Constant fatigue reduces the capacity to work and quality of life. Dr Galland-Decker et al. report in the British Medical Journal that a fifth of the population suffers from fatigue, with several different causes.

Feeling spent all the time can be the early sign of a grave health problem. However, the good news is that early diagnosis and treatment can reverse some of these disorders and prevent others from progressing. Unfortunately, many people do not seek medical help for fear of being labelled as lazy or fussy.

Are you always feeling tired?

Do you feel tired on most days, even after a good night’s rest, and never think that you’re functioning at your best? Don’t shrug it off. Review your lifestyle and see if you can tweak it to get more rest and better nutrition. Some fixes are easy, some not, but they’re worth trying before visiting your doctor. Lifestyle factors often underlying perpetual fatigue:

• An improper or restrictive diet
• Caffeine overload
• Inadequate sleep.

If you’ve tried all the lifestyle fixes and you’re still tired all the time, respect the warning your body’s giving you. Diseases first showing up as fatigue can progress to a dangerous stage if ignored. Here’s list of top reasons that could be behind your feeling always tired.

Top reasons why you feel might be feeling constantly tired

1. Thyroid Deficiency

Thyroid deficiency, more common in women, usually results from an autoimmunity disorder. Reduced production of the thyroid hormones manifests as tiredness and excessive sleepiness.

Other signs are constipation, slow heartbeat, unexpected weight gain, and hoarseness. Women often have heavy periods.

Your doctor will diagnose thyroid deficiency [hypothyroidism] by measuring the thyroid hormone levels in the blood, by a blood test. It is simple to treat, requiring a dose of thyroid hormone every morning.

2. Diabetes

It’s not usual, but sometimes the first sign of diabetes is constant tiredness. Lack of energy, increased hunger and thirst, and an increased frequency of urination are the common signs of this disease.

Diabetes, if not controlled early, damages the heart, kidneys, nervous system, and other organs. Diagnosis is by urine and blood tests for glucose. Treatment doesn’t always mean drugs or injections; dietary and lifestyle changes can control diabetes for many years.

3. Anaemia

Haemoglobin in the red blood cells carries oxygen from the lungs to the rest of the body. A reduced amount of this vital molecule is called anaemia.

Anaemia can be because of:

• Low production [deficiency of iron, folic acid, vitamin B12; blood cancers; genetic defects, and several other reasons].
• Increased blood loss or destruction of the red blood cells [heavy periods, accidents and injuries with blood loss, hemolytic diseases].

Your doctor can often diagnose anaemia at a glance, but finding the cause needs laboratory investigations and diligence. The common causes of anaemia are nutritional and are straightforward to treat.

4. Mineral and Vitamin Deficiencies

Minerals like iron, magnesium, potassium, and others are vital for our body’s smooth running. They’re part of several enzyme systems, electrolyte balances, and metabolic pathways essential to our life processes. Vitamins also act on or facilitate several of the processes in our body.

Deficiencies of these crucial micronutrients cause tiredness and lethargy. They can be diagnosed by distinct clinical features apart from fatigue and confirmed by laboratory tests.

Most deficiencies are treated by altering the diet and providing oral supplements for a while. Some deficiencies [like vitamin B12] need a course of injections.

5. Heart Disease

A heart attack is dramatic and unmissable, but heart disease can be slow and sneaky, too. The heart gradually loses its capacity to pump blood efficiently, and fatigue is one of the early manifestations.

If you could easily climb up three flights to work but are now struggling and breathless, schedule an appointment with your doctor. Heart disease is one of the most frequent causes of sudden death.

6. Sleep Apnea

It’s pretty common, but not well known. Breathing slows or stops for a while during sleep, and blood oxygen levels drop.

Sleep apnea reduces the quality of sleep. Though you sleep enough, you don’t feel rested in the morning. Noisy breathing and snoring during sleep is a sign of partially blocked airways. Once your doctor suspects sleep apnea, a sleep study will establish the diagnosis.

Treatment is by a device used at night while you sleep. Called a CPAP [continuous positive airway pressure] machine, it keeps your airways open during sleep.

Obesity and smoking both contribute to this condition; you can help yourself by eliminating them. Sometimes, surgery is needed to clear airway obstruction.

7. Stress and depression

Mental health issues like stress, depression, and anxiety, etc. can leave you emotionally and physically tired. Apart from the direct effect, they also reduce the duration and quality of sleep, further contributing to tiredness.

Do you have difficulty sleeping at night and waking up in the morning? Do small tasks scare you? Are you finding it hard to concentrate on your work? These are common among people with depression. A mental health professional can help you.

8. Shift work sleep disorder

Do you work the night shift at your workplace? Or do your work hours change every week?

Working during the night, or at different times from time to time, is associated with poor sleep, appetite, and energy. Research has shown that those who work in clockwise shifts do better than those who function in anti-clockwise shifts. (Read more about the effects of shift work » Shift-proof your slumber)

9. Chronic Fatigue Syndrome [CFS]

CFS is also called myalgic encephalomyelitis. This is a condition lasting months, and we don’t yet know the cause.

The important manifestation is feeling sick after any physical effort. Other symptoms are tiredness, headache, sore throat, and joint pains. Fatigue persists even after sleeping well.

Chronic fatigue syndrome is a physical, bodily disorder, not a psychiatric or psychological one. Initially, it needs evaluation by a specialist in internal medicine.

Treatment is unsatisfactory and depends on the manifestations each individual has.

10. Restless Legs Syndrome

This is a condition of strange feelings in the legs when resting, relieved by movement. Sometimes, it manifests as aches and deep pain. Sufferers have to keep moving their legs or getting up to walk.

People suffering from this condition often have difficulty sleeping for years. Fatigue during the day is a frequent accompaniment.

11. Food Intolerance

Many people have low-grade allergies to food, called food intolerance. These don’t trigger dramatic reactions such as breathing difficulties, circulatory failure, etc., but cause long-term symptoms. Food intolerance often shows up as bloating, tiredness, anaemia, and digestive disturbances.

Once you realise food is causing your problem, you’ll have to work to identify the foods that cause your symptoms. Food and symptom diaries, elimination diets, and laboratory tests help in this. Changing your food habits to avoid the offending foods will usually see you regain your energy and enthusiasm.

12. Overweight or Obesity

Putting on weight puts a strain on your heart, skeleton, and muscles. The body has to work harder for usual things like walking to work and household tasks.

Constant fatigue and low energy levels often accompany obesity.

Other reasons for always feeling tired

Almost any disease that persists for a long time will drain you. While the illnesses listed below cause fatigue, it is rare for that to be the first manifestation.

• Cancer
• Mononucleosis
• AIDS
• Allergic rhinitis

Plan of action

Try the lifestyle fixes first.

Get enough sleep. Balance and regularise your meals. Drink plenty of liquids; dehydration often leads to feelings of tiredness.

Get some exercise. This sounds counterintuitive since you are already feeling so tired. But exercise improves your mood and confidence, and enhances the working of your heart, lungs, and muscles.

Losing weight, if you are overweight, is a good idea. It’ll not only give you a sense of purpose and achievement, but will also reduce the strain on your heart, bones, and joints.

If you’re still not feeling rested and energetic, make a medical appointment. As Drs Eccles and Davies point out, the “red flags” pointing to dangerous diseases will be looked for first. Further process will look for the cause of your fatigue and attempt to correct it.

Conclusion

The normal you should be healthy, enthusiastic, and whole. Your ability to live and enjoy your best life must be unrestricted.

Tiredness after a hard day’s work is normal; always feeling tired is a warning. If lifestyle modifications aren’t doing the trick, don’t wait too long to get medical help.

The post Always Feeling Tired? It Could Be an Underlying Condition appeared first on Complete Wellbeing.

Now, new research published in the journal Psychological Science has shown that becoming happy improves your health. The researchers employed tactics that were specifically designed to boost subjective wellbeing. The study found that both online and in-person psychological interventions have positive effects on self-reported physical health. What’s more, there was no difference between the impact of online and in-person interventions—they were found to be equally effective.

“Though prior studies have shown that happier people tend to have better cardiovascular health and immune-system responses than their less happy counterparts,” said Kostadin Kushlev, a professor in Georgetown University’s Department of Psychology and one of the authors of the paper, “our research is one of the first randomised controlled trials to suggest that increasing the psychological wellbeing even of generally healthy adults can have benefits to their physical health.”

Kushlev and his colleagues at the University of Virginia and the University of British Columbia spent six months examining the impact of improving the subjective wellbeing of otherwise healthy individuals on their physical health.

How the study was conducted

155 adults between the ages of 25 and 75 were randomly assigned either to a wait-list control condition or a 12-week positive psychological intervention that addressed three different sources of happiness: the “Core Self,” the “Experiential Self,” and the “Social Self.”

The first three weeks of the programme focused on the Core Self, helping individuals identify their personal values, strengths, and goals. Then, for the next five weeks, the focus shifted to the Experiential Self, covering emotion regulation and mindfulness. This phase also gave participants tools to identify maladaptive patterns of thinking. The final four weeks of the programme addressed the Social Self, teaching techniques to cultivate gratitude, foster positive social interactions, and engage more with their community.

Called Enduring Happiness and Continued Self-Enhancement (ENHANCE), the programme consisted of weekly modules either led by a trained clinician or completed individually using a customised online platform. None of the modules focused on promoting physical health or health behaviours such as sleep, exercise, or diet.

Each module featured an hour-long lesson with information and exercises; a weekly writing assignment, such as journaling; and an active behavioural component, such as guided meditation.

“All of the activities were evidence-based tools to increase subjective wellbeing,” Kushlev noted.

When the programme concluded, researchers gave participants individual evaluations and recommendations of which modules would be most effective at improving their happiness in the long term. Three months after the conclusion of the trial, researchers followed up with the participants to evaluate their wellbeing and health.

The finding: Becoming happy improves your health

Participants who received the intervention reported increasing levels of subjective wellbeing over the course of the 12-week programme. They also reported fewer sick days than control participants throughout the programme and three months after it ended.

The study found that the online mode of administering the programme was as effective as the in-person mode that trained facilitators led.

“These results speak to the potential of such interventions to be scaled in ways that reach more people in environments such as college campuses to help increase happiness and promote better mental health among students,” Kushlev said.

—Link to original research

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Right now, there is no vaccine for COVID-19, although scientists and researchers are at work. But regardless of a vaccine, the best way to stay protected from the coronavirus—or any other disease-causing microbe for that matter—is to possess a strong immune system, which is nothing but your body’s intrinsic intelligence.

The good news is that you can strengthen your immune system by inculcating a few simple lifestyle habits.

5 healthy habits to build immunity

The five lifestyle habits listed below will protect you not only from disease-causing microbes such as coronavirus but will also help you reduce the risk of many other illnesses such as heart disease, blood pressure, diabetes and even cancer.

1. Hydrate (but not with colas!)

Did you know that having just two tablespoons of refined white sugar temporarily lowers your immune system? And a can of Coke contains as much as eight tablespoons of sugar. Your immune system will thank you for eliminating soft drinks from your diet.

But don’t just stop at that. You need to hydrate yourself and what better way to do that than zero-calorie water? The list of benefits of drinking water is long. Here are a few ways water helps keep your immune system in good shape:

• Water helps carry oxygen throughout the body — to organs, tissues, and blood cells. It pumps up bodily functions to full capacity making you feel and perform better physically.
• Water promotes adaptive immune response. It does so by helping your kidneys get rid of toxic foreign invaders from the body. Water also prevents toxin build-up which, in turn, boosts immune function.
• Water pushes bodily waste into the lymph nodes where lymphocytes destroy them, keeping them from impairing the immune function and causing life-threatening conditions.

So stay hydrated with water. Proactively incorporate the habit of keeping yourself hydrated throughout the day.

Three delicious drinks to improve your immunity with water

1. Lemonade: Vitamin-C helps boost immunity, fights infection and aids digestion
2. Black tea, freshly brewed: Tannins and alkylamines in tea help fight infection
3. Honey Water: Honey has antioxidant and antibacterial properties.

2. Oxygenate

About two-third of your body is oxygen. Oxygenated cells imply that your muscles and organs are working efficiently which, in turn, translates into superior immunity. Due to lack of sufficient oxygen, your lungs could be functioning sub-optimally making you more prone to infections. In fact, COVID-19 is known to affect your lungs. Your lungs bear the brunt of poor levels of oxygen, which is why respiratory infections including common cold, frequent headaches, itchy throat and symptoms of flu, are more common among young, urban professionals and people who are mostly indoors.

Here’s how fresh air keeps your immune system healthy:

• Fresh air helps your lung’s airways to dilate, releasing airborne toxins from your system
• The white blood cells that fight bacteria and other foreign invaders in your body need oxygen to function effectively; no wonder being in open spaces strengthens your immunity
• Oxygen is antiviral in nature; oxygen in blood helps reduce viral proliferation.

Easy ways to improve oxygen intake

1. Open doors: Open windows, doors and let in sunlight and fresh air as often you can
2. Take regular breaks at work: Allow yourself a few minutes of fresh air during work hours
3. Do deep diaphragmatic breathing: By helping your lungs to expand, it maximises your oxygen inhalation. It also switches off the fight/flight response and activates your body’s rest and repair mechanism for healing and recovery
4. Incorporate Pranayama in your daily schedule: It helps reduce stress and anxiety, which boosts the immune system
5. Place indoor and outdoor plants: Having plants in your home and workplace helps purify air

3. Move

“A body in motion shall keep moving longer
A body at rest shall rest in peace faster.”

Regular physical movement is key to good health. Just like healthy eating, exercise contributes to general good health and therefore to a healthy immune system.

Here are three ways how exercising can strengthen your immunity:

• Regular moderate exercise reduces the risk of infections as compared to a sedentary lifestyle
• Physical movement promotes good circulation, which allows the cells and substances of the immune system to move through the body freely and do their job efficiently.
• Moderate physical activity helps flush bacteria out of the lungs and airways (beneficial for COVID-19). This may reduce your chance of getting a cold, flu, or other illness.

4 ways to get sufficient exercise

1. 1. Yoga: Try Surya Namaskar — it is a great way to move your entire body and has many proven health benefits
   2. Walking or Running: Walking and running are among the best forms of cardio workout
   3. Home Workout: Without stepping out of your home, you could do skipping, trampoline jumping, and Tabata
   4. Resistance: Push ups, pull ups, squats, burpees, jumping jacks are great ways to use your body weight to strengthen your muscles and your immunity.

4. Nourish

What you eat decides whether you’re feeding the virus or your immune system. Food influences as much 70% of your immune system.

Checklist of dietary changes for boosting immunity

1. Eliminate: All types of processed food including meat, refined oils and dairy. Frozen and ready-to-cook foods are a strict no-no
2. Consume moderately: Fresh meat (cooked with bone), whole eggs, fresh curd and cow milk, healthy fats like ghee, coconut oil, olive oil and other healthy cold pressed oils. If you are a vegetarian or vegan, get good quality oils and protein from vegetable sources like nuts and seeds
3. Eat more: Fresh fruits and vegetables, sprouts, lentils and other veggies
4. Vitamin D3: Check your Vitamin-D3 levels for better immunity
5. Pre & Probiotic for Gut Health: Gut health is vital for a healthy immune system. Add foods rich in probiotics: rice kanji, fermented vegetables, homemade pickles, good quality yogurt. Also include prebiotics such as garlic, banana, apple cider vinegar, apples.
6. Include immune boosting foods: Ghee, cold pressed coconut oil, turmeric and black pepper combination, amla, garlic, ginger, onions, citrus fruits, dates, pumpkin, pumpkin seeds, cucumber, carrot, capsicum, celery, jowar, masoor and chana dal.
7. Eat home cooked food: Commercially prepared food contains many ingredients that can weaken your immunity

5. Sleep

Your body, and especially your brain, needs a good night’s sleep for healing and repair. Sleep is the elixir for our wellbeing because it is considered as an important modulator of our immune system.

Did you know? Sleeping less than five hours a day reduces your immunity by as much as 70%. Water, oxygen, exercise or good food are necessary but cannot compensate for the lack of sufficient sleep.

Fact: World Health Organization (WHO) regards working night shifts as a probable carcinogen (cancer causing) because it disrupts the body’s Circadian Rhythm.

Key points to remember about sleeping enough

1. Regularity: One cannot over-emphasise the importance of a regular sleep schedule. Going to bed and waking up at the same time each day is greatly beneficial to your wellbeing
2. Sleep Hygiene: Avoid looking at screens at least two hours prior to sleep; also avoid bright lights as your sleeping time approaches—use dim yellow light instead
3. Dinner gap: Maintain a gap of two or more hours between your last meal and going to bed
4. Duration: Most people need 7 – 8 hours of sleep to be refreshed; get a minimum of six hours
5. Calm the mind: Prepare your mind to relax before sleeping; try some gratitude exercises or a sleep meditation
6. Environment: Make sure your room is cool, dark and comfortable

Remember, the best way to deal with the current crisis is to stay calm but cautious.

The post 5 healthy habits to build immunity against infections like coronavirus appeared first on Complete Wellbeing.

Here are five things I do as I wake up every morning, holidays included, to make sure that my day is happy and productive.

5 Things That Should Be a Part of Your Morning Routine

1. Wake up with gratitude

As soon as I open my eyes, even before I get out of bed, I take a few moments to be thankful for the gift of another day. I then place both my hands on my heart and greet myself with a cheerful “good morning”. I started doing after watching this video by Shauna Shapiro. Try it! It’s a sweet little gesture to begin your day on a happy note.

Then, as I face the mirror to brush my teeth, I do some mirror work as taught by Louise Hay. Mirror work is where you look at yourself in the mirror and say positive and loving things to yourself. Most of us are quick to criticise ourselves for our weaknesses but reluctant to praise and appreciate ourselves for our strengths. And nothing could be worse for our self-esteem than berating ourselves first thing in the morning. So, I make sure to smile at myself when I face my reflection in the mirror each morning and say words of praise and appreciation. This part of my morning routine instantly improves my mood and my energy.

2. Make your bed as soon as you’re out of it

This may seem as something insignificant but it has many benefits. It’s the first ‘task’ of the day and I use it as an opportunity to practise mindfulness.

As I fold the sheets and make the bed, I try to stay in the present moment and not let my mind play a rerun of yesterday’s events or plan for the day ahead. A neat bed makes the whole room look more organised and gives a fresh feeling. Be sure to teach this to your children, early on.

In this talk, Navy Seal Admiral McRaven emphasises how a mundane task as making your bed every morning can give you a sense that the little things in life matter and, if you can’t do the little things right, how can you trust yourself to do the big ones right?

3. Expose your eyes to natural light

The human body has a natural inbuilt clock, known as the diurnal cycle or circadian rhythm. Exposing your eyes to natural light in the morning helps to reset this body clock. I allow natural light fall on my retina as soon as possible in the morning. You could just stand at the window and look skyward. Or go outdoors and soak up the sun to expose your eyes to natural light—vitamin D is a bonus. Exposure to natural light increases the secretion of serotonin, a hormone that makes you alert, awake and feel good. And it’s free! So why not include it in your morning routine?

4. No internet for first 2 hours

In this era of hyper-connectedness, guess what is the first thing we reach out for as soon as we wake up? You’re right: It is the smartphone. Turning on the phone wifi/data [I turn it off before sleeping] results in a barrage of notifications, causing my attention to scatter and bring on a feeling of overwhelm. So I have made it a point not to check my phone till at least two hours after waking up—longer if possible. This also helps me avoid checking my email, social media, WhatsApp messages and news first thing in the morning. It is an entirely avoidable stimulus in the morning, especially because I know it engages my mind in unproductive ways. I make an exception to this morning routine rule only if I am expecting an urgent email or message, and then too keep my focus only on business at hand.

5. Get done with the important stuff

If there is something that you really want to [have to] do, but you tend to push it down on your priority list as the day progresses, get that one thing done ASAP. As a yoga trainer it’s important for me to keep up my yoga practice atleast 3 – 4 times a week [besides other forms of exercise]. On days when I skip my morning yoga in the hope that I will do it in the evening, I’m often unable to do it altogether as other things take precedence. So even if it’s just 10 minutes, I make sure that I do yoga in the morning itself. Whether you need to write, run, read, or practise some skill, make sure you do it in the morning before other important/unavoidable tasks take over your time. You don’t want to end your day with feelings of guilt and regret for not having done what matters to you the most.

I urge you to tweak your morning routine for four weeks; to include the above suggestions and notice the difference to your sense of purpose and your energy levels.

The post 5 Things That Should Be a Part of Your Morning Routine appeared first on Complete Wellbeing.

More sleep means less chances of getting the flu

In 2015 researchers at Carnegie Mellon University conducted a study involving 153 participants who documented their sleep patterns and voluntarily subjected themselves to rhinovirus infused nasal drops. The results were overwhelming, showing that individuals who sleep an average of six hours or less each night are over four times more likely to catch the common cold than those who sleep seven hours or more. Participants who averaged five hours showed even greater susceptibility to infection. In other words, the more sleep you get in the weeks leading up to viral exposure, the less likely you are to catch a bug.

Quality is as important as quantity

But it wasn’t simply the duration of sleep that proved significant in flu prevention. Sleep efficiency, a measure that accounts for overall sleep quality by discounting disturbances and middle-of-the-night awakenings, was the primary predictor of infection. More so than age, BMI, race, sex, season of exposure, psychological factors such as stress, or health practices such as smoking and physical activity, the quality of your sleep is the most predictive measure of your viral susceptibility. So, the deeper you sleep, the less likely you are to come down with a cold or a flu.

Sleep also helps to heal an infection sooner

Sleep not only promotes your ability to avoid infection, but it’s a major factor in the ability to recover once you’ve contracted a virus. Extended periods of deep sleep allow for the production of immune bodies such as T cells. T Cells exist in two varieties, Killer T Cells, which scan the body and destroy infected and cancerous cells and Helper T Cells, which coordinate immune responses through the release of messenger molecules called cytokines. Cytokines travel throughout the body regulating and activating appropriate pathways within your body’s adaptive response to pathogens. Sleep deprivation prevents proliferation of these essential immune bodies, depleting your arsenal and leaving you with weakened defense.

Interestingly, in the Carnegie Mellon study I cited earlier, the sensation of feeling “well rested” was not a sure indicator of good health in study participants. It was the objective measure of sleep quality and duration rather than perceived energy level that carried weight. There is no shortchanging the physiological processes that repair our bodies and brains and bolster our immune responses while we sleep. It’s not always easy to get the 7 – 9.5 hours of sleep necessary to optimise your physical and cognitive health, but if you prioritise your commitments and exercise good sleep hygiene, you’ll be well on your way to kicking the common cold and keeping the flu at bay.

The post Adequate sleep is your best bet in flu prevention appeared first on Complete Wellbeing.

1. Establish a regular sleep-wake schedule

The single most effective strategy for improved sleep is establishing a consistent schedule. Go to bed and wake up at the same time every day. Pre-deadline days, weekends, birthdays, and holidays are no exception; your circadian rhythm does not, unfortunately, accommodate your social life or your professional obligations. It is vital to maintain consistency despite the occasion.

Inconsistent sleep schedules correlate with poor sleep quality, increased sleep latency [time it takes to fall asleep], and shortened sleep duration. To establish consistency in your sleep routine, start by determining your sleep need. The majority of the adult population requires 7.5 to 9 hours each night for optimal performance and alertness the following day. However, this need fluctuates with age and activity level, and is largely specific to the individual.

Studies show that most people overestimate their actual sleep and underestimate their sleep need [you would have thought it’s the other way!], so choose a realistic schedule that fulfills your true sleep need and stick to it. Adding one to two more hours can dramatically change your health, your mood, and your daytime performance.

2. Ditch the snooze button

If you’re getting enough sleep and keeping a regular schedule, you should have no use for an alarm, much less the snooze button. It’s not an issue of mind over matter, it’s a physiological necessity. If you’re not getting enough sleep or if you’re waking up in the middle of a sleep cycle, you’re going to feel drowsy, but pressing the snooze button won’t help.

Pressing it affords you only a few minutes of fragmented rest, which leaves you feeling more groggy than you would otherwise. Either set your alarm later to maximise quality sleep or bite the bullet and wake up on the first alarm and plan for a power nap or an earlier bedtime.

3. Expose yourself to bright light every morning

Your body’s physiological [circadian] rhythm is a symphony of physiological and behavioral patterns conducted by the suprachiasmatic nuclei [SCN], a 20,000 neuron area in the brain’s hypothalamus. Through electrical impulse, the SCN controls the crescendos and decrescendos of body temperature, hormone production and release, neural activity, and resultant patterns of drowsiness and alertness. These cycles maintain a pattern that is nearly 24 hours in length, but they depend on external stimuli, namely light, to keep the cycle in sync with the 24 hour progression of the external world.

Start your day by exposing yourself to bright [ideally natural] light for at least 15 minutes first thing in the morning to “sync” your circadian rhythm and activate the systems that keep you awake and active.

4. Avoid light exposure within one hour of sleep

Melatonin is a hormone chiefly responsible for coordinating your circadian rhythm. Its release is dependent on the absence of light. The absence of light triggers melatonin release, which initiates the onset of sleep and is integral to every stage of sleep thereafter.

Electronic devices like TV and iPads emit daylight spectrum light. As long as you’re in front of a screen or under bright household lights, you’re inhibiting melatonin release and sleep onset. It’s important to avoid light exposure for an hour before going to sleep or wear blue light blocking glasses to prevent retinal stimulation. This cues your body to release melatonin and ready itself for sleep.

5. Cut caffeine from late afternoon to bedtime

It takes at least six hours to metabolise caffeine, so it’s a good idea to stop drinking energy drinks, sodas, coffee, and tea from late in the afternoon until bedtime. Also avoid other caffeine sources, including chocolate or java flavoured desserts and protein bars, and more surprising sources including some weight-loss pills and pain relievers.

The final caffeine caveat is to mind your decaffeinated beverages. The FDA designates decaffeinated coffee as containing 2-5mg of caffeine per 5oz cup. This concentration alone can disrupt sleep and considering that most retailed decaf coffee contains levels far exceeding this limit, it’s wise to completely cut coffee consumption from mid afternoon.

6. Avoid alcohol consumption within three hours of bedtime

If you’re one to partake, you know that alcohol, being a depressant, can make you drowsy. But don’t let this sensation fool you into believing that alcohol consumption aids sleep. Alcohol, in fact, does just the opposite. It disrupts your circadian rhythm, causing mid-night awakenings and preventing restorative REM sleep.

Aside from disturbing your physiological sleep rhythm, alcohol can increase snoring and sleep apnea by decreasing muscle tone and it will likely cause disruptive trips to the restroom [not the kind of rest you want or need].

Avoiding alcohol consumption within three hours of bedtime ensures a restful and uninterrupted snooze.

7. Exercise regularly

Regular exercise reduces the incidence of insomnia, decreases snoring and sleep apnea through weight loss, and improves overall restfulness through improved respiration and circulation.

Body temperature is an important component of circadian rhythm. Core body temperature spikes during exercise, then plummets approximately five hours later. Coordinating this with the natural rise in body temperature in the morning or the natural drop in body temperature preceding sleep optimises the onset, quality, and duration of sleep.

Morning and afternoon exercise are therefore optimal, while evening and late night workouts are likely to delay the onset of sleep. However, if you opt for a morning workout, be sure not to compromise your nocturnal sleep requirement.

8. Eat a balanced, anti-inflammatory diet

When it comes to diet, the major aim is stabilising blood sugar, obtaining necessary micronutrients, and balancing consumption of protein, fibre, and healthy fat. Doing so will promote healthy hormone production and release, avoid inflammation, equip your body with adequate fuel, and ultimately contribute to optimal sleep latency, quality, and duration.

Stabilise blood sugar by eating meal low in glycemic index every five hours. Avoid processed foods and added sugar. This will help regulate cortisol levels, preventing disruption of REM sleep.

Build your meals up from a base of vitamin and mineral rich veggies, clean proteins, and healthy fats. This will provide the necessary precursors for sleep inducing hormones, while minimising inflammation and spikes in blood glucose.

Begin curbing difficult-to-digest foods three hours before bedtime. This includes spicy, fried, and high protein foods. Instead, opt for fruits such as cherries, kiwis, and bananas, which are readily digestible and packed with potassium and magnesium for muscle relaxation.

9. Quit smoking

Cigarette smoke is a multifaceted sleep thief. Nicotine, a stimulant, inhibits the onset of sleep and causes insomnia and increased awakenings. Individuals who smoke cigarettes are also 2.5 times more likely to suffer from obstructive sleep apnea due to inflamed tissues in the nose and throat.

Smoking alters the expression of genes that facilitate circadian rhythms and may permanently hamper the quality of your sleep. Quitting relieves symptomatic sleep problems and avoiding cigarettes altogether places you among the soundest sleeping demographic.

10. Practice mindfulness

Maintaining a prayer life or cultivating a meditation or yoga practice has been linked to healthier sleep habits and sounder sleep. These practices maintain stress hormone levels during the day that otherwise accumulate to disrupt the onset and depth of sleep come nighttime.

Meditation enhances neural plasticity and network synchronisation, which allows for seamless transitions into and out of deep sleep.

The post Daytime strategies to help you sleep better appeared first on Complete Wellbeing.

When you’ve lain in bed for hours, tossed and turned until your body aches, glanced at the clock more times than you can count, tried every mantra, meditation, and visualisation you’ve ever learned to no avail, insomnia has you in its clutches.

Hopefully, it’s a passing phase prompted by external circumstances like an impending exam, a recent breakup, or financial problems. Most people go through periods of difficulty sleeping. But one in ten people struggle with sleeplessness night after night, month after month, sometimes for years, beset by chronic insomnia.

Sleep is fragile

Sleep is remarkably fragile, despite its persistence and universality. All manner of conditions can fray its fabric, and little works to restore the weave once it’s lost. Heat, cold, good food, bad food, solitude, company, noise, silence, new love, the loss of love—you name it—can banish sleep from the bedroom.

There are many things we can do to sleep better, or a little longer. We can cool and darken our bedrooms, establish a regular sleep schedule, avoid stimulants, alcohol, and electronics before bed, take calming teas, supplements, or medications, and learn to control our catastrophising thoughts. These are good things to do, but they rarely crack the nut of habitual insomnia.

Too awake to sleep

One of the most surprising discoveries to emerge from 21st century sleep research is that insomnia is not just a problem with sleep; it is a disorder of our waking lives as well. Scientists have learned that people who struggle with ongoing insomnia tend to live in a state of hyper-arousal characterised by higher body temperatures, faster heart rates, stronger high-frequency brain waves, increased levels of cortisol and adrenaline, and lower levels of melatonin 24 hours a day, whether they are awake or asleep. These folks are remarkably quick and sharp, but their nervous systems run on high alert as if living in a war-zone. Simply put, they are too awake to sleep. In fact, many are somewhat awake even when sleeping!

Eons ago, in our evolution as human beings, our bodies developed the capacity to mobilise in the face of danger, enabling us to respond quickly and forcefully when necessary. If your child runs out into traffic, you need that ability to charge out and grab him or her out of harm’s way immediately. It has an obvious evolutionary advantage. Once your child is safe, your heart will hopefully stop throbbing, your breathing will slow down, and the stress hormones coursing through your blood will return to normal levels.

However, if you are genetically inclined towards anxiety, have experienced long-term stress, repeated traumas, or life-threatening insecurities, your body may gradually lose the knack of calming down, even when resting. The brain simply stays busy and the heart keeps racing regardless of what is happening. When hyper-arousal becomes the norm, rather than the exception, it’s nearly impossible to get good sleep.

Even if you aren’t predisposed towards anxiety, and haven’t experienced major traumas, the pace, pressures and insecurities of contemporary life in the 24/7 global economy may be pushing you into hyper-arousal without your knowing. We are surrounded by bright lights and street noises throughout the night, encouraged to consume stimulating foods and drinks, rewarded for being alert, quick and aggressive, and often required to work longer hours.

No quick fix

How can our bodies remember how to relax enough to sleep under these conditions?

One thing is certain: there is no quick fix. We have to cultivate our abilities to calm down, let go, and go within to counteract the tendencies to gear up, grab on, and get ahead that are so encouraged in our society. Lowering arousal levels is a gradual process that requires many small shifts in the ways we go about our days and nights as we weed out old habits that interfere with sleep and develop new ones to restore calm.

The process is also very individual; there are no standard answers. What helps one person may not help another, or in some cases even make things worse. For example, a family pet may be soothing to one family member and stressful to another. Each of us needs to experiment with lifestyle changes, observe the results, and adapt accordingly.

Here’s what you can do

Here are some things that have helped others:

• Develop a meditative practice that you can do on a regular basis. That can be something as simple as walking to work, listening to music before bed, even closing your eyes and taking three deep breaths a few times a day. Or you could join a weekly meditation group, take a yoga or t’ai chi class, or sing in a choir. Many of these activities involve breathing more fully, which works to calm down the nervous system.
• Practise putting aside your worries, even if you plan to pick them up later. Anxiety is the enemy of sleep. Make a list of what you need to address later, fold it up, and tuck it away. Our unconscious minds mull over our problems while we sleep, and often pose solutions the next day that we couldn’t figure out on our own. A friend of mine likes to imagine that all her anxieties are written out on a large chalkboard; when she lies down to sleep, erasers wipe them away. Napoleon used fall asleep by seeing himself pushing away his concerns as if closing the drawers of a bureau, one by one. When I was a child, I was so anxious about taking tests that I often couldn’t sleep beforehand. Finally, one sleepless night, I had a fantasy that I was an eighty-five-year old grandmother looking back over my life. Did I care how well I did on that math class in third grade? No! Realising that the things that worried me at the time were insignificant in the big picture enabled me to relax and get some sleep.
• Make a point of spending time with people whose company you enjoy. You can comb and braid your children’s hair, or read them bedtime stories, join a soccer team, go out dancing or play cards with friends at the club. We need trust and a sense of safety to unwind. As social creatures, we derive that sense of safety from the people who care for us, look out for us, and have our backs. Money in the bank and locks on the doors can help, but there is nothing like the comfort of relationships.
• Finally, if you can’t sleep, get up and do something. Read, draw, email friends, water plants, have a cup of tulsi [basil] tea or warm milk, whatever. Abraham Lincoln and Charles Dickens used to take long walks when they couldn’t sleep. My grandmother typed Braille books. Doing something will distract you from the effort to sleep, and probably help you to fall asleep later. Besides, it is fine to sleep in stretches of a few hours at a time. Naps are efficient forms of sleep. The key is to remain calm and trust that the sleep you get, however little, is enough.

Remember: climbing back off the ledge of insomnia takes time. Every little step you take to calm your nerves, day after day, night after night, gradually restores the peace that enables sleep.

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As your body rests, the skin repairs itself. When you slip into the second phase of your sleep at night—what we call the delta phase—your hormone levels are at their peak, and that’s when cell repair takes place.

So what happens really is that any damage to the collagen and elastin under your skin that might have taken place due to free radicals are repaired as you sleep. Free radicals are one of the biggest culprits in premature ageing.

Want glowing skin? Then hit the bed every night at around the same time, and sleep well. Give your skin cells time to rest, repair, and restore. If it’s only five hours you can manage every night, then it’s better to sleep early and wake up early than to sleep late and wake up later

As your body rests, the skin repairs itself

Deep sleep = Radiant complexion

Lack of sleep constricts the blood vessels on your face. It looks dull, and lacklustre. Sleep actually helps in collagen production. And you need loads of that for skin that is supple and elastic.

Do you feel tautness in your skin when you wake up? That happens when your skin loses hydration at night as you sleep. All that repair work underneath tends to pull out water from the top layer, that is if your air conditioner spares some.

Do this – Drink at least a glass of water before going to bed and apply a hydrating moisturiser to ensure that your skin does not lose hydration from the outside.

Deep sleep + vitamin enriched night cream = Supple, line-free complexion

You can actually help your skin in its repairing efforts by adding some extra dose of vitamins and essential skin actives. When you wake up your skin will thank you for it. I am sure you will also feel very nice about it too.

Deep sleep + anti-wrinkle under eye cream = Smooth toned, clear sparkling eyes

There’s nothing like a good night’s sleep to fight puffy eyes and dark circles. I am sure you have noticed that after a good night’s sleep your eyes look bright, and the under eye area looks smooth and toned. We Indian girls tend to suffer from uneven skin tone, especially under the eyes. This is something you can take care of as you sleep. A little care goes a long way.

Do this – Buy a lightening under eye cream—look for ingredients like licorice and vitamin E. Don’t rub, but dab the cream in circular motion around the area. Go to sleep and wake up with prettier eyes. Go low on salt after sunset. You can also put two pillows to prop yourself. Sleep on your back and not on your sides or stomach.

There’s nothing like a good night’s sleep to fight puffy eyes and dark circles

Your pre-sleep prepping routine

1. Remove make up, and cleanse your face with a cleanser. Use soft cotton pressed pads to wipe away the dirt
2. Use a face wash to wash off the residue. Exfoliate if you feel the need
3. Go for deep cleansing shower/bath with exfoliating body wash
4. Use a muslin cloth/ towel to dab your face and body. It retains water in the skin without leaving it wet
5. Put on your under eye cream, dab and leave it to soak into the skin
6. Apply an AHA-based hand and body lotion. Slather it on nicely. Massage gently till the lotion soaks in. Apply your foot cream as well
7. Massage a rich night cream all over your face, neck, and décolletage in upward and circular motion
8. Drink a glass of warm water before going to bed.

The Sleep Pattern

First three hours: You get the deepest sleep of the night. Your body produces the most human growth hormones, which are crucial to skin and hair repair.

Middle two hours: Deep sleep shortens and rapid eye movement (REM) sleep begins. Melatonin, a hormone that’s also a skin-protecting antioxidant, increases.

Last three hours: This is when you get the most REM sleep. Your skin’s temperature reaches its lowest point and your muscles relax, giving your skin its deepest recovery.

Sleeping positions: Be mindful of your sleeping positions. Always sleep on your back. Compressing your face against the pillow will cause more creases, alter facial shape, and cause acne.

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Within 15 minutes of your child falling asleep, he enters his deepest sleep of the night. This period of slow wave sleep, will typically last from 45 – 75 minutes. At this time, most children will transition to a lighter sleep stage or will wake briefly before returning to sleep. Some children, however, get stuck—unable to completely emerge from slow wave sleep. Caught between stages, these children experience a period of partial arousal.

Partial arousal states are classified in three categories: sleep walking, confusional arousal, and true sleep terrors.

These are closely related phenomena that are all part of the same spectrum of behaviour. Sleep terrors are more common in boys and less common after age seven.

How long do night terrors last?

Most often, a confusional arousal will last for about 10 minutes, although it may be as short as one minute, and it is not unusual for the episode to last for a seemingly eternal 40 minutes.

Are these similar to nightmares?

Nightmares are quite common, occurring in about 60 per cent of children in the preschool years. You won’t become aware of your child’s nightmares until after she awakens and tells you about them. They are scary dreams that usually occur during the second half of the night, when dreaming is most concentrated. A child may be fearful following a nightmare, but will recognise you and be reassured by your presence. She may have trouble falling back asleep, though, because of her vivid memory of the scary dream.

What does it mean if your child has confusional arousal?

When most people speak of sleep terrors, they are generally referring to what are called confusional arousals by most paediatric sleep experts.

Confusional arousals are quite common, taking place in as many as 15 per cent of toddlers and pre-school children. They typically occur in the first third of the night on nights when the child is over-tired, or when the sleep-wake schedule has been irregular for several days.

A confusional arousal begins with the child moaning and moving about. It progresses quickly to the child crying out and thrashing wildly. The eyes may be open or closed, and perspiration is common. The child will look confused, upset, or even “possessed” [a description volunteered by many parents]. Even if the child does call out her parents’ names, she will not recognise them. She will appear to look right through them, unable to see them. Parental attempts to comfort the child by holding or cuddling tend to prolong the situation.

True sleep terrors

True sleep terrors are a more intense form of partial arousal. They are considerably less common than confusional arousals, and are seldom described in popular parenting literature. True sleep terrors are primarily a phenomenon of adolescence. They occur in less than one per cent of the population. These bizarre episodes begin with the child suddenly sitting bolt upright with the eyes bulging wide open, and emitting a blood-curdling scream. The child is drenched in sweat with a look of abject terror on his or her face. The child will leap out of bed, heart pounding, and run blindly from an unseen threat, breaking windows and furniture that block the way. Thus true sleep terrors can be quite dangerous, in that injury during these episodes is not unusual. Thankfully they are much shorter in duration than the more common confusional arousals of the pre-school period.

The tendency toward sleepwalking, confusional arousals, and true sleep terrors often runs in families. The events are frequently triggered by sleep deprivation or by the sleep schedule’s shifting irregularly over the preceding few days. A coincidentally timed external stimulus, such as moving a blanket or making a loud noise, can also trigger a partial arousal.

Interestingly, a study published in The Journal of Pediatrics in January 2003, showed that children who have recurrent partial arousal states may also have other sleep disorders [including sleep disordered breathing and restless leg syndrome] that may benefit from a physician’s care.

How does one treat night terrors?

Treatment usually involves trying to avoid letting the child get over-tired, and keeping the wake/sleep schedule as regular as possible. When an event does occur, do not try to wake the child—not because it is dangerous, but because it will tend to prolong the event. It is generally best not to hold or restrain the child, since her subjective experience is one of being held or restrained; she would likely arch her back and struggle all the more. Instead, try to relax and verbally comfort the child if possible. Speak slowly, soothingly, and repetitively. Turning on the lights may also be calming. Protect your child from injury by moving furniture and standing between him or her and windows. In most cases the event will be over in a matter of minutes. True night terrors, or bothersome confusional arousals, can also be treated with medications, hypnotherapy, or with other types of relaxation training.

Recently, my youngest son was having a confusional arousal, and his mother observed that these events are most common at the same ages that children are becoming aware of the bladder feeling full during sleep. Perhaps some of these kids just need to go to the bathroom? We stood him in front of the toilet, and he urinated, still not awake. The episode faded abruptly, and he returned to sleep. The calm was dramatic.

Was this a coincidence? Or might this be a revolutionary new help for parents whose kids have these frightening episodes? I have sat with my children through confusional arousals, and know how powerfully these episodes tug at a parent’s heart. Just understanding what they are [normal childhood sleep phenomena that children outgrow—not a sign of maladjustment or the result of bad parenting] helps tremendously.

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When it began for me, I can’t remember. What I do remember is the following scene, played at various times throughout my youth:

“But I can’t sleep!” I’d protest as my parents tried to wrestle me into bed at what they called a decent hour, meaning any time before 1 am.

“Nonsense,” said my father, “of course you can. “Everyone knows how to sleep. Why, even animals know how to sleep. Just close your eyes, relax, and you’ll get sleepy. It’s the most natural thing in the world, sleep.” My father was a normal sleeper, and to the normal sleeper, sleep is “the most natural thing in the world.”

“But Daddy, I can’t! I don’t know how!”

“Well, you get all wound up. Now if you’d only listen to your mother and go to bed earlier…”

My father was a doctor, an old-style family practitioner who carried a black bag and delivered babies at home, one of a heroic, vanished breed. But that didn’t mean he knew a thing about sleep. Sleep had no part in the medical school curriculum at Yale in the 1930s. Sleep has little part in medical curricula today, when doctors get an average of one to two hours instruction in sleep disorders. The advice he gave me is a version of the advice I’ve been hearing ever since: you’re stressed out, you’re anxious, you’re depressed, you have poor habits, if you only wouldn’t stay up so late… Take a hot bath, drink a glass of warm milk, don’t let it get you down.

We hear a lot of cheer-up-it’s-not-so-bad advice: “Don’t worry about it—you probably just worry too much.” “You probably just need more exercise—try yogi” [that’s not a typo]. I have tried yoga. I swim three times a week and walk on the days I don’t swim.

The well meaning advice that is always useless

When people can see a problem, they can understand and empathise. But when a condition is invisible—and when it goes on and on for no apparent reason—it calls forth a lot of dumb advice. Friends of mine who live with chronic pain, headache, back pain, arthritis tell me they also get advice like this. And insomnia is not easy for us to talk about.

“Oh, you know, a bad night,” I say to a colleague on one of my walking-into-walls days. “Why, Gayle, what do you have to lose sleep about? You’ve got no problems,” says my colleague, eyebrows raised. If I’d been up with a bad tooth or a sick child, that’s something he would understand. If I just plain ‘can’t sleep’, that’s weird.

“Toughen up, get a grip”­—we hear this from friends, family, and doctors. “Nobody ever died of insomnia” is something else we hear a lot. [Actually, that may not be true: insomnia puts us at higher risk for depression, alcoholism, suicide, accidents, hospitalisations; although we may not drop dead of it the next day, it may be cutting years off our lives.]

Some of the least helpful advice I’ve heard comes from the ‘experts.’ “Insomniacs may be naturally short sleepers who are unaware of their lessened need for sleep,” wrote a Stanford researcher in 1993. “Their notion that they need more sleep is an ‘erroneous assumption.’” “Worries by such insomniacs about a ‘lack of sleep’ are unjustified,” says British researcher James Horne, who is himself, as he told me, a good sleeper: insomniacs “just need to be reassured that their sleep is sufficient, despite what they believe in this respect.”

Trust me, if I were a short sleeper, I’d know it by now. I have known such people. I’m not one. I’m a person with a normal seven-hour sleep need, trapped in a body that seems to think I’m someone else.

The invisible problem of insomnia

It’s no surprise that insomnia is not taken more seriously, since sleep itself is not. This is a 24 x 7 culture where “sleep is for the weak,” “you snooze, you lose.”

And yet humans are programmed—or most are—to spend a third of their lives in sleep. Researchers still can’t tell us exactly why we need sleep, but they do know that we need it. They can see what happens when we do without. Studies show that sleep deprivation compromises immune function, ratchets up the stress system and creates hormonal imbalances that predispose us to weight gain and diabetes.

I can tell you what sleep deprivation does to me. It hollows me out, eats me away, takes me apart. These are terms I heard from the insomniacs I talked to while writing my book Insomniac—comatose, spaced out, running on empty, nobody’s home, zombie, zomboid, zombied out—such words describe our feeling that our souls and spirits have taken leave, only our physical shapes are left stumbling around, as in that old movie The Night of the Living Dead.

Lose sleep, lose your ‘self’

When you lose sleep, you lose the better part of yourself. Creative thinking is one of the first things to go, along with mood. Researchers who give sleep-deprived subjects tests that require flexibility, the ability to change strategy and generate unusual ideas, find these capabilities impaired. Neuroimaging shows that the frontal cortex, the seat of “higher order” mental abilities [sometimes called the frontal lobes], is most affected: it doesn’t light up, as it does in the scans of people who’ve slept well. This is the most recent addition to the human brain, in evolutionary terms; on this, the so-called executive functions depend—selective attention, problem solving, decision making, organisation, judgment, reason, abstraction, language. This is where humans are thought to form their sense of who they are, the seat of self-awareness; this is where the self resides. And this is what’s most clobbered by sleep deprivation.

The dreams we miss

When your sleep is as broken and truncated as mine, you’re deprived of REM [rapid eye movement], the sleep stage where we have the most vivid, memorable dreams. Something in nature wants us to dream, since between a quarter and a fifth of sleep is normally spent in REM. That’s six or seven years of a 90-year life. And when we’re deprived of REM, the brain tries to make up for it; there is rebound, an increase in the amount and intensity of REM.

Nobody knows exactly what dreams are for, but recent research suggests that they’re associated with learning, the laying down of new neural pathways and reinforcing of old ones. And the learning that’s at stake here is much more than the French phrases we try to cram into our memory on a flight to France: it’s about extracting meaning from the world around us, making sense of our experiences, making judgment calls, negotiating a delicate situation with a colleague, say, or heading off a divorce. Anything that undermines these processes compromises our ability to deal with our lives.

Sleep repairs your life

If lack of sleep takes us apart, sleep puts us back together again, knits up the ravelled sleeve of care. On days when I wake up after seven or eight hours of sleep [which almost never happens without medication, alas], I’m all there, mended in mind, body, and mood. My head doesn’t ache and my heart doesn’t pound and my skin’s not parched and my eyes don’t sting and tear, and the world comes into focus. I can face the book I’m writing, the classes I’m teaching, the stacks of papers on my desk and floor. I know what goes where and how it fits together, and I have energy to take it on.

It’s ironic that sleep is sometimes feared as the loss or disappearance of the self, when it may actually be the way we become most fully ourselves, our most creative, intelligent, and alive. You might even say: I sleep, therefore I am.

There are many ways people come by insomnia, many routes to this place. Some insomnia is inborn and genetic, some is hormonal, brought on with menopause, and some is conditioned—i.e., we go through a stressful period and then it settles in. But much is simply not understood. People are differently endowed in the sleep department, as in all other departments.

I wrote Insomniac to find out what is known about insomnia, and to hear from others who live with the condition about what they’ve found that works. There are plenty of experts who are ready with glib advice, but we are the ones who live in our bodies—we are the ones who can say what works. So read widely, go on the web, learn all you can—the web is a goldmine of information [misinformation, too, of course]—and find out what people say. Then try things out for yourself, being careful, of course, and knowing that someone else’s experience with a method or medication may not be yours. There’s no one-size-fits-all solution; there is only what you can cobble together that works.

This was first published in the October 2014 issue of Complete Wellbeing.

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