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Sharpen Your Cognitive Health and Eliminate Brain Fog

Out of the Fog: Strategies to Prevent Brain Fog and Sharpen Cognitive Function

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It’s easy to take your mental health for granted until one day you realize that you haven’t been feeling as mentally sharp as you once were. Maybe you’re having more frequent slips in memory or you feel like you’re walking around with your head in a cloud. When these moments occur, you may be quick to dismiss them, but brain fog, in a sense, is the body’s way of indicating that the brain is not working the way it’s supposed to be. So, what is brain fog and why does it happen?

Brain fog is not an actual clinical condition, but rather a term for a subjective set of symptoms that people experience. Some may be affected by poor concentration or a decrease in intellectual productivity, while others may experience memory problems (difficulty with recalling words, details, etc.). Other symptoms can include feelings of confusion, depression, and headaches. People of any age and gender can experience any one or all of these symptoms at any given time.

These changes in cognitive function are not only mentally exhausting, but they can also have a very real effect on a person’s emotional wellbeing. Operating in a reduced state of mental acuity can knock down a person’s self-confidence, cause workplace productivity to suffer, and may even be a reason to withdraw from social outings. But it’s important to understand that brain fog is not a normal part of the aging process.

There are many factors that can initiate symptoms of brain fog; some that you may not think are related. Unlike dementia, which can be permanent, and in some cases, progressive, brain fog symptoms are likely to improve when contributing factors are addressed.

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How to Get Rid of Brain Fog

Here are 6 common contributors with tips on what you can do to improve or even eliminate your symptoms altogether.

1. Poor nutrition.

The connection between the brain and the gut is also known as the “gut-brain axis.” It’s a bi-directional connection, which means that the gut and the brain essentially speak to each other. This means that when the integrity of one component is compromised, the other is directly affected. Therefore, poor nutritional choices will have a direct effect on brain function.

Highly processed meals and drinks that are loaded with simple sugars and other artificial ingredients can cause a disruption in the gut flora and lead to a condition called intestinal permeability, or leaky gut. When the gut lining is weakened unwanted substances are able to break through the protective filter between the intestines and our bloodstream. The are several issues that then become a problem. The first is that the body will start to make antibodies to foods, causing allergies to foods we would not have been sensitive to when the intestine was healthy. The other issue is that when the intestinal barrier is impaired, the barrier around the brain that helps protect our brains from immune substances floating in the blood now can enter the brain and incite an inflammatory reaction. This can show up as fatigue, sleep disturbances and alterations in mood, anxiety, and depression, and brain fog.

In addition, common food additives like aspartame, Monosodium Glutamate (MSG), and nitrates/nitrites promote widespread inflammation and oxidative stress by producing free radicals that cause damage to brain cells and DNA when they overwhelm antioxidant levels in the body.

Solution: We should never take our food choices for granted! There are things that can be done nutritionally to help clear brain fog, boost energy, and increase productivity. Start by cutting down on processed foods and eating whole, organic, and non-GMO foods whenever possible. Next, eat probiotic-rich foods to help balance your gut flora and get rid of harmful bacteria. Probiotic-rich foods include sauerkraut, kimchi, Kombucha (watch out for sugar content), and kefir. If you have trouble getting these foods onto your plate, another great way to get good bacteria into your diet is supplementing with a daily probiotic.

2. Biotoxicity and Neurotoxicity

Biotoxins and neurotoxins are environmental toxins that can poison our physical and mental health. As toxins penetrate the blood-brain barrier, they are free to circulate throughout the body – including the brain! Once there, the glial cells that work to defend the nerves and brain cells from damage are compromised and unable to do their job. Although the symptoms vary, a common complaint of someone diagnosed with some form of toxicity is brain fog.

Solution: Eliminating biotoxins and neurotoxins from your home is the first step in any detoxification process. This may mean professional removal of mold-infested areas, air purification, and a change to buying “green” products that do not contain harmful ingredients like pesticides and other toxic ingredients. You’ll also need to make changes to your diet to exclude food items that may contribute to leaky gut. A compromised gut lining will allow more toxic substances to circulate through your body instead of being eliminated. If you have symptoms of brain fog talk to your physician about whether getting tested for the presence of biotoxins or neurotoxins makes sense for you.

3. Sleep Disorders

In the United States, as many as one-third of adults do not get the quality of sleep the body requires. It’s during sleep when the body is able to repair itself by calming inflammation and maintaining hormone production. When these two processes – both important elements in brain health – are compromised it can negatively impact your memory, decision-making, the capacity to focus one’s attention, and the ability to complete complex creative activities, among other things.

Solution: There are a lot of things you can do to improve your sleep pattern. Breathing techniques, meditation, dietary adjustments, starting an exercise routine (or adjusting your current one), and establishing a bedtime routine are just a few examples. If you think you may have an actual sleep disorder, a first step in further evaluation is to answer the eight questions on the Epworth Sleepiness Scale. If your score is equal to, or higher, than 10, the results should be discussed with your doctor.

4. Celiac Disease

People with Celiac Disease (CD) are no strangers to brain fog. Just like poor nutritional choices can lead to leaky gut, so can an allergy or sensitivity to gluten. The difference is, with Celiac Disease your immune system mistakes gluten, a normally benign food ingredient for most, as a foreign and deadly invader. When it’s detected in the body, the immune system begins to attack and destroy the gut lining and causes leaky gut. Once the villi are damaged the body is unable to absorb the nutrients it needs to keep the brain and body healthy and allows harmful substances to enter. Brain fog is a common symptom of people who are ultimately diagnosed with Celiac Disease or gluten intolerance.

Solution: Patients who have been diagnosed with Celiac disease and/or gluten intolerance report a noticeable and significant improvement in cognitive impairment after eliminating gluten from their diet.

5. Estrogen

In women, the onset of menopause can trigger a myriad of symptoms including fatigue, weight gain, mood swings, hot flashes, joint pain, and brain fog. Research suggests that when it comes to changes in memory and other mild cognitive impairments that accompany menopause, the decline of estrogen levels may be partly to blame. We know that the brain is full of estrogen receptors that have neuroprotective and antioxidant benefits. The decline of estrogen during menopause compromises neuronal function and increases the risk of developing age-related neurodegenerative disorders.

Solution: Although there is no single solution that works for every woman, bioidentical hormone replacement therapy can relieve many of the unpleasant symptoms that most women experience during menopause, including brain fog. Talk to your doctor about a screening that will help identify hormonal imbalances so they can be effectively treated.

6. Side-Effects from Medication

Statistics show that over 20% of US adults report using 3 or more prescription drugs in the past 30 days and nearly 12% use 5 or more. Additionally, it’s not unusual that patients receive prescriptions from specialists in addition to their primary care physician, and supplement use is not always reported accurately. This leaves a lot of room for unwanted side effects, including brain fog.

Solution: Make sure to review your medications with your primary physician annually, and more often if necessary, particularly if you feel like you haven’t been yourself.

In sum, the good news about brain fog is that there are ways to help clear it up, boost your energy, and improve your productivity and memory. The key is keeping your brain well-fed, your body well-rested, and keeping your physician in the know about any changes in your mental acuity.

For individuals who would like to work directly with our providers, we offer comprehensive services that utilize the best alternative and conventional medicine solutions to keep your brain young, healthy, and vital. For more information or to make an appointment with one of our providers please call 703-532-4892.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

References:

Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals of Gastroenterology. 2015;28(2):203-209.

Jedrychowski, Et al. Cognitive function of 6-year old children exposed to mold-contaminated homes in early postnatal period. Prospective birth cohort study in Poland. Physiology & Behavior. Volume 104, Issue 5, 24 October 2011.

Lichtwark , Et al. Cognitive impairment in coeliac disease improves on a gluten‐free diet and correlates with histological and serological indices of disease severity. Alimentary Pharmacology & Therapeutics. Volume 40, Issue 2, July 2014.

Yelland GW, Gluten-induced cognitive impairment (“brain fog”) in coeliac disease. Journal of Gastroenterology and Hepatology. 2017 Mar; 32 Suppl 1:90-93. doi: 10.1111/jgh.13706.

Zárate S, Stevnsner T, Gredilla R. Role of Estrogen and Other Sex Hormones in Brain Aging. Neuroprotection and DNA Repair. Frontiers in Aging Neuroscience. 2017;9:430. Published 2017 Dec 22. doi:10

Downshift_for_restful_sleep

Downshift Your Day and Get Set for Restful Sleep

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Great things happen when we are well-rested: our breath is full, slow, and deep, the digestive system works well, and the body can focus on repair – including reduction of inflammation, tissue repair, and hormone production. In fact, getting regular, restful sleep is the best medicine for improving a health condition or for simply maintaining a healthy lifestyle. But modern living comes with a price. Overbooked, highly stressed, and often running on reserves, as many as one-third of adults in the United States are not getting the quality of sleep the body requires.

Impact of Stress on Body

Let’s face it, stress is a fact of life. Stress is a biological and psychological response that occurs when we encounter a threat that we do not feel we have the resources to deal with. Any number of stressors, such as exams, divorce, illness, the death of a loved one, moving, or job loss, will create a physical response in the body. You may experience an increase in heart rate, an increase in breathing, a rush of energy to the limbs, a decrease in digestive activity (impacting elimination), and the liver is stimulated to release glucose for energy.

This physiological process also referred to as fight, flight, or freeze, is an instinctual survival mechanism controlled by the autonomic nervous system (ANS). When we operate under stress on a daily basis, the heightened activity of the ANS can end up causing more damage than benefits. The key becomes how a person can effectively manage – or downregulate – the stress response, and this is something that can be practiced and developed over time.

Self-Assessment

By answering a few simple questions you can get a good sense of whether the amount and quality of sleep you are getting on average per night is enough. If your answer is “no” to any one of the questions below, it’s a good indicator that your sleep pattern needs adjustment*.

  1. Do you have a regular bedtime?
  2. Do you get up at the same time every day?
  3. Do you sleep the entire night through?
  4. Do you have a way to downshift or release stress from your day?
  5. Do you wake up in the morning feeling rested and restored?

 

*If you are concerned that your sleep pattern indicates a serious problem, please give us a call at 703-532-4892 and ask to speak to a nurse or schedule an appointment. 

Preparing for Restful Sleep

Once you’ve identified that your sleep pattern needs improvement, there are several ways to teach yourself how to downregulate the nervous system in order to prepare for a better night’s sleep. This means setting some guidelines for yourself during the day and establishing a nighttime/sleep routine.

During the daytime:

  • Avoid drinking caffeinated beverages after noon and exercise should also be completed a solid two hours before sleeping.
  • If there are worries on your mind, jot them down in a journal to temporarily release them from your mind. Keeping a running list of “things to do” handy also helps to clear your mind before the evening.
  • Another extremely important element to getting restful sleep is managing others’ expectations and honoring your own boundaries. Taking on more tasks than one can handle is quite common, but it can really push us to our limits and cause unintentional stress. By setting some boundaries and staying within those lines as much as possible we can make more time available to decompress from the day’s activities.

In the evenings, aim for the following:

  • Avoid food or excessive drink after 7 p.m.
  • Avoid caffeine after Noon
  • Avoid alcoholic beverages
  • Honor your bedtime
  • Dim lights & disconnect from technology 2 hours before bed. Yes, 2 hours!
  • Arrange for comfort (soft sheets, warm blankets, and comfortable clothing)
  • Set the room temperature to one that is comfortable for you (some people sleep better in a cooler room)
  • Soothe the nervous system with meditation and stress reduction exercises – for tips, read on!

Stress Reduction

Aside from meditation, there are a number of exercises and other techniques to relax the nervous system before bed that can be done either with a partner or alone.

Just Breathe…

Belly breathing, also called diaphragmatic breathing, can soothe the nervous system. Watch and feel your belly expand with each inhalation. Breathing into the belly, instead of the upper lungs, can slow the heart rate and calm the nervous system. In addition, when your exhale breath is longer than your inhale breath, the heart rate slows down.

Practice inhaling for 2 counts and exhaling for 4 counts and repeat. As your heart rate slows, you may try to do a 4 count inhale and a 6 count exhale. Repeat this 4-5 times at least 30 minutes before bed. Note that your body may respond differently to the breathing, listen to your body and notice what calms your system and practice that.

Adrenal HoldAdrenal Hold

This is a soothing partner activity which involves cradling the adrenals to initiate feelings of calmness and relaxation. We have two adrenal glands, located on the top of each kidney. The adrenals are responsible for releasing the hormones cortisol, aldosterone, adrenaline, and noradrenaline that, among other processes, are involved in the fight, flight or freeze response.

Have the receiver sit comfortably in a chair so their partner, the holder, can easily reach their back to gently cradle the adrenals with warm hands (please, no energy work or bodywork). The holder creates a “safe basket” of warmth for the glands and allows the receiver to relax. This can also be done without a partner by using a warm pack for 5 minutes on the area. After a few minutes, the receiver will notice that they start to slow their breathing and may start to feel more relaxed. This is a wonderful way to calm down after a busy day of work and settle into a restful evening.

Triple Warmer Meridian

Within Traditional Chinese Medicine’s perspective on healing, you’ll find the concept of body meridians. Twelve major meridians channel life energy – or Qi – throughout the body, interacting with every major organ system. Good health is an indicator of balance within these energy pathways; likewise, diminished health and illness are indicative of an imbalance that must be corrected.

Triple Warmer is the meridian that controls our fight, flight or freeze response. According to Donna Eden, author of Energy Medicine, the triple warmer impacts the immune system and our ability to manage stress. When it is activated, the body is on high alert. When you practice tracing your triple warmer meridian backward, it can sedate or calm the fight or flight response.

For Triple Warmer techniques based on Donna Eden’s program, click here.

Other Tools to Achieve a More Restful Sleep

Create a bedtime routine to prepare your body for sleep.  This may include setting the stage so you are most comfortable and relaxed and ready for sleep:

  • Calming fragrances (lavender, chamomile)
  • Calming beverages (Organic Chamomile tea, Sleepy Time tea)
  • Dimming bedroom lights at least an hour before bed
  • Eye bags
  • SleepPhones and soothing sounds
  • White noise or a fan
  • Weighted Blanket – The deep pressure generated from a weighted blanket signals the brain to release serotonin, which in turn naturally calms and relaxes the body, promoting sleep and stress relief. Weighted blankets help calm children and adults with sensory integration disorder, autism, Rett Syndrome, Asperger’s Syndrome, ADHD, PTSD and Restless Leg Syndrome!

Sleep is our birthright and we have more control over it than we may think! Find the methods that work best for you to enjoy better quality sleep and the health benefits that go along with it.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

References

Centers for Disease Control and Prevention: Sleep and Sleep Disorders

AlShareef SM. The impact of bedtime technology use on sleep quality and excessive daytime sleepiness in adults. Sleep Sci. 2022 Apr-Jun;15(Spec 2):318-327. doi: 10.5935/1984-0063.20200128. PMID: 35371396; PMCID: PMC8906383.

Green, M. Cohen-Zion, A. Haim & Y. Dagan (2017) Evening light exposure to computer screens disrupts human sleep, biological rhythms, and attention abilities, Chronobiology International, 34:7, 855-865, DOI: 10.1080/07420528.2017.1324878

Cleveland Clinic: Diaphragmatic Breathing

Ma X, Yue ZQ, Gong ZQ, Zhang H, Duan NY, Shi YT, Wei GX, Li YF. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Front Psychol. 2017 Jun 6;8:874. doi: 10.3389/fpsyg.2017.00874. PMID: 28626434; PMCID: PMC5455070.

The Relationship Between Sleep & Good Health

The Relationship Between Sleep & Good Health

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In our pursuit of optimal health, we often concentrate on diet and exercise, sometimes overlooking a critical aspect: sleep. The connection between sleep and good health is profound, influencing various facets of our well-being that go beyond just feeling rested.

At the heart of this connection is the fundamental role sleep plays in regulating our body’s functions and supporting the day to day activities that our body carries out. Adequate sleep isn’t merely about feeling refreshed,  it’s a cornerstone of good health.

Here are six benefits of getting good quality sleep

1) Heart health
Sleep plays a pivotal role in our cardiovascular and metabolic health. Consistently getting a good night’s sleep of at least seven hours can help regulate our blood pressure and reduce the risk of heart disease and stroke. In fact, studies have shown that sleep deprivation is associated with an increased risk of hypertension, coronary heart disease and diabetes. So sleep has an outsized impact on our heart.

2) Enhanced mental health
Quality sleep is closely linked to mental wellness. It contributes to cognitive function, memory consolidation, and emotional stability. Additionally, the link between sleep and mental health is bi-directional. This means that experiencing conditions such as anxiety and depression can affect our sleep. Sleep can impact our mental health and mental health can impact our sleep.

3) Immune system support
The process of sleep gives the immune system a chance to strengthen, repair and rejuvenate itself. During sleep, the immune system releases proteins known as cytokines, which increase during periods of infection, inflammation, or stress. Sleep deprivation can lower the production of these cytokines and reduce the number of infection-fighting antibodies and cells.

4) Weight management
The relationship between sleep and weight is intricate. It is governed by hormones that regulate hunger and satiety -the feeling of being full. It is also tied to our metabolism and insulin levels.. When the link between these factors is disrupted, it can result in unforeseen weight gain. Inadequate sleep acts like a disruptor and it can lead to increased appetite and weight gain over time.

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5) Removal of waste products from the brain
Researchers believe that sleep may promote the removal of waste products or toxins from brain cells—something that appears to occur less efficiently when the brain is awake. Essentially, sleep helps to flush out toxins in the brain that build up during waking hours.

6) Cellular restoration
Sleep is a crucial time for the body to repair tissues, restore energy, and release growth factors essential for growth and development.

Sleep is an extremely complicated process that even scientists do not fully understand. But when you consider that we spend about one third of our life sleeping, the process of sleep takes on even greater importance. Therefore, understanding the significance of quality sleep in overall good health is vital.

How much sleep should you get

The question of how much sleep to get each night is both easy and hard to answer. Different people require differing amounts of sleep to stay healthy so exact sleep time needs vary from person to person. Officially, the Centers for Disease Control (CDC) recommends that most adults get between 7 and 9 hours of sleep per night. But when it comes to how much sleep you personally need, listening to your body is incredibly important. Consider how you feel when you wake up – are you refreshed or still tired? The goal is to wake up from sleep feeling alert, energetic and not fatigued. That would be considered as having a good night of quality sleep.

Strategies for better quality sleep 

For the reasons listed above, good sleep plays a key role in our health. Conversely, insufficient sleep and untreated sleep disorders can be detrimental to it. When thinking about good sleep hygiene and strategies for better sleep, remember to:

  • Prioritize sleep: Make a conscious effort to get 7-9 hours of quality sleep each night. Create a relaxing bedtime routine, limit screen time before bed, and ensure your sleeping environment is comfortable and conducive to rest.
  • Establish a sleep schedule: Consistency is key. Going to bed and waking up at the same time every day helps regulate your body’s internal clock, promoting better sleep quality.
  • Environment matters: Make sure your bedroom is quiet, dark and at a comfortable temperature. The idea is to make your space for sleep a warm, welcoming and relaxing one.
  • Get your exercise done earlier on in the day: Engage in regular physical activity but try to complete your workout at least a few hours before bedtime. Exercise can contribute to better sleep but intense workouts too close to bedtime may have the opposite effect.
  • Limit screen-time: Studies confirm that screen time in the evening can disrupt your natural sleep-wake cycle. At least one hour before going to bed, unplug from all of your gadgets and consider removing electronic devices, such as tablets, computers, and smartphones, from the bedroom altogether.
  • Watch what – and when – you eat: Eating close to bedtime not only affects digestion and sleep quality but it can also lead to other health problems like GERD. Avoid eating meals or excessive drink (including alcohol) after 7 p.m. and avoid drinking caffeinated beverages after noon.

A lot of good things happen in our brains while we sleep: learning and memories are consolidated, waste is removed and the immune system works to restore and repair cellular damage. So remember to ask for help if you’re having difficulty falling asleep or staying asleep – a good night’s sleep is worth investing in.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845795/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

ttps://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html

 

 

TAKE THE QUIZ

Take the sleep apnea quiz.
lifestyle_medicine

Lifestyle Medicine and Chronic Disease

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Changing behavior is hard. Changing the way we think about a topic, an issue, or a pattern that we routinely engage in is hard. In fact, making change is so difficult that there’s an entire field of psychology dedicated to it. It’s the science of behavioral change and it looks at how we make change successfully and why.

Whether it’s the ability to start exercising, eating healthier foods, or just doing things to reduce stress levels, change takes effort. For example, study after study shows that after starting a new diet, most people will eventually regain the weight they lost. Experts think that as many as 80 to 95% of dieters gain back the weight they worked so hard to lose. Although that’s a bit disheartening, the point is that making meaningful and lasting change is a process and not a quick fix. This is true for many things, but it is especially true for lifestyle habits that impact our health. And this is where lifestyle medicine enters the picture.

What is Lifestyle medicine?

Lifestyle medicine is a field of medicine that uses behavioral change psychology to help tackle the rising levels of chronic disease. Chronic problems like heart disease, obesity, stroke, hypertension, cancer, and diabetes are among the most prevalent and costly health conditions in the United States. Consider that approximately 60% of all Americans suffer from at least one chronic disease; and this number is only increasing.

Lifestyle medicine can play an important role in the management of chronic disease because many of these conditions revolve around the same lifestyle issues – exercise, healthy eating, restful sleep, ideal body weight and reducing the esposure of harmful substances. Furthermore, promoting healthier habits and reducing stress can serve as an important tool for lowering inflammation and mitigating pain and depression – components of many chronic diseases. We know from research that engaging in certain positive lifestyle changes early on can dramatically lower the risk of developing these illnesses in the first place.

Lifestyle medicine focuses on these key aspects of health:

Physical activity

Study after study shows that regular and consistent physical activity is one of the best ways to improve mood, health, and longevity.

Stress

Periods of stress that come and go are natural but if stress becomes a constant part of an individual’s life, it can have negative impact on health. Ongoing stress can affect heart health, digestion, mental wellbeing (mood, focus), and physical health.

Nutrition

Research has highlighted the benefits of a healthy and nutrient-rich diet in lowering inflammation and reducing the risk of heart disease, high blood pressure and other medical conditions. The role of good nutrition in overall wellbeing cannot be understated.

Restorative sleep

Good sleeping patterns and habits can help bolster the immune system, remove waste products from the brain, improve focus and physical energy, and help lower the risk of stroke, obesity, heart disease and high blood pressure.

Mental health

Human beings are social creatures and meaningful social connections make up a large part of one’s mental and spiritual well-being. Research has shown that individuals who have stronger social connections are more resilient and less likely to develop cognitive impairment.

Lifestyle medicine attempts to address all of these areas. It does not mean that all of these items need to be fixed in a jiffy; it just means that the importance of these factors and their role in good health should be recognized. If there is a particular area where changes can be made to improve your health, then a discussion should be had with your provider.

Where do you begin?

The first step is being open to change; self-motivation is key. You should educate yourself and be open to understand the benefits of the change you want to make to keep you motivated and focused on your goals. Can you foresee some challenges? Try o identify any barriers that are keeping you from moving forward and be prepared to deal with setbacks because they will happen. Be forgiving and keep moving forward.

For many, having an accountability partner or being a part of a structured program that considers the key aspects listed above can be the difference between success and failure. Lifestyle program teams are trained and experienced in these challenges and are supportive to those who are ready to embrace these changes.

Lifestyle medicine is relatively new as a field of practice and its principals are very similar to those of functional medicine (functional medicine also investigates and treats the root cause of disease and dysfunction). It sheds light on the importance of the day-to-day activities that we undertake, how they impact us, and why small changes can make a huge difference. Although change is hard, it is possible, and lifestyle medicine speaks to the tools and resources that we can use to help bring those positive changes about.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

 

References

https://www.acpm.org/initiatives/lifestyle-medicine/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876976/

https://health.clevelandclinic.org/why-people-diet-lose-weight-and-gain-it-all-back/

https://www.cdc.gov/chronicdisease/index.htm

https://pubmed.ncbi.nlm.nih.gov/21056174/

https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-science-of-sleep-understanding-what-happens-when-you-sleep

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9985951/

 

 

Identifying_sleep_apnea

Could You Have Sleep Apnea? 3 Things to Consider

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Obstructive Sleep Apnea (OSA) is a condition characterized by pauses in breathing while you sleep. It usually occurs when the soft tissue in the rear of the throat collapses and the airway is blocked. Throughout the night as an individual struggles to breathe, they repeatedly leave deep sleep and partially awaken as they gasp for air. However, when morning comes they are unaware of their sleep disturbance. According to the National Sleep Foundation, sleep apnea affects somewhere between 10-30% of adults.

Symptoms and risk factors

OSA symptoms may first be noticed by another person, like snoring loudly (although not everyone who snores has sleep apnea), gasping for air, and moments when you stop breathing during sleep. Other symptoms can include headaches, daytime sleepiness, and waking up with a dry mouth.

The risk factors for the disorder include being overweight, male, and more than 40 years of age; but the disorder can affect anyone (even small children whose breathing may be obstructed by enlarged tonsils). Unfortunately, most sufferers are unaware that they have the disorder, so it often remains undiagnosed. But ignorance is not bliss.

Untreated obstructive sleep apnea can cause a host of serious medical problems including chronic tiredness, headaches, memory lapses, irritability, weight gain, depression, increased sensitivity to body aches and pain, and for postmenopausal women, an increase in joint pain. It also places sufferers at a higher risk of developing heart disease, stroke, and high blood pressure.

Finally, excessive sleepiness has public safety consequences: The American Automobile Association (AAA) estimates that one out of every six (16.5%) deadly traffic accidents, and one out of eight (13%) crashes requiring hospitalization of car drivers or passengers is due to drowsy driving.

Diagnosis and treatments

If you suspect you may have sleep apnea, you shouldn’t delay an evaluation. A good place to start is the Epworth Sleepiness Scale. It asks Eight Questions to assess your risk – if your score is equal to or higher than 10, you are at high risk for sleep apnea and should consult your provider. At The Kaplan Center, to help us detect sleep apnea, as well as providing markers for quality of sleep, we prescribe our patients a recyclable Home Sleep Apnea Test called the WatchPAT ONE (scroll down for more information).

Although there is no cure, there are steps you can take to help you get a more restful sleep. Here are 3 things to consider doing now:

  1. Examine your lifestyle factors. Weight loss and/or maintaining a healthy weight, eliminating alcohol, and smoking cessation have all been shown to improve sleep. A one-step-at-a-time approach for any major lifestyle modifications will help you maintain these healthier practices for life.
  2. Consider trying a mouthpiece. Patients diagnosed with mild to moderate sleep apnea may benefit from using an oral appliance. These are customized mouthpieces that are meant to reposition your jaw and/or tongue, depending on the specific device, to help keep your airway passage open while you sleep. If you think this may be a good fit for you, speak to both your healthcare provider and dentist for more information.
  3. If you have been diagnosed with moderate-to-severe sleep apnea, a CPAP (continuous positive airway pressure) machine may be recommended by your provider. The machine uses a mask that fits over the mouth and nose, or just the nose, and gently blows air into the throat. The pressure from the air helps keep the airway open during sleep, minimizing disturbances due to sleep apnea.

Again, if you think you may be suffering from sleep apnea or another type of sleep disorder, don’t put off seeking help. Your sleep is very important, and we are here to get you back on track. Call us at 703-532-4892, ext. 2 to make an appointment.

WatchPAT® ONE for Diagnosing Sleep Apnea and Other Sleep Disorders

WatchPAT ONE Home Sleep Apnea Test (HSAT) can be a valuable tool to help us monitor if there are adequate amounts of Deep and REM sleep, apnea episodes, oxygen and heart rate, snoring, movement, and more.

Patients benefit from:

  1. Convenience. WatchPAT ONE utilizes Bluetooth technology which allows patients to pair the device to their smartphone using Itamar’s proprietary app. Sleep study data is collected during the test and automatically sent to a secure, cloud-based server. Once the test is complete, a comprehensive report is automatically generated and sent directly to the prescribing physician.
  2. An accelerated diagnosis. The sooner we have your data the sooner we can devise a treatment plan to improve your sleep.
  3. Less travel. Patients do not need to come into our office to pick up or return their equipment.
  4. A safe, hygienic product. Using a fully disposable product cuts down on the concern of spreading infection. No cleaning, sanitizing, or reusing of equipment.

For more information about sleep apnea, please visit the National Institute of Neurological Disorders & Stroke website.

This article was originally published in March 2016. It was reviewed and updated in May 2023.

We are here for you, and we want to help.

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References

National Sleep Foundation

Owens, J.M., Dingus, T.A., Guo, F., Fang, Y., Perez, M., McClafferty, J. & Tefft, B.C. (2018). Prevalence of Drowsy Driving Crashes: Estimates from a Large-Scale Naturalistic Driving Study (Research Brief). Washington, D.C.: AAA Foundation for Traffic Safety.

Li, M., Zou, X., Lu, H. et al. Association of sleep apnea and depressive symptoms among US adults: a cross-sectional study. BMC Public Health 23, 427 (2023). https://doi.org/10.1186/s12889-023-15358-8

Odai T, Terauchi M, Umeki H, Miyasaka N, Somekawa Y. Sleep apnea in postmenopausal women is associated with joint pain severity and fatigability: a cross-sectional study. Menopause. 2022 Jun 1;29(6):680-686. doi: 10.1097/GME.0000000000001974. PMID: 35231006.

Gomase VG, Deshmukh P, Lekurwale VY. Obstructive Sleep Apnea and Its Management: A Narrative Review. Cureus. 2023 Apr 10;15(4):e37359. doi: 10.7759/cureus.37359. PMID: 37182079; PMCID: PMC10174073.

RMIT University. (2019, January 31). Sleep apnea creates gaps in life memories: People with sleep apnea struggle to remember details of memories from their own lives, putting them at risk of depression. ScienceDaily.

 

 

 

Dealing with Anxiety

8 Commonly Overlooked Causes Of Anxiety and Depression

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With the right treatment, people seeking relief from depression or anxiety can live happy, productive lives. But if you’re one of the many Americans seeking relief from depression or anxiety, you’re no doubt aware of just how elusive successful treatment can be. It is estimated that as many as 30% of depressed patients do not respond to treatment, raising an important question: could it be that we’re thinking about — and therefore treating — these conditions in the wrong way?

A growing body of research suggests that depression and anxiety might not be mental disorders in and of themselves, but rather symptoms of a physical inflammation stemming from increased microglial activity in the brain. Microglia are the immune cells of the Central Nervous System (CNS) and are responsible for producing inflammatory chemicals in response to infection or other CNS damage.

This gives the medical community and those living with these debilitating conditions new hope. In thinking about depression and anxiety as symptoms, we’re afforded new insights into potential root causes, as well as alternative methods of treatment.

Here are eight often-overlooked causes of depression and anxiety that you should consider:

1. Celiac disease or gluten intolerance.

About 1% of Americans have celiac disease, an autoimmune disorder caused by the body’s negative reaction to gluten, the protein found in wheat, barley and rye. And gluten intolerance — also called non-celiac gluten sensitivity — is estimated to impact six times as many Americans.

While we don’t yet understand the mechanism of gluten intolerance in the body, the impact can be very similar to that seen with celiac disease. While intestinal complaints are most common, research is showing that some people with these conditions may, in fact, present with anxiety and depression as the only symptoms.

You can test for celiac disease with a simple blood test. The only way to test for gluten intolerance is to go gluten-free for six weeks and watch for any improvement. (Before making any major dietary changes, make sure to consult your provider or a registered dietitian.)

2. Sleep apnea.

There are two types of sleep apnea. Obstructive sleep apnea is the more common form and occurs when the soft tissue in the back of the throat collapses, thereby blocking the airway during sleep. Central sleep apnea, although not as common, is a result of the brain forgetting to tell the body to breathe. Studies confirm the relationship between sleep apnea and depression.

If you get plenty of sleep but never feel quite rested, or you find yourself often nodding off, a first step you can take is to answer the 8 questions on the Epworth Sleepiness Scale. If your score is equal to or higher than 10, the results should be discussed with your provider.

3. Lyme disease.

Lyme and other tick-borne diseases are becoming increasingly prevalent. While the most common symptom is joint pain, these diseases can also be associated with depression and anxiety disorders (affective disorders).

This link between Lyme disease and neuropsychiatric disease was first documented in 1994 in the American Journal of Psychiatry and has been widely documented since, but the potential connection is frequently overlooked when diagnosing those with psychiatric illness. If you are suffering from chronic pain and a mental disorder, this diagnosis should be considered.

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4. Unhealthy diet.

A study published in PNAS (Proceedings of the National Academy of Sciences of the United States of America) confirmed that “…frequent fried food consumption is strongly associated with a higher risk of anxiety and depression.”

On the other hand, eating a diet high in omega-3 fatty acids (fish oils, walnuts, and flaxseed) and antioxidants (colorful fruits, berries, and greens including spinach, broccoli, and collards) can help provide the brain with the nutrients it needs to repair free radical damage and optimize function.

5. Thyroid disease.

Both an under-functioning thyroid (hypothyroidism) and an over-functioning thyroid (hyperthyroidism) can present as depression or anxiety — not to mention other symptoms like weight changes and exhaustion. If you suffer from depression or anxiety, you may wish to have your thyroid hormone levels checked to rule out any disorder.

6. Medications.

It’s also possible that regular medications may be causing or worsening your depression or anxiety. Beta-blockers used to treat high blood pressure are known to cause depression, and acne-fighting Accutane, birth control pills, and even statins all list depression as a possible side effect.

If you take medication regularly, I recommend talking with your provider about the chances that your medication is bringing you down or making you anxious.

7. Toxic mold exposure.

Exposure to certain indoor molds can result in a wide range of symptoms, including depression, ADHD, difficulty concentrating, fatigue, chronic sinus infections, and various pulmonary and neurologic issues. If you fear that you’ve been exposed to indoor molds, it’s critical that you speak with a physician who is familiar with mold toxicity disorder.

8. Coffee.

Several studies have demonstrated a link between coffee consumption and heightened anxiety. While most people can tolerate one to two cups of coffee per day without issue, if you are prone to anxiety, you may want to rethink your morning pick-me-up. Try cutting out coffee altogether for at least two months and observe whether or not your mental state changes as a result.

This article first appeared in Dr. Kaplan’s column on MindBodyGreen.com in September 2015. It was reviewed and updated in May 2023.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Additional Resources

Harding CF, Pytte CL, Page KG, Ryberg KJ, Normand E, Remigio GJ, DeStefano RA, Morris DB, Voronina J, Lopez A, Stalbow LA, Williams EP, Abreu N. Mold inhalation causes innate immune activation, neural, cognitive and emotional dysfunction. Brain Behav Immun. 2020 Jul;87:218-228. doi: 10.1016/j.bbi.2019.11.006. Epub 2019 Nov 18. PMID: 31751617; PMCID: PMC7231651.

Temple JL, Bernard C, Lipshultz SE, Czachor JD, Westphal JA, Mestre MA. The Safety of Ingested Caffeine: A Comprehensive Review. Front Psychiatry. 2017 May 26;8:80. doi: 10.3389/fpsyt.2017.00080. PMID: 28603504; PMCID: PMC5445139.

supplement labels

Sleep Supplement Study Exposes Label Inaccuracies

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During the Covid-19 pandemic, many people turned to sleeping pills and supplements to improve disturbed sleep cycles either for themselves or for their children.

In 2022, prompted by a large increase in pediatric melatonin poisonings, particularly during the pandemic, researchers from the Cambridge [MA] Health Alliance and the University of Mississippi looked to assess several brands of the popular sleep supplement, melatonin. What they specifically wanted to examine was the quantity of melatonin as compared to its label and if any other non-labelled ingredients such as cannabidiol (CBD) were present.

The study, which was published in JAMA in April 2023, looked at 25 over-the-counter brands of melatonin gummies and found that most of them (88%) contained more melatonin than the labeled quantity, in some cases far more, and five brands even contained CBD! While the study only looked at a small sample of supplements, this is not very reassuring for the supplements industry.

To understand how this can happen you have to understand how the Federal Drug Administration (FDA) “regulates” supplements. The FDA does not approve dietary supplements before going to market; their role in regulating supplements begins after the product is available to consumers. According to the Dietary Supplement Health & Education Act of 1994 (DSHEA)

  • Manufacturers and distributors of dietary supplements and dietary ingredients are prohibited from marketing products that are adulterated or misbranded. That means that these firms are responsible for evaluating the safety and labeling of their products before marketing to ensure that they meet all the requirements of the Federal Food, Drug, and Cosmetic Act as amended by DSHEA and FDA regulations.(1)
  • FDA has the authority to take action against any adulterated or misbranded dietary supplement product after it reaches the market.(2)

Again, it is the manufacturer’s responsibility to provide a good, safe product that is effective and free of impurities and contaminants. The FDA will act only when an issue has been brought to their attention.

Now, are all sleeping aids bad? Do you have to stop buying supplements? Absolutely not. But we must work within the framework we are given, which means when it comes to buying supplements, making sure you’re buying from a trusted source.

Once restricted to just our patients, in 2021 we opened The Kaplan Center Store to the public. Now anyone looking to buy high-quality supplements can access our store. Our providers have taken the time to vet every one of the manufacturers we carry and can attest to the fact that they provide a quality product that’s been thoroughly tested and contains the ingredients it claims to contain.

Supplements are not a replacement for a healthy diet and lifestyle but can provide essential nutrients and support when deemed necessary. And remember, before you start taking any new supplement or medication, make sure to talk to your provider to avoid any possible drug interactions or adverse reactions.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

(1),(2) U.S. Food & Drug Administration / Dietary Supplements

Dr. Gary Kaplan on Dirobi Health Show

Dr. Gary Kaplan on Dirobi Health Show – Living healthy in a toxic world.

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Dr. Kaplan was a guest on Dave Sherwin’s Dirobi Health Show about how to live healthy in a toxic world.

Highlights –

Inflammation Nation

The list of autoimmune diseases is long: Lyme Disease, Chronic Fatigue Syndrome, Fibromyalgia, Arthritis, Lupus, Celiac…and these are only a few of the crippling disorders that affect the entire body. The immune system breaks down, and inflammation attacks both the brain and the gut, joints, muscles, and nervous system. (2:30)

Post Covid “Cytokines”

Many who have previously suffered from Covid may have noticed problems with their sense of smell and other lingering issues. Dr. Kaplan attributes these chronic problems to white cells that are spewing out lots of inflammatory particles called cytokines. (9:00)

Brain Care

Regular, aerobic exercise is one of the best anti-inflammatory remedies for the brain. (10:45)

The “Roll” of Nutrition

An inflamed gut will result in brain inflammation. (23:00)

The Hypoallergenic Diet

A hypoallergenic diet has the least number of allergens (26:00)

Sleep Apnea

Sleep apnea can reduce lifespan. Warning signs include fatigue during the daytime, snoring at night and lapses in breathing during sleep. (36:55)

 

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

 

10_ways_to_get_good_nights_sleep

Are You Dying For A Good Night’s Sleep?

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It is estimated that over 70 million people suffer from a chronic sleep disorder in the United States, impacting not only the individual struggling to get a good night’s sleep but potentially all of us. It is conservatively estimated that more than 91,000 car accidents resulting in 800 deaths and 51,000 injuries each year are the result of driver fatigue.

And here’s another thought that might keep you up at night

One of the most common medical responses to helping you sleep may actually be putting your health at risk. About 4% of U.S. adults use a prescription sleeping aid in any given month. Yet taking as few as 18 sleeping pills a year increases your risk of dying 3.6 fold compared to people not using them. Those who take a prescription sleeping medication more than 132 nights a year have a 6.6-fold increase of death and a 35% increased risk of developing cancer.

A better response?

Individualized treatment to discern the underlying cause of sleep loss.

Sleep deprivation is the most common sleep disorder.

Newborns need as much as 18 hours a day, while teenagers — the most notoriously sleep-deprived group — require nine to 10 hours. Adults should have between seven and eight hours a night of restful sleep, yet a 2013 Gallup poll found that as many as 40% of Americans get only six hours or less of sleep a night.

Sleep deprivation can exhibit as insomnia, taking longer than 20 minutes to fall asleep, multiple awakenings during the night with difficulty returning to sleep, early wakening, and shortened sleep due to demands of work or school. Whatever the cause, its long-term consequences on your health and well-being are the same.

In the short term, your mental performance and reaction time when chronically sleep-deprived are the equivalent of being drunk. And like the inebriated, the chronically sleep-deprived do not recognize the extent of their impairment. Lack of sleep compromises the normal functioning of your immune system, and long-term sleep deprivation causes your body and brain to be in a chronic state of inflammation, potentially leading to an increase in heart disease, stroke, obesity, chronic pain, ADD, depression, and anxiety. The problem is also bidirectional; conditions such as chronic pain, depression, and heart disease can cause sleep disturbance, which then worsens the underlying condition.

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So how sleepy are you?

If you think you may be suffering from sleep apnea or another type of sleep disorder, don’t put off seeking help. Being this tired is a potential danger to your own health as well as the health of others. One way to quickly assess your level of daytime sleepiness is the Epworth Sleepiness Scale. It takes about a minute to complete the test and should be part of any medical exam when someone is complaining of fatigue. A score of 10 or higher is suggestive of a significant sleep issue.  At the Kaplan Center, we also utilize WatchPAT ONE, a recyclable Home Sleep Apnea Test (HSAT) to help us detect sleep apnea as well as providing markers for quality of sleep.

Here are some steps you can take right now to improve the length and quality of your sleep:

  1. Go to your room! Try to tuck in and rise around the same time each day.
  2. Move it! Regular exercise improves sleep and regular sleep improves exercise performance. The regular practice of yoga, especially in older adults, has been shown to improve the duration and quality of sleep.
  3. Cut caffeine. If you have a sleep problem, minimize or eliminate your caffeine consumption. Caffeine in all forms — tea, chocolate, energy drink or pill — disrupts sleep.
  4. Eat more fish. Eating fatty fish, salmon, and tuna appears to not only lower your risk of heart disease but also betters your sleep.
  5. Eat at regular intervals. When and how much we eat, as well as the types of foods we eat, impact our internal clock, called our circadian rhythm. While we are just beginning to understand the relationship between food and internal clocks, it is clear that the two are related and the consequences of eating at irregular intervals are obesity and increased risk for disease, in addition to disruption of your sleep.
  6. Cooldown to sleep sound. People may have trouble falling asleep because they have trouble cooling down their core temperature, which reaches its maximum typically around 3 pm. A warm room will exacerbate the problem. Temperatures above 75 degrees and below 54 degrees Fahrenheit can disrupt sleep. So what is ideal for sleep? The consensus is that a room temperature between 65 and 68 degrees is probably ideal; this will vary among individuals.
  7. Go dark. Light is a major factor that regulates our sleep-wake cycle. Light exposure at night not only disrupts our sleep but also increases our risk for obesity, high blood pressure, and possibly breast cancer in women.
  8. Keep it quiet. Any amount of noise starting at 30 to 40 decibels, a level between a whisper and a quiet conversation, begins to impact sleep quality. That said, people generally find the sounds of their usual environment relaxing. Sound can also be used to help with sleep. One study looking at patients suffering from a generalized pain syndrome called fibromyalgia found that music embedded with a specific sound frequency called Delta wave that pulsated between .25 to 4 Hertz improved the quality of patients’ sleep and decreased their pain symptoms.
  9. Meditate. Numerous studies demonstrate that the regular practice of meditation can improve the quality of sleep, as well as help in the treatment of anxiety disorders, depression, and chronic pain.
  10. Sample supplements. Some supplements that might help in getting a good night’s sleep include 5-HTP and melatonin. The FDA does not regulate supplements, so be careful that the supplement you purchase actually contains the substance and the amount of the substance stated on the label. Also, supplements are drugs and can have side effects and interactions with other medications. If you are taking medications on a regular basis, please check with your physician before taking any supplements.

For more information on identifying & treating sleep disorders click here.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Note: This post was originally published in August 2014 and has been reviewed and updated for accuracy. 

exercise_for_immune_health

7 Minutes a Day For Better Health

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Get moving and boost your immune system!

A N.Y. Times article cited a 2020 study out of Stanford where 36 subjects with various fitness levels exercised on a treadmill for 9-10 min and using the latest techniques showed almost 10,000 molecular changes during and after exercise.

With these new techniques, called “omics”, the researchers have isolated various molecules in our bloodstream that alter our biology. Metabolomics looks at molecules like appetite hormones and enzymes produced by the microbes in the gut; genomics looks at changes in gene expression; immunomics looks at the changes in the immune system; and, proteomics and lipidomics look at changes in proteins and fats. The list goes on. The author of the study quotes there is an “ orchestrated choreography of biologic processes” demonstrated to occur.

Why is this research important?

Recently we find that we are spending more time at home. We find ourselves sitting in front of the computer more than ever. Sitting too much weakens our immune system, increases the risk of diabetes, heart disease, depression and decreases bone density. We need to learn to be more creative about how we move our bodies.

We are all concerned about how robust our immune system is against potential illnesses.

One of the best immune boosters is exercise and this recent study out of Stanford, published in the journal Cell, showed even less than 10 min of exercise produces changes in thousands of molecules which affect inflammation, DNA and tissue repair, insulin resistance, oxidative stress, metabolism, immunity, and appetite.

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With less access to gyms, we need to be creative about making sure we incorporate exercise into our daily routine.

Hiking, biking, running, and many online classes including yoga are available. In addition, a total body workout is ideal to keep all of our muscles strong and stimulate bone density.

If time is short, one way is to do a 7-8 min workout using body weight and minimal props. Combining this with yoga improves bone density, strengthens our immune system, and stimulates proteins that reverse aging. So get out of your chair and move!

And there’s more to keep in mind…

  • Post-menopausal women have an increased risk of osteoporosis. Exercise is a key factor to improve bone density. Make sure you get a DEXA scan and review options for treating osteopenia and osteoporosis.
  • Evaluating gut health not only can boost your immune system but also can improve brain health. We have several tests to look at digestive health and a dietitian to help you navigate food choices.
  • Balancing your hormones (i.e. thyroid and sex hormones) can improve your metabolism. We have advanced testing to look at these hormones including cortisol to evaluate adrenal function.
  • NAD infusions can reduce DOMS (delayed onset muscle soreness), improve cognition and fatigue, reduce pain, and improve sleep.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2