prescription drugs.
Biden has tried to address the price of drugs, though his efforts haven’t registered with many voters. While its name doesn’t suggest landmark health policy, the Inflation Reduction Act, or IRA, which the president signed in August 2022, included a provision allowing Medicare to negotiate prices for some of the most expensive drugs. It also capped total out-of-pocket spending for prescription drugs for all Medicare patients, while capping the price of insulin for those with diabetes at $35 a month — a limit some drugmakers have extended to patients with other kinds of insurance.
Drugmakers are fighting the Medicare price negotiation provision in court. Republicans have promised to repeal the IRA, arguing that forcing drugmakers to negotiate lower prices on drugs for Medicare beneficiaries would amount to price controls and stifle innovation. The party has offered no specific alternative, with the GOP-led House focused primarily on targeting pharmacy benefit managers, the arbitrators who control most Americans’ insurance coverage for medicines.
Costs of Coverage
Health care costs continue to rise for many Americans. The cost of employer-sponsored health plans have hit new highs in the past few months, raising costs for employers and workers alike. Experts have attributed the increase to high demand and expensive prices for certain drugs and treatments, notably weight loss drugs, as well as to medical inflation.
Meanwhile, the ACA is popular. The KFF poll found that more adults want to see the program expanded than scaled back. And a record 21.3 million people signed up for coverage in 2024, about 5 million of them new customers.
Enrollment in Republican-dominated states has grown fastest, with year-over-year increases of 80% in West Virginia, nearly 76% in Louisiana, and 62% in Ohio, according to the Centers for Medicare & Medicaid Services.
Public support for Obamacare and record enrollment in its coverage have made it politically perilous for Republicans to pursue the law’s repeal, especially without a robust alternative. That hasn’t stopped Trump from raising that prospect on the campaign trail, though it’s hard to find any other Republican candidate willing to step out on the same limb.
“The more he talks about it, the more other candidates have to start answering for it,” said Jarrett Lewis, a partner at Public Opinion Strategies, a GOP polling firm.
“Will a conversation about repeal-and-replace resonate with suburban women in Maricopa County?” he said, referring to the populous county in Arizona known for being a political bellwether. “I would steer clear of that if I was a candidate.”
Biden and his campaign have pounced on Trump’s talk of repeal. The president has said he wants to make permanent the enhanced premium subsidies he signed into law during the pandemic that are credited with helping to increase enrollment.
Republican advisers generally recommend that their candidates promote “a market-based system that has the consumer much more engaged,” said Lewis, citing short-term insurance plans as an example. “In the minds of Republicans, there is a pool of people that this would benefit. It may not be beneficial for everyone, but attractive to some.”
Biden and his allies have criticized short-term insurance plans — which Trump made more widely available — as “junk insurance” that doesn’t cover care for serious conditions or illnesses.
Entitlements Are Off-Limits
Both Medicaid and Medicare, the government health insurance programs that cover tens of millions of low-income, disabled, and older people, remain broadly popular with voters, said the Democratic pollster Celinda Lake. That makes it unlikely either party would pursue a platform that includes outright cuts to entitlements. But accusing an opponent of wanting to slash Medicare is a common, and often effective, campaign move.
Although Trump has said he wouldn’t cut Medicare spending, Democrats will likely seek to associate him with other Republicans who support constraining the program’s costs. Polls show that most voters oppose reducing any Medicare benefits, including by raising Medicare’s eligibility age from 65. However, raising taxes on people making more than $400,000 a year to shore up Medicare’s finances is one idea that won strong backing in a recent poll by The Associated Press and NORC Center for Public Affairs Research.
Brian Blase, a former Trump health adviser and the president of Paragon Health Institute, said Republicans, if they win more control of the federal government, should seek to lower spending on Medicare Advantage — through which commercial insurers provide benefits — to build on the program’s efficiencies and ensure it costs taxpayers less than the traditional program.
So far, though, Republicans, including Trump, have expressed little interest in such a plan. Some of them are clear-eyed about the perils of running on changing Medicare, which cost $829 billion in 2021 and is projected to consume nearly 18% of the federal budget by 2032.
“It’s difficult to have a frank conversation with voters about the future of the Medicare program,” said Lewis, the GOP pollster. “More often than not, it backfires. That conversation will have to happen right after a major election.”
Addiction Crisis
Many Americans have been touched by the growing opioid epidemic, which killed more than 112,000 people in the United States in 2023 — more than gun deaths and road fatalities combined. Rural residents and white adults are among the hardest hit.
Federal health officials have cited drug overdose deaths as a primary cause of the recent drop in U.S. life expectancy.
Republicans cast addiction as largely a criminal matter, associating it closely with the migration crisis at the U.S. southern border that they blame on Biden. Democrats have sought more funding for treatment and prevention of substance use disorders.
“This affects the family, the neighborhood,” said Blendon, the public opinion researcher.
Billions of dollars have begun to flow to states and local governments from legal settlements with opioid manufacturers and retailers, raising questions about how to best spend that money. But it isn’t clear that the crisis, outside the context of immigration, will emerge as a campaign issue.
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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Slow-Cooker Moroccan Tagine
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Tagine (طاجين) (tā-jīn) is a traditional dish named after, well, the traditional dish that it’s cooked in. Here’s an example tagine pot on Amazon. It’s a very nifty bit of kit, and while it’s often used for cooking over charcoal, one of its features is that if you have a hot sunny day, you can just leave it out in the sun and it will cook the contents nicely. Today though, we’re going to assume you don’t have one of these, and are going to give instructions for cooking a tagine-style dish with a slow cooker, which we’re going to assume you do have.
You will need
- 2 large red onions, finely chopped
- 2 large red peppers, cut into 1″ chunks
- 2 large zucchini, cut into ½” chunks
- 1 large eggplant, cut into ½” chunks
- 3 cups tomato passata
- 2 cups cooked chickpeas
- 16 pitted Medjool dates, chopped
- ½ bulb garlic, finely chopped
- 1 tbsp ras el-hanout
- A little extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Let your slow cooker heat up while you chop the things that need chopping
2) Add a splash of olive oil to the slow cooker; ensure the base is coated and there’s a little oil spare in there too; a thin coat to the base plus a couple of tbsp should do it nicely.
3) Add the onions and garlic, and leave for an hour.
4) Add the passata, dates, ras el-hanout, stir it and leave for an hour.
5) Add the chickpeas, peppers, and eggplant; stir it and leave for an hour.
6) Add the zucchini, stir it and leave for an hour.
7) Serve—it goes great with its traditional pairing of wholegrain couscous, but if you prefer, you can use our tasty versatile rice. In broader culinary terms, serving it with any carb is fine.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
Don’t Forget…
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