
Sleeping on Your Back after 50; Yay or Nay?
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Sleeping Differently After 50
Sleeping is one of those things that, at any age, can be hard to master. Some of our most popular articles have been on getting better sleep, and effective sleep aids, and we’ve had a range of specific sleep-related questions, like whether air purifiers actually improve your sleep.
But perhaps there’s an underlying truth hidden in our opening sentence…is sleeping consistently difficult because the way we sleep should change according to our age?
Inspired by Brad and Mike’s video below (which was published to their 5 million+ subscribers!), there are 4 main elements to consider when sleeping on your back after you’ve hit the 50-year mark:
- Degenerative Disk Disease: As you age, your spine may start to show signs of wear and tear, which directly affects comfort while lying on your back.
- Sleep Apnea and Snoring: Sleep Apnea and snoring become more of an issue with age, and sleeping on your back can exacerbate these problems; when you sleep on your back, the soft tissues in your throat, as well as your tongue, “fall back” and partly obstruct your the airway.
- Spinal Stenosis: Spinal Stenosis–the often-age-related narrowing of your spinal canal–can put pressure on the nerves that travel through the spine, which equally makes back-sleeping harder.
- GERD: The all-too-familiar gastroesophageal reflux disease can be more problematic when lying flat on your back, as doing so can allow easy access for stomach acid to move upwards.
Alternatives to Back Sleeping
Referencing the Mayo Clinic’s Sleep Facility’s director, Dr. Virend Somers, today’s video suggests a simple solution: sleeping on your side. The video goes into a bit more detail but, as you know, here at 10almonds we like to cut to the chase.
Modifications for Back Sleeping
If you’re a lifelong back-sleeping and cannot bear the idea of changing to your side, or your stomach, then there are a few modifications that you can make to ease any pain and discomfort.
Most solutions revolve around either leg wedges or pillow adjustments. For instance, if you’re suffering from back pain, try propping your knees up. Or if GERD is your worst enemy, a wedge pillow could help keep that acid down.
As can be expected, the video dives into more detail:
How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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Sleep Smarter – by Shawn Stevenson
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You probably know to avoid blue light before bed, put a curfew on the caffeine, and have fresh bedding. So, what does this book offer that’s new?
As the subtitle suggests, it’s 21 tips for better sleep, so if even half of them are new, then it’ll still be adding value.
This is a book review, not a book summary, but to give an idea of the kind of thing you might not already know: there’s a section on bedroom houseplants! For example…
- Which plants filter the air best according to NASA, rather than “according to tradition”
- Which plants will thrive in what will hopefully be a cool dark environment
- Which plants produce oxygen even at night, rather than just during the day
The writing style is personable without losing clarity or objectivity:
- We read personal anecdotes, and we read science
- We get “I tried this”, and we get “this sleep study found such-and-such”
- We get not just the “what”, but also the “why” and the “how”
We get the little changes that make a big difference—sometimes the difference between something working or not!
Bottom line: if you’d like to get better sleep and a blue light filter hasn’t wowed you and changed your life, this book will bring your sleep knowledge (and practice) to the next level.
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Just Be Well – by Dr. Thomas Sult
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Firstly, what this is not: a “think yourself well” book. It’s not about just deciding to be well.
Rather, it’s about ensuring the foundations of wellness, from which the rest of good health can spring, and notably, an absence of chronic illness. In essence: enjoying chronic good health.
The prescription here is functional medicine, which stands on the shoulders of lifestyle medicine. This latter is thus briefly covered and the basics presented, but most of the book is about identifying the root causes of disease and eliminating them one by one, by taking into account the functions of the body’s processes, both in terms of pathogenesis (and thus, seeking to undermine that) and in terms of correct functioning (i.e., good health).
While the main focus of the book is on health rather than disease, he does cover a number of very common chronic illnesses, and how even in those cases where they cannot yet be outright cured, there’s a lot more that can be done for them than “take two of these and call your insurance company in the morning”, when the goal is less about management of symptoms (though that is also covered) and more about undercutting causes, and ensuring that even if one thing goes wrong, it doesn’t bring the entire rest of the system down with it (something that often happens without functional medicine).
The style is clear, simple, and written for the layperson without unduly dumbing things down.
Bottom line: if you would like glowingly good health regardless of any potential setbacks, this book can help your body do what it needs to for you.
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I’m iron deficient. Which supplements will work best for me and how should I take them?
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Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women are low in iron compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant.
The body needs iron to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration.
If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day?
Here are some tips to help you work out how, when and what iron supplement to take.
LittlePigPower/Shutterstock How do I pick the right iron supplement?
The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need.
The sweet spot is between 60-120 mg of elemental iron. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain.
Low iron can especially affect people during pregnancy and women who do a lot of sport. Kamil Macniak/Shutterstock In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). The iron salts you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%).
These formulations all work similarly, so your choice should come down to dose and cost.
Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency.
Should I take tablets or liquid formulas?
Iron contained within a tablet is just as well absorbed as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference.
The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term.
What should I eat with my iron supplement?
Research has shown you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone.
If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it.
Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other vitamin C-rich foods.
Taking your supplement alongside foods rich in vitamin C, like orange juice or kiwifruit, can help your body absorb the iron. Anete Lusina/Pexels On the other hand, tea, coffee and calcium all decrease the body’s ability to absorb iron. So you should try to limit these close to the time you take your supplement.
Should I take my supplement in the morning or evening?
The best time of day to take your supplement is in the morning. The body can absorb significantly more iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest.
Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can limit your ability to absorb it. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop.
Our research has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes).
My supplements are upsetting my stomach. What should I do?
If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily.
Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study has shown taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects.
Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success.
It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, iron can be toxic, so you don’t want to be consuming additional iron if your body doesn’t need it.
If you think you may be low on iron, talk to your GP to find out your best options.
Alannah McKay, Postdoctoral Research Fellow, Sports Nutrition, Australian Catholic University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Sesame & Peanut Tofu
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Yesterday we learned how to elevate tofu from “nutrition” to “nutritious tasty snack” with our Basic Baked Tofu recipe; today we’re expanding on that, to take it from “nutritious tasty snack” to “very respectable meal”.
You will need
For the tofu:
- The Basic Baked Tofu that we made yesterday (consider making this to be “step zero” of today’s recipe if you don’t already have a portion in the fridge)
For the sauce:
- ⅓ cup peanut butter, ideally with no added sugar or salt (if allergic to peanuts specifically, use almond butter; if allergic to nuts generally, use tahini)
- ¼ bulb garlic, grated or crushed
- 1 tbsp tamarind paste
- 1½ tbsp tamari sauce (or low-sodium soy sauce, if a substitution is necessary)
- 1 tbsp sambal oelek (or sriracha sauce, if a substitution is necessary)
- 1 tsp ground coriander
- 1 tsp ground black pepper
- ½ tsp ground sweet cinnamon
- ½ tsp MSG (or else omit; do not substitute with salt in this case unless you have a particular craving)
- zest of 1 lime
For the vegetables:
- 14 oz broccolini / tenderstem broccoli, thick ends trimmed (failing that, any broccoli)
- 6 oz shelled edamame
- 1½ tsp toasted sesame oil
For serving:
- 4 cups cooked rice (we recommend our Tasty Versatile Rice recipe)
- ½ cup raw cashews, soaked in hot water for at least 5 minutes and then drained (if allergic, substitute cooked chickpeas, rinsed and drained)
- 1 tbsp toasted sesame seeds
- 1 handful chopped cilantro, unless you have the “this tastes like soap” gene, in which case substitute chopped parsley
Method
(we suggest you read everything at least once before doing anything)
1) Combine the sauce ingredients in a bowl and whisk well (or use a blender if you have one that’s comfortable with this relatively small quantity of ingredients). Taste it, and adjust the ingredient ratios if you’d like more saltiness, sweetness, sourness, spiciness, umami.
2) Prepare a bowl with cold water and some ice. Steam the broccolini and edamame for about 3 minutes; as soon as they become tender, dump them into the ice bathe to halt the cooking process. Let them chill for a few minutes, then drain, dry, and toss in the sesame oil.
3) Reheat the tofu if necessary (an air fryer is great for this), and then combine with half of the sauce in a bowl, tossing gently to coat well.
4) Add a little extra water to the remaining sauce, enough to make it pourable, whisking to an even consistency.
5) Assemble; do it per your preference, but we recommend the order: rice, vegetables, tofu, cashews, sauce, sesame seeds, herbs.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Tofu vs Seitan – Which is Healthier?
- Plant vs Animal Protein: Head to Head
- Sweet Cinnamon vs Regular Cinnamon – Which is Healthier?
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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Ice Baths: To Dip Or Not To Dip?
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We asked you for your (health-related) view of ice baths, and got the above-depicted, below-described, set of responses:
- About 31% said “ice baths are great for the health; we should take them”
- About 29% said “ice baths’ risks outweigh their few benefits”
- About 26% said “ice baths’ benefits outweigh their few risks”
- About 14% said “ice baths are dangerous and can kill you; best avoided”
So what does the science say?
Freezing water is very dangerous: True or False?
True! Water close to freezing point is indeed very dangerous, and can most certainly kill you.
Fun fact, though: many such people are still saveable with timely medical intervention, in part because the same hypothermia that is killing them also slows down the process* of death
Source (and science) for both parts of that:
Cold water immersion: sudden death and prolonged survival
*and biologically speaking, death is a process, not an event, by the way. But we don’t have room for that today!
(unless you die in some sudden violent way, such as a powerful explosion that destroys your brain instantly; then it’s an event)
Ice baths are thus also very dangerous: True or False?
False! Assuming that they are undertaken responsibly and you have no chronic diseases that make it more dangerous for you.
What does “undertaken responsibly” mean?
Firstly, the temperature should not be near freezing. It should be 10–15℃, which for Americans is 50–59℉.
You can get a bath thermometer to check this, by the way. Here’s an example product on Amazon.
Secondly, your ice bath should last no more than 10–15 minutes. This is not a place to go to sleep.
What chronic diseases would make it dangerous?
Do check with your doctor if you have any doubts, as no list we make can be exhaustive and we don’t know your personal medical history, but the main culprits are:
- Cardiovascular disease
- Hypertension
- Diabetes (any type)
The first two are for heart attack risk; the latter is because diabetes can affect core temperature regulation.
Ice baths are good for the heart: True or False?
True or False depending on how they’re done, and your health before starting.
For most people, undertaking ice baths responsibly, repeated ice bath use causes the cardiovascular system to adapt to better maintain homeostasis when subjected to thermal shock (i.e. sudden rapid changes in temperature).
For example: Respiratory and cardiovascular responses to cold stress following repeated cold water immersion
And because that was a small study, here’s a big research review with a lot of data; just scroll to where it has the heading“Specific thermoregulative adaptations to regular exposure to cold air and/or cold water exposure“ for many examples and much discussion:
Health effects of voluntary exposure to cold water: a continuing subject of debate
Ice baths are good against inflammation: True or False?
True! Here’s one example:
Uric acid and glutathione levels (important markers of chronic inflammation) are also significantly affected:
Uric acid and glutathione levels during short-term whole body cold exposure
Want to know more?
That’s all we have room for today, but check out our previous “Expert Insights” main feature looking at Wim Hof’s work in cryotherapy:
A Cold Shower A Day Keeps The Doctor Away?
Enjoy!
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Managing Your Mortality
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When Planning Is a Matter of Life and Death
Barring medical marvels as yet unrevealed, we are all going to die. We try to keep ourselves and our loved ones in good health, but it’s important to be prepared for the eventuality of death.
While this is not a cheerful topic, considering these things in advance can help us manage a very difficult thing, when the time comes.
We’ve put this under “Psychology Sunday” as it pertains to processing our own mortality, and managing our own experiences and the subsequent grief that our death may invoke in our loved ones.
We’ll also be looking at some of the medical considerations around end-of-life care, though.
Organizational considerations
It’s generally considered good to make preparations in advance. Write (or update) a Will, tie up any loose ends, decide on funerary preferences, perhaps even make arrangements with pre-funding. Life insurance, something difficult to get at a good rate towards the likely end of one’s life, is better sorted out sooner rather than later, too.
Beyond bureaucracy
What’s important to you, to have done before you die? It could be a bucket list, or it could just be to finish writing that book. It could be to heal a family rift, or to tell someone how you feel.
It could be more general, less concrete: perhaps to spend more time with your family, or to engage more with a spiritual practice that’s important to you.
Perhaps you want to do what you can to offset the grief of those you’ll leave behind; to make sure there are happy memories, or to make any requests of how they might remember you.
Lest this latter seem selfish: after a loved one dies, those who are left behind are often given to wonder: what would they have wanted? If you tell them now, they’ll know, and can be comforted and reassured by that.
This could range from “bright colors at my funeral, please” to “you have my blessing to remarry if you want to” to “I will now tell you the secret recipe for my famous bouillabaisse, for you to pass down in turn”.
End-of-life care
Increasingly few people die at home.
- Sometimes it will be a matter of fighting tooth-and-nail to beat a said-to-be-terminal illness, and thus expiring in hospital after a long battle.
- Sometimes it will be a matter of gradually winding down in a nursing home, receiving medical support to the end.
- Sometimes, on the other hand, people will prefer to return home, and do so.
Whatever your preferences, planning for them in advance is sensible—especially as money may be a factor later.
Not to go too much back to bureaucracy, but you might also want to consider a Living Will, to be enacted in the case that cognitive decline means you cannot advocate for yourself later.
Laws vary from place to place, so you’ll want to discuss this with a lawyer, but to give an idea of the kinds of things to consider:
National Institute on Aging: Preparing A Living Will
Palliative care
Palliative care is a subcategory of end-of-life care, and is what occurs when no further attempts are made to extend life, and instead, the only remaining goal is to reduce suffering.
In the case of some diseases including cancer, this may mean coming off treatments that have unpleasant side-effects, and retaining—or commencing—pain-relief treatments that may, as a side-effect, shorten life.
Euthanasia
Legality of euthanasia varies from place to place, and in some times and places, palliative care itself has been considered a form of “passive euthanasia”, that is to say, not taking an active step to end life, but abstaining from a treatment that prolongs it.
Clearer forms of passive euthanasia include stopping taking a medication without which one categorically will die, or turning off a life support machine.
Active euthanasia, taking a positive action to end life, is legal in some places and the means varies, but an overdose of barbiturates is an example; one goes to sleep and does not wake up.
It’s not the only method, though; options include benzodiazepines, and opioids, amongst others:
Efficacy and safety of drugs used for assisted dying
Unspoken euthanasia
An important thing to be aware of (whatever your views on euthanasia) is the principle of double-effect… And how it comes to play in palliative care more often than most people think.
Say a person is dying of cancer. They opt for palliative care; they desist in any further cancer treatments, and take medication for the pain. Morphine is common. Morphine also shortens life.
It’s common for such a patient to have a degree of control over their own medication, however, after a certain point, they will no longer be in sufficient condition to do so.
After this point, it is very common for caregivers (be they medical professionals or family members) to give more morphine—for the purpose of reducing suffering, of course, not to kill them.
In practical terms, this often means that the patient will die quite promptly afterwards. This is one of the reasons why, after sometimes a long-drawn-out period of “this person is dying”, healthcare workers can be very accurate about “it’s going to be in the next couple of days”.
The take-away from this section is: if you would like for this to not happen to you or your loved one, you need to be aware of this practice in advance, because while it’s not the kind of thing that tends to make its way into written hospital/hospice policies, it is very widespread and normalized in the industry on a human level.
Further reading: Goods, causes and intentions: problems with applying the doctrine of double effect to palliative sedation
One last thing…
Planning around our own mortality is never a task that seems pressing, until it’s too late. We recommend doing it anyway, without putting it off, because we can never know what’s around the corner.
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