How to Fall Asleep Faster: CBT-Insomnia Treatment
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Insomnia affects a lot of people, and is even more common as we get older. Happily, therapist Emma McAdam is here with a drug-free solution that will work for most people most of the time.
Cognitive Behavioral Therapy for Insomnia (CBTI)
While people think of causes of insomnia as being things such as stress, anxiety, overthinking, disturbances, and so forth, these things affect sleep in the short term, but don’t directly cause chronic insomnia.
We say “directly”, because chronic insomnia is usually the result of the brain becoming accustomed to the above, and thus accidentally training itself to not sleep.
The remedy: cut the bad habit of staying in bed while awake. Lying in bed awake trains the brain to associate lying in bed with wakefulness (and any associated worrying, etc). In essence, we lie down, and the brain thinks “Aha, we know this one; this is the time and place for worrying, ok, let’s get to work”.
So instead: if you’re in bed and not asleep within 15 minutes, get up and do something non-stimulating until you feel sleepy, then return to bed. This may cause some short term tiredness, but it will usually correct the chronic insomnia within a week.
For more details, tips, and troubleshooting with regard to the above, enjoy:
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Want to learn more?
You might also like to read:
How to Fall Back Asleep After Waking Up in the Middle of the Night
Take care!
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What is a virtual emergency department? And when should you ‘visit’ one?
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For many Australians the emergency department (ED) is the physical and emblematic front door to accessing urgent health-care services.
But health-care services are evolving rapidly to meet the population’s changing needs. In recent years, we’ve seen growing use of telephone, video, and online health services, including the national healthdirect helpline, 13YARN (a crisis support service for First Nations people), state-funded lines like 13 HEALTH, and bulk-billed telehealth services, which have helped millions of Australians to access health care on demand and from home.
The ED is similarly expanding into new telehealth models to improve access to emergency medical care. Virtual EDs allow people to access the expertise of a hospital ED through their phone, computer or tablet.
All Australian states and the Northern Territory have some form of virtual ED at least in development, although not all of these services are available to the general public at this stage.
So what is a virtual ED, and when is it appropriate to consider using one?
Shutterstock/Nils Versemann How does a virtual ED work?
A virtual ED is set up to mirror the way you would enter the physical ED front door. First you provide some basic information to administration staff, then you are triaged by a nurse (this means they categorise the level of urgency of your case), then you see the ED doctor. Generally, this all takes place in a single video call.
In some instances, virtual ED clinicians may consult with other specialists such as neurologists, cardiologists or trauma experts to make clinical decisions.
A virtual ED is not suitable for managing medical emergencies which would require immediate resuscitation, or potentially serious chest pains, difficulty breathing or severe injuries.
A virtual ED is best suited to conditions that require immediate attention but are not life-threatening. These could include wounds, sprains, respiratory illnesses, allergic reactions, rashes, bites, pain, infections, minor burns, children with fevers, gastroenteritis, vertigo, high blood pressure, and many more.
People with these sorts of conditions and concerns may not be able to get in to see a GP straight away and may feel they need emergency advice, care or treatment.
When attending the ED, they can be subject to long wait times and delayed specialist attention because more serious cases are naturally prioritised. Attending a virtual ED may mean they’re seen by a doctor more quickly, and can begin any relevant treatment sooner.
From the perspective of the health-care system, virtual EDs are about redirecting unnecessary presentations away from physical EDs, helping them be ready to respond to emergencies. The virtual ED will not hesitate in directing callers to come into the physical ED if staff believe it is an emergency.
The doctor in the virtual ED may also direct the patient to a GP or other health professional, for example if their condition can’t be assessed visually, or if they need physical treatment.
The results so far
Virtual EDs have developed significantly over the past three years, predominantly driven by the COVID pandemic. We are now starting to slowly see assessments of these services.
A recent evaluation my colleagues and I did of Queensland’s Metro North Virtual ED found roughly 30% of calls were directed to the physical ED. This suggests 70% of the time, cases could be managed effectively by the virtual ED.
Preliminary data from a Victorian virtual ED indicates it curbed a similar rate of avoidable ED presentations – 72% of patients were successfully managed by the virtual ED alone. A study on the cost-effectiveness of another Victorian virtual ED suggested it has the potential to generate savings in health-care costs if it prevents physical ED visits.
Only 1.2% of people assessed in Queensland’s Metro North Virtual ED required unexpected hospital admission within 48 hours of being “discharged” from the virtual ED. None of these cases were life-threatening. This indicates the virtual ED is very safe.
The service experienced an average growth rate of 65% each month over a two-year evaluation period, highlighting increasing demand and confidence in the service. Surveys suggested clinicians also view the virtual ED positively.
The right advice could tell you whether you need to visit hospital in person or not. 1st footage/Shutterstock What now?
We need further research into patient outcomes and satisfaction, as well as the demographics of those using virtual EDs, and how these measures compare to the physical ED across different triage categories.
There are also challenges associated with virtual EDs, including around technology (connection and skills among patients and health professionals), training (for health professionals) and the importance of maintaining security and privacy.
Nonetheless, these services have the potential to reduce congestion in physical EDs, and offer greater convenience for patients.
Eligibility differs between different programs, so if you want to use a virtual ED, you may need to check you are eligible in your jurisdiction. Most virtual EDs can be accessed online, and some have direct phone numbers.
Jaimon Kelly, Senior Research Fellow in Telehealth delivered health services, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Bold Beans – by Amelia Christie-Miller
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We all know beans are one of the most healthful foods around, but how to include more of them, without getting boring?
This book has the answer, giving 80 exciting recipes, divided into the following sections:
- Speedy beans
- Bean snacks & sharing plates
- Brothy beans
- Bean bowls
- Hearty salads
- Bean feasts
The recipes are obviously all bean-centric, though if you have a particular dietary restriction, watch out for the warning labels on some (e.g. meat, fish, dairy, gluten, etc), and make a substitution if appropriate.
The recipes themselves have a happily short introductory paragraph, followed by all you’d expect from a recipe book (ingredients, measurements, method, picture)
There’s also a reference section, to learn about different kinds of beans and bean-related culinary methods that can be applied per your preferences.
Bottom line: if you’d like to include more beans in your daily diet but are stuck for making them varied and interesting, this is the book for you!
Click here to check out Bold Beans, and get your pulse racing (in a good way!)
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The Inflammation Spectrum – by Dr. Will Cole
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We’ve previously reviewed Dr. Cole’s other book “Gut Feelings”, and now he’s back, this time to tackle inflammation.
The focus here is on understanding what things trigger inflammation in your body—personally yours, not someone else’s—by something close to the usual elimination process yes, but he offers a way of sliding into it gently instead of simply quitting all the things and gradually adding everything back in.
The next step he takes the reader through is eating not just to avoid triggering inflammation, but to actively combat it. From there, it should be possible for the reader to build an anti-inflammatory cookbook, that’s not only one’s own personal repertoire of cooking, but also specifically tailored to one’s own personal responses to different ingredients.
The style of this book is very pop-science, helpful, walking-the-reader-by-the-hand through the processes involved. Dr. Cole wants to make everything as easy as possible.
Bottom line: if your diet could use an anti-inflammatory revamp, this is a top-tier guidebook for doing just that.
Click here to check out The Inflammation Spectrum, find your food triggers and reset your system!
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I Contain Multitudes – by Ed Yong
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A little while back we reviewed a book (Planet of Viruses) about the role of viruses in our lives, beyond the obvious. Today’s book gives the same treatment to microbes in general—mostly bacteria.
We all know about pathogens, and we all know about gut microbiota and that some (hopefully the majority) there are good for our health. This book covers those things too, but also much more.
Pulitzer Prize-winning science writer Ed Yong takes a big picture view (albeit, of some very small things) and looks at the many ways microbes keep us alive, directly or indirectly. From the microbes that convert certain proteins in breast milk into a form that babies can digest (yes, this means we produce nutrients in breast milk that have been evolved solely to feed that bacterium), to those without which agriculture would simply not work, we’re brought to realize how much our continued existence is contingent on our trillions of tiny friends.
The style throughout is easy-reading pop-science, very accessible. There’s also plenty in terms of practical take-away value, when it comes to adjusting our modern lives to better optimize the benefits we get from microbes—inside and out.
Bottom line: if you’d like to learn about the role of microbes in our life beyond “these ones are pathogens” and “these ones help our digestion”, this is the book for you.
Click here to check out I Contain Multitudes, and learn more about yours and those around you!
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Eating disorders don’t just affect teen girls. The risk may go up around pregnancy and menopause too
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Eating disorders impact more than 1.1 million people in Australia, representing 4.5% of the population. These disorders include binge eating disorder, bulimia nervosa, and anorexia nervosa.
Meanwhile, more than 4.1 million people (18.9%) are affected by body dissatisfaction, a major risk factor for some types of eating disorders.
But what image comes to mind first when you think of someone with an eating disorder or body image concerns? Is it a teenage girl? If so, you’re definitely not alone. This is often the image we see in popular media.
Eating disorders and body image concerns are most common in teenage girls, but their prevalence in adults, particularly in women, aged in their 30s, 40s and 50s, is actually close behind.
So what might be going on with girls and women in these particular age groups to create this heightened risk?
Drazen Zigic/Shutterstock The 3 ‘P’s
We can consider women’s risk periods for body image issues and eating disorders as the three “P”s: puberty (teenagers), pregnancy (30s) and perimenopause and menopause (40s, 50s).
A recent report from The Butterfly Foundation showed the three highest prevalence groups for body image concerns are teenage girls aged 15–17 (39.9%), women aged 55–64 (35.7%) and women aged 35–44 (32.6%).
We acknowledge there’s a wide age range for when girls and women will go through these phases of life. For example, a small proportion of women will experience premature menopause before 40, and not all women will become pregnant.
Variations in the way eating disorder symptoms are measured across different studies can make it difficult to draw direct comparisons, but here’s a snapshot of what the evidence tells us.
Puberty
In a review of studies looking at children aged six to adolescents aged 18, 30% of girls in this age group reported disordered eating, compared to 17% of boys. Rates of disordered eating were higher as children got older.
Pregnancy
During pregnancy, eating disorder prevalence is estimated at 7.5%. Almost 70% of women are dissatisfied with their body weight and figure in the post-partum period.
Pregnancy can represent a major change in identity and self-perception. Pormezz/Shutterstock Perimenopause
It’s estimated more than 73% of midlife women aged 42–52 are unsatisfied with their body weight. However, only a portion of these women would have been going through the menopause transition at the time of this study.
The prevalence of eating disorders is around 3.5% in women over 40 and 1–2% in men at the same stage.
So what’s going on?
Although we’re not sure of the exact mechanisms underlying eating disorder and body dissatisfaction risk during the three “P”s, it’s likely a combination of factors are at play.
These life stages involve significant reproductive hormonal changes (for example, fluctuations in oestrogen and progesterone) which can lead to increases in appetite or binge eating and changes in body composition. These changes can result in concerns about body weight and shape.
These stages can also represent a major change in identity and self-perception. A girl going through puberty may be concerned about turning into an “adult woman” and changes in attitudes of those around her, such as unwanted sexual attention.
Pregnancy obviously comes with significant body size and shape changes. Pregnant women may also feel their body is no longer their own.
While social pressures to be thin can stop during pregnancy, social expectations arguably return after birth, demanding women “bounce back” to their pre-pregnancy shape and size quickly.
Women going through menopause commonly express concerns about a loss of identity. In combination with changes in body composition and a perception their appearance is departing from youthful beauty ideals, this can intensify body dissatisfaction and increase the risk of eating disorders.
These periods of life can each also be incredibly stressful, both physically and psychologically.
For example, a girl going through puberty may be facing more adult responsibilities and stress at school. A pregnant woman could be taking care of a family while balancing work and other demands. A woman going through menopause could potentially be taking care of multiple generations (teenage children, ageing parents) while navigating the complexities of mid-life.
Research has shown interpersonal problems and stressors can increase the risk of eating disorders.
Body image concerns and eating disorders are not limited to teenage girls. transly/Unsplash, CC BY We need to do better
Unfortunately most of the policy and research attention currently seems to be focused on preventing and treating eating disorders in adolescents rather than adults. There also appears to be a lack of understanding among health professionals about these issues in older women.
In research I (Gemma) led with women who had experienced an eating disorder during menopause, participants expressed frustration with the lack of services that catered to people facing an eating disorder during this life stage. Participants also commonly said health professionals lacked education and training about eating disorders during menopause.
We need to increase awareness among health professionals and the general public about the fact eating disorders and body image concerns can affect women of any age – not just teenage girls. This will hopefully empower more women to seek help without stigma, and enable better support and treatment.
Jaycee Fuller from Bond University contributed to this article.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. For concerns around eating disorders or body image visit the Butterfly Foundation website or call the national helpline on 1800 33 4673.
Gemma Sharp, Professor, NHMRC Emerging Leadership Fellow & Senior Clinical Psychologist, The University of Queensland; Amy Burton, Lecturer in Clinical Psychology, University of Technology Sydney, and Megan Lee, Assistant Professor, Psychology, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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At The Heart Of Women’s Health
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A woman’s heart is a particular thing
For the longest time (and still to a large degree now), “women’s health” is assumed to refer to the health of organs found under a bikini. But there’s a lot more to it than that. We are whole people, with such things as brains and hearts and more.
Today (Valentine’s Day!) we’re focusing on the heart.
A quick recap:
We’ve talked previously about some of these sex differences when it comes to the heart, for example:
Heart Attack: His & Hers (Be Prepared!)
…but that’s fairly common knowledge at least amongst those who are attentive to such things, whereas…
…is much less common knowledge, especially with the ways statins are more likely to make things worse for a lot of women (not all though; see the article for some nuance about that).
We also talked about:
What Menopause Does To The Heart
…which is well worth reading too!
A question:
Why are women twice as likely to die from a heart attack as their age-equivalent male peers? Women develop heart disease later, but die from it sooner. Why is that?
That’s been a question scientists have been asking (and tentatively answering, as scientists do—hypotheses, theories, conclusions even sometimes) for 20 years now. Likely contributing factors include:
- A lack of public knowledge of the different symptoms
- A lack of confidence of bystanders to perform CPR on a woman
- A lack of public knowledge (including amongst prescribers) about the sex-related differences for statins
- A lack of women in cardiology, comparatively.
- A lack of attention to it, simply. Men get heart disease earlier, so it’s thought of as a “man thing”, by health providers as much as by individuals. Men get more regular cardiovascular check-ups, women get a mammogram and go.
Statistically, women are much more likely to die from heart disease than breast cancer:
- Breast cancer kills around 0.02% of us.
- Heart disease kills one in three.
And yet…
❝In a nationwide survey, only 22% of primary care doctors and 42% of cardiologists said they feel extremely well prepared to assess cardiovascular risks in women.
We are lagging in implementing risk prevention guidelines for women.
A lot of women are being told to just watch their cholesterol levels and see their doctor in a year. That’s a year of delayed care.❞
Source: The slowly evolving truth about heart disease and women
(there’s a lot more in that article than we have room for in ours, so do check it out!)
Some good news:
The “bystanders less likely to feel confident performing CPR on a woman” aspect may be helped by the deployment of new automatic external defibrillator, that works from four sides instead of one.
It’s called “double sequential external defibrillation”, and you can learn about it here:
A new emergency procedure for cardiac arrests aims to save more lives—here’s how it works
(it’s in use already in Canada and Aotearoa)
Gentlemen-readers, thank you for your attention to this one even if it was mostly not about you! Maybe someone you love will benefit from being aware of this
On a lighter note…
Since it’s Valentine’s Day, a little more on affairs of the heart…
Is chocolate good for the heart? And is it really an aphrodisiac?
We answered these questions and more in our previous main feature:
Chocolate & Health: Fact or Fiction?
Enjoy!
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