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More Than Half of Elderly Report Sleep Problems

But simple lifestyle changes can improve rest, researcher says

MONDAY, July 31 (HealthDay News)  More than 1/2 of older Americans have trouble sleeping & accept it as a normal part of aging.

But there are steps elderly people can take to improve their sleep, a researcher says.

"Sleep requirements & patterns change throughout life, but sleep problems in the elderly aren't a normal part of aging," Dr. Julie Gammack, assistant professor of geriatrics at Saint Louis University, said in a prepared statement.

It's important to attempt to solve sleep problems, which can be a health risk & have a negative effect on quality of life.

"Sleep disturbance in the elderly is associated with decreased memory, impaired concentration & impaired ability to function. It contributes to an increased risk of accidents, falls & chronic fatigue," said Gammack, the author of a review article published in July's American Journal of Medicine.

The first step for elderly people with sleep problems is to keep a diary for a week or 2 that tracks: usual wake-up & bedtimes; timing & size of meals; amount of exercise; medications & descriptions of how much & how restful sleep was each night.

This information will help a doctor establish whether a person truly has insomnia.

Before prescribing medications for sleep problems, doctors should recommend certain lifestyle changes, Gammack said.

"A daytime walk with correctly timed daylight exposure is useful for insomnia. Appropriate temperature controls, adequate ventilation & dark sleep environment may also lead to dramatic improvement in sleep quality," she said.

Here are some other suggestions:

  • Increase exposure to bright light & natural light during the day & early evening.
  • Avoid napping after 2 p.m. & limit yourself to one 1/2-hour nap a day.
  • Check the effect of medications on sleep.
  • Wait until you're sleepy to go to bed.
  • Avoid heavy meals before bedtime. If you're hungry, eat a light snack.
  • Limit liquids in the evening.
  • Keep a regular schedule.
  • Rest & retire at the same time each day.
  • Eat & exercise regularly.
  • Manage stress by discussing worries long before bedtime & by using relaxation techniques.

More information

The National Sleep Foundation has more about sleep & aging (www.sleepfoundation.org ).

slowly absorb the information....

Suggestions for Better Sleep
By Michael Kirtley
The following suggestions can help you achieve better sleep & the benefits it provides. If you have trouble falling asleep, maintaining sleep, awaken earlier than you wish, feel tired after sleep, you may want to consult your physician. Be sure to tell him/her if you've already tried these ideas & for how long.

Maintain a regular bed & wake time schedule including weekends. Our sleep-wake cycle is regulated by a "circadian clock" in our brain & the body's need to balance both sleep time & wake time. A regular waking time in the morning strengthens the circadian function & can help with sleep onset at night.
That's also why it's important to keep a regular bedtime & wake-time, even on the weekends when there's the temptation to sleep-in. Establish a regular, relaxing bedtime routine such as soaking in a hot bath or hot tub & then reading a book or listening to soothing music.
A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound & deep sleep or remain asleep.
Avoid arousing activities before bedtime like working, paying bills, engaging in competitive games or family problem-solving. Some studies suggest that soaking in hot water before retiring to bed can ease the transition into deeper sleep, but it should be done early enough that you're no longer sweating or over-heated.
If you're unable to avoid tension & stress, it may be helpful to learn relaxation therapy from a trained professional. Finally, avoid exposure to bright light before bedtime because it signals the neurons that help control the sleep-wake cycle that it's time to awaken, not to sleep.

Create a sleep-conducive environment that's dark, quiet, comfortable & cool. If your mattress isn't comfortable & supportive, you might consider investing in an upgrade. Have comfortable pillows & make the room attractive & inviting for sleep but also free of allergens that might affect you & objects that might cause you to slip or fall if you have to get up during the night.
Design your sleep environment to establish the conditions you need for sleep – cool, quiet, dark, comfortable & free of interruptions. Consider using blackout curtains, eye shades, ear plugs, white noise machines, humidifiers, fans & other white noise devices to block out distractions.

Finish eating at least 2-3 hours before your regular bedtime. Eating or drinking too much may make you less comfortable when settling down for bed. It's best to avoid a heavy meal too close to bedtime.
Also, spicy foods may cause heartburn, which leads to difficulty falling asleep & discomfort during the night. Try to restrict fluids close to bedtime to prevent nighttime awakenings to go to the bathroom, though some people find milk or herbal, non-caffeinated teas to be soothing & a helpful part of a bedtime routine.

Exercise regularly. It's best to complete your workout at least a few hours before bedtime. In general, exercising regularly makes it easier to fall asleep & contributes to sounder sleep. However, exercising sporadically or right before going to bed will make falling asleep more difficult.
In addition to making us more alert, our body temperature rises during exercise & takes as much as 6 hours to begin to drop. A cooler body temperature is associated with sleep onset... Finish your exercise at least 3 hours before bedtime. Late afternoon exercise is the perfect way to help you fall asleep at night.

Avoid stimulants such as caffeine & nicotine close to bedtime. They can keep you awake. Caffeine products, such as coffee, tea, colas & chocolate, remain in the body on average from 3 to 5 hours, but they can affect some people up to 12 hours later. Even if you don't think caffeine affects you, it may be disrupting & changing the quality of your sleep.
Avoiding caffeine within 6-8 hours of going to bed can help improve sleep quality.

If you continue to have sleep problems:

Use a sleep diary & talk to your doctor. Note what type of sleep problem is affecting your sleep or if you're sleepy when you wish to be awake & alert. Try these tips & record your sleep & sleep-related activities in a sleep diary.
If problems continue, discuss the sleep diary with your doctor. There may be an underlying cause & you'll want to be properly diagnosed. Your doctor will help treat the problem or may refer you to a sleep specialist.

slowly absorb the information....

You Are Getting Sleepy

How to fight the need to sleep and sleep.
By PsychologyToday.com

Wouldn't it be nice to curl up and take a nap right now? About twenty million insomniacs pace the halls each night, but it's difficult to assess how many people suffer from excessive daytime sleepiness, known as hypersomnia. The National Sleep Foundation estimates that up to 40 percent of Americans have at least some of the condition's symptoms some of the time. Its consequences are worse than decreased productivity: Fatigue causes at least 100,000 car accidents per year, estimates the U.S. National Highway Traffic Safety Administration.

Mass drowsiness can't be pinned on any one culprit. "Sleep lives at the nexus of our social life, biology, and behavior," says James Wyatt, director of the Sleep Disorders Service and Research Center at Rush University Medical Center in Chicago. Wyatt and his colleagues send patients an eight-page questionnaire and meet with them for an hour before arriving at even a preliminary diagnosis. "We're not looking for the smoking gun, we're looking for all the indicators... it could be a biological sleep disorder, it could be a medication you are taking, and it could also be that you live near an airport or sleep with a noisy pet."

In a Trance

Hypersomnia is not merely feeling tired after a late night out. It's a stronger, more consistent sleepiness that compels you to nap, even at inappropriate times. See your primary care physician if you have a particularly hard time waking up, if you are especially anxious and irritable, and/or if you've lost your appetite. Unsurprisingly, excessive daytime sleepiness can cloud your thinking and mar your memory or even spur hallucinations.

Sleepy Sources

You can make yourself sleepy by repeatedly staying up. But narcolepsy, a neurological condition marked by uncontrollable urges to sleep, or sleep apnea, which causes interrupted breathing during sleep, are involuntary potential root causes. Factors that bring on hypersomnia (separately or in combination) also include depression or bipolar disorder, the use of prescription medicines, drug or alcohol abuse, a head injury, and a genetic predisposition toward drowsiness.

Wake-up Calls

Hypersomnia can indeed be treated. Once a doctor determines what is causing your sleepiness, he or she would treat a primary sleep disorder first.

Sufferers of sleep apnea, i.e., may be advised to use a CPAP (continuous positive airway pressure) device, a mask attached to a machine that blows air to keep nasal passages open during the night.

Antidepressants could be prescribed if your doctor believes depression, anxiety, or bipolar disorder is causing your excessive sleepiness. Stimulants are also a common treatment for hypersomnia - & new drugs such as modafinal are thought not to be habit-forming.

Exposure to artificial bright light in the morning can help reset your body's internal clock. Your doctor may advise you to cut down on your drug, alcohol & caffeine, or may use cognitive-behavioral therapy techniques to help you establish a more consistent sleep routine.

Sweet Dreams

You've heard some of these sleep hygiene tips before, no doubt, but incorporating them requires not just knowledge but self-discipline. Try keeping a sleep diary each day to hold yourself accountable as you develop better habits.

Most importantly, go to bed & wake up at set times. Try to exercise for at least 20 minutes, preferably 5 to 6 hours before bedtime. Establish a relaxing nighttime ritual such as taking a warm bath or reading - avoid watching TV or surfing the Internet too late as those images will get your mind racing when it should be settling down.

source: MSNBC / MSN Health

Teens' Sleeplessness Leads to Falling Grades

Study finds more evidence that poor rest habits lower grade point averages

THURSDAY, Feb. 1 (HealthDay News) Sleepless nights can leave their mark on teens' report cards, a new study finds.

Researchers from the University of Colorado School of Medicine analyzed 238 surveys filled out by middle-school & high-school students. The findings showed that students with lower grade point averages (GPA) were more likely to have:

  • restless, aching legs when they were trying to fall asleep
  • difficulty concentrating during the day
  • snoring every night
  • difficulty waking up in the morning
  • daytime leepiness
  • problems with falling asleep in class

The study was published in the Feb. 1 issue of the Journal of Clinical Sleep Medicine.

"While a series of previously-conducted studies all found that adolescents reporting inadequate sleep, irregular sleep patterns, &/or poor sleep quality don't perform as well in school as students without sleep complaints, this study provides additional evidence indicating that sleep disturbances occur at high frequencies in adolescents & significantly affect daytime performance, as measured by GPA," study author Dr. James F. Pagel said in a prepared statement.

He said it's important for parents to discuss their teen's sleep-related problems with a doctor.

Here are some sleep tips for teens, courtesy of the American Academy of Sleep Medicine:

  • Get a full night's sleep on a regular basis. Don't stay up late doing homework or studying for an exam.

  • If you're not asleep within 20 minutes after going to bed, get up & do something relaxing, such as reading a book or listening to music, until you're tired enough to go back to bed.

  • Get up at the same time every morning.

  • Try not to take naps after school. If you feel you have to, don't nap for more than an hour.

  • Keep a regular schedule.

  • Don't read, write, eat, watch TV, talk on the phone, or play cards in bed.

  • Don't have any caffeine after lunch.

  • Your bedroom should be quite, dark & a bit cool.

  • Don't go to bed hungry, but don't eat a big meal just before bedtime.

  • Don't do any vigorous exercise within 6 hours of your bedtime.

More information

The National Sleep Foundation has more about teens and sleep.

Sleeping Pill Sales Surge in U.S.

Americans' use of prescription sleeping pills rose nearly 50% - from 29 million to 43 million prescriptions - between 2001 & 2005, according to a study by the Consumers Union, which publishes Consumer Reports magazine.

The study said the growth in direct-to-consumer advertising of sleeping pills is one reason for surging sales, the Los Angeles Times reported.

The findings add to the debate about how drug company advertising influences medical choices made by doctors & patients. Some critics say sleeping pill ads may lead to unnecessary use of the drugs.

"We've always known there are people who suffer from insomnia. But what the advertising has done is make a big noise about a problem that may not have been that big of a problem. In a sense, they've helped create the disease," Dr. Marvin M. Lipman, chief medical officer for Consumers Union, told the Times.

In 2005, the drug industry spent more than $4 billion in consumer advertising, a fivefold increase from a decade ago. The United States is one of the few countries that allows direct-to-consumer prescription drug advertising.

Sleep Apnea Raises Truckers' Crash Risk

More must be done to curb this highway hazard, researchers say

FRIDAY, Aug. 18 (HealthDay News)  Truckers with severe sleep apnea or who sleep less than 5 hours a night when they're at home are more likely than other truckers to experience sleepiness & impaired ability while driving, a U.S. study finds.

"In the United States, approximately 5,600 people are killed annually in crashes involving commercial trucks," study author Allan L. Pack, of the University of Pennsylvania, noted in a prepared statement.

"Falling asleep while driving is an important factor in serious crashes involving commercial vehicles, prompting the question, why?" he said.

This study concluded that obstructive sleep apnea & chronically insufficient sleep are 2 main reasons.

Pack & his colleagues tested hundreds of truck drivers for sleep apnea, sleepiness & performance impairment.

"In this study, we showed that both subjective & objective sleepiness, as well as performance impairments, are common in our sample of commercial driver's license holders," Pack said.

"Chronic short sleep duration is a risk factor for subjective sleepiness, objectively measured sleepiness & performance impairments," he said. "The results for sleep apnea are less clear."

Among drivers with less than 5 hours of sleep, 49.5% had 2 or 3 performance impairments, Pack's team reported in the August issue of the American Journal of Respiratory and Critical Care Medicine.

The U.S. federal government needs to do more to reduce sleepiness in commercial truck drivers, the study authors said. This should include programs that identify "sleep-impaired" drivers thru objective testing; pinpoint & treat drivers with severe sleep apnea & monitor their adherence to therapy & promote increased sleep duration among truck drivers.

More information

The National Sleep Foundation has more about drowsy driving (www.sleepfoundation.org ).

Childhood Sleep Apnea Linked to Brain Damage

Ivanhoe Newswire

It's a wake-up call for both parents and doctors: If sleep apnea is undiagnosed or untreated in children, it might cause brain damage.

New research from Johns Hopkins University in Baltimore, reveals children with the disorder seem to have problems in 2 parts of the brain linked to learning ability.

The study compared 19 children with severe obstructive sleep apnea (OSA) to 12 children without the condition. All were between ages 6 & 16. Researchers used a special type of MRI to find changes in the hippocampus & the right frontal cortex.

IQ tests & other standardized performance tests linked the changes to deficits in neuropsychological performance like attention, learning & memory.

"We can't say with absolute certainty that sleep apnea caused the injury," reports lead author Ann Halbower, M.D., of Johns Hopkins Children's Center. "But what we found is a very strong association between changes in the neurons of the hippocampus & the right frontal cortex & IQ and other cognitive functions in which children with OSA score poorly."

Previous research has linked untreated sleep apnea to cardiovascular problems as well as problems with learning & memory in both children & adults. But this new report shows the cognitive effects of not having the condition treated might be far more damaging in children than in adults because they occur during critical developmental periods.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

SOURCE: Public Library of Science Medicine, published online Aug. 22, 2006

Sleep Apnea in Children Linked to Lower IQ Scores, Learning Impairment

Whether damage is permanent or reversible needs further investigation, study says

By Rick Ansorge
HealthDay Reporter

TUESDAY, Aug. 22 (HealthDay News) Children with untreated sleep apnea perform significantly worse on IQ tests & may have some brain impairment that could hinder their ability to learn new tasks, according to new research from Johns Hopkins University.

"This is paving new ground, scary new ground," said Dr. Ronald D. Chervin, the director of the University of Michigan Sleep Disorders Center, who wasn't associated with the study.

"The fact that children with sleep apnea would score worse on neurocognitive testing than normal children isn't new. The new part is actually showing evidence of neurochemical changes in the brain."

For the research, published in the Aug. 22 online issue of the journal Public Library of Science Medicine, Dr. Ann Halbower, medical director of the pediatric sleep disorders program at the Hopkins' Children's Center in Baltimore & colleagues looked at 31 children between the ages of 6 & 16.

19 of them had untreated severe sleep apnea, a condition associated with repeated nighttime awakenings & daytime grogginess.

Using a special type of magnetic resonance imaging (MRI), the researchers found that those children with sleep apnea had significant changes in two brain regions associated with higher mental function: the hippocampus & the right frontal cortex.

They also determined that the children had altered ratios of 3 brain chemicals:

  • N-aceytl aspartate
  • creatine 
  • choline

-- which are indicative of brain damage.

The kids with sleep apnea had lower mean IQ test scores than the healthy children (85 compared to 101) & performed significantly worse on standardized tests that measure executive functions such as verbal working memory & verbal fluency.

"Executive function is the ability to take an old memory & put it to use in a new situation," Halbower explained. "It's what makes smart people smart. The clinical implications are that doctors need to understand that sleep apnea is more of a problem that we thought it was. It's not just a disease of old people."

Because untreated sleep apnea appears to impair brain chemistry, its effects could be permanent, Halbower added.

"We can only assume that it could turn an otherwise smart kid into a mediocre kid, which could mark him for life," she said.

But it's also possible that these effects are reversible. Halbower's next study will try to determine whether sleep-apnea treatment can restore normal brain chemistry and cognitive function.

The standard treatment for sleep apnea in children is surgical removal of enlarged tonsils & adenoids, which can obstruct breathing.

Other treatments include removal of excess tissue in the back of the throat or nose & the use of continuous positive airway pressure (CPAP) machines to maintain normal airflow during sleep.

Because untreated sleep apnea may have even more severe effects in children than in adults, the sooner it's detected, the better, Halbower said.

So parents should be aware that one of the most important symptoms of sleep apnea is frequent pauses in breathing that result in arousal from sleep & stirrings in bed.

Other symptoms include snoring, labored or loud breathing, coughing, choking, gasping, excessive nighttime sweating & sometimes, bedwetting by children older than 6.

"If you're looking at an infant or young child, they may sleep in odd positions," Chervin said. "They may sleep with their rear end up in the air & their head tilted back, which is probably an effort to open their airway."

Daytime signs of sleep apnea include sleepiness, an inability to concentrate & poor performance in school. "But it should be remembered that younger children with sleep apnea aren't just sleepy," Halbower pointed out. "They also show signs of hyperactivity & irritability."

Studies have also shown that some children with sleep apnea also have attention deficit hyperactivity disorder (ADHD).

"If you have a child who snores & has behavioral problems during the day associated with ADHD, conduct disorder or oppositional-defiant disorder, talk to your pediatrician about the possibility that there could be a relationship," Chervin said. " I don't think that sleep apnea explains a majority of ADHD, but it may explain a minority of ADHD."

While the prevalence of snoring in children is about 16% to 20%, the prevalence of true obstructive sleep apnea in children is only 2% to 3%, Halbower said.

But, like the adult version, children's sleep apnea is usually unrecognized & it's often difficult for doctors to diagnose because its effects may not be evident during a typical examination.

However, Chervin cautioned that the Hopkins study, because of the small number of children studies, shouldn't be considered the last word on any possible link between sleep apnea & brain damage.

"I'd describe it as preliminary news, because it opens up a whole area that needs further investigation," he said. "It'll be fascinating to see if the neurochemical changes that were present before treatment are still present after treatment."

More information

For more on sleep apnea, visit the National Institute of Neurological Disorders & Stroke. (www.ninds.nih.gov )

Back-to-School Means Adjusting Kids' 'Sleep Clocks'

Tips on keeping youngsters well-rested as fall term begins

SUNDAY, Aug. 20 (HealthDay News)Along with getting new school supplies & clothing, re-establishing children's sleep habits should be on parents' back-to-school to-do lists.

Children tend to go to go to bed & wake up later during the summer & altering this cycle can be difficult, note experts at the University of Florida, Gainesville.

Parents should try to get their children back into a school-year sleeping schedule at least 1 or 2 weeks before classes start, said Dr. Anne-Marie Slinger, assistant professor of pediatrics, UF College of Medicine.

If a child isn't properly prepared & doesn't get enough sleep, it can really affect their school performance.

"Sleep deprivation can have a pretty significant effect on concentration, memory & even mood. If a child is chronically sleep deprived, it's far more difficult for them to participate in classroom activities & learn new things. If they're tired, they won't be engaged," Slinger said in a prepared statement.

In general, children require at least 9 hours of uninterrupted sleep to be ready for learning.

Establishing a regular sleep schedule also makes it easier to children to wake up in order to have enough time to have a healthy breakfast, another important factor in school performance.

"To help them prepare for a new school year, it's important to talk to kids so they know what to expect & to familiarize them with their daily schedule before the school year begins. There are a lot of things parents can do to ease that transition back to school," Slinger said.

For example, parents can schedule activities - such as brushing teeth, taking a bath, or reading a story - that assist the transition to bedtime.

More information

The U.S. National Sleep Foundation has more about children & sleep (www.sleepfoundation.org ).

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