Sleep: Things to consider when affected by a chronic disease

There is a strong link between lack of sleep and chronic disease. According to the Centers for Disease Control and Prevention (CDC), insufficient sleep has been linked to the development and management of a number of chronic diseases and conditions, including diabetes, cardiovascular disease, obesity, and depression. Sleep and Sleep Disorders

So how much sleep do we need? There are a number of variables that can impact what we need-age, (newborns require 12-18 hours, while adults need 7-9 hours according to the National Sleep Foundation), job, pregnancy to name a view. There are people who are just fine on five hours a night and others who need at least nine. However, the one thing everybody needs is a nap.

According to John Medina, the author of “Brain Rules,” “Napping is normal. Ever feel tired in the afternoon? That’s because your brain really wants to take a nap. There's a battle raging in your head between two armies. Each army is made of legions of brain cells and biochemicals –- one desperately trying to keep you awake, the other desperately trying to force you to sleep. Around 3 p.m., 12 hours after the midpoint of your sleep, all your brain wants to do is nap. Taking a nap might make you more productive. In one study, a 26-minute nap improved NASA pilots’ performance by 34 percent. Don’t schedule important meetings at 3 p.m. It just doesn’t make sense.”

So what happens when we sleep? According to the National Institute of Neurological Disorders and Stroke, our brains are very active during sleep….Nerve-signaling chemicals called neurotransmitters control whether we are asleep or awake by acting on different groups of nerve cells, or neurons, in the brain. Neurons in the brainstem, which connects the brain with the spinal cord, produce neurotransmitters such as serotonin and norepinephrine that keep some parts of the brain active while we are awake. Other neurons at the base of the brain begin signaling when we fall asleep. These neurons appear to "switch off" the signals that keep us awake. Research also suggests that a chemical called adenosine builds up in our blood while we are awake and causes drowsiness. This chemical gradually breaks down while we sleep….During sleep, we usually pass through five phases of sleep: stages 1, 2, 3, 4, and REM (rapid eye movement) sleep. These stages progress in a cycle from stage 1 to REM sleep, then the cycle starts over again with stage 1. We spend almost 50 percent of our total sleep time in stage 2 sleep, about 20 percent in REM sleep, and the remaining 30 percent in the other stages. Infants, by contrast, spend about half of their sleep time in REM sleep.

Many people, including many with chronic conditions, take sleeping medications. However, a recently released study of 10,000 Americans, with matched controls, found that those take prescription sleep medications (such as Ambien, Lunesta) are more likely to develop cancer and are far more likely to die prematurely than those who take no sleep aids. Further, the increased rates start at low levels of prescription use. For those prescribed as few as one to 18 sleeping pills in a year, deaths were more than three and a half times greater than for those who didn’t take the medication. At the highest end, for those who took more than 132 pills a year, the risk of death was five times higher when compared to those not taking the pills. BMJ Open Access Journal

Things to Consider
• You need sleep, but how much you need can vary throughout your life. If you feel you are getting too much or too little, talk to your medical provider .

• Avoid the 3 pm medical appointment if possible, as neither you nor your provider will be at your best.

• Take a nap, even if it’s closing your office door and putting your head on the desk for five minutes. If you find napping interferes with your sleeping at night, limit your nap to no more than 30 minutes.

• Fatigue among caregivers, due to lack of sleep or sleep that is frequently interrupted, is extremely high. Consider the following:
-Arrange for respite care and/or family or friends that can stay overnight several times a week, and/or allow you to take naps.
- Set limits as to what you can do as a caregiver. If possible, encourage the person you are caring for to be more independent and/or accept help from others. Recognize that you may reach a point that the best solution for you and the person you are caring for is some type of long term care facility-such as assisted living or even a nursing home.
- Keep a “sleep log” so you are aware that you have a sleep/fatigue issue.
- Take care of yourself first and foremost because if you don’t, you wont be able to care for anyone else.

• Try to avoid sleeping medication.

• Adopt sleep habits:
- Stick to a sleep schedule
- Monitor what you eat and drink before going to bed. Too little or too much can interfere with sleep, as can what you eat-avoid nicotine, caffeine, alcohol. If you have gastric reflux, don’t eat before going to bed.
- Eliminate electronic devices in the bedroom.
- Be careful watching TV before sleep. If you do watch it, select shows that wont arouse you.
- Listening to soothing sounds and music can help you to relax.
- Meditation, prayer and deep breathing can help to calm your mind. If you wake in the middle of the night, focusing on a meditation can help you return to sleep. Avoid thinking about problems during the night by praying etc.
- Eliminate as many distractions in the bedroom as possible and create an environment that promotes sleep for you-comfortable pillow, bedding, shades, fan, earplugs etc.
- Exercise daily
- Reduce stress as much as possible

For more information on sleep, checkout the National Sleep Foundation

Take a Break: Celebrate April Fools

Celebrated throughout the world on April 1. The origins are really unknown. It may date back to 1582 when the Gregorian Calendar was introduced in France and New Year’s Day was moved from March 25-April 1 (New Year’s week) to January 1. Since communication wasn’t the best in those days, there were those who didn’t learn about the change for years, and others who refused to adopt the change, and so those who celebrated on the last day (April 1) were called “fools.” These people had practical jokes played on them and were the butt of many pranks.

Here are a variety of things you can try for April Fools this year.

• Learn more about April Fools history

• Food Pranks: There are lots of fun ways to do make dinner like dessert and vice versa. Try one of the recipes from the Food Network’s “fake out” desserts.

There is also the “meatloaf cake,” where you make your favorite meatloaf recipe in a cake pan and use mashed potatoes as the “frosting.” You can even dye the mashed potatoes a different color

• Create soap that wont lather by painting the soap with clear fingernail polish

• Bug ice-cubes: Pick up some realistic plastic bugs, ants, flies etc. Place one in each cube of an ice tray. Fill with water and place in the freezer. Serve cold drinks with the ice cubes.

• On the rocks: You can pick up a bag of rocks at the Dollar Store, clean them and when serving a drink “on the rocks,” hold off on the ice (unless it’s a bug cube) and use the clean rocks.

• 33 Harmless, Pesky Pranks

Healing the Whole Person: Ways to Increase Well-Being

2015 Edition Healing the Whole Person: Ways to Increase Well-Being

Whether you are a caregiver or living with a chronic or life threatening condition, you are more than the diagnosis. Fear, shame, vulnerability and powerlessness can be common emotions. It is easy to define yourself by what you can no longer do and how you appear. You might even feel that you have been robbed of everything that makes life worth living. Yet great things can be achieved by connecting with your inner self, identity, soul, spirit or whatever form you choose to call the core of who you are versus what you appear to be.

Regardless of your diagnosis, and maybe because of it, well-being is achievable by being positive; engaged in life; and having a sense of purpose and strong connections with others. 

While a cure for your specific condition is the direction you are moving towards, it is investing in the process that will help you heal.

Keep in mind the following:

• “Start where you’re at.” Accept and embrace that you are the way you are.

• Everything changes, including how you feel.

• Illness, aging, loss, or anything that makes one uncomfortable or suffer is not a reflection on being a good or bad person. Rather it is an opportunity for growth and change. Think of it as a “course correction” to put you on a different path.

• There’s no benefit in blaming yourself or others for your present situation

• You are doing the best you can and your best is more than good enough.

• Every one has “something” to deal with. This is your something.

• Feeling fear, rage, rejection, anger, anxiety, loneliness as well as joy, happiness, love and contentment are all part of being human.

• We’re wired for fear and it can easily run/ruin your life if you let it. As scary and frightening as loss and crisis might be, we are wired to be resilient.

• Contentment is happiness


• You can have feelings of being disconnected to yourself, family and friends. You may find yourself feeling extremely angry or sad. Be patient with yourself. If the feelings continue to persist for several weeks, or are interfering with your life, get professional help.

• Breathe!

Live in the present: Be aware of your present and not trying to relive the past or be in fear of the future.

Practice Compassion of Self and Others. Accept yourself and others for who they are, not who you think they should be. We all make mistakes. We are all worthy of love, respect and kindness. Be “for yourself.”


Know Your Purpose

Increase contentment by:
• Giving: Do things for others
• Relating: Connect with People-Call a friend, have lunch
• Exercising: Reduce TV viewing and on-line time. Take a walk, dance
• Appreciating: Notice the world around you
• Trying out: Keep learning new things
• Direction: Have goals to look forward to
• Resilience: Find ways to bounce back
• Emotion: Take a positive approach
• Acceptance: Be comfortable with who you are
• Meaning: Be part of something bigger

I believe that the very purpose of life is to be happy. From the very core of our being, we desire contentment. Dali Lama

Develop or use your spirituality and/or faith: For some this may be a renewed faith in their religion for others it is an opportunity to find beliefs that provide comfort.

Don’t lose hope

Make achievable goals

Ask for Help

Keep a Journal: Write about feelings and thoughts.

Take an Art Break: Engaging in art activities can reduce stress and increase well being. Check out the Take a Break Pinterest for lots of ideas.


Meditate/Breathe: Meditation comes in many forms. A simple meditation is one where you notice your breathe. Inhale through your nose to the count of four or more. Exhale slowly, with lips puckered, through your mouth for as long as you can. As you exhale, listen to the sounds you make. Notice how it feels to breathe in and out. Do you notice a difference in how your face feels as you let go of the tension? Repeat as many times that are comfortable for you, keeping in mind the saying, “take 10 deep breaths.” Take 10 Through Out the Day.

Manage Your Health
• Keep a health notebook: You can now do this on-line.
• Maintain healthy habits by:
    Eating whole foods-at least five servings of fruits and vegetables daily;
  -
      - Reducing sugar & caffeine in your diet;
      - Limiting alcohol to a glass of wine daily if allowed with current medications;
      - Regular exercise as health permits (consider yoga, Tai Chi and Qigong);
       - Getting sufficient sleep
• Keep medical appointments
• Join a support group to help yourself and so you can help others

• Use an advocate to help you navigate the medical system and to support you.
• Recognize you are in charge of your health care and act accordingly
• Identify resources in your community that can help you get what you need
• Develop and maintain good relationships with your health providers