Safe Effective Sleep Aids For Seniors
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Safe Efective Sleep Aids For Seniors
Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:
Review of Safety and Efficacy of Sleep Medicines in Older Adults
Let’s break it down…
What’s not so great
Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.
Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.
Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.
See also: Benzodiazepine and z-drug withdrawal
(and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)
Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.
What about cannabis products?
We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.
How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.
Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.
See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
Melatonin: a powerful helper with a good safety profile
We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.
Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:
Melatonin: A Safe Natural Sleep Supplement
Herbal options: which really work?
Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.
Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).
But here’s one study that found it helped significantly:
The effects of chamomile extract on sleep quality among elderly people: A clinical trial
Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!
Technological interventions
We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:
White Noise Is Good; Pink Noise Is Better
Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.
We reviewed some sleep apps; you might like those too:
The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
Enjoy, and rest well!
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Why do some people’s hair and nails grow quicker than mine?
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Throughout recorded history, our hair and nails played an important role in signifying who we are and our social status. You could say, they separate the caveman from businessman.
It was no surprise then that many of us found a new level of appreciation for our hairdressers and nail artists during the COVID lockdowns. Even Taylor Swift reported she cut her own hair during lockdown.
So, what would happen if all this hair and nail grooming got too much for us and we decided to give it all up. Would our hair and nails just keep on growing?
The answer is yes. The hair on our head grows, on average, 1 centimeter per month, while our fingernails grow an average of just over 3 millimetres.
When left unchecked, our hair and nails can grow to impressive lengths. Aliia Nasyrova, known as the Ukrainian Rapunzel, holds the world record for the longest locks on a living woman, which measure an impressive 257.33 cm.
When it comes to record-breaking fingernails, Diana Armstrong from the United States holds that record at 1,306.58 cm.
Most of us, however, get regular haircuts and trim our nails – some with greater frequency than others. So why do some people’s hair and nails grow more quickly?
Remind me, what are they made out of?
Hair and nails are made mostly from keratin. Both grow from matrix cells below the skin and grow through different patterns of cell division.
Nails grow steadily from the matrix cells, which sit under the skin at the base of the nail. These cells divide, pushing the older cells forward. As they grow, the new cells slide along the nail bed – the flat area under the fingernail which looks pink because of its rich blood supply.
A hair also starts growing from the matrix cells, eventually forming the visible part of the hair – the shaft. The hair shaft grows from a root that sits under the skin and is wrapped in a sac known as the hair follicle.
This sac has a nerve supply (which is why it hurts to pull out a hair), oil-producing glands that lubricate the hair and a tiny muscle that makes your hair stand up when it’s cold.
At the follicle’s base is the hair bulb, which contains the all-important hair papilla that supplies blood to the follicle.
Matrix cells near the papilla divide to produce new hair cells, which then harden and form the hair shaft. As the new hair cells are made, the hair is pushed up above the skin and the hair grows.
But the papilla also plays an integral part in regulating hair growth cycles, as it sends signals to the stem cells to move to the base of the follicle and form a hair matrix. Matrix cells then get signals to divide and start a new growth phase.
Unlike nails, our hair grows in cycles
Scientists have identified four phases of hair growth, the:
- anagen or growth phase, which lasts between two and eight years
- catagen or transition phase, when growth slows down, lasting around two weeks
- telogen or resting phase, when there is no growth at all. This usually lasts two to three months
- exogen or shedding phase, when the hair falls out and is replaced by the new hair growing from the same follicle. This starts the process all over again.
Each follicle goes through this cycle 10–30 times in its lifespan.
If all of our hair follicles grew at the same rate and entered the same phases simultaneously, there would be times when we would all be bald. That doesn’t usually happen: at any given time, only one in ten hairs is in the resting phase.
While we lose about 100–150 hairs daily, the average person has 100,000 hairs on their head, so we barely notice this natural shedding.
So what affects the speed of growth?
Genetics is the most significant factor. While hair growth rates vary between individuals, they tend to be consistent among family members.
Nails are also influenced by genetics, as siblings, especially identical twins, tend to have similar nail growth rates.
But there are also other influences.
Age makes a difference to hair and nail growth, even in healthy people. Younger people generally have faster growth rates because of the slowing metabolism and cell division that comes with ageing.
Hormonal changes can have an impact. Pregnancy often accelerates hair and nail growth rates, while menopause and high levels of the stress hormone cortisol can slow growth rates.
Nutrition also changes hair and nail strength and growth rate. While hair and nails are made mostly of keratin, they also contain water, fats and various minerals. As hair and nails keep growing, these minerals need to be replaced.
That’s why a balanced diet that includes sufficient nutrients to support your hair and nails is essential for maintaining their health.
Nutrient deficiencies may contribute to hair loss and nail breakage by disrupting their growth cycle or weakening their structure. Iron and zinc deficiencies, for example, have both been linked to hair loss and brittle nails.
This may explain why thick hair and strong, well-groomed nails have long been associated with perception of good health and high status.
However, not all perceptions are true.
No, hair and nails don’t grow after death
A persistent myth that may relate to the legends of vampires is that hair and nails continue to grow after we die.
In reality, they only appear to do so. As the body dehydrates after death, the skin shrinks, making hair and nails seem longer.
Morticians are well aware of this phenomenon and some inject tissue filler into the deceased’s fingertips to minimise this effect.
So, it seems that living or dead, there is no escape from the never-ending task of caring for our hair and nails.
Michelle Moscova, Adjunct Associate Professor, Anatomy, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Alzheimer’s Sex Differences May Not Be What They Appear
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Alzheimer’s Sex Differences May Not Be What They Appear
Women get Alzheimer’s at nearly twice the rate than men do, and deteriorate more rapidly after onset, too.
So… Why?
There are many potential things to look at, but four stand out for quick analysis:
- Chromosomes: women usually have XX chromosomes, to men’s usual XY. There are outliers to both groups, people with non-standard combinations of chromosomes, but not commonly enough to throw out the stats.
- Hormones: women usually have high estrogen and low testosterone, compared to men. Again there are outliers and this is a huge oversimplification that doesn’t even look at other sex hormones, but broadly speaking (which sounds vague, but is actually what is represented in epidemiological studies), it will be so.
- Anatomy: humans have some obvious sexual dimorphism (again, there are outliers, but again, not enough to throw out the stats); this seems least likely to be relevant (Alzheimer’s is probably not stored in the breasts, for examples), though average body composition (per muscle:fat ratio) could admittedly be a factor.
- Social/lifestyle: once again, #NotAllWomen etc, but broadly speaking, women and men often tend towards different social roles in some ways, and as we know, of course lifestyle can play a part in disease pathogenesis.
As a quick aside before we continue, if you’re curious about those outliers, then a wiki-walk into the fascinating world of intersex conditions, for example, could start here. But by and large, this won’t affect most people.
So… Which parts matter?
Back in 2018, Dr. Maria Teresa Ferretti et al. kicked up some rocks in this regard, looking not just at genes (as much research has focussed on) or amyloid-β (again, well-studied) but also at phenotypes and metabolic and social factors—bearing in mind that all three of those are heavily influenced by hormones. Noting, for example, that (we’ll quote directly here):
- Men and women with Alzheimer disease (AD) exhibit different cognitive and psychiatric symptoms, and women show faster cognitive decline after diagnosis of mild cognitive impairment (MCI) or AD dementia.
- Brain atrophy rates and patterns differ along the AD continuum between the sexes; in MCI, brain atrophy is faster in women than in men.
- The prevalence and effects of cerebrovascular, metabolic and socio-economic risk factors for AD are different between men and women.
See: Sex differences in Alzheimer disease—the gateway to precision medicine
So, have scientists controlled for each of those factors?
Mostly not! But they have found clues, anyway, while noting the limitations of the previous way of conducting studies. For example:
❝Women are more likely to develop Alzheimer’s disease and experience faster cognitive decline compared to their male counterparts. These sex differences should be accounted for when designing medications and conducting clinical trials❞
~ Dr. Feixiong Cheng
Read: Research finds sex differences in immune response and metabolism drive Alzheimer’s disease
Did you spot the clue?
It was “differences in immune response and metabolism”. These things are both influenced by (not outright regulated by, but strongly influenced by) sex hormones.
❝As [hormonal] sex influences both the immune system and metabolic process, our study aimed to identify how all of these individual factors influence one another to contribute to Alzheimer’s disease❞
~ Dr. Justin Lathia
Ignoring for a moment progesterone’s role in metabolism, estrogen is an immunostimulant and testosterone is an immunosuppressant. These thus both also have an effect in inflammation, which yes, includes neuroinflammation.
But wait a minute, shouldn’t that mean that women are more protected, not less?
It should! Except… Alzheimer’s is an age-related disease, and in the age-bracket that generally gets Alzheimer’s (again, there are outliers), menopause has been done and dusted for quite a while.
Which means, and this is critical: post-menopausal women not on HRT are essentially left without the immune boost usually directed by estrogen, while men of the same age will be ticking over with their physiology that (unlike that of the aforementioned women) was already adapted to function with negligible estrogen.
Specifically:
❝The metabolic consequences of estrogen decline during menopause accelerate neuropathology in women❞
~ Dr. Rasha Saleh
Critical idea to take away from all this:
Alzheimer’s research is going to be misleading if it doesn’t take into account sex differences, and not just that, but also specifically age-relevant sex differences—because that can flip the narrative. If we don’t take age into account, we could be left thinking estrogen is to blame, when in fact, it appears to be the opposite.
In the meantime, if you’re a woman of a certain age, you might talk with a doctor about whether HRT could be beneficial for you, if you haven’t already:
❝Women at genetic risk for AD (carrying at least one APOE e4 allele) seem to be particularly benefiting from MHT❞
(MHT = Menopausal Hormone Therapy; also commonly called HRT, which is the umbrella term for Hormone Replacement Therapies in general)
~ Dr. Herman Depypere
Source study: Menopause hormone therapy significantly alters pathophysiological biomarkers of Alzheimer’s disease
Pop-sci press release version: HRT could ward off Alzheimer’s among at-risk women
Take care!
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Do we need animal products to be healthy?
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Do we need animal products to be healthy?
We asked you for your (health-related) perspective on plant-based vs anima-based foods, and got the above-pictured spread of answers.
“Some or all of us may need small amounts of animal products” came out on top with more votes than the two more meat-eatery options combined, and the second most popular option was the hard-line “We can all live healthily and happily on just plants”.
Based on these answers, it seems our readership has quite a lot of vegans, vegetarians, and perhaps “flexitarians” who just have a little of animal products here and there.
Perhaps we should have seen this coming; the newsletter is “10almonds”, not “10 rashers of bacon”, after all.
But what does the science say?
We are carnivores and are best eating plenty of meat: True or False?
False. Let’s just rip the band-aid off for this one.
In terms of our anatomy and physiology, we are neither carnivores nor herbivores:
- We have a mid-length digestive tract (unlike carnivores and herbivores who have short and long ones, respectively)
- We have a mouthful of an assortment of teeth; molars and premolars for getting through plants from hard nuts to tough fibrous tubers, and we have incisors for cutting into flesh and (vestigial, but they’re there) canines that really serve us no purpose now but would have been a vicious bite when they were bigger, like some other modern-day primates.
- If we look at our closest living relatives, the other great apes, they are mostly frugivores (fruit-eaters) who supplement their fruity diet with a small quantity of insects and sometimes other small animals—of which they’ll often eat only the fatty organ meat and discard the rest.
And then, there’s the health risks associated with meat. We’ll not linger on this as we’ve talked about it before, but for example:
- Processed Meat Consumption and the Risk of Cancer: A Critical Evaluation of the Constraints of Current Evidence from Epidemiological Studies
- Red Meat Consumption (Heme Iron Intake) and Risk for Diabetes and Comorbidities?
- Health Risks Associated with Meat Consumption: A Review of Epidemiological Studies
- Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality
- Meat consumption: Which are the current global risks? A review of recent (2010-2020) evidences
If we avoid processed and/or red meat, that’s good enough: True or False?
True… Ish.
Really this one depends on one’s criteria for “good enough”. The above-linked studies, and plenty more like them, give the following broad picture:
- Red and/or processed meats are unequivocally terrible for the health in general
- Other mammalian meats, such as from pigs, are really not much better
- Poultry, on the other hand, the science is less clear on; the results are mixed, and thus so are the conclusions. The results are often barely statistically significant. In other words, when it comes to poultry, in the matter of health, the general consensus is that you can take it or leave it and will be fine. Some studies have found firmly for or against it, but the consensus is a collective scientific shrug.
- Fish, meanwhile, has almost universally been found to be healthful in moderation. You may have other reasons for wanting to avoid it (ethics, environmentalism, personal taste) but those things are beyond the scope of this article.
Some or all of us may need small amounts of animal products: True or False?
True! With nuances.
Let’s divide this into “some” and “all”. Firstly, some people may have health conditions and/or other mitigating circumstances that make an entirely plant-based diet untenable.
We’re going light on quotations from subscriber comments today because otherwise this article will get a bit long, but here’s a great example that’s worth quoting, from a subscriber who voted for this option:
❝I have a rare genetic disease called hereditary fructose intolerance. It means I lack the enzyme, Aldolase B, to process fructose. Eating fruits and veggies thus gives me severe hypoglycemia. I also have anemia caused by two autoimmune diseases, so I have to eat meat for the iron it supplies. I also supplement with iron pills but the pills alone can’t fix the problem entirely.❞
And, there’s the thing. Popular vegan talking-points are very good at saying “if you have this problem, this will address it; if you have that problem, that will address it”, etc. For every health-related objection to a fully plant-based diet there’s a refutation… Individually.
But actual real-world health doesn’t work like that; co-morbidities are very common, and in some cases, like our subscriber above, one problem undermines the solution to another. Add a third problem and by now you really just have to do what you need to do to survive.
For this reason, even the Vegan Society’s definition of veganism includes the clause “so far as is possible and practicable”.
Now, as for the rest of us “all”.
What if we’re really healthy and are living in optimal circumstances (easy access to a wide variety of choice of food), can we live healthily and happily just on plants?
No—on a technicality.
Vegans famously need to supplement vitamin B12, which is not found in plants. Ironically, much of the B12 in animal products comes from the animals themselves being given supplements, but that’s another matter. However, B12 can also be enjoyed from yeast. Popular options include the use of yeast extract (e.g. Marmite) and/or nutritional yeast in cooking.
Yeast is a single-celled microorganism that’s taxonomically classified as a fungus, even though in many ways it behaves like an animal (which series of words may conjure an amusing image, but we mean, biologically speaking).
However, it’s also not technically a plant, hence the “No—on a technicality”
Bottom line:
By nature, humans are quite versatile generalists when it comes to diet:
- Most of us can live healthily and happily on just plants if we so choose.
- Some people cannot, and will require varying kinds (and quantities) of animal products.
- As for red and/or processed meats, we’re not the boss of you, but from a health perspective, the science is clear: unless you have a circumstance that really necessitates it, just don’t.
- Same goes for pork, which isn’t red and may not be processed, but metabolically it’s associated with the same problems.
- The jury is out on poultry, but it strongly appears to be optional, healthwise, without making much of a difference either way
- Fish is roundly considered healthful in moderation. Enjoy it if you want, don’t if you don’t.
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Chickpeas vs Black Beans – Which is Healthier?
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Our Verdict
When comparing chickpeas to black beans, we picked the black beans.
Why?
They’re both great! But we consider the nutritional profile of black beans to be better:
In terms of macros, black beans have a little more protein, while chickpeas have more carbohydrates. Generally speaking, people are not usually short of carbs in their diet, so we’ll go with the one with more protein. Black beans also have more fiber, which is important for heart health and more.
In the category of micronutrients, black beans have twice as much potassium and twice as much calcium, as well as twice as much magnesium. Chickpeas, meanwhile are better for manganese and slightly higher in B vitamins, but B vitamins are everywhere (especially vitamin B5, pantothenic acid; that’s literally where its name comes from, it means “from everywhere”), so we don’t consider that as much of a plus as the black beans doubling up on potassium, calcium, and magnesium.
So, do enjoy both, but if you’re going to pick, or lean more heavily on one, we recommend the black beans
Further reading
See also:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Easily Digestible Vegetarian Protein Sources
- What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
Enjoy!
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Understanding and Responding to Self-Harm – by Dr. Allan House
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Whether it’s yourself, or (statistically much more likely) a loved one, it’s common to be faced with the deeply unpleasant reality of self-harm. This is a case where most definitely, “forewarned is forearmed”.
Dr. House covers not just the “what” and “why” of self-harm, but also the differences between suicidal and non-suicidal self-harm, as well as the impulsive and the planned.
Stylistically, the book is well-written, well-edited, and well-formatted. All this makes for easy reading and efficient learning.
Much of the book is, of course, given over to how to help in cases of self-harm. More specifically: how to approach things with both seriousness and compassion, and how to help in a way that doesn’t create undue pressure.
Because, as Dr. House explains and illustrates, a lot of well-meaning people end up causing more harm, by their botched attempts to help.
This book looks to avoid such tragedies.
Bottom line: if you’d rather know these things now, instead of wishing you’d known later, then this book is the one-stop guide it claims to be.
Click here to check out Understanding and Responding to Self-Harm, and be prepared!
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What Matters Most For Your Heart?
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Eat More (Of This) For Lower Blood Pressure
Heart disease remains the world’s #1 killer. We’d say “and in the US, it’s no different”, but in fact, the US is #1 country for heart disease. So, it’s worse and perhaps some extra care is in order.
But how?
What matters the most
Is it salt? Salt plays a part, but it’s not even close to the top problem:
Hypertension: Factors Far More Relevant Than Salt
Is it saturated fat? Saturated fat from certain sources plays more of a role than salt, but other sources may not be so much of an issue:
Can Saturated Fats Be Heart-Healthy?
Is it red meat? Red meat is not great for the heart (or for almost anything else, except perhaps anemia):
The Whys and Hows of Cutting Meats Out Of Your Diet
…but it’s still not the top dietary factor.
The thing many don’t eat
All the above are foodstuffs that a person wanting a healthier heart and cardiovascular system in general might (reasonably and usually correctly) want to cut down, but there’s one thing that most people need more of:
Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
And this is especially true for heart health:
❝Dietary fiber has emerged as a crucial yet underappreciated part of hypertension management.
Our comprehensive analysis emphasizes the evidence supporting the effectiveness of dietary fiber in lowering blood pressure and reducing the risk of cardiovascular events.❞
Specifically, she and her team found:
- Each additional 5g of fiber per day reduces blood pressure by 2.8/2.1 (systolic/diastolic, in mmHG)
- Dietary fiber works in several ways to improve cardiovascular health, including via gut bacteria, improved lipids profiles, and anti-inflammatory effects
- Most people are still only getting a small fraction (¼ to ⅓) of the recommended daily amount of fiber. To realize how bad that is, imagine if you consumed only ¼ of the recommended daily amount of calories every day!
You can read more about it here:
Dietary fiber critical in managing hypertension, international study finds
That’s a pop-science article, but it’s still very informative. If you prefer to read the scientific paper itself (or perhaps as well), you can find it below
Recommendations for the Use of Dietary Fiber to Improve Blood Pressure Control
Want more from your fiber?
Here’s yet another way fiber improves cardiometabolic health, hot off the academic press (the study was published just a couple of weeks ago):
How might fiber lower diabetes risk? Your gut could hold the clues
this pop-science article was based on this scientific paper
Gut Microbiota and Blood Metabolites Related to Fiber Intake and Type 2 Diabetes
Take care!
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