Having Trouble Sleeping?

The inability to fall asleep and wake up feeling refreshed is an exceedingly common problem.  The reasons behind it are multiple, and often it is a combination of things that interfere with our ability to get good sleep.  

Just like everyone else, I have to balance the demands of work and my family.  I get home late, so I eat dinner right before bed.  I drink caffeine throughout the day.  And, there is a TV going in the bedroom and books/journals on the nightstand.   Then I wonder why I have trouble getting to sleep at night?!  

There are many ways to try and improve our sleep habits and get more restful sleep besides starting medication for a sleep aid:

Set up a Pattern – Try to stick to a schedule as best you can.  Get into a rhythm so that after a couple of weeks your body knows that at the same time each day it is time to start winding down.  The same routine of trying to relax and perform the same tasks like brushing/flossing right before you climb into bed help train your body for the arrival of sleep.   Just as important as the nighttime routine is the idea of getting up at the same time.  A little bit of sleeping in on the weekend is fine, but grabbing 4 extra hours of sleep is disruptive to establishing and keeping your body trained for sleep and in a rhythm.  

Tone Down the House & Your Activity - Try to turn the TV off for a while before bed and let the house get quiet.  Read something that while interesting, doesn’t get your heart racing.  Tune the radio onto a station playing something relaxing and keep the volume low.  Do regular exercise a few days a week, but early in the day or afternoon so your body can calm down and relax after the exertion.  Eat at a reasonable hour so your body isn’t working to digest the food while you are trying to get comfortable and off to sleep.  Be mindful to avoid caffeine late in the evening whether it comes from coffee, tea, chocolate, or soda. 

No Daytime Naps – Sleeping during the day may be necessary for infants and young children, but not adults.  Excessive daytime sleepiness can be a symptom of something more significant like sleep apnea and should be discussed with your doctor. 

Keep the Bed for its Intended Purpose – Too many of us use the bedroom as a multipurpose room.  We keep the TV on watching late night television, read books or magazines in bed, do homework, fold the laundry and so on.  This teaches the brain that the bed is for more than just rest.  The standard teaching is the bed is only for sleep and sex.   If you want to watch TV, get out of the bed.  If you want to read a few pages from a book or magazine, get out of bed.   Keep your mind on the idea that once you get into bed, it is time to sleep.   

 Still not Sleepy? – Don’t lie in the bed and keep checking the clock.  Peeking at the clock and calculating “how much sleep you can get if you fall asleep right now” only increases your anxiety and keeps you from falling asleep.  Get up out of bed, leave the room and go back in after 15 minutes to try again.  If you still aren’t asleep in 15 minutes, get up and out of bed again and again until you fall asleep.   If you wake up early in the morning the same rules apply, don’t lie in bed if you are not sleepy.  

When Discussing it with your Provider - Before you see your provider for trouble sleeping, try to keep a diary of your sleep habits for about 2 weeks.  The diary should note the time you last had anything to eat, the time you laid down, approximately when you fell asleep, any naps you took throughout the day, any alcohol intake, cigarette smoking, any pain you may have, and all medications, vitamins or supplements that you are taking. 

In summary, these simple things are the first things your provider will tell you to try when the evaluation for insomnia is being done.  Be patient and give it an honest effort for a few weeks.  Sleep habits form over your lifetime and will take some time to be adjusted.  Sweet Dreams!

-Posted by Graham Dondlinger, MD

Watching Tragic Events Can Create Stress

Over the past few weeks, it seemed that any time you turned on the radio, booted up a computer, checked the news on an iPhone or looked at the TV, there was a consistent bombardment of tragic pictures and personal testimonials of horrific scenes in world news – some of which included wind-torn, devastated towns in Oklahoma.

While we want to remain informed and are drawn to this news, our own empathic values allow us to absorb the heartache of traumatic stories, which can then become entangled with the real stresses of our daily life.  Visual pictures make an impression in our brains that inform our bodies how to regulate the impacts of traumatic events, regardless of them being in real time, past or remote.

In real time, we react to current traumatic situations by becoming more attentive; our pulse rate increases allowing more blood to the brain, our frontal lobe activity is elevated (required for decision making), and our bodies are ready for action.  This mode is a “flight or fight” mode and is a reaction that allows for our survival.

Sometimes, an event is portrayed in the news which looks and feels real because of the emotional connection our brains make to the event.  We can be triggered by sensory stimulation; a similar place, feeling, or reaction of others.  Under this triggered stress, the brain can get confused and react as if the event was happening in real time.  The news and images evoke stress triggers which resonate as real fears, real depression, and real hopelessness.

If you are watching the news and you feel your heart begin to race, your temperature rise and/or your pulse increase, you are experiencing a response to what you see or hear.  Your resourceful brain is responding and getting ready to react.

So, what do you do?  Take a break.  Don’t let this physical response continue.  Remind yourself that you are safe, this is not happening now.  If your thoughts are telling you that you are not safe, this could be the first sign of acute stress.  Share your feelings with someone else, a relative and/or a friend.

If these feelings continue and create problems in your everyday life, such as disrupt your work day, wake you up in the middle of the night, and/or cause issues within your family, then you should consider calling a professional counselor to help you learn ways to cope. 

-Posted by Dawn Perez, LPC, NCC 

*Dawn Perez, LPC, NCC is now accepting new patients in the Gainesville office*

Sources: http://udini.proquest.com/preview/media-coverage-of-terrorism-a-meta-goid:216938409/

The Importance of Cooking & Eating Out Less

I grew up in a time when eating out was considered a special treat. I bet if you’re over 30, you did too. My family went out for Mexican food, our favorite, about once a month. My sister and I were even allowed to order a soda! Woo hoo!

Nowadays, Americans eat out a whopping average of 4-5 times per week! The proliferation of fast food restaurants and mid-priced chain restaurants, along with more two-income families, made that number possible.

The decline in cooking at home and the rise in eating out correspond to the rise in overweight and obesity in the U.S. Research has shown that eating at restaurants is associated with higher BMI and weight gain. A restaurant meal is more likely to be higher in unhealthy fats, sugar, sodium, and calories than a home-cooked meal, plus restaurant portions are likely to be significantly larger than home-cooked meals.

I tell my patients that cooking at home is probably the most important thing you can do to improve your diet. It doesn’t even matter what you cook - it’s the act of cooking itself. People who cook eat a healthier diet and smaller portions without giving it a thought. Think about it – are you really going to eat French fries that often if you cook at home? No! Are you going to eat four cups of pasta on a giant restaurant-size plate? Probably not.

For those that claim “I don’t have time to cook,” I urge you to rephrase that to “Cooking is not a priority.” We find the time for activities we value, like surfing the internet or watching TV. The problem is we don’t value cooking enough.

For those that claim “I can’t cook,” I say “Yes you can.” Don’t be turned off by watching fancy chefs on Food TV. Cooking can be easy and like anything else, you get better with practice. Tag recipes that catch your eye in cookbooks and websites and follow the instructions!  My current favorite sources are RealSimple.com and EatingWell.com.  I pick quick recipes so I’m not in the kitchen for more than 30 minutes.  I use ZipList.com to help me organize my recipes, plan my meals, and create grocery lists. I plan 4-5 meals a week to leave wiggle room for a meal out or leftovers. Sometimes, I also use Sundays to prep for the week.

Make cooking at home a priority and I bet you’ll see your health improve. Schedule a consult with one of Nova’s dietitians to help you make cooking and healthy eating a part of your life.

-Posted by Nicole Holovach, RD

Healthy Weight as a Lifestyle

Not too long ago, it occurred to me that the only difference between me and someone who doesn’t feel that he/she will ever “master” this wellness thing (a healthy weight, regular fitness, etc.) is that I just keep getting back in the saddle.  (Remember, I used to be 50 pounds overweight, so I’ve had lots of practice over the years...and still do!)

Think about it: How did you ever succeed at your first job, or the next job, or the one you’re in now? What about being a good parent or spouse?  So-called failures are inherent in life; in fact, they are so necessary for us to grow that I don’t believe in failures, only lessons.  For some reason, though, patients look at weight loss as not only a task to complete, but one that must be done “right.”  When that’s the viewpoint, as soon as you lose your footing, you’re likely to think it’s time to hang up the reins.  

What if you started looking at your weight and life as a journey?  Not just a "to-do" to check off. (After all, your weight is never “done” because there’s this "next-level" game called “maintenance” - for which you’re immediately qualified!)  And, not something that has to look a certain way.  But rather another wonderful path by which you get to prove your perseverance and refine your character.  

For example, there’s never any going “off” your plan if you see healthy eating as a long-term lifestyle.  This would mean that you realize that it's vital to treat yourself regularly, rather than a short-term diet that causes deprivation.  It’s still important to have structure, but it needs to be a flexible, freeing, innately natural structure.  Not regimented or forced structure that has you going from an “all” to “nothing” mentality in .5 seconds. 

No matter what happened yesterday–whether I overdid the Extreme Cookies ‘n Cream and ended up feeling sluggish OR I had 7 servings of veggies and a kickin’ run–either way, I know I’m gonna be back on the trail today. That’s how I think now that I know health is a lifestyle.  

To help you think about your weight and wellness as a lifestyle, it’s important to examine your beliefs and patterns, and customize a plan of action.  The following coaching questions will help:

1. What’s your biggest challenge? (i.e. Mindless snacking, not planning or preparing meals, feeling overwhelmed at work, unmotivated to exercise)
2. Why is it a challenge? (What mindset or life circumstances make it difficult for you?)
3. What’s one thing you will do today and this week to shift your perspective and practice something new? (i.e. Pausing to rate your hunger on a hunger scale and eliminating distractions in order to combat mindless snacking, or expanding your definition of exercise to include your past love of dance and researching some DVD or class options) 

 

--Posted by Sarah Sutton, MS, CHWC, CPT, Wellness Coach

 

D3 - The Supreme Vitamin: What's Your Level?

For the past few decades, Vitamin D has continually been featured in the news.  And, recently, has been considered one of the most supreme nutrients for its ability to promote optimal health and prevent today's chronic degenerative diseases.  

Vitamin D is freely available to everyone through sun exposure.  Specifically, its production is the result of an interaction of the ultraviolet B (UV-B) ray and cholesterol in our skin.  But, for the past half century, Vitamin D deficiency has become a worldwide problem.  Why?  Well, many people are increasingly working indoors and overall, getting less exposure to sunlight.  Especially those who live further away from the equator.  Additionally, getting Vitamin D from food sources like fish and eggs is very difficult since there's usually such a minimal amount present.  In order to get an optimal level of Vitamin D level in our bodies on a daily basis, nutritional supplementation of Vitamin D is often necessary.

So, what's all of the hype - why is Vitamin D so important?  One of the most common functions associated with Vitamin D is its ability to optimize bone health.  This is because it promotes calcium absorption in the gut and a normal bone formation in our bodies.

According to the newest research published in an April 2013 issue of the journal JAMA Neurology, babies born in the month of May have significantly lower levels of Vitamin D and are at greater risk for developing multiple sclerosis (a chronic degenerative autoimmune disease that attacks the brain and the nervous system) than babies born in November.  This is not the only study that shows the association; previous studies have also found the same outcomes.

In addition to multiple sclerosis, several studies have shown a strong association of low Vitamin D with other autoimmune diseases including rheumatoid arthritis, type 1 diabetes, psoriasis, and scleroderma.  Besides autoimmune diseases, Vitamin D deficiency also increases the risk of developing other chronic degenerative diseases, including bone loss (osteopenia and osteoporosis), diabetes (type 1 and 2 diabetes), high blood pressure, heart disease, fatigue, muscle and bone pain, depression, memory loss (dementia and Alzheimer), chronic respiratory infections, and various cancers.

So, how do we test the Vitamin D level and what is an optimal level?   A simple blood test called “25-Hydroxy Vitamin D” will tell you both your vitamin D2 (synthetic form) and vitamin D3 (natural form) levels.  The optimal level of Vitamin D should be around 60 to 80 ng/mL, preferably in the natural form of 25-Hydroxy Vitamin D3.

In order to achieve and maintain the optimal level of vitamin D, you may need 2,000 to 10,000 IU/day of Vitamin D3, best taken with food.   Ask your doctor to check your Vitamin D status and discuss the right dosage of Vitamin D3 supplementation for you.

-Posted by Teerawong Kasiolarn, ND, MSAc, LAc.