Sleep. Your life depends on it.

I’ve noticed a trend in many of my patients:  There is a desire to eke out every bit of the day, and that means staying up late.  Just one more episode of the latest binge.  A little more quiet time without the kids.  A bit more time with their spouse or friends.

But what this means is that the alarm still goes off at the same time the next morning and work starts at the same time regardless.  What gives is sleep.  

Americans are sleeping on average 40% less than they did in the 1940’s.  And 40% are getting 6 hours or less a night.  What suffers with lack of sleep? Your health and how you function both at work and at home. 

What gives when you’re sleep deprived?

  • Weight.  There is a clear connection to weight gain and lack of sleep.
  • High blood pressure.  This is actually the number one cause of death in the world, and too little sleep is a contributor to developing elevated blood pressure.
  • Heart disease.  Nearly 2/3’s of us in the US will die of a heart attack or stroke.  One step towards healthier arteries?  Sleep.
  • Diabetes and insulin resistance.   Lack of sleep worsens our metabolism and contributes to the development of pre-diabetes and diabetes.
  • Cognitive function.  This is apparent in work and school performance.  But, in one recent study, that lack of sleep was shown to increase your risk of Alzheimer’s dementia. 
  • Mood. Most of us have experienced the irritability that comes with a poor night’s sleep.  But is also increases the risk of depression and anxiety.  So unfortunately, anxiety can keep you up and lack of sleep can cause anxiety.
  • Immune system.  This is weakened with lack of sleep, making you more vulnerable to infections, including colds and flu, as well as other more serious infections.
  • Ability to drive.  Hand-eye coordination suffers with lack of sleep and can be as dangerous as driving drunk.
  • Energy.  Fatigue increases with lack of sleep.
  • Libido and fertility.

All of this adds up to not just misery, but to a shortened life expectancy.

So how much sleep do you need?  That depends on your age and how sleep deprived you are.  For most adults, we need between 7 and 9 hours a night.

The most common complaint that patients come to me with is fatigue and the first place to start is looking at their sleep, both for quantity and quality.  Worry and interrupted sleep are 2 big reasons that I see that effect sleep, besides not making enough time for sleep a priority.

Here’s a start to improving the quantity and quality of sleep:

  • Make sure that you give yourself enough time in bed to get enough sleep.  Include in that time space to wind down and do your night time rituals.  This is key and may take some change in your habits.
  • Decrease interruptions.  These often come from a full bladder, a snoring or moving spouse, or pets or children in bed.  Limit the amount of fluid that you drink after dinner so that you are less likely to have to get up to pee.  Put children in their own bed and kick pets out of your bed.  Sometimes mattresses that don’t translate motion across them can be helpful.
  • Make sure that your bed is comfortable and that your bedroom is dark, quiet, and cool.
  • Limit caffeine during the day.  Yes, it can help you make it through with less sleep, but caffeine, with a half life of 6-7 hours, for most of us hangs out in our systems.  This means that you have 1/4 of the caffeine that you had for the morning at bedtime, and might be just enough to add to being awake in the middle of the night.
  • Sleep at regular times, going to bed and getting up at the same time each day.  Our bodies crave regularity and habit.  Focusing on being as consistent as possible, even on the weekends, can go a long way to improving sleep.  Staying up late over the weekend is a big contributor to feeling like Mondays are, well, Mondays.  This is known as social jet lag and takes a couple of days to recover from.
  • Manage your anxiety.  Relaxation recordings, yoga nidra, hypnosis, mediation, and personal biofeedback (like HeartMath) are just some of the ways to help you wind down and go to sleep.
  • Limit alcohol.  Alcohol may help you fall asleep, but it often is a big contributor to awakening in the middle of the night.  Try a period of not drinking, I suggest 3-4 weeks, and see how this effects your sleep.

If you would like to know more about how the new medicine of integrative and functional medicine can help you to optimize your health, schedule a free 15 minute discovery phone call with me.

Schedule Free Discovery Phone Call

Office closure 9/24-10/5/15

I’m off to the high desert of New Mexico for a little R&R. Part of my journey will be an age old healing tradition of “taking the waters.” There are plenty of rich mineral hot springs around Santa Fe and Taos, that have soothed the weary and achy for as long as there have been humans. There is also something so healing about the clear mountain air, brilliant sunshine, and the sheer beauty of the land, now highlighted with aspen trees turning bright yellow. Nature is the perfect antidote to our modern, crazy pace. I will see you after 10 days of resting and hiking, and continue the healing journey in the office refreshed. Dr. Babak Kanani will be available by phone for your emergency needs while I’m away.

When is your next walk or soak in nature?

Detox Advanced Practice Module

I’m off once again to an Institute of Functional Medicine conference, this time on detox, “Understanding Biotransformation and Recognizing Toxicity: Evaluation and Treatment in the Functional Medicine Model.” Certainly “detox” is quite a buzz word now and the band wagon is full of detox products and protocols. Sorting out what is needed for an individual is key – our bodies are constantly in the process of eliminating toxic substances that we absorb and some do this better than others, and some used to do it better than they do now. Figuring this out, how and when to support one’s detox systems, can make a huge difference to our health as we all now live in the toxic swamp that is modern life.

The office will be closed from July 13th through the 15th, reopening on Thursday the 16th. As always, I will be available for urgent calls and by email while I’m in Chicago for this conference.

Office closing 3/27/14-3/30/14

Leonardo_da_vinci,_Heart_and_its_Blood_Vessels

“Heart and its Blood Vessels” by Leonardo da Vinci

I’m off to Boston for an Institute of Functional Medicine conference on Cardiovascular issues for this long weekend.  The office will be closed but I will be available by phone should you need me (unless it is an emergency, then the ER or 911 would be appropriate). The office will reopen Monday, 3/31/14.

About 2/3 of us will succumb to heart attacks.  This was not always the case.  Our modern diet and lifestyle are to blame for most of this.  Integrative medicine already has so much wisdom around how to reduce one’s risk, including options like changing to the Mediterranean diet.  This diet is based on vegetables, fruits, nuts, olive oil and fish, with small quantities of meat and poultry, with very little processed foods, flour, or sweets, and is proven to reduce your risk of heart attack, even if you’ve already had one.  This reduction can be up to 70%, more than any drug can boast, including statins.

This conference will dive more deeply into strategies to help prevent, reduce, and, in some cases, even reverse coronary artery disease and high blood pressure.  I’m excited to bring this knowledge back to all of you.

Deena

Kale Smoothies

Kale is the basis of my smoothies these days, and the farmer’s markets are overflowing with bunches. I taste a little piece of each kind and pick the sweetest most flavorful variety. These days, the lacinato kale (also known as dinosaur, Tuscan, or black kale) usually wins.

As a member of the Brassica family, also known as cruciferous vegetables, kale is a potent anti-cancer green and can help balance and detoxify hormones. As a dark green leafy veggie, it can also play a large role in keeping your brain healthy as you age. For flavor, I sweeten the smoothie with an apple and/or berries, and add a slice of lemon and a stalk or 2 of celery to balance acidity and salt. Don’t peel the lemon, as the peel has limonene, among a multitude of other antioxidants, phytonutrients and minerals, that can help the strengthen the detoxification pathways of your liver.

Kale Smoothie

Try this recipe for a Vitamix or Magic Bullet smoothie

3-4 leaves of kale
2-3 leaves of romaine lettuce
2 medium stalks of celery (I don’t add the leaves as I find them bitter)
Several stems of cilantro
¼ lemon
1 apple
¼ cup raw cashews
¼ in. slice of fresh ginger
Water and ice to help blend

What Can You Do About Your Stress?

This little video by Dr. Mike Evans packs a big punch. Stress is one of our modern scourges, and as it turns out, there are a few simple things that we can do to leave it mostly behind us. Small changes can indeed make a giant difference in our lives. Did you know that up to 70% of visits to the doctor are stress related? It increases our risks of heart attacks, depression and anxiety, and a poorer quality of life. The pharmaceutical companies do not have a cure. The commonly used SSRI class of antidepressants, for example, is no better than placebo in multiple studies for mild to moderate depression.

But what can help? As it turns out, changing our thinking is the key to managing our stress. The good news is that this can be learned. We can have a big impact on our lives by changing our thinking style by:

  • Cultivating positive thought patterns, or reframing the habitually negative ones
  • Choosing where to put our attention
  • Maintaining a focus on the big picture of our lives
  • Being in the present moment!

Virtually all diseases have better outcomes if we manage our stress well. Check out this video by Dr. Mike Evans for some inspirational and scientific details:

Asparagus is Here!

I love asparagus season. Every year, starting in March there’s a trickling of expensive asparagus, usually from Mexico, and then around April the farmer’s market fills up with the local, sweetest stalks of the year.

A native of Europe, North Africa, and Western Asia, asparagus is in the Lilly family, a cousin of the onion. Many of us know that promptly after eating asparagus, our urine has a distinctive odor. But it seems that only about 50% of Americans can detect this smell, whereas 100% of the French can, and almost no Chinese. There is debate as to whether this difference is because of one’s ability to metabolize what’s in asparagus into the stinky sulfur containing compounds, or is it the actual ability to smell them. It may be a combination of both, but the group 23andme did a population based study and may have found the autosomal dominant gene that allows us to smell that asparagus pee smell.

Its health benefits have been known for millennia throughout Europe and Asia and include cancer prevention and the treatment of heart disease, gout, joint pains, and constipation. It is a diuretic and may help prevent kidney stones and urinary tract infections. Given its high folic acid content, regular consumption can prevent neural tube birth defects. Asparagine, a “non-essential” amino acid (originally isolated from asparagus), is essential to nerve and brain function and has been used as a nerve tonic among herbalists. Asparagus is loaded with antioxidants and many vitamins including vitamins C, A, E and K, folic acid, thiamin, riboflavin, rutin, niacin, and the minerals potassium, iron, phosphorus, copper, magnesium, manganese, selenium, and chromium.

I always enjoy simply steaming or boiling asparagus briefly (2-4 minutes depending on the size) and adding a little olive oil, lemon, salt, and pepper. This year, I’ve also been eating it raw, sliced very thinly in salads with radishes, herbs, and little gem lettuce.

Asparagus scramble:
1 bunch medium sized asparagus, sliced at a diagonal
2 medium red spring onions, coarsely diced
2 tsp Dijon mustard
6 eggs
Salt and pepper to taste

Sauté the onion until translucent, about 5 minutes. Add the asparagus and continue to cook for 2-3 minutes until it turns bright green. Add a pinch of salt. Meanwhile, scramble the eggs, adding the mustard to the eggs until mixed well. Add the eggs to the pan with the onion and asparagus. Cook as you would scrambled eggs. Serve with fresh fruit or a small salad and garnish with chopped parsley or tarragon.

5 Hot Flash Remedies

Menopause can be a challenging time for many women and hot flashes are one of the most troubling symptoms. They can be embarrassing in public or at work, and they often disrupt sleep which makes all of live harder.

There are many small changes that can have big effects on hot flashes. Here are just a few:

Manage Your Stress
Our high adrenaline lifestyle may be why we have a much greater incidence of hot flashes than in other parts of the world. Find a daily method to bring calmness and relaxation that works for you. Breathing exercises can be particularly effect, like “paced breathing” where you count to 5 on the in breath, pause, and count to 5 on the out breath, making in and out the same length of time. Do this for a minimum of 3 breaths at a time, anytime and throughout your day, and notice how your body relaxes more and more with each time you practice.

Ground Flax Seed
This little seed is full of great nutrition and fiber. One small study showed a reduction of hot flashes by 50% with 2 tablespoons of flax seed taken daily. Start at about ½ Tb daily and increase the amount over a week or 2 to the full 2 Tbs. Add it to cereal, salads, or a smoothie. You can sprinkle it on almost any food.

Moderate Exercise
The benefits of daily exercise are remarkable, reducing risks of heart disease, stroke, breast cancer, and osteoporosis. Moderate daily exercise may also reduce hot flashes. Be careful, for some women, overly vigorous exercise may increase them, so pay close attention to your body.

Maca
This “super food” of the Andes was shown in a small study to reduce hot flashes. It may also have many other fantastic benefits for menopause including helping with sleep, concentration, energy, vaginal dryness, and regulating adrenal function. It is generally considered safe since it’s been eaten as a food for millennia, and the dose studied was 2 grams of the dried root daily. Add the powdered form to your daily smoothie or it can be taken in a capsule as a standardized extract of 500 mg daily. As with all herbs, check with your health care provide when taking it, and always have herb holidays.

Bioflavonoids
Rutin, hesperidin and quercetin are common bioflavonoids, well known for their antioxidant and anti-inflammatory properties. Hesperidin is found abundantly in citrus, particularly the peel. An old study from the 1960’s showed relief from hot flashes with the combination of 900 mg hesperidin, 300 mg hesperidin methylchalocone, and 1200 mg of vitamin C daily for four weeks. It can be found in citrus bioflavonoid supplements. You can also get these powerful nutrients by adding lemon or orange slices (including the peel) to your smoothie.