Doctor Is In: A Stress-Free Holiday Season

“Happy” Holidays?: Holiday Stressors• What do Americans stress about most during the

holidays?5. Seeing certain relatives (24%)4. Travel (25%)3. Gift shopping (28%)T2. Debt (37%)T2. Gaining weight (37%)1. Crowds and long lines (68%)

Holiday Stress: Planning Ahead

• Identify Your Triggers

• Plan for the “big” days

• Set aside “me time”

Holiday Stress: The Soda Bottle“Calming the Fizz”• Deep Breathing

• Relaxing Activities

• Scheduled Stress Time

“Managing the Explosion”• 3 Rules of Safety

– Self– Others– Property

• Exercise• “Controlled Explosions”

Holiday Stress: Asking for Help• Signs you should seek more help:

– Consistently sad, anxious, or angry– Difficulty enjoying activities– Significant changes in sleeping or eating habits– Thoughts about harm– Significant mood changes lasting past the holidays

LCSW Resources• Jeanne Armour – Main Campus, Wabash,

Jacksonville, and Carlinville• Brian Gazdziak – Lincoln and Taylorville• Mercedes Kent – Main Campus, Wabash, and

Decatur• Barb Mackey-Bruzetti – SPAC• Thomas Moll – Effingham and Hillsboro

FACTS

Do you know what your blood pressure reading is? Have you had your blood pressure checked in the last year?

If you are a man over age 45 or a woman over age 55, especially if you are African-American, high blood pressure is a condition you can't ignore.

According to the U.S. Centers for Disease Control and Prevention, more than half of all men and women will

develop high blood pressure after age 55.

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STAGE I

STAGE 2

WHY DO WE CARE ABOUT HIGH BLOOD PRESSURE (HYPERTENSION)

No 1 cause of- heart attack and stroke, two of the three leading causes of death for Americans.

You can have high blood pressure without experiencing any symptoms –

That is why- even if you know that you have a normal blood pressure reading today….you want to do everything you can to keep it normal

Reason for high BPGetting older,

being African-American,

having diabetes

having a family history of diabetes

How to keep your BP under control

Exercise

Lose excess weight

Eat healthy

Shake the salt habit Put the brakes on smoking

and drinking

Exercise.

1) Stimulates your body to release a substance called

nitric acid.

2) Nitric acid causes blood vessels to open up, which

reduces blood pressure.

3) Exercise also helps to strengthen your heart muscle,

reduce stress, and aid weight loss.

Lose excess weight. 1) There's no getting around the fact that blood pressure

goes up as the pounds pile on.

2) Being overweight increases your risk for heart disease and diabetes, too.

3) Losing even 10 pounds can start to make your blood pressure go back down.

Eat healthy1) Eating the right type of diet can lower your risk for high

blood pressure or help you return to normal blood pressure.

2) Clinical studies show that a diet high in fruits, vegetables,

low-fat dairy, whole grains, poultry, fish, and nuts really

works.

3) You also need to avoid fats, red meat, and excess sugar.

Excerpt from the AHA website (www.heart.org)

1) Visit our Simple Cooking with Heart website, and learn to use nutritious

ingredients and follow a healthy preparation routine.

2) Use our Healthy Diet Goal guidelines to make smart choices to benefit your

heart and your overall health.

3) Get tips on staying heart-smart and making healthy choices at the store.

4) Learn to eat healthy when you dine out.

5) Learning how to read and understand food labels can help you make

healthier choices.

Shake the salt habit. 1) Your body only needs about 500 milligrams of salt a day, but…….

2) For optimal heart-health, the American Heart Association recommends

people aim to eat no more than 1,500 milligrams of sodium per day

3) if you are like the average American you may be consuming up to 9,000 mg

a day.

4) Studies show that high salt leads to high blood pressure.

5) Due to such a high intake, BP advantages are seen even

with cutting salt intake to < 2,400 mg per day.

• 1/4 teaspoon salt = 575 mg sodium• 1/2 teaspoon salt = 1,150 mg sodium• 3/4 teaspoon salt = 1,725 mg sodium• 1 teaspoon salt = 2,300 mg sodium

Top six sodium sources in the U.S. diet.

breads and rollscold cuts and cured meatspizzasoupsandwichespoultry

Put the brakes on smoking and drinking.

1) Alcohol raises blood pressure and adds empty calories.

2) A safe amount of alcohol is only one drink a day for women

and two for men.

3) Smoking is not safe in any amount. Nicotine causes blood

vessels to constrict and that raises blood pressure. Quitting

will also lower your risk of cancer and heart disease

Function of Sleep• Memory restoration• Body reparation• Immune system function• Sleep Deprivation leads to poor concentration, poor

mood and decreased performance• Complete lack of sleep leads to death within a few

days

Sleep is Active

Sleep Stages

Cycles Of Sleep Stages In a Night

Sleep Changes with Age• Increased awakenings and arousals• Decreased REM sleep• (Probably) Decreased SWS• Fewer “cycles”• Reduced sleep efficiency• Phase advancment

Sleep Disorders• Multitude Sleep disorder diagnosis, at this time over

200 described conditions• At some point in time most people will suffer from

some sleep problem• Over 20% of the general population will suffer from a

chronic sleep problem• Development of Sleep medicine and Professionals to

treat Sleep Disorders

Sleep Disorders• Two main symptoms:

1) Always Sleepy2) Cannot Sleep

• Sleepiness can present in many ways fatigue, poor memory, agitated, grumpy, and even hyperactive.

What is sleep deprivation ?• A reduction in sleep required to fulfill an individuals

physiological needs1) Quantity of sleep2) Quality of sleep

• Different mechanisms with possible similarconsequences socially, psychologically

and medically.

Sleep DeprivationConsequences of sleep deprivation• Poor mood and depression• Decreased work performance• Motor vehicle accidents• Cardiovascular problems• Decreased immunity• Decreased fertility• Acid Reflux

Sleep Deprivation• How much sleep?• On average most individuals need 8 hours of sleep,

but most are only getting 6.5 hours• Every individual needs are variable• The right amount is that which allows a person fully

alert and energetic throughout the day

How much sleep do we need ?• NEWBORNS (0–2 months) 12–18 hours • INFANTS (3–11 months)  14–15 hours • TODDLERS (1–3 years) 12–14 hours • PRESCHOOLERS (3–5 years) 11–13 hours • SCHOOL-AGE CHILDREN (5–10 years) 10–11 hours • TEENS (10–17) 8.5–9.25 hours • ADULTS   7–9 hours (Taken from the National SleepFoundation Web site.)

How much are we sleeping• On average the general population is sleeping 7 hours• 39.3% of adults are sleeping 5-6 hours• 62% of adults reporting less than 7 hours of sleep

during weekdays

Effects of Sleep Deprivation• Medical /Physiologic• Social• Psychological

Medical effects• Decreased Alertness greatest effect of sleep

deprivation with greatest impact on individual and public.

Alertness

Alertness

Medical effects

Immunity and Sleep Deprivation• One whole night of sleep deprivation before

vaccination suppresses antibody response to hepatitis A vaccine about 50%

• Chronic sleep loss in shift workers is associated with increased infections

• Severe chronic sleep loss in rats results in breakdown on intestinal defenses and systemic invasion by intestinal flora

Sleep and hormonal regulation• Sleep restriction increases daytime growth hormone,

ghrelin and evening cortisol levels• Increase in cortisol and growth hormone lead to insulin

resistance• Increase ghrelin and decrease leptin contribute to

increase in appetite

Sleep ,appetite and weight• Those who reported sleeping < 5h/night gained more weight than those

sleeping 7h/night (Patel et al 2006)• Women who slept <5h/night at 6months post partum had greater odds of

substantial weight gain by 1 year post partum compared to 7h/night (Gunderson et al 2008)

• Mean sleep at ages 3-5 years was 30min less for those who became overweight compared to those who did not, most of which was daytime sleep. (Agras et al 2004)

• Increasing sleep problems at 2-4 years of age was associated with increasing BMI and overweight/obesity at age 21 (Al Mamun et al 2007)

Medical effects

Sleep and Diabetes• Odds of incident diabetes were higher for those reporting sleeping

6h/night and 7h/night (Yaggi et al 2006)• Odds of incident impaired glucose tolerance/type 2 diabetes were

higher for those reporting sleeping <6h or >9h compared to those sleeping 7h (Chaput et al )

• Odds of incident diabetes was higher in those reporting sleeping <5h/night compared to 7-8h/night. Longer day napping was also associated with increased odds of incident diabetes. (Xu et al 2010)

Sleep and cardiovascular disease• Shorter sleep duration sleep and lower sleep maintenance were both associated

cross sectionally with higher blood pressure ( CARDIA study)• Several prospective epidemiologic studies in the US found that those reporting

<5h sleep compared to those 7h had increased odds of incident hypertension. (NHANES and CARDIA study)

• CARDIA study also examined incidence of coronary artery calcification. Longer sleep duration was associated decreased odds of calcification

• Subjective insomnia or insomnia symptoms associated with increased cardiovascular events or mortality

• Laboratory studies sleep restriction associated with elevated cardiac symphatho-vagal balance estimated from heart rate variability

Medical effects

Psychological effects

Effects of Sleep Deprivation

Social implications• Work absenteeism• Industrial and motor vehicle accidents (chernobyl,3 mile

island,exxon valdez)

• Impaired cognitive and executive functions to perform duties (libby zion)

• Impaired physical performance (athletic training)

• Marital discord

Drowsy driving and motor vehicle accidents

• 250,000 US driver fall asleep at the wheel daily• Drowsy driving causes

– A crash every 25 seconds• 1.2 million drowsy driving crashes/year

– Debilitating injury every 10 minutes• 55,000 debilitating injuries/year

– A fatality every 70 minutes• approx. 7,500 deaths/year

Psychological effects• Some patient develop acute paranoid schizophrenia• Acute confusional state• Dependent on

a) Ageb) Personalityc) underlying psychopathology

Social Causes• Light bulb• 24/7/365 culture /shift work/ entertainment• Family pressure more working mothers• Poor sleep hygiene/ Distracters/Social media• Increased stress levels/insomnia• Drugs/alcohol use• School start times

Gender Differences in Sleep• Complaints of sleep disturbance are more prevalent for

women than men across the lifespan

• Compared to men and younger women, post menopausal women are more likely to take hypnotics for sleep

Better Sleep HabitsBetter sleep habits: • Regular sleep routine with minimum of 7 hours but need to find

individual need• Reduce caffeine use• No food or exercise within 2 hours of sleep• Bedroom only for sleep , no TV/internet/social media• Dark bedroom• Good temperature/humidity• School/work start time• Bed partner snorer, leg kicker

“Early to bed, early to rise makes a personhealthy, wealthy and wise.”

Benjamin Franklin