Melatonin: A Safe, Natural Sleep Aid?

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Melatonin: A safe sleep supplement?

Melatonin is a hormone normally made in our pineal gland. It helps regulate our circadian rhythm, by making us sleepy.

It has other roles too—it has a part to play in regulating immune function, something that also waxes and wanes as a typical day goes by.

Additionally, since melatonin and cortisol are antagonistic to each other, a sudden increase in either will decrease the other. Our brain takes advantage of this, by giving us a cortisol spike in the morning to help us wake up.

As a supplement, it’s generally enjoyed with the intention of inducing healthy, natural, restorative sleep.

Does it really induce healthy, natural, restorative, sleep?

Yes! Well, “natural” is a little subject and relative, if you’re taking it as a supplement, but it’s something your body produces naturally anyway.

Contrast with, for example, benzodiazepines (that whole family of medications with names ending in -azopan or -alozam), or other tranquilizing drugs that do not so much induce healthy sleep, but rather reduce your brain function and hopefully knock you out, and/but often have unwanted side effects, and a tendency to create dependency.

Melatonin, unlike most of those drugs, does not create dependency, and furthermore, we don’t develop tolerance to it. In other words, the same dose will continue working (we won’t need more and more).

In terms of benefits, melatonin not only reduces the time to fall asleep and increases total sleep time, but also (quite a bonus) improves sleep quality, too:

Meta-Analysis: Melatonin for the Treatment of Primary Sleep Disorders

Because it is a natural hormone rather than a drug with many side effects and interactions, it’s also beneficial for those who need good sleep and/but don’t want tranquilizing:

The Efficacy of Oral Melatonin in Improving Sleep in Cancer Patients with Insomnia: A Randomized Double-Blind Placebo-Controlled Study

Any other benefits?

Yes! It can also help guard against Seasonal Affective Disorder, also called seasonal depression. Because SAD is not just about “not enough light = not enough serotonin”, but also partly about circadian rhythm and (the body is not so sure what time of day it is when there are long hours of darkness, or even, in the other hemisphere / other time of year, long hours of daylight), melatonin can help, by giving your brain something to “anchor” onto, provided you take it at the same time each day. See:

As a small bonus, melatonin also promotes HGH production (important for maintaining bone and muscle mass, especially in later life):

Melatonin stimulates growth hormone secretion through pathways other than the growth hormone-releasing hormone

Anything we should worry about?

Assuming taking a recommended dose only (0.5mg–10mg per day), toxicity is highly unlikely, especially given that it has a half-life of only 40–60 minutes, so it’ll be eliminated quite quickly.

However! It does indeed induce sleepiness, so for example, don’t take melatonin and then try to drive or operate heavy machinery—or, ideally, do anything other than go to bed.

It can interfere with some medications. We mentioned that melatonin helps regulate immune function, so for example that’s something to bear in mind if you’re on immunosuppressants or otherwise have an autoimmune disorder. It can also interfere with blood pressure medications and blood thinners, and may make epilepsy meds less effective.

As ever, if in doubt, please speak with your doctor and/or pharmacist.

Where to get it?

As ever, we don’t sell it (or anything else), but for your convenience, here is an example product on Amazon.

Enjoy!

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  • Vital Aspects of Holistic Wellness

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    It’s Q&A Day!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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

    Q: I am interested in the following: Aging, Exercise, Diet, Relationships, Purpose, Lowering Stress

    You’re going to love our Psychology Sunday editions of 10almonds! You might like some of these…

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  • Unlock Your Air-Fryer’s Potential!

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    Unlock Your Air-Fryer’s Potential!

    You know what they say:

    “you get out of it what you put in”

    …and in the case of an air-fryer, that’s very true!

    More seriously:

    A lot of people buy an air fryer for its health benefits and convenience, make fries a couple of times, and then mostly let it gather dust. But for those who want to unlock its potential, there’s plenty more it can do!

    Let’s go over the basics first…

    Isn’t it just a tiny convection oven?

    Mechanically, yes. But the reason that it can be used to “air-fry” food rather than merely bake or roast the food is because of its tiny size allowing for much more rapid cooking at high temperatures.

    On which note… If you’re shopping for an air-fryer:

    • First of all, congratulations! You’re going to love it.
    • Secondly: bigger is not better. If you go over more than about 4 liters capacity, then you don’t have an air-fryer; you have a convection oven. Which is great and all, but probably not what you wanted.

    Are there health benefits beyond using less oil?

    It also creates much less acrylamide than deep-frying starchy foods does. The jury is out on the health risks of acrylamide, but we can say with confidence: it’s not exactly a health food.

    I tried it, but the food doesn’t cook or just burns!

    The usual reason for this is either over-packing the fryer compartment (air needs to be able to circulate!), or not coating the contents in oil. The oil only needs to be a super-thin layer, but it does need to be there, or else again, you’re just baking things.

    Two ways to get a super thin layer of oil on your food:

    • (works for anything you can air-fry) spray the food with oil. You can buy spray-on oils at the grocery store (Fry-light and similar brands are great), or put oil in little spray bottle (of the kind that you might buy for haircare) yourself.
    • (works with anything that can be shaken vigorously without harming it, e.g. root vegetables) chop the food, and put it in a tub (or a pan with a lid) with about a tablespoon of olive oil. Don’t worry if that looks like it’s not nearly enough—it will be! Now’s a great time to add your seasonings* too, by the way. Put the lid on, and holding the lid firmly in place, shake the tub/pan/whatever vigorously. Open it, and you’ll find the oil has now distributed itself into a very thin layer all over the food.

    *About those seasonings…

    Obviously not everything will go with everything, but some very healthful seasonings to consider adding are:

    Garlic and black pepper can go with almost anything (and in this writer’s house, they usually do!)

    Turmeric has a sweet nutty taste, and will add its color anything it touches. So if you want beautiful golden fries, perfect! If you don’t want yellow eggplant, maybe skip it.

    Cinnamon is, of course, great as part of breakfast and dessert dishes

    On which note, things most people don’t think of air-frying:

    • Breakfast frittata—the healthy way!
    • Omelets—no more accidental scrambled egg and you don’t have to babysit it! Just take out the tray that things normally sit on, and build it directly onto the (spray-oiled) bottom of the air-fryer pan. If you’re worried it’ll burn: a) it won’t, because the heat is coming from above, not below b) you can always use greaseproof paper or even a small heatproof plate
    • French toast—again with no cooking skills required
    • Fish cakes—make the patties as normal, spray-oil and lightly bread them
    • Cauliflower bites—spray oil or do the pan-jiggle we described; for seasonings, we recommend adding smoked paprika and, if you like heat, your preferred kind of hot pepper! These are delicious, and an amazing healthy snack that feels like junk food.
    • Falafel—make the balls as usual, spray-oil (do not jiggle violently; they won’t have the structural integrity for that) and air-fry!
    • Calamari (vegan option: onion rings!)—cut the squid (or onions) into rings, and lightly coat in batter and refrigerate for about an hour before air-frying at the highest heat your fryer does. This is critical, because air-fryers don’t like wet things, and if you don’t refrigerate it and then use a high heat, the batter will just drip, and you don’t want that. But with those two tips, it’ll work just great.

    Want more ideas?

    Check out EatingWell’s 65+ Healthy Air-Fryer Recipes ← the recipes are right there, no need to fight one’s way to them in any fashion!

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  • What Are The “Bright Lines” Of Bright Line Eating?

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    This is Dr. Susan Thompson. She’s a cognitive neuroscientist who has turned her hand to helping people to lose weight and maintain it at a lower level, using psychology to combat overeating. She is the founder of “Bright Line Eating”.

    We’ll say up front: it’s not without some controversy, and we’ll address that as we go, but we do believe the ideas are worth examining, and then we can apply them or not as befits our personal lives.

    What does she want us to know?

    Bright Line Eating’s general goal

    Dr. Thompson’s mission statement is to help people be “happy, thin, and free”.

    You will note that this presupposes thinness as desirable, and presumes it to be healthy, which frankly, it’s not for everyone. Indeed, for people over a certain age, having a BMI that’s slightly into the “overweight” category is a protective factor against mortality (which is partly a flaw of the BMI system, but is an interesting observation nonetheless):

    When BMI Doesn’t Quite Measure Up

    Nevertheless, Dr. Thompson makes the case for the three items (happy, thin, free) coming together, which means that any miserable or unhealthy thinness is not what the approach is valuing, since it is important for “thin” to be bookended by “happy” and “free”.

    What are these “bright lines”?

    Bright Line Eating comes with 4 rules:

    1. No flour (no, not even wholegrain flour; enjoy whole grains themselves yes, but flour, no)
    2. No sugar (and as a tag-along to this, no alcohol) (sugars naturally found in whole foods, e.g. the sugar in an apple if eating an apple, is ok, but other kinds are not, e.g. foods with apple juice concentrate as a sweetener; no “natural raw cane sugar” etc is not allowed either; despite the name, it certainly doesn’t grow on the plant like that)
    3. No snacking, just three meals per day(not even eating the ingredients while cooking—which also means no taste-testing while cooking)
    4. Weigh all your food (have fun in restaurants—but more seriously, the idea here is to plan each day’s 3 meals to deliver a healthy macronutrient balance and a capped calorie total).

    You may be thinking: “that sounds dismal, and not at all bright and cheerful, and certainly not happy and free”

    The name comes from the idea that these rules are lines that one does not cross. They are “bright” lines because they should be observed with a bright and cheery demeanour, for they are the rules that, Dr. Thompson says, will make you “happy, thin, and free”.

    You will note that this is completely in opposition to the expert opinion we hosted last week:

    What Flexible Dieting Really Means

    Dr. Thompson’s position on “freedom” is that Bright Line Eating is “very structured and takes a liberating stand against moderation”

    Which may sound a bit of an oxymoron—is she really saying that we are going to be made free from freedom?

    But there is some logic to it, and it’s about the freedom from having to make many food-related decisions at times when we’re likely to make bad ones:

    Where does the psychology come in?

    Dr. Thompson’s position is that willpower is a finite, expendable resource, and therefore we should use it judiciously.

    So, much like Steve Jobs famously wore the same clothes every day because he had enough decisions to make later in the day that he didn’t want unnecessary extra decisions to make… Bright Line Eating proposes that we make certain clear decisions up front about our eating, so then we don’t have to make so many decisions (and potentially the wrong decisions) later when hungry.

    You may be wondering: ”doesn’t sticking to what we decided still require willpower?”

    And… Potentially. But the key here is shutting down self-negotiation.

    Without clear lines drawn in advance, one must decide, “shall I have this cake or not?”, perhaps reflecting on the pros and cons, the context of the situation, the kind of day we’re having, how hungry we are, what else there is available to eat, what else we have eaten already, etc etc.

    In short, there are lots of opportunities to rationalize the decision to eat the cake.

    With clear lines drawn in advance, one must decide, “shall I have this cake or not?” and the answer is “no”.

    So while sticking to that pre-decided “no” still may require some willpower, it no longer comes with a slew of tempting opportunities to rationalize a “yes”.

    Which means a much greater success rate, both in adherence and outcomes. Here’s an 8-week interventional study and 2-year follow-up:

    Bright Line Eating | Research Publications

    Counterpoint: pick your own “bright lines”

    Dr. Thompson is very keen on her 4 rules that have worked for her and many people, but she recognizes that they may not be a perfect fit for everyone.

    So, it is possible to pick and choose our own “bright lines”; it is after all a dietary approach, not a religion. Here’s her response to someone who adopted the first 3 rules, but not the 4th:

    Bright Lines as Guidelines for Weight Loss

    The most important thing for Bright Line Eating, therefore, is perhaps the action of making clear decisions in advance and sticking to them, rather than seat-of-the-pantsing our diet, and with it, our health.

    Want to know more from Dr. Thompson?

    You might like her book, which we reviewed a while ago:

    Bright Line Eating – by Dr. Susan Peirce Thompson

    Enjoy!

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  • What you need to know about xylazine

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Xylazine is a non-opioid tranquilizer designed for veterinary use in animals. The sedative is not approved for use in people, yet it’s becoming more prevalent in the illicit drug supply.

    Sometimes called “tranq,” it’s often mixed with other drugs, such as fentanyl, a potent opioid responsible for a growing number of overdose deaths. Last year, the White House Office of National Drug Control Policy declared fentanyl mixed with xylazine an “emerging threat.”

    Read on to learn more about xylazine: what happens when people take it, what to do if an overdose is suspected, and how harm reduction tools can prevent overdose deaths.

    How are people who use drugs exposed to xylazine?

    Studies show people are exposed to xylazine—knowingly or unknowingly—when it’s mixed with other drugs like heroin, cocaine, meth, and, most frequently, fentanyl. When combined with opioids or other drugs, it increases the risk of a drug overdose.

    What happens if someone takes xylazine?

    Taking xylazine can cause drowsiness, amnesia, slow breathing, slow heart rate, dangerously low blood pressure, wounds that can become infected, and death, especially when taken in combination with other drugs.

    Why does xylazine increase the risk of overdose?

    Xylazine is a central nervous system depressant, which means that it slows down the body’s heart rate and breathing. It can also enhance the effects of other depressants, such as opioids, which may lead to suffocation.

    What are the signs of a xylazine-related overdose?

    Xylazine-related overdoses look like opioid overdoses. A person who has overdosed may exhibit a slow pulse, slow breathing, blurry vision, disorientation, drowsiness, confusion, blue skin, and loss of consciousness.

    How many people die from xylazine-related overdoses in the U.S.?

    Xylazine-related overdose deaths in the U.S. rose from 102 deaths in 2018 to 3,468 deaths in 2021. Most occurred in Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia. Fentanyl was the most frequently co-occurring drug involved in those deaths.

    What should I do if an overdose is suspected?

    If you suspect that a person has overdosed on any drug, call 911 and give them naloxone—sometimes sold under the brand name Narcan—a medication that can reverse an opioid overdose. You should also stay with the person who has overdosed until first responders arrive. Most states have Good Samaritan laws, which protect people who have overdosed and those assisting them from certain criminal penalties.

    While naloxone cannot reverse the effects of xylazine alone, experts recommend administering naloxone if an overdose is suspected because it’s often mixed with opioids.

    You can get naloxone for free from some nonprofit organizations and government-run programs. You can also purchase over-the-counter naloxone at pharmacies, grocery and convenience stores, and other retailers.

    Learn how to use naloxone in this short training video from the American Medical Association, or sign up for a free online training.

    How can people prevent xylazine-related overdoses?

    Harm reduction programs are community programs that prevent drug overdoses, reduce the spread of infectious diseases, and connect people to medical care. These programs provide lifesaving tools like naloxone, as well as fentanyl and xylazine test strips, which can detect the presence of these drugs in a substance and prevent overdoses. Drug test strips can also be ordered online.

    However, test strips are considered “drug paraphernalia” in some states and are not legal everywhere. Learn more about state laws around drug checking equipment from the Network for Public Health Law.

    Learn more about harm reduction from the CDC.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • What’s the difference between ADD and ADHD?

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    Around one in 20 people has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood.

    ADHD is diagnosed when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home.

    Some people call the condition attention-deficit disorder, or ADD. So what’s the difference?

    In short, what was previously called ADD is now known as ADHD. So how did we get here?

    Let’s start with some history

    The first clinical description of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still presented a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate.

    Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions.

    The first DSM, published in 1952, did not include a specific related child or adolescent category. But the second edition, published in 1968, included a section on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder.

    Kids in the 60s playing
    It took a while for ADHD-type behaviour to make in into the diagnostic manual. Elzbieta Sekowska/Shutterstock

    In the early 1980s, the third DSM added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder with hyperactivity (ADDH) and attention deficit disorder as the subtype without the hyperactivity.

    However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today:

    • predominantly inattentive
    • predominantly hyperactive-impulsive
    • combined.

    Why change ADD to ADHD?

    ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons.

    First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was initially named, little research had been done to determine the similarities and differences between the two sub-types.

    The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions?

    Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours may not necessarily be disruptive and challenging but are more likely to be forgetful and daydreamers.

    Woman daydreams
    People with inattentive behaviours may be more forgetful or daydreamers. fizkes/Shutterstock

    Why do some people use the term ADD?

    There was a surge of diagnoses in the 1980s. So it’s understandable that some people still hold onto the term ADD.

    Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits.

    Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed.

    How is ADHD currently diagnosed?

    The three sub-types of ADHD, outlined in the DSM-5 are:

    • predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions
    • predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control
    • combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive.

    ADHD diagnoses continue to rise among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses.

    However, some international experts contest the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors.

    Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.

    Kathy Gibbs, Program Director for the Bachelor of Education, Griffith University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Building Psychological Resilience (Without Undue Hardship)

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    What’s The Worst That Could Happen?

    When we talk about the five lifestyle factors that make the biggest difference to health, stress management would be a worthy addition as number six. We haven’t focused explicitly on that for a while, so let’s get ready to start the New Year on a good footing…

    You’re not going to have a stress-free 2024

    What a tender world that would be! Hopefully your stressors will be small and manageable, but rest assured, things will stress you.

    And that’s key: “rest assured”. Know it now, prepare for it, and build resilience.

    Sounds grim, doesn’t it? It doesn’t have to be, though.

    When the forecast weather is cold and wet, you’re not afraid of it when you have a warm dry house. When the heating bill comes for that warm dry house, you’re not afraid of it when you have money to pay it. If you didn’t have the money and the warm dry house, the cold wet weather could be devastating to you.

    The lesson here is: we can generally handle what we’re prepared for.

    Negative visualization and the PNS

    This is the opposite of what a lot of “think and grow rich”-style gurus would advise. And indeed, it’s not helpful to slide into anxious worrying.

    If you do find yourself spiralling, here’s a tool for getting out of that spiral:

    RAIN: an intervention for dealing with difficult emotions

    For now, however, we’re going to practice Radical Acceptance.

    First, some biology: you may be aware that your Central Nervous System (CNS) branches into the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS).

    The PNS is the part that cues our body to relax, and suppresses our fight/flight response. We’re going to activate it.

    Activating the PNS is easy for most people in comfortable circumstances (e.g., you are not currently exposed to stressful stimuli). It may well be activated already, and if it’s not, a few deep breaths is usually all it takes.

    If you’d like a quick and easy Mindfulness-Based Stress Reduction (MBSR) technique, here you go:

    No-Frills, Evidence-Based Mindfulness

    Activating the PNS is hard for most people in difficult circumstances (e.g., you either are currently exposed to stressful stimuli, or you are in one of the emotional spirals we discussed earlier).

    However, we can trick our bodies and brains by—when we are safe and unstressed—practicing imagining those stressful stimuli. Taking a moment to not just imagine it experientially, but immersively. This, in CBT and DBT, is the modern equivalent to the old samurai who simply accepted, before battle, that they were already dead—and thus went into battle with zero fear of death.

    A less drastic example is the zen master who had a favorite teacup, and feared it would get broken. So he would tell himself “the cup is already broken”. One day, it actually broke, and he simply smiled ruefully and said “Of course”.

    How this ties together: practice the mindfulness-based stress reduction we linked above, while imagining the things that do/would stress you the most.

    Since it’s just imagination, this is a little easier than when the thing is actually happening. Practicing this way means that when and if the thing actually happens (an unfortunate diagnosis, a financial reversal, whatever it may be), our CNS is already well-trained to respond to stress with a dose of PNS-induced calm.

    You can also leverage hormesis, a beneficial aspect of (in this case, optional and chosen by you) acute stress:

    Dr. Elissa Epel | The Stress Prescription

    Psychological resilience training

    This (learned!) ability to respond to stress in an adaptive fashion (without maladaptive coping strategies such as unhelpful behavioral reactivity and/or substance use) is a key part of what in psychology is called resilience:

    Psychological resilience: an update on definitions, a critical appraisal, and research recommendations

    And yes, the CBT/DBT/MBSR methods we’ve been giving you are the evidence-based gold standard.

    Only the best for 10almonds subscribers! 😎

    Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions

    ❝That was helpful, but not cheery; can we finish the year on a cheerier note?❞

    We can indeed:

    How To Get Your Brain On A More Positive Track (Without Toxic Positivity)

    Take care!

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