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As discussed last week in Part I of Cervical Pillows, studies on cervical or neck pillows have shown that those using a cervical pillow demonstrated a significant reduction in chronic neck pain and headaches. However, researchers cautioned that there are many different types of pillows and that, depending on the individual; some may be more effective than others. This week, I offer tips on choosing the best pillow for you.

  1. Get a Diagnosis –
    • If possible, visit your physician to find out why you have neck pain and headaches. For example, those with arthritis, osteoporosis, degenerative disk disease or other bone and joint problems have great difficulty finding a comfortable position to sleep due to pain, stiffness and headaches upon waking up in the morning and may benefit from a proper pillow.
  2. Try it Out in the Store -
    • Cervical or neck pillows are designed to provide support specifically to the cervical or neck area of the spine. In theory, the pillow attempts to align and support the natural shape of the neck while one is sleeping.
  3. One Size Does Not Fit All -
    • A traditional pillow is often designed as a one-size-fits-all rectangle that is more about form than function. Imagine that small-framed women (5 feet tall, weighing 100 pounds) may use the same pillow as a large male football player (6 feet 5 inches, weighing 350 pounds). It is obvious that these two individuals have very different head, neck and shoulder sizes and therefore require two very different pillows.  
  4. Age Matters –
    • Ages 16 to 40 have flexible and hydrated discs and benefit more from a contour pillow with a bump, core or butterfly shape. A thinner pillow that allows the neck to extend and distract while sleeping is helpful. Ages 65 and older often have arthritic and dehydrated discs with a more rigid spine and benefit more from a thicker pillow with comfortable material such as synthetic down or memory foam to keep the neck in a slightly elevated and flexed position to avoid hyperextension. Ages 40 to 65 are in between and may need to experiment with pillows that allow extension, flexion or neutral.  
  5. Special Circumstances –
    • There are exceptions to every rule. For example, those with allergies should always ask for hypoallergic materials. Those with respiratory conditions or hiatal hernias often require elevation for comfortable sleeping. Try an 8-to-10-inch wedge to elevate the head and chest with a full pillow.
  6. Standard Filled Pillows –
    • These pillows can be filled with hard or soft materials such as synthetic or real down and resemble a more traditional-looking pillow. They allow for individual manipulation and shaping.
  7. Memory Foam Pillow -
    • This unique material offers individualized support for almost all body types. However, it is expensive (there are cheap versions) and it retains heat, so it is warm in the summer. This type may not be suitable for very small-framed individuals may not be able to compress the material and fail to find benefit. (www.tempurpedic.com), (www.thergear.com).
  8. Contour Pillow –
    • These ergonomically designed pillows are contoured to support the “hollow” of the neck with a “bump” or “core.” Some offer a cut out for the side sleeper such as the” butterfly” pillow. They work best for younger, more flexible spines and small-framed people. Contour pillows can be found at: (www.coreproducts.com),  (www.bodyline.com).
  9. Travel Pillow –
    • These pillows offer proper support to prevent your head from bobbing up and down while sleeping in a car or on a airplane. Most are horseshoe collar shaped and I am partial to the inflatable version from BrookstoneR  due to its portability (www.brookstone.com).
  10. Keep Trying -
    • It is important to remember, there is no one pillow fit for everyone…they are unique to each person. Pillow type should be based on body type, head size, shoulder width, favorite position of sleep and medical conditions. Always try to sample a cheaper version of a product when possible.  

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Are you one of the millions of people who suffer from chronic neck (cervical) pain and headaches? Did you ever wonder if your pillow is right for you? Studies on cervical or neck pillows have shown that those with chronic neck pain showed a significant reduction in neck pain and headaches when using a cervical pillow for four weeks when compared to the control group. However, there are many types of cervical pillows, and there is no single best choice for everyone. This column will give you an overview of the different types of cervical pillows, and hopefully this information will help guide you to the right pillow for your individual size and shape.  

Introduction:

People who suffer from back and neck pain are always in search of something to lessen their pain and stiffness. Those with conditions such as arthritis, osteoporosis, or other bone and joint problems have great difficulty finding a comfortable position to sleep, and they often wake up with pain, stiffness and headaches in the morning. For these people, a cervical pillow may offer great comfort, because it is specifically designed to alleviate these symptoms.

Traditional pillows have drawbacks mainly because they are designed as a one-size-fits-all rectangle with greater emphasis placed on form than on function. Very often, a small-framed woman (5 feet tall, weighing 100 pounds) may find herself using the same style of pillow as a large male with the build of a football player (6 feet 5 inches weighing 350 pounds). It is obvious these two individuals have very different head, neck and shoulder sizes, and therefore they require two very different types of pillows.  

Cervical or neck pillows come in a variety of shapes and sizes, and they are designed to provide support specifically to the cervical area of the spine. In theory, a cervical pillow attempts to align and support the natural shape of the neck while one is sleeping. Those suffering from neck or shoulder pain, degenerative cervical disc disease, or conditions such as arthritis or osteoporosis may find these pillows valuable.

Types of Pillows:

Cervical pillows are made by many different manufacturers and come in a variety of sizes, designs and shapes. Manufacturers claim that these pillows offer the benefits of increased circulation, improved breathing, reduced snoring and lessened neck and shoulder muscle pain and stiffness. One manufacturer, Tempur-PedicR (www.tempurpedic.com), boasts special memory foam technology that, they claim, offers unique and individualized support to accommodate the weight of every body type.

When selecting a cervical pillow, it is important to remember several things. First, know that most manufacturer claims are not subject to validation by independent research studies. Second, remember that, regardless of what a manufacturer states, no single pillow is right for every person. Third, realize that the most expensive option is not necessarily the best. Although many people consider Tempur-PedicR to be the leader in the field, they are costly, ranging from $89 to $349. If you shop around, you can find several companies that offer alternatives—both of similar and alternative designs—that may actually be a better fit for your neck and your budget.

Other companies producing cervical pillows include CoreR, which offers support around the periphery with a special or dip (or “core”) in the middle in which your head rests (www.coreproducts.com),  MediflowR, which offers a water pillow with multiple options and BodyLineR, which offers a model with both a large and a small orthopedic “bump” in one pillow (www.bodyline.com). These pillows are economical, ranging in price from $35 to $100.

Regardless of what brand of pillow you select, it is likely to fall into one of the following three categories:

Conclusion:

It is important to remember that there is no one pillow fit for everyone, each person’s needs are unique. You should select your pillow type based on your body type, head size, shoulder width, favorite sleeping position, and medical conditions, such as neck or lower back pain, osteoarthritis, headaches, etc. When choosing a pillow, try to sample a cheaper version of the product when possible. For example, if you think you might like the “orthopedic bump” style from Tempur-PedicR that costs $200, consider trying the $50-60 version from TherGearR first. Better yet, if you have a friend or relative with a similar body type and problem who successfully uses a cervical pillow, try borrowing it! Finding the right pillow is a process of trial-and-error, so not get frustrated or give up. If you succeed in finding the right pillow for you, the result will be worth the search.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy - Next Week, Part II of II: Tips to Select a Good Cervical Pillow For You.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!Next Week, Part II of II: Tips to Select a Good Cervical Pillow For You.

According to American Association of Retired Persons (AARP), those 50 years old and older are seniors! By this definition, as hard as it is to admit, I am well into senior status and as one, I offer holiday health tips for seniors.

Overindulgence during the holidays causes many seniors to make New Year's resolutions related to diet and exercise. But, this year, I propose that seniors incorporate healthy habits during the holiday season, and you may find that your resolutions are not as hard to keep.

  1. Exercise every day. - Every evening, get out of the house for a walk to view the Christmas lights. Dress for the weather, walk with a companion, and take along a flashlight to illuminate your path. Use caution to avoid falls on slippery sidewalks.
  2. Combine shopping and walking. - In inclement weather, combine holiday shopping with your daily dose of exercise. Indoor malls are great places to walk. Inquire with the mall management about walking clubs. Plan to shop early or late to avoid crowds. If you are planning on shopping in a particular store, park at the opposite end of the mall -- even if time is short, you will still get some exercise.
  3. Remember to take your medications. - Routines are disrupted during the holidays, and you may forget important medications. Make a special reminder to take your medications or order re-fills. If you are traveling, be sure to take enough medications with you in case of delays and have a copy of your prescriptions in case of loss. Be sure to bring a phone number for your doctor along with your health insurance cards, in case of emergency. Carry your medications in your carry-on luggage if you are flying.
  4. Eat your vegetables and salad first. - Beginning your meal with healthy vegetables and salads will fill you up and reduce the temptation to over-indulge in high-fat, high-calorie foods. Taste your holiday favorites in small amounts to satisfy your palate.
  5. Be aware of drug interactions. - According to Dr. Amy Anderson, internal medicine physician on the medical staff at Baylor University Medical Center," says holiday spices like cloves, thyme and sage can interfere by as much as 50 percent with the body's natural ability to utilize common drugs." Talk with your doctor or pharmacist about your medications and find out if there are any foods you should avoid while taking them. Also, be aware that alcohol should be avoided when taking many drugs.  
  6. Know your food ingredients. - If you have food allergies, ask about ingredients before you indulge. Be especially careful of home-baked goods if you have an allergy to tree nuts or peanuts. Those ingredients can be deadly if you are affected by these types of allergies.
  7. Practice allergy-free decorating. - If you suffer from allergic rhinitis, holiday decorations stored in the attic and basement can build up a coating of dust and mold that can trigger allergies. Some people may also need to rethink Christmas tradition and substitute with an artificial tree.
  8. Get vaccinated for covid, flu and RSV. - The holiday season includes plenty of kissing and handshaking. Getting yearly vaccinations and frequent hand washing are your best defense for avoiding the covid, flu and RSV. If you are sick with a cold or flu, limit contact with others until you are symptom free, so you don’t infect others.
  9. Get a good night's sleep. - Holiday preparations and helping Santa means less sleep. Do your best to get to sleep 6-7 hours every night and avoid heavy foods and alcoholic beverages before bedtime. If you need to recharge, take a nap during the day.
  10. Spend Time With Loved One’s - The holiday season and throughout the year, be proactive and participate in outings with family and friends. Make a call and invite a loved one over for coffee and eagerly accept invitations. Studies show those who are social and interactive are mentally and physically healthier.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

The “first Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.

Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things; family, good friends, food, shelter, and health. It turns out that being grateful is, not only reflective and cleansing; it is also good for your health!

Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:

There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.

7 Proven Health Benefits of Being Grateful

  1. Being Grateful is Contagious!
    • Studies show that something as simple as saying “thank you” to a stranger holding a door open for you or sending a co-worker a thank you note for helping you with a project makes them more likely to continue the relationship. Showing gratitude can improve your life by fostering solid friendships.
  2. Being Grateful Improves Physical Health
    • Research has found that those who are grateful experience fewer aches and pains and tend to report that they feel healthier than most people. Moreover, grateful people are more likely to be health conscious and live healthier lifestyles.
  3. Being Grateful Improves Psychological Health
    • Multiple studies have demonstrated that gratitude reduces many negative emotions. Grateful people have less anger, envy, resentment, frustration or regret. Gratitude increases happiness and reduces depression.
  4. Being Grateful Fosters Empathy and Reduces Aggression
    • Participants in a study by the University of Kentucky found that those who scored higher on gratitude scales were less likely to retaliate against others and were more sensitive and empathetic when compared to low gratitude scorers.
  5. Being Grateful Promotes Better Sleep
    • A study published in Applied Psychology, found that 15 minutes of writing down a gratitude list before bed led to better and longer sleep.
  6. Being Grateful Improves Self-Esteem
    • When studying athletes, it was determined that those who scored high on gratitude scales demonstrated improved self-esteem which led to optimal performance. Conversely, those athletes who were not grateful and resented contemporaries making more money, for example, had lower self-esteem and negative performance outcomes.
  7. Being Grateful Improves Mental Strength
    • Research has repeatedly shown that gratitude not only reduces stress, but also improves one’s ability to overcome trauma. For example, Vietnam veterans who scored higher on gratitude scales experienced lower incidences of post-traumatic stress disorder. Recognizing all you have to be thankful for, even during the worst times of your life, fosters resilience.

Conclusion:

Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!

Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”

Visit your doctor regularly and listen to your body.     

 Keep moving, eat healthy foods, exercise regularly, and live long and well!

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

The “First Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate be grateful for the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.

Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things; family, good friends, food, shelter, and health. This year, I am also thankful for the dedicated scientists who developed the COVID 19 vaccination so we can safely enjoy Thanksgiving with our families. It turns out that being grateful is, not only reflective and cleansing; it is also good for your health!

Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:

There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.

7 Proven Health Benefits of Being Grateful

  1. Being Grateful is Contagious!
    • Studies show that something as simple as saying “thank you” to a stranger holding a door open for you or sending a co-worker a thank you note for helping you with a project makes them more likely to continue the relationship. Showing gratitude can improve your life by fostering solid friendships.
  2. Being Grateful Improves Physical Health
    • Research has found that those who are grateful experience fewer aches and pains and tend to report that they feel healthier than most people. Moreover, grateful people are more likely to be health conscious and live healthier lifestyles.
  3. Being Grateful Improves Psychological Health
    • Multiple studies have demonstrated that gratitude reduces many negative emotions. Grateful people have less anger, envy, resentment, frustration or regret. Gratitude increases happiness and reduces depression.
  4. Being Grateful Fosters Empathy and Reduces Aggression
    • Participants in a study by the University of Kentucky found that those who scored higher on gratitude scales were less likely to retaliate against others and were more sensitive and empathetic when compared to low gratitude scorers.
  5. Being Grateful Promotes Better Sleep
    • A study published in Applied Psychology, found that 15 minutes of writing down a gratitude list before bed led to better and longer sleep.
  6. Being Grateful Improves Self-Esteem
    • When studying athletes, it was determined that those who scored high on gratitude scales demonstrated improved self-esteem which led to optimal performance. Conversely, those athletes who were not grateful and resented contemporaries making more money, for example, had lower self-esteem and negative performance outcomes.
  7. Being Grateful Improves Mental Strength
    • Research has repeatedly shown that gratitude not only reduces stress, but also improves one’s ability to overcome trauma. For example, Vietnam veterans who scored higher on gratitude scales experienced lower incidences of post-traumatic stress disorder. Recognizing all you have to be thankful for, even during the worst times of your life, fosters resilience.

Conclusion:

Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!

Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”

Visit your doctor regularly and listen to your body.     

 Keep moving, eat healthy foods, exercise regularly, and live long and well!

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!

Whether you are a student, athlete, or just trying to live a healthy life, we could all benefit from a routine of adequate sleep. However, according to the Centers for Disease Control and Prevention, 1 in 3 American adults get less than seven hours per day, which is the recommended amount to maximize wellness. William Dement, M.D. argues in his book, The Promise of Sleep, that our patterns of rest are the single most important determinant of our length of life. But what is a “healthy” sleep schedule?  It turns out that while inadequate sleep is common in the US, there can indeed be too much.

So how much sleep do I need?

The National Sleep Foundation (NSF) has recommendations depending on your age group. The average for adults is 7-9 hours. As you get older, they recommend a shorter amount of time needed for sleep each night. However, they urge each person to reflect on how they feel each day and adjust their habits accordingly.

If you are one of the 33% of Americans not getting enough sleep you have probably tried or are willing to try anything to avoid staring at the ceiling for hours before falling asleep. For these unfortunate people, the moment the lights go off, their brain switches on…tossing and turning, wrestling and twitching until they reach exhaustion. One new product that has been receiving plenty of attention is a weighted blanket.

While sleeping with a weighted blanket may seem a little extreme at first, many believe that sleeping with the equivalent of a 30 pound toddler evenly distributed across their body, is very effective in calming anxiety, promoting relaxation and sleep.

What is a Weighted Blanket?

A weighted blanket is filled with plastic pellets or glass beads that add weight to the blanket. These blankets range in weight from five to 30 pounds. The sensation is similar to the lead vest worn during dental x-rays and the extra weight provides deep pressure to relieve anxiety and reduce insomnia.

Choosing the optimal weight or type of blanket is not an exact science. Manufacturers recommend adults use a blanket that is equal to 10% of their body weight. The filler determines the thickness and texture. Glass beads are smaller and produce a thinner blanket as compared to plastic pellets.

For those concerned with temperature, some blankets use bamboo as a cover for cooling, while others offer additional filling for warmth.

Theory

The theory behind the use of weighted blankets for anxiety and insomnia rests on previous research related to deep pressure stimulation…gentle pressure applied over the entire body (like being wrapped in a swaddle or sharing a prolonged hug).

The concept of deep pressure for stress and anxiety reduction is not entirely new. Occupational therapists working with children with autism spectrum disorders have used deep pressure to promote a calming and relaxing effect.

Effectiveness

Research supporting the efficacy of weighted blankets is limited and varied. While some studies suggest weighted blankets offer promise for those suffering from anxiety, far less support their effectiveness for insomnia.

One study of 32 adult volunteers, reported 63% lower levels of anxiety after lying under a 30 pound blanket for 5 minutes. In another study, 30 participants who were hospitalized for a mental health crisis demonstrated 60% reduction in anxiety after using the blanket.

Weighted Blanket Products

Luxome: Made from bamboo and hypoallergenic glass beads with fibers known for moisture-wicking and cooling. Rated #1 with 6,000 five-star Reviews. $119.99 (luxome.com)

Layla: Made from high density micro glass beads with cotton, polyester and mink outer materials. Sized for one or two people. $129.00 (queen size) (laylasleep.com)

YNM: Made from bamboo and hypoallergenic glass beads. Sized for one or two people. $79.90  (amazon.com)

Reviews: While the research may be lacking, the testimonials and customer product reviews are very favorable for satisfaction, durability and effectiveness.

Conclusion

It may be too early to tell according to the scientific literature. However, there is some indication that weighted blankets may reduce anxiety in some. It is less certain that these blankets will reduce insomnia. There are no studies that indicate that weighted blankets are harmful and may be worth a try for those who have exhausted more traditional options for anxiety and insomnia as a replacement or adjunct.

Read Dr. Mackarey’s Health & Exercise Forum – every Monday. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

See all of Dr. Mackarey's Articles at https://mackareyphysicaltherapy.com/forum/

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.

Part II of II

Difficulty sleeping during the COVID-19 quarantine has become a common problem and can be manifested in a variety of ways; insomnia, fragmented sleep and nightmares. National prescription providers have reported a 21% increase in anti-insomnia, anti-anxiety and antidepressant medications since March of 2020. The past two weeks in Health & Exercise Forum” have been dedicated to sleep wellness.

Last Week in 'Health and Exercise Forum'

We discussed the importance of sleep for health and wellness. Sleep is crucial to us as a species, but it is not always easily attained. For many individuals across the globe, sleeping properly can be a challenge. The trial and tribulations of the human experience can lead to restless nights and early morning risings without adequate sleep. This week, we will discuss how lack of quality or quantity of sleep can impact our lives in many ways and make suggestions to improve your sleep hygiene.

Cognitive Performance

Although it may be tempting to sleep in on weekends after a long week of classes, some studies report that this habit results in a smaller volume of the gray matter of the brain in adolescents. Also, in this report, students who altered their sleep pattern on weekends had a lower grade average than those who did not. Therefore, it seems that it is not only important to maintain an average healthy average amount of sleep each night, but also to stay consistent with the hours that you are asleep.

Physical Fitness

There are many studies that have linked unhealthy sleep patterns to obesity. Inadequate sleep causes irregular levels of the hormones that are responsible for telling our brains when we need to eat. Therefore, this hormone imbalance can lead to obesity and thus make us vulnerable to the dangerous effects dramatically increased body fat.

Longevity

A healthy sleep schedule has been shown to reduce the risk of heart disease and stroke, which are two of the leading causes of death in the United States. For example, interruptions in sleep due to disorders like sleep apnea have been shown to be a risk factor for stroke and that persistent tiredness often preceded heart disease.

Physical performance

Whether you are a high school or collegiate athlete, or simply enjoy some daily exercise, a healthy sleep schedule can help maximize performance. It is worth noting that it is possible that athletes require different sleep patterns than the general population to reach peak performance. Moreover, it has been shown that sleep loss is linked to a decreased ability in athletes to store sugar in the muscle to use as energy during a workout.

Needless to say, there are a plethora of things that can negatively impact our sleep. Even one night of poor sleep can drastically impact our performance and ability to concentrate the following day. So how do we combat this? There are several simple habits that can improve sleep hygiene and increase the likelihood of getting a good night’s sleep.

TIPS TO IMPROVE SLEEP HYGIENE:

  • Set a routine- Going to bed and waking at the same time every day, even on weekends, strengthens our circadian rhythms. Our brains become accustomed to the routine and allow us to fall asleep quicker, reach more restful sleep faster, and wake up feeling refreshed rather than startled by the blaring of our alarms.
  • Limit screen time before bed- As stated earlier, the light from our devices tricks our eyes into believing it is day rather than night. Try to stop using your devices an hour before you head to bed to allow your brain to naturally power-down for the day. This means limiting falling asleep to Netflix as best we can. An even better idea would be to remove TVs from the bedroom all together.
  • Exercise earlier in the day- While frequent exercise is essential to our health and helps us fall asleep, working out right before bed can result in poorer sleep. Avoid strenuous exercise at least one hour before bed.
  • Meditation- Alright, I can hear the groans already, but it works- especially in individuals who have difficulty quieting their minds after a hectic day. An article released by the Journal of the American Medical Association (JAMA) demonstrated significant improvements in the quality of sleep in those who practiced mindfulness meditation and compared to those who did not.
  • Moving when you have difficulty falling asleep- If you find yourself unable to fall asleep within 30 minutes of lying down, get out of bed. Go to another room and read in dim lighting or listen to music until you feel tired and try again. 

There are thousands of other resources that can help us achieve a great night’s sleep. Apps like “Calm” and “Headspace” have guided meditations and relaxation techniques to help us unwind before bed. More useful information about healthy sleep and why it is important can be found on Harvard Medical School’s Healthy Sleep website. And there are hundreds of thousands of YouTube videos with relaxation techniques and informative healthy sleep videos to be discovered. If these interventions do not improve your sleep, talk to your primary care doctor and see which next steps are right for you.

 Sleeping well is not always easy and there will undoubtedly be nights on which rest eludes us despite our best efforts. But with consistent healthy sleep habits, we will be on our way to a healthier and better tomorrow.

For More Informations:

-http://healthysleep.med.harvard.edu/healthy/

-https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110998

-https://www.sciencedirect.com/topics/medicine-and-dentistry/insomnia

Timothy Farrell, MD3

Tim Farrell is a third year medical student at Geisinger Commonwealth School of Medicine. Originally from Clarks Summit, Pennsylvania, Tim received his bachelor’s degree from Loyola University Maryland in Baltimore, MD. Currently a 2nd Lieutenant in the US Army, he enjoys listening to music, running, and spending time with his two dogs. He volunteers with the Cody Barrasse Foundation in the Organ Transplant Assistance Program, where he helps patients receive grant funding as they await their transplant surgery. He hopes to pursue a career in General Surgery.

Read Dr. Mackarey’s Health & Exercise Forum – every Monday or at https://mackareyphysicaltherapy.com/forum/

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.

Part I of II

Difficulty sleeping during the COVID-19 quarantine has become a common problem and can be manifested in a variety of ways; insomnia, fragmented sleep and nightmares. National prescription providers have reported a 21% increase in anti-insomnia, anti-anxiety and antidepressant medications since March of 2020. The next two weeks in Health & Exercise Forum” will be dedicated to sleep wellness.

Everyone Needs Sleep!

We do it every night, hopefully. Children are doing it. Our grandparents are doing it. Teenagers do it all the time. We sleep of course. These hours in which we slumber are vital to our ability to function during the day and to our health overall. It does not appear evolutionarily advantageous for us to be unconscious for extended periods of time. Modern science tells us that much of our body’s restoration, strengthening, and processing occurs while we sleep. Our brains consolidate the information they have learned throughout the day and enhance our memory. Additionally, sleep restores sugar storage in our brains and improves the functioning of our immune system. But science does not illuminate why we need such a prolonged period other than the fact that we just seem to get sleepy after a long day.

How much Sleep Do I Need?

Sleep is crucial to us as a species, but it is not always easily attained. For many individuals across the globe, this author included, sleeping properly can be a challenge. The trial and tribulations of the human experience can lead to restless nights and early morning risings without adequate sleep. But what is considered “adequate” sleep? The answer depends on your age. As we grow older, our sleeping requirements change drastically from infancy to elderdom. Infants are learning and processing so much information of this new world they now inhabit. Thus, their brains need enough time to analyze and consolidate the data, necessitating 12 to 15 hours of sleep. As we advance into adulthood, our sleep requirements drop to approximately 7 to 9 hours with some variability from person to person. Good indications of a restful night’s sleep include waking up feeling refreshed, functioning with enough energy for your daily tasks, and having continuous sleep- meaning there are not extended periods of time of wakefulness when we are supposed to be sleeping.

You are not alone, roughly 100 million people suffer from insomnia at some point each year!

This seems easy enough to say, but significantly more difficult to do. Current reports demonstrate that roughly 100 million people suffer from insomnia at some point each year, with 25% progressing to long-term chronic sleep insufficiency. Insomnia is described as difficulty falling asleep or staying asleep for three nights per week for at least two consecutive weeks in a three-month period. There are a lot of unhealthy sleeping habits permeating the country. We measure the quality of sleep in two different dimensions duration (quantity) and depth (quality). The duration is straightforward enough. Do you sleep for the recommended 7 to 9 hours per night? The quality is a little more difficult to quantitate. Some individuals may sleep for the proper duration of time, but the depth is not adequate. Sleep quality is determined by the number of arousals or awakenings in a given night.  As few as 5 arousals in a night can result in daytime sleepiness and performance deficits. In addition, how long we remain in certain phases of sleep also determines the quality of our sleep. There are four stages of sleep: N1, N2, N3, and REM with N3 being the most restful of the stages. When we fall asleep, we go through a predictable descent into sleep. We repeat the cycle of N1 to N2 to N3 to REM sleep every 60 to 90 minutes. The more time we remain in the restful stages, N3 and REM, the better our sleep is. As we age, we inevitably spend less and less time in restful sleep.

What causes poor sleep and why are so many Americans suffering from insomnia?

There are many factors that influence how we sleep. Everything from what we drink to the type of curtains we have can impact those crucial hours of sleep. Some of the more common culprits that disrupt our sleep are:

For More Informations:

-http://healthysleep.med.harvard.edu/healthy/

-https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110998

-https://www.sciencedirect.com/topics/medicine-and-dentistry/insomnia

Read Dr. Mackarey’s Health & Exercise Forum – every Monday. Next Week Read, Sleep and Wellness Part II.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.

Read all of Dr. Mackarey's articles in our health and exercise forum: https://mackareyphysicaltherapy.com/forum/

Guest Columnist: Timothy Farrell, MD3

Tim Farrell is a third year medical student at Geisinger Commonwealth School of Medicine. Originally from Clarks Summit, Pennsylvania, Tim received his bachelor’s degree from Loyola University Maryland in Baltimore, MD. Currently a 2nd Lieutenant in the US Army, he enjoys listening to music, running, and spending time with his two dogs. He volunteers with the Cody Barrasse Foundation in the Organ Transplant Assistance Program, where he helps patients receive grant funding as they await their transplant surgery. He hopes to pursue a career in General Surgery.