L.J. Rohan

L.J. Rohan

Certified Gerontologist

Good Sleep Suggestions Part I

September 16, 2019

So how can women over 55 get the healing slow wave activity and REM sleep they need to take over the world?—I mean optimally function in the world?

Separating the cow patties from the gems on the internet, the solid gold research points to a number of practices we can adopt to get the REM age-defying sleep after menopause we need. O.K., I added “youthening” to the list, because sleep slows the signs of aging, as I discussed in my September 2, 2019 post, and clears out the gunk from our aging brain, while it reverses telomeres aging—all of which keep us younger than our drivers’ licenses claim we are. Let’s start with the a few easy choices we can make to improve our sleep, and then add a few others that require a little more time to implement.

Dr. Breus clinical psychologist and author of The Sleep Doctor’s Diet Plan: Lose Weight Through Better Sleep says, “If you do only one thing to improve your sleep, this is it: Set a sleep schedule—and stick with it.” Going to bed at the same time every night and getting up at the same time every morning—even on weekends, presently shows incredible promise as a magic formula for getting good sleep. A consistent sleep routine keeps our biological clocks finely calibrated so we rest better, plus exposure to a regular pattern of light and dark helps, too.  Opening the blinds or going outside right after awakening can help us stay in sync and keep our clocks humming.

Here are some additional things you might try:

 1. Keep a sleep diary

Dr. Lisa Shives of the National Sleep Foundations suggests: “To help you understand how your habits affect your rest, track your sleep every day for at least 2 weeks. Write down not only what’s obviously sleep related—what time you go to bed, how long it takes you to fall asleep, how many times you wake up during the night, how you feel in the morning—but also factors like what you ate close to bedtime and what exercise you got. Comparing your daily activities with your nightly sleep patterns can show you where you need to make changes.”

2. Review your medications

Beta-blockers (prescribed for high blood pressure) may cause insomnia; so can SSRIs (a class of antidepressants that includes Prozac and Zoloft); these are only the tip of the mountain of drugs that cause us to lose sleep. Write down every drug and supplement you take (as they could interact), and have your supplements expert evaluate how they may be affecting your sleep.

3. Cut caffeine after 2 pm

That means coffee, tea, and cola—all caffeine, even chocolate, if you’re sensitive.

4. Write down your woes

“The number one sleep complaint I hear? ‘I can’t turn off my mind,’ ” says Dr. Breus. To quiet our anxious mind, every night jot down your top concerns—then write down the steps you can take to solve the problem. Once concerns are converted into some kind of action plan, you’ll “put your mind at rest,” as the cliché goes.

5. Take time to wind down

“Sleep is not an on-off switch,” says Dr. Breus. “It’s more like slowly easing your foot off the gas.” Give your body time to transition from your active day.

 Dr. Shives suggests:

  • First 20 minutes: Prep for tomorrow (pack your bag, set out your clothes).
  • Next 20: Take care of personal hygiene–take a warm bath (my personal go-to for transitioning), brush your teeth, moisturize your face, and brush your hair to relax your scalp, brush slowly and turn upside down, too; this calms your mind, as well.
  • Last 20: Relax in bed, reading with a small, low-wattage book light or practicing deep breathing.

6. Don’t drink alcohol at least 2 hours before bed

A few hours after drinking, alcohol levels in your blood start to drop, which signal your body to wake up. It takes an average person about an hour to metabolize one drink, so if you have two glasses of wine with dinner, finish your last sip at least 2 hours before bed.

7. Snack on cheese and apple slices

The ideal nighttime treat combines carbohydrates and either calcium (unless dairy sensitive) or a protein that contains the amino acid tryptophan—studies show that both of these combos boost serotonin. Finish up your snack about an hour before bed so that the amino acids have time to reach your brain.

In my next post I will add a few more suggestions to the list to help you get your ZZZ’s.

Until next time…Be Vibrant!

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Sleep and Women: At Midlife and Beyond

September 9, 2019

The National Sleep Foundation Senior Health website recommends for adults 65 and older, 7-8 hours of sleep per night for better cognition, mental, and physical health. Seniors, especially women, suffer from sleep deprivation due to trouble falling asleep. Additionally, women often sleep less deeply, and have less slow brain wave activity (REM)—that body-restoring and rebuilding phase of sleep. We also wake up more often throughout the night, creating daytime tiredness and the perchance for napping. Sleep issues affect as many as 25% of senior women.

The Nurses’ Health Studies, among the largest studies into the risk factors for major chronic diseases in women was begun in 1976, and is ongoing. The studies have compiled data on more than a quarter of a million women. Using the benchmark of seven hours of sleep per night, the NHS found: Shorter and longer sleepers were less physical active, and had higher body mass indices. Less than five-hour sleepers scored significantly lower on cognitive tests. The shortest sleepers experienced the worst cognitive decline later in life. Just two hours a night less over time was enough to accelerate this decline.

Overlaying directly with the NHS, Daniel Polesel PhD., at Federale Universidad de Sao Paulo found Obstructive Sleep Apnea Syndrome (OSAS) is prevalent in postmenopausal women, especially in “late postmenopause,” noting OSAS in women increases significantly after menopause. For moderate and severe OSAS, the researchers found our waist circumference in both early and late postmenopause to be the main factors for sleep apnea. Dr. Polesel noted that late postmenopause may potentially exacerbate the presence of sleep disturbances and that reducing our waist measurement may be an important way to help manage OSAS.

A huge study—2,789 women, reported the addition of bedwetting (nocturnal enuresis-NE) along with OSAS. The symptoms associated with NE include: obesity, snoring, poor sleep quality, sleep fragmentation, daytime sleepiness, and hypertension. Each additional OSAS risk factor significantly increased the odds of having NE in comparison with women with no risk factors. What is the cause behind this sensitive, underdiagnosed issue? We experience apnea-associated changes in the air pressure in our lungs which leads to increased urine output. To further mess with our shut-eye, NE may be a surrogate condition for nocturia, a condition causing us to wake up during the night because we have to urinate. As we get older, many of us urinate more frequently, especially at night. In general, women, and men, over 60 do not usually urinate more than twice a night. “Patients with severe nocturia may get up five or six times to go to the bathroom,” said, Dr. Robert S. Rosenberg, a pulmonologist and medical director of the Sleep Disorders Center of Prescott Valley and Flagstaff, Arizona. “Sleep apnea triggers the frequent urination.” If you wake up to pee more than twice, give your doctor a call.

 Another cause of disruptive, fragmented, less restorative sleep? Post-menopausal hormone levels. It’s often called hormonal insomnia or progesterone insomnia. At all stages of a woman’s life, the hormone progesterone affects brain function. When in balance, it produces a sense of calmness, and its sedating and anti-anxiety qualities help promote rejuvenating sleep. Progesterone and sleep are tightly connected as our brains are highly sensitive to progesterone. As we know, our progesterone levels drop drastically after menopause.

All of us on the other side of fifty-five, know the multitude of ways menopause affects sleep. Bio-identical hormone replacement therapy is one option to tame those symptoms, if started within one year of entering post-menopause. This therapy received bad press fifteen years ago, and, many of us threw our hormones in the trash, stomped on them for good measure, and then incinerated them. However, once cooler heads prevailed, and the smoke had cleared from all those fires, subsequent research drilled into the flawed Women’s Health Initiative Study and proved bio-identical hormones–those biologically identical to the hormones our bodies produce, are a safe and effective way to even out hormone depletion and keep a woman’s body firing on all cylinders. Whew.

Another hormone, dehydroepiandrosterone, or DHEA, also helps maintain normal sleep patterns. DHEA peaks when we are young and carefree, and then begins to decline.  By the time we reach seventy, our DHEA levels may be less than one- fifth of what we had at age twenty.

Our thyroid glands also have an impact on every system in our body. Thyroid levels affect our energy levels, mental focus and functions, sleep cycles, and more. About 25% of women develop thyroid problems by the time they reach their early forties.

To add another bug in the bathwater, stress and high cortisol levels wrecks sleep. At night, just as we need to wind down, cortisol levels rise. We then feel more alert and awake at bedtime, making sleeping impossible. This cycle of exhaustion repeats itself, never allowing us to get the restorative sleep that would help bring our levels back to normal. Also, a lack of sleep raises our cortisol levels even more. Cortisol is made in the adrenal cortex from progesterone. The small amount of progesterone being produced (and that is a micro-dot amount compared to our pre-menopause days) creates cortisol, which allows little or no progesterone to come to our sleep aid.

But, there is hope on the horizon, and in the coming weeks I will share some proven ways to sail off to the land on Nod.

Until next time…Be Vibrant!

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Let Me Sleep on That

September 2, 2019

“Taken together, the results of studies looking at the role of sleep in hormonal, immunological and memory functions suggest that if you do not get enough, you could—besides being very tired—wind up sick, overweight, forgetful and very blue,” says Dr. Robert Stickgold, PhD., at the Harvard Medical School and a sleep researcher focusing on the relationship between sleep and learning.

We now know, sleep doesn’t just have a one purpose. Instead, it appears to be needed for a many of our biological processes to work at their best and slow our biological aging—from our immune system, to hormonal balance, our emotional and psychiatric health, our learning and memory, to the clearance of toxins from the brain. At the same time, none of these functions fails completely in the absence of sleep, but years of sleep deprivation will make many of these short-circuit and ruin our health. 

Just one night of complete, or even partial, sleep loss can interfere with all kinds of bodily functions, such as hormonal activity and our immune protection against infections. Reduced sleep seems to lead to increased weight gain—a theory now supported by at least fifty studies; studies which point to a fifty percent increase in obesity among those studied getting fewer than six hours of sleep. Research also shows an association between sleep restriction and the development of type 2 diabetes.

Adding to the huge effects restricted sleep has on immune and hormonal function, its greatest impact probably occurs in the brain. It seems that when we are sleep deprived, our brain remembers negative words and experiences twice as much as positive words and experiences. Just another reason to get our zzz’s so that we can see the glass as always at least half-full.

“Indeed, several studies over the past 25 years have now concluded that poor sleep can, under certain circumstances, lead to depression severe enough to be diagnosed as major depression and may contribute to other psychiatric disorders as well.” The link with depression has become clearer and seems to directly connect to sleep apnea, a disorder in which the flow of air into the lungs becomes interrupted during sleep. A 2012 study by the CDC found that folks with sleep apnea—men twice as often, and women 5.2 times more often, are likely to experience  major depression than their better-rested neighbors. “Of course, finding a correlation between these two conditions is not the same thing as proving that one causes the other,” Stickgold says.

Presently, researchers suspect that the sleep helps the brain transform our waking experiences into memories. A bushel basket of new science published in the last twenty years reveals that sleep participates in memory processing—it controls what we remember, and how we remember it. Something I found very cool is the research showing that memories can change, or be lost altogether, even after the brain records and consolidates them. One recent study finds that sleep does more than just stabilize memories and keep them from deteriorating over time; it actually improves them!

What Stickgold and others now firmly believe: during different stages of sleep and emotional memories are more favorably enhanced during sleep. Science shows us anything we think is important is selectively retained while we float along in dreamland. The bottom line? Sleep, and not wake time, selectively strengthens memories that our brain decides has value to us.

Dr. Daniel Schacter of Harvard University believes our memory is about the future, not the past; we use prior experience to enhance our future performance.  When we talk about sleeping on a problem, we want our brain to take the information that is already stored there and do some kind of calculation, to juxtapose different possibilities, to find the best solution to a problem. Lucky for us, it can!

If all the above information doesn’t convince you to make sleep a priority, research now adds to the list that sleep clears waste products from the brain. When the investigators injected beta-amyloid (the precursor of the amyloid plaques—the cause of Alzheimer’s disease) into mice, they found that it was cleared from the brain during sleep at twice the rate as during awake times.

I’ll bet you had no idea how important getting adequate sleep each night truly is for every facet of our health and our aging process. I sure didn’t before I became a gerontologist, but now, don’t get between me and my eight and a half hours. (Yes, I need extra!) Over the next few posts I will be putting on my dive suit to get to the bottom of this not yet fully understood phenomenon that all living creatures share here on Planet Earth. I’ll also add suggestions that may help us sleep deeply, experience healthy aging, and feel vibrant every day.

Until next time…Be Vibrant!

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Food for Thought: Which Ones Slow Down Aging?

July 28, 2019

I am asked everyday a version of the same question: “Do you have any great anti-aging advice?” The answer is a bold YES! However, I am not a fan of the word “anti-aging” when it implies stopping aging, because as an expert in the aging process, I know for true that nothing exists which can do this, short of calling it a day and hanging with the angels. However, in my quiver are many arrows available to drastically slooooow down the aging of our minds, bodies, and spirit.

Today, I pull the arrow marked telomeres and aging as it relates to what we decide to put into our mouths. Once again, my favorite girl gang (G.G.), Dr. Elizabeth Blackburn and Dr. Elisa Epel and their team have looked at how proper diet can strengthen and lengthen our telomeres.  A little refresher to define telomere: telomeres are the protective endcaps on the threads of our DNA, like those on the tips on our favorite lace-ups, and are found in the brain, where they affect all our cognitive function, as well as in every cell of our bodies. So, they are well worth preserving in any way we can.

My G.G. looks at the three key factors affecting telomeres:

  • Inflammation
  • Oxidative Stress
  • Insulin Resistance

Excess weight on our bodies, and thus on telomeres, results in shorter telomeres, which allow cells to become easily damaged when reproducing. Not only does reproduction slow down but also our brains and memory can malfunction, and we experience greater cellular aging which makes us look and feel older.

A direct correlation exists between insulin resistance and diabetes, and shorter telomeres. The greater our waist-to-hip ratio is—the classic “apple” shape, with extra belly fat and love handles– the higher our insulin resistance will be. A damaging cycle forms with this situation: people with belly fat develop shorter telomeres over the years, and these shorter telomeres may worsen the insulin resistance problem. Researchers tell us abdominal fat causes more inflammation in our bodies than thigh fat. As the GG says, “The pathway from belly fat to diabetes may also be traveled via chronic inflammation.” Inflammation and telomere damage go together, one causing the other in a continual feedback loop.

Even more important than losing weight, improving one’s metabolic health keeps telomeres longer and stronger. Good metabolic health includes having ideal levels of blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference, without using medications.  How do we perk up our metabolic health? Exercise. Weight cycling, something so many of us are too familiar with—the gaining and losing of those same bloody ten pounds– shortens our precious telomeres. Blackburn and Epel also think being physically active and eating nutritious, low Glycemic Index foods are better choices than “dieting” by restricting calories. In fact, they found that “calorie restriction has no positive effect on human telomeres.”

Well, that’s good news. Not good news: A study at the University of California at San Francisco found shorter telomeres in the cells of folks who had restricted their calories for long periods of time. Even worse, the telomeres in their immune cells and vital T-cells were also affected. The findings suggest a link between our immune systems and aging. I have more to say on this important topic, so stay tuned!

Until next time…Be vibrant!

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It’s Never Too Late to Help Our Aging Brain!

July 22, 2019

Did you know, when we take our first breath, there exists no difference in the length of our telomeres between those newborns sporting blue booties and those stylin’ with pink ones? Quick science lesson recap: Telomeres are the protective end caps of our chromosomes—think the plastic protective tip of your shoelace. Telomeres are found in every cell throughout our bodies. The longer and stronger our telomeres are, the higher functioning our brains and minds will be, and the less our bodies will decline and age.  However, once we are all grown up, telomeres are longer in women than in men. (Sorry, fellows.)

 The medical world now knows the hormone estrogen creates this disparity between the sexes. Research also reveals estrogen may regulate the number of telomeres we have, as well.  Before menopause, the estrogen we produce protects women’s telomeres from shortening and keeps our telomeres strong and growing.

Interestingly, we postmenopausal women with a history of long-term hormone therapy (HRT) use show longer telomere length than do those who didn’t use hormone replacements after menopause. It seems the extra years of estrogen in our systems kept our telomeres long and strong. That information led me to ask: “For the millions of women who did use HRT, and have finished the recommended protocol of time, what do we do now?”

Drilling into the science, the answer occupying the number one position is exercise. If you have followed my posts for a while, you will be slowly nodding your head, as I have written this word once or twice before about exercise and aging ;-0

What I haven’t really focused on before is how much exercise benefits postmenopausal women as a way to slow aging. Since we lose our armor of hormone protection at menopause, because our ovaries produce most of our estrogen, we are left with our fat cells and adrenals as the only sources for this precious substance. Stress causes the adrenals to switch from making estrogen (even a smidge) to adrenalin and the enemy of all people, cortisol. This makes our chances of getting even a drop of this elixir needed for keeping our brain memory functioning at peak level, well, pretty much zero.  

However, there’s good news! For the millions of women who did, and the millions who didn’t opt in for HRT, there is great hope! You may also remember when I wrote about the breakthroughs scientists had made a couple of decades ago in understanding the brain. We now know the brain grows and changes throughout our lives until we take that last breath. We call that development neuroplasticity. That means we are only in the third quarter of the game after we finish HRT, and can still bring home a win in the final one. It is looking as if exercise expands and strengthens our telomeres. More research is needed, but my favorite girl gang, those Nobel Prize winner dynamic dames, Dr. Elizabeth Blackburn and Dr. Elissa Epel, the experts in telomeres and aging, would take the bet that exercise looks like the magic bullet.  Even better news? Midlife men also seem to benefit from exercise, telomere-wise!

A ground-breaking study from South Korea and published in the highly respected Menopause: The Journal of the North American Menopause Society states:

“Compared with a sedentary lifestyle, long-term aerobic exercise and increasing levels of physical activity are associated with reduced telomere attrition [shortening]. This cross-sectional study demonstrated that postmenopausal women who perform habitual physical exercise have significantly longer telomere lengths than do those with sedentary lifestyles.” Straight from the horse’s, researchers, mouth, so to speak.

Compiling this information on how to slow down aging inspires me to put on my tennies this very minute and take a brisk stroll. Come join me!

Until next time….Be Vibrant!

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