Make the most of your morning hours for more productive days

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Family Features - From a regenerative bath to that first cup of coffee, early morning rituals have the power to heal, restore and fuel. They can leave you feeling accomplished, empowered and ready to take on the day. How you spend your hours from 5-9 each day can ensure you're well prepared to tackle whatever your 9-5 throws your way.

Establishing a well-planned and consistent routine removes the guesswork and makes it easy to accomplish more during these essential hours that set the stage for the day ahead. Get a jumpstart on your day with these tips to make the most of your morning routine.

Set Personal Goals

Just as no two people are exactly alike, your morning routine should reflect your unique needs. Some people need these early hours to ease out of sleep and gradually work toward a busy day while others jump out of bed ready to set the day in motion. Decide what you can realistically accomplish in your waking hours before you hit the office or school drop-off line and plan a sequence that makes sense for you and your family. When you have a steady routine in place, it's typically easier to keep up with habits like early morning workouts, and on days when your energy is lagging, you can shift into autopilot and still get everything done.

Create a Rejuvenating Space

No matter your 5-9 routine, the bathroom is central to it. You can start the day with a more positive outlook when you get ready in a space that's equal parts functional and beautiful. With stunning design, innovative features that make life easier, environmentally conscious performance and do-it-yourself installation ease, the Aspirations Collection from American Standard provides a full suite of bathroom products to start your day right.

This collection gives you plenty of reason to consider upgrades, whether coordinating a full bathroom and accessories or installing just one or two elements like a unique faucet. Choose one with a pull-out, swivel spout to quickly clean those hard-to-reach corners or a touchless option for hands-free convenience. Find the right sink to match with four different stylish options that lend a personal design while streamlining morning routines for you and your family. Awaken your senses with a four-function showerhead and keep all your bathing essentials organized with a clever shelving wall panel. Reflecting nearly 150 years of quality craftsmanship, design and reliability, each piece within the collection delivers big on style and performance.

Practice Good Sleep Habits

The way you end each day influences how you start the next one. Going to bed on time, avoiding screen time before you turn out the lights and creating a comfortable sleep environment are all keys to restful sleep. However, managing your sleep doesn't end once you reach dreamland; your wake-up routine is also an essential aspect of a healthy sleep schedule. One of the biggest detriments to quality sleep is hitting snooze to delay your day. Just a few more minutes easily becomes 20, 30 or more and none of that time is quality rest, so you're not really gaining anything.

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Ensure You're Well-Equipped

Few things can sidetrack a good morning routine like discovering an empty bottle of shampoo or an empty can of shaving cream. Make a habit of regularly taking inventory of your morning supplies. Watch for sales so you can keep backups on hand to ensure you'll always have your favorite toiletry items ready to help you feel refreshed and ready to go.

Make Time for Breakfast

Countless studies affirm the importance of a well-rounded breakfast. Researchers have found good nutrition provides fuel to help give you energy, promote clearer thinking and problem solving, improve mood and memory, and more. If you can't stomach a full meal, look for alternatives to give your system a morning boost, such as a protein-rich smoothie early and a more substantial snack later in the morning.

Enjoy a Mindful Moment

Making time to relax or do something you enjoy can set a positive tone for the day. You might savor a few quiet moments over a cup of coffee or spend quality time with a pet. Early morning light and nature sounds can provide calming background for meditation, or you might simply use the time to organize your to-do list so you feel better prepared to tackle the day.

Take Time to Tidy Up

When it's time to put the workday behind you, it can be easier to make the mental shift from work mode to life mode when there's not a list full of chores awaiting you at home. As part of your morning routine, make your bed, clean your vanity countertop and complete other small chores to make your evening load lighter.

Boosting your immunity, expert offers a few tips

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NewsUSA - The recent pandemic highlighted the importance of keeping your immune system strong and healthy. According to Leonard A. Farber, MD, a healthcare executive and expert in emerging technologies and their impact on public health, a weak immune system increases your risk not only for developing illness, but an even more severe case if you do become ill with something such as COVID, says Dr. Farber, who also serves as a spokesperson for nutritional supplement manufacturer Quadramune.

Fortunately, there are many ways the average person can strengthen his or her immune system. In many cases, following the obvious and well-known advice to get enough sleep, eat a healthy diet, and exercise regularly can help boost your immune system. Other factors include avoiding smoking and excessive alcohol consumption, and incorporating ways to relieve stress, such as with yoga, tai chi, or other mindfulness-related activities.

In addition, the right nutritional supplements can play an important role in reducing inflammation in the body and supporting a healthy immune system, says Dr. Farber. “At early stages, our bodies’ inflammatory response can fight off infection as well as play an integral role in injury repair. When inflammatory cells reach an unhealthy level such as in chronic inflammation, they can trigger your body’s immune system to attack healthy tissues and organs,” Dr. Farber explains.

Nutritional supplements, such as those developed by Quadramune, are designed to help keep the immune system in balance. Anti-inflammatory foods such as salmon, tofu, walnuts, grapes, and olive oil can have a positive effect on the immune system, and many of the active ingredients in these foods are actually found in Quadramune supplements.

The Quadramune supplements provide the benefits of infection-fighting power and protection against chronic inflammation, according to the company website. Several key ingredients in Quadramune supplements include:

Pterostilbene. A natural dietary compound that has shown antioxidant activity and inflammatory properties.

Epigallocatechin gallate. This powerful antioxidant plant compound boasts antioxidant properties and potential ability to help protect the lungs and promote healthy T cell activity.

Sulphoraphane. This natural plant compound has been shown to help reduce inflammation, which may help protect your lungs and reduce your vulnerability to respiratory infections.

Thymoquinone: phytochemical compound found in the plant Nigella sativa. This active ingredient is chemically related to hydroxychloroquine, but with no prescription needed. It has demonstrated to stimulate natural killer (NK) cells which are antiviral, and is a potential antiviral itself based on its mechanistic effects on cells.

This combination of ingredients “can be immune stimulating or boosting and preventative of an unhealthy immune response,” says Dr. Farber. “This allows the body a better chance not only to fight the onset of an infection or inflammatory reaction but also to lessen the severity of certain illnesses, especially those that are inflammatory-based in nature,” he adds.

For more information, visit buyquadramune.com.

Daylight Savings Time is coming, start preparing your body for time change

Photo: Andrea Piacquadio/PEXELS

Family Features - Millions of Americans will soon get extra sunlight in the evenings when daylight saving time (DST) - observed by every state except Arizona and Hawaii - begins on the second Sunday in March and clocks are set ahead by one hour at 2 a.m.

While the extra daylight is a welcome change for most, failing to prepare for DST can have consequences. In fact, research from the Sleep Foundation has found a lack of sleep caused by the time change can affect thinking, decision-making and productivity. The change can alter your circadian rhythm, the body's internal clock that helps control sleep and other biological processes, which may cause mood fluctuations, and the transition has been associated with short-term risk of heart attack, stroke and traffic accidents.

However, making small adjustments ahead of DST can help reduce its impact on your sleep and minimize negative effects. Consider these tips to help navigate the time change.

Reset Your Internal Clock
As you get ready to "spring forward," gradually adjust your sleep schedule throughout the week leading up to the time change, which can help prevent unnecessary shock to your system. The American Academy of Sleep recommends going to bed 15-20 minutes earlier each day than normal, and other daily activities like mealtimes and exercise can also be moved up slightly to help acclimate to the change. Awakening earlier and getting extra light exposure in the morning can also help adjust your circadian rhythm.

Upgrade Your Sleep Environment
Creating a bedroom environment that is conducive to sleep can help ensure you get a good night's rest, which is especially important leading up to the time change when you effectively lose an hour of sleep. Start optimizing your sleep space comfort by choosing a supportive mattress and comfortable bedding then block out unwanted light with blackout curtains and dampen unwanted noises using a fan or soothing white noise machine.

To help regulate temperature, set the thermostat to 60-70 F - a cooler thermostat setting helps maintain a lower core temperature - then adjust if too hot or too cold by adding or removing blankets or changing your pajamas. Lavender essential oils, or another fragrance like peppermint or heliotropin, can also help improve relaxation and sleep quality.

Avoid Screens Before Bed
In the days leading up to DST, experts recommend turning off electronics, including televisions, computers, smartphones and tablets, at least 1 hour before bedtime as the blue light from screens can suppress production of melatonin, the substance that signals the body it's time for bed. If necessary, cut back on screentime in smaller increments leading up to the time change or swap evening screen usage for other activities like crossword puzzles, meditation or reading a book.

Phase Out Caffeine in the Evenings
While avoiding caffeine later in the day can help you fall asleep easier at night, experts suggest limiting and slowly reducing your caffeine intake in the days prior to DST. Choosing half-caffeinated coffee, mixing regular and decaf or cutting out 1-2 caffeinated drinks during the week can help sleep patterns ahead of the change. However, be wary that giving up caffeine "cold turkey" can sometimes lead to headaches.

Find more tips for healthy living all year at eLivingtoday.com.

The video sharing app seems to have something for everyone – from makeup trends and relationship advice to comedy sketches and life hacks. In fact, the company’s tagline in TV commercials is even, “TikTok taught me.” While recipes, fashion finds or cleaning hacks found on the app can certainly provide a smile, improve your life or save you time – sometimes the advice from TikTok influencers can fall flat, especially when that advice is medical in nature.

Crushing the SAT or ACT Exam; how to prep the night before

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StatePoint Media - Taking the SAT or ACT exam is the culmination of months of test-specific preparation, and in truth, years of schooling. While knowing that can feel like a lot of pressure, there are steps you can take the night before the exam to calm your nerves and enter the testing site with confidence:

1. Pack your essentials: Going to bed knowing you’ve packed everything you need to succeed during the test will help you sleep soundly and make the morning less frenzied. Your packing list should include an official, currently valid photo identification, your admission ticket to the test, No. 2 pencils (be sure they have erasers), a snack and water bottle (staying fueled is essential), a sweater (testing sites are often chilly and being uncomfortable can throw you off your game), and of course, a calculator.

The best exam day calculator is one that’s easy to use and has an intuitive icon menu, such as the fx-9750GIII graphing calculator. While you won’t need all of its 2,900 functions during your test, or its programming capabilities, this Casio calculator is a great companion for high school juniors and seniors as it can support high-level STEM learning in the classroom, as well as go into exam mode for use during the PSAT, SAT, ACT, and other major standardized exams, like AP and SAT subject tests. To familiarize yourself with the calculator and its interface, be sure to use the same calculator for test prep as well.

2. Eat right: Proper nutrition and cognition go hand-in-hand. The night before your exam, fuel yourself with brain foods containing a mix of antioxidants, protein and Omega-3s. Fresh fruits and vegetables, fish, nuts, beans, whole grains, tofu and lean meats are all great choices. Try to avoid food unfamiliar to you, as you don’t know how it will settle and it could cause a stomachache.

You should also forgo overly sugary or processed treats, which can lead to an energy crash. Being thirsty during your test is not only distracting, dehydration can actually impair cognition and brain health. Be sure to drink plenty of water the night before your test to keep the mental juices flowing.

3. Sleep tight: It can be difficult to settle in for a night of sound sleep before an important event. Reduce the chances of tossing and turning by putting down your devices at least an hour before bed, as blue light can suppress melatonin secretion and impact sleep. Instead, read, journal or do another quiet, enjoyable activity. On that note, avoid a last-minute study session or practice exam.

The night before the test is not the time to cram. It’s a time to relax so your mind is fresh when it counts. If you do have trouble falling asleep, don’t panic. Resting quietly with your eyes closed can be beneficial too, and may help you doze off eventually.

By checking a few pre-test tasks off your to-do list the night before, you can be fueled, rested and geared up for your college entrance exams.

Napping, how much sleep should infants and small children get

by Tim Ditman
OSF Healthcare

DANVILLE - Decades ago, a day at school for a kindergartener would usually involve an afternoon nap. Today, some schools have phased that out, leaving parents to wonder what’s right.

Luis Garcia, MD, an OSF HealthCare pediatrician, says daytime sleep plays an important role in a child’s development. He says parents should look at it in terms of daytime sleep and nighttime sleep added up to total sleep. He stresses that each child has unique needs, and you should get to know your child’s sleep habits. But there are guidelines. For young kids, Dr. Garcia says nighttime sleep stays mostly consistent at 10 hours. Daytime sleep varies by age.

“Usually, the need for naptime decreases when kids reach 4 to 6 years old,” Dr. Garcia says. “At that point, they only need to sleep the 10 hours at night.”

When and how long

Dr. Garcia says naps for kids should be 30 minutes to two hours. So, you can do some math. For example: your 2-year-old needs four hours of daytime sleep with naps no greater than two hours. So, aim for some two-hour slumbering mid to late morning and early afternoon.

“It’s not recommended to nap after 3 or 4 p.m. to avoid causing disruptions at bedtime,” Dr. Garcia warns. “We want to allow at least four hours between last nap and bedtime to avoid the kids being too tired at bedtime.”

Bad nighttime sleep leads to irritability and poor concentration the next day, he adds.

No more naps

Dr. Garcia suggests parents look for signs that their child is ready to stop napping.

“Is the kid refusing or having a hard time taking a nap? If they do take a nap, do they have a problem falling asleep at night?” Dr. Garcia asks.

You should also talk to your child’s school or day care. If they have daily nap time, let that continue until the child ages out of the facility. If the facility is flexible, inform them of your child’s sleep habits and come up with a plan.

When the time comes to stop naps, Dr. Garcia recommends a clean break. There will likely be some fussiness, but it will subside. Moving bedtime up by 20 to 30 minutes can help.

Sleep tips Some general good sleep tips:

Make your home’s lighting natural: bright during the day, darker as night approaches and dark at night.

Make the bed the place to sleep. Do other activities like looking at screens in another room, and don’t look at screens right before bedtime.

Get into a routine by going to sleep and waking up at around the same time each day. And make the sleep and wake times normal. Waking up mid-morning each day, while a routine, isn’t the best idea.

Avoid large meals and caffeine before bed.

If you are a light sleeper, use an artificial noise machine.

Sundowning; What happens when the sun goes down

by Tim Ditman
OSF Healthcare

Courtney McFarlin, PA

GODFREY - The 2015 horror film “The Visit” gives the Hollywood treatment to sundowning. An impostor grandmother is seen running the halls, scratching the walls and vomiting, terrorizing two children in the home.

A little exaggerated, says Courtney McFarlin, PA, an OSF HealthCare internal medicine provider who specializes in geriatrics. But she says sundowning is an all too real experience for some older adults.

What is sundowning?

McFarlin explains that sundowning is not a medical condition, but rather a way to describe behavior seen at night. It’s triggered by a disruption in your circadian rhythm.

“That’s our body’s natural, 24-hour sleep/wake cycle,” McFarlin says. “It’s regulated by the hypothalamus in the brain. Based on daylight and darkness, it tells our body to be alert during the day. And it helps us settle down in the evening to want to go to sleep.”

Key takeaways:

Sundowning describes nighttime behavior in older adults, especially those with dementia, due to a disruption in the circadian rhythm. The person may be agitated, moody, not want to go to sleep or physically aggressive.

Ways to help include medicine like melatonin, eliminating long naps and practicing general good sleep hygiene. Homes should also be arranged so the elder does not fall or wander outside.

A caregiver may ultimately have to decide whether to move the person to an assisted living facility.

Many things can disrupt your circadian rhythm, like illness, stress, artificial light and genetic factors. But McFarlin says sundowning is most often seen in older adults with dementia and similar disorders like Parkinson’s disease and Huntington’s disease. Chronic alcohol use can also bring about sundowning.

What does sundowning look like? McFarlin says the person may be agitated, have mood changes and pace around. They may not want to go to sleep. And the person may even physically lash out at others.

“Reports and research have shown that it’s most common when people are in mild or moderate stages [of dementia],” McFarlin says. “You would think as one progresses with dementia, it would get worse. But it actually improves a little bit.”

How to help

McFarlin says caregivers of older adults often come to her with a plea: help us do something about my loved one’s nighttime behavior. The caregivers are sometimes awake through the night keeping an eye on things, leading to sluggishness, crankiness and other issues during their workday.

First, McFarlin reminds you that support groups exist – if not in-person in your community, then online – for caregivers of older adults. But for medicinal aids, McFarlin says melatonin is a good first option.

“It’s a natural hormone that our body produces that helps aid in sleep,” she says.

McFarlin adds that studies have found decreased levels of melatonin in older adults with or without dementia.

Serotonin-based medications, hypnotics and anti-anxiety medications can also help. Paxil, Prozac, Seroquel, Risperdal and Haldol are common brand names. Talk to your health care provider or a sleep specialist if you have questions about these medicines.

Something to strike from your loved one’s routine: long naps.

“It’s suggested that a less than three-hour naptime schedule is advised,” McFarlin says. “If I find my patients are napping quite a bit, I’ll encourage them to take less naps.”

Other sleep hygiene tips:

Make your home’s lighting natural: bright during the day, darker as night approaches and dark at night.

Make the bed the place to sleep. Do other activities like looking at screens in another room, and don’t look at screens right before bedtime.

Get into a routine by going to sleep and waking up at around the same time each day. And make the sleep and wake times normal, as if the older adult was going to work. Waking up mid-morning each day, while a routine, isn’t the best idea.

Avoid large meals, caffeine and alcohol before bed. McFarlin says lunch should be the biggest meal.

Stay busy during the day so you feel tired at night. Regular exercise can help with this.

If you are a light sleeper, use an artificial noise machine.

Since people with sundowning behaviors can pace and wander, make sure your home is trip-proof and escape-proof. Rugs, chairs and nightstands should be moved or removed. McFarlin says providers can also recommend physical therapy or devices like a walker, wheelchair or bed alarm.

“[People can] actually unlock the door and wander outside in the middle of the night,” McFarlin warns. “So, make sure the door is properly locked. If the adult is someone who wanders at night, make sure they don’t have the ability to leave home.”

Ultimately, you may have to decide whether a different living arrangement is best for your loved one.

“That could be remaining at home and more family coming in. Because that’s our first choice – to leave the person at home as long as they can,” McFarlin says.

“But when it becomes unsafe for the person or exhausting the caregiver, it’s my responsibility to engage other options,” like an assisted living facility, she says.

Clinical trial for people who can't sleep with CPAP in progress

Photo: Quin Stevenson/Unsplash

BPT - If you are one of the more than 35 million Americans who are estimated to have obstructive sleep apnea (OSA), you already know how disruptive it can be to your life. While OSA is one of the most common and serious sleep disorders, the condition is widely under-diagnosed, so the number of affected Americans may be far greater.

What is obstructive sleep apnea?

OSA occurs when the muscles in the throat relax during sleep, blocking normal breathing. This can lead to low levels of oxygen in your blood while you sleep and result in poor sleep, fatigue and sleepiness that can negatively impact quality of life for many. In the long term, OSA has also been shown to contribute to high blood pressure, diabetes, cardiovascular disease and stroke.

Most people diagnosed with OSA are prescribed positive air pressure therapy devices such as continuous positive airway pressure, or CPAP, which can work very well in helping people receive the oxygen they need while they are sleeping. However, because many have difficulty using or tolerating these devices, a significant percentage of the population with OSA remains untreated, undertreated and at risk.

A new option for treating obstructive sleep apnea

Apnimed is a pharmaceutical company working to change the way OSA is treated. The company recently completed a large Phase 2b clinical trial, called MARIPOSA, to study AD109 (an investigational medication which is a single pill taken at bedtime) as a possible treatment for obstructive sleep apnea.

AD109 has the potential to be the first oral medication that treats both the underlying cause of OSA - airway obstruction at night - and improve the daytime symptoms of OSA, such as fatigue. It is designed to treat people with OSA from mild to severe.

Many patients with OSA are unable to adequately treat their condition with existing options, and the team at Apnimed is driven to find new solutions for patients and their doctors to overcome these barriers to treatment. The success of this effort is largely dependent on the dedicated work done by patients and doctors in the community who take part in clinical research.

"MARIPOSA results showed that AD109 improved daytime fatigue, which is an often debilitating effect of poor sleep due to OSA," said Paula Schweitzer, Ph.D., an investigator in the MARIPOSA trial and director of research at St. Luke's Sleep Medicine and Research Center, Chesterfield, Missouri. "For those who cannot tolerate current treatments, AD109 has the potential to be a convenient oral pill that could improve people's quality of life at night and during the daytime as well."

Learn about enrolling in the clinical trial

With the promising results from the MARIPOSA study, a new study is now available for people with OSA.

If you or a loved one has obstructive sleep apnea and you are unable to successfully use or tolerate treatment with a CPAP machine, you could be eligible to enroll in a six-month clinical trial called SynAIRgy.

To learn more about the clinical trial and to enroll, visit: www.SynAIRgyStudy.com.

Reporter panics at diagnosis, then discovers simple, no-cost solution

Photo: Shane/Unsplash

Sleeping on your back contributes to snoring and blockages, especially as you age and the muscles in the throat become looser. Sleeping on your side could help improve your sleep quality.

by Jay Hancock
Kaiser Health News

I woke up in a strange bedroom with 24 electrodes glued all over my body and a plastic mask attached to a hose covering my face.

As a journalist — and one terrified by the diagnosis — I set out to do my own research. After a few weeks of sleuthing and interviewing experts, I reached two important conclusions.

First, I had moderate apnea, if that, and it could be treated without the elaborate machines, mouthpieces, or other devices that specialists who had consulted on my care were talking about.

Second, the American health care system has joined with commercial partners to define a medical condition — in this case, sleep apnea — in a way that allows both parties to generate revenue from a multitude of pricey diagnostic studies, equipment sales, and questionable treatments. I was on a conveyor belt.

As a journalist who spent years covering the business of health care, I found there was more motivating my expensive testing cascade than concerns about my health.

It all began with a desire for answers: I had been feeling drowsy during the day, and my wife told me I snored. Both can mean obstructive sleep apnea. With obstructive sleep apnea, the mouth and throat relax when a person is unconscious, sometimes blocking or narrowing the airway. That interrupts breathing, as well as sleep. Without treatment, the resulting disruption in oxygen flow might increase the risk of developing certain cardiovascular diseases.

So I contacted a sleep-treatment center, and doctors gave me an at-home test ($365). Two weeks later, they told me I had “high-moderate” sleep apnea and needed to acquire a continuous positive airway pressure, or CPAP, machine, at a cost of about $600.

Though I had hoped to get the equipment and adjust the settings to see what worked best, my doctors said I had to come to the sleep lab for an overnight test ($1,900) to have them “titrate” the optimal CPAP air pressure.

“How do you treat central sleep apnea?” I worriedly asked the technician after that first overnight stay. She said something about an ASV (adaptive servo-ventilation) machine ($4,000). And one pricey lab sleepover wasn’t enough, she said. I needed to come back for another.

(Most procedures and devices mentioned in this article were covered or would have been covered by insurance — in my case, Medicare, plus a supplemental plan. Unnecessary care is a big reason Americans’ insurance costs — premiums, copays, and deductibles — tend to rise year after year.)

As a journalist who spent years covering the business of health care, I found there was more motivating my expensive testing cascade than concerns about my health.

The American Academy of Sleep Medicine, or AASM, a nonprofit based near Chicago, decides what is sleep apnea and how to treat it. Working with sleep societies around the world, it publishes the International Classification of Sleep Disorders, relied on by doctors everywhere to diagnose and categorize disease.

But behind that effort lie considerable conflicts of interest. Like so much of U.S. health care, sleep medicine turns out to be a thriving industry. AASM finances its operations in part with payments from CPAP machine manufacturers and other companies that stand to profit from expensive treatments and expansive definitions of apnea and other sleep disorders.

Zoll Itamar, which makes the at-home testing device I used, as well as implantable nerve-stimulation hardware for central sleep apnea, is a $60,000, “platinum” partner in AASM’s Industry Engagement Program. So is Avadel Pharmaceuticals, which is testing a drug to treat narcolepsy, characterized by intense daytime sleepiness.

Almost everybody breathes irregularly sometime at night, especially during REM sleep, characterized by rapid eye movement and dreams.

Other sponsors include the maker of an anti-insomnia drug; another company with a narcolepsy drug; Fisher & Paykel Healthcare, which makes CPAP machines and masks; and Inspire Medical Systems, maker of a heavily advertised surgical implant, costing tens of thousands of dollars, to treat apnea.

Corporate sponsors for Sleep 2022, a convention AASM put on in Charlotte, North Carolina, with other professional societies, included many of those companies, plus Philips Respironics and ResMed, two of the biggest CPAP machine makers.

In a statement, AASM spokesperson Jennifer Gibson said a conflict-of-interest policy and a non-interference pledge from industry funders protect the integrity of the academy’s work. Industry donations account for about $170,000 of AASM’s annual revenue of about $15 million, she said. Other revenue comes from educational materials and membership and accreditation fees.

Here’s what else I found. Almost everybody breathes irregularly sometime at night, especially during REM sleep, characterized by rapid eye movement and dreams. Blood oxygen levels also fluctuate slightly.

But recent European studies have shown that standards under the International Classification of Sleep Disorders would doom huge portions of the general population to a sleep apnea diagnosis — whether or not people had complaints of daytime tiredness or other sleep problems.

A study in the Swiss city of Lausanne showed that 50% of local men and 23% of the women 40 or older were positive for sleep apnea under such criteria.

Such rates of disease are “extraordinarily high,” “astronomical,” and “implausible,” Dr. Dirk Pevernagie, a scientist at Belgium’s Ghent University Hospital, wrote with colleagues two years ago in a comprehensive study in the Journal of Sleep Research.

“Right now, there is no real evidence for the criteria that have been put forward to diagnose obstructive sleep apnea and rate its severity,” he said in an interview.

Likewise, 19% of middle-aged subjects in a 2016 Icelandic study appeared to have moderate to severe “apnea” under one definition in the International Classification of Sleep Disorders even though many reported no drowsiness.

“Most of them were really surprised,” said Erna Sif Arnardóttir, who led the study and is running a large European program to refine detection and treatment of apnea.

Nevertheless, the official AASM journal recommends extremely broad screening for sleep apnea, looking for patients who have what it defines as illness. Everybody 18 and older should be screened every year for apnea if they have diabetes, obesity, untreated high blood pressure, or heart disease — even if they have never complained about sleep problems, the group says.

AASM “continually evaluates the definitions, criteria and recommendations used in the identification of sleep apnea and other sleep disorders,” Gibson said in the statement. Meanwhile, routine screening by primary care doctors “is a simple way” of gauging whether a high-risk patient may have obstructive sleep apnea, the statement said.

The U.S. Preventive Services Task Force, an authoritative body that reviews the effectiveness of preventive care, takes a conservative view, more like that of the European researchers, concluding there is “insufficient” evidence to support widespread screening among patients with no symptoms.

Many insurers refuse to pay for CPAP machines and other treatments prescribed for people at the outer edges of the AASM’s apnea definition. But AASM is pressuring them to come around.

After all my reporting, I concluded that my apnea is real, though moderate. My alarming reading in the overnight lab — diagnosed quickly as central sleep apnea — was a byproduct of the testing machinery itself. That’s a well-described phenomenon that occurs in 5% to 15% of patients.

And when I looked closely at the results of my at-home diagnostic test, I had an epiphany: My overall score was 26 breathing interruptions and blood-oxygen level declines, on average, per hour — enough to put me in the “high-moderate” category for apnea. But when I looked at the data sorted according to sleeping positions, I saw that I scored much better when I slept on my side: only 10 interruptions in an hour.

So I did a little experiment: I bought a $25 pulse oximeter with a smartphone app that records oxygen dips and breathing interruptions. When I slept on my side, there were hardly any.

Now I sleep on my side. I snore less. I wake up refreshed. I’m not daytime drowsy.

None of my specialists mentioned turning on to my side — known in medical parlance as “positional therapy” — though the intervention is recognized as effective by many researchers.

“Positional patients … can sleep in the lateral position and sleep quite well,” said Arie Oksenberg, a sleep researcher formerly at Loewenstein Hospital in Israel.

But it’s not easy to find this in the official AASM treatment guidelines, which instead go right to the money-making options like CPAP machines, surgery, central apnea, and mouth appliances.

Dealing with apnea by shifting slightly in bed gets little more than a couple of paragraphs in AASM’s guideline on “other” treatments and a little box on a long and complex decision chart.

A third or more of patients wear CPAPs only a few hours a night or stop using them. It turns out people don’t like machines in their beds.

“Positional therapy is an effective treatment option for some patients,” said the AASM’s Gibson. But she said there are concerns about whether patients will sleep on their sides long term and whether trying to stay in one position might cause sleep interruptions itself.

It’s true that And it often takes practice. (Some people tape a tennis ball to their pajamas to keep them off their backs.) Even conservative sleep doctors say CPAP machines are the best solution for many patients.

But there is a largely overlooked alternative.

“Are we missing a simple treatment for most adult sleep apnea patients?” was the name of a 2013 paper that Oksenberg and a colleague wrote about positional therapy.

In my case, the answer was “yes.”

Jay Hancock is a former KHN senior correspondent.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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For night owls the pandemic may have improved sleep habits

by Krishna Sharma, Kaiser Health News

Photo: Victoria Heath/Unsplash

Many so-called night people feel that, when it comes to society’s expectations about when the workday should start, they drew the short straw.

“It is harder for night owls to function in the world because they’re out of sync with the conventional schedule,” said Kelly Baron, an associate professor at the University of Utah who studies sleep health and clinically treats patients who have insomnia. She noted that poor sleep is also a driver of worker absenteeism and use of sick days. “We would get better performance out of employees if they were allowed to work at their best working time.”

Her research has found that keeping late evening hours can cause even healthy night owls to be prone to bad habits like eating fast food, not exercising, and socializing less.

But the covid-19 pandemic, which forced many people to telework, allowed more flexibility in work schedules, prompting sleep scientists to rethink assumptions about sleep and how to assess patients.

The pandemic “was an international experiment to understand how sleep changes when work hours and work environments change,” said Baron.

Researchers in Italy are among those tapping into this question. In a recent study, they found that many Italians who don’t typically fit into a traditional daylight timetable thrived and their health improved when the pandemic’s remote working conditions allowed them to work later hours.

Federico Salfi, a doctoral student at the University of L’Aquila and self-professed night owl, joined with colleagues late in 2020 to examine how the work-from-home trend influenced Italian sleep habits. Through social media, they identified 875 people who represented in-office and remote workers. They then used web-based questionnaires to discover the impacts of remote working on sleep health. The findings: The pandemic’s work-from-home flexibility helped the participants better align their work and sleep schedules — many of them for the first time.

More specifically, the researchers found evidence that evening-type people slept longer and better while working from home, with a corresponding decrease in symptoms of depression and insomnia.

They also pointed out an important theme that echoes other studies — that people who fall into the night-owl category regularly sleep less than early risers. On his podcast, Matthew Walker, a professor of neuroscience and psychology at the University of California-Berkeley and author of “Why We Sleep,” said it was the difference of 6.6 hours a night versus more than 7 hours a night, leading night owls to accumulate a chronic sleep debt. (The study is available as a preprint and has not yet been peer-reviewed.)

So why don’t such people just go to bed earlier? The answer is complicated.

To feel sleepy requires a biochemical cascade of events to kick into action, and that timing is determined by a person’s chronotype. A chronotype is an internal “body clock” that determines when people feel awake or tired during a 24-hour period. The cycles are genetically set, with about half of people falling into the midrange — meaning they neither wake at dawn nor fall asleep past midnight — and the others evenly split as morning larks or night owls.

In prehistoric times, a mix of mismatched bedtimes served an evolutionary purpose. Evening types would watch over morning types while they slept, and vice versa. Modern society, however, rewards early risers while stigmatizing those burning the midnight oil, said Brant Hasler, associate professor at the University of Pittsburgh and part of the university’s Center for Sleep and Circadian Science. “We are catering to one portion of our population at the expense of another.”

Walker has outlined specific health consequences on his podcast. Late-night types are 30% more likely than early birds to develop hypertension, which can lead to strokes or heart attacks, and 1.6 times as likely to have Type 2 diabetes since sleep affects blood sugar regulation. They are also two to three times as likely to be diagnosed with depression and twice as likely to use antidepressants.

A study published in February also found that evening people who slept more during the pandemic still had remarkably poorer mental health compared with morning larks.

Neither Walker nor Hasler was involved in the Italian study.

Still, some experts noted that the Italian study had limitations.

“I couldn’t find clearly included in the study: Were people always on those schedules? [Or did they change after the pandemic?] Because that is something that really matters,” said Stijn Massar, a senior research fellow at the National University of Singapore. Plus, since covid has drastically affected almost all aspects of life, pandemic-era sleep data can get muddied by the many lifestyle changes people have had to endure.

Moreover, sleep scientists are still wondering if it is always healthier for someone to sleep in sync with their chronotype.

It’s a question of prioritizing individual schedules versus community schedules. But “sleep is one of the great mysteries of life,” said Massar. “This is all somewhat speculative,” with each new study providing glimpses of the bigger picture.

Subscribe to KHN's free Morning Briefing.

Five natural ways to boost your immune system

Photo by Caleb Oquendo/Pexels

(Family Features) - Your body's immune system protects against illness and infection, fighting off threats before you even know there's a problem. Even though your immune system usually does its job automatically, you can give it a boost with habits that promote wellness and support immunity.

Eat healthy fruits and vegetables
Although you may not be aware they contain flavonoids, these phytochemicals found in some fruits and veggies are a vital part of maintaining health. Flavonoids are found in colorful fruits and vegetables like cranberries and elderberries. When it comes to power foods, elderberries' exceptional flavanol levels make them an immune system powerhouse. Especially important during cold and flu season, elderberries can also be enjoyed in a cup of warm tea for instant comfort.

Reduce stress with outdoor activity
Keeping physically fit provides numerous health benefits such as reducing stress by being one with nature through taking a walk outside. The sun's UV rays help your body produce vitamin D, which is important for your bones, blood cells and immune system, as well as helping absorb and use certain nutrients. Yoga and massage can also be used to help stimulate the immune system and promote well-being.

Keep a regular sleep schedule. Sleep gives you an opportunity to recharge. This is when cellular regeneration and other healing is most efficient. Keeping a regular routine helps signal to your system that it's time to rest so you can fall asleep easier and reap the whole-body benefits of a healthy sleep cycle.

Wash hands frequently
Especially during the school year, when germs are rampant and easily carried from school to home, you can give your immune system a hand, literally, by frequently scrubbing away germs before they have the chance to attack.

Rely on natural remedies
Modern, stressful lifestyles and exposure to environmental pollutants can put immune systems under pressure. However, some of your existing soothing rituals can actually support better health, too. One example is relaxing with a hot cup of tea. The natural and organic ingredients found in Buddha Teas provide numerous health benefits. Options like Mushroom Wellness, Divine Immunity, Elderberry Tea and Reiki Mushroom blends all contain immunity-boosting ingredients.

While they're not an obvious ingredient, mushrooms have been incorporated into healing practices for thousands of years for their immune-boosting, anti-inflammatory and antioxidant-rich properties. There are several powerful medicinal mushrooms but one stand-out is the reishi mushroom, known as the "mushroom of immortality" and "divine plant of longevity." This anti-inflammatory powerhouse is known to promote healthy cell growth and healthy blood pressure, along with improving immune function.

Learn more about boosting your immunity naturally at buddhateas.com.

A Golden Way to Get Better Sleep

While golden milk has become a trendy beverage of choice, this comforting, herb-filled blend is actually ancient. For thousands of years, golden milk has been an Ayurvedic ritual, with Indian families enjoying a warm nightly cupful before bed.

In Ayurvedic medicine, turmeric, the main component in golden milk, is thought to impart the energy of the sun to the body, hence its radiant, golden color. Turmeric's documented healing properties impart substance to this traditional "elixir," and have given golden milk a reputation as a healing cup of comfort.

In addition to improving physical and mental well-being, regularly drinking golden milk has the potential to lessen your chance of becoming ill in the first place. It's also an anti-inflammatory that supports healthy digestion and promotes calm.

This turmeric-dominant blend includes ginger root and black pepper to aid digestion; ashwagandha to tonify, energize and calm; and cardamom, nutmeg and vanilla bean, all meant to encourage rejuvenation and peace. Consider an option like Buddha Teas' CBD Organic Golden Milk, which includes a THC-free CBD isolate for added wellness benefits.

Prepared by mixing with a warm cup of your favorite milk, the smooth, slightly sweet, pungent brew offers a soothing treat just before bed. Many people also enjoy golden milk prepared cold.

Make the most of your morning hours for more productive days

Boosting your immunity, expert offers a few tips

Daylight Savings Time is coming, start preparing your body for time change

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