Update on the Sleep Clinic & Recommendations

Well I guess it's time I give an update on the results from my sleep study. This follow-up appointment was so much different than any follow-up I've been to before. I went in there and the nurse practitioner went through my different sleep cycles and brain waves and limb movements... which all looked like the picture you see on the left. Those lines signify all the different hook-ups I talked about in the previous post.

So it ended up that out of the 8.4 hours they were doing the study (from lights off until lights on), I slept 4.8 hours of it. I only recall waking up for 1 prolonged period of time and that is where I was laying there thinking about how best to let the tech know I wanted to get up to pee. In the summary part of this long report they gave me, it says that I waked up 13 times/hr throughout the night, which obviously disrupts my sleep (normal is less than 5). They also wrote down here that my REM sleep is slightly low (that's why I don't have a lot of good dreams!), I have mild snoring when laying on my back (knew that...), and that I have rare bursts of periodic limb movements (about 3/hr). Very interesting... right? So, it says here I have chronic insomnia which pretty much just means that I don't have apnea or narcolepsy, or some reason like that that I can't sleep...

After she went through all that stuff with me, she started talking about different options I could choose to help with my sleep. This is the different part... I'm used to a doctor just writing me a prescription and calling it a day, but she gave me a whole bunch of things I can choose from, and kinda left it at that. I like this approach, because some people... like myself want to try to fix things without prescription drugs, and some people don't. Here are the options given to me, and if you have sleeping issues too, you should definitely try them.

-Cognitive Behavioral Therapy

-Light Therapy with a SunBox light box (http://www.sunbox.com)

-Melatonin (found at a health food store or a drugstore)

-Neurontin (prescription used for epilepsy, pain disorders, restless legs syndrome, and insomnia)

-Rozerem (prescription - has more drug interactions and side effects than neurontin, so they try neurontin first...)

-They also said that for chronic insomnia, they don't recommend Ambien or Lunesta because you gain tolerance to them and they're only used for the short term.

I decided to start with Melatonin because it seemed like the easiest for me. On the bottle, it says to take 30 minutes before you go to sleep, but the nurse practitioner told me to take it around the time the sun goes down (but since that's anywhere between 5pm and 9pm around here, she usually tells people around 7pm). Honestly, I have no idea if I'm still waking up those 13times/hr, but I feel like I've been sleeping a lot better so far on it. I've actually slept through the night a couple times in the past week or so, and that never happens to me. It definitely makes you feel sleepy after you've taken it, so if you want to go out on the weekend or something, I would delay the dose. Anyway, I'm pretty happy with it right now, and kind of feel like my body is trying to make up for the 10 years of sleep loss. I'm hoping the melatonin will be enough and I won't have to take a prescription drug.... but we'll see :). Let me know how any of the options work out for you if you try them!

Why Sleep is Important to Your Health... and My Experience at a Sleep Clinic

Ok, so obviously there's a crazy picture of me with a bunch of wires hooked up to the right from when I recently went to a sleep clinic and got a Polysomnogram, but I'll get back to that...

Getting the right amount of sleep is a lot more important than most people may think. Some problems associated with chronic untreated sleep disorders are: high blood pressure, heart attack, stroke, obesity, depression, etc. One study even found that reduced sleep time has a greater mortality risk than smoking, high blood pressure, and heart disease. Given all of these problems from sleep deprivation, hopefully my description of my experience going to a sleep clinic will result in some people trying it out and getting the treatment they need.

Back to my story... for the past 5-10 years, I've had issues sleeping compared to other people around me. On an average night, I'll go to bed around 11pm, get up at 2am, be up for about 1.5hrs, go back to bed, and be up by 6am. About 5 days/month in a row, it's worse, and I'm up about 3 times for an hour each time and finally get pissed off around 5am and just get up for the day. I've tried the whole laying in bed and trying to go back to sleep thing but that always leads to less sleep. I'm also extremely tired by about 4pm (which sucks when meetings go until 5:30...), and have a hard time driving more than an hour without almost falling asleep (which I actually did once when I was 18... flipped my car a couple times, and almost died). So finally my doctor referred me to a sleep clinic... I called and set up an appointment.

For my initial appointment, I had to fill out a bunch of papers about my sleeping patterns and just talked to a doctor for half an hour... not too exciting. I set up the appointment for my overnight assessment to get a Polysomnogram (I had no idea what was going to go on at this point... I don't really ask questions). I showed up to the sleep place around 6:30pm, which kind of looked like a cross between a hotel and a doctor's office. One of the techs on duty gave me a tour and there are about 6 separate bedrooms with patients occupying all of them, a couple bathrooms with towels, shampoo, showers, and also a snack / breakfast area with fruit, oatmeal, cereal, and a bunch of other free stuff. I got sent to my private room with a queen sized memory foam mattress and a flat panel TV... pretty sweet. This is also when I noticed the security camera that would be staring at me all night on the ceiling, and also some other medical equipment I figured would probably be hooked up to me later.

After a while, the tech came in after I was in my jammies and told me he was going to start putting the electrodes on me. He explained everything, put some wires on my legs, chest, and face with some sticky patches, along with 2 stretchy bands around my waist and chest. At this point, he was going to start placing electrodes on my head that are used to measure what sleep state you're in. He had to measure my head, mark it with a red grease pencil where each electrode would be placed. It felt like there was a million, but I think it was probably about 20. Each location needed to be cleaned with a q-tip with some stuff on it, and sometimes it felt like he was rubbing pretty hard, but I think that was needed for the electrodes to work correctly. The electrodes were put on with what he called model airplane glue (yeah, don't think your hair is going to look pretty after this... ). This whole process took about an hour, but when they're monitoring all of your brain activity, your breathing, your leg movements, etc, I guess it takes a while to prep for that :). I went back to my room to watch the Bachelor, of course.

The tech said he would come back in around 10:30pm and I should have brushed my teeth and anything else I needed to do because I will be hooked up all night. Although, if I needed anything, like to go to the bathroom, I could just ask him if he could unhook me....since he would be listening to and staring at me all night through another camera thing next to the bed. Awesome, he's going to listen to me snoring with my mouth open all night... He hooked the thing up that I have in my hand in the picture to a machine, and taped a tube onto my face with one part going into my nose and the other part going into my mouth.

At this point, I asked him... how am I going to sleep with all this stuff! He responded with "everyone says that, but everyone end up sleeping...". So it took me about an hour to fall asleep because I always sleep on my stomach and couldn't, but I did fall asleep with all that stuff on, and you kind of forget about most of it after a while. I woke up around 2am, the normal time, stared off into space, and after about 45 min decided that I do need to get up, but felt awkward being like... helloooo, are you there? So I just stared at the camera thing until the guy asked me if I needed anything...haha. He came in and unhooked me, and I walked around for a while, ate a couple bites of a granola bar, and went back into the room. I really wanted to go to my own house at this point, but he made me try to go back to bed to finish the study.

I ended up sleeping until about 5am and he came in at 6am to unhook me and take all the stuff off. It only took about 10 minutes to get everything off and now I had globs of glue in my hair... sexy for work. He gave me a couple bottles of this oil stuff that was supposed to help get it all out, so I worked that into my hair for about 15 minutes in the shower, and got most of it out and went to work. I told everyone not to pay attention to any globs of glue that may be falling off my head that day. By the next wash it was all out.

So that was how everything went, and I have my follow up appointment this Thursday, so I'm really excited to see if there's anything wrong with me, or if I'm just crazy :). All in all, I think it will all be worth it. They really try as hard as they can to make you feel comfortable given the situation with the bed, TV, and free continental breakfast, but obviously it's not going to be like your own home. In the long run, it's only 1 night, and it could change your life. The doctor told me almost all sleep disorders can be treated...so hey, why not. At least you know what to expect now...

For a lot more info on sleeping, go to WebMD... they have a huge section on it.

NuVal - Overall Nutritional Quality Index (ONQI)

So there's this thing called NuVal that is a pretty complex nutritional scoring system which has started to trickle into supermarkets and seems like it's aimed to be available at every supermarket in the country, eventually. The NuVal system was created by a team of independent nutrition, public health, and medical experts and scores food on a 1-100 scale (100 being healthiest) to try and help people learn how to eat healthier. This score will be located directly on the shelf tag to be easily viewable.

Considering the fact that currently, 34% of Americans are obese, and that number is expected to hit 43% by 2018, I honestly think that something like this is very much needed right now to help people to make healthy choices at the grocery store. Most people don't go through the stores analyzing everything located on a food label before they purchase it, and a lot of people don't know everything they'd be looking for even if they had the time to compare every single label. It's a good quick way to see the relative healthiness of what you're picking up and putting into your cart.

Anyway, some science behind the whole NuVal thing... Their scoring system looks at more than 30 different nutrients and nutrition factors to make it a very comprehensive rating system. I'm sure their whole algorithm is really complicated, but essentially, nutrients with favorable effects of health are placed in the numerator (higher value = higher score), and nutrients with unfavorable effects on health are placed in the denominator (higher value = lower score). If you want to get a quick idea of the numerator and denominator nutrients, just look at the image I've attached... I think it makes it very easy to understand.

In addition to these good and bad nutrients, the NuVal system also takes into account other key factors that measure the quality and density of nutrients and the strength of their effect on your body (i.e. trans fat). Since trans fat is very much associated with heart disease, foods with trans fat get a weighting coefficient which is aimed at lowering the overall score. Other things that factor into the score: fat quality, protein quality, glycemic load, energy density, etc.

On their website, you can find a store near you that has already implemented the NuVal scoring, check out the scores of your favorite foods, look at their trading up tips (kind of like an eat this, not that type thing), and read a whole lot more of background on it than what I gave you. I was reading up online about this (off of their site), and there was one discussion I saw where someone was complaining about how yogurt with fake sure had a higher score than yogurt with real sugar, and the Dr. who was the lead on this NuVal score thing wrote a very detailed response. He started off by saying that he doesn't like eating things with fake sugar, and how you should think of this rating system as you would a GPS... if you don't know where you're going, it will guide you, but if you do know where you're going, you're obviously going to make those choices by yourself. Then he went into the science about it and how it has not been proven that fake sugars harm you, so foods don't get penalized for containing it. So I guess the main point of why I shared that story is that NuVal scoring only takes into account things that have been scientifically proven, so just keep that in mind, and use the number as a guide in your healthy lifestyle.

Oh, also, they have A LOT more foods to rate. On their website they say they've rated about 100,000, but they don't list very many at all.... so I think it's going to be a very gradual thing.

Foods scoring 100: blueberries, broccoli, green beans, and Hodgson Mill unprocessed wheat bran...and the only food on their website right now with a score of 1: Glutino pretzel twists gluten free. See...obviously they don't have everything on here yet, I mean where are the Reeses Peanut butter cups??

NuVal website

The Details Behind Small, Frequent Meals

Ok so most likely you've already heard that eating small, frequent meals throughout the day is good for you and will help you with your weight loss goals...but you may still be wondering, WHY?

If you don't know reasons behind why things work, you may never try them, and this is why this post is for my boyfriend, my brother, and all those other people out there who have not believed me about small, frequent meals and who make fun of me for eating a million times a day :).

As many of you may not know, I'm studying to get my Personal Training certification through ACSM (American College of Sports Medicine), and as I was studying the other day, I came across a couple pages completely dedicated to the fact that consuming the same amount of calories in 1 day does not do the same thing to your body if you space it out during the day vs. eating it all in 1 meal. I got excited... now I have PROOF for these non-believers. That is, if you're willing to believe ACSM...

Here are the main points described in my book:

If you consume lets say 2000 calories/day and burn 2000 calories during the day, you're in this thing called "energy balance". HOWEVER, how you ingest these calories during the day makes a difference. If you skip breakfast, skip lunch, and eat all of your day's calories in 1 big meal, what you've done is spend most of your day in an energy deficient state (even though you may still be in "energy balance"). This yields different results than if you had eaten the 2000 calories in 6 small meals during the day.

Benefits of eating small, frequent meals:

• maintain metabolic rate
• lower body fat
• lower body weight while eating more calories
• better glucose tolerance and lower insulin response - this makes it less likely that fat will be produced from the food you eat
• lower stress hormone production
• maintain muscle mass easier
• improve physical performance

Problems with energy deficits (i.e. only eating 1 or 2 big meals a day):

• poor maintenance of carbohydrate storage
• problems maintaining lean muscle mass
• lower metabolic rate
• harder time meeting nutritional needs
• increased risk of injury

I hope this helps some people understand more as to why it's a good idea to eat several small meals throughout the day... and if you're one of those people (like me) who eats constantly all day while getting made fun of, just refer those people to this blog :).

The Truth About Vitamins

We all know that vitamins are those things we're supposed to get from eating healthy and having enough fruits, vegetables, etc, and if we aren't perfect, we can supplement some of our poor eating habits with a multi-vitamin, right?

Well, that's fine if that's all you're having, but this post is mainly targeted to those who take a multivitamin AND like 10 other vitamins... because they think it makes you healthier. I thought about this group of people as I was studying the "Nutrition and Human Performance" chapter in my American College of Sports Medicine personal training book. There is an entire section on vitamin requirements, their functions, food sources, and of course deficiency and toxicity. Yes, toxicity. Given that term toxicity, it's no surprise that this book stresses that nothing over a multi-vitamin should be taken unless a doctor has told you that you have a deficiency and that you need to take a specific vitamin to over-come that. Did I get the attention of the 10 vitamin a day people?

Anyway, I thought I'd share some of the interesting information from my book about a few popular vitamins + minerals... 2 of which are very toxic if you intake too much...

Vitamin C:

• 75-90 mg/day
• Functions: antioxidant, collagen formation, iron absorption
• Deficiency: bleeding gums, fatigue, muscle pain, easy bruising, depression, sudden death
• Food Sources: vegetables (particularly high in citrus fruits and cherries)

Vitamin A:

• 700-900 mg/day
• Functions: vision, growth, immune function, healthy skin
• Deficiency: night blindness, eye disease, unhealthy skin, susceptibility to infections
• Toxicity: headache, vomiting, hair loss, liver damage, death
• Food Sources: fish liver oils, butter, milk fortified w/ vitamin A + D

Vitamin D

• ~5 mg/day - hard to establish because variations in sun exposure
• Functions: calcium absorption, mineralization of bone
• Deficiency: osteomalacia, poor bone mineralization
• Toxicity: renal damage, cardiovascular damage - is the most toxic of all vitamins
• Food Sources: fish liver oils, milk fortified w/ vitamin A+D, skin synthesis w exposure to light

Calcium

• 1000 mg/day
• Functions: structure of bones and teeth, blood coagulation, nerve impulse transmission
• Deficiency: reduced bone density, osteoporosis, stress fractures
• Food Sources: milk and other dairy products, dark green leafy vegetables

Iron

• 700 mg/day
• Functions: involved in oxygen transfer to cells, in numerous oxidative enzymes
• Deficiency: microcytic anemia, leading to weakness, loss of energy, easy fatigue (most common mineral deficiency)
• Food Sources: meats, poultry, fish, egg yolk, dark green vegetables

So, this post is not meant to scare anyone, but is meant to share some useful information about vitamins and minerals, and to point out the fact that if you eat a well balanced diet, you should have no reason to need singular supplementation of any of these. And of course, if you're one of those people popping 10 different vitamins a day, realize that you're probably wasting your money (unless your doctor has told you to take them), and that a multivitamin will be just as effective as what you're doing now. Also, I'm sure you don't want the problems associated with a vitamin A or D toxicity... death does not sound fun...

p.s. Research shows that vitamin and mineral deficiencies are uncommon for most people...

Gym closed New Years Day?...and you need workout ideas?

It's New Years Eve, and you're thinking "crap, my gym is closed tomorrow... ". Well, you can still workout (if you want). To help you with this, I'm writing down a couple things I like to do when the gym is not an option, or I'm just too lazy to get in the car and freeze for 10 minutes on the way there...and maybe a couple other ones too...

Option 1: Go cross country skiing, downhill skiing, snowshoeing, sledding, ice skating, etc with your family. You won't even know you got a workout in when you're done. If you live where it isn't freezing outside, go for a hike, walk, run, bike, anything else outside.

Option 2: If watching something on TV helps you pass the time during a workout, try doing 2 to 3 sets of the following list of moves (... but don't go into a TV coma and stop paying attention to your workout!) I sometimes do this one when I really want to watch something on TV... but want to get a workout too :). One set should take about 15 to 20 minutes... depending on if you rest between movements (suggested). Also, only do this if you have been working out and know that you won't have any medical issues completing it!!

• 15 jump squats (go into a squat, jump up and bring your hands up. When you land, let your legs give so you go back into a squat - kind of like a frog. This is something called a plyometrics move (explosive movement). If you need something less intense, keep it to just squats without the jumping).
• 60 seconds of jumping jacks
• 15 alternating jump lunges (similar to the squats, but done as a lunge. Go into a lunge position, jump up, switch your feet, and land in the opposite lunge. This is another plyometrics move, so if you need a less intense version, keep it to alternating lunges without the jump).
• 60 seconds of jumping rope (you can fake it if you don't have a rope)
• 60 seconds of high knees (kind of like running but pull your knees up to your chest)
• 15 side kicks per side (pull your knee up first, then kick out to the side)
• 60 seconds of mountain climbers (hands on floor, alternate pulling your legs up to your chest).
• 60 seconds of jumping jacks
• 60 seconds of running butt kicks (like running, but kick your butt)
• 15 burpees (start standing, put your hands on the ground, jump your legs back so your feet are on the floor and you're kind of in a plank position, jump your legs back to where your hands are, stand up... that's 1. If this is too much, try the mountain climbers again.)
• 15 push-ups (or as many as you can do. If you need to, you can do these on your knees)
• 60 seconds of jumping rope
• 60 seconds of bicycle crunches (on your back, hands supporting head, pull opposite elbow to knee, alternate)
• 60 seconds of jumping rope or jumping jacks
• 60 seconds of a plank (elbows on ground, feet behind on ground, body straight.

Option 3: Watch some Exercise TV on Demand workouts or Fit TV workouts. A lot of them are not very long, but you can do 2 or 3 of them if they aren't. My favorites for Exercise TV on Demand are Jillian Michael's Boost Metabolism (~1hr) and No More Trouble Zones (~1hr), and all of Jackie Warner's exercises (3x20 min, 1-45 min). Check out my forum for reviews on some of the Exercise TV on Demand workouts!

Option 4: Do an hour of Wii Fit or one of the other new fitness things for the Wii. I made a post about Wii workouts a while ago; you could check it out on the right hand side of the blog. I will do this in a pinch if at my parents house (because I'm not cool enough to have one). I try to alternate between the super hula hoop (is anyone else horrible at 1 direction with this??), advanced step, long run, and a bunch of the yoga and strength exercises. The balance games won't give you a great cardio or strength workout, but they will improve your balance (duh).

Have a great New Year and let me know how you stayed active over the holidays!

Moisture Wicking Performance Clothing - Still stinks after washing??

Ok, so strange blog title... I know. But if you own workout clothes that are made out of that performance moisture wicking material stuff, and you sweat, you know what I'm talking about...or not.

This blog was originally for my brother because he was wondering why his Nike Dry Fit clothes still smelled like a dirty sock after washing, but then I thought back to the numerous times that my boyfriend told me my performance clothing smelled like something died (after it had been washed), and wouldn't come near me until I took it off. So, it's for both my brother and I, and for everyone out there who wants to smell pretty for the people around them. Not to mention, you don't want to be that person at the gym that STINKS and no one will step on the cardio equipment within a 3 foot radius of them.

Anyway, like a good sister, girlfriend, whatever, I researched this topic online for over an hour and wrote down all of the ideas I found, and it seems that half of the United States stinks like sweat as well...haha. Now originally I was just searching about Nike Dry Fit, but it seems like people have issues with any moisture wicking performance material...which is probably the reason all of my free performance shirts from races I've run in stink too. Ok, so see below for solutions I found at about 20 different website forums on this topic, and don't yell at me if they don't work because I haven't tested any of them yet :)...

Pre-soak with detergent, antibacterial hand soap, dish detrgent, an ammonia-water mix, or a vinegar-water mix in sink for a couple hours, swish around, then wring out and throw in w/ rest of laundry.

Performance fabric detergents or phosphate free tech soap that can be found at sporting good stores such as Dicks or EMS (Win SportWash, Penguin SportWash,etc). Also brought up was Method brand laundry detergent which is found anywhere like your local grocery store or Target but is not specifically made for performance clothing.

Things to add into the wash (only 1 at a time):
1/4 cup baking soda
A scoop of Oxy Clean
Borax washing powder
1 cup of white vinegar

Put your clothing in the freezer for a while; it kills bacteria.
Spray with Febreeze.
Puckskins brand shirts apparently don't hold the smell but are hard to find in the US. They can be found in Canada.

Oh, and a couple other little tid bits for keeping your moisture wicking performance clothing new as long as possible (what I have been scewing up on apparently): DON'T use fabric softners because they clog the wicking pores in the fabric, and you can put in dryer on low heat, but DON'T use dryer sheets.

Hopefully after reading this, less of the country will smell like sweat (especially my brother...and I) :)...let me know what works out!